A visit to the doctor

(versión en español: pinchar aquí)

I just got back from the doctor’s office. I visited him because I want to have a blood test. In my last lab results (February 2014) ferritin and iron levels were high and want to know the effect of the blood donations I made during the last months. I am not worried about cholesterol or transaminases because I am sure they are pretty well. I also want to see my fasting glucose level, because although it is in the normal range, it was little high.

It was my first visit to this doctor. I told him a resumé of my medical history and when I told him the type of diet I follow he asked me what exactly I was eating. And I told him that. Since that moment the visit became quite weird, and I found myself repeatedly telling the doctor that I disagreed with what he was telling me. He told me that he was uncomfortable with the idea of “eating more than 2 or 3 eggs a week”, and I stayed silent because telling him the little influence of dietary cholesterol on blood cholesterol would take too long. When he told me that he didn’t approve “eating too much animal fat” and that he recommended fish and vegetable fats, I told him that according to the latest meta-analysis, which reviewed 72 studies, no relationship was found between saturated fat and cardiovascular disease (see). When the visit was almost ending, he told me that one of his teachers used to say that “nutrition was more a question of mathematics than of medicine. In the end it is a matter of calories“. Again I couldn’t shut up and I told him that I disagreed completely (in fact I advance that I’ll talk about that topic in one of my next posts). He also told me that, in his opinion, “now that I had lost weight, I should go back to eating carbs, because we need to eat the three types of macronutrients”. I told him that we don’t, that eating fat and protein is enough and that carbs are not needed at all. When I said that I could give him scientific references, he refused. “In nutrition you can find studies that suit every taste and opinion,” he told me. And it’s true.

I left the office with a weird feeling. I did not mean to argue with him, nor try to convince him of anything.

Nonetheless, it seems clear that the real risk of low-carb diets is that you will tell your doctor that you are on such a diet and they will come up with their recommendations based on the FDA-REMS/ETASU. R. D. Feinman

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