How I survived 5 days of Holiday eating in New Orleans

I flew into New Orleans on Nov. 19, 2019 Tues 
Red Dog Diner  link
I had Old Fashion
Sphagetti Bolonese



Weds 11-20-19
Cooked shrimp scampi in Timeshare
Wine

Thurs 11-21-19
Compere Lapin link
Spiced Pig Ears
Great small oysters from Alabama
Curry Goat
Collards and coconut cream
Sazerac cocktail
Wine
 Amazing restaurant.  Everything we ate was unique and wonderful.

Fri. 11-22- 19
Luke restaurant link
Oyster Happy Hour
75 cents per oyster.
I had cocktails and wine.
I always try to hit this on my trips to NOLA

Sat. 11-23-19
Cooked Lamb and Salmon in Timeshare
Wine
Salad


Sunday 11-24-19
Ruby Slipper  link
I had two vodka bloody mary's.  Excellent with more pepper than spice as do it in NOLA
Migas plate
Only breakfast I ate in NOLA


I survived the Holidays in New Orleans with my new diet approach
 INTERMITTENT FASTING ON LOW CARB HIGH FAT.

I went on stricter IF here link 

Earlier I was able to do below:

 IF with help of Continuous Glucose Monitor link



Notice on the BIA scale below, lower weight had more fat. 

How to get your NON-fasting triglyceride less than 100

I wrote advice to get NON-fasting triglycerides less than 100 link

Now, I want to point out the 3 items to get to that goal:

1- Low carbohydrate high fat #ketosis diet

2- Enduracin (nicotinic acid) 1,000 mg/d

3- Lovaza (omega-3-acid ethyl esters) 1,000 to 4,000 mg a day

I will start with discussing the brand name: Lovaza.

I go to my pharmacy and ask for the generic version of Lovaza. 

It is very easy to do.  

You do need a Doctors prescription.

I like Lovaza because positive trials were done with it in Italy.

GISSI trial 1986

I like buying this drug (nutrient) because it has been much cheaper, especially on my medicare with the supplemental drug coverage. 

If no coverage you can find the cheapest SAM's or COSTCO version.  

Just do the math. 

1,000 mg Lovaza = EPA 465 mg + DHA 375 mg

Concerns have been expressed that DHA raises LDLc.

It is a fluffier, larger LDLp.

Thus the LDLp increase was never an issue for me in my practice. 

New great trials with only the EPA component suggest they may be better. 

1-statin

2-Enduracin

3-Zetia. 

All 3 are now generic (inexpensive) and at low doses have few sides effects.

I continue that model with generic Lovaza. 

Now that high triglycerides are receiving much more attention, I give the 3 steps (items) above. 

Try it out, then:

Add Zetia and then statin to get the 

MULTIPLIER EFFECT (link) 

that I write about.

This approach will achieve superlative target values as good as the 

expensive intravenous PCSK9 drug

Best Breakfasts in the World : New Orleans

Best Breakfasts in the World :  New Orleans

Many great breakfast spots such as Mothers on Canal.

Ruby Slipper very popular. 

Lines outside restaurant form early.

All excellent and unique specials. 

I had Migas below. 

 I would have it again.

Maybe the best Tortilla chips ever.

Spanish Omelete 

The roasted potatoes were the best.

French Toast 

Alcohol with breakfast?  Dat true in New Orleans

Great article on Bariatric surgery. My review on excerpts.

Great article on Bariatric surgery.  

My review on excerpts IN PURPLE

ONE

Good lead to the title of my book that I published last year. 

                                                                           

I guess the author never heard of :

The National Weigh Control Registry (NCWR) link

Very Low Calorie diets (VLCD) 800-1000 calories do counter hunger with ketosis in first 9-12 months. 

                      Remember that bariatric surgery does not affect the number of fat cells.  After 10 years 30% of bariatric patients regain their weight as the Sponge syndrome keeps their leptin low which causes decreased thermogenesis and increased hunger. 
                                                             
                                    TWO

THIS IS A GREAT ADVANCE. 

HOPEFULLY ALL STATES WILL EXPAND THEIR MEDICAID.

NOW THEY HAVE TO PAY FOR MULTIPLE DIET MEDICATIONS FIRST BEFORE SURGERY

MULTIPLE DIET MEDICATIONS.  LINK

THREE

The statement above is not accurate as it does not take into account the Waterfall Effect of all diet trials. 

FOUR

Again I think fails for many patients. Dr. Rosenbaum talks about 

'set point' here  link

FIVE

I think we have to  wait five years at least before we can say the bariatric surgery does actually do this.  The shrunken fat cells eventually win and cause weight regain.

No one addresses Sponge Theory  of mine.

SIX

The 3-9% re-operation rate for bypass and sleeve are major reasons to use  combination multiple diet medications first.

SEVEN

But how many gained their weight back?

It is a bias to not share the waterfall weight change of the whole group.

EIGHT

Exactly. 

"safe and effective" on average"

Not very encouraging for such an expensive operation that fails 30% of patients 

after 10 years they regain their weight with potential death.

NINE

TEN

ELEVEN

Very important 0.3% mortality risk

 and other potential harms. 

3 out of 1,000 patients will die.

TWELVE

EXACTLY. 

 MANY OF THE BARIATRIC TRIALS FLAWED.

I RARELY SEE 

INTENTION TO TREAT NUMBERS. 

 I HAVE TRIED TO WRITE AUTHORS FOR INFORMATION  AND THEY DON'T HAVE IT. 

THIRTEEN

My worry is that other than trials or large centers this long term follow up is not done

FOURTEEN 

FIFTEEN

This is his opinion.  

We now have multiple diet medications that can be taken at same time for life. 

Why risk being one of the three in 1,000 that die. 

SIXTEEN

GASTRIC LEAKS 5%

BARRETTS ESOPHAGUS 17%

SEVENTEEN

Suicide 

Drug and Alcohol disorders. 

EIGHTEEN

How many pts did I know had ASHD?

Here is all the data.
 Maybe you can count the exact numbers.  Looks like 50% had documented CVD?
I started the list here.

My thanks to Ivor and Tro for their leadership in getting me to try Intermittent Fasting.

I have done well just having coffee for breakfast and lunch since Nov 13, 2019

11-16-19 results.  CGM advised by Dr. Tro has made a big motivator to stay fasting.

I stared modified intermittent fasting Nov 9 

Blog to starting IF link 

Eat Rich Live Long p. 297

Initially I thought intermittent fasting was too restrictive for general public. 

I found I developed hyperphagia if I skipped a meal.

Now I realize it is easy to skip breakfast but I was taught never to skip breakfast. 

Despite Low Carb High Fat and nutritional ketosis I was having trouble getting below 210 lbs and staying there. 

I have an advantage. 

I take the diet medications Victoza and Belviq.

I also take Invokana and metformin. 

My problem is night eating. 

I realize with dark roast coffee I am not having too much trouble skipping breakfast and lunch. 

My steps this week ranged from 5,000 to 10,000 a day.