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  #1   ^
Old Thu, May-14-20, 05:18
Kristine's Avatar
Kristine Kristine is offline
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Plan: Primal
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Default Diabetes Canada Position Statement on LC Diets

Baby-stepping their way toward accepting LC and VLC diets as an acceptable approach to diabetes care, without admitting they were wrong all along with that high-carb low-fat crap.

https://doi.org/10.1016/j.jcjd.2020.04.001

Quote:
Recommendations
1. Individuals with diabetes should be supported to choose healthy eating patterns that are consistent with the individualís values, goals and preferences.
2. Healthy* low or very-low-CHO diets can be considered as one healthy eating pattern for individuals living with type 1 and type 2 diabetes for weight loss, improved glycemic control and/or to reduce the need for antihyperglycemic therapies. Individuals should consult with their health-care provider to define goals and reduce the likelihood of adverse effects.
3. Health-care providers can support people with diabetes who wish to follow a low-CHO diet by recommending enhanced blood glucose monitoring, adjusting medications that may cause hypoglycemia (sulfonylureas and insulin), or increase risk for DKA (SGLT2 inhibitors, underdosing insulin in those with insulin deficiency), and to ensure adequate intake of fibre and nutrients.
4. Individuals and their health-care providers should be educated about the risk of euglycemic DKA while using SGLT2 inhibitors and low-CHO diet, and further educated about the strategies to mitigate this risk (33).2
5. People with diabetes who begin a low-CHO diet should seek support from a dietitian who can help create a culturally appropriate, enjoyable and sustainable plan. A dietitian can propose ways to modify CHO intake that best aligns with an individualís values, preferences, needs and treatment goals as people transition to or from a low-CHO eating pattern.
* Canadians, with and without diabetes, who prefer to adopt a low or very low-CHO dietary pattern, should be encouraged to consume a variety of foods recommended in Canadaís Food Guide. Regular or frequent consumption of high energy foods that have limited nutritional value, and those that are high in sugar, saturated fat or salt, including processed foods and sugary drinks, should be discouraged.


Bold mine... where I'm cringing and slapping my forehead thinking, "you are SOOOOOO close!"

They make it sound like it's incredibly freakish to want to stop eating BG spiking sugar and grains in favour of eating real food, and that you need a dietitian's guidance to do this. What a turn-off. No wonder people feel intimidated by it. I fully support anyone who wants a dietitian's help, and the dietitians who can better explain it, but you lose people when you make it sound so much more complicated than it is.

Encouraging point: there are a ton of dietitians coming around. I follow a lot of them on twitter. They're good peeps.
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  #2   ^
Old Thu, May-14-20, 06:37
GRB5111's Avatar
GRB5111 GRB5111 is offline
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Plan: Ketogenic (LCHFKD)
Stats: 227/186/185 Male 6' 0"
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Location: Herndon, VA
Default

They're getting closer. I'm questioning the use of CHO for carbohydrates. Who in the general population knows what that means?

Quote:
People with diabetes who begin a low-CHO diet should seek support from a dietitian who can help create a culturally appropriate, enjoyable and sustainable plan. A dietitian can propose ways to modify CHO intake that best aligns with an individualís values, preferences, needs and treatment goals as people transition to or from a low-CHO eating pattern.

Transition to or from a low-CHO eating pattern? The inference is always that it's not sustainable, and I suppose to many steeped in modern day "eating patterns," it's not because low-CHO is the antithesis of how people were told they should eat. Therefore, without the metabolic buzz and temporary satisfaction from processed carbs, they feel they're missing something, and the only thing missing is the elimination of their distorted appetite caused by years of eating crap. The ADA is also taking baby steps, and you're right, they'll never admit to being wrong. At this point, I'll accept anything that can be considered progress even if we're doomed to relive "The Emperor's New Clothes."
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  #3   ^
Old Thu, May-14-20, 13:41
Ms Arielle's Avatar
Ms Arielle Ms Arielle is offline
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Plan: atkins
Stats: 255/214/153 Female 5'8"
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Who was the audience for this new recommendation?? Looks like the professionals like physicians and nutrtionists and politicians.

