Random finding (plus pi) - The best part of parenting (so far)? Helping your kids overcome things you struggled with. It’s at least in the top 5.

Last Saturday my daughter came home from dance class—something she normally loves—and seemed upset. A bit of prodding led to the cause: a girl in her dance class told her she was “as fat as a hippopotamus.”  My first reaction (note to self: probably not the right one) was to laugh out loud, given that my daughter is probably in the 1.

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I’m worried she’s too skinny! Of course I realized quickly the “facts” were irrelevant in this case. Her body habitus was moot. But her feelings were hurt, and as we all know this wouldn’t be last time someone said something to her—true or untrue—that would hurt her feelings.  I won’t go through the entire discussion we had, as I’m sure those of you with kids have already been through this, and those of you without kids probably aren’t worrying about this type of interaction. I did, however, decide to tell her about all the people who dislike me and say mean things about me, usually things that aren’t true. She was shocked, “Like what, daddy?” I gave example after example.

She was amazed—and relieved, I suspect—to know that she wasn’t alone and that I was able to shrug it off after temporarily being upset by it. I even told her about folks posting videos on You. Tube specifically attacking me.

So, when our little talk was over she asked if she could see one of the videos I alluded to. I was a bit hesitant, if only for some of the language used when folks rant against my existence (if she’s going to learn choice 4- letter words in earnest, it should be from me after all), but I figured it was a good idea. She could actually see for herself that people say mean things about her dad and he’s still, more or less, ok. Which brings me to the point of this quasi- post…In searching for said You. Tube videos, which I eventually found, I stumbled across two talks I gave last year which made their way online, unbeknownst to me.

In keeping with the current spirit of my cop- op blog posts, below are links to the two talks. This talk is an updated version of a talk I gave a few years ago and shared on the blog, in 2.

I think. Even if you watched the earlier version of the talk, if you find this question interesting—what is the case for restricting saturated fat (SFA) intake—it’s worth watching this version. I find this particular topic especially interesting because I think it highlights the challenge we all have, myself included, in setting aside bias when confronted with new information. My friend Carol’s amazing book, Mistakes Were Made (But Not By Me) cannot be recommend highly enough for people who want to understand how cognitive dissonance wreaks havoc in even otherwise functioning societies.)And contrary to what some (perhaps many) of you might think, I don’t believe this is a settled debate across the board. What do I mean by that (i. Certainly in this presentation I try to make the case that the continually falling recommendations for SFA—from 1. In fact, such recommendations likely do harm, courtesy of the “substitution effect,” i.

PUFA)—that likely cause greater metabolic derangement. However, some readers may interpret the data I present to mean it’s perfectly safe to consume, say, 2. SFA. I realize I may have to turn in my keto- club card, but I am convinced that a subset of the population—I don’t know how large or small, because my “N” is too small—are not better served by mainlining SFA, even in the complete absence of carbohydrates (i. Let me repeat this point: I have seen enough patients whose biomarkers go to hell in a hand basket when they ingest very high amounts of SFA.

This leads me to believe some people are not genetically equipped to thrive in prolonged nutritional ketosis. In one particularly interesting case, a patient in self- prescribed nutritional ketosis presented to me with an LDL- P of more than 3. L (i. e., more particles than could be measured by the NMR machine so the report simply said “> 3,5. L”) despite feeling, performing, and looking great. Based on his through- the- roof desmosterol and cholanstanol levels, and a curb- side consult from the Godfather I mean Dr. Tom Dayspring, I decided to try an experiment. You see, the logical thing to do in this setting would have been to start two drugs immediately (a potent statin to address the hypersynthesis and ezetimibe to address the hyperabsorption) or tell him to abandon ketosis altogether.

But this patient was adamant about staying in ketosis given the other benefits, though obviously worried about the long- term coronary implications. So, we agreed that for a 3 month trial period he would reduce SFA to an average of 2. MUFA). Parenthetically, we also reduced his omega- 3 PUFA given very high RBC EPA and DHA levels. So, on balance, he consumed about the same number of calories and even total quantity of fat, but his distribution of fat intake changed and he heavily swapped out SFA for MUFA. The result? His LDL- P fell from > 3,5. L to about 1,3. 00 nmol/L (about 5. CRP fell from 2. 9 mg/L to < 0.

L (and for the lipoprotein cognoscenti, both desmosterol and cholanstanol fell). Pretty cool, huh? So, my point is this: while I believe the population- based guidelines for SFA are not supported by a standard of science I consider acceptable, it does not imply I believe SFA is uniformly safe at all levels for all individuals. Some of you may be wondering about me. It turns out I’m in the group (recall: I have no idea how large or small this group is) that seems to do well—at least by the tools we have available to assess risk—with large amounts of SFA in my diet, if and when I elect to. Watch This Must Be The Place Online. Even when I was in ketosis, eating 4,0.

SFA alone) my biomarkers—cardiovascular, insulin resistance, inflammation—were excellent. Better than they ever were or even are today. Though, my point still stands: there are some people who do not appear able to safely consume massive amounts of SFA. One last point I’ll make on this highly charged topic. I realize there is a contingent within the LCHF community who argue that traditional biomarkers of coronary risk—such as LDL- C or its superior cousin LDL- P—“don’t matter” if one is on a low carb or ketogenic diet.

Maybe they are right. I guess time will tell. But I am not convinced, at least not yet.  As a doctor I can’t look a patient in the eye and tell them a sky- high LDL- P is ok because they don’t eat carbohydrates. So if you’re following such a diet, and your LDL- P goes through the roof, I’d urge you to consider a variation of the diet.(Note: If you post your NMR results, please understand I will not comment on them.)This presentation has nothing to do with nutrition but is, nevertheless, a topic I’m pretty obsessed with: how do we achieve cost containment on healthcare in the United States?

Sorry non- U. S. readers, but we have a bigger problem right now, so I’m focusing on ours over yours!)This is a pretty controversial topic, so before you jump down my throat, try to sit through the entire talk, especially the parts where I frame the question as one of optimization. Most problems that have been heavily politicized suffer a common problem: they fail to distinguish between what is desirable in a resource unconstrained world (e. Hope you enjoy the departure from the usual topics.

Pi Day. The math geeks in the audience will appreciate that yesterday, March 1. Normally, March 1. Yesterday, however, being the pi day in 2. If you’re a watch geek, in addition to being a math geek–yes, I realize this is not a huge club–the beauty of a perpetual calendar (a type of watch that shows time, month, date, and year inclusive of leap years), made it a really fun day!

Why? Because at 9: 2. After capturing this wonderful moment in time, I sent the picture, below, to my watch mentor (also a math geek; yes I just wrote the words “watch” and “mentor” next to each other).