3

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Grains - is 2 servings per day REALLY needed? And other questions... Met with a dietician yesterday

Answered on August 19, 2014
Created September 06, 2012 at 1:27 PM

Just to give you a little background. I have lost 21 pounds since August 1st by eating paleo and tracking my food consistently. I have been seeing an Integrative physician since July and she has been fantastic although she initially recommended I do the Mediterranean diet. When I told her I've dabbled with Paleo in the past and had great success (plus it made sense to me) and I wanted to go down that path again, she was very supportive. She recommended I meet with a dietician that is very open minded and not your "typical dietician" who also specializes in people with binge history (such as myself). I quite liked the dietician I met with yesterday in general, but there were a few things that she mentioned that bugged me a bit.

  1. She saw my Fat/Carb/Protein percentages (I brought a detailed printout of all my intake since August 1st) and she made a comment that she didn't want me to eat like this long term for risk of heart attack. I was like wha-wha-what?! My average weekly ratio is around 60% fat/12% carb/28% protein... Also carbs are anywhere from 20-70 g per day.

  2. She was concerned the lack of "whole grains" in my diet. She said I need to have 2 servings per day (paleo or not). I really don't feel the need to adjust what I am eating to be honest, it's working for me and I feel GREAT. I have always felt like CRAP when eating grains like oatmeal.

  3. She doesn't think "paleo" is a long term diet but rather a "fad diet". She is concerned with any diet eliminating certain food groups (like grains/dairy/etc) especially with my binge history. I haven't felt the need to binge since July so I'm not sure why the issue there?

  4. She mentioned she could easily find studies blowing paleo concepts out of the water. To this I countered with "I'm sure you can find studies to support your point of view one way or the other. And I think you would agree with me that there hasn't been extensive studies done longterm on those that have followed this diet."

I will give her credit that she said she is open minded and would like to see how Paleo works for me long term and did say if it's working for me don't change anything until I get closer to my weight loss goal (I have another 70 or so pounds to go).

Questions...

  1. Is my fat/carb/protein percentage okay?
  2. Is the 2 grain serv per day really necessary?
  3. Do you consider paleo a fad diet?
  4. Are there studies that "blow paleo out of the water" or is that just hyperbole? Everything I have personally read as of late has been very complimentary, including the fact it just MAKES SENSE to eat real food.

I have felt so fantastic I am not planning on changing how I am eating at this time but would like a little insight and ammunition to provide when and if I meet with her again. Thank you!

3ed47bb3513ed0b4849e6b492422cadf

(90)

on September 10, 2012
at 10:02 AM

The Eat several servings of "Healthy Grains" a day has helped establish the worst epidemic of obesity and heart disease /Diabetes in human history. The woman is part of that culture and being funded by you know who. Ignore her lol.

B3173217a49b5b0116078775a17eb21d

(11488)

on September 09, 2012
at 09:49 PM

The woman is an idiot.

Af939911afa817f79a4625d4f503c735

(552)

on September 09, 2012
at 01:37 PM

"...it's working for me and I feel GREAT." Does anything else really matter? There are always going to be people telling you that what you're doing is wrong - but studies, nutritional dogma, and popular opinion can't argue with how you FEEL, perform, and look.

Bdf98e5a57befa6f0877f978ba09871c

on September 07, 2012
at 01:01 AM

major snaps for this answer.

724ac8ed9ddc603e87adf6cfb901a8d8

(325)

on September 06, 2012
at 07:09 PM

This is a really wonderful answer and I appreciate the lack of snark...thanks, Julie :)

518bce04b12cd77741237e1f61075194

(11577)

on September 06, 2012
at 06:46 PM

Wow she's "not your typical dietitian" if by that your doctor meant "she is exactly your typical dietitian". This is what dietitians say.

44349dd8bf3bc226731d2f6bd42e8124

(318)

on September 06, 2012
at 05:15 PM

I never said I trusted a mainstream nutritionist. I merely asked questions in regards to her suggestions. Additionally, she's not what is considered "mainstream". I have read a lot about primal and paleo so please don't assume. I'd say a lot of people that ask questions on this site are wanting validation on what they have read and to continue learning about this lifestyle. Isn't that the point of the site?

