For today’s edition of Dear Mark, we’ve got a three question roundup. First, I hear from a nursing, weight-lifting, child-chasing mother of four who’s concerned about the amount of food she’s craving – even though she’s already at her pre-baby weight. I (hopefully) allay her concerns in my response. Next, I discuss the ridiculous nature of the conventional dietary advice we give to type 2 diabetics, as well as how there may be a light at the end of the tunnel. I also issue a formal invitation to Tom Hanks, who’s just been diagnosed with the disease. Finally, I explore whether or not DHA truly is bad for adults. Should we only give it to our kids after all?
I realized recently I’ve never written this kind of open letter. I figure if kids and Taco Bell got the benefit, maybe primary care physicians could as well. Kidding aside, there’s a genuine mismatch these days between standard medical advice and effective lifestyle practices. I think we can all do better. I’m not letting patients off the hook here either. (Maybe that’s fodder for another letter.) However, we naturally look to our physicians as our healers, as the experts, as our guides. Unfortunately, we’re not always well served by that kind of faith. I’m of course not talking about any one doctor or set of doctors. I happen to know a great many primary care doctors and other medical practitioners who are incredibly forward and critical thinking professionals. They balance their perspectives with the likes of medical logic, broad based study of existing research and close attention to real life results. While I think I’m not the only one who would have much to say to many specialists out there as well, let me specifically address primary care physicians here. They’re on the front lines – for all the good and ugly that goes with it. More than any specialist, they have the whole picture of our health (and a fair amount of our life stories to boot). It’s more their job (and billing categorization) to provide general health and lifestyle counseling to their patients. It’s with great respect that I offer these thoughts. As my readers can guess, this could easily be a tale of ninety-nine theses, but let me focus on a few central points.
You’ve probably heard that the American Medical Association recently classified obesity as an official disease. I’m still mulling the whole deal over, and I’m not quite sure what to think about the decision. First, what exactly is a disease?
A disease is defined thusly:
Before we get into the big job of interpreting cholesterol numbers, let’s review what cholesterol actually is.
Cholesterol is cholesterol: a waxy steroid of fat that serves as an essential structural component of cellular membranes and in the production of steroid hormones, vitamin D, and bile acids. Contrary to what the terminology indicates, there’s actually only one “type” of cholesterol in the human body, and it’s called, quite simply, cholesterol. What we think of when we use the word “cholesterol” is actually a lipoprotein – a fatty conglomerate of protein and lipids that delivers cholesterol and fat and fat-soluble nutrients to different parts of the body. It’s not just free cholesterol floating around in your blood; it’s cholesterol bound up by lipoproteins.
Allow me to preface this post series with a wholehearted acknowledgment of the beneficial role antibiotics have played, and continue to play, in fighting infections that might otherwise take limbs or lives. Before formal antibiotics, ancient and traditional cultures employed antibacterial herbs, tinctures, and even moldy bread, but regardless of the various methods’ efficacies, they were largely operating in the dark. They knew what worked, but not why it worked. When we use antibiotics today, we (mostly) understand what they are doing on a micro level, and we aren’t (ideally) just relying on hearsay, anecdote, and experimentation. This is a good thing.
So, how do antibiotics work, exactly? There are four primary routes taken by various antibiotics:
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