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MWHIGGINS's Photo MWHIGGINS Posts: 9,630
5/7/20 8:24 P

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Rusty, take a copy of what you just wrote with you when you meet with the dietician,nutritionist. Give it to him or her to read right after you introduce yourself and lay out your goals. This will help him/her know your mindset and what types of plan adjustments you are willing to take on.

I agree that all of these medical pros are tools that we use and I hope one day to have the successes you have... I'd love to get off my meds and not have to stick myself and prick my fingers all the time.

One success at a time, One day at a time


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2/19/20 12:36 A



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I guess it is a fine line that you walk. Some people with diabetes, following a very low carb diet have excellent results all round, however there are others who will have to eat a little more carbs to prevent lows and keep their blood sugars on an even keel. Maybe she will suggest smaller meals more frequently instead of raising your carbs.

Why are you worried that she may suggest eating some whole-grains?

Kris

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RUSTY_WOODS Posts: 1,014
2/18/20 11:47 P

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I saw my doctor today, and I told her I have been experiencing low blood sugars, so she recommended a dietitian. So I will be seeing one in a week or so.

I eat low carb. By that, I mean under 25 g of carbs daily. With meds, that keeps my blood sugars low enough, but at times, my diet does too good of a job. I'm willing to go up to 35 g a day, and I can eat more veggies to get there, but worried that they will suggest grains, or dairy products I don't eat. I eat eggs, meat and veggies, and occasionally nuts, or berries. This doesn't leave much room for adjustments, but I am looking for some ideas on how to add another 10 g of carbs into my diet, as well as space them out, so I get less low blood sugars, while I work to get back off the diabetes meds. I was off meds completely from 2011-16, with A1C's in the 5.0-5.5 range.. but the past year has seen a rise, due to not following the plan. I am back on plan, but while my numbers are great, I don't want low blood sugars every day or 2.. a few more carbs should help, but I want to discuss it with a professional. I hope they can work with me, on MY diet, since they are supposed to be able to help with any meal plan, not just the one they prefer, but I have limitations on what they can do, since I am not showing up with a blank slate, asking for them to design a diet I should eat.. I am simply looking for how they can help me eat the diet I eat, and it has worked in the past, but usually results in low blood sugars, until my doctor cuts my diabetic pills. That takes a while to gain their trust that you will stay on plan, so you don't have unchecked blood sugars.

We'll see if the dietitian can do anything for me, or tries to switch me to a diet they prefer. I know what I want, and will lay that out.. what I will, or will not do, and see if we can work together to solve my problems. If not, I will thank them for their time, and move on.

Medical professionals are tools. We work with them to improve our health. To do that, we have to agree on the plan, and move forward, then follow up, to see if we get the results we are looking for. If they do not share your plan, or think you are wrong, you have to decide if you agree with them, and will change.. if not, working together is a waste of time for both of you. Find someone who you can agree with.

That may be a LC dietitian, but my doctor thinks I'll be fine with any dietitian, and they can work with me on my diet. I hope so.



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2/15/20 9:58 P



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If your Registered Dietitian isn't any more help than that, I would be seeking the input from another one who IS prepared to work with you.

Make sure you weigh all of your food for increased accuracy and enter it into the Nutrition Tracker, then it will give you the % - you will be able to tweak accordingly.

If your Dr told you to cut out dairy, wheat and meat after a colonoscopy, I would definitely be inclined to do that, because depending on what the issue is, you could do long-lasting damage. My son-in-law has Celiac's Disease, and he was told not even a little bit for that reason. He does 'sneak' a little in occasionally, but ends up suffering the physical consequences.

A Registered Dietitian (one who actually properly works WITH you) should be able to help you in that department, too.

Where are you getting the B12 Supplements from? Ensure that they are from a reputable source, because not all supplements are therapeutic strength, or even in a properly absorbed form. Make sure that you consume Vitamin C with the B12, and talk with your Dr again, about it, because there are other ways that they can increase it, including increasing the dose. My sister's were prescribed, but there were times she needed and an infusion to bring it up to an appropriate level.

Also, perhaps you could talk with your Dr about a liquid meal substitute, because they have all the nutrients that your body requires. It may be that you have that in addition to your meals.

