I'm a Dietitian - ask me anything

[doesthisseemright]

This one may be a bit dull but ask away.

UserThenLotsOfNumbers, there sure is an anti-inflammatory diet recommendation for UC! It's not the one that you see which eliminates lots of food groups but richer in whole fruits and vegetables, whole grains, legumes, and lean protein. These foods contain nutrients believed to combat the inflammatory process.
So you would need to include omega 3 fats, richly coloured fruit and vegetables, have a probiotic, include quercetins (in onions, apples, blueberries, cherries, broccoli, spinach, kale) and vitamin d. You would need to reduce triggers like processed foods and sugar.

The only problem with UC is you need to adapt around your symptoms, as you would imagine, so would need to be tinkered with to individualise.

Oh, yes and this is absolutely general information. Any specific information or plans for ANYONE would need to include a full assessment of medical history and meds, symptoms etc etc - just want to make that clear.

Ooh I have a question - this is a silly one.

So, the 5 a day guidelines say only 1 portion of a given fruit or vegetable count towards your 5 a day (presumably to encourage variety and not eating a pound of tomatoes or 5 bananas and saying OK job done)

If I eat three peppers chopped up, one red, one yellow and one green - does that count as 3 portions cos they're different colours, or 1 portion cos they're all peppers

This is just to settle an argument!!

watelego, no I don't believe so. Type 1 Diabetes is an autoimmune condition and Type 2 is, typically, associated with weight and insulin resistance and pancreatic failure. The school of thought on this, just now, is that eating sugar doesn't directly cause Diabetes unless it contributes to weight gain or is part of a generally messy diet/ lifestyle.

Thank you so much - really appreciate your advice.

FancyADoughnut, any dietary "plan" or lifestyle changes to reduce weight would include a Dietitian looking at the whole picture and adapting to fit. I always get a look at who is in the household, routines, cooking ability, shopping etc and work from there.

As mentioned above, many Dietitians are now working on non-diet approaches so may not give a "diet plan" but would more likely do work on eating family meals but learning about portions, hunger, fullness and eating what the body needs in terms of nutrition. In saying that, it's an individual approach, and some need and do better with plans so these will be adapted to your life. Hopefully, a healthy eating plan will work with the whole family anyway, just with guidelines on portion needs. We do try to make these user-friendly and take into account family and time restrictions. Its a kinder approach than just telling you to go paleo or suchlike.

Good morning @

I normally have my toast about 10/11am and that normally keeps me going until dinner at around 4/5pm. I’m just getting so frustrated with it all! Thank you xx

Failed to tag @doesthisseemright x

bananafish81, gosh that's a tricky one! I think 1/2 pepper on average is a portion and the colours do have slightly different nutrition (red is great!) but I'm going to opt for the portions needing to be different. Sorry if that doesn't land on your side of the argument.
(Also would be chuffed if someone was eating large portions of peppers if they had no other vegetables though)

@doesthisseemright I have another thread going actually and would love your or any other dietitians option of what you would advise ? My thread I started was me saying where Iv started to take apple cider vinegar out of desperation.... in the morning my stomach is relatively flat, by he end of the day I look nearly 9 months pregnant. Have looked at intolerances and I can’t eat a lot of dairy or wheat so avoid these as much as I can... I also take pro biotics. Gp just say IBS but I don’t agree as I don’t have any other issues, no toileting problems etc?

KittyVonCatsworth, you will need some more lean protein so I would try having some lean meat and salad/vegetables at lunch. Keep your sweet potato to a fist size or 1/4 plate and work on some resistance and muscle building training.
Oh, and I know it sounds naff but really do try to also look at outcomes rather than weight loss so you have something positive coming out of your hard work- things like nutritional quality, enjoyable activity, well being etc.

My 15 month old daughter has CPMA we started the milk ladder a couple of weeks ago and she reacted. How long would you recommend leaving it before trying again?

