A big Thank You!!!
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dtobio
Posts: 55 Member
I don't post here often, but I wanted to stop by and say a huge thank you to the people on this board. The short version of what I'm about to say is that for the first time in my life, I felt like I was equipped and educated enough to competently stand up to a medical professional, advocate for my healthcare, and do what I feel is truly best for my health.
I met with a nutritionist a few weeks ago who gave me a gestational diabetes diet (I am 18 weeks pregnant) that called for approximately 180 gm of carbs a day (more than 3 times what I was eating pre-pregnancy). I have been around 125-150 gm a day (with my OB's blessing) since I found out I was pregnant, and the nutritionist cautioned me that was way too low. I added extra carbs to play along and see what that does to my body (I started eating a piece of fruit every day), and gained 10 lbs in 3 weeks. My hair started falling out again, and my blood sugar (I check twice daily) was all over the place.
So today I handed the diet back to her and told her my baby is progressing right on schedule and not showing any sign of distress or defect and I would be going back to about 100-125 gm of carbs per day (which is still double what I ate pre-pregnancy and FAR from putting me into ketosis). She gave me a speech about how I must be gaining 10 pounds in three weeks because I was previously starving myself (I wasn't, and my OB agrees I wasn't), and that a 10 pound gain in 3 weeks and my hair falling out were normal parts of pregnancy (they aren't).
I'm not advocating blindly disregarding medical professional's opinions but I will say that the research on this isn't as current as it could be and I do advise always asking questions about what is really best for you.
I met with a nutritionist a few weeks ago who gave me a gestational diabetes diet (I am 18 weeks pregnant) that called for approximately 180 gm of carbs a day (more than 3 times what I was eating pre-pregnancy). I have been around 125-150 gm a day (with my OB's blessing) since I found out I was pregnant, and the nutritionist cautioned me that was way too low. I added extra carbs to play along and see what that does to my body (I started eating a piece of fruit every day), and gained 10 lbs in 3 weeks. My hair started falling out again, and my blood sugar (I check twice daily) was all over the place.
So today I handed the diet back to her and told her my baby is progressing right on schedule and not showing any sign of distress or defect and I would be going back to about 100-125 gm of carbs per day (which is still double what I ate pre-pregnancy and FAR from putting me into ketosis). She gave me a speech about how I must be gaining 10 pounds in three weeks because I was previously starving myself (I wasn't, and my OB agrees I wasn't), and that a 10 pound gain in 3 weeks and my hair falling out were normal parts of pregnancy (they aren't).
I'm not advocating blindly disregarding medical professional's opinions but I will say that the research on this isn't as current as it could be and I do advise always asking questions about what is really best for you.
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Replies
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Sometimes healthcare providers want to treat patients in a "one-size fits all" manner, which simply isn't true. Good job in testing the nutritionist's recommendations against your personal situation and standing firm in knowing your body's limits.2
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Sometimes healthcare providers want to treat patients in a "one-size fits all" manner, which simply isn't true. Good job in testing the nutritionist's recommendations against your personal situation and standing firm in knowing your body's limits.
Thank you! That's exactly right. I acknowledge that for many of her patients, 180 gm of carbs a day and eating whole wheat English muffins IS an improvement, and that's fine. Medicine just isn't one size fits all. I just can't understand how my OB is so open to hearing me and working with me on this and then this nutritionist dumps all over it telling me I'm starving myself and need to "pick at food" all day (no, I need to listen to my body's hunger signals that I spent a year re-learning), eat lean meats (again, no- the body needs something to burn and since I'm not going to give it all the carbs, it's gotta have fat), and that I shouldn't be on a fad diet (entire cultures have been eating this way for centuries with plenty of healthy births).1 -
Sometimes healthcare providers want to treat patients in a "one-size fits all" manner, which simply isn't true. Good job in testing the nutritionist's recommendations against your personal situation and standing firm in knowing your body's limits.
Thank you! That's exactly right. I acknowledge that for many of her patients, 180 gm of carbs a day and eating whole wheat English muffins IS an improvement, and that's fine. Medicine just isn't one size fits all. I just can't understand how my OB is so open to hearing me and working with me on this and then this nutritionist dumps all over it telling me I'm starving myself and need to "pick at food" all day (no, I need to listen to my body's hunger signals that I spent a year re-learning), eat lean meats (again, no- the body needs something to burn and since I'm not going to give it all the carbs, it's gotta have fat), and that I shouldn't be on a fad diet (entire cultures have been eating this way for centuries with plenty of healthy births).
