Dietitian-Approved Breakfasts For Diabetics

      82 Comments on Dietitian-Approved Breakfasts For Diabetics

I had an interesting back-and-forth debate on Twitter yesterday with a doctor who took offense to my previous post, tweeting that it’s NOT dietitians who are going after Tim Noakes, and that I’d needlessly insulted an entire profession of hardworking folks.

I pointed that I’d blamed – in plain English – the dietitians in South Africa, not the entire profession. As for whether dietitians are behind the Noakes witch-hunt, Marika Sboros (who’s done more reporting on the trial than anyone I’m aware of) weighed in that one:

Quite right, Tom. The number is shockingly high – dietitians in practice and academia – involved directly and indirectly and all heavily conflicted.

And again:

HPCSA went for Tim Noakes at behest and whim of dietitians and still going. Number of dietitians in practice and academia involved directly and indirectly is mind-boggling.

As for the profession of hardworking folks, I replied that their professional organizations are heavily funded and influenced by the makers of industrial foods (a fact anyone can check), and that one of those hardworking professionals had my diabetic father-in-law eating pancakes with syrup for breakfast … but no butter, because butter is bad for the heart, ya see.

The doctor replied that now I was impugning an entire profession because of bad advice from one dietitian.

Well, at least he agreed it’s bad advice. I replied that it’s very typical advice: you need to eat those carbs for energy even if you’re a diabetic (exactly what the dietitian told Chareva’s father, in fact), then handle the glucose spike with more insulin. I pointed out that the hardworking professional who had him eating pancakes and syrup for breakfast was the staff dietitian at the hospital where he was recovering from surgery. Very unlikely she’d gone rogue.

No, no, no, that’s not typical advice from a hardworking professional dietitian, the doctor insisted over and over. He demanded I provide citations to prove that it is. So replied with this quote from the Dear Dietitian column I mentioned in a previous post:

There is no need to remove carbs from your diet… Anyone who has diabetes should be able to consume 12 to 15 servings of carbohydrate foods each day while maintaining healthy blood glucose levels.

And I cut and pasted this quote directly from our friends at the Academy of Nutrition and Dietetics (whose president encourages members to report “disruptors” who offer alternative advice):

If you have diabetes, a healthy daily eating plan includes: starchy foods including breads, cereals, pasta, rice, other whole grains and starchy vegetables such as beans, corn and peas.

The doctor offered this reply:

You think grains = pancakes? Damn… no wonder your logic is so weak. And that means you have no evidence that this was typical advice. As I thought.

Hmmm, I’m pretty sure pancakes are made from grains. And while the Academy of Nutrition and Dietetics didn’t mention pancakes specifically in that quote, I can’t see any reason dietitians who are trained to serve starchy foods including breads, cereals, pasta, rice and other whole grains to diabetics would object to pancakes. In fact, I’d bet dollars to donuts (and you can keep the donuts) that plenty of dietitian-approved hospital meals served to diabetics include pancakes.

So out of curiosity, I went looking for hospital menus online. I found three that include both advice for diabetics and menu offerings. And remember, hospital meals are approved by registered dietitians, not just some schmuck in the cafeteria.

Here’s part of the advice for diabetics offered by Northwestern Memorial Hospital:

Starch: Include 2 to 3 servings per meal, or 6-11 servings per day.
Fruits: Include 1 with each meal, or 2 to 4 per day.

Two or three servings of starch per meal. Got it. And here’s one of the offerings on the menu that’s labeled as a single serving of starch:

1 waffle or pancake

And here’s an entry from Other Sugars and Starches, and again labeled as one serving:

1 Tbsp sugar/syrup

Yup, a dietitian could give a diabetic pancakes or waffles with syrup for breakfast and be within the official guidelines – designed by dietitians, of course.

Here’s the advice for diabetics from UAB hospital in Alabama:

Your menu includes the number of carbohydrate (carb) servings in brackets to help manage your blood sugar levels. One carb {1} equals 15 grams of carbohydrates. This number is based on a portion size, which has been adjusted for your diet restriction. The average diabetic diet includes three to five carbohydrates per meal.

So the average meal for diabetics (designed by a hardworking professional dietitian) includes 45 to 75 grams of carbohydrate. Awesome. And here are some items from the menu, with the number of carb servings in brackets.

