T Nation

Things my doctor said

#1 On diabetes
My glucose test was normal (93):
Me: [jokingly] Oh good, I don’t have to go on a special diet or anything
Doc: That’s not what causes it. It’s caused by insulin resistance.
Me: Well, what causes that?
Doc: Most of the time if one of your parents had it, you will get it.
Me: My dad had it but he drank a bottle of vodka every day, ate sweets constantly and never exercised.
Doc: Well if he developed it, you might too.
Me: ??? But if you drop carbs, cant you increase insulin sensitivity?
Doc: Never do that. It’s terrible. When no-carb diets became popular in the 80’s people started dying like crazy and the medical institution didn’t know why. It took a while and a lot more deaths to figure it out.

#2 cry me a liver
On this site we like to poke at doctor’s credibility, but when you’re in the doctor’s office and he says, “we have a problem, your test results show liver damage”, all the doubts about what doctors say vanishes instantly. That statement instantly becomes reality.
This was about a liver test which showed elevated ALT value 54 (normal < 41).
Me: I don’t drink alcohol at all. I eat right and I exercise. The only processed things I take are diet coke and protein powder.
Doc: there you go, protein powder. Not necessary. Cut it completely. It’s a myth that you need a lot of protein - even to get muscular.

Later modok set me straight, and I saw that it’s noted in literature about the ALT that strenuous physical activity can elevate results.

Is this why the ALT becomes elevated?: When you eat a one pound stake (100g protein), it takes like 10 hours for it to work its way through your system. That’s 10g of protein per hour processed through your liver. When you drink 35g of hydrolyzed whey protein, it goes through your liver in 15 minutes. The liver is not designed to handle such big loads at once so problems occur.

I’m curious about the “high protein is not necessary to get muscular” statement. Anyone here got bigger eating <1g/lb?

i got really strong just eating shitloads of carbs

Lets be real, most doctors don’t exercise , let alone know much about eating correctly for for our form of exercise intensity. They only know what the bare minimum requirements of nutrition is needed for a sedentary individual in order to survive and prevent certain deficiencies. Wouldn’t common sense tell us that if we exercise more, put our bodies under more stress that our nutritional requirements will have to change

I’m no doctor at all. I just did a few google searches. Maybe it’s because of the waste products of protein include ammonia (highly toxic) and your body isn’t getting rid of it fast enough. I’m really pulling at straws here, but maybe drink more water/eat more fiber?

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I cut doctors some slack but it would be good if their nutrition advice wasn’t exactly the same as the stuff from the Reader’s Digests in their waiting rooms.

About the diabetes comment that children of diabetic parents are at risk of developing diabetes (type 2). I say that people who have bad eating and exercising habits, create a bad environment for their children to emulate.

Everything I’ve read about type 2 diabetes hypotheses that it is caused by eating habits and lack of physical activity. Am I wrong about this?

My dad got it but he drank a bottle of vodka a day, ate sweets throughout the day, and never exercised. I don’t think it was pre-destined. I just have to avoid those types of behaviors.

I think my doctor just can’t be real about it for insurance and medical practices reasons.

I think you are right about the type 2 diabetes causes. I’ve never met a fit diabetic (unless they had diabetes from before). Self-malnourishment is the worst thing someone can do to themselves, and if you are really concerned about your liver, I’d get re-tested after a deload or off week (not strenuous).

So, just so we’re clear: no one here thinks there is a genetic component to an individual’s predisposition to any given disease?

[quote]qsar wrote:
On this site we like to poke at doctor’s credibility, but when you’re in the doctor’s office and he says, “we have a problem, your test results show liver damage”, all the doubts about what doctors say vanishes instantly. That statement instantly becomes reality.[/quote]

It’s times like these when patients realize they don’t know how to perform surgical procedures and manage therapeutic treatments after skimming a Wikipedia article… and they’re instantly grateful that they’ve got the guy with 10+ years of strict education and years more of experience in this area telling them what they need to do.

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[quote]anonym wrote:
So, just so we’re clear: no one here thinks there is a genetic component to an individual’s predisposition to any given disease?[/quote]

Some, but not many, and even then it won’t big a big part of it.