44349dd8bf3bc226731d2f6bd42e8124

(318)

on September 06, 2012
at 03:54 PM

I've ate paleo without measuring and find that when I do so I overdo it and don't see the weight loss. That could be part of my binge eating history, but so far it's working for me. Thanks for the feedback!

44349dd8bf3bc226731d2f6bd42e8124

(318)

on September 06, 2012
at 03:53 PM

So many agendas involved it makes my head spin. I'm going to focus on my own agenda (health & weight loss) as I have up until this point and I believe I can't go wrong doing that.

44349dd8bf3bc226731d2f6bd42e8124

(318)

on September 06, 2012
at 03:53 PM

Jamie, lots of good stuff here. Thanks.

44349dd8bf3bc226731d2f6bd42e8124

(318)

on September 06, 2012
at 03:52 PM

Rob, thanks for the comment and article. I have never understood the push of grains...

44349dd8bf3bc226731d2f6bd42e8124

(318)

on September 06, 2012
at 03:51 PM

K8lynn6, thanks for the comments. I have no intention at this point to add anything (like grains) back in, at least while I feel great and am having success. Yep, strength training is happening. Like the idea on protein/fats. Thanks!

44349dd8bf3bc226731d2f6bd42e8124

(318)

on September 06, 2012
at 03:50 PM

I did get blood work done in July and I was told it was excellent. I do realize I need to get my hands on the specific numbers. Here's the deal, my blood work is always EXCELLENT even eating a SAD. I don't know if that's genetics or what. What I'd like to do is have the blood work redone approx 6 months in and see how it compares to what I had done in July.

44349dd8bf3bc226731d2f6bd42e8124

(318)

on September 06, 2012
at 03:47 PM

I agree. I believe the two culprits in my binge eating madness have been grains & (non-fruit) sugar. Since eliminating those two evils life has been good.

44349dd8bf3bc226731d2f6bd42e8124

(318)

on September 06, 2012
at 03:43 PM

I LOVE THIS. Thank you

Medium avatar

(3213)

on September 06, 2012
at 03:36 PM

If you trust what a mainstream nutritionist tells you, you shouldn't be Primal/Paleo. Plus, you have a lot of reading to do

E5a6bfd9cdfaef445bbfaa548897738f

(106)

on September 06, 2012
at 02:34 PM

Forgot to mention how much paleo overlaps with SCD and the Whole90 diets for treating other illnesses. SCD diet never lets grains back in...

Bb3d1772b28c02da2426e40dfcb533f5

(5381)

on September 06, 2012
at 02:18 PM

^ The point about funding is very true. Its the grain industry than demonised saturated fat with the lipid hypothesis. Now its the dairy industry that discovered/developed our understanding of small dense LDL. Virtually every study is funded by a company who will profit from the conclusion, and thus almost all the standard dietary advice we get comes originally from people pushing product. Not to say it makes every conclusion untrue, but its another good reason to be skeptical of conclusions that arent heavily tested (ie lots of attempts to prove it WRONG)

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17 Answers

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16
5f3e1f803d7a9b8704bb11cda26bcf9a

on September 06, 2012
at 03:02 PM

She says she can bring you studies that show that the Paleo way of eating is not OK? Tell her to BRING IT ON. Then read them with an eye towards the following: 1. Who funded the study? 2. How many were in the sample (N=?) 3. What variables did they account for? (a red meat study recently touted in the media as showing that red meat causes heart disease didn't account for the fact that most of their red meat eaters ate lots of other crap and many of them SMOKED!) 4. Did they show CAUSATION? not CORRELATION? 5. What were the conclusions and are they supported in the study?

This is how you can argue your point (if you feel like arguing): 1.) Your weightloss 2.) Your blood tests 3.) How you feel. 4.) The fact that her studies show nothing substantial, and why.

44349dd8bf3bc226731d2f6bd42e8124

(318)

on September 06, 2012
at 03:43 PM

I LOVE THIS. Thank you

Bdf98e5a57befa6f0877f978ba09871c

on September 07, 2012
at 01:01 AM

major snaps for this answer.

