Synopsis
Book by De Vany PhD Arthur
Extrait
CHAPTER 1
My Journey
It seems as though I have been researching this book all my life.
I began lifting weights and taking an interest in diet at the age of 14. As I have heard many others say, it all began in a garage with a 90-£d weight set. My gains came quickly, so at 16 I joined a gym operated by John Farbotnik, a former Mr. America. John's gym was a hangout for Olympic athletes from the Pasadena Athletic Club, and I wanted to be around them. I weighed 196 £ds at age 16 (almost 60 years later I weigh about the same) and began lifting in the demanding Olympic style because it was more athletic than what I had been doing.
I had hopes of playing professional baseball and felt that the speed and power I developed through weight training were what I needed to gain a competitive edge. It was a good move because few ballplayers then lifted, and it made me strong and quick. I signed a contract with the Hollywood Stars, a minor league team that was part of the Pittsburgh Pirates organization, right out of high school. But my eyesight and ambitions got the better of my baseball career. I went on to UCLA, where I got my Ph.D. in economics. After a few years working in think tanks, I became an academic so I could follow my own research interests.
I was primarily interested in studying what was not known in my field, which took me into the realm of complex systems, wild variations, and extreme events--the so-called black swans that author Nassim Nicholas Taleb writes about. This led me back to Hollywood, not to play baseball but to study the movie business and how it adapted to uncertainty. I didn't know it at the time, but this was excellent preparation for the study of metabolism. I wrote a book about the economics of Hollywood and settled into the University of California, Irvine Department of Economics and Institute for Mathematical Behavioral Sciences for the last 20 years of my academic career.
My education in metabolism began the year I was a visiting scholar at the University of Chicago, during the blizzard of '79. My youngest son, Brandon, had developed type 1 diabetes, probably from a viral infection that triggered a strong immune response. The doctors believed that my son's pancreas suffered collateral damage from the firepower his immune system aimed at the virus. When this happens, insulin secretion in the important beta cells of the pancreas stops or is severely depressed.
Only type 1 diabetics suffer this autoimmunity, for reasons that are still unclear. There is a genetic link--my wife, Bonnie, later developed diabetes, too--but something has to trigger the expression of the genes that cause this excessive response from the immune system. My guess is that both my wife and son had very active and aggressive immune systems, since they almost never got sick. In Brandon's and Bonnie's cases, their immune systems permanently altered their metabolisms.
Because I was an academic at heart, I responded to my son's medical crisis by going to the university bookstore. I bought books on diabetes and metabolism and a large textbook on endocrinology that I owned until a few months ago, when I donated it to the local library. I learned as much as I could about insulin and diabetes. Eventually, I knew enough to discuss these topics intelligently with Brandon's doctors, and even to engage them in friendly debate about various treatments and appropriate insulin injection doses.
Food was our most contentious topic. My son's doctors wanted him to eat cereal or pancakes with syrup and orange juice for breakfast, sandwiches or pasta for lunch with Jell-O for dessert, and beans or potatoes and low-fat meats for dinner. Carbs were friendly, the doctors maintained, and fat was the enemy. Doughnuts were fine and starches were healthy. The American Diabetes Association still recommends a relatively high-carb, low-saturated- fat diet some thirty years later.
But it was evident to me that my son was not eating the right foods. He was getting too much carbohydrate and injecting too much insulin to manage the load it imposed on his damaged metabolism. Each dose of carbohydrate had to be followed by an injection of insulin or his blood glucose would rise too high. But if we injected too much insulin, his glucose level would drop dangerously, and he would become jittery and angry. If this condition worsens, it can lead to unconsciousness and death. Brandon would sometimes even refuse to take a glucose tablet, a problem many diabetics experience as their blood glucose drops and they become emotional and stubborn. Their brains, in glucose crisis, descend into primitive behavior and lose control of rational decision making.