IMO, if one were to stay lean (not just skinny) with exercise and proper diet (maybe something like Paleo or darn close) they would almost never develop T2 diabetes, even if everyone in their family has it. Now, is that to say the disease itself is genetically based? Perhaps the parents DNA changed some when they lead a poor lifestyle and it got passed on. I doubt that T2 diabetes is a natural disease in and of itself, if that makes sense.

Both my parents had heart attacks before age 50, so for life insurance that hurts me. Yet, they both smoke, don’t workout, eat garbage…

It was once (and still by many) thought that Alzheimer’s and Parkinson’s was greatly genetic, when new research is showing that not to be the case, only a very small % 5-10, even then only half of those would develop it.

The power of diet and exercise IMO is greatly underestimated by the health industry for preventing disease.

Of course, there’s also the environmental factor and stress, but come on. Most diseases are not seen in non-western/industrialized cultures.

How many tigers or lions develop half the disease of man?

[quote]jehovasfitness wrote:

[quote]anonym wrote:
So, just so we’re clear: no one here thinks there is a genetic component to an individual’s predisposition to any given disease?[/quote]

Some, but not many, and even then it won’t big a big part of it.

IMO, if one were to stay lean (not just skinny) with exercise and proper diet (maybe something like Paleo or darn close) they would almost never develop T2 diabetes, even if everyone in their family has it. Now, is that to say the disease itself is genetically based? Perhaps the parents DNA changed some when they lead a poor lifestyle and it got passed on. I doubt that T2 diabetes is a natural disease in and of itself, if that makes sense.

Both my parents had heart attacks before age 50, so for life insurance that hurts me. Yet, they both smoke, don’t workout, eat garbage…

It was once (and still by many) thought that Alzheimer’s and Parkinson’s was greatly genetic, when new research is showing that not to be the case, only a very small % 5-10, even then only half of those would develop it.

The power of diet and exercise IMO is greatly underestimated by the health industry for preventing disease.

Of course, there’s also the environmental factor and stress, but come on. Most diseases are not seen in non-western/industrialized cultures.

How many tigers or lions develop half the disease of man?[/quote]

The key to all of this is that neither side is 100% correct. Type 2 diabetes shows much more of a genetic component than Type 1. This is a predisposition, not an absolute. Those with DM2 in either parent would do well to keep their diet in check as they are more likely to develop the disease, but it is not a certainty; just as a person with no DM2 in their family can certainly develop it with longstanding poor eating/exercise habits.

I actually had to put a guy in the ICU about 3 weeks ago after he came in in DKA with an anion gap of ~34. This was a young, athletically built guy, but his hemoglobin A1C was literally unreadable. This is the type of guy who would likely have a genetic predisposition to DM2 and will have to do VERY well with diet and exercise to maintain a high quality of life (avoiding retinopathy, nephropathy, neuropathy, etc.)

Genetic structure is not changed by diet. Gene expression certainly is, but not the actual DNA which is passed from parent to child.

As far as the Alzheimer’s and Parkinson’s: there are subtypes of both of these disease processes, and neither is anywhere near fully classified. It appears there is a familial form of Alzheimer’s, which is very early onset; but has different genetics than other forms of Alzheimer’s (and likely a different genetic locus altogether). There is also a lot of research now into what’s being called Type 3 Diabetes and it’s link to alzheimers, although this is not the leading theory currently. Parkinson’s also involves many of the same themes as above.

Anyway, the new thinking seems to be genetic predisposition + environment (nutrition, exposure) for most disease processes, with neither being the absolute “most important element”.

I totally agree that diet is grossly underestimated in western civ and medicine. As for the “most diseases aren’t seen in non-western countries” comment, what do you mean by this?

[quote]bam7196 wrote:

[quote]jehovasfitness wrote:

[quote]anonym wrote:
So, just so we’re clear: no one here thinks there is a genetic component to an individual’s predisposition to any given disease?[/quote]

Some, but not many, and even then it won’t big a big part of it.

