Foie gras, c'est moi?

 
As I was flying back from France a few days ago I had one of those experiences touchy, feely types call synchronicity. I was reading the International Herald Tribune and came upon an article entitled “The ethical calculus of foie gras” about the ongoing battle between animal rights activists and foie gras producers, and how they were both, strangely enough, working together. Legislators with the help of foie gras producers are drafting a bill that would basically put these same producers out of business in 2016. The activists are signing on, figuring that 2016 will ultimately arrive and the producers will be finis. The producers are signing on because such a bill will give them breathing room to move their business somewhere more simpatico without a lot of hassle in the intervening years.
I have never seen ducks force fed, and had always imagined it to be pretty brutal, so I was interested to read the following:

To animal welfare groups, the obscenity of force-feeding, known by the French word “gavage,” is self-evident. But Ginor and his partner Izzy Yanay, who runs the farm, accuse their critics of anthropomorphism and ignorance of duck anatomy and behavior. They say the practice is as benign as it is ancient, since waterfowl lack a gag reflex and have sturdy throats that easily tolerate grains, grit, stones and inflexible gavage tubes. To understand gavage, they say, is to accept it – as they insist poultry researchers have, after examining birds for signs of undue suffering during gavage and finding none.
I visited Hudson Valley Foie Gras recently, seeing gavage for the first time. I saw no pain or panic in Yanay’s ducks, no quacking or frenzied flapping in the cool, dimly lighted open pens where a young woman with a gavage funnel did her work. The birds submitted matter-of-factly to a 15-inch tube inserted down the throat for about three seconds, delivering about a cup of corn pellets.
The practice, done three times a day, for a month, followed by slaughter, seemed neither gentle nor particularly rough. It was unnerving to see the tube going down, and late-stage ducks waddling bulkily in their pens, but no more so than watching the epic gorging at an all-you-can-eat buffet, where morbid obesity is achieved voluntarily with knife and fork. (my italics)

The synchronicity of all this came when just as I was reading the last words of the article, the flight attendant put before me a plate of – you guessed it – foie gras. (It was Air France, after all) I’ve had foie gras a few times before, and I can take it or leave it. But, admittedly, I ate this batch with a little more interest.
When I looked closely at the piece of almost solid fat before me, I reflected on the author’s comment about how humans can make their own livers foie gras-like with knife and fork. He’s absolutely right. I’ve taken care of many, many overweight patients who had fatty livers, and, in fact, fatty liver is becoming a major health problem.
People who consume too much alcohol over too long a time period develop first a fatty infiltration of their liver cells, then inflammation that progresses to fibrosis, then ultimately, if the drinking doesn’t stop, to cirrhosis and possibly even liver cancer. This same exact progression takes place in the livers of many people who are overweight and/or insulin resistant. It is indistinguishable from the alcoholic variety, and is diagnosed only by the fact that the patient doesn’t drink to excess. The disorder is called non-acoholic fatty liver disorder (NAFLD) and is widespread. How widespread? A recent study in the American Journal of Physiology determined that 33.6% of subjects from an ethnically diverse population in Dallas County (Texas) had fatty infiltrations of their livers to a significant degree. Thats one third of the people!
I can across a report of an even more alarming statistic. Jeffrey Schwimmer, MD, a pediatrician and director of the fatty liver clinic at Children’s Hospital and Health Center in San Diego presented data at a Digestive Disease meeting in New Orleans earlier this year that is truly frightening. In an autopsy study of 238 children ages 9-19 from the San Diego area, 17% were found to have fatty livers. Among obese children, the statistics were even more dreadful: 45% had NAFLD. As Dr. Schwimmer noted, based on those statistics and with an estimated 9 million obese children in the US today, “that’s a lot of kids walking around with liver disease that no on knows about.”
How is it treated? In my opinion it is treated most effectively with a low-carb diet. My wife and I have both treated many hundreds of patients with NAFLD with a low-carb diet. And we’re not the only ones who believe in this kind of nutritional therapy. A study was published late last year by researchers from Johns Hopkins University in Digestive Diseases and Sciences who concluded:

There were no significant associations between either total caloric intake or protein intake and either steatosis [fatty infiltration], fibrosis, or inflammation. However, higher CHO [carbohydrate] intake was associated with significantly higher odds of inflammation, while higher fat intake was associated with significantly lower odds of inflammation. In conclusion, present dietary recommendations may worsen NAFLD histopathology.

So there you have it. As you’re pondering all this, remember, they don’t gavage the ducks with steak, eggs, and ham – they gavage them with GRAIN, that wholesome stuff that most of the brain-dead nutritional advisers recommend you eat a half dozen times a day (the ducks only get it three times per day, and look at their livers). So, to avoid having the fate of the gavaged ducks befall you, avoid grains and other high carb fare and eat your steak and eggs. Or even eat your foie gras, just don’t become it.