Big Tobacco -- sorry, Big Food -- fights back.

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Toward the end of my time in DC, I was in a bad way. I had been on and off diets for about 50 years, losing hundreds of pounds, only to gain them all back, plus some. I was on two high-priced drugs for type 2 diabetes, one of which was Ozempic. I knew that diets didn't work, and yet every doctor I saw told me I needed to go on another one. When I resisted, I was called noncompliant. The whole dance stressed me out and gave me a binge eating disorder. 

Then a therapist told me about health at every size. The idea is that the scale is not the be-all and end-all -- that your weight doesn't matter as long as your blood pressure, etc., are fine. I glommed onto the idea like a life preserver. The therapist sent me to a dietitian, who recommended a book called The F*ck-It Diet: Eating Should Be Easy. (The publisher put the asterisk in the title, not me.) A lot of what the author wrote made sense to me, so I decided to try eating whatever I wanted, whenever I was hungry.

My fasting blood sugar shot up to about 180. (Note to those who know nothing about blood sugar readings: a fasting reading of between 70 and 100 is normal; 200 is high; at 400, you need to go to the E.R.; and if it's as high as 600, you could go into a coma and die.) I started to maybe think I was being sold a bill of goods -- that as a diabetic, maybe I couldn't eat whatever I wanted. When I broached the subject with the dietitian, I was a titch confrontational -- but the upshot was that she didn't know whether a fasting blood sugar reading of 180 was dangerous for a diabetic or not. We parted ways immediately. Very shortly thereafter, I also parted ways with the therapist who'd sent me to her.

This was not my first run-in with dietitians and nutritionists, although it was the most egregious. So this past week, I wasn't terribly surprised to see this article in the Washington Post: "As obesity rises, Big Food and dietitians push 'anti-diet' advice". It's a gift article, so feel free to click through and read it. The bottom line is that big food manufacturers like General Mills are co-opting the health-at-every-size message and turning it on its head. They claim to be empowering people to reject fat shaming and eat anything they want -- including, of course, Big Food's highly-processed products. To get there, they're enlisting dietitians as social media influencers, even to the extent of paying them to promote the manufacturers' products. (That link is also to a gift article. Both are the result of a new partnership between the Post and The Examination, a nonprofit news organization that specializes in coverage of public health issues around the world.)

The worst part is how these food manufacturers are distorting the health-at-every-size message. Its roots are in the 1960s civil rights movement, according to the article; the original goal was to promote equal access to healthcare. By 1995, the movement had come up with "intuitive eating" as a way for people, including those with eating disorders, to learn to listen for internal hunger cues that diet culture had taught them to ignore. 

As interest in intuitive eating increased, Big Food began to pay attention. Clearly, the industry is scared that the anti-diet movement, along with the success of drugs like Wegovy (aka Ozempic formulated for weight loss) in tamping down desire for junk food, are going to upend their business model. After all, obesity has been deemed a healthcare crisis. So the industry is manipulating the movement's message by "essentially shift[ing] accountability for the health crisis away from the food industry for creating ultra-processed junk foods laden with food additives, sugars and artificial sweeteners," as last week's article says.

This looks suspiciously like the sort of propaganda that Big Tobacco employed for decades to convince its customers that its addictive, cancer-causing products weren't really that bad, and were even healthy.

Last fall, according to the Post/Examination article, the Federal Trade Commission cracked down on a number of influencers and food industry trade groups for not being explicit about who was funding the influencers' posts. But that just means the influencers have to be clear about who's paying for their messaging. They don't have to change their advice.

I'm not trying to discredit all dietitians. I'm sure many of them offer nutritionally sound information and don't take kickbacks for social media posts from anybody. But we've received so much terrible information about nutrition from "experts" over the years -- eggs cause high cholesterol (LOL, nope), margarine is better than butter (actually, the trans fats in margarine make butter the better choice), high fructose corn syrup is fine (not so much), dairy fat is bad (that one's being disproven, too) -- that, well, just be careful about whom you listen to. Especially if it's a paid influencer on social media.

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By the way, I didn't lose any weight on Ozempic. See, Ozempic makes your appetite go away. But a big appetite was never my problem; my problem was binge eating due to stress. I ate whether I was hungry or not. It wasn't until I retired, moved cross-country, and started low-carbing that I've lost weight and kept it off.

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These moments of doughnut moustrapping have been brought to you, as a public service, by Lynne Cantwell. Stay safe!

