“Why Are We Hungry?” will return next week.

Note that if you’re new to my ongoing blockbuster series “Why Are We Hungry?”, it’s best to start at Part I. Otherwise, if you haven’t already, you should read the latest installment, "When Satiation Fails"—because like the previous article "When Satiety Fails", it both presents important information and ties together a lot of issues that are currently vexing the community. And we’re not done yet!

Finally, I note with pleasure that several readers and regular commenters are already starting to pull together the Big Picture on their own. This is great! If I’ve explained the science correctly, the consequences and conclusions should follow logically and be non-controversial.

Ever since I was little, my mother used an analogy that, for me, is still the mental equivalent of worn-out disc brakes squealing in metal-to-metal contact—or the incessant, high-pitched, yelping bark of an obsessively manicured lapdog suffocating in a cloud of its owner’s perfume.

She called it the “pain thermometer”, and it goes something like this:

It doesn’t matter how much you don’t like something or how much it hurts. Until your pain thermometer reaches the top, you won’t do anything about it.

Typing that still makes me wince, so I’ll say it my way:

This is a powerful concept, and it explains so much about the world and our lives. We want honest politicians, but we’re willing to tolerate corrupt, venal liars. We want privacy, but we’re willing to tolerate a surveillance state. And we want to be healthy and fit, but we’re willing to tolerate being sick, obese, and diabetic.

Stated more explicitly, it doesn’t matter how crummy your life is or how much pain you’re in—unless you get so fed up that you finally do something about it.

“Network” was released in 1976—35 years ago—and that speech could have been made yesterday. Think about that for a minute.

Unfortunately, yelling out your window won’t solve anything, which is where Howard Beale’s ideas ran out. But until you’ve decided that you’re no longer willing to tolerate your situation, nothing will change. The change is up to you.

How Did We Get Here?

Based on the paleo eaters I’ve talked to, including the authors of more than one well-known paleo diet book, very few of us came to the concept of ancestral health from a position of strength. Most of us tried a paleo diet because of medical problems that the medical establishment was (and is) remarkably powerless to treat, or because the side effects of the medications were just as bad as the disease. GERD, IBS, arthritis, innumerable autoimmune syndromes, poor sleep and digestion, or just long-term malaise…and, of course, anywhere from 15 to 200 extra pounds of fat and its associated metabolic syndromes that both “heart-healthy whole grains” and “eat less, move more” were powerless to shed.

In other words, we had to become so broken that we were no longer willing to tolerate being broken.

This leads naturally into my review of “Sugar Nation”.

Congratulations, You’re Prediabetic: Jeff O’Connell’s Wakeup Call

Synopsis: Jeff O’Connell, despite being tall, slim, and apparently in decent physical shape (he’s been the editor of everything from Muscle & Fitness to Men’s Health to Bodybuilding.com), finds out that he’s not just stressed out from work: he’s inherited his father’s Type II diabetes. He doesn’t want to end up like his father, dying bedridden with amputations and on dialysis, and the advice he was given upon diagnosis seems remarkably inadequate:

    Dr. H, having told me that I was prediabetic, mumbled something about switching from white rice to brown. He also instructed me to come back in six months for another round of blood work. Wow, that’s it? I thought. I didn’t know much about disease, but managing it seemed like it should require more than tweaking my order at the local Chinese restaurant.
…
    What I didn’t receive, and what most patients don’t receive, is any advice that would address, let alone fix, the problem…”

The rest of “Sugar Nation” recounts Jeff’s effort to understand what Type II diabetes is, and what he can do about it—with an additional twist that I’ll leave readers to discover. Though Jeff’s prescription will be shocking to anyone in the mainstream, its two pillars shouldn’t be a great surprise to most of my readers, or anyone in the paleosphere: T2D is a defect of glucose metabolism, it is treatable by diet and exercise, and you should therefore 1) stop eating so much friggin’ glucose, i.e. eat a low-carb diet, and 2) perform short, intense, glycogen-depleting exercise to help restore your insulin sensitivity.

