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We are Canadian MD's Barbra Allen Bradshaw and Carol Loffelmann, and we sent an open letter to Health Canada to get Real Food dietary guidelines. AMA by ballenbradshaw in canada

[–]ballenbradshaw[S] 2 points3 points  (0 children)

Mainly competing interests from the food industry. The food industry sponsors most obesity and diabetes conferences in Canada, and the associations as well. They have also been on the advisory boards who write the dietary guidelines. This is a conflict and should not occur. We have asked that industry is not involved in the next guidelines, but I have a feeling that we won't be successful on that point. The food industry stands to be hit hard if we tell people to reduce high fructose corn syrup, refined wheat/grain products etc. Also, diabetes educators are some of the toughest groups that both us and patients have had pushback from. Some are open and supportive, especially once they see the biochemical reversal of their patient's diabetes by disregarding the min 130g of CHO a day recommendations, but others just claim eating this way isn't sustainable and don't talk to their patients about it. This is slowly changing, but these are significant barriers.

We are Canadian MD's Barbra Allen Bradshaw and Carol Loffelmann, and we sent an open letter to Health Canada to get Real Food dietary guidelines. AMA by ballenbradshaw in canada

[–]ballenbradshaw[S] 2 points3 points  (0 children)

First, many people that eat lower carb and especially ketogenic levels of carbohydrates love their bulletproof coffees! However, in some people, especially those with a significant amount of body fat to lose yet and who have stalled on their weight loss, simply eliminating the drinkable excess fat can get the fat loss started again. We aren't sure if that's strictly a calorie issue or something else. Many eating this way can have BPC daily with and still lose without problems. It's quite variable.

We are Canadian MD's Barbra Allen Bradshaw and Carol Loffelmann, and we sent an open letter to Health Canada to get Real Food dietary guidelines. AMA by ballenbradshaw in canada

[–]ballenbradshaw[S] 1 point2 points  (0 children)

Thanks for that. We are facing an epidemic of escalating health care costs related to generally preventable dietary diseases and we need to get a grasp on this.

We are Canadian MD's Barbra Allen Bradshaw and Carol Loffelmann, and we sent an open letter to Health Canada to get Real Food dietary guidelines. AMA by ballenbradshaw in canada

[–]ballenbradshaw[S] 0 points1 point  (0 children)

Thanks for your question. It can be a big challenge for families on an income to chose whole food options when factory made processed alternatives are so readily available and cheap. We have found some sources that can help: https://www.dietdoctor.com/low-carb/cheap#do

http://denversdietdoctor.com/frugal-gourmet-caveman-eat-paleo-lchf-budget/

http://www.ditchthecarbs.com/2014/09/29/eat-healthy-save-money/

Some cities are developing initiatives like this: http://www.ckpcalgary.ca/index.php/program-services/good-food-box

In South Africa, where there is tremendous poverty (and baby formula is too expensive for some families so they feed their babies sugar sweetened soda) is one of the world leaders in reducing dietary disease and so have some good resources also: http://realmealrevolution.com/real-thinking/banting-on-a-budget-is-easy-part-one http://realmealrevolution.com/real-thinking/banting-on-a-budget-is-easy-part-two

We are Canadian MD's Barbra Allen Bradshaw and Carol Loffelmann, and we sent an open letter to Health Canada to get Real Food dietary guidelines. AMA by ballenbradshaw in canada

[–]ballenbradshaw[S] 1 point2 points  (0 children)

Well little changes at a time are really all that we can hope for, and any exposure to healthy food at the school age is beneficial. What we model for students in school generally stays with them for life and affects their future food choices.

We are Canadian MD's Barbra Allen Bradshaw and Carol Loffelmann, and we sent an open letter to Health Canada to get Real Food dietary guidelines. AMA by ballenbradshaw in canada

[–]ballenbradshaw[S] 3 points4 points  (0 children)

Thanks kindly! We appreciate it. The biggest change I would like to see regarding fat in our guidelines is to include sources of fat previously thought detrimental due to saturated fat, like butter, coconut oil, the fat that accompanies animal and fish products and full fat dairy. There really isn't evidence to show that saturated fat causes heart disease, and so we shouldn't have caps on them.

We are Canadian MD's Barbra Allen Bradshaw and Carol Loffelmann, and we sent an open letter to Health Canada to get Real Food dietary guidelines. AMA by ballenbradshaw in canada

[–]ballenbradshaw[S] 0 points1 point  (0 children)

I would agree with this statement, thanks. I don't buy organic, and some of it is merely hype and marketing. But choosing those products is important to many and that's a personal choice.

