Low Carb Clinical Guidelines for Type 2 Diabetes Among Goals of New Nonprofit, SMHP

Adele Hite, RD, PhD, Optimistic About Future of Therapeutic Carbohydrate Restriction

 

When Dr. Adele Hite starts talking about the Society of Metabolic Health Practitioners (SMHP), her enthusiasm is palpable.

That’s because to Adele—a registered dietician with a PhD in rhetoric, communication, and digital media—the newly launched non-profit organization has the potential to usher in a new era in the low-carb world.

The SMHP, headed by LowCarbUSA® founder Doug Reynolds, represents researchers and practitioners working to improve metabolic health through education, training, and support of evidence-based nutritional approaches.

“When I start thinking about this organization I get very excited, said Adele. “I think this is the best thing since steak. The SMHP will allow us to do so many things we could not do before.”

Among the most important objectives of this new organization, according to Adele, are the continued work on the development of Clinical Guidelines and Standard of Care for therapeutic carbohydrate restriction.

Adele has been instrumental in the creation of Clinical Guidelines in her work with LowCarbUSA® over the past few years, and these guidelines will be one of the cornerstones of the SMHP. The guidelines provide clinicians with a general protocol for implementing therapeutic carbohydrate restriction as a dietary intervention in hospitals or clinics.

The Guidelines were announced and formally published on the LowCarbUSA® site at the Seattle event in May, 2019 and they have been embraced by the low carb medical community.

With the creation of the SMHP, the expectation is that the guidelines will continue to be refined, and work is now underway to create condition-specific addenda that will provide practitioners with protocols for type 2 diabetes and other conditions such as cardiovascular disease, neurological disorders, and other chronic diseases.

“My big dream is for a clinical protocol to be written around type 2 diabetes, that does all of the things and has the same principles as we have in the general protocol,” said Adele. “It’s not a prescription that’s hard and fast, but rather a way of fitting a diet to a patient in a way that the patient can be successful.”

The expectation is that these guidelines will serve to bring practitioners together and lead to establishing Standard of Care around carbohydrate restriction.

“The idea of standard of care is important,” said Adele, who is careful to point out the differences between Standard of Care and guidelines.

“I sat in as part of a jury on a malpractice case, and it taught me what Standard of Care is. Standard of Care is not a guideline, which is what I had thought it was, and what most of us all think it is. That’s not actually how Standard of Care works. Legally, Standard of Care is how a professional group with the same background and education practices their profession, for a particular specific population.”

“So for us, that might be family practitioners who have taken the SMHP courses and have gotten the certification as a metabolic health provider who treats people who have diabetes or prediabetes a certain way. And that creates a standard of care.”

So while the Clinical Guidelines document itself is not Standard of Care, it is a way of gathering the community to talk about, and to act together around, the idea of practicing low carb nutrition.

Adele’s work on creating the Clinical Guidelines had its start during a phone meeting she had back in June 2015 with a few other people interested in low carb, including author/journalist Gary Taubes, Rodney Cartocci and Dave Weed, PsyD.

“Gary and I had been tossing around this idea of creating a community of low carb practitioners,” Adele recalled, “and we couldn’t really figure out how to do it, how to materialize it.”

Rodney and Dave created an email group called the Reduced Carbohydrate Network, a place for clinicians to informally talk about things such as guidelines, how to treat patients, what to do about certain lab results, and a variety of other topics.”

As part of her participation in the group, Adele began to document some of these thoughts and ideas.

“One day Gary Taubes sent some of my documents around Standard of Care and creating this community of clinicians to Doug Reynolds, and apparently, his mind sort of exploded,” recalled Adele. “He realized how much bigger this was than what he initially thought it was going to be.”

“And from that, we decided to create this clinical protocol. So I worked on it, and Doug put together the advisory board. And what I would do is outline it and people would fill it in, and I would go back in time, try to resolve any conflicting information or if anything was vague. And we went back and forth like that probably for about nine months, maybe close to a year.”

“I think when Doug saw the potential to create a community and to establish a Standard of Care and really [help] change things, that was the catalyst for him to go ahead and launch the Society for Metabolic Health Practitioners.

“Doug chose very wisely when he named the group, the Society for Metabolic Health Practitioners,” said Adele. “We don’t care how you get to metabolic health, we care about metabolic health. What we’re concerned about is not how much you weigh, not what your macronutrient content of your diet is, not your political stance on meat eating. We care about your health, specifically your metabolic health. If we can quantify it, we can track it. And we know what these metabolic health metrics relate to in terms of chronic disease.”

Adele is hopeful that the SMHP can help the low carb community avoid a repeat of the travesty that happened back in the 70s when a clinical intervention meant for a clinical population got turned into public health guidance with the USDA Dietary Guidelines.

“The low-fat diet, low-cholesterol, low sodium diet was meant for a clinical population. It was meant specifically for people with a high risk of heart disease, or who had already had a cardiac event, or for people who were specifically obese…”

Adele thinks the existing dietary guidelines are inappropriate, and that they should be done away with. But she doesn’t want to see another fiasco.

“We certainly don’t need another clinical intervention, replacing a previously wrongheaded, poorly conceived, inappropriate clinical intervention, being used as dietary guidelines.”

“So what we created with the clinical protocol, is just that—it’s a clinical protocol.”

“And what we are creating with the Society for Metabolic Health Practitioners is a way for people to gather around and expand on that clinical protocol to create and to improve other ways of intervening with other clinical interventions.”

Adele is excited about the prospect of the SMHP, as a nonprofit, to be able to raise money to push forward the organization’s mission.

“If we can fundraise, we can do a lot of things,” said Adele. “It allows us to get the message out, and to interact with other organizations.

“As an organization with a name, and with leaders, we can go to other organizations like the American Diabetes Association and address the fact that they have said that a low carbohydrate diet can be part of a therapeutic intervention for people with diabetes, yet they don’t seem to know much about that. We can ask them if they would like us to help them learn.”

Interested in joining the Society of Metabolic Health Practitioners or learning more? Sign up here.