Two ADAs: Same Awful Advice

Whether you’re talking ADA, as in, American Diabetes Association or, ADA as in American Dietetic Association, the advice is the same and the effects are the same: not helpful at best, deadly at worst.

This is a sort of follow-on to my recent post on registered dietitians.

One of my readers, Steve Cooksey, offered to share his experience with the “ADA,” and it doesn’t really matter which one, or both. He might have died but for his finding Mark Sisson and from there, others in the paleo / primal blogging community.

Before you see Steve’s amazing story in his own words, let’s pause for a little history. While I was aware of Dr. Richard Bernstein’s history concerning the development of home-test blood glucose meters, I hadn’t put all the pieces together until listening to Jimmy Moore’s amazing hour-long interview with the doctor. I very highly recommend listening to that for all, and if you’re diabetic, it’s essential.

Very simply and briefly, it turns out the the various admonishments to eat all sorts of grains, starches, and even sugar that you hear from the ADA has some rational basis. See, there used to be no such thing as knowing what your BG was at any given time. Diabetics used to go in once per month for a glucose test. They had no way of knowing how a meal or any food affected them throughout the day. Well, if you’re on insulin, which would be a prescribed dose at given fixed intervals, then there would be a real, life threatening danger of going hypoglycemic (dangerously low blood glucose) if you didn’t have enough carbs in your diet.

Knowing diabetics would be eating some range of carbohydrate, dose needed to be set in a way to make sure BG didn’t get too high, then admonish patients to get their X number of servings of whole grains & starches. Better the BG gets to high than too low, and if the patient eventually goes blind or has limbs amputated then, well, that’s just an aspect of the disease. But dying of hypoglycemia put blame square on the treating physician. So, for liability reasons, we have high carb diets for diabetics.

Dr. Bernstein’s argument was that with home monitoring, people could effectively manage BG on their own, eat far fewer carbs and reduce the meds. He was met with strong resistance all along the way. The medical establishment did not want to control glucose, only dose, and so high carbs were necessary. Now that monitors are readily available, blood glucose control is in reach of every diabetic, and yet, the dietary advice has yet to change.

So, the takeaway for me is that I’m willing to cut them all a little slack in terms of the foregoing. But, now that meters are available for all, it is time to alter the dietary advice and to teach patients how to modify their own dose in response. And, those who still want to munch high carbs can, though carbs act far quicker than insulin, and excess insulin is a slow killer. If your A1C hemoglobin is more than 4.5-5, you are probably aging yourself far faster than you otherwise would.

And now to Steve’s story.

I was an obese diabetic who weighed as much as 235 lbs and I had missed several weeks of work the last several years due to respiratory issues. I was typically being diagnosed with bronchitis or “episodic asthmatic” events.

My health deteriorated to the point that in February 15, 2009, after two doctor visits earlier in the week, I told my wife to take me to the doctor or the hospital. Literally…I could barely move.

Long story short, I was taken to the hospital in an ambulance with a BG reading of 700+ and an A1C that was literally “too high to read”. Three days later I was discharged home as a Diabetic and while the doctors were not sure, I was told that I was likely a Type 1 and that I would be on insulin and medications for the rest of my life.

While still in the hospital, I was given an ADA Food Pyramid by the “hospital nutritionist” and upon inquiry was informed to “eat the food groups” but stay below 2200 calories. This seemed odd to me but at the time, I was a mental wreck — having been given several body blows — so I took the advice and ordered my meals from the hospital menus. To be honest…they looked a hell-u-va-lot like what I ate ordinarily….

So, I go home and start researching what to do. I was determined to do ALL I could to stop taking insulin and medications. I’d seen too many relatives go down this road…and quite frankly…I did not like the destination nor the ride to get there.

A couple days later after discharge, a home health nurse came by — I also quizzed her about my diet — SHE HANDED ME ANOTHER ADA Food Pyramid and told me to “eat the food groups”.

A couple of days later my doctor told me to check out the Low Glycemic Index to see if that would help…it did and it started me on a journey that lead me to Mark Sisson’s website where I explored all things Primal.

Today, with the benefit of a great workout program and a Primal diet, I am 75 pounds lighter and I take -0- insulin and -0- medications. My latest blood work showed NO EVIDENCE OF DIABETES NOR OBESITY! (I am still diabetic, you just wouldn’t know it from my blood work).

I have been insulin and medication free for about 6 months. Because I know how utterly confusing and hopeless life can be when diagnosed with diabetes, I have attempted to reach out to “spread the word” about paleo / Primal eating and living. I often “befriend” people in social media groups and strike up a conversation.

