Re: Full Liquid Diet? Evidence based?

[Guest guest]

In our facility we're deleting it from our diet list this month - just have to

get the nurses to stop " advancing as tolerated " and a few damn surgeons to stop

ordering it.   But it can still be found in the Nutrition Care Manual online

(pdf about what it is and that there is no evidence for it).

Holly

 ----------

Holly Lee Brewer, MS RD CDE

Pediatric Dietitian, Diabetes Educator

Medical Nutrition Therapist, Las Vegas, NV

Maj Holly Brewer, USAFR BSC http://hollyinbalad.blogspot.com

301st MDS, NAS JRB Fort Worth (Carswell), TX

Joint Base Balad, Iraq (Jan-Jul 2009)

________________________________

To: rd-usa

Sent: Wed, June 15, 2011 10:22:25 PM

Subject: The Great Cancer Hoax - Full Liquid Diet? Evidence based?

 

Too busy lately, so getting into this discussion late.

For all the RDs that SAY they insist on Evidence Based Medicine, I ask;

Show me the evidence for hospitals to serve full liquid diets. I've NEVER

found it, but tens of thousands of RDs nationwide still do this. (I THOUGHT

that practice was stopped years ago!)

I don't work in hospitals anymore, but recently was visiting a friend in

CCU for GI bleed with a full liquid diet on his plate. 2% milk, pudding,

cream of potato soup, and ice cream.

I was embarrassed for my profession.

Please, would some RD that insists on EBM please show me the evidence for

that?

Jan Patenaude, RD, CLT

Director of Medical Nutrition

Signet Diagnostic Corp.

Telecommuting Nationwide

(Mountain Time)

Fax:

DineRight4@...

Certified LEAP Therapist and specialist in food sensitivity for IBS,

migraine, fibromyalgia and multiple inflammatory conditions. Co-author of the

Certified LEAP Therapist (CLT) Training Course.

Re: The Great Cancer Hoax - extended thru 6/20

_http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/_

(http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/)

On Mon, Jun 13, 2011 at 11:18 PM, Jacqui Pressly <_Jpress50@..._

(http://health.groups.yahoo.com/group/rd-usa/post?postID=gJl7O9-0Wsq_2MXaOdDcGaM\

Ti7GYQ

qfD4nP2Os6mSiBLs_6OsOEUFIunjUNDecytZLrYhlHZ) > wrote:

>

>

>

> ,

> Where is it that this dx doesn't exist? That's what I would be cautious

> about.

>

> Jacquelyn A. Pressly, RD, CLT

> The NATURAL dietitian

> Specializing in Wellness and Prevention, Personal Nutrition Coaching

> and Designer Lifestyle Plans to help you get on the health track

> Northeast Ohio & Western Pennsylvania

> Internet and telecounseling available for distance clients

>

> _jpress50@..._

(http://health.groups.yahoo.com/group/rd-usa/post?postID=2n1nW2HOEaLO84cXflZaGxn\

6_ABLxdnwkd6i4Xoi6_FNA0sRcNMgb3hQgncOHblofIntwCHgp7gClw

)

>

> If you are what you eat, then dietitians are the doctors of the future

>

>

> Re: The Great Cancer Hoax - extended thru 6/20

>

> But are they doing things like adrenal fatigue (dx doesn't exist), liver

> detox, homeopathy and this type of medicine - red flags should be up

IMHO.

> As should traditional medicine MDs when excessive and unwarranted and

over

> prescribing drugs.

[Guest guest]

Colleagues,

Reply to RD-USA listserv only. You do not have my permission to forward.

As the editor who created the Nutrition Care Manual, vetted the authors

/ reviewers and edited every word for the initial launch and the first

update, I can tell you why the Full Liquid diet is in NCM. Dietitians

who ordered NCM complained to the publisher that their facility's

doctors wanted a full liquid diet so the publisher insisted the full

liquid diet be added to NCM over my objections and documentation that

there is no science in published literature for a full liquid diet or a

progression from clear liquid to full liquid to soft to regular diets.

This and clear liquid diets are the only instance of a diet being

inserted in NCM that are not evidence or research based.

healthy regards,

Joanne Larsen MS RD LD

>

> In our facility we're deleting it from our diet list this month - just

> have to

> get the nurses to stop " advancing as tolerated " and a few damn

> surgeons to stop

> ordering it. But it can still be found in the Nutrition Care Manual

> online

> (pdf about what it is and that there is no evidence for it).

>

> Holly

> ----------

> Holly Lee Brewer, MS RD CDE

> Pediatric Dietitian, Diabetes Educator

> Medical Nutrition Therapist, Las Vegas, NV

>

> Maj Holly Brewer, USAFR BSC http://hollyinbalad.blogspot.com

> 301st MDS, NAS JRB Fort Worth (Carswell), TX

> Joint Base Balad, Iraq (Jan-Jul 2009)

>

> ________________________________

> From: " Dineright4@... <mailto:Dineright4%40aol.com> "

> <Dineright4@... <mailto:Dineright4%40aol.com>>

> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> Sent: Wed, June 15, 2011 10:22:25 PM

> Subject: The Great Cancer Hoax - Full Liquid Diet? Evidence

> based?

>

>

>

> Too busy lately, so getting into this discussion late.

>

> For all the RDs that SAY they insist on Evidence Based Medicine, I ask;

> Show me the evidence for hospitals to serve full liquid diets. I've NEVER

> found it, but tens of thousands of RDs nationwide still do this. (I

> THOUGHT

> that practice was stopped years ago!)

>

> I don't work in hospitals anymore, but recently was visiting a friend in

> CCU for GI bleed with a full liquid diet on his plate. 2% milk, pudding,

> cream of potato soup, and ice cream.

>

> I was embarrassed for my profession.

>

> Please, would some RD that insists on EBM please show me the evidence for

> that?

>

> Jan Patenaude, RD, CLT

> Director of Medical Nutrition

> Signet Diagnostic Corp.

> Telecommuting Nationwide

> (Mountain Time)

> Fax:

> DineRight4@... <mailto:DineRight4%40aol.com>

>

> Certified LEAP Therapist and specialist in food sensitivity for IBS,

> migraine, fibromyalgia and multiple inflammatory conditions. Co-author

> of the

> Certified LEAP Therapist (CLT) Training Course.

>

> Re: The Great Cancer Hoax - extended thru 6/20

>

> _http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/_

>

> (http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/)

>

>

> On Mon, Jun 13, 2011 at 11:18 PM, Jacqui Pressly <_Jpress50@..._

>

(http://health.groups.yahoo.com/group/rd-usa/post?postID=gJl7O9-0Wsq_2MXaOdDcGaM\

Ti7GYQ

>

> qfD4nP2Os6mSiBLs_6OsOEUFIunjUNDecytZLrYhlHZ) > wrote:

>

> >

> >

> >

> > ,

> > Where is it that this dx doesn't exist? That's what I would be cautious

> > about.

> >

> > Jacquelyn A. Pressly, RD, CLT

> > The NATURAL dietitian

> > Specializing in Wellness and Prevention, Personal Nutrition Coaching

> > and Designer Lifestyle Plans to help you get on the health track

> > Northeast Ohio & Western Pennsylvania

> > Internet and telecounseling available for distance clients

> >

> > _jpress50@..._

>

(http://health.groups.yahoo.com/group/rd-usa/post?postID=2n1nW2HOEaLO84cXflZaGxn\

6_ABLxdnwkd6i4Xoi6_FNA0sRcNMgb3hQgncOHblofIntwCHgp7gClw

>

> )

> >

> > If you are what you eat, then dietitians are the doctors of the future

> >

> >

> > Re: The Great Cancer Hoax - extended thru 6/20

> >

> > But are they doing things like adrenal fatigue (dx doesn't exist), liver

> > detox, homeopathy and this type of medicine - red flags should be up

> IMHO.

> > As should traditional medicine MDs when excessive and unwarranted and

> over

> > prescribing drugs.

>

>

[Guest guest]

Colleagues,

Reply to RD-USA listserv only. You do not have my permission to forward.

As the editor who created the Nutrition Care Manual, vetted the authors

/ reviewers and edited every word for the initial launch and the first

update, I can tell you why the Full Liquid diet is in NCM. Dietitians

who ordered NCM complained to the publisher that their facility's

doctors wanted a full liquid diet so the publisher insisted the full

liquid diet be added to NCM over my objections and documentation that

there is no science in published literature for a full liquid diet or a

progression from clear liquid to full liquid to soft to regular diets.

This and clear liquid diets are the only instance of a diet being

inserted in NCM that are not evidence or research based.

healthy regards,

Joanne Larsen MS RD LD

>

> In our facility we're deleting it from our diet list this month - just

> have to

> get the nurses to stop " advancing as tolerated " and a few damn

> surgeons to stop

> ordering it. But it can still be found in the Nutrition Care Manual

> online

> (pdf about what it is and that there is no evidence for it).

>

> Holly

> ----------

> Holly Lee Brewer, MS RD CDE

> Pediatric Dietitian, Diabetes Educator

> Medical Nutrition Therapist, Las Vegas, NV

>

> Maj Holly Brewer, USAFR BSC http://hollyinbalad.blogspot.com

> 301st MDS, NAS JRB Fort Worth (Carswell), TX

> Joint Base Balad, Iraq (Jan-Jul 2009)

>

> ________________________________

> From: " Dineright4@... <mailto:Dineright4%40aol.com> "

> <Dineright4@... <mailto:Dineright4%40aol.com>>

> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> Sent: Wed, June 15, 2011 10:22:25 PM

> Subject: The Great Cancer Hoax - Full Liquid Diet? Evidence

> based?

>

>

>

> Too busy lately, so getting into this discussion late.

>

> For all the RDs that SAY they insist on Evidence Based Medicine, I ask;

> Show me the evidence for hospitals to serve full liquid diets. I've NEVER

> found it, but tens of thousands of RDs nationwide still do this. (I

> THOUGHT

> that practice was stopped years ago!)

>

> I don't work in hospitals anymore, but recently was visiting a friend in

> CCU for GI bleed with a full liquid diet on his plate. 2% milk, pudding,

> cream of potato soup, and ice cream.

>

> I was embarrassed for my profession.

>

> Please, would some RD that insists on EBM please show me the evidence for

> that?

>

> Jan Patenaude, RD, CLT

> Director of Medical Nutrition

> Signet Diagnostic Corp.

> Telecommuting Nationwide

> (Mountain Time)

> Fax:

> DineRight4@... <mailto:DineRight4%40aol.com>

>

> Certified LEAP Therapist and specialist in food sensitivity for IBS,

> migraine, fibromyalgia and multiple inflammatory conditions. Co-author

> of the

> Certified LEAP Therapist (CLT) Training Course.

>

> Re: The Great Cancer Hoax - extended thru 6/20

>

> _http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/_

>

> (http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/)

>

>

> On Mon, Jun 13, 2011 at 11:18 PM, Jacqui Pressly <_Jpress50@..._

>

(http://health.groups.yahoo.com/group/rd-usa/post?postID=gJl7O9-0Wsq_2MXaOdDcGaM\

Ti7GYQ

>

> qfD4nP2Os6mSiBLs_6OsOEUFIunjUNDecytZLrYhlHZ) > wrote:

>

> >

> >

> >

> > ,

> > Where is it that this dx doesn't exist? That's what I would be cautious

> > about.

> >

> > Jacquelyn A. Pressly, RD, CLT

> > The NATURAL dietitian

> > Specializing in Wellness and Prevention, Personal Nutrition Coaching

> > and Designer Lifestyle Plans to help you get on the health track

> > Northeast Ohio & Western Pennsylvania

> > Internet and telecounseling available for distance clients

> >

> > _jpress50@..._

>

(http://health.groups.yahoo.com/group/rd-usa/post?postID=2n1nW2HOEaLO84cXflZaGxn\

6_ABLxdnwkd6i4Xoi6_FNA0sRcNMgb3hQgncOHblofIntwCHgp7gClw

>

> )

> >

> > If you are what you eat, then dietitians are the doctors of the future

> >

> >

> > Re: The Great Cancer Hoax - extended thru 6/20

> >

> > But are they doing things like adrenal fatigue (dx doesn't exist), liver

> > detox, homeopathy and this type of medicine - red flags should be up

> IMHO.

> > As should traditional medicine MDs when excessive and unwarranted and

> over

> > prescribing drugs.

>

>

[Guest guest]

Colleagues,

Reply to RD-USA listserv only. You do not have my permission to forward.

As the editor who created the Nutrition Care Manual, vetted the authors

/ reviewers and edited every word for the initial launch and the first

update, I can tell you why the Full Liquid diet is in NCM. Dietitians

who ordered NCM complained to the publisher that their facility's

doctors wanted a full liquid diet so the publisher insisted the full

liquid diet be added to NCM over my objections and documentation that

there is no science in published literature for a full liquid diet or a

progression from clear liquid to full liquid to soft to regular diets.

This and clear liquid diets are the only instance of a diet being

inserted in NCM that are not evidence or research based.

healthy regards,

Joanne Larsen MS RD LD

>

> In our facility we're deleting it from our diet list this month - just

> have to

> get the nurses to stop " advancing as tolerated " and a few damn

> surgeons to stop

> ordering it. But it can still be found in the Nutrition Care Manual

> online

> (pdf about what it is and that there is no evidence for it).

>

> Holly

> ----------

> Holly Lee Brewer, MS RD CDE

> Pediatric Dietitian, Diabetes Educator

> Medical Nutrition Therapist, Las Vegas, NV

>

> Maj Holly Brewer, USAFR BSC http://hollyinbalad.blogspot.com

> 301st MDS, NAS JRB Fort Worth (Carswell), TX

> Joint Base Balad, Iraq (Jan-Jul 2009)

>

> ________________________________

> From: " Dineright4@... <mailto:Dineright4%40aol.com> "

> <Dineright4@... <mailto:Dineright4%40aol.com>>

> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> Sent: Wed, June 15, 2011 10:22:25 PM

> Subject: The Great Cancer Hoax - Full Liquid Diet? Evidence

> based?

>

>

>

> Too busy lately, so getting into this discussion late.

>

> For all the RDs that SAY they insist on Evidence Based Medicine, I ask;

> Show me the evidence for hospitals to serve full liquid diets. I've NEVER

> found it, but tens of thousands of RDs nationwide still do this. (I

> THOUGHT

> that practice was stopped years ago!)

>

> I don't work in hospitals anymore, but recently was visiting a friend in

> CCU for GI bleed with a full liquid diet on his plate. 2% milk, pudding,

> cream of potato soup, and ice cream.

>

> I was embarrassed for my profession.

>

> Please, would some RD that insists on EBM please show me the evidence for

> that?

>

> Jan Patenaude, RD, CLT

> Director of Medical Nutrition

> Signet Diagnostic Corp.

> Telecommuting Nationwide

> (Mountain Time)

> Fax:

> DineRight4@... <mailto:DineRight4%40aol.com>

>

> Certified LEAP Therapist and specialist in food sensitivity for IBS,

> migraine, fibromyalgia and multiple inflammatory conditions. Co-author

> of the

> Certified LEAP Therapist (CLT) Training Course.

>

> Re: The Great Cancer Hoax - extended thru 6/20

>

> _http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/_

>

> (http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/)

>

>

> On Mon, Jun 13, 2011 at 11:18 PM, Jacqui Pressly <_Jpress50@..._

>

(http://health.groups.yahoo.com/group/rd-usa/post?postID=gJl7O9-0Wsq_2MXaOdDcGaM\

Ti7GYQ

>

> qfD4nP2Os6mSiBLs_6OsOEUFIunjUNDecytZLrYhlHZ) > wrote:

>

> >

> >

> >

> > ,

> > Where is it that this dx doesn't exist? That's what I would be cautious

> > about.

> >

> > Jacquelyn A. Pressly, RD, CLT

> > The NATURAL dietitian

> > Specializing in Wellness and Prevention, Personal Nutrition Coaching

> > and Designer Lifestyle Plans to help you get on the health track

> > Northeast Ohio & Western Pennsylvania

> > Internet and telecounseling available for distance clients

> >

> > _jpress50@..._

>

(http://health.groups.yahoo.com/group/rd-usa/post?postID=2n1nW2HOEaLO84cXflZaGxn\

6_ABLxdnwkd6i4Xoi6_FNA0sRcNMgb3hQgncOHblofIntwCHgp7gClw

>

> )

> >

> > If you are what you eat, then dietitians are the doctors of the future

> >

> >

> > Re: The Great Cancer Hoax - extended thru 6/20

> >

> > But are they doing things like adrenal fatigue (dx doesn't exist), liver

> > detox, homeopathy and this type of medicine - red flags should be up

> IMHO.

> > As should traditional medicine MDs when excessive and unwarranted and

> over

> > prescribing drugs.

>

>

[Guest guest]

Thanks Joanne for the explanation. ly, if a resident in my SNF cannot eat

solid food of any texture for any reason, I provide a liquid diet composed of

food, not medical nutritionals. It tastes better and often the residents accept

it in mugs or through a straw if SLP allows their use. Evidence based is needed,

but the reality out there at times is very different and we have to improvise

and compromise to take care of the residents, and at times, their families. I

have found it very helpful to be able to quote the NCM as “the†backup for

providing such a diet many times, especially when dealing with a hospice patient

whose family does not accept NPO, or a demented resident that won’t allow

anyone to feed them but will pick up a mug or bowl and drink out of it. My

justification for its use is always close at hand and adds not only to my

credibility but also to my comfort level doing this.

Digna

From: rd-usa [mailto:rd-usa ] On Behalf Of Joanne

Larsen

Sent: Thursday, June 16, 2011 8:27 AM

To: rd-usa

Cc: hl brewer

Subject: Re: Full Liquid Diet? Evidence based?

Colleagues,

Reply to RD-USA listserv only. You do not have my permission to forward.

As the editor who created the Nutrition Care Manual, vetted the authors

/ reviewers and edited every word for the initial launch and the first

update, I can tell you why the Full Liquid diet is in NCM. Dietitians

who ordered NCM complained to the publisher that their facility's

doctors wanted a full liquid diet so the publisher insisted the full

liquid diet be added to NCM over my objections and documentation that

there is no science in published literature for a full liquid diet or a

progression from clear liquid to full liquid to soft to regular diets.

This and clear liquid diets are the only instance of a diet being

inserted in NCM that are not evidence or research based.

healthy regards,

Joanne Larsen MS RD LD

>

> In our facility we're deleting it from our diet list this month - just

> have to

> get the nurses to stop " advancing as tolerated " and a few damn

> surgeons to stop

> ordering it. But it can still be found in the Nutrition Care Manual

> online

> (pdf about what it is and that there is no evidence for it).

>

> Holly

> ----------

> Holly Lee Brewer, MS RD CDE

> Pediatric Dietitian, Diabetes Educator

> Medical Nutrition Therapist, Las Vegas, NV

>

> Maj Holly Brewer, USAFR BSC http://hollyinbalad.blogspot.com

> 301st MDS, NAS JRB Fort Worth (Carswell), TX

> Joint Base Balad, Iraq (Jan-Jul 2009)

>

> ________________________________

> From: " Dineright4@... <mailto:Dineright4%40aol.com>

<mailto:Dineright4%40aol.com> "

> <Dineright4@... <mailto:Dineright4%40aol.com>

<mailto:Dineright4%40aol.com>>

> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

<mailto:rd-usa%40yahoogroups.com>

> Sent: Wed, June 15, 2011 10:22:25 PM

> Subject: The Great Cancer Hoax - Full Liquid Diet? Evidence

> based?

>

>

>

> Too busy lately, so getting into this discussion late.

>

> For all the RDs that SAY they insist on Evidence Based Medicine, I ask;

> Show me the evidence for hospitals to serve full liquid diets. I've NEVER

> found it, but tens of thousands of RDs nationwide still do this. (I

> THOUGHT

> that practice was stopped years ago!)

