Difficulty reaching daily calorie intake due to health issues

rieraclaelin

Hi everyone! This is my first time posting here, and I hope I can get some tips. I've kinda looked around a bit before deciding to post here, so I have some ideas, but, well.

I was diagnosed with severe fatty liver about four weeks ago, and I go in for a FibroScan in about two weeks to hopefully rule out NASH. Fingers crossed it's still in the NAFLD stages. On top of that, I am a type 2 diabetic and morbidly obese.

So, basically, my diet is kinda limited to what I can and can't eat. I'm hoping I can make an appointment to sit down with an actual nutritionist within the next few weeks, but, it's really hard to get an appointment there. I was approved by my doctors for bariatric surgery, but unfortunately, my insurance won't cover it. I can fight the decision, but, I decided to attempt this the "natural" way, first, and re-evaluate at the first of the year.

The doctors I've talked to all say the same thing. Limit bad fats, eat healthy fats, eat lean meats (avoid red meats with fatty liver), and tons of fresh fruit and vegetables. I was also put on a high fiber diet to help with digestive issues (and that has helped).

My issue is that I'm supposed to be getting around 2,000 calories a day, and I'm lucky if I can get it to 1,400. Then I'm stuck trying to find anything I can to get me up as close to the 2,000 as I can get, but, with all the fresh fruits/vegetables/healthy fats (avocado, peanut butters, olive oils, salmon), all of my daily nutrients are getting maxed out. Same with fibers, and because of diabetes I have to keep my carbs somewhat low, and because of the fatty liver and diabetes, sugar even lower. I know natural sugars don't count as the daily intakes, only added sugars, and I avoid that like the plague. I've also done a lot of research on fatty liver diets, and most places I visit say to limit protein, too, and try to eat more plant protein than meat (which is kinda hard, honestly). But, if I eat pasta, I eat the type that's made from chickpeas, and all the breads I eat are whole wheat breads. I tend to stick with sweet potatoes, but occasionally I'll let myself have a little bit of white potatoes.

Has anyone else here been in this type of situation and have any advice on how to help? I can't exactly eat a bowl of ice cream, or grab a candy bar for those quick, dense calories, when it will add all those added sugars to my liver and hurt it even more, or spike my sugar levels. I'm kind of new to this counting carbs thing, so, I don't even know if I'm counting them properly or not. I don't know if the carbs that are listed on the backs of food are the way I'm supposed to be counting?

I don't feel hungry during the day with what I'm eating, but, I know losing weight too fast is not good for your health, and even worse when your liver is already compromised. I've lost 17 pounds since I started this new diet, which was around June 25th. (plus, it adds the 10 pounds I had lost a year ago, so now it says I've lost a total of 27 pounds, which is a nice number so far :P Just not as accurate as I want) Granted, a lot of that was water weight at the beginning, but now I want to make sure I can keep it around that 1-2 pounds a week, and I'm afraid if I can't get these calories up I'll be losing it way too fast.

Anyway, sorry for the long post! Like I said earlier, any tips would be appreciated!

HeidiCooksSupper

You may be making this more complicated than it needs to be. Lots of us are in similar situations. First, the best thing you can do for fatty liver disease and type II diabetes is to lose weight and exercise. And MFP is a great place to do it in a reasonable and healthy way.

How did you calculate 2000 calories/day? How fast does it assume you will lose weight?

In just over 5 weeks, you've lost just over 3 pounds a week which is a bit fast but not wholly unusual for one just starting out or who is more than 100 pounds overweight. If you are less than 100 pounds overweight, it is probably a bit too fast. So, I would work on calculating how many calories per day you should be eating to lose 1 to 2 pounds a week and be healthy.

For example, I am 5'4", 69 y.o. female who weighs 246 pounds. A TDEE calculator (https://tdeecalculator.net/) set to sedentary gives 1951 as my daily number of calories to stay exactly the weight I am. I set my target to 1725 calories/day which means I have a calorie deficit of about 225 calories/day but then I do exercise for 250 to 750 calories/day which means at this calorie level I am losing about 1.75 pounds a week. My macros are set at 40% carbs, 30% protein and 30% fat. I'm usually over a bit on fat and under on protein but I'm managing to keep the carbs under control and the endocrinologist likes this distribution.

I'm okay with my present eating and exercise. It's sustainable for me. I alternate walking outside, pool walking, and a bit of weight machine training -- none of it very hard core.

What the doctors told you about eating is about right in its own general way. Eat healthy fats, avoid saturated and transfats, eat lean proteins, eat lots of vegetables and some fruit, and try to get a good amount of fiber every day. To do this, you don't need to go all out. You can do this eating a wide variety of foods. You don't have to become completely pure in all this because therein lie excuses to quit. Be reasonable with yourself and your diet. Plan to learn and change as you go along.

I've learned a lot about healthy eating from Harvard University's "Nutrition Source," https://www.hsph.harvard.edu/nutritionsource/, especially starting with their "Healthy Eating Plate."

