Frequently asked questions during a nutrition consultation | Podcast Em Banho Maria
"Do bananas make you fat? Does the glycemic index matters for weight loss? How can I easily count macros? Should we eat when we are hungry or when it's time to eat? Do I need to take probiotics?"
In partnership with the Portuguese Registered Dietitian Margarida Beja, we challenged nutrition professionals into sharing questions asked during nutrition consultations that sometimes are not-simple-nor-easy to answer.
Margarida is a Registered Dietitian based in the UK and started her podcast Em Banho Maria as a hobby, a way of sharing evidence-based nutrition information and tackling myths about nutrition, as well as feeling closer to home. Her podcast is very dynamic, with fascinating guests with which Nutrium has partnered.
As promised, we have compiled all of the questions during nutrition consultations that were answered on the podcast for professionals to read and share with their clients or even send to them whenever these questions arise.
Find out the answer to these questions and much more discussed in her podcast episode.
Register for free and learn more about the nutrition software that Margarida uses to follow-up with her clients.
Frequently asked questions during nutrition consultations
1. Is breakfast mandatory?
No meal should be seen as mandatory. We should eat according to our taste, lifestyle, and needs. Breakfast is not considered the most important meal of the day in the light of the most recent evidence. When it comes to weight control, studies do not show breakfast be more beneficial, nor significant.
The fact is that for some people, this can be considered a strategy, even though it should not be considered a rule for everyone. During childhood, for example, breakfast is thought to have a positive effect on concentration, learning, and school performance.
It is always important to consider each case as unique. Some people do not eat breakfast for the most various reasons, either because it does not make sense for them or because they don't need it.
2. How long should I take between follow-up consultations?
It can differ from patient to patient. Some people need closer monitoring and access to regular consultations, either from a strategic approach, motivational reasons or just to make sure they are compliant.
3. What is the role of the glycemic index and glycemic load on weight loss?
The glycemic index (GI) has little applicability, and sometimes, people end up getting obsessed with choosing foods with a low glycemic index. The GI is a value assigned to foods based on how slowly or how quickly they cause increases in blood glucose levels. This means that it is not this factor that tells us that food makes people gain more or less weight.
If a food product has a low GI does not mean that it will provide a higher feeling of satiety. This may not be true when we are talking about diabetics. In my opinion, the concept that we should be looking into is the glycemic load, which also includes the amount of a food product that is consumed.
A food with a high GI can have a low glycemic load and vice versa. That is why these two concepts should not weigh on our food choices.
4. Eating carbs at night makes me fat?
No. Assuming that a single macronutrient makes us fat is highly oversimplified. Every food has calories and can contribute to weight gain. Carbs eaten in the morning or at night have the same energetic value (4 calories/gram).
5. Fruit with higher calories makes me fat?
Fruit does not make us fat, as we talking about a food group that is generally low in calories. The evidence suggests otherwise: the consumption of fruit can and should be allied in weight loss. Ultimately, everything that has any calories and contributes to a positive energy balance will contribute to weight gain... attributing all of that only to fruit, seems unreasonable.
6. How can I easily count macros?
This question is often asked during nutrition consultations. Personally, I do not promote macro counting in any approach, as this can have two different outcomes. On one hand, it makes clients aware of how much they eat and learn about the energy value of food, leading to better food choices, and on the other hand, it creates obsession and the idea that we should follow a strict set of macro distribution.
In addition to that, people need to have a certain level of knowledge to know how to count macros efficiently.
In clinical practice, it is relatively challenging to create a meal plan that fits macros perfectly, and most of the time, it is not worth the while. Except for some clinical conditions or specific situations such as with high-performance athletes.
To sum up: I do not recommend counting macros, even though this can be used in weight loss as a way to control caloric intake when restricting.
7. Do we all need to drink 1.5L of water a day?
No. This is the average recommendation based on a study from 2010, in healthy individuals, who are sedentary and live in a moderate climate. The individual recommendations are 35 ml of fluids (not only water) per kg of body weight. But not all of us have the same lifestyle, so this can vary.
Although this is an oversimplified recommendation, and that ideally all advice should be individualized, this can be an excellent place to start.
8. Probiotics and pre-biotics - do I need to take them?
Assuming that the question refers to supplementation - not everyone needs them, and this recommendation should be assessed individually. It is essential to know the end goal of the client and make sure that only the most relevant supplements are used.
Prebiotics are foods with intestinal bacteria that we can quickly obtain through certain foods.
Fermented foods contain beneficial microorganisms for our health, but not all of them are probiotics. Thus it might make sense to supplement in this case.
