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Taxbane 01-09-2013 10:34 AM

Cloak of Authority: Nutritionists v. Doctors
 
It is always interesting when it comes down to discussions of LC WOE v traditional WOE and diets, that most people believe that MDs and government agencies know what is best for weight loss and proper macronutrient levels for living.

That said, I was wondering if anyone knew off hand what is the most effective appeal to "authority" when it comes to getting weight loss advice, and why?

For example, do most people just trust their general physician's advice over all else, or do they prefer a specialist's advice? Who has more authority (clout) in your mind (or in the public mind) a general MD, or a nutritionist?

What about clout among different specialists such as Endocrinologists, Cardiac Surgeons, v. nutritionists?

That all said, does anyone know off-hand what the education requirements are to become a certified nutritionist? Given the amount of time many of us spend researching aspects of LC, it may be worthwhile to obtain some form of online degree/certification in nutrition, just for the clout the extra title alone would bring to the LC WOE community as a whole, and I imagine overtime the rest of society would come to recognize the legitimacy of LC WOE faster.

Leo41 01-09-2013 10:40 AM

You might not want to waste your time becoming credentialed if you assume it will help you change anything.

Many years ago, a young engineer named Richard Bernstein was diagnosed as a Type 1 diabetic. He faithfully followed the nutritional advice provided for diabetics, and he could not control his blood sugars. As a trained engineer, he began experimenting and discovered how low-carb eating could help him manage his diabetes.

No one would pay any attention to him, so he went to medical school and eventually became a board-certified endocrinologist. In the many, many years that he's been practicing, he has helped enormous numbers of diabetics, not only his own patients but via his books, too.

However, he has not changed the medical situation one iota. The 'establishment' ignores him and continues to promote a diet guaranteed not to help diabetics. The conventional wisdom that he knows is totally wrong is still 'standard practice.'

Melle's_Sweetheart 01-09-2013 10:53 AM

Taxbane--I LOVE the way you think.

Quote:

That said, I was wondering if anyone knew off hand what is the most effective appeal to "authority" when it comes to getting weight loss advice, and why?
I'd say for most people it's the government!

How many people BLINDLY follow what the American Heart Association's recommendations? How often do people refer to the "food pyramid" in reference to healthy eating?

It's unfortunate for society when critical thinking is completely squelched by government constantly making special interest groups (like AHA) the authority on healthy living.

Quote:

I imagine overtime the rest of society would come to recognize the legitimacy of LC WOE faster
Low carb will never gain legitimacy while the low fat mantra is still so popular, JMHO.

Leo--my mother became an insulin dependent diabetic about 10 years ago. At that time, I was shocked to see the "diabetic" diet that she was given by the nutritionist in the hospital---they suggested 5 fruits and 7 servings of bread A DAY! After some thought I realized---bread and fruit are LOW FAT. In order for the diabetic diet to incorporate the low fat dogma, they had to increase the carbohydrate element (which totally negates the benefits of the diet). Bunch of maroons.

LadyN 01-09-2013 10:57 AM

Quote:

Originally Posted by Leo41 (Post 16183507)
You might not want to waste your time becoming credentialed if you assume it will help you change anything.

Many years ago, a young engineer named Richard Bernstein was diagnosed as a Type 1 diabetic. He faithfully followed the nutritional advice provided for diabetics, and he could not control his blood sugars. As a trained engineer, he began experimenting and discovered how low-carb eating could help him manage his diabetes.

No one would pay any attention to him, so he went to medical school and eventually became a board-certified endocrinologist. In the many, many years that he's been practicing, he has helped enormous numbers of diabetics, not only his own patients but via his books, too.

However, he has not changed the medical situation one iota. The 'establishment' ignores him and continues to promote a diet guaranteed not to help diabetics. The conventional wisdom that he knows is totally wrong is still 'standard practice.'

:goodpost: The "Established Authority" seems to be quite stuck on stupid. I don't know what to call it when one ignores study after study and still parrots the same mumbo jumbo to people. It is up to you though if you would like to become credentialed. Just be ready to parrot whatever they say so you can pass your tests!

Janknitz 01-09-2013 10:59 AM

Today I listened to a podcast of the Diane Rehm radio show interview with Dr. Lustig who is hawking his new book, "Fat Chance: Beating The Odds Against Sugar, Processed Food, Obesity, and Disease". Dr. Lustig is the pediatric neuro-endocrinologist who was interviewed on sixty minutes last April.