Can only wait and see how this is rolled out to the public, in layman speak.
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  #4   ^
Old Thu, May-14-20, 14:24
Grav Grav is offline
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I'm actually okay with point number 5, since point number 1 says to respect the individualís values, goals and preferences. To seek help from a dietitian is only going to be a bad thing if that dietitian doesn't adhere to point number 1.
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  #5   ^
Old Thu, May-14-20, 15:21
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bevangel bevangel is offline
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Plan: modified adkins (sort of)
Stats: 265/176/167 Female 68.5 inches
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Well Grav, I'd agree with you EXCEPT that for far too many nutritionists, "sustainable" automatically means "it can't be truly low carb (i.e., under about 150 g/day) because "WE KNOW that that is NOT SUSTAINABLE... nor it it HEALTHY." (If you can't see it, my tongue is planted firmly in my cheek!)

Seriously, when a traditionally trained nutritionist runs up against a patient whose values, goals, and preferences are to go to a truly low carb diet (under 25 g/day) while everything in their training tells them that the patient HAS to have at least 150g of carbs per day to stay healthy, they're going to give the patient advice on how "limit" their carbs to 150g/day. No way they're going to provide advice on consuming only 1/6th that number.
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  #6   ^
Old Thu, May-14-20, 15:31
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Kristine Kristine is offline
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Plan: Primal
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Quote:
Originally Posted by Ms Arielle
Who was the audience for this new recommendation?? Looks like the professionals like physicians and nutrtionists and politicians
It's going to be published in the Canadian Journal of Diabetes, so academics and health care professionals, mostly. We'll have to wait and see about the rate at which it slowly dribbles down the pipe to us lay folk. I think more/better info is coming from the opposite direction via social media and the vocal LC health care professionals.
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  #7   ^
Old Thu, May-14-20, 16:54
Ms Arielle's Avatar
Ms Arielle Ms Arielle is offline
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Plan: atkins
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Quote:
Originally Posted by bevangel

Seriously, when a traditionally trained nutritionist runs up against a patient whose values, goals, and preferences are to go to a truly low carb diet (under 25 g/day) while everything in their training tells them that the patient HAS to have at least 150g of carbs per day to stay healthy, they're going to give the patient advice on how "limit" their carbs to 150g/day. No way they're going to provide advice on consuming only 1/6th that number.




I have been to the same councelor twice. The first time I dropped the 300 carb , portion control, 3 meals /2snacks crap in the trash and depended on DANDR. The second visit some years later, was exactly the same. And I kept my copies of DANDR handy.

Have little faith that nutrition councelors are any better than the pyramid/plate sceme.
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  #8   ^
Old Thu, May-14-20, 16:59
Ms Arielle's Avatar
Ms Arielle Ms Arielle is offline
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Plan: atkins
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Quote:
Originally Posted by Kristine
It's going to be published in the Canadian Journal of Diabetes, so academics and health care professionals, mostly. We'll have to wait and see about the rate at which it slowly dribbles down the pipe to us lay folk. I think more/better info is coming from the opposite direction via social media and the vocal LC health care professionals.



Right. Im grateful to see these changes, even if implimetation will be very slow. Any change is very slow. And the greater push for change will continue to be grassroots and the growing number of vocal health care professionals. There is nowa closing distance between the two. Hurray !

Now, to get US government to change its position. With UK changing and now Canada, praying US will be forced to change. Can only wait and see.
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  #9   ^
Old Thu, May-14-20, 17:26
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JEY100 JEY100 is offline
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Plan: Keto/DrWestman/IF/DrFung
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The US is tip-toing towards Low Carb...you have to really dig to find it in their materials

American Diabetes Association endorses low-carb diet as option

https://www.dietdoctor.com/american...-diet-as-option

https://forum.lowcarber.org/showthread.php?t=482388

Last edited by JEY100 : Fri, May-15-20 at 05:31.
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  #10   ^
Old Thu, May-14-20, 18:35
Ms Arielle's Avatar
Ms Arielle Ms Arielle is offline
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Plan: atkins
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Yes, ADA has dipped its toe.

