Husband of one, father of six, grandfather of 15. Chancellor Emeritus, SMUG. Emeritus staff of Mayo Clinic. Founder of HELPcare and Administrator for HELPcare Clinic.
That’s the title of this video, which came up in Lisa’s YouTube related videos feed about a year ago.
It’s a gripping TEDMED talk from 2013 by Dr. Peter Attia, who confesses the judgmental attitude he had harbored six years earlier toward an obese patient who had come into the emergency department with foot ulcerations.
She obviously must have let herself go, he thought, consuming too many calories and not moving enough.
But then three years later he found himself 40 lbs. overweight and with metabolic syndrome, and he knew that physical inactivity was not the cause in his case: he had been “exercising three to four hours every day, and following the food pyramid to the letter.”
It led him to wonder whether, in the case of obesity, insulin resistance and type 2 diabetes, the medical community might have the chain of causation backwards.
Watch this video. It’s totally worth the 16 minutes.
I have found Dr. Attia one of the most thoughtful online voices when it comes to evaluating and making sense of dietary and lifestyle research related to both longevity and healthspan.
As he says in this video, perhaps he’s been humbled by what the thought he knew that turned out to be mistaken.
I expect I will have several more posts in this series that feature (or at least mention) Dr. Attia. His website is an amazing resource, and his podcast, The Drive, is the only one for which I pay for premium access.
Like Tim Ferriss, Dr. Attia also has introduced me to many other leading researchers and thoughtful analysts. Follow him on Twitter.
As I have pivoted (in Silicon Valley lingo) my blog from its social media focus and taken a new role as Chancellor Emeritus, I’ve been ruminating on a blog name that would capture the essence of what I will be writing here.
I had considered Interesting Stuff I’m Studying, but the acronym for that title would have been…unfortunate.
I thought Stuff You Might Find Interesting (SYMFI) would be a good one. It’s reader-focused…it’s about things I think you might like. Unfortunately, there’s a drug called Symfi, and the last thing I want is to get cease-and-desist nastygrams from pharma company attorneys with trademark objections.
I finally settled on a new name that I plan to implement soon: Stuff I Find Interesting (SIFI). A couple of advantages in this one:
Truth in Advertising. The name describes exactly what I will be writing here.
In the Spring of 2008, I had some amazing things happening in my life, both personally and professionally:
I learned that our first grandchild (coming in August) was going to be a girl, and that her name would be Evelyn.
We were launching several of our early Mayo Clinic social media channels, including YouTube, Twitter and some blogs (News and Podcast) that have since been replaced by more robust offerings.
I was blogging like a crazy man, with 33 posts in April, 17 in May and 24 in June. This was peak SMUG, just after I had rebranded my blog.
But from a health perspective, I was at the start of some disturbing developments.
For several years, I had been giving blood every 10 weeks (or whatever the required waiting period was at that time.) When I went to the Mayo Clinic Blood Donor Center to give my unit of A+ blood (only the best!), the helpful staff would always help me preschedule the next donation.
But in the Summer of 2008, I began to notice that my pre-donation hemoglobin test, which started with a reading of something like 16, was declining a little each time.
I didn’t think much of it when it was 15, and then 14-something, but then it got to 13…and finally, in January 2009, to 12.4.
The magic of that number and why it’s memorable to me is that 12.5 is the minimum level required to donate.
I was officially anemic. They wouldn’t accept my blood.
I thought I should see if there was some underlying problem. Lisa also said she thought I wasn’t looking healthy.
I was at about 225 lbs. and playing pick-up basketball, and so I had attributed my reasonable weight (at 6’6″) as due to getting lots of exercise.
Lisa thought I was gaunt – skinny in a not-healthy way. Haggard. Cadaverous might be overstating, but it made an alliterative headline. And when you look at all of the synonyms, one of them is anemic:
So I went to my doctor, a high school classmate and great friend, Dr. David Strobel, and he started by looking for the most common causes of anemia for someone my age: namely, unexplained blood loss.
I recently wrote a post on the Mayo Clinic Social Media Network site about that celiac disease journey that highlights how social media helped me to cope: to learn about gluten free eating and where to find gluten-free restaurants.
The story I didn’t tell in that post was what gluten-free eating to manage my celiac disease did to my weight.
Because I have celiac disease, eating gluten had caused my immune system to attack and severely damage the villi in my small intestine, which made it hard for my body to absorb nutrients.
I was anemic because I wasn’t absorbing iron. I was gaunt because I wasn’t absorbing other nutrients well either, even though I was eating a lot.
The good news is most people with celiac disease have their villi restored when they eat a strictly gluten free diet, and that was true for me as well.
My iron and ferritin (a measure of stored iron) levels gradually increased.
So did my weight, and not necessarily in a good way. I was eating as I always had, but now I was absorbing all of those nutrients.
By March of 2013, my medical chart says I weighed 117.7 kg, which translates to 259.48 lbs. Two years later I was 117 kg – staying below the dreaded 260 lbs. mark, but just barely. In February 2016 the charts say 117.9 kg.