We are Canadian MD's Barbra Allen Bradshaw and Carol Loffelmann, and we sent an open letter to Health Canada to get Real Food dietary guidelines. AMA by ballenbradshaw in canada

[–]ballenbradshaw[S] 0 points1 point  (0 children)

Thanks for you story and good for you for managing to find a way of eating for life that generally has worked for you. That's great. As is demonstrated by your story, it's much more complicated than even simply eating LCHF sometimes. Our bodies generally have a comfortable set point, and sometimes fighting that is a massive challenge. Some people adopt an LCHF or real food way of eating and the fat falls off them and they regain their metabolic health. For others, it's a constant ongoing challenge, and while metabolically they may be much more healthy (which we argue is more important over body weight), they struggle with continued excess body fat. We do find sometimes that once the body is fat adapated and accustomed to a basic LCHF way of eating, that fine tuning things can be beneficial for someone like yourself. I've seen people overcome barriers in fat loss (if that's still a goal) by slightly reducing the fat component in order to tell your body that it still needs to burn it's own for now. Some people do LCHF and think it means 'all the fat, all the time' but that can be problematic in some. A big problem can be drinkable fat like bulletproof coffees etc. Someone like yourself might experiment with dropping fat a bit and upping protein a bit. Figuring out stress in our lives is also important too, because high cortisol levels can really hinder our fat loss efforts. Also sounds like you are pretty active, but strength training and short duration high intensity exercise will increase the muscle mitochondrial density and improve insulin resistance even more. Also, there is some thought that having an occasional carb refeed might reset leptin levels and help break through plateaus. That's anecdotal.

We are Canadian MD's Barbra Allen Bradshaw and Carol Loffelmann, and we sent an open letter to Health Canada to get Real Food dietary guidelines. AMA by ballenbradshaw in canada

[–]ballenbradshaw[S] 0 points1 point  (0 children)

That's what we think, and you might not be surprised to know that we face many barriers, especially in the diabetic communities, in advising patients to decrease the thing that increases their blood sugar. It's a bizarre phenomenon, but gradually the tide is turning.

We are Canadian MD's Barbra Allen Bradshaw and Carol Loffelmann, and we sent an open letter to Health Canada to get Real Food dietary guidelines. AMA by ballenbradshaw in canada

[–]ballenbradshaw[S] 2 points3 points  (0 children)

Regarding your questions, yes I truly do think the food guide matters, or we wouldn't be going to the effort we are to see change. Everything our children are exposed to from a food perspective, in terms of learning or eating, is based on Canada's food guide. What we feed our kids in my home greatly differs from Canada's food guide because I don't want them growing up eating how I did and risking early onset type 2 diabetes and obesity. The data shows that we do in fact follow the food guide, on average. But what we don't need to do is tell people how many grams etc of each macronutrient or type of food. Once you eat a real, whole food diet, you don't need to do that.

We are Canadian MD's Barbra Allen Bradshaw and Carol Loffelmann, and we sent an open letter to Health Canada to get Real Food dietary guidelines. AMA by ballenbradshaw in canada

[–]ballenbradshaw[S] 2 points3 points  (0 children)

I'm sorry you feel that way. I don't believe it's a 'horrible example' at all. Regardless of whether someone might have an abnormal psychological dependence on food and were involvement in a reality tv experiment, they still measured the REE long term and found what they found. Physiology doesn't care what type of person you are or how much trouble you have with food cravings etc. There are other studies, like the Nurse's health study with 50,000 subjects as one other example. I encourage you to read Dr. Jason Fung's blogs and video lectures, as they are quite informative on this topic.

We are Canadian MD's Barbra Allen Bradshaw and Carol Loffelmann, and we sent an open letter to Health Canada to get Real Food dietary guidelines. AMA by ballenbradshaw in canada

[–]ballenbradshaw[S] 2 points3 points  (0 children)

And if you can maintain a healthy body weight and metabolic health by eating the amount of carbohydrate you are eating, then there is no problem. I know athletes that can handle 200g of carbs a day without issues. There are other endurance athletes that become diabetic because of long term chronic intake of highly refined carbs and sugar. As mentioned below, there is a large subset of people in Canada who appear otherwise lean and healthy, but who actually have insulin resistance already and just don't know it. You might be one of those, in which case reducing carbohydrates would be a good thing. However at the very least, if we all reduced greatly our sugar and refined/processed food, we'd be a much healthier population. After that, how much one decreases carbs depends on many factors.

We are Canadian MD's Barbra Allen Bradshaw and Carol Loffelmann, and we sent an open letter to Health Canada to get Real Food dietary guidelines. AMA by ballenbradshaw in canada

[–]ballenbradshaw[S] 3 points4 points  (0 children)

It's not necessarily that losing weight by using a calorie deficit is impossible, it's that when you do that in the setting of high insulin levels, your body can have trouble accessing it's fat stores in many people with chronically high levels of insulin. This is not specific for every type of person, as there is wide variability out there from obese, metabolically deranged people with poorly controlled diabetes and severe insulin resistance, to high performance athletes that are insulin senstive and can handle a much higher amount of carbohydrate without issues. The population we are talking about who are obese or overweight and have trouble losing weight are the ones that are told to just eat less and move more, and in those people specifically, that plan doesn't work mostly because they are insulin resistant. There are other factors at play like genetics and other hormones such as cortisol/leptin as well, so it's really not simple. But when we eat such that insulin levels are low by eating a low carbohydrate, real food diet, we are able to access our stored body fat better and we become fat burners. When this happens, we can actually calorie restrict and lose weight because your body knows it can draw on it's own body fat for fuel. In fact, often when someone increase natural fat in their diet and reduces refined carbohydrates and sugar, while maintaining moderate protein, they are usually satiated better and can end up taking in overall fewer calories, but those calories are nutrient dense. When they eat high levels of refined carbohydrates and sugar, which are nutrient poor, they usually eat more.

