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Are dietitians the same as nutritionists?

 

I recently wrote a post called What I Eat in a Day as a Registered Dietitian. Some of you may be wondering what exactly a Registered Dietitian is, and probably even more of you are wondering if or how it is different from a nutritionist. I can help! Here are some of the basics about Registered Dietitians and what we do.

 

What is a Registered Dietitian?

 

Registered Dietitian is the designation given by the Academy of Nutrition & Dietetics (at least in the US) to people who have completed certain requirements to be considered nutrition experts. Here are the requirements from the Academy to become an RD:

  • Complete a bachelor’s degree – The classes you take must meet nutrition-related requirements set forth by the Accreditation Council for Education in Nutrition and Dietetics, a brand of the Academy. Some course requirements include anatomy, physiology, chemistry, biochemistry, basic nutrition, macronutrients, micronutrients, clinical nutrition, food science, weight management, and medical nutrition therapy.
  • Complete nutrition internship hours in a variety of settings – Since dietitians work in so many different types of roles, internships need to include several of those experiences. My internships included clinical inpatient nutrition, outpatient nutrition counseling, food service management, dialysis nutrition, childhood nutrition at a WIC clinic, and senior nutrition with Meals on Wheels.
  • Pass the RD exam – This test covers all of the required competencies put forth by the Academy

Registered Dietitians must also complete 75 hours of continuing education every 5 years to maintain their registration.

 

How are dietitians different from nutritionists?

 

Simply put, “nutritionist” is not a protected term, while “dietitian” is. Nutritionist is a term for anyone who teaches about nutrition, while dietitian is reserved for those who have met the criteria described above. So all dietitians are inherently nutritionists, because they teach nutrition, but not all nutritionists have completed the requirements to become dietitians.

This obviously creates a bit of confusion for consumers – I get these types of questions all the time! A few years ago, the Academy of Nutrition & Dietetics also coined the term “Registered Dietitian Nutritionist,” and allows their RDs (or RDNs) to use that term if desired to help clarify their roles as nutritionists.

 



 

Where do dietitians work?

Dietitians are working all around you, and you may not even realize it! Dietitians may do all of the following:

  • Calculate recommendations for tube and IV feedings and nutrition supplementation for critically ill patients in hospitals
  • Plan nutritionally balanced menus for large food service operations at long-term care facilities and schools
  • Teach nutrition for general health, managing and preventing chronic medical conditions, and navigating food allergies/intolerances in private practices, hospitals, medical clinics, and chiropractic offices
  • Provide nutritional guidance to low-income populations in WIC clinics and community health centers
  • Teach specialized diets for clients in dialysis centers
  • Monitor the nutritional health of residents in long-term care facilities
  • Provide nutrition information to the public via social media, blogs, websites, newspapers, etc.
  • Support athletic performance with proper nutrition in health clubs, gyms, on military bases, and with sports teams

These are just some examples of roles that dietitians fill. Stay tuned, because I plan to make a post soon featuring “a day in the life” of several different dietitians who all work in different settings, to give you an idea of what all kinds of different dietitians eat!

 

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Archives

 

Being married to a dietitian, my husband is often asked, “What does she eat? I bet she eats perfectly all the time!” He usually chuckles and tells them about my love for ice cream and all things salty, including tortilla chips with “plastic cheese” (you know, the liquid “cheese-like food product” you get from a high school football game concession stand? Mmmm…) Eating to feed both your body and your soul is important! If you what you eat most of the time is good for your body, then you can enjoy soul food sometimes without guilt or health consequences.

 

I thought I would take the opportunity to show you what one Registered Dietitian eats in a day…or rather, three days. I chose to include three days to give you a better average and to avoid the bias of a “perfect day” since I knew I would be recording it. As you read through this post, try not to compare my diet with yours. Everyone’s healthy looks different, and there is no one right way to eat! What matters is that what you eat works for your body, your life, your schedule, and your happiness. These days represent what works for me.

 

Day 1

7:00 am – The day started with a tropical smoothie that contained leftover banana and pineapple with some spinach, nonfat vanilla Greek yogurt, orange juice, and chia seeds. As always and of course, I had a cup of tea!