My chart says my blood pressure in the pre-colonoscopy physical was 155/94, but later that year I was “only” 139/92.
The highest I remember reaching when I would weigh before workouts at the local YMCA was 265. But here’s the highest photographic evidence I have, from May 21, 2016:
So my Body Mass Index (BMI) on that date was 30.3.
But going from haggard to hefty – to the tune of 40 extra pounds – between 2009 and 2013, and then spending four years within five pounds either side of 260, and with borderline or high blood pressure, was not a healthy development.
In my next post I’ll tell why this was so frustrating for me.
As my blog starts its new direction, I had planned on beginning in my next few posts with some background on my health exploration journey, but a news release about a study from Mayo Clinic that came into my inbox yesterday caused me to revise my plan.
The study in the Rochester, Minn. area identified 116 patients with diabetes and 232 who didn’t have diabetes, but otherwise were matched for heart failure risk factors like age, hypertension, sex, coronary artery disease and diastolic dysfunction.
Following both groups for 10 years, researchers found that 21% of the patients with diabetes developed heart failure, while just 12% of the patients without diabetes did.
So while we’ve long known that diabetes is associated with a host of health problems, here’s fresh evidence of another: almost doubling the risk of heart failure, although in this study it didn’t increase mortality.
Diabetes and its complications, deaths, and societal costs have a huge and rapidly growing impact on the United States. Between 1990 and 2010 the number of people living with diabetes tripled and the number of new cases annually (incidence) doubled. Adults with diabetes have a 50% higher risk of death from any cause than adults without diabetes, in addition to risk for myriad complications. Reducing this burden will require efforts on many fronts—from appropriate medical care to significant public health efforts and individual behavior change across the nation, through state- and community-specific efforts.
That same paper suggests that in the next decade
the total number of Americans with diabetes will increase from 43 million to nearly 55 million,
that annual diabetes-related deaths will increase by more than 55,000 and
annual diabetes medical costs will go up almost $100 billion.
It all means that preventing (or even reversing) type 2 diabetes is probably the most important thing we can do.
But the statistics are clear: what we’ve been doing as a society for the last 30 years hasn’t been working.
What I’ve been learning and experiencing over the last three years through personal investigation and application suggests that we have more ability to influence this trajectory than we might think.
I’ve read about thousands of patients with prediabetes or type 2 diabetes getting their Hemoglobin A1c levels down to the point where (under medical supervision, of course) they have been able to discontinue taking insulin or diabetes medications, and are no longer considered even prediabetic.
I know some people are skeptical that type 2 diabetes can be reversed, but given the scope of the problem it sure seems worth exploring.
If type 2 diabetes is three times as prevalent as it was a generation ago, this can’t be a genetic problem. Our genes don’t change that fast.
Since changes in our environment and behavior are likely responsible for the epidemic, shouldn’t we look at reversing those changes as much as we can, at least in our personal lives, where we have the most control?
I was never diagnosed as prediabetic, but I’ve made some significant changes and have seen lots of benefits in my own health. I couldn’t have made them all at once, but I evolved them over time.
Type 2 diabetes isn’t the only disease that seems to have potential for lifestyle prevention or reversal. Some of the same interventions seem to work in other diseases, too – mainly because diabetes, as we see in this Mayo Clinic study, is a risk factor for a host of other ailments.
It’s time now (or rather past time) to reorient it based on the fact that my career has evolved far beyond anything I could have dreamed when I gave myself the title of Chancellor.
My idea was that through SMUG I would learn in public and invite others to come along for the ride. I would develop some curriculum categories, and other communications professionals who wanted to learn to use social media could use my example as a resource.
I had a lot of fun with it, and one of the best points was when people would greet me with my self-appointed title.
But then in 2010 my employer, in response to a proposal I helped to develop, created the Mayo Clinic Center for Social Media, which in 2015 became the Mayo Clinic Social Media Network (MCSMN). It was gratifying that this teaching role I had created for myself on my personal blog became part of my day job.
We provide learning resources for our Mayo Clinic staff to help them apply social media in their work, and also open membership – Basic (free), Premium and Corporate – to provide access to these resources to colleagues globally. Oe of the best parts is that we also learn from them!
So while Social Media University, Global was a lighthearted, tongue-in-cheek phrasing, MCSMN made that global vision a reality.
As a result, when I have written online about social media, I have been much more likely to do it on the MCSMN site instead of here. So after averaging 160 posts a year in 2009-10, since 2016 my SMUG post average has been… 3.
As of today I’m recognizing that reality, and will be coming up with a new name for this blog. I’ll probably keep the same domain name for a while at least: no one types URLs anyway, and it’s kind of a pain to switch. All of my previous posts from the SMUG era will remain available.
I don’t expect that my post volume will approach 2009 levels, but I will be a lot more regular in my blogging. Over the last three years I’ve been reading and learning a lot about health, diet and fitness that’s pretty radically different from what I had previously heard and believed.
It’s made a huge difference for me.
I’ll start telling that story tomorrow.
I’ll also use this space to write about other things I find interesting. That will be the common thread.