Edited by: SLIMMERKIWI at: 2/15/2020 (22:01)
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QUERIDAANA's Photo QUERIDAANA Posts: 1,316
2/15/20 9:20 P

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I need more guidance in creating a meal plan than my dietician gives me, as well. I cannot translate her recommendations to eat certain % of carbs, proteins, and fats into meals. I want her recommendations on what to eat so that I don’t suffer deficits, but she cannot help me put together meals. Maybe because her employer offers a nutrition bootcamp with more structure, and she is probably not allowed to compete with it. I am relying on the Spark People meal planner to plan my meals and have been having good results. My colonoscopy doctor told me to cut out dairy, wheat, and meat, but when I did, my hemoglobin plummeted despite taking B12 supplements and probiotics. So I added them back.

It's the journey. We can do this.

Mary


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MILLER-S's Photo MILLER-S Posts: 25,519
1/2/20 7:12 A

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Hi, no you didn't overstep and I appreciate all your suggestions and advice. Since my husband retired last February, he does help in the kitchen sometimes. He actually enjoys cooking, but hasn't learned to cook many things yet. He's good at cooking breakfast, but for our dinner meals, he will mostly help (if I ask) while I do the main parts.

The second dietician I met with actually did give me the amounts of carbs and protein we should have each meal, but that still left me feeling like I wanted more direction, i.e., actually meal plans with recipes. I checked out the websites Kris provided last night and have already found some recipes I want to try.

I do steam vegetables in the microwave, use rotisserie chickens about once a week, and have learned to cook more in my slow cooker. My husband really likes salads, so that does help.

Unfortunately, my husband does not monitor his blood sugar levels. He does get his A1c checked every six months at his doctor's office. He takes Metformin and I really wish he would monitor his blood sugar as he should. That said, at least he is now walking and has stopped eating bread and sweets. He sees his doctor later today and we're hoping the A1c results from the blood work he had done at the lab last week will show good results from his efforts.

We recently switched to Medicare and also have Medicare Supplemental policies. I believe they do have nurses and wellness coaches - we just haven't yet taken advantage of them. That is a good idea.

I'm very glad your pulmonary embolism was caught in time and that you have been able to reduce your A1c so much. I wish you continued good health.

Thanks again for all your help.

Miller






Edited by: MILLER-S at: 1/2/2020 (07:13)
Miller

"Create the kind of self that you will be happy to live with all your life."

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1/1/20 10:13 P

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Miller, first let me apologize if I overstep as that isn’t my intention. I’m speaking from a roughly similar experience where my husband hates being in the kitchen but knows we need to be there to keep me healthy and he being very overwhelmed by having to process that knowledge.

Miller unless you rely solely on frozen foods I’m not sure a 2 week rotation will work. Veggies & fruits come and go into season. Then there is the issue of availability and affordability. Not to mention just getting bored with same meals.

Also I’m assuming your husband’s blood sugar levels are monitored so it may be difficult to use such restriction when his body may fluctuate if he’s stressed or sick.

But I do understand what you are shooting for as I struggled with the same thing and it seemed no one could answer my questions so that I could translate their answers to my everyday life. I’m prediabetic so getting it right to lose weight and lower my A1c is essential.

I finally got some answers when I asked roughly how many carbs, protein, sodium, fat & fiber I should have each meal. I’d tried some of the stuff one the diabetic websites and didn’t find it useful because I tend to cook whole food from scratch. It really sounds like a lot of work but it isn’t. I pre-cook& freeze a lot.

Also if you have insurance like UHC or Cigna take advantage of phone consultations with nurses or wellness coaching. Doing that helped me find tools to lose about 65 lbs and drop my A1c from 6.1 to 5.8. Checking in with your coach will help you fine tune what works and what doesn’t.

My point is you’re going to have to cook but can you get your husband in the kitchen with you?. Start small and work at adding things. For example, steam in bag veggies (without extra sauces) and a lean protein are simple. Salads beyond simple basic garden salad are very good and easy. Don’t think you have to cook everyday. Rotisserie chicken is your friend. Crockpots are your friend. I’ve not got on board with instantpots but many speak very highly of them.

Those websites you were provided and starting small so that you’re not overwhelmed by this really does help. That’s why I asked if your husband can help. It helps when you’re not doing this alone and so that you don’t feel so consumed by being your husband’s cook especially if you don’t want to be in the kitchen.

