Replies

• Doug, What a beautiful, moving tribute to my amazing colleague and friend. Adele was one of a kind, and I too am deeply shaken by her loss. However, I'm so proud of all that she did to advance low-carb acceptance over the years and, of course, her creation of the Clinical Guidelines for Therapeutic Carbohydrate Restriction. What an honor it has been to have known and worked closely with this incredible woman. RIP, Adele. You have truly made a difference in the lives of countless people.
  April 29, 2022

• Great tribute, Doug! I had the pleasure of being on a few zoom calls with Adele and even in those brief moments she made an impact on me as a practitioner. She will be missed but the mission remains!
  April 28, 2022

• I still cannot believe she is gone. She was a speaker at my very first Low Carb USA conference and I was so impressed by her straight forwardness, no tolerance for exaggeration of data and just stating the facts! The Clinical Guidelines have been so helpful that I cannot imagine not having that resource to our disposal. A great loss to our community.
  April 28, 2022

• Thank You Amanda! Worked for ME!
  March 12, 2022

• The terms 'low carb' and 'keto' are laymen's terms and help people to identify this way of eating when seeking dietary management. Educating the patient then involves explaining the difference between 'low carbohydrate' - LCHF and 'very low carbohydrate' - VLCHF approaches. LCHF was previously referred to as 'low carb high fat' and PhD Dietitian Caryn Zinn from Auckland University initiated an important change years ago to 'low carb healthy fat'. Researchers also use the terms LCHF and VLCHF. There is nothing to stop people who are currently applying the term 'low carb' to a 45% carb ratio to do the same with TCR. This is not an appropriate reason to change the language. There is nothing wrong with the language. Low carb or very low carb healthy fats describes this dietary approach perfectly. I believe 'therapeutic carbohydrate restriction' is a step down from that. It is less descriptive and completely ignores the fact that focusing on healthy fats is of equal importance. It should remain part of our message, and part of the dialogue. Those of us who use these dietary approaches consider low carb intake to be over 50 g and under 130 g of carbohydrate. This isn't technically correct as there are people who can tolerate higher carb and remain in ketosis, particularly with longer term use and optimal metabolic health. Very low carbohydrate approaches are not as easy to define, as the amount of carbohydrate it takes to enter ketosis is an individual approach and differs according to metabolic health and other factors. VLCHF should be described as 'the amount of carbohydrate reduction required to induce ketone production and nutritional ketosis, as measured by urine, breath or blood' (many studies fail to test for ketosis which is a fundamental flaw). In case I haven't made myself clear - I am apposed to this proposed change.
  February 24, 2022

• What a thoughtful comment! And I see your point that are health and wellness audience may not identify with the term therapeutic. In cases where we are proposing an alternative to the current standard of care then I think we need to retain "therapeutic." When we're talking about the enormous opportunities in improving metabolic health and wellness then "calibration" (or "recalibration") seems like a great fit because we could apply that to so much more than carbohydrates. Look at the lasting impact of Dale Ornish's work. A lifestyle program that achieved better results, not because the diet was ideal but instead because he built a community around it. It might help us to create a Venn diagram or an infographic that illustrates this.
  February 24, 2022

• Ps, If you haven't attended one prior, you'll go to the Education Tab above, then navigate in the drop down to Grand Rounds. The zoom link to join in will be within description boxes!
  February 5, 2022

• Hi Amanda, I have had a couple RD's reach out to me who do virtual visits and I am trying to verify if they bill insurance. Is virtual a possibility for your team?
  September 28, 2021

• Hi Amanda, That would be great, I would appreciate her insights. Thank-you!
  September 28, 2021

• Hey Polly! I bet my friend Jennifer Williams that was at San Diego would have an opinion on this. Diabetes is her specialty! If you are still looking for insight I can connect you.
  September 28, 2021