Conversation about Starch with the endocrinologist

[jyotipethe]

My daughter is 8 year old and overweight. (86lbs / 50 inches) We have always been vegetarian, she has hated milk too. So, she has been a near vegan. She NEVER eats Pizza, Candy, Cookies, Cakes. etc. The only junk food she likes is Chips. (I started making them in the Microwave like Mike Teehan suggests.) Anyway, there is no reason she should be overweight. but she is. The doctor suggested we see an Endocrinologist because her TSH was high- 6.2

She has the blackening of her neck skin, Acanthosis Nigricans, which indicates a pre-diabetes. She has had this for more than a year now. That was the reason we went to the pediatrician last year. Her Glucose is normal every time, but the triglycerides are high.

The endocrinologist was more concerned about it than the TSH. She said, if the root cause is not addressed, the kid might become diabetic when she reaches adolescence. I told her that my daughter eats NO junk food at all. (This is weird, but true. Her choice is always simple homemade food.) Like every doctor we have seen before, she brushed it aside and asked what we eat regularly. Doctors always think I am lying I guess. I told her, we are from India. We eat Rice- dal (lentils) -Roti (wheat tortilla)- vegetables (very little oil) - fruits. No dairy. No animal products.

I asked if TSH can effect insulin resistance too?
She said "No, it is due to high BMI."

(If high TSH makes it easy to gain weight and hard to loose it, it effects the BMI obviously and the BMI effects insulin resistance...so TSH can make you insulin resistant??)

Doc: Right, But animal products contain no Starch. She needs to cut down starch. Tortillas and Rice.
Me : She is a near Vegan (by her own choice. she has hated milk since she was 2.). She will be left with nothing if I don't give her rice and tortilla.
Doc : She does not need to 'stop' eating rice, but cut it in half. All starchy food needs to be cut down to 50%.
Me : But then, she will go hungry because that is the mainstay of her diet.
Doc : No, she won't. There is food other than rice and tortillas for her.
Me: Like what?

At this, the doctor gave me a dirty look, got up and said, "we will check her TSH/ T4. the nurse will come take you to the lab" and walked out on us.

(I have met rude doctors in the past, but not pediatric specialists.)

How exactly does Insulin resistance result in Acanthosis Nigricans and how can you deal with it on a starch based diet?

Could the meeting with a doctor gone any smoother for a starch eater?

Does anyone have a perspective on this?

[jamietwo]

I can't comment on your daughter's specific medical condition, but that's great that she doesn't eat any animal products (I assume that includes all eggs, cheese, and by-products)!

Four things I would suggest if she needs to lose weight.
1. review Dr. McDougall's Maximum Weight Loss (MWL) program.
2. Remove ALL added oils and high-fat plant foods.
3. Remove the flour products (i.e. tortillas) and concentrate on whole starches (brown rice, oats, white potatoes, sweet potatoes, etc).
4. Make sure she is getting plenty of vegetables, but no more than 2 pieces of fruit a day.

[Katydid]

Just doing a quick search on Google Scholar found many scientific paper linking insulin resistance and Acanthosis Nigricans. Has your daughter seen a gynocologist lately? The combination of weight gain, high TSH, insulin resistance and AN can all be linked to PCOS.

Kate

[jyotipethe]

@katydid Nope. Never been to a gynaec. She is only 8.
We went to a regular pediatrician who sent us to the Endo.

Everyone thinks she eats loads of Junk food. I feel so bad about it. She is different kid, she comes home hungry from birthday parties!

Shouldn't her pediatrician suggest we see a Gyneac? Why is that doctors do nothing, just suggest 'diet changes.'

When i told them she eats a banana every morning, (she cannot eat anything more solid first thing in the morning.), they say replace it with Apple. I mean, really? Banana is making her fat?
I wish I could take her to Dr Mcdougall.

[blueberries]

What does "very little oil" mean? I ask because I have found that people can mean very different things when they say that.

What are your daughter's activities outside of school? Does she get plenty of physical activity as well as some vigorous exercise?

What are your eating habits as a family? Are you a normal weight? Are there a lot of celebrations, like the birthday parties you mention, or perhaps eating out or special family dinners and snacks. It's great that you stopped using regular chips. Those are some of the worst foods around.

I hope the doctors are able to help your daughter. It must be so frustrating to know you have fed her the best you know how and then feel like they are assuming you are giving her fast food like so many other children they see.

[oregonmom]

I would keep a very honest food log. Enter everything into a tool like cronometer to calculate what she's getting.
I do have a few questions though. You state you're vegetarians, but not that you eat plant based. It's very easy to have things, seemingly harmless things sneak into your diet. If you're eating oils, that could be the problem. Also, that's she eating at school? And yes, there are plenty of other things besides rice are tortillas she can eat. We rarely eat either of those.

[jyotipethe]

She has never eaten school lunch in her 4 years of schooling. Home lunch ALWAYS. Food log is a good idea, but it works for someone who eats variety She eats the same foods over and over again. It's boring for me to make the same things, but not for her to eat them.

I use 2-3 teaspoons of oil in dal and same for the vegetable dish I make. That recipe is enough for 3 of us for lunch and dinner, so let's say 6 meals in 6 teaspoons of oil. Her share should come to 2 teaspoons.

[TerriT]

Hi Jyotipethe

I'm sorry to hear about your daughter's health difficulties.

I would recommend you remove all oil from your diet. It adds fat and calories and does not contain any valuable nutrients. The following thread from Jeff Novick's forum explains why oil is not recommended:

viewtopic.php?t=5868

(I would also recommend reading all the threads under "hot topics" in Jeff's forum because it's a good way to learn all the principles behind this way of eating. See viewtopic.php?f=22&t=7828)

It is very easy to cook with oil once you learn how. It just takes a little practice. I cook a lot of Indian food (my husband is of Indian descent) and my family didn't even notice when I started leaving the oil out. You can sauté onions, garlic and ginger in water, then add ground spices. For a dal where you add ground spices at the end, toast them briefly in a dry pan instead. For whole spices, just add them to a hot pan (mustard seeds will still pop even without oil).

Another advantage to cooking without oil is it makes cleanup much easier and my stove top doesn't get greasy anymore!

Best of luck in your quest for health.

Terri

[jonesiesgirl]

I don't have any advice about your daughter, but I have a link that you might find useful with information about oil-free vegan Indian cooking. The 21 Day Vegan Kickstart India has lots of low fat vegan recipes that you might find helpful. I registered for it last year and there were also videos of cooking demonstrations. I'm sure you would be able to adapt the oil-free cooking techniques to your own recipes.

http://support.pcrm.org/site/PageServer ... tart_india

[Izbet]

Hi Jyotipethe,
I have been reading through this site for several days now and I joined only because your post really resonated with me. I don't have any dietary advice/ suggestions for you, it sounds like you are pretty good at that part anyway. My question is, have you considered other enviromental factors? If what you put IN your body is decent, what about what you put ON it? (Such as the chemicals that mimic and/or disrupt your body's natural hormones.) I ask this because I have had some similar problems as your daughter, although they didnt begin till I was an adult. I am had some relief from eliminating ALL parabens, sulfates, etc... from my lifestyle. I have changed my laundry detergent, dish soap, shampoo, bar soap, etc... It has changed my body so much. Before changing my enviroment, I had Acanthosis Nigricans on my neck also. Even though my glucose levels were always normal through all the tests they said I must be "on the borderline of getting pre-diabetes." Now, I have soft regular skin. (Among many other positive changes.)
Wishing you and yours the best,
Iz

[eri]

Iz, do you mind sharing what you use now?

Jyoti, how is your daughter doing now?