I understand that just not everyone can stand up to a physician. But the good news is, not everyone needs to. My husband is a disabled veteran and he has a couple of significant conditions that are definitely helped by a carnivore diet, but that he is not going to recover from. He has several doctors and several medications that actually improve his quality of life. He also has others that absolutely will not. As an admittedly extreme position, he has occasionally just accepted a scrip from a doctor and simply not filled it, or, if the doctor fills it and has it mailed to him he simply does not take it. He doesn't discuss it with the doc, he just does what he knows to be right for himself, and allows the doc to believe he is "compliant". What I would say to her is, if it's too hard to stand up to a doctor, don't, Just do you and let the doctor believe you're doing what they want. If doc asks you whether you are having any trouble with the "new meds" just say no. and let it go. I'd bet it won't come up again. It's absolutely ethical to tell her she does not have to take any medication she doesn't want to take, and that her doctor is a PAID CONSULTANT, not her boss!

My personal "food hierarchy" is focused on tolerance and inflammation rather than nutrition. Most whole animal sourced foods will be nutritionally sufficient under ordinary circumstances, but each client will have individualized injuries and intolerances. Most people who seek coaching need a therapeutic diet as opposed to an "optimized" one. My approach is "what foods will give YOU the greatest advantage, not merely nutritionally, but lifestyle-wise as a whole?" If I'm doing my job, as I see it, the client will gradually learn to tell if they're on the right track by the way they feel. I always recommend a food diary when starting out so there can be no question whether a food is associated with negative symptoms. Having said all that, to finally answer the question you asked (rather than the question I wanted to answer 😆), I believe that red meat along with its associated fat derived from pasture fed ruminants is probably the most superior food for human beings. Followed closely by cold water wild seafood, whole eggs, and any other meat raised as close to nature as practically possible. Now, having said ALL THAT, I'm convinced that for most people sufficient is just as good as optimal. If it makes you feel good, eat it. Eat as much as you can of the highest quality meat and fat you can afford, and that will be enough for most people to see satisfactory health gains.

@James Dawkins this is an important part of my book. In my book I point out that quantifying intake by calories is like measuring distance in gallons or liters. There tortured ways one can do it, but the inaccuracies are baked in.

It all comes down to educating the client on the understanding of human metabolism. I refuse to do "Just tell me what to eat!" If the client is disinterested in the basic understanding of WHY certain foods are inappropriate, I'm not a good match as a coach. To be clear, I'm not going to quiz them or anything, but if they're going to ask me whether a food is appropriate, they will also hear WHY it is or isn't. If they just want to be fed, they can hire a chef. I can do that too, as it happens, but it's WAAAY more expensive. As long as the client is dependent on a paid consultant to decide what to put in their mouth, they're susceptible to being both ripped off and injured. THAT is a failure of me as a coach.

You make it sound like neutral results are a negative outcome! Most people I've worked with have chosen to work with me because of downward trending results. When we have 12 weeks that have stopped a downward trend, that seems to me to be a victory. But if you're referring to a case of someone who doesn't seem to have experienced any improvement at all, over 12 weeks in my experience that's rather rare. I always presume there WILL be some improvement, but for some reason it's been overlooked. When a client has a particular outcome "at heart" so to speak, and that outcome doesn't look like they expect, it can be so disappointing that they may completely ignore improvements that are more subtle but just as indicative. If a client is over focused on, say, weight loss, or A1c, things like improved sleep, reduced cravings, more energy, and better digestion can go unremarked and underappreciated because they don't realize that these changes are often a better indicator of improvement than the "big numbers". I do my best to show a client that their body is a complex system, and that small improvements in any part of it are are evidence that the whole system is improving. Once that conversation has been accomplished, the next discussion is "If you are not making the kind of progress you would like to, perhaps you are one of those who will need to be more strict for a period of time. Perhaps food is not the only lifestyle change you will have to make. Perhaps there are other behaviors that can be changed which will better support your goals." At this point I like to ask the client "If you could wave a magic wand and achieve your health goals tomorrow, what would you do to celebrate? (not to include any behavior that has already been determined to be detrimental) The client will usually discuss some activity that they are too unhealthy to take part in, but have dreamed of doing. Here is where I ask, "How much would you be willing to give up if you knew for sure that you would be able to do that, eventually?" Then we have a conversation about what can be done to further fine tune their practice. Most people end up being very enthusiastic and motivated to "up the ante."

Well, I think I understand your intent, and in general I agree. Ultimately, one must always be prepared to acquiesce to the suggestion that one may not be the "means" by which the "ends" are achieved, regardless of competence. My goal in that case would be to part company in as supportive and generous a manner as possible. If circumstances change we would prefer to retain the possibility of further collaboration in the future. Even if all they take away from their experience with me is their conviction that I truly have their best interests at heart, that, in itself, has value.