I by no means have an ideal marriage but I had a pulmonary embolism that was caught just in time. My husband hates cooking but knows he doesn’t want me to get that ill again. So he helps me in kitchen, as sous chef (rough chopping, grating cheese, washing & peeling veggies), shopping, & modifying recipes to make them healthy. This keeps me on track with eating better. It has helped me tremendously and it lets him feel less anxious about my health.

At the very least it won’t hurt to ask for his help. Then discuss how he might assist and then let him.


MILLER-S's Photo MILLER-S Posts: 25,519
1/1/20 8:44 P

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Thanks, Kris!!!! emoticon emoticon emoticon

Miller

"Create the kind of self that you will be happy to live with all your life."

"Praise is like sunlight to the human spirit: we cannot flower and grow without it." ~unknown

"Let me not miss all that I am by punishing myself for what I am not." - unknown

"The rest of your life is being shaped right now by the dreams you have, the choices you make, & the person you decide to be."~unknown


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1/1/20 7:55 P



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Miller - a 2 week rotating menu would be a bit restrictive on a permanent basis, however if you could stretch it out to 3 or 4 weeks it would be a lot better. It doesn't mean that you can only eat the one meal in the 3 or 4 week basis, but it gives the opportunity to have something different which adds to a good balance of nutrients.

This link is from the Diabetes site.
www.diabetesfoodhub.org/all-recipes.html?p
rev_scroll=891


This Heart Healthy one is from Mayo Clinic and totally suitable for Diabetics:
www.mayoclinic.org/healthy-lifestyle/recip
es/heart-healthy-recipes/rcs-20077163


I suggest you look through and see what interests you and print off the recipes, then put them in an order so that you are getting some variety from one day to the next.

Kris xxx

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MILLER-S's Photo MILLER-S Posts: 25,519
1/1/20 7:11 P

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I've been to two registered dieticians and was not happy with either one. I think I'm expecting them to provide something they just don't provide.

I answered their questions and listened to their recommendations, but ALSO told them I wanted 14 days of meals (with recipes) for diabetics that my husband and I could eat every two weeks. The second dietician I saw said, "Oh, you Really don't want to eat the same 14 meals for the rest of your life." And I said, "Yes, I REALLY do!"

I want the guesswork taken out of it and just be told what to do so I don't have to worry that the meals I prepare are going to hasten my diabetic husband's need for insulin (or death). I absolutely HATE to cook and just need 14 days of worth of good healthy diabetic meal ideas (with recipes) that would appeal to us.

I never could figure out why that was so hard for them to do... especially for what I was paying them.
emoticon

Miller

"Create the kind of self that you will be happy to live with all your life."

"Praise is like sunlight to the human spirit: we cannot flower and grow without it." ~unknown

"Let me not miss all that I am by punishing myself for what I am not." - unknown

"The rest of your life is being shaped right now by the dreams you have, the choices you make, & the person you decide to be."~unknown


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ROSEAVON's Photo ROSEAVON Posts: 168
12/15/19 8:49 P

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I found a registered dietician because not only was I working to lose weight but having BP and heart related issues too, so I needed someone who could give me the correlations between different foods, the drugs I was on, and how each was affecting the issues I was having. It cost $350 BUT can be reimbursed by insurance apparently.

One thing I will say, is that you really have to get to know your own body ... and actually LISTEN to it. It almost seems ridiculous as to how well I have had to get to know mine.

You need someone who will work with you and take into account all your idiosyncracies, not just expect you to fall into a certain plan or stick to a one-size-fits-all eat -this-don't-eat-that. And that takes into account your food likes, so that you can always have them as part of your food intake. Someone who can help you adjust home cooked foods to lower fat/salt/sugar whatever and help you manage take-out splurges.

For instance, my passions are Indian and Chinese food, and I have seriously had to adjust them for my health so as not to experience severe fluctuations in heart rate and blood pressure. I now get take out, and I divvy a take out into 5 protions and freeze. When I have one, I add a portion of peas and carrots, or stir fry veg, to it. What affects me most - the sodium, fat and the metabolic stuff that goes with spicy food - is lessened to a much lower level and the added veg bulks up the meal, and adds nutrients and food value in a good way.

A good clinical dietician can help you figure out how to work around any health issues/drug side effects by helping you understand the relationships between them and certain foods, and by examining your diet and see which may be affecting you in adverse ways.

