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Professional Q&A: Advice from a Registered Dietitian

  • April 20, 2016
  • By Brittany
Professional Q&A: Advice from a Registered Dietitian

Hi all!  Welcome to the final installment of Professional Q&A!  In this series, I ask a health or fitness professional your most important questions to help YOU live your healthiest and best life.  So far we’ve had a health coach, a personal trainer, an athlete and a dermatologist.  I’m super excited for the final installment today from a registered dietitian.

Everyone, please welcome Melissa to the blog today.  She is a registered dietitian, certified diabetes educator, certified yoga instructor and blogs at The ValentineRD.  In case you didn’t know, a registered dietitian is a licensed healthcare professional who can give you advice on nutrition and diet. An RD has to go through an accredited bachelor’s degree program to satisfy the academic requirements and then must also pass an exam to be licensed.  A clinical component (i.e. working in the field) is also usually required.  Suffice to say, Melissa knows her stuff when it comes to food and nutrition.  She is also an all-around great person!  So let’s get started.

We hear a lot about added sugar in products that are often considered healthy (for example, yogurts, sports bars, etc).  When trying to decide what products to buy, how we know how much sugar is too much?

According to the American Heart Association, the guideline for the amount of added sugar per day for men is 9 teaspoons (150 calories) and for women, 6 teaspoons (100 calories).  Every gram of sugar is equal to 4 calories.  Added sugar is different than naturally occurring sugar.  Sugars that occur naturally found in foods like pure fruit (fructose) or pure milk (lactose) are not considered added sugars.  Added sugars do come into play with packaged foods.  In addition to reading labels to determine the number of servings in a product, it is important to read the ingredients on a food label.  Anything with an “ose” suffix indicates sugar.  Ingredients are listed in descending order of amount included in the product so that may play a part in helping you determine if the grams of sugar featured on the Nutrition Facts label are added vs. naturally occurring sugars.  The Nutrition Facts Label is up for a revamp and in July 2015, the FDA issued a Supplemental Proposed Rule about including %DV (Percent Daily Value) for Added Sugars in the newest iteration of the Nutrition Facts Label once the new version is approved.

Lately I’ve heard a lot about intermittent fasting, which involves eating a certain number of calories for a few days a week and then fasting (eating an extremely low number of calories) on other days of the week.  Is this a healthy practice and a good weight loss tool or a recipe for binge eating?

