experiences with nutritionist

[Guest guest]

Hi, everyone -- it's been a while since I posted anything, but I have

been an avid reader of everyone else's contributions.

I'm puzzling over a recent experience and wonder if others have had

one like it. In February, I started working with a wellness center

at a major hospital in the city where I live for the purpose of

embarking on a medically monitored weight loss program. The team

consists of a nutritionist, a m.d., a psychologist, and a

physiotherapist.

Up until I started working with the nutritionist, I had been doing

reasonably well controlling my bg levels with diet and medications. I

take Avandia and Metformin, and I eat a fairly stable diet -- steel

cut oatmeal and fruit in the morning, a salad for lunch, grilled meat

and veggies for dinner, fruit in the afternoon and in the evening. I

was limiting fruit to things I knew wouldn't egregiously blow my bg

levels -- apples, pears, bananas. The only carbs are the oatmeal in

the morning and whatever carbs I get from eating veggies like peas

and corn, which I do on occasion. I wasn't eating bread or pasta or

potatoes or anything else. My A1c's were coming in just below 7 for

nearly two years. I ain't saying I was perfect about this food plan,

but I was pretty consistent. I didn't feel deprived and have been

feeling healthier in general for it.

The nutritionist I was working with, however, insisted that I add

more carbs to my diet -- at least two pieces of whole grain bread a

day, brown rice or whole grain pasta in the evening. She also wanted

me to add protein in the morning (which I did by adding a slice or

two of canadian bacon), and she said I could and should eat every

kind of fruit -- including grapes, oranges and other types that I

know to have high sugar contents.

I should mention that I'm very picky about the breads and pastas I

buy, only 100% whole grains and only if a sweetener is low on the

list of ingredients. I don't eat white potatoes at all, but at her

urging, have added a small yam or half a large one.

Suddenly, my bg levels started to change. I test before every meal,

and my bg leves are usually between 105 and 120, sometimes a tad

higher in the morning due to the dawn effect. Once I started eating

as the dietician recommended, however, my bg levels started moving

up. They began to hover between 140 and 180, one day even going

above 200.

The nutritionist knows I'm diabetic, and she knows I was eating a

food plan that was controlling the diabetes. I'd assumed she knows

something about the dietary needs of a diabetic. Now I'm confused as

to how to proceed -- do I go back to what I know works and what kept

me quite happy, or do I do as she says and live with the higher

levels.

As anyone else ever gotten this advice from a dietician?

I'd appreciate any feedback anyone has...

vicky

[Guest guest]

Maybe you need a different nutritionist. Maybe it is not you but

the nutritionist that is wrong. Medical authorities can be wrong.

Why risk your eyesight, etc., because of what one nutritionist

says. Maybe you could find a different one that is more aware of

your needs.

>

> Hi, everyone -- it's been a while since I posted anything, but I

have

> been an avid reader of everyone else's contributions.

>

> I'm puzzling over a recent experience and wonder if others have

had

> one like it. In February, I started working with a wellness

center

> at a major hospital in the city where I live for the purpose of

> embarking on a medically monitored weight loss program. The team

> consists of a nutritionist, a m.d., a psychologist, and a

> physiotherapist.

>

> Up until I started working with the nutritionist, I had been doing

> reasonably well controlling my bg levels with diet and

medications. I

> take Avandia and Metformin, and I eat a fairly stable diet --

steel

> cut oatmeal and fruit in the morning, a salad for lunch, grilled

meat

> and veggies for dinner, fruit in the afternoon and in the

evening. I

> was limiting fruit to things I knew wouldn't egregiously blow my

bg

> levels -- apples, pears, bananas. The only carbs are the oatmeal

in

> the morning and whatever carbs I get from eating veggies like peas

> and corn, which I do on occasion. I wasn't eating bread or pasta

or

> potatoes or anything else. My A1c's were coming in just below 7

for

> nearly two years. I ain't saying I was perfect about this food

plan,

> but I was pretty consistent. I didn't feel deprived and have been

> feeling healthier in general for it.

