Strong professional protocols are a relatively recent aspect of medical practice. Dr Blake Donaldson, had apparently been prescribing variation of an all meat diet since the 1920's. He published his book called "Strong Medicine" in 1961. Dr Alfred W. Pennington, heard about a very low carbohydrate diet, from Dr Donaldson in 1944, and after some self experimentation, began to use it with his clients. Dr Robert Atkins in turn learned about the diet from Pennington.
Dr Alfred W. Pennington presented a paper on this topic at the Postgraduate Assembly, Boston, October 29, 1952. By this time even Prof. Mark Hegsted at Harvard University was interested. Pennington got a polite reception at a Harvard Obesity Symposium, that prompted more publicity, and then an adverse reaction from the American Medical Association. JAMA took the position that calorie restriction was the only legitimate way to induce weight loss. By the time Dr Atkins came along 20 years later the "fact" that calorie restriction was the only way to reduce weight was deeply embedded.
Dr Atkins got his timing wrong. Although, according to Dr Eric Westman, Atkins kept patients records that were of excellent quality, and showing great success. But, Atkins was strongly attacked by the establishment. That attack was so strong that other doctors were discouraged from looking into the Atkins Diet. Why?
To publicly support the Atkins Diet, might lead to the questioning of your right to be a medical professional.
Almost 20 years later in 1991, we believe, a very young and uncertain Dr Eric Westman, rang Dr Atkins to see if he could learn how and why two of his patients, had miraculously lost weight and reversed their diabetes. Dr Atkins said that nobody else had shown any interest in his work, since the 1970's. The profession had cast him out, but he was never taken to court.
We can see that same problem, when Dr Richard Bernstein tried to get the Diabetes Association and the medical establishment to recognise his treatment protocol for Type I Diabetes. Even today that battle continues.
Dr Annika Dahlqvist in Sweden was the first doctor, that we know of, to be taken to court in 2005, for recommending a LCHF diet. The complaint against her was made by dietitians. The Swedish Board of Health and Welfare, wrote in Jan. 2008. "low carbohydrate diets can today be seen as compatible with scientific evidence, and best practice for weight reduction for patients who are overweight or who have diabetes type 2. A number of studies have shown effect in the short term and no evidence of any long term harm has emerged."
Prof. Tim Noakes Accused of "unprofessional conduct."
The Health Professions Council of South Africa investigated Prof. Tim Noakes for "unprofessional conduct". ADSA (Association for Dietetics in SA) president Claire Julsing Strydom laid the charge against Noakes in February 2014.
The Association for Dietetics in SA (ADSA), reported Noakes to the Council for a single tweet, advising a mother to wean her baby onto meat and vegetables. The recommended practice is to wean babies onto grain based solid foods the ADSA claimed.
Open Future Health followed the trial closely. There are fourteen URL's perhaps as many as 70 printed pages of detail available here. Best for a wide screen, maybe a tablet, but not suitable for a phone (far too many poor quality screenshot images).
Dr. Doron Sher, Dr. Gary Fettke, Dr. Maryanne Demasi (Science Journalist), and Dr. Peter Brukner.
Two surgeons, a journalist and a doctor on sports medicine. They talk about the professional risks of recommending a very low carbohydrate diet to patients, going against the current dietary guidelines. The moderator is Dr Paul Mason. Gary Fettke was reported by the Dietitians and was investigated by AHPRA (Australian Health Practitioner Regulation Agency) and the discussion begins there. They later discuss weight loss as an alternative to knee replacements. They discuss the politics of change (Don't wait for the guidelines to change.). Pain reduction and inflammation is discussed. They finish talking about cholesterol as a necessary part of good health.
Low Carb Down Under Sydney
Published on 15 Sep 2018
Dr Bourdua-Roy explains how she discovered low-carb for herself and her patients, and how complaints from four other professionals to the College of Physicians in Quebec, threatened her practising certificate in Canada.
Published on 12 May, 2020
In Canada there was a push from doctors to get the recommended diet and the protocol for diabetes management changed. There was a letter to Health Canada dated December, 2016. And there is this letter in the Huffington Post in April, 2017.
There are increasing numbers of professionals simply doing what their practice knowledge and experience tells them is the right thing. Often led by personal experience of obesity or type II diabetes. Here are some examples of the trouble that can bring. Of course there are successes too, like the work of Dr David Unwin in the UK, or Dr Eric Westman in the USA.
In South Africa, Dr Timothy Noakes, was actively campaigning to get what universities teach medical students changed. He says that a "world class university" cannot continue to teach a treatment protocol for type II diabetes, where the known outcome, is that the disease gets progressively worse over time. While actively and systematically campaigning against a alternative protocol which enables almost all the patients to be medication free, and without any significant indication of ongoing diabetes symptoms. No world class university can teach a system that they know fails, while refusing to even consider a different protocol that obviously works. Sadly true of all universities in the UK, Canada, Australia and New Zealand, I believe, except, perhaps, AUT in Auckland. Academia is very keen to protect the tradition of their scholarship. Yet in the trial of Prof. Noakes, after three years the Adjudicator ruled ten counts to zero in favour of Dr Noakes. A bit of a thrashing for the Health Professions Council of South Africa, and the Universities that united against him.
In the meantime, what do you do? In the U.K. NICE guidelines tell doctors to work with patients in establishing common clinical objectives for treating the disease. Very few patients want to be on daily medication, and they are usually willing and quite capable of both understanding the dietary requirement and sticking to the task. In some practices we know about nurses are often the first person a patient meets in preparation for time with the doctor. If diabetes or weight loss is an issue, patients might be told that the doctor often suggests a diet, "I'm doing it, .... ," so patients arrive thinking already that to be put on the diet might work well. Some clinics have coaching sessions for people using the diet.
In the USA, insurance companies control what they will pay for. They will pay for the standard protocol. They will also pay for the Banting solution if the results of the doctor show that he can reduce insurance company costs. That's fairly easy to demonstrate.
In South Africa, Dr Timothy Noakes, faced a charge of unprofessional conduct for giving "unconventional advice" to a breast feeding mother on a social network (Twitter). The charge was initiated by the Dietitians Association in South Africa. Dr Noakes was asked to answer on ten counts. The adjudicator found the NONE of the ten counts against him could be sustained. Promotion of the Banting Diet is very strong in South Africa, and called "The Real Meal Revolution." Many aspects of that trial should interest NZ medical professionals.
In Australia one dietitian (with 30 years experience) has been censored and sacked for recommending a Banting like diet. An Orthopedic Surgeon in Tasmania, Dr Gary Fettke, was forbidden from speaking in public about the use of low-carbohydrate high-fat diets in the treatment of diabetes. Since then Gary Fettke has been cleared of all charges.
It's been quieter in New Zealand. In The Lecture near the end I highlight Prof. Schofield, Dr Caryn Zinn, the next page is about Prof. Jim Mann, and Otago University, while the third page in the set suggests that nobody is going to stir the pot. These three pages of the Lecture begin here:
Dietitian, Caryn Zinn PhD. at the Auckland University of Technology, has been warned not to speak about low-carbohydrate high-fat diets in a way that reflects poorly on other NZ Dietician's. Prof. Grant Schofield hasn't made the headway everyone expected. There's apparently opposition hiding in the bushes.