New USDA guidelines

Regarding the whole milk vs. skim milk, are you being told to always use skim milk, or is this more to do with the treatment of a low? I have seen the difference in the amount of time it takes to bring up low blood sugar with whole versus low fat milk and it can be a significant difference. I know this may not be the case, but possibly this is the reason for the push for lower fat milk.

 

No she told me that whole milk was not recommended for T1D because the saturated fat was linked to heart disease. The new guidelines do not consider there to be a link between saturated fat and heart disease. (Dietary butter and milk fat actually negatively correlate to heart disease, as several of my links support). She put two things in her notes. She didn't like him waking up under 100 in the morning or going to bed under 130 and replace whole milk with skim or 2% at mealtime. Oh and that he had hypo unawareness because he came to lunch at 68 a couple of times feeling fine.

She also told me that they don't tell parents how to feed their kids or make dietary recommendations, but that they were not in support of an isocaloric or zone diet because it wasn't healthy. Well the government says that they are now.

Well then we go to the pediatrician two weeks ago and I tell her that we are doing great with a diet that has less than 50% carbs, and whole milk and eggs, and meat, and she nods and says "well that's where the research seems to be headed" and then she writes in my kids notes that she advises replacing whole milk with skim or 2%. Whether doctors get sued or lose certifications for going against a set of association guidelines or not, they sure seem to think that they might. If you stick to the published guidelines then you may have some protection.

 

By the way, I think that the new guidelines are particularly important regarding T1D because I personally feel that humalog can work to fast for a 30% carb meal. When it was developed, only 45%+ carb diets fit into the ACC and USDA guidelines. I won't really know until I get the dexcom (soon).

 

Over time a good match/relationship with the endo is going to be a big asset for your son. I think it is definitely worth meeting/interviewing some others before settling in.

We've only had the one but nutrition is not discussed in the way you describe - so that is endo specific.

 

So, this is not you ... http://tnation.t-nation.com/free_on...rmance_bodybuilding/mertdawg_12_weeks_program

 

That is me. Almost every nutritional chemistry and human performance scientist connected to two of my grad programs has an account on that site. The site actually started back around 1998, but they reformulated things around 2004 or so, and you have to realize that if you were researching nutrition and physiology and applied biochem in the late 90s internet forums were far and away the quickest way to get feedback on research design or proposed biochemical pathways from fellow researchers. I said in a prior post that I used a name from another forum, but didn't realize you were after my deepest psychological underpinnings with regard to a user name. So I guess you have compelled me to share that I have earned advanced degrees and done research in nutritional chemistry, human performance, applied biochemistry, genetic mechanisms of human adaptation, developmental biology, et al. And the fact that I also have several t1d athletes whom I have worked with. I am still not presenting anything here on the basis of my expertise so what's your point?

 

I appreciate that it's all on the table. I have to admit I'm a little confused that you would refer to your transparency as one "after my deepest psychological underpinnings". We, and I say this with deference to this community, just want to know where advice is coming from. We now know more.

 

1) regarding "after my deepest psychological underpinnings" because I doubt that most people are asked to explain their reason for choosing or changing a user name and then investigated online and then cross examined regarding their stated explanation.

2) I have not given advise.

 

Just to make sure we're clear ... in this day and age it's not "investigated" when someone Googles. Also, it's not "cross examined" when asked to back up a claim. In addition, an assertion is indeed implied advice.

And changing your name, in my opinion, is certainly indicative of your hesitance to be affiliated with your online history.

 

In my experience --almost 12 yrs dealing with D, 3 endo's, a couple of CDEs-- the best endo's have the most patient experience and are not researchers. The latter not only have less time for patients, they tend to think in theories and the theories often don't play out in kids with D. You have also indicated elsewhere that your endo might not be the most forward thinking so if you are in a position (geographically) to do so I think you should shop around.

I don't find the initial thread off topic but we do have an off topic list.

 

So how many people have you googled who made an assertion on this site? You should write your own dictionary!
I left my prior username in the signature, but part of the reason for removing it from the heading was that someone actually could have tracked down my prior activity and concluded based on my contacts and past conversations that I WAS an expert which would have become apparent if someone scoured my history under that name.

If an assertion was implied advice it would be called implied advice.
In this day and age, given the information available it is precisely "investigated" when someone googles.
And I wasn't cross examined about a claim, I was cross examined about a personal explanation of my motive for changing a username which was true, and which only I could know and which was not refuted (but you wanted the long 200 word explanation of why I chose a new username).

Can you give me one good reason why I would want to distance myself from a forum that is frequented by human performance scientists?

