Thanks for publishing my photo, PoPville, in Councilmember Grosso: “The criminalization of sex work has caused more harm than good. D.C. needs a new approach.”

2019.10.04 DC People and Places, Washington, DC USA 277 09012
2019.10.04 DC People and Places, Washington, DC USA 277 09012 (View on Flickr.com)

Thanks for publishing my photograph, @Popville.

It’s an image of the White House, in Washington, DC (of course), from a newly remodeled rooftop. Enjoy.

Photo by PoPville flickr user Ted EytanEd. Note: Yesterday we heard the other side.From Councilmember Grosso’s office:”The following is Councilmember David Grosso’s opening statement delivered at the Committee on Judiciary and Public Safety hearing on the Community Safety and Health Amen

Source: PoPville » Councilmember Grosso: “The criminalization of sex work has caused more harm than good. D.C. needs a new approach.”

Just Read: Plant-based foods are 70% of Americans’ Daily Calories – What should future dietary guidance be?

2018.05 Low Carb and Low Carbon - Ted Eytan MD 2-1002 800
2018.05 Low Carb and Low Carbon – Ted Eytan MD 2-1002 800 (View on Flickr.com)

This data isn’t new, and it’s not enjoyed by anyone I’ve seen write about it, including plant-based or plant-free eating advocates.

It paints an unseemly picture of the Standard American Diet (SAD) or a diet gone wrong.

According to ERS’s loss-adjusted food availability data, total daily calories per person decreased by 2 percent between 2000 and 2010 from 2,545 to 2,481 calories. The share of calories from animal- and plant-based foods was the same in both years at 30 percent and 70 percent, respectively. In both years, grains were the primary contributor to daily calories per capita (596 in 2000 and 581 in 2010). Added plant-based fats and oils—such as salad and cooking oil, margarine, and shortening—ranked second (480 in 2000 and 518 in 2010), followed by meat, poultry, and fish (438 in 2000 and 416 in 2010).USDA ERS – A Look at Calorie Sources in the American Diet

The accuracy of food availability data is also challenging, even if it’s loss adjusted (meat tends to have lower food loss % than non-meat foods). However/and, the data is consistent with this year’s study using the NHANES data set, which shows that plant-sources are dominant, unfortunately, unhealthy ones are dominant, too:

2018.05 Low Carb and Low Carbon - Ted Eytan MD-1001 803
2018.05 Low Carb and Low Carbon – Ted Eytan MD-1001 803 (View on Flickr.com)
1968 Cereal Ad, Quaker Diet Frosted Rice Puffs & Wheat Puffs Cereals
1968 Cereal Ad, Quaker Diet Frosted Rice Puffs & Wheat Puffs Cereals (View on Flickr.com) (Used under creative commons license)

The data

  • The biggest caloric contributor to the American Diet is now grains (USDA & NHANES).
  • The biggest contributor of grains is now refined grains (NHANES)
  • Americans have not become more plant-based, nor have more Americans become vegan or vegetarian (USDA, Gallup)
  • Americans’ protein sources have not switched from animal to plant-based (future post) either (NHANES)
  • The above status quo does not bode well for our planet, as it results in more health care use (10% of carbon emissions in the US) and more pharmaceuticals (more carbon emissions than the auto industry)

I’m including a short timeline and my experience of what happens/what has happened when people/our country have substituted fat in their diet for carbohydrates.

They did as they were told, and these have been the results. A generic “eat more plants” or “eat more carbs” does not serve us well. A more specific “eat better plants, and eat better carbs” has had some results, but not very impressive ones, in the last 10 years.

Questions – Healthy People, Healthy Planet

One correction below with newer data, Insulin is now the 7th most expensive liquid on the planet. It’s still right behind Chanel No. 5.

A recap of how we got here

In 1961, spurred by emerging medical and epidemiologic research, the AHA issued dietary recommendations to reduce the intake of total fat, saturated fat, and cholesterol.Cohen E, Cragg M, DeFonseka J, Hite A, Rosenberg M, Zhou B. Statistical review of US macronutrient consumption data, 1965–2011: Americans have been following dietary guidelines, coincident with the rise in obesity. Nutrition [Internet]. 2015 May 1 [cited 2017 Dec 4];31(5):727–32. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25837220

2018.05 Low Carb and Low Carbon - Ted Eytan MD-1001 797
2018.05 Low Carb and Low Carbon – Ted Eytan MD-1001 797 (View on Flickr.com)

