RD Q&A vol. 27

Another Q&A and more great questions — thank you! 🙂

Katie: I actually have 2 questions for you. I just completed my second degree in dietetics and am excited to apply for internships this winter. I am freaking out a little bit though, I feel so unprepared! Do you have any advice for an aspiring RD starting an internship? What things should I focus most on knowing? I completed my degree online, so I feel like I lost out on so much interaction with professors and students so any advice you could impart would be great!

Prevention RD: Hi Katie! Congrats to you! Internships are so competitive — I would call local hospitals, nursing homes, out-patient clinics, WIC offices…anywhere, asking to shadow RD’s or volunteer time. Having experience in dietetics, paid or otherwise, is invaluable and is what will set you apart from other applicants. I remember writing PSA’s for a local sports dietitian and at the time thought, “how dumb!” but in the end, it set me apart from the pack. I would also suggest you pick-up a book or two on motivational interviewing — it is truly a skill that needs to be practiced to perfect, but this was an up and coming area of nutrition and counseling when I graduated in 2008 and has continued to be talked about throughout the nutrition community. Get out there, get some experience in various settings working with or shadowing RD’s or DTR’s, and learn as much as you can hands-on. You’ll learn all the clinical stuff over time…for now it’s all about exposure 🙂 Best of luck!

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Katie: Second question is about sweeteners. You read alot of bloggers lately touting natural sugars, pure cane sugar, muscavodo, brown rice syrup, etc. as being far superior to regular refined white sugar. Am I wrong in thinking that basically it is all carbohydrate with the same amount of calories so one isn’t really “healthier”? I understand some may be lower on the glycemic index but that is about all that is different. Could you explain?

Prevention RD: Katie, I will answer with my thoughts and I would love to hear others’ comments below! I think you will get a different answer with every RD and person you ask. Ingredients like honey and agave are more “natural” and lower on the glycemic index. Does that make them better? I guess it depends who you ask. As someone who works with an obese population who are highly susceptible to diabetes and other obesity-related chronic diseases, I would focus more on the quantity of sugar rather than the source. If you speak to a more “holistic” RD who believes in a minimally processed diet, more natural sugars would be preferred. I guess I play for both sides, see the good and bad in each, and use them all in moderation. I stock granulated sugar, powdered sugar, turbinado, brown sugar, agave, honey, and coconut sugar. It really depends on what I’m doing with that sugar on which I’ll choose. I shy away from demonizing any food — they’re all sugar and all relatively the same number of calories, like you said. No need to marry just one! That is until I can make good chocolate chip cookies with honey, anyways. 😉 I adore honey!

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Haley: What is your opinion on protein powder? I’m confused between what is the “healthiest” form: is whey better than soy isolate? What about pea protein isolate? Different products seem to be popping up everywhere, and while I do like to add the powder occasionally into a smoothie or into some pancake mix, I would like to know the differences and the benefits of the different types. Generally speaking, I buy protein powder that is low in sugar, contains between 10-24 grams of protein per serving, and has a small ingredient list consisting of mostly “natural” products.

Prevention RD: Haley, thanks for another great question! Protein powders remain a hot topic year after year, it’s amazing! Protein powders that talk about “isolates” simply mean to say that the protein source stands alone and the water (and other components in small amounts) has been removed. Fancy term for something so un-fancy, huh? 🙂 What is left is “pure” protein (about 90% or more, anyways). If someone wants to go the protein powder route, I suggest whey protein (unless they’re vegan) because it is soluble in water. It tastes better, too. Whey and soy protein powder (should) contain all 9 essential amino acids and are therefore “complete” proteins. I think I shy away from protein powders because few Americans truly NEED supplements — the average adult and recreational athlete eat adequate protein to support muscle growth and repair. I would much rather see someone choose heart-healthy protein sources in the diet before turning to a supplement, but both whey and soy are perfectly safe to use in moderation. My opinion is probably a bit biased — I’ve never been one to turn to a supplement before a meal or snack that I can chew 🙂

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Alex: I am hoping to get pregnant this year, but I am about 40lbs overweight. I am currently trying to lose weight, but was wondering if I do get pregnant before hitting my goal- what is a good pregnancy diet? And is it okay to lose a little weight during pregnancy if I’m overweight as long as I am getting the nutrients I (and the fetus) need?

