Frequently Asked Questions

Do you have addtional questions about nutritional counseling? If so, the following FAQs may help you out.

Q: How long does nutritional counseling take?
It varies depending on each person and the focus of the nutrition counseling sessions. Research has shown that 3-4 visits with a registered dietitian are needed for optimal lowering of cholesterol levels. Similar recommendations exist for those with diabetes along with the addition of an annual check of progress. For weight loss, weekly or bi-weekly follow up for the first 6 sessions with continued follow up at bi-weekly or monthly intervals improves success.
Q: Is nutritional counseling covered by health insurance?
Health insurance plans vary widely in whether they cover nutritional counseling and for which conditions they cover nutritional counseling. It even varies from plan to plan within a particular health insurance company. Your best approach is to call them and ask. Tell them what you are looking for and any related health conditions that would be impacted by changing your eating habits.
Q: What results can I expect with nutritional counseling?
Lifestyle changes can decrease LDL (bad) cholesterol by 25-30%, which is enough for some and will decrease the amount of cholesterol lowering medication needed for others (decreases cost of medication and the chance of medication side effects). Initially, a decrease of 1% in your HgbA1c can be expected for diabetes. For high blood pressure, a change in diet and lifestyle can be as effective as adding a medication. Permanent weight loss is the goal for losing weight. A 10% weight loss in 6 months is reasonable, but results vary widely. People who are heavier to begin with or are male tend to lose weight faster than those who are not quite so heavy or are female. We continue to monitor how you are doing and evaluate when the effort of continuing to lose weight is too great to continue at that time. Then, we switch to maintenance of weight loss as the focus for a period of time similar to the time you spent losing weight. When you are ready again, we can re-institute the weight loss phase.
Q: What about nutritional supplements? Do you recommend a particular kind?
I may recommend a particular type of nutritional supplement for different clients depending on their needs. For others, I may evaluate the supplements they are currently taking in comparison with their needs. I do not recommend particular brands nor do I sell supplements.
Q: Won’t my child just grow into his or her weight?
It depends on how old the child is, how long he/she has been overweight, and how heavy he/she is. In general, the older a child is, the longer they have been overweight, and the heavier they are, the more likely that their overweight will persist into adolescence and adulthood. Some children will grow into their weight but many others will not without intervening in some way. A nutrition assessment will help you decide whether growing out of a weight problem is likely or not for your child. If you do decide to take action, nutrition counseling is a safe way to do it that protects your child’s growth.
Q: My child is under age 6, will nutrition counseling help him or her?
Parents have almost total environmental control for a child under age 6. For this reason, parents are the focus of change for very young children. What I do is conduct a pediatric nutritional assessment with the parents and the child, then address my recommendations and plans to the parents only. Once a child enters elementary school, they do have some measure of control over their own food intake and physical activity. This is also the time when self-esteem issues might start to emerge from childhood teasing. Nutritional counseling for your child can be helpful once they enter elementary school, showing them what they can do and that their parents are right there to help them and accept them no matter which way their body grows.
Q: I don’t want to deprive my other (thin) child. Can we just institute changes for my overweight child?
Eating healthy and being physically active is healthy for everyone. My approach to nutrition counseling emphasizes family change, not individual child change. Parents and siblings all benefit from living healthier. One sibling may need to eat more and larger servings at meals and snacks to get enough calories but they don’t need to eat different kinds of food. Remember, the emphasis is on living healthy, not changing a particular family member’s weight.
Q: Will all this emphasis on weight increase the chance that my child will develop an eating disorder?
Follow up research done with family-based weight control programs for children have shown no increase in eating disorders among the participants. In fact, a treatment that emphasizes healthy eating and activity habits may reduce risk factors associated with eating disorders. Also, part of our work in family nutritional counseling will encourage parents and children to talk about feelings and how to work together to solve problems. This can help a child dealing with distress around food and provide them with tools and skills to promote a healthy relationship with food.

Glossary

This Glossary will help you understand some of the terms that I use as I provide you with Nutrition Counseling.

Calorie
Calorie with a capital “C” is actually a kilocalorie or the amount of heat (energy) needed to raise one kilogram of water 1° Celsius.
Diet
To a nutritionist this is everything you eat; not just a special way of eating to lose weight or lower your cholesterol.
DRI’s
Dietary Reference Intakes were developed by experts commissioned by the Institute of Medicine as a guide for nutrient requirements for persons in Canada and the United States. They actually contain 4 different values, the Estimated Average Requirement or EAR (for each gender and age grouping), the Recommended Dietary Allowance or RDA (calculated from the EAR so that it represents the needs of 97-98% of the population for that gender and at that age), Adequate Intake or AI (not enough information available to set an EAR but enough to give good guidance), and the Tolerable Upper Intake Level or UL (intakes above this level increase the risk of a toxic overdose). These guides represent a consensus of all the best experts for each of the nutrients.
Nutrients
All of the substances your body must obtain from food in order to carry out all of its metabolic, repair and growth activities. This includes carbohydrate, fat, protein, vitamins and minerals.
Nutritional Analysis
A listing of all the nutrients and how much of each one is contained in a food, a menu, or a person’s regular food intake.