Saturday, July 14, 2012

What Dietitians Say

So, I called the nurse hotline about the headache, fatigue, and stomach pain and I could have predicted what I was told: stop eating so much fat. Wheat and other whole grains are *good* for you. Too much meat, especially fatty cuts, can lead to lots of health problems. Eat more vegetables, fruits, and whole grains. Cut way back on the fat. Substitute beans and legumes for meat on some days. And if that doesn't help or if symptoms get more severe, come in to be checked. (I was already in recently for headaches and fatigue and had a complete checkup and bloodwork, so although those symptoms have been *worse*, the thing she was most concerned about was the stomach pain but it was blamed on my "diet far too high in fat and meat products"). I was also offered the chance to see a dietitian to help me understand the benefits of whole grains and less meat and fat. I declined.

Doctors are not nutritionists. Nurses aren't, either. But even most dietitians are taught in the traditional Food Pyramid concept with "bread, cereal, rice and pasta" making up the entire base for the human diet. Even the new USDA MyPlate, which replaced the food pyramid in 2011, shows that more than 1/4 of one's intake should be from grains (and "try to make at least half of your grains whole grains"). Fat is not even mentioned or shown on MyPlate, but there is a note that milk should be fat free or 1%. I personally think MyPlate misses the mark incredibly, but it is probably a good starting point for those on the standard American Diet. Anyway, my point is that you will get that kind of feedback from the dietitians, usually. Heck, my daughter's dietitian recommended that I give her a milkshake made with ice cream EVERY DAY to boost her fat and calories! A milkshake! Not a smoothie, some full fat yogurt, or adding olive oil to her food. Sugary, processed ice cream was the answer. (No I did not follow it. I went with the smoothies/yogurt/olive oil/avocado/natural nut butters and my daughter did very well). So if you are trying to eat whole foods, or eat in a non-traditional way such as higher (healthy) fats, more meats, no grains or legumes, it is generally looked at as some kind of fad or at least poor nutrition. We are left to do the research and make those decisions on our own.

Last night I had no stomach pains so that is good. I did cut back my fat intake, not severely restricting but also not eating a half an avocado in one sitting. I had my 2-egg breakfast with black coffee and a sliced kiwi. I used healthy oils in cooking but did not eat fatty cuts of meat. I had some Greek yogurt. I ate some unsweetened coconut. I munched on fresh local organic carrots and peaches. I haven't tried the whey protein yet but might have it today.

If you've been to a dietitian or nutritionist, I'd love to hear about their advice to you. Did they stick to the traditional Food Pyramid or MyPlate? Did any of them think eating higher fat percentages (50% or more) or more meat was a good idea? Did you get good advice that you could use?


Kristi said...

The way you are asking is if you found a dietician that gave you "good advise" and to keep at 50% fat or more. Very few would give you that good advise. Trust me. My Rotherham is a top heart surgeon in California. He jokingly says Adkins, and other high fat diets are the best. They keep him in business.

Sugar said...

Even though I am vegetarian, I tried to go off grain I.e rice and wheat though I continued to eat pulses and legumes for protien.i found that eating like that gave me fast weight loss but landed me in pretty bad gastritis and stomach ulcer! I have brought back some grain into my diet. My energy levels are far better! And so is my stomach.

Lyn said...


actually they are separate questions. I'd love to hear anything you were told that turned out to be "good advice" for you personally. I'd also be curious if anyone was given the okay by a dietician to eat higher fat percentages.

screaming fatgirl said...

There are many blogs out there written by nutritionists that you may want to read. None of the ones I have read have any issues with whole grain carbs. They feel there is a place and percentage for everything in a healthy diet and never advise cutting out macro-nutrients of any kind in favor of top-loading a diet with something else. That is, none say to cut carbs way down or eliminate fats or to eat more protein. Nutritionists, as opposed to dieters, tend to generally concur with the information offered by the government in terms of overall balance. Doctors and nurses tend to say "reduce fats" because people so often overeat them that they believe they shouldn't encourage them or people will go overboard.Also, some people do have problems (like acid reflux or indigestion) when they consume too many fats, too little or too much fiber, etc. Trouble-shooting digestion issues is tricky, but doctors tend to choose common causes first and see where those changes lead the patient. If changing diet doesn't work, they'll recommend something else.

There's an excellent blog written by a nutritionist who specializes in helping people with eating disorders here:

Anonymous said...

Hi Lyn
I have often thought it was odd that my doctor has NEVER once recomended diet change as a part of treatment for certain ailments. I have also been to a Naturopath and found them to be much more helpful. They look at symptoms in a very wholistic way and think of diet and stress levels as part of the healing process. The food pyramid is way off and I find Naturopathic doctors are much more in tune with a clean eating type of diet.