Buttermilk Pancakes {2}
French Toast {2}
Cheerios {1}
Blueberry Muffin {2}
Bagel {2}

Yup, those sure look like ideal foods for diabetics to me. Heck, at five carb servings per meal, your diabetic relative could order the pancakes and the blueberry muffin and still be within the guidelines developed by one of those hardworking professionals. But let’s not forget dessert:

Angel Food Cake {1}

And now for the punchline: the buttermilk pancakes, Cheerios, bagel and angel food cake all have the “heart-healthy” symbol next to them on the menu. That’s what the typical hardworking, professional dietitian believes: low-fat = heart-healthy. So my diabetic father-in-law was served pancakes in a hospital … but no butter. That would be bad for his heart.

By the way, syrup is listed on that menu as condiment, but there’s no number in brackets indicating to count it as a serving of carbs.

And finally, we turn to the dietitian-approved menu at Good Samaritan Hospital – which reminds patients to talk to a staff dietitian about their needs. The hospital offers a Cardiac Diet, which it describes as a “heart-healthy diet” featuring low-fat, low-cholesterol, and low-sodium foods. It also offers a Diabetes Diet designed to control blood sugar … which it defines as not exceeding four servings of carbohydrate per meal.

Here are some foods on the breakfast menu and the number of servings of carbohydrate:

Fresh Breads (1)
Freshly Baked Blueberry Muffins (2)
French Toast (2)
Buttermilk Pancakes (2)

The menu says the pancakes can be served with sugar-free or maple syrup, but doesn’t give a carb-count figure for the maple syrup. Poking around the menu, I saw that bread, cream of wheat, macaroni and cheese, vanilla soy milk, granola and fruit, and of course angel food cake are all listed as “heart-healthy” — for diabetics.

So yes, I’m going to maintain that it’s quite typical for those hardworking, professional dietitians to serve pancakes with syrup to diabetic patients.

Someone, perhaps Milton Friedman, once explained that people are either foolish or wise, and either diligent or lazy. That creates four combinations. The people who most benefit the rest of us are wise and diligent. People who are lazy (whether wise or foolish) generally don’t have much effect on the rest of us. But people who are both foolish and diligent cause a lot of trouble.

I wish a whole lot of those hardworking, professional dietitians would be less hardworking. Or better yet, wise up.


82 thoughts on “Dietitian-Approved Breakfasts For Diabetics

  1. Walter

    Dollars to doughnuts is not the one sided bet it was. IIUC when the saying was coined doughnuts were 5 cents or fewer. In fact it’s been so long since I bought a doughnut that that for all I know they may cost more than a buck.

      1. Firebird7478

        Interestingly, around these parts, Dunkin’ Donuts gives away free coffee after an Eagles win. They’re stingy on the donuts. Must be the more expensive item on the menu. My niece works for a local bakery. For whatever reason, I get put on dessert patrol for family gatherings, so I ordered a baker’s dozen of donuts from the place she works. $7.50 for 13.

          1. JillOz

            I ought a paleo doughnut recently from a raw foods bakery, just to try. It was the size of a hand with green tea glaze. About USD7, $10 Australian.
            Quite tasty but unaffordable on a regular basis!

      2. Orvan Taurus

        It’s about even, at least at the grocery store I go to. A “bakery fresh!” doughnut is $0.99 (for the not-so-fancy ones. The fancier, the pricier, of course) – and my dollar is better spent on something other.

        1. Walter

          A dollar is better spent almost anyplace else, including a lottery ticket. Purchase of a lottery ticket will not harm you beyond the price paid.

  2. Jim Tubman

    Tom, I saw that conversation happening on Twitter. If that was a rogue dietician, then he/she must also work at the Canadian hospital where my type-2 diabetic mother had surgery last year.

    Her meals came with little printed stubs that listed her name, the foods in the order, and the fact that she was diabetic. The meals included bread, potatoes, fruit, and lots of fruit juice (but no salt or butter!). Her blood sugar skyrocketed to 2.5 times its typical level and they had to give her insulin shots. When she was at home, eating her normal diet, her blood sugar wasn’t anywhere close to what it was in the hospital.

    The hospital send a finger-wagging diabetes educator around to talk to her, while those of us in her family happened to be visiting her. We complained about all the carbs that the hospital was feeding Mother, which really annoyed Miss Diabetes, who had no coherent reply.

    Sad, pathetic, dangerous.

    1. Tom Naughton Post author

      Perhaps the dietitian who served pancakes and syrup to my diabetic father-in-law hops on a plane every day to split time between a hospital in Tennessee and a hospital in Canada.

