Archived Ask a Dietitian 4/24/14 - 10/21/14 Topic

Dietitian 04/24/14
Hi Folks, use this new discussion topic if you have questions for me. I just archived the previous discussion topic so that it wouldn't take so long to scroll through if you use your phone for forum access.

And by the way, if you use web for forum access, you will have all of the features available- you can see posts from all 5 years, search by topic, and also, create or join groups/teams.

Best,
Kathy Isacks, MPS, RD, CDE

U5740621 04/24/14 replied to Dietitian
Hello!
I've got plenty of questions. My major question is how much I've messed up my system and lab results with terrible eating habits.
Before now I would occasionally eat a piece of toast at breakfast then not eat again until about 5 that night. I'd eat a huge dinner and snack at night before bed. I had gone to the doctors with pain and pins and needles in my hands/arms and feet/legs. My lab tests show pre diabetes. This was something that I had suspected and started testing my sugar previous to the labs but the majority of my tests showed normal ranges.
Now I am eating regularly doing my best for low sugar healthy choices. Since I've made this change my numbers are much higher, some in the 220-250 range. Could I have been masking diabetes with my eating habits?
Thanks

U5350024 04/24/14 replied to U5740621
Thank you Kathy for listening to my suggestion and for the info about the website. That is so good to know. You are awesome. Be well.

Yasmingaballa 04/25/14 replied to U5350024
Hi Kathy, I lost 25 kg in 4 months as a result of putting a gastric ballon in my stomach and will remove the ballon after 2 months, so I'm so afraid of return back ð???ð??? any advises not to return back to that fat, obese, ugly girl

U5741214 04/25/14 replied to Yasmingaballa
Hey, I'm 16 year old guy who's 5'9'' and my weight is currently hovering around 160, in the past year I've weighed 200 and it took me from November to lose the weight, my parents now seem to thing something's wrong with me, i do an hour of pretty challenging cardio every day which burns about 700 to 900 calories, it seems like every app I use tells me something different about what to eat, I just want to stay in good shape and maintain a weight of 155-160 but I'm not sure how many calories I should actually be eating daily

K8sMom2002 04/25/14 replied to U5741214
This may have been asked before but here goes ...

I'm 4'10" and weigh around 88 lbs, so my maintenance calories are lower than most, around 1,400 a day. I am in my early 40s.

I've tried to eat mostly whole foods with as little processed foods as possible, with an emphasis on fruits and veggies, though I don't always get in 3 a day. We don't eat much meat ... A 3 ounce or so serving with our dinner at MOST, and sometimes we swap that out for a meatless option.

I'm staying at or just under my calorie limit, but my weekly analysis keeps giving me thumbs down on iron and calcium. According to MND, I'm getting around half of what I need, which worries me.

But if I eat any more of the foods they suggest, I would be over my calorie limit.

I wonder ... Are these iron and nutrient levels calculated on a 2000 calorie diet, or are they customized to my calorie needs?

Dietitian 04/25/14 replied to U5740621
Hi U5740621, if you are testing your blood glucose more regularly, then you might be catching more highs (that might have been missed with less frequent testing).

When you test after meals you should wait at least 1 hr or 2 hrs after the first bite of the meal since that is what post-meal norms are based upon.

Also, make sure you understand how to use your blood glucose meter and that the settings are correct. Make sure the blood glucose meter is testing accurately - ask for the testing solution and make sure the test solution reading is within the range printed on the strips container. Also, always check that your strips are not expired.

Also, not washing your hands before testing your finger could result in a high value that is related to what is still on your fingertips. Lots of foods and household chemicals can affect the blood glucose reading so be sure your hands are clean and dry before the test.

In terms of eating, carb counting means counting total carbs, not just sugar grams. If you just count sugar, you underestimate your true carb load at any given meal or snack. All digestible carbs (starches and sugars) will break down and eventually travel through the blood as glucose.

To learn more about how diet/eating affects blood glucose, be sure to read my article on Diabetes Basics: http://www.mynetdiary.com/food-diary-for-diabetes.html

And here is an article just on carbs: http://www.mynetdiary.com/carbs-in-weight-loss.html

You can access those articles via web or via Library row in MyNetDiary apps.

