Sunday, September 9, 2012

The Nutrition Debate #65: Introducing the Low Carb Dietitian

Browsing on one of my favorite websites, Dr. Bernstein’s Diabetes Forum, I came across a post by a “newbie” who had “discovered” a blog called Low Carb Dietitian. I clicked on it and read 4 posts that persuaded me there is indeed hope for the salvation of our health care community.

Let me share with you my impressions of this Low Carb Dietitian’s transformative experience. Throughout this post I will quote selectively from 2 posts to provide my readers with a brief digest of where she started, how she evolved and where she is today. And while she is still evolving, and there are a few areas where I think she is still encumbered by her training, it is truly an inspirational transformation. I hope she is not embarrassed by this praise, or defensive about where we still disagree. And to be clear, she does have the “benefit” of  formal training and the advantage that she educates herself and her clients full time, whereas I am just an amateur of the n = 1 variety.

This Low Carb Dietitian is Franziska Spritzler, RD, CDE. In her own words, on the About Me tab of her web site, she says,
“I've always had a strong belief in the power of good nutrition.  After eight years as a court reporter, I became a dietitian because I wanted to help people improve their health by making dietary changes.   Once I began working in the outpatient nutrition setting, I quickly developed a passion for diabetes management.  As a certified diabetes educator, my goal is to provide accurate, useful information and support people's efforts to optimize their blood glucose control and achieve a healthy weight.”
That’s all well and good, but that’s not where she started. In her very first post on her blog (7/22/11) she explains,
“My purpose in creating this website is to inform people about healthy low carb living.  This site contains information that is likely very different from that which can be found on the websites of other dietitians.   However, if you'd told me a year ago that I'd be touting the benefits of a low carb lifestyle, I would have probably said you were crazy!”
Before she “saw the light,” she followed standard establishment public health community  diet and nutrition advice.
“I'd been eating a very healthy, semi-vegetarian or pescatarian diet (I consumed dairy, eggs, and fish but no poultry or meat) for many years.  Because of genetically high cholesterol, I limited my saturated fat intake, always ordering egg white omelets instead of regular, eschewing butter and choosing trans-fat-free margarines instead, and avoiding cheese and cream sauces.  I rarely ate desserts, occasionally having just a bite or two of my husband's cake/ice cream/cheesecake, etc., when we were dining out.”
That’s when this person, who had recently attained both RD and CDE credentials, got the bad news.
“So when I received the results from labs that were done for life insurance purposes back in January of this year [2012], I was speechless. Not only was my LDL ("bad") cholesterol elevated, but my fructosamine (a measure of blood sugar levels over a two-to-three-week period of time) was flagged as high, indicating the potential for diabetes. And my hemoglobin A1c (a measure of blood sugar levels over a two-to-three-month period of time), although still within normal range at 5.5%, was still far higher than would be expected for someone my size who ate the way I did. Now, while these numbers were not outrageously high, as one who works with people who have diabetes or prediabetes every day, they certainly suggested to me that something was not right with my blood glucose metabolism [emphasis added].  I purchased a glucometer and began testing after meals, and discovered my blood sugar levels at one hour were significantly higher than they should be. Within the next few weeks, I saw that the more carbohydrates I ate, the higher the number would go.  My fasting blood sugar always remained within normal range, however.”
So, since her education and clinical experience had taught her that “something was not right with (her) blood glucose metabolism,” what did she do? In her own words Franziska Spritzler tells us the incredible tale of what happened next.
“I made an appointment with an endocrinologist, who wasn't overly concerned since my fasting levels were so normal. He did want to retest my A1c, and by that point, it had increased slightly to 5.6%.  I cut down on the carbs slightly (not too much, though -- I'd been taught that we need enough carbs to keep our brains and other organs working properly), and then I started doing research online about strategies to control postprandial, or post-meal, blood glucose.  It seemed that many people were using low carbohydrate diets with great success in managing their diabetes and postprandial blood sugars. I was skeptical, but once I started reading the available research on carbohydrate restriction, it all started to make complete and perfect sense [emphasis added]. I discovered that that the high carbohydrate, low fat diet I'd been taught to believe was ideal was anything but for many people struggling with diabetes, insulin resistance, obesity, and dyslipidemia.  This was quite difficult for me to accept at first, but now that I have, I'm quite excited about the potential to help people struggling with these conditions.”
The inescapable conclusion: Not only did those who educated her in nutrition and nutritional counseling fail her, the endo, the medical specialist she consulted about her blood glucose metabolism, failed to recognize or be “overly concerned” because her fasting levels were normal. He failed to recognize her insulin resistance and her impaired glucose tolerance. Franziska had to take charge of her health and treat herself. Fortunately for her, and for the patients she counsels, she now has the knowledge to act and eat to her meter. And that’s the story of this Low Carb Dietitian. 
© Dan Brown 9/9/12

No comments:

Post a Comment