Disconnect Seen Between PCPs, Obese Patients

This was the headline of an article I just read this morning in Family Practice News, the April 1, 2010 edition Vol. 40, No. 6. The article itself was on page 5. Basically the article goes on to say that 'Patients want information on weight control, but physicians say they don't have enough training.'

It was very encouraging reading that statement because it is true. We physicians receive very little instruction in the treatment of obesity and what we do learn in medical school, internship, residency and at our conferences is just plain wrong. I received 2 weeks of 'formal'instruction in nutrition in medical school taught to me by an overweight dietitian. I didn't learn the correct way to eat until many years later.

I would go on to add that not only do physicians need more information on the treatment of obesity, but heart disease and type 2 diabetes as well. You see, the common denominator in the treatment of these diseases is the understanding that it is sugar molecules (glucose, fructose, galactose) that the body converts into plaque forming deadly cholesterol and makes us fat. Until physicians are taught this, we will not solve any of the medical problems as delineated above.

I gave a lecture to a small group last night and one of the participants stated her doctor told her flat out that carbohydrate consumption does not increase inflammation in the body. This is false, it does. I bet this same doctor does not understand that cholesterol and fat production starts with sugar molecules, yet, it does.

My point is that when doctor's believe certain things, like what they are taught in medical school, they hold on tenaciously to that belief despite overwhelming contradictory evidence proving otherwise. Beliefs are hard to crack.

We need to start educating our health care providers on the correct way to eat so they can properly educate the millions of patients they collectively see throughout our nation.

dr jim 'the shock doc'

Plaque Builup

Hi Doc,

I just discovered your blog, and I'm liking it very much!

You mention in one of your posts that you want to see a Trig/HDL ratio that is 2 or less, and if it's higher you worry about a plaque rupture until it comes down (enter statins). Can you explain how lowering this ratio reduces the risk of a plaque rupture (as opposed to further plaque build-up)? Also, can switching to a low-carb diet reverse plaque build-up?

Thanks,JW

My answer;

Hi There!

Yes, I want a TG/HDL ration at or under 2 as this equates with a lower relative insulin level in the bloodstream. Now its not so much that this will lower the possibility of plaque rupture, it is more to prevent the further buildup of plaque, which increases the possibility of rupture. More plaque= higher probability of plaque rupture since there is more plaque within the arterial wall, which could rupture.

This goes for all arteries, not just the carotid or coronary.Since the plaque buildup comes from the transformation of sugar molecules into cholesterol, following a low carb diet will not give our bodies what it needs to create the plaque in the first place.

It's interesting that we have no studies which show that the fat/cholesterol in the diet has ever been linked to the plaque buildup within our arteries; but we do have studies that every carbon atom in cholesterol can come from sugar. Also, a review of the biochemical pathways reveals the direct way that a sugar molecule will be transformed to cholesterol.Also, the only thing that I've seen significantly raise the good cholesterol, the HDL, has been the consumption of more saturated fat/cholesterol in our diet.

The whole system, and all the organizations promoting low fat/low cholesterol are so bass ackwards, it'd amazing we all aren't dropping dead from heart disease...oh, wait a minute we are...

Dunno if a low carb diet will reverse plaque buildup, no studies I know about, but it will certainly halt the creation and buildup of anymore plaques and this will be very advantageous for us.

Hope this helped!

Thanks for the questions!

dr jim

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