A New Little Black Dress – a Dietitian’s Journey continues

May 25 2008 and June 15 2019

Yesterday I had an occasion to wear a new little black dress that I had bought, and remembered the last time I wore one. Ironically, it was for my Master’s convocation just over 11 years ago, and the dress was a size 16. My degree was in Human Nutrition, yet I was very overweight and had pre-diabetes.

The degrees on the wall did not help me understand why — despite my best efforts to “exercise more and eat less”, I was still overweight.  Despite my research related to the neurotransmitter dopamine, it was not known at the time how dopamine is involved in the potent joint reward system of eating foods that are a combination of both carbohydrate and fat (you can read more about that here). 

I did not understand why following the advice of my physician didn’t help.  I ate according to the (then) Canadian Diabetes Association (now called Diabetes Canada)’s recommendation to eat 65 g of carbohydrate at each meal and 25-45 g of carbs at each snack — along with lean protein and monounsaturated and polyunsaturated fat and participated in exercise several days each week. I ate “plenty of healthy whole grains” and “lots of fruit and vegetables“, along with low fat dairy,  yet a year later progressed to Type 2 Diabetes; what I was told was a “progressive, chronic disease”.

My studies didn’t help me understand the impact of high levels of circulating insulin on obesity and the effect of the after-meal and after-snack rise in insulin and then it’s drop shortly later on hunger. The reality was, the advice we were taught to “eat less and move more” did nothing to address the underlying issue of being hungry every few hours. In fact, the detrimental effects of high circulating levels of insulin weren’t taught; only the effects of high blood sugar.

My studies didn’t help me understand that “plenty of healthy whole grains” for someone who is already insulin resistant, with high levels of circulating insulin isn’t helpful.  I didn’t understand how eating plenty of fruit was further contributing to my problems;  both because of it’s high carbohydrate load, as well as it being a high source of fructose. I drank 3 glasses of low-fat milk daily, but didn’t understand the effect of all of those extra carbohydrates on my blood sugar, as well as underlying insulin response.  It was not part of what I studied — either in my undergraduate degree or Master’s studies, because it simply was not well known.

It is only recently (April 18, 2019) that the American Diabetes Association (ADA) issued their Consensus Report which indicated that “reducing carbohydrate intake has the most evidence for improving blood sugar” (you can read more about that here). In fact, the ADA now includes both a low carbohydrate eating pattern and a very low carbohydrate (keto) eating pattern as Medical Nutrition Therapy for the treatment of those with pre-diabetes, as well as adults with Type 1 or Type 2 Diabetes.

While these are not currently part of Diabetes Canada‘s options, they are recommendations available to those in the United States.

In fact, the European Association for the Study of Diabetes (EASD) also classifies low carb diets as Medical Nutrition Therapy (see here) and Diabetes Australia released their own updated position paper for people diagnosed with Diabetes who want to adopt a low carbohydrate eating plan. 

Many studies already demonstrate that a well-designed low carbohydrate diet is both safe and effective for the treatment of obesity and Diabetes (you can find a convenient list of studies under the Physician and Allied Health Provider tab), but much of this has only come to light in the years since I graduated with my Master’s degree.

In the last 4+ years since I first learned about the therapeutic use of a low carbohydrate diet, I have read scores of studies in an effort to become well-informed and continue to do so in order to stay current with the emerging evidence. Under the Science Made Simple tab, you can read some of the almost 170 articles I have written so far, many of them fully referenced.

April 2017 – April 2019

On March 5, 2017 I began what I have called “A Dietitian’s Journey” where over the subsequent two years, I put my Type 2 Diabetes into remission, lowered my dangerously high blood pressure and achieved a normal body weight and optimal waist circumference. You can read my story under A Dietitian’s Journey.

I have been in maintenance mode for more than three months and have been able to maintain my weight loss and health gains with little effort. My ongoing personal articles since being in maintenance appear under Making Health a Habit which can be read here.

I continue to maintain my original Dietetic practice that focuses on food allergy and food sensitivity (including Celiac disease, Irritable Bowel Syndrome, Inflammatory Bowel Disease) through BetterByDesign Nutrition, and through continued reading in the scientific literature, I am now able to provide a range of options for weight loss and improvement in many metabolic conditions, including Type 2 Diabetes, hypertension and abnormal cholesterol that I was unable to offer a few years ago.  Through BetterByDesign Nutrition, I offer variety of evidence-based approaches, including a Mediterranean Diet, a plant-based whole foods approach (vegetarian or including meat, fish and poultry), as well as a low carbohydrate approach and through this division, The Low Carb Healthy Fat Dietitian I focus exclusively on using a low carbohydrate or ketogenic approach.

If you would like to learn how I might be able to help you, you can learn more about my services under the Services tab or in the Shop.

If you have questions, please feel free to send me a note using the Contact Me form above and I will reply as soon as I can.


To your good health!


NOTE: This post is classified under “A Dietitian’s Journey” and is my personal account of my own health and weight loss journey that began on March 5, 2017. Science Made Simple articles are referenced nutrition articles, and can be found here.

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