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Tuesday, 2 December 2014

Low carb diet not evidenced based

I received an email today with a link to a facebook account. Self explanatory post below.

"Hi everyone

I like to ask for some help/advice from the group please. A dietitian in my area (I’m in Australia) has put in a complaint to my employers and DAA (Dietitians Association Aust) about my use of a lower carb approach in the management of type 2 diabetes. The allegation is that lower carb diets do not conform to current guidelines and are not evidence based.

My response to my employers was that DAA recommends Aust dietitians follow ADA’s guidelines, and ADA says that low carb diets, ie between 21 gm carb to 40% energy from carbs, have a place in diabetes management.

I’ve shown my employers these guidelines and explained that because my suggested eating plans are between 21 gm carb to 40% energy from carbs (I felt that I had to spell it out), my practice is in line with the guidelines and therefore evidence based. Even so, they have decided against me. One work place has said that I have to prescribe a dietary intake of not less than 40% carbs to people with type 2. I’m yet to hear from DAA.

I’m stumped as to where I go from here and I’d love to hear any comments or advice from this group. Are dietitians in the US using lower carb approaches? Is it accepted practice?
Thanks in advance, Jen"


Link to facebook page here.

If the low carb diet for diabetics is not evidenced based what is? How about the official NHS audited annual statistics for diabetes control. Just about the most 'evidenced based' data it is possible to obtain and it makes for very grim reading. Nothing could provide more evidence of the total failure of the NHS to control diabetic blood glucose. As we all know the NHS does not recommend a low carb diet. What does the NHS diet achieve. 

Results for England. The National Diabetes Audit 2010-2011

Percentage of registered Type 1 patients in England

HbA1c >= 6.5% (48 mmol/mol) = 92.6%
HbA1c >   7.5% (58 mmol/mol) = 71.3%
HbA1c > 10.0% (86 mmol/mol) = 18.1%

Percentage of registered Type 2 patients in England

HbA1c >= 6.5% (48 mmol/mol = 72.5%
HbA1c > 7.5% (58 mmol/mol) = 32.6%
HbA1c >10.0% (86 mmol/mol) = 6.8%

These results are very similar to those obtained in previous NHS audits over the past 5 - 6 years.

Link to NHS audit here. 

It's my opinion if you want to go with a so called 'evidenced based' diet start looking for a good funeral plan, a wheel chair and learning braille might be a good idea.


Eddie

2 comments:

Lisa said...

What is it about reducing carbs in your diet that makes everyone feel so threatened? Yet eat poisonous food, and nobody even notices!

Judy Benoit Milner said...

A general lack of knowledge of the role insulin and ignorance of good fats in our diet or more likely basic economics.

Low carbs invariably means high fat, natural high fat diets are not economically beneficial for mass production.
They feed animals grain, even dog owners are encouraged to feed processed grain based feed instead of meat and bones. (Complete dog food, complete crap)
Feeding the population grains is cheaper and more profitable./