There has been some limited evidence has shown that Intermittent Fasting does have an effect on weight loss and reducing some negative risk factors but the evidence isn’t strong enough for me to recommend IF as a lifestyle.  IF is not a quick fix for weight loss and for those with diabetes or on daily medications, IF can be downright dangerous!  The physical side effects from very low calorie intake that accompany fast days (light headedness, dizziness and nauseated) may negatively affect daily activities like work, driving (!) and general interaction with other human beings (Hello, Oscar The Grouch!).
If you are an athlete of any kind (weekend warrior, fitness enthusiast or elite athlete), please know that IF has not been found to improve athletic performance to any significant degree.
As humans, we do engage in our own form of IF every day when we sleep and break the fast (hence, breakfast) after we wake.  This is the only form of IF that I would advocate as an RD.
[bctt tweet=”Get in the know with advice from a registered dietitian! #nutrition #diet #food” username=”MyOwnBalance”]
Juices and smoothies are often a staple of healthy diets but I know you are a big proponent of chewing your food.  What is a good approach if we want to add in juice or smoothies to our diets?
Juices and smoothies can be a part of any healthy intake.  Being conscious of the contents of what is in your juice or smoothies is important. For example: fruit, added sugars, sodium, preservatives, bacteria – especially if it is cold pressed juice and not pasteurized, etc, added vitamins/minerals/herbs which may be of a proprietary blend your juice/smoothie is packaged – these blends may not be approved by the FDA and/or interact with medications or possibly make your intake of specific vitamins.
Over the last few years we’ve become increasingly educated about sugars and sugar substitutes.  There has been a lot of back in forth as to which are better for you.  Besides using it in moderation, should we be using real sugar or a sugar substitute for example, in our morning coffee or baking?
In my opinion, real sugar or honey is the way to go.  Many of the sugar substitutes out there that many believe are natural, aren’t.  Agave is processed is akin to high fructose corn syrup.  Stevia, widely used in South American countries as sweetening alternative, is now being thought of as the go-to calorie free sweetener is not only also processed but minor research has shown that stevia may have negative effects on reproductive capacity (stevia leaf extracts were used by Guarani Indians in Paraguay as an oral contraceptive).  The FDA recognizes stevia as GRAS – Generally Recognized As Safe – which means it is exempt from any FDA approval for safety. More conclusive research is definitely needed when it comes to stevia.
In February 2016, CSPI (Center for Science in the Public Interest) downgraded the sweetener sucralose (Splenda) from “Caution” to “Avoid” because researchers found that it caused leukemia and blood cancers in mice.  In 2013, CSPI changed their recommendation on sucralose from “Safe” to “Caution”.  
Although we know that too much sugar isn’t good for us, there is a reason it’s thought of as nature’s candy.  As humans, we are born with an innate preference for sweet tastes but it is our culture that cultivates the desire for more, more, more, more, more when it comes to everything, including sugar.  We are a culture who believes we are virtuous when we restrict ourselves.  The drama of will power is removed when the emphasis on education of real food in appropriate portions comes into play.  (Sorry, I couldn’t help it).
When buying dairy products, we see options for nonfat, lowfat and full fat.  What should we consider when trying to make a healthy dairy choice?
While dairy products are not a necessity, they are a great source of protein and helps provide  three nutrients of public health concern: calcium, potassium and Vitamin D.  However, let it be known that vegetarians, vegans and those that are lactose intolerant can obtain their required intake of calcium from foods like green leafy vegetables, broccoli, soy and calcium fortified milks and juices.  A separate Vitamin D supplement is often required for those avoiding dairy (and for those without adequate exposure to sunlight).  Vitamin D deficiency is on the rise in general given the attention given to sun protection.
When it comes to dairy, there is definitely controversy when it comes to whether we recommend too much dairy in the US for daily consumption, the effect on acne, increasing cases of food allergy, weight control and cancer risk (protective against colorectal cancers but high calcium intake might increase prostate cancer risk) but we do know about dairy’s protective attributes for bone health, heart disease and possibly for diabetes risk.
In my practice, if dairy is part of someone’s intake, I recommend low to full fat dairy based upon their health profile.  If someone has risk factors for heart disease (family history, high cholesterol, etc.) or are managing their weight, I recommend low fat dairy.  When there is no fat in dairy (or any other product), the lack thereof is usually substituted with other things (sugar, chemicals or preservatives).  
Fat helps keep us satisfied and is necessary for many bodily functions.  A little fat helps reduce the intake of excess sugar or other ingredients.  If someone is underweight or an athlete, full fat dairy within adequate portion sizes is more than acceptable.

Many people who are lactose intolerant but deficient in calcium and/or Vitamin D can consume dairy products that contain low lactose (hard cheeses) or and even yogurt!  Bacteria in yogurt produce the enzyme lactase that helps break down the milk sugar lactose that those with lactose intolerance cannot digest (because their bodies do not produce or produce adequate lactase enzyme).

Thanks Melissa!  I know I’ve found your insight into these issues to be really enlightening.  Your points are really interesting!  Readers, if you want more of Melissa’s expertise, check out her nutrition services or follow her at:
Twitter: @mburton0214
Instagram: @mburton0214

Readers, what are some diet and nutrition questions you have?  Did you know that you should only consume 100g of added sugar a day!?  Are you a fan of low-fat or full-fat dairy?

By Brittany, April 20, 2016
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  • Kate |
    April 20, 2016

    I am registered dietitian myself and wouldn’t even add a word to Melissa’s answers. I think Q&A format with professionals is really excellent source of scientific based information. However there is nothing clearly white or clearly black when it comes to dietetics.

  • Holly
    April 28, 2016

    This is a really helpful blog post, Brittany. Melissa has given me some very good information. As a result some of my choices at home will be adjusted according to her recommendations. It will be good for me and good for the dieter in my home. Thanks!

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