Reality Check: Nutritionist Advice

[Blueberry]

So I saw a nutritionist today (actually an RD) at the recommendation of my new primary care. I've been trying to lose weight and have been stuck despite eating a pretty healthy diet and having a regular exercise habit. I'm wondering if I found the wrong person (or if I've just had a lot of misconceptions over the years). Here are the changes she wants me to make that have be scratching my head (there are others I agree with like playing with my meal timing):

1) Halve my veggies. I'm not eating crap - but I'm now pretty severely limited. We're taking about less salad, broccoli, cabbage, etc. Not the starchy stuff.
2) Reduce my protein to a total of 5 ounces a DAY. So - with my 2 egg lunch, I get 3 ounces for dinner (with no cheese, tofu, beans, etc.). Assuming I didn't have any for breakfast.
3) Increase my grains - she doesn't care what kind. So - more bread (her recommendation is English muffins or bagels), more oats (I can live with that), more pasta, more rice.
4) Never, ever replace any calories burned in exercise. No matter what. I'm not talking about supplementing after an hour on the trainer (I don't - but I do try to eat part of the next meal so I'm not starving). I get 1800 calories a day even if I'm on my bike the entire day. Yes, I double checked. I told her that (if the stars align and my hamstring starts behaving - a big if), I want to train for a 200 mile ride. 1800 calories a day.

This sounds completely nuts to me - and contrary to what my research has uncovered. On the other hand, I haven't managed to lose weight on my own - so maybe I'm not in a position to be questioning it. Thoughts? Am I crazy or is she?

[zoom-zoom]

This sounds like pretty much the opposite of what I'm doing and I've lost 12#s since 1/1 (have been in a water weight stall for a couple of weeks, thanks to TOM/AF). Is she super old-school, or what? FEWER veggies, MORE nutritional-desert refined carbs...seriously? Potentially eating WAY under 1200 net calories/day (which is the realm of the female athlete triad of eating disorders). Lemme guess...all fat is evil, better make that 5oz of protein in the form of egg whites and skinless chicken breast.

I would be firing this "nutritionist" STAT and finding someone who actually is versed in the dietary needs of endurance athletes. Check out the Feed Zone books.

[maillotpois]

Hey friend -

Ok yeah that sounds completely insane. Completely.

WTF about not eating veggies????? And starchy "grains" like bagels and muffins - those are completely empty calories! I wouldn't even consider them grains! FWIW, I'm not eating much bread at all anymore EXCEPT during long rides (long for me = 200k and above right now). Which brings me to the subject of not replacing calories burned. That's crazy too!! You shouldn't go out and eat a whole pizza because you rode 2 days ago (I used to have that mind set), but if you don't replace some of what you are bringing there is no way you are going to be properly fuelled to do ANYTHING.

And lower protein? Weird.

Honestly that whole eating "plan" is completely the opposite of what I have been doing since about August of last year. And during that time, I've lost 20 pounds (gained while being moderately depressed/in pain/inactive before my hip surgery) and my athletic performance is about the best it has ever been.

I don't get that at all. Could you ask her for studies or theories substantiating these particular recommendations?

Sarah

[zoom-zoom]

I don't get that at all. Could you ask her for studies or theories substantiating these particular recommendations?

Seriously, call her to the table. Pretty much ALL of her recommendations go against modern sports nutrition and actually sound pretty dangerous. No woman should dip below 1200 net calories/day.

[OakLeaf]

Seriously, call her to the table. Pretty much ALL of her recommendations go against modern sports nutrition and actually sound pretty dangerous. No woman should dip below 1200 net calories/day.

+1

If she's got research to back it up, she should be happy to share. Otherwise ... it just sounds really, really wrong to me.

FWIW, I've read recently that endurance athletes shouldn't go full low-carb, because our bodies will learn not to burn carbs during competitions when we need quick energy. But grains are the most acidifying component of most people's diets, and I can't imagine increasing grains. I feel *so* much better since I reduced my grain intake. My weight's reasonably stable and has been for a while, but since I reduced grains, my mostly sedentary DH has followed along to a lesser extent and spontaneously lost like 15# without making any other changes.


Also FWIW, you might search for a nutritionist who's a member of Dietitians for Professional Integrity. I certainly would make sure I'm taking advice from someone who's more interested in health than corporate sponsorship ...

[Blueberry]

Thanks, ladies. I thought my gut was correct on this one, and you're definitely confirming that. I suspect I need to balance my meals better (move more calories earlier in the day), but that *what* I'm eating isn't fundamentally incorrect (when I eat carbs, it's things like sweet potato for the most part). I should have known I was in trouble when she asked what "subclinical hypothyroidism" meant.