I also found the website to be great as you can record your food and it tells you the specific nutrients that you have consumed and still need.

i should be full said...

Every body is different and responds to food differently. Nutritionists and dieticians are focusing on what is most average.

You were wise yesterday when you said you have to find what works for you. I would gain weight if all I ate were 600 calories each day of popcorn. But 1800 calories of tuna fish, cheese, yogurt, and meats and I'll lose weight.

If your experiencing discomfort and you think it's food related then adjust your diet, but don't bring back things you've already learned cause you other problems.

I went to a nutritionist 12 years ago in NYC who told me I needed to avoid sugar, flour, and wheat. I didn't believe her. Now, I wish I still lived there so I could see her again!

Theresa said...

My dietician gave me a copy of the Canada Food Guide (which has been proven to cause a yearly weight gain if followed!) she then said I should call her weekly for us to tweak it. All this amounted to was more money for her by making many appointments. At the end of it all she never once designated any difference between a package of ichiban and a bowl of rice noodles. It was a complete waste of time and money. What I specifically asked for was a set nutritional daily plan using wholesome foods only. Ie chia seeds, nutritional yeast, Greek yogurt, fruits, vegetables, legumes. She gave me recipes for deep fried tofu, desserts full of sugar and white flour and then some butter chicken with white naan. It's like she listened to me speak then said I've got this plan...... And the plan had nothing to do with my needs. I will never waste money like that again. A good weight watchers leader would have been a greater benefit! Believe it or not one of the best resources for healthy eating has been KERF. I can't think of a better eating plan than hers.

Em said...

I see a wonderful nutritionist (RD, MS) who specializes in eating disorders and keeps very current in the science of the field. She fully supports my recent move towards much higher-fat eating; she says it encourages satiety and that the consensus in the field has moved away from "dietary fat causes heart disease" hypothesis and towards a focus on triglycerides and systemic inflammation, which are linked to—that's right—carbohydrates.

Karen said...

Conventional advice and my willingness to follow it kep me stuck for years.

Any luck connecting with others at a primal or paleo board?

timothy said...

dr's do NOT want you to be healed just to not die and stay sick enough for their mercedes payments.and as far as so many slamming atkins the diabetic "diet" is atkins exactly! and when people ate the way he advises (NOT the induction the actual plan) there was NO heart disease that directly correlates to the upsurge in sugar consumption! end of tirade! lol i think avacodo is great in tiny portions a half or whole one is a LOT of fat and sugar and too much natural sugar/carbs will get you almost as quickly as added sugar does. use it sparingly and you should be fine. medu=itation might actually help with the enrgy and headaches so mayhaps you should give that a whirl! xoxoxoxo

Andra said...

"Dieticians, for the record, are the sub-class of processed food grunts who regurgitate government-approved nutritional DIS-information and design school lunch programs, prison food programs and hospital food programs. These are, for the record, the three worst places to get food, as nearly all the food served in these locations will leave you even more diseased than ever."

LHA said...

I have a wonderful nutritionist who does not hold me to any one specific plan or percentage of anything. Her goal in working with me is to help me find a balance in eating and most of all to STOP overeating. She is extremely knowledgeable about food, nutrition, psychological/eating issues and exercise. She has always read the latest research and has new ideas to try. Also, she is understanding and encouraging, never disparaging or negative no matter how slow the progress is at times.

A good nutritionist will serve as a guide to help you find the way of eating that can get you healthy and keep you healthy for life. She will know that there are many roads to this same goal, and she will also always help you see how far you have come. From what I can tell, Lyn, I live on the other side of the country from you (I live in the southeast) so this won't help you but at least it does prove that not all nutritionists are useless!

Good luck to you, and glad you are feeling better.

Anonymous said...

The best advice I ever got was to keep my calories between 1200-1300 daily, and fat between 20-25 g daily. It did not matter what I ate, as long as my fat and calories stayed within those ranges. It worked. Not saying it will work for anyone as it takes discipline, but it worked for me. Do you think thin people stay thin by eating 125 grams of fat per day? Good god, no. They stay thin by eating in moderation. You are trying so hard to find "the secret" but there really isn't one. You have to be disciplined and eat in moderation. Nothing less, nothing more. If you are not willing to eat in moderation (all foods! meat! dairy! grains! carbs! (OMG!) ) then you aren't willing to be a healthy weight.

MargieAnne said...

Hi Lyn.

I think you will find this website helps answer some of your questions.

Maria explains nutritional content and has many great recipes and why she chooses those particular combinations.

