Cognitive dissonance doesn’t care about science, sadly, and for him to admit you are right he must admit he has made medical decisions which have done harm, potentially.
Live well, get blood tests, and laugh when he is perplexed.
The gauntlet has been thrown!
Barbara_Greenwood
(Barbara Greenwood)
#28
I have this lovely image of those pesky insulin molecules being dragged inexorably out of the bloodstream…
But seriously… is it that we are producing non glucose stimulated insulin… or that we are inappropriately releasing glucose from the liver (due to liver insulin resistance), and the pancreas is secreting more insulin to try to keep a lid on it? Which comes first - the insulin, or the glucose?
BillJay
#29
Spot on - cognitive dissonance is a big barrier to keto for people in general and even more of an issue for a medical doctor.
I would focus on the testimonials from medical doctors who’ve had their epiphanies and gone keto, or at least LCHF, for themselves and their patients since that’s a cohort he can probably relate to.
MKChitown
(Michelle)
#30
Exactly @Donna and @BillJay . I think that’s a big part of it. For one, he’s a man (no offense to any men here), but men can be a bit stubborn about admitting mistakes. And two, he’s a doctor, who has been classically educated in western medicine. Comes from a dad that was a doc and mom was a nurse. So, he’s hesitant to go against his “roots” so to speak. With anything that he invests in - he does tons of research. Like more than anyone I’ve seen - whether it be a camera, an appliance, etc. He does his homework.
What I can do is keep throwing study after study to him, and keep chipping away. Real medical studies from people he respects and trusts. I asked for his support with my keto lifestyle and I know he will. Just don’t know if it will turn his head in the right direction. Time will tell!!
At the bare minimum maybe I can get him to stop eating cereal or pop tarts for breakfast…
djindy
#31
From the sounds of it, I think people may actually be too harsh on him here. He might be a bit like me, where he’s willing to accept new, counter ideas, but will pick them apart from every angle possible first to see how well they stand up to scrutiny. If you can show that it does stand up to scrutiny, he’ll likely become a huge proponent of the new concept, and feel secure that he is well equipped to answer any questions or challenges from others as he’s already investigated those avenues himself and has found answers. There is, of course, also a possibility of finding somewhere in between as being the believed case, but not as a way of compromise so much as a similar belief shift to what seems the most convincing or reasonable.
This is another way of learning (and avoiding deception), it’s not necessarily a bad thing or a willful stubbornness.
richard
(Richard Morris)
#32
Ever hear of the parable of the blind men describing an elephant, that’s what the story of type 2 Diabetes seems like sometimes.
So if we’re going to go down this rabbit hole there are 3 major axes of dysfunction involved in type 2 Diabetes. The Pancreas, the Liver and the Fat cell.
It’s reasonable to observe a pancreas unable to keep up with demand, that seems to happen because of increasing insulin resistance causing more and more insulin to be needed to control high glucose. Most of the glucose used in the body is used by skeletal muscles, it appears that high insulin causes insulin resistance in skeletal muscle cells, and a high carbohydrate diet in certain people appears to cause chronic high insulin. When glucose can’t be cleared into skeletal cells it is sequestered by fat cells. For these people changing the diet (or fasting) to reduce exposure to insulin fixes the problem - I would say that Dr Fung is very much in this camp.
It’s also reasonable to observe that insulin resistance in pancreatic alpha cells is failing to inhibit glucagon which over drives the liver to produce more and more glucose, which causes greater secretion of insulin which drives ectopic fat into pancreatic cells making the insulin resistance worse. Again excess glucose if converted into fat and stored. prof Tim Noakes and prof Roy Taylor are probably more in this camp.
And finally you can make a great argument that insulin resistance in fat is the start of the cascade. Fat cells are supposed to sequester energy when insulin is about. If fat cells become resistant to insulin they release free fatty acids into circulation. At the pancreas free fatty acids amplify the glucose stimulated secretion. So there is another vicious reinforcing cycle - and I think it’s probably the simplest that requires only the well documented behaviour of both organs. Eventually the fat cell becomes so insulin resistant that no amount of insulin can hold back the overflow of free fatty acids and having FFA AND Insulin means that muscle cells take up the lipids but can’t burn them (insulin inhibiting mitochondrial transport of fats) causing build up of intramyocellular lipids that will inhibit glucose coming in - and without it’s primary sink glucose rises. There is another mechanism where an overflow of FFA reaching the liver causes glucose overproduction but I’m not as well across that mechanism. Anyway Gabor @erdoke and Ivor are in this camp.
Any of these could cause most of the observations of the progression of Diabetes, I suspect all of them are occurring in most type 2 diabetics. The root cause in all three is exposure to chronic high insulin. Normally we cycle through high insulin when eating and low insulin when fasting. But one common feature of type 2 diabetics is we make insulin even when we don’t have secretagogues (glucose, alanine in the presence of leucine).
