Joseph Finau: A Kiwi Tongan Being Like Daphnis

Australia’s Indigenous Health Woes

The official statistics I have quoted on indigenous health related to diabesity are appalling.  Anecdotally too, there are horrific case examples.

We looked at the nonsensical state of innovation in diabetes and diet. In a situation analogous to the slowness to accept the cure for scurvy, we have seen forces that appear to be holding back effective dietary solutions for indigenous health. Those solutions, based on a traditional diet, were demonstrated back in the 1980s.

The situation looks bleak, but the low-carbohydrate movement has always focussed on grassroots solutions. That is a good strategy. You see the stakeholders who have the most to gain are people whose health is improved. The problem with low carb is that almost everyone else has something to lose. That is particularly the case for the food and pharmaceutical industries who benefit from the status quo. If you are in government and reading this, I have a message. It is incredibly short-sighted not to openly understand whether there are the disempowered stakeholders you should put first. This is an ancient problem for bureaucracy. You need to be counter-intuitive and anthropological. But we are getting deep.  The efficient management of innovation by the government is a topic for another post.

Be Like Daphnis

Be Like Daphnis
Be Like Daphnis (C) Astrokatie

The good news is that change is happening at the grassroots. I came across this Internet meme about Daphnis.  It is one of the smaller moons of Saturn and the small ripples it makes in the rings of its much larger neighbour, and it seems appropriate to represent the change we can individually make. I think it is also very apt for this post.

We examined the success of Joy Aghogho in Nigeria. Dr Jay Wortman has done fantastic work with the First Nations peoples of Canada (see his comment in a previous post). Island nations like Vanuatu are going back to traditional foods although one wonders if they have the science completely right.

Joseph Finau: A Kiwi Tongan

I want to focus on the efforts of one individual in New Zealand who is making a difference. Joseph Finau commented on one of my posts, and I think it is worth considering his recent journey.

Joseph is a single dad from Auckland, New Zealand who has a remarkable story of battling diabesity and weathering personal tragedy.  Losing 100KG (220 lb) is something entirely amazing but moving beyond that I want to celebrate his success in innovating within his community. 

According to the 2013  NZ census, about 60,000 people of Tongan descent live in New Zealand.  Most live in the North Island in and around Auckland. Like many Pacific peoples, and in common with the Aboriginal and Torres Strait Islanders, Tongans have suffered from diabesity in the transition from a hunter-gatherer diet and lifestyle to a Western diet and lifestyle. For their diet, diabesity is commonly blamed on the eating of turkey tails, lamb flaps and corned beef.  Joseph has a different point of view- one born from the perspective of his success.

I believe that going back to the way our ancestors ate is the only way to cure ourselves from this western disease (Diabetes). for the last 3 years I’ve been eating Island foods mixed in with Western foods. example: Taro leaves & coconut cream & corned beef. Tongans loves corned beef but told it’s no good. the thing is? CORNBEEF has NO CARBOHYDRATES or SUGAR which means it’s low carb.

Joseph has adapted the Western foods Tongan’s love with some traditional food (less the starchy staples) to make Tongan and Pacific island dishes the low-carb way. That is also what the Nigerians have done and it is also what Western low-carbers have done. Corned beef cooked with cabbage in coconut cream and raw fish (AKA ceviche or kokoda) are but two dishes. Joseph has addressed one of the complaints, that low carb is too expensive, by also thinking about the economics for large families who need to be fed on a budget.

Is Low Carb Too Expensive?

The economics of low carb are an interesting topic perhaps for a future post. Let us just say here that the current criticism that low carb is expensive has some validity.  It is also true that economies of scale have not yet kicked into the food supply. For sure there will be winners and losers.  We only need to look at what has happened to the cost of solar power as economies of scale kicked in. A technology that was always a great idea but was uneconomic is now economic.

