RD Q&A vol. 23

Thanks to the “L” ladies –Lisa, Lena, and Liz for today’s Q&A questions 🙂

Lisa: I’d be interested in your professional opinion of the Paleo diet (no plans, just curious). I see it popping up all over the web.

Prevention RD: Interesting question and I’m glad you asked! I studied the Paleo diet during a “fad diet” course in grad school. It has some interesting points, like, why weren’t cavemen diabetic or obese? I can rebuttal with, why didn’t they live to be well into their 90’s and 100’s like people of this era? The concept of Paleo eating comes from the premise that if we eat like “cavemen”, hunters and gatherers eating meat, vegetables, fruits, and nuts, we would weigh less and be a healthier species today. Major food groups like dairy and all things grain (breads, cereals, rice, etc) are omitted completely. I can be semi-comfortable with dairy-free as there are plentiful sources of calcium and vitamin D in the Paleo diet, but grains?! The red flag here is that the diet is going to be very high in protein and fat, and low in carbohydrate. The rough estimates are about 40% fat, 40% protein, and 20% carbohydrate which varies greatly from the well-researched macronutrient distribution ranges of 10-35%, 20-35%, and 45-65% for protein, fat, and carbohydrate, respectively. Furthermore, grains supply an abundance of vitamins, minerals, and fiber which would most likely be deficient in a strict Paleo diet. Because exercise and carbohydrates work hand-in-hand this diet would not be suitable, and perhaps dangerous long-term, for the avid exerciser or athlete. My take? It’s a fad and not a safe distribution of any micro or macronutrient.

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Lena: Do you know about milk and eggs that are required to be refrigerated in the US but not elsewhere? I know it has to do with the pasteurization (at least for milk) but is there an advantage for one over the other?

Prevention RD: You’re exactly right — they’re pasteurized to inhibit bacterial growth for milk and eggs, actually. Even after being pasteurized, however, milk and eggs are required to be refrigerated in the US; storing milk above 45 F shortens its shelf-life dramatically. In the US, milk is pasteurized, but eggs are not, hence, it is not advisable to consume raw or under-cooked egg or egg products (ahem…cookie dough!). The US is known for their very strict standards when it comes to food storage, and this is presumably the reason why we refrigerate pasteurized milk while other countries do not. There are some vitamin losses (B12, thiamin), but they are not significant. Better safe than sorry, right?

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Liz: Do you have any suggestions for managing weight gain during pregnancy?  I am 10 weeks pregnant (yay!) and had my first pre-natal appointment recently.  I am considered obese based on BMI and the doctor advised me to gain no more than 10-15 pounds.  I have been watching what I am eating very carefully and have not gained any weight.   I exercise 4-5 days per week (mostly cross-fit type workouts 3-4 days/week with biking, swimming, or yoga sprinkled in 1 day/week).  I’m concerned with limiting my weight gain while maintaining my activity level and ensuring that I eat a varied, nutritious diet.  Any general suggestions about a healthy diet during pregnancy would be great too!  

Prevention RD: Liz, I’m so glad you asked! In my new role I am responsible for our gestational diabetes (pregnancy-induced diabetes) program and I am quickly learning more and more about pregnancy, weight gain, and wellness. After attending a session on pregnancy at AADE and in speaking with my hospital’s OB physicians, times are changing. Pregnant women should do a few things: intake at least 1800 calories and 175 grams of carbohydrate daily, drink plenty of water, and keep active. If women are obese pre-pregnancy, weight gain is not required. In fact, it is becoming more and more common that obese women LOSE weight during pregnancy. Of course this should be discussed with your provider and each woman should be assessed individually. It sounds like you’re set up for a healthy and happy pregnancy! All my best 🙂

Have a wonderful weekend! And as always, please feel free to send along your questions as a comment below, via email at preventionrd at gmail dot com, or on Facebook!

Be well,