Multiple times — I’d say at least 4-5 times — I have began a conversation with a “Certified Diabetes Educator”. EVERY SINGLE TIME — NO EXCEPTIONS — they do not HAVE A CLUE when it comes to paleo / Primal eating. Honestly…I find this disgusting. Especially when I have to hear (or read) how they are required to go to X number of hours of recertification classes and how they are trained on the latest…blah, blah, blah. ALL of this is bad enough, but here’s the kicker…

THEY ATTEMPT TO CONVINCE ME TO STOP!!! …And go back to eating grains, beans, rice, pasta etc. THE AUDACITY!!! EVEN AFTER they know that I have lost weight and kicked diabetes in the ass (for now) they try to get me back on the train…the train to hell.

WHY? Why would they do this?????

Certified Diabetes Educator: “Because you are missing nutrients and fiber.”

Fiber? …I laugh… “so you are telling me to go back to insulin and meds …for fiber?

CDE: “you need a balanced diet from a variety of sources and all of the nutrients”

….”Ok… tell me what nutrients I am missing from eating meats, broccoli, cauliflower, greens, celery, tomato, green peppers, mushrooms and nuts….. plus I take a multivitamin… Tell me exactly what nutrients I’m missing that is worth going back on insulin and medications.”

I have never received an explanation or answer to that question…. NONE!

Richard, I understand that not every Type 2 is going to be able to stick to a Very Low Carb diet… I get that. BUT the ADA should PUSH Very Low Carb diet as the PRIMARY solution and IF THE PATIENT CAN NOT Stick to it…then promote the carb laden diet that keeps people “carbing up and shooting up”.

So there you have it. Is it really necessary for me to add anything? Didn’t think so.

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  1. O Primitivo on December 11, 2009 at 13:06

    The American Diabetes Association receives millions of dollars from its pharmaceutical sponsors. Imagine if tomorrow they would come up with some new Paleolithic Food Pyramid, and most diabetics would immediately reduce, or even eliminate, diabetic medications/insulin? Certainly those sponsors would disapprove that uneconomical idea. You can see exactly what amount of money were talking about here ->

  2. Bob from Buffalo on December 11, 2009 at 10:11

    Apparently, the earth is still flat. Thanks for passing this along, Richard.

  3. CFS on December 11, 2009 at 10:16

    Awesome, inspiring story. Thanks a lot for sharing it, Richard and Steve.

  4. Dave, RN on December 11, 2009 at 10:50

    As a nurse, the fact that Conventional Medical Wisdom won’t change in spite of success stories like his, mine and countless others disgusts me. They even have a name for it: The Semmelweis Reflex. The Semmelweis Reflex is when a discovery of important scientific fact is punished rather than rewarded. Named after Dr. Ignaz Semmelweis, …physician who discovered the cause of puerperal fever, a now-obsolete disease which, in Semmelweis’s primitive era, yearly killed a vast number of women in childbirth. Semmelweis was fired from his hospital, expelled from his medical society, denounced and ridiculed widely, reduced to abject poverty and finally died in a madhouse.

    • Dave, RN on December 11, 2009 at 11:04

      I should have mentioned that the reason for the Purpural fever was the fact that the docs did not wash their hands between handling cadavers and assisting in a childbirth. Semmelweis was proven correct when he instituted a handwashing policy. Then the docs stopped washing and the disease returned. Even today we still struggle to get them to wash their hands when entering and exiting a patients room.
      I can tell you from experience that doctors (most of them anyway) hate to be wrong. There are some good ones, but they need to be in the majority, not the minority.

  5. Diana on December 11, 2009 at 11:25

    What a great story, and I can totally relate! I was diagnosed in Jan 2009, but, fortunately I allready had a foot in the door with low carb eating, and I am so thankful that I did! I agree that it is soooo frustrating to see on myself (or yourself) that this works (last A1c was 5.1), but that so many diabetics are loosing their eyes, limbs, kidneys because all they know is what they are told by their docs and diabetes educators. WE CAN’T SHOUT IT LOUD ENOUGH!!!
    Congrats on the weight loss, and the blood sugar control. Keep on talkin-even if it’s only to one person, you may save their life, or the quality of it at least.

  6. Diana on December 11, 2009 at 11:29

    Sorry- forgot one more thing, If doctors and diabetes educators were to steer people to low carb/paleo to control blood sugars, they would be slitting their own throats! Directly or indirectly, their salary depends on more people becoming and staying diabetic.

    thanks again for posting this, like I said above to Steve, if even just 1 person benefits, thats one less person to suffer from complications.