…the shift in the share of fat and carbohydrate is primarily due to an almost 65 g, or about a 260 kcal, daily increase in Americans’ intake of carbohydrate from 1965 to 2011.Cohen E, Cragg M, DeFonseka J, Hite A, Rosenberg M, Zhou B. Statistical review of US macronutrient consumption data, 1965–2011: Americans have been following dietary guidelines, coincident with the rise in obesity. Nutrition [Internet]. 2015 May 1 [cited 2017 Dec 4];31(5):727–32. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25837220

2018.05 Low Carb and Low Carbon - Ted Eytan MD 3-1003 795
2018.05 Low Carb and Low Carbon – Ted Eytan MD 3-1003 795 (View on Flickr.com)

There is a strong relationship between the increase in carbohydrate share of total intake and obesity. This is reflected by the high correlation at the individual level between caloric share from carbohydrate and adult BMI: 85.3% for men and 91.2% for women.Cohen E, Cragg M, DeFonseka J, Hite A, Rosenberg M, Zhou B. Statistical review of US macronutrient consumption data, 1965–2011: Americans have been following dietary guidelines, coincident with the rise in obesity. Nutrition [Internet]. 2015 May 1 [cited 2017 Dec 4];31(5):727–32. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25837220

2018.05 Low Carb and Low Carbon - Ted Eytan MD 3-1003 801
2018.05 Low Carb and Low Carbon – Ted Eytan MD 3-1003 801 (View on Flickr.com)

After 2000, shifts in scientific evidence and dietary guidelines promoted health benefits of healthy fats and plant sources of protein and the harms of low-quality carbohydrates.Shan Z, Rehm CD, Rogers G, Ruan M, Wang DD, Hu FB, et al. Trends in Dietary Carbohydrate, Protein, and Fat Intake and Diet Quality Among US Adults, 1999-2016. JAMA [Internet]. 2019 Sep 24 [cited 2019 Sep 30];322(12):1178. Available from: https://jamanetwork.com/journals/jama/fullarticle/2751719

41 years later

2019.06.27 Low Carb and Low Carbon, Washington DC USA 1780005
2019.06.27 Low Carb and Low Carbon, Washington DC USA 1780005 (View on Flickr.com)
2018.05 Low Carb and Low Carbon - Ted Eytan MD 1001 755
2018.05 Low Carb and Low Carbon – Ted Eytan MD 1001 755 (View on Flickr.com)
2018.05 Low Carb and Low Carbon - Ted Eytan MD-1001 788
2018.05 Low Carb and Low Carbon – Ted Eytan MD-1001 788 (View on Flickr.com)
2018.05 Low Carb and Low Carbon - Ted Eytan MD 7-1001-610
2018.05 Low Carb and Low Carbon – Ted Eytan MD 7-1001-610 (View on Flickr.com)
2018.05.29 Low Carbohydrate Meetup, Washington, DC USA 452
2018.05.29 Low Carbohydrate Meetup, Washington, DC USA 452 (View on Flickr.com)

My Conflicts of Interest

You can access these on my disclosures page. Short version, I have none.

References

  1. Shan Z, Rehm CD, Rogers G, Ruan M, Wang DD, Hu FB, et al. Trends in Dietary Carbohydrate, Protein, and Fat Intake and Diet Quality Among US Adults, 1999-2016. JAMA [Internet]. 2019 Sep 24 [cited 2019 Sep 30];322(12):1178. Available from: https://jamanetwork.com/journals/jama/fullarticle/2751719 (See this post for conflict of interest noted in this piece, they are significant)
  2. Cohen E, Cragg M, DeFonseka J, Hite A, Rosenberg M, Zhou B. Statistical review of US macronutrient consumption data, 1965–2011: Americans have been following dietary guidelines, coincident with the rise in obesity. Nutrition [Internet]. 2015 May 1 [cited 2017 Dec 4];31(5):727–32. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25837220
  3. https://www.ers.usda.gov/amber-waves/2016/december/a-look-at-calorie-sources-in-the-american-diet/
  4. https://www.flickr.com/photos/[email protected]/10821800065

Thanks for Publishing my Photo, Urban Turf, in NIMBYs, TODs and 100-Year Floods: Land Use Amendments Reflect DC’s Changing Development Priorities

2019.09.14 DC People and Places, Washington, DC USA 257 27020
2019.09.14 DC People and Places, Washington, DC USA 257 27020 (View on Flickr.com)

Thanks for publishing my photograph, Urban Turf DC.

