Dietitian Expelled from Dietitians Association of Australia for Providing Advice “Inconsistent with Evidence-Based Practice”
Jennifer and me in Melbourne, August 2014
For those of you who don’t know Jennifer Elliott, she is a dietitian and author from New South Wales, Australia, who has been practicing for more than 30 years. For the past ten, she has recommended a moderately low-carbohydrate diet for people with diabetes and insulin resistance, many of whom have experienced significant improvement as a result of following her advice. This approach arose out of her own extensive research into the causes of insulin resistance, along with the overwhelmingly positive impact carbohydrate restriction has had on her middle daughter, who was diagnosed with this condition as a teen (You can read the full story on Jennifer’s website, along with her recent blog posts about the expulsion). She is an extremely bright, responsible, well-regarded dietitian who truly cares about her patients and does everything she can to help them. .Jennifer is also my friend and someone I speak with on a frequent basis.
In Australia, Accredited Practicing Dietitians (APD’s, similar to Registered Dietitians or RD’s in the US) are required to provide nutrition recommendations that adhere to Australia’s Dietary Guidelines. Jennifer has been genuinely perplexed as to how the situation has unfolded. Australia looks to the US, specifically the American Diabetes Association (ADA), as a trusted source of evidence-based information on diabetes management, and in the past DAA has stated that they endorse the ADA guidelines for use by dietitians in Australia. Jennifer has stayed up to date with these guidelines and the changes over the years, including their 2013 position paper Nutrition Therapy Recommendations for the Management of Adults with Diabetes, which states:
“Evidence suggests that there is not an ideal percentage of calories from carbohydrate, protein, and fat for all people with diabetes; therefore, macronutrient distribution should be based on individualized assessment of current eating patterns, preferences, and metabolic goals….A variety of eating patterns have been shown modestly effective in managing diabetes including Mediterranean-style, Dietary Approaches to Stop Hypertension (DASH) style, plant-based, lower-fat, and lower-carbohydrate patterns.”
It is disingenuous of the DAA to find against Jennifer for using a lower-carbohydrate approach for patients with diabetes and insulin resistance, when the ADA states that it is indeed one of several options that may be followed by such patients. In fact, the ADA asked me to write an article about carbohydrate restriction for their journal Diabetes Spectrum nearly three years ago.
I find it very upsetting and extremely unfair that a caring, dedicated dietitian such as Jennifer, who has helped so many patients improve their health and quality of life, is being treated this way. At this point, several like-minded dietitians, doctors, and researchers are working to publicize Jennifer’s story and provide her with support in fighting this ruling. We can use help in spreading the word. And please stay tuned for further details as they become available.
“When you believe in something, fight for it. And when you see injustice, fight harder than you’ve ever fought before.” – Brad Meltzer
I am so shocked and feel not only is this sad but it is an injustice to our patients and science on the whole. I am a dietitian and feel that a restricted carb diet has many health benefits! It is also scary to think we might be expelled for handing out this advise to patients.
Thanks for your comments, Rosemary. I agree.
The truth as far as I am concerned, is that Tim Noaks is right!
Four years ago I had a triple heart by-pass operation and at the same time was diagnosed as a type two diabetic. I won’t go into all the details except to say that the doctors told me that I would have to take statins and blockers for the rest of my life.
I decided to do some research into WHY I had come to the situation in which I found myself:
I very quickly discovered dietdoctor.com and Dr Natasha Campbell McBride, and later Tim Noaks.
I decided to try the LCHF diet.With in a very short time I noticed a marked improvement in my health and after digging deeper into the history of the lipid hypothesis, I came to the realization that I had been following the wrong trail health wise. I decided to dump the medications in the bin and take control of my own health.
Now nearly five years on, the doctor who told me that I had to take all the meds rang to tell me that I am no longer type two diabetic, and that what ever I am doing to KEEP DOING IT!
I was born on the 24th of May 1934 and am fitter than the average 81 year old, with only one regret and that is that: had I known twenty years ago, what I have learned in the last four to five years, I believe I would not have developed the need for a heart operation OR type two diabetes and their related symptoms!
