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My Very Fresh Initial Thoughts of AHS 2011

READERS SUMMARY:
1. Why you need to get outside of your box and go to a conference you just don’t have time for!
2. Why people you meet can make you more healthy
3. My big regrets……..?
4. What I heard and my interpretation of it?

I left the Ancestral Health Symposium about an hour ago and my mind was abuzz with many thoughts and I was quite excited by what I heard these last few days. What was more inspiring to me was some of the people I met. Some were people I had an “ambient awareness” from their internet persona and others were completely new to me who made an indelible impact. Others came up to me to introduce themselves and just talk, and they made me a better person for sharing some ideas with me. I was so inspired, that as I drove back to the hotel I had to call my wife to tell her about the talks that just blew me away. I know many of the “chronologically younger” paleo netizens are out partying in West Hollywood tonight, but I have to sleep to protect my telomeres! And yes my telomeres are now at 29 years old for this old man down form 55 yrs old when I was a fat ass at 350 lbs.. So I think I am doing well blogging while others are out configuring Tabata sexual clinical trials. ( check the AHS twitter feed for an explanation) So what happened? I had my core shaken about exercise and then I was brought to tears about a talk on Zoo’s from a guy from NYC who made a “Jumbo” elephant very relevant to this surgeon. Lets dive into the Paleopalooza…

The first day I got up very early at 3 AM for two crazy reasons. The first one was because I was seriously Jet lagged because the airlines lost my luggage and I had no clothes and none of my supplements to offset my jetlag. The second, more important reason was to write a blog on August 5th because of two UCLA students I met on the Santa Monica pier that I cataloged on my blog. I went to the mall in Santa Monica and scored some clothes for the first day of AHS11 (not sure if it was sweatpunk Melissa?) but at the end of the day I was dead tired because of the events surrounding my arrival. It bummed me out because I had planned to meet up with some “netizens” but my bad luck put that too bed literally and figuratively. I truly regret not having the opportunity to meet these folks because I feel I missed out on something big. I felt this way because of the “new people” I did meet completely blew my mind and really made this trip a lifetime experience. I met several docs, who will rename nameless, (lol) who are firmly in our paleo camp but have not figured out how to come “out of the closet” to their fellow MD’s. These people are awesome docs. Really, they made this trip special for me. I re-lived my own coming out to them and told them its not as bad as they think. They were here because they knew from a gut level they needed to be there but they had no idea how to make this work with their practice in their current jobs. This is not a topic I would expect any of my readers to fully understand, but as a surgeon who has had to live that painful experience, I felt an immediate bond with them and I wanted to lend my support in any way possible. These are the people who will eventually serve our “Paleolites” in the future. Even people well steeped in a paleo lifestyle will need a doc at some point whether they believe it now or not. These docs took the greatest first step in realizing that they needed to be here even if they felt “lost” in how to apply what they now know to be what out new paradigm should be.

I met 17 patients at the AHS 2011. I got a ton of business cards and made notes on every one. I will answer your inquires, I promise. Many just walked up stuck a hand in my hand and just began to talk openly to me. This displayed to me massive trust. It was rather refreshing to say the least. I heard and felt their frustrations. I did all that I could in the short time we had but my interactions with these people made me realize that I have to continue on fighting the battle to get to change in my profession. I was particularly moved by one man from SF who had a serious genetic disease who was here to get to the bottom of his condition. He asked great questions to one of the presenters and after that talk he came up to me to ask for my clinical insights. His story made my resolve even greater that there is a huge need in the paleo community to meld the “best clinical and academic research” with the best clinical medicine we have to offer him. I hope there is more clinical application talks in future AHS 2012 talks for sure. I thought this was the gaping hole in the conference.