Here is the disclaimer at the bottom of every page. Messages are the opinion of the person posting, and posts may or may not be accurate. By the way, no one has challenged any of my opinion with evidence, though I've asked for it. The insecure one's around here don't set the same standard for themselves that they set for others. They give opinion but they don't give evidence when I ask. Experience is all that matters.

Can you give me an assertion that you question and provide counter evidence? How many of the sources I've linked to on this thread have you read? I have answered as many of your questions as you deserve. In fairness, I deserve to have my questions answered if you want to talk to me or about me.

I have asked Sarah, you, WILF, rgcainmd, and Christopher to provide support for specific claims or to answer questions about certain claims, or to answer questions about their comments. They ignore the requests, go away, come back like I never asked, and go back to asking their questions or making off-handed remarks. There is no reciprocity. It is basically how a high school bully sees the other students. (I also taught high school AP chem, anatomy and physiology and bio for 12 years while my wife finished medical school, residence and fellowship) WHILE staying active in the research community.

If you answer all of my questions on this post you may converse with me in the future.

One last thing. Almost from the first day I posted on this site, I started getting PMs apologizing and explaining that there are 3-4 posters on this site who would continue to show up and attack anything I posted that made them feel uncomfortable-that they were just programmed for confrontation and were typical forum bullies. It is the same on other forums.

 

If you have a question you want to ask me, go ahead. I will answer it if I feel like it. Just like you are free to answer or not answer questions posed to you if you feel like it.

 

I had two. One is, I would like you to show me legitimate evidence that a doctor can recommend whatever they feel is appropriate for their individual patients regardless of government guidelines. My wife's group meets once a month to talk about published standards of care, and what are the justifications for going against standards of diagnosis or treatment, or ACC guidelines. They have to document their reason for going against standards of treatment (not that they "felt" like it) and the documented reason has to fall within certain categories (not that they FEEL that the old guidelines of <35% fat is not generally appropriate). See this and others: http://www.nolo.com/legal-encyclopedia/what-the-medical-standard-care-malpractice-case.html
http://www.alllaw.com/articles/nolo/medical-malpractice/negligence.html

Doctors who deviate from published guidelines can and are sued on the basis of those guidelines all the time. In fact, most of the re-certification process is showing that you know and apply the current guidelines. RGcainmd and sarah both mis-represented me by saying that it was not legally binding (which is not what I said) and then when I pointed it out they slipped away for a while. Anyway, the question is, WHAT is your basis for stating that doctors can recommend whatever they FEEL is appropriate for their individual patients regardless of any particular government guideline? And what do you mean they CAN? That they won't go to jail, won't get sued, won't be denied re-certification or won't be sanctioned by their hospital supervisor?
To be fair, I was wrong in that a doctor CAN recommend something that falls within the standards over something else that also falls within the standards, but they can't recommend outside the standards without exposing themselves to consequences, particularly being fired, sued or losing certification. Do you think that a doctor faces no risk in going against ACC or USDA guidelines?


The second question is why isn't the USDA's definition and identification of a heart healthy and a heart disease promoting diets and nutrients related to "Type 1 diabetes and how to manage it?"

Since these are basically your two POINTS for entering this thread I guess I might also ask, WHY?

 

I am not really interested in the first one. If your wife has real life experience then I'll take your word for it. Honestly, it has no bearing on my life or how I manage my daughters Type 1 diabetes.

As for the second one, yes, nutrition is one aspect of managing Type 1 diabetes. My point was that while you seem very focused on micro managing that aspect of it, I do not. As I said before, we have different approaches. To each their own.

Anything else?

 

Thought I'd add this http://www.medpagetoday.com/PrimaryCare/DietNutrition/52289

 

If your not interested in the nutritional aspects then why are you opening threads about them? (I don't micro manage anything. How could you know that? Anyway I've been calculating carb/fat/protein ratios in my head in my line of research for two decades. I don't spend any time on it. Words like obsessed and micro-manage are assumptions that are really not appropriate without knowing me.)

 

I made a comment on one of your threads. I am free to comment on any thread I like.

And just a minor correction: I AM interested in the nutritional aspect of managing Type 1 diabetes (to a degree). What I said was I am not interested in having a huge discussion about what a Dr. can or can't tell a patient.

 

Yes i am asking what was your motivation for clicking open this thread about USDA guidelines. I am not denying your right to do so. I am asking a personal question. Were you interested in the guidelines (in the light of the fact that you stated you are not focused on nutrition). Since your comment was basically contrary to the idea that the thread had value, did you expect something different? Do you just open every new thread. Do you like threads that I start because you just never find me posting anything that you have to argue about....

 

I really don't need to justify to you my "motivation" for looking at a thread. That's silly. If you want to talk about managing your child's diabetes, great, let's do that.

 

I agree. Thanks for posting the info, Theo's dad.