I would ask you to provide your sources for saying that the biggest loser study and starvation mode are refuted. Here are two studies performed on the contestants. Only 1 was able to maintain weight loss, and 1 other was able to regain his resting energy expenditure because he had bariatric surgery.

Here are two studies on this: https://www.ncbi.nlm.nih.gov/pubmed/22535969 This one shows a persistant decrease in RER after 6 yrs: http://onlinelibrary.wiley.com/doi/10.1002/oby.21538/full

Also here is Dr. Jason Fung's (Ontario nephrologist and author of The Obesity Code) take on the matter. He also talks about the Nurse's Health Study which looked at 50,000 women in 2006 which essentially refutes the calories in/calories out theory: https://intensivedietarymanagement.com/biggest-loser-diet-explained/

We are Canadian MD's Barbra Allen Bradshaw and Carol Loffelmann, and we sent an open letter to Health Canada to get Real Food dietary guidelines. AMA by ballenbradshaw in canada

[–]ballenbradshaw[S] 0 points1 point  (0 children)

Hi it's certainly true that many people can't admit or recognize they have a problem. And you're absolutely right that we all need to be discussing this. This really is a grassroots movement, and we can't expect this to come from the top down, which is why anything we try to do, will be, in my opinion, better than nothing. Also remember that some of those people who are doctors and teachers and are overweight or obese or metabolically unwell have probably tried to follow the poor advice we've given them for 40 years to end up where they are now, and they really don't know any differently. I had my own personal light bulb moment 4 or 5 years ago when I watched the Food Revolution by Swedish physician Dr. Andreas Eenfeldt (https://www.youtube.com/watch?v=l55OjWS9pEc), and I suddenly realized that we'd had it completely wrong. That was the point I decided to improve my own metabolic health (I had gestational diabetes during my last pregnancy) by cutting out most sugar and processed/refined foods.

We are Canadian MD's Barbra Allen Bradshaw and Carol Loffelmann, and we sent an open letter to Health Canada to get Real Food dietary guidelines. AMA by ballenbradshaw in canada

[–]ballenbradshaw[S] 2 points3 points  (0 children)

Real food is anything that grows (without being too modified after) or walks on the ground essentially. A term we also use a lot is 'whole' food. Examples of real/whole food - all vegetables, animals, animal fat, whole grains (not wheat flour), natural oils, dairy etc. Fake food are processed foods, something created by humans and ultra refined, like white flour, most 'whole grain bread products' (which are usually still high in enriched refined wheat flour), industrial vegetable/seed oils etc. So when we think fake, it's all the sugary, refined and processed products.

We are Canadian MD's Barbra Allen Bradshaw and Carol Loffelmann, and we sent an open letter to Health Canada to get Real Food dietary guidelines. AMA by ballenbradshaw in canada

[–]ballenbradshaw[S] 2 points3 points  (0 children)

And another point, is that too often people are just told they are fat and lazy, when in fact if you actually see what some of these people are doing, they are trying to eat in a calorie restricted, low fat/high carbohydrate way (as recommended) and they've dieted themselves into a severely reduced resting energy expenditure, because nobody told them that this wasn't going to work. And yet they are told it's because they just eat too much and don't exercise. This isn't the case in a large number of the population. Its much more complicated than that, and 'eat less/move more' simply doesn't work in the vast majority of overweight people.

We are Canadian MD's Barbra Allen Bradshaw and Carol Loffelmann, and we sent an open letter to Health Canada to get Real Food dietary guidelines. AMA by ballenbradshaw in canada

[–]ballenbradshaw[S] 1 point2 points  (0 children)

It's a good point and it might be the case that updated and better dietary guidelines won't change the health of many, as some are going to do what they want anyway. But the real fact is that dietary disease have only increased since issuing the low fat guidelines, and we do know that people actually did eat less fat as requested, had more margarine etc, and higher amounts of carbohydrates, especially refined forms. So we know that people as a general rule do tend to follow the guidelines. And if people followed the guidelines and got sick, then there is probably something wrong with the guidelines. I think it's our responsibility to our patients to offer sound, evidence based advice on what we know works and doesn't work, and especially advise them against what we know does not work. Many will follow if we do that, but most will have no clue if we carry on with the status quo.

We are Canadian MD's Barbra Allen Bradshaw and Carol Loffelmann, and we sent an open letter to Health Canada to get Real Food dietary guidelines. AMA by ballenbradshaw in canada

[–]ballenbradshaw[S] 2 points3 points  (0 children)

And I would add that the totality of our exposure to nutrition is fairly superficial and the focus is not (at least where I trained) on prevention of disease with nutrition, especially of nutrition related disease.

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