>

> The nutritionist I was working with, however, insisted that I add

> more carbs to my diet -- at least two pieces of whole grain bread

a

> day, brown rice or whole grain pasta in the evening. She also

wanted

> me to add protein in the morning (which I did by adding a slice or

> two of canadian bacon), and she said I could and should eat every

> kind of fruit -- including grapes, oranges and other types that I

> know to have high sugar contents.

>

> I should mention that I'm very picky about the breads and pastas

I

> buy, only 100% whole grains and only if a sweetener is low on the

> list of ingredients. I don't eat white potatoes at all, but at

her

> urging, have added a small yam or half a large one.

>

> Suddenly, my bg levels started to change. I test before every

meal,

> and my bg leves are usually between 105 and 120, sometimes a tad

> higher in the morning due to the dawn effect. Once I started

eating

> as the dietician recommended, however, my bg levels started moving

> up. They began to hover between 140 and 180, one day even going

> above 200.

>

> The nutritionist knows I'm diabetic, and she knows I was eating a

> food plan that was controlling the diabetes. I'd assumed she

knows

> something about the dietary needs of a diabetic. Now I'm confused

as

> to how to proceed -- do I go back to what I know works and what

kept

> me quite happy, or do I do as she says and live with the higher

> levels.

>

> As anyone else ever gotten this advice from a dietician?

>

> I'd appreciate any feedback anyone has...

>

> vicky

>

[Guest guest]

I honestly have to say, get a second opinion. OR, let her know that You do

not feel comfortable eating this way. My guess is that she is trying to

help you get more fiber in your diet. Ask about a fiber " replacement " . Eat

the foods that you feel comfortable eating.

seems that you have tried it, and its not working for you. Let her (or him)

know and ask for an alternitave (other than more meds).

Many dieticians have a " set " diet that they have to follow. It's what they

are told to use. This may be the case. Dont give up.

I had the same problem with the nutritionalist that I saw. She was obvously

a vegitarian, and thought that everyone in the world needed to be one too.

My family eats meat. We raise our own beef. we hunt. Nothing is going to

change that. I ended up coming home and throwing her " diet " out. I talked

to my brother in law (who is also a nutritionalist) and he gave me a better

eating plan. I lost weight, and felt good doing it =)

I eat lots and lots of veggies! I can sit and eat a whole bag (the 5 oz

size) of salad with 2 tbsp of dressing mixed with a little water. mmmmm...

=) good stuff!

Eat what you can eat and still be healthy. Ask if there is a reason that

you 'have' to eat these foods.

Angelia in OR

----- Original Message -----

From: " rhetorvic "

>

> As anyone else ever gotten this advice from a dietician?

>

> I'd appreciate any feedback anyone has...

>

> vicky

[Guest guest]

>

>

> The nutritionist knows I'm diabetic, and she knows I was eating a

> food plan that was controlling the diabetes. I'd assumed she knows

> something about the dietary needs of a diabetic. Now I'm confused as

> to how to proceed -- do I go back to what I know works and what kept

> me quite happy, or do I do as she says and live with the higher

> levels.

I'm confused on this concept. First and foremost, I'm a human being.

Aren't my nutritional needs the same as any other human being? Of course

there are differences for activity levels... I know I don't need the same

foods as a marathon runner or power lifter. But all in all, just because I

have diabetes doesn't mean I need less protein, more vitamin C or other

changes in my nutritional needs as a human being.

The nature of my disease means that my body doesn't produce

(adequate) insulin or lacks the ability to effectively use insulin; to

utilize the food that I consume.

In some cases, the problem is resolved (to a degree at least) by reducing

the amount of food consumed, if that amount is in excess of what I need.

However, since there is a 'malfunction' in this process I don't agree that

eating to avoid meds is 100% the appropriate approach. Certainly not to the

condemnation of all nutritionists (which seems to be the trend on this

list).

Rather than assume that your nutritionist doesn't know what he/she is

talking about, I suggest you find out why they are recommending you make the

changes requested. It makes more sense to me that you tell them what these

changes to your diet do to your blood sugar and find out if that is the

intent. And, if it is, why?