Prevention RD: Hi Alex! Babies! Exciting! Just as I had emailed you, Liz asked a very similar question a few weeks ago. Overweight or not, pregnant women need 1800 calories and 175 grams of carbohydrate a day. You can also find out how much protein you need by taking your weight in pounds, dividing by 2.2 (this is your weight in kilograms), multiplying by 0.8 and adding 25 to that number. Are you totally confused? 🙂 If so, shoot me an email with your weight and I would be happy to figure it out for you. In addition, proper hydration and keeping active are the keys to a healthy 9 months. So long as you’re meeting these recommendations each day, don’t aim for a certain weight gain or loss. I can only imagine that that type of pressure during such an exciting time can be stressful and unpleasant. But it is true that overweight and obese women need not gain weight during pregnancy, and can safely lose weight even. I hope that helps. Good luck to you! **this response had a typo — 175 grams of CARBOHYDRATE, not protein 🙂 Sorry!

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Samantha: Have you heard of this “symptom” for lack of a better word called leaky gut? Apparently it happens when people switch from eating gluten to eating gluten free? I was wondering if you knew about this and if it were an actual syndrome or symptom or whatever?

Prevention RD: See, I love Q&A’s because I learn, too. I’ve been in an RD in medicine for 3 1/2 years now and I’ve never heard the term “leaky gut” or seen that term in a medical chart. And let me tell you, I’ve read THOUSANDS. I think two things are for sure. First, “leaky gut” (syndrome? symptom? who knows?) is caused from increased permeability of the intestine. Things like amino acids (protein) transverse the intestinal lining all the time based on the needs of the body. Major changes in diet (i.e. gluten vs. gluten-free) would likely cause some nutrient shifts that would cause nutrients (that may have been previously deficient?) to transverse the lining in a different way or at a different speed. Let me be honest, that last part is an educated guess on my part. The second thing we know is that any “leaky gut” is likely a result of a condition such as Celiac disease or Crohn’s. It’s important to treat the condition itself rather than jump to managing symptoms. Such interesting stuff — thanks for the question, Samantha!

 Feel free to pass along YOUR question to me at preventionrd (at) gmail (dot) com! Thanks in advance and thank you for all of today’s wonderful questions!

See you tomorrow with a recipe! 😀

Be well,

Share With Your Friends!

22 Comments

  1. September 13, 2012 / 6:41 am

    Leaky gut doesn’t sound very pleasant!

    Another great series of questions (and answers) – I keep telling the bf next time I start pondering out loud about anything relating to nutrition I need to write it down and submit it to you sometime!

    • Nicole, RD
      Author
      September 13, 2012 / 8:54 am

      Yes, you do! 🙂 jk…but I’d love you to!

  2. September 13, 2012 / 7:10 am

    I love reading these. Ok, so I completely agree with you on the sugar and the protein powder questions/answers…..but I TOO am so confused about leaky gut !! I’ve had a couple customers/clients tell me they have it, and I don’t really get it. I’ve never heard that it’s caused by switching from a gluten to a gluten-free diet (that’s new to me) but most of the people I’ve talked to say that toxins in the environment “Caused it”. Or, stress. It’s odd. Very few doctors know about it and I have yet to find consistent information about it online. I need an unbiased webinar on the topic or something. I hear it more and more!!

    • Nicole, RD
      Author
      September 13, 2012 / 8:54 am

      I figured of anyone, you had heard of leaky gut! And the “research”, like you said, isn’t really there. At least not online…yet. I did read somewhere that it can be linked to stress, but so can diarrhea, you know? It’s all very interesting!

  3. Emily
    September 13, 2012 / 7:35 am

    GREAT responses again, Nicole! 🙂 I couldn’t agree with you more – sugar is sugar, and of course, FOOD first! 🙂 It’s refreshing to hear another RD with the same thoughts, I must be surrounded by too many holistic ones 😉 And I also have never heard the term “leaky gut” in a medical setting..

    • Nicole, RD
      Author
      September 13, 2012 / 8:53 am

      Oh, Emily…it is so refreshing, isn’t it? 🙂 I figure, no one is perfect when it comes to…anything. Why stress so, so much about sugar you add to your cookies when you turn around and binge at a restaurant or backyard barbecue? It makes no sense. Everything in moderation 🙂

      • Emily P
        September 13, 2012 / 9:07 am

        Amen to that!

