Sunday, October 11, 2015

As a physician I beilieve in using medicines long term to prevent diseases especially in the chronic obese

It's time for NLA to not prevent CVD with diet.

It's a mistake to advise less than 200 mg Cholesterol a day and less than 7% saturated fats.

As a Diplomate of Lipidology and about to take the American Board of Obesity Boards I see a science gap between the two disciplines.

We have conquered a major risk factor in America: smoking.

Diet and Exercise have not conquered Obesity.

The Mediterranean diet has not conquered Cardiovascular disease.

When I went to the Obesity Medicine Association last week in Washington the overriding theme was not how to lose weight, it was how to maintain weight loss.

It is clear to rank and file of OMA that LCHF or Atkins is the only diet that has satiety and can be sustained for a long time.  It works because Ad libitum it is a low calorie diet.

However,  in the reduced obese state simply going from 1500 cal/d to 1620 cal/day will lead to 10 lb  weight gain in one year.

Also increasing to 400 minutes exercise a week will not necessarily maintain weight loss.  The body believes it is starving because of low leptin levels.  At plateau the body temperature is turned down to conserve energy.  This diet and exercise is not sustainable except for the few in the National Weight Control Registry.

Even Atkins will not be sufficient over 5-10 years.  I believe the reduced obese who have the disease of Chronic obesity will need to be on long term diet medication as well.

Most of the reduced obese have insulin resistance and metabolic syndrome and dyslipidemia and early CVD.

Please NLA, don't tell them to eat less than 200 mg Cholesterol/d and less than 7% saturated fats.

These  people need a diet with the satiety of protein and the taste of fat.

I am upset NLA makes these recommendations without LDLp, CAC and CIMT data.

NLA proposes individual treatment.

If the IR patient on Atkins needs a statin, give him a statin not fruit or a low calorie diet they can't sustain.











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