    1. Tom Naughton Post author

      Wow. Buttermilk pancakes with maple syrup and margarine, listed right there under the “Cardiac Diet” menu. And yet my doctor friend refuses to believe it’s typical for a dietitian to serve pancakes and syrup to a diabetic.

  3. Lorna

    I was referred to a hospital dietitian by the diabetes clinic. She asked what I normally ate for breakfast. I told her an egg on toast. She frowned and said, much better to mash a banana on your toast, preferably without butter. I told the diabetes clinic what she had suggested. They told me there is a different approach to diabetes now. There is no blame, so there are no restrictions on what you eat. Eat ‘normally’ and adjust with injected insulin. Increase in weight and increase in insulin is ‘normal’ because diabetes is a progressive disease and there is no way to do anything about it. I went low carb and was off insulin in less than a month and been off for over 2 years. She was delighted with weight loss until she found out how I had done it, then told me to stop low carb – it was dangerous – when I refused she told me to leave if I wouldn’t listen to experts. lol

  4. Bob Johnston

    The rise of social media has either caused the world to go mad or it already was mad and I just didn’t know it.

    About 10 years ago I became interested in logical fallacies and how human biases cloud thinking (in regards to global warming at the time), I know now that erroneous beliefs cannot be changed with reason because the beliefs were never based upon reason. Offer up reasonable evidence against someone’s ill-conceived ideas and you’ll be branded as a fool, a fraud, a racist, a crook… whatever it takes so the person can dismiss anything you’ve said. It’s only until there are actual consequences for bad ideas that a mind will consider alternatives – in the case of your Twitter tormentor I fear his mind won’t change until he develops diabetes himself (and maybe not even then).

    I don’t judge these people even though I am judged mightily because I know it’s their human nature working against them. But boy, that is a hard thing to do when you’re getting abuse heaped on you, sometimes even by relatives.

    1. Tom Naughton Post author

      I believe social media has simply made us aware of how illogical people can be. Aristotle wrote that some people are convinced by reason, while others are immune to reason because their beliefs are based on emotions. It’s nearly impossible to convince an illogical person that his beliefs are illogical, because it requires a logical mind to recognize what isn’t logical. It’s like expecting a tone-deaf person to hear that he’s singing out of tune.

    1. Tom Naughton Post author

      I understand the urge, but it’s nearly impossible to successfully sue people for following official guidelines, even if the results are damaging.

      1. Jeffrey T Ranney

        Except at the Nuremburg trials. There should be no excuse these days as “just following orders”. But, there is.

  5. Jacqueline

    And it all stems from fear of fat! It breaks my heart to see a pre-diabetic friend eating fake “diabetic” foods and margarine, because butter is unhealthy, and my perfectly fit 75 yo father swallowing statins, because of some imaginary risk of heart disease. The fact that his legs hurt and he’s becoming a bit confused couldn’t possibly be anything to do with the pills because his doctor says they’ll save him! I’m so angry but it seems people refuse to believe that butter and bacon won’t kill them. I no longer try to explain this WOE, I direct them to this and other websites. Thank you for your blog, I look forward to it every week.

    1. Tom Naughton Post author

      Yup, fear of fat is the root cause of so much bad advice. Diabetics are prone to heart attacks, so let’s see … well, we JUST KNOW that fat causes heart disease, so we need to put them on low-fat diets, which in turn means a diet where their energy has to come from carbs.

      1. JillOz

        Don’t forget the turf war. If people don’t have diabetes, dietitians and the diabetes industry personnel are out of work.

          1. Walter

            Dialysis is a big industry on its own. Remember Dr. Jason Fung got into the fasting protocols, because he was tired of treating people with kidney damage.

            The makers and purveyors of insulin and other diabetes drugs also have a stake.

            1. Tom Naughton Post author

              Absolutely. The American Diabetes Association is a trade organization for doctors who treat diabetics. What would happen to their revenues if diabetes rates plummeted?

  6. Mike

    Brilliant article Tom. I follow you on others we know on Twitter as well. It is amazing how many dietitians don’t have a clue what they are talking about. Pancakes are not grains ? No comments about basic knowledge!

    1. Tom Naughton Post author

      I have to admit, that last one surprised me. Of course it’s not true that grains = pancakes, but it’s certainly true that pancakes = grains.

  7. Tom Welsh

    It would be interesting to learn which hospitals the doctor who ragged you is affiliated with, and see what their dietary advice is.

