The Sante Medical Festive 5

By December 22, 2018 No Comments
With the year drawing to a close and the Festive Season in full swing, I thought I’d bring to you the Sante Medical 2018 Festive Five. This is a somewhat eclectic group of five things I happen to be thinking about and reading this festive season. As always, tell me what you think and here’s to a Merry Christmas for all!

The “Sante” cocktail menu description. Not low carb, but let’s enjoy sugar/alcohol ‘in their place’ 🙂


  1. Low Carb censoring on the internet – WTF?!

This is an interesting one… In very non-festive style, it seems some faceless entities have been ‘internet censoring’ Low Carb Diets and prominent Low Carb figures. As an example, a Scottish doctor, Dr Malcolm Kendrick, who is outspoken on his critique of the diet-heart hypothesis (the idea that the more saturated fat you eat, the higher your cholesterol will be, the higher your cholesterol is, the higher your risk of heart disease – a hypothesis that almost all experts will agree is not the full story) has had his Wikipedia page deleted.

Nope, Malcolm’s not showing up in a Wiki search

He talks about that here in his blog. Quite disturbing. There’s also been talk of ‘down-ranking’ of Low Carb pages in Google searches. Indeed, a Google search for ‘best diet for diabetes’ shows the top ranked page (at least under my Google login) is from Diabetes Australia,  which advises people with diabetes to eat a ‘low fat diet’ and ‘follow the dietary guidelines’. Then clicking through to the Dietary Guidelines reveals that they are intended for the healthy population (ie: NOT people with diabetes). It’s unfortunate that there’s this thing called logic which rains down on current nutrition advice but the powers that be don’t seem to let that get in their way! On the Google search, the Diet Doctor website which attracts 200 000 visitors per day and has over 500 000 email subscribers is hidden down towards the bottom of page 3. Interesting, given that Diet Doctor has 130 000 Instagram followers compared to Diabetes Australia’s 2300 followers. I don’t profess to have any understanding whatsoever of search engine optimisation (SEO) and how it works, to me it’s akin to black magic.
But something does seem to be amiss with the Google algorithm. I smell a rat. Could this be a targeted censorship of Low Carb Diets, which good science tells us is a viable option for people who might be struggling with weight control, diabetes or other health concerns? I admit it sounds a bit conspiracy-theorist and the five years ago me would have laughed at such a suggestion. But the today me is not so sure, it definitely seems strange and somewhat disturbing. I’m hoping one of the smart investigative journalists such as Maryanne Demasi, Nina Teicholz, Gary Taubes or Marika Sboros look into this further – I’m sure someone will.
  1.     Cholesterol… my brain hurts

The topic of blood cholesterol is not particularly festive, I know. However, it is something I’ve been looking into it lately and it is one of those areas that the more you look, the more complex it becomes. There is currently a lot of debate over the significance cholesterol plays in the development of heart disease. The crux of the disagreement is this: does elevated LDL cholesterol, traditionally thought to be ‘bad cholesterol’, have a harmful effect on the arteries of all people, regardless of the rest of their overall health? A subset of people who adopt a LCHF diet experience a raise in their total and LDL cholesterol (but it is only a subset of those people on LCHF. Some will notice their cholesterol stays about the same and in some it will decrease). One ‘camp’ in the debate believes that any elevation in LDL is a bad thing, and efforts should be made to lower it, usually in the form of taking medications such as statins, fibrates or PCSK-9 inhibitors or using plant phytosterols such as those found in certain margarines and ’special’ Weetbix. The literature, is not clear about if actively aiming to reduce LDL cholesterol by medication in these people who have no pre-existing heart disease and have never had a heart attack is of any benefit at all. And the downside is to take a medication regularly for the rest of your life, particularly if you are young. The is quite a lot to weigh up in this type of situation. (It should be noted however, that there is much better evidence of people gaining benefit from statin medications after having had a heart attack and this improving their health outcomes.) The ‘other’ camp in the Great Cholesterol Debate suggests that an elevation of LDL in a person following a low carb diet, who otherwise appears to be in optimal health, is of no consequence. Usually in this situation, the patient will see an improvement in their other biomarkers of cardiovascular risk such as blood pressure, blood sugar, weight and waist measurement. Indeed, this sub-population of people who are metabolically healthy and have high LDL cholesterol is under-represented in the current literature and so the truth is we just don’t know the answer to this question. It is a tricky topic and hotly debated amongst world experts. Watch this space as I think in the next few years some interesting developments will come to light.
  1.     Book I’ve just finished – ‘Deep Work’ by Cal Newport

