What is a Hiatal Hernia and How Can Dietary Changes Help?

Introduction More than half of middle-aged people have a hiatal hernia (sometimes referred to as a “hiatus hernia“), but most people are only diagnosed when their symptoms become problematic, or inadvertently when having medical tests for something else. A hiatal hernia is where part of the stomach bulges up through the space (called a “hiatus”, … Read more

Why Grazing Can Look Like a Scene From Hoarders

Introduction Most people know that prediabetes and diabetes is having “high blood sugar,” but just how much sugar is actually in the human body? And how does “grazing” all day long, rather than eating set meals, affect this? An adult has 5 liters of blood circulating in their body at any one time. A healthy … Read more

How Much Protein is Best Depends on Different People’s Needs

Introduction I often hear the question, “how much protein is best?” but that depends for whom. Different people have different protein needs. A healthy man or woman seeking to build muscle has a different protein need than an older adult wanting to reduce the risk of sarcopenia (muscle loss) or someone simply wanting to prevent … Read more

Diabetes Canada’s 7-day Low Carb Meal Plan – includes bread, pasta, rice

Introduction I was excited when I saw a thread on social media over the weekend about Diabetes Canada’s new 7-day Low Carb Meal Plan. After all, last May they released a Position Statement summarizing the evidence for the role of low carbohydrate diets (<51-130g carbohydrate/day) and very low-carbohydrate diets (<50g carbohydrate/day) in the management of … Read more

Negative Effect of Dietary Carbohydrate on the Gut Microbiome in IBD

Introduction Several recent studies have found a relationship between the species of bacteria and fungi that live in our large intestine, carbohydrate intake, and Irritable Bowel Disease (IBD), including Ulcerative Colitis and Crohn’s disease. This article elaborates on how this knowledge may help improve symptoms for those with IBD. The Gut Microbiome & Mycobiome The … Read more

A Keto Diet is Only About How Much Carbohydrate it Contains

Introduction The myth persists that a “keto” diet followed for weight loss or improved metabolic health is all about the fat…bacon, heavy whipping cream, and fat bombs. It’s about adding butter and MCT oil to coffee, about eating fatty cuts of meat and lots of avocado. It isn’t. What makes a diet “low carb” or … Read more

No Underlying Health Conditions – likely assumed not assessed

Introduction News outlets highlight when someone has died of complications of COVID-19, stressing that the person “had no underlying health conditions“, but the problem is that this is often assumed, not assessed. Just because a person wasn’t diagnosed with diabetes, heart disease or high blood pressure does not mean that they have no underlying health … Read more

Food Sensitivity Tests versus Food Allergy Tests

Introduction One of the more frustrating things that I experience as a Dietitian who works with people with food allergy is when people come to me with a lab report listing foods they are ‘allergic’ to—only for me to get a multi-page report that they paid $650-750 out of pocket for, and which measures IgG … Read more

Stages of Change and Why Most People Regain Weight Loss

Note: This article was originally posted on November 6, 2020 and was updated and reposted on November 27, 2025. Introduction Historically, studies have shown that more than half of weight loss is regained within 2 years, and more than 80% of weight loss is regained by 5 years [1]. Recent data indicate that within 1 … Read more

Is a Diet High in Carbohydrate Appropriate for Humans?

Introduction This post comes out of some recent lively discussion on social media where I was challenged to reconsider my position that a low-carbohydrate or keto diet can put people into remission of type 2 diabetes (T2D), but does not reverse it, and is not a cure. The discussion centred around whether metabolic diseases may … Read more

The Stereotypical High Fat Keto Diet is Only ONE Type

Introduction There is a common but mistaken belief that there is such a thing as “THE keto diet” (singular)—which is high in fat of all types, including cream, butter, bacon, and fatty cuts of meat. In fact, there are a wide range of “keto diets” (plural), including several different therapeutic ones as well as those … Read more

The Keto Diet — a potentially dangerous and an unhealthy diet

Introduction I’ve heard other Dietitians say that the keto diet is potentially dangerous because it focuses on ‘high intakes of processed meat, butter and cream’. Some have said harmful effects were seen years later, including newly diagnosed diabetes and non-alcoholic fatty liver disease (NAFLD). However, clinical evidence suggests these conditions often develop years before a … Read more

New Protocols for In-Person Clinical Operation for Health Professionals

Introduction WorkSafeBC has released the requirements for regulated health professionals, such as Dietitians, to safely run an in-person clinical practice in British Columbia during the COVID-19 outbreak. These protocols are much more involved than initially imagined and are in addition to obligations prescribed by our professional college and the provincial health officer. Understanding the Risk … Read more

Diabetes Canada Deems Low Carb and Very Low Carb Diet Safe

Introduction Diabetes Canada has just released a new Position Statement acknowledging that a low carb and very low carb (keto) diet is both safe and effective for adults with diabetes. Reflecting back on their 2018 Clinical Practice Guidelines, Diabetes Canada clarified that it was not their intention to restrict the choice of individuals with diabetes … Read more

Now That Things Are Getting Back to Normal

Introduction Governments around the world are beginning to relax lock-down measures put in place due to the COVID-19 pandemic. Many are looking forward to life ‘getting back to normal,’ but how soon will that happen? In British Columbia, we are expecting the restoration of some medically-related services under enhanced protocols starting in mid-May [1]. What … Read more

Better Outcome in Covid-19 and T2D with Well-Controlled Blood Sugars

Introduction A study published in the journal Cell Metabolism has reported that people with type 2 diabetes (T2D) are at much greater risk of having a poor outcome in COVID-19 if they have poorly controlled blood glucose. This study analyzed data from over 7,300 people hospitalized in Hubei Province, China, specifically comparing those with well-controlled … Read more

Too Much and Too Little is Killing Us – reducing comorbidities

Introduction I just got “the call” that my mother has tested positive for COVID-19. She has all of the major comorbidities, so the prognosis is not good. We know that age, obesity, hypertension, and diabetes significantly increase the risk of hospitalization and death. While we cannot change our age, we CAN reduce our weight, lower … Read more

Obesity Poses Significant Risk to People under Sixty with COVID

Introduction As covered in the preceding article, we now know from US data between March 1-30, 2020, that older adults and those with hypertension (high blood pressure), obesity, diabetes, and CVD are at an increased risk of requiring hospitalization should they contract Covid-19, but a new study finds that so are young people with obesity. … Read more