Tro Profile picture
17 Sep, 5 tweets, 1 min read
THREAD

These naive little med students & personal trainer PhDs don’t have to call families of patients who die from diabetic complications like sepsis, MI

They have never seen an amputation

If they had they‘d likely change their tune about their oreo &poptart inclusionism

1/5
These people often med students, dietitians and trainers...
who come on twitter, bombastically call for higher forms of evidence, calling people charlatans

& yet, they never truly observed the system fail. They dont even understand the problem. No experience.

2/5
If you want regurgitated vegan agenda, detox plans, supplements, or a fairy tale approach to macros or some nonsense/koombaya feeling of food inclusionism... you’ve come to the right place... twitter (im looking at you #rdchat ), not that the LC echo chamber is much better

3/5
It’s a wonderful place actually and yet a terrible place.

Its where brilliant minds can be reached within seconds. But also a place of complete ignorance.

4/5
I love twitter, it has taught me more than many CME lectures! But at the same time, particularly as followers increase, it can be a very dark place.

RANT OVER

5/5

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More from @DoctorTro

5 Sep
RANT (non-medical, avoid if talking about racism is a sensitive topic for you)🚨

I lived in Harlem, literally across the streets from the projects.

I didn’t believe in systemic racism and oppression until the age of 23 when I saw it play out in plain site.
It’s hard for people who don’t see it or feel it to believe. So I don’t blame most people who don’t think racisms exists

Just some random examples:
Harlem post office: long lines, bulletproof glass, no self-checkout kiosks
20 blocks south: post office with smiles, no lines, many kiosks

Public schools too. Harlem had brutally underfunded schools with teachers not trained to deal with or understand the unique issues of the community. 20 blocks south everything was fine.
Read 22 tweets
5 Sep
🚨 THREAD ON WEIGHT LOSS & EXERCISE 🚨

Many patients ask me about exercise for weight loss, and getting toned.

We are often advised to exercise, however, if we are severely overweight this can be quite challenging.
I typically advise patients to focus on fixing the diet first and forgo exercise for the first 6-8 weeks of any weight loss plan. if your diet isn’t in order & your appetite isn’t controlled, exercise will increase appetite and likely stall weight loss.
While it is true that over a long enough time, patients may experience changes in body composition (ie getting toned) they won’t see the scale move and the process will be slow and this can be discouraging to patients.
Read 14 tweets
16 Aug
I literally begged a researcher for help and dialogue for over a year. He denied me several times, bordering on insulting me on several occasions

Now he comes to me & says I should apologize to all the low carb researchers for not citing/thanking them in our recent paper

WTF🤔
I don’t have a research division. It’s literally me and me bugging really smart people like @drericwestman @davidludwigmd for basic direction.

It’s me and a couple medical students, residents and collaborators.
This is not my full time job, I see patients all day. I’m just trying to bring what I see to the medical literature.

So discouraged after this private message today... just a terribly heinous act.

Funny enough I thank the giants on the podcast & in office DAILY...
Read 4 tweets
11 Aug
LATE NIGHT BINGING:

•3pm to 11pm = time of highest perceived cravings

•Corresponds to the LOWEST blood sugar of the day

@drrajitastress showed mild hypoglycemia ⬆️ desire for hyperpalatble food

@AgnesAyton showed 100% of evening/nighttime binging is NOVA-4 foods
•As you overconsume hyperpalatable processed carbage, over time you will develop fatty liver then hyperinsulinemia

•Your body will have more glycemic excursions, stress responses on blood sugars will exacerbate

•if continued you will gain weight, develop MetS & prediabetea
•as you becomig metabolically sick, your triglycerides will rise and the work of Suzanne Craft shows that this goes to the brain an causes leptin/insulin resistance making you MORE hungry despite weight gain

•as you gain weight, fatty liver and diabetes worsen
Read 6 tweets
1 Jul
THREAD ALERT 🚨

CALORIE TRACKING, LOGGING, ESTIMATION all are consistently unreliable in the medical literature

KNOWLEDGE of calories has little effect on intake

In this thread ill highlight some of the negative data on “calories” having any impact on intake or weight loss
Calories on labels have no effect on ordering: ncbi.nlm.nih.gov/pmc/articles/P…

People don’t use calories when ordering: pubmed.ncbi.nlm.nih.gov/19299679/

No changes in intake with calorie information nature.com/articles/ijo20…
Less than 35% can correctly estimate calories of food, calorie labeling increases accuracy of calorie estimation from 15% in low income consumers to 24% but does not effect food intake

ncbi.nlm.nih.gov/pmc/articles/P…
Read 9 tweets
21 Jun
THREAD:

I was told as a medical intern that my refusal to take the influenza vaccine was a disgrace. My argument relied on Jefferson’s Meta analysis which demonstrated it’s limited utility in healthy adults

My personal opinion was that the risk/benefit wasn’t favorable for me
I agreed for it’s use in elderly & immune compromised, but there was even an interventional trial in residents that showed no work days gained from taking the vaccine!

I also argued that there wasn’t any good randomized placebo controlled trials for the vaccine.
I also argued that ILI was a terrible endpoint to track for efficacy. None of this mattered as I received an intense barrage of insults and I feared losing my job.

But I stood my ground.
Read 12 tweets

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