For thirty years I loved my medical practice in Tumbler Ridge. Then I semi-retired in order to pursue a career in palaeontology. However, I had a sense of unfinished business. For decades I had been practicing what I had been taught to do, and had done it to the best of my ability. But more and more I had begun to question what I was telling my patients, especially those with type 2 diabetes. And I thank my astute patients for pointing this out to me. I would prescribe some folks insulin and they would tell me they could then not stop gaining weight. One person with very high glucose readings told me he did not want the meds I offered him, and would get his act together using diet instead – three months later, after cutting back on his carbs, he came back and his readings were normal. I knew there was no medication that could be that effective. And I saw the problems I was creating by prescribing statin drugs to some patients who didn’t really need them.
In my last year of medical practice I worked closely with Charissa Tonnesen, our pharmacist, doing the most comprehensive polypharmacy reduction project ever attempted anywhere in the world. We spent an hour with each patient in town who was over 65 and taking five or more prescribed medications. In most cases we found that they could safely stop many of them, giving them an enhanced quality of life and fewer side effects.
All this made me wonder about the wisdom of what I had been taught to do. If we were on the right track, why were the rates of type 2 diabetes, obesity, mental health problems, auto-immune conditions, and dementia increasing so much over the past 50 years? After all, these are the chronic diseases that are threatening to bankrupt our health care system and our economy.
This 50-year time interval of worsening global health coincided with when we began to advise patients to follow a low-fat diet. My palaeontology teaching allowed me to see this from a deep-time perspective. What was the basis for those recommendations, and in retrospect, were they valid? The answers to these questions stunned me, and it became time to acknowledge that I and my medical colleagues had gotten a lot wrong by believing what we had been taught about fat being the main enemy.
So, I had retired, but I knew there was work to do. I was invited to represent the Rural Coordination Centre of BC by joining the Board of Directors of IPTN (the Institute for Personalised Therapeutic Nutrition) and I jumped at the opportunity. This non-profit group advocates a food-first approach to not just putting type 2 diabetes into remission, but also treating mental health problems and dementia. Next, I was asked by IPTN if I would be a podcast host for them, interviewing experts and patients from around the world—another opportunity that I gleefully grabbed.
Aligning with all of this was the great work of Dr Lenouvel and her team, who received funding for Tumbler Ridge to be one of two pilot projects in rural BC for a food-first approach to put type 2 diabetes into remission. We presented to Mayor and Council on what we were trying to achieve, and received broad-based community support. I did a presentation to the TR Seniors group and the TR Health fair, organized by Dr Akanegbu, and was astonished by the level of interest and engagement. People somehow knew that what had been tried for decades was not working, and that it was time for a new approach. The Tumbler Ridge Medical Conference became an ideal venue to focus on this topic, and I was surprised also by the lack of push-back by my medical colleagues.
Since then I have hosted about fifteen podcasts, each lasting about an hour, and one is being released every two weeks. The series is named At The Helm, with IPTN’s Anne Mullens as producer and Graeme Wheeler as our technical guru. All the podcasts can be accessed at https://www.therapeuticnutrition.org/post/new-iptn-podcast-charts-a-new-course-for-health and as a result, I have met the most fascinating people and listened to inspiring success stories.
For example, Chris Xi is a pharmacist and a medical student who reversed his diabetes using diet only—cutting out sugars and processed foods, for example—and remains in remission (he will be coming to TR as a speaker for the 2025 medical conference). Ajalah Efem is a single mom from the South Bronx —under the guidance of endocrinologist Dr Mariela Glandt she managed to get down from 15 medications to zero, to bring her HbA1C from 15 to 5.5, and to lose 30 kgs, all by embracing a ketogenic diet. And I have spoken to experts from the UK, India, Chicago, South Africa and Israel, as well as Canada’s leader in mitochondrial research. Another physician guest, from the Yukon, had gone a whole year in the Yukon eating only locally-sourced food.
One interview resonated with me, and that is because First Nations in BC bear the brunt of these chronic diseases. For many in these communities, it is not a question of “I wonder if I may develop diabetes one day”, but “when will I develop diabetes”. Therefore, being able to interview Dr Don Wilson, an Indigenous obstetrician with a refreshing view on metabolic health and Indigenous Health, was of pivotal importance. I am pleased to say that he will be a keynote speaker at the 2025 TR medical conference.
My producer, Anne Mullens, has an interesting TR history. She was the Vancouver Sun journalist who spent the summer of 1983 here, sending twice-weekly dispatches to readers as the town was being built, earning a prestigious award in the process. She went on to become the Sun’s medical reporter for a decade, and had her own revelation in her 50s when she reversed her prediabetes by increasing protein and reducing her daily carbohydrate load. We are planning for her to attend the conference as well.
What, then is the core message of IPTN and of the podcast series? Firstly, we know that there are people who are paid huge salaries to (quite legally) develop heavily processed foods that taste absolutely irresistible to us, and to which we become addicted. We need to push back. How do we do that? Not by telling people exactly what to do and eat, but to respect their knowledge of what works for them. It matters not whether you follow a palaeo diet, vegan or vegetarian diet, carnivore diet, ketogenic diet, Mediterranean diet, intermittent fasting, etc. What matters are the basic principles of healthy eating: focus on protein, cut down on sugars and starches, avoid highly processed food, do not fear healthy fats, etc.
And we need to look for the root causes of so many of the problems that beset us. For every person with established type 2 diabetes there are many more with prediabetes, and if they can be identified and offered advice early, that will be a victory. Will this approach work for everyone? No, some folks will want to depend on pills rather than take control over their lives. Nonetheless, we are at a point where we can say that everyone with type 2 diabetes has the right to know that remission may be possible without medications. And for any of you suffering from mental health challenges or worried you may be developing dementia, we can say that if you have not tried a dietary approach you simply have not fully explored your options.
Hosting a podcast series has been an unexpected joy in my life. My desire is that At The Helm succeeds and inspires people around the world to appreciate that science evolves over time, and that we now know things that we didn’t know before. Better still, it may give them hope and a sense of control over their lives.
For Episode 9 – At the Helm – Fewer Medications; Better Community Health With Charissa Tonnesen, PharmD, see: youtu.be/6AyCoMTUxtA?si=DmSJ52I-perFf_sH