 

healthy breakfast

 



 

10:30 am – Mid-morning after a few hours of work, hunger set in and I had a piece of whole wheat toast with some spreadable butter.

 

healthy bread

 

 

12:35 pm – After my workout I was very ready for lunch! Lunch was a leftover mish-mash. A large salad with a salmon burger patty, sunflower seeds, croutons, and bleu cheese dressing. Clementine kombucha to drink!

 

healthy lunch

 

1:30 pm – Not too long after lunch I realized that it hadn’t been quite enough and that I was needing a bit more in the way of carbohydrates for energy to get me through the afternoon. I had one of these marshmallow pies left over from our Memorial Day camping trip. It went peacefully.

 

tasty treat

 

6:30 pm – I gardened for a few hours and then I was ravenous! For dinner I made beef ravioli with marinara and sauteed mushrooms, onions, and spinach.

 

beef ravioli with spinach, onions, and mushrooms in marinara

 



 

8:30 pm – While watching Captain America: Winter Soldier with my kids in the evening, I had one of these raspberry fruit juice popsicles. So delicious!

 

 

Day 2

7:15 am – We still had leftover  pineapple, so I made another tropical smoothie with pineapple, leftover fruit salad, and spinach. I also made toast and a poached curried egg, so I didn’t add the Greek yogurt to the smoothie this time.

 

 

9:45 am – Snack time! In between appointments I nibbled on some roasted ranch flavored chickpeas for some carbohydrate and protein.

 

 

11:30 am – After seeing another client and doing a quick pilates workout, I ate the last of the leftover salad and the leftover ravioli from last night for lunch. I chased it with a square of Dove chocolate. Yum!

 

 

 



 

1:15 pm –  Throughout the afternoon, I focused on blogging and admin work. I snacked on raw veggies w/light ranch dip and clementine oranges.

 

 

4:25 pm – Hunger set in and I still had one more client until dinner. I had exhausted the food I brought for the day, so I walked around the corner to Arby’s for some of their snack-sized curly fries. I. Love. Curly Fries.

 

 

7:15 pm – This particular night at our house is a “use up” night, so I get the night off from cooking and everyone eats their own thing. Tonight, I finished off some leftover homemade baked beans and butternut squash.

 

 

Day 3

7:35 am – Today I ate a bit of an unconventional breakfast. Today’s tropical smoothie included pineapple, 1/2 canned peach, spinach, orange juice, and milk. Alongside that was the rest of a half-eaten sandwich prepared by one of our boys and then abandoned. Poor sandwich. So I played garbage disposal today. 🙂  #momlife

 

 



 

12:30 am – I was running late to work and was busy seeing clients once I arrived, so I didn’t get a chance for my mid-morning snack. I was HUNGRY by lunch time. So hungry that I skipped my workout and went straight for food. Today, I ate some pasta salad that I doctored up with chicken, corn, and sauteed peppers and spinach. Once I started eating it, I realized that it didn’t have very much chicken in it, so I tossed in a handful of my roasted ranch chickpeas for some added protein.

 

 

5:30 pm – I ate a lot of pasta salad for lunch, so I never got hungry for my afternoon snack. Plus, we were eating an early dinner so we could get to my son’s band concert on time. For dinner, I made pupusas (a Salvadoran savory corn “pancake” with chicken, cheese, and refried beans). I topped mine with salsa and ate a couple of leftover spiced pears. More kombucha to drink!

 

 

9:30 pm – After the concert, they had cookie trays and I love me a good white chocolate macadamia nut cookie! So delicious.

 



 

So there you have it! Three pretty typical, if not unvarying, examples of days in my food life. In hindsight, I perhaps shouldn’t have chosen 3 days in a row simply because I eat a lot of leftovers so several things showed up repeatedly. For example, I don’t usually have a smoothie every morning, but I did for these three days since we had leftover pineapple we needed to use up.

Other than that, these days show the typical pattern that works for me: balanced healthful meals with a treat or two just about every day. I love the food that I eat. Having plenty of tasty healthful foods I love and not denying myself “unhealthful” delicious treats in moderation makes for a great and delicious balance. Let me know in the comments if you have any questions or ideas for other posts you would like to see!