Data from the Solar Energy Industries Association and GTM Research show the inverse relationship between scale and cost. CREDIT: SEIA.org
Data from the Solar Energy Industries Association and GTM Research show the inverse relationship between scale and cost. CREDIT: SEIA.org

However, for the moment Joseph does have solutions that work for him and his community on a budget. As he shows, it doesn’t have to be about grass fed steak, tinned corned beef (which Tongans already eat) is fine.

LOW CARBZ 4 STARTERS & BIG FAMILIES. (Food is medicine)

Joseph has a Facebook group to reach out to people in his community and around the world.  He runs cooking workshops, and his group has a procession of recipes from the one thousand or so members.

Kiwi Tongan Cooking
Joseph Finau shows how to cook LCHF Tongan style

Now one thousand members may be small compared to the 340,000 now in the Ketogenic Lifestyle (Nigerian) group, but with 190,000,000 Nigerians and only 170,000 Tongans and Kiwi Tongans, it is actually quite significant.

What are the lessons for Australia?

Many people have long regarded Tongan diabesity as an intractable problem. Joseph is proving them wrong.

It seems that low-carb can be adapted to almost any cuisine and budget. By analysis of the Nyungar diet and by looking at the work of Prof. O’Dea and (most importantly) consulting with the communities, we should be able to adapt Western food to be closer to the macronutrients that Aboriginal and Torres Strait Islanders became metabolically used to for 30,000 to 50,000 years. It should be possible to make it affordable, available, and it should be more culturally appropriate than the food choices available today.

I am not saying it would be easy. I hesitate to suggest solutions for a people who have had plenty of ‘advice’ from my kind in the past. Social issues are always complex. Any solution must come from their grassroots. We need some champions like Joseph to lead the way to say eating needs to be different. Staple ‘modern’ bush tucker needs to be redefined and delineated from a preference for McDonalds or KFC. Awareness needs to be built about traditional diet and the reasons that fats and sugars are sought after, but need not be consumed in excess. That needs to be internalised. If it is hard for urban dwellers to avoid fast food, then the other side of the coin is poor access to healthy food in remote communities.

In the end, it will be a personal choice. However, if people and communities don’t have knowledge of this option, how can they choose a traditionally oriented diet for optimum health? 

‘Blind Freddy’ can see that the existing approach is not working.  It doesn’t work for the indigenous people of the world, and it isn’t working for us. We need different thinking.

Is a ‘Sugar Tax’ a Solution?

A sugar tax might provide revenue for some change while food supply economics normalise. If we are to have a sugar tax, why not apply it to tax the majority of unhealthy eating Australians to subsidise the food supply of those who may struggle to afford healthy food because of their socioeconomic or geographic disadvantage? Focus the funds on innovation to change ingrained food habits. This would be likely to normalise when the economics of the food supply and demand and supply settle down anyway.

No-one is arguing any more against sugar being unhealthy (apart from the food lobby). Before taxing other ‘unhealthy’ foods, the science needs to be settled.

It is in the nature of researchers to always call for more research funding. Frankly, when you see misguided research that appears to be being undertaken into diabesity, there are much better uses for the money. I am neither anti-research nor anti-academic, but funding should be judicious and focussed on settling the science for starters.

What are the lessons for NZ?

My Anzac cousins, you chose not to federate with us, and I get that. The last thing you need is some Aussie blogger telling you what to do!  Joseph is doing fine, and you have other fantastic people in the low-carb community, but I have to question:

Why on Earth do your bureaucrats and food policy people follow Australia when we think that our dietary guidelines and institutions are dumb and broken?

It perhaps says a lot about the power of trans-Tasman economics over trans-Tasman rivalry, and there is probably a PhD thesis somewhere in that.

I think it is time to assert some of that famous independent Kiwi thinking. Otherwise, pretty soon the change will be over in Australia, and we will claim that Prof. Grant (Schofield) was really an Aussie researcher- just like Split Enz was an Aussie rock band.

Keep Going Joseph

My message to Joseph is simple. You may not have 340,000 group members on facebook but you are like Daphnis, and you are making waves at the grass-roots and leading by example.