I wish you well in finding the right person for you. It took me a few weeks of calling places and talking to different nutritionists and dieticians before I found the one who was right for me, and quite happy to work with me the way I needed her to



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8/21/19 9:29 P

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redmanchronic - good luck with finding a plan/concept that works for you. I've never done well with ready-made plans. Tried Dr. Fung's plan, didn't work for me, felt so sick all the time.



Nobody can have it all, you can only have what you love most.


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8/20/19 4:46 A

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@remanchronic, another poster in another post provided this regarding Dr Jason Fung's approach. Don’t get turned off because Dr Fung is a nephrologist who treats diabetic patients. The information is still good.

https://www.dietdoctor.com/intermittent-fasting/questions-and-answers

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8/20/19 4:11 A

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@redmanchronic one last thing. you do need to pay attention to your level of hunger. You should always listen to what your body is telling you as that is part of the process. But you will need to determine if you’re actually hungry or eating out of habit or for some other non-hunger related reason. Begin each meal with water or unsweetened d tea (sounds awful but it really isn’t).

If you can swing it, read Dr Jason Fung’s Obesity Code book. But I warn you it’s long and he breaks down quite a bit of the studies that have been done on diet and exercise over more than 50 years. You can probably find him on YouTube as well. But book is better.

BTW, I was always skeptical of Fung because I thought, OH GAWD NOT ANOTHER LERSON TELLING ME WHAT I SHOULD DO TO LOSE WEIGHT!!! But it’s really good information but definitely goes against the grained what’s normally presented for healthy eating.

I did use a nutritionist but I really had to tweak the info given as I moved along my journey. Also it’s ABSOLUTELY OK to go against a lot of the recommendations especially calories in and calories out and in reader exercise. Sure that’s great but it only gets you so far. It’s not always that simple. If you want to understand more about why that’s where reading Fung may help.

Good luck. It’s good you’re tackling this before you get too far overweight and recognized you have an issue with gain. Be good to you.

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8/20/19 3:58 A

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@redmanchronic what you’re asking for should be the norm. But do go into this with some info on what you want to achieve and ask for where you need help. Do NOT be afraid to speak up. You’re paying this person for a service after all. But also keep in mind that many are trained and will give you information based on the FDA food guidelines. That does not work for everyone because it may be too high in carbs from grains and fruit. What may work better is to choose portions by what’s on your plate. Go for higher percentages of veggies and lean proteins. You will need to tweak things a bit as you go along. That’s part of the process. Also make your changes so that they are not too extreme but are changes you can live with for life.

If you don’t cook you’re going to have to learn how to at least do the basics.

REDMANCHRONIC's Photo REDMANCHRONIC Posts: 502
8/17/19 6:29 P

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I started gaining weight the minute I was discharged from the Army. It got really out of control and discussed it with my PCP at the VA who suggested I go to see a dietitian/nutritionist.

I am now with the third one because the first one did nothing but 'fat shame' me and the second one didn't seem to care. They only looked into their computer screen and never looked at me when we were in conversation.

What I would like to do with my dietitian is to work together and develop a meal plan. Not just this many calories per meal....but actual meals showing portions and calorie count. Once I have that, I can focus on that rather than let my level of hunger dictate what I will eat.

Am I asking too much? All those years in the military, I learned to follow training schedules on a day to day basis. This meant I always knew what I was supposed to be doing.

http://www.facebook.com/redmanchronic

'If you don't wanna, you ain't gonna.' - Red Hoffman


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8/17/19 10:40 A

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One of the things I love about SparkPeople is the opportunity to get an education on healthy eating and living habits. I do a lot of reading and trial and error on my own and SP's Nutrition Tracker with its ability to add nutrients and log in one's own foods and their numbers is one of the reasons I'm back here. I find the experimenting interesting, even exciting emoticon and that is often enough to keep me at it, keep me thinking and learning and improving my health.

I think a dietician/nutritionist can be a good, personal opportunity for a bit of education, kind of like a doctor; but what they have to say, their approach and what they offer has to be looked at based on one's own knowledge and interests and willingness to try some of the things they have to offer or challenge them or read about them one's self and make up one's own mind. I think one of the goals is to know one's own body well so one can apply all the various information out there and see what works or is worthwhile and what is not. Like everything else, what is "learned" about human nutrition, what is the "in" thing at the moment, the new diet, etc. changes over time and our job is to evaluate and take what is useful to us from all the stuff coming at our windshield.