724ac8ed9ddc603e87adf6cfb901a8d8

(325)

on September 06, 2012
at 07:09 PM

This is a really wonderful answer and I appreciate the lack of snark...thanks, Julie :)

9
Eedf46c82d0356d1d46dda5f9782ef36

(4464)

on September 06, 2012
at 01:49 PM

  1. I dunno. I'm sure others will answer that one. I'm not a measure/count/ratios kinda guy.
  2. Nope.
  3. Oldest fad on the planet, for sure. Like squirrels are on this fad of eating nuts. It'll never last!
  4. Sure - there are studies that prove/disprove just about every idea. Your comment that it just MAKES SENSE makes more sense than a lot of studies. Look at nature when studies fail.

44349dd8bf3bc226731d2f6bd42e8124

(318)

on September 06, 2012
at 03:54 PM

I've ate paleo without measuring and find that when I do so I overdo it and don't see the weight loss. That could be part of my binge eating history, but so far it's working for me. Thanks for the feedback!

8
Bb3d1772b28c02da2426e40dfcb533f5

(5381)

on September 06, 2012
at 02:13 PM

"Is my fat/carb/protein percentage okay?"

In terms of heart disease the disjointed and nebulous theory goes like this ->

Increased saturated fat intake = increase blood LDL = risk factor for heart disease.

Each of those steps is a little speculative, but the important thing to note is the bridging. Its not sticking food in your mouth that has connection in the theory to heart disease, its the elevated blood lipids, for which there are two unmentioned risk factors, triglycerides and small dense LDL, both of which are connected to carb intake, not fats.

But, assuming you buy into this whole nebulous chain of propositions, I would ask you - whats your blood LDL like? HDL? triglycerides and most importantly small dense LDL?

If they are healthy looking, according to the conventional view, or not far out of range, then I suggest you tell your dietician to mind their own business. I say this because I used to eat really mainly just carbs and my LDL was very borderline, now I am eating lots of fat and virtually not carbs, my LDL has gone down to in normal range, and my triglycerides are almost non-existant.

So, to sum, even if you buy the lipid hypothesis its "food" -> " blood lipids" -> "heart risk". If the food doesnt do that to your blood lipids, your a glaring exception to their whole chain of logic.

You also may wish to read the paleo take on heart disease. Small dense LDL is THE highest risk factor, much higher than normal LDL, and its linked to dietary carbs, not fat.

"Is the 2 grain serv per day really necessary?"

Ask her -what for? What useful thing do grains offer, than you cant get from other foods? Fibre? -> Fruit, nuts and veg (both soluble and insoluble fibre can be found in a variety of foods. Things like pumpkins, avocados and nuts are pretty high). Nutrients? Well hardly, they are packed with anti-nutrients and have virtually none. Your likely to lose more nutrients than you gain. I have no idea why someone would suggest grains as a nessasary food really. Madness.

"Do you consider paleo a fad diet?"

If you consider tens of thousands of years of human evolution a fad, and the last couple of centuries as a permenant lifestyle, then yes its a fad.

lol. What would it matter if it was a "fad diet"? Its either healthy or its not. if popularity was a measure of good health, drinking, sitting in the dark, smoking, cars, fast food would all be good for you. Playstation would be like taking a walk every day. Thats just an illogical way to belittle something, and undermines the credance IMO, of the person doing so. If the general public was a pure font of wisdom and intelligence, I imagine the world would be a much different place.

"Are there studies that "blow paleo out of the water" or is that just hyperbole? "

No. Nutritional science is really vague as a general rule, as far as conclusions go. Its largely stastics, and contains ALOT of uncontrolled variables. Some of them use genetically flawed animals to draw conclusions about humans.

Its a little better than postulating the existance of god, but not much.

Paleo is pretty understudied. Most of the studies ive heard of have been pretty favourable. Thankfully they werent statistics.

I spent my university years studying psychology. That was after a computer diploma, and years of reading about physics. I though psychology was a "soft science", but I hadnt met with nutritional science then. At least social science is clever enough to pull their punches and recognise their theories as theories, and not facts. And to be honest, they are much more aware of confounding variables.