I met two CEOs of major companies who sat me down and wanted to know what they could do make a difference. I think they wanted to know about themselves but I told them instead to focus on their employees. If their business ran smoothly with their employees, and kept the owner’s cortisol low, I felt this would be the best way to keep them healthy long term. They both looked at me with big eyes, but admitted they never thought about that angle. I told them both that they need to focus less on cost savings and more on keeping their work force healthy to increase their employees productivity. I gave them my top five Rx’s for doing this and I told them they needed to track down Jamie Scott at this meeting. His talk, done in concert with Emily Deans MD, really spoke to me about the need for employers to make the well being of their employees a big priority in their business plans going forward. If you do not take care of your main capital investment, people, who are your interface to the outside world, they will fail under the load of stressors you put them under! After all, we are only as strong as our weakest link. I briefly met Jamie at Masterjohn’s talk, and shared with him some of the ideas Google has instituted in their corporate culture to offset the cortisol releases they put their employees under. Jamie’s talk really got me thinking about my own environment in surgery and my own team. They are vital to my success and I need to use some of Jamie’s keys myself. We all can seek to improve our former selves. Thanks for that reminder, Jamie. Dude…loved the accent as well.

I listened intently to Dr Richard Feinman’s (Downstate medical school professor of biochemistry and Metabolism in NY) talk and realized that this man speaks softly and carries a large stick. He spoke on nutrition but what he said between the lines about the current political situation in academic medicine was spot on. I spoke briefly to Karen DeCoster (blogger) about this issue late today, and I believe what Dr. Feinman was concerned about was real. There are always secondary gain issues we must remain cognizant of in research and in academic medicine for sure. But we can also use that issue to our own devices in the paleo community if we understand the “other side” of the sword. I believe my message to Karen was loud and clear and hopefully she considers what I said carefully.

Dr. Lustig maybe just the Rx the paleo community needs if we all play our cards correctly. Now getting to Dr. Lustig’s talk…personally, I felt his lecture was electric and far better than the “Sugar the Bitter Truth” that made him world famous several years ago on YouTube. I had time to speak with him several times and have him answer one of my questions on vagal nerve stimulation for weight loss (levee five). While I completely understand Dr Feinman’s strong objections to the Dr Lustig’s current political agenda in the SF basin with regards to government intervention in the fructose battle, Dr. Lustig has now made it clear to the world that he has embraced leptin as a major player in the development of childhood metabolic syndrome. His data will be published in the Journal of Pediatrics in a few weeks. I think this will open some eyes in the world I swim in. This is a huge step for Dr. Lustig, but an even bigger step for “Paleo mankind” if you ask this surgeon. We need to have more docs realize this movement is based upon deep science and not cavemen reenactments. The Kracken brought that point to our community with laser beam focus today in his talk. We need more docs in academic medicine to embrace a new paradigm. While Dr. Lustig’s approach may not serve Dr Feinman’s vision, I can not tell you how happy I was to see Dr. Lustig put both of his feet firmly in the paleo community whether he likes to admit it openly or not. I really like the old guy to be honest. He reminds me of what I do not like in academic medicine, but my gut tells me that is is “good people” at his core. We will see if my gut or Dr Feinman’s brain is correct.

Lustig’s talk was a beacon sign that change is indeed possible even in academic medicine. I believe Dr. Lustig’s talk at the AHS will set a new bar in many of my fellow MD’s minds about thinking about about fructose and leptin resistance. While I dont think fructose is the “DOMINANT CAUSE” of our current obesity epidemic in the USA, I do think in children it is the major driving factor. I think in adults excess omega 6 consumption in concert with fructose and carbohydrate excesses are the classic perfect storm story for obesity. Both of these substances cause leptin resistance and both need to be removed from our diets. This is why a paleolithic diet is a complete Rx for rockstar health. Their deadly combination make sense to eliminate and there is great evidence for it in the literature and it is biologically most plausible etiology we have in 2011.