*If* I go to the second appointment, I'll definitely ask her for sources. When I pushed a little today, and responded in a "if you want to lose weight, you will do what I say" manner. She also said (when I pushed on compensating some for exercise) that we could talk about that when I stopped wanting to lose weight. Not before.

I *think* her theory is that my calories have been running below my base metabolic rate (from tables, which she believes to be accurate). Basically, I've been trying to lose weight for so long my body is quite used to starving. I don't see how giving it more grains and less "good stuff" helps that, though - and she didn't have a great response other than "it thinks it's starving."

Zoom - she's not absolutely against fat - but only 5 tsp a day total. Heavy on dairy (which, ironically, can be full fat). Basically, it's the freaking food pyramid that researchers have now fairly conclusively doesn't work. Will definitely check out the Feed Zone books. Assuming my hamstring calms down (and my PT approves), I might also consider a coach/personal trainer to help me safely ramp my activity back up. I expect that will help much more than following this plan.

[Crankin]

This sounds really ***-backwards. That's the way I used to eat when I was in my thirties, teaching 7 aerobics classes a week. I weighed 92 and everyone thought I had a severe eating disorder. I would run, run, run away and find an RD who has a specialty in sports nutrition.

[thekarens]

There are certain vegetables that are better and worse when you have thyroid issues, but I certainly wouldn't limit the amount just change the type.

[Blueberry]

Thanks for the continued feedback! I do have subclinical hypothyroidism (said nutritionist wasn't sure what that was), but it's well controlled. I just had blood work checked by my primary care, and I'm happy with the numbers. The primary care said she wasn't sure what else to check medically - hence, the nutritionist. Not sure where else to look medically - since there's really not more blood work to check. I do need to get the knee resolves, so I can get back to my level of activity.

The veggie advice was in no way related to the thyroid issue. There are veggies that can interfere with thyroid hormone, but what my doc told me is that if I eat them consistently, my dosage will compensate (i.e., if they depress the levels, the dosage gets adjusted up, and we dose based on part of the dosage not being absorbed). I'm OK with that, and it mirrors my research. Soy, cabbage, and broccoli are all potentially problematic - but I eat them very consistently and my numbers are fine. I do try to add seaweed and other iodine rich foods as an added bonus.

[OakLeaf]

Just off the top of my head, and with no idea how you're eating now, are you sure you're getting enough fat? You might try adding a tablespoon of Udo's Choice at breakfast and see what happens ...

[Triskeliongirl]

I would not listen to this dietician or go back for a second visit. I would try a very low carb ketogenic diet. I highly recommend the book The Art and Science of Low Carbohydrate Performance by Phinney and Volek. Real science by scientists that study this stuff: http://www.amazon.com/Art-Science-Lo...tephen+phinney

Its what I teach medical students to control weight, especially for type ii diabetics and insulin resistant patients. It puts your body in a hormonal state that favors fat burning. Once u become fat adapted, u will burn you body fat stores when u cycle.

[maillotpois]

This article is interesting in relation to the subject - and positively mentions Phinney cites above: http://www.timeslive.co.za/lifestyle...many-questions

[OakLeaf]

OTOH, I've been doing a teensy bit of poking around, and with the huge caveat that I haven't even bothered to investigate how rigorous the studies or the journals might be, I've run across several studies that say a low-carb diet can depress thyroid function in susceptible individuals. So - especially considering that your hypothyroidism is more subtle and thus possibly more reactive to environmental factors - maybe increasing your carbs somewhat isn't such a crazy idea.

I know nothing about it - but it's possible that's some of what she's going for.

[Catrin]

OTOH, I've been doing a teensy bit of poking around, and with the huge caveat that I haven't even bothered to investigate how rigorous the studies or the journals might be, I've run across several studies that say a low-carb diet can depress thyroid function in susceptible individuals. So - especially considering that your hypothyroidism is more subtle and thus possibly more reactive to environmental factors - maybe increasing your carbs somewhat isn't such a crazy idea.

I know nothing about it - but it's possible that's some of what she's going for.

For some women, very low carb doesn't work well (nor does intermittent fasting), and by low carb I mean <60 grams per day. There are other good nutrition-dense carb vegetable sources than grains however, so those are worthy of exploring if you want to avoid them. I don't eat grains of any kind, and I've no problem consuming enough carbs to fuel my energy needs for my activities. I no longer do endurance cycling however, I don't know how well that would have worked for me.

[thekarens]

That's what I was wondering, if you couldn't just eat carbs other than grains.