Do any of you understand the ADA exchange diet?

[Guest guest]

Cliff went to see his dietician today who totally poo pooed the

Atkins approach diet we have been using. We are staying away from

many of the fatty foods but have cut the carbs out as much as

possible. This woman handed Cliff a 1200 calorie diet with the ever

confusing to me exchange method. UGH First of all he is not

overweight at 224 and 6ft 4in tall. this was unreal! They finally

settled on an 1800 cal diet. I hate dealing with this exchange diet

thing. The atkins is working much better these days along with the

switching around his meds. Even the ER doc said the Atkins was a

great diet for diabetics. What do y'all think?

Hugs

[Guest guest]

> Cliff went to see his dietician today who totally poo pooed the

> Atkins approach diet we have been using. We are staying away from

> many of the fatty foods but have cut the carbs out as much as

> possible. This woman handed Cliff a 1200 calorie diet with the ever

> confusing to me exchange method. UGH First of all he is not

> overweight at 224 and 6ft 4in tall. this was unreal! ...

> What do y'all think?

I think the reality of modern medical care is that you cannot trust anyone a

priori. If something does not make sense to you, don't take anyone's word for

it until they have explained it well and clearly and convincingly enough that

it does make sense. And if they don't, go talk to somebody else. Don't trust

a dietitian or a doctor because of their diploma, but only if they have

earned your trust or that of other people you know. And even then sometimes

they will be wrong...

Similarly, don't trust my advice or that of anyone else on this list unless it

clearly makes sense, matches other things you have heard or read, or you have

read the list long enough to come to trust them.

In direct response to your question, I think that 1200 calories for a 6'4 "

male is a starvation diet, and 1800 is clearly going to make him lose weight

unless his activity level is very low. However, I think I disagree with you

about Cliff not being overweight at 224 lbs:

Here are some data from the University of Michigan Health System:

http://www.med.umich.edu/1libr/primry/life15.htm

-------------------------------------------------

Height in Shoes Small Frame Medium Frame Large Frame

6'4 " 162 to 176 lb 171 to 187 lb 181 to 207 lb

6'3 " 158 to 172 lb 167 to 182 lb 176 to 202 lb

6'2 " 155 to 168 lb 164 to 178 lb 172 to 197 lb

6'1 " 152 to 164 lb 160 to 174 lb 168 to 192 lb

From height and weight tables of the Metropolitan Life Insurance Company,

1983. The ideal weights given in these tables are for ages 25 to 59. The

weights assume you are wearing shoes with 1-inch heels and indoor clothing

weighing 5 pounds.

------------------------------------------------

So even if we assume Cliff is large framed, we add an inch (5 pounds) for the

shoes and then we take off 5 pounds for the clothing, we end up with a

desired weight of 181-207 lbs. Which means he would be healthier if he lost

some weight. (Not that I should talk, at 195 pounds and 5'9 " , but it's a lot

easier to give advice than to take it).

So to get back to the diet issue, if you guys agree that he needs to lose more

weight/gain better control and your previous diet was not quite getting

there, maybe you want to consider the dietitian's advice. Or maybe you want

to go back to your modified Atkins, but keep closer track of the total

calories and keep them under 2000...

My impression is that you can pretty much tell in a month or less if a diet is

working to lose weight, and in a week or less (assuming you test several

times a day) if a diet is working to control blood glucose. So you lose

little by trying something, as long as you keep good records.

Hope this helps a little, and good luck!

Pablo, probably LADA type 1, treated with insulin, with horrible levels that I

will not confess. Still trying to improve...

[Guest guest]

Life saving advise!!! Well saud,

> I think the reality of modern medical care is that you cannot trust

anyone a

> priori. If something does not make sense to you, don't take

anyone's word for

> it until they have explained it well and clearly and convincingly

enough that

> it does make sense. And if they don't, go talk to somebody else.

Don't trust

When I posted my " fish tale " I didn't connect it very well to the

topic which was " high HbA1c " When my daughter was being treated for

reoccurring vaginal yeast infections prior to her first birthday I

was ignorant of causes for such and it seems the doctors were too.

Almost 9 years later and a whole range of symptoms that should have

just screamed " diabetes " a doctor did say diabetes. His initial

advice to me was to know what was being done, why it was and if I

didn't agree don't do it. That has been life saving advice. Twenty

years later a doctor said of my 92 year old mother " she is old let

her die " I've seen many things that fall between these to extreams.

If I could " rewind " life back to that infant daughter I would

certainly do things differently. Life is a learning experience.

Betty

[Guest guest]

> This woman handed Cliff a 1200 calorie diet with the ever

> confusing to me exchange method. UGH First of all he is not

> overweight at 224 and 6ft 4in tall. this was unreal!

With no other information, this shows that the dietician is clueless.

The exchange program allows far too many carbs per day. Type 2 diabetes

is, at its root, a condition where the carb intake exceeds the body's

ability to deal with it. The way to cope is *not* to add more carbs, then

add more drugs. Atkins is a very good program. Since your husband isn't

overweight, he could go straight onto the miatnenance verison of Atkins,

tailoring his carb intak using the gluclose meter and drug intake.

I think the qulaifications and training for dieticians and CDEs is

minimal. Thye sometimes have useful insights on other topics (exercise,

for example) but they are mostly worthless in discussions of diet,

especially as related to carb intake.

> The atkins is working much better these days along with the

> switching around his meds. Even the ER doc said the Atkins was a

> great diet for diabetics. What do y'all think?

>

2 excellent reasons to stick with Atkins.

- Bob niederman, type 2, diet and exercise, dx 1998, 204/182/155