I want to talk about two villages on a diet. I have had a hard time watching the CBC series, “Village on a Diet”, as it seems to be mainly focussed on exercise as a weight loss strategy for the people of Taylor, BC. It is becoming increasingly clear that the approach being used is not science-based but designed for maximum emotion and drama. Watching overweight and unfit people being pushed to exercise beyond their capacity to the point where they are often in tears gives me no pleasure. This is especially true since I know from reading the science in this area that it is not helping and may even be counterproductive.
My wife and I watched a recorded episode last night where the fitness guys are personally affronted by the fact that the townspeople are ungrateful for their efforts to whip them into shape. The number of people willing to subject themselves to their abuse was rapidly dwindling. It looked like only a couple of dozen were still trying. I thought the townspeople were reacting normally to an unreasonable intrusion into their lives, but I suspect I am in the minority with that opinion.
The part of the show that was really offensive, however, was the interaction between the “professional chef” and the lady who runs the local pizza parlour. After showing the school kids how to make “healthy” granola bars that were over 50% dried fruit (!) he goes to the pizza shop to demand that “healthy” thin crust pesto pizzas be put on the menu. The owner, rightfully, points out that he doesn’t know her business. She had already tested the recipe he provided and it tasted like cardboard. This doesn’t stop him from berating her until she has an emotional meltdown (great TV!) and ends up closing up shop and leaving town. He effectively drives her out of business! This is a single mom with kids to support! WTF!
Now, I could understand how this would be defensible if she was the local crack dealer . And I am not a big fan of pizza because there is too much carbohydrate in the crust for me. But, I will feed it to my son who has a higher carbohydrate tolerance. And, when he has some, I sometimes will eat just the topping of cheese, tomato sauce and pepperoni. My son gets virtually no sugar and his pizza would be accompanied by a glass of water, not a soft drink and it won’t be followed by an ice-cream sundae. If you eat only the pizza and you don’t have a carbohydrate intolerance, like I do, it’s not going to hurt you.
Try telling that to the team in Taylor, though. It’s as though the pizza lady was personally responsible for the weight problems of the whole town. They even have pizza lunches at the school! The horror! Good enough reason to ruin her livelihood and drive her out of town. I can’t believe the CBC is party to this travesty.
Okay, that’s my rant on Village on a Diet … for now. Let’s talk about another village. This is where CBC redeems themselves by reporting on the amazing work of a young South African doctor, Stefan Du Toit, who has been getting people to lose weight in Valemount, BC. Stefan lost about 40 lbs using a very low calorie, low-fat, low-carb diet before moving to Valemount from South Africa a couple of years ago. When staff in his clinic learned of this they asked him to put them on the same diet. It worked so well that patients began asking for it, too. Stefan now has treated over 100 people with this diet approach and has had amazing results. Their total weight loss is over 3000 lbs! The really interesting thing about this, when compared to the approach used in Taylor, is that Stefan expressly forbids his patients to exercise until they have reached their goal weight. He says, accurately in my opinion, that exercising makes dieting more difficult because it stimulates your appetite. He has many people who have lost over 90 lbs using this approach and they are encouraged to exercise once they have lost the weight but not before.
I have visited his practice and talked to some of his patients. Their stories are remarkable. They get off virtually all their medications and stick to a diet that even I find somewhat extreme for months on end. Stefan doesn’t swear or bully them and there is no drama and emotion so it would make for boring TV, but the joy these people exhibit is a wonderful testament to their amazing accomplishments.
Here is where you can see the news clip on the REAL Village on a Diet:
http://www.cbc.ca/video/#/News/TV_Shows/The_National/Health/1244506052/ID=1778824999
I am curious about the description of the Valemount diet as “low-cal, low-fat, low-carb” and in the CBC article it is described as low glycemic. So, what is it?
Dr Jay’s Reply:
All of the above. They start off eating about 80g of carbs per day and the carbs allowed are low in glycemic value. I prefer a diet that starts out lower than that but a lot of people can get into ketosis if they are under 100g or so. Most people eat about 250-300g per day. You can do low-carb and low-fat as long as you are burning off your body fat. Once you stop losing weight, though, you would need to add fat to your diet to compensate. A very low-carb/low-fat/low-cal diet can work well as long as you are getting enough protein and maintaining your electrolyte balance. And the weight loss can be sustained long term as long as you add fat back into your diet and not carbs.
It looks as though this “Village on a Diet” show is snuff porn for sadistic personal trainers and sanctimonious lean people who were born lucky and think they possess superior will power. Shame on CBC for producing it.
I have been experimenting eating a lot of fat the past few weekends to test the calories-in calories-out dogma. It is difficult to eat a tremendous amount of fat because you feel so full, but I gave it a try. We had country pork ribs on Friday–I ate the fat the rest of the family trimmed. Next night we had duck confit–again I ate up all the fat trimmings. I also discovered some excellent smoked pork jowl from a Mennonite farm that feeds the pigs whey runoff from my favourite artisan cheesemaker. Had lots of that. (Slightly heated in a pan until the fat softens and gets transluscent. Bliss.) Then the usual coconut oil, cheese, avocados, fatty cuts of meat, creme fraische and such. I figured I ate over 10,000 calories of fat per weekend. Low-carb, of course.
