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Old 12-23-2013, 10:35 AM   #1
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Visit to Nurtritionist today, worried...questions now

Ok, so i've been steadily moving along in induction for about 5 weeks now. Starting at 257+ and now down to about 235. I had made an appt 2 weeks ago with my physician and he was on board with what I had been doing. He just suggested I meet with the Practice's nutritionist just to let her know what I was doing.

I initially started with a relatively higher daily carb allowance (20 net) and have since moved down to really no more than 12-15 total carbs.

So I just got back from seeing the nutritionist now and while she had stated that she "didn't want to mess with things too much, because you're losing well", she did say she wanted to "tweak" a couple things.

She stated that I was in "ketoacidosis" (which from reading DANDR I dispute) and that my body was getting energy from Proteins/muscle mass and not as much from fat as I think. I mentioned ketosis-lipolysis and she didn't have much to say other than I wasn't breaking down as much fat as I thought.

Her suggestion was to keep my meals the same BUT to add two snacks, one between breakfast and lunch and one between lunch and dinner. In those snacks she said I needed to take in fruit carbs. A full serving, like an extra small banana, 3/4 cup of pineapple, 1 cup of raspberries, 1 1/4 cup strawberries, those types of things. These things are obviously NOT induction friendly at all.

She said she worries about my kidneys at such a low carb consumption level and that adding these fruits in will provide the right kind of energy between meals so my kidneys aren't working overtime and my body goes to fat reserves instead of muscle mass.

The problem is, each of those snacks is 15 grams of net carbs. That's an additional 30 net carbs a day! This will clearly knock me squarely out of ketosis. (maybe what she's looking for?) She also states that "I gurantee you that you will lose more fat and less protein/muscle mass this way".

She additionally wants me to eat 1oz of protein right before bed, like nuts. Says it will also keep my metabolism from trying to burn muscle mass in the overnight hours.

I dont want to undo what i've done these past 5 weeks, but I dont want to discount what a nutritionist says, and I certainly dont want to harm my kidneys.

Confused....any thoughts?
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Old 12-23-2013, 10:44 AM   #2
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Most nutritionist don't support Atkins. It goes against what they learned in school.

Do you have prior kidney problems or something that makes you worry about your kidneys?
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Old 12-23-2013, 10:44 AM   #3
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My thoughts..... the nutritionist doesn't know what she is talking about and should be ignored.

You are already under the advice (via the book) of a cardiologist that dedicated his life to studying the effects of a LC diet.

Who is more qualified?

ETA: if she doesn't know the difference between dietary ketosis and keto acidosis she shouldn't be practicing at all.

Boy do I sound cranky this morning.

Last edited by GME; 12-23-2013 at 10:47 AM..
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Old 12-23-2013, 10:55 AM   #4
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No, I do not have any kidney issues, and truthfully since i've been on induction i've felt better than i've felt in quite some time. Have more energy, and still, despite my low carb levels am taking in more veggies than I did previously. She didn't come out and straight up discount Atkins, in fact she called her modifications "Atkins-Light". Btw, Psmileyf I am also from the philly burbs. Western, to be exact.

I hear you GME, logic tells me to listen to Atkins. It just threw me for a loop a bit.
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Old 12-23-2013, 11:46 AM   #5
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Quote:
Originally Posted by GME View Post
My thoughts..... the nutritionist doesn't know what she is talking about and should be ignored.

You are already under the advice (via the book) of a cardiologist that dedicated his life to studying the effects of a LC diet.

Who is more qualified?

ETA: if she doesn't know the difference between dietary ketosis and keto acidosis she shouldn't be practicing at all.
This. Just exactly this.

Her ketoacidosis comment would have been a huge red flag for me. I would have known right then and there to just ignore her comments.

I would report back to the referring doctor that she was spreading dangerous misinformation, and that I was very concerned about what she is telling less informed people. If nothing else. She needs to read a freaking book!
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Old 12-24-2013, 01:38 AM   #6
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Did she or your physician happen to mention a change in your blood pH to reinforce what she was saying about your being in ketoacidosis? If not, then I believe she is just confused on the difference between ketosis (nutritional) and ketoacidosis. If this is the case, the fact that a health professional doesn't know the difference between ketoacidosis and nutritional ketosis is unsettling. I would speak to your physician and clarify the findings. If there is no support for a diagnosis of ketoacidosis, I would ignore her input...
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Old 12-24-2013, 02:20 AM   #7
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If she were in ketoacidosis, she would not be functioning normally. She would be in the hospital. It is not a state that one can simply push through. And it is not a state that non-type 1 diabetics can get into without doing more than simply eating LC.
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Old 12-24-2013, 07:31 AM   #8
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Quote:
Originally Posted by bluex View Post
No, I do not have any kidney issues, and truthfully since i've been on induction i've felt better than i've felt in quite some time. Have more energy, and still, despite my low carb levels am taking in more veggies than I did previously. She didn't come out and straight up discount Atkins, in fact she called her modifications "Atkins-Light". Btw, Psmileyf I am also from the philly burbs. Western, to be exact.