>

> I don't work in hospitals anymore, but recently was visiting a friend in

> CCU for GI bleed with a full liquid diet on his plate. 2% milk, pudding,

> cream of potato soup, and ice cream.

>

> I was embarrassed for my profession.

>

> Please, would some RD that insists on EBM please show me the evidence for

> that?

>

> Jan Patenaude, RD, CLT

> Director of Medical Nutrition

> Signet Diagnostic Corp.

> Telecommuting Nationwide

> (Mountain Time)

> Fax:

> DineRight4@... <mailto:DineRight4%40aol.com>

<mailto:DineRight4%40aol.com>

>

> Certified LEAP Therapist and specialist in food sensitivity for IBS,

> migraine, fibromyalgia and multiple inflammatory conditions. Co-author

> of the

> Certified LEAP Therapist (CLT) Training Course.

>

> Re: The Great Cancer Hoax - extended thru 6/20

>

> _http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/_

>

> (http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/)

>

>

> On Mon, Jun 13, 2011 at 11:18 PM, Jacqui Pressly <_Jpress50@..._

>

(http://health.groups.yahoo.com/group/rd-usa/post?postID=gJl7O9-0Wsq_2MXaOdDcGaM\

Ti7GYQ

>

> qfD4nP2Os6mSiBLs_6OsOEUFIunjUNDecytZLrYhlHZ) > wrote:

>

> >

> >

> >

> > ,

> > Where is it that this dx doesn't exist? That's what I would be cautious

> > about.

> >

> > Jacquelyn A. Pressly, RD, CLT

> > The NATURAL dietitian

> > Specializing in Wellness and Prevention, Personal Nutrition Coaching

> > and Designer Lifestyle Plans to help you get on the health track

> > Northeast Ohio & Western Pennsylvania

> > Internet and telecounseling available for distance clients

> >

> > _jpress50@..._

>

(http://health.groups.yahoo.com/group/rd-usa/post?postID=2n1nW2HOEaLO84cXflZaGxn\

6_ABLxdnwkd6i4Xoi6_FNA0sRcNMgb3hQgncOHblofIntwCHgp7gClw

>

> )

> >

> > If you are what you eat, then dietitians are the doctors of the future

> >

> >

> > Re: The Great Cancer Hoax - extended thru 6/20

> >

> > But are they doing things like adrenal fatigue (dx doesn't exist), liver

> > detox, homeopathy and this type of medicine - red flags should be up

> IMHO.

> > As should traditional medicine MDs when excessive and unwarranted and

> over

> > prescribing drugs.

>

>

[Guest guest]

Thanks Joanne for the explanation. ly, if a resident in my SNF cannot eat

solid food of any texture for any reason, I provide a liquid diet composed of

food, not medical nutritionals. It tastes better and often the residents accept

it in mugs or through a straw if SLP allows their use. Evidence based is needed,

but the reality out there at times is very different and we have to improvise

and compromise to take care of the residents, and at times, their families. I

have found it very helpful to be able to quote the NCM as “the†backup for

providing such a diet many times, especially when dealing with a hospice patient

whose family does not accept NPO, or a demented resident that won’t allow

anyone to feed them but will pick up a mug or bowl and drink out of it. My

justification for its use is always close at hand and adds not only to my

credibility but also to my comfort level doing this.

Digna

From: rd-usa [mailto:rd-usa ] On Behalf Of Joanne

Larsen

Sent: Thursday, June 16, 2011 8:27 AM

To: rd-usa

Cc: hl brewer

Subject: Re: Full Liquid Diet? Evidence based?

Colleagues,

Reply to RD-USA listserv only. You do not have my permission to forward.

As the editor who created the Nutrition Care Manual, vetted the authors

/ reviewers and edited every word for the initial launch and the first

update, I can tell you why the Full Liquid diet is in NCM. Dietitians

who ordered NCM complained to the publisher that their facility's

doctors wanted a full liquid diet so the publisher insisted the full

liquid diet be added to NCM over my objections and documentation that

there is no science in published literature for a full liquid diet or a

progression from clear liquid to full liquid to soft to regular diets.

This and clear liquid diets are the only instance of a diet being

inserted in NCM that are not evidence or research based.

healthy regards,

Joanne Larsen MS RD LD

>

> In our facility we're deleting it from our diet list this month - just

> have to

> get the nurses to stop " advancing as tolerated " and a few damn

> surgeons to stop

> ordering it. But it can still be found in the Nutrition Care Manual

> online

> (pdf about what it is and that there is no evidence for it).

>

> Holly

> ----------

> Holly Lee Brewer, MS RD CDE

> Pediatric Dietitian, Diabetes Educator

> Medical Nutrition Therapist, Las Vegas, NV

>

> Maj Holly Brewer, USAFR BSC http://hollyinbalad.blogspot.com

> 301st MDS, NAS JRB Fort Worth (Carswell), TX

> Joint Base Balad, Iraq (Jan-Jul 2009)

>

> ________________________________

> From: " Dineright4@... <mailto:Dineright4%40aol.com>

<mailto:Dineright4%40aol.com> "

> <Dineright4@... <mailto:Dineright4%40aol.com>

<mailto:Dineright4%40aol.com>>

> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

<mailto:rd-usa%40yahoogroups.com>

> Sent: Wed, June 15, 2011 10:22:25 PM

> Subject: The Great Cancer Hoax - Full Liquid Diet? Evidence

> based?

>

>

>

> Too busy lately, so getting into this discussion late.

>

> For all the RDs that SAY they insist on Evidence Based Medicine, I ask;

> Show me the evidence for hospitals to serve full liquid diets. I've NEVER

> found it, but tens of thousands of RDs nationwide still do this. (I

> THOUGHT

> that practice was stopped years ago!)

>

> I don't work in hospitals anymore, but recently was visiting a friend in

> CCU for GI bleed with a full liquid diet on his plate. 2% milk, pudding,

> cream of potato soup, and ice cream.

>

> I was embarrassed for my profession.

>

> Please, would some RD that insists on EBM please show me the evidence for

> that?

>

> Jan Patenaude, RD, CLT

> Director of Medical Nutrition

> Signet Diagnostic Corp.

> Telecommuting Nationwide

> (Mountain Time)

> Fax:

> DineRight4@... <mailto:DineRight4%40aol.com>

<mailto:DineRight4%40aol.com>

>

> Certified LEAP Therapist and specialist in food sensitivity for IBS,

> migraine, fibromyalgia and multiple inflammatory conditions. Co-author

> of the

> Certified LEAP Therapist (CLT) Training Course.

>

> Re: The Great Cancer Hoax - extended thru 6/20

>

> _http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/_

>

> (http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/)

>

>

> On Mon, Jun 13, 2011 at 11:18 PM, Jacqui Pressly <_Jpress50@..._

>

(http://health.groups.yahoo.com/group/rd-usa/post?postID=gJl7O9-0Wsq_2MXaOdDcGaM\

Ti7GYQ

>

> qfD4nP2Os6mSiBLs_6OsOEUFIunjUNDecytZLrYhlHZ) > wrote:

>

> >

> >

> >

> > ,

> > Where is it that this dx doesn't exist? That's what I would be cautious

> > about.

> >

> > Jacquelyn A. Pressly, RD, CLT

> > The NATURAL dietitian

> > Specializing in Wellness and Prevention, Personal Nutrition Coaching

> > and Designer Lifestyle Plans to help you get on the health track

> > Northeast Ohio & Western Pennsylvania

> > Internet and telecounseling available for distance clients

> >

> > _jpress50@..._

>

(http://health.groups.yahoo.com/group/rd-usa/post?postID=2n1nW2HOEaLO84cXflZaGxn\

6_ABLxdnwkd6i4Xoi6_FNA0sRcNMgb3hQgncOHblofIntwCHgp7gClw

>

> )

> >

> > If you are what you eat, then dietitians are the doctors of the future

> >

> >

> > Re: The Great Cancer Hoax - extended thru 6/20

> >

> > But are they doing things like adrenal fatigue (dx doesn't exist), liver

> > detox, homeopathy and this type of medicine - red flags should be up

> IMHO.

> > As should traditional medicine MDs when excessive and unwarranted and

> over

> > prescribing drugs.

>

>

[Guest guest]

Thanks Joanne for the explanation. ly, if a resident in my SNF cannot eat

solid food of any texture for any reason, I provide a liquid diet composed of

food, not medical nutritionals. It tastes better and often the residents accept

it in mugs or through a straw if SLP allows their use. Evidence based is needed,

but the reality out there at times is very different and we have to improvise

and compromise to take care of the residents, and at times, their families. I

have found it very helpful to be able to quote the NCM as “the†backup for

providing such a diet many times, especially when dealing with a hospice patient

whose family does not accept NPO, or a demented resident that won’t allow

anyone to feed them but will pick up a mug or bowl and drink out of it. My

justification for its use is always close at hand and adds not only to my

credibility but also to my comfort level doing this.

Digna

From: rd-usa [mailto:rd-usa ] On Behalf Of Joanne

Larsen

Sent: Thursday, June 16, 2011 8:27 AM

To: rd-usa

Cc: hl brewer

Subject: Re: Full Liquid Diet? Evidence based?

Colleagues,

Reply to RD-USA listserv only. You do not have my permission to forward.

As the editor who created the Nutrition Care Manual, vetted the authors

/ reviewers and edited every word for the initial launch and the first

update, I can tell you why the Full Liquid diet is in NCM. Dietitians

who ordered NCM complained to the publisher that their facility's

doctors wanted a full liquid diet so the publisher insisted the full

liquid diet be added to NCM over my objections and documentation that

there is no science in published literature for a full liquid diet or a

progression from clear liquid to full liquid to soft to regular diets.

This and clear liquid diets are the only instance of a diet being

inserted in NCM that are not evidence or research based.

healthy regards,

Joanne Larsen MS RD LD

>

> In our facility we're deleting it from our diet list this month - just

> have to

> get the nurses to stop " advancing as tolerated " and a few damn

> surgeons to stop

> ordering it. But it can still be found in the Nutrition Care Manual

> online

> (pdf about what it is and that there is no evidence for it).

>

> Holly

> ----------

> Holly Lee Brewer, MS RD CDE

> Pediatric Dietitian, Diabetes Educator

> Medical Nutrition Therapist, Las Vegas, NV

>

> Maj Holly Brewer, USAFR BSC http://hollyinbalad.blogspot.com

> 301st MDS, NAS JRB Fort Worth (Carswell), TX

> Joint Base Balad, Iraq (Jan-Jul 2009)

>

> ________________________________

> From: " Dineright4@... <mailto:Dineright4%40aol.com>

<mailto:Dineright4%40aol.com> "

> <Dineright4@... <mailto:Dineright4%40aol.com>

<mailto:Dineright4%40aol.com>>

> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

<mailto:rd-usa%40yahoogroups.com>

> Sent: Wed, June 15, 2011 10:22:25 PM

> Subject: The Great Cancer Hoax - Full Liquid Diet? Evidence

> based?

>

>

>

> Too busy lately, so getting into this discussion late.

>

> For all the RDs that SAY they insist on Evidence Based Medicine, I ask;

> Show me the evidence for hospitals to serve full liquid diets. I've NEVER

> found it, but tens of thousands of RDs nationwide still do this. (I

> THOUGHT

> that practice was stopped years ago!)

>

> I don't work in hospitals anymore, but recently was visiting a friend in

> CCU for GI bleed with a full liquid diet on his plate. 2% milk, pudding,

> cream of potato soup, and ice cream.

>

> I was embarrassed for my profession.

>

> Please, would some RD that insists on EBM please show me the evidence for

> that?

>

> Jan Patenaude, RD, CLT

> Director of Medical Nutrition

> Signet Diagnostic Corp.

> Telecommuting Nationwide

> (Mountain Time)

> Fax:

> DineRight4@... <mailto:DineRight4%40aol.com>

<mailto:DineRight4%40aol.com>

>

> Certified LEAP Therapist and specialist in food sensitivity for IBS,

> migraine, fibromyalgia and multiple inflammatory conditions. Co-author

> of the

> Certified LEAP Therapist (CLT) Training Course.

>

> Re: The Great Cancer Hoax - extended thru 6/20

>

> _http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/_

>

> (http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/)

>

>

> On Mon, Jun 13, 2011 at 11:18 PM, Jacqui Pressly <_Jpress50@..._

>

(http://health.groups.yahoo.com/group/rd-usa/post?postID=gJl7O9-0Wsq_2MXaOdDcGaM\

Ti7GYQ

>

> qfD4nP2Os6mSiBLs_6OsOEUFIunjUNDecytZLrYhlHZ) > wrote:

>

> >

> >

> >

> > ,

> > Where is it that this dx doesn't exist? That's what I would be cautious

> > about.

> >

> > Jacquelyn A. Pressly, RD, CLT

> > The NATURAL dietitian

> > Specializing in Wellness and Prevention, Personal Nutrition Coaching

> > and Designer Lifestyle Plans to help you get on the health track

> > Northeast Ohio & Western Pennsylvania

> > Internet and telecounseling available for distance clients

> >

> > _jpress50@..._

>

(http://health.groups.yahoo.com/group/rd-usa/post?postID=2n1nW2HOEaLO84cXflZaGxn\

6_ABLxdnwkd6i4Xoi6_FNA0sRcNMgb3hQgncOHblofIntwCHgp7gClw

>

> )

> >

> > If you are what you eat, then dietitians are the doctors of the future

> >

> >

> > Re: The Great Cancer Hoax - extended thru 6/20

> >

> > But are they doing things like adrenal fatigue (dx doesn't exist), liver

> > detox, homeopathy and this type of medicine - red flags should be up

> IMHO.

> > As should traditional medicine MDs when excessive and unwarranted and

> over

> > prescribing drugs.

>

>

[Guest guest]

ly, Jan, I'm surprised that someone as sharp as you would be so uninformed

about evidence-based medicine and that you select one instance in one facility

in order to justify an anti-science bias. There are so many unfounded rumors

surrounding use of evidence to support practice.

Please take a look at the many outstanding resources and tutorials on EBM that

are available, such as the Centre for Evidence Based Medicine, Bandolier, and

others. Have you looked at the Cochrane Library for systematic reviews?

The full liquid diet has been shown in several studies to not be useful. I would

argue that it is not the physician who is leading the charge to keep it, rather

it's the RD who does not have the gumption to stand up to the physician and

explain that full liquid diets are not useful, nor are they evidence-based. In

fact, there is a trend to longer hospitalization when regular diets are

withheld.

It is not only RDs who " insist " on using EBM. We have a healthcare system that

can no longer afford to pay for treatments and therapies just because one

clinician " gets good results " (that's my favorite pet peeve these days; RDs who

say " I get good results when I ....... " My question is " good results compared to

what? " ). CMS is moving towards paying for treatments that are evidence-based.

Where the evidence does not exist, strong cohort studies, case series, etc can

stand in until the research is done.

EBM also does not mean that everything we do must have tons of research. Look at

insulin. When insulin was first isolated and produced in the 1920s, there were

no cries for randomized controled trials. Rather, at that time type 1 diabetes

had a 100% fatality rate. Lacking insulin, patients died. Thus, knowing that

insulin was the hormone that lowered blood sugar, human use began. I sort of

liken that to the use of parachutes in airplanes. We don't need a trial to know

that parachutes prevent fatal plummets to the earth.

The history of EBM is fascinating. The first known randomized controlled trial

was that done by Lind in the Royal Navy when he determined that there was

some factor in citrus fruits that prevented scurvy. In the mid-1800s, Semmelweis

proved that hand washing was a strong preventive factor for puerperal fever. In

both cases, it took over 50 years for practice to change. In fact, we still

fight the handwashing battle. Why? There are many theories and change management

is a relatively new area of science. Basically, change is easy..... if the

change is easy.

Evidence based medicine, or evidence based practice, simply says that before you

try something new or different on real people you should have some evidence that

you will not hurt them Do no harm. I'm not sure anyone would be opposed to that?

Pam Charney, PhD, RD

Author, Consultant

pcharney@...

" Lead, follow, or get out of the way! "

>

> Too busy lately, so getting into this discussion late.

>

> For all the RDs that SAY they insist on Evidence Based Medicine, I ask;

> Show me the evidence for hospitals to serve full liquid diets. I've NEVER

> found it, but tens of thousands of RDs nationwide still do this. (I THOUGHT

> that practice was stopped years ago!)

>

> I don't work in hospitals anymore, but recently was visiting a friend in

> CCU for GI bleed with a full liquid diet on his plate. 2% milk, pudding,

> cream of potato soup, and ice cream.

>

> I was embarrassed for my profession.

>

> Please, would some RD that insists on EBM please show me the evidence for

> that?

>

>

> Jan Patenaude, RD, CLT

> Director of Medical Nutrition

> Signet Diagnostic Corp.

> Telecommuting Nationwide

> (Mountain Time)

> Fax:

> DineRight4@...

>

> Certified LEAP Therapist and specialist in food sensitivity for IBS,

> migraine, fibromyalgia and multiple inflammatory conditions. Co-author of the

> Certified LEAP Therapist (CLT) Training Course.

>

> Re: The Great Cancer Hoax - extended thru 6/20

>

> _http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/_

> (http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/)

>

> On Mon, Jun 13, 2011 at 11:18 PM, Jacqui Pressly <_Jpress50@..._

>

(http://health.groups.yahoo.com/group/rd-usa/post?postID=gJl7O9-0Wsq_2MXaOdDcGaM\

Ti7GYQ

> qfD4nP2Os6mSiBLs_6OsOEUFIunjUNDecytZLrYhlHZ) > wrote:

>

> >

> >

> >

> > ,

> > Where is it that this dx doesn't exist? That's what I would be cautious

> > about.

> >

> > Jacquelyn A. Pressly, RD, CLT

> > The NATURAL dietitian

> > Specializing in Wellness and Prevention, Personal Nutrition Coaching

> > and Designer Lifestyle Plans to help you get on the health track

> > Northeast Ohio & Western Pennsylvania

> > Internet and telecounseling available for distance clients

> >

> > _jpress50@..._

>

(http://health.groups.yahoo.com/group/rd-usa/post?postID=2n1nW2HOEaLO84cXflZaGxn\

6_ABLxdnwkd6i4Xoi6_FNA0sRcNMgb3hQgncOHblofIntwCHgp7gClw

> )

> >

> > If you are what you eat, then dietitians are the doctors of the future

> >

> >

> > Re: The Great Cancer Hoax - extended thru 6/20

> >

> > But are they doing things like adrenal fatigue (dx doesn't exist), liver

> > detox, homeopathy and this type of medicine - red flags should be up

> IMHO.

> > As should traditional medicine MDs when excessive and unwarranted and

> over

> > prescribing drugs.

>

>

[Guest guest]

ly, Jan, I'm surprised that someone as sharp as you would be so uninformed

about evidence-based medicine and that you select one instance in one facility

in order to justify an anti-science bias. There are so many unfounded rumors

surrounding use of evidence to support practice.

Please take a look at the many outstanding resources and tutorials on EBM that

are available, such as the Centre for Evidence Based Medicine, Bandolier, and

others. Have you looked at the Cochrane Library for systematic reviews?

The full liquid diet has been shown in several studies to not be useful. I would

argue that it is not the physician who is leading the charge to keep it, rather

it's the RD who does not have the gumption to stand up to the physician and

explain that full liquid diets are not useful, nor are they evidence-based. In

fact, there is a trend to longer hospitalization when regular diets are

withheld.

It is not only RDs who " insist " on using EBM. We have a healthcare system that

can no longer afford to pay for treatments and therapies just because one

clinician " gets good results " (that's my favorite pet peeve these days; RDs who

say " I get good results when I ....... " My question is " good results compared to

what? " ). CMS is moving towards paying for treatments that are evidence-based.

Where the evidence does not exist, strong cohort studies, case series, etc can

stand in until the research is done.