He spent an hour laying out his carefully researched theories of why sugar is so bad, especially fructose. In the very last three minutes of the interview, a registered dietician called in to complain that his book was nothing more than yet another diet book had mouthing a single macro-ingredient "when we all know" that weight loss comes down to calories in, calories out. Lustig--justifiably IMHO--blew like a top, but because the show was winding to a close he couldn't go very far.

It's been 10 years since I worked in a hospital setting, but since when did RD's think they know more than a neurologist heavily steeped in research??? Yet most people will probably still believe the RD and consider Lustig an outlier for suggesting that their beloved sugar is implicated in our health crisis.

LadyN 01-09-2013 10:59 AM

Quote:

Originally Posted by Melle's_Sweetheart (Post 16183547)
Taxbane--I LOVE the way you think.



I'd say for most people it's the government!

How many people BLINDLY follow what the American Heart Association's recommendations? How often do people refer to the "food pyramid" in reference to healthy eating?

It's unfortunate for society when critical thinking is completely squelched by government constantly making special interest groups (like AHA) the authority on healthy living.



Low carb will never gain legitimacy while the low fat mantra is still so popular, JMHO.

Leo--my mother became an insulin dependent diabetic about 10 years ago. At that time, I was shocked to see the "diabetic" diet that she was given by the nutritionist in the hospital---they suggested 5 fruits and 7 servings of bread A DAY! After some thought I realized---bread and fruit are LOW FAT. In order for the diabetic diet to incorporate the low fat dogma, they had to increase the carbohydrate element (which totally negates the benefits of the diet). Bunch of maroons.

Isn't it an awful diet! I can't get my MIL to listen to me about that diet not helping her. It in fact keeps many people dependent on insulin even more! GRRRRRR!!!

DiamondDeb 01-09-2013 11:07 AM

I would not ask for nutritional advice from a doctor or a nutritionist. Doctors don't usually know anything & most nutritionists have been trained to push the food pyramid.

A holistic nutritionist might be a better choice but, honestly, all the information anyone needs is available for free.

I don't know why anyone would think a government agency knows anything about nutrition - or anything else for that matter! :laugh:

I am very well self-educated on nutrition & do not discuss my nutrition much with my doctor.

NineOhNine 01-09-2013 11:35 AM

I agree with DiamondDeb. I'm the authority in my life.

TigerlilyCA 01-09-2013 12:05 PM

The government, bless their hearts, I suppose they're trying to be helpful, but their guidelines just...aren't. Though, to be fair, they are supposed to theoretically apply across the board to all populations and they don't. They're not for weight loss. Also, just too many lobbying groups.

I don't think the government should tell us what to eat. That's not going to help. We in the U.S. need to develop an actual food culture that isn't surrounded by McDonalds and Hot Pockets. I actually do think it's beginning to swing in that direction somewhat, with people becoming more aware of the foods they eat and a focus on a more "whole foods" type diet instead of all the processed sugary junk. But we have a way to go.

biggestloser 01-09-2013 12:07 PM

DiamondDeb & NineOhNine, I'm with you also.

I see an internal medicine doctor for my primary care. I have several weird health problems and internists seem the best at investigating and managing my care. She even has recommended a lower carb diet for me, South Beach. I'm not sure how she feels about Atkins, but I look forward to hearing her opinion on it since I have great respect for her. I'll keep doing it regardless of what she says though, especially since MDs get very little nutritional education. We each are responsible for our own health!

Dr. Lustig is amazing! If you haven't seen it, he has an amazing talk about how terrible sugar is for us. Sugar: The Bitter Truth - UCTV - University of California Television

rose1 01-09-2013 12:10 PM

Quote:

Originally Posted by DiamondDeb (Post 16183599)
I would not ask for nutritional advice from a doctor or a nutritionist. Doctors don't usually know anything & most nutritionists have been trained to push the food pyramid.

A holistic nutritionist might be a better choice but, honestly, all the information anyone needs is available for free.

I don't know why anyone would think a government agency knows anything about nutrition - or anything else for that matter! :laugh:

I am very well self-educated on nutrition & do not discuss my nutrition much with my doctor.

Quote:

Originally Posted by NineOhNine (Post 16183678)
I agree with DiamondDeb. I'm the authority in my life.