The title is a mouthful; it refers to Washington, DC’s comprehensive plan, which is of great importance in our nation’s capital.

The photograph is from one of Washington, DC’s newest rooftops, in the NoMA neighborhood. Enjoy.

This Element of the recently released Comprehensive Plan draft establishes new growth priorities while undermining NIMBY arguments.

Source: NIMBYs, TODs and 100-Year Floods: Land Use Amendments Reflect DC’s Changing Development Priorities

Just Read: Trends in Dietary Carbohydrate, Protein, and Fat Intake and Diet Quality Among US Adults, 1999-2016 – 83% of Carbohydrates are from low quality sources

2018.05 Low Carb and Low Carbon - Ted Eytan MD-1001 803
2018.05 Low Carb and Low Carbon – Ted Eytan MD-1001 803 (View on Flickr.com)

This paper is a review of the dietary habits of Americans from 1999 – 2016, a follow-up from a previous analysis, using the NHANES database.

As the chart above shows:

  • As of 2015, the majority of energy in a typical American’s diet comes from carbohydrates (50.5%), 83.2% of them considered low quality. This has gone down slightly from 85.7 % in 1999.
  • Total percent of energy from low quality carbohydrate sources: 41.8 %

A recap of how we got here

In 1961, spurred by emerging medical and epidemiologic research, the AHA issued dietary recommendations to reduce the intake of total fat, saturated fat, and cholesterol.Cohen E, Cragg M, DeFonseka J, Hite A, Rosenberg M, Zhou B. Statistical review of US macronutrient consumption data, 1965–2011: Americans have been following dietary guidelines, coincident with the rise in obesity. Nutrition [Internet]. 2015 May 1 [cited 2017 Dec 4];31(5):727–32. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25837220

2018.05 Low Carb and Low Carbon - Ted Eytan MD-1001 797
2018.05 Low Carb and Low Carbon – Ted Eytan MD-1001 797 (View on Flickr.com)

…the shift in the share of fat and carbohydrate is primarily due to an almost 65 g, or about a 260 kcal, daily increase in Americans’ intake of carbohydrate from 1965 to 2011.Cohen E, Cragg M, DeFonseka J, Hite A, Rosenberg M, Zhou B. Statistical review of US macronutrient consumption data, 1965–2011: Americans have been following dietary guidelines, coincident with the rise in obesity. Nutrition [Internet]. 2015 May 1 [cited 2017 Dec 4];31(5):727–32. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25837220

2018.05 Low Carb and Low Carbon - Ted Eytan MD 3-1003 795
2018.05 Low Carb and Low Carbon – Ted Eytan MD 3-1003 795 (View on Flickr.com)

There is a strong relationship between the increase in carbohydrate share of total intake and obesity. This is reflected by the high correlation at the individual level between caloric share from carbohydrate and adult BMI: 85.3% for men and 91.2% for women.Cohen E, Cragg M, DeFonseka J, Hite A, Rosenberg M, Zhou B. Statistical review of US macronutrient consumption data, 1965–2011: Americans have been following dietary guidelines, coincident with the rise in obesity. Nutrition [Internet]. 2015 May 1 [cited 2017 Dec 4];31(5):727–32. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25837220

2018.05 Low Carb and Low Carbon - Ted Eytan MD 3-1003 801
2018.05 Low Carb and Low Carbon – Ted Eytan MD 3-1003 801 (View on Flickr.com)

After 2000, shifts in scientific evidence and dietary guidelines promoted health benefits of healthy fats and plant sources of protein and the harms of low-quality carbohydrates.Shan Z, Rehm CD, Rogers G, Ruan M, Wang DD, Hu FB, et al. Trends in Dietary Carbohydrate, Protein, and Fat Intake and Diet Quality Among US Adults, 1999-2016. JAMA [Internet]. 2019 Sep 24 [cited 2019 Sep 30];322(12):1178. Available from: https://jamanetwork.com/journals/jama/fullarticle/2751719

2018.05 Low Carb and Low Carbon - Ted Eytan MD 2-1002 800
2018.05 Low Carb and Low Carbon – Ted Eytan MD 2-1002 800 (View on Flickr.com)

Reason to hope for better adherence (?)