EBM also does not mean that everything we do must have tons of research. Look at

insulin. When insulin was first isolated and produced in the 1920s, there were

no cries for randomized controled trials. Rather, at that time type 1 diabetes

had a 100% fatality rate. Lacking insulin, patients died. Thus, knowing that

insulin was the hormone that lowered blood sugar, human use began. I sort of

liken that to the use of parachutes in airplanes. We don't need a trial to know

that parachutes prevent fatal plummets to the earth.

The history of EBM is fascinating. The first known randomized controlled trial

was that done by Lind in the Royal Navy when he determined that there was

some factor in citrus fruits that prevented scurvy. In the mid-1800s, Semmelweis

proved that hand washing was a strong preventive factor for puerperal fever. In

both cases, it took over 50 years for practice to change. In fact, we still

fight the handwashing battle. Why? There are many theories and change management

is a relatively new area of science. Basically, change is easy..... if the

change is easy.

Evidence based medicine, or evidence based practice, simply says that before you

try something new or different on real people you should have some evidence that

you will not hurt them Do no harm. I'm not sure anyone would be opposed to that?

Pam Charney, PhD, RD

Author, Consultant

pcharney@...

" Lead, follow, or get out of the way! "

>

> Too busy lately, so getting into this discussion late.

>

> For all the RDs that SAY they insist on Evidence Based Medicine, I ask;

> Show me the evidence for hospitals to serve full liquid diets. I've NEVER

> found it, but tens of thousands of RDs nationwide still do this. (I THOUGHT

> that practice was stopped years ago!)

>

> I don't work in hospitals anymore, but recently was visiting a friend in

> CCU for GI bleed with a full liquid diet on his plate. 2% milk, pudding,

> cream of potato soup, and ice cream.

>

> I was embarrassed for my profession.

>

> Please, would some RD that insists on EBM please show me the evidence for

> that?

>

>

> Jan Patenaude, RD, CLT

> Director of Medical Nutrition

> Signet Diagnostic Corp.

> Telecommuting Nationwide

> (Mountain Time)

> Fax:

> DineRight4@...

>

> Certified LEAP Therapist and specialist in food sensitivity for IBS,

> migraine, fibromyalgia and multiple inflammatory conditions. Co-author of the

> Certified LEAP Therapist (CLT) Training Course.

>

> Re: The Great Cancer Hoax - extended thru 6/20

>

> _http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/_

> (http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/)

>

> On Mon, Jun 13, 2011 at 11:18 PM, Jacqui Pressly <_Jpress50@..._

>

(http://health.groups.yahoo.com/group/rd-usa/post?postID=gJl7O9-0Wsq_2MXaOdDcGaM\

Ti7GYQ

> qfD4nP2Os6mSiBLs_6OsOEUFIunjUNDecytZLrYhlHZ) > wrote:

>

> >

> >

> >

> > ,

> > Where is it that this dx doesn't exist? That's what I would be cautious

> > about.

> >

> > Jacquelyn A. Pressly, RD, CLT

> > The NATURAL dietitian

> > Specializing in Wellness and Prevention, Personal Nutrition Coaching

> > and Designer Lifestyle Plans to help you get on the health track

> > Northeast Ohio & Western Pennsylvania

> > Internet and telecounseling available for distance clients

> >

> > _jpress50@..._

>

(http://health.groups.yahoo.com/group/rd-usa/post?postID=2n1nW2HOEaLO84cXflZaGxn\

6_ABLxdnwkd6i4Xoi6_FNA0sRcNMgb3hQgncOHblofIntwCHgp7gClw

> )

> >

> > If you are what you eat, then dietitians are the doctors of the future

> >

> >

> > Re: The Great Cancer Hoax - extended thru 6/20

> >

> > But are they doing things like adrenal fatigue (dx doesn't exist), liver

> > detox, homeopathy and this type of medicine - red flags should be up

> IMHO.

> > As should traditional medicine MDs when excessive and unwarranted and

> over

> > prescribing drugs.

>

>

[Guest guest]

ly, Jan, I'm surprised that someone as sharp as you would be so uninformed

about evidence-based medicine and that you select one instance in one facility

in order to justify an anti-science bias. There are so many unfounded rumors

surrounding use of evidence to support practice.

Please take a look at the many outstanding resources and tutorials on EBM that

are available, such as the Centre for Evidence Based Medicine, Bandolier, and

others. Have you looked at the Cochrane Library for systematic reviews?

The full liquid diet has been shown in several studies to not be useful. I would

argue that it is not the physician who is leading the charge to keep it, rather

it's the RD who does not have the gumption to stand up to the physician and

explain that full liquid diets are not useful, nor are they evidence-based. In

fact, there is a trend to longer hospitalization when regular diets are

withheld.

It is not only RDs who " insist " on using EBM. We have a healthcare system that

can no longer afford to pay for treatments and therapies just because one

clinician " gets good results " (that's my favorite pet peeve these days; RDs who

say " I get good results when I ....... " My question is " good results compared to

what? " ). CMS is moving towards paying for treatments that are evidence-based.

Where the evidence does not exist, strong cohort studies, case series, etc can

stand in until the research is done.

EBM also does not mean that everything we do must have tons of research. Look at

insulin. When insulin was first isolated and produced in the 1920s, there were

no cries for randomized controled trials. Rather, at that time type 1 diabetes

had a 100% fatality rate. Lacking insulin, patients died. Thus, knowing that

insulin was the hormone that lowered blood sugar, human use began. I sort of

liken that to the use of parachutes in airplanes. We don't need a trial to know

that parachutes prevent fatal plummets to the earth.

The history of EBM is fascinating. The first known randomized controlled trial

was that done by Lind in the Royal Navy when he determined that there was

some factor in citrus fruits that prevented scurvy. In the mid-1800s, Semmelweis

proved that hand washing was a strong preventive factor for puerperal fever. In

both cases, it took over 50 years for practice to change. In fact, we still

fight the handwashing battle. Why? There are many theories and change management

is a relatively new area of science. Basically, change is easy..... if the

change is easy.

Evidence based medicine, or evidence based practice, simply says that before you

try something new or different on real people you should have some evidence that

you will not hurt them Do no harm. I'm not sure anyone would be opposed to that?

Pam Charney, PhD, RD

Author, Consultant

pcharney@...

" Lead, follow, or get out of the way! "

>

> Too busy lately, so getting into this discussion late.

>

> For all the RDs that SAY they insist on Evidence Based Medicine, I ask;

> Show me the evidence for hospitals to serve full liquid diets. I've NEVER

> found it, but tens of thousands of RDs nationwide still do this. (I THOUGHT

> that practice was stopped years ago!)

>

> I don't work in hospitals anymore, but recently was visiting a friend in

> CCU for GI bleed with a full liquid diet on his plate. 2% milk, pudding,

> cream of potato soup, and ice cream.

>

> I was embarrassed for my profession.

>

> Please, would some RD that insists on EBM please show me the evidence for

> that?

>

>

> Jan Patenaude, RD, CLT

> Director of Medical Nutrition

> Signet Diagnostic Corp.

> Telecommuting Nationwide

> (Mountain Time)

> Fax:

> DineRight4@...

>

> Certified LEAP Therapist and specialist in food sensitivity for IBS,

> migraine, fibromyalgia and multiple inflammatory conditions. Co-author of the

> Certified LEAP Therapist (CLT) Training Course.

>

> Re: The Great Cancer Hoax - extended thru 6/20

>

> _http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/_

> (http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/)

>

> On Mon, Jun 13, 2011 at 11:18 PM, Jacqui Pressly <_Jpress50@..._

>

(http://health.groups.yahoo.com/group/rd-usa/post?postID=gJl7O9-0Wsq_2MXaOdDcGaM\

Ti7GYQ

> qfD4nP2Os6mSiBLs_6OsOEUFIunjUNDecytZLrYhlHZ) > wrote:

>

> >

> >

> >

> > ,

> > Where is it that this dx doesn't exist? That's what I would be cautious

> > about.

> >

> > Jacquelyn A. Pressly, RD, CLT

> > The NATURAL dietitian

> > Specializing in Wellness and Prevention, Personal Nutrition Coaching

> > and Designer Lifestyle Plans to help you get on the health track

> > Northeast Ohio & Western Pennsylvania

> > Internet and telecounseling available for distance clients

> >

> > _jpress50@..._

>

(http://health.groups.yahoo.com/group/rd-usa/post?postID=2n1nW2HOEaLO84cXflZaGxn\

6_ABLxdnwkd6i4Xoi6_FNA0sRcNMgb3hQgncOHblofIntwCHgp7gClw

> )

> >

> > If you are what you eat, then dietitians are the doctors of the future

> >

> >

> > Re: The Great Cancer Hoax - extended thru 6/20

> >

> > But are they doing things like adrenal fatigue (dx doesn't exist), liver

> > detox, homeopathy and this type of medicine - red flags should be up

> IMHO.

> > As should traditional medicine MDs when excessive and unwarranted and

> over

> > prescribing drugs.

>

>

[Guest guest]

Pam,I am sorry to be the one who says that, but I am very surprised how harsh

and " personal " your response was. these kind of responses hold many on the list

from participating in active discussion. We are not all informed 100% on 100% of

the topics, and no one should be expected to be an expert on every single topic.

It is impossible and very unhealthy, professionally, to anyone,to assume they

" know all " .Sometimes clear liquid or full liq diets are the only thing pts can

tolerate and its better then NPO, and it should not be used more then few days

bc it is nutritionally lacking. But with all do respect to EBM - textbook and

studies are not case study and real practice. Pts are not textbook nor a study,

and even in EMB there is a value to case studies. Respected journals publish

them all the time. thats why they are called case studies. and to say that

clear of full liq diet is just wrong all across the board is wrong too.

Pam, your knowledge and experience are priceless and greatly appreciate, but we

need to leave room for ppl to ask freely, without the fear of being scrutinized

by others.

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

> To: rd-usa

> From: pcharney@...

> Date: Thu, 16 Jun 2011 09:10:24 -0700

> Subject: Re: Full Liquid Diet? Evidence based?

>

> ly, Jan, I'm surprised that someone as sharp as you would be so

uninformed about evidence-based medicine and that you select one instance in one

facility in order to justify an anti-science bias. There are so many unfounded

rumors surrounding use of evidence to support practice.

>

> Please take a look at the many outstanding resources and tutorials on EBM that

are available, such as the Centre for Evidence Based Medicine, Bandolier, and

others. Have you looked at the Cochrane Library for systematic reviews?

>

> The full liquid diet has been shown in several studies to not be useful. I

would argue that it is not the physician who is leading the charge to keep it,

rather it's the RD who does not have the gumption to stand up to the physician

and explain that full liquid diets are not useful, nor are they evidence-based.

In fact, there is a trend to longer hospitalization when regular diets are

withheld.

>

> It is not only RDs who " insist " on using EBM. We have a healthcare system that

can no longer afford to pay for treatments and therapies just because one

clinician " gets good results " (that's my favorite pet peeve these days; RDs who

say " I get good results when I ....... " My question is " good results compared to

what? " ). CMS is moving towards paying for treatments that are evidence-based.

Where the evidence does not exist, strong cohort studies, case series, etc can

stand in until the research is done.

>

> EBM also does not mean that everything we do must have tons of research. Look

at insulin. When insulin was first isolated and produced in the 1920s, there

were no cries for randomized controled trials. Rather, at that time type 1

diabetes had a 100% fatality rate. Lacking insulin, patients died. Thus, knowing

that insulin was the hormone that lowered blood sugar, human use began. I sort

of liken that to the use of parachutes in airplanes. We don't need a trial to

know that parachutes prevent fatal plummets to the earth.

>

> The history of EBM is fascinating. The first known randomized controlled trial

was that done by Lind in the Royal Navy when he determined that there was

some factor in citrus fruits that prevented scurvy. In the mid-1800s, Semmelweis

proved that hand washing was a strong preventive factor for puerperal fever. In

both cases, it took over 50 years for practice to change. In fact, we still

fight the handwashing battle. Why? There are many theories and change management

is a relatively new area of science. Basically, change is easy..... if the

change is easy.

>

> Evidence based medicine, or evidence based practice, simply says that before

you try something new or different on real people you should have some evidence

that you will not hurt them Do no harm. I'm not sure anyone would be opposed to

that?

>

> Pam Charney, PhD, RD

> Author, Consultant

> pcharney@...

>

> " Lead, follow, or get out of the way! "

>

>

>

>

>

>

>

>

> >

> > Too busy lately, so getting into this discussion late.

> >

> > For all the RDs that SAY they insist on Evidence Based Medicine, I ask;

> > Show me the evidence for hospitals to serve full liquid diets. I've NEVER

> > found it, but tens of thousands of RDs nationwide still do this. (I THOUGHT

> > that practice was stopped years ago!)

> >

> > I don't work in hospitals anymore, but recently was visiting a friend in

> > CCU for GI bleed with a full liquid diet on his plate. 2% milk, pudding,

> > cream of potato soup, and ice cream.

> >

> > I was embarrassed for my profession.

> >

> > Please, would some RD that insists on EBM please show me the evidence for

> > that?

> >

> >

> > Jan Patenaude, RD, CLT

> > Director of Medical Nutrition

> > Signet Diagnostic Corp.

> > Telecommuting Nationwide

> > (Mountain Time)

> > Fax:

> > DineRight4@...

> >

> > Certified LEAP Therapist and specialist in food sensitivity for IBS,

> > migraine, fibromyalgia and multiple inflammatory conditions. Co-author of

the

> > Certified LEAP Therapist (CLT) Training Course.

> >

> > Re: The Great Cancer Hoax - extended thru 6/20

> >

> > _http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/_

> > (http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/)

> >

> > On Mon, Jun 13, 2011 at 11:18 PM, Jacqui Pressly <_Jpress50@..._

> >

(http://health.groups.yahoo.com/group/rd-usa/post?postID=gJl7O9-0Wsq_2MXaOdDcGaM\

Ti7GYQ

> > qfD4nP2Os6mSiBLs_6OsOEUFIunjUNDecytZLrYhlHZ) > wrote:

> >

> > >

> > >

> > >

> > > ,

> > > Where is it that this dx doesn't exist? That's what I would be cautious

> > > about.

> > >

> > > Jacquelyn A. Pressly, RD, CLT

> > > The NATURAL dietitian

> > > Specializing in Wellness and Prevention, Personal Nutrition Coaching

> > > and Designer Lifestyle Plans to help you get on the health track

> > > Northeast Ohio & Western Pennsylvania

> > > Internet and telecounseling available for distance clients

> > >

> > > _jpress50@..._

> >

(http://health.groups.yahoo.com/group/rd-usa/post?postID=2n1nW2HOEaLO84cXflZaGxn\

6_ABLxdnwkd6i4Xoi6_FNA0sRcNMgb3hQgncOHblofIntwCHgp7gClw

> > )

> > >

> > > If you are what you eat, then dietitians are the doctors of the future

> > >

> > >

> > > Re: The Great Cancer Hoax - extended thru 6/20

> > >

> > > But are they doing things like adrenal fatigue (dx doesn't exist), liver

> > > detox, homeopathy and this type of medicine - red flags should be up

> > IMHO.

> > > As should traditional medicine MDs when excessive and unwarranted and

> > over

> > > prescribing drugs.

> >

> >

[Guest guest]

Full liquid is still useful with speech pathologists. It can also be

interpreted in many ways - full liquid thicken - honey, nectar etc. I think

it is the inappropriate use that should be looked at, not some real uses for

it.

Interesting people are upset with Pam but not for LEAP. When are real

studies going to be done - not saying it doesn't work but maybe it could be

EBM if the LEAP company and therapists would do some studies and have it

published. Just a thought...I would love to recommend it but I do want some

data first, not testimonials.

>

>

>

> Pam,I am sorry to be the one who says that, but I am very surprised how

> harsh and " personal " your response was. these kind of responses hold many on

> the list from participating in active discussion. We are not all informed

> 100% on 100% of the topics, and no one should be expected to be an expert on

> every single topic. It is impossible and very unhealthy, professionally, to

> anyone,to assume they " know all " .Sometimes clear liquid or full liq diets

> are the only thing pts can tolerate and its better then NPO, and it should

> not be used more then few days bc it is nutritionally lacking. But with all

> do respect to EBM - textbook and studies are not case study and real

> practice. Pts are not textbook nor a study, and even in EMB there is a value

> to case studies. Respected journals publish them all the time. thats why

> they are called case studies. and to say that clear of full liq diet is just

> wrong all across the board is wrong too.

> Pam, your knowledge and experience are priceless and greatly appreciate,

> but we need to leave room for ppl to ask freely, without the fear of being

> scrutinized by others.

> Merav Levi, RD, MS, CDNA dietitian, not the food police.

> http://www.linkedin.com/in/meravlevi

>

> " Life is not measured by the number of breath you take, but by the moments

> that take your breath away. " - Carlin " People don't forget the truth,

> they just become better in lying " (Revolutionary Road)

>

>

> > To: rd-usa

> > From: pcharney@...

> > Date: Thu, 16 Jun 2011 09:10:24 -0700

>

> > Subject: Re: Full Liquid Diet? Evidence based?

> >

> > ly, Jan, I'm surprised that someone as sharp as you would be so

> uninformed about evidence-based medicine and that you select one instance in

> one facility in order to justify an anti-science bias. There are so many

> unfounded rumors surrounding use of evidence to support practice.

> >

> > Please take a look at the many outstanding resources and tutorials on EBM

> that are available, such as the Centre for Evidence Based Medicine,

> Bandolier, and others. Have you looked at the Cochrane Library for

> systematic reviews?

> >

> > The full liquid diet has been shown in several studies to not be useful.

> I would argue that it is not the physician who is leading the charge to keep

> it, rather it's the RD who does not have the gumption to stand up to the

> physician and explain that full liquid diets are not useful, nor are they

> evidence-based. In fact, there is a trend to longer hospitalization when

> regular diets are withheld.

> >

> > It is not only RDs who " insist " on using EBM. We have a healthcare system

> that can no longer afford to pay for treatments and therapies just because

> one clinician " gets good results " (that's my favorite pet peeve these days;

> RDs who say " I get good results when I ....... " My question is " good results

> compared to what? " ). CMS is moving towards paying for treatments that are

> evidence-based. Where the evidence does not exist, strong cohort studies,

> case series, etc can stand in until the research is done.

> >

> > EBM also does not mean that everything we do must have tons of research.

> Look at insulin. When insulin was first isolated and produced in the 1920s,

> there were no cries for randomized controled trials. Rather, at that time

> type 1 diabetes had a 100% fatality rate. Lacking insulin, patients died.

> Thus, knowing that insulin was the hormone that lowered blood sugar, human

> use began. I sort of liken that to the use of parachutes in airplanes. We

> don't need a trial to know that parachutes prevent fatal plummets to the

> earth.

> >

> > The history of EBM is fascinating. The first known randomized controlled

> trial was that done by Lind in the Royal Navy when he determined that

> there was some factor in citrus fruits that prevented scurvy. In the

> mid-1800s, Semmelweis proved that hand washing was a strong preventive

> factor for puerperal fever. In both cases, it took over 50 years for

> practice to change. In fact, we still fight the handwashing battle. Why?

> There are many theories and change management is a relatively new area of

> science. Basically, change is easy..... if the change is easy.

> >

> > Evidence based medicine, or evidence based practice, simply says that

> before you try something new or different on real people you should have

> some evidence that you will not hurt them Do no harm. I'm not sure anyone

> would be opposed to that?

> >

> > Pam Charney, PhD, RD

> > Author, Consultant

> > pcharney@...

> >

> > " Lead, follow, or get out of the way! "

> >

> >

> >

> >

> >

> >

> >

> >

> > >

> > > Too busy lately, so getting into this discussion late.

> > >

> > > For all the RDs that SAY they insist on Evidence Based Medicine, I ask;

>

> > > Show me the evidence for hospitals to serve full liquid diets. I've

> NEVER

> > > found it, but tens of thousands of RDs nationwide still do this. (I

> THOUGHT

> > > that practice was stopped years ago!)