More on low carbing and such.

 

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Before I move on from the topic of low carbing (trust me, I will move on!), I wanted to clear up a few things.

After last week's post, I had a few questions about whether low carb is the same thing as gluten free. Short answer: It's not. Here's why.

Gluten is the thing that holds bread together. It's a protein found in wheat and certain other grains (there's a list at the link). Folks with celiac disease, which is an autoimmune disease, can't eat anything with gluten in it, because their bodies fight back by attacking the lining of the small intestine. Eventually it affects their body's ability to absorb nutrients from the food they eat. The symptoms range from bloating, constipation and diarrhea to migraines to anemia to anxiety. Not everybody gets all of the symptoms, and some folks get none of them. There's a test your doctor can give you to find out whether you have the disease.

Then there are the folks who don't have celiac disease, but they're sensitive to gluten. They feel better when they avoid foods containing it.

Lots of foods are high in carbs but have zero gluten -- for example, potatoes, tortilla chips, candy*, and regular sodas. Some types of flour are okay for the gluten-free crowd but have too many carbs for a low-carb diet -- for example, cornmeal and rice flour. By the same token, some flours are low carb but bad for the gluten-free crowd; I mentioned last week that vital wheat gluten is one of these. 

It gets crazier, particularly for folks with diabetes, because diabetics are virtually always told to eat whole grains like brown rice and whole wheat bread -- even though brown rice has a glycemic index (how quickly a food will raise your blood sugar, from 0 to 100) of 55 and whole wheat flour's glycemic index is 69.

Cornmeal's glycemic index is 70. Coconut flour, which shows up in a lot of low-carb foods, has a glycemic index of 50.

Now, 50 is supposedly pretty low. But compare it with almond flour's glycemic index of zero. And nuts, of course, have no gluten. So almond flour is a good choice for both folks avoiding carbs and folks avoiding gluten.

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A word about the graphic up top: I'd never heard of a paleo AIP diet before, so I looked it up. 

I'd heard of paleo, which is all about eating like our Neanderthal forebears did. You're allowed meat, seafood, eggs, fruits, veggies, and nuts and seeds. Verboten foods include beans and legumes, dairy, refined sugars, grains, any flour, anything fermented, and coffee. I couldn't tell you why some of these foods are off limits -- seems like even a Neanderthal could gather wild grains for porridge or something -- but anyway, that's how the eating plan works.

AIP was a new one on me. It's short for "autoimmune protocol," and it's basically an elimination diet to help reduce inflammation, which is suspected to cause some autoimmune disorders. First you do a version of paleo for a few weeks; then you gradually add back in certain foods and keep track of whether they make your symptoms worse.

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Speaking of nuts and diabetes: This past week, the American Academy of Pediatrics made me all kinds of crazy when they issued new guidelines for treating obesity in children. The AAP is now recommending that pediatricians prescribe weight loss drugs for kids as young as 12 and bariatric surgery for kids 13 and up. For the younger set -- maybe as young as six, or even two! -- doctors should embark on an intensive program of lifestyle therapy, including behavioral and nutritional advice, for both the child and the parents.

Do you suppose it's a coincidence that this new, intensive approach has followed so closely on the heels of the Food and Drug Administration's approval of Wegovy (a.k.a. Ozempic, an injectible drug for diabetes) as a weight loss drug for kids as young as 12? Yeah, neither do I.

The AAP says the old approach of waiting to see whether the kid will outgrow the fat isn't working anymore. Too many fat kids are turning into fat teens, the AAP says, with the attendant risks of heart disease and diabetes and yada yada. Okay, but much of the weight loss advice I've received from doctors and dieticians over the years has been simplistic, outdated, and just plain wrong. Do we really want to hand our kids over to Big Pharma and Big Diet? Because it'll be lobbyists from those industries that shape the assistance our kids get, and I don't trust those lobbyists to be helpful to anyone but their investors.

Remember when Big Tobacco promised to 'fess up about how unhealthy and addictive smoking is, and then finessed their way around that promise? If you don't think this thing with kids and obesity is going to go down the same road, you're living in a fantasy world.

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*You'd be surprised what manufacturers sneak flour into. Even some candies have flour in them -- caramel creams immediately come to mind. Gotta check the ingredients on everything.

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These moments of floury blogginess have been brought to you, as a public service, by Lynne Cantwell. Stay safe!