Why the opposition to low carb?

[low carb dietitian]

Why are many national diabetes and dietetic organisations opposed to low carb diets in the management of T2D, despite proven efficacy? What’s happening in Australia may provide some insight.


Investigative journalist Marika Sboros of Foodmed.net recently published a four-part series on DAA conflicts of interest, and the DAA’s (Dietitians Association of Australia) treatment of three dietitians.


The fourth post includes the story of my deregistration by DAA after a complaint was made that my recommendation of low carb diets for diabetes was not evidence based.

http://foodmed.net/2017/01/30/daa-targets-dietitians-with-fake-news/


I’d love to know what you think.

 

[Deleted member 308541]

I have not read your links yet.

The diabetic educator I see here in Bundaberg did not bat a eyelid when I said I was following a LCHF diet. She said I was going in the right direction and was very pleased with me.

How ever another CDE/ Nutritionist in Bundaberg is a bit of a rip off artist by charging patients on a healthcare plan $90.00 for the first free visit.

Needless to say I told her where to go when she tried it on when making a appointment. I have no idea what diet she was pushing, but I would bet that it was not LCHF.

Sorry to hear you were deregistered though.

Edit: extra info

 

[jay hay-char]

Hi there; I'm sorry to hear about your problems. I think perceptions are in the process of changing but it's a long haul.

Official UK guidelines are still that you follow a "balanced plate" diet with quite a large proportion of starchy carbs included. Dieticians and other healthcare professionals feel compelled to follow the official line because they are potentially exposing themselves to the same kinds of problem that you have encountered if they don't. Having said which, the Practice Nurses at my surgery are well aware that I follow a low carb diet but have never remonstrated with me about it beyond a token statement in the early days saying that what I'm doing does not reflect official advice. In fact, having run through my numbers at my last review, and told me that they were very good, the Nurse said "whatever you're doing, keep on doing it". The phrase "Low Carb Diet" was never mentioned, but I think it was what they call a coded message

Incidentally, you may get more of a response to your post if you have it moved to the Low Carb Diet Forum (apologies if you've tried posting there already). @Administrator can move it for you, should you wish.

 

[BarbaraG]

The NICE guidelines of 2015 talk about patient preferences and personalised Carbohydrate targets. This is a softening of the stance towards low carb, which means if you tell your team you want to manage your diabetes with a keto diet (for example) they are supposed to support you in doing that rather than tell you to eat more bread.

What it doesn't do is encourage them to promote low carb. In practice that means that only those doctors, DSN's and dietitians who have seen the low carb light will actively recommend it to their patients. So far they are a small minority, but appear to be growing.

As to the question in the OP - why the opposition - I dunno, it beats me! "fat is bad" is so ingrained in common knowledge it takes an avalanche for people to think differently.

I 'celebrate' 19 years since diagnosis this month. I can remember the nurse giving me the diet leaflet, which was all low fat, and saying "we were killing diabetics with all that fat we were feeding them"

 

[catherinecherub]

Moved from General Chat.

 

[walnut_face]

There is no money in it for the food 'industry' nor the phamaceuticals . IMHO there are many vested interests at stake if suddenly the market for meds shrinks ( along with our waistlines) and the cornies stay on the shelf.


Edit: Hope you have found gainful employment.

 

[Squire Fulwood]

Phrases like "We support the evidence-based Australian Dietary Guidelines (ADG), " do not sit well with me. In particular it's the words "evidence-based" that give me difficulty. How can anyone possible carry out a double blind RCT type study on a subject like this.

None of it bears any resemblance to any dietary advice I have been given. I was handed one diet sheet published by the British Hypertension Society and another typewritten one that looked like a nanny ran it up on a wet Sunday afternoon.

It all leaves me with the impression that dietitians are a self seeking club that is beginning to see a problem coming in the near future and are trying to keep the gravy boat afloat. (See how I got a food item in there).

