Jeff Novick, MS, RD: [RE: Why does my doctor recommend a low carbohydrate diet?] Because most doctors are unfamiliar with these programs, if they know about them do not think you will do it, and the popular and current trend is for the to recommend low carb. This is why, in most cases, we do not take nutrition advice from most doctors. There are a few exceptions who have made nutrition their main interest. (https://drmcdougall/forums/viewtopic.php?p=471633#p471633) --- [On Sodium and Novick and McDougalls recommendations] The McDougall diet is a low(er) sodium diet and our recommendations are very similar and I teach my guidelines in several classes during the 10-day program. We both agree that, for those who want, if you remove the salt from the food, you can add some at the table and still not over do it. His position is often misrepresented. Quoting from Dr McDougalls most recent book, the Starch Solution: Adding a half teaspoon of salt at the table to your starch-based meals over the course of a day adds about 1,110 milligrams of sodium, for a daily total of about 1600 milligrams, 700 milligrams below the 2010 USDA Dietary Guidelines of less than 2,300 milligrams daily, That is identical to my guidelines and can only be achieved by greatly minimizing and/or avoiding added salt in the food. (https://drmcdougall/forums/viewtopic.php?p=471663#p471663) --- [RE: Compliance on a Healthy Diet] On Kaisers recent embrace of a low-fat, whole-foods, plant-based diet that Novick can endorse: I would like to say that I think it is very important but I am skeptical and hesitant, but hopeful. :) There are several reasons why... 1) We have been here before I first saw a similar movement, in the early 70s. While it was not as well supported medically and scientifically, there was a huge push towards healthier diets, vegetarianism, natural health, organic gardening, etc. We were considered alternative, but there was a growing attention to it. However, it never got out of the alternative perception. Then, in the mid to late 1980s, a very similar event as this one, was happening... a group of dietitians who were vegetarian/vegan had started up a practice group and were applying to the ADA for official recognition, which they eventually received. The first formal position paper on vegetarian diets was published by the ADA which addressed many of the myths. While we already had the work of Pritikin, McDougall and Kempner available, we now also had the work of Ornish and Esselstyn coming out. Many other MDs were writing and speaking out about this WOE. By 1990, the initial finding from the China Study were coming out. In 1991, first National Conference on the Elimination of Coronary Artery Disease was held and in 1997, a follow-up conference, the Summit on Cholesterol and Coronary Disease, was held which brought together more than 500 physicians and health-care workers. The terms vegetarian and vegan became buzz words and became the leading trends in the restaurant and food industry. As a result of all of this, I really thought we were at a turning point This was one of the many reasons that motivated me to go back to officially become a RD in 1992 as I figured with all this happening, it would be just a few more years at most before we saw a real shift in our culture. What happened? Well, we gained a little bit of respectability but not much. Restaurants and food companies started producing more vegetarian food but most all of it was just junk food. The few good items that came out, that were vegetarian and truly low fat, low sodium and low sugar, did not last long. I can only think of a handful that were available then that are still available. Our health in many ways is not better, the American diet is not better but worse. The food supply is now worse than ever as there is more processed junk foods, most of all of which are claiming to be healthy. Which, leads me to the next point. 2) The pleasure trap and a cultural palate change Part of the problem is that we dont just need more MDs on board, we need a full cultural shift not just in our society but more importantly in our palate. We now live in a very toxic food environment. Just recommending people to change, even from MDs, is not going to work on its own. It can happen as we have had several examples where we have made these cultural shifts and they took much more than just recommendations from healthcare professionals. One example is smoking. The company I work with in NYC was an outspoken and leading medical advocate for anti-smoking long before it became popular, yet nothing changed until decades later.. We needed a full cultural shift in our society from government, business, education, etc where smoking was no longer accepted for the change to really happen. However, 20% of Americans still smoke. When it comes to food, this may be our greatest challenge. The reasons is, we are not just recommending vegan or plant-based food, which is easy to make fit the current culture and toxic food environment. We are recommending and needing healthy food that is plant based and low in salt, sugar, fat and for people to like that there has to be a major shift in their palates. The current food supply is very high in sugar, salt and fat and making the shift, without the support of the food industry and our culture, is extremely difficult. Just read the stories here in the forums. Just look at all the food that is marketed advertised and promoted as being plant based and is popular and making it in the world.., most all of it is high fat, salt, sugar and not healthy. Look at what is served at most veg/vegan restaurants. Read my thread on when vegan is not enough. I can see writing a similar one in a few years called, when plant strong is not enough. So, the cultural shift and shift in our cultural palate may be the most important issue and I am not sure how it will happen, if it will every happen. 3) Accuracy While the paper is great, it got several key issues wrong and so to promote it is to also promote these errors. These errors are around some key issues, such as complete proteins, that can just backfire on all of this if they end up getting promoted again. I have had quite bit of feedback on this issue in regard to this paper already 4) Cost cutting One of the reasons driving Kaiser (and others) to look at these options is cost savings. While that is noble, I am not sure that is the primary driver that will win in the end, as the data already exists that this WOE will result in major savings for the the individual and for healthcare costs. I have worked with the food industry (then and now), the health care industry (then and now) and also the population at large (both sick and healthy) and have some serious concerns. So, while I am glad to see this, I am not sure of the impact it will actually have. However, I will remain skeptical & hesitant but hopeful and keep marching forward. :) https://drmcdougall/forums/viewtopic.php?p=471663#p471663
Posted on: Tue, 25 Nov 2014 22:37:25 +0000
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