Re: Full Liquid Diet? Evidence based? (Reply 1)

[Guest guest]

AMEN Joanne! Thank you for stating that so succinctly. And, as much as

I'd love to share this with other listservs, I WILL NOT per your privacy

request! And, hey, if Holly's getting it off their list of diets, maybe my

rants are serving a higher purpose.

It makes me crazy when RDs insist on EBM for others but then don't think

it's important in their own work, being willing to prescribe full liquid

diets is one of those instances. And, if a doc orders a diet with no merit, is

it my job to just let it go, or is it my job to educate the doctor? I'd

say the latter. If we want to advance our profession scientifically, stop

accepting a stupid diet order just because " the doctor ordered it. "

(And, maybe there are times a liquid or pureed diet IS merited, but does it

have to be milk based and just a standard order that doesn't even take

into consideration if a client is lactose intolerant or not? Why are potatoes

okay in a soup but not mashed? If potatoes can be used in full liquid

soup, why not carrot or squash? The current Full Liquid diet I've seen just

isn't logical/scientific.)

Now, that said - when the research isn't in yet, sometimes we use WHAT

WORKS to get the sick client well! That's the " Practice and Science of

Nutrition. " If docs only practiced EBM, we'd still think that hand-washing

didn't get rid of little invisible bugs that make us ill and that stomach ulcers

were caused by stress and food. Innovators in medicine are willing to step

out of the box a moment before the research is fully done, just because

they " see " the results in their " practices " before there's enough money

available to " prove " what we already know.

I prefer past ADA President, Laramee's description of EBM in JADA

March 2005. Summarized here:

Evidence-based practice uses:

The best available evidence

The results of peer-reviewed scientific studies

And, when science is lacking, expert opinion and experience

You won't believe how often LEAP therapists have to make requests to the

doctor to order tests he never considered. (MRT, Celiac, HBT, Vit D, heavy

metals, parasites, etc) - And, guess what, when their sick patient finally

gets properly diagnosed, treated and WELL - They respect us MORE, not less,

because we weren't willing to back down, and tell the patient, " sorry, we

just don't know what's wrong " and toss them off to another practitioner,

like their docs so often do.

Okay, done with another rant. Missing many posts here lately with just

too much work happening, but do enjoy this listserv and everybody's input.

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.

In a message dated 6/20/2011 4:05:22 A.M. Mountain Daylight Time,

rd-usa writes:

>> To: _rd-usa@...-_ (mailto:rd-usa )

<mailto:rd-usa%mailto:rd-usa%mai>

>> CC: _hlbrewer@..._ (mailto:hlbrewer@...)

<mailto:hlbrewer%mailto:hlbr>

>> From: _joanne@..._ (mailto:joanne@...)

<mailto:joanne%mailto:joannmai>

>> Date: Thu, 16 Jun 2011 09:26:55 -0600

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

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>> Colleagues,

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

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

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

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

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

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

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

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

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

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

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>> inserted in NCM that are not evidence or research based.

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>> healthy regards,

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>> Joanne Larsen MS RD LD