Say the word diet to 95% of Americans and they'll think about their weight. We haven't dealt with this issue in our house, but we're about to.
My wife Wendy is overweight, and it's been getting worse during the past 5 years. We've been so busy taking care of our kids, we forgot to take care of ourselves. Now we have no choice.
Wendy's aunt Sara died last year, at a relatively young age. Sara was diabetic most of her adult life, yet she ate sugar with reckless abandon. "I just take more insulin to make up for it." she quipped. Ten years ago she developed diabetic neuropathy, a horrible, painful condition. Other complications soon followed, and we were almost relieved when Sara was finally at peace and pain free.
I mention this because Wendy has a quarter of Sara's genes. She also has half her mother's genes, another lifetime diabetic with burgeoning neuropathy. Her grandfather also suffered from neuropathy. If Wendy doesn't lose weight, her future is preordained, and it isn't pretty!
A nearby hospital has a weightloss program, and Wendy attends the introductory meeting. They recommend a liquid diet - no food at all. You just drink their shakes morning noon and night, and pay $500 a month (assuming our insurance won't cover any of it, and it probably won't). Well Wendy would give it a go, and I'd certainly spend the money, if it would work, and if it was the only way. But I've been studying diets for ten years, and I think there are other options. Three, to be precise.
A) The Zone diet. This has a high success rate, but requires careful planning and tracking. Restaurants are out of the question, and my kids love to go out to eat. No - we need a diet that is compatible with at least some restaurants. We just don't have time to cook everything from scratch and count carbs, proteins, and fats.
B) Low carb - about 60 per day. Wendy likes this one because she gets an occasional piece of toast or chocolate, if it fits within her carb budget. But it still requires careful planning, and it's very easy to fall off the slippery slope, especially at a restaurant. "Well that looks like a cup of potatoes, I think. How many carbs are in a cup of potatoes? I don't remember. ... Let me taste that dressing. That doesn't taste too sweet. I don't think it has much sugar in it. I'll just put a little on my salad." So much for plan B.
C) No starches, grains, or processed foods. Wendy eats meat, fish, fruit, and vegetables, in their original forms. There's no slippery slope here; the diet is well defined. And it is almost restaurant compatible.
D) The hospital-monitered liquid diet. Wendy doesn't think she can drink prescribed shakes morning noon and night while all around her are eating real food. And she has to go back to food eventually, so why not skip the middle step?
On May 1st, Wendy begins her new diet, which is a radical departure from her former eating habits. The kids hardly notice, because she doesn't whine and complain - but it is a difficult regimen. It's certainly more restrictive than John's diet, and I'm going to mention this the next time he complains about his lot in life.
I hope diet (C) works for Wendy, because we really don't want to move on to (D).
As soon as Wendy falls asleep I slip down stairs and bring up google. There's lots of information on low carb diets, and most of it is even true. Lots of websites talk about a strange breath, caused by ketones. In the absence of glucose, the body draws energy from fat. That's the whole point of the diet, isn't it? Well anyways, fatty acid chains are snipped into dimers that take the form of acetic acid. Most of these molecules are burned for energy, but some are joined together to form anhydrous acetate, which then becomes ketones. Acetone for one. I always thought acetone was an incredibly toxic compound. Apparently it is one of the many ketones that is produced when fat is being metabolized. Most people excrete it via breath and urine, and it causes no trouble.
So one of the mysteries is finally solved. John's disorder produces ketones, and lots of them! Perhaps some of these ketones (and they are small molecules) cross the blood brain barrier and derail John's emotions. But this invites yet more questions.
Ketones are produced by a low carb diet. why does John produce truckloads of them on a high carb diet? Here are two, highly speculative theories.
1. Most of his high carb treats are also high fat. Cookies, crackers, ice cream, fries, fast food, pizza, etc. Burning dietary fat can generate ketones, just like burning body fat, especially if you are deficient in one of the <pathway enzymes>. Perhaps he simply has trouble metabolizing fat. I'll have to run a low fat high carb test this summer.
2. There is a bacteria in his colon, which is not part of the normal flora. This bug digests excess sugar, and especially nondigestable oligosaccharides, in a low-oxygen environment, and respiration stops at acetic acid. As mentioned earlier, fats break up into acetic acid too, and if his liver doesn't tolerate this particular compound, then the extra load from the bacteria could definitely push him over the edge.
I sent email to a couple people on the Net, authors of the best websites on this subject. They are stumped! Nobody understands it. John is definitely an unusual case. The bad news is, you've slogged through 50 pages of my writing, and at the end, my conclusions won't help you a bit. You probably react to wheat, or red#40, or salicylates, or something simple like that. But John? I don't know - he's way out there. Maybe it's a snorkasaurus, rather than a horse.