Tuesday, August 30, 2011

Meeting with the Nutritionist, Part 1

I have a health professional who recommended I go speak with a nutritionist about my inability to lose weight. I think she's just sick of me whining about being uncomfortable in my own skin, Linkand we've ruled out thyroid. So I said ok, but was reticent because doing my own research has pointed me in a non-Conventional Wisdom direction, as you know.

It went about as well as I expected, and I know the nutritionist could tell I wasn't exactly thrilled, though I tried to be polite. She seemed a little disturbed at the end of the appointment that a light bulb hadn't gone off in my head and I wasn't completely convinced by her points. I told her I would give her tips a try.

Even if I disagree, I'll give it a try.

So here's how it went down. I prepped for this meeting by printing out 4 months' worth of food logs and meticulously writing down my workout on each log day (since SparkPeople doesn't have a report function that lets you print nutritional data and workouts. Get on that, SparkPeople.)

First off, I give the nutritionist credit for generally respecting the fact that I don't want to eat grains, especially wheat. I think it helps that gluten intolerance is getting a lot of exposure in the media nowadays. She was ok with that and we turned to my food charts. She said, "Hmm, well you're averaging about 1500-1800 calories per day based on these. Would you say that's about right?" I nodded. Then she said the thing that made me lose hope, which is, "Well, what it really comes down to is making sure you're taking in fewer calories than you're expending."

Oh really? That's all there is to it? Why didn't I think of that?!

So we went through my standard day, assuming I get up in the morning to work out. It was actually interesting to see when I eat. I usually do pretty good during the day with only eating when I'm actually hungry. It's when faced with a treat at home in the evening that I cave. Which is why I minimize the number of treats we actually have in our home. Which is why Jason always complains that there's nothing to snack on. To him I say, you're welcome.

Anyway, a standard day that begins with a swim goes like this:

6 AM: pre-workout snack of half of a Larabar (to stave off the working out with no food migraine. I get those. Not everyone does. Pre-workout eating is a personal decision, I believe.)

8:30-9 AM: breakfast (usually 4 eggs I cook before work and bring in with me in a 1/2 T of butter. Sometimes I'll have a piece of fruit or half a cup of milk with the eggs, depending on how hungry I am from my swim.)

12:30-1 PM: lunch (big salad. Greens + protein (chicken/tuna/salmon/turkey) + 1-2 T gorgonzola or feta cheese + 1/2-1 oz. sunflower seeds + 1 T. balsamic vinaigrette/bleu cheese/some other vinaigrette dressing)

4 PM: snack (apple/banana/carrots and hummus/celery and natural peanut butter/raw nuts)

7:30-8 PM: dinner (protein + pile of vegetables + possibly some sweet potato or beets)

If I don't work out, I don't eat the pre-workout Larabar (but I might have a Larabar for my afternoon snack), and I usually lose the piece of fruit with breakfast.

So we went through my meals and discussed what I should do differently. First, breakfast. She asked me, "Why do you eat 4 eggs?" Yes, the emphasis was there. I responded that I'm usually starving after swimming and I've found that keeps me satiated until lunch. Now, let's be clear. If we're talking about calories, my breakfasts usually wind up being around 400 calories. I think that's pretty reasonable for breakfast, considering that I have often just swam laps for 45-60 minutes.

Here's how she wants me to change it: lose 2 of the egg yolks. She made some comment about cholesterol. NEVER MIND that the link between dietary cholesterol and blood cholesterol has been basically negated, so much so that it's even been reported in popular media. NEVER MIND that despite my massive egg intake I actually have low cholesterol (which I told her).

Also, she suggested I add some veggies to the eggs and plan to eat my optional piece of fruit.

This morning I didn't swim so no Larabar. I prepared my eggs and dutifully dumped 2 egg yolks down the drain. Sad. So pretty and yellow and full of nutrients. I didn't have any veggies on hand to throw in easily. I'll work on that for tomorrow. I ate my eggs, and then I ate a banana mid-morning because I was hungry.

(I'm just going to note - usually with 4 eggs, I'm not hungry mid-morning on days I don't work out)

I found it kind of hilarious that after redoing my breakfast plan, she proceeded to draw me a little timeline showing that we use the energy in carbohydrates first, and protein gives more satiety. Then as a quiet side note she tacked on fat at the end and mentioned that it satiates the most and provides energy the longest.

Her chart:




(the horizontal line represents a few hours)

So, wait. She basically just told me to add in more carbohydrates to my breakfast, even though I told her the protein and fat keeps me satiated and even though her very own diagram shows that energy from carbohydrates is used first and used quickly. I feel like there's a huge disconnect between what she feels like is the correct thing to say and what even she knows is correct science.

It seems to me that it would make more sense to use such a diagram with someone who eats a bagel or a couple doughnuts for breakfast every day. Not for someone who is just fine with a nice protein and fat combo every morning.

Tomorrow: Part 2 in which we discuss lunch, dinner and shaving around 150 calories per day. Also, I am moderately insulted by the nutritionist.


Joanne said...

I would just give what she suggests the good ol' college try so-to-speak. (Who knows, maybe she knows something she's not saying?). Then, if it doesn't work - she'll see see it directly and can make tweaks where necessary from there? I'd say since nothing else to this point has had the desired effect, it can't hurt to try her suggestions...

I have a good friend (former roommate) who was finishing her Masters in Nutrition and she said something to me one day that has stuck with me ever since: She said that an 1800 calorie diet is the right target for most people - that you don't want to go above it (unless you're an athlete or training for a marathon or something beyond usual exercise) OR BELOW it, and that if you're religiously sticking (no frills or gimmicks) to that 1800 caloric intake and the weight isn't falling - it's highly likely the exercise that needs the attention. Now I've never used swimming as a means of exercise and I'm positive it's good exercise, but you might consider changing it up a bit? Your body adapts to exercise and if you're doing the same sort of exercise over and over again - the muscles aren't getting as efficient of a workout. Take it all with a grain of salt - I don't know your routine - just what I read here; but I would hate to see you shave more calories off your diet when that might not be the route to focus on. Maybe personal trainer instead?

Amazon Alanna said...

I could see why you'd be insulted. You obviously went in there with a larger knowledge base than most of her clients and probably didn't think you'd catch her inconsistencies.

I'm with the previous poster, if you don't see results, get a personal trainer who knows a lot about sports injuries, since you tend to have sore parts off and on.