> > >

> > > I don't work in hospitals anymore, but recently was visiting a friend

> in

> > > CCU for GI bleed with a full liquid diet on his plate. 2% milk,

> pudding,

> > > cream of potato soup, and ice cream.

> > >

> > > I was embarrassed for my profession.

> > >

> > > Please, would some RD that insists on EBM please show me the evidence

> for

> > > that?

> > >

> > >

> > > Jan Patenaude, RD, CLT

> > > Director of Medical Nutrition

> > > Signet Diagnostic Corp.

> > > Telecommuting Nationwide

> > > (Mountain Time)

> > > Fax:

> > > DineRight4@...

> > >

> > > Certified LEAP Therapist and specialist in food sensitivity for IBS,

> > > migraine, fibromyalgia and multiple inflammatory conditions. Co-author

> of the

> > > Certified LEAP Therapist (CLT) Training Course.

> > >

> > > Re: The Great Cancer Hoax - extended thru 6/20

> > >

> > > _

> http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/_

> > > (

> http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/)

>

> > >

> > > On Mon, Jun 13, 2011 at 11:18 PM, Jacqui Pressly <_Jpress50@..._

> > > (

>

http://health.groups.yahoo.com/group/rd-usa/post?postID=gJl7O9-0Wsq_2MXaOdDcGaMT\

i7GYQ

> > > qfD4nP2Os6mSiBLs_6OsOEUFIunjUNDecytZLrYhlHZ) > wrote:

> > >

> > > >

> > > >

> > > >

> > > > ,

> > > > Where is it that this dx doesn't exist? That's what I would be

> cautious

> > > > about.

> > > >

> > > > Jacquelyn A. Pressly, RD, CLT

> > > > The NATURAL dietitian

> > > > Specializing in Wellness and Prevention, Personal Nutrition Coaching

> > > > and Designer Lifestyle Plans to help you get on the health track

> > > > Northeast Ohio & Western Pennsylvania

> > > > Internet and telecounseling available for distance clients

> > > >

> > > > _jpress50@..._

> > > (

>

http://health.groups.yahoo.com/group/rd-usa/post?postID=2n1nW2HOEaLO84cXflZaGxn6\

_ABLxdnwkd6i4Xoi6_FNA0sRcNMgb3hQgncOHblofIntwCHgp7gClw

> > > )

> > > >

> > > > If you are what you eat, then dietitians are the doctors of the

> future

> > > >

> > > >

> > > > Re: The Great Cancer Hoax - extended thru 6/20

> > > >

> > > > But are they doing things like adrenal fatigue (dx doesn't exist),

> liver

> > > > detox, homeopathy and this type of medicine - red flags should be up

> > > IMHO.

> > > > As should traditional medicine MDs when excessive and unwarranted and

>

> > > over

> > > > prescribing drugs.

> > >

> > >

[Guest guest]

absolutely. EBM is what we base our practice on, but it is what it is " base " or

basis, the foundation we build on, and after which we practice what the pt

need/able to tolerate. not all pts fit all knowledge we have and we need to

modify to each situation. Remember, what we know is based on what we know TODAY.

We know how EBM changed and and changing as we go.

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

> To: rd-usa

> From: nrord1@...

> Date: Thu, 16 Jun 2011 13:52:33 -0400

> Subject: Re: Full Liquid Diet? Evidence based?

>

> Full liquid is still useful with speech pathologists. It can also be

> interpreted in many ways - full liquid thicken - honey, nectar etc. I think

> it is the inappropriate use that should be looked at, not some real uses for

> it.

>

> Interesting people are upset with Pam but not for LEAP. When are real

> studies going to be done - not saying it doesn't work but maybe it could be

> EBM if the LEAP company and therapists would do some studies and have it

> published. Just a thought...I would love to recommend it but I do want some

> data first, not testimonials.

>

>

>

> >

> >

> >

> > Pam,I am sorry to be the one who says that, but I am very surprised how

> > harsh and " personal " your response was. these kind of responses hold many on

> > the list from participating in active discussion. We are not all informed

> > 100% on 100% of the topics, and no one should be expected to be an expert on

> > every single topic. It is impossible and very unhealthy, professionally, to

> > anyone,to assume they " know all " .Sometimes clear liquid or full liq diets

> > are the only thing pts can tolerate and its better then NPO, and it should

> > not be used more then few days bc it is nutritionally lacking. But with all

> > do respect to EBM - textbook and studies are not case study and real

> > practice. Pts are not textbook nor a study, and even in EMB there is a value

> > to case studies. Respected journals publish them all the time. thats why

> > they are called case studies. and to say that clear of full liq diet is just

> > wrong all across the board is wrong too.

> > Pam, your knowledge and experience are priceless and greatly appreciate,

> > but we need to leave room for ppl to ask freely, without the fear of being

> > scrutinized by others.

> > Merav Levi, RD, MS, CDNA dietitian, not the food police.

> > http://www.linkedin.com/in/meravlevi

> >

> > " Life is not measured by the number of breath you take, but by the moments

> > that take your breath away. " - Carlin " People don't forget the truth,

> > they just become better in lying " (Revolutionary Road)

> >

> >

> > > To: rd-usa

> > > From: pcharney@...

> > > Date: Thu, 16 Jun 2011 09:10:24 -0700

> >

> > > Subject: Re: Full Liquid Diet? Evidence based?

> > >

> > > ly, Jan, I'm surprised that someone as sharp as you would be so

> > uninformed about evidence-based medicine and that you select one instance in

> > one facility in order to justify an anti-science bias. There are so many

> > unfounded rumors surrounding use of evidence to support practice.

> > >

> > > Please take a look at the many outstanding resources and tutorials on EBM

> > that are available, such as the Centre for Evidence Based Medicine,

> > Bandolier, and others. Have you looked at the Cochrane Library for

> > systematic reviews?

> > >

> > > The full liquid diet has been shown in several studies to not be useful.

> > I would argue that it is not the physician who is leading the charge to keep

> > it, rather it's the RD who does not have the gumption to stand up to the

> > physician and explain that full liquid diets are not useful, nor are they

> > evidence-based. In fact, there is a trend to longer hospitalization when

> > regular diets are withheld.

> > >

> > > It is not only RDs who " insist " on using EBM. We have a healthcare system

> > that can no longer afford to pay for treatments and therapies just because

> > one clinician " gets good results " (that's my favorite pet peeve these days;

> > RDs who say " I get good results when I ....... " My question is " good results

> > compared to what? " ). CMS is moving towards paying for treatments that are

> > evidence-based. Where the evidence does not exist, strong cohort studies,

> > case series, etc can stand in until the research is done.

> > >

> > > EBM also does not mean that everything we do must have tons of research.

> > Look at insulin. When insulin was first isolated and produced in the 1920s,

> > there were no cries for randomized controled trials. Rather, at that time

> > type 1 diabetes had a 100% fatality rate. Lacking insulin, patients died.

> > Thus, knowing that insulin was the hormone that lowered blood sugar, human

> > use began. I sort of liken that to the use of parachutes in airplanes. We

> > don't need a trial to know that parachutes prevent fatal plummets to the

> > earth.

> > >

> > > The history of EBM is fascinating. The first known randomized controlled

> > trial was that done by Lind in the Royal Navy when he determined that

> > there was some factor in citrus fruits that prevented scurvy. In the

> > mid-1800s, Semmelweis proved that hand washing was a strong preventive

> > factor for puerperal fever. In both cases, it took over 50 years for

> > practice to change. In fact, we still fight the handwashing battle. Why?

> > There are many theories and change management is a relatively new area of

> > science. Basically, change is easy..... if the change is easy.

> > >

> > > Evidence based medicine, or evidence based practice, simply says that

> > before you try something new or different on real people you should have

> > some evidence that you will not hurt them Do no harm. I'm not sure anyone

> > would be opposed to that?

> > >

> > > Pam Charney, PhD, RD

> > > Author, Consultant

> > > pcharney@...

> > >

> > > " Lead, follow, or get out of the way! "

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > > >

> > > > Too busy lately, so getting into this discussion late.

> > > >

> > > > For all the RDs that SAY they insist on Evidence Based Medicine, I ask;

> >

> > > > Show me the evidence for hospitals to serve full liquid diets. I've

> > NEVER

> > > > found it, but tens of thousands of RDs nationwide still do this. (I

> > THOUGHT

> > > > that practice was stopped years ago!)

> > > >

> > > > I don't work in hospitals anymore, but recently was visiting a friend

> > in

> > > > CCU for GI bleed with a full liquid diet on his plate. 2% milk,

> > pudding,

> > > > cream of potato soup, and ice cream.

> > > >

> > > > I was embarrassed for my profession.

> > > >

> > > > Please, would some RD that insists on EBM please show me the evidence

> > for

> > > > that?

> > > >

> > > >

> > > > Jan Patenaude, RD, CLT

> > > > Director of Medical Nutrition

> > > > Signet Diagnostic Corp.

> > > > Telecommuting Nationwide

> > > > (Mountain Time)

> > > > Fax:

> > > > DineRight4@...

> > > >

> > > > Certified LEAP Therapist and specialist in food sensitivity for IBS,

> > > > migraine, fibromyalgia and multiple inflammatory conditions. Co-author

> > of the

> > > > Certified LEAP Therapist (CLT) Training Course.

> > > >

> > > > Re: The Great Cancer Hoax - extended thru 6/20

> > > >

> > > > _

> > http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/_

> > > > (

> > http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/)

> >

> > > >

> > > > On Mon, Jun 13, 2011 at 11:18 PM, Jacqui Pressly <_Jpress50@..._

> > > > (

> >

http://health.groups.yahoo.com/group/rd-usa/post?postID=gJl7O9-0Wsq_2MXaOdDcGaMT\

i7GYQ

> > > > qfD4nP2Os6mSiBLs_6OsOEUFIunjUNDecytZLrYhlHZ) > wrote:

> > > >

> > > > >

> > > > >

> > > > >

> > > > > ,

> > > > > Where is it that this dx doesn't exist? That's what I would be

> > cautious

> > > > > about.

> > > > >

> > > > > Jacquelyn A. Pressly, RD, CLT

> > > > > The NATURAL dietitian

> > > > > Specializing in Wellness and Prevention, Personal Nutrition Coaching

> > > > > and Designer Lifestyle Plans to help you get on the health track

> > > > > Northeast Ohio & Western Pennsylvania

> > > > > Internet and telecounseling available for distance clients

> > > > >

> > > > > _jpress50@..._

> > > > (

> >

http://health.groups.yahoo.com/group/rd-usa/post?postID=2n1nW2HOEaLO84cXflZaGxn6\

_ABLxdnwkd6i4Xoi6_FNA0sRcNMgb3hQgncOHblofIntwCHgp7gClw

> > > > )

> > > > >

> > > > > If you are what you eat, then dietitians are the doctors of the

> > future

> > > > >

> > > > >

> > > > > Re: The Great Cancer Hoax - extended thru 6/20

> > > > >

> > > > > But are they doing things like adrenal fatigue (dx doesn't exist),

> > liver

> > > > > detox, homeopathy and this type of medicine - red flags should be up

> > > > IMHO.

> > > > > As should traditional medicine MDs when excessive and unwarranted and

> >

> > > > over

> > > > > prescribing drugs.

> > > >

> > > >

[Guest guest]

absolutely. EBM is what we base our practice on, but it is what it is " base " or

basis, the foundation we build on, and after which we practice what the pt

need/able to tolerate. not all pts fit all knowledge we have and we need to

modify to each situation. Remember, what we know is based on what we know TODAY.

We know how EBM changed and and changing as we go.

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

> To: rd-usa

> From: nrord1@...

> Date: Thu, 16 Jun 2011 13:52:33 -0400

> Subject: Re: Full Liquid Diet? Evidence based?

>

> Full liquid is still useful with speech pathologists. It can also be

> interpreted in many ways - full liquid thicken - honey, nectar etc. I think

> it is the inappropriate use that should be looked at, not some real uses for

> it.

>

> Interesting people are upset with Pam but not for LEAP. When are real

> studies going to be done - not saying it doesn't work but maybe it could be

> EBM if the LEAP company and therapists would do some studies and have it

> published. Just a thought...I would love to recommend it but I do want some

> data first, not testimonials.

>

>

>

> >

> >

> >

> > Pam,I am sorry to be the one who says that, but I am very surprised how

> > harsh and " personal " your response was. these kind of responses hold many on

> > the list from participating in active discussion. We are not all informed

> > 100% on 100% of the topics, and no one should be expected to be an expert on

> > every single topic. It is impossible and very unhealthy, professionally, to

> > anyone,to assume they " know all " .Sometimes clear liquid or full liq diets

> > are the only thing pts can tolerate and its better then NPO, and it should

> > not be used more then few days bc it is nutritionally lacking. But with all

> > do respect to EBM - textbook and studies are not case study and real

> > practice. Pts are not textbook nor a study, and even in EMB there is a value

> > to case studies. Respected journals publish them all the time. thats why

> > they are called case studies. and to say that clear of full liq diet is just

> > wrong all across the board is wrong too.

> > Pam, your knowledge and experience are priceless and greatly appreciate,

> > but we need to leave room for ppl to ask freely, without the fear of being

> > scrutinized by others.

> > Merav Levi, RD, MS, CDNA dietitian, not the food police.

> > http://www.linkedin.com/in/meravlevi

> >

> > " Life is not measured by the number of breath you take, but by the moments

> > that take your breath away. " - Carlin " People don't forget the truth,

> > they just become better in lying " (Revolutionary Road)

> >

> >

> > > To: rd-usa

> > > From: pcharney@...

> > > Date: Thu, 16 Jun 2011 09:10:24 -0700

> >

> > > Subject: Re: Full Liquid Diet? Evidence based?

> > >

> > > ly, Jan, I'm surprised that someone as sharp as you would be so

> > uninformed about evidence-based medicine and that you select one instance in

> > one facility in order to justify an anti-science bias. There are so many

> > unfounded rumors surrounding use of evidence to support practice.

> > >

> > > Please take a look at the many outstanding resources and tutorials on EBM

> > that are available, such as the Centre for Evidence Based Medicine,

> > Bandolier, and others. Have you looked at the Cochrane Library for

> > systematic reviews?

> > >

> > > The full liquid diet has been shown in several studies to not be useful.

> > I would argue that it is not the physician who is leading the charge to keep

> > it, rather it's the RD who does not have the gumption to stand up to the

> > physician and explain that full liquid diets are not useful, nor are they

> > evidence-based. In fact, there is a trend to longer hospitalization when

> > regular diets are withheld.

> > >

> > > It is not only RDs who " insist " on using EBM. We have a healthcare system

> > that can no longer afford to pay for treatments and therapies just because

> > one clinician " gets good results " (that's my favorite pet peeve these days;

> > RDs who say " I get good results when I ....... " My question is " good results

> > compared to what? " ). CMS is moving towards paying for treatments that are

> > evidence-based. Where the evidence does not exist, strong cohort studies,

> > case series, etc can stand in until the research is done.

> > >

> > > EBM also does not mean that everything we do must have tons of research.

> > Look at insulin. When insulin was first isolated and produced in the 1920s,

> > there were no cries for randomized controled trials. Rather, at that time

> > type 1 diabetes had a 100% fatality rate. Lacking insulin, patients died.

> > Thus, knowing that insulin was the hormone that lowered blood sugar, human

> > use began. I sort of liken that to the use of parachutes in airplanes. We

> > don't need a trial to know that parachutes prevent fatal plummets to the

> > earth.

> > >

> > > The history of EBM is fascinating. The first known randomized controlled

> > trial was that done by Lind in the Royal Navy when he determined that

> > there was some factor in citrus fruits that prevented scurvy. In the

> > mid-1800s, Semmelweis proved that hand washing was a strong preventive

> > factor for puerperal fever. In both cases, it took over 50 years for

> > practice to change. In fact, we still fight the handwashing battle. Why?

> > There are many theories and change management is a relatively new area of

> > science. Basically, change is easy..... if the change is easy.

> > >

> > > Evidence based medicine, or evidence based practice, simply says that

> > before you try something new or different on real people you should have

> > some evidence that you will not hurt them Do no harm. I'm not sure anyone

> > would be opposed to that?

> > >

> > > Pam Charney, PhD, RD

> > > Author, Consultant

> > > pcharney@...

> > >

> > > " Lead, follow, or get out of the way! "

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > > >

> > > > Too busy lately, so getting into this discussion late.

> > > >

> > > > For all the RDs that SAY they insist on Evidence Based Medicine, I ask;

> >

> > > > Show me the evidence for hospitals to serve full liquid diets. I've

> > NEVER

> > > > found it, but tens of thousands of RDs nationwide still do this. (I

> > THOUGHT

> > > > that practice was stopped years ago!)

> > > >

> > > > I don't work in hospitals anymore, but recently was visiting a friend

> > in

> > > > CCU for GI bleed with a full liquid diet on his plate. 2% milk,

> > pudding,

> > > > cream of potato soup, and ice cream.

> > > >

> > > > I was embarrassed for my profession.

> > > >

> > > > Please, would some RD that insists on EBM please show me the evidence

> > for

> > > > that?

> > > >

> > > >

> > > > Jan Patenaude, RD, CLT

> > > > Director of Medical Nutrition

> > > > Signet Diagnostic Corp.

> > > > Telecommuting Nationwide

> > > > (Mountain Time)

> > > > Fax:

> > > > DineRight4@...

> > > >

> > > > Certified LEAP Therapist and specialist in food sensitivity for IBS,

> > > > migraine, fibromyalgia and multiple inflammatory conditions. Co-author

> > of the

> > > > Certified LEAP Therapist (CLT) Training Course.

> > > >

> > > > Re: The Great Cancer Hoax - extended thru 6/20

> > > >

> > > > _

> > http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/_

> > > > (

> > http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/)

> >

> > > >

> > > > On Mon, Jun 13, 2011 at 11:18 PM, Jacqui Pressly <_Jpress50@..._

> > > > (

> >

http://health.groups.yahoo.com/group/rd-usa/post?postID=gJl7O9-0Wsq_2MXaOdDcGaMT\

i7GYQ

> > > > qfD4nP2Os6mSiBLs_6OsOEUFIunjUNDecytZLrYhlHZ) > wrote:

> > > >

> > > > >

> > > > >

> > > > >

> > > > > ,

> > > > > Where is it that this dx doesn't exist? That's what I would be

> > cautious

> > > > > about.

> > > > >

> > > > > Jacquelyn A. Pressly, RD, CLT

> > > > > The NATURAL dietitian

> > > > > Specializing in Wellness and Prevention, Personal Nutrition Coaching

> > > > > and Designer Lifestyle Plans to help you get on the health track

> > > > > Northeast Ohio & Western Pennsylvania

> > > > > Internet and telecounseling available for distance clients

> > > > >

> > > > > _jpress50@..._

> > > > (

> >

http://health.groups.yahoo.com/group/rd-usa/post?postID=2n1nW2HOEaLO84cXflZaGxn6\

_ABLxdnwkd6i4Xoi6_FNA0sRcNMgb3hQgncOHblofIntwCHgp7gClw

> > > > )

> > > > >

> > > > > If you are what you eat, then dietitians are the doctors of the

> > future

> > > > >

> > > > >

> > > > > Re: The Great Cancer Hoax - extended thru 6/20

> > > > >

> > > > > But are they doing things like adrenal fatigue (dx doesn't exist),

> > liver

> > > > > detox, homeopathy and this type of medicine - red flags should be up

> > > > IMHO.

> > > > > As should traditional medicine MDs when excessive and unwarranted and

> >

> > > > over

> > > > > prescribing drugs.

> > > >

> > > >

[Guest guest]

PS. Not upset with Pam, but just surprised at the response and didn't like it.

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

> To: rd-usa

> From: nrord1@...

> Date: Thu, 16 Jun 2011 13:52:33 -0400

> Subject: Re: Full Liquid Diet? Evidence based?

>

> Full liquid is still useful with speech pathologists. It can also be

> interpreted in many ways - full liquid thicken - honey, nectar etc. I think

> it is the inappropriate use that should be looked at, not some real uses for

> it.