The net result was a loss of one pound over three weeks. I do exercise, mostly walking and jogging our dog each morning.
I am unsure whether this would work to lose a lot of weight (stored fat), but it sure did not make me gain weight.
Murray
Dr Jay’s Reply:
Great testimonial! Man, but I’m envious of those pork jowls! Too bad you can’t get the family onside, though. I thought Gary’s latest book would have done the trick.
Yeah, I’m disappointed with CBC, too, but at least their news division did a good story on Valemount. One has to remember that there are different divisions in that corporation and it appears that at least the news guys haven’t capitulated.
Kudos to this doctor. Do you think he can claim it to BC ministry of health, as regular doctor visits?
They are definitely eating healthier with low-fat and low-carb, particularly when low-carb really just means, no food in the doughnut genre. But I think his clients succeed primarily because they are eating low-calorie, and have a support group.
And I’d like to know what he means by no exercise. Sure they’re not parked in front of the computer all day and the tv at night. Dogs to be walked, papers to be delivered, snow to be shoveled, etc.
About the other village.
It’s scripted Jay. Rehearsed, they are auditioned just like any other drama. The producers choose people who are volatile and emotional (as well as being obese and willing to act).
It follows a format. The Debbie Travis show is another one of this type.
OK, I guess I’m finally being converted. After years of gaining weight by eating lots of carbs and no fat, I just started low carb and I’m happy with how it is going. But, it got me wondering about all the other so called expert advice I have heard over the years. Is it all bunk too? For example, have been told never to go below 1200 calories as it is dangerous and will stall weight loss. Is this a lie as well?
Dr Jay’s Reply:
There is a lot of misinformation out there. For instance, the idea that you need to drink eight glasses of water a day or even more is something you run into all the time. There is no basis in science for this. You should drink when you are thirsty and avoid drinking calories. On a low-carb diet if you drink excess water you may exacerbate the tendency to develop hyponatremia (too little sodium in the blood) on this type of diet. When you stop carbs your kidneys will excrete salt and you need to make sure you are getting enough. Unfortunately, you see a lot of examples where wrong advice is given and people are told to restrict salt and drink lots of water. This is guaranteed to give you problems if you are doing low-carb. I believe this is one of the reasons the recent Foster et al low-carb study had a high drop-out rate. Another myth is the admonition that rapid weight loss is harmful. You will commonly hear that it is bad to lose more than a couple of pounds per week. Maybe that is the case with a semi-starvation diet but most people who do low-carb will lose as much as a pound a day at the beginning. Some of this is fluid due to the salt excretion but this is a good thing as it reduces bloating and lowers blood pressure. I lost about a pound a day for the first month when I did this with no ill effect. In either case, the important thing is attention to your electrolytes which means supplementing with salt. The use of very low calorie diets is not uncommon and, as far as I know, there is no threshold below which weight loss stalls. Of course, if you are doing low-carb, you don’t need to count calories. Make sure you are getting adequate protein but remember, this is not a high protein diet. It is high fat. While you are losing weight by burning off your body fat you can do low-carb/low-fat but once the weight loss levels off, you will need to add more fat to your diet, not more protein. My advice is to eat when you are hungry and stop when you are full. If you do that, and as long as you scrupulously avoid carbs, you will lose weight. If you are on meds for blood pressure or blood sugar you will need to reduce or discontinue them fairly rapidly. This is best done with guidance from your doctor. Get yourself a copy of the latest Atkins book as a guide and good luck!
Hi All, I sent a copy of my summary of CGBC to Dr. Du Toit out in Valemont and I was elated to get a phone call from him! Unfortunately, I missed the call but he did leave a message. When I call him back (making sure I take into account the time difference) I urge him to join Dr. Jay’s blog pages. It was very encouraging to see this on the CBC as an antidote to the shameful VOAD. I hope there are lots of emails going to the CBC to complain.
Dr Jay’s Reply:
Dr Du Toit is doing amazing work in Valemount. I can’t say enough about how terrific I think he is. On the other hand, the whole Village on a Diet thing is not primarily about the health of the people in the village of Taylor, it’s about entertainment following the format of American reality television. This means lots of angst, emotion, conflict and drama. It would be interesting to see how many Canadians do find this entertaining as I suspect our sensibilities are more nuanced than those of our southern neighbours.
I was wondering if you were watching. I couldn’t. My question. How are you getting along with your fellow Vancouver Docs. Do you have a good hand book that could be passed out to patients. ( Ministry approved of course )
Dr Jay’s Reply:
To be honest, I have the episodes recorded on my PVR but have had a hard time watching. I find it is an exercise in masochism on my part since I disagree with so much of what they are doing. Obviously, I know too much.
I don’t have a handbook. At the present time, I am recommending people get a copy of the new Atkins book which was written by my friends Drs Eric Westman, Steve Phinny and Jeff Volek. For people with metabolic syndrome or diabetes I recommend they stay on the induction phase indefinately. We are testing this in a family practice near Vancouver to see if their diabetic patients get results by using the book.