    From what you report of his correspondence with you, he sounds to me exactly like any standard run-of-the-mill Internet troll. As soon as you point out where he is wrong, he shifts his ground and then accuses you of shifting yours.

    People like that are not worth wasting your time on. They “know” they are right and you are wrong, which causes acute cognitive dissonance when you repeatedly refute their claims and support yours. So they start to behave rudely and irrationally.

    Although I must admit that – equally irrationally – I would like to see his justification of that last reply: “You think grains = pancakes? Damn… no wonder your logic is so weak. And that means you have no evidence that this was typical advice. As I thought”.

    Obviously, grains are not the same as pancakes. But that’s not really a matter of logic, is it? And how on earth does he get from criticizing your “weak logic” to doubting your evidence? His reply is written in English and is grammatical, but beyond that I can tease no sense out of it at all.

    1. Tom Naughton Post author

      Yeah, he tried changing the argument on me, demanding at one point that I prove pancakes-for-breakfast is evidence-based. I of course replied that I never claimed it was evidence-based, only that it’s typical of what a dietitian serves a diabetic for breakfast.

  8. Tom Welsh

    Actually, come to think of it, do you have any solid evidence that this person really is a doctor? (Other than that he claims to be one).

    He sounds more like an underground vegan extremist.

  9. JR62

    “One carb {1} equals 15 grams of carbohydrates”

    Now they could begin to use only the first part of this wisdom and say that their advise is also low carb because it is only 12-15 carb per day! So of course it suits for diabetic.

  10. Jeanne

    Typical diabetic breakfast at the hospital where I work: Dry boxed cereal, low fat milk, orange juice and dish of fresh fruit.
    Standard “diabetic” fare.

        1. Matt

          I was in the hospital for a long time recently. Except for when they had me on a miserable “clear liquids diet”, I was on unrestricted menu, and I could have what I wanted for breakfast – scrambled eggs and ham. Yes, they included cold cereal and milk, but I never got to the cereal and just drank the milk and the usual orange juice.

  11. Thomas E.

    Here at work, every Wednesday morning 4 or 5 dozen of the things show up in the break room. Cheapest corner shop donuts. And for me, it is pretty easy to pass on.

    But, and I can help myself, every time I see them, my stomach turns a bit. First, the smell, which I used to love, now smells kinda rancid. But, knowing what the ingredients are, they are a complete dietary catastrophe. We also have free new-age coffee machine that has all of the syrups and such in it.

    One of the gentlemen I worked with gained about 15 lbs in a year of working here. The only dietary change was the donuts once a week and drinking 2 (+- 1) vanilla mocha things from the coffee machine.

    As far as your dietitian friend, it makes me think that I need to reengage in Twitter, there are about 3 or 5 people I would like to follow, your account included.

    Ahhh, if I only had more time in my day.

    Thank you again Tom


    1. Tom Naughton Post author

      The smell of donuts, cakes, etc., kind of turns my stomach a bit now too. Maybe it’s purely psychological.

      1. Sandy

        When we went to the PNE (a large fair type of event in Vancouver BC) last fall, a few of the folks we went with were quite excited about mini donuts. I wasn’t excited and didn’t intend to have any, but was definitely in the minority. Once the donuts were purchased and everyone was digging in, I was pretty grossed out by the smell. MAYBE its psychological, but to me they smelled like fake syrup deep fried in rancid fat (which probably isn’t too far from the truth). I think it’s more likely that having gotten away from that kind of crap, my senses recognize it for what it really is and my body is pretty willing to avoid it.

        1. Tom Naughton Post author

          That’s a good guess. After Chareva and I went back to eating real fats instead of vegetable oils, we noticed that the fried food in restaurants has a rancid taste we didn’t sense before.

      2. Bob

        My last workplace had bi-weekly “Friday Food Fests”. Doughnuts and pastries were typical fare. Every so often I would try a small bite of the chemical-lade “chocolate cake”. It astonishes me that in an earlier life I actually found that stuff palatable. It tastes horrible now.

  12. GrannyMumantoog

    After watching my BFF of 40+ years die a few years ago I completely agree that hospital dietitians make menus loaded with carbs. I had a conversation with one while ordering my friends food one day and complained that it was all processed and full of starches and sugars. She said that they had to use the USDA guidelines when preparing the menus. It’s time for the USDA to stop paying farmers to grow grains and maybe get out of the food business altogether. Ever since they came out with their very first food pyramid in the early 80s the country has gotten sicker and sicker.

