Maybe I’m just lucky but my family’s contact with RDs has been much more nuanced. I was originally given a “meal plan” of 275 carbs a day and when I told the RD that I couldn’t keep to the plan she asked whether it was too few and when I told her I couldn’t possibly eat that many carbs, she said fine. A couple of years ago, when I asked about Bernstein her response was something like “he has some good ideas”. She has never been in the there are no bad foods camp. Her list of avoid/limit include transfats, saturated fats (limit), excess salt, sugar alcohols.
My wife had a meeting with another RD (a T1) for her borderline T2 and was told to eat about 135 carbs per day and to spread them out. Not low carb but certainly not 45%-65% of her total daily calories either. It has actually proved to be useful advice which she can more or less follow.
I think the major problem is their lack in scientific and medical knowledge and perhaps, interest in such information. Information is always changing and new info is being presented. If they don’t keep up, they will quickly be providing outdated and less than ideal information to clients. It’s really the system that has taught them what they know. Of course, those that continue along the path blindly are choosing to ignore all the other scientific literature out there which should be making them question all their beliefs along the way-it’s the only responsible way to practice their career, in my opinion. That career is not set up that way and as a result, people like us have frustrations with them, even though we truly appreciate their help and intent.
A dietician should be able to tell you what to do when you get a high reading. They often don’t understand the patterns. My first dietician told me that because my readings were high in the morning I was eating before I went to sleep…period. That being said, I did have one fabulous dietician. Unfortunately, the job in the clinic was temporary for her as her goal was to be a personal trainer and to open her own gym. She was the only one who actually looked healthy and understood that exercise involved more than walking each day.
2004: My first booklet was “Don’t Let Anyone Tell You That You Can’t Eat Sugar!” There was a picture of a birthday cake and other baked goodies. The content included responses aimed towards those of the ignorant public who might not understand that the idea that diabetics couldn’t eat sugar was out of date. Why would anyone give such a booklet to an overweight Type 2??? I guess that was the “No Bad Foods” era.
There STILL aren’t any bad foods. Rather, the issue is do you want to deal with the consequences of eating that food? If you’re on track 98% of the time, and it’s your grandchild’s birthday, a tiny piece of cake (like 2 bites worth) is really NOT going to hurt you. I think the key is keep the portions small and the occasions rare, because we are all human, and it’s a basic human need to share food socially.
Put that way, you are of course, right, Natalie. And I personally dislike the very notion of “bad” or “forbidden” foods as it is a way of infantalizing people into “good children” and “bad children” and then making rebelling even more attractive. But I think the “no bad foods” campaign (nice to finally have a name for it!) went further than that in giving people blanket permission to eat “whatever they want” and abdicating responsibility for providing helpful guidelines. So instead of either the “bad! No! No!” approach or the “go forth and indulge” approach what is needed is just what you said, education about consequences. So using my own example I shared above, when I was diagnosed and said “I’m a vegetarian, I eat healthy and never eat sugar”, instead of colluding with me that I was fine and didn’t need to change anything (which I didn’t until I started on insulin and learned about carbs!) the dietician could have said something like, "Do you eat a lot of pasta and rice? Those are very high carb and probably spike your blood sugar. You might try testing 2 hours after eating those foods and see how your blood sugar is, then if it is too high you can experiment with serving size or consider substituting more diabetes friendly foods in your diet.
Well I actually like my Dietician very much! She’s young, forward thinking (compared to some that have been quoted on here), and always open to new ideas. The best advice she gave me when I was diagnosed was that not to say that I absolutely cannot have anything foodwise. Her opinion was that if you make it “forbidden” then you will want it more. Just human nature, again in her opinion. She also said that I would learn that if I did go nuts with some kind of food that my body would show me that it’s not a good idea to eat that, meaning that I’d feel like Hell!
Her best saying as she gives me advice… "Control…Control… you must learn control! Master Yoda says it best!"
I’m a bit of a geek so I just soaked that right up!
That sounds really hopeful Dude…something like the young dietician that I mentioned. Does she actually look at your meter and food logs to help you figure out how to avoid the spikes?
I’ve kinda always hated RDs myself but the one I went to at the outpatient Joslin Clinic in NH was pretty awesome because she gave me specific goals and tips like adding more protein to make my snacks more robust in order to keep me from eating extra calories by treating lows 24/7. She gave me ideas but never said I had to start eating X. The other thing she recommended to me was to go shopping every week with a plan and build a basic food pantry (read graduate student who lacks the time for cooking). I actually walked out of the appointment feeling refreshed and motivated which is the way it should be.
Same here. I ate some home-fry potatoes and some ice cream yesterday, and OK, that’s done, and now I’m back to where I should be. Only bad part is that I discovered that I had a bad set (FIRST time in 12 years!), and the friggin’ BG wouldn’t go down. So I took a shot and all’s well!
That’s great. I have to say that the only one who has had any idea of what to do with the numbers on my logs is the personal trainer at my gym. She knows how to combine foods in order to avoid spikes. As I have booked an appointment for a new diet, she has already discussed everything with me at length and will be visiting bloodsugar101 and the Tudiabetes Site among others to ensure that she is current. I’m sure there are a lot of trainers and dieticians that spend this time. You seem to have one Dude. Wish there was a way to recognize their efforts. To all those dieticians and trainers lurking and learning here: Thanks so much!
They push a lot of products that are sugar free but have sugar alcohol in them. If I don’t watch it these spike me pretty good. I have arguments about my spikes with her too. What she considers ok I find real bad for me. She wants me to eat spaghetti and rice which is really bad for me.
I am now having problems now with going hypo with my own insulin and am reactive hypoglycemic after meals now so I am tinkering with my carbs on my own.
Another thing to mildly dislike about the way the dietician industry operates, at least in my experience, is that any “food” questions at a doctor seem to be “deflected” to the dietician? I have run into some pump adjustments recently (which, in retrospect may have been because the pump was ready to blow? gets denial letter from MiniMed) and, at one point, mentioned to the doctor, or to her nurse through whom I correspond, that “I do a lot of adjusting by bolusing for like 25G of carbs and eating 17 if I feel like there’s dawn phenomenon brewing” which makes total sense to me but got the “here’s the number to our dietician” reply which is sort of useless?
Now that I have a new/ rebuilt pump, I will sort of keep an eye on things and perhaps adjust it and try to move to more accurate counting but my goal isn’t to get a ratio, it’s to keep my BG ok. I could, obviously recalculate everything and perhaps derive the correct ratio but am intending to increase my running steadily over the summer so I am not thinking I will be a useful “crash test dummy” anyway since everything will be in a state of flux until 100911 anyway. But I am certain that if I went, I will get "I’ve calculated a meal plan for you…which will be 180-270G of carbs, 3x30-45G meals and 3x 15-30G snacks rather than what I’m eating and doing ok with, around 130-170G. For $30 for me and $150 to Blue Cross? pass
The other problem with sugar alcohols, is not only do they have carbs in them, but they often don’t agree with the intestines. I tried Truvia (a stevia product), and not only did it not taste good, but each packet had 3g of carbs (and I use 5 packets in my double teacup, for a total of 15g of carbs – too much??) AND I had explosive appointments with the toilet on two separate days that I tried it. I suppose there are other stevia products, but if I ever try one again, I will read the label more carefully!
Carb Gang. Definitely. Although Queasy Rider is a VERY close second in my case, LOL!! I have a woman friend who rides, and has a magnificent purple sparkly Harley, and she offered me a ride, and I was too frickin’ scared!!
