NHS Dietician or Nutritional Therapist ?

[Celeriac]

I have T2DM and eat low carb organic or wild food.

My GP is neutral on that and my ophthalmic consultant very much pro organic. I saw a DSN who was against low carb and in the end I resorted to distracting her with my husband (who was an NHS manager then) so they had a chinwag about other stuff instead

IMO, food is the first line of attack against diabetes, so I'm invested in giving my body the right nutrition.

To me, that means removing all processed carbohydrates firstly, so that the carbs in my diet come from natural sources only. I feel that it makes sense to remove foods which my body has problems processing.

The second step, for me, was to remove as many of the additives and pesticide residues as I could by going organic. This should mean also, that I'm not ingesting second-hand genetically modified organisms, antibiotics and growth hormones.

Currently, I'm working on a document to list the nutritional content (where stated) of everything I buy.

I want to go to my GP and get tested for B12 for example along with my routine bloods.

My plan is then, is either to take GP up on his dietician offer or seek an appointment with a nutritional therapist.

So, I'm interested in hearing your experiences with NHS dieticians, especially if you low carb.

Secondly, there is a nutritional therapist in the next town, with a degree in nutrition from an Aussie uni. An appointment with her is £50 for an hour. Has anyone consulted a nutritional therapist or non-NHS dietician ?

Thanks in advance !

 

[urbanracer]

An NHS dietician or even diabetician, is extremely unlikely to advise you to low carb. They will most likely tell you to eat a balanced diet and that fatty foods are bad for you because that's been the the standard view of doctors, scientists and institutions for decades.
There are an increasing number of reports in the media about sugar in foods, there hasn't quite been a large scale connection with carbs yet but this view is changing slowly.
So you may get lucky and find someone who is prepared to offer some forward thinking advice but as long as being on a balanced diet remains the mantra of the NHS, these people will be few and far between..

 

[donnellysdogs]

@Celeriac. Your food lists sound like mine. I eat totally unprocessed non additive foods...

I am lucky that my current consultant is 100% behind me as she sees the difference that this has made to me and my bloods and health. She is also Indian and believes in items such as coconut oil, good vegetables, home cooking etc. my dsn is also a low carber due to her own food intolerances. So I am lucky. I have never seen a dietitian or nutritionalist in 30 years. A previous dsn and folk here at one point suggest to me that I had porridge or bread/toast for breakfasts but this was horrendous for me personally.

I would speak or email with the nutritionalist before paying. I think you can get a good clue about people from this..
NHS dietitians.. From what I hear only... They have been taught the NHS way and daren't veer from it.

An example of this sort of thing is my GP who I know quite well. To patients directly he has to encourage flu jabs... To me privately he doesn't and says why should we fill our body with toxins each year when flu is likely only to affect us once in 40 years and that can't even be sure of targetting the right flu strain...

So dietitian wise with NHS I personally would not go to see them until NHS advise changes.

I have lived lower carb for best part of my 52 years. I have been pretty much a size 8/10 for my adult life only putting on weight when I tried adding in toast etc.

I found out this year that in 2003 I should have been advised about intolerance to aspartame and sweeteners. Although I have never had a lot of them I have cut unnatural additives and preservatives and sweeteners out totally.

Personally I prefer to use Dr Google now as I believe people that are educated in nutrition only follow guidelines that they were taught. They don't live in our bodies or realise the impact of intolerances. I am lucky with my diabetic care team at hospital that they have experiences themselves. My GP care team from my Practice have no experiences and go on their taught education only. I also dislike it because they are physically looking obese themselves and yet will not entertain the idea that I have intolerances to carbs due to watching my bg's and SCT as well.

Not consulted either just due to the above reasoning....

 

[NoCrbs4Me]

I have T2DM and eat low carb organic or wild food.

My GP is neutral on that and my ophthalmic consultant very much pro organic. I saw a DSN who was against low carb and in the end I resorted to distracting her with my husband (who was an NHS manager then) so they had a chinwag about other stuff instead

IMO, food is the first line of attack against diabetes, so I'm invested in giving my body the right nutrition.

To me, that means removing all processed carbohydrates firstly, so that the carbs in my diet come from natural sources only. I feel that it makes sense to remove foods which my body has problems processing.

The second step, for me, was to remove as many of the additives and pesticide residues as I could by going organic. This should mean also, that I'm not ingesting second-hand genetically modified organisms, antibiotics and growth hormones.

Currently, I'm working on a document to list the nutritional content (where stated) of everything I buy.

I want to go to my GP and get tested for B12 for example along with my routine bloods.

My plan is then, is either to take GP up on his dietician offer or seek an appointment with a nutritional therapist.

So, I'm interested in hearing your experiences with NHS dieticians, especially if you low carb.

