You Are Your Own Doctor

The more I learn about the medical profession, the more alarmed I become. The stories of inaccuracy, odd and highly negative outcomes, and even cases of the overt intimidation of very sick people are not uncommon. Many are given treatments that don’t work or they didn’t really want. Everyone has these stories. The tale of the last weeks and months my parents were alive haunts me to this day.

Nevertheless, I am an avid consumer of health care because under the right circumstances, the medical profession in the United States is incredible and with the right doctor, great outcomes are possible. BUT, it is very apparent that the primary care physician in the office must be you. You have to be coached up enough on the issues to interpret your doctor’s directions and ideas and take the ones that serve you and discard ideas that don’t.

I like my primary care physician and respect his opinion, but an example of how I must parse his recommendations was evident after a recent physical. My health numbers based on measurements and a recently ordered blood test are pristine: low A1C, cholesterol numbers well in range, low resting heart rate, great BMI… and on and on. I take care of myself and my doctor recognized this and was generally encouraging and complimentary.

But afterward the visit, he entered his field notes and they were conveyed to me via the health portal his practice maintains and it was there that I received this dietary advice: “low-carb, low fat.”  

Now, there are only three macros; carbs, fats, and proteins. I need about 2000 calories to maintain my weight, which is right where it needs to be, so let’s assume that 15% means low. That means that 300 calories would come from carbs, and 300 more from fat. I’d have to make up the rest with very lean protein. One way to do that would be to eat a lot of chicken breast. Protein has 4 calories per gram and so to get 1400 calories I’d need to eat 350 grams of chicken, or about 12.5 ounces, which are four 3 ounce servings. A three ounce serving is about what you find on a chicken sandwich, and I’d have to eat four a day.

This does not seem wise to me. I’d have to eat my four chicken breast with a salad and maybe some bread and that would be it, over and over. I could add fish or maybe pork, but beef has too much fat so that would be out. I could put some olive oil on my many salads, but not much because of the fat. Can’t put the chicken in pasta with alfredo sauce because of the fat and carbs.

In short, I can’t take this advice, and I’m not going to. Dr. Tom got those great numbers with a keto, fat-friendly diet and I feel great on it. Eggs are mandatory every day along with pork, beef, bacon, some bread and some fruits and a serving of vegetables that’s been braised in the meat drippings so they taste good. And, a beer. I hate defying a doctor I empower to advise me, but I suspect that the low fat mantra has been so ingrained that nearly all doctors can’t let it go and the low carb advice comes from the realization that carbs are making people fat.

So, I’m in charge and I have to be. You do as well because much science is complete crap and you just can’t fully trust any sources, certainly not this one.

Do your own reading, listen to your body, cook your own food, and live.

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