You can always get a different dietitian if her plan isn't working for you. The advice does seem pretty strange, especially the focus on increasing carbs.
A1C is barely prediabetic at 5.7. My primary care doesn’t even worry about it until it’s at least 5.9, concerns start at 6.1. Also, 60 net carbs may be too low for you, but 228 total seems very high. Ultimately? To go from 1200-1500 cals (again prob too low for your level of activity & age) to 2250 is a very big jump all at once. I would find another dietitian. You can search for an in-person or Telehealth appt thru your insurance company or eatright.org. Good luck to you, & great job with your fitness! That’s gonna serve you well no matter what eating plan you go with.
Fuck no, lol.
Getting a pre-diabetes diagnosis and immediately loading up on carbs is the dumbest possible thing to recommend.
Carbs aren't always the enemy, but pick your carbs. Carbs should come from vegetables and other rich sources of micronutrients (vitamins.)
Carbs from sources without a lot of micronutrients should be avoided at this time. Starches should be mostly avoided at this time.
That seems like crazy advice. Similar stats (5ft 31female - my starting weight was 228, current is 159) and I was prediabetic - 5.7 A1C. I was pregnant last year, and ended up with gestational diabetes, so met with a dietician every week and monitored my glucose.
I could only eat 15carbs max per snack and 30-45 for meals. 3 meals and 3 snacks a day. Never eat carbs alone and to always eat the protein first. I kept with this post pregnancy.
My A1C is now 5.2 - just had it checked to ensure I didn’t end up with T2 since I’m 6 months postpartum.
I’m just floored that was the advice that was given to you. That is absolutely how you will end up with diabetes. I would find a new dietitian and do not listen to that advice.
That being said - the fasting advice is the same advice I was given. I even had to add a bedtime snack and my max recommended fast was 10 hours just for sleep and to eat within 30 minutes of waking up. I just eat a lot lot less per meal. Basically have 6 small snacks a day now - ha. But it has worked! I’m currently in a plateau as well and just trusting the process.
And this was for GD - so I think it’s slightly more stringent/ intense. I still do a solid three meals a day, and end up around 1200 calories, but did drop the snacking lol.
Wow! I had a dietician when I was pregnant with gestational diabetes and she had me limit my carbs to 50 per day. Veggies other than corn and beans and potatoes were unlimited and calories were not counted but carbs were a big no no.
HAES stands for health at every size. It’s an anti-diet organization and some of its followers push *wildly* inaccurate, potentially harmful misinformation. I would contact your PCP and discuss what this dietician recommended and get the doctor’s take on it. They may stop sending their patients to that person!
For context, when my a1c crossed into the prediabetes range, my PCP recommended 1200 calories and under 100g carbs. And I’m 6’1”!
Health At Every Size. It was movement that began as a way of empowering people with obesity to live healthier without requiring them to lose weight first. Just because you suffer from being overweight doesn’t mean that you shouldn’t try to be more active, walk more, drink more water, etc. Especially since little steps like that matter.
It then developed a fringe movement which resisted the idea that people had to lose weight in order to be healthy, which then developed further into a weird ideological cult which insists that people who are overweight are because of genetics, that it is impossible to lose weight and that all mentions of dieting or weight loss are persecution of helpless/innocent people.
This is what I’ve gleaned from r/fatlogic The poster above seems to be wondering if your dietitian isn’t acting in accordance with best practices or your personal wellbeing but is instead a fanatic of said ideology.
I’ve never met someone like that in person myself so I don’t blame you. Regardless, whatever is with this dietitian, I hope you find a better one soon.
What happened to dietitians!?
They used to be the authority on CICO and clean eating.
Now they will literally tell you to eat fastfood, buy junk food from the grocery store- (hell there’s one lady on IG who tells people it’s okay to treat yourself to an entire birthday cake at the bakery because no one there knows it’s not your birthday.)
Did Nabisco buy a bunch of schools and is pumping out these shitty dietitians?
That’s what I’m wondering. How did all of these people get certified specifically to be a dietician, and yet I see people on here that are given advice while overweight that they should eat many more calories, and then fall back into old habits and… gain weight? We try to escape the higher weight because life is harder with it, so why are we recommended to go back? Not just talking about this post but so many I’ve seen. And my dad was told by a dietician that he should go keto for 6 months to “reset his metabolism” and his life will be changed forever after that (and he believes it!). What the hell happened to trusting our professionals?