Secondly, there is a nutritional therapist in the next town, with a degree in nutrition from an Aussie uni. An appointment with her is £50 for an hour. Has anyone consulted a nutritional therapist or non-NHS dietician ?

Thanks in advance !

Sounds like you have absolutely no need to consult with a dietitian or a nutritional therapist.

 

[Robbity]

I was expecting to see a dietician along with my other original check up appointments, but that one never materialised. Having learned what I know now, both with respect to what I need to eat to manage my glucose levels, and what I've learned about current NHS one size fits all dietary recommendations, I'd turn it down flat if I was offered an appointment now.

So personally I feel you'd be throwing away good money as you sound as though you're doing fine on your own, but I think perhaps it's worth asking yourself what do you believe you're going to learn from a consultation that you don't already know?

Robbity

 

[Celeriac]

Thank you all for the replies ! X

What I want, is for someone to be able to pinpoint micronutrients which I might need to eat more of.

My approach was to Google lists of foods from many sources, which came up as being pancreas-friendly, heart-friendly, liver-friendly kidney-friendly etc and try to make sure that I eat as many of them as I can within the low carb framework. I haven't dug into the antioxidant, flavonoid, plant sterol etc micronutrients.

Also, I don't want to exclude something which newer research shows could be a positive thing for my health, if I can eat it,

I have noticed that low carb advocates all seem to differ on vegetables. Radishes, carrots, fennel, celeriac, swede, butternut squash and pumpkin are allowed or forbidden by different people. If I knew how much of the vegetable was considered the optimal nutrient-giving amount, I could check with my meter and decide whether I needed to find an alternate, instead of just ditching all of those.

It is sounding like NHS dieticians do the same as the DNS, ie toe the NHS line. If they aren't up to date with new thinking and research then I think I'd be wasting my time. I certainly wouldn't want another bullying lecture on eating <insert expletive of choice> porridge.

Maybe it would be a good idea to ask questions of the nutritional therapist and see how current she is. If I come away from an appointment with lots of ideas to explore the £50 would be worth it. If I came away thinking I could have Googled that, it wouldn't be. Supposedly, professionals have access to paper on nutrition and attend conferences etc that I, as a lay person, don't have access to.

 

[NoCrbs4Me]

Just do the exact opposite of the NHS diet guidelines and you'll be fine.

 

[Enclave]

My DSN said I must see the dietitian... I said yes that's fine ... But they must understand vegetarian foods and Low carb med fat way of eating ... I am still waiting..that was over 2 years ago I don't think a dietitian will help you, as you seem to be doing good on your own.

 

[donnellysdogs]

As I have slow colonic transit and even the gastroenterologist could only advise to take movicol and enemas for this then sometimes we have to find out what is right for our own bodies.

I went full on heavy fats when I realised I wasn't having enough fat... Despite it being ok for loads of others here it wasn't for me or my hubby. He ended up on 40mg atoravastatin... Since then we changed totally to Mediterranean eating with avocado, olives, olive dressing. Hubby is having his cholesterol checked this week but is already down to 10mg since changing from the heavy fats to the med diet.

Analysis is great but we both decided to still take a multivitamin, oils, I also take alpha lipoic and I think evening primrose and omega 3 tablets as well.

I don't think there is a better person than yourself to analyse your day today living and nutritional requirements.

I even have my Fitbit surge to check that I do my 10,000 steps a day and 10 flights of stairs etc and watch my calorie expenditure on that... Just to check that I keep balanced with my fitness activities and eating to keep weight on!!

I worry about advice purely taken from people that have studied it only... They probably have no experience of living it....

 

[Celeriac]

Wow, life is certainly too short to wait two years to see a dietician and I thought waiting 6 weeks to see a physio was a long wait !

Sometimes all this reading does my head in and besides online, I've got a pile of books on diabetes and low carbing by my bed. It would be nice to encounter professionals who could explain it all.

Dr Sarah Hallberg did a vlog in which she said that if you eat right you don't need supplements but if you want insurance take these and I forgot to write them down. #InfoOverload.

 

[photognut]

@Celeriac I have been searching for a Cardiologist in the UK who has adopted a progressive approach to nutrition and Orthomolecular medicine....... I have yet to find one . I rely on my ability to research, analyse, listen to my body to tell me if something does or doesn't work until such times as a Cardiologist grows a pair, and breaks away from the ranks

 

[Celeriac]

It's not as scary as it was at first, and I feel lucky that I was able to email doctors and researchers abroad and have them give me answers. Without them I would have stayed on the low fat high carb diet and deteriorated rapidly.

We shouldn't have to do this though, the doctors went to medical school.

 

[Indy51]

I thought myfitnesspal and other food tracking programs also tracked nutrients and reported on them? I think nutritionists/dietitians use similar programs when they design eating plans for people?