Exactly this.

clackley 01-09-2013 12:30 PM

Quote:

Originally Posted by NineOhNine (Post 16183678)
I agree with DiamondDeb. I'm the authority in my life.

Agreed! I have very little respect for nutritionist and dieticians in general these days. Most appear to be parrots and some even have gotten their old learning wrong.

A nutritionist was quoted in a major newspaper here saying this:

Quote:

Holwegner explains that humans can go without water for only a few days and while the body can go without food for longer (if the body has enough fat and muscle stores) significant damage occurs. She says that: “the body requires at least 130 grams of carbohydrates per day (the equivalent of about one cup of rice, two pieces of bread and several servings of fruits and veggies) for basic central nervous system functioning, and even more carbohydrates for your muscles and physical activity. When this is not supplied the body goes into a state of ketosis, where the body breaks down fat and muscle to keep the brain and body functioning. This lowers the metabolic rate, greatly decreases cognitive functioning and places significant strain on the body organs.” Hunger strikers who take water, vitamins, glucose and salt, should last longer.
No matter what one may think about low carb diets, this information is just wrong. :stars:

Vilya 01-09-2013 12:57 PM

You know, this happens with veterinarians, too. They do not get much training in canine nutrition, and yet people will blindly believe whatever the vet tells them about what food to feed. Since most vets sell prescription dog food, I find it more than a little shady for vets to be giving out food recommendations.

Sorry, I know that's off-topic a bit!

Basically, ever since I was dx'd with diabetes, I have taken full control of my own research and only believe what I can satisfactorily prove to myself with solid science. Everything else is bunk, IMO. I'm the one living with this, so I'm the one who's going to decide how to treat it.

rubidoux 01-09-2013 01:29 PM

Quote:

Originally Posted by Vilya (Post 16183878)
You know, this happens with veterinarians, too. They do not get much training in canine nutrition, and yet people will blindly believe whatever the vet tells them about what food to feed. Since most vets sell prescription dog food, I find it more than a little shady for vets to be giving out food recommendations.

Sorry, I know that's off-topic a bit!

Basically, ever since I was dx'd with diabetes, I have taken full control of my own research and only believe what I can satisfactorily prove to myself with solid science. Everything else is bunk, IMO. I'm the one living with this, so I'm the one who's going to decide how to treat it.

Yes, I know its off topic, but I just gotta say that I am so freaked out that my dogs' food is only like 18% fat. I've just started giving them some EVCO on top and I'm gonna switch to grain free (but its still low fat).

I've taken the same approach with my diabetes. I had an aha moment after about the first 8 years, in or about 2000, where I realized that I didn't just have to keep pumping more and more insulin, I could go lower on the carbs. :doh:

omgtwins 01-09-2013 01:59 PM

6 months into my pregnancy I had some rather bad pains - didnt know which way anything was gonna come out, I was felling so sick - I went to medical - being Navy, I didnt have a specific Dr I saw, just whoever was on duty - One of the things they did was monitor the baby's heart - it was supposed to be a 10 procedure. 45 minutes later, the test ended and they admitted that there was 2 occasions in which the baby's heart rate went over 180.
Because the duty station I was at didnt have the resources, I was sent to Arnold Palmer (one of the top neo natal care units in the country) for the duration on my pregnancy.
They looked at what the Navy said then had me come in every 2 weeks. never once did they see her heart rate go up. I told them that I was on the monitor for 45 minutes and only saw it twice and they were checking me for a few moments.
Long story short, at 8 months they caught her heart rate near the 200 range and a c-section was ordered.
I stared at them in amazement. They - the TOP neo natal care unit of the country - had me for 2 months and NOW it was an emergency??
To add salt to the wounds they blamed it on hereditary. What? You have no answers so you're going to blame it on something you cant prove? I mean, come on! The medical profession on this kinda stuff wasnt in existence when my mother was born or before that and THATS what yer gonna blame? How convenient.
I learned then to push for second opinions - especially after they were filling out the discharge papers for my newborn and I one minute then hauling our daughter to NICU the next because her heart rate was OVER 250 and wouldnt come down ... then, come to find out, there was medicine I could have taken IF Arnold Palmer believed in the Navy.
So thats my take on the medical profession.
Government? Wellllll .... we elect these people, not because they deserve it, but because the other choices were worse. It's no longer who you vote for, but who you dont.
We (America) - in general - are a lazy society and we tend to keep to that which makes us comfortable and keeps us in the job we have.