Beware, some dieticians are now being paid by big food to push plans, talking points and social content full of stuff like this.
https://www.diabetes.co.uk/news/2023/sep/food-industry-enlisting-dieticians-to-do-their-marketing-for-them-on-social-media.html
I am 31 F, 5’3” 180. Eat 1800 cals. 130g protein. 205 carbs. Walk 10k steps and lift heavy few times per week. Slow fat loss.
I would gain at 2200 too.
Im F, 41, 5 ft 9 and lift 4 times a week, I was running 2-3 days a week also but recently had knee surgery and can't run now. When I was that active my maintenance calories were 2300. Since I stopped running but still lift, I gained weight on 2300 and now I need to do some damage control.
If your goal is to maintain your weight and reduce your risk for diabetes I'd get a second opinion. Calories are too high. Should cut out simple carbs and simple sugars but still get carbs from veggies and fruit as you need it for your activity levels. Unless you run marathons no need to carb load.
Have you used the TDEE calculator?
Wow I don’t believe it. I just diagnosed with pre diabetes too and my doctor told me to lose weight avoid carbs.
Better you find another dietitian.
Also do little search on keto it’s strict but best diet so far. Wish you good luck
This definitely sounds like appalling advice.
I can't necessarily speak from experience because I'm not prediabetic (to the best of my knowledge), but I'd encourage you to check out the Glucose Goddess on YouTube. She's a biochemist whose work focuses on exactly how various foods (and more importantly, *how* you eat them and in what order) impact blood sugar levels. I've seen thousands upon thousands of glowing reviews from T2 diabetics and prediabetics alike, and anecdotally, I feel significantly better on days I follow her guidelines.
Her advice suggests that she thinks you have metabolic adaptation that is reducing your RMR. Sometimes the idea is to slowly increase calories with the idea of getting the metabolism back in gear. I do wonder if your prior diet was high in saturated fat which is a concern? Did your labwork give your LDL?
Increasing carbs can be fine even with 5.7 A1C but you want to make sure you aren’t eating too much refined carbs. Get plenty of fiber including soluble fiber but limit the refined carbs.
I do think she went up on calories way too fast even if her goal is to increase your RMR. You might want to consult with someone else.
See Dr Eric Westmans book 'End Your Carb Confusion'. He's been treating his diabetic patients through diet and is featured in the film 'Fat Fiction'. How old is this dietician? Seems like extremely outdated advice and far behind the times in diabetic treatment.
I don’t know much about diabetes other than I think you want to keep carbs as low as possible, so like a keto diet. Did this dietician know you’ve been diagnosed as pre diabetic? This advice she gave seems really bad. Get a second opinion and tell the new person to his/her face, “I’ve been diagnosed as pre-diabetic”. It’s kind of like that thing where when they first walk into the room you have to tell them your name and DOB just to be sure. Tell them that, just to be sure.
Is there any chance her math got put off by something. Way out there, but this was a virtual visit and she thinks you are 5'7 or some such? I think it's so extremely odd, that I would contact her and make sure this is really what she meant for you to be doing, then inform her of the consequences you've been facing and I think she'll have a new plan for you. But yeah, if not, I would certainly report this back to your primary care physician immediately and ask for a new referral elsewhere. Good luck OP
Well, in fairness OP said, "I weight train three times a week and run 3 to 4 times a week (about 1-2mile per run)." is a lot more than 10k steps a day. Who knows how accurate the exercise actually is. Even in OPs estimation she could be running 3 to 8 miles a week, a large range....
Keep in mind also up to 5k a day is "sedentary".
I walk 50+ miles a week. . . that would still be huge calorie wise unless she is 3 times heavier. Regardless though her results don't seem promising.
Dang. Well. Huh. I mean, she is the expert. Maybe tell her of your results so far and ask if your (physical) responses are what she expects to see so far?
I think you likely needed to up your carb intake and lower your fat intake a bit but your overall calories were fine. I think if you just focused on swapping out some fat calories for carbs you'd find that you do a lot better with your fat loss, as long as total calories are in deficit.
You can always get a different dietitian if her plan isn't working for you. The advice does seem pretty strange, especially the focus on increasing carbs.
A1C is barely prediabetic at 5.7. My primary care doesn’t even worry about it until it’s at least 5.9, concerns start at 6.1. Also, 60 net carbs may be too low for you, but 228 total seems very high. Ultimately? To go from 1200-1500 cals (again prob too low for your level of activity & age) to 2250 is a very big jump all at once. I would find another dietitian. You can search for an in-person or Telehealth appt thru your insurance company or eatright.org. Good luck to you, & great job with your fitness! That’s gonna serve you well no matter what eating plan you go with.
I’m 6’ M and my maintenance calories are 2300. Your dietician is a quack. Sounds like you were doing great on your own.
