health

 Sometimes it seems like NYC government isn't sure what to do about food. There is a push towards a more paternalistic food policy, but it's rather laughable. For example, the "food desert" issue. Some time ago, food policy researchers started talking about "food deserts", places where it's almost impossible to get fresh fruits and vegetables without traveling a great distance. Some places in NYC were pegged as food deserts and the city had a few insipid initiatives to "help" the situation. One of them was fresh fruit and vegetable carts, called "green carts." They subsidized these carts, hoping to encourage them in these "food deserts." The problem was that savvy folks were more than happy to take the subsidy and set up in a gentrified area on the edge of a "food desert," such as Morningside Heights near Columbia University. They set up near upscale grocery stores, who were unhappy that the city was subsidizing their competition. In the meantime, I wonder how well those food policy experts who study food deserts looked into the grey market here. Get off a subway in East New York and you'll usually find several hawkers of fresh mango and other fruit. The problem is that these carts are illegal for some reason. So at the same time the city has been subsidizing Green Carts in areas where they weren't needed, they have been cracking down on some of these sidewalk vendors. The crackdown has unfortunately also happened in my neighborhood, which is economically mixed. The government says the produce might be unsafe because of car exhaust from the roads. I wonder if the government has ever heard of pesticides? The government has also been cracking down on people gathering wild berries, greens, and mushrooms from parks, a hobby of both immigrants and locavores. 

Either way, I think in urban areas like NYC, the idea that people are suffering from diabetes because they don't have fruit is delusional. Harlem is a diabetes hotspot and there is PLENTY of healthy fresh food in most of the same areas where diabetes, obesity, and heart disease is rampant. Every other store seems to have sidewalk displays of ample fresh produce, some very exotic

Display of fruits and vegetables in Hamilton Heights in Harlem, the restaurant next door is Dunkin Doughnuts

The problem here isn't lack of produce, the problem is that every other store that doesn't have produce seems to be a fried chicken joint or Dunkin doughnuts. People are so focused on the myth that produce is a magic bullet that they forget that plenty of unhealthy people eat fruits and vegetables. What's more important in making someone healthy? The inclusion of fresh produce or the exclusion of vegetable oil and sugar? Remember how much better the latter two taste anyway. In areas of the city with less of an immigrant population, efforts to get bodegas to sell fruits and vegetables have led to many bodegas having displays of rotting bananas and apples. If your store sells slurpies and apples, which one are the children going to pick? There is also the issue that in many immigrant communities vegetables might actually be a source of unhealthy eating, as they are frequently fried in the same way as in places like China, where produce consumption is connected with obesity. I find that in many immigrant communities there isn't much awareness about the health effects of using things like vegetable "ghee" or hydrogenated lard. Indeed, now that researchers are finally studying such immigrant communities, they are finding that access to produce doesn't have a connection with obesity. There have been some efforts in certain cities to limit the number of fast food restaurants, usually targeting chains, but a lot of restaurants serving fried sugary food are not chains, they are little mom and pops like the arepa stand in my neighborhood, where the well-meaning woman blissfully coats all her arepas with the cheapest margarine available. I have to wonder if she really knows that margarine isn't a good choice? The government certainly isn't about to tell her. 

 I read this story today about a man with type one diabetes who has controlled it for 85 years with a low-carb diet. 

However, despite treatment, many Type 1 diabetics die prematurely, often having suffered adverse effects from their diabetes, including blindness, nerve damage, kidney disease, skin ulcers, and amputations. Bob Krause, on the other hand, appears to be in great shape (especially bearing in mind his advanced years). What is clear is that Bob has managed his diabetes with meticulous care. What is especially noteworthy is that his eating regime contrasts sharply with the standard advice given to diabetics: Eat three meals a day and include starchy carbohydrates with every meal.

What is noteworthy here besides his success is his low-carb diet, which really honestly doesn't look what more low-carb bloggers eat:

Actually Bob normally eats twice a day. His breakfast is usually made up of nuts with some prunes. His dinner is protein plus salad. He doesn’t eat much. And critically, he doesn’t eat much carbohydrate.

It sounds like CRON (calorie restriction with optimal nutrition) to me. 

When reading this I remembered Michelle, a young blogger I had read about in Loren Cordain's newsletter who was having success using the paleo diet. I wonder if many people noticed that she quit the paleo diet?

My sugars started increasing to the 140s-150s in March and I went back on insulin. The diet really wasn't helping. However, I stayed on the paleo diet for a few days but I couldn't take it anymore and started having dairy, grains, and legumes again.

My opinion is that the diet is too restrictive and is very difficult to follow (100%). You almost have to be obsessed with the food that goes in your mouth. I am very happy to have the freedom of my food choices.
 