The strength of conclusions that people bring to nutrition makes me laugh. Id love to put them in a room with a chemist, biologist, engineer, or physicist to discuss how they controlled for the variables in there experiment, and rigirously tested their hypothesis.

I would suggest that, if its not your general practice to critically examine the merits and faults of scientific studies, then it would be redundant for her to bring such studies to you.

Then again, it was rather redundant of her to say she could, when it seems probably IMO, that she cant. Or she just really doesnt understand science generally, and has only been drip fed nutritional science in dietician school. If so, I suggest she spend some time learning how real science is supposed to be done, and how hard conclusions are supposed to be established.

44349dd8bf3bc226731d2f6bd42e8124

(318)

on September 06, 2012
at 03:53 PM

Jamie, lots of good stuff here. Thanks.

7
11b7b7ba720a5cd43c74a0ef99a16adb

(3448)

on September 06, 2012
at 05:15 PM

A couple of questions to throw back at her re two servings of grains per day:

1) Is eating 5 servings of table sugar a day a requirement to be healthy?

Carbohydrate is just a fancy name for sugar (table sugar is a carbohydrate). The digestible carbs in two pieces of whole wheat toast is 22 grams, which--when it is digested and broken dwon into simple sugar molecules--ends up in your blood stream as 5 teaspoons of sugar (there are 4.2 grams in one teaspoon).

To put that in perspective, your body holds over 1,000 teaspoons of blood. How much of that should be sugar? One (and only one) teaspoon. So, when you eat just two pieces of whole wheat toast, you are pumping 5 times the amount of sugar you should have into your bloodstream (which is why eating toast spikes your insulin levels).

I guess the point of this question is to determine if she understands that carbs are just sugar molecules chained together. If she says they aren't ask her for to explain what a polysaccharide is, and to give you some examples (table-sugar, the startch in potatoes, and the carbohydrates in whole wheat toast are all polysaccharides). Ask why the polysaccharides in table-sugar are bad for you, but the polysaccharides in whole wheat toast are good for you?

2) Is the fiber in grain superior to the fiber in other foods?

Two pieces of whole wheat toast: 4 grams of fiber. One large apple: 5 grams of fiber.

On top of that, when it comes to vitamins and minerals, the apple beats the snot out of the two pieces of bread.

The point of this question is to determine if she understands that there are plenty of non-grain sources of fiber and that they (for the most part) contain more vitamins and minerals than grain products.

7
45ace03a0eff1219943d746cfb1c4197

(3661)

on September 06, 2012
at 01:51 PM

If health is your goal, grains are not only not necessary, they're detrimental.

4
Fd70d71f4f8195c3a098eda4fc817d4f

(8014)

on September 06, 2012
at 07:01 PM

"She is concerned with any diet eliminating certain food groups."

I always wonder what these dieticians say to vegetarians. :-/

4
C1c86f42410cd4788bd9c5cf801dcd8f

(2246)

on September 06, 2012
at 02:07 PM

  1. If it working don't ** with it. Unless you stop getting results. Then you can start changing and modifying it.
  2. If it is i'm screwed. (3 years... mind you I do eat grains sometimes. X-mas etc)
  3. I think people turn it into a fad diet with all the new books and everything people keep cashing in on. However its here to stay.
  4. Yep. There are, most studies in general are flawed. They are funded to prove a point for example drinking milk is good for you. If people find out that hey we don't require milk to be healthy, funding is cut and goes to someone else who can support the drinking milk is good for you theory.

    Think about were funding from studies come from, there is a multi-billion dollar industry to prove that milk and grains are healthy. There is nothing really to prove that the paleo diet is.

44349dd8bf3bc226731d2f6bd42e8124

(318)

on September 06, 2012
at 03:53 PM

So many agendas involved it makes my head spin. I'm going to focus on my own agenda (health & weight loss) as I have up until this point and I believe I can't go wrong doing that.

