The 14 most common questions in a nutritionist's office

Nutrition matters more than ever.

Oliver Thansan
Oliver Thansan
22 May 2023 Monday 15:03
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The 14 most common questions in a nutritionist's office

Nutrition matters more than ever. You just have to take a look at which are the most recurring topics on social networks, where experts (and unfortunately, also false food gurus) publish all kinds of content about this science. On these platforms, dietary advice or healthy recipes abound and the most deeply rooted food myths are denied. But nutritionists continue to answer the same questions over and over again in their private practices.

Should I supplement with vitamin B12 if I follow a vegan or vegetarian diet? If I eat nuts, will I gain weight? Can I lose weight after 50 years? Is there a pill that helps lose weight quickly? Five nutrition professionals answer the most common questions from their patients:

Questions around weight, understandably, are the most common. But the one that the doctor and nutritionist Madga Carlas finds the most is if from the age of 50 you can lose weight. The answer is yes, but it is more difficult. "From this age the metabolism slows down, especially in the case of women. There are also a series of hormonal changes that cause weight loss not to happen so easily," she says.

At this vital moment, explains Carlas, it is necessary to observe the general state of health and find the causes of that overweight that worries us, in addition to ruling out possible pathologies. Once the analysis is done, personalized advice is given. "At this age it is necessary to order the diet more, reduce alcohol intake and watch out for unhealthy snacks. You have to take better care of yourself and have fewer whims," ​​says the expert.

It is striking how many of these doubts revolve around the best and worst times to eat fruit, one of the healthiest foods in the diet. A very recurring question is whether eating fruit for dessert after dinner is harmful. "It is believed that you gain more weight at this time of day," says nutritionist and pharmacist Natalia Moragues. "The sugar contained in the fruit generates misgivings, but there is no reason to stop consuming it at dinner. It is curious, because they rarely ask you if having a bowl of ice cream at night is bad," she jokes.

The only case in which eating fruit at the end of the day can be a problem is if we gorge ourselves, but it is not very common. Despite the fact that Spain is one of the European countries with the highest intake of this food, according to Eurostat data, only 63% of Spaniards eat between 1 and 4 servings of fruit and vegetables a day. And consumption decreases year after year.

Another question that arises with this food is whether accompanied by yogurt or even alone, it can become a dinner. As previously mentioned, it is not a problem to eat fruit at night, but having it be the only content on the plate is not so advisable. "If we only eat fruit, we are displacing other foods that are important to consume, such as eggs, fish or vegetables," says dietitian-nutritionist Júlia Farré, from the Júlia Farré Center in Barcelona.

The expert recommends that dinner include all the nutrients and that we only eat fruit and/or yogurt on those days when we are not hungry, when we do not feel well or when we fancy a lighter bite due to the high temperatures, which reduce appetite. "But I wouldn't make it a habit or say it's a healthy practice," she insists.

Although more and more people are jumping on the bandwagon of veganism or vegetarianism, it is not clear whether following this type of diet requires supplementing with vitamin B12, says nutritionist Antonio Gómez, from the Aleris Center. "In principle, taking this supplement is necessary for both vegetarians and vegans." And he adds that even if there is no deficiency of this vitamin "nothing happens if we exceed it, because consuming more will not result in a health problem."

In any case, it is advisable to take it only if prescribed by a professional. It is important that we do not lack this nutrient, because it could lead to health problems. "In extreme cases, it can even cause cognitive damage," warns Gómez, who recalls that omnivores can also have a B12 deficiency.

Intermittent fasting has been rising as the most popular diet for several years, despite the fact that it is not too clear if it is really beneficial. Experts agree that it is one more technique to lose weight, but it does not work for everyone. "You have to study who does it, how many hours you fast and what food you eat the rest of the time," says Carlas. It is a practice that also has to be able to adapt to the rhythm of life of the person who follows it, for this reason it is not recommended in all cases.

Farré adds that while it is true that several investigations have proven that it can have some benefits, it is a technique that only makes sense to perform over a long period of time, not on a specific day. However, she does not usually recommend fasting as a weight-loss strategy in her office. "I think there are better methods." The expert adds that if we intend to follow this diet, it is best to consult a professional to advise us.

They stand out for their healthy fat and fiber content, as well as for their satiating effect, which prevents us from resorting to unhealthy snacks between meals. But many doubt if they have a place in a weight loss diet. "They have a very high caloric density. But they also have many advantages, especially walnuts and hazelnuts, which are a good source of omega-3 and calcium, respectively," says Moragues.

In short, eating nuts is highly recommended, but do not overdo it. Nutritionists advise not to exceed 25-30 grams per day, that is, "what fits in one hand, not counting the fingers," says Moragues. Nor should we go too far with avocado, which is another very healthy food, but with many calories. "If we add it to breakfast every day, it is best to take only a quarter of fruit," he recommends. Also, keep in mind that there are other more sustainable options.