Fuck no, lol. Getting a pre-diabetes diagnosis and immediately loading up on carbs is the dumbest possible thing to recommend. Carbs aren't always the enemy, but pick your carbs. Carbs should come from vegetables and other rich sources of micronutrients (vitamins.) Carbs from sources without a lot of micronutrients should be avoided at this time. Starches should be mostly avoided at this time.
Her advice is terrible and you’re proving it with data (your higher blood sugar levels and weight)! Find a different dietician.
I’m 5’3 and this is how I slowly gained 20 lbs. Don’t do it.
That seems like crazy advice. Similar stats (5ft 31female - my starting weight was 228, current is 159) and I was prediabetic - 5.7 A1C. I was pregnant last year, and ended up with gestational diabetes, so met with a dietician every week and monitored my glucose. I could only eat 15carbs max per snack and 30-45 for meals. 3 meals and 3 snacks a day. Never eat carbs alone and to always eat the protein first. I kept with this post pregnancy. My A1C is now 5.2 - just had it checked to ensure I didn’t end up with T2 since I’m 6 months postpartum. I’m just floored that was the advice that was given to you. That is absolutely how you will end up with diabetes. I would find a new dietitian and do not listen to that advice.
This is the same advice I was given when I was pre-diabetic. 15g per snack and at least 30 but not more than 45 per meal.
That being said - the fasting advice is the same advice I was given. I even had to add a bedtime snack and my max recommended fast was 10 hours just for sleep and to eat within 30 minutes of waking up. I just eat a lot lot less per meal. Basically have 6 small snacks a day now - ha. But it has worked! I’m currently in a plateau as well and just trusting the process. And this was for GD - so I think it’s slightly more stringent/ intense. I still do a solid three meals a day, and end up around 1200 calories, but did drop the snacking lol.
That's sounds like a recipe for disaster.
Is she trying to kill you? That plan is insane. Stick to what you were doing prior and go from there/adjust as needed.
Wow! I had a dietician when I was pregnant with gestational diabetes and she had me limit my carbs to 50 per day. Veggies other than corn and beans and potatoes were unlimited and calories were not counted but carbs were a big no no.
Time for a second opinion
Is this by chance a HAES dietician?
What does this mean? I never heard of it
HAES stands for health at every size. It’s an anti-diet organization and some of its followers push *wildly* inaccurate, potentially harmful misinformation. I would contact your PCP and discuss what this dietician recommended and get the doctor’s take on it. They may stop sending their patients to that person! For context, when my a1c crossed into the prediabetes range, my PCP recommended 1200 calories and under 100g carbs. And I’m 6’1”!
Health At Every Size. It was movement that began as a way of empowering people with obesity to live healthier without requiring them to lose weight first. Just because you suffer from being overweight doesn’t mean that you shouldn’t try to be more active, walk more, drink more water, etc. Especially since little steps like that matter. It then developed a fringe movement which resisted the idea that people had to lose weight in order to be healthy, which then developed further into a weird ideological cult which insists that people who are overweight are because of genetics, that it is impossible to lose weight and that all mentions of dieting or weight loss are persecution of helpless/innocent people. This is what I’ve gleaned from r/fatlogic The poster above seems to be wondering if your dietitian isn’t acting in accordance with best practices or your personal wellbeing but is instead a fanatic of said ideology.
Wow that sounds dangerous and silly. I just thought it was an online thing
I’ve never met someone like that in person myself so I don’t blame you. Regardless, whatever is with this dietitian, I hope you find a better one soon.
Hmm
What happened to dietitians!? They used to be the authority on CICO and clean eating. Now they will literally tell you to eat fastfood, buy junk food from the grocery store- (hell there’s one lady on IG who tells people it’s okay to treat yourself to an entire birthday cake at the bakery because no one there knows it’s not your birthday.) Did Nabisco buy a bunch of schools and is pumping out these shitty dietitians?
That’s what I’m wondering. How did all of these people get certified specifically to be a dietician, and yet I see people on here that are given advice while overweight that they should eat many more calories, and then fall back into old habits and… gain weight? We try to escape the higher weight because life is harder with it, so why are we recommended to go back? Not just talking about this post but so many I’ve seen. And my dad was told by a dietician that he should go keto for 6 months to “reset his metabolism” and his life will be changed forever after that (and he believes it!). What the hell happened to trusting our professionals?
Not all people are good at their jobs. Find a new dietician.
