RD Q&A vol. 24

Samantha: I don’t know if you have talked about this or not, but can you explain the dangers of high fructose corn syrup and maybe even the difference between that and high maltose corn syrup? What do they do to your body and why does EVERYTHING contain them?!

Prevention RD: Samantha, great questions! There are 3 monosaccharides (single sugars in their most simple form): glucose, fructose, and galactose.  When we combine 2 monosaccharides, we get disaccharides (2 monosaccharides together): sucrose (glucose + fructose), maltose (glucose + glucose), and lactose (galactose + glucose). Fructose being the sweetest monosaccharide makes high fructose corn syrup sweeter than high maltose corn syrup, but both are processed sugars from corn that are used abundantly in processed foods. What do these sugars do to your body? The short answer is that too much sugar in the diet causes an increased insulin response (insulin is the hormone secreted by the pancreas* to decrease blood glucose levels which rise with the ingestion of carbohydrate or the presence of excess glucose in the blood). Over time, over-secretion of insulin causes the pancreas to work in over-drive while an abundance of calories (in this instance, from processed sugars) cause an increase in weight and thus, decreases the cell’s response to insulin. Over time with obesity paired with high sugar intake, we are asking our bodies and insulin to work harder than designed to do while simultaneously dampening the body’s ability to use insulin effectively. Eventually, we end up with diabetes. Why are these corn sugars in everything? Because they’re cheap and shelf-stable, is the concise and accurate answer. Just for reference, I wrote this post on high fructose corn syrup about 2 years ago. My take home message: it’s how MUCH sugar American’s are eating that’s the real problem.

*this was a typo…sorry! Corrected!

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Kelly: What would you recommend to someone transitioning into a vegan diet to make sure they get all the proper nutrients and remain healthy?

Prevention RD: Hi, friend! Great question! My biggest beef (haha…pun intended!) with people blindly choosing the vegan route is that they don’t go into it with a good understanding of what their body requires nutritionally. The biggest nutrients of concerns are vitamin B12 (which exclusively exists in animal products), calcium, and iron. Of these, vitamin B12 requirements are the most difficult to meet and fortified cereals and plant milk (soy, hemp, coconut, rice, etc.) are required to meet B12 requirements without supplementation. That said, a 10 microgram B12 supplement daily is recommended for vegans and strict vegetarians. In short, I would encourage new vegans to 1) read labels, especially in regard to B12, calcium, and iron and 2) be sure they are meeting the DRI for each of those nutrients. I think it’s also wise to be sure that the calorie intake is falling within the macronutrient distribution ranges of 45-65% of calories from carbohydrate, 20-35% of calories from fat, and 10-35% of calories from protein. Including omega 3’s in the diet is important, too – flaxseed and walnuts!

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Haley: What do you think is the best pre- and post-workout fuel for an endurance runner? I run cross country for my high school and my coach has also added two cross fit sessions a week prior to our normal workout. I don’t have much time at all between the cross fit sessions and our regular practices to eat something big or elaborate (and I wouldn’t want to anyway considering I’m about to run), but I’m always hungry before our regular training! What’s something I could eat/drink after my cross fit workout that has a good protein to carb ratio?

Prevention RD: I was a cross country runner once upon a time (albeit not so competitively 😉 )…so fun! Pre-workout you definitely want a snack that is mostly carbohydrate. Protein, fat, and fiber are not digested as quickly. To ease any discomfort from fullness during exercise, the snack should be consumed 30-40 minutes before exercise. After exercise, it’s important to get in carbohydrate and protein — peanut butter and fruit, nuts and fruit, a sandwich, Greek yogurt and honey, cottage cheese and fruit, etc. This snack (or meal) should ideally be within 30-60 minutes after exercise. The best nutrition practice for optimal fueling and performance is to always stay hydrated and to eat a balanced diet every day. Hope that helps! 🙂

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Kierstan: Should Kierstan become a dietitian?

Prevention RD: Of course! But seriously, I love my job. Nutrition has been the perfect fit for me, personally, and even in my young career it amazes me all that dietitians can do. I have worked in hospital kitchens and dialysis units, ran a small private practice, performed diabetes education for Native Americans, taught college, started a blog, and am writing a cookbook. What other profession has such a vast scope of practice?! I am so passionate about what I do and would recommend it to anyone with interest in nutrition. 🙂

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Corey: I just started running again and am currently training for my very first half-marathon.  While I’ve never had a “terrible” diet, I think I need some healthier choices when it comes to meals, especially on my training days. What are some foods that I should add to my diet to help with training?  What foods should I try to cut out (or at least eat less of)?  The only caveat is that I can’t completely cut out any cheeses — I’m a Wisconsin girl and can’t live without my cheese! Also, I’m pretty tired and not very hungry when I get back from my runs in the evening…are there any quick, easy dinners that I can make that will help me recover from my run?

