My Visit to the Nutritionist

The reason I was referred to a nutritionist

When my cholesterol numbers came back high, my primary care physician freaked out a bit and recommended a low fat diet and asked me if I would go see the nutritionist. I did not agree with the advice to follow a low fat diet, but I was interested in going to see a nutritionist. I was concerned that the advice I would receive from the nutritionist would be the same thing my primary care doc recommended, but I quickly decided that hearing a point of view from an expert in the field of nutrition would be helpful, even if the advice I received differed from my own thoughts on the subject. I actually think listening to someone who I disagree with is very important. Finding the truth does not happen if we only surround ourselves with people who think like us. We need to have opportunities to listen to both sides of an issue if we really want to make an informed decision.

I decided to go to my appointment with an open mind, but I must say I went with really low expectations. I realize how arrogant it sounds to say I was pretty confident I would know more about nutrition than the nutritionist, but those were my thoughts going in. This has nothing to do with the MD letters behind my name. We are taught almost nothing about nutrition during medical school. I have just done so much research in the nutrition field over the past few months that I feel pretty confident about my current position.

The appointment

As the appointment started, the nutritionist realized I was a doctor and immediately started touting her credentials as a nutrition expert. She sounded a bit defensive - perhaps my skepticism was manifesting in my posture and manner of speech. But then we got into the reason I was there - my high cholesterol. She looked at my numbers and said she wasn’t worried about them. She then started to explain how the science demonizing cholesterol is flawed and that heart disease is really all about inflammation. My posture changed and I started leaning forward. “I agree with everything you just said”, I told her. I then shared some of my thoughts on the subject and she expressed complete agreement. I learned that she is in the middle of receiving her doctorate in nutrition and that she is constantly studying the scientific literature about every question that comes up regarding nutrition. Her biggest fear is not being up to date on the latest knowledge when her patients need it. We spent the rest of the appointment talking excitedly about all of our similarities in regards to nutrition. She was especially happy to hear me say that most physicians really don’t know enough about nutrition to be giving advice about it.

Anti-inflammatory meal planning

I asked her what diet she recommends and she responded with the perfect answer. She recommends “Anti-inflammatory meal planning” using real, whole foods. She recommends filling most of our plate with non-starchy vegetables, then filling the rest of the plate with protein, healthy fats, and a few other carbs from whole food sources. She recommends avoiding processed foods and added sugars. She does not promote fringe diets like Keto or Vegan, but prefers the middle ground with an emphasis on obtaining enough nutrients through a variety of foods with color and fiber. She then gave me a handout that details specific foods that decrease inflammation as well as foods to try and avoid. This list is very close to the list I have created with only a few exceptions.

She also shared a different handout that outlines what our plate should look like. But she pointed out that she would change it in the following ways. Make the Carbs section much smaller and make sure the majority of our carbs come from non-starchy vegetables. And she would increase the healthy fats section to be larger. This handout also lists foods that are common causes of inflammation for some people and may need to be avoided. No surprises on this list - dairy, eggs, gluten, food coloring, food flavoring, nightshade vegetables, peanuts, sweeteners. This handout also reminds us that our focus should be on both Quality and Quantity and that we should be checking ingredients carefully.

My nutritionist and I parted as good friends. She said that was the most enjoyable initial visit she has ever had because she didn’t have to convince me of anything. We agreed that I didn’t need to come back and see her for another visit, but she encouraged me to reach out to her with any questions I come across in the future. She also asked me to try and spread the word to other physicians that the science regarding nutrition has changed. She also promised me she would do the same with the nutritionists. I left with a big smile on my face. I guess I need to look somewhere else for a dissenting point of view to challenge my beliefs.