I also believe that the two most dangerous places to be in town are in a doctors consulting room and the center of a super market!
I am living proof that the LCHF diet works, I have been on both side of the debate and no one, repeat, NO ONE is going to convince me that the main line medical profession are helping people who are ill from the wrong nutrition.
My motto is, “Learn from other’s mistakes, You won’t live long enough to make them all yourself!”
Thanks so much for sharing your story, Arthur. Congratulations on the many health improvements you’ve experienced via a LCHF lifestyle. Truly inspirational!
Hi Franziska
I was aware of this lamentable situation regarding Jennifer Elliott, before reading your post, and I am appalled this has happened. As you say the American Diabetes Association recommended a lower carb diet as an option for diabetes control years ago.
The latest advice from the largest nutritional organisation in the world, the Academy of Nutrition and Dietetics, regarding healthy fats and I quote.
“The Academy submitted comments supporting the scientific process used by the Dietary Guidelines Advisory Committee in drafting its recommendations for the 2015 Dietary Guidelines for Americans. The Academy’s recommendations to the Departments of Agriculture and Health and Human Services include: 1) Supporting the DGAC in its decision to drop dietary cholesterol from the nutrients of concern list and recommending it similarly drop saturated fat from nutrients of concern, given lack of evidence connecting it with cardiovascular disease”
I have as you know, controlled my type two diabetes for over seven years, as have countless others all over the world, with a low carb higher fat diet. Naysayers have said for a long time our good news was only anecdotal. Now the latest science and recommendations back up the lower carb diet, with the lost calories, if required, replaced with high quality saturated fats.
Increasingly, forward thinking medical professionals such as University Professors, GP’s and Dietitians, are putting their heads above the parapet of failed dogma and working with the new science discoveries and latest dietary guidelines. They must be supported at every opportunity, the travesty regarding Jennifer Elliott is ludicrous, and I hope the DAA reverses their decision swiftly and offer a full apology. The old dietary guidelines have failed, especially for type two diabetics, the evidence is plain to see, long live the new guidelines. You finished with a quote, this quote comes to mind.
First they came for the Socialists, and I did not speak out
Because I was not a Socialist.
Then they came for the Trade Unionists, and I did not speak out
Because I was not a Trade Unionist.
Then they came for the Jews, and I did not speak out
Because I was not a Jew.
Then they came for me and there was no one left to speak for me. Martin Niemöller
Kind regards Eddie
Hello Eddie,
Thanks so much for your comments. I know Jennifer appreciates your support.
I wrote a letter to the DAA politely expressing my thoughts. It was a handwritten letter.
Fantastic work, Jill!
I received a response from the DAA, promoting the DAA.
I too read this via Dr Karen Zinn’s Facebook page. It simply astounds me that recommending low carb for a diabetic is considered wrong. The madness is that diabetics are now told sugar is just another carb and eat carbs like a normal person.
Great points, Lynda, thanks.
They should be ashamed of themselves. My HbA1C has gone down from 9.3 to 6.1 in a few months just by eating LCHF. How is that for evidence?
Congratulations, Elaine! This is the sort of improvement I see time in again when people with diabetes adopt a carb-restricted diet. Keep up the great work!
The DAA says that their complaints process mirrors that of AHPRA. Yes. But the DAA has no transparency in its decision making. It’s all “confidential”. I can go and read the details of why a doctor, nurse, dentist, insert other health professional, was suspended or struck off. But a dietitian? No.
All this does is protect the DAA, it does not protect the dietitian. Reading the documents on Jennifer’s page it appears that the client got a few details mixed up. And I wonder about the real motives of the mystery reporting dietitian.
Thanks very much for your insightful comments Suzanne. Appreciated!
This is despicable. What can we do to get this lady reinstated, if indeed that’s what she wants….
Having read the correspondence between the ADA and Jennifer that Jennifer has bravely made public, I found the ADA’s decision appalling. A pity that the ADA doesn’t appear to be regulated by AHPRA, the body to which most Australian health professions belong. The process may have been handled more professionally and fairly.
Apologies. My earlier comment stated ADA when clearly I should have written DAA. Mea Culpa.