My husband will often email me links to articles that he thinks I’ll find interesting. Earlier this year, he emailed me this book review article where the book reviewed discusses the difficulties concentrating on reading in depth material in the modern world. This article interested me as I had noticed this in myself. In my childhood and teens I would effortlessly devour a book quickly, being able to get ‘lost’ reading for extended periods at a time. Recently, I’ve noticed this has become much more difficult or almost impossible. I’ll sit down to read a book and I’ll find my mind quickly gets distracted, wanting to check a fact quickly on the web or check social media. I’ve felt more ’scatty’ trying to read meaningful material like a book in recent years and I’m sure a lot of this has to do with my use of smart devices (not to mention the increased complexity of life as an adult compared to that of a teen).
I recently read ‘Deep Work’ by Cal Newport which delves into this topic and gives suggestions on how to overcome it. He talks about how ‘deep work’ is becoming ever more rare in this modern world and ’shallow’ and distracted work is the norm. Cal explained on a podcast that he views social media as ‘junk food’ for the brain. To put it another way, he uses his brain for a living (he’s a university professor) and he hasn’t completely banned social media but he puts it in its place. I found this idea very profound and I started to draw parallels between this and my view of sugar in the diet. It’s not about being all sanctimonious and judgy about dietary sugar and social media, the reality is both can be great fun! Instead, we should recognise them for what they are – recreational tools. And I don’t think anyone would agree that it’s a good idea to use a recreational tool all of the time. Alcohol is another obvious example. Given that smart devices and social media are very ‘new’ phenomena in the context of human history, I don’t think the full extent of their downsides has yet become apparent.  I suspect they will in the next few years though.
My suggestion is try to implement some controls over your use of your smart device, rather than have it control you. In order to do this, you could set a time limit where you will resist checking your phone for a 15 minute period or the duration of standing in a line. Try this a few times per day to begin with, and see how you feel. It will probably feel uncomfortable at first, it did for me!  But like anything, after time and practice you will feel more comfortable and start to see the benefits in your background anxiety and overall feeling of well-being. Some people then move onto a relinquishment of devices at the front door on return home from work or school or a ‘Tech Sabbath’ (ie: a full day of no devices). There are many ways to do it, but I’d suggest to start small, see how you feel and go from there.
Which brings me to my next point in the Festive 5 which discusses an app that I think will help retrain my brain to be better at ‘deep work’…
  1.     App I’m using – ‘Waking Up’ by Sam Harris

Five-years-ago me would have scoffed at the idea of meditation. Who’s got time to sit cross legged on a cushion saying ‘hommmmm’?? In the past couple of years though, I’ve started to recognise the benefits of using meditation to help calm the mind, helping me to be happier and less reactive in everyday life. Because of this, I’ve recommended some form of meditation to my patients for the past year or so, particularly those who are struggling with anxiety and depression. I must admit however, I’ve been a bit ’stop-start’ with it myself. I’m making an effort to get back into it though, as a complement to what I learnt about in ‘Deep Work’. The idea is that among other benefits, meditation can help your concentration in other areas of life because you are ‘flexing’ the muscle of your brain that helps you maintain attention on a task or object. During meditation, you might focus on the breath coming in and out of the body, for example, and you keep trying to bring your attention back to this focus point. Invariably your mind will wander, random thoughts will come into your mind. This is ok, as the mind is designed to do this. But in order to improve concentration reading a book or doing important work, you can ’train your brain’ to focus on the task at hand and not look for distraction (like social media) when the task gets ‘hard’. Like anything, the more you practice this, the easier it will become. I’ve downloaded the ‘Waking Up’ app which has a free introductory course and then moves into paid material. Last year I paid for the Calm app which was great, and I’ve heard Headspace is good too. The key is to try some different techniques or apps and find what resonates. I think an App is a good place to start for beginners, but do be careful not to ‘quickly check’ social media or email first when you plan to use the app for a meditation session because you could find yourself lost down a rabbit hole 45 minutes later! I personally turn off notifications and banners of social media apps to help keep this in check.  You could also put your phone on ‘airplane mode’ which you are using the meditation app to avoid any calls or ping-interruptions.
  1.     2019 Horizons

It would be hard to have a Festive Five without considering what’s on the horizon for 2019. As a practice, Sante Medical is in it’s infancy. It’s small at the moment, but I’ve got some exciting things planned for next year. Some of the things I’m working on for next year include a structured weight loss program, organising cooking demos and generally giving more people who might benefit from the option of trying a lower carbohydrate approach to improve their health. With weird internet censorship (as outlined in point #1) and headlines coming out regularly with all sorts of conflicting information about nutrition, I think it’s important to have straight-talking and unbiased health professionals and that’s what I’m trying to do with Sante. Have an awesome Festive Season, and here’s to an exciting 2019!
PS: In case you were wondering: I don’t receive any payment or commission for any book or product I mention in the blog posts or anywhere on the website.