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NHS Dietician or Nutritional Therapist ?
- Thread starter Celeriac
- Start Date
ButtterflyLady
Well-Known Member
See post #3 where donnellysdogs talked about health professionals such as dieticians toeing the NHS line, using her GP's views on the flu shot as an example. I wanted to comment on it because of the importance of the flu shot for diabetics, in case a new member read it. I think next time I will just a new thread, it's less hassle.
Celeriac
Well-Known Member
OK thanks for that. I have had the flu shot every year since diagnosis and my husband used to have it every year when he worked in NHS and had a lot of patient contact. I don't believe any of the Daily Mail stories about dementia and flu vaccine and I know how badly colds affect me.
donnellysdogs
Master
Yes it was a comparison: sorry for the confusion. I'm sure the question of flu clinics and injections will arise shortly as our flu clinics start in October.. So we'll all be getting letters and reminders!!
Sorry that my comparison detracted from the nutrionalist / dietitian debate...I still think NHS dietitians and indeed nurses etc have to follow the NHS guidelines unless like Southport GP when he has been able to use his voice and comments as a study...
My nurse and consultant who back my choice of foods do it in a very subtle choice of wording... They also compare it their own life's and choices.. They don't use their wordings as actual advice to me on diet.. Just friendly comparisons of how we diets are similar etc to each other because of food intolerances... Very subtly agreeing in a form of friendliness rather than official NHS advice.
Perhaps that is the difference between the NHS dietitians advises ... They have no actual living with illnesses and blood levels, intolerances to gain experience of actual living and managing. Perhaps thats why like my nurse feels anle to discuss how she limits certain foods because we literally are only discussing how we help ourselves naturally...
Sorry that my comparison detracted from the nutrionalist / dietitian debate...I still think NHS dietitians and indeed nurses etc have to follow the NHS guidelines unless like Southport GP when he has been able to use his voice and comments as a study...
My nurse and consultant who back my choice of foods do it in a very subtle choice of wording... They also compare it their own life's and choices.. They don't use their wordings as actual advice to me on diet.. Just friendly comparisons of how we diets are similar etc to each other because of food intolerances... Very subtly agreeing in a form of friendliness rather than official NHS advice.
Perhaps that is the difference between the NHS dietitians advises ... They have no actual living with illnesses and blood levels, intolerances to gain experience of actual living and managing. Perhaps thats why like my nurse feels anle to discuss how she limits certain foods because we literally are only discussing how we help ourselves naturally...
ButtterflyLady
Well-Known Member
Personal experience of living with a condition is valuable, but not necessary when giving professional health advice. There are thousands of illnesses, and professionals can't be expected to have personal experience of them. The way knowledge is found and shared within health professions is adequate and legitimate. It's the unprofessional style and manner of some professionals that weakens public trust in them, not the inadequacy of the knowledge they hold. Personal experience is valuable and often very interesting but it is not as reliable as scientific knowledge, because of the way that knowledge is found and agreed on.
donnellysdogs
Master
Its just why nobody can give official advice about less carbs than the 230g upward per day within NHS circles when talking about diabetes. Its allowed for epliepsy or say for other problems such as needing less fat or fibre due to kidney or liver or gall bladder or spleen probs.
They don't mind us T1's basal testing for 10hrs without carbs-lol.
My gastro chap is good at recognising that due to SCT I Can't eat heavy carbs such as bread etc so why are NHS people for diabetes so against less carbs??
ButtterflyLady
Well-Known Member
Do we know for sure that no NHS-employed endocrinologist ever says reducing carbs is good for diabetes? I don't think we could ever know that. There are anecdotal reports on this forum of NHS health professionals who do accept the current research about carbs.
It's true that most NHS nurses, dieticians, and GPs repeat the party line, but that's likely because they don't have the level of training and experience that an endo has. The body of research literature about carbs is increasing and I believe one day it will be so impossible to ignore that it will become guideline and then slowly all these people will need to change what they are saying. It will take a long time. In the meantime, endos have the skills to be up to date and the freedom to use their medical training and position to be able to say what they believe the research shows. So I think they are the ones who are most likely to start talking about low carbing. Dieticians will probably be the last, because carbs are so ingrained in their knowledge base that is used for training. Changing what they say will really require turning the juggernaut around.
The examples of other conditions that you mentioned are all areas where the role of carbs, fat and fibre have been known by researchers and guideline-writers for longer and are more accepted as mainstream in those specialties. As an example, carbs worsen SCT because of the obvious effect they have inside the gut within hours of eating. This is quite different to the effect carbs have on blood glucose over several days. There are more steps involved as the carbs are digested and metabolised. It's harder to demonstrate the effect and to communicate it in ways that guideline writers and their audience will accept. But it's not impossible.
Celeriac
Well-Known Member
The only UK doctors espousing fewer carbs that I'm aware of, Dr John Briffa and Dr Charles V Clark are both in private practice, thus avoiding censure from NHS over low carb.
Jamie Oliver was making a documentary on sugar and I saw a photo of him with Dr Lustig and Dr Malhotra on Twitter but haven't seen anything else about it - has it aired yet ? Jamie has been very anti-Paleo diet though.
Jamie Oliver was making a documentary on sugar and I saw a photo of him with Dr Lustig and Dr Malhotra on Twitter but haven't seen anything else about it - has it aired yet ? Jamie has been very anti-Paleo diet though.