Prevention RD: Hi Corey 🙂 Congrats on your training! There’s no greater feeling than finishing a distance race…and it’s addicting — you’ve been warned! I am never hungry after evening runs, either. What I find to work best is to increase the calories you consume at breakfast and lunch and to eat a lighter dinner. As far as foods to add, I would simply be sure that 50-60% of your calories are coming from carbohydrate. Distance runners needs plenty of quick energy to get the job done. There’s really no foods to include or exclude, but hey…I think it’s challenging enough to limit salt and saturated fat, eat plenty of fiber, and focus on heart-healthy fats and lean protein. If that’s not enough to juggle, I don’t know what is! I think not skipping meals and being sure you’re intaking enough fluid and calories is of top priority…no reason to give up cheese! As for quick meals, I would opt for pastas or grain-based salads that you can have on hand. Omelets, sandwiches, and jazzed up baked potatoes are also great go-to’s. I hope that helps some. Also check out the quick meals recipes I’ve posted for some ideas!

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Corey: I know lots of people are big into quinoa and kale.  I’ve only tried each of those in small amounts and don’t really know the benefits of adding them to my diet.  What’s a simple way to make either of them a part of a meal?  Are there any great alternatives if your grocery store doesn’t carry quinoa or kale?

Prevention RD: Kale is high in iron and vitamin K and quinoa is high in protein and is a whole grain (well, it’s a seed, technically). I don’t really believe in “super foods”, as these are touted — no one (or 2!) foods makes for a healthy diet. I would put spinach, collards, and turnip greens as equals to kale and seeing as most Americans intake plenty of protein, quinoa appeals more to those following a lower carbohydrate lifestyle. I would suggest barley, whole wheat pasta, brown rice, wild rice, wheat berries, or farro in place of quinoa. A good substitute for quinoa may also be lentils or beans which are also high in protein, and fiber. Hope that helps!

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Kathryn: I was wondering your thoughts on buying organic food? Do you try to eat organic when possible?

Prevention RD: Hi Kathryn! Thanks for your question! I believe in organics, but I don’t personally buy strictly organic. I choose to focus more on local versus organic and sometimes, it’s hard enough to do one, much less both. By participating in a CSA (Community Shared Agriculture), farmer’s markets, and gardening, I try to buy and eat with good intentions in regards to both my health and sustainable agriculture. That said, I’m not willing, personally, to buy everything organic due to cost and availability. I tend to buy the organic version of the Dirty Dozen, when available, and I typically purchase meat, fish, and dairy that has not been grain fed or treated with hormones. I think this is a very personal decision and as an RD I promote eating more fruits and vegetables overall. For those who can find and afford organics, more power to them!

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Kathryn: I’ve been reading your blog for a while and I see that you put letter grades next to recipes (under recipe index) you have made. Why not put the letter grade at the end of the post when you critique also? Silly question-I know:)

Prevention RD: Not a silly question at all! I thought about this and even discussed it with Mr. Prevention. My typical routine is to update my recipe index every 6-8 weeks with all the new recipes and at that time, he and I think back to the recipes we enjoyed most. For me, it’s easier to compare them to one another to truly indicate our “favorites” rather than looking at each recipe individually. That probably makes no sense 🙂 I will definitely consider adding a grade to each post and would love to hear others’ feedback on this, as well! Thanks for the question/suggestion…and thanks for reading!

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Mandie: I have a healthcare background (I’m an RN), so I understand a little bit about iron metabolism. But I’m still looking for some answers and my PCP was unhelpful. I’ve been having some serious issues with my iron levels. In January my ferritin was 1. At the advice of my PCP, I started taking iron 325 mg 3x/day. We rechecked my levels 6 months later, and my ferritin only rose to 3. To top it off, now my hemoglobin is low as well (now it’s only 10). I tried to take vitamin C to help aid in metabolism, but the excess vitamin C was giving me some serious GI issues, so that’s not an option at the moment. To add to the fun-ness of this problem, I have serious GERD, for which I have to take omeprazole 2x/day. I understand this also hampers my iron metabolism, but this has been an issue for years and I was taking the drug long before I had iron issues. I guess I have 2 questions. 1) what is happening that I am suddenly not absorbing iron? 2) do I have any other options besides IV iron at this point?

Prevention RD: My clinical side immediately thinks to rule out GI bleed, Chron’s, ulcerative colitis, Celiac disease, etc or excessive blood loss during menses. A gastroenterologist appointment, stool sample, and perhaps a scope would be my presumed course of diagnostic work-up. There’s anemia and there’s medication interactions…and then there’s a ferritin of 1. Eek! My gut says that this isn’t nutrition-related but is likely a GI issue (I hope I’m wrong!). In the meantime, I would continue pairing high iron foods with vitamin C from dietary sources to help better tolerate the vitamin. A multi vitamin-mineral supplement would be a good insurance policy, as well. Good luck and if you think of it…please let me know what you find out! Best wishes!

Thanks for all the great Q&A questions! Please send your questions to me at preventionrd at gmail dot com! I will post Q&A’s just as soon as I have a few questions in queue! 🙂

Be well,

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23 Comments

  1. August 23, 2012 / 6:22 am

    Another wonderful and informative post!