There are other things needed in your diet than to simply control carbs.

Fiber has been proven to help prevent many forms of cancer. Maybe this is

the concern? Whole grains contain carbs, but they also contain fiber.

Fruits of various colors contain various antioxidents (the red and dark

colored fruits from what I understand... this would include grapes).

I can't help but think that building your nutritional intake on a finite

group of foods simply with your eye to a glucometer might be a short-sighted

approach.

I urge you to talk to them and find out why they make the recommendations

they do, rather than just assume they are wrong.

Mike

[Guest guest]

Great reply Mike!

There has to be a reason...

Angelia in OR

----- Original Message -----

From: " Mike "

I urge you to talk to them and find out why they make the recommendations

they do, rather than just assume they are wrong.

Mike

[Guest guest]

In a message dated 5/26/2006 12:29:41 A.M. Eastern Daylight Time,

rhetorvic@... writes:

The nutritionist knows I'm diabetic, and she knows I was eating a

food plan that was controlling the diabetes. I'd assumed she knows

something about the dietary needs of a diabetic. Now I'm confused as

to how to proceed -- do I go back to what I know works and what kept

me quite happy, or do I do as she says and live with the higher

levels.

Hi Vicky,

If I had followed the food plan my educator gave me, I would probably be on

double meds and even insulin by now. I'm not putting down meds, just stating

that my educator wanted me to eat too much food.

The only person that can tell you how and what to eat is yourself and your

meter. It is your body, you know how you feel, so I suggest you stick with a

food plan that you are comfortable with and one that is working for you.

hugs

Eunice

[Guest guest]

Just figures doentt it? I threw out all the stuff my nutritionist told me

to do because it kept my bg high. Ultimately you are in charge of yourself

not your nutrionist. If you bg level were stable with what you were doing

why change??? If it aint broke dont fix it.

sharon

experiences with nutritionist

Hi, everyone -- it's been a while since I posted anything, but I have

been an avid reader of everyone else's contributions.

I'm puzzling over a recent experience and wonder if others have had

one like it. In February, I started working with a wellness center

at a major hospital in the city where I live for the purpose of

embarking on a medically monitored weight loss program. The team

consists of a nutritionist, a m.d., a psychologist, and a

physiotherapist.

Up until I started working with the nutritionist, I had been doing

reasonably well controlling my bg levels with diet and medications. I

take Avandia and Metformin, and I eat a fairly stable diet -- steel

cut oatmeal and fruit in the morning, a salad for lunch, grilled meat

and veggies for dinner, fruit in the afternoon and in the evening. I

was limiting fruit to things I knew wouldn't egregiously blow my bg

levels -- apples, pears, bananas. The only carbs are the oatmeal in

the morning and whatever carbs I get from eating veggies like peas

and corn, which I do on occasion. I wasn't eating bread or pasta or

potatoes or anything else. My A1c's were coming in just below 7 for

nearly two years. I ain't saying I was perfect about this food plan,

but I was pretty consistent. I didn't feel deprived and have been

feeling healthier in general for it.

The nutritionist I was working with, however, insisted that I add

more carbs to my diet -- at least two pieces of whole grain bread a

day, brown rice or whole grain pasta in the evening. She also wanted

me to add protein in the morning (which I did by adding a slice or

two of canadian bacon), and she said I could and should eat every

kind of fruit -- including grapes, oranges and other types that I

know to have high sugar contents.

I should mention that I'm very picky about the breads and pastas I

buy, only 100% whole grains and only if a sweetener is low on the

list of ingredients. I don't eat white potatoes at all, but at her

urging, have added a small yam or half a large one.

Suddenly, my bg levels started to change. I test before every meal,

and my bg leves are usually between 105 and 120, sometimes a tad

higher in the morning due to the dawn effect. Once I started eating

as the dietician recommended, however, my bg levels started moving

up. They began to hover between 140 and 180, one day even going

above 200.