>

> Interesting people are upset with Pam but not for LEAP. When are real

> studies going to be done - not saying it doesn't work but maybe it could be

> EBM if the LEAP company and therapists would do some studies and have it

> published. Just a thought...I would love to recommend it but I do want some

> data first, not testimonials.

>

>

>

> >

> >

> >

> > Pam,I am sorry to be the one who says that, but I am very surprised how

> > harsh and " personal " your response was. these kind of responses hold many on

> > the list from participating in active discussion. We are not all informed

> > 100% on 100% of the topics, and no one should be expected to be an expert on

> > every single topic. It is impossible and very unhealthy, professionally, to

> > anyone,to assume they " know all " .Sometimes clear liquid or full liq diets

> > are the only thing pts can tolerate and its better then NPO, and it should

> > not be used more then few days bc it is nutritionally lacking. But with all

> > do respect to EBM - textbook and studies are not case study and real

> > practice. Pts are not textbook nor a study, and even in EMB there is a value

> > to case studies. Respected journals publish them all the time. thats why

> > they are called case studies. and to say that clear of full liq diet is just

> > wrong all across the board is wrong too.

> > Pam, your knowledge and experience are priceless and greatly appreciate,

> > but we need to leave room for ppl to ask freely, without the fear of being

> > scrutinized by others.

> > Merav Levi, RD, MS, CDNA dietitian, not the food police.

> > http://www.linkedin.com/in/meravlevi

> >

> > " Life is not measured by the number of breath you take, but by the moments

> > that take your breath away. " - Carlin " People don't forget the truth,

> > they just become better in lying " (Revolutionary Road)

> >

> >

> > > To: rd-usa

> > > From: pcharney@...

> > > Date: Thu, 16 Jun 2011 09:10:24 -0700

> >

> > > Subject: Re: Full Liquid Diet? Evidence based?

> > >

> > > ly, Jan, I'm surprised that someone as sharp as you would be so

> > uninformed about evidence-based medicine and that you select one instance in

> > one facility in order to justify an anti-science bias. There are so many

> > unfounded rumors surrounding use of evidence to support practice.

> > >

> > > Please take a look at the many outstanding resources and tutorials on EBM

> > that are available, such as the Centre for Evidence Based Medicine,

> > Bandolier, and others. Have you looked at the Cochrane Library for

> > systematic reviews?

> > >

> > > The full liquid diet has been shown in several studies to not be useful.

> > I would argue that it is not the physician who is leading the charge to keep

> > it, rather it's the RD who does not have the gumption to stand up to the

> > physician and explain that full liquid diets are not useful, nor are they

> > evidence-based. In fact, there is a trend to longer hospitalization when

> > regular diets are withheld.

> > >

> > > It is not only RDs who " insist " on using EBM. We have a healthcare system

> > that can no longer afford to pay for treatments and therapies just because

> > one clinician " gets good results " (that's my favorite pet peeve these days;

> > RDs who say " I get good results when I ....... " My question is " good results

> > compared to what? " ). CMS is moving towards paying for treatments that are

> > evidence-based. Where the evidence does not exist, strong cohort studies,

> > case series, etc can stand in until the research is done.

> > >

> > > EBM also does not mean that everything we do must have tons of research.

> > Look at insulin. When insulin was first isolated and produced in the 1920s,

> > there were no cries for randomized controled trials. Rather, at that time

> > type 1 diabetes had a 100% fatality rate. Lacking insulin, patients died.

> > Thus, knowing that insulin was the hormone that lowered blood sugar, human

> > use began. I sort of liken that to the use of parachutes in airplanes. We

> > don't need a trial to know that parachutes prevent fatal plummets to the

> > earth.

> > >

> > > The history of EBM is fascinating. The first known randomized controlled

> > trial was that done by Lind in the Royal Navy when he determined that

> > there was some factor in citrus fruits that prevented scurvy. In the

> > mid-1800s, Semmelweis proved that hand washing was a strong preventive

> > factor for puerperal fever. In both cases, it took over 50 years for

> > practice to change. In fact, we still fight the handwashing battle. Why?

> > There are many theories and change management is a relatively new area of

> > science. Basically, change is easy..... if the change is easy.

> > >

> > > Evidence based medicine, or evidence based practice, simply says that

> > before you try something new or different on real people you should have

> > some evidence that you will not hurt them Do no harm. I'm not sure anyone

> > would be opposed to that?

> > >

> > > Pam Charney, PhD, RD

> > > Author, Consultant

> > > pcharney@...

> > >

> > > " Lead, follow, or get out of the way! "

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > > >

> > > > Too busy lately, so getting into this discussion late.

> > > >

> > > > For all the RDs that SAY they insist on Evidence Based Medicine, I ask;

> >

> > > > Show me the evidence for hospitals to serve full liquid diets. I've

> > NEVER

> > > > found it, but tens of thousands of RDs nationwide still do this. (I

> > THOUGHT

> > > > that practice was stopped years ago!)

> > > >

> > > > I don't work in hospitals anymore, but recently was visiting a friend

> > in

> > > > CCU for GI bleed with a full liquid diet on his plate. 2% milk,

> > pudding,

> > > > cream of potato soup, and ice cream.

> > > >

> > > > I was embarrassed for my profession.

> > > >

> > > > Please, would some RD that insists on EBM please show me the evidence

> > for

> > > > that?

> > > >

> > > >

> > > > Jan Patenaude, RD, CLT

> > > > Director of Medical Nutrition

> > > > Signet Diagnostic Corp.

> > > > Telecommuting Nationwide

> > > > (Mountain Time)

> > > > Fax:

> > > > DineRight4@...

> > > >

> > > > Certified LEAP Therapist and specialist in food sensitivity for IBS,

> > > > migraine, fibromyalgia and multiple inflammatory conditions. Co-author

> > of the

> > > > Certified LEAP Therapist (CLT) Training Course.

> > > >

> > > > Re: The Great Cancer Hoax - extended thru 6/20

> > > >

> > > > _

> > http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/_

> > > > (

> > http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/)

> >

> > > >

> > > > On Mon, Jun 13, 2011 at 11:18 PM, Jacqui Pressly <_Jpress50@..._

> > > > (

> >

http://health.groups.yahoo.com/group/rd-usa/post?postID=gJl7O9-0Wsq_2MXaOdDcGaMT\

i7GYQ

> > > > qfD4nP2Os6mSiBLs_6OsOEUFIunjUNDecytZLrYhlHZ) > wrote:

> > > >

> > > > >

> > > > >

> > > > >

> > > > > ,

> > > > > Where is it that this dx doesn't exist? That's what I would be

> > cautious

> > > > > about.

> > > > >

> > > > > Jacquelyn A. Pressly, RD, CLT

> > > > > The NATURAL dietitian

> > > > > Specializing in Wellness and Prevention, Personal Nutrition Coaching

> > > > > and Designer Lifestyle Plans to help you get on the health track

> > > > > Northeast Ohio & Western Pennsylvania

> > > > > Internet and telecounseling available for distance clients

> > > > >

> > > > > _jpress50@..._

> > > > (

> >

http://health.groups.yahoo.com/group/rd-usa/post?postID=2n1nW2HOEaLO84cXflZaGxn6\

_ABLxdnwkd6i4Xoi6_FNA0sRcNMgb3hQgncOHblofIntwCHgp7gClw

> > > > )

> > > > >

> > > > > If you are what you eat, then dietitians are the doctors of the

> > future

> > > > >

> > > > >

> > > > > Re: The Great Cancer Hoax - extended thru 6/20

> > > > >

> > > > > But are they doing things like adrenal fatigue (dx doesn't exist),

> > liver

> > > > > detox, homeopathy and this type of medicine - red flags should be up

> > > > IMHO.

> > > > > As should traditional medicine MDs when excessive and unwarranted and

> >

> > > > over

> > > > > prescribing drugs.

> > > >

> > > >

[Guest guest]

,

Here I thought I was the only one that was skeptical about LEAP.

Pam:

Your reply to Jan was surprising. I am the first to admit that I do not

always agree with Jan. However, indirectly, your reply only contributes to

my impression that there is a bias between the upper echelon educated

dietitians and lower echelon educated dietitians. I am most certainly

outspoken, but I don't think I could have ever replied publicly in the

fashion in which you did.

As a dietitian who spends 50% of her time in rehabilitative medicine and 50%

with longer care and with some very aggressive speech therapists, I agree

with Digna and . I have not eliminated Full Liquid diet from our

approved diets for exactly the reasons both Digna and stated.

Quite frankly, if I may turn the tables: ly, Pam, I'm surprised that

someone as sharp as you would be so uninformed about medical nutritional

therapy outside of the box. In rehabilitative nutritional care and

nutrition care for the dementia and Alzheimers, it appears you have

forgotten that there are most certainly times that EBM contradicts the

actual practice I select your reply as an example of how dietitians, in

general, have a tendency to NOT to think outside of the box. Are you going

to deny a person nutrition because what the patient can tolerate is contrary

to EBM when it comes to a Full Liquid diet? Wouldn't that go against the

premise of " Do No Harm? " Throw the unfounded the rumors to the wind. If a

patient cannot tolerate anything other than full liquids - for whatever

reason - will ultimately result in starvation. Sure, that is the extreme

outcome. But it is far better to give real food in a texture the person can

tolerate than some commercial canned nutrition supplement. Of course we base

our standards of care on EBM, but sometimes there are EBM that we have to

interpret, extrapolate for the individual person. The individualized care

is what we all supposed to be about, if I am not mistaken "

Your reply, as condescending as it was, makes me cringe that I am a

professional in a professional organization that would treat each other in

this manner. My primary goal is the patient. If the patient needs a full

liquid, I am going to make sure I get them a full liquid, even though it

might be contrary to EBM. I do hope that people who are reading this

realize that looking down their educational nose to their colleagues is not

how to make friends and amicable colleagues.

> Full liquid is still useful with speech pathologists. It can also be

> interpreted in many ways - full liquid thicken - honey, nectar etc. I think

> it is the inappropriate use that should be looked at, not some real uses

> for

> it.

>

> Interesting people are upset with Pam but not for LEAP. When are real

> studies going to be done - not saying it doesn't work but maybe it could be

> EBM if the LEAP company and therapists would do some studies and have it

> published. Just a thought...I would love to recommend it but I do want some

> data first, not testimonials.

>

>

>

> >

> >

> >

> > Pam,I am sorry to be the one who says that, but I am very surprised how

> > harsh and " personal " your response was. these kind of responses hold many

> on

> > the list from participating in active discussion. We are not all informed

> > 100% on 100% of the topics, and no one should be expected to be an expert

> on

> > every single topic. It is impossible and very unhealthy, professionally,

> to

> > anyone,to assume they " know all " .Sometimes clear liquid or full liq diets

> > are the only thing pts can tolerate and its better then NPO, and it

> should

> > not be used more then few days bc it is nutritionally lacking. But with

> all

> > do respect to EBM - textbook and studies are not case study and real

> > practice. Pts are not textbook nor a study, and even in EMB there is a

> value

> > to case studies. Respected journals publish them all the time. thats why

> > they are called case studies. and to say that clear of full liq diet is

> just

> > wrong all across the board is wrong too.

> > Pam, your knowledge and experience are priceless and greatly appreciate,

> > but we need to leave room for ppl to ask freely, without the fear of

> being

> > scrutinized by others.

> > Merav Levi, RD, MS, CDNA dietitian, not the food police.

> > http://www.linkedin.com/in/meravlevi

> >

> > " Life is not measured by the number of breath you take, but by the

> moments

> > that take your breath away. " - Carlin " People don't forget the

> truth,

> > they just become better in lying " (Revolutionary Road)

> >

> >

> > > To: rd-usa

> > > From: pcharney@...

> > > Date: Thu, 16 Jun 2011 09:10:24 -0700

> >

> > > Subject: Re: Full Liquid Diet? Evidence based?

> > >

> > > ly, Jan, I'm surprised that someone as sharp as you would be so

> > uninformed about evidence-based medicine and that you select one instance

> in

> > one facility in order to justify an anti-science bias. There are so many

> > unfounded rumors surrounding use of evidence to support practice.

> > >

> > > Please take a look at the many outstanding resources and tutorials on

> EBM

> > that are available, such as the Centre for Evidence Based Medicine,

> > Bandolier, and others. Have you looked at the Cochrane Library for

> > systematic reviews?

> > >

> > > The full liquid diet has been shown in several studies to not be

> useful.

> > I would argue that it is not the physician who is leading the charge to

> keep

> > it, rather it's the RD who does not have the gumption to stand up to the

> > physician and explain that full liquid diets are not useful, nor are they

> > evidence-based. In fact, there is a trend to longer hospitalization when

> > regular diets are withheld.

> > >

> > > It is not only RDs who " insist " on using EBM. We have a healthcare

> system

> > that can no longer afford to pay for treatments and therapies just

> because

> > one clinician " gets good results " (that's my favorite pet peeve these

> days;

> > RDs who say " I get good results when I ....... " My question is " good

> results

> > compared to what? " ). CMS is moving towards paying for treatments that are

> > evidence-based. Where the evidence does not exist, strong cohort studies,

> > case series, etc can stand in until the research is done.

> > >

> > > EBM also does not mean that everything we do must have tons of

> research.

> > Look at insulin. When insulin was first isolated and produced in the

> 1920s,

> > there were no cries for randomized controled trials. Rather, at that time

> > type 1 diabetes had a 100% fatality rate. Lacking insulin, patients died.

> > Thus, knowing that insulin was the hormone that lowered blood sugar,

> human

> > use began. I sort of liken that to the use of parachutes in airplanes. We

> > don't need a trial to know that parachutes prevent fatal plummets to the

> > earth.

> > >

> > > The history of EBM is fascinating. The first known randomized

> controlled

> > trial was that done by Lind in the Royal Navy when he determined

> that

> > there was some factor in citrus fruits that prevented scurvy. In the

> > mid-1800s, Semmelweis proved that hand washing was a strong preventive

> > factor for puerperal fever. In both cases, it took over 50 years for

> > practice to change. In fact, we still fight the handwashing battle. Why?

> > There are many theories and change management is a relatively new area of

> > science. Basically, change is easy..... if the change is easy.

> > >

> > > Evidence based medicine, or evidence based practice, simply says that

> > before you try something new or different on real people you should have

> > some evidence that you will not hurt them Do no harm. I'm not sure anyone

> > would be opposed to that?

> > >

> > > Pam Charney, PhD, RD

> > > Author, Consultant

> > > pcharney@...

> > >

> > > " Lead, follow, or get out of the way! "

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > > >

> > > > Too busy lately, so getting into this discussion late.

> > > >

> > > > For all the RDs that SAY they insist on Evidence Based Medicine, I

> ask;

> >

> > > > Show me the evidence for hospitals to serve full liquid diets. I've

> > NEVER

> > > > found it, but tens of thousands of RDs nationwide still do this. (I

> > THOUGHT

> > > > that practice was stopped years ago!)

> > > >

> > > > I don't work in hospitals anymore, but recently was visiting a friend

> > in

> > > > CCU for GI bleed with a full liquid diet on his plate. 2% milk,

> > pudding,

> > > > cream of potato soup, and ice cream.

> > > >

> > > > I was embarrassed for my profession.

> > > >

> > > > Please, would some RD that insists on EBM please show me the evidence

> > for

> > > > that?

> > > >

> > > >

> > > > Jan Patenaude, RD, CLT

> > > > Director of Medical Nutrition

> > > > Signet Diagnostic Corp.

> > > > Telecommuting Nationwide

> > > > (Mountain Time)

> > > > Fax:

> > > > DineRight4@...

> > > >

> > > > Certified LEAP Therapist and specialist in food sensitivity for IBS,

> > > > migraine, fibromyalgia and multiple inflammatory conditions.

> Co-author

> > of the

> > > > Certified LEAP Therapist (CLT) Training Course.

> > > >

> > > > Re: The Great Cancer Hoax - extended thru 6/20

> > > >

> > > > _

> >

> http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/_

> > > > (

> >

> http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/)

> >

> > > >

> > > > On Mon, Jun 13, 2011 at 11:18 PM, Jacqui Pressly <_Jpress50@..._

> > > > (

> >

>

http://health.groups.yahoo.com/group/rd-usa/post?postID=gJl7O9-0Wsq_2MXaOdDcGaMT\

i7GYQ

> > > > qfD4nP2Os6mSiBLs_6OsOEUFIunjUNDecytZLrYhlHZ) > wrote:

> > > >

> > > > >

> > > > >

> > > > >

> > > > > ,

> > > > > Where is it that this dx doesn't exist? That's what I would be

> > cautious

> > > > > about.

> > > > >

> > > > > Jacquelyn A. Pressly, RD, CLT

> > > > > The NATURAL dietitian

> > > > > Specializing in Wellness and Prevention, Personal Nutrition

> Coaching

> > > > > and Designer Lifestyle Plans to help you get on the health track

> > > > > Northeast Ohio & Western Pennsylvania

> > > > > Internet and telecounseling available for distance clients

> > > > >

> > > > > _jpress50@..._

> > > > (

> >

>

http://health.groups.yahoo.com/group/rd-usa/post?postID=2n1nW2HOEaLO84cXflZaGxn6\

_ABLxdnwkd6i4Xoi6_FNA0sRcNMgb3hQgncOHblofIntwCHgp7gClw

> > > > )

> > > > >

> > > > > If you are what you eat, then dietitians are the doctors of the

> > future

> > > > >

> > > > >

> > > > > Re: The Great Cancer Hoax - extended thru 6/20

> > > > >

> > > > > But are they doing things like adrenal fatigue (dx doesn't exist),

> > liver

> > > > > detox, homeopathy and this type of medicine - red flags should be

> up

> > > > IMHO.

> > > > > As should traditional medicine MDs when excessive and unwarranted

> and

> >

> > > > over

> > > > > prescribing drugs.

> > > >

> > > >

[Guest guest]

,

Here I thought I was the only one that was skeptical about LEAP.

Pam:

Your reply to Jan was surprising. I am the first to admit that I do not

always agree with Jan. However, indirectly, your reply only contributes to

my impression that there is a bias between the upper echelon educated

dietitians and lower echelon educated dietitians. I am most certainly

outspoken, but I don't think I could have ever replied publicly in the

fashion in which you did.

As a dietitian who spends 50% of her time in rehabilitative medicine and 50%

with longer care and with some very aggressive speech therapists, I agree

with Digna and . I have not eliminated Full Liquid diet from our

approved diets for exactly the reasons both Digna and stated.

Quite frankly, if I may turn the tables: ly, Pam, I'm surprised that

someone as sharp as you would be so uninformed about medical nutritional

therapy outside of the box. In rehabilitative nutritional care and

nutrition care for the dementia and Alzheimers, it appears you have

forgotten that there are most certainly times that EBM contradicts the

actual practice I select your reply as an example of how dietitians, in

general, have a tendency to NOT to think outside of the box. Are you going

to deny a person nutrition because what the patient can tolerate is contrary

to EBM when it comes to a Full Liquid diet? Wouldn't that go against the

premise of " Do No Harm? " Throw the unfounded the rumors to the wind. If a

patient cannot tolerate anything other than full liquids - for whatever

reason - will ultimately result in starvation. Sure, that is the extreme

outcome. But it is far better to give real food in a texture the person can

tolerate than some commercial canned nutrition supplement. Of course we base

our standards of care on EBM, but sometimes there are EBM that we have to

interpret, extrapolate for the individual person. The individualized care

is what we all supposed to be about, if I am not mistaken "

Your reply, as condescending as it was, makes me cringe that I am a

professional in a professional organization that would treat each other in

this manner. My primary goal is the patient. If the patient needs a full

liquid, I am going to make sure I get them a full liquid, even though it

might be contrary to EBM. I do hope that people who are reading this

realize that looking down their educational nose to their colleagues is not

how to make friends and amicable colleagues.