MYJUNIEMOON's Photo MYJUNIEMOON Posts: 6,071
8/14/19 4:30 P

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Over 30 years ago I was 35-40 pounds overweight and 30 years old, I was diagnosed with high blood pressure and my physician referred me to a nutritionist. It was absolutely the best 90 minutes spent in my life. She asked me for a typical day's menu. Then she told me I would never be able to eat like that ever again after walking out of her clinic.

I spent the next 10 minutes crying. She educated me on the evil of fat-free products (they replace the taste you crave with worse fillers). She educated me on how to shop in grocery stores (outer aisles only). She educated me on how to read labels, the disguises sodium and sweeteners use for labeling purposes and how to order when dining out at popular restaurants.

She taught me how to navigate food and that it's a lifestyle, not a diet. Then she introduced me and gave me a copy of The DASH Diet.

I owe her my life. I am fit for 64, still eating a huge salad for one meal every day....and running in 5Ks. Am I perfect? Not even! Am I grateful? Yes!

And, Oh! I'm off that high blood pressure medicine.


Edited by: MYJUNIEMOON at: 8/14/2019 (16:37)
~ Candace ~ Midland, Texas
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MRSLIVINGWELL's Photo MRSLIVINGWELL Posts: 823
7/29/19 9:33 A

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Sadly, the dietician I went to for advice about how to cook for a diabetic husband only included reduction in sugar intake (use splenda and other non sugar sweeteners)--which ignores the big issue of fat found in cells that prevents insulin from entering and working. No mention about how to make recipes low-fat. She lumped Good carbs and bad carbs together as "don't eat carbs."

DH A1C has been reduced from 7.0 steadily down to prediabetic and we hope soon NOT diabetic by following the Whole foods Plant based No oil diet recommended by Drs. McDougall, Barnard, Gregor,Fuhrman, Esselstyne ....It works and is healthy for your arteries, heart and kidneys as well.

Mrslivingwell
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It's not about perfect, it's about effort. Jillian Michaels


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OLDZELDA13's Photo OLDZELDA13 Posts: 2,758
7/26/19 2:26 A

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@SLIMMERKIWI Sad. I guess the lesson I would take from this is to use your best thoughts and intuition as to whether or not this is someone here to help, or just earning a paycheck. Just like other areas - some graduate at the top of their class and some at the bottom. So glad you found one that helped.

Life is good.

Dream as if you'll live forever; live as if you'll die today.

"Don't confront me with my failures...I have not forgotten them."-Jackson Browne


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7/25/19 5:37 A



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@OLDZELDA13 OMG - THAT Dietitian could have been the same one as one I was initially referred to for a health condition many years ago. She wouldn't look at what I ate or listen to me. Instead she assumed and refused to talk about *MY* diet. She discharged me (she was a Hospital Dietitian) telling my GP that I was non-compliant and not interested in applying her recommendations. She didn't recommend anything, and how can you when you aren't prepared to find out about the client's lifestyle/diet. It was a load of clap trap and fortunately my GP was aware. A few years later when I was referred to the one who I adored, I happened to mention this other Dietitian to her. She said that she was well known in the system for exactly the same reasons I disliked her and also said that most of her clients felt the same way as me. She also said "fortunately she is only working part-time now"

Kris

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OLDZELDA13's Photo OLDZELDA13 Posts: 2,758
7/25/19 5:10 A

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If I was looking for a dietitian, I would know what I expected from them and they would work within any parameters I had. The last one I spoke with was made available to me and others that were attending rehabilitation sessions for a medical condition. Her initial consult with me was mainly cutting down on sweets that she assumed I was having. She never bothered to ask what I was eating or what my weaknesses were. I know my issue is portion control. I seldom have sweets or desserts and if sugar was to disappear from this earth, I would be fine. Those assumptions left me thinking I would be better off without her help and judgment.

Life is good.

Dream as if you'll live forever; live as if you'll die today.