No worries, Marilyn. I knew you meant DAA. Confusing acronyms! Appreciate your comments.
On Jimmy Moore’s recently completed eighth low-carb cruise one of the diabetic attendees had persistent high blood glucose despite almost 200 units of insulin per day. At the recommendation of a prominent physician she stopped all carbohydrates and cut her insulin. Within the week she was completely off her insulin with blood glucose in the 100 range. A dramatic case that this is not uncommon with proper, aggressive, appropriate treatment of diabetes. Jennifer is spot on.
Hello Phil,
Thanks for sharing that amazing Low Carb Cruise success story. Yes, those of us who use a carb-restricted approach often see significant improvement in a very short period of time. Hard to see the arguments against it in the face of so much supporting evidence. Appreciate you taking the time to comment here!
SO disappointed to read this & see Jennifer Elliott – someone who finally ‘GETS IT” about the effects of carbs on a Diabetic’s health – being vilified & ousted by the DAA. I just put this post on their fb page.
I find it appalling that you recommend high glycemic foods to Diabetics! I’m a Type 2 Diabetic and if I eat one plain slice of bread my reads would go from e.g. 6 up to around 15/16 – are you kidding me to recommend this???!!!!! After being a Type 2 Diabetic for over 20yrs & finally going Paleo – cutting out almost all carbs (incl. all grains) – I now need very little medication, am healthy & immediately lost 16kg – impossible whilst on meds, & I hear the same kinds of stories repeatedly from other Diabetics after cutting out most carbs & going Paleo. Wake up DAA & Medical Profession – or are we making you all too much money & creating too many jobs by being sick?????!!!!!!! In my mind recommending high glaecemic cards to a Diabetic just goes to prove there is corruption somewhere, otherwise why would you recommend something that keeps people sick & on meds – do the Insulin Drug Companies sponsor the DAA/something???!!!!! Breads, potatoes, rice, corn & sugars should all be eliminated as much as possible from the diet of a Diabetic IF they wish to properly manage their blood sugar levels and be healthy – NOT to do so or in fact for the DAA to recommend otherwise would make it obvious to me that there is corruption afoot to keep us (Type 2 Diabetics) on medications for life & NOT to help us get off them & get healthy. I am totally appalled with the vilification of Jennifer Elliott for being ON TRACK. Open your mind DAA – you should be ashamed!
it is shameful that this should happen! There is so much evidence that this helps people! Everyone is advocating something similar and then these associations can do this!! At least people are opening their eyes to these ‘new’ trends and are taking their health into their own hands. Well don
Maybe the dietitians will change their ideas when they get sued by patients for giving false / outdated advice
Completely agree – there needs to be class actions all over the world facilitated and coordinated by experienced medical litigators.
Totally horrified that the people who are charged with looking after our health, are doing their best to make us unhealthy. The only person who has given me decent advice is a naturopath. She recommended 15 grams of carbs max for a meal and 7 grams for a snack. The Diabetes educators recommended 30grams for a snack and a whopping 60 grams for a meal.
If I had 60 grams of carbs in anything I would be showing readings off the scale. I got banned from a facebook site for suggesting that Himalayan Sea Salt was helpful
That’s great advice from your naturopath, Alain. And I’m a fan of Himalayan sea salt as well.
Utterly appalling Jennifer Elliott has been victimized for providing clients with sound, healthful guidance. A witch hunt. Hoping DAA’s unconscionable actions results in a backlash that raises awareness & reinstates Jennifer. Kudos for getting her story out. My health as a T1 would be severely compromised if I followed standard dietary advice.
I am saddened by this news. I am not insulin resistant, but I have also benefitted from a low carb, high fat diet. It has rid me of a host of illnesses and I’ve lost my visceral belly fat. No other diet was effective in healing my body as the low carb, high fat was. I hope that the ADA sees the error of their ways and re-instate Dr. Jennifer Elliott ASAP. We have more than 77000 people following that diet here in South Africa with amazing results, especially for the diabetics.