> Full liquid is still useful with speech pathologists. It can also be

> interpreted in many ways - full liquid thicken - honey, nectar etc. I think

> it is the inappropriate use that should be looked at, not some real uses

> for

> it.

>

> Interesting people are upset with Pam but not for LEAP. When are real

> studies going to be done - not saying it doesn't work but maybe it could be

> EBM if the LEAP company and therapists would do some studies and have it

> published. Just a thought...I would love to recommend it but I do want some

> data first, not testimonials.

>

>

>

> >

> >

> >

> > Pam,I am sorry to be the one who says that, but I am very surprised how

> > harsh and " personal " your response was. these kind of responses hold many

> on

> > the list from participating in active discussion. We are not all informed

> > 100% on 100% of the topics, and no one should be expected to be an expert

> on

> > every single topic. It is impossible and very unhealthy, professionally,

> to

> > anyone,to assume they " know all " .Sometimes clear liquid or full liq diets

> > are the only thing pts can tolerate and its better then NPO, and it

> should

> > not be used more then few days bc it is nutritionally lacking. But with

> all

> > do respect to EBM - textbook and studies are not case study and real

> > practice. Pts are not textbook nor a study, and even in EMB there is a

> value

> > to case studies. Respected journals publish them all the time. thats why

> > they are called case studies. and to say that clear of full liq diet is

> just

> > wrong all across the board is wrong too.

> > Pam, your knowledge and experience are priceless and greatly appreciate,

> > but we need to leave room for ppl to ask freely, without the fear of

> being

> > scrutinized by others.

> > Merav Levi, RD, MS, CDNA dietitian, not the food police.

> > http://www.linkedin.com/in/meravlevi

> >

> > " Life is not measured by the number of breath you take, but by the

> moments

> > that take your breath away. " - Carlin " People don't forget the

> truth,

> > they just become better in lying " (Revolutionary Road)

> >

> >

> > > To: rd-usa

> > > From: pcharney@...

> > > Date: Thu, 16 Jun 2011 09:10:24 -0700

> >

> > > Subject: Re: Full Liquid Diet? Evidence based?

> > >

> > > ly, Jan, I'm surprised that someone as sharp as you would be so

> > uninformed about evidence-based medicine and that you select one instance

> in

> > one facility in order to justify an anti-science bias. There are so many

> > unfounded rumors surrounding use of evidence to support practice.

> > >

> > > Please take a look at the many outstanding resources and tutorials on

> EBM

> > that are available, such as the Centre for Evidence Based Medicine,

> > Bandolier, and others. Have you looked at the Cochrane Library for

> > systematic reviews?

> > >

> > > The full liquid diet has been shown in several studies to not be

> useful.

> > I would argue that it is not the physician who is leading the charge to

> keep

> > it, rather it's the RD who does not have the gumption to stand up to the

> > physician and explain that full liquid diets are not useful, nor are they

> > evidence-based. In fact, there is a trend to longer hospitalization when

> > regular diets are withheld.

> > >

> > > It is not only RDs who " insist " on using EBM. We have a healthcare

> system

> > that can no longer afford to pay for treatments and therapies just

> because

> > one clinician " gets good results " (that's my favorite pet peeve these

> days;

> > RDs who say " I get good results when I ....... " My question is " good

> results

> > compared to what? " ). CMS is moving towards paying for treatments that are

> > evidence-based. Where the evidence does not exist, strong cohort studies,

> > case series, etc can stand in until the research is done.

> > >

> > > EBM also does not mean that everything we do must have tons of

> research.

> > Look at insulin. When insulin was first isolated and produced in the

> 1920s,

> > there were no cries for randomized controled trials. Rather, at that time

> > type 1 diabetes had a 100% fatality rate. Lacking insulin, patients died.

> > Thus, knowing that insulin was the hormone that lowered blood sugar,

> human

> > use began. I sort of liken that to the use of parachutes in airplanes. We

> > don't need a trial to know that parachutes prevent fatal plummets to the

> > earth.

> > >

> > > The history of EBM is fascinating. The first known randomized

> controlled

> > trial was that done by Lind in the Royal Navy when he determined

> that

> > there was some factor in citrus fruits that prevented scurvy. In the

> > mid-1800s, Semmelweis proved that hand washing was a strong preventive

> > factor for puerperal fever. In both cases, it took over 50 years for

> > practice to change. In fact, we still fight the handwashing battle. Why?

> > There are many theories and change management is a relatively new area of

> > science. Basically, change is easy..... if the change is easy.

> > >

> > > Evidence based medicine, or evidence based practice, simply says that

> > before you try something new or different on real people you should have

> > some evidence that you will not hurt them Do no harm. I'm not sure anyone

> > would be opposed to that?

> > >

> > > Pam Charney, PhD, RD

> > > Author, Consultant

> > > pcharney@...

> > >

> > > " Lead, follow, or get out of the way! "

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > > >

> > > > Too busy lately, so getting into this discussion late.

> > > >

> > > > For all the RDs that SAY they insist on Evidence Based Medicine, I

> ask;

> >

> > > > Show me the evidence for hospitals to serve full liquid diets. I've

> > NEVER

> > > > found it, but tens of thousands of RDs nationwide still do this. (I

> > THOUGHT

> > > > that practice was stopped years ago!)

> > > >

> > > > I don't work in hospitals anymore, but recently was visiting a friend

> > in

> > > > CCU for GI bleed with a full liquid diet on his plate. 2% milk,

> > pudding,

> > > > cream of potato soup, and ice cream.

> > > >

> > > > I was embarrassed for my profession.

> > > >

> > > > Please, would some RD that insists on EBM please show me the evidence

> > for

> > > > that?

> > > >

> > > >

> > > > Jan Patenaude, RD, CLT

> > > > Director of Medical Nutrition

> > > > Signet Diagnostic Corp.

> > > > Telecommuting Nationwide

> > > > (Mountain Time)

> > > > Fax:

> > > > DineRight4@...

> > > >

> > > > Certified LEAP Therapist and specialist in food sensitivity for IBS,

> > > > migraine, fibromyalgia and multiple inflammatory conditions.

> Co-author

> > of the

> > > > Certified LEAP Therapist (CLT) Training Course.

> > > >

> > > > Re: The Great Cancer Hoax - extended thru 6/20

> > > >

> > > > _

> >

> http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/_

> > > > (

> >

> http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/)

> >

> > > >

> > > > On Mon, Jun 13, 2011 at 11:18 PM, Jacqui Pressly <_Jpress50@..._

> > > > (

> >

>

http://health.groups.yahoo.com/group/rd-usa/post?postID=gJl7O9-0Wsq_2MXaOdDcGaMT\

i7GYQ

> > > > qfD4nP2Os6mSiBLs_6OsOEUFIunjUNDecytZLrYhlHZ) > wrote:

> > > >

> > > > >

> > > > >

> > > > >

> > > > > ,

> > > > > Where is it that this dx doesn't exist? That's what I would be

> > cautious

> > > > > about.

> > > > >

> > > > > Jacquelyn A. Pressly, RD, CLT

> > > > > The NATURAL dietitian

> > > > > Specializing in Wellness and Prevention, Personal Nutrition

> Coaching

> > > > > and Designer Lifestyle Plans to help you get on the health track

> > > > > Northeast Ohio & Western Pennsylvania

> > > > > Internet and telecounseling available for distance clients

> > > > >

> > > > > _jpress50@..._

> > > > (

> >

>

http://health.groups.yahoo.com/group/rd-usa/post?postID=2n1nW2HOEaLO84cXflZaGxn6\

_ABLxdnwkd6i4Xoi6_FNA0sRcNMgb3hQgncOHblofIntwCHgp7gClw

> > > > )

> > > > >

> > > > > If you are what you eat, then dietitians are the doctors of the

> > future

> > > > >

> > > > >

> > > > > Re: The Great Cancer Hoax - extended thru 6/20

> > > > >

> > > > > But are they doing things like adrenal fatigue (dx doesn't exist),

> > liver

> > > > > detox, homeopathy and this type of medicine - red flags should be

> up

> > > > IMHO.

> > > > > As should traditional medicine MDs when excessive and unwarranted

> and

> >

> > > > over

> > > > > prescribing drugs.

> > > >

> > > >

[Guest guest]

Excellent Carol. YOu said it better then me.

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

> To: rd-usa

> From: carolscasey@...

> Date: Thu, 16 Jun 2011 14:22:34 -0400

> Subject: Re: Full Liquid Diet? Evidence based?

>

> ,

>

> Here I thought I was the only one that was skeptical about LEAP.

>

> Pam:

>

> Your reply to Jan was surprising. I am the first to admit that I do not

> always agree with Jan. However, indirectly, your reply only contributes to

> my impression that there is a bias between the upper echelon educated

> dietitians and lower echelon educated dietitians. I am most certainly

> outspoken, but I don't think I could have ever replied publicly in the

> fashion in which you did.

>

> As a dietitian who spends 50% of her time in rehabilitative medicine and 50%

> with longer care and with some very aggressive speech therapists, I agree

> with Digna and . I have not eliminated Full Liquid diet from our

> approved diets for exactly the reasons both Digna and stated.

>

> Quite frankly, if I may turn the tables: ly, Pam, I'm surprised that

> someone as sharp as you would be so uninformed about medical nutritional

> therapy outside of the box. In rehabilitative nutritional care and

> nutrition care for the dementia and Alzheimers, it appears you have

> forgotten that there are most certainly times that EBM contradicts the

> actual practice I select your reply as an example of how dietitians, in

> general, have a tendency to NOT to think outside of the box. Are you going

> to deny a person nutrition because what the patient can tolerate is contrary

> to EBM when it comes to a Full Liquid diet? Wouldn't that go against the

> premise of " Do No Harm? " Throw the unfounded the rumors to the wind. If a

> patient cannot tolerate anything other than full liquids - for whatever

> reason - will ultimately result in starvation. Sure, that is the extreme

> outcome. But it is far better to give real food in a texture the person can

> tolerate than some commercial canned nutrition supplement. Of course we base

> our standards of care on EBM, but sometimes there are EBM that we have to

> interpret, extrapolate for the individual person. The individualized care

> is what we all supposed to be about, if I am not mistaken "

> Your reply, as condescending as it was, makes me cringe that I am a

> professional in a professional organization that would treat each other in

> this manner. My primary goal is the patient. If the patient needs a full

> liquid, I am going to make sure I get them a full liquid, even though it

> might be contrary to EBM. I do hope that people who are reading this

> realize that looking down their educational nose to their colleagues is not

> how to make friends and amicable colleagues.

>

>

> > Full liquid is still useful with speech pathologists. It can also be

> > interpreted in many ways - full liquid thicken - honey, nectar etc. I think

> > it is the inappropriate use that should be looked at, not some real uses

> > for

> > it.

> >

> > Interesting people are upset with Pam but not for LEAP. When are real

> > studies going to be done - not saying it doesn't work but maybe it could be

> > EBM if the LEAP company and therapists would do some studies and have it

> > published. Just a thought...I would love to recommend it but I do want some

> > data first, not testimonials.

> >

> >

> >

> > >

> > >

> > >

> > > Pam,I am sorry to be the one who says that, but I am very surprised how

> > > harsh and " personal " your response was. these kind of responses hold many

> > on

> > > the list from participating in active discussion. We are not all informed

> > > 100% on 100% of the topics, and no one should be expected to be an expert

> > on

> > > every single topic. It is impossible and very unhealthy, professionally,

> > to

> > > anyone,to assume they " know all " .Sometimes clear liquid or full liq diets

> > > are the only thing pts can tolerate and its better then NPO, and it

> > should

> > > not be used more then few days bc it is nutritionally lacking. But with

> > all

> > > do respect to EBM - textbook and studies are not case study and real

> > > practice. Pts are not textbook nor a study, and even in EMB there is a

> > value

> > > to case studies. Respected journals publish them all the time. thats why

> > > they are called case studies. and to say that clear of full liq diet is

> > just

> > > wrong all across the board is wrong too.

> > > Pam, your knowledge and experience are priceless and greatly appreciate,

> > > but we need to leave room for ppl to ask freely, without the fear of

> > being

> > > scrutinized by others.

> > > Merav Levi, RD, MS, CDNA dietitian, not the food police.

> > > http://www.linkedin.com/in/meravlevi

> > >

> > > " Life is not measured by the number of breath you take, but by the

> > moments

> > > that take your breath away. " - Carlin " People don't forget the

> > truth,

> > > they just become better in lying " (Revolutionary Road)

> > >

> > >

> > > > To: rd-usa

> > > > From: pcharney@...

> > > > Date: Thu, 16 Jun 2011 09:10:24 -0700

> > >

> > > > Subject: Re: Full Liquid Diet? Evidence based?

> > > >

> > > > ly, Jan, I'm surprised that someone as sharp as you would be so

> > > uninformed about evidence-based medicine and that you select one instance

> > in

> > > one facility in order to justify an anti-science bias. There are so many

> > > unfounded rumors surrounding use of evidence to support practice.

> > > >

> > > > Please take a look at the many outstanding resources and tutorials on

> > EBM

> > > that are available, such as the Centre for Evidence Based Medicine,

> > > Bandolier, and others. Have you looked at the Cochrane Library for

> > > systematic reviews?

> > > >

> > > > The full liquid diet has been shown in several studies to not be

> > useful.

> > > I would argue that it is not the physician who is leading the charge to

> > keep

> > > it, rather it's the RD who does not have the gumption to stand up to the

> > > physician and explain that full liquid diets are not useful, nor are they

> > > evidence-based. In fact, there is a trend to longer hospitalization when

> > > regular diets are withheld.

> > > >

> > > > It is not only RDs who " insist " on using EBM. We have a healthcare

> > system

> > > that can no longer afford to pay for treatments and therapies just

> > because

> > > one clinician " gets good results " (that's my favorite pet peeve these

> > days;

> > > RDs who say " I get good results when I ....... " My question is " good

> > results

> > > compared to what? " ). CMS is moving towards paying for treatments that are

> > > evidence-based. Where the evidence does not exist, strong cohort studies,

> > > case series, etc can stand in until the research is done.

> > > >

> > > > EBM also does not mean that everything we do must have tons of

> > research.

> > > Look at insulin. When insulin was first isolated and produced in the

> > 1920s,

> > > there were no cries for randomized controled trials. Rather, at that time

> > > type 1 diabetes had a 100% fatality rate. Lacking insulin, patients died.

> > > Thus, knowing that insulin was the hormone that lowered blood sugar,

> > human

> > > use began. I sort of liken that to the use of parachutes in airplanes. We

> > > don't need a trial to know that parachutes prevent fatal plummets to the

> > > earth.

> > > >

> > > > The history of EBM is fascinating. The first known randomized

> > controlled

> > > trial was that done by Lind in the Royal Navy when he determined

> > that

> > > there was some factor in citrus fruits that prevented scurvy. In the

> > > mid-1800s, Semmelweis proved that hand washing was a strong preventive

> > > factor for puerperal fever. In both cases, it took over 50 years for

> > > practice to change. In fact, we still fight the handwashing battle. Why?

> > > There are many theories and change management is a relatively new area of

> > > science. Basically, change is easy..... if the change is easy.

> > > >

> > > > Evidence based medicine, or evidence based practice, simply says that

> > > before you try something new or different on real people you should have

> > > some evidence that you will not hurt them Do no harm. I'm not sure anyone

> > > would be opposed to that?

> > > >

> > > > Pam Charney, PhD, RD

> > > > Author, Consultant

> > > > pcharney@...

> > > >

> > > > " Lead, follow, or get out of the way! "

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > > >

> > > > > Too busy lately, so getting into this discussion late.

> > > > >

> > > > > For all the RDs that SAY they insist on Evidence Based Medicine, I

> > ask;

> > >

> > > > > Show me the evidence for hospitals to serve full liquid diets. I've

> > > NEVER

> > > > > found it, but tens of thousands of RDs nationwide still do this. (I

> > > THOUGHT

> > > > > that practice was stopped years ago!)

> > > > >

> > > > > I don't work in hospitals anymore, but recently was visiting a friend

> > > in

> > > > > CCU for GI bleed with a full liquid diet on his plate. 2% milk,

> > > pudding,

> > > > > cream of potato soup, and ice cream.

> > > > >

> > > > > I was embarrassed for my profession.

> > > > >

> > > > > Please, would some RD that insists on EBM please show me the evidence

> > > for

> > > > > that?

> > > > >

> > > > >

> > > > > Jan Patenaude, RD, CLT

> > > > > Director of Medical Nutrition

> > > > > Signet Diagnostic Corp.

> > > > > Telecommuting Nationwide

> > > > > (Mountain Time)

> > > > > Fax:

> > > > > DineRight4@...

> > > > >

> > > > > Certified LEAP Therapist and specialist in food sensitivity for IBS,

> > > > > migraine, fibromyalgia and multiple inflammatory conditions.

> > Co-author

> > > of the

> > > > > Certified LEAP Therapist (CLT) Training Course.

> > > > >

> > > > > Re: The Great Cancer Hoax - extended thru 6/20

> > > > >

> > > > > _

> > >

> > http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/_

> > > > > (

> > >

> > http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/)

> > >

> > > > >

> > > > > On Mon, Jun 13, 2011 at 11:18 PM, Jacqui Pressly <_Jpress50@..._

> > > > > (

> > >

> >

http://health.groups.yahoo.com/group/rd-usa/post?postID=gJl7O9-0Wsq_2MXaOdDcGaMT\

i7GYQ

> > > > > qfD4nP2Os6mSiBLs_6OsOEUFIunjUNDecytZLrYhlHZ) > wrote:

> > > > >

> > > > > >

> > > > > >

> > > > > >

> > > > > > ,

> > > > > > Where is it that this dx doesn't exist? That's what I would be

> > > cautious

> > > > > > about.

> > > > > >

> > > > > > Jacquelyn A. Pressly, RD, CLT

> > > > > > The NATURAL dietitian

> > > > > > Specializing in Wellness and Prevention, Personal Nutrition

> > Coaching

> > > > > > and Designer Lifestyle Plans to help you get on the health track

> > > > > > Northeast Ohio & Western Pennsylvania

> > > > > > Internet and telecounseling available for distance clients

> > > > > >

> > > > > > _jpress50@..._

> > > > > (

> > >

> >

http://health.groups.yahoo.com/group/rd-usa/post?postID=2n1nW2HOEaLO84cXflZaGxn6\

_ABLxdnwkd6i4Xoi6_FNA0sRcNMgb3hQgncOHblofIntwCHgp7gClw

> > > > > )

> > > > > >

> > > > > > If you are what you eat, then dietitians are the doctors of the

> > > future

> > > > > >

> > > > > >

> > > > > > Re: The Great Cancer Hoax - extended thru 6/20

> > > > > >

> > > > > > But are they doing things like adrenal fatigue (dx doesn't exist),

> > > liver

> > > > > > detox, homeopathy and this type of medicine - red flags should be

> > up

> > > > > IMHO.

> > > > > > As should traditional medicine MDs when excessive and unwarranted

> > and

> > >

> > > > > over

> > > > > > prescribing drugs.

> > > > >

> > > > >

[Guest guest]

This conversation reached a new low.Ciao

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

To: rd-usa

CC: hlbrewer@...

From: joanne@...

Date: Thu, 16 Jun 2011 09:26:55 -0600

Subject: Re: Full Liquid Diet? Evidence based?

Colleagues,

Reply to RD-USA listserv only. You do not have my permission to forward.

As the editor who created the Nutrition Care Manual, vetted the authors

/ reviewers and edited every word for the initial launch and the first

update, I can tell you why the Full Liquid diet is in NCM. Dietitians

who ordered NCM complained to the publisher that their facility's

doctors wanted a full liquid diet so the publisher insisted the full

liquid diet be added to NCM over my objections and documentation that

there is no science in published literature for a full liquid diet or a

progression from clear liquid to full liquid to soft to regular diets.