Vegetarian and vegan patients also have many questions about legumes. Can you substitute animal protein? And if so, how can we make them resemble meat foods? "They are a very complete food, because they have carbohydrates, fiber and protein," says Farré. But if we want the protein contribution to be the same, they must be the protagonists of the dish, and not just a garnish. "For example, if we serve ourselves a good amount of lentils, it is not necessary to accompany them with meat," the expert clarifies.

As for whether it is necessary to combine legumes with cereals to obtain the complete protein, Farré answers that half. "It is not necessary to incorporate the cereal in the same meal. If we have had bread throughout the day and then we eat a stew of white beans, we will already have the complete protein," he clarifies.

Another challenge for vegans and vegetarians is how to cook legumes following the example of a dish that is traditionally prepared with animal protein. "If we want to make a meal that resembles macaroni with minced meat, we can use peas or textured soybeans to imitate it," recommends Antonio Gómez. These products (already available in many supermarkets) must be rehydrated and spiced. That way they will look more like meat. "On the other hand, if we seek to reproduce the flavor of the fish, we can resort to algae, which will give the dish a taste of the sea."

A very common question in the consultation of the dietitian-nutritionist Mariana Álvarez is whether bananas have a place in a healthy diet. "This fruit is the queen of food restrictions when trying to take care of your diet. It is among the ones that contain the most sugars and was removed from the diet plans indicated for losing weight in the past. But to this day, there is no research that justifies this restriction," he says. "Unless we are talking about specific pathologies in which the doctor has indicated a decrease in potassium consumption."

It also makes no sense that the goal of limiting banana consumption is that it raises blood glucose. "It is unlikely, because the fiber in the fruit acts as a protection factor. But if that were the case, an individualized treatment would have to be prescribed in which the patient can enjoy the advantages of consuming fruit without putting their health at risk," he says. the nutritionist. However, this recommendation is not valid for all diabetics, as many people believe.

At the moment, there are no quick solutions to lose weight, but several patients continue to ask Magda Carlas if there is a miracle pill that achieves this end. "I wish it were like that, but there are no express formulas that are worth it." Despite the fact that we live in a society that rewards immediacy, the expert insists that there are things in life that cannot keep up with this rhythm. "We're not machines. Plus, it's not just about losing weight, it's also about figuring out what led us to that goal."

For a long time, nutritionists' consultations emphasized the amounts to be consumed of each food, but it is impossible to give the same recommendations to the entire population. "The portions that each person should take depend on several factors and therefore it is not something that can or should always be strictly adhered to," explains Álvarez.

One of the factors that can condition the amounts, says the dietitian-nutritionist, is the hunger-satiety mechanism. "If we are full, we must adapt to that circumstance and eat less," she recommends. On the contrary, if we are very hungry, the portion or composition of the dish will also vary.

More and more people are switching to vegetable milk, an alternative that can be healthy and totally valid. However, making this decision based on the belief that dairy products are harmful is a mistake. "They will be less or more beneficial depending on which ones you take and how you use them. They have advantages and disadvantages," says the doctor and nutritionist Magda Carlas. To give an example, the fermented ones are a highly recommended option, and then there are many interesting products due to their calcium content. "Not everything is black and white. The only foods that we should limit are ultra-processed ones. They have no nutritional interest."

Dissociated diets have spread the belief that taking mixed foods makes you fat, but this is not the case. In fact, explains Natalia Moragas, making the dishes as varied as possible will help us obtain different nutrients in a simple and tasty way. "What we should pay attention to is the amounts of each food. The best thing to do is to take the Harvard dish as an example, which defends that food should be made up of 50% fruits and vegetables, 25% whole grains and 25% protein," says the nutritionist.

The egg is another food that generates a lot of controversy. A few years ago its consumption was discouraged due to its cholesterol content, then the opposite was said and currently it is not clear what the healthiest intake is.

"You can eat eggs every day. Perhaps what should be limited more is the yolk, because it is where this cholesterol is found," explains Júlia Farré. The recommended amount is between two and four eggs a week, but everything will depend on the protein that we consume in our day to day. "A person who eats a lot of food of animal origin does not need to eat so many eggs," explains the specialist.

This is a question that arises above all in those people who set a specific weight as their goal and not health. Mariana Álvarez believes that it is not appropriate to focus on this indicator, but that the loss of body fat should be addressed. "For this to happen, it is necessary to modify the strategy while the results are being seen and that takes a time that we cannot estimate just by looking at the external appearance of the person."

On the other hand, the expert points out, the goal should be to improve lifestyle habits in general, not just diet. "We can't know in advance how long it may take a person to change those habits, any more than we can predict how the day will end," she concludes.