You are not half the man you used to be, but twice the man most of us will ever be.

“Kai mate”, my Kiwi Tongan friend, and may that eating be low carb for a long and healthy life.

Nigeria: Sisters are Doin’ it for Themselves

Our Shame

In Australia, our fat-cat bureaucrats, egghead scientists, over-lobbied politicians, salivating not-for-profit CEOs, conflicted dietitians organisations, greedy pharmaceutical companies and over sweetened food industry CEOs are debating obesity strategy and sugar or health taxes. The government has already dispensed a National Diabetes Strategy that this motley crew put together that wouldn’t even make it onto the fiction best seller’s list, let alone solve the problem, as it fails to contemplate changing dietary recommendations as solutions. Taxing us to tackle obesity? Unfortunately, they take themselves too seriously.

As a health consumer, what do you think? Before you answer, I’ll tell you that you should simply not give a damn (or insert your favourite four letter word here). Sorry for the language but when you realise that other than your statistic, it is not about you. Not one of these is truly advocating for you with your chronic obesity or diabetes. It is all to do with their interests like funding for their members and organisations, research buckets of money or profits. They have forgotten you and the experts are dead. After all, if they actually fix your chronic diabetes or obesity, what would they do with themselves?

Meanwhile, In Nigeria…

A quiet revolution is underway. Let us look at something that really should matter to you much more than the business plans and career advancement of all those types above.

Nigeria’s population is pushing 190 million. The traditional diet is quite high in carbohydrates with palm oil and other fats, and it used to be a sign of affluence to be chubby- but not anymore. It has upwards of five percent of those people with diabetes, many more pre-diabetic and far too many are obese. The obesity rate climbed eight times from 1.3% in 1974 to 10.3% in 2014.  Fertility is impacted by PCOS. Yessiree, Nigeria has an insulin resistance problem.

Is Nigeria Lacking Dietetic Advice?

How can this be? Surely most people are not so affluent as to be obese? Nigerians probably have a good deal of plant-based diet as meat is more expensive. They have national dietary guidelines that are just as good as ours. Those guidelines recommend that Nigerians have a rich carbohydrate diet, limit fat and avoid saturated fat. Those guidelines say they should have lots of fruits and vegetables and not eat too much red meat. They have a dietitians association that gives them the same advice as everyone else in the world gets. Perhaps Nigerian Dietitians have the same problem as the DAA in that they have the same fantastic dietary guidelines, but no one follows them. Strangely this is an epic fail in every country, but we keep on doing the same thing and hearing the same excuses.

Perhaps it is all the new sedentary jobs in Nigeria that have caused these health problems? The Internet penetration is at about 52%- approximately 97 million people and about 16 million of those are on Facebook. Of course, to think of Nigeria as a poor, backwards country is not only insulting, it is untrue. There is one key technology statistic they lead in. I noticed that they even beat the United States.

Google Trend

If you search for the term ‘ketogenic’ on Google Trends, you see that Nigeria beats all other places in the world. “It must be some mistake,” you say? It is not. While our societies are nauseatingly debating sugar taxes, how to prevent obesity, coming up with ineffective national diabetes strategies and suppressing low carb for greed under a thin veneer of philanthropy, the ladies of Nigeria are transforming their health and the health of their country.

Now the low-carb deniers are probably going to suggest some tin-foil hat conspiracy. Maybe Prof. Tim Noakes has been commuting North every week spreading his vile message? No. It is a grassroots revolution.

In Nigeria, the low-carb diet is best known under the term ‘ketogenic’ diet, and so it has slipped under the radar compared to terms like Paleo, LCHF and Banting.  

Nigeria Ketogenic search trend
Nigeria Ketogenic Diet Rapid Growth

The Google trend search also shows that adoption has been extremely rapid. From a near standing start, it accelerated in about August of last year. It had the usual January bump that we see in diet trends. What is driving this? No surprises folks. It is because it works and the ladies know it.