Personally I steer clear of most dietitions and doctors recommendations. I was introduced to a paleo elimination diet in the late 1970s. I wish I'd listened more to his advice but it seemed he was still learning and I felt as though I was an experiment.

I did learn enough to understand that starches are my enemy but I continued to struggle because I did not understand that wheat was a major factor. It was not until this year when I became 100% wheat free and began to read blogs like Fathead that I understood the science.

Interestingly Tom Naughton's latest post has an article about the political manouvering being done by dietitions against people who do not follow their line.

Hope this helps.


Sassle said...

I've been eating Paleo/Primal now for over 2 months and I have lost over 30 pounds doing it. I eat meat, fat, fruits, vegetables and have let go of conventional wisdom, because CW has not helped me, this has however. I finally feel like I can actually eat this way for the rest of my life, it's not a diet. Ok so I don't eat grains, sugar or flour and frankly I don't even miss the stuff. I would highly recommend to look into it further. There's so much BS that we are being fed. Just my 2 cents.

Taryl said...

Someone else mentioned it but it bears repeating - her books are absolutely excellent and the blog is, too:

Sensible nutritionist who parses out why whole grains and low fat is NOT the way to go. She isn't a high far advocate, but neither does she skimp on it.

Sassle said...

Dang Lyn, I see you are on the Primal plan, sorry for comment above, I'm glad you are doing it. I'm catching up on your posts!!

Anna Down Under said...

A diet that high in fat is not only not healthy, it's downright deadly, causing damage to your arteries and you may not even realise it until you've got heart disease. Here's a great 1-minute video on that:

Even if you did lose weight on a high fat diet, at what cost? Do some research - in addition to books on your chosen diet, consider also reading books by Drs McDougall, Esselstyne, Campbell, Fuhrman or Barnard. Esselstyne and Campbell have each done studies lasting more than 25 years PROVING the connection between high fat and high protein diets and heart disease, cancer, diabetes - all the major killers of the western world.

There's also these videos on why early humans, or hunter-gatherers, primarily lived on plant foods:

j said...

i'm curious if you have ever heard of the documentary 'forks over knives' that came out not too long ago and is now streaming online. it actually makes a very strong medical case against meat and dairy. it got a lot of attention and i found it really mind-blowing. check it out - a completely different perspective than paleo OR the food pyramid:

Meghan said...

Bodies are so different. My mom and I have the same build, struggle with weight gain in the same places (super pear shaped), and share other metabolic similarities. For example, we both experience the same cycle in a diet like Atkins. It'll work miraculously for a few days. Then we feel greasy, weak, and listless end up "breaking" induction with nuts or some other barely permissible thing we're supposed to have in moderation, which leads into a full scale carb binge.

That said? My mom's best fit, weight management wise, is low fat. She tries to stay around 25 grams per day, and splits the rest between carbs and protein. It's a diet much lower in fats than most would recommed today. But it gives her the most energy and is the most effective and easiest for her to follow. Eating that many carbs for me triggers binges and sugar-cravings. I eat between 40%-50% of my calories from fat. I try to avoid saturated when I can. But avocado, hummus, olive oils and coconut oils (even though high in saturated fats) are big parts of my day. (Today I had about 1150 calories.43% were from fat). I feel so much fuller when I eat these, even though conventional wisdom is that these are so calorically dense, you have a lot more room in your stomach and will be hungry. I don't feel the need to binge and I don't feel deprived but sated, because food still tastes rich and flavorful. This isn't a diet that fits a ton of people, (it sounds like it might not be the way to go for you, for example). It's also not how I lost all of my weight. But for the last three years of maintenance, it's really worked for me.

My roommate is a nutritionist/rd and we talk regularly about how much everyone's still learning about nutrition, weight and what's universally applicable versus completely dependent from person to person. Have you watched the HBO special on the Weight of the Nation? It's available for free online and I'd highly recommend it if you haven't. I feel like most chronic dieters are pretty well-informed when it comes to weight loss info. But this one had some new stuff, differing perspectives, and was very well done. Some things I always intuitively "knew", got some research confirmation which was pretty gratifying. For example, the 140 pound person who's lost over 50 lbs and is struggling to keep it off (me) needs approximately 20% fewer calories than the 140 lb person who's never lost weight. And this isn't true just after you stop dieting. The study followed individuals for five years and it still held true. Depressing. Sobering. A little unfair. But I'd rather know it than not. 20% of your daily calories is a lot fewer calories!
(cont. Sorry for the longest post ever :)

Meghan said...

I also welcomed the research that debunks "a calorie is a calorie" weight wise. Our bodies do treat different calories differently. (A person in maintenance can eat more calories of protein/fat than carbs to maintain weight, for example.)