Speaking of “Dominant causes of obesity”………..The buzz from day one was from Gary Taubes “ripping” Stephen Guyenet on his food reward series. Personally, many of you know I completely disagree with Dr. Guyenet on this topic, but I think he is a great blogger with a great mind. Maybe Gary’s tact could have been better allocated; but he said what had to be said, in my view. I would also remind many that even within a family it is normal to have disagreements from time to time. I personally think this a good thing that with in a group of like-minded folks we can disagree at times. I complained loudly to Jimmy Moore on his Facebook wall and forum about Gary Taubes being “soft” with Dr. Oz earlier this year. So I can not fault him one bit when he decided to sink his canines in to Dr Guyenet at the AHS. I personally wanted to see Gary bare some teeth after the Dr. Oz debacle and this weekend’s showing tells me he can evolve. That to me was a positive in a bad situation. It does not in one bit negate the major contributions of Dr. Guyenet at all in my view. I just think he had a bad day with his food reward series. We all have bad days at times. No harm no foul.

The afternoon session of today was just magical. It began after a lunch break where I had the chance to interact with many people I had never met. That meeting was just humbling. They shared stories with me that just made me realize how lucky I am to be a physician when people can just tell you such personal things without evening knowing them. It began with Melissa McEwen talk about the colon and gut microbiome. She gave me some insight to sacral iliac degeneration that I had never considered before when she showed pictures of the anatomy of the great apes pelvis on a slide. I wrote down these thoughts I had, and I promise you she may help lots of patients in Nashville with her talk. Her boyfriend, Chris Masterjohn’s talk, also was highly informative and provocative. It became more personal when an audience member stood up and asked Chris what to do about his Familial Hypercholesterolemia. To me…that made the session. It brought it from the research bench top hypothesis to real clinical medicine in about 90 seconds. A good job for sure by a real bright guy. UConn is fortunate to have him in my view.

Next up was John Durant. You must visit this guy’s blog. When he began talking about zoos…and elephants I was ready to run for the pisser in the hall. But then he got into the story of Jumbo the elephant in a Paris zoo and PT Barnum in NYC…and well, then I cried. Seriously, no bullshit. Like real crying paleo style. Like some one stole my carcass post kill. I cried not for Jumbo, but I cried for my wife’s pet, Mr Big. My wife Sandy, is a huge horse lover. She has owned horses her entire life and it is an integral part of who she is. I have to be brutally honest and tell you that as a former NYer, horses never have moved me at all. I just don’t get it I guess. I thought of them as something one hires on 59th and 5th Ave. for a ride from Central Park to the Carnegie deli. But last month my wife’s prized show horse had to be put down. He developed a cervical disc herniation and suddenly became partially paralyzed. It absolutely devastated my wife and I could see it in her face and her sleep patterns. I felt her grief not from the horse…but from her own misery and decline in her health for those two weeks. I never fully understood what she was going through until I heard Mr Durant’s talk about Jumbo. When he was speaking at the AHS, it dawned on me that my wife’s horse may have gotten his cervical herniation from his grain diet. I recalled, as a spine surgeon, that a lumbar cage we used 15 years ago in neurosurgery was developed by a vet in Louisville, KY who worked on horses. I emailed this vet while John spoke about Jumbo and how he died because of his bad dentition from grain and whiskey drinking! Yes……John said this! And the vet replied to me that indeed he developed the BAK cages because of grain induced degeneration of horse vertebral discs! The irony was not lost on me. Here I was a spine surgeon, listening to a talk on a Jumbo elephant by a guy from NYC who has long hair and runs bare foot…and he opened my eyes to why my wife’s horse had to be euthanized. I felt sick to my stomach. Her horse died from a neolithic disease right under my own nose and I could have have saved my wife’s heartbreak if I would have applied the paleo principles at home as I do at work. It killed me. I cried right there in Ackerman Hall and called my wife to tell her what I knew. I also shared it with John Durant. Crazy how things are connected I tell you.

Next up was Andreas Eenfeldt MD. Dude is like 6’5 and trim and has a way cool accent. They call him the diet doctor in Sweden. He is a tight friend of Jimmy Moore who is a pretty cool guy in his own right. Glad I got to meet Jimmy and hear Dr. Eenfeldt. We American docs can learn a lot from our Swedish counterparts. It amazed me that in Sweden their medical board tried to have a doctor’s privileges removed for curing type two diabetes using paleo techniques. It was also cool seeing one of Dr Eenfeldt’s success story patients make the trip to LA to show us all what is possible live. Great talk and motivational for sure. When the talk is released online make sure you watch his map of the USA graphic several times. It shows what has occurred in the USA since USDA told us to go low fat high carb. I promise you if that does not hit you in the gut nothing will.

