Dietician ?

Hi! I am a newbie (12 weeks out) and I have noticed that a lot of vets complain about the advice they got from their NUTs. Can you give some examples of their bad advice? I am not thrilled with my dietician but this is what she does for a living so she should know better than me, but sometimes I wonder...

I've seen LOTS of bad advice over the years. Off the top of my head:

• You're losing slowly because you're eating too much and you're in "starvation mode"
• Add carbs to lose faster
• It's important to eat MUCH more when you exercise (500+ calories)
• Use protein shakes/bars as a long-term strategy to meet macros

There seem to be two main problems with dietitians: lack of familiarity with bariatric patients, and not keeping up with current research, both of which cause serious problems.

Keep in mind there are differences between nutritionists and Registered Dietitian. 

Anyone can call themselves a nutritionist. I can spend a hundred bucks online and get a certificate naming me a nutritionist. It's pretty meaningless.

A Registered Dietitian has to have college degrees, take exams to be certified, and take cpntinuing education classes to keep their certification. So they have a lot of education. But, they may know very little about nutrition as it applies to us. A lot of what they learn is specific to infants, children, the elderly, etc etc. And it just doesn't apply to us.

And forget about surgeons. They may have had zero education in nutrition.

My nutritionist said all proteins are equal, so those little one ounce shots with 20 grams of protein were fine. But, other people have told me that we don't absorb that kind of protein and it is a waste and misleading.

The truth is that many nutritionists are trained with conventional nutritional information which contradicts biochemistry directly.  Many will suggest higher carb diets which, if you have been very morbidly obese, will be unlikely to be tenable depending on 1) one's addiction, if any, which is present and 2) it's simply easier to lose weight when you don't eat a ton of carbs. 

Conventional nutrition and FDA requirements actually don't match much of biochemistry.  In biochemistry, we actually don't need to eat any carbohydrate.  At all.  The body can produce its own glucose.  In fact, protein also raises blood sugar.  In addition to this, a hormone called glucagon becomes more dominate when we restrict carbohydrate intake past a point, and this also raises our blood sugar (insulin is the reverse, and it works to lower blood sugar).  This is why you can be on a ketogenic or very low carb diet and not have a drastic peak in serum levels.

Many nutritionists tout the "you must have so many carbs a day" and will restrict fat.  It is true fat has more calories than other macronutrients, however it is far from evil.  The brain and other tissues actually love ketones (products of fat burning) for fuel.  In fact, most psychiatric drugs are lipophilic, meaning they love fat and attach to it faster than a codependent ex!  Lipophilic drugs cross the blood brain barrier very easily.

I am not saying we know as much as professionals.  As a counselor though, I always encourage my clients to learn and engage in discussions with me.  I explain why I do things and back it up with direct evidence rather than secondary sources.  I firmly believe that no one is too stupid to understand science.  I seek out nutritionists who do the same.  If a nutritionist can't describe to me her reasons for her suggestions with clinical proof I disregard them.  I am fortunate that I have a fabulous nutritionist in my bariatric program who supports my low carb diet.

My Nutritionist told me I could eat 1/2 cup of carbs every meal.  I just ignored her, and continued to avoid carbs because I knew that carbs cause food cravings for me. 

But I think this is standard "best practices" in the American nutrition community.  It just doesn't work for me. 

When I told her I wasn't eating carbs, she didn't fight me on it, but she didn't support it either.

But I can live with that.  Other than this, I didn't have any problems with my NUT.

best wishes,

Carol

Thank you so much for all the thoughtful and insightful replies!