Interestingly, Bob Krause's son, who also is type 1, couldn't follow his father's footsteps:

And though Tom Krause inherited his father's diabetes, he doesn't share his father's regimented control of the illness.
"My dad, he is just a machine in how well he cares and manages his diabetes, with his willpower and how long he's been doing it," Tom Krause said.

I get the sense that Bob is a person with unusual willpower and obsessiveness. It makes sense that he was an engineer. I understand why Tom and Michelle had trouble. I did CRON strict paleo for awhile and thought it was hell. Anyone who is even slightly disorganized or who actually likes food is going to have trouble on such a diet. 

But here is a story from Robb Wolf's blog about a young man who did a strict paleo diet and eventually was able to eat more carbs. But the article notes that even Robb Wolf says that only 5% of his type 1D patients have that kind of recovery. 

What do you think? Do you think you could follow an extremely strict diet where cheating means serious illness if it meant better long term health? 

I tried it to be game and see if I could give orthodox paleo a chance. Most of you by now realize I'm not a fan of "orthodox" paleo. And doing it again reminded me why.

After a week the symptoms that I think caused me to be hospitalized last year with fainting came back. My doctor had said they were likely caused by low blood pressure, under 90/60, and if I didn't get them under control I would have to take drugs. I got them under control mainly with greater calorie consumption, which mostly involved adding potatoes, dairy, and rice back into my diet. Last week without those foods I started having trouble with things again. Dizziness, orthostatic hypotension, ringing in my ears, irritability, and fatigue were my main symptoms.

I'm convinced more than ever that an 80/20 approach is best for me. But with a different approach than the standard 80/20. I think of that 20% non-paleo as being whole real foods rather than "cheats." So butter, cheese, rice, and potatoes for me. Sometimes grits as a cultural concession, but I do think these muck my digestion up a bit.

I was talking with two other health bloggers, both young men who have never had a weight problem. Both of them have had similar issues with strict paleo. I think the calorie deficit is the main issue. It's hard for me to get enough calories from only meat even when presented with unlimited amounts because of lower appetite. Add on the fact that I sometimes have to eat out and most restaurants skip on meat...and you have me getting less than 1000 calories a day in some instances.

Perhaps that's good for people suffering from metabolic syndrome, but that's not me. Some other tips for those suffering from low blood pressure, besides eat MORE and stop being strict, are

1. Licorice and yerba mate tea in the morning

2. Lots of salt. I like to snack on Hawaiian red clay salt.

I would be a little concerned that these challenges are just going to make people feel hungry and irritable if done cold-turkey. It takes time to adjust to cooking and buying real foods. It's been four years for me and I'm still challenged sometimes.

But all wasn't a loss for me. I realized that I am a little sensitive to some "young" cheeses like my beloved ricotta. But I also realized that I wasn't even eating much butter and in fact my naughty roommates had eaten it all because I've had SO much tallow from my lamb.

I also became a big fan of coconut aminos, a soy sauce replacement that is actually really tasty. I braised some lamb shanks last night in the crock pot with a 1/4 cup coconut aminos, 1 cup coconut vinegar, 1 cup coconut milk, and a bunch of bird chilis, cilantro, and freshly ground black pepper. Mmm adobo.

I got this at my local convenience store for $7. Jealous? Well, I'm jealous of all the people who don't pay a gazillion dollars to share an apartment. Although if you can get together a group of like-minded paleos, the Amazon link above gets you 12 bottles for about $90 including shipping, which would make a good bulk buy.

Edit. So while I've done orthodox paleo before, I did it when I was unemployed and ate all my meals at home. I didn't say that orthodox paleo=calorie deficit. I said it was hard. And is it always unnecessary? Is butter really so much worse than tallow?

Thanks for all the kind words yesterday! I have learned so much recently and had to face up the fact that eating paleo isn't going to erase staying up until 4 AM. So far my plan to get better includes:

1. Blackout curtains

2. Going to bed at a normal time and working normal hours

3. Morning sunlight

4. Not pressuring myself to do something all the time (easier said than done)

5. Meditation

6. Quitting the coffee treadmill

7. One alcoholic drink a week. This is a tough one, but I come from a family of people who had to quit drinking for very good reasons. Maybe in the future I can resume drinking again, but for now it seems like a bad idea.

8. Figure out what I want to do with my life. Right now I'm not exactly living my dreams. I have a love-hate relationship with my city and a mostly hate relationship with work. Honestly, there has to be something out there for me right? I'm not that happy sitting in front of the computer, even if I make more money and have more flexibility. I thought that was freedom— I was wrong.