9. Are leafy green vegetables enough for calcium intake?
It is true that with a vegan lifestyle, people can have an adequate calcium intake, even though this implies some planning. To my knowledge, when we talk about leafy green vegetables, we should take into account compounds such as oxalates and phytates, which can decrease the absorption of calcium. Thus, the calcium present in leafy green vegetables is less bioavailable.
That is why it is also essential to also consider fortified foods, for example. And it is also crucial to find each individual case and see if supplementation is needed.
10. Are vegetable drinks as healthy as cow milk?
If we remove topics like ethics and sustainability when discussing this topic, cow milk is a nutritionally dense food with scientifically proven benefits for our health. So we should not demonize these categories of foods.
Even though it is important to note that we should also consider a more sustainable eating approach and reduce the number of animal foods consumed, such as milk and milk products.
11. Should we only look for a nutrition professional to lose weight?
A nutrition professional works in many different areas and nutritional contexts.
- weight loss (gain, or to support situations with nutritional risk);
- gastrointestinal conditions;
- before and after surgery;
- oncology (prevention of malnutrition and symptom management);
Sometimes a nutrition consultation can be a moment to discuss eating habits and work on nutritional education.
12. Do I need to remove carbs from my diet to lose weight?
False. Carbohydrates can actually be a great ally for weight loss as they are sources of fiber that help balance satiety levels.
13. Should I take probiotics on and off or during extended periods?
In theory, probiotics (supplementation) only produce an effect during intake periods. Even though there have been reports of benefits even after stopping taking them, it can vary a lot.
14. What supplements can I take to lose weight?
Generally speaking, none. Eating well and be at peace with what we eat, doing physical activity, and work with a professional that you trust to supports us during this process.
15. I already eat healthily, why don't I lose weight?
Healthy eating can be very subjective. Personally, I don't like to name foods as healthy, because no food is good nor bad. Healthy is an individual concept, which to me may not mean the same as to you.
If you already have a healthy lifestyle and you don't lose weight, it might be because you are not in a calorie deficit. This should be addressed by a nutrition professional because it might not be easy to identify what is preventing you from losing weight.
16. Do bananas make me fat?
On average, a banana provides 100 kcal, which means that it is more calorie-dense than raspberries, for example. But that is no reason why it should not be included in your eating pattern or on a weight loss intervention.
As for sugar, the one present in fruit occurs naturally, which means that it cannot be compared to the added sugar of pastries, for example. Fruit also includes fiber, vitamins, and minerals, which are important to our health. But keep in mind that we do not consume nutrients, we consume foods.
17. Should we eat when we are hungry or when it's time to eat?
This is somewhat controversial and depends a lot. Our organic needs are not always aligned with our hunger signals, and that is why it is not as linear as it seems.
During consultations, when the client looks for specific bodyweight goals, it is important to structure a routine. For others, it can also be encouraged a more intuitive approach, even though this is a learning process as no one can eat intuitively on the next day.
18. Is rapeseed oil bad?
Nothing in moderation is bad. Rapeseed oil has an interesting lipidic profile, high in "good fats", and it is pretty stable when in high temperatures. The only question is that there are only a few studies that associate its benefits to cardiovascular health or other health issues. On the other hand, olive oil has a vast scientific base proving its benefits.
To sum up, rapeseed oil is not harmful and can be added to a healthy eating pattern, in moderation.
19. What are the benefits of water with lemon? And apple cider vinegar?
These two have been associated with several health claims, such as anti-inflammatory, weight loss, diabetes control, etc. Even though they lack the scientific evidence to back them up.
20. Snacks: yes or no?
It depends. Some people benefit from snacking between meals, more so when their routines demand it. But again, each case should be addressed individually.
21. For someone who does not like dairy products, how can they increase their protein intake without having to turn to eggs?
Hummus, chicken sandwiches, or other protein, nuts, soy drinks or yogurts (since this is the only alternative with a similar nutrient profile to milk), vegetable-based protein supplements can also be an option.
22. Are beets good anti-cancer food?
Antioxidants have a preventive benefit on health, even though no food should be labeled as anti-cancer as there is no such thing.
For people with cancer, eating habits should not be seen as a cure as it is realist, but as an ally to control symptoms and the nutritional status of the patient, which is highly correlated with the disease outcomes. So you can eat beets if that is something that you like, but it is not the magic recipe or cure... we wish!
Register for free and learn more about the nutrition software that Margarida uses to follow-up with her clients.
We hope these examples of questions during nutrition consultations will help you with your clients and it will make it easier for you to provide information to your clients.