Irresponsible advice from dietitian?

ashleyisgreat

I recently got blood work and found that my cholesterol levels were pretty high and my blood pressure is in the hypertension phase. I've been good about tracking all my food on here, but I figured that I should see a registered dietitian to help get a better sense of what kinds of foods I should be eating to help with these two problems. A registered dietitian is different from a "nutritionist" in that they have a degree and have passed federal board tests, so I assumed that she would be knowledgeable and reliable. I wanted specific advice for these two issues, rather than just the general paean of "eat more fruits and veggies!" that I might get from a nutritionist.

Anyway, when I met with her, the first things she told me to do were 1) stop counting calories and 2) stop weighing/measuring my food. What the what? She claimed that the only way for me to lower my numbers is to follow the federal government's "MyPlate" guidelines (it's the graphic of the plate, split into parts...you can look at it here: http://www.choosemyplate.gov/index.html). She also implied that counting calories and weighing food is an unhealthy behavior that puts you into "dieting mode" rather than "lifestyle change mode". I know that she probably does see a lot of people who have unhealthy ideas about weight and dieting (she works at the university where I am a grad student), but she is wrong to assume that anyone who tracks their food intake must be a pathological dieter.

Overall, much of what she said seemed like terrible advice, and I resisted the idea that I should stop counting calories and weighing/measuring my food. It seemed like borderline irresponsible advice to be giving someone who needs to lose weight and lower their blood pressure and cholesterol. Plus, she never did give me specific advice on those two issues...she just showed me a picture of the plate and said "do this." Hmmm....What do you guys think?

castelluzzo99

I don't really care for what the government puts out. Seems like every year they come out with a new guideline. When I was in my teens it was the food pyramid. I remember learning about it on the back of cereal boxes (which proudly inserted a picture of their brand into the bottom of it, of course!). Before that it was the 4 food groups or something like that. And I don't remember before that, cuz I wasn't born yet.

Honestly, some people have trouble eating fruit and veggies at the same meal, so right there it's flawed. That, and it fails to take into account things like potatoes. They would be more in line with grains than veggies in terms of starch, and beans have a lot of carbs too, and everything has protein, so to say I must divide my plate like that is kind of silly. Did you hear about that potato farmer who ate only potatoes for 60 days in protest of people saying that potatoes were not health food? Google it if you haven't.

I need to go, but I'll comment more later. But for now, yeah, I don't think her advice was very good.

laurahamm96

LOL. I could pile SO much meat and pasta in to the parts of the plate where they belong. No, that is crappy advice.

xscat

I am no nutritionist so it's not my place to comment on her plate theories... But trust me I struggled with both anorexia and bulimia and it was NOTHING like weighing your food or counting calories.....

Also my father suffered from high cholesterol for a while. His doctor told him to exercise more, eat less red meat and stop drinking. So he beat it by exercising regularly (jogging, basketball), reducing the amount of red meat he ate and cutting back on alcohol (from drinking on a stressed out day to drinking only on important holidays). Maybe this could help with your situation as well?

GLH2576

Can you get a refund? I think her advice was not particularly useful and, depending on who you ask, may not be based on current research. If you have the time, get (it is probably available at a local library) a copy of Gary Taubes "Good Calories - Bad Calories" and see how many of the government's recommendations for eating came to be put into practice. After reading it you will take any dietary guidelines with a grain of salt.

navyrigger46

Yeah, I would regard that as horrible advice. Pretty much any time someone refers me to the government for advice I figure they don't know their @$$ from a hole in the ground. The my plate thing is basically high carb, low fat low protein bunk. And stop weighing your food? What purpose does that serve?

Ignore that "nutritionist" and find someone else.

Rigger

terizius

By no means am I a dietition/nutritionist, etc.. nor even a personal trainer.. but I personally believe that only by tracking your intake and the changes that take place can one truly have "control" of their life and body. Otherwise, its all a shot in the dark. I'm trying to gain weight. Without tracking my calories, I wouldn't know if I was getting enough to actually gain, wouldn't know if my protein intake was adequate or if my macro ratios were correct. I also track my body measurements, Body Fat % and lift stats weekly. I have specific goals for the first Qtr of 2014 and without tracking these things, I wouldn't know if I was on track. Once I reach my goals, I will probably back off and track little if anything, but tracking is key for meeting goals.