The nutritionist knows I'm diabetic, and she knows I was eating a

food plan that was controlling the diabetes. I'd assumed she knows

something about the dietary needs of a diabetic. Now I'm confused as

to how to proceed -- do I go back to what I know works and what kept

me quite happy, or do I do as she says and live with the higher

levels.

As anyone else ever gotten this advice from a dietician?

I'd appreciate any feedback anyone has...

vicky

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[Guest guest]

Vicky,

One thing I forgot to ask was is this a program where they are going

to require you to keep food diaries that you have to hand in each

week? Some wellness centers do that.

[Guest guest]

Vicky,

yes, I am getting the same general message from the nutritionist at the endo

team I use. I don't understand it. Maybe I will at some point, but it is

frustrating me too. Maybe when/if I figure out how to add more fiber it

will fall into place? And also when/if I figure out a way to eat smaller

but more meals each day too? Exercise is not an option for me.

JUDITH

> The nutritionist I was working with, however, insisted that I add

> more carbs to my diet -- at least two pieces of whole grain bread a

> day, brown rice or whole grain pasta in the evening. She also wanted

> me to add protein in the morning (which I did by adding a slice or

> two of canadian bacon), and she said I could and should eat every

> kind of fruit -- including grapes, oranges and other types that I

> know to have high sugar contents.

>

> I should mention that I'm very picky about the breads and pastas I

> buy, only 100% whole grains and only if a sweetener is low on the

> list of ingredients. I don't eat white potatoes at all, but at her

> urging, have added a small yam or half a large one.

>

> Suddenly, my bg levels started to change. I test before every meal,

> and my bg leves are usually between 105 and 120, sometimes a tad

> higher in the morning due to the dawn effect. Once I started eating

> as the dietician recommended, however, my bg levels started moving

> up. They began to hover between 140 and 180, one day even going

> above 200.

>

> The nutritionist knows I'm diabetic, and she knows I was eating a

> food plan that was controlling the diabetes. I'd assumed she knows

> something about the dietary needs of a diabetic. Now I'm confused as

> to how to proceed -- do I go back to what I know works and what kept

> me quite happy, or do I do as she says and live with the higher

> levels.

>

> As anyone else ever gotten this advice from a dietician?

>

> I'd appreciate any feedback anyone has...

>

> vicky

>

--

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[Guest guest]

rhetorvic rhetorvic@...> wrote:

> As anyone else ever gotten this advice from a dietician?

Yes, the dieticians and doctors in the hospital (a hospital specialised

in treating diabetics) where I was IP suggested a diet high in " good

carbs " including fruits and a lower protein and fat intake.

The people in my class were all IDDM though, T1 or T2. Every patient has

to attend classes about diabetes, use of insulin and nutrition in this

hospital. There were individual meetings with the patients if they asked

for it. The dieticians there are nutritionists with an additional

training in diabetics.

It seems to be fairly new though that nutritionists suggest more carbs

and less protein and fat. However, I can only speak for IDDM patients.

Mohira

[Guest guest]

Mike schappaugh@...> wrote:

> I can't help but think that building your nutritional intake on a finite

> group of foods simply with your eye to a glucometer might be a short-sighted

> approach.

>

> I urge you to talk to them and find out why they make the recommendations

> they do, rather than just assume they are wrong.

I think you made a very good point here.

Mohira

[Guest guest]

>

>

> Subject: experiences with nutritionist

As anyone else ever gotten this advice from a dietician?

************

Yes, and that is why I will never go back. She said to eat 60 carbs per

meal. And I still have to pay for that " advice " .

Kathy

[Guest guest]

>

>

> Yes, and that is why I will never go back. She said to eat 60 carbs per

> meal. And I still have to pay for that " advice " .

That 'advice' was given with specific reason I'm sure. Did you ever ask

why? Did you ask questions about how that carb amount impacted your blood

sugar and why it was recommended?

I know we all think we know better than persions trained in these specific

fields, however doesn't it seem wise to *ASK* questions about the advice

they are giving, and *WHY* they are doing it? Maybe there is something we

can learn from it?

Also, it certainly doesn't do future people going through these classes any

good if feedback isn't provided.

