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Visit to a dietitian

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Old 02-27-2013, 01:24 PM   #1
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Default Visit to a dietitian

I found out that my insurance covers 6 visits a year to a dietitian for weight management, so I made an appointment with a woman recommended by a coworker.

There was quite a bit of paperwork--typical medical stuff, list of all medications, 4 day food log, recent blood work. I actually had all of that stuff (bloodwork was done a few weeks ago) and I track in MFP, so it was easy to print out a week of my food log.

I'm about 5'2" tall, and currently at 215 lbs. I've lost 15 lbs since I started this Jan 7th. My triglycerides are high. My other cholesterol is in range and my diabetes is under control. The "in range" and "under control" stuff is new--my blood work would have been much different in December. I think it might take longer for triglycerides to come down than the other cholesterol numbers, so I'm hoping for improvement when we re-do the bloodwork in 6 months.

So, here's what she told me:
  • Increase my protein intake to 81g/day
  • Decrease carbs to no more than 55% of my daily intake
  • Stay at 1400-1500 calories (MFP has me at a net of 1260, so that's pretty close to what she's recommending). She calculated my maintenance level at 2400, so that number is in keeping with my 2 lbs/week loss so far
  • Continue with my walking (about 40 minutes a day, in 3 chunks)
  • Increase fiber to 25g/day (which will help my elimination issues)
  • Check to be sure my calcium has D3 in it, and add a supplement if it doesn't
  • Increase my Omega-3
  • Add ground flaxseed to recipes where possible to fight inflammation
  • Drink a bottle of water every day (I currently am a diet coke addict)
  • Drink hot water with lemon to stimulate bowels
Looking at my food diary, upping my protein is going to be hard. I'm going to have to search some low carb recipes out to reverse the carb/protein amounts in my breakfasts in particular.

We talked about the need to not be overly restrictive so that one goes off their diet completely--she was glad to hear that I'd planned treats for my big baking weekend (this weekend!), because no one can make a 12x18 pan of brownies and not eat any!

She was also concerned about my hunger levels and she wanted me to pay attention to that. I'm really not hungry as long as I eat at a reasonable time. This is no problem during the week but a bit harder on the weekends where my schedule isn't as regular.

I really liked her--she seemed competent, informed, and responsive. She's a believe in small steps at a time rather than wholesale change. Although that list seems long, they're all sort of intertwined and quite do-able. I'm sure we'll address my reliance on processed frozen meals at a future appointment, but this should keep me going for the next 4 weeks.

Just thought I'd share. Anyone else have dietitian's advise they'd like to share?
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Old 02-27-2013, 01:43 PM   #2
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That seems pretty similar to what a dietician told me last year, except I dont hav eany problems with bloodwork except extremely low vitamin D levels (now I take a 5000 iu supplement most days).

Have you tried Nutiva organic hemp protein powder? the high fiber version has 80 cal, 12g carb, 11g protein, 12g fiber and only 1g sugar per 3 tbsp serving. I mix it with 8 oz of almond milk and a banana and its delicious. If you leave out the banana, your carb-protein-fiber ratio would be super. You could also just mix it into other regular foods (like your brownies, lol).
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Old 02-27-2013, 03:56 PM   #3
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I'm also struggling with elimination issues due to gluten intolerance and how its hidden in seemingly innocent food. I once read to drink 2 warm/hot glasses of water as soon as I wake up (after I weigh), to help wake up my system and to let it know sleep is over, and its time to begin our day. Especially as I tend to eat smaller breakfasts, my body isn't getting the wake up signal. It seems to be helping. Good luck!
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Old 02-27-2013, 04:09 PM   #4
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Great advice!

I recently saw a dietician. She lectured my about not eating enough veggies lol
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Old 02-27-2013, 08:57 PM   #5
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Default re:

Her advice seems reasonable to me.

A word on triglycerides and cholesterol. Sometimes high cholesterol and triglycerides can be side effects of a certain medicines. It might be worthwhile to look into any you're on and see if that's possible, especially if it doesn't come down over time.

Some people just have high cholesterol too and require medication. I took mine about 50lbs in (6 months) and it hadn't changed. That was a year ago so I'm hoping to see an improvement this year. I started out taking omega 3 - just as your nutritionist recommends, but decided to stop, so I could get a TRUE picture of what my levels are.

I wish I knew a how long it takes for those levels to go down, but unfortunately I don't.
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Old 02-27-2013, 09:24 PM   #6
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Quote:
Originally Posted by Vex View Post
A word on triglycerides and cholesterol. Sometimes high cholesterol and triglycerides can be side effects of a certain medicines. It might be worthwhile to look into any you're on and see if that's possible, especially if it doesn't come down over time.

Some people just have high cholesterol too and require medication.
I already take meds for cholesterol and diabetes--it's the whole metabolic syndrome thing (although I don't have high blood pressure). I was thrilled with the 'high' level they are--because it's lower than they've been!
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Old 03-02-2013, 05:17 PM   #7
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I have Celiac disease...and taking magnesium (worked up slowly to 1000mg.) has kept me quite 'regular'. I also use flaxseed (have a muffin made from it every other day)...I was categorized Metabolic syndrome at the start of my weightloss journey, but not now, and no more Metformin for me.

My extremely high cholesterol was because I was untreated for hypothyroidism...and one of the dieticians who I was working with at the time suggested I be tested (and not TSH...Free T4, Free T3)...it fell like a rock in water once my levels were brought to normal.

I'm a little wait and see on my tri glys..on lowcarb they were under 40...but know they will start coming up as I've switched to a no gluten/no sugar, but calorie counting and more carbs.
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Old 03-02-2013, 09:50 PM   #8
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Eating a maximum of 10 grams of saturated fat per day (recommended by dietician) really lowers the cholesterol. No meds required!
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Old 03-03-2013, 12:58 AM   #9
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Thanks for posting- I have an appointment with a dietician on the 12th, so its interesting for me to see what was talked about in your appointment.
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Old 03-07-2013, 10:46 PM   #10
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I never even considered my insurance paying for a dietician visit! Did you just call and ask your insurance provider? I would love to go and see what one has to say. Those that have been, is that who ordered the blood test to check your vit D, etc, levels?
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Old 03-07-2013, 11:07 PM   #11
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I was actually looking at the website for other information and saw it listed there as a benefit.

My PCP had ordered a whole host of annual blood work a few weeks earlier so I had all that information.

It was well worth my time--and I've adjusted my eating to fit her recommendations.
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