  13. John

    Everyone with diabetes needs to check their blood sugar level with a home monitor after every meal. They will get a fright after they eat those healthy pancakes.

    1. Tom Naughton Post author

      I don’t worry about climate change because so many deep thinkers on the subject (Al Gore included) assured us 20 years ago that if we didn’t act within the next 10 years, it would be too late. So it’s already too late.

      Groupthink is of course a real problem, but I see it among all kinds of groups with all kinds of beliefs.

  14. Emily

    Even the best people are not diligent and wise all the time. Everyone has blind spots, everyone gets lazy at least sometimes. The real danger is when people don’t admit this about themselves. But, of course, the vast majority (all?) of humanity has trouble doing that consistently too.

    1. Tom Naughton Post author

      Sure, we all have our good and bad moments. But our basic personality traits tend to be pretty consistent.

  15. JillOz

    In any area, if one complains about the QUALITY of the job eg bad research, poor knowledge, malpractice – one invariably is told that the one who performed badly is “caring” or “hardworking” or “experienced” therefore your complaint can’t possibly apply.

    Always evasive, never tackling the issue. It’s always protecting the member of the industry.

    Because apparently, people who “work hard” are perfect angels by fiat.

    And that’s why bad practice continues.

  16. chris c

    Let me guess, he had a name not dissimilar to McAsswipe?

    I still remember the “diabetes diet” leaflet I was given.

    Breakfast – a bowl of oatmeal with a banana, a slice of toast with low-fat spread and no-sugar-added marmalade, and a glass of no-sugar-added orange juice.

    It was sponsored by Takeda.

    Now most Type 2s, a lot of Type 1s and undoubtedly many “nondiabetics” who are just “not diabetic yet” have far higher insulin resistance/lower insulin sensitivity in the morning. In order to stay more or less euglycemic I used to be limited to about 15g carbs at breakfast and 30g by evening. After I gave my IR a damn good kicking I was actually reduced to 10g carbs at breakfast but 50 – 80g by evening, and sometimes 100g as a party trick. Generally I stick to 50g or so, mostly in the evening.

    I worked this out by using the glucometer I was expressly told NOT to use.

    A friend who was in hospital a few years back described her diet as “carb sandwiches on toast with cow carbs, washed down with orange juice”. As a Type 1 she could cope but only by massively jacking up her insulin doses.

    So no, it is so commonplace as to be unremarkable. Anyone who claims otherwise is either lying or deluded, or both.

      1. chris c

        I had a brainwave earlier while reading one of the cancer trolls, who believe that keto diets should not only never be used in cancer but should not even ever be researched.

        It struck me that these people may think like this:-

        the reason low fat diets don’t work is because SOMEONE ELSE is not eating them. They must be stopped at once and then the diet will start to work for me.

        There are now a considerable number of doctors, and even dieticians, who have more sense. The clueless ones always trumpet “evidence based medicine”. Perhaps they should read this

  17. Dianne

    That diabetic menu information from the UAB Hospital looked VERY familiar, so I went back and re-read a comment I had posted here on November 1, 1916, under your October 31 “From the News” post. (Funny thing — that post led off with an item about Tim Noakes.) Hospitals must be getting this stuff all pre-packaged from a common source — the American Diabetes Association, perhaps?

    Below is my original comment:

    Dianne says:

    November 1, 2016 at 6:43 pm

    Hi Tom,

    Back on June 10 I posted a comment mentioning the sugary, starchy meals our local Baylor, Scott and White hospital was feeding my diabetic husband. Now I’m wondering if hospitals are required to shape their menus according to the government’s “wisdom” in order to receive Medicare payments. Or something.

    I very recently got home from receiving a nice new hip at a different Baylor hospital. It was my third joint replacement there, and as always, the nursing care was superb, the atmosphere pleasant, and the food delicious and well-prepared. But the dietary advice on the menu they gave me was appalling. “Heart Healthy” items were marked with a little heart symbol, and these included 1% milk, skim milk, fruit juices, oatmeal, grits, bagels, margarine (but not butter), all cereals including the sugary ones, grilled chicken breast, certain sandwiches, low cholesterol eggs and scrambled egg whites. Regular eggs, bacon strips, and pork sausage didn’t get little hearts.