Bb3d1772b28c02da2426e40dfcb533f5

(5381)

on September 06, 2012
at 02:18 PM

^ The point about funding is very true. Its the grain industry than demonised saturated fat with the lipid hypothesis. Now its the dairy industry that discovered/developed our understanding of small dense LDL. Virtually every study is funded by a company who will profit from the conclusion, and thus almost all the standard dietary advice we get comes originally from people pushing product. Not to say it makes every conclusion untrue, but its another good reason to be skeptical of conclusions that arent heavily tested (ie lots of attempts to prove it WRONG)

3
D41bd7b3d3b962eb0146f471eb632f56

on September 07, 2012
at 04:03 AM

The food group thing always makes me laugh. I have to laugh or I'll cry.

"Food groups" are a recent construct that really have very little to do with nutrition and more to do with politics. If it were about macronutrients, roots, tubers, and legumes would be paired with whole grains, and dairy would be lumped in with either fats or meats + eggs, instead of hanging out in their own clique. Micronutrient profiling might shift things even more. In this perspective, a paleo diet only excludes certain botanical groups--not nutritional (excluding cereals and pseudocereals, but not tuber-based starches, for example). And there are plenty varieties of plant life and animal life that are deadly to eat. A meal of oleander and polar bear liver will surely kill you. Does excluding those things and other poisonous foods too "exclusive" of a diet to be healthy? I believe the concern over excluding a food should only be permitted under one of two conditions, 1) are you malnourished in a nutrient that can only be obtained from that food? and 2) does excluding this food make the entire lifestyle too difficult (ie. encourage binging, undereating, make it too difficult to get a well-rounded diet, encourage other unhealthy habits, etc.).

But in the end, you have to find out what works best for you. I'm sure I don't have a popular diet on this forum. I eat gluten-free grains (mostly buckwheat and rice) and beans. I follow a more carb-managed Weston A. Price model of eating, since, for me, when prepared properly, I tolerate them well and they add to my quality of life and personal nutritional profile. But they are by no means a daily requirement. Same goes for macronutrient ratio. I work best at roughly 80g-100g protein/100g fat/100-200g carbs. My carbs are higher than a lot of paleo followers, but any lower on a regular basis and my menstrual cycle stops. Though much higher than 200 and my carb habits get out of control. I can maintain that ratio well without much effort and maintain a balance of health. But, that's just me. And what works for you probably won't be anyone else's ideal diet.

3
Adeb72a71b7cd3f4dd75795eb9c11ad9

on September 06, 2012
at 02:34 PM

Most dietitians are still going to recommend a "healthy" SAD diet. Even though being open minded, there are still those that have a hard time letting go of the fat is bad whole grains are good ideal. I would also like to point out that you say you have not had a problem with the binging so therefore this proves (in my mind) that grains has been a culprit to your binges. Of course I only speak from my experiences :) I was a binger too.. But going Paleo I have never had as much control with food intake then now and honestly it feels pretty good.

I would also like to say that I agree with you, Paleo does makes sense...Good luck on the rest of your weight loss...I'd definitely like to hear about how things go with you and this dietitian if you decide to go back.

44349dd8bf3bc226731d2f6bd42e8124

(318)

on September 06, 2012
at 03:47 PM

I agree. I believe the two culprits in my binge eating madness have been grains & (non-fruit) sugar. Since eliminating those two evils life has been good.

2
0b4326a4949718451a8571b82558dc10

on September 06, 2012
at 10:31 PM

haha fad diet...so the past 200,000 years + of eating was just a fad?

when you feel like crap that's when you should start worrying about your diet. I think your good for now.

2
Af3e3615beba642bcafd0f21d64d74f7

on September 06, 2012
at 10:19 PM

I am concerned with a diet that adds a food group that did not exist 99% of our existence. do the placebo patient method and pretend you are eating "healthy whole grains", when your blood is right and everything is superb, then tell them what you really do.

2
E5a6bfd9cdfaef445bbfaa548897738f

(106)

on September 06, 2012
at 02:32 PM

I can't answer all the questions, but there have been studies that say saturated fats arent the problem with cholesterol and bad fats in the blood and heart attacks. Also, if you are burning fat, your body keeps the blood lipids in check. Grains defeat your body's goal of running on fat. If grains make u feel like hell, dont eat them! That should be conveyed to your dietician. Just like "if it hurts, dont do it". Everyone else made extremely valid and helpful points so i wont reitterate. And, would they tell someone with a gluten allergy to still eat grains? Essentially, those of us that switched to the paleo diet habe some sort of "allergy" or intolerance to grains to begin with. Some just disnt know how bad until its eliminated. Prove your dietician wrong... Keep up wit what you've been doing and seeing results with. The only thing i might suggest is to increase your protein a little and start doing some strength training. The more muscle and increase activity will help you lose the weight. And decrease your fats on days you do strength training, this will help mobilize the fat on your body to get rid of it for energy needs. Good luck!