  4. Brooke S
    September 13, 2012 / 8:35 am

    Hi Nicole, It is so strange that you posted the question about the internship. In was going to email you a similiar question. I know the internships are often picked by computer, how does that work. I am a single mom trying to figure out how to go back and finish my degree and I would like to do it in dietetics. I do not have the luxury of moving for an internship so it would have to be close to home. Is this something you usually have to move for. Also what can you do with the degree if you can not get an internship? I know you can not be an RD. Thank you!

    • Nicole, RD
      Author
      September 13, 2012 / 8:51 am

      Brooke, I’d love to include this in next week’s Q&A if that’s okay 🙂 The match system is confusing, but it is methodical. You certainly don’t have to travel to do your internship and as of recently, it is possible to set-up your own internship. I just got a call the other day from a student looking for internship sites. I would look into this and if she calls, I’ll ask where she’s attending online! 🙂

      • Brooke S
        September 13, 2012 / 10:27 am

        Answering the question next week would be great. It is a confusing process and even just finding the right school and classes is confusing and frustrating to say the least. I am glad to hear that you can set up your own internship also. Thank you so much for your Q and A. I look forward to reading more about this subject.

  5. Brooke S
    September 13, 2012 / 8:36 am

    Kate, Do you mind me asking what school you used online for your degree? I have been researching all my options.

    • Katie
      September 13, 2012 / 8:59 am

      Brooke I got my degree from the University of Northern Colorado. They also have an distance internship so that you can pick your own preceptors close to home. Check out the Academy of Nutrition and Dietetics website for more options!

      • Brooke S
        September 13, 2012 / 10:30 am

        I was actually finding all the school online through the Academy of Nurtition and Dietetics website. Did you do your core classes online also? I don’t have many core classes that I have to take, I already have my associates and I know many of the classes I did take are transferable to some schools. However there are a few science classes I am missing and I can not find how to take those online if possible. I do not live close to any University, just community colleges. Did you like the program from Colorado? That is one of the ones I have looked at.

        • Katie
          September 13, 2012 / 11:14 am

          I took some of my classes at my local community college. Email me at [email protected] and I would be happy to get into more detail!

    • Nicole, RD
      Author
      September 18, 2012 / 9:04 pm

      I’ve been meaning to say 1) thank you and 2) yum! 🙂

  6. September 13, 2012 / 9:59 am

    Maybe you can address this question in your next Q&A:

    My brother-in-law has Crohn’s disease and it is very severe. Unfortunately, his diet is craptastic and consists of lots of fast food, caffeine, sugar, and refined carbs. He says that eating a lot of vegetables can be painful to his stomach but I’m pretty concerned that his bad diet combined with the inability to absorb nutrients because of his damaged intestines is causing him to be nutrient deficient. I can even witness this in his inability to focus and his poor sleeping patterns (and those are just the problems that I see!)
    I know that part of the problem is just getting him to eat right to begin with, but I’m also curious what sort of diet is recommended for someone with Crohn’s to ensure that they are getting all their nutrients?

  7. Rachel
    September 13, 2012 / 10:09 am

    The “leaky gut” isn’t caused by switching to a gluten free lifestyle, it’s caused by gluten. The anti-nutrients in gluten and other grains irritates the lining causing permeability, and therefore systemic inflammation.

    This whole issue is explained/documented very well in the book, “It Starts with Food.”

  8. September 13, 2012 / 9:49 pm

    I love these because it’s awesome to see my own beliefs reinforced by an “expert.” I choose natural sugars too, and just try to limit the quantity.

  9. Pingback: RD Q&A vol. 28
  10. December 5, 2013 / 8:45 am

    Hi Nicole,
    I would like to know what would be the Glycemic Index value of fried eggs with bacon-I understand that mixing protein and fat with your carbs,the glucose rise would be smaller because you would digest them slowly-
    Best regards,
    Leo

  11. December 5, 2013 / 10:03 am

    Sorry Nicole,in my breakfast,I forgot to include the 2 slices of whole grain bread as my carbs-
    Best regards,
    Leo

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