    They at least did have a glimmer that carbohydrates are important, but under the heading “For our Patients with Diabetes” they wrote: Our menu includes the number of carbohydrate servings to help you manage your blood sugars. One serving of carbohydrate equals 15 grams. The average diabetic diet includes three to five carbohydrate servings per meal.

    In other words, diabetics should limit their carbs to between 45 and 75 grams PER MEAL! Surely by now there are dieticians and nutritionists who know better – who know that a truly low carb diet is a diabetic’s one best hope. I would think these people would be starting a revolution. And if they aren’t, why aren’t they? Is Medicare exerting pressure on doctors and hospitals to conform to the old, failed standards? I suppose that makes me sound like some sort of conspiracy theorist, but I just have to wonder.

    1. Tom Naughton Post author

      The dietitians who know better apparently aren’t in charge of the menus yet. Of course, any government-affiliated institution is stuck with USDA guidelines.

  18. Namu

    If it nags like a quack in denial, rants like a quack in denial, and grasps at strawmen like a quack in denial… then maybe it’s a duck ?

    Meanwhile, in the real world of real people… I have here a promotion leaflet by the local hard-discount retailer Aldi, prominently featuring Paleo- and Primal-labelled stuff. Not quite yet grain-free, but gluten-free and corn-free at the very least, and nowhere a notion of saturated fat being bad (they tout avocado, salmon, almonds and coconut fat). Someone is paying attention.

      1. Firebird7478

        I have been treating myself once a week to Birdseye’s Lentil and Zucchini penne pasta. I tried their attempt at mac and cheese. Not the cleanest ingredients but still better than what Kraft makes. Tasted great but the annatto extract they use for coloring left my joints with a burning sensation for a couple of days.

        A friend of mine tells me that 7-11 is carrying roasted chick peas and reports they are quite good.

      2. Walter

        Which surprises none of you regular readers. There is a big incentive to stock what customers want. You can draw people to you store for those items and they are likely to buy other stuff, contrariwise they do their shopping elsewhere.

  19. Bonnie

    When I had back surgery about 5-6 years ago, my supper was a huge plate of creamed chicken over noodles. It was delicious & I ate it because my meal was hours late (they had lost my meal order) & I was too hungry to resist. I don’t remember what my other meals were. I’m much more low carb than I was then, so if I need surgery in the future, I’ll be micromanaging my meals – even if it means bringing in my own food.

    1. Tom Naughton Post author

      Well, one bad meal won’t kill you. But it’s an outrage at what passes for “healthy” meals in hospitals.

      1. Firebird7478

        I actually left your Fat Head Facebook page years ago because I was vilified by several members for eating Wendy’s chili one night when I was in a pinch. Your response was my response and it didn’t go over very well as I recall. LOL

        1. Tom Naughton Post author

          Yup, unfortunately we do get some fanatics in the group. Strange, considering the film features me spending a month on a fast-food diet.

  20. Firebird7478

    I caught some of that Twitter war last night. Quite entertaining. Your evidence turned them all into ground hogs as they have disappeared back into the woodwork.

    1. Tom Naughton Post author

      Yeah, when I tweeted photo clips from several more “heart healthy” hospital menus, Dr. Alastair chose not to continue the argument. The adult response, of course, would have been to admit that he was wrong. It was clear from the beginning he’s incapable of such maturity.

  21. Kathy Sollien

    Long story short, my stay in the cardiac ICU after a stent in my LAD was told I could not get a black cup of coffee. After all, “I was in the cardiac unit”. They could get me instant decaf if I wanted. Was then served a breakfast of french toast with fake syrup, orange juice, low fat milk, cereal, margarine and that decaf coffee. I had my husband go down to the Dunkin Donuts located inside the hospital to get me real coffee and an egg and sausage sandwich. I ate without the bread.
    A year later at a different hospital (both well known, teaching hospitals) and my second stent – another long story – again, could not get a black cup of coffee. Was served a full sized coke, crackers and peanut butter before my dinner of some kind of meat with gravy, mashed potatoes and a roll plus a fruit cup of sorts. My terrific nurse helped me to order an appropriate breakfast with real coffee for the next morning. This hospital also had a Dunkin Donuts outside their own cafeteria.
    I told the dietitian and the cardiologist that until they started practicing what they preach as well as to stop sending such conflicting messages that they were loosing a lot of credibility.
    I stay healthy with a LCHF diet and specific supplements of my choosing and research. I refused all statins, beta blockers and now off all blood thinners.
    I tell people to question everything……..


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