44349dd8bf3bc226731d2f6bd42e8124

(318)

on September 06, 2012
at 03:51 PM

K8lynn6, thanks for the comments. I have no intention at this point to add anything (like grains) back in, at least while I feel great and am having success. Yep, strength training is happening. Like the idea on protein/fats. Thanks!

E5a6bfd9cdfaef445bbfaa548897738f

(106)

on September 06, 2012
at 02:34 PM

Forgot to mention how much paleo overlaps with SCD and the Whole90 diets for treating other illnesses. SCD diet never lets grains back in...

2
Fdf101349c397fbe1ecb98b310fb3737

(358)

on September 06, 2012
at 02:19 PM

1 and 2. To paraphrase Robb Wolf, if you look feel and perform better, and your biomarkers are improving, what could be wrong with that? Your FCP ratios are fine as long as it works for you.

  1. It's a shame that paleo has this fad diet label. Bottom line is that it is a whole foods diet that excludes three classes of nutrient poor "foods" that are demonstrably, provably bad for a large portion of the population (grains, added sugar, seed oils).

  2. I do not believe that there are any studies that blow paleo out of the water. They simply have not been done. Most of the sensational headlines come from epidemiological studies, and those don't blow anything out of the water.

Have you gotten some blood work done that you would like to share?

44349dd8bf3bc226731d2f6bd42e8124

(318)

on September 06, 2012
at 03:50 PM

I did get blood work done in July and I was told it was excellent. I do realize I need to get my hands on the specific numbers. Here's the deal, my blood work is always EXCELLENT even eating a SAD. I don't know if that's genetics or what. What I'd like to do is have the blood work redone approx 6 months in and see how it compares to what I had done in July.

1
3491e51730101b18724dc57c86601173

(8395)

on September 09, 2012
at 06:25 AM

I highly recommend the book, Wheat Belly, by William Davis. Pay special attention to his explanation of the morphine-like exoprhin compounds in wheat that cause addiction. With an eating disorder history, the last thing you need to do is eat "whole grains" every day.

This dietician doesn't sound very open-minded to me.

1
61c1efcc482019e016c45270b18c7453

(645)

on September 06, 2012
at 02:15 PM

  1. No one can tell you if your percentages are ok other than you. It also depends on the level of activity that you do everyday. One of the primary goals of paleo is to get your body used to burning fat for energy, however high intensity exercise needs a good dose of carbs. If you feel energetic during your workouts then don't change anything.

  2. 2.

No it's not. Why would it be? Ask your dietitian this question. What's so essential about whole grains that you can't get in green vegetables?

3.

No it's not a fad diet. It's only fad if it was designed to make you lose weight. With Paleo, like just any other diet, you can lose weight or gain weight.

4.

Not really. Here's another study that supports Paleo.

http://www.cbsnews.com/8301-505269_162-57505149/modern-wheat-a-perfect-chronic-poison-doctor-says/

In my opinion one of the main reasons that people diss on Paleo is because they don't understand what it is. They think the goal is to eat like our Paleolithic ancestors did, when in fact it's simply about eating what your body was designed to process through hundreds of thousands of years of evolution.

44349dd8bf3bc226731d2f6bd42e8124

(318)

on September 06, 2012
at 03:52 PM

Rob, thanks for the comment and article. I have never understood the push of grains...

0
05de181d71c1df6304a03566fe821d4b

on September 09, 2012
at 06:33 AM

ehh most dieticians are taught according to the food pyramid of death.

I eat under 50g of carbs, under 70 protein (not exceeding more than 25g protein per meal) and at least 100g of high quality fats.

Since when is gliadin, lectin, gluten, phytic acid, and saponins essential for our bodies? :P

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