This and clear liquid diets are the only instance of a diet being

inserted in NCM that are not evidence or research based.

healthy regards,

Joanne Larsen MS RD LD

>

> In our facility we're deleting it from our diet list this month - just

> have to

> get the nurses to stop " advancing as tolerated " and a few damn

> surgeons to stop

> ordering it. But it can still be found in the Nutrition Care Manual

> online

> (pdf about what it is and that there is no evidence for it).

>

> Holly

> ----------

> Holly Lee Brewer, MS RD CDE

> Pediatric Dietitian, Diabetes Educator

> Medical Nutrition Therapist, Las Vegas, NV

>

> Maj Holly Brewer, USAFR BSC http://hollyinbalad.blogspot.com

> 301st MDS, NAS JRB Fort Worth (Carswell), TX

> Joint Base Balad, Iraq (Jan-Jul 2009)

>

> ________________________________

> From: " Dineright4@... <mailto:Dineright4%40aol.com> "

> <Dineright4@... <mailto:Dineright4%40aol.com>>

> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> Sent: Wed, June 15, 2011 10:22:25 PM

> Subject: The Great Cancer Hoax - Full Liquid Diet? Evidence

> based?

>

>

>

> Too busy lately, so getting into this discussion late.

>

> For all the RDs that SAY they insist on Evidence Based Medicine, I ask;

> Show me the evidence for hospitals to serve full liquid diets. I've NEVER

> found it, but tens of thousands of RDs nationwide still do this. (I

> THOUGHT

> that practice was stopped years ago!)

>

> I don't work in hospitals anymore, but recently was visiting a friend in

> CCU for GI bleed with a full liquid diet on his plate. 2% milk, pudding,

> cream of potato soup, and ice cream.

>

> I was embarrassed for my profession.

>

> Please, would some RD that insists on EBM please show me the evidence for

> that?

>

> Jan Patenaude, RD, CLT

> Director of Medical Nutrition

> Signet Diagnostic Corp.

> Telecommuting Nationwide

> (Mountain Time)

> Fax:

> DineRight4@... <mailto:DineRight4%40aol.com>

>

> Certified LEAP Therapist and specialist in food sensitivity for IBS,

> migraine, fibromyalgia and multiple inflammatory conditions. Co-author

> of the

> Certified LEAP Therapist (CLT) Training Course.

>

> Re: The Great Cancer Hoax - extended thru 6/20

>

> _http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/_

>

> (http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/)

>

>

> On Mon, Jun 13, 2011 at 11:18 PM, Jacqui Pressly <_Jpress50@..._

>

(http://health.groups.yahoo.com/group/rd-usa/post?postID=gJl7O9-0Wsq_2MXaOdDcGaM\

Ti7GYQ

>

> qfD4nP2Os6mSiBLs_6OsOEUFIunjUNDecytZLrYhlHZ) > wrote:

>

> >

> >

> >

> > ,

> > Where is it that this dx doesn't exist? That's what I would be cautious

> > about.

> >

> > Jacquelyn A. Pressly, RD, CLT

> > The NATURAL dietitian

> > Specializing in Wellness and Prevention, Personal Nutrition Coaching

> > and Designer Lifestyle Plans to help you get on the health track

> > Northeast Ohio & Western Pennsylvania

> > Internet and telecounseling available for distance clients

> >

> > _jpress50@..._

>

(http://health.groups.yahoo.com/group/rd-usa/post?postID=2n1nW2HOEaLO84cXflZaGxn\

6_ABLxdnwkd6i4Xoi6_FNA0sRcNMgb3hQgncOHblofIntwCHgp7gClw

>

> )

> >

> > If you are what you eat, then dietitians are the doctors of the future

> >

> >

> > Re: The Great Cancer Hoax - extended thru 6/20

> >

> > But are they doing things like adrenal fatigue (dx doesn't exist), liver

> > detox, homeopathy and this type of medicine - red flags should be up

> IMHO.

> > As should traditional medicine MDs when excessive and unwarranted and

> over

> > prescribing drugs.

>

>

[Guest guest]

Joanne and others: What would you have instead??

>

> This conversation reached a new low.Ciao

>

> Merav Levi, RD, MS, CDNA dietitian, not the food police.

> http://www.linkedin.com/in/meravlevi

>

> " Life is not measured by the number of breath you take, but by the moments

> that take your breath away. " - Carlin " People don't forget the truth,

> they just become better in lying " (Revolutionary Road)

>

>

> To: rd-usa

> CC: hlbrewer@...

> From: joanne@...

> Date: Thu, 16 Jun 2011 09:26:55 -0600

> Subject: Re: Full Liquid Diet? Evidence based?

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

> Colleagues,

>

> Reply to RD-USA listserv only. You do not have my permission to forward.

>

>

>

> As the editor who created the Nutrition Care Manual, vetted the authors

>

> / reviewers and edited every word for the initial launch and the first

>

> update, I can tell you why the Full Liquid diet is in NCM. Dietitians

>

> who ordered NCM complained to the publisher that their facility's

>

> doctors wanted a full liquid diet so the publisher insisted the full

>

> liquid diet be added to NCM over my objections and documentation that

>

> there is no science in published literature for a full liquid diet or a

>

> progression from clear liquid to full liquid to soft to regular diets.

>

> This and clear liquid diets are the only instance of a diet being

>

> inserted in NCM that are not evidence or research based.

>

>

>

> healthy regards,

>

> Joanne Larsen MS RD LD

>

>

>

>

>

> >

>

> > In our facility we're deleting it from our diet list this month - just

>

> > have to

>

> > get the nurses to stop " advancing as tolerated " and a few damn

>

> > surgeons to stop

>

> > ordering it. But it can still be found in the Nutrition Care Manual

>

> > online

>

> > (pdf about what it is and that there is no evidence for it).

>

> >

>

> > Holly

>

> > ----------

>

> > Holly Lee Brewer, MS RD CDE

>

> > Pediatric Dietitian, Diabetes Educator

>

> > Medical Nutrition Therapist, Las Vegas, NV

>

> >

>

> > Maj Holly Brewer, USAFR BSC http://hollyinbalad.blogspot.com

>

> > 301st MDS, NAS JRB Fort Worth (Carswell), TX

>

> > Joint Base Balad, Iraq (Jan-Jul 2009)

>

> >

>

> > ________________________________

>

> > From: " Dineright4@... <mailto:Dineright4%40aol.com> "

>

> > <Dineright4@... <mailto:Dineright4%40aol.com>>

>

> > To: rd-usa <mailto:rd-usa%40yahoogroups.com>

>

> > Sent: Wed, June 15, 2011 10:22:25 PM

>

> > Subject: The Great Cancer Hoax - Full Liquid Diet? Evidence

>

> > based?

>

> >

>

> >

>

> >

>

> > Too busy lately, so getting into this discussion late.

>

> >

>

> > For all the RDs that SAY they insist on Evidence Based Medicine, I ask;

>

> > Show me the evidence for hospitals to serve full liquid diets. I've NEVER

>

> > found it, but tens of thousands of RDs nationwide still do this. (I

>

> > THOUGHT

>

> > that practice was stopped years ago!)

>

> >

>

> > I don't work in hospitals anymore, but recently was visiting a friend in

>

> > CCU for GI bleed with a full liquid diet on his plate. 2% milk, pudding,

>

> > cream of potato soup, and ice cream.

>

> >

>

> > I was embarrassed for my profession.

>

> >

>

> > Please, would some RD that insists on EBM please show me the evidence for

>

> > that?

>

> >

>

> > Jan Patenaude, RD, CLT

>

> > Director of Medical Nutrition

>

> > Signet Diagnostic Corp.

>

> > Telecommuting Nationwide

>

> > (Mountain Time)

>

> > Fax:

>

> > DineRight4@... <mailto:DineRight4%40aol.com>

>

> >

>

> > Certified LEAP Therapist and specialist in food sensitivity for IBS,

>

> > migraine, fibromyalgia and multiple inflammatory conditions. Co-author

>

> > of the

>

> > Certified LEAP Therapist (CLT) Training Course.

>

> >

>

> > Re: The Great Cancer Hoax - extended thru 6/20

>

> >

>

> > _

> http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/_

>

> >

>

> > (

> http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/)

>

> >

>

> >

>

> > On Mon, Jun 13, 2011 at 11:18 PM, Jacqui Pressly <_Jpress50@..._

>

> > (

>

http://health.groups.yahoo.com/group/rd-usa/post?postID=gJl7O9-0Wsq_2MXaOdDcGaMT\

i7GYQ

>

> >

>

> > qfD4nP2Os6mSiBLs_6OsOEUFIunjUNDecytZLrYhlHZ) > wrote:

>

> >

>

> > >

>

> > >

>

> > >

>

> > > ,

>

> > > Where is it that this dx doesn't exist? That's what I would be cautious

>

> > > about.

>

> > >

>

> > > Jacquelyn A. Pressly, RD, CLT

>

> > > The NATURAL dietitian

>

> > > Specializing in Wellness and Prevention, Personal Nutrition Coaching

>

> > > and Designer Lifestyle Plans to help you get on the health track

>

> > > Northeast Ohio & Western Pennsylvania

>

> > > Internet and telecounseling available for distance clients

>

> > >

>

> > > _jpress50@..._

>

> > (

>

http://health.groups.yahoo.com/group/rd-usa/post?postID=2n1nW2HOEaLO84cXflZaGxn6\

_ABLxdnwkd6i4Xoi6_FNA0sRcNMgb3hQgncOHblofIntwCHgp7gClw

>

> >

>

> > )

>

> > >

>

> > > If you are what you eat, then dietitians are the doctors of the future

>

> > >

>

> > >

>

> > > Re: The Great Cancer Hoax - extended thru 6/20

>

> > >

>

> > > But are they doing things like adrenal fatigue (dx doesn't exist),

> liver

>

> > > detox, homeopathy and this type of medicine - red flags should be up

>

> > IMHO.

>

> > > As should traditional medicine MDs when excessive and unwarranted and

>

> > over

>

> > > prescribing drugs.

>

> >

>

> >

[Guest guest]

, et al,

My comment below was to clarify the lack of evidence for a full liquid

diet as a progressive diet from clear to soft to regular.

If a patient cannot tolerate solid food, it should be the recommendation

of the dietitian to order the appropriate consistency using real food

first, then liquid supplements whether that be liquid, pureed or ground.

If we are to disagree, disagree with a position, not attack the person

please.

IMHO

healthy regards,

Joanne Larsen MS RD LD

> Joanne and others: What would you have instead??

>

> On Thu, Jun 16, 2011 at 3:25 PM, Merav Levi wrote:

>

>> This conversation reached a new low.Ciao

>>

>> Merav Levi, RD, MS, CDNA dietitian, not the food police.

>> http://www.linkedin.com/in/meravlevi

>>

>> " Life is not measured by the number of breath you take, but by the moments

>> that take your breath away. " - Carlin " People don't forget the truth,

>> they just become better in lying " (Revolutionary Road)

>>

>>

>> To: rd-usa

>> CC: hlbrewer@...

>> From: joanne@...

>> Date: Thu, 16 Jun 2011 09:26:55 -0600

>> Subject: Re: Full Liquid Diet? Evidence based?

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>>

>> Colleagues,

>>

>> Reply to RD-USA listserv only. You do not have my permission to forward.

>>

>>

>>

>> As the editor who created the Nutrition Care Manual, vetted the authors

>>

>> / reviewers and edited every word for the initial launch and the first

>>

>> update, I can tell you why the Full Liquid diet is in NCM. Dietitians

>>

>> who ordered NCM complained to the publisher that their facility's

>>

>> doctors wanted a full liquid diet so the publisher insisted the full

>>

>> liquid diet be added to NCM over my objections and documentation that

>>

>> there is no science in published literature for a full liquid diet or a

>>

>> progression from clear liquid to full liquid to soft to regular diets.

>>

>> This and clear liquid diets are the only instance of a diet being

>>

>> inserted in NCM that are not evidence or research based.

>>

>>

>>

>> healthy regards,

>>

>> Joanne Larsen MS RD LD

>>

>>

>>

>>

>>

>>> In our facility we're deleting it from our diet list this month - just

>>> have to

>>> get the nurses to stop " advancing as tolerated " and a few damn

>>> surgeons to stop

>>> ordering it. But it can still be found in the Nutrition Care Manual

>>> online

>>> (pdf about what it is and that there is no evidence for it).

>>> Holly

>>> ----------

>>> Holly Lee Brewer, MS RD CDE

>>> Pediatric Dietitian, Diabetes Educator

>>> Medical Nutrition Therapist, Las Vegas, NV

>>> Maj Holly Brewer, USAFR BSC http://hollyinbalad.blogspot.com

>>> 301st MDS, NAS JRB Fort Worth (Carswell), TX

>>> Joint Base Balad, Iraq (Jan-Jul 2009)

>>> ________________________________

>>> From: " Dineright4@...<mailto:Dineright4%40aol.com> "

>>> <Dineright4@...<mailto:Dineright4%40aol.com>>

>>> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

>>> Sent: Wed, June 15, 2011 10:22:25 PM

>>> Subject: The Great Cancer Hoax - Full Liquid Diet? Evidence

>>> based?

>>> Too busy lately, so getting into this discussion late.

>>> For all the RDs that SAY they insist on Evidence Based Medicine, I ask;

>>> Show me the evidence for hospitals to serve full liquid diets. I've NEVER

>>> found it, but tens of thousands of RDs nationwide still do this. (I

>>> THOUGHT

>>> that practice was stopped years ago!)

>>> I don't work in hospitals anymore, but recently was visiting a friend in

>>> CCU for GI bleed with a full liquid diet on his plate. 2% milk, pudding,

>>> cream of potato soup, and ice cream.

>>> I was embarrassed for my profession.

>>> Please, would some RD that insists on EBM please show me the evidence for

>>> that?

>>> Jan Patenaude, RD, CLT

>>> Director of Medical Nutrition

>>> Signet Diagnostic Corp.

>>> Telecommuting Nationwide

>>> (Mountain Time)

>>> Fax:

>>> DineRight4@...<mailto:DineRight4%40aol.com>

>>> Certified LEAP Therapist and specialist in food sensitivity for IBS,

>>> migraine, fibromyalgia and multiple inflammatory conditions. Co-author

>>> of the

>>> Certified LEAP Therapist (CLT) Training Course.

>>> Re: The Great Cancer Hoax - extended thru 6/20

>>> _

>> http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/_

>>

>>> (

>> http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/)

>>

>>> On Mon, Jun 13, 2011 at 11:18 PM, Jacqui Pressly<_Jpress50@..._

>>> (

>>

http://health.groups.yahoo.com/group/rd-usa/post?postID=gJl7O9-0Wsq_2MXaOdDcGaMT\

i7GYQ

>>

>>> qfD4nP2Os6mSiBLs_6OsOEUFIunjUNDecytZLrYhlHZ)> wrote:

>>>> ,

>>>> Where is it that this dx doesn't exist? That's what I would be cautious

>>>> about.

>>>> Jacquelyn A. Pressly, RD, CLT

>>>> The NATURAL dietitian

>>>> Specializing in Wellness and Prevention, Personal Nutrition Coaching

>>>> and Designer Lifestyle Plans to help you get on the health track

>>>> Northeast Ohio & Western Pennsylvania

>>>> Internet and telecounseling available for distance clients

>>>>

>>>> _jpress50@..._

>>> (

>>

http://health.groups.yahoo.com/group/rd-usa/post?postID=2n1nW2HOEaLO84cXflZaGxn6\

_ABLxdnwkd6i4Xoi6_FNA0sRcNMgb3hQgncOHblofIntwCHgp7gClw

>>

>>> )

>>>> If you are what you eat, then dietitians are the doctors of the future

>>>> Re: The Great Cancer Hoax - extended thru 6/20

>>>> But are they doing things like adrenal fatigue (dx doesn't exist),

>> liver

>>

>>>> detox, homeopathy and this type of medicine - red flags should be up

>>> IMHO.

>>>> As should traditional medicine MDs when excessive and unwarranted and

>>> over

>>>> prescribing drugs.

>>>

[Guest guest]

that diet isn't that useful to speech pathologists anymore since there

are thickeners now that are amylase resistant and those products are alot better

to train swallowing reflexes.

Merav full liquid diet in hospital setting even if that is the only thing that

the patient can tolerate it is unacceptably, a college of mine did a cost

comparison with enteral nutrition products and it was alot cheaper using them.

Apart from the monetary costs those diets hardly can give patients their

nutritional needs.

I was in an internship the last 2.5mo in an hospital were surgeons just left the

patients with clear liquids for 10 days because of gastric bleeding. I just

asked them directly what miracle they wanted me to perform when they called me

to optimize the patient nutritional status before surgery after they made them

save all those days. After talking to them for several hours and show them the

evidences most of them realized how wrong was what they did. Nowdays with

artificial nutrition support these kind of acts should be called malpractice.

I advise you to read about ERAS program (Early recovery after surgery).

Just a note, in the hospital that I did that internship they did bromatological

analysis to the liquid diet and at max (even if optimized with energy dense

liquids) it gave 800Kcal and 40g of protein. Don't ask me because they kept it,

apparently the nutrition services director didn't want to bother to change ...

Catia Borges

>

> >

> >

> >

> > Pam,I am sorry to be the one who says that, but I am very surprised how

> > harsh and " personal " your response was. these kind of responses hold many on

> > the list from participating in active discussion. We are not all informed

> > 100% on 100% of the topics, and no one should be expected to be an expert on

> > every single topic. It is impossible and very unhealthy, professionally, to

> > anyone,to assume they " know all " .Sometimes clear liquid or full liq diets

> > are the only thing pts can tolerate and its better then NPO, and it should

> > not be used more then few days bc it is nutritionally lacking. But with all

> > do respect to EBM - textbook and studies are not case study and real

> > practice. Pts are not textbook nor a study, and even in EMB there is a value

> > to case studies. Respected journals publish them all the time. thats why

> > they are called case studies. and to say that clear of full liq diet is just

> > wrong all across the board is wrong too.

> > Pam, your knowledge and experience are priceless and greatly appreciate,

> > but we need to leave room for ppl to ask freely, without the fear of being

> > scrutinized by others.

> > Merav Levi, RD, MS, CDNA dietitian, not the food police.

> > http://www.linkedin.com/in/meravlevi

>

[Guest guest]

So you would be for it being not a progression but a stand by itself diet or

not at all?

> , et al,

> My comment below was to clarify the lack of evidence for a full liquid diet

> as a progressive diet from clear to soft to regular.

>

> If a patient cannot tolerate solid food, it should be the recommendation of

> the dietitian to order the appropriate consistency using real food first,

> then liquid supplements whether that be liquid, pureed or ground.

>

> If we are to disagree, disagree with a position, not attack the person

> please.

>

> IMHO

>

>

> healthy regards,

> Joanne Larsen MS RD LD

>

>

>

>> Joanne and others: What would you have instead??

>>

>> On Thu, Jun 16, 2011 at 3:25 PM, Merav Levi wrote:

>>

>> This conversation reached a new low.Ciao

>>>

>>> Merav Levi, RD, MS, CDNA dietitian, not the food police.

>>> http://www.linkedin.com/in/meravlevi

>>>

>>> " Life is not measured by the number of breath you take, but by the

>>> moments

>>> that take your breath away. " - Carlin " People don't forget the

>>> truth,

>>> they just become better in lying " (Revolutionary Road)

>>>

>>>

>>> To: rd-usa

>>> CC: hlbrewer@...

>>> From: joanne@...

>>> Date: Thu, 16 Jun 2011 09:26:55 -0600

>>> Subject: Re: Full Liquid Diet? Evidence based?

>>>

>>>

>>>

>>>

>>>

>>>

>>>

>>>

>>>

>>>

>>>

>>>

>>>

>>>

>>>

>>>

>>>

>>>

>>>

>>>

>>>

>>>

>>>

>>>

>>>

>>>

>>>

>>>

>>> Colleagues,

>>>

>>> Reply to RD-USA listserv only. You do not have my permission to forward.