The attached editorial says the following:

The evidence of some improvement in diet quality reported by Shan and colleagues offers reasons to hope that continued national,local,and individual efforts encouraging population-wide adherence to the US Dietary Guidelines for Americans could subsequently improve health and delay onset of chronic disease.1. Van Horn L, Cornelis MC. US Dietary Guidance—Is It Working? JAMA [Internet]. 2019 Sep 24;322(12):1150. Available from: https://jamanetwork.com/journals/jama/fullarticle/2751694

41 years later, this is what hope looks like in everyday life

2019.06.27 Low Carb and Low Carbon, Washington DC USA 1780005
2019.06.27 Low Carb and Low Carbon, Washington DC USA 1780005 (View on Flickr.com)
2018.05 Low Carb and Low Carbon - Ted Eytan MD 1001 755
2018.05 Low Carb and Low Carbon – Ted Eytan MD 1001 755 (View on Flickr.com)
2018.05 Low Carb and Low Carbon - Ted Eytan MD-1001 788
2018.05 Low Carb and Low Carbon – Ted Eytan MD-1001 788 (View on Flickr.com)
2018.05 Low Carb and Low Carbon - Ted Eytan MD 7-1001-610
2018.05 Low Carb and Low Carbon – Ted Eytan MD 7-1001-610 (View on Flickr.com)
2018.05.29 Low Carbohydrate Meetup, Washington, DC USA 452
2018.05.29 Low Carbohydrate Meetup, Washington, DC USA 452 (View on Flickr.com)

Conflicts of Interest Disclosed

I’d call them “numerous”

For the first reference (Shan Z, Rehm CD, Rogers G, Ruan M, Wang DD, Hu FB, et al. Trends in Dietary Carbohydrate, Protein, and Fat Intake and Diet Quality Among US Adults, 1999-2016):

Dr Rehm reported receipt of personal fees from Nestec Ltd and the Dairy Management Institute. Dr Hu reported receipt of grants from the CaliforniaWalnut Commission and personal fees from Metagenics, Standard Process, and Diet Quality Photo Navigation. Dr Mozaffarian reported receipt of grants from the Gates Foundation; receipt of personal fees from GOED, Nutrition Impact, Pollock Communications, Bunge, Indigo Agriculture, Amarin, Acasti Pharma, Cleveland Clinic Foundation, America’s Test Kitchen, and Danone; scientific advisory board membership from Elysium Health (with stock options), Omada Health, and DayTwo; and receipt of publication royalties from UpToDate; in addition, Dr Mozaffarian reported holding patents US8889739 and US9987243 listing Dr Mozaffarian as a coinventor for use of transpalmitoleic acid to prevent and treat insulin resistance, type 2 diabetes, and related conditions as well as reduce metabolic risk factors. No other disclosures were reported.

For a previous reference related to this work

Since this issue is coming up in other venues for other studies, I noted this conflict of interest from one of the authors for previous work on this topic. I would also call these significant conflicts.

Dr Mozaffarian reported receiving honoraria from Nutrition Impact, Haas Avocado Board, Amarin, and AstraZeneca; personal fees from Bunge, Life Sciences Research Organization, and Boston Heart Diagnostics; serving on advisory boards for Unilever North America (ended 2014); and chapter royalties from UpToDate. No other disclosures were reportedRehm CD, Peñalvo JL, Afshin A, Mozaffarian D. Dietary intake among US Adults, 1999-2012. JAMA – J Am Med Assoc [Internet]. 2016 Jun 21;315(23):2542–53. Available from: http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2016.7491

My Conflicts of Interest

You can access these on my disclosures page. Short version, I have none.

References

  1. Shan Z, Rehm CD, Rogers G, Ruan M, Wang DD, Hu FB, et al. Trends in Dietary Carbohydrate, Protein, and Fat Intake and Diet Quality Among US Adults, 1999-2016. JAMA [Internet]. 2019 Sep 24 [cited 2019 Sep 30];322(12):1178. Available from: https://jamanetwork.com/journals/jama/fullarticle/2751719
  2. Cohen E, Cragg M, DeFonseka J, Hite A, Rosenberg M, Zhou B. Statistical review of US macronutrient consumption data, 1965–2011: Americans have been following dietary guidelines, coincident with the rise in obesity. Nutrition [Internet]. 2015 May 1 [cited 2017 Dec 4];31(5):727–32. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25837220
  3. https://www.ers.usda.gov/amber-waves/2016/december/a-look-at-calorie-sources-in-the-american-diet/
  4. https://www.flickr.com/photos/[email protected]/10821800065

Just Re-Read: Americans have been following dietary guidelines, coincident with the rise in obesity

2018.05 Low Carb and Low Carbon - Ted Eytan MD-1001 797
2018.05 Low Carb and Low Carbon – Ted Eytan MD-1001 797 (View on Flickr.com)

For me this is actually a re-read, since NHANES data is continually being recycled to attempt to describe what’s been happening with American diets.