 

[ButtterflyLady]

Secondly, there is a nutritional therapist in the next town, with a degree in nutrition from an Aussie uni. An appointment with her is £50 for an hour. Has anyone consulted a nutritional therapist or non-NHS dietician ?

Thanks in advance !

As far as I know, anyone can call themselves a nutritional therapist and charge money for giving nutritional advice. With what you know, you could probably do it too. It's good that she has a degree in nutrition - many don't.

Some have degrees from unaccredited institutions in the US. There is a woman in NZ calling herself Dr [surname] and giving primary care medical advice to people based on a PhD in an unrelated field from such an institution. People believe the hype and don't check out these qualifications first. In NZ the term Doctor is not a protected professional title, so it hasn't been possible to legally stop her doing this, to protect the public.

I assume the UK has Registered Dieticians, like NZ. This gives some assurance that the person is properly trained and overseen by a licensing body. If you go to a nutritional therapist they may not be registered or licensed with anyone. Just something to keep in mind. If they are registered/licensed then complaints can be made against them - this tends to promote better and safer practice.

 

[ButtterflyLady]

@Celeriac.

An example of this sort of thing is my GP who I know quite well. To patients directly he has to encourage flu jabs... To me privately he doesn't and says why should we fill our body with toxins each year when flu is likely only to affect us once in 40 years and that can't even be sure of targetting the right flu strain...

I'm going to respond to this example and I think it is on-topic for this thread because it is about choosing the professionals that help us, and how we can know they provide good nutritional or health care advice. This is a really important issue for people with diabetes.

I don't mean to cause any offence to you, and I'm sure he's a doctor that you like and enjoy working with, but I am questioning this aspect of what he believes. It's nothing personal. I'm concerned to hear he is against the flu vaccine. Do you know if he also has an anti-vaccination view when it comes to early childhood vaccinations against measles, rubella, and polio etc?

Influenza is a highly contagious and potentially life threatening infection. The vaccine does not contain "toxins" at a level higher than in everyday products like deodorants, and certainly not at a level that will harm. The benefits of good protection against the most common flu strains that are circulating that year far outweigh the risks, which are very small. Extremely small.

The flu vaccine is especially important for people with diabetes because we are more likely to catch influenza and be hospitalised by it. The risk of pandemic is real, and only 6 years ago, there was a swine flu pandemic that killed a significant number of people, many of whom were otherwise healthy. In fact, every year, people die from influenza. Babies aged under 6 months can't have the vaccine, and rely on herd immunity provided by vaccinated people they come into contact with.

I am not aware of any medical evidence that the flu is only likely to affect us once in 40 years. The estimates I have read are 15 years. But the point is, why take the risk at all, especially when children, the elderly, and those with respiratory illness and diabetes are at greater risk?

High numbers of people with severe influenza also fill up the hospitals in winter, and put extra strain on staffing numbers, and the ability of people with other illnesses to get a bed. This is one of the reasons why governments promote and in many cases pay for the flu vaccine.

It always concerns me when a GP expresses anti-vaccination views because it shows me they believe misinformation and they haven't accepted the scientific evidence available to them. So I would worry about the rest of their advice, and how much of it is based on science or hearsay.

Just to share a bit of my experience, I had the flu once, many years before I became diabetic, and it was horrible. 2 weeks off work, much of it spent in bed. Sometimes people who have never had the flu think it's like a bad cold. It's not. I hate to think what it would be like now that I have diabetes and even the common cold sends me to bed. So I get the flu vaccine every year, and feel a bit less scared of getting sick with the flu. I'm also helping with herd immunity, that benefits those who can't have the vaccine because of medical issues. I'm also helping keep the hospitals less full.

 

[Indy51]

It's a pretty big leap to say someone who doesn't think the flu vaccine is particularly effective (and this GP is far from the only person/group questioning that) to saying he's a anti-vaxxer in general.

 

[ButtterflyLady]

It's a pretty big leap to say someone who doesn't think the flu vaccine is particularly effective (and this GP is far from the only person/group questioning that) to saying he's a anti-vaxxer in general.

I didn't say he was, I asked if he was. The arguments used against the flu vaccine are basically the same as those used against the other vaccines. The flu vaccine is effective against the strains that it includes for that year. I have less of an issue with a layperson questioning the flu vaccine than I do with a medical practitioner doing it.

 

[ButtterflyLady]

I'm happy to discuss vaccination until the cows come home but can I suggest we wait for donnellysdogs to respond if she wishes to, or start a new thread about vaccination because otherwise the mods might have something to say about being on topic. Thanks.

 

[donnellysdogs]

My GP does support people getting flu jabs through NHS but it was his PERSONAL opinion that they are not necessary. Two different aspects to consider.

 

[ButtterflyLady]

My GP does support people getting flu jabs through NHS but it was his PERSONAL opinion that they are not necessary. Two different aspects to consider.

I may be a bit slow, because I don't understand what difference that makes?