For your specific problem.. my wife has borderline hypertension. She also started working out this year. She tracks her calories, and I track her measurements (though she doesn't care as much about that). Just yesterday, she told me "My blood pressure was almost normal today". Of course, she only knows that because she tracks her blood pressure regularly.

Like I said, I'm not a dietition, but healthy eating, reducing foods high in cholesterol and sodium and regular exercise are all known to reduce high BP and cholesterol.

jayjay12345654321

I think she needs to have her license yanked. I'm also an RD, and I would never give someone that kind of advice! I was diagnosed with hypothyroid whose side effects, to name a few, are weight gain and high cholesterol. The weight gain led to hypertension and fatty liver. (BP was 220/150, cholesterol was 356). Once I started hormone therapy, I turned my focus to undoing what my defunct thyroid had done to me. And I did that by weighing my food and tracking my calories and macros! I can't believe she told you that. I've met a few who push the My Plate because I think they just don't know better. They spew out what the government tells them without looking at individual cases and doing actual research for themselves.

I'm not your dietitian, you don't have to listen to me. But I'm a product of my own teachings and it's worked out well for me personally. I'm not "dieting." I'm living a lifestyle that didn't support obesity, and therefore the pounds slipped away naturally. No fads. No quick fixes. Just a healthy lifestyle and everything moved into position of its own accord.

AnninStPaul

Can you get a refund? She's no help at all.

mathiseasy

I went to the website...and within a 30-second skim I saw a calorie tracking section, where it has bmi calculators and the like so I'm not sure this person actually knows what's on the site haha.

That being said, I remember learning about the food pyramid too and the government has changed its mind so much since then, I say go with your gut. I don't know what the line between dietician and psychologist is, if she's so worried about the "diet mode" vs "lifestyle change mode", especially if she had no real advice about lowering your cholesterol and blood pressure. Seems like that's the kind of stuff she should know hehe.

I'm no expert, but I'd say keep on keepin' on, tracking your food and calories

amgreenwell

My best friend is a dietician who puts EVERY SINGLE ONE of her clients on MFP. She has them measure everything and log everything they eat and do for exercise. She is the one who got me interested in signing up and I'm so glad she did. She's never tried to show me a government issued plate to tell me how to eat. She, like most well educated dieticians, know that measuring your portions and controlling your calories is the only way most people can lose weight.
Sorry about your experience with this "professional". I would certainly get a second opinion from another dietician in your community or local hospital.

NualaTW

Yeah, sounds bad. I see an RD myself, and even though she mentions the "my plate", she also was the person who encouraged me to get online with MFP. She follows my food diary on here in between appointments so that we can discuss my food diary and any possible "tweaks" whenever we meet.

She also provided me with lots of detailed literature on how to parse out my portions every day to get all of what I need for my particular condition (pre-diabetic when I started seeing her).

Since I've been seeing her and being on MFP, my AC1 dropped from 6.5 to 5.3 in one year. Cholesterol and BP have also become much healthier numbers.

PaleoPath4Lyfe

What she is saying is contradictory and doesn't make sense.

She is telling you to go by the government guidelines of how many servings to get in each day according to the "my plate" guidelines, but doesn't want you to weigh or measure?

How are you supposed to know you are getting in their recommended servings???

I *think* she is trying to get you to eat more "intuitively" which is great for those people that don't really eat boxed or packaged food, but someone that includes those things needs to know the serving size of what your eating.

I don't track calories at all. I am tracking to ensure nutritional density and I have been slacking on that. I have just been eating intuitively and having success, but I also only eat proteins, fats, vegetables and fruit.

ThickMcRunFast

Yeah, that's pretty bad.

I've also seen people claiming to be dieticians here lack even a basic understanding of human biology, so clearly that degree isn't everything. Find a new dietician.

ashleyisgreat

Yeah, sounds bad. I see an RD myself, and even though she mentions the "my plate", she also was the person who encouraged me to get online with MFP. She follows my food diary on here in between appointments so that we can discuss my food diary and any possible "tweaks" whenever we meet.