Finally, one thing you didn't mention is alcohol. Those with fatty liver disease should definitely give up the booze. But you did mention NAFLD so hopefully that means you aren't a drinker.

rieraclaelin

I have been exercising as much as I'm able to. I have been trying to work out for about 30 minutes a day five days a week. I have access to a stationary bike, an elliptical and the internet at my house. I recently found a nice workout channel on YouTube called Body Project, and I've been doing some of their workouts from home. None of it is hardcore, but enough that I need to set my activity level as slightly active, I feel?

The daily calories kind of confuse me. According to MFP, with the light workouts I do, and my weight, I need to eat 1990 calories to lose 2 pounds a week. I should mention that I'm a 5'9" female, age 37, and at my last weigh in on Monday, 363 pounds. My "goal" weight is around the 150-170 pounds. With that link you sent me, with light exercise, I would need to eat 3294 calories just to maintain, so, that means 2294 to lose two pounds a week? Man, I barely even got to 1800 today! I've managed to get my glucose numbers down close to normal ranges, at least, with this new diet. My goal is to be able to cut back on my metformin by the first of the year, if possible (I take 1000mg of metformin twice a day)

I am definitely going to take a look at that link from the Harvard University! Thank you so much for that!

And as for alcohol, no, I am not a drinker. I don't even remember the last time I even had any sort of alcohol. But yeah, that was the first thing the doctors asked me and warned me about when I was first diagnosed.

Geneveremfp

Nuts and seeds (hemp hearts are great for plant protein) , an extra spoonful of peanut butter, avocado, extra virgin olive oil, coconut - flesh or the milk that comes in cans. All of the above are a few higher calorie but still nutrient dense foods you could try. A large sprinkle of seeds and a tablespoon of olive oil could increase a salad by a couple of hundred calories with relative ease.

rieraclaelin

Geneveremfp wrote: »

Nuts and seeds (hemp hearts are great for plant protein) , an extra spoonful of peanut butter, avocado, extra virgin olive oil, coconut - flesh or the milk that comes in cans. All of the above are a few higher calorie but still nutrient dense foods you could try. A large sprinkle of seeds and a tablespoon of olive oil could increase a salad by a couple of hundred calories with relative ease.

Thank you so much! I do have some seeds here that I bought and keep forgetting about. I'll have to remember to add that to my next salad!

I do tend to have peanut butter as a snack, sometimes with an apple. Or I'll have hummus with carrots/bell peppers for some extra calories with the hummus.

Redordeadhead

Are you weighing all the food you eat in grams/oz on a scale and remembering to measure and log any oils etc. used in cooking?

rieraclaelin

Yep! We bought a food scale last year when I first tried dieting, and I use it constantly. That, and measuring cups/spoons. I'm pretty obsessive with measuring. We went to my mother-in-law's for dinner the other night and I packed my scale so I could measure how much of each ingredient was in the grilled chicken salad that she gave me instead of just guessing, hehe.

I'm going to play around today. I think I've been limiting myself too much on the "good carbs", like the brown rice and stuff like that. So, I think I will make sure my meal for dinner tonight has some brown rice or something, and allow myself to eat a little more of that for the extra calories and good carbs.

HeidiCooksSupper

I think, from all your thoughtful reactions and planning that you are going to be great at this!! Just remember, nobody's perfect and you are changing the habits of a lifetime so it's hard to do. Congratulate yourself for every step in the right direction!!

rieraclaelin

Thank you! And thank you all for the very friendly responses and advice!

southernskeeter

I fully understand where you are coming from with the not getting in enough calories. I have the same struggle. I too am a type 2 diabetic so I have to watch carbs and sugar. I had a heart attack on 7/5/20 so also have to watch sodium and fats. MFP has me set for 1630 calories a day and today right now i still have about 600 left. I still have a lot of protein left also but I am full. my issue is I eat something mid-morning
(usually a banana and 10 red grapes) then not hungry till afternoon. its a struggle to take in enough calories!
It is a learning experience for me. I do not like a lot of vegetables and cant do raw due to teeth issues. I find the same foods repetitive make me not want to eat.
Keep up your diligent work and good luck with your health issues. I hope for you like me this dieting and counting becomes second nature and much easier.

rieraclaelin

southernskeeter wrote: »

I fully understand where you are coming from with the not getting in enough calories. I have the same struggle. I too am a type 2 diabetic so I have to watch carbs and sugar. I had a heart attack on 7/5/20 so also have to watch sodium and fats. MFP has me set for 1630 calories a day and today right now i still have about 600 left. I still have a lot of protein left also but I am full. my issue is I eat something mid-morning
(usually a banana and 10 red grapes) then not hungry till afternoon. its a struggle to take in enough calories!
It is a learning experience for me. I do not like a lot of vegetables and cant do raw due to teeth issues. I find the same foods repetitive make me not want to eat.
Keep up your diligent work and good luck with your health issues. I hope for you like me this dieting and counting becomes second nature and much easier.

Oof, I hope you are able to work out a way to get yourself the calories you need, as well! This dieting stuff is hard enough without limitations, yeesh!

I changed my macros around this morning, and I'm going to try to set my daily meal plans first thing in the morning so I have time to tweak it throughout the day if I need to (like, if I end up working out more/less than usual), and that way I'm not scrounging around at the end of the day trying to get in these extra calories.

But yes, I hope this all becomes second nature for us, too! ♥