• Guest - w'd love to know what you think about the forum! Take the 2025 Survey »

Dietitian and Low Carbs

Gudrun

Well-Known Member
Messages
279
Location
Leeds
Type of diabetes
Parent
Treatment type
Diet only
Dislikes
Hmmm.. probably a lot less than stuff I like
What is it with Dietitians and low carb diets?

I was sent to a dietitian last month as my blood sugar kept rising and I'm morbidly obese (BMI 43). I saw her on 12th March and was told to follow the Eat Well Plate with smaller portions (fistsize potato, bread, etc.) and to come back today. I had told her that my main concern is my blood sugar, and my weight only in as far as it impacts my health.

I followed (more or less) her advice for the first 25 days and my blood sugar stayed pretty much the same. I lost 1 kg of weight. Then I joined the Diabetes forum and discovered the joys of Low Carb Medium Fat... For the next 23 days I followed this way of eating and my blood sugar went down from an average of 6.22 in March, to 5.32 for the last 23 days.

I went back to the dietitian today and showed her the monthly average data I had collected since I measured my fasting BS:

August 2013 - 5.57
September 2013 - 5.79
October 2013 - 5.94
November 2013 - 6.05
December 2013 - 5.78
January 2014 - 5.80
February 2014 - 5.99
March 2014 - 6.22

I then told her that I had followed a low carb medium fat diet and my average blood sugar is down now to 5.32 (and I lost another half stone in the last 3 weeks).

She didn't know what to do.... She kept congratulating me at how wonderful my results were, and in the same sentence told me that I must incorporate starchy carbohydrates with my meals. "but why?" I asked and pointed to the better results in lowering BS. She told me that low carb eating would damage my kidneys. I asked her to explain in what way the kidneys would be damaged and she was a bit evasive... kept saying that it could eventually lead to dialysis and kidney damage, even kidney failure. I pressed her for more specific reasons and research and finally she confessed she didn't know but would have to read up on it.

She pointed to the damage caused by saturated fat and again I asked her for specific research into this as compared to the damage caused by diabetes.

Poor woman... I think she was glad when I finally left. She did say in parting, that she is obsessed with carbohydrates. I could detect a definite sigh of relief when I said I don't need to see her again
 
awesome its all part of the change, and now you are a part of it its not actually their fault, they have been taught a certain thing and its hard to accept their tutorings where wrong, but we know the truth
 
Congratulations on the BG control and the weight loss. That is brilliant. I have a theory about why the dietitians promote the higher carb diets. One of the other forum members found some papers published in the 40s that said high carbo diets helped control blood sugars.

I believe that back in the day a high carbohydrate diet was not so much bread and potatoes and pasta but was high in lower calorie dense vegetables. The big difference was that the typical high carbo diet included high volume of fiber over 50g a day.

I think that the dietitians forget this fact - supposedly the true paleo diet would include over 100g of fiber a day. Just as we all forget the pigs fat is far different nutrition wise than pigs fat was a century ago - pigs forged for food and are grubs etc instead of corn feed and rendered blood products.

I've found that if you plan your meals targeting 50g of fiber a day of NOT calorie dense foods or fiber supplements you end up eating a lot of carbs to get that 50g of fiber.

Anyway that is just my opinion.


Sent from Runner2009 Burt
 


Thanks, Burt.

To be honest, I don't measure how many carbs I eat. Having cut out bread, pasta and rice completely, and eating potatoes no more than once a week I tend to eat pretty much whatever else I fancy. I do eat quite a bit of vegetables, but never really checked their carb content. Still, as long as the BS (and weight) go down, I feel I'm ok.

I have read some of your posts before and I think you are very much a man who goes into whatever you do systematically and thoroughly, with research and statistics to back it up. Well done for that. I think we can learn a lot from you.
 
Good work Gudrun on the weight loss, bg control and challenging your dietitian!

Like you, I don't count carbs. I just avoid all the carb-heavy foods and eat what is left over. It works for me.

I was warned too about damaging my kidneys if I low carbed. The assumption was that I would have to increase my protein if I dropped my carbs. Never occurred to her that I would increase my fat instead
 
Hi Gudrun! Me too! Don't have the potatoes as not keen on them - apart from crisps and chips - lol! Don't count either! Great bs - well done! Plateaued last 2 weeks! Driving me nuts but keeping the faith! Now between a 16-18. Yay!
Dn at hospital exactly the same - can't wait to go on their "education" course - I think I might cause havoc when I mention my results!
Good to hear it's going well! Take care!
 
Well done on your blood sugar control

Well done on collecting and delivering your evidence

Well done on standing up for yourself

And WELL DONE for for finding out what works for your body, and sticking to it!
 
What the nurse is referring to is an increased risk of ketosis because the lchf way of eating reduces your insulin production and as your eating low carbs less glucose is being produced and your body is relying on energy from the fat when that burns up your body burns it's fat and muscle. I'm surprised your nurse wasn't able to give you this answer tbh. Just be sure to get your urine tested.
 
I have been asking for this reply for the past 3 months. When I asked my dn, as I was trying to get my head round this, she stone walked me. I also asked the consultant and was told you are burning the wrong kind of energy but wouldn't elaborate further. As I've got stacks of fat to burn (I could probably supply enough energy to keep a whole village going) I won't worry fora while but will keep an eye on my pee. Thanks for the heads up!
 