@doesthisseemright thank you so much for replying ❤️ I absolutely agree about the other benefits, I’m really enjoying not feeling bloated and nasty as I did after takeaways and processed food. My skin is glowing as well! Thanks again x

Ilmb , that's where it gets into a tricky area for Dietitians. If someone came to me with symptoms, I would first make sure that they had a full diagnosis before proceeding. This is especially so for gut issues. When people come in to see me with IBS, it's important to have ruled out so many other conditions. Bloating can be associated with a few things but it comes down to two things - 1) has your GP now diagnosed IBS? If so, that's where I would focus on and 2) are you not convinced that's a diagnosis/are you concerned its more? If so, Id head back and ask them to just rule out anything else for your peace of mind.

That being said, if that's a definitive diagnosis of IBS, which would be odd with just one symptom if you look at the diagnostic criteria, then I would go via the NICE guideline approach - phase 1 , general lifestyle changes and watching resistant fibre etc and if no help then 2) fodmap elimination and challenge diet (and then maybe consider SIBO)

In the interest of ethics and safety, once again going to put a disclaimer here that if you are concerned about a health or weight issue, you are best going for a full assessment with a medical professional or Dietitian to take into account all of your medical and other issues. All information here is general.

pandabear13, I'm afraid that one would be as discussed and recommended by a supervising Dietitian. (sorry).

If one has a significant amount of weight to lose, does losing it gradually decrease the deflated loose skin effect, or is it essentially the same whatever speed the weight is lost? Thanks!

Thank you for answering doesthisseem.

Can eating too much fruit cause weight gain? My colleague eats punnets of cherries/strawberries/plums/apricots/grapes/nectarines/blueberries following the Slimming World plan but is gaining weight instead of losing. She's disheartened having stuck rigidly to the SW plan.

Thanks for replying. I am looking at the no diet thing and reading the book you mentioned at the beginning.

I have another question. How important is it to really chew your food? I like hot food and tend to eat quickly before it can go cold and therefore don't actually chew it much. Does it really make much of a difference?

One of my DC (older teen) is very underweight and their bmi has now dropped to 14.4. This is predominantly through controlling what they eat.
Their GP is aware of this (he was the one that weighed them) but as my DC doesn't think it's an issue he won't refer them on.
Any snippets of advice to help me help them please?

Just popping off for a bit to do some writing work but saw your post Notabee . It reads like this is an issue and you need to grab it NOW. You don't want this to escalate so you need a second opinion and to be referred on to a cahms service. Also, consider a psychologist. That's a really low weight and the fact there is restricting would make me very concerned. Evidence shows the earlier you can address this, the better the outcomes.

@doesthisseemright thank you for taking the time to reply.
I'll call the GP's today and see what I can do. It's hard when they're over 16 so you can't set anything up on their behalf (other than another doctors appointment - which I'll make sure I do get).
They've been slim for a while but they're so skinny now.

Any advice for managing reactive hypoglycemia? Mine seems to be affected by hormone changes during my cycle too.

If it's not too late, two questions:

My 4 year old dd is very fussy about food, seemingly texture based, and eats almost no vegetables. She will eat leek in risotto, the odd tinned carrot and nibble broccoli under duress but that's it. She likes some fruits (is off skin again though) and drinks milk/loves dairy. She loves anything salty so olives, capers, cheese. Do we need to worry? She does seem to be increasingly narrowing her repertoire and prefers easy to eat food like cottage/fish pie (but will pick out any veg in it) so summer is proving to be a challenge!

2nd, I've had various dx of lactose intolerance, ibs over the years. Coeliac test was negative but I do seem affected by gluten - but also by commercial gluten substitutes with lots of starch (especially cake ) and sugary/fatty foods. I'm on a waiting list for NHS dietician but I'm so fed up with not knowing how what I put in my mouth will affect me next! Any ideas? I'm thinking going private might be the best thing.

Thanks!

Two more questions, please. We are elderly.

DW has been placed on a low residue diet (no fibre, no raw veg/salad nor fruit) whilst waiting for an operation to remove part of her sigmoid colon. Some suggestions as to types of food to eat for essential nutrients would be much appreciated.

Fructose. I eat a lot fruit, which contains a lot of fructose (sugar) as well as fibre. Apparently, there's lots of sugar in honey as well, which is favourite of mine. Some guidance on amount of fruit/honey would also be appreciated.

Thank you. Brilliant thread by the way.