"Don't confront me with my failures...I have not forgotten them."-Jackson Browne


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RENAHF's Photo RENAHF Posts: 42
7/15/19 5:55 P

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I am a naturopath so I set a high bar for what I would expect from a dietician/nutritionist. When I went to a coach to get my weight loss started, part of his "package" was a number of appointments with his nutritionist. She really wasn't very good, but I didn't really need her to help me create a diet in any case; I just needed the coaching support to get myself back on track.

A good nutritionist can help you to create a food plan (not a diet, but a food plan for living) that fits YOUR needs - with an eye to your health issues as well as just incorporating things that you like to eat - and no food group should be cut out. Minimized, yes, but not cut out.



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ENGINEERMOM's Photo ENGINEERMOM Posts: 1,184
6/25/19 5:10 P

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I worked with a registered dietitian in Seattle who was very helpful in identifying ways to tweak my diet to address some health concerns. She was well-versed in the local food movement, in addition to dealing with endocrin disorders via diet (I have genetically high cholesterol).

1. Be very clear what your ultimate goal is, what is "non-negotiable" for you right now, and that you are willing to put in the work (recording diet, learning new cooking methods, etc.). For example, my "non-negotiable" was I won't eliminate entire food groups from my diet. Period. I'm perfectly willing to limit items, or learn to make swaps that will help my health, but you are not going to talk this cheese-loving omnivore into becoming a vegan. I'm also not willing to cook against the seasons - no salads in January, no winter squash in June. In addition to everything being shipped ridiculous distances, stuff just tastes better in season!

2. Don't be afraid to "fire" your provider if things aren't working out. Sometimes there are personality clashes, or your provider just isn't as educated in a particular area as you need. If possible, keep things civil and ask for a referral to another provider who can better serve your needs.

Take life one day at a time - enjoy today before you worry about tomorrow.


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MCFLUBBER1's Photo MCFLUBBER1 Posts: 13
6/24/19 4:28 P

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I've enjoyed this conversation. It's been helpful. Thanks for sharing.



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6/21/19 5:09 A



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@LADIASTER If you manually enter in your ingredients AND you track trans fats, you will see what you are wanting to know. You can do this by going to "Tools and Settings" in your Nutrition tracker and selecting Fatty Acids. Remember to save this before you leave.

Kris

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6/20/19 11:16 A

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What I need from a dietician is the formula for figuring the amount of sat fat in a recipe. I cut out a recipe from the newspaper and it has all of the nutrition except for sat fat. Help.

Go Hogs!


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TRUEPEACENIK's Photo TRUEPEACENIK Posts: 1,318
6/20/19 10:43 A

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I think “what you want/what are your expectations” is a question to be answered before any appointment.
Massage, nutritionist, therapist, etc.

So what do you want?
What do you expect the professional to do?
And mind reading isn’t an answer.

Wake up every day knowing you make the decision to begin your journey anew.

This choice in this moment defines now.
What is your now?

Making do or saving every cent you can? Join us on team LIVING LIFE ON A SHOESTRING teams.sparkpeople.com/LLife


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FOXGLOVE999 SparkPoints: (30,644)
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6/20/19 9:56 A

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To everyone who has gotten help from nutritionist/dieticians, I'm happy for you, I wish it was that way for everyone.

But I'm tired of being told that I should import a large portion of my calories from tropical regions because coconut everything. I live in Oregon, I shouldn't "need" to import anything. I'm okay with importing spices, seasoning, small indulgences, but not most of my diet.

Thanks to all encouraging me with my endeavors. I get so discouraged.

Nobody can have it all, you can only have what you love most.


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INTOTHENEW's Photo INTOTHENEW Posts: 734
6/19/19 6:12 P

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“I have 80 acres and the desire to produce most of my food from this land, so that is what I'm going to do.”

That is really refreshing to hear.

Well over 50% of my diet comes from my property, my hands, when I am at home. That is upwards of 75% this time of year.

Work has me traveling a bit, I’ve learned to navigate that rather well.

Step away from the barcode. Lol

There is no bad food, only bad cooks.
JEANKNEE's Photo JEANKNEE Posts: 22,905
6/19/19 12:43 P

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For me, I am looking for someone to help me learn to recognize which foods do and do not support my health and well-being. Elimination diets have been a part of that process.

I would also like assistance in identifying any nutrient gaps and learning what I can do to rectify the situation.

I have worked with a couple of nutritionists during the course of my life. Both of them have supported my process well.