 

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Healthy Lifestyles

do you have a food addiction?

 

Many of my clients wonder if they have a problem with food, because they find themselves craving sugar or bingeing on snacks or treats, especially at nighttime. There are several steps you can take to identify or overcome food addiction. The first and most important thing is to determine what causes your food cravings. Determining the cause will help you discover whether or not you have a food addiction or if there is another potential cause for your food cravings.

 

How to Determine what triggers your cravings

 

Check in with your intakes 

Most of the time, cravings are a response to a need for fuel. Many of my clients get cravings in the evenings, especially for sweets or salty snacks, because they are undereating either carbohydrates or calories throughout the day. More than half of my clients who are trying to lose weight are actually undereating, so honestly assess the possibility that you might be over-restricting. Common symptoms include low energy, poor sleep (or sleeping too much), brain fog, fatigue, memory issues, and food cravings, especially cravings for carbohydrates or sugar.

If you aren’t sure (most of my clients assume they need to eat less than they actually should), find a Registered Dietitian to help you know how much you should actually eat. For reference, most adult clients should be eating more than 1400 calories and well over 100 grams of carbohydrate daily (even if you’re trying to lose weight or if you have diabetes). Calorie tracking apps and online calculators are often inaccurate.

 



 

Assess your emotions

If you are certain you are meeting your body’s nutritional needs and you still struggle with a compulsion to eat unhealthful foods on a regular basis, try looking at your emotions. The second most common cause of food cravings has to do with dopamine, a neurotransmitter in the brain that makes us feel content. Negative emotions are usually paired with low dopamine. The brain sees low dopamine as a problem that needs to be fixed and will often go hunting for a way to raise it. Eating delicious food is a quick way to get a rush of dopamine, so often our brains go straight to the fridge to fix the problem. Your brain doesn’t care if you eat ice cream, it wants dopamine. Ask yourself if you are experiencing a negative emotion. Boredom, loneliness, stress, anxiety, and depression are common culprits.

If so, the first line of attack is to try to raise dopamine in a way that doesn’t involve food. You can do this by turning to an activity that you truly enjoy. Calling a friend, doing a crossword, going for a walk, or reading a book are examples of activities my clients have used. The key is that you enjoy it – otherwise it doesn’t raise your dopamine!

Sometimes you don’t have the time to do an alternative activity, so the next line of attack is to try to find a healthier food option. Craving salty snacks? Go for a couple handfuls of tortilla chips with salsa,  pretzels, or whole grain chips or crackers (Sun Chips and Triscuits are great options). Sweet tooth calling out to you? Try frozen grapes,  graham crackers, or berries with vanilla yogurt or whipped topping.

Finally, if you know that a healthier activity or alternative will not do the trick, it’s not a failure. The best thing you can do is try to moderate the amount of food you eat. Three to four bites of a desired food can cause the peak amount of dopamine response within the following 10-15 minutes. The take-home message? Rather than eat continually until your dopamine peaks and you feel better, try to savor that tasty food for 3-4 bites then wait 10-15 minutes. After that, reassess to see if you still feel like you need more.

 



 

Seek an outside opinion

If you have evaluated the above topics and are still struggling to get to the root of your food cravings, it could be possible that you have a food addiction. Evaluation for food addiction is still in its early stages. Researchers from Yale University have created a food addiction scale but the scoring system is complex and it is not widely used. For now, the best method is to meet with a Registered Dietitian and a Licensed Mental Health Counselor. Since food addiction by nature exhibits crossover between mental health and food habits, each professional can have valuable perspective. If it turns out that you do have addictive food behaviors, a holistic treatment plan will involve them both as well.

 

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How Your Body Works Wellness Tips

Sometimes life gets in the way of meeting the goals we want to meet…some things don’t seem realistic in the moment, but that doesn’t mean you should let the time pass you by! Learn something new, take a baby step, or build on your basics. Just keep moving forward!

 

keep moving forward

Goal Setting

 

To round out this series on fitness for backpacking, I thought I would offer you a little bonus post on nutrition for the trail.