Barbara Corkey has a novel hypothesis of a mechanism that causes non glucose stimulated insulin secretion that ties all of these together that she talks about in her Banting Lecture, and on the IAS video
Dr Corkey may just be another blind person describing an elephant. But the important thing for me is that that production of basal insulin is my remaining problem (now that keto has fixed my glucose excursions). So I am very interested in her hypothesis.
Barbara_Greenwood
(Barbara Greenwood)
#33
That’s very helpful, Richard, thank you.
To corrupt the metaphor… interesting as it is to discuss the shape of the elephant, at the end of the day I’m more concerned with training it not to crush me to death. Whichever is the fundamental mechanism (if there is only one… there could be several), the keto diet helps.
Keeping calm and ketoing on…
Groversaurus
(David)
#34
Personally, I would stop trying to convince him. Keep bookmarking things to give him, but keep hold of them, don’t pass them over. Just keep everything you learn about this WoE to yourself (for now). I’m sure curiosity will get the better of him, and he’ll come asking for these references when he notices you are benefitting.
Have you ever tried to get the attention of a kid to look at something you want to show them, but they obstinately refuse to pay attention. UNTIL you treat it like a secret that you don’t want them to know about, and then all of a sudden they are there “show me, show me”?
I don’t think men are much different 
Men grow older, but they don’t grow up.
MKChitown
(Michelle)
#35
haha!! made me laugh. and yes, I will keep calm and keto on and he can stew for a while.
gardengirlkp
(Karen Parrott)
#37
Waste zero time on linking up studies-IMO. Spend a lot of time eating Keto - out, at home, buying keto at the grocery. Wearing Keto revenge clothes, showing BF your great bio-markers post blood draws.
It’s a great dating test- IMO. No need to prove anything. For every study you find, he will find an opposite study. So time wasted.
Looking to see how he adapts to you and your opinions respectful vs low emotional intelligence tells a lot about how things will go in the future. Hopefully he’s a great guy and will go a long on your Keto ride. LOL. Onward and here’s to Ketoing on by your own examples. Keto tastes good, so I think many would go along with that.
janknitz
(jketoscribe)
#39
Compendium of science literature on the health benefits of low carbohydrate high fat ketogenic diets, and carbohydrate restriction and ketosis in general. With hundreds of research papers and scholarly journal articles from the past century, addressing 15 major health and fitness topics covering hundreds of general subjects, this is the most comprehensive scientific coverage of the myriad health outcomes of ketosis, high fat consumption, and carbohydrate restriction. A must have for anyone who wants all the evidence from the last century in their pocket. Papers are presented chronologically in each section. Chapters: - Very Low Carbohydrate and Ketogenic Diet Research Papers - General Ketosis and Significant Carbohydrate Restriction - Low to Moderate Carbohydrate Restriction - Animal Studies - Heart Disease, Metabolic Disorders, Blood Lipids, Cholesterol - Diabetes - Weight Loss - Exercise and Performance - The Brain, Neurodegenerative Disease, Epilepsy, Cognition, Depression - Hunger and Appetite Regulation - Muscles, Bones, and Body Composition - Cancer - Organs - Hormones - Carbohydrates Role In Human Nutrition - References
There are some less expensive used copies available, and I have the kindle version.
nvmomketo
(Nicole)
#41
I would start with Big Fat Surprise and Good Calories Bad Calories. If that doesn’t gte him interested, I doubt much will.
BillJay
#42
These are probably the best books to try to convince someone that carbs are bad and would at the very least stimulate a curiosity that maybe what everyone’s been hearing for the 30+ years about carbs=good and fat=bad is NOT based on science.
I’d suggest that if someone is actually willing to read these books to completion, even if they appear to disagree, that 1) reading them shows a commitment that is important to recognize/acknowledge and 2) the information will plant the seeds to make them more open to the idea of LCHF/keto.
Mike_W_Ellwood
(Michael Wallace Ellwood)
#43
I don’t know what an internal medicine doctor is, but is he ever likely to have to treat obese, diabetic or pre-diabetic patients himself?
He seems to at least consider the theoretical possibility that keto diets can be useful in those cases.
Perhaps if he was dealing with people like that, and was open to them trying keto, he would hopefully see what a great benefit it was in their cases, and also how bad it was for them if they went back on carbs.
He might still believe that keto is not necessary for “most” people (although given the high proportion of pre-diabetics now, that in itself is questionable), but I still feel that exposute to patients who were successful on keto, perhaps over a number of years, would begin to soften his views.
MKChitown
(Michelle)
#45
yes, @NelleG got it right. He’s trained as a generalist doc, the one you would go to for any/all ailments before you see a specialist. He is now in charge of all the residents at his hospital, so he can make a big impact with diet and medicine. He told me to keep sending him studies, and I will.
cansel
(Candace)
#46
I’m about half way through Big Fat Surprise (audio book), it is fantastic! I love how she takes all of these studies and explains the good and the bad. Good Calories Bad Calories is on my list