Mike

[Guest guest]

>>>>She said to eat 60 carbs. And I still have to pay for

that " advice " . That 'advice' was given with specific reason I'm

sure. Did you ever ask why? Did you ask questions about how that

carb amount impacted your blood sugar and why it was recommended?

When I was first diagnosed, the dietitian told me that it was carbs

that was causing my diabetes. Then

she told me to eat 45 carbs per meal. I was not overweight and that

was more carbs than I was already eating. I told her that I didn't

understand, if it was carbs that was causing me the problem, then why

would I eat more? She just looked at me like I was being a smart-a__

and continued with the 45 grams of carbs per meal bit. I never went

back. They are just telling you what they are taught and they really

don't have a clue.

Maybe we need to go to a diabetic dietitian........ Kat

[Guest guest]

Mike schappaugh@...> wrote:

> That 'advice' was given with specific reason I'm sure. Did you ever ask

> why? Did you ask questions about how that carb amount impacted your blood

> sugar and why it was recommended?

>

> I know we all think we know better than persions trained in these specific

> fields, however doesn't it seem wise to *ASK* questions about the advice

> they are giving, and *WHY* they are doing it? Maybe there is something we

> can learn from it?

>

> Also, it certainly doesn't do future people going through these classes any

> good if feedback isn't provided.

You're absolutely right. Instead of just complaining about how

incompetent nutritionists are, ask about their decisions and why they

gave you this advice.

I'm still surprised how differently diabetes seems to be treated in

different countries when it comes to nutrition.

Best wishes

M.

[Guest guest]

katakaniki kpaulmt@...> wrote:

> Maybe we need to go to a diabetic dietitian...

Definitely. Go to dieticians who had special training!

[Guest guest]

> I'm still surprised how differently diabetes seems to be treated in

> different countries when it comes to nutrition.

>

> Best wishes

> M.

>

What is different in other countries regarding nutrition and diabetes?

[Guest guest]

mkcheerfulheart joyfulhearts4him@...> wrote:

> What is different in other countries regarding nutrition and diabetes?

The recommended amount of carbs seems to be somewhat different. I was

told that a diabetic can eat everything a " normal " person *should* eat,

too. No different food pyramid or something. There are no strict diet

plans anymore on which you have to count carbs (older diabetics in the

hospital remembered these days with some kind of horror). During my

hospital stay I was on 14.5 KE a day which means 145 grams of carbs and

a lot of patients had even more. If I would've wanted more bread for

breakfast or more fruit for snacks it would've been no problem. In class

patients were told to limit fat intake and also to limit protein intake

a bit instead of carbs. However, I can only speak for IDDM patients.

There were Type 1 and 2 IDDM in class.

I've seen people on various lists who are limited to low amounts of

carbs. However, I do not know if they limited the carbs themselves

because they read about it in books or if it was recommened by doctors

or dieticians.

Best wishes

M.

[Guest guest]

>

> Here's something cute:

>

> http://www.diabetes.org/all-about-diabetes/chan_eng/i2/i2p6.htm

>

> " You're the Director!

> Diabetes puts you in the director's chair. You're in charge of the

> daily decisions that help keep your blood sugar on track -- deciding

> what and how much to eat, remembering to take your medicine, doing

> blood sugar checks, and choosing to be more active. Think of the

> health care team as your Assistant Directors. "

You know, I understand the sentement here, but if you gave a 10 year old a

car, that doesn't make them a driver.

To make them a driver, you still need to educate them and even when they are

old enough and educated enough and have 'passed the tests' they STILL must

defer to a higher authority (i.e., the laws of the land, police and courts).

I prefer to think of my doctor as the 'CEO' while I'm the manager. It's up

to me to make sure that the directives of the CEO are implemented and

followed on a daily basis. AND.. like any good company, the CEO is always

available for consultation and is always someone that you can present new

ideas to and discuss alternative plans. But in the end, the CEO is

responsible for setting the course.

