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

Visita al médico

(english version: click here)

Acabo de volver de la consulta del médico de cabecera porque quiero hacerme un análisis de sangre. En mis últimos análisis (febrero 2014) la ferritina y el hierro seguían elevadas y quiero saber el efecto de las donaciones de sangre que he hecho desde entonces. No me preocupan el colesterol ni las transaminasas porque estoy convencido de que seguirán muy bien. También quiero ver la glucosa, porque aunque está en el rango de normalidad, salió un poco alta.

Era mi primera visita a este médico. Le he contado un poco mi historial médico y al contarle el tipo de dieta que sigo me ha preguntado qué comía exactamente. Y se lo he contado. A partir de ese momento ha sido una visita un poco extraña, diciéndole varias veces al médico que discrepaba de lo que me estaba contando. Me ha dicho que no veía claro “comer más de 2 ó 3 huevos a la semana“, y me he callado porque contarle la poca influencia del colesterol dietario en el colesterol en sangre era demasiado largo. Cuando me ha dicho que él “no veía claro tomar demasiada grasa animal” y que él recomendaba la grasa de pescado y la vegetal, le he dicho que según el último meta-análisis, que revisó 72 estudios, no se ha encontrado una relación entre la grasa saturada y la enfermedad cardiovascular (ver). Casi acabando me ha contado que, según decía un profesor suyo, “la nutrición era más cuestión de matemáticas que de medicina. Al final todo es una cuestión de Calorías“. Nuevamente no me he contenido y le he dicho que discrepaba completamente (de hecho adelanto que hablaré de eso en una de mis próximas entradas). También me ha dicho que en su opinión “ahora que había adelgazado debería volver a comer carbohidratos, porque es necesario comer de los tres tipos de macronutrientes“. Le he contestado que no era así, que con tomar grasa y proteínas es suficiente y que los carbohidratos no son necesarios. Cuando le he dicho que si quería referencias bibliográficas se las pasaba, me ha contestado que no. “En estos temas se pueden encontrar estudios para todos los gustos y opiniones“, me ha dicho. Y es verdad.

He salido de la consulta con una sensación rara. No era mi intención discutir con él, ni tratar de convencerle de nada.