Healthy eating and carb controlling meals and snacks should help LOWER your blood glucose readings, not elevate them. In the pre-diabetes state, the 2 factors that reduce the risk for progressing to Type 2 diabetes the most are weight loss and regular exercise.

If you are truly seeing blood glucose readings in the 200's even after checking for stuff I mentioned above, then ask your doctor for the "A1C" test - you might actually have Type 2 diabetes.

Best,
Kathy Isacks, MPS, RD, CDE

Dietitian 04/25/14 replied to Yasmingaballa
Hi U3870321, while you still have the balloon in (and are benefiting from feeling full on less intake), start practicing healthy eating with a balanced plate, and portion control. Those are skills that you will need when the balloon comes out. Also, exercise is a critical component of helping you keep the weight off so start moving more now. Aim for 10,000 steps daily to keep activity up to an hour or more daily.

And be sure to continue tracking intake and exercise even after the balloon comes out.

Be sure to read the articles and blog posts to give you ideas on foods/activities:

Articles: http://www.mynetdiary.com/diet-and-weight-loss-resources.html

Blog: http://www.mynetdiary.com/blog.html

Simple balanced plate: http://www.mynetdiary.com/do-we-have-a-contender-harvards-healthy-eating.html or

https://healthy.kaiserpermanente.org/health/care/!ut/p/a0/FclBDsIgEEDRq9gDkBGttHEnBS7gQmE3IRNLSpGQUePttcv_PgS4Qyj4Tg_k9CyY_-0jFaZ2Li9uaVO4QYCw1CthizP4mTDz_N3VjEzbwsYpZgKv1aD0yY1COWWFlHYvdK-NMPYgjZPT1B8HqOs6fi5d9wPV1UM_/

Best,
Kathy Isacks, MPS, RD, CDE

Dietitian 04/25/14 replied to U5741214
Hi U5741214, first, congrats on your weight loss - you are at a healthy weight for your height. Activity recs for teens your age is 60 minutes or more daily so you are right on target.

Trackers use different equations and activity levels - they are not all the same. MyNetDiary uses the Institute of Medicine's DRI equations so you have to be careful to use the correct overall activity level setting. Most people should use sedentary if they also log exercise.

MyNetDiary uses Daily Analysis to account for exercise logged for the final calories bottom line given your estimated maintenance calories, target weight and target date.

Please read this article on how calories work at MyNetDiary and let me know if that helps: http://www.mynetdiary.com/diet-and-weight-loss-resources.html

FYI - using MND (IOM/DRI equations), active setting, 16 yo, 5'9", 160 lb, male - estimated kcal to maintain your wt would be about 3178 kcal. If you use that setting, then don't log exercise since it is already accounted for.

If I drop your overall activity to sedentary level (so no exercise, just activities of daily living including incidental walking up to a mile), then the kcal for maintenance drops to about 2600 kcal. In that case, you would log your exercise. And, you would use the Daily Analysis to see the bottom line for calories.

Best,
Kathy Isacks, MPS, RD, CDE

Dietitian 04/25/14 replied to K8sMom2002
Hi K8sMom2002, the calcium and iron goals used are the RDAs for those nutrients (IOM/DRI guidelines in the U.S.). If you consume less than the RDA, that is not necessary going to cause a nutrient deficiency, but a chronically low intake that is less than 50% is likely a red flag for intake that is too low.

Sometimes just picking different foods can boost the calcium and iron. Or, some people choose to take a daily vitamin/mineral supplement that provides 100% DV (not megadoses).

You might find these articles/blog posts helpful:

Calcium: http://www.mynetdiary.com/calcium-get-enough-but-not-too-much.html

Iron: http://www.mynetdiary.com/are-you-getting-enough-iron-how-ironic-that-one.html

Foods to meet nutrient needs: http://www.mynetdiary.com/foods-nutrient-needs.html

Best,
Kathy Isacks, MPS, RD, CDE

Archived Ask a Dietitian 4/24/14 - 10/21/14