This paper modeled data from 1965 (pre-NHANES, USDA Household Food Consumption Survey used for this year) through to 2011. It describes what is essentially a flip in the American population in the percentage of calories coming from fat vs carbohydrates.

2018.05 Low Carb and Low Carbon - Ted Eytan MD 2-1002 794
2018.05 Low Carb and Low Carbon – Ted Eytan MD 2-1002 794 (View on Flickr.com)

The image in the slides is taken from a trip I took to the Library of Congress photo archives. While searching for something else, I happened on this series, “Harried Housewife preparing dinner w/ convenience foods,” from 1968, which was remarkable to me for many reasons:

  • Notice how thin she is. The average BMI of a person in 1965 was 24 kg/m2, below the threshold for overweight (25 kg/m2)
  • Look at what she’s photographed making – ultra-processed, high carbohydrate foods. This was not by accident – with the understanding that carbohydrates contain less calories per gram than fats, promotion and production of these products was encouraged, as this USDA report shows (The Many-Splendored Potato, a Marvel of Convenience)
2018.05 Low Carb and Low Carbon - Ted Eytan MD 3-1003 795
2018.05 Low Carb and Low Carbon – Ted Eytan MD 3-1003 795 (View on Flickr.com)

…the shift in the share of fat and carbohydrate is primarily due to an almost 65 g, or about a 260 kcal, daily increase in Americans’ intake of carbohydrate from 1965 to 2011.Cohen E, Cragg M, DeFonseka J, Hite A, Rosenberg M, Zhou B. Statistical review of US macronutrient consumption data, 1965–2011: Americans have been following dietary guidelines, coincident with the rise in obesity. Nutrition [Internet]. 2015 May 1 [cited 2017 Dec 4];31(5):727–32. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25837220

We know what happened next.

2018.05 Low Carb and Low Carbon - Ted Eytan MD 4-1004 796
2018.05 Low Carb and Low Carbon – Ted Eytan MD 4-1004 796 (View on Flickr.com)

“Most people became heavier at about the same time. …We believe it is implausible that each age, sex and ethnic group, with massive differences in life experience and attitudes, had a simultaneous decline in willpower related to healthy nutrition or exercise.” Rodgers A, Woodward A, Swinburn B, Dietz WH. Prevalence trends tell us what did not precipitate the US obesity epidemic. Lancet Public Heal [Internet]. 2018 Mar; Available from: http://linkinghub.elsevier.com/retrieve/pii/S2468266718300215

Correlation is not causation

There is a strong relationship between the increase in carbohydrate share of total intake and obesity. This is reflected by the high correlation at the individual level between caloric share from carbohydrate and adult BMI: 85.3% for men and 91.2% for women.Cohen E, Cragg M, DeFonseka J, Hite A, Rosenberg M, Zhou B. Statistical review of US macronutrient consumption data, 1965–2011: Americans have been following dietary guidelines, coincident with the rise in obesity. Nutrition [Internet]. 2015 May 1 [cited 2017 Dec 4];31(5):727–32. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25837220

Here’s an example of a spurious correlation (there are many more at this site)

Drivers killed in collision with car, pick-up truck or van correlates with Per capita consumption of whole milk (US)
See: Drivers killed in collision with car, pick-up truck or van correlates with Per capita consumption of whole milk (US)

Ultimately, it is not known what caused the rise in obesity, even if we can speculate on what didn’t cause it. The physical activity analyses of NHANES are not enlightening on this point either, I will post on that next.

The photos tell the stories

There’s an additional photo which I cannot show here for copyright reasons, called “Well kept refrigerator for the man-about-town” from Look Magazine in 1965. That one shows what one would expect in 1965’s refrigerators – real food, including meat and dairy. If you make it to Washington, DC and can stop in to the Library of Congress, have a look 🙂 .