IMO, if one were to stay lean (not just skinny) with exercise and proper diet (maybe something like Paleo or darn close) they would almost never develop T2 diabetes, even if everyone in their family has it. Now, is that to say the disease itself is genetically based? Perhaps the parents DNA changed some when they lead a poor lifestyle and it got passed on. I doubt that T2 diabetes is a natural disease in and of itself, if that makes sense.

Both my parents had heart attacks before age 50, so for life insurance that hurts me. Yet, they both smoke, don’t workout, eat garbage…

It was once (and still by many) thought that Alzheimer’s and Parkinson’s was greatly genetic, when new research is showing that not to be the case, only a very small % 5-10, even then only half of those would develop it.

The power of diet and exercise IMO is greatly underestimated by the health industry for preventing disease.

Of course, there’s also the environmental factor and stress, but come on. Most diseases are not seen in non-western/industrialized cultures.

How many tigers or lions develop half the disease of man?[/quote]

The key to all of this is that neither side is 100% correct. Type 2 diabetes shows much more of a genetic component than Type 1. This is a predisposition, not an absolute. Those with DM2 in either parent would do well to keep their diet in check as they are more likely to develop the disease, but it is not a certainty; just as a person with no DM2 in their family can certainly develop it with longstanding poor eating/exercise habits.

I actually had to put a guy in the ICU about 3 weeks ago after he came in in DKA with an anion gap of ~34. This was a young, athletically built guy, but his hemoglobin A1C was literally unreadable. This is the type of guy who would likely have a genetic predisposition to DM2 and will have to do VERY well with diet and exercise to maintain a high quality of life (avoiding retinopathy, nephropathy, neuropathy, etc.)

Genetic structure is not changed by diet. Gene expression certainly is, but not the actual DNA which is passed from parent to child.

As far as the Alzheimer’s and Parkinson’s: there are subtypes of both of these disease processes, and neither is anywhere near fully classified. It appears there is a familial form of Alzheimer’s, which is very early onset; but has different genetics than other forms of Alzheimer’s (and likely a different genetic locus altogether). There is also a lot of research now into what’s being called Type 3 Diabetes and it’s link to alzheimers, although this is not the leading theory currently. Parkinson’s also involves many of the same themes as above.

Anyway, the new thinking seems to be genetic predisposition + environment (nutrition, exposure) for most disease processes, with neither being the absolute “most important element”.

I totally agree that diet is grossly underestimated in western civ and medicine. As for the “most diseases aren’t seen in non-western countries” comment, what do you mean by this?[/quote]

Tooth decay, heart disease, cancer (certain types seem to be more diet based), Alz, Parkinson’s, T2 diabetes, obesity, etc. I’m not talking about just other countries, I’m referring to societies that are or were largely hunter-gatherers.

[quote]jehovasfitness wrote:
How many tigers or lions develop half the disease of man?[/quote]

Seriously?

How many lions and tigers (call it ligers) get blood work, autopsies and genetic testing performed on them?

How much interest is there on liger health? How much money is being poured into it? Genetic research isn’t exactly a cheap, weekend endeavor. We haven’t even figured ourselves out yet. By a long shot.

I’m not even a vet, and I can’t imagine anyone who isn’t a veterinarian specializing in big cat health care being able to give much detail about this.

Here is what is referred to as a “morbid map”. Pick a chromosome and see all the diseases that are related in some fashion to a gene located on your chromosome of choice:

http://www.ornl.gov/sci/techresources/Human_Genome/posters/chromosome/map.shtml

Kinda a lot there, right?

As BBB and bam wrote, it is a combination of environmental and genetic factors at play here. Some smokers live to be 90. Some people have extremely high cholesterol despite being vegetarians while their friends have six pack abs and perfect blood work on a McDonald’s diet.

Some things you can largely prevent (don’t smoke and you’ll have a great chance of not getting lung cancer). Some things you can’t (you cant out-diet Huntington’s disease). Medical history is rife with people who have “done everything right” and still gotten the Grim Reaper’s scythe up their ass before they hit 40. C’est la fuckin’ vie. Unpredictable – at least, with today’s technology and understanding.

Arguing that genetics have minimal impact on disease is silly. It’s who we are at the most fundamental level.