She also provided me with lots of detailed literature on how to parse out my portions every day to get all of what I need for my particular condition (pre-diabetic when I started seeing her).

Since I've been seeing her and being on MFP, my AC1 dropped from 6.5 to 5.3 in one year. Cholesterol and BP have also become much healthier numbers.

See, that sounds wonderful! And it's what I expected, especially the bit about getting what you need for your particular condition.

I am so glad to hear that you guys think it was bad advice too. It was just so bizarre, and even when I sat there I didn't know what to say when she told me to stop tracking my food and weighing! I was dumbfounded. And I even asked her if she would like to look through my diary on MFP to see what I've been eating, and maybe she could give me suggestions, and she didn't want to do it. What the heck? Glad to hear that other dietitians are better!

stefjc

I'd say she has a point!

Especially that bit about lifestyle versus diet. If you measure everything forever you do become obsessed. She was suggesting you tried a more holistic approach - look at the whole range of food you eat rather than focussing on the micronutrients and kcals.

But if you have cholesterol and hypertension troubles then, yes, a whole life change needs to be made, not just a quick tweak of what food group you eat/ignore.


Then again I am a Brit and don't get the whole micromanaging, tight focus, sugar is the devil thing, nutrient density, eat weird none food foods thing.

jesindc

Yeah, that advice stinks. I wish I were someone who could stop counting calories, but whenever I do, I tend to put on weight. Counting calories is part of my healthy lifestyle and thanks to great apps like MFP, it isn't all that difficult to do.

I got my high cholesterol WAY down by staying in my calorie range, using olive oil in place of butter and eating salmon at least once a week. Those are the changes I made and my LDL is now 115 (good=below 130) and HDL is 88 (good=above 60).

ashleyisgreat

I'd say she has a point!

Especially that bit about lifestyle versus diet. If you measure everything forever you do become obsessed. She was suggesting you tried a more holistic approach - look at the whole range of food you eat rather than focussing on the micronutrients and kcals.

But if you have cholesterol and hypertension troubles then, yes, a whole life change needs to be made, not just a quick tweak of what food group you eat/ignore.


Then again I am a Brit and don't get the whole micromanaging, tight focus, sugar is the devil thing, nutrient density, eat weird none food foods thing.

Well, I can see that point, too. I am certainly not the kind of person who will cut out food groups or remove all sugar from my diet. In fact, I am kind of the opposite, where I will eat whatever and as long as I can come close to my calorie and macro goals, I am happy. But with these two particular issues, I thought that there might be ways to shift my diet so as to control them without meds. For example, let's say that deli meat is terrible for people with high BP. I eat quite a bit of deli meat, and it would be useful to know that info. Or if certain veggies are shown to help people with high cholesterol---I want to know that. I was looking for that kind of help and advice. Does that make sense?

Mycrazypumpkins

I'm reading a great book called the "DASH" weight loss plan. I've tried other weight loss plans but it was too hard. This book scientifically helps you determine your daily needs of protein, fats, carbs...etc. It gives you a guideline of how much to eat of each every day. It's set on the premise that blood sugar levels should be kept even so you also don't have horrible cravings and that "crash" feeling. They give you all the information you need to know to eat smart every day. They allow a certain amount of sweets, too...such as baked banana drizzled with chocolate syrup, yogurt drizzled with it too. They give you weeks worth of menus to help people like me who are lazy, lol...(with recipes). I tried weight watchers but it was too much work. This book has made it so easy for me to eat healthy but still have treats. Good luck!

lafilledelarue

I think your "gut" is right about the advice you received.

On a personal note, I weigh and measure my food and count calories so that I'm AWARE of what I'm eating and how much I've eaten at the end of the day. I have a calorie "budget."

I think of dieting as deprivation. Weighing and measuring and tracking calories does not necessarily infer DEPRIVATION or a DIET MENTALITY.

Are you familiar with the names Robert Lustig, MD and Gary Taubes, PhD? Check them out on YouTube and Google them. Their research (controversial to many in the "establishment") may be of interest to you.

MoreBean13

Yep, she's terrible.

Aside from the dietitian, did the doc talk to you about medication for the hypertension while you're trying to lose the weight? Really you shouldn't let that go unchecked even in the short term, the vascular damage needs to be controlled.