All of you commenters have done your job.  You’ve brought up several issues that I neglected to address in my last post.  Let me address them now.

First and foremost is the question about peri- and post-menopausal hormonal balance.  From long experience I can tell you that it is difficult for many women to lose weight in the peri- and post-menopausal years, especially the peri-menopausal years, without some hormonal balancing. It can be done, but it is more difficult.  MD keeps promising to post on the subject in detail, but right now she’s up to her eyes in another couple of projects that are consuming most of her time.  That time not consumed by her projects is consumed by little ole me, who needs his fair share.

There is a book on balancing hormones that I feel is the best one of the bunch out there right now.  It is by an acquaintance of mine, whom I run into at medical meetings all over the place.  His name is Uzzi Reiss, M.D, and he is the gyn doc to the stars.  I’m not kidding.  He probably takes care of half the peri- and post-menopausal Hollywood crowd.  He has an enormously busy practice.  I pushed him to write a book early on, but he deferred saying that he couldn’t afford the time away from his practice.  But he finally did come out with one.  It was published about 7 or 8 years ago, and so isn’t completely up to date, but, as I said, I think it’s the best of the bunch out there, written by someone who certainly knows what he’s doing.

At the time he wrote this book, he was using Tri-Est, which is a blend of all three forms of estrogen found in the normal female.  MD prefers more estradiol than found in Tri-Est for weight loss purposes; in fact, she, herself, uses only estradiol.  At the time Dr. Reiss’s book was written compounding pharmacies weren’t as common as they are today, so it wasn’t as easy to get estrogen compounded so specifically.  I think for those of you interested, Dr. Reiss’s book will give you a lot of information to get you started on your own quest.  Many women – MD included – started out on Tri-Est and starting fiddling from there.  The most important thing is to work with a physician who knows what he/she is doing to get your hormones working for you instead of against you.

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A recent, well-financed study shows the glycemic index (GI) to be a less-than-optimal way of managing diabetes with diet.  Meanwhile, a major name in the world of mainstream nutrition comments on this study and shows his own bias.  Oh dear.  Let’s take a look.

Before we launch into this study, which we’re going to just briefly review because I want to spend more time on the commentary, I want to propose to you a thought experiment.  Suppose I ask you to design a study to see what happens when subjects with diabetes eat low-GI carbs as compared to what happens when they eat high-GI carbs.  It seems pretty simple.  If you’ve got half a brain, you would recruit subjects with diabetes, go through all of the randomizing rigmarole to ensure that both groups of subjects were as alike as possible, i.e., subjects in both groups were about the same size, same ratio of sexes, same degree of blood sugar elevation, etc.  Then you would start the subjects in one group on an amount of carbohydrate, let’s say 220 gm per day, that were mainly low-GI carbs and the other group on about the same amount of carbohydrate composed of high-GI carbs.  You would teach each of these groups how to follow their specific GI diets and would have a way of monitoring for compliance.  Then you would set them to it and recheck them in 3 months or 6 months or a year or whatever you decided your study length to be.  Pretty simple stuff, right?

Just for grins, let’s throw in a twist.

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`I quite agree with you,’ said the Duchess; `and the moral of that is–Be what you would seem to be–or if you’d like it put more simply–Never imagine yourself not to be otherwise than what it might appear to others that what you were or might have been was not otherwise than what you had been would have appeared to them to be otherwise.’

`I think I should understand that better,’ Alice said very politely, `if I had it written down: but I can’t quite follow it as you say it.’

Lewis Carroll

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You think carbohydrates aren’t addictive?  You think it’s easy to give them up?  You don’t think it possible that people might prefer carbs to life?

Think again.

A story appeared in the online version of Time Magazine last year that I read when it came out, put aside to blog about later, then got sidetracked.  A reader sent me a link to it a few days ago, which brought it back to the front of my mind.

The article discusses a study being done in Germany using a carb-restricted diet to fight cancer.  In pre-WWII days, a German scientist, Otto Warburg, received a Nobel Prize for his work in sussing out the fact that cancer cells don’t generate energy the same way that normal cells do.  Cancer cells get their energy, not like normal cells, from the mitochondrial oxidation of fat, but from glycolysis, the breakdown of glucose withing the cytoplasm (the liquid part of the cell).  This different metabolism of cancer cells that sets them apart from normal cells is called the Warburg effect.  Warburg thought until his dying day that this difference is what causes cancer, and although it is true that people with elevated levels of insulin and glucose do develop more cancers, most scientists in the field don’t believe that the Warburg effect is the driving force behind the development of cancer.

But it stands to reason that it can be used to treat cancer that is already growing.  Since cancers can’t really get nourishment from anything but glucose, it stands to reason that cutting off this supply would, at the very least, slow down tumor growth, especially in aggressive, fast-growing cancers requiring a lot of glucose to fuel their rapid growth.

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