>>>

>>>

>>>

>>> As the editor who created the Nutrition Care Manual, vetted the authors

>>>

>>> / reviewers and edited every word for the initial launch and the first

>>>

>>> update, I can tell you why the Full Liquid diet is in NCM. Dietitians

>>>

>>> who ordered NCM complained to the publisher that their facility's

>>>

>>> doctors wanted a full liquid diet so the publisher insisted the full

>>>

>>> liquid diet be added to NCM over my objections and documentation that

>>>

>>> there is no science in published literature for a full liquid diet or a

>>>

>>> progression from clear liquid to full liquid to soft to regular diets.

>>>

>>> This and clear liquid diets are the only instance of a diet being

>>>

>>> inserted in NCM that are not evidence or research based.

>>>

>>>

>>>

>>> healthy regards,

>>>

>>> Joanne Larsen MS RD LD

>>>

>>>

>>>

>>>

>>>

>>> In our facility we're deleting it from our diet list this month - just

>>>> have to

>>>> get the nurses to stop " advancing as tolerated " and a few damn

>>>> surgeons to stop

>>>> ordering it. But it can still be found in the Nutrition Care Manual

>>>> online

>>>> (pdf about what it is and that there is no evidence for it).

>>>> Holly

>>>> ----------

>>>> Holly Lee Brewer, MS RD CDE

>>>> Pediatric Dietitian, Diabetes Educator

>>>> Medical Nutrition Therapist, Las Vegas, NV

>>>> Maj Holly Brewer, USAFR BSC http://hollyinbalad.blogspot.com

>>>> 301st MDS, NAS JRB Fort Worth (Carswell), TX

>>>> Joint Base Balad, Iraq (Jan-Jul 2009)

>>>> ________________________________

>>>> From: " Dineright4@...<mailto:Dineright4%40aol.com> "

>>>> <Dineright4@...<mailto:Dineright4%40aol.com>>

>>>> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

>>>> Sent: Wed, June 15, 2011 10:22:25 PM

>>>> Subject: The Great Cancer Hoax - Full Liquid Diet? Evidence

>>>> based?

>>>> Too busy lately, so getting into this discussion late.

>>>> For all the RDs that SAY they insist on Evidence Based Medicine, I ask;

>>>> Show me the evidence for hospitals to serve full liquid diets. I've

>>>> NEVER

>>>> found it, but tens of thousands of RDs nationwide still do this. (I

>>>> THOUGHT

>>>> that practice was stopped years ago!)

>>>> I don't work in hospitals anymore, but recently was visiting a friend in

>>>> CCU for GI bleed with a full liquid diet on his plate. 2% milk, pudding,

>>>> cream of potato soup, and ice cream.

>>>> I was embarrassed for my profession.

>>>> Please, would some RD that insists on EBM please show me the evidence

>>>> for

>>>> that?

>>>> Jan Patenaude, RD, CLT

>>>> Director of Medical Nutrition

>>>> Signet Diagnostic Corp.

>>>> Telecommuting Nationwide

>>>> (Mountain Time)

>>>> Fax:

>>>> DineRight4@...<mailto:DineRight4%40aol.com>

>>>> Certified LEAP Therapist and specialist in food sensitivity for IBS,

>>>> migraine, fibromyalgia and multiple inflammatory conditions. Co-author

>>>> of the

>>>> Certified LEAP Therapist (CLT) Training Course.

>>>> Re: The Great Cancer Hoax - extended thru 6/20

>>>> _

>>>>

>>>

>>> http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/_

>>>

>>> (

>>>>

>>> http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/

>>> )

>>>

>>> On Mon, Jun 13, 2011 at 11:18 PM, Jacqui Pressly<_Jpress50@..._

>>>> (

>>>>

>>>

>>>

http://health.groups.yahoo.com/group/rd-usa/post?postID=gJl7O9-0Wsq_2MXaOdDcGaMT\

i7GYQ

>>>

>>> qfD4nP2Os6mSiBLs_6OsOEUFIunjUNDecytZLrYhlHZ)> wrote:

>>>>

>>>>> ,

>>>>> Where is it that this dx doesn't exist? That's what I would be cautious

>>>>> about.

>>>>> Jacquelyn A. Pressly, RD, CLT

>>>>> The NATURAL dietitian

>>>>> Specializing in Wellness and Prevention, Personal Nutrition Coaching

>>>>> and Designer Lifestyle Plans to help you get on the health track

>>>>> Northeast Ohio & Western Pennsylvania

>>>>> Internet and telecounseling available for distance clients

>>>>>

>>>>> _jpress50@..._

>>>>>

>>>> (

>>>>

>>>

>>>

http://health.groups.yahoo.com/group/rd-usa/post?postID=2n1nW2HOEaLO84cXflZaGxn6\

_ABLxdnwkd6i4Xoi6_FNA0sRcNMgb3hQgncOHblofIntwCHgp7gClw

>>>

>>> )

>>>>

>>>>> If you are what you eat, then dietitians are the doctors of the future

>>>>> Re: The Great Cancer Hoax - extended thru 6/20

>>>>> But are they doing things like adrenal fatigue (dx doesn't exist),

>>>>>

>>>> liver

>>>

>>> detox, homeopathy and this type of medicine - red flags should be up

>>>>>

>>>> IMHO.

>>>>

>>>>> As should traditional medicine MDs when excessive and unwarranted and

>>>>>

>>>> over

>>>>

>>>>> prescribing drugs.

>>>>>

>>>>

[Guest guest]

,

Liquid consistency would be a texture modification for any nutrition

therapy the same as pureed or ground. It should not be limited to what

in the past was used as a " liquid diet " with foods that were liquid at

98.6 degrees Fahrenheit including frozen ice cream and used as a

progressive diet from clear liquid to soft diet. Any texture

modifications should be considered when prescribing a nutrition therapy

for a patient.

For instance, I have prescribed a liquid diet for people with a wired

jaw due to trauma which is actually more of a thin pureed texture

modification where food can be drank through a straw placed between

cheek and gums unless a straw is contraindicated by the attending

physician. The goal is to prevent weight loss during the 6 weeks a

person's jaw is wired. They are usually provided with wire cutters in

case they choke on anything or vomit to prevent aspiration. Also

prescribed liquid diet for a person with a tongue resection due to oral

cancer after surgery.

healthy regards,

Joanne Larsen MS RD LD

> So you would be for it being not a progression but a stand by itself

> diet or not at all?

>

> On Thu, Jun 16, 2011 at 4:17 PM, Joanne Larsen <joanne@...

> > wrote:

>

> , et al,

> My comment below was to clarify the lack of evidence for a full

> liquid diet as a progressive diet from clear to soft to regular.

>

> If a patient cannot tolerate solid food, it should be the

> recommendation of the dietitian to order the appropriate

> consistency using real food first, then liquid supplements whether

> that be liquid, pureed or ground.

>

> If we are to disagree, disagree with a position, not attack the

> person please.

>

> IMHO

>

>

> healthy regards,

> Joanne Larsen MS RD LD

>

>

>

> Joanne and others: What would you have instead??

>

> On Thu, Jun 16, 2011 at 3:25 PM, Merav Levi<meravls@...

> > wrote:

>

> This conversation reached a new low.Ciao

>

> Merav Levi, RD, MS, CDNA dietitian, not the food police.

> http://www.linkedin.com/in/meravlevi

>

> " Life is not measured by the number of breath you take,

> but by the moments

> that take your breath away. " - Carlin " People don't

> forget the truth,

> they just become better in lying " (Revolutionary Road)

>

>

> To: rd-usa <mailto:rd-usa >

> CC: hlbrewer@...

>

> Date: Thu, 16 Jun 2011 09:26:55 -0600

> Subject: Re: Full Liquid Diet? Evidence based?

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

> Colleagues,

>

> Reply to RD-USA listserv only. You do not have my

> permission to forward.

>

>

>

> As the editor who created the Nutrition Care Manual,

> vetted the authors

>

> / reviewers and edited every word for the initial launch

> and the first

>

> update, I can tell you why the Full Liquid diet is in NCM.

> Dietitians

>

> who ordered NCM complained to the publisher that their

> facility's

>

> doctors wanted a full liquid diet so the publisher

> insisted the full

>

> liquid diet be added to NCM over my objections and

> documentation that

>

> there is no science in published literature for a full

> liquid diet or a

>

> progression from clear liquid to full liquid to soft to

> regular diets.

>

> This and clear liquid diets are the only instance of a

> diet being

>

> inserted in NCM that are not evidence or research based.

>

>

>

> healthy regards,

>

> Joanne Larsen MS RD LD

>

>

>

>

>

> In our facility we're deleting it from our diet list

> this month - just

> have to

> get the nurses to stop " advancing as tolerated " and a

> few damn

> surgeons to stop

> ordering it. But it can still be found in the

> Nutrition Care Manual

> online

> (pdf about what it is and that there is no evidence

> for it).

> Holly

> ----------

> Holly Lee Brewer, MS RD CDE

> Pediatric Dietitian, Diabetes Educator

> Medical Nutrition Therapist, Las Vegas, NV

> Maj Holly Brewer, USAFR BSC

> http://hollyinbalad.blogspot.com

> 301st MDS, NAS JRB Fort Worth (Carswell), TX

> Joint Base Balad, Iraq (Jan-Jul 2009)

> ________________________________

> From: " Dineright4@...

> <mailto:Dineright4%40aol.com

<mailto:Dineright4%2540aol.com>> "

> <Dineright4@...

> <mailto:Dineright4%40aol.com

<mailto:Dineright4%2540aol.com>>>

> To: rd-usa

>

<mailto:rd-usa ><mailto:rd-usa%40yahoogroups.com

> <mailto:rd-usa%2540yahoogroups.com>>

> Sent: Wed, June 15, 2011 10:22:25 PM

> Subject: The Great Cancer Hoax - Full Liquid

> Diet? Evidence

> based?

> Too busy lately, so getting into this discussion late.

> For all the RDs that SAY they insist on Evidence Based

> Medicine, I ask;

> Show me the evidence for hospitals to serve full

> liquid diets. I've NEVER

> found it, but tens of thousands of RDs nationwide

> still do this. (I

> THOUGHT

> that practice was stopped years ago!)

> I don't work in hospitals anymore, but recently was

> visiting a friend in

> CCU for GI bleed with a full liquid diet on his plate.

> 2% milk, pudding,

> cream of potato soup, and ice cream.

> I was embarrassed for my profession.

> Please, would some RD that insists on EBM please show

> me the evidence for

> that?

> Jan Patenaude, RD, CLT

> Director of Medical Nutrition

> Signet Diagnostic Corp.

> Telecommuting Nationwide

> <tel:> (Mountain Time)

> Fax: <tel:>

> DineRight4@...

> <mailto:DineRight4%40aol.com

<mailto:DineRight4%2540aol.com>>

> Certified LEAP Therapist and specialist in food

> sensitivity for IBS,

> migraine, fibromyalgia and multiple inflammatory

> conditions. Co-author

> of the

> Certified LEAP Therapist (CLT) Training Course.

> Re: The Great Cancer Hoax - extended thru 6/20

> _

>

>

http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/_

>

> (

>

>

http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/)

>

> On Mon, Jun 13, 2011 at 11:18 PM, Jacqui

> Pressly<_Jpress50@..._

> (

>

>

http://health.groups.yahoo.com/group/rd-usa/post?postID=gJl7O9-0Wsq_2MXaOdDcGaMT\

i7GYQ

>

> qfD4nP2Os6mSiBLs_6OsOEUFIunjUNDecytZLrYhlHZ)> wrote:

>

> ,

> Where is it that this dx doesn't exist? That's

> what I would be cautious

> about.

> Jacquelyn A. Pressly, RD, CLT

> The NATURAL dietitian

> Specializing in Wellness and Prevention, Personal

> Nutrition Coaching

> and Designer Lifestyle Plans to help you get on

> the health track

> Northeast Ohio & Western Pennsylvania

> Internet and telecounseling available for distance

> clients

> <tel:>

> _jpress50@..._

>

> (

>

>

http://health.groups.yahoo.com/group/rd-usa/post?postID=2n1nW2HOEaLO84cXflZaGxn6\

_ABLxdnwkd6i4Xoi6_FNA0sRcNMgb3hQgncOHblofIntwCHgp7gClw

>

> )

>

> If you are what you eat, then dietitians are the

> doctors of the future

> Re: The Great Cancer Hoax -

> extended thru 6/20

> But are they doing things like adrenal fatigue (dx

> doesn't exist),

>

> liver

>

> detox, homeopathy and this type of medicine - red

> flags should be up

>

> IMHO.

>

> As should traditional medicine MDs when excessive

> and unwarranted and

>

> over

>

> prescribing drugs.

>

>

[Guest guest]

,

Liquid consistency would be a texture modification for any nutrition

therapy the same as pureed or ground. It should not be limited to what

in the past was used as a " liquid diet " with foods that were liquid at

98.6 degrees Fahrenheit including frozen ice cream and used as a

progressive diet from clear liquid to soft diet. Any texture

modifications should be considered when prescribing a nutrition therapy

for a patient.

For instance, I have prescribed a liquid diet for people with a wired

jaw due to trauma which is actually more of a thin pureed texture

modification where food can be drank through a straw placed between

cheek and gums unless a straw is contraindicated by the attending

physician. The goal is to prevent weight loss during the 6 weeks a

person's jaw is wired. They are usually provided with wire cutters in

case they choke on anything or vomit to prevent aspiration. Also

prescribed liquid diet for a person with a tongue resection due to oral

cancer after surgery.

healthy regards,

Joanne Larsen MS RD LD

> So you would be for it being not a progression but a stand by itself

> diet or not at all?

>

> On Thu, Jun 16, 2011 at 4:17 PM, Joanne Larsen <joanne@...

> > wrote:

>

> , et al,

> My comment below was to clarify the lack of evidence for a full

> liquid diet as a progressive diet from clear to soft to regular.

>

> If a patient cannot tolerate solid food, it should be the

> recommendation of the dietitian to order the appropriate

> consistency using real food first, then liquid supplements whether

> that be liquid, pureed or ground.

>

> If we are to disagree, disagree with a position, not attack the

> person please.

>

> IMHO

>

>

> healthy regards,

> Joanne Larsen MS RD LD

>

>

>

> Joanne and others: What would you have instead??

>

> On Thu, Jun 16, 2011 at 3:25 PM, Merav Levi<meravls@...

> > wrote:

>

> This conversation reached a new low.Ciao

>

> Merav Levi, RD, MS, CDNA dietitian, not the food police.

> http://www.linkedin.com/in/meravlevi

>

> " Life is not measured by the number of breath you take,

> but by the moments

> that take your breath away. " - Carlin " People don't

> forget the truth,

> they just become better in lying " (Revolutionary Road)

>

>

> To: rd-usa <mailto:rd-usa >

> CC: hlbrewer@...

>

> Date: Thu, 16 Jun 2011 09:26:55 -0600

> Subject: Re: Full Liquid Diet? Evidence based?

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

> Colleagues,

>

> Reply to RD-USA listserv only. You do not have my

> permission to forward.

>

>

>

> As the editor who created the Nutrition Care Manual,

> vetted the authors

>

> / reviewers and edited every word for the initial launch

> and the first

>

> update, I can tell you why the Full Liquid diet is in NCM.

> Dietitians

>

> who ordered NCM complained to the publisher that their

> facility's

>

> doctors wanted a full liquid diet so the publisher

> insisted the full

>

> liquid diet be added to NCM over my objections and

> documentation that

>

> there is no science in published literature for a full

> liquid diet or a

>

> progression from clear liquid to full liquid to soft to

> regular diets.

>

> This and clear liquid diets are the only instance of a

> diet being

>

> inserted in NCM that are not evidence or research based.

>

>

>

> healthy regards,

>

> Joanne Larsen MS RD LD

>

>

>

>

>

> In our facility we're deleting it from our diet list

> this month - just

> have to

> get the nurses to stop " advancing as tolerated " and a

> few damn

> surgeons to stop

> ordering it. But it can still be found in the

> Nutrition Care Manual

> online

> (pdf about what it is and that there is no evidence

> for it).

> Holly

> ----------

> Holly Lee Brewer, MS RD CDE

> Pediatric Dietitian, Diabetes Educator

> Medical Nutrition Therapist, Las Vegas, NV

> Maj Holly Brewer, USAFR BSC

> http://hollyinbalad.blogspot.com

> 301st MDS, NAS JRB Fort Worth (Carswell), TX

> Joint Base Balad, Iraq (Jan-Jul 2009)

> ________________________________

> From: " Dineright4@...

> <mailto:Dineright4%40aol.com

<mailto:Dineright4%2540aol.com>> "

> <Dineright4@...

> <mailto:Dineright4%40aol.com

<mailto:Dineright4%2540aol.com>>>

> To: rd-usa

>

<mailto:rd-usa ><mailto:rd-usa%40yahoogroups.com

> <mailto:rd-usa%2540yahoogroups.com>>

> Sent: Wed, June 15, 2011 10:22:25 PM

> Subject: The Great Cancer Hoax - Full Liquid

> Diet? Evidence

> based?

> Too busy lately, so getting into this discussion late.

> For all the RDs that SAY they insist on Evidence Based

> Medicine, I ask;

> Show me the evidence for hospitals to serve full

> liquid diets. I've NEVER

> found it, but tens of thousands of RDs nationwide

> still do this. (I

> THOUGHT

> that practice was stopped years ago!)

> I don't work in hospitals anymore, but recently was

> visiting a friend in

> CCU for GI bleed with a full liquid diet on his plate.

> 2% milk, pudding,

> cream of potato soup, and ice cream.

> I was embarrassed for my profession.

> Please, would some RD that insists on EBM please show

> me the evidence for

> that?

> Jan Patenaude, RD, CLT

> Director of Medical Nutrition

> Signet Diagnostic Corp.

> Telecommuting Nationwide

> <tel:> (Mountain Time)

> Fax: <tel:>

> DineRight4@...

> <mailto:DineRight4%40aol.com

<mailto:DineRight4%2540aol.com>>

> Certified LEAP Therapist and specialist in food

> sensitivity for IBS,

> migraine, fibromyalgia and multiple inflammatory

> conditions. Co-author

> of the

> Certified LEAP Therapist (CLT) Training Course.

> Re: The Great Cancer Hoax - extended thru 6/20

> _

>

>

http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/_

>

> (

>

>

http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/)

>

> On Mon, Jun 13, 2011 at 11:18 PM, Jacqui

> Pressly<_Jpress50@..._

> (

>

>

http://health.groups.yahoo.com/group/rd-usa/post?postID=gJl7O9-0Wsq_2MXaOdDcGaMT\

i7GYQ

>

> qfD4nP2Os6mSiBLs_6OsOEUFIunjUNDecytZLrYhlHZ)> wrote:

>

> ,

> Where is it that this dx doesn't exist? That's

> what I would be cautious

> about.

> Jacquelyn A. Pressly, RD, CLT

> The NATURAL dietitian

> Specializing in Wellness and Prevention, Personal

> Nutrition Coaching

> and Designer Lifestyle Plans to help you get on

> the health track

> Northeast Ohio & Western Pennsylvania

> Internet and telecounseling available for distance

> clients

> <tel:>

> _jpress50@..._

>

> (

>

>

http://health.groups.yahoo.com/group/rd-usa/post?postID=2n1nW2HOEaLO84cXflZaGxn6\

_ABLxdnwkd6i4Xoi6_FNA0sRcNMgb3hQgncOHblofIntwCHgp7gClw

>

> )

>

> If you are what you eat, then dietitians are the

> doctors of the future

> Re: The Great Cancer Hoax -

> extended thru 6/20

> But are they doing things like adrenal fatigue (dx

> doesn't exist),

>

> liver

>

> detox, homeopathy and this type of medicine - red

> flags should be up

>

> IMHO.

>

> As should traditional medicine MDs when excessive

> and unwarranted and

>

> over

>

> prescribing drugs.

>

>