What a load of @#$%%$# BS! Wake up to the 20th century DAA. This just proves what I have thought for a long time – you guys are well out of touch with Diabetes management and must enjoy being in bed with the pharmaceutical companies. I went against the medical model of medications for my Type II Diabetes, refused the medications and managed it with my naturopath with a low carb diet. I reversed it within 12 months, to the “astonishment” of my GP who said the results must have been wrong in the first place. Funny that she didn’t even bother to ask how I had “reversed it”. It seems to be a popular trend at the moment- Pete Evans is getting a grilling for promoting healthy real food – forget the “paleo name tag” for a minute here – he is promoting proper real healthy food. Why is that such a frigging problem? Which part of that is so hard to understand? It’s real healthy food. Why do the DAA have such an issue with real healthy food when its a much better way to go than processed crap filled with sugar and by the way, causes so many health issues today……. wait for it……. diabetes included….. WOW……Most of the health issues are life style related, which funnily enough, can be reverted when you eat real healthy food and not processed crap. The research is out there if you can be bothered to read it. I know who I’m backing here. I sure hope the DAA come to their senses and retract their expulsion of Jennifer Elliott. They have completely lost my respect.
Perhaps the expelled dietitians could start their own organization.
Yes, well, all ‘Associations’ or ‘bodies’ are just groups of people who set themselves up as the definitive ‘go-to’ experts on any given subject. you are expected to believe in and ‘conform’ to their opinions in order to fulfil their criteria and ‘win’ their qualifications.
All qualifications are based on opinion or what any given current opinion or belief is in any given subject or field at any given time.
Just because certain ‘bodies’ set themselves up as the definitive expertise on anything doesn’t actually mean diddly-squat. Jennifer Elliott is far better off kicking the dust off her heels and putting as much distance between herself and this self-appointed ‘expert’ panel as is humanly possible.
There is an overweening plethora of self-important, self-righteous, self-appointed ‘bodies’ and ‘associations’ out there. You know the only one that would actually be worth listening to, that as far as I know has never been created?
The Common Sense Association……
Thanks Franziska,
The Dietitians Association of Australia actions are clearly suspect and discriminatory. They promote plant based foods … anything less is apparently substandard. Now they are stuck doing lots of damage control after making a bad decision to expel Jennifer.
There are many versions of whole foods diets with similar themes but the Association has chosen to draw a line in the sand. Too bad.
Why can’t we all work together and find common ground?
Excellent points, Jeff. Thanks for your comments and support.
As a Dr I would just like to put my hand up as a supporter of low carb diets. They make complete metabolic sense for diabetics, those with insulin resistance related disorders and for weight loss, and the evidence is now starting to role in in support of these diets. Add to that the thousands of people benefitting, and I think it is just a question of time before we start to see changes in recommendations, it’s inevitable, and those trying to hold back the tide are irresponsible and ill informed. I agree with the author, Jennifer is actually operating within their guidelines ( which have no force in law anyway, they are merely ‘expert’ group recommendations. ) Unfortunately, since these guidelines have been in use for nearly 50 years, they are not questioned and are applied with almost religious conviction. To disagree is to be branded a heretic. The comparison with Galileo is apt! I think like minded professionals who believe this is the way forward should set up their own association and start making their own recommendations based on current evidence and free of the taint of commercial support. Why is support from the likes of nestle and coca cola needed anyway? it completely ethically compromises these organisations in my opinion, and cannot be justified.
Thank you, Leslie, for your insightful comments and support of those who advocate carbohydrate restriction.
I have come to the conclusion a long time ago that there is just too much money to be made out of us all being unwell or sick, just imagine for a minute if people didn’t need drugs or stopped eating all the so called food from the middle isles in the supermarket. So we as individuals have to take control..
I can’t believe actions of DAA are juridically solid. The act of expelling based on something close to an anonymous complain without any opportunity for self-defense should be an easy target for any layer.
why not do a test or survey of the diabetes sufferers and their Dr and Diets followed. see who comes out alive is what is the end result is. I have change OUR diets for my husbands sake and he is no longer pre-diabetic, in under 6 months. I have benefited by losing 6 kg, and I thought I was at a healthy weight of 60kg 165cm. no arthritis and cramps have eased off, more energetic. both our blood test showed improvements, yet our LDL readings were higher, my bloods were normal except the LDL, but I’m going for another test to see if they are the good FAT LDLs as pointed out by Dr Gary Fettke, if so, im on a winning eating regime. LC/HF
Congratulations on your health improvements and those of your husband, Debbie! Yes, I’d really like to see a study that looks at the long-term outcomes (complications, quality of life, mortality) of those who manage diabetes with a low-fat diet vs. carbohydrate restriction.