SunnyExpat
Well-Known Member
Mine has no problem at all with my diet.
(Well they did when I was obese, but then they were against carbs, fat, and protein.)
I lost weight, I have normal bloods in all tests, I'm obviously healthy in all other aspects, I actually haven't met anyone who is obsessed with carbs in the NHS.
They all seem pretty much 'take it or leave it' if it works.
But possibly perceptions of the NHS advice are different to each of us, as I'm not personally anti carb, as even shortly after diagnosis and much testing, I soon saw they didn't all affect me in the same way.
So maybe what they say to me could be said to someone else, who may hear it completely differently.
Sid Bonkers
Well-Known Member
The NHS dietician I saw was quite happy that I was dieting and eating around 60g of carbs a day, the only comment she made was that I should eat more oily fish but as I dont happen to like oily fish that never happened, dont knock NHS dieticians unless youve seen one
@Celeriac; A registered dietician takes A levels and a degree plus years of dedicated training where as a nutritionist is a made up title that I could use if I had a mind to. I would put my trust in a registered and trained dietician every time but the choice is obviously yours.
Read my comment above not everyone has a negative experience with a dietician, I had to supply a 2 week food diary, I was eating approx 60g of carbs a day at that time and she wasnt fazed by it at all and this was 5 years ago now, she could see I was losing weight and was well controlled. She did make some useful recommendations and I got a lot out of it, but I did go in with an open mind, Ive always found that building a good relationship with doctors and other health care professionals to be to my advantage, I wouldnt go the extra mile for a client that I didnt like or was rude or hostile to me and I wouldnt expect someone I was hostile to do either
so even if they dont always agree with you if you have a good working relationship you can usually expect a better response IMHO.
Celeriac
Well-Known Member
Thanks for that Sid. I may ask my GP if he knows any of the local registered dieticians and what their attitude to low carb is. I don't mind paying out £50 but not for quackery.
What I want to know, is whether the range of poultry, fish,vegetables, game and meat that I eat, contain all the necessary nutrients and are there any which I should be eating more of just because I have diabetes.
I did a food diary for my GP. He looked through it and told me I was eating too many ready meals. Told him that we cook everything from scratch and he gave a rueful smile and said that I was eating better than him !
What I want to know, is whether the range of poultry, fish,vegetables, game and meat that I eat, contain all the necessary nutrients and are there any which I should be eating more of just because I have diabetes.
I did a food diary for my GP. He looked through it and told me I was eating too many ready meals. Told him that we cook everything from scratch and he gave a rueful smile and said that I was eating better than him !
amanda19640
Well-Known Member
Went to see my dietician tod, had the usual comments there is no evidence to prove that lchf is beneficial, but did suggest I eat less carbs, she could see how well I had done in a month, & I told her that without all the help, advice & support iv had from this forum I would be a mess, so thank u guys xx
NoCrbs4Me
Well-Known Member
Here in Canada, HCPs seem to have had very little interest in my diet. None of my GPs ever asked what I ate. The dietitian and diabetes nurse both pushed the standard government recommended diet on me: oatmeal for breakfast, lots of whole grain bread/pasta, low fat, very little red meat, lots of fibre, etc. When I finally had a consultation with a doctor that specialized in diabetes, I told him what I ate (meat, non-starchy vegetables, cheese, full-fat yoghurt, etc), he said that it was an excellent diet. We had a nice discussion about how unhealthy refined carbohydrates and factory processed food are.
@Celeriac, you are probably wasting your time and money trying to get an answer to your question. The reality is that nobody knows what the optimal diet for humans is. However, I'm pretty sure that your diet of poultry, fish,vegetables, game and meat has sufficient micro-nutrients.
@Celeriac, you are probably wasting your time and money trying to get an answer to your question. The reality is that nobody knows what the optimal diet for humans is. However, I'm pretty sure that your diet of poultry, fish,vegetables, game and meat has sufficient micro-nutrients.
Celeriac
Well-Known Member
Before seeing NoCrbs4Me's post I had Googled 'Registered Dietician', and found that there are some who work privately, and around five in my county. Nosing around the BDA website I found a factsheet for T2DM and although it did yawn on about starchy carbs there actually is a paragraph mentioning low carb https://www.bda.uk.com/foodfacts/diabetestype2.pdf
I hope my diet is adequate, but I'd like to be sure. But what I think I'll do is talk to my GP first.
I hope my diet is adequate, but I'd like to be sure. But what I think I'll do is talk to my GP first.
SunnyExpat
Well-Known Member
Nobody?
Darwinism tends to suggest otherwise.
amanda19640
Well-Known Member
I agree
SunnyExpat
Well-Known Member
I've read that before.
Some on here have said they get a three hour lecture.
Mine trained for 10 years.
Maybe she did more than one rainy Tuesday morning in the ten years she trained for.
Maybe she didn't.
SunnyExpat
Well-Known Member
That's a loaded question.
Would you really be happy to pay £50 to someone you know is happy simply to say what you want to hear to justify your opinion?
I'd rather pay £50 to someone to tell me what they believe, and have a valid argument to justify it.
If you want to be told you are right, I'll do it for £20.
I'm a holistic nutritionist.
ButtterflyLady
Well-Known Member
I think it's safe to say the answer to your question is likely to be no, there aren't any foods you should be eating more of just because you have diabetes. That is most likely what your doctor would say.
