Random Thoughts of a Dietitian: Post #1
Updated: Aug 29, 2022
An Introduction to "Random Thoughts of a Dietitian"
As a dietitian, I've had the unique privilege of working with hundreds of incredible people, one-on-one, on a regular basis. Some people experience major hurdles; some don't. Some struggle with emotional eating, while some have to contend with late snacking. As such, my clients & I run into an array of unique hurdles, requiring even more unique solutions.
I also receive some really difficult questions that make me question my understanding of nutrition. And personally, I continually focus on self-education outside of my sessions to stay on the edge of the available evidence.
A problem I've identified, though: I don't record/publish these experiences, thoughts, questions, or knowledge. Instead, I usually review these things introspectively, work them into my mental framework as best I can, and leave it at that.
The goal of this series is for me to journal the various situations, thoughts, ideas, facts, questions, topics, and theories that I encounter as a private dietitian, and think could be useful to anyone (especially students) trying to forge a more solid understanding of nutritional science & nutrition counseling/coaching.
What you will find in these entries are my honest thoughts, uncorrupted by any ulterior motives. No ads, profit chasing, or corporate partnerships.
Many topics will leave the reader feeling unsatisfied. Like there's a lack of closure. And that's good; that's where much of nutritional science actually is right now. Nutrition today is analogously where surgery was in the 1800s; it is not settled science. I think it's important for people to realize that, myself included.
Okay let's get into it.
"This is why Noble Nutrition doesn't currently offer genetic testing."
Although we have more secure & healthy food than ever, proper nutrition is still difficult to achieve. There are a number of biological variables involved that we don't fully understand, and some we may not even know exist (yet.) Example: While the evidence suggests that starches/glucose are a crucial source of energy for people, I'm confident a subset of people may achieve greater health outcomes eating a diet very low in carbohydrates.
How do we reconcile this? Will we eventually be able to take a sample of DNA and clearly determine which diet will work best for them? Genetic testing related to nutrition does exist, but it is a novelty, not an evidence-based tool. Anyone who claims otherwise is misunderstood, or may be misleading. This is why Noble Nutrition doesn't currently offer genetic testing. While some genetic-phenotypical associations are becoming more well-understood, currently, we cannot make any concrete determinations about lifestyle change based on any sequence in a person's genome.
"First, ask yourself where this lack of variety is most problematic (breakfast, dinner, etc.). For many people, having the same breakfast & lunch is fine. We tend to be busiest here & palate appeal just isn’t as important.”
Whenever someone starts "eating right", one of the most difficult things many people grapple with is a lack of variety. I see people drive themselves crazy trying to find "the perfect recipe" for every meal.
The best guidance I have for this hurdle: "First, ask yourself where this lack of variety is most problematic (breakfast, dinner, etc.). For many people, having the same breakfast & lunch is fine. We tend to be busiest here & palate appeal just isn’t as important. Dinner seems to be the most common place where lack of variety can become an annoyance.
Once you narrow your focus, identify what dinner recipes you already have banked up. They could be recipes you're renown for, or recipes you've found somewhere online. Write them in a numbered list. When you're done, ask yourself: "Okay, so I feel like I have a lack of variety at dinner. But I have eight recipes listed here. Is it really a lack of substantive variety?"
For most people, having eight good dinner recipes is enough. If you feel like eight actually isn't enough, then consider procuring two more & search based on the most common meats/veggies/starches you cook with. Add good ones to your list & keep the list on your fridge.
Or, if you feel like eight recipes is enough, but you still feel like you have a lack of variety, the issue might not be a lack of available variety. It might be because it's easier to make the same recipes every night & stepping outside of what you usually do can be daunting.
In which case, I recommend picking one of the 8 recipes you cook least often/enjoy most, and revisit making it one night. You'll likely find switching it up is not nearly as stressful as you think :)
"After all, there is very real reason to believe those holding the reigns of US food production/healthcare are invested in Americans being unhealthy & depressed."
The two most important electrolytes in our bodies are sodium and potassium. Much of their importance lies in their role in blood pressure regulation. We know that consuming too much sodium and too little potassium can result in high blood pressure, amongst a number of other potential health issues.
Epidemiological data suggest that people get far too much sodium in their diets, with the average American consuming 3,400 mg/day (compared to the recommendation of 2,300 mg/day.) This is a major contributor to the epidemic of hypertension ("high blood pressure") we observe in today's first world societies. People love adding salt to their food, especially here in the South. And no wonder; it's delicious.
Even further, we also know that people tend to consume far too little potassium. According to 2003-2008 NHANES data, it's estimated that less than 2% of Americans are getting enough potassium. This is less about what we add to our food, and more about what we're leaving out; we get potassium almost exclusively from fruits and vegetables, which are severely lacking in most Americans' diets.
"So, what's the deal? Can't a person just take a supplement to increase potassium?" You can, but most potassium gluconate supplements are severely lacking. You're talking maybe 2-3% of the daily recommendation.
Instead, there's a product that many people don't know about, and I'm beginning to think the lack of coverage on this class of products is intentional. After all, there is very real reason to believe those holding the reigns of US food production/healthcare are invested in Americans being unhealthy & depressed.
The name of these "Salt Substitutes" are Light Salt or NoSalt, and most of you have probably never heard of them.
As mentioned earlier, people typically use pure table salt ("sodium chloride") in their cooking, which will increase sodium intake.
What's cool about Light Salt: It's half sodium chloride, but half potassium chloride.
Meanwhile, NoSalt is made exclusively of potassium chloride. This is a more extreme option; I'll explain why in a second.
So, in using either of these products, you can achieve increased flavor, reduced sodium, and increased serum potassium. You can find these products next to the regular salt in your local grocer.
Switching to Light Salt is a good way to ease into salt substitutes, instead of jumping right into NoSalt. This is because:
1.) It's half sodium chloride ("table salt"), so it will taste more like regular salt.
2.) It's half sodium chloride, and sodium is still a very important nutrient; too much or too little of anything can kill you, potassium/sodium included.
Starting with a pure potassium chloride based salt (such as "NoSalt") can present some unique risks for certain populations:
1.) People with kidney/heart issues should be very careful with NoSalt; too much potassium can lead to serious health issues/death if renal/cardiac function is abnormal. If you determine it's safe after speaking with your physician, the key is to work it in very gradually.
2.) If you work in too much/too quickly, it can lead to issues with loose stools; it's temporary, and can be avoided by incorporating into your diet very gradually.
3.) If you work in too much NoSalt too quickly, you may experience an unusual flavor, if you're not used to it. When I first incorporated NoSalt, I got too excited & it made my first meal almost taste metallic. So again, start with a small amount & increase gradually.
So, if you're experimenting with salt substitutes, it might make sense to start with a Light Salt sodium/potassium mix, and see how you respond. If there's some reason you still need more potassium but struggle to achieve it through diet, then you might consider incorporating some NoSalt, as well.
As with any diet change, start low, go slow, and observe how you respond.
Until next time,
Tim Smith MS, RD, LDN