I hear you GME, logic tells me to listen to Atkins. It just threw me for a loop a bit.
I was raised in the north western suburbs, but I am south of the city now, almost into DE.

I think if you don't previously have any kidney problems, then you should not worry about it. There a ton of different medical opinions and studies to support every way of eating and to discount others.
I know I feel better on low carb and that my bloodwork has shown it is beneficial for me. So, I listen to my body and know this works for me, no matter what anyone else says.
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Old 12-24-2013, 12:59 PM   #9
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UGH! Dieticians are typically not educated on low carb eating, and she obviously proved it to you.

One of my doctors told me the other day that it's not impossible to eat low carb for more than 2 months without destroying your kidneys. I told her to look at my lab work that had been done 2 weeks prior. I've been low carb for 10 months, never leaving ketosis, and my kidneys are just fine.

My regular Dr does blood work on me every 3 months to make sure that every thing is fine, and my lab work has never been better. If you're concerned, I would just ask your regular dr to keep tabs on everything and be sure that everything is functioning properly. Once she sees how great your lab work is, that you're feeling better, and that you're losing weight, I'm sure you'll win her over to your way of thinking.
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Old 12-24-2013, 01:38 PM   #10
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I would provide her with some literature explaining the difference between nutritional ketosis and ketoacidosis, and then I would find a different nutritionist.

I would DEFINITELY NOT consume the high-carb snacks no matter how "healthy" they are: bananas, raisins, fruit in general, whole-grain anything, etc.
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Old 12-28-2013, 11:20 PM   #11
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I was seeing a nutritionist to stop binge eating. I let her know that I had done Atkins years ago and saw a lot of success, she said of course, but it's not good for your heart, yada yada. Fast forward a few months and a colitis diagnosis and she hands me a "new diet" packet from some biochemist... You guessed! It was Atkins with a different name, just for colitis.
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Old 12-29-2013, 02:09 AM   #12
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how did she determine that you were in what she thinks is "ketoacidosis"? Did she test your urine for ketones and sugar? Did she test your blood pH?

She doesn't sound like she knows the difference tween Ketosis and Ketoacidosis as one is just the extra production of ketones from fat burning and the later is an elevated blood pH due to excess Ketones or excess blood sugar in the presence of excess Ketones, both of which affect ph.

If your body is NOT able to process sugar and is in ketoacidosis, then ADDING dietary sugar is NOT what you'd want to do. You'd essentially be diabetic and burning yourbody alive from the inside out and you'd be on insulin injections to bring down the blood sugars.

I don't think she knows what she's talking about and I'd have said so to her face and to the doctor who sent you to her.

If you are eating dietary protein, then your body would be using that and NOT body tissue, that is basic physiology 101. Then your body is using that dietary protein and fat and body fat to make the glucose you need. How can she not know that and be a dietician?

The body doesn't go to muscle mass instead of fat reserves, it uses BOTH to make glucose , The only reason your body would break down your own muscle is if you not only have not enough glucose but also did not consume enough protein. You are creating a glucose dietary deficiency, but not a protein deficiency.

and that nonsense about giving the kidneys carb energy is bullocks. even if you were eating carbs, your kidneys would still have to process the protein in your meals, it's not doing any more work than if you were eating normally.

Don't listen to her. She's quacking at you.
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Old 12-30-2013, 07:04 AM   #13
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I agree and thanks for all the responses. I appreciate a good logical argument, but sometimes it's a bit easy to become side-tracked by someone that should be "in the know".

The moment in our conversation where she showed she wasn't knowing the difference between dietary ketosis and ketoacidosis was like an alarm to me. But the "I dont want you to damage your kidney's" thing was enough to cloud me for a bit.

Thanks for all the reasonable responses......it all makes sense, and lines up with what I read in the book.

"Just add these 2 little snacks a day" (not bothering to tell me that those 2 snacks would equal 30g of carbs)....well, I dont care what her theory is, I KNOW it would have stopped the progress.

The Christmas holiday has worked out great for me......I cooked a fantastic Prime Rib dinner, complete with a nice gorgonzola, butter, heavy cream and garlic dressing for it, dined out on a great steak dinner at The Capital Grille and really have eaten out alot over the holiday and i'm down 4lbs in that week and a half time. I feel as if i've feasted well, I feel fantastic and the weight has dropped. It's been pretty encouraging.
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Old 12-30-2013, 04:27 PM   #14
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That is awesome. The prime rib sounds delicious!
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Old 12-31-2013, 07:32 AM   #15
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Have been eating the leftovers all week.....lol
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