Friday, February 1, 2013

Dude, where's my Pancreas?

I suppose on some level I should be grateful for celebrities, because without them I would have less blog material.  Like the story this week on Ashton Kutcher's hospitalization and the subsequent commentary that went along with it.  Let's look at what's wrong with this story, shall we?

First of all, we don't know by reading this article, or anywhere else, what he really had.  The only indicators that he gives is the abdominal pain and his "pancreas levels were out of whack."  I think that he might be referring to the levels of "pancreatic enzymes" perhaps?  So, quite possibly, given his abdominal pain and elevated pancreatic enzymes it is quite possible he had pancreatitis, but we don't really know as we are not privy to the rest of his medical history.  And even if we had all of that, you can't just diagnose because you read something on the internet.

Second of all we have the logical fallacy of "post hoc ergo propter hoc" or "after this, therefore because of this."  In other words, he went on a crazy diet, had problems, therefore it must be part of the diet.  Once again, we don't know all of the information about Mr. Kutcher's medical history, what other food/beverages he might have been injesting (or not injesting) before/during his all-fruit diet, what (if any) medications he was taking, what (if any) herbal products he was using, what his lab work really was like, etc.  So we can't assume that whatever he had was exactly a direct cause of the diet.

Third, let's pretend for a moment that he did really have acute pancreatitis.  Could the "all fruit diet" actually cause pancreatitis?   The quote from the dietitian referenced in the CNN article almost implied that it could, but that is highly unlikely (and she might have been misquoted anyway).  Yes, your pancreas does produce insulin, and yes when you are eating a lot of carbohydrate your pancreas will make more insulin (the pancreas also does other things like produces enzymes to help us digest fat).  But if hyperinsulinemia (aka. over production of insulin) caused pancreatitis, then everyone with pre-diabetes and early stage Type 2 would have acute pancreatitis.    Pancreatitis is usually caused by gall-bladder problems or chronic alcohol use.  Some people have had acute pancreatitis because of having triglycerides over 1000 mg/dL (although you are considered at risk if they are >500 mg/dL), and high triglycerides can result from elevated insulin levels (although usually at that level we also have some genetic disorder and/or medication reactions to thank for that)--so I suppose you could stretch it to say that he might have had elevated triglycerides.    But once again--that's just a leap, we don't have all the information.

So, yes, a diet that consists only of fruit can cause other problems--mainly a lack of protein and essential fats.  Was the diet the cause of the illness of the star of  "Dude, Where's My Car?"  Probably not, but once again, we don't have all the info.  And if you take medical advice from a celebrity?  You probably need more help than I can give you.  And that "mucusless" diet that Steve Jobs was following?  That is another post for another day.....

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