Thread by @ahhite

I would say "anger" motivates me as well. But not MY anger.

I have in my heart & in my head the voices of the dozens of (mostly) women patients who tried hard, for years, to bring their heath in line by following the guidance they were given.

https://twitter.com/ChristianTams/status/1246058826547302402

They were told to
--eat less and move more, as if these two things are independent of each other
--count calories in/out, as if health is a math problem
--drink more water, as if that can nourish an underfed body
--write down everything, as if this would "Make It So."

When these things didn't work, they were scolded. They were told they must not be "trying" or "paying attention." They were told they needed to "keep better track" and "not fool themselves."

And they did. They tried harder. They wrote everything down. It still didn't work.

And they still were not taken seriously by their doctors or dietitians.

When they found out that carb reduction DID work - without hunger or counting or scolding - they were (I think justifiably) angry.

One woman said to me that she'd been hungry *since her teenage years.* And told repeatedly that she was "not reporting accurately" when she failed to lose weight on a low-fat, low-calorie diet.

By the time I met her, she'd been hungry for DECADES.

I think you'd be angry too.

And I'm not even going to start talking about the people who have lost limbs, eyesight & kidneys to an intervention for T2DM that INSISTS that fruit & starches must be included in any diet in order for it to be considered "healthy."

Okay I *am* gonna talk about them. During my hospital rotation, every time I had to work in the "Diabetes Wound Clinic" (which looked like what I thought of when I read Red Badge of Courage), I drove home crying.

Because my dad had T2DM too.

His doctor put him on a low-carb diet (Why? Bc his doc was Old School.)

I knew that my dad would likely keep his toes, eyesight & kidneys. (He did.)

I wasn't sad about MY dad. But other kids had parents who did not get the same option.

When I spoke to folks in the wound clinic, they'd never heard of a low-carb diet. They wanted to know why they were never told about that option.

I didn't have an answer.

For many of them, it was too late in terms of amputations. Toes - sometimes feet - were already gone.

So the anger that some folks out here feel is not "misplaced" & frankly @ChristianTams your comments come off as condescending & tone-deaf.

You are right that low-carb advocates have some extremist in their midst. Folks who want low-carb for everyone all the time, etc.

Those folks annoy me too.

But mainstream nutrition has the same kind of extremism: Folks who think grains/cereals/legumes/fruit for everyone all the time is the *only* way to be healthy.

I understand that you @ChristianTams see the job of RDs differently. That RDs should tailor the diet to the person. I applaud that.

But you can't discount or deny that many RDs, now & in the past, have been not just dismissive, but adamantly AGAINST low carb as an option.

I don't know whether you @ChristianTams realize that the reality is *still* that low-carb is NOT offered as an option to most patients with metabolic conditions for which low carb has been shown to be useful.

I'd like to change that. Maybe you would like to change that too?