Girl asks what she can do to avoid breast cancer, tell her to pick the right parents. Having the right BRCA1/2 genes is a huge advantage.

[quote]anonym wrote:

[quote]jehovasfitness wrote:
How many tigers or lions develop half the disease of man?[/quote]

Seriously?

How many lions and tigers (call it ligers) get blood work, autopsies and genetic testing performed on them?

How much interest is there on liger health? How much money is being poured into it? Genetic research isn’t exactly a cheap, weekend endeavor. We haven’t even figured ourselves out yet. By a long shot.

I’m not even a vet, and I can’t imagine anyone who isn’t a veterinarian specializing in big cat health care being able to give much detail about this.

Here is what is referred to as a “morbid map”. Pick a chromosome and see all the diseases that are related in some fashion to a gene located on your chromosome of choice:

http://www.ornl.gov/sci/techresources/Human_Genome/posters/chromosome/map.shtml

Kinda a lot there, right?

As BBB and bam wrote, it is a combination of environmental and genetic factors at play here. Some smokers live to be 90. Some people have extremely high cholesterol despite being vegetarians while their friends have six pack abs and perfect blood work on a McDonald’s diet.

Some things you can largely prevent (don’t smoke and you’ll have a great chance of not getting lung cancer). Some things you can’t (you cant out-diet Huntington’s disease). Medical history is rife with people who have “done everything right” and still gotten the Grim Reaper’s scythe up their ass before they hit 40. C’est la fuckin’ vie. Unpredictable – at least, with today’s technology and understanding.

Arguing that genetics have minimal impact on disease is silly. It’s who we are at the most fundamental level.

Girl asks what she can do to avoid breast cancer, tell her to pick the right parents. Having the right BRCA1/2 genes is a huge advantage.[/quote]

Well said, I don’t mean to imply that genetics don’t matter. i just think genetics are overly emphasized for many diseases.

Genetics load the gun, lifestyle/environment pull the trigger. Overly simplified, but the human body or any living organism for that matter, to me just doesn’t make sense for most of our “common” diseases to be natural. I dunno, maybe I’m being narrow-minded here.

diabetes doesn’t seem like something organisms would “naturally” suffer from.

really, is there any other animal in the world, not domesticated (I say that b/c dogs are getting a ton of “human” diseases b/c of piss poor nutrition) that suffers as much disease as we do?

do birds get T1 diabetes?

and yes, while T1 may be genetic and it’s not directly lifestyle, we can’t discount the work of Loren Cordain and his thoughts on autoimmune diseases being diet related as well, maybe even before one is born.

I respect your thoughts above, I don’t pretend to have the answers :smiley:

[quote]jehovasfitness wrote:
I respect your thoughts above, I don’t pretend to have the answers :D[/quote]

lol, me neither man.

Though I do have a copy of Nutrition and Physical Degeneration sitting on my bookshelf. I’m gonna get to it after finishing Know Your Fats. It’s a thick-ass book with surprisingly small print, so hopefully I’ll pick up a thing or two along the way.

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[quote]qsar wrote:

I’m curious about the “high protein is not necessary to get muscular” statement. Anyone here got bigger eating <1g/lb?
[/quote]

Uh, yes. Genetics again dictate how much of what you eat is processed into muscle tissue. I knew guys in college whose diets were mostly carbs and fats. They played ball and mostly ate what they wanted and still maintained physiques most posters here would have to train years to attain.

Is it ideal? Probably not, but don’t assume every human NEEDS large amounts of protein to gain muscle mass above average. Yes, there are people who can eat pizzas and beer and still gain more muscle than you, at least up to a point.

[quote]anonym wrote:

[quote]jehovasfitness wrote:
I respect your thoughts above, I don’t pretend to have the answers :D[/quote]

lol, me neither man.

Though I do have a copy of Nutrition and Physical Degeneration sitting on my bookshelf. I’m gonna get to it after finishing Know Your Fats. It’s a thick-ass book with surprisingly small print, so hopefully I’ll pick up a thing or two along the way.[/quote]

How is “Know Your Fats”? the author is greatly respected and sounds like the book has great info, but is there much in there that is “new” to those of us who aren’t afraid of saturated fats?