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Initial Goal Weight, 144
Current Goal Weight, 120

"Believe me, your body has the ability to restore itself to perfect health, once you eliminate the foods and other forces that prevent it from healing." ~ Steven R. Gundry, MD

"I'd like to dispel once and for all the myth that any single diet approach works for every individual." ~ Peter J. D'Adamo, ND


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6/18/19 8:44 A

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URBANREDNEK - your response is pretty similar to how I feel and what I was looking for, instead all that I have been offered are cookie cutter approaches not taking into account any personal issues or preferences.

I am tired of medical professionals that just don't help. I keep trying and am forever disappointed and upset by them.

I am fortunate as well to have the time to figure things out myself, and I guess that is going to have to be enough. I have 80 acres and the desire to produce most of my food from this land, so that is what I'm going to do.

Nobody can have it all, you can only have what you love most.


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SLIMMERKIWI's Photo SLIMMERKIWI SparkPoints: (336,785)
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6/18/19 7:18 A



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Sometimes we NEED a Registered Dietitian in person, rather than online. I had a Registered Dietitian for a few years and saw her regularly for monitoring.

After taking into account my medical situation including weight, height and blood results, AND the severe pain, AND after looking a some of my Nutrition Tracker printouts, she was able to identify WHY I was having great difficulty in even maintaining weight (very gradually creeping up). She initially gave me a calorie to aim for (not a range)

I started to lose weight. When I went back about a month later and took the printouts for every day. I found she didn't really need to ask any questions, but was able to make a couple suggestions re tweaking. Mind you, she also stated that she had never had a patient who had been able to provide very accurate information that she needed and it made it a lot easier for her. She also stated that she wished her other patients did the same.

If I were you at that initial appointment I would state:

* I want to lose weight but need help

* I would like to be able to enjoy the foods I like without having to cut them totally out, so help me find ways to accommodate this.

* What calorie range is best for me

If you have multiple health issues, ensure that your Dietitian is taking ALL of them into account. My sister is a Diabetic and was referred to a Registered Dietitian. She was told to NOT count calories, but she was told to eat x amount of carbs. She also wouldn't take into account her other health issues, such as the low fat diet she had been recommended to eat re Gall Bladder issues and Pancreatitis.

Some Dietitians are excellent, such as the one I had, but some ..... well, there is good and not so good in every profession.

Good luck,
Kris

Co-Moderator Dealing with Depression
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ndividual.asp?gid=953


Team Leader Essential Tremors :-) (Benign and Familial) www.sparkpeople.com/myspark/groups_i
ndividual.asp?gid=30225


Co-Leader Crohn's Can't Stop Me
www.sparkpeople.com/myspark/groups_i
ndividual.asp?gid=17464


I am not a Dr - please check with your qualified Health Professional for a diagnosis and treatment plan


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NITEMAN3D's Photo NITEMAN3D Posts: 23,851
6/18/19 4:11 A

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Becky Hand is my nutritionist. I study her writings and videos right here on SparkPeople and put them into action (for free). I do this because when I came here I quickly recognized the Spark Method as a balanced eating plan that made logical sense to me. There are times I don't agree with Becky or one of the other advisors here, but I stick with it and make compromises and do workarounds that keep me on point and that point is to maintain a calorie deficit to lose weight and maintain a good balance of macro and micronutrients. I never miss an appointment.

@URBANREDNEK makes a great case for the futility of finding that perfect advisor. I'm argumentative at best and do better on my own, so I'm not saying you should avoid going, but rather just a cautionary thought that what you've already discovered in your search for a great dietician may be that the search is unending?

I have presented some of the SparkPeople reports to various health professionals and the consensus seems uniformly positive. I guess my point is this... if you still feel the need, keep searching, but in the meantime, the tools you'll find here are pretty amazing and the program works if you do. Best of luck with your goals!

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Dave A.- South Central PA, USA

I still find each day too short for all the thoughts I want to think, all the walks I want to take, all the books I want to read, and all the friends I want to see. - John Burroughs


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URBANREDNEK Posts: 13,520
6/18/19 1:44 A

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Unfortunately, I haven't been able to find a dietitian with an approach that I would appreciate (but, fortunately, I have been able to figure it out for myself).