 

[carol43]

Hi Jennifer, lovely to see you on our site and sorry that you have suffered from such a blinkered view in your country.

 

[Tophat1900]

Because they cannot admit they're wrong. There is no other word for it. Wrong. To admit it would bring forth a huge amount of legal action imo.

The current baseless guidelines are why there is an epidemic of obesity and diabetes world wide. There is no evidence to support the current guidelines. None back in the late 70's when guidelines were introduced in the US and everyone else just followed that blindly like sheep. And there is none to support it still, bit hard to claim the current guidelines are the result of expert doctor and dietician based advice... when there has never been any.

The advice handed out by diabetes Australia has never improved any of the health parameters of anyone, if you are T2 you end up on insulin and then taking more and more insulin, struggle to control weight and avoid complications. Their method is treat the symptoms and keep treating them as they get worse... blind to the fact they are making those worse. Or you decide to educate yourself and start making positive progress rather then listen to ignorant advice that is slowly killing you.

Not my idea of health care...

 

[Lamont D]

I do believe that the dietary advice given to diabetics is similar for all types! (Regardless of type!) And of course we should all eat a certain amount of carbs (150gms) because we risk brain function!
It is also, the best balanced healthy meal for normal (not diabetic) people!

When you add what posters have already said, that is why?

Vested interest is the major cause!
Non diabetics not thinking for themselves advising a healthy diet, but what is healthy for most non diabetics, is not healthy for those that are!

If people have intolerance to food types, why ask them to eat it?
Would doctors prescribe eating peanuts if you have a peanut allergy?
If you have a carb intolerance, why insist that you must eat them?
Oh yeah! Brain function! If you need so much glucose (carbs) to deter mental health issues, then why has it made my brain more lucid and being away from carbs has improved my health so much! You don't need that level of glucose.
Glucogenesis will assist most people when necessary!

Finally, I have been told that I'm insulin intolerant and glucose intolerant! As well as carb intolerant! (Not my words!)
How do I live a healthy full life at my age!

It it completely the opposite of what I had been told to do, dietary advice, by GPs, dsns, dieticians, specialist and until my present endocrinologist agreed with me, that eating like I do (ultra low carb) is so healthy for me!

Finally (2)!

If someone who has just been diagnosed with T2 or prediabetes, the simple fact that reducing your carbs and sugars, reducing your plate size and increasing your exercise in most cases can have such a really good effect on a person's likelihood of complications later in life!

Sorry about your job, there is always something along the way and I'm sure with the good knowledge you have on low carbing, you will soon get work!

Best wishes.

 

[JRTwalker]

Hi there; I'm sorry to hear about your problems. I think perceptions are in the process of changing but it's a long haul.

Official UK guidelines are still that you follow a "balanced plate" diet with quite a large proportion of starchy carbs included. Dieticians and other healthcare professionals feel compelled to follow the official line because they are potentially exposing themselves to the same kinds of problem that you have encountered if they don't. Having said which, the Practice Nurses at my surgery are well aware that I follow a low carb diet but have never remonstrated with me about it beyond a token statement in the early days saying that what I'm doing does not reflect official advice. In fact, having run through my numbers at my last review, and told me that they were very good, the Nurse said "whatever you're doing, keep on doing it". The phrase "Low Carb Diet" was never mentioned, but I think it was what they call a coded message

Changing attitudes and our NHS policies is like turning the oil tanker whilst moving at speed. It takes far longer than it ought, especially when Diabetes is used so often as the reason the NHS is creaking at the seams.
The Obesity clinic near me has a mural on the wall of the waiting room promoting starch and five-a-day fruit & veg whilst discouraging anything with fat. I often wonder what influence the food and low-fat dieting industries have over our UK establishment that prevents changes happening as they should? I think we can probably guess the answer though.