As you may know, insulin's job is to extract glucose (a form of sugar) from the bloodstream to store it for later use. But things go wrong when this hormone performs its task too well. It will actually withhold glucose from the bloodstream even when the brain is being denied this essential fuel and nears unconsciousness. The other hormones that can also mobilize energy are powerless to help. The brain in those instances could extract the glucose it needs from elsewhere in the body, mainly from the liver and muscle-- except that the insulin overrides the hormones (glucagon and cortisol) responsible for that task. Insulin is essential but also potentially dangerous; it is the instrument of choice in movies (and sometimes, in reality) when a doctor wants to murder his wife or a rogue nurse wants to kill patients.
I knew as an economist that it made no sense to try to manage blood glucose, which is a flow, with a storage hormone like insulin. Eating carbohydrates and then hoping to inject just the right amount of insulin to utilize the glucose was a crude, imprecise approach to disease management. It was bound to make my son gain excess weight, because safety required that he consume more sugar than he needed, lest his brain get too little glucose and go into shock.
Eventually, we got off the carbs-insulin seesaw. But not just yet.
My education in metabolism was furthered when my wife, Bonnie, also developed type 1 diabetes, 12 years after Brandon. We weren't sure why this happened, and neither were her doctors--type 2 diabetes is the form of the disease typically referred to as "adult-onset." My hunch was that she had been taking too much thyroid medicine, which stressed her metabolism to the breaking point. We had better tools for diabetics by then; meters had become simple and inexpensive, so we could measure her blood glucose more accurately than we could Brandon's when he was diagnosed.
Bonnie ate as her doctors suggested because she loved pasta, potatoes, pancakes, and bread. But injecting insulin to manage her starchy diet made her gain weight, too, and soon she was doing her best to balance between too little insulin and too much. We experienced many terrifying nights with Bonnie deep in insulin shock as I tried to get some glucose into her.
I began to examine Bonnie's testing numbers and correlate her blood glucose with her meals. I used my training in statistics to look for patterns in her readings; I wanted to see if I could find the triggers for her worst episodes of insulin shock and high glucose. I tried to determine which foods increased her blood glucose and how much insulin was necessary to bring it back down to a healthy level.
It soon became apparent that striving to keep blood glucose in a narrow range using insulin injections was counterproductive, even dangerous; this is a conclusion that current research also supports. It is now well recognized that tight glucose control improves a few markers of damage from hyperglycemia, but is associated with higher mortality. Both my wife and my son experienced too many episodes of low blood glucose that put them in or close to insulin shock. These ordeals were exhausting for them. They became depressed and gained weight. Brandon, who had been lean, became a chubby boy. Bonnie, who had been a slim Vogue cover girl, put on weight and then dropped it again in cycles. She still was beautiful, but the stress was taking its toll.
It became clear that each drastic rise and fall in their blood glucose level increased the likelihood of similar events happening down the line. This suggested that the brain has a metabolic memory that records events and responds in similar ways when they occur again. The brain was learning to make the adjustments necessary to bring blood glucose into a stable range. But soon it was overreacting, like a driver oversteering as he tries to control a swerving car. The cycle of swinging back and forth is itself dangerous. Some type 1 diabetics become what doctors call "brittle," meaning that they swing too easily from high to low blood glucose levels.
We needed to teach the brain a better strategy. I believed we had to let the brain learn to mobilize glucose from sources inside the body instead of relying on external supplies, meaning carbs. We had to use less insulin, and to do that we had to eat fewer foods that raised blood glucose.
The New Evolution Diet developed directly out of our experiments with food and Bonnie's response to them. She tested her blood glucose after each meal, and then we examined the data to see what had triggered an elevation in that level and how much insulin was needed to bring it back to a healthy range.