*puts away my soapbox*

We do what we do in whatever way suits us and, if we have questions, we either figure it out ourselves, look to someone we trust (maybe even get a 2nd or 3rd opinion), or (smartest thing yet) do both.

Being the lazy person *I* am, I do what works for me until I've learned the hard way on what REALLY works. :P

Trigger828 01-09-2013 03:25 PM

Quote:

Originally Posted by NineOhNine (Post 16183678)
I agree with DiamondDeb. I'm the authority in my life.

I agree and I do the same.




I think alot of people do look for authority to tell them something. sign of the times. easier to have someone else do your thinking I guess, but that is sure not me one bit.

we are rogues :) :)

unna 01-09-2013 11:59 PM

Nice question.

Here is my opinion:

Nutritionists typically have 4 years of university education. When they leave, most do not know how to read a real scientific article and have never performed research themselves. Thus, it is easy for them to believe that what is written in textbooks is absolute knowledge.

Doctors: Most doctors initially decide to go to medical school because it is a socially desired career path. In the beginning, at least, they have quite similar motivations as law students. This motivation often changes after many years, and they truly develop a desire to help people. You've found a good doctor if he/she feels this way.

They go to school twice as long as nutritionists, so they do have a better understanding of general physiology. In this case, if you feel you have to decide between a nutritionist or a doctor, then I'd probably choose the doctor's opinion.

However, most doctors in western medicine complain that they only spend a very short period studying nutrition. Doctor's are often so overworked that they have no energy to read/keep updated on the latest scientific studies. Even if they do spend a large portion of their time reading "scientific studies", these studies are probably not about nutrition, but focus on other topics.

You should certainly listen to your doctor's opinion, but if you want to make a more educated conclusion about nutrition, you are going to have self-test and keep up with the latest research from a variety of universities. If you don't understand the results of the study fully, you could always email one of the authors and ask. Then, you need to decide what conclusions to draw from the study (what are the study's limitations). Compare these to other studies.

Your "best bet" for a reliable authority on nutrition, someone who has a deep understanding of the body's workings, is going to be an older research scientist working at a university (which hopefully isn't heavily endowed by a single corporation). But I still would not blindly trust one of these (always question!), because they may be heavily biased, yet unaware of their bias.

As far as the government is concerned, we have to ask "What is a government?" A government is simply a group of people that make decisions for the whole. In our case, they are elected. Most who run are chosen because of their party status, and not because of their intellectual merit or wisdom.

There is no "authority". But, there are people with a deeper knowledge of the body's physiological processes - unfortunately, these people are typically not nutritionists or medical doctors. Of course, practicing specialists would be getting closer to the truth, but one could also argue that their perspective becomes too particular, for it neglects the other parts of the body.

clackley 01-10-2013 06:42 AM

Unna makes some very good points and in terms of a 'best bet' I think it is critical thinking. I think of it as 'show me the evidence'. Then the critical thinking comes in in being able to assess studies and other scientific evidence. Tom Naughton has videos on youtube on the subject of 'good science'.

avid 01-10-2013 06:48 AM

I wonder...with all of the diabetics here at LCF, some of them must have questioned their doctors when told to eat the recommended diabetes association diet which is rediculously high in insulin spiking carbs.
I wonder what these "experts" said in response to questions such as "why on earth would I eat 7 servings of carbs when each one will spike my blood sugar?"

Becky 01-10-2013 07:03 AM

My motto is 'Question EVERYTHING!!'

I, in general do not trust doctors, they are not know it all Gods, they are humans wheo have done a lot of reading and have real life experience (though with some experimental therapies they havn't even had the real life experience). Case in point: (looooooong story short: my autistic son was having seizures went to hospital got a great neuro, went on meds seizures stopped, then a year later came back in a different form, switched to another med, he's fine...just for a look see and comparison he went in for another series of EEG, MRI and PET scan. He was in the hospital for 3 days with the testing. Another neuro took over but Zach's neuro was still in on all the testing, so the new neuro come in to talk to me and was miffed that they didn't see any seizures in Zach's first day at the hospital (DUH! he hasn't had one for Months!!) so she takes Zach off his meds to try and "goose" a seizure...haha! Didn't work (I knew it wouldn't as he has missed a does here and there and never had one). So lady neuro come in to talk to us right as Zach was getting discharged and basically said Zach was a great candidate for brain surgery for his seizures....WHAT?!?! The child is doing fine and dandy on his medication and his original neuro let us know that there are 30 meds available to try before anything invasive would even be considered, but woman neuro was ready to crack open Zach's scull after only trying 2 meds! My husband was livid!! She really phrased it like we should schedule surgery soon! The child has been seizure free on a basically side effect free med for months now (almost a year)....

