March 27, 2016
Have Your Doctor Read This about LCHF
Keith Runyan, MD, is a retired physician, with type 1 diabetes, who graduated from Emory University School of Medicine in 1986. A vast majority of physicians he has encountered during his career have the patient’s best interest in mind and want to improve their health.
So if you learn about the benefits of a low carbohydrate lifestyle from books, articles published in medical journals, or God forbid, the INTERNET, you might wonder why your doctor is either not supportive or even cautions you against it.
His description of what doctors do not know is funny. He says the answer is simpler than you might think. It is not that your doctor does not want you to experience the benefits. It is most likely that your doctor was not educated about the effect of diet on disease. To understand this, let me give you some background about medical education.
In order to get into medical school in the first place, you have to be an excellent student. In our current education system, being an excellent student means being able to learn and retain lots of information in a short period of time and accurately recall that information on a test or later in medical training with their patients. It does not require that they be creative thinkers or innovators, or question what they are being taught. Once a student enters medical school, the amount and pace of learning is accelerated further. There is literally no time to question the validity of the material.
Most medical students have heard from their wise professors the phrase, “half of what you just learned is wrong, but we don’t know which half. However, that is a difficult concept to accept given the time and effort spent learning all that material. In essence, the overwhelming feeling at the end of medical school is, I know I don’t know everything, but at least I know what matters the most.”
The next piece to this puzzle is to know that nutrition is barely discussed in most (not all) medical schools. At Emory, in 1982, we had about 2 weeks of education in “nutrition.” But, what was covered was how the body metabolizes protein, carbohydrate, and fat, nutritional deficiency diseases, and the nutritional requirements to prevent those diseases. The fact that many chronic diseases like cancer, heart disease, diabetes, and digestive diseases were rare prior the adoption of the Western diet was not covered. He states that, “I did not learn this until 2011 when I read Good Calories, Bad Calories by Gary Taubes.”
Some physicians will be familiar with the low carbohydrate diet already and others may be willing to learn about it and support you especially when they see your condition is improving as a result. However, other physicians may immediately recognize it is not part of their armamentarium, therefore it must be either not effective, or possibly dangerous, especially if the word “ketosis” or “ketones” is mentioned. Although doctors should know the difference between “nutritional ketosis” and “ketoacidosis,” the term “nutritional ketosis” is only mentioned in the context of a low carbohydrate ketogenic diet and therefore is not discussed in medical school. So the only context in which most doctors know about “ketosis” is one of the following: starvation ketosis, diabetic ketoacidosis, or alcoholic ketoacidosis, none of which are good.
Dr. Runyan says, “For reasons that are beyond the scope of this article, it is best to have your physician on board with your low carbohydrate lifestyle. It will affect the need for or lack thereof of many of your medications. There can be side effects that are easily corrected with knowledge of how the diet works.”
I would advise reading the complete blog as this only covers part of it. Dr. Runyan covers a lot in his blog.