Hello Franziska,
The DAA has acted in an appalling way. There is absolutely no justification for this treatment of Jen Elliott. In fact it is much worse because the approach it is trying to defend does not work and there is no reliable evidence to even suggest that it does. By contrast there is sound research to show that LCHF is very successful for many people. It is ludicrous to dismiss the personal experience of hundreds, if not thousands, of individuals who have effectively cured T2D with LCHF. On top of all this, many have been able to come off drugs completely and improved their health enormously. To imply that all of these are liars and charlatans, which what the DAA action means, is simply ridiculous and insulting. The DAA needs to take advice from independent competent scientists. If it does it must overturn this stupid decision
and stop giving advice which is causing unnecessary suffering and premature death on a scale which it is impossible to assess. Is there no way in which this organisation can be charged with “Professional misconduct” ?
Verner Wheelock
Thanks so much for taking the time to comment here, Werner. I appreciate your support and know that Jennifer does as well.
Verner,
I have put on a post suggesting that people may want to write to Hon Jillian Skinner and ask for an enquiryto be opened into the conduct of the AAD. This is a replay of what happened to Dr Dahlqvist in Sweden some years ago, which prompted a thorough review of research on dietary advice. The result, as you all know, is that the guidelines were changed and the good Dr Dahlqvist was exonerated.
I do believe what has happened is highly unethical. How can dietary advice which causes harm be defended.
I don’t know what other legal remedies are available in Austalia but this case needs to get into a courtroom somehow or other, if no enquiry into the conduct of the AAD is forthcoming. You might want to have chat with any friends in the legal profession. There have to be some lawyers who have diabetes and have been using a lchf diet.
And you might want to read this,everyone, if you haven’t already. The whole sorry tale of how we got to where we are on diets and other health issues https://doc.research-and-analytics.csfb.com/docView?language=ENG&source=ulg&format=PDF&document_id=1053247551&serialid=MFT6JQWS%2B4FvvuMDBUQ7v9g4cGa84/gpv8mURvaRWdQ%3D
Very best wishes
Gillian
Her expulsion is better evidence that she is qualified than her degree ever was!
I’m not saying there’s a massive conspiracy, but I am saying that all the incentives are in place to protect the status quo… Money, power.. entire careers in medicine, science and the corporate world have been built on the faulty/fraudulent “fat phobic” foundation.
The long knives come out when the opportunity presents..
Have you heard about what Noakes is going through? I first heard about him being called before a 2 day hearing for unprofessional conduct in this awesome debate he had with a status quo dietitian: https://www.youtube.com/watch?v=SQXd6tpu5bE
found more info here:
http://you.co.za/news/tim-noakes-in-trouble-over-advice-he-gave-on-twitter/
Hearing postponed:
http://www.biznews.com/low-carb-healthy-fat-science/2015/06/05/tim-noakes-and-the-peculiar-hearing-that-didnt-happen/
They are trying to smear him and discredit him, as they have Jennifer..
Dear All,
I live in the UK and am appalled at what has happened to Jennifer. Some of us have emailed the Minister of Health in New South Wales asking for an enquiry to be opened to examine the conduct of the AAD. This is one way of supporting Jennifer and exerting pressure to get this injustice properly investigated. The Health Minister is Hon. Jillian Skinner and her two email addresses are on this site here- http://www.parliament.nsw.gov.au/prod/parlment/members.nsf/0/517fd3b146c5aa674a25674500016598?OpenDocument
Thank you very much, Gillian. I wrote a letter to Ms. Skinner several weeks ago and shared widely on social media, encouraging others to do the same. I hope that our efforts result in a hearing.
Thank you, Franziska.
I note that I referred to the organisation concerned as AAD, rather than DAA, apologies for my error.