Pasta and potatoes sent her blood glucose through the roof, requiring a large injection of insulin to bring it back down. So pasta and potatoes were the first entries on our list of offending dishes. We identified all such foods and simply cut them out. We did not just reduce her intake of these foods--we banished them. I did not want her reactivating old metabolic memories by eating small amounts of offending dishes. The list of forbidden foods grew over time, and our mealtimes became an experiment: We'd test the reaction of her blood glucose to a specific food and note the amount of insulin that was needed to bring it back to a healthy range. We did not know it at the time, but 25 years ago we were creating our own glycemic index, which is used to determine acceptable carbohydrates for the Zone diet, the South Beach Diet, and many other popular eating regimens.
Right behind pasta and potatoes, bread and beans made the list of banned foods, because they, too, prompted a large rise in blood glucose. Breakfast cereal and cinnamon buns, Bonnie's favorite, went on the list next.
The program was a success. Soon, a minimal amount of insulin was needed to keep my wife and son stable. One doctor refused to believe Bonnie was a diabetic because she was injecting so little insulin.
Today it is generally accepted that there's a strong link between diabetes and obesity. Overweight people (even nondiabetics) are often insulin- resistant, meaning their bodies don't respond properly to the existing insulin levels, and so they require more of the hormone. An important cause of insulin resistance among type 2 diabetics is the inflammation that is caused by elevated blood glucose and excess body fat. So you see, fat isn't just this stuff inside your body that expands your waistline. It is metabolically active tissue with organlike capabilities. Fat secretes hormones that make other tissues resist the action of insulin. An overweight person requires more insulin than a slender person to manage glucose.
The fresh vegetables and fruit we were consuming drastically reduced my wife's inflammation as she lost weight and excess body fat. In response, her insulin sensitivity increased. Best of all, we ate wonderfully on our new diet. We didn't feel the least bit deprived. After a while, it didn't require any self-control, which is a good thing for several reasons. Most people don't realize that acts of self-control are such hard mental work that they actually deplete the glucose levels in the brain. Therefore, you will lack willpower when glucose is low or cannot be mobilized effectively. It's a big reason why dieting doesn't work.
As Bonnie's stress level was reduced, her brain's metabolic memories of past trauma began to fade. Her neural networks had reformed as the old ones faded for lack of use. In fact, at this point all of our bodies had adjusted--so much so that eating any of the offending substances left us feeling sick and bloated.
From then on, I cooked dinner quite a lot, which was a new experience for me. I had previously been on the relatively high-carbohydrate diet that was popular in athletic circles. I recall seeing pictures of Olympic athletes "carbing out" before events by eating big platefuls of pasta. I had never eaten that way on a daily basis, but before a big athletic event I would often load up on starches. Now I had to learn to eat differently.
I would stop at the store on the way home from work and browse the produce section, looking for something fresh and colorful. Then I would go to the seafood or meat aisle for some healthy protein before heading home to make dinner with whatever I had found. My shopping trips were confined to the periphery of the supermarket, meaning I seldom ventured into the center aisles, where the processed and packaged foods are located. I usually would cook more than we could eat at one meal, so we could have breakfast, lunch, or another dinner from the leftovers. It was faster than fast food. Much better and cheaper, too.
So this was a breakthrough for us, but it was still just our little family project. Then one day in my office, I was talking with an anthropology graduate student who had come in to discuss a project she was working on, which explored reciprocity between members of a tribe.
We talked about meat sharing, and I brought up our new diet. I told her that my family and I had begun eating only fresh vegetables, fruits, nuts, seafood, and meat. She told me that the tribal members she studied ate the same way. It should have been obvious to me, but I hadn't thought about it: I had come up with a typical hunter-gatherer meal plan.
Intrigued, I made the rounds among my anthropologist colleagues at the institute to discuss this and to ask what I should read on the subject. I found it ironic that these people who knew so much about hunter-gatherers all ate a high-carb diet. Many of the scholars were overweight. I thought, if they know so much about the human mind and its evolution, why are they so heavy? I think they had separated their knowledge of science from their personal habits, as many people seem to do, but gave little thought to what they ate.
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