My daughter is Type 1 and her diabetes nurse told her she would get diabetic Ketoacidosis and be really sick and weak all the time if she tried to eat low carb. We only told her she was aiming for 100g. Well, she's been about 30g or less (usually closer to 10), been feeling the best she has in forever, brought her A1C from over 14 to her goal of 7 in about 10 weeks too. Not even a hint of DKA, which was a recurring problem prior to going low carb.
That nurse has literally refused to see my daughter again because she's convinced she's going to end up killing herself without carbs! Lol3 -
That's such excellent progress for your daughter!! It is really terrifying to me that we count on these healthcare professionals for guidance and what we get in return is misinformation. I'm sure not every doctor or nutritionist or gestational diabetes educator is like this but there are enough of them that are. It's a very closed-minded approach.
I even cited my husband's success- he's lost 60 pounds in a year by moving to 75-100 carbs a day. He's the healthiest he's ever been (all his lab work is squeaky clean for the first time in his life- no high blood pressure, no high cholesterol, his A1C is great- nothing for them to pick at). I can understand not being in ketosis while pregnant (and I had to research it myself because she couldn't explain that either), but I'm far from it (I wasn't even close at 50gm a day).
I think she also has ketosis (which is a controlled, insulin-regulated response to a lack of carbs or a fast) confused with ketoacidosis (which is a lack of insulin). I can see where ketoacidosis is a concern especially for a T1 diabetic, but it seems that if you stop introducing foods that spike an insulin response, that is far less likely to occur (correct me if I'm wrong). It's scary to think what this diet they recommend might do to a T1 diabetic.1 -
Here is a good link explaining the two K words... Ketosis is usually 0.5 to 3 millimolars of ketones, ketoacidosis starts at 11 or higher, I heard on a recent podcast (2ketodudes, I think).
http://eatingacademy.com/nutrition/is-ketosis-dangerous
key point:
But this state of metabolic derangement is not actually possible in a person who can produce insulin, even in small amounts. The reason is that a feedback loop prevents the ketone level from getting high enough to cause the change in pH that leads to the cascade of bad problems. A person who is said to be “keto-adapted,” or in a state of nutritional ketosis, generally has beta-hydroxybutyrate levels between about 0.5 and 3.0 mM. This is far less than the levels required to cause harm through acid-base abnormalities.1 -
Here is a good link explaining the two K words... Ketosis is usually 0.5 to 3 millimolars of ketones, ketoacidosis starts at 11 or higher, I heard on a recent podcast (2ketodudes, I think).
http://eatingacademy.com/nutrition/is-ketosis-dangerous
key point:
But this state of metabolic derangement is not actually possible in a person who can produce insulin, even in small amounts. The reason is that a feedback loop prevents the ketone level from getting high enough to cause the change in pH that leads to the cascade of bad problems. A person who is said to be “keto-adapted,” or in a state of nutritional ketosis, generally has beta-hydroxybutyrate levels between about 0.5 and 3.0 mM. This is far less than the levels required to cause harm through acid-base abnormalities.
That's it right there. And even though my daughter produces zero insulin and is of course one of the people that is actually at risk of DKA, it IS NOT because of her diet, it is because of her potential for going without insulin.
She wears an insulin pump that gives her between 1-1.5 units per hour around the clock, so as long as she continues to get insulin and doesn't go on a carb binge without covering for it and checks her blood sugar as usual, she's at no more risk of DKA than anyone else. But that nurse doesn't seem to even understand how DKA happens, much less nutritional ketosis. Darn shame!1 -
Many medical professionals don't understand anything about ketosis or ketoacidosis or that there is even a difference. This is the same crap my husband was handed two years ago on a pamphlet provided by the folks who make a top-selling diabetes medication.
For point of reference, this diet recommends 40 carbs (whole wheat bread! whole wheat pasta! whole wheat English muffins! anyone see a theme?) at breakfast and lunch and 60 at dinner, paired with (LEAN!!!) proteins, and 15 carbs at each snack, 3 snacks per day. Considering the way I used to eat 2 years ago I can understand that this might be a huge improvement for some, but it's making me just as ill as I was then, and I won't go backwards now. 100-125 gm is hard enough for me because I try to be sure to get those carbs from nutrient dense foods that don't spike a huge insulin response. I am so grateful to this board for helping me find the information I need to be successful and healthier.3