I am so pleased to hear that so many have already protested about Jennifer’s situation.
I am not a dietician but I am doing my best to keep up with the implications of the impact, over at least 30 years, of the fraudulent research of Ancel Keys (diet heart hypothesis). And what I have discovered about the dominance of this flawed research has been a revelation. I don’t believe there is anything more important than good dietary advice as it affects us all.
I have no doubt whatsoever that those with diabetes benefit from restricting their intake of carbs. Jennifer is a person of good standing in your professional community, and with good reason. She has done her research carefully and my impression, from reading about her, including her own blog, is that the DAA would have served those patients with diabetes far better had they allowed themselves to be open to new evidence based research and to learning from Jennifer. It horrifies me that patients with diabetes who follow the advice to eat plenty of carbs are, effectively, condemned to the real risks of terrible health complications, no matter how hard they try. I believe this is deeply unethical. And, unfortunately, we face the same problems in the UK where inappropriate advice is still being dispensed.
The weight of evidence supporting carb restriction for those with diabetes is increasing. Unless organisations like the DAA get themselves on board, they may well find themselves on the receiving end of future big legal class actions for harm caused to patients by following inappropriate advice. If the DAA fail to redress this injustice then they may have a hard time, at some point in the future, explaining why they did not take the opportunity now to conduct a review of research. They are letting down the very people who should be able to rely on them for up to date advice.
I hope Jennifer is going to get a hearing.
Warmest wishes to you all.
Thanks so much for your astute and insightful comments, Gillian. I agree with them wholeheartedly.
Hi Franziska
From: Dr Verner Wheelock
I am extremely concerned about the expulsion of Jennifer Elliott from the Dietitians Association of Australia (DAA) because of her recommendation to lower carbohydrate diets to people with insulin resistance and type 2 diabetes (T2D). Furthermore I find it incomprehensible that the Southern New South Wales Local Health District (SNSW Health) has issued the following instruction that:
“Nutritional advice to clients must not include a low carbohydrate diet. Jennifer will be advised on the information that she may provide to clients…. ”
Which translates to in my opinion..
The diet of slow death for diabetics must be adhered to, our big pharma and junk food paymasters insist upon it.
Kind regards Eddie
Thanks for your comments, Eddie.
Keep up the great work!!!!
Thanks very much, Sarah!
By definition, anyone agreeing with the author’s post is sane, sensible, fair-minded and probably very flexible. But in the media, the public face of dieticians seems to be dominated by naturally thin, po-faced, holier-than-thou, disapproving types who want people to follow cookie-cutter approaches to diet which bang on about being evidence-based but are in fact folk theory (common sense, which is not always right, and is often based on moralising: overweight? you need to be made to suffer — having judged others for difficulties they don’t have themselves, they want them to “pay the price” of their bad habits). Also they conflate “overweight and obese” to disguise the actual scope of the issue of weight and entrench themselves as the guardians of dietic virtue. (Yes I have someone particular in mind, but if the cap fits, wear it, Person X.)
These dieticians seem to still be terrified of being treated like quacks, and fighting to be accepted as real professionals, so they attack fiercely anyone who looks like threatening their position. A doctor giving diet advice is complained about by a hospital dietician (we know what kind of food you get in hospital!) for daring to go onto their own original medical turf (recall the Hippocratic oath, of which the FIRST sentence is this: “I will apply dietetic measures for the benefit of the sick according to my ability and judgement; I will keep them from harm and injustice.”
It is the weak and defensive who attack others to shore up their own inferior position — there is no room for a broad church when you are fighting for supremacy. The same thing happened in psychology, which split in two when behaviourists got into bed with statisticians and tried to go “scientific” (quantitative big data, which strips out the art and skill of diagnosis and leads to medicalised approaches to the psyche). They abandoned a whole dimension of their discipline in doing so (depth psychology, introspection, self-reporting, observation, not to mention humanist psychology generally).
There are SO MANY VARIABLES in any big data set! Meta-studies are worse, because they strip out anything of interest. I am looking forward to the backflip when the evidence for gut bacteria and LCHF becomes inescapable (but hell may freeze over first).