Furthermore, he repeatedly hammers home that the progression from insulin resistance to T2D to numbness, dialysis, amputations, and blindness is a direct consequence of diabetes “treatment” that advises patients who cannot properly metabolize carbohydrates to eat lots of carbohydrates—and, with them, an ever-expanding pharmacopoiea of drugs that fail to mitigate their poisonous effects.

Where I find the book to be most interesting, and most valuable, is in two areas: the history of diabetes treatment (as with obesity, past treatment programs were often more effective) and the demographics of its relentless spread, and in the dysfunctionality and outright corruption of the medical industry. He lays bare the deep, incestuous financial relationships between the American Diabetic Association and the pharmaceutical and medical equipment manufacturers who profit so handsomely from diabetics—as well as the profoundly malicious cluelessness of the mainstream medical community, including the NIH and AAFP:

    During a 2007 interview with the American Association of Family Physicians’ then-president James King, M.D., a family physician in Selmer, Tennessee, I asked him how to eat properly as a prediabetic so that I could inform others in the pages of Men’s Health.
    “I tell diabetic patients to consume more carbohydrates—mainly from fruits and vegetables, not from simple sugars and starches—while decreasing the amount of meat and fat in their diet,” he said.
…
    I e-mailed the lead author, Philip E. Cryer, M.D., professor of endocrinology and metabolism at Washington University School of Medicine … “A glucose-tolerance test is never indicated in the evaluation of a patient for hypoglycemia,” he wrote back.
…
    “I’m sorry, but that item’s not recommended for your diet,” said the pleasant woman on the other end of the line. I had told the doctors that I was prediabetic. I was impressed that this information had been conveyed to the cafeteria.
    But I was also confused. “What, the peaches?” I asked.
    “No, the sausage.”

O’Connell is an experienced writer and journalist, and it shows: he exposes the rampant corruption and cluelessness in a remarkably neutral tone, without coming across as either paranoid or a crusader.

His understanding of the science is reasonably sound, too: he understands the role of glycogen depletion and how it improves metabolic flexibility, and even touches on the known issue of mitochondrial dysfunction in the obese. My only quibble is a whiff of saturated fat phobia here and there—but on the whole he does a solid job of understanding and communicating that low-carb necessarily means high-fat as well as high-protein, and that this is not a problem. And despite the title “Sugar Nation”, he is clear on the fact that “heart-healthy whole grains” are just as carb-heavy—and, therefore, unhealthy—as refined grains and refined sugars. However, I wish Jeff had summarized his hard-won knowledge at some point in the book: a short chapter, or even just a bullet list of “Here’s how I manage my Type II diabetes”, would have been welcome.

In conclusion, “Sugar Nation” is a hard-hitting exposé that reads more like a biography. While its basic prescription won’t be news to you, my readers, it’s a shocking accounting of the cluelessness and corruption of the mainstream medical establishment, and the extent of the suffering its terrible advice causes. It’s also a solid source of information for people in your life who can’t swallow “paleo” or “primal” but are still in danger of ruining their health. And it’s full of scary facts and trenchant observations, so I’ll close with one:

…The standard recommendation of consuming 50 percent of your calories from carbohydrates translates to 250 to 300 grams’ worth a day. Split over three squares a day…means consuming more than a glucose tolerance test’s worth of carbs at each meal. “We use glucose tolerance as a metabolic stress test and yet prescribe a diet that produces that at every meal,” says Raab. “It highlights just how ridiculous this advice is.”

Wrapping It Up: What Was Your Wakeup Call?

“Sugar Nation” is Jeff O’Connell’s story.
What was YOUR wakeup call?
What finally made you say “I’ve got to do something about this” and motivated you to start eating like a predator?
Leave a comment, even if it’s just a link to the bio on your own blog…it’s always fascinating to hear others’ stories.

Live in freedom, live in beauty.

JS

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