Good choices for trail foods are:

  • lightweight
  • do not require refrigeration
  • are nutrient dense
  • may or may not require cooking – while either can work if you bring a stove, this is a factor to consider!

Some of the parameters you might look for in your day-to-day food might be a bit different when hiking or backpacking. Your needs for calories, carbohydrates, and sodium are higher when you are active (especially if you’re carrying a pack). Don’t worry if some of the foods you eat are higher in these nutrients than what you normally eat. Here is a list of ideas for meals and snacks while hiking or backpacking:

 

Breakfast

  • Oatmeal – Portion oatmeal, dried fruits, protein powder, cinnamon, and brown sugar into individual packets or zipper plastic bags.
  • Breakfast bars – Homemade or store-bought bars that contain whole-grain carbohydrates and protein can be great options. Oats, nuts, seeds, honey, and dried fruits are all good potential ingredients. Here is a recipe for homemade breakfast bars that I’ve made before and enjoyed!
  • Instant Breakfast Packets – While these are probably not sufficient by themselves to prep you for a day of hiking, you can mix these packets into your oatmeal, coffee, or water for some added carbohydrate and protein.

 



 

Lunch

  • Wraps – Whole-grain tortillas with peanut butter and a banana or a pouch of chicken with spinach are easy to whip out for a quick lunch break.
  • Hummus “plate” – Depending on how long you’re hiking, you can sometimes get away with some crunchier veggies (carrots, broccoli, cauliflower) in your bag for a day or two. Toss in some pita bread and a container of hummus and you’ve got a nutritious and delicious no-cook meal.

 

Dinner

  • Pasta- Particularly if you’ve hiked all day, do not fear the carbohydrates! Pouches of pasta sides are convenient and easily cooked with a camp stove. Add a packet of chicken or tuna or some slices of summer sausage for protein, and toss in some dehydrated veggies.
  • Beans and rice – Find a mix of rice and beans to which you can add some dry ranch dressing or onion soup mix and some dehydrated veggies. Boil it up!
  • Freeze-dried backpacking meals – These guys can be super-light and very convenient, but sometimes expensive. Watch to make sure they have the right amount of calories, carbohydrates, and protein for you after a long day on the trail. Unless you’ve been sweating a lot throughout the day, aim to keep the sodium under 40% DV.

 



 

Snacks

  • Dried fruits – These make excellent snacks, loaded with carbohydrates for energy and are quite light with all of the water dehydrated from them. Try dried peaches, strawberries, kiwis, or bananas.
  • Trail mix – Sorry to state the obvious, but this high-calorie, high nutrient density snack is really in its element in the out-of-doors.
  • Harvest Snaps – These crunchy puffed snacks made from peas, lentils, and other legumes have carbohydrate (important when hiking), protein, and a decent amount of fiber. Plus they are very light!
  • Whole grain crackers – Light and nutritious, these help provide necessary fiber and energy.
  • Jerky – Buy it or marinate and dehydrate some yourself.
  • Treats – Pack a little something to treat yourself after a long day of hoofing it! Choose individual packages of a favorite cookie or candy to enjoy around the campfire.

 

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Hiking/Backpacking

Stretches for hikers

 

Are you getting excited to hit the trail yet? I know I am! Every sunny day gets me one day closer to our first backpacking trip! We’ve covered endurance and joint stability so far, and today we’re going to talk about flexibility. While by no means is it necessary to be gumby to enjoy a day on the trail, working on your flexibility can help you hike with less soreness and risk of injury. As an added bonus, performing these stretches after a day of hiking may prevent or lessen muscle tightness the following day.

 

The primary muscle groups that are going to benefit from increased flexibility in this case are: hip flexors (on the front of your hips), glutes (buttox), quads (thighs), hamstrings (the backs of your upper legs) and calves. If you are carrying a pack, we’ll toss in your upper and lower back, and pectorals (chest) as well.

 

I’ll show you 4 stretches that will catch each of these muscle groups. You want to hold each stretch for 30-60 seconds, 1-3 times a day. Press gently into the stretch until you feel tension but not pain. As you sit in the stretch, take deep breaths. You’ll often feel your muscles release some tension after 20-30 seconds and you’ll be able to go a little deeper without pain.

