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NHS Dietitian Contradicting Himself

I saw a dietician (2 of them) 3 times over a 6 week period, and the first one asked me to keep a food & injection diary, when I returned I saw a different person who asked me to keep a different diary, which I took to my 3rd appointment, where I saw the first dietician who couldn't work with their colleagues diary and theirs wasn't current so I gave up....

Edit, it was a long time back when we started working out carbs to fast acting insulin....
 
Decades ago I went along to the baby clinic and explained that I was breast feeding and becoming exhausted, but the midwife then demanded to know if I was adding anything to the milk.
My son was at the very top of the graph for weight gain and she thought that I was giving extra carbs.
I looked at her blearily from the depths of sleep deprivation and inquired how I could get it in there so he would let me sleep for more than two hours at a time.
Some HCPs have their minds set on rails and they just do not think before speaking, plus their attitude is always that the patient is in error.
 

My nurse is the same. At my first appointment I was given the glossy guide to the Eatwell Plate and told all the things most of us are - jacket spuds, baked beans, wholemeal bread etc. At my next but one meeting with her she could see how well I was doing, both weight-wise and BS-wise, and how happy I was with my LCHF eating plan. She never mentioned the Eatwell Plate stuff again, and instead told me about Trudi Deakin's book "Eat Fat", of which she had a copy. Her problem, and probably the same with every other DN, is that she has to complete a tick box on my computer records. One of these tick lists is about which diet I follow. There is a list of several choices. Low carb is not among them, although low fat is. I don't really fall in any of these, so she ticks "high fibre" in order to get round it. She is slim and non-diabetic but eats low carb in order to stay that way.
 
When first diagnosed I had a 30 minute discussion with a NHS dietician. She advised a restricted carb diet and, when pushed said 30-40g carb per meal. I stuck to that immediately and since. I resisted the temptation to just have 8 meals per day!
This was the opposite of the Desmond course which I also attended.
I now see a Health Care Assistant who is almost worse than useless. Fortunately I have full access to my medical records and his record of my recent review bears little resemblance to what actually happened!
 
Hi,
I heard Dr.Tedstone on radio 4 lunch time program the other week.
I wouldn't say what she said was a complete waste of space, but IMHO!.. I
was astounded by the complete lack of a strategy to deal in any constructive way with the current epidemic of obesity.
D.
 
rab5 said:
How where you cheating , did he elaborate. A HBa1C of 38 is a fantastic drop well done. But it works out at an average of
6.39 mmol/l thats if Im reading this right.
Click to expand...
It really is an idiotic comment isn't it.
 

Fat health care workers deserve to be shamed, not because they are fat, but because they are part of a system that goes to extraordinary lengths to prevent valid scientific discussion of the subject and refuse to act on evidence of misconduct in research. Health care workers who aren’t fat deserve to be shamed for the same reason.
 
I find it hard to understand why your dietician thinks you are cheating!!!! I can only assume he is thinking that if you go back to what is classed as "normal eating" your levels would rise. To me that is like saying to someone with a peanut allergy they are only keeping healthy because they are not eating nuts!!! As long as people are happy to maintain their new lifestyle and as long as it keeps working I don't regard it as cheating and think we should be congratulated for taking (for some people) drastic changes to their diet and lifestyle. Rant over lol
 
So let's take the word 'fat' out then and just say 'health care workers'! Oh and for the record I don't agree with you, it's only those who make the policies that are to blame, not the workers. Surely the fat ones are victims of the system themselves?
 
Agree. I think of them like I do call centre workers, who have to stick to a script, get tight control on the restrictive things they can and cannot say, and get loads of abuse and flack from customers while getting paid a pittance.

I suspect very few people can afford to only work in jobs where they agree with all of what they have to say and do, and most people do a lot of good in amongst the bad bits.
 
lucylocket61 said:
Agree. I think of them like I do call centre workers, who have to stick to a script, get tight control on the restrictive things they can and cannot say, and get loads of abuse and flack from customers while getting paid a pittance.
Click to expand...

Also agree. Medical practitioners have to follow approved guidelines, and if they don't, risk sanctions up to and including being struck off and unable to do their jobs. So if the official diet guidance is the Eatwell plate, that's what we'll be told until that changes. And getting that changed would need evidence showing benefits, ie trials, papers etc, which is happening.