Could this be a piece of the puzzle of why some people may be predisposed to unregulated weight gain?
http://www.theglobeandmail.com/life/health/health/a-new-prime-suspect-behind-the-global-upsurge-in-obesity-and-diabetes-the-womb/article1930666/
Dr Jay’s Reply:
The whole science of epigenetics is fascinating. I do think the intrauterine environment is important with respect to nutrition. This is why my wife stuck to a very low-carb diet throughout her recent pregnancy. If a pregnant woman is diabetic, it is clear this has long term consequences for the child. When you consider what is different in a diabetic womb, it is mainly two things: the fetus will be exposed to high sugars and high insulin. If the mother eats a very low-carb diet during pregnancy, regardless of whether or not she is diabetic, both of these influences will be minimized. We have a very sturdy, healthy, thriving little girl as a result. She is 18 months old now, is growing like a weed and has never had so much as a fever or rash. I’ll get back to you in a few years on the long-term effects.
Hey there Jay; Well I guess I am ready to revisit the Dr. Atkins diet, which I tried many years ago with some success. That was way before so many of my family and friends had succumbed to diabetes. I just finished the latest Gary Taubes book and that has me intrigued. We are well placed for starting the diet as last year we caught a mess of sockeye, when the run was so good. And we have freezers full of organic chicken and deer as well. So maintaining a traditional diet should be relatively easy. In fact we are about to put down the crab and prawn traps and do some clam digging for the day. However, my husband indicated we would bring along Indian candy, made from last years sockeye, as lunch, and I am hunching, the glaze is too sweet to not be sugar or syrup. I am wondering if you have any advice on a healthy way to smoke or cure fish that is diet friendly. We also have regular hot and cold smoked salmon…but in our circle of friends, the Indian candy is the preferred method. It is great to see your work on this front. Thanks and cheers, Ardyth
Dr Jay’s Reply:
You are right about the Indian candy. It is too sweet. I have had similar smoked salmon without the sugar and it is quite good, of course. The addition of sugar would be a recent development as the traditional diet was devoid of sugar. I am not as adept as you are at the traditional food-gathering and preparing so I don’t have a good answer to your question. I do love the lemon pepper smoked salmon, though. I envy you that!
Here is some seemingly conflicting info – coffee good, coffee bad – what’s a person to think?
http://www.uoguelph.ca/news/2011/04/got_a_hankering.html
http://www.theglobeandmail.com/life/health/new-health/conditions/diabetes/coffee-may-help-keep-diabetes-at-bay/article1509476/
Dr Jay’s Reply:
Beats me! I gave up coffee years ago because I couldn’t stand being addicted to something. If I didn’t get my morning cup of coffee, I would have a headache by 10:00 am.
I just found your blog today and was thrilled to see that were raised not far from where I was raised! Small world 🙂
I noticed that in your links and in your comments that you mention Dr. Atkins(The Atkins Diet) and Dr Eades(Protein Power). I’m curious to know if you have read anything by Dr. Loren Cordain(The Paleo Solution) or Mark Sisson(The Primal Blueprint). If you have, what is your take on their ideas?
(for full disclosure, I personally follow the Primal Blueprint as I found it fairly close to how I ate growing up minus the homemade bread and bannock. )
Dr Jay’s Reply:
Nice to hear from someone from my home territory. I was up there for a visit last fall – first time in over 50 years! I had forgotten how beautiful it was.
I am familiar with Courdain but not Sisson. I think Courdain has done some excellent work elucidating ancient diets. I have one beef with him, however. He is still stuck on the current dogma that saturated fat is bad. He either goes through some contortions to explain how a traditional diet was low in saturated fat or he finds “evidence” that people who ate a high fat diet were unhealthy. For instance, he cites the case of some ancient Aleut remains which had evidence of cardiovascular disease. He attributes this to their high fat diet. He conveniently ignores the fact that their lungs were black with soot. I think it is far more likely that they were exposed to harmful smoke in their indoor environment that would have been the cause of the CVD, not their high fat diet.
Apart from that one quibble, I think he does good work.
I completely agree about Cordain! I ,unfortunately, forgot about his beliefs about saturated fat until a couple days after I posted lol!
Mark Sisson’s approach is much more rounded, plus he tries to incorporate a sustainable lifestyle approach. I hope you get a chance to read his books.
Do you have any idea when My Big Fat Diet will be airing on CBC again? I really want my mother to watch it as she is a type 2 diabetic and LOVED Village on a Diet (sigh…) I have sent her the DVD Fathead and the book Protein Power, but I doubt she has watched/read them. I’m hoping that it will open her up to some ideas that she has studiously ignored, mainly because I mention them lol.
Dr Jay’s Reply:
My mother won’t take my advice, either. I think it is because, even though she is in her 80’s, she can still remember changing my diapers and the cognitive dissonance required to accept authoritative medical advice from me is too much for her.
You should be able to get a copy of My Big Fat Diet from the producer’s website: http://www.mybigfatdiet.net.
I don’t know when CBC plans to re-broadcast it. If I find out I will post the date here.