Ketogenic Lifestyle

One of the largest groups on Facebook is called “Ketogenic Lifestyle”.  It started posting its ketogenic information in August of last year when the surge happened. It has about 316,000 members and has grown very fast. What may surprise you is that this group caters to provide support for Nigerian low-carbers. Almost all of the members are Nigerian, and the majority are women. How the three admins manage a Facebook group with over 300,000 people is probably worthy of a separate post (and a gold medal)!

This group was started by Joy Aghogho whom some of the members refer to as “Aunty Joy”. Joy is exactly what they feel every time a sister, infertile in the past from PCOS, announces their pregnancy. The posts are a procession of advice and information and then beautiful ladies. Beautiful and large before, beautiful and healthier after keto. They know the keto diet is a therapeutic diet that can counter the health scourges of their country (diabesity) as well as PCOS and epilepsy. There is not a dietitian in sight. These are ketogenically educated ladies, and they seem to know it better than most Australian APDs!

The Numbers

Let us just run some numbers for the bureaucrats and CEOs who may happen to come across this health consumer’s blog. 316,000 Nigerian Facebook users can actually be doubled when you consider that their partners are probably eating keto too. That is four percent of the Facebook user population. Given that societies like Nigeria have very dynamic and active personal networks radiating from each user, that figure may well be a good proxy for the penetration of the ketogenic diet into Nigeria itself. This figure is significant as the official rate of diabetes in Nigeria is 5%, and the ketogenic diet normalises and reverses type 2 diabetes and offers type 1s normal blood glucose. There is likely to be a great crossover between the obese and diabetic population (10.3% and 5%) and the ketogenic diet population.

The Implications

So here are some questions and implications for various people from the ketogenic health explosion in Nigeria.

For Government Health Ministers and Health Bureaucrats:

Will Nigeria beat diabesity before your country even considers the right move? It looks like you need to get away from the noisy lobbyists and interest groups and investigate what is happening for health in our own Facebook communities.

For Pharma CEOs:

Nigeria is probably not even a blip on your sales figures, but you now have a duty to your shareholders to inform them of the risk from other country populations adopting low carb- particularly at the rate of growth seen in Nigeria.

For Pharma Shareholders:

Along with the Credit Suisse report, time to reassess your long-term investment unless your CEO has communicated a clear strategy to manage dietary change to low carb.

For Diabetes Not-for-profits:

Are you really committed to innovation to improve the lives of people with diabetes? If not then find another job.

For Food and Drink Industry CEOs:

Time to stop resisting with marketing that will damage your future brand. Consider what your products will be in a low carb future and like pharma executives- consider your projections carefully.

For Food and Drink Company Shareholders:

Along with the Credit Suisse report, time to reassess your long-term investment unless your CEO has communicated a clear strategy.

For Dietitians and their Not-for-profits:

Even if you STILL think this is a diet fad, shame on you to force health consumers to fix themselves via Facebook. Ignoring this health revolution is making you irrelevant.

For the higher carb chronic disease sufferer:

Time to try what these smart Nigerian ladies know.

For the researcher:

Plenty of epidemiological data here about the mass-effect of ketogenic diets on weight loss, POCS, Diabetes and health. Time to pull out your head and head to Abuja or talk nicely to Joy.

For the existing low-carber:

See what the low carb community can do.
Keep calm and keto on with our Nigerian sisters!

The Death of Experts

Who Killed the Experts?

So the experts have told you that you have a chronic or incurable condition? Maybe you have diabetes, metabolic syndrome or obesity or just cannot lose weight?  Possibly you are someone who wants to understand medical innovation?  Perhaps you were caught by the title and wanted to know how the experts died, who killed them and why?

Let us start to make some sense of an ‘unsatisfactory predicament’.