 

Hip Flexors, Quads, & Calves

Stand with your feet hip width apart and place your hands on your hips or against a tree or wall for balance. Step your right leg forward into a lunge position. Bend your right knee, press your left hip forward. Keep your left leg as straight as you can and press your left heel toward the ground. You should feel this stretch in the front of your left hip, down into your left thigh, and in your left calf. Hold for 30-60 seconds. Repeat on the other side.

 

hip flexor and calf stretchhip flexor and calf stretch side view

 



 

Hamstrings & Glutes

Stand with your feet hip width apart and place your hands on your hips or against a tree or wall for balance. Step forward with your right foot. Keeping your right heel on the ground, bend your left leg and shift your weight downward as if you were going to sit down. You should feel this stretch in the back of your right leg and in your right buttock. Hold for 30-60 seconds. Repeat on the other side.

 

glute and hamstring stretch

 

Upper & Lower Back

You can do this stretch standing or on all fours. Placing your hands on the ground or on your knees, pull your stomach muscles toward your spine and round your shoulders and back. You should feel this stretch in between your shoulder blades and around your spine. Hold this stretch for 30-60 seconds.

 

back stretch standing

back stretch kneeling



Chest

Standing with feet hip-width apart, reach both hands behind you and interlock your fingers. Roll your shoulders back and press down into your fingers. Keep a slight bend in your arms to avoid locking your elbows. You should feel this stretch in your chest. Hold for 30-60 seconds. If you are not able to clasp your fingers together behind you, you can press your arm against a tree or wall behind you to stretch it.

 

chest stretch

 

And that’s it! Four simple stretches to help improve your backpacking experience. Consistency is key with flexibility – try to do these exercises daily (or several times daily, you overachiever, you). It only takes 5 minutes!

 

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Hiking/Backpacking

physical therapy for hiking and backpacking

 

When you’re out on the trail, there’s a good chance you’ll be dealing with some unstable or uneven ground. Between sticks, rocks, and roots, there is quite a bit of potential for strained or sore joints. Your knees and hips can run into trouble with instability, but there’s good news. The endurance training plan from my last post will strengthen and stabilize these joints. No need for anything extra – I love an efficient training program! There is another joint, however, that could benefit from a little extra attention.

 

The most likely victims of instability on the trail are your ankles. Since they allow movement in multiple directions, they are usually less stable and can be susceptible to strains and sprains. On my first overnight backpacking trip, this completely snuck up on me. Fortunately I didn’t sprain my ankle, but carrying my pack and hiking on uneven ground for several miles caused my ankles to be sore for months afterward. In fact, I used some of the exercises below to help regain my ankle stability.

 

This routine shouldn’t take you any more than 5 minutes. You can do all of the exercises You’ll need a resistance band for this quick ankle routine.

 

Front-to-Back Stability

  1. Sit on the floor with your legs straight out in front of you. Hook the resistance band around the ball of your foot and hold the ends of the band in your hands. With controlled movements, slowly press the ball of your foot away from you. Slowly return to the starting position. Repeat this exercise 15 times on each foot.ankle flexion exercise for backpacking

 



Left-to-Right Stability

2. Anchor your resistance band around the leg of a heavy table or bookshelf. Sit on the floor with your legs perpendicular to your anchor. Loop the resistance band around the inside edge of the ball of your foot. Keeping your leg still, rotate your ankle to point your toes away from the anchor against the resistance of the band. Slowly return to the starting point. Repeat 15 times on each foot.

3. Repeat this exercise with the band looped around the outside edge of your foot. This time you will rotate your ankle the opposite direction to move your toes away from your anchor.

lateral ankle exercise

 



 

360-degree Stability

4. Sit on the floor with your legs straight out in front of you. Hook the resistance band around the ball of your foot and hold the ends of the band in your hands. Slowly turn your ankle in a clockwise circle 15 times. Repeat in the other direction. Repeat both directions on the other foot.

ankle rotation exercise

 

You can complete this 5-minute routine anywhere from 2-3 times weekly to 2-3 times daily. The more often you do it, the more stability you can build in your ankles.

 



 

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Hiking/Backpacking