Agh, I get I just talked myself in circles a little. On the one hand, it's nice to see validation of things that are "true" for me. And maybe there's even a nugget of universality in that information. On the other, I'm not really sure that the same things would be true for you. I mean, so what if research says you should be able to eat more fat/protein than carbs to maintain weight if you are personally miserable on a low carb diet and can't maintain it? You're better off counting calories and carbs. I really do think that a lot of weight management is distilling all the information that's out there and figuring out what works best for you physiologically, mentally, and in the fitting room. I feel like it's why so many people who lose weight end up writing about it. There really is so much trial and error required, that when you get to what works, you feel like you've had this Eureka moment and discovered a secret key, even if on the book shelf that secret key doesn't always look that different from everyone else's secret keys. It is. Those tweaks you made may seem small looking from the outside in, but they required so much work, so much trial and error, so much willingness to get back up there and try again. And those tiny tweaks can make a huge difference.It's just, maybe some other dieter can't do the work for you. Maybe most people have to suck it up, invest the time and find their own. Because while there's a lot of helpful info out there and it's a great starting place, it's just that. To make health and weight management work, I really think you have to invest time into figuring out what's both effective and sustainable for you. And while I know it's a frustrating process, it sounds like you're putting in your time. Good luck, Lynn!

(Sorry for the novel!)

PuffsPlus said...

Here is an RD who is doing paleo/primal:

I recently stumbled across the blog of another RD who was vegan but who is now doing paleo also. Darn, can't locate her blog right now. When I find it I will post the link.

PuffsPlus said...

One counterpoint to those who say high fat is dangerous: Define "high fat". The Mediterranean diet eaten by the people of Crete who had low levels of heart disease and other diseases had actually 40% of calories form fat, most of it from olive oil.

Anonymous said...

Rather than a nutritionist, have you considered utilizing a university diet program? Is there a teaching hospital near you? Most large hospitals have excellent programs that are likely covered by insurance. BTW, I cannot imagine any responsible medical professional recommending a high fat diet!

You've struggled a long time with your weight. I don't want to give you advice, but have you even considered returning to Medifast to lose the last 40 pounds, then going through Transition and Maintenance as they recommend? I'm in the midst of Medifast, I can understand that you got sick of it, but if you could just power through, especially since they provide you the foods free of charge, you can always do Paleo or some variation for maintenance (as many MF graduates have done.)

Best wishes and best of luck to you!

HikerRD said...

HI there,
I can't take responsibility for my colleagues, but I can at least demonstrate that we don't all fit in that unfortunate box you gathered us in. Thank you ScreaminFat Girl for noting that Drop It and Eat is in fact different!
First, a clarification: "nutritionist' is a meaningless term--at least in the US. Registered Dietitian requires academic degrees, successfully passing a national exam, and maintenance of continuing education. That said, we often call ourselves "nutritionists", a throwback, I think, to the era when dietitian connoted hospital dietitians only, with a very different image. But a nutritionist could be someone who work at Whole Foods or the local supplement store...

Next--I'm with you about My Plate. I wrote about this when it came out:
But I have as many issues with Paleo, Atkins, and simply restrictive dieting--so come by and check out the blog!

Anyway, nice job on this piece!

Lyn said...


No, there isn't one, but I did go through a hospital nutrition and weight loss program back in 1992! I am sure things have changed since then, though.


Hey, thanks for stopping by! I was looking at your blog yesterday and it's very informative. I appreciate your take on things and I'll be reading your older posts as well. So glad you are keeping up with current studies and researching things, not just accepting the government's declarations of "healthy eating." Thanks again :)

Diandra said...

Most nutritionists I know have taken that job because they are "on a mission" - and that is never a good reason to start a job. I haven't been ot one, I trust my body to tell me what works, and I read and research a lot.

As for the whole grain thing... for about two days, I have been trying something that is completely different (or maybe not?) from the whole Primal/Paleo thing. It is a (if followed 100%, which I do not intend to) vegan diet concentrating mainly on whole grain and starch-laden vegetables and legumes, with a side of fresh colorful vegetables and fruit and some condiments. Before, I had been stuck at the same weight and finally even slightly gaining with different degrees of low-carb and similar diet approaches. Cooking vegan is a challenge for me, but let me just say I have been feeling amazing (no stomach pains, no gas, no fatigue) and after just two days, the numbers on the scale have been impressive as well. I am really curious to see how that continues and whether my body will keep enjoying this way of eating.

(But then, of course, every body is different.)

Val said...

Lyn, I am late on catching up on my blog reading after vacation, but I hope you are still checking comments.
Your symptoms sound very much like gallbladder disease & I would urge you to have this checked out (vs taking advice of random stranger on the Internet ;-)