Chronic Disease

What is a chronic disease? It is a medical problem that doesn’t go away on its own or with finite treatment for complete cure. It may have a symptom or multiple symptoms. Those symptoms may get better or worse in severity over time. You may be taking medicine to manage the condition. It usually isn’t communicable to others and usually isn’t ‘believed’ to be caused by yeast, parasite, virus or bacteria. I say ‘believed’ because it may be that it is and yet the experts do not acknowledge it. It could also be that some organism is opportunistic and remains present or recurs because of low immunity and there is an underlying reason (the root cause).

Our Medical Systems

What happens with chronic disease in our medical system? You see the doctor, and the doctor diagnoses you or refers you to s a specialist who diagnoses you. You take your medicine- which helps- but it doesn’t get better. It is a managed condition.  Eventually, you accept this. The condition is chronic or terminal, and you learn to ‘live’ with it.  The problems continue because you have not addressed the ‘root cause’.

Alternatively, you hop from doctor to doctor hoping for a later opinion to give you a cure. (However, there is a problem with this which we will understand better later). Maybe then after a while, you accept it and learn to ‘live’ with it.  You may manage the condition for the rest of your life.

Complications

Alternatively, you get secondary effects, the condition worsens, and you have unwanted complications like blindness, amputation and kidney failure. You may have more radical treatment like surgery or and eventually, it is terminal. That would be typical for diabetes for example. If it were cancer, say prostate or breast cancer, it could be more aggressive, but the outcome is still the same- a continued decline.

Adding complication, you may have multiple symptoms. You may get depression (or this may, in fact, be your primary problem), hypertension, high cholesterol or any number of other problems. Pretty soon you can be on a cocktail of medicines- polypharmacy- and you need them long term. In a further complication, your livelihood, work, family, and social life may be adversely affected.

Example of Obesity

If you want a simple example that fits many of us, then I give you- obesity.  Well, I don’t literally give it to you because many of us already have this chronic condition.  Is it a disease, symptom, condition, malady or just a fact of life?  Obesity could be any of the above.  It can make us depressed or at least unhappy, and it often gets progressively worse.  We diet and lose weight yet it most often comes back. We follow the experts to ‘move more and eat less’ but despite weight loss industry being worth billions of dollars no one seems to know the root cause.  The best they can say is:”It is complicated.  It is multi-factorial.”. Obesity is a chronic condition, and the experts are dead.  

Whether your problem is obesity, diabetes or something more immediately serious, I would hope for you is that there is an alternative. There is a solution out there to your medical problem. Someone has beaten the incurable problem. Someone is treating the problem successfully and perhaps unconventionally. There is perhaps new research that you could try or a study in which you could be involved. How would you find that?

Type 2 Diabetes and Obesity Solved!

Well if your problem is obesity or type 2 diabetes, then there almost certainly is such a solution.  If you have type 1 diabetes, there is also the chance for marked improvement.  If you remember I said that you could learn by imitation?  You certainly can for those (and related) conditions because the solution I have followed should also work for you.

At this point, medical people would be telling you that I am “peddling false hope”. You see they ‘know’. They are the experts and what is happening to you is what happens to all of their patients. If the best expertise, which they embody, cannot cure you- then everything else is just pseudoscience. I am understanding of that logic, and you also need to be. I would not want to get your hopes up.  What I did may not work for you. The solution to your problem may not surface in your lifetime, or indeed it may be lost in time.

My Case

I can tell you that in my case it was true that I went through years of managing a chronic condition, that if I had the correct advice from the start, would never have progressed. In fact, as it occurs, my problem has reversed by addressing the root cause. I could have saved much heartache and damaged health. In my case, it would have mattered little if I went from expert to expert. The only solution that would have helped me was to understand that, for my problem, the experts were dead. When you accept that metaphor, you can open up the possibility that there is a better solution out there and find it for yourself.

That is not to say that the conventional wisdom is all wrong. What we need to do, while getting the best possible outcome from the conventional wisdom, is to explore the alternatives.

Take a Journey

man on a journey

If that prospect is something you would like to evaluate through my experience, or if you are a medical professional wanting to understand how to lift your innovation game, then this blog is for you.