Thanks for the explanation. It does seem odd that the dietician couldn't tell me about ketosis. I agree with Scandichick, though... having so much fat to lose there's plenty of energy to burn up before it uses up muscles.
 
You can get ketone-detecting strips to dip in your urine to test whether you are in ketosis. But this won't really prove anything except that you have been using fat as fuel. The fat could have come from bodily fat stores or food.

There have, at various times, been theories that high protein and high fat diets damage the kidneys, due to the extra work the kidneys have to do to eliminate the wastes from these diets.

This is what probably causes the knee jerk ketones-are-bad reaction in medical staff.

However, I believe that recent studies have established that prolonged periods of ketosis only affect kidneys that are already malfunctioning. Healthy kidneys cope perfectly well. So it probably makes more sense to test for kidney damage than for the presence of ketones!
 
Gudrun said:
I have read some of your posts before and I think you are very much a man who goes into whatever you do systematically and thoroughly, with research and statistics to back it up. Well done for that. I think we can learn a lot from you.
Click to expand...

Thank you for such kind words. I can't describe how frighten and overwhelmed I was when first diagnosed.

I wish I had found this forum at the beginning. The people and support and knowledge I've found is beyond amazing.

Late this afternoon I had the worse hypo I've had in months. I could not feel it coming on except when I started feeling irritated with our little dog and wanted to kick it.

I got very muddled in my thinking and wanted to lie down on the floor.

I forced myself to eat some sugar cubes but could hardly open the jar.

It took about 3-hours to start feeling well and lucky this time I didn't over eat.

I'm not sure what the difference is as I've not been exercising for the last week as I hurt my back.

As my dad used to say 'sometimes things just happen' and for me sometimes not knowing isn't enough.


Sent from the Diabetes Forum App
 
Gudrun said:
I agree with Scandichick, though... having so much fat to lose there's plenty of energy to burn up before it uses up muscles.
Click to expand...

Hey Gudrun I'm not 100% sure about this and mentioned this on a previous post, but it was my understanding that your body when in ketosis first uses up all the glycogen and then goes after muscle and protein and lastly fat.

So according what I was taught you have to watch for muscle loss and eat more protein.

I'm not sure if this has been replaced with updated info?


Sent from the Diabetes Forum App
 
runner2009 said:
Late this afternoon I had the worse hypo I've had in months. I could not feel it coming on except when I started feeling irritated with our little dog and wanted to kick it.

Sent from the Diabetes Forum App
Click to expand...

Sorry to hear about your hypo, Burt. I have never experienced something like this (being 'only' prediabetic), but I remember my mother having it a few times, and not knowing where she was or what to do. It certainly sounds a scary sensation to have and one to avoid it at all possible. You said you didn't feel it coming? Do they come suddenly, without warning? If your fist knowledge of this hypo was wanting to kick your dog, then we have to be aware of mood swings (is that a symptom?).

I do like your last sentence... Not knowing isn't enough. Well said and it is exactly how I feel. I hate to follow blindly someone's instructions unless I understand why they are given and what is to be achieved.

I'll have a browse around ketosis on the web and see what I find. I don't really eat that much more meat than before. What I have increased is a little more fat and that seems to have taken the cravings of carbs. I think my portions are smaller and I snack less between meals.
 


Well, that's me done for! I already have kidney disease and I only have one kidney! I hope she's wrong!
 
SJC said:
Well, that's me done for! I already have kidney disease and I only have one kidney! I hope she's wrong!
Click to expand...

Hi,

I suggest you do a bit of reading on the subject.

I may be wrong on the details here (you can check whether I am right!) but I think that
  • ketoacidosis is very bad for the kidneys - caused by very high blood sugar
  • Ketosis - caused by low carb and/or high protein diets - makes the kidneys work harder, eliminating the ketones, and need to be approached with care by people with kidney problems but can be made to work
  • Low carb diets can be either high fat, or high fat + high protein - it is the high protein that causes the problems
  • I am not aware that eating high fat affects the kidneys
  • High fat diets do not automatically result in weight gain - you just substitute the calories you were eating as carbs, with calories from fats, preferably healthy fats
So you can still go low carb without harming your kidneys, you will just have to watch your protein intake doesn't get too high. You can get your calories from fat instead of filling up on carbs and excess protein.

But please do not follow this advice without checking the facts first!

These links may start you off, and I'm sure others will be along to correct me, or give further links.

Somewhere on this site is an analysis of a study looking at the effect of low carb diets on kidney function
http://www.bloodsugar101.com

This site gives lots of information on Low Carb Healthy Fats, not necessarily high protein
http://lowcarbhealthyfat.com
 
@Brunneria

I've heard and read conflicting accounts of whether high protein damages kidneys.

Is there any studies that prove this and have a handle on just how much protein is considered high?

It is my understanding that if your kidneys start leaking protein you have about 10-years time before you end up in end stage renal failure.

Just don't know that much about it


Sent from the Diabetes Forum App[/b]
 
Last edited by a moderator:
SJC said:
Well, that's me done for! I already have kidney disease and I only have one kidney! I hope she's wrong!
Click to expand...
Well HFLC diet has raised my eGFR by 18 since I started SO FAR (from 18 to 36)
 
You must log in or register to reply here.
Menu
Log in
Register
Cookies are required to use this site. You must accept them to continue using the site. Learn More.…