  7. Ken on December 11, 2009 at 11:36

    Yet another excellent point/story.
    After getting so frustrated trying to get people to open up their minds, it came to me to just be a living example and tell my story, letting folks check it out or continue as usual. That being said, I want to take some people and slap them around a bit seeing them rigidly stick to what is killing them out of fear and ignorance.

  8. Vivian on December 11, 2009 at 12:10

    My story is nearly identical to Steve’s (minus the 700+ blood glucose reading – wow!). My Dr. didn’t want to know how I did it. She was not dismissive, just uninterested. The conventional diabetes “educators” (nutritionists all) on the other hand, were massively dismissive.
    During the course of the diabetes education classes the other participants dropped out, week by week, until by the last class I was the only participant who showed up. I was also the only one who was consistently losing weight and bringing my blood glucose under control. During that lonely final class, I was asked how easy/hard I was finding it to follow the regimen they were teaching. I sheepishly (in hindsight I should have been assertive, but I was still overwhelmed by my diagnosis) I told them I was following my own path, low-carb/paleo (although I didn’t have the words for it at the time) and was feeling great. I was informed, rather haughtily, that not many could stick to that approach and I probably wouldn’t be able to in the long term either and all the weight and the diabetic blood sugars would not only return, but I’d be even heavier and sicker. And that my eating plan was not acceptable without grains/fiber and with fat, and I was harming my body. There was no way they were going to teach an approach to managing blood sugar that they saw as unsustainable and unhealthy, no matter to evidence to the contrary right in front of their eyes. Apparently it’s better to push conventional “wisdom” of portion control, fat control and gorging on carbs covered by meds than it is to empower diabetics to control their own condition. Still makes me furious to think about it 3 years later.
    These 3 years later, like Steve, I’ve maintained a 75lb weight loss, effortlessly, along with normal blood sugars without any meds at all. I’m full-on low-carb paleo and I love it. And so does my health.

    • Richard Nikoley on December 11, 2009 at 12:27

      Wonderful, Vivian. These posts make my day, and more than anything else, are what’s it’s all about for me.

      What a payday!

  9. Anne on December 11, 2009 at 20:54

    Richard, you wrote about why diabetics were told to eat carbs before the days of home glucometers. My sister was T1DM before these devices were available. She used urine strips. I remember she told me that she liked to be spilling a little sugar and that way she could keep from going too low. Needless to say, she died way too young.

    I am T2DM and have been able to lower my blood glucose nicely with that “dangerous” low carb diet.

    Steve, I celebrate your success.

  10. jon w on December 12, 2009 at 10:13

    solid gold. while it will take decades for a “top-down” approach to change conventional wisdom, I think stories like this, told and retold in chat rooms and forums and blog responses to all audiences, will spread the word from the bottom up. enough people in the general population, including MDs and PhDs and journalists, still have open minds and have not invested their careers in a mistake.

  11. Mike Opteris on December 14, 2009 at 03:14

    My story is quite the same (without the excessively high BG). For 12 years I followed the conventional wisdom regarding diabetes and progressively needed more and more medication and finally insulin. Then I met ‘Grok’. This immediately made sense and I began by eliminating all sugar, grains, and legumes from my diet. I noticed significant improvements in my BG immediately as well as weight loss. Then I found Dr. Bernstein and he backed up what I had learned and put it all into a diabetic milieu that I found to be a life saver. The ADA and others including diabetis advocates are still being influenced by big pharm and big Ag.
    Thanks Richard, keep up the good work.

  12. Steve Cooksey on December 28, 2009 at 13:48

    Hello All,

    Just wanted to thank everyone for the kind comments and for those that have the same sense of injustice as I have.

    Congrats to those who have similar experiences as well… as well all know, dealing with diabetes is not easy…but once you go Paleo/Primal… it become easier.

    Special thanks of course to Richard for sharing my story on his blog as well as to “O Primitivo” for posting over 19 million reasons why the ADA supports a high carb diet. I shared that on my FB Page…I’d give you props but I can’t read your website. :)

    Thanks again all and let’s take the word to the people….


  13. New Year’s Day | Louisville CrossFit - Derby City CrossFit on December 31, 2009 at 18:05

    […] 3 rounds: 400m row 15 Pull Ups 15 Sumo Deadlift High Pulls with Kettlebell (53#/35#) Two ADAs; Same Awful Advice (link) Keep Your Eye on the Ball (link) Louisville Derby City CrossFit – Snatches […]

  14. Giving Credit to Richard Nikoley on January 20, 2016 at 10:45

    […] also posted my story on his blog, “Two ADAs“… this TOO increased my confidence 100 […]

  15. […] I have an even longer history with Steve. I’m pretty sure he got his Warrior start in an email to me, which I eagerly published, on December 11, 2009. […]

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