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Which is better? Nutritionist or dietitian?


jenna-hines

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For the past month or so, I've been trying to decide who to consult for help with establishing a diet plan for me. I have a seizure disorder and tried the keto diet (recommended by my neurologist) but it caused my seizures to go haywire. Should I see a nutritionist or a dietitian? I don't know which one would benefit me.

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Depending on where you are in the world, a dietician typically has to go through university education and certification from a governing body. That provides a certain level of 'cover your ass', with going in trusting that they know what they're talking about. Conversely, that often also means that dieticians are less likely to discuss nutritional approaches outside of the official recommended intakes, which may/may not jive with what your personal goals and preferences are.

 

A nutritionist may have a certification of some kind, but they are less likely to be a regulated profession, and therefore there is a higher risk of hiring someone whom may not have the level of knowledge they should to be advising others. On the flip side, they may be more familiar/comfortable with 'alternative' dietary options - but keep in mind they may not be qualified to ensure it's a SAFE alternative.

 

Depending your needs though, you may not need either. Unless your doctor has diagnosed a nutritional deficiency or dietary restriction (at which point they would also likely prescribe appropriate supplements or refer you to a dietician), you can probably follow the same recommendations which work well for the vast majority of the population:

 

- ideally 5-8+ servings of fruit & vegetables every day

- 0.6-1g of protein per lb of bodyweight every day (if you'd like to build muscle or lose fat, err towards the higher end of that range)

- try to keep the majority (let's say at least 80%) of your food selection to less processed options. eg. whole grains more often than pasta; keep stuff like cold cuts, most cheese, pre-made sauces with lots of sugar, etc. to the occasional use rather than every day

- try to eat within your TDEE - or at a number appropriate for your goals which doesn't put your health at risk

 

 

If you have a goal like losing fat or gaining muscle in addition to your normal daily maintenance, that's a different consideration when creating an eating plan, but the same principles apply. When in doubt focus on increasing your fruit and vegetable intake, and getting in enough protein to support your goals. Be safe, and don't forget to have fun!

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If I may drop my two cents in.

 

If your neurologist suggests keto, ask them for recommendation of "diet coach". There are so many myths and misunderstandings about keto, one can deal big amount of damage just by trying it the wrong way. Especially when done for medical reasons. 

 

If your neurologist is so open-minded to consider keto, they should know trustworthy dietarian who could guide you through adaptation and beyond. 

On the other hand, they might be just careless and recommending keto randomly without deeper insight - in this case, change your neurologist. 

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I absolutely CAN run on caffeine and hatred. But only with a dash of milk.

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5 hours ago, aramis said:

If your neurologist suggests keto, ask them for recommendation of "diet coach".

 

If your neurologist is so open-minded to consider keto, they should know trustworthy dietarian who could guide you through adaptation and beyond. 

On the other hand, they might be just careless and recommending keto randomly without deeper insight - in this case, change your neurologist. 

At my last appointment when I ask about "diet coach", they just brushed it off like it was nothing.

 

They do know some dietarian but didn't give me their names which baffled me and my parents.

 

I plan on changing my neurologist and find someone closer in my area so I don't have to drive 45 minutes up north. I can't stand my current one. They keep pushing me on getting brain surgery. Keep changing the dose on my medications. Sign me up for study cases on new medications without my consent. It's ridiculous and all they want is nothing but money without thinking about my well-being and improving my lifestyle.

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Um, yeah, I'd definitely get a different doctor. That sounds super sketchy.

 

A ketogenic diet can help some types of epilepsy, but it should be closely monitored by both a dietician and your neurologist to ensure it doesn't negatively affect the patient. Since you've tried it in the past to ill effect, that goes doubly in  your case. I hope that you find someone who listens to you, and is more willing to work with you in a partnership for your treatment.

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59 minutes ago, Defining said:

A ketogenic diet can help some types of epilepsy

Yes, it was first designed for this. But it has great influence on many other issues, like Alzheimer, Parkinson, some types of cancer. It regulates blood sugar and insuline levels, can help with balancing hormones and cholesterol. As it's fairly young, there are still ongoing studies about it in various situations. 

But on the other hand, as I mentioned earlier - done the wrong way it may do lots of harm. 

1 hour ago, Defining said:

Since you've tried it in the past to ill effect, that goes doubly in  your case.

I disagree. I suspect the experiment done without guidance was done wrong - hence it backfired. I wouldn't scratch out another try, but this time under supervision of someone who knows what is doing. I don't say keto WILL help - I'm just saying not to demonize it. 

 

But most important - changing a neurologist sounds like a first step here. 

I absolutely CAN run on caffeine and hatred. But only with a dash of milk.

Challenges' status: 

Spoiler

Not gonna Challenge anymore for now. I took Steve's words and started thinking in days and years. Challenges are just short-term distractions. 

 

#16 | #15 (Xmas mini) |  #14 | #13 | #12 | #11 | #10 | #9 | #8 | #7 | #6 | #5 | #4 | #3 | #2 | #1

 

Other activities: Bike build

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9 hours ago, Defining said:

Um, yeah, I'd definitely get a different doctor. That sounds super sketchy.

 

I hope that you find someone who listens to you, and is more willing to work with you in a partnership for your treatment.

My parents thought the same way since every appointment is 10-15 minutes long which is too short. I take four medications per day so the time length should be longer. The only time it's long is when a student from a medical school is with them and goes into full detail about my situation which makes no sense to me.

 

Anyway, I hope so too.

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1 minute ago, jenna-hines said:

My parents thought the same way since every appointment is 10-15 minutes long which is too short. I take four medications per day so the time length should be longer. The only time it's long is when a student from a medical school is with them and goes into full detail about my situation which makes no sense to me.

 

Anyway, I hope so too.

You keep mentioning your parents, how old are you?

Current Challenge Original 1,2,3, R 1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51

52,53,54

"By the Most-Righteous-and-Blessed Beard