Mike

[Guest guest]

My teenage son was dx in October with type 1. He was told to eat a 'normal'

healthy diet. They went over the basics of nutrition and the only

difference for him vs a non diabetic was that they suggested he stick to the

same approx # of carbs for all bkfsts and then the same approx # carbs for

lunches, etc for all meals..so the insulin could be set to cover them.

Their reasoning for not limiting the total amount of carbs, etc was b/c he

is a growing teen but also b/c they didn't want to put him on a limiting

diet that he probably wouldn't be able to stick with over time. That makes

sense to me..for him. He is growing and he will be on insulin forever

anyway so the amount of insulin can cover the amt of carbs he eats. I can

see why someone with type 2 might want to limit carbs, etc in an effort to

control it thru diet and exercise.

Barbie

_____

From: diabetes [mailto:diabetes ] On Behalf

Of styxia@...

mkcheerfulheart joyfulhearts4him@...> wrote:

> What is different in other countries regarding nutrition and diabetes?

The recommended amount of carbs seems to be somewhat different. I was

told that a diabetic can eat everything a " normal " person *should* eat,

too. No different food pyramid or something. There are no strict diet

plans anymore on which you have to count carbs (older diabetics in the

hospital remembered these days with some kind of horror).

_____

[Guest guest]

>

> The recommended amount of carbs seems to be somewhat different. I was

> told that a diabetic can eat everything a " normal " person *should* eat,

> too. No different food pyramid or something.

It's pretty much the same here. The difference is like you mentioned

people are following books they read or research or other drs. A lot

have multiple health problems so it is more or less customized to fit

those health problems as well. I think some are finding they can't

eat just whatever everyone else eats. (although in beginning stages of

diabetes and those well controlled they very well can do this) Some

people react to things worse than others, and even if one could

tolerate certain carb amounts before, later in the stages of diabetes

they might not be able to. It just depends on how long a person has

had diabetes, what stage of progression their disease is in, and how

many other health issues they have. It also will depend on what meds

they use or if they are on insulin. It all varies so much.

I think the limits you notice people are imposing on themselves is

because they have figured out what works and doesn't. Some people

have allergies which throws into the diabetes ball park a totally

different way to handle it. Some have digestion issues; some thyroid

problems and the list could go on. So we are learning it is not a one

size fits all type of thing. But overall the standard recommendations

sound similar it's just that maybe you are noticing more people doing

their own thing.

It is interesting to find out what others are doing world wide though.

If you can eat whatever you want then that is great! Whatever works

for you. Don't feel like because you hear others doing something else

you would have to as well. What country are you in?

[Guest guest]

> My teenage son was dx in October with type 1. He was told to eat a

'normal'

> healthy diet.

Yes, teens and children with Type 1 are going to follow a different

regiment than a Type 2 adult would. Good point! Now we even have Type

1.5 so there's another story. A good dietician should be able to

customize a diet fit to the person's age, height, weight, and other

medical issues. A one size fits all diet/carb count would generally

fit a person who is normal, healthy and no other medical issues, but

throw in a few other heart issues, endocrinological problems,

menopause and a number of any other issues and it makes it a bit more

complicated. Senior citizens or the elderly in nursing homes are going

to have a whole set of different problems as well. Glad your son has

a good plan set in place. Hope he is doing well.

[Guest guest]

mkcheerfulheart joyfulhearts4him@...> wrote:

> Now we even have Type

> 1.5 so there's another story.

How exactly do you define Type 1.5?

[Guest guest]

mkcheerfulheart joyfulhearts4him@...> wrote:

> What country are you in?

Germany.

[Guest guest]

>

>

> Subject: Re: Re: experiences with nutritionist

>

>

I know we all think we know better than persions trained in these specific

fields, however doesn't it seem wise to *ASK* questions about the advice

they are giving, and *WHY* they are doing it? Maybe there is something we

can learn from it?

*********

No, I did not ask why. The reason I know it will not work for me is beacuse

that is more carbs than I was eating before I met with her. The only way I can

get my bs under 200 is to eat nothing but meat, cheese, and broccoli. I am on 3

medications and Lantus. Still over 250 most of the time. I go to an endo

Tuesday. I can't wait.

Kathy/NC