    You also make me *really* want to consider going back to school to be an R.D. !

  2. August 23, 2012 / 7:02 am

    I absolutely love these Q&As! They really get me thinking about things that I might not have otherwise!

  3. August 23, 2012 / 7:04 am

    Wowza, these are some fabulous questions! And great answers, as always. I actually sat through a lecture from the Corn Association, all about how similar HFCS is to regular sugar. It was quite fascinating, actually. They convinced me 100% that HFCS is no different than sugar.

    As for the vegan question, I always tell clients to use nutritional yeast. I’m so obsessed with that stuff! Nicole, have you ever used it in your cooking? I can’t remember if we’ve talked about that before.

    • Nicole, RD
      Author
      August 23, 2012 / 7:13 am

      I didn’t even think of nutritional yeast – thanks! I just checked the label of the one I have and 3 tablespoons contains 150% the DRI for B12. Nice! Thanks, girl!

  4. Chelsea
    August 23, 2012 / 8:14 am

    Correct me if I’m wrong, but isnt it the beta cells of the pancreas that secrete insulin?

    • Nicole, RD
      Author
      August 23, 2012 / 9:01 am

      Chelsea, you are correct! Typo, sorry! I corrected it 🙂 Thanks for catching that!!!

  5. Chelsea
    August 23, 2012 / 9:05 am

    🙂 Just wanted to make sure I wasnt misunderstanding!

  6. August 23, 2012 / 9:15 am

    I love your answer about nutrition for endurance runners!! I can always use more advice on that front. 🙂

  7. Laura
    August 23, 2012 / 9:37 am

    Mandie- I have the same problem! My ferriton was 1, and hemoglobin was 9. Iron supplements weren’t helping. After going to one of the top GI doctors at MGH, we can’t figure out why I don’t absorb iron, even though I eat a lot of foods containing iron. However, they took me off omeprazole (like you, I had been on it for years without a problem), and i went to an amazing hematologist. I got the IV iron which helped like nothing else, I finally started to feel like myself! I now have to get B12 shots once a month, and I get IV iron usually once every two years. It doesn’t sound great, but every two years isn’t bad and I finally feel better. My advice would be to go see a GI doctor AND a hematologist ASAP!

    • Nicole, RD
      Author
      August 24, 2012 / 10:01 am

      I’m glad you found some relief, Laura! Great suggestions for Mandie…and so unfortunate that many people suffer from this same issue!

  8. August 23, 2012 / 10:05 am

    Great Q&A today! I found a lot of the questions applied to me.
    I have issues with iron too — my ferritin always hovers at “anemia” levels (I think it was 3 last time I tested)– and also my B vitamins levels are low if I don’t supplement.
    I never got the big deal with low iron levels though. I mean, I never have any symptoms of anemia and I have tonnes of energy so I’m always surprised when my numbers come back low :-S

    Haley – my favourite pre-run snack is raisins or dates because they’re portable, non-perishable, and all the sugars give you a big carbohydrate boost before you run. Good luck with your cross country season!

  9. Haley Peterson
    August 23, 2012 / 10:10 am

    Thanks so much for answering my question! I’ll definitely focus on getting the right pre- and post-workout nutrients. Thanks Nicole!

  10. August 23, 2012 / 1:24 pm

    Loving all these informative posts Nicole! 😀

  11. Lizzie
    August 23, 2012 / 1:42 pm

    Once again, I am impressed with your responses. You’re both knowledgeable and reasonable! What a treat for us 🙂 I agree with what another commenter said – you make me want to become an RD.

    I emailed you a question about Barilla Plus and Dreamfields pasta few weeks ago, but I haven’t seen it posted on the Q&A for the site yet. Just wanted to remind you of that if you’re looking for more questions to post!

    • Nicole, RD
      Author
      August 24, 2012 / 10:00 am

      Thanks for reminding me! I did email you back but forgot it in the Q&A, right? Hopefully!

      • Lizzie
        August 24, 2012 / 10:06 am

        Correct, you did email me back 🙂

  12. August 23, 2012 / 9:39 pm

    I love your stance on organics, because I have the same thoughts.

  13. August 24, 2012 / 3:44 am

    Great job as always! For the question about becoming an RD, I am in agreement. Where else can you do such a wide variety of things all within the same profession. I love my job!

  14. Crystal
    August 25, 2012 / 2:21 am

    I have a question about the first question that I would appreciate if you could answer. Is there a difference between corn syrup and high fructose corn syrup? I can’t seem to find any information about corn syrup other than that it is what high fructose corn syrup is made of (so I’m assuming the less processed version of HFCS?).

    • Nicole, RD
      Author
      August 25, 2012 / 11:25 am

      Crystal: Yep, basically. Corn syrup is made from the starch or corn or corn starch where as HFCS undergoes processing to contain fructose to make it sweeter. Hope that helps!

      • Crystal
        August 25, 2012 / 11:53 am

        Thank you!

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