article

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

Practitioner’s Preface In addition to several types of therapeutic ketogenic diets, such as the Classic Ketogenic Diet (KD) used in the treatment of epilepsy, there is another type of therapeutic ketogenic diet used in the treatment of type 2 diabetes and for weight loss. This is referred to in the clinical literature as a Very … Read more

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

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

Introduction The recommendation to lower the consumption of saturated fat in the diet to reduce the risk of cardiovascular disease (CVD) has been a central theme in both the US and Canada since 1977. However, a landmark report published by the American College of Cardiology has stated that there is no beneficial effect on either … Read more

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

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

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

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

Introduction A new large-scale study looking at data from more than 4,000 COVID-19 patients in New York City found that outside of older age (>75 years), obesity was the single most significant risk factor contributing to hospitalization and critical care [1]. This reinforces findings that in people under the age of 60, obesity poses a … Read more

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

Introduction It is well-known that older adults are at greater risk of complications from COVID-19, but few realize that the majority of those hospitalized in the US [1] have common underlying medical conditions. These comorbid conditions include high blood pressure, obesity, diabetes, and cardiovascular disease. While we focus on physical distancing and hygiene, we must … Read more

Introduction Note: This article is a follow-up to previous reports regarding the presence of COVID-19 in Vancouver and federal recommendations for outbreak preparedness. On February 24, 2020, Provincial Health Officer Dr. Bonnie Henry identified a seventh case of COVID-19 in BC. This case involves a man in his 40s who was a close contact of … Read more

Introduction Note: This article is a follow-up to previous reports regarding COVID-19 in the Vancouver area. This article includes updates posted on February 23rd, 2020. Provincial Health Officer Bonnie Henry announced on February 20th that a woman in her 30s returning from Iran is British Columbia’s sixth case of the novel COVID-19 coronavirus. This case … Read more

Introduction The American Diabetes Association (ADA) has released its Standards of Medical Care in Diabetes (2020) [1]. This update reinforces the April 2019 Consensus Report, emphasizing that there is no “one-size-fits-all” eating pattern for diabetes management. Instead, the ADA underscores that Medical Nutrition Therapy (MNT) must be individualized to the patient. The ADA explicitly recommends … Read more

Introduction Many people say they plan to lose weight or lower their blood sugar, pressure, or cholesterol in the New Year, but the difference between a “wish” and a “resolution” is having a plan in place to actually do it. Wish or Resolution? A “wish” is really just a hope that something will occur, whereas … Read more

Introduction Historically, “when we eat” was a non-issue; we ate when it was daylight and food was available, and we fasted when it was dark. With modern lighting and refrigeration, our “day” lasts as long as the lights are on, and food is available around the clock. To understand the current science of meal timing, … Read more

Introduction There are two large-scale meta-analyses — one from 2013 and the other from 2017 that indicate that Vitamin D supplementation can reduce the risk of getting an upper respiratory infection (URI) including influenza (“the flu”). Studies Showing that Vitamin D Attenuates the Flu The first study by Bergman et al [4] analyzed data from … Read more

Introduction There is much “push back” when it comes to the standard advice to “eat less and exercise more” as a means of losing weight, and for good reason. For one, metabolism will slow as a result of caloric restriction—making it that much more difficult to lose weight when deliberately cutting calories. Another reason is … Read more

Introduction In the first two articles of this series on Small Intestinal Bacterial Overgrowth (SIBO), I covered what SIBO is, its prevalence, symptoms, and the various diagnostic tests used to identify it. I also discussed why Irritable Bowel Syndrome (IBS) that does not improve with standard dietary changes may actually be SIBO. In this third … Read more

Introduction In the first article of this series about Small Intestinal Bacterial Overgrowth (SIBO), I covered what SIBO is, how common it is, and its primary symptoms. If you haven’t read that introduction yet, it provides essential context for our discussion. In this second article, I cover the different tests used in diagnosing SIBO, exploring … Read more

Introduction I used to believe that SIBO was a condition that only alternative medicine practitioners, such as naturopaths, identified and treated. I thought it wasn’t a real diagnosis at all, and it seems I was not alone in this belief. This is the first article about SIBO, outlining what it is, its symptoms, and its … Read more