And the junkfood lobby would no doubt object. As might people who've been promoting bad diets, which is another huge industry and could be better regulated. As long as authors are careful about how they promote health benefits, there'd be nothing stopping me publishing the "Chip Butty Diet" and stating it may prevent Kuru.
 

I think the problem is that there are a lot of fad diets, or diets that become fad if explained wrong, like the Atkins diet. Actually I think that a diet explained wrong, because is on a tabloid paper and the like, is a fad.
Now operators in the public health have to follow the published guidelines because as you explained it if they don't stick to it, they are considered liable.

There are a lot of really of diets intermixed with decent ones, and I think in most cases is because someone is trying to sell you something.
Sauerkrauts can help to lower cohlesterol and tho control BG spikes, but eating only cabbage isn't a good idea. Same for some raw diets. Eating salads is a good thing and being from Turin I think that raw meat with lemon, salt and olive oil is a treat, especially if you put some truffles on it. But eating only raw foods sounds me a weird thing.


My idea is that Eatwell plate is prone to misunderstanding. The "Carbs and cals" book follows the principles of the eatwell plate BUT they are a bit better explained. I have it and is an interesting read because makes you aware of the actual nutrients contents of food.
 
When first diagnosed, I reduced the "extras" in my diet - biscuits, crisp etc. I was already on a "eat well" diet at home as my wife follows slimming world - low fat, fruit & veg, cook from scratch etc. Removing the "extra's" did help - In 5 months I lost 6 kg's and my HbA1C dropped from 52 to 48. So the Eat well plan does work. I think it just does not work well enough or is not explained well enough.

Following the education course, I then switched to LCHF. Over the next 3 months, I lost another 6 kgs and my HbA1C dropped to 44.
The biggest unexplained (for me) factors are that the eat well plate advises you to eat brown carbs and allows fruit. The last is probably a mistake for someone like me who was 7-8 pieces of fruit a day before diagnosis. Fruit is very good for you just not in the quantities I was eating . Typically I would eat 2 apples, 2 bananas. kiwi fruit, oranges, berries (of all kings), Grape and so on in one day. The HCP team reckons the fruit intake (sugar) was a contributory factor.

As my wife pointed out the Eat well plate is aimed at the general population and the NHS is trying to improve the dietary intake which is sustainable. If we were all told to stop eating bread, pasta, rice etc. from day one, how many would succeed and keep on it? I have but I slip every so often. It can be trying and a pain in the rear to measure the carbs. Yesterday on top of my normal meals I had 150g of pistachios and around 75 g of chocolate...the result my carb intake for the day was over 130g (my target is 75). 130g is still low carb it is just over my target.
 
He is cheating!! He's cheating an early death or serious illness!
D.
 
Agreed, and perhaps she was interested in low-carbing to help her and was asking all those questions because of that. I had a long conversation about low carbing from the practice nurse (the surgery doesn't have a DN) who last took bloods; in fact I had to finish the conversation to get back to work! She was also asking a lot of questions and was genuinely interested in how it helped with bg and weight.
 

They're in a stupid place where they can't advise anything that isn't in their operating instructions. Having said that, last year I did actually get to see a diabetic specialist nurse at the local hospital who asked me to go through my diet with her. No problem, it was not only all written down but input into my "Weight by Date" software which shows up to 10 bits of info of what I've eaten including calories, carbs and another 8 things of my choosing (from their list of many).

She said "I don't suppose I need to give you this then?", it was a book called "Low Carb Diets for Diabetics". Maybe you could get a copy and send it to your NHS Dietitian, he obviously isn't keeping up with the program, just reeling out the same old guff (foolish talk or ideas) or, (in Scotland it means an unpleasant smell). As side issue, she was going on an Abbott run, one day training course, on the FreeStyle Libre although she did think it unlikely that our CCG (Chilterns) would fund it.

BTW, if you google "Low Carb Diets for Diabetics" there's some interesting web pages to read.

Edit: Forgot to say "Cheating?", cheeky . . . . . . . . . . (choose any expletive). What would be the pointing in not coming clean with your health advisor (so called professional who was lacking in how to deal with patients.
 
I'd really like to be able to press the "funny" emoji twice. You had amazing control
 
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