Here are more photos of the harried housewife and her engineered foodstuffs

References


1. Rodgers A, Woodward A, Swinburn B, Dietz WH. Prevalence trends tell us what did not precipitate the US obesity epidemic. Lancet Public Heal [Internet]. 2018 Mar; Available from: http://linkinghub.elsevier.com/retrieve/pii/S2468266718300215
2. Cohen E, Cragg M, DeFonseka J, Hite A, Rosenberg M, Zhou B. Statistical review of US macronutrient consumption data, 1965–2011: Americans have been following dietary guidelines, coincident with the rise in obesity. Nutrition [Internet]. 2015 May 1 [cited 2017 Dec 4];31(5):727–32. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25837220

Photo Friday: Invisibility is so 20th Century

2019.10.08 SCOTUS Protest for LGBTQ Equality, Washington, DC USA 281 24030
2019.10.08 SCOTUS Protest for LGBTQ Equality, Washington, DC USA 281 24030 (View on Flickr.com)

This photo was taken in front of the Supreme Court of the United States, in Washington, DC (of course), and I’m sharing it here on national coming out day.

What was remarkable about the moment this and additional photos were taken was that amidst the worry, fear, contention, counter-protesting going on, a group of faith-based leaders stepped forward and began singing, “we are not afraid.”

Indeed, the 20th Century ended a long time ago, and it’s not coming back.

Enjoy the photos, and celebrate the people in your life who are living as their authentic selves. Some days it’s hard to do this. It’s worth it every day.

Thanks for Publishing my Photo, PoPville in “Eaton DC going beef- free for the month of October 2019.” – except why not replace with a whole food plant-based option instead of an artificial, bio-engineered one?

2019.04.23 Eaton Workshop, Washington, DC USA 01608
2019.04.23 Eaton Workshop, Washington, DC USA 01608 (View on Flickr.com)

Thanks for including my photo in this reprint of an @EatonWorkshop press release.

As I mentioned when @FastCompany published a similar article, I have questions about how helpful this substitution is:

Thanks for Publishing my Photo, FastCompany, in Eaton DC hotel goes beef-free to help … except I’m not sure how replacement with ultra-processed, bioengineered food is helpful…

Since that time

  • The author of the fast company article and I have corresponded about this piece:

2018.05 Low Carb and Low Carbon - Ted Eytan MD-1001 793
2018.05 Low Carb and Low Carbon – Ted Eytan MD-1001 793 (View on Flickr.com)
2018.05 Low Carb and Low Carbon - Ted Eytan MD 2-1002 791
2018.05 Low Carb and Low Carbon – Ted Eytan MD 2-1002 791 (View on Flickr.com)

What hasn’t changed

  • There are still concerns (which I share) around replacing unprocessed/minimally processed food with ultra-processed, genetically engineered forms.
2018.05 Low Carb and Low Carbon - Ted Eytan MD 2-1002-763
2018.05 Low Carb and Low Carbon – Ted Eytan MD 2-1002-763 (View on Flickr.com)

I’ve been asked to eat one of these food products while wearing a continuous glucose monitor to see how they impact blood sugar levels. I’ll consider it. If someone else has done this and can spare my metabolism, let me know.

  • The recommendations made in the previous post are still the same
    • Add whole-food plant-based version of food to the menu during this trial and not an artificial, genetically engineered one.

    • Look at at energy use. Is Eaton Workshop reducing its carbon footprint by investing in non-fossil-fuel sources of energy (easy to do)? I’m about to write a post on how I did this for myself and my carbon footprint. It’s far more useful if large organizations do this too.

1201 K Street, NW. Photo by PoPville flickr user Ted EytanFrom a press release:”Eaton DC has announced their decision to go beef-free for the month of October 2019. The hotel has decided to make this change in response to the record-breaking fires destroying the Amazon rainforest and the eff

Source: PoPville » “Eaton DC has announced their decision to go beef- free for the month of October 2019.”

Calculating carbon footprint as a non-diabetic physician on an LCHF diet

2018.05 Low Carb and Low Carbon - Ted Eytan MD-1001 793
2018.05 Low Carb and Low Carbon – Ted Eytan MD-1001 793 (View on Flickr.com)

People who eat animal-sourced foods to maintain their metabolic health are equicapable and equiresponsible for mitigating climate change.

Calculating carbon footprint

It’s very difficult, if not impossible, to accurately calculate one’s carbon footprint, because of the different assumptions made about lifestyle in each model.

I’ve purchased offsets through the United Nations so I’m using their calculator as a baseline. A more comprehensive calculator with good documentation developed at UC Berkeley is also available (see references).

Diet

Estimations of animal sourced food vs a vegan diet seem to range between increase in emissions by 0.8 – 2 metric tons of carbon emissions/person/year. The UN model adds 1.21 tons for a meat-inclusive diet so that’s what’s I went with.