I would appreciate a dietitian who started out by requesting two weeks worth of tracking of my "normal" way of eating - with no attempt to change anything - to be sent in just prior to first appointment. Tracking could be digital or just notes on paper of what was eaten, in rough portions, at what time, and with notes on hunger level prior to eating, fullness level afterwards, hunger level 2 hours later, and a note or two on emotions / focus / situation with each eating episode. It would be great to start out by basing my "new normal" on the flavour / timing / satiation preferences that I've developed over my lifetime --- so that new additions aren't such massively jarring changes.

I would appreciate a dietitian asking for a copy of my most recent blood work, and reviewing my health status and history.

I would appreciate a dietitian asking what my health goals are, what is my definition of "healthy enough", what part food plays in my family / friends / social life / emotion life, what areas I am open to change in and which ones I'm not, what food allergies / restrictions / intolerance / dislikes I am aware of, and how much time I truly can commit each day to planning and preparing foods.

I would appreciate a dietitian who doesn't automatically focus on body weight over and above everything else, and dictate "going on a diet", or pay lip-service to the idea of gradual and permanent changes but pushes severe calorie restriction dieting regardless (with the apparently sincere belief that 1200 calories per day is the most important part of "nutrition").

I would appreciate a dietitian who is interested in working with me to choose foods that provide necessary amounts of all nutrients: vitamins and minerals and essential fatty acids --- and doesn't just focus on the calories and suggest taking a supplement. Bonus points for one who actually has read and can cite some of the research showing that supplements do not provide the equivalent health benefit of ingesting nutrients as natural parts of whole foods.

I would appreciate a dietitian who understands the local food supply systems, what is available, what limitations there are, and asks what importance various attributes of the system have in my choices (sustainable soil practices, pasturing of meat, local sourcing, seasonal supply, home storage abilities / space).

I would appreciate a dietitian who can take the information gathered, and come up with suggestions suited for my individual needs and preferences --- based on what would be a "healthy enough" approach for me in the long term (years - not weeks).

So far, dietitians I've met with have been strongly against the idea of NOT severely restricting calories (I was flat-out told that I was an idiot for suggesting gradually working my way down to a reasonable maintenance calorie range for what would be a healthy BMI --- and that only dropping to "dieting" range could be useful for getting healthier). I haven't found one yet who could come up with suggestions besides supplements to deal with my personal health issues (yet I have managed to correct deficiencies and maintain healthy levels purely with foods). I haven't found one who was conversant with food supply systems / agricultural innovation / soil limitations --- or thought that it was important to know about when trying to understand the actual nutrition of foods.

I am extremely fortunate in having enough time to devote to learning about my nutritional needs and the various aspects of food that are important to me and my personal health. If I did not have the time and the access to information - as well as a very supportive medical team - and had just attempted to follow the instructions from the Registered Dietitians... well, I strongly suspect that I would maybe have starved myself down a few pounds, but would have gone back to my "old normal" within a short period of time due to feeling basically like crap and loathing the restrictions. I would likely be still taking the supplements though - since they are "essential due to the health issues".

I do realize that what I would appreciate from a Registered Dietitian is time consuming and far beyond the scope of what insurance companies would be willing to pay for - so can understand why those I have met with are limited in what they provide in a "typical" appointment. Those I have met with truly did try their best to give a solid overview of the generic "dieting for better health" approach, with as much personalization as they had time to give.

Sir Terry Pratchett: "Science is not about building a body of known 'facts'. It is a method for asking awkward questions and subjecting them to a reality-check, thus avoiding the human tendency to believe whatever makes us feel good."

"The Inuit Paradox" ( discovermagazine.com/2004/oct/inuit-
paradox
): "...there are no essential foods—only essential nutrients. And humans can get those nutrients from diverse and eye-opening sources. "

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6/17/19 11:34 P

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So, I have had my share of appointments with each and the last one I spoke to asked me what I wanted from him. I wasn't prepared for that. His question wasn't sincere, it was a response to my unwillingness to exclude large food groups from my diet. But, it has caused me to evaluate that question.

If I was a dietician/nutritionist, my first question would be "what do you like to eat, how can we tweak that to make it healthier?

I am a big fan of harm reduction, and believe that perfection is the enemy of good.

What are you looking for in a dietician/nutritionist?

Nobody can have it all, you can only have what you love most.


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