 

[Lamont D]

I've just remembered something that my present endocrinologist said to me about two years ago when he noticed my fruit intake.
He said for a normal person (non diabetic) the balance of portions of fruit, vegetables for a healthy diet should change from five of each to seven veg, three fruit!
So if he is advising that, what should it be diabetics?

Fruit is a form of fructose, which is obviously glucose!

 

[Squire Fulwood]

Oh yes, and if I didn't make myself clear before, welcome Jennifer, it's good to have you aboard.

 

[992947x]

I've just remembered something that my present endocrinologist said to me about two years ago when he noticed my fruit intake.
He said for a normal person (non diabetic) the balance of portions of fruit, vegetables for a healthy diet should change from five of each to seven veg, three fruit!
So if he is advising that, what should it be diabetics?

Fruit is a form of fructose, which is obviously glucose!

My understanding is that fructose and glucose are quite different, and are matabolised differently. Fructose is more likely to be turned into fat than glucose, and less likely to raise blood sugar as much as glucose. Fruit usually contains both glucose and fructose.

 

[Squire Fulwood]

At the risk of getting another smack round the head Professor Lustig says that fructose is metabolised into fat within the liver and so contributes to fatty liver.

 

[GrantGam]

It's an interesting concept...

Before I go any further, I do not entirely support the NHS "eat well" plate or whatever it's called. To base a meal on starchy carbs is inviting extra work load for the diabetic, regardless of type...

What I find interesting (and quite entertaining) is the fact that many dieticians are not quite, how do we put this, "well maintained" themselves. I can imagine that those dieticians who are active and fit, probably don't consume anywhere near the circa 300g/day of carbohydrate, currently endorsed as a "normal" diet. But ask them "how many carbs a day is okay to eat?", they can only really answer from the current NHS guidelines - as opposed to what they may do themselves...

 

[bwims]

"Why are many national diabetes and dietetic organisations opposed to low carb diets"

Mainly because if we all ate low carb diets, only a tiny number of these people would be needed - if indeed the remaining requirement could not be addressed by General Practice. This is why many of their organisations are funded by producers of high carb foods.

 

[JRTwalker]

For me, sugar is sugar and carbs are carbs and most fruit have more than I want. I used to eat a banana for breakfast but an average size fruit has 17g of Carbs. Apple 13g, Orange 13g, dried Cranberries 24g for 30g of fruit. If you want to keep daily intake at less than 40/50g then 5-a-day will likely blow this out. Vegetables are on my menu but not root vegetables and peas in small quantities only. Mainly courgette, broccoli, cauliflower, green beans, cabbage. Asparagus also good and I'm getting used to avocado. A good-sized baked potato will have as much or even more sugar than a can of full-fat Cola although I recognise it has much more nutritional value otherwise.

 

[Doriand]

Why are many national diabetes and dietetic organisations opposed to low carb diets in the management of T2D, despite proven efficacy? What’s happening in Australia may provide some insight.


Investigative journalist Marika Sboros of Foodmed.net recently published a four-part series on DAA conflicts of interest, and the DAA’s (Dietitians Association of Australia) treatment of three dietitians.


The fourth post includes the story of my deregistration by DAA after a complaint was made that my recommendation of low carb diets for diabetes was not evidence based.

http://foodmed.net/2017/01/30/daa-targets-dietitians-with-fake-news/


I’d love to know what you think.

My wish is to live long enough to see Dieticians, Diabetic Nurses, Doctors and all other health 'professionals' (as well as state and federal Health Ministers) admit that following a 1950's health model of low fat low calorie diet IS WRONG! I am so sick of DAA's 'evidence based practice'. My own evidence based practice is: I eat high carb meal, my BSL will increase. I eat a HFLC meal my BSL will remain the same. Maybe that is too simplistic for those university trained 'professionals'. One last thing, why is the head of DAA ... uhmm, a bit, uhmm 'un-thin'? Maybe she follows the food pyramid too closely

 

[low carb dietitian]

Moved from General Chat.

Thanks for moving my post, Catherine