I may follow-up with a post that goes into more detail about my calculations here. In the meantime:

  • Animal sourced food diets emit more carbon than vegan ones, the question is by what margin
    • I am aware of the literature around regenerative agriculture and other approaches; my understanding is that these are still in the theoretical stage – if anyone has better information, send my way.
  • Models I’ve found are typically based on the Standard American Diet (SAD) and not low carbohydrate, healthy fat, real food (LCHF) approaches
    • They include snacking, refined grains, and artificial foods, and do not incorporate impacts of greater health care use from these things
    • They assess food source based on carbon emissions per kcal, which has implications based on nutrient density, amount of food required for nourishment and associated carbon costs (packaging, transport, etc etc).

Goods and services, including health care

Here’s that image, again.

2018.05 Low Carb and Low Carbon - Ted Eytan MD 1001-766
2018.05 Low Carb and Low Carbon – Ted Eytan MD 1001-766 (View on Flickr.com)

Energy – source of greatest emissions

  • Not owning a car reduces emissions by 2.51 metric tons / year
  • Household energy use and air travel are significant contributors to the carbon footprint

The much greater impact overall is in large organizations doing this at scale – reducing fossil fuel use and investing in renewable energy and regenerative agriculture projects.

Overall footprint, carbon offsets

The greatest impact on carbon footprint is in managing energy use, and that includes energy used for transportation as well as to create goods and services whose use could be averted (such as health care).

The much greater impact overall is in large organizations doing this at scale – reducing fossil fuel use and investing in renewable energy and regenerative agriculture projects.

I have purchased carbon offsets for the footprint above – see: Purchasing Carbon Offsets as a non-diabetic physician on an LCHF diet – How, What, Why

Our climate is changing:

2018.05 Low Carb and Low Carbon - Ted Eytan MD-1001-781
2018.05 Low Carb and Low Carbon – Ted Eytan MD-1001-781 (View on Flickr.com)

And, we’re in the era of diabetes reversal, why don’t more doctors know?

Feel free to check my work in the comments, we have a desire to know rather than a desire to be right.

References

  1. United Nations: offset.climateneutralnow.org
  2. CoolClimate Network: coolclimate.org/calculator
  3. Jones CM, Kammen DM. Quantifying Carbon Footprint Reduction Opportunities for U.S. Households and Communities. Environ Sci Technol [Internet]. 2011 May [cited 2019 Oct 3];45(9):4088–95. Available from: https://pubs.acs.org/doi/10.1021/es102221h

Disclosures

See my disclosures page. Short version: I have none.

Purchasing Carbon Offsets as a non-diabetic physician on an LCHF diet – How, What, Why

2018.05 Low Carb and Low Carbon - Ted Eytan MD 2-1002 791
2018.05 Low Carb and Low Carbon – Ted Eytan MD 2-1002 791 (View on Flickr.com)

It’s relatively easy to offset one’s carbon footprint with verified projects/vehicles through the United Nations (@UNFCCC) as well as other organizations.

How

  1. I visited the site(s) of reputable carbon offset providers. I elected to go with the United Nations, as well as another provider, CoolEffect.
    a. I chose not to go with a provider related to fossil fuel production or use.
  2. I reviewed specific projects that are (a) verified and (b) align with my values and interests.
    a. Because the major determinants of climate change are fossil fuel use, I selected a renewable energy project for the bulk of the offsets.
    b. Verified projects have documents indicating how they sequester or reduce carbon emissions.
  3. I purchased the offsets and received certificates. An offset opportunity is limited, i.e. people cannot overbuy a project once it is funded.
    a. The United Nations directs payment to the project itself, which provides an invoice and receipt.
    b. CoolEffect handles the transfer of funds with a small (around 10%) overhead as a non-profit organization

What

2018.05 Low Carb and Low Carbon - Ted Eytan MD 3-1003 792
2018.05 Low Carb and Low Carbon – Ted Eytan MD 3-1003 792 (View on Flickr.com)

These are projects that reduce carbon in the atmosphere in measured amounts, via means that include replacing fossil fuel energy with renewable sources (the project from the United Nations – @UNFCCC), or prevent carbon sinks from being destroyed (the project from Cool Effect – @Cool_Effect ).

Since I purchased from Cool Effect, that project has met its goal and no more offsets are available for sale for this project.