So yeah, I question Everything that pertains to my family's health.

ravenrose 01-10-2013 12:21 PM

For my particular body/medtabolism, all those "experts" I have ever dealt with have no idea at all what would work for me. They are so sure they know stuff, and it's just WRONG. I'm sure my body is indeed unusual, but so are a lot of other people's.

solarpluvia 01-10-2013 08:45 PM

Yeah, it was a real eye-opener for me when my (former) vet told me that the only nutrition training he had was a 3 hour lecture given by a representitive from Hill's (the company that makes the prescription food most vets use). Just Wow.

And it is astonishing how much the diet recommendations of major organizations and government agencies are influenced by industry lobbyists.

fiddlejen 01-10-2013 10:19 PM

Quote:

Originally Posted by Taxbane (Post 16183485)
It is always interesting when it comes down to discussions of LC WOE v traditional WOE and diets, that most people believe that MDs and government agencies know what is best for weight loss and proper macronutrient levels for living.

That said, I was wondering if anyone knew off hand what is the most effective appeal to "authority" when it comes to getting weight loss advice, and why?

For example, do most people just trust their general physician's advice over all else, or do they prefer a specialist's advice? Who has more authority (clout) in your mind (or in the public mind) a general MD, or a nutritionist?

What about clout among different specialists such as Endocrinologists, Cardiac Surgeons, v. nutritionists?

That all said, does anyone know off-hand what the education requirements are to become a certified nutritionist? Given the amount of time many of us spend researching aspects of LC, it may be worthwhile to obtain some form of online degree/certification in nutrition, just for the clout the extra title alone would bring to the LC WOE community as a whole, and I imagine overtime the rest of society would come to recognize the legitimacy of LC WOE faster.

Actually I think that who people trust the most and has the most clout, is the marketers and the happy-journalists who repeat as "science" any new so-called studys' conclusions that are press-released to them, and who can't help but give more emphasis to conclusions they--or their advertisers--like better.

The reason I say it really is the marketers & journalists that have the most clout? It's because most people after going to their MD or RD will then share the nutrition info with the people around them. (For example, the friends with whom they eat lunch.) And if that MD's or RD's advice is too far removed from what their friends have been hearing on Dr. Oz or GMA, the friends will view the MD or RD as marginal or unreliable, and will urge the dieter to doubt their health professional.

And the doctors & dieticians are aware of this. Maybe not specifically, but as a part of the peer-pressure to conform. Their reputations matter to them. Doctors or dieticians that want to promote something other than the standard dietary advice, really do have to Take A Stand.

So, ideas how to change the American perception of nutrition? I'd suggest getting an MD degree... and then a TV show!

clackley 01-11-2013 02:47 PM

Quote:

Originally Posted by fiddlejen (Post 16187442)
Actually I think that who people trust the most and has the most clout, is the marketers and the happy-journalists who repeat as "science" any new so-called studys' conclusions that are press-released to them, and who can't help but give more emphasis to conclusions they--or their advertisers--like better.

The reason I say it really is the marketers & journalists that have the most clout? It's because most people after going to their MD or RD will then share the nutrition info with the people around them. (For example, the friends with whom they eat lunch.) And if that MD's or RD's advice is too far removed from what their friends have been hearing on Dr. Oz or GMA, the friends will view the MD or RD as marginal or unreliable, and will urge the dieter to doubt their health professional.

And the doctors & dieticians are aware of this. Maybe not specifically, but as a part of the peer-pressure to conform. Their reputations matter to them. Doctors or dieticians that want to promote something other than the standard dietary advice, really do have to Take A Stand.

So, ideas how to change the American perception of nutrition? I'd suggest getting an MD degree... and then a TV show!

Sadly, I think you are right - particularly the last line!


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