The next talk that was note worthy for me was that of Erwan LeCorre of MovNat.com If you don’t know about him. You better go find out about him. The ladies will be seduced by his good looks, his accent, and his soft calming tone of his voice, but I was transfixed by his message. This was the best talk of AHS in my opinion. I thought nothing could top Lustig’s talk…but for me…this was the pinnacle. Words can not describe how serenely he described his method and his craft. As I listened, I felt more calm and even made a twitter comment to Dr. Deans that I felt my cortisol was dropping as he spoke. This talk needs to be viewed by all non-attendees and re reviewed by all of us who heard it. It was that good. Just awesome wrapped around WOW surrounded by thick pastured bacon strip! I will need to rethink my exercise position and I am clearly signing up for MovNat at some point.

The last talk I went to……was Brent Pottenger’s et al. And while I never expected it to raise my BP and ire…WOW did it. It may have been the quickest talk but most important. The point of the talk was how can we bridge the gap of evolutionary biology and our current healthcare system. Brent and Joe Sobolewski think Kaiser’s or the VA’s model may hold the answer. This surgeon could not disagree more vehemently. I think all those who heard me speak post-meeting know where I stand. Seth Roberts, Karen DeCoster and Jolly all saw it…and Jolly photographed the jugulars bulging from my neck. I definitely think Brent’s idea to make a Paleo ACO or insurance pool is a great idea…but how we implement it is another story for another day. Those young bucks who have just begun to play in the healthcare cesspool system we have have much to learn. I bet Brent changes the most as he enters medical school in 5 days. When he comes out of an orthopedic residency I already know what he can not fathom yet…Kaiser is the last place on earth he would ever practice orthopedics when he knows what this surgeon knows today. Paleo needs a system that is completely free of the hospital complex in my view. This maybe a place I take my blog now……not sure my health could handle it though.

WRAPPING IT UP:

I hope AHS 2012 incorporates an iPhone/iPad list of all attendees numbers, twitter accounts, and emails so that we can make more connections when we meet. We need a live feed for the rest of our paleo community to live this as we did. I really regret not being able to meet some people I wanted to meet like Dr. Deans (best blogger in my view), Paul Jaminet, and Mike Eades and some of the PH crew I interact with. I did not get to speak long to Robb Wolf or to Mark Sisson but both of their talks were solid. The Kracken…well, he is just a geeks dream to speak too. I briefly met Denise Minger and she made a nice impression. A beautiful young lady with a gorgeous mind. I hope to one day share some wine with her. Jimmy Moore is just a great PR guy for our community. I can not say enough good things about what he does to further the cause. I also wish I could have spent more time with some of those patients who laid their cards on the table. I also enjoyed speaking with future paleo doctors I met there. Four future docs to be exact, who got an eye wide open view to our profession. I know this blog was long…….but I had to write it once I got back to the hotel room……….it was so fresh and I was very inspired. I love mind expansion. In the poster section, I must give a shout out to David Pendergrass of the University of Kansas. His poster was rockstarish if you ask me. The neuroregulation of appetite is a tough assignment to push out on a poster, but I loved watching Karen Pendergrass getting this info from David. Just so cool to see information transfered without a USB drive live. You can see thinking occur in peoples eyes as you speak……to me that is totally paleo! OK……enough. While the rest of community is out partying I am going to lift heavy things and try to climb some trees MovNat style. Erwan got me motivated. Its on like Donkey Kong now.

What I like best about conferences is how they force me to think outside my usual construct. If we always do what we’ve always done, we will get what we’ve always got. I really enjoy getting my mind stretched like a canvas, because in the end it never goes back to its earlier dimension.

When this conference gets posted on the net watch it…….there might be a few thoughts in there that could change your own DNA.