Ask: Do we need 100% of nutrients every day?

As humans, we've evolved with cycles of food availability. For example, you couldn't eat bread until the grain had been harvested and milled. If you wanted strawberries you had to wait until they ripened. Today, we hear about recommended daily allowances of vitamins and minerals constantly. We take daily vitamins to be sure we're getting 100%. But do our bodies need 100% every day? Do we, for example, need more vitamin C just when the summer fruits come in season? Do our bodies need more protein in the winter, when fresh fruits and veggies weren't available but meat could be caught? I'm wondering if our bodies need a cycle, and not a daily dose.


This is a multi-part question, and I will do my best to address all of it - some ventures outside the realm of my expertise, and some parts are simply opinion or do not have clear cut answers at this point.

Ask: When to see a dietitian?

How does a person decide if he/she needs to see a nutritionist or a dietician?

Before I answer this question, I want to mention the differences between a dietitian and a nutritionist. "Nutritionist" is a blanket term. There is no regulation regarding its use (unfortunate, because I happen to like the word better). As such, anyone may call his/herself a nutritionist, whether knowledgeable about nutrition or not.

In contrast, a registered dietitians (RDs) have spent years studying biology, chemistry, clinical nutrition and food science, and are required to pass a national exam administered by the American Dietetic Association. Throughout their careers, RDs are required to accrue continuing education credits in order to keep up to date with the latest nutrition advancements. Someone with a Masters degree in nutrition has likely received additional training in clinical nutrition, research interpretation/evaluation and behavioral theory. 

Ok, on to the question: there are many reasons to visit a dietitian/nutritionist! It is, of course, a personal decision involving not only health, but convenience and cost as well. More and more dietitians are venturing into teledietetics (nutrition counseling by phone/internet), which is a great option for folks in rural areas or with limited mobility. In any event, I am focusing on health reasons. Let's see how many I can come up with:

• Prevention of Disease. Visit a dietitian for a general nutrition check-in. Are you eating as well as you think you are? Are you bored with your food? Can't decipher nutrition labels and health claims? A dietitian can help you sort fact from fiction and identify ways to improve (and inspire) your diet and lifestyle. You can't change your genetic susceptibility to illnesses such as diabetes, heart disease and cancer, but you can give yourself a better chance at beating the odds.
  
  
• Support during Disease. Visit a dietitian if you are diagnosed with a medical condition, especially:
• Diabetes or insulin resistance (may be called "prediabetes")
• High Cholesterol or Heart Disease
• Kidney disease
• Liver disease
• Food Allergies
• Any Gastrointestinal-related disorder, including GERD, gastritis, ulcerative colitis, Crohn's disease, irritable bowel syndrome and many more.
  
  
• Pregnancy (before, during and after).
  
  
• Weight Loss. Sure, you might know generally what you need to do, but meeting with a dietitian, having s/he perform a diet analysis can be very helpful. Continuing to meet occasionally will help keep you on the right track. This is true of any medical condition requiring nutrition and lifestyle changes.
  
  
• Family Nutrition. There are dietitians who specialize in pediatric and family nutrition. Everyone's heard the stories about kids who only eat beige foods...
  
  
• Disordered Eating. Ideally, treatment of eating disorders should take a multidisciplinary approach and include - at a minimum - a physician, a dietitian and a mental health professional (psychiatrist or psychologist).
  
  
• Sports and Fitness. A sports dietitian will help you maximize the benefits from your fitness training. Ensure that your physical efforts are supported by the appropriate nutrition strategies.
  
  
• Supplement Confusion. Unlike drugs, there is little regulation of supplements. What is safe? What really works? What the heck do those claims mean, like "supports healthy cholesterol levels"? A dietitian has the knowledge and resources to help you sort it through.

Hope this is of some help, and thanks for the question!

P.S. Either spelling (dietitian or dietician) is correct, but dietitian is most commonly used, and is the choice of the American Dietetic Association.

Ask: Meal Replacement Protein Shakes

I have been drinking protein shakes sometimes for breakfast and sometimes for both breakfast and dinner. The drinks I have been using are called Isagenix and I add a scoop of the Isagenix whey protein in the shakes as well. I was wondering what your thoughts are on meal replacement protein shakes and what I should be looking for in a shake if I was to continue to use them. I don't mind if you specifically speak to the Isagenix products and give your thoughts on them. Just curious. 

Thanks for the great question. Meal replacements, be it protein shakes, powders or bars are very popular and often used in weight loss strategies. How well meal replacements work for this purpose really depends on the person: some folks are happy knowing exactly what and how much to eat. It's easy, eliminates guesswork and they can stick to it. Other people find this too restrictive and end up "rebelling" by eating a meal and the meal replacement!

In the short term, meal replacement shakes can be a useful tool to control portion sizes, jump start a diet and lead to weight loss. However, there is not great deal of research regarding long term use [1] and I would not recommend them for other than occasional or convenience use. Here are some of my concerns: