A Case of Mayonnaise
When I joined Columbia University in 1985, I worked with a nurse who was, to put it mildly, overweight. One afternoon, I stopped by her desk to ask her a question and found her preparing for a well-deserved lunch. First, she brought out an enormous bowl of salad, full of greens, a few carrots thrown in for color. The gargantuan portion didn’t faze me, because I had already been in the United States for five years and had become quite familiar with American eating habits. Actually, I was pleasantly surprised by her rigor in selecting such a healthy salad with essentially no fat in it. For a moment, I began to wonder why she was so bulky when her diet was so exemplary. But not for long. From another plastic bowl that she had brought from home, she unleashed several heaping spoonfuls of a thick, yellow-white salad dressing that looked like pure mayonnaise. I casually chatted with her about a patient we were treating, but I couldn’t keep my eyes off the salad bowl. Rest assured, I had no interest whatsoever in sharing her meal; rather, it was the incongruity between the over-grown, leafy salad and the heavy, viscous dressing that struck me.
For years, I have watched such odd maneuvers with the distant curiosity of a physician who includes dietary advice as a prime component in his repertoire. But a few years ago, one of these
newfangled culinary approaches struck a raw nerve in me.
Aggressive Dieting May Carry Risks: Lou’s Story
A fifty-two-year-old psychiatrist-friend of mine, Lou, has always had a weight problem. So when I visited him and his family in suburban Westchester County, New York, in early 1998, I was quite surprised by what I saw. He had lost at least thirty pounds, and while not yet slim, he was getting pretty close. Lou proudly informed me that he was on a protein-rich and fatty food diet with no carbohydrates. No cereal, wheat, corn, rice, pasta, sugar, or potatoes. It seemed like an unnatural
challenge to the normal course of healthy bodily metabolism, but I was pleased by his successful effort to shed a few pounds. In fact, more than a few.
A month later, I got a frantic telephone call from his wife, who informed me that her husband had just suffered a full-blown heart attack. I dropped what I was doing to help her during this emergency. Her husband underwent a balloon angioplasty and was able to gradually get back to work within a few weeks. ‘‘Low-carb” is now a taboo word in conversations in their house, because she feels that the diet precipitated her husband’s heart attack. My friend also happens to have a strong family history of heart disease, making it hard to determine exactly what caused his heart attack. Given this uncertainty, I cannot say that the diet was the culprit. However, from a physiologic standpoint, we know that most cells in the body, and nearly all the cells in the brain, use carbohydrates like glucose or other simple sugars like fructose and galactose as their main energy source. For fats and proteins to be used as an energy source, they first have to be converted to glucose by specialized enzymes that parade up and down a series of dancing biochemical pathways. A diet that excludes carbohydrates puts extra pressure on the enzymes that lubricate this chemical maze, and they are now forced to work overtime on fats and proteins instead of on the carbohydrates that they prefer to face. This
upsetting of the normal balance leads to weight loss, which can be dramatic, as occurred in my friend’s case.
Taken From: The Memory Program How to Prevent Memory Loss
and Enhance Memory Power