The average physician is ignorant of a low carb diet. And doctors, in my experience, take no action until full on diabetes.
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  #11   ^
Old Thu, May-14-20, 20:28
deirdra's Avatar
deirdra deirdra is offline
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Plan: HF/vLC/GF,CF,SF
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I choose to interpret "Regular or frequent consumption of high energy foods that have limited nutritional value, and those that are high in sugar, saturated fat or salt, including processed foods and sugary drinks, should be discouraged" to mean that well-salted roasted chicken thighs with skin have great, not "limited" nutritional value and are therefore fine for me to eat.

The fact that they think some may be transitioning to a low carb diet to control diabetes is encouraging, unless they think "low" means 100-150g carbs.

Last edited by deirdra : Thu, May-14-20 at 20:34.
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  #12   ^
Old Fri, May-15-20, 08:37
Dodger's Avatar
Dodger Dodger is offline
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Plan: Paleoish/Keto
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Quote:
Originally Posted by deirdra
...

The fact that they think some may be transitioning to a low carb diet to control diabetes is encouraging, unless they think "low" means 100-150g carbs.

Well, most nutritionists are aware that the human brain uses 120g of glucose daily so, of course, they would recommend not less than that per day.
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  #13   ^
Old Fri, May-15-20, 09:18
GRB5111's Avatar
GRB5111 GRB5111 is offline
Posts: 3,426
 
Plan: Ketogenic (LCHFKD)
Stats: 227/186/185 Male 6' 0"
BF:
Progress: 98%
Location: Herndon, VA
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Quote:
Originally Posted by Dodger
Well, most nutritionists are aware that the human brain uses 120g of glucose daily so, of course, they would recommend not less than that per day.

And the irony is that while I don't have diabetes, eating 120g of carbs (CHO) per day would lead me in that direction.
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  #14   ^
Old Fri, May-15-20, 11:48
bevangel's Avatar
bevangel bevangel is offline
Posts: 2,263
 
Plan: modified adkins (sort of)
Stats: 265/176/167 Female 68.5 inches
BF:
Progress: 91%
Location: Austin, TX
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Quote:
most nutritionists are aware that the human brain uses 120g of glucose daily so, of course, they would recommend not less than that per day.
Geeze, I MUST LITERALLY be brain-dead by now since I have not ingested anywhere near 120g of carbs on any single day for over SIX years now! Not even on my very occasional brownie binges have I gone that high. NOT ONCE. If I need to eat 120 g of CHO per day for my brain to continue functioning, then there is no possible way my brain is still functioning!

Oh wait... there is that whole gluconeogenesis metabolic pathway thing where, in the absence of dietary carbohydrates one's liver produces all the glucose the brain needs out of protein and the by products of fat metabolism.

No doubt most nutritionists also hear SOMETHING about gluconeogenesis in their training classes but I suspect many react with, "OMG, that's complex biochemistry... I don't wanta study biochemistry... it's too hard to understand... I just wanta learn about food and what's healthy to eat.... So, I'll just forget about gluconeogenesis and remember the simple rule, brain needs 120g CHO per day. If I just tell all my future clients to eat at least that much carbohydrates per day then I can forget about all the hard stuff. Not important anyway."

Maybe nutrition classes need to simplify and just tell their students, "Yes, the gluconeogenic metabolic pathway is complex but the overall concept is simple. When the brain needs more glucose than is readily available, the liver converts excess fat and protein into glucose to feed the brain. Just remember that when people eat fewer carbs, the brain does NOT starve. Instead the body naturally starts burning EXCESS FAT and ingested protein to feed the brain... and for people with too much stored body fat, that is a GOOD THING!"
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