Why

2018.05 Low Carb and Low Carbon - Ted Eytan MD-1001 793
2018.05 Low Carb and Low Carbon – Ted Eytan MD-1001 793 (View on Flickr.com)

The idea that diet is the only/best way to mitigate carbon footprint, or that people who eat meat in pursuit of metabolic health are exclusively unable to mitigate their carbon footprint is counterproductive and inaccurate.

I’ve written a separate post detailing the carbon footprint calculation I used to determine how many offsets to purchase. Sneak peak via the image on the right.

A few things are obvious

  • The amount required to offset personal carbon footprints isn’t that great – from cents to dollars per metric ton of carbon
  • The contribution of diet to carbon footprints within personal carbon footprint isn’t that great – the difference between a diet heavy in read meat and one that’s vegan accounts for substantially less than 10 % of personal carbon footprint, probably less than 5 % – the most important mitigation actions involve energy derived from fossil fuels

Also

  • A person making dietary choices in the pursuit of metabolic health (which many are doing today) is not absolved of ethical responsibilities to procure food that’s produced responsibly
  • This procedure is going to be far more effective when performed at scale, by large organizations/communities, who are able to shift energy consumption patterns to ones that emit less carbon

We don’t need to ban cars; we need to electrify them (and we need that electricity to come from clean energy). We don’t need to ban burgers; we need climate-friendly beef…The bigger issue is that focusing on individual choices around air travel and beef consumption heightens the risk of losing sight of the gorilla in the room: civilization’s reliance on fossil fuels for energy and transport overall, which accounts for roughly two-thirds of global carbon emissions.See: Individual Choices Won't Be Enough to Save the Planet | Time@MichaelEMann

And:

  • This exercise is useful in personal understanding of the carbon cycle and what’s being doing to mitigate climate change, which is a threat to human health
  • We’re in the era of diabetes reversal, why don’t more doctors know?

Projects

References

Disclosures

My disclosures are on this page. Short version, I have none. No endorsement of organizations mentioned here is implied.

Photo Friday: “Look Out!” – Haunting reminders of doctors not meeting people where they are (failure rate of this approach: 100%), Washington, DC USA

2019.10.04 50 Years of Queer DC Photo Exhibit, Washington, DC USA 277 16015
2019.10.04 50 Years of Queer DC Photo Exhibit, Washington, DC USA 277 16015 (View on Flickr.com)
2019.10.04 50 Years of Queer DC Photo Exhibit, Washington, DC USA 277 16016
2019.10.04 50 Years of Queer DC Photo Exhibit, Washington, DC USA 277 16016 (View on Flickr.com)

This happened in our lifetimes. I have witnessed examples just like this in my own career. Including in this decade.

Look Out! In this undated photo, DC First Responders are warned that residents of certain homes are suffering from AIDS.

These photographs are part of an exhibit of queer history in Washington, DC.

2019.10.04 50 Years of Queer DC Photo Exhibit, Washington, DC USA 277 16023
2019.10.04 50 Years of Queer DC Photo Exhibit, Washington, DC USA 277 16023 (View on Flickr.com)
2019.10.04 50 Years of Queer DC Photo Exhibit, Washington, DC USA 277 16022
2019.10.04 50 Years of Queer DC Photo Exhibit, Washington, DC USA 277 16022 (View on Flickr.com)

Success rate of imposing our values/identities on the people we serve: 0 %

“The Jury looked at all the facts and recognized that Tyra was not a man dressed as a female but a human being,” said Earline Budd a transgendered (sic) activist who watched most of the trial.

The future of LGBTQ rights was born here, too: Vermont Avenue and the Death of Tyra Hunter
Source: Timeline of Triumph – Capital Pride Alliance

A (the) most famous case of animus directed by the medical profession against people different than them is the death of Tyra Hunter, who was refused medical care by a physician based on her identity. The resultant lawsuit and multi-million dollar judgement against the city forever changed Washington, DC into a place with the strongest human rights protections in the United States, and yet still with challenges:

See: The future of LGBTQ rights was born here, too: Vermont Avenue and the Death of Tyra Hunter

I still see versions of this approach directed toward the people we serve – the imposition of identity, orientation, or lifestyle choices, such as diet, without a basis in science. This should be undertaken with great care, or actually not at all, since the failure rate of this approach is 100 %.

We should always think about the impact of what we do. We cannot bring back people, communities, generations of people lost to due to the inability to meet people where they are.

Additional photos are below.

Source: Washington Blade (@WashBlade) photo archives, on display at the Outrage (@its_the_outrage), Washington, DC