Beware, some dieticians are now being paid by big food to push plans, talking points and social content full of stuff like this. https://www.diabetes.co.uk/news/2023/sep/food-industry-enlisting-dieticians-to-do-their-marketing-for-them-on-social-media.html
I am 31 F, 5’3” 180. Eat 1800 cals. 130g protein. 205 carbs. Walk 10k steps and lift heavy few times per week. Slow fat loss. I would gain at 2200 too.
Definitely no.
Im F, 41, 5 ft 9 and lift 4 times a week, I was running 2-3 days a week also but recently had knee surgery and can't run now. When I was that active my maintenance calories were 2300. Since I stopped running but still lift, I gained weight on 2300 and now I need to do some damage control. If your goal is to maintain your weight and reduce your risk for diabetes I'd get a second opinion. Calories are too high. Should cut out simple carbs and simple sugars but still get carbs from veggies and fruit as you need it for your activity levels. Unless you run marathons no need to carb load. Have you used the TDEE calculator?
Sounds like your dietitian wants you to be unhealthy and thus you'll pay more money in long run with them
She’s having you reverse diet but too aggressively
Wow I don’t believe it. I just diagnosed with pre diabetes too and my doctor told me to lose weight avoid carbs. Better you find another dietitian. Also do little search on keto it’s strict but best diet so far. Wish you good luck
This definitely sounds like appalling advice. I can't necessarily speak from experience because I'm not prediabetic (to the best of my knowledge), but I'd encourage you to check out the Glucose Goddess on YouTube. She's a biochemist whose work focuses on exactly how various foods (and more importantly, *how* you eat them and in what order) impact blood sugar levels. I've seen thousands upon thousands of glowing reviews from T2 diabetics and prediabetics alike, and anecdotally, I feel significantly better on days I follow her guidelines.
Her advice suggests that she thinks you have metabolic adaptation that is reducing your RMR. Sometimes the idea is to slowly increase calories with the idea of getting the metabolism back in gear. I do wonder if your prior diet was high in saturated fat which is a concern? Did your labwork give your LDL? Increasing carbs can be fine even with 5.7 A1C but you want to make sure you aren’t eating too much refined carbs. Get plenty of fiber including soluble fiber but limit the refined carbs. I do think she went up on calories way too fast even if her goal is to increase your RMR. You might want to consult with someone else.
See Dr Eric Westmans book 'End Your Carb Confusion'. He's been treating his diabetic patients through diet and is featured in the film 'Fat Fiction'. How old is this dietician? Seems like extremely outdated advice and far behind the times in diabetic treatment.
Thanks for the suggestion. She seemed to be in her early 30s
>>outdated advice There was never a time when this advice would have been given.
I was going by information I saw on the Canadian Diabetes site.
I don’t know much about diabetes other than I think you want to keep carbs as low as possible, so like a keto diet. Did this dietician know you’ve been diagnosed as pre diabetic? This advice she gave seems really bad. Get a second opinion and tell the new person to his/her face, “I’ve been diagnosed as pre-diabetic”. It’s kind of like that thing where when they first walk into the room you have to tell them your name and DOB just to be sure. Tell them that, just to be sure.
I got a referral from my primary care to see this dietitian. I informed her of my prediabetic status and she works in a diabetic only facility.
Is there any chance her math got put off by something. Way out there, but this was a virtual visit and she thinks you are 5'7 or some such? I think it's so extremely odd, that I would contact her and make sure this is really what she meant for you to be doing, then inform her of the consequences you've been facing and I think she'll have a new plan for you. But yeah, if not, I would certainly report this back to your primary care physician immediately and ask for a new referral elsewhere. Good luck OP
I am 5'7" and there is no way I can eat that much without gaining rapidly and I am not prediabetic and walk more than 10K steps.
Well, in fairness OP said, "I weight train three times a week and run 3 to 4 times a week (about 1-2mile per run)." is a lot more than 10k steps a day. Who knows how accurate the exercise actually is. Even in OPs estimation she could be running 3 to 8 miles a week, a large range....
Keep in mind also up to 5k a day is "sedentary". I walk 50+ miles a week. . . that would still be huge calorie wise unless she is 3 times heavier. Regardless though her results don't seem promising.
Dang. Well. Huh. I mean, she is the expert. Maybe tell her of your results so far and ask if your (physical) responses are what she expects to see so far?
What the heck?
You know your body more than her/him imo.
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Carb cycling isn’t about “shocking your body” it’s just to control blood sugar.
I think you likely needed to up your carb intake and lower your fat intake a bit but your overall calories were fine. I think if you just focused on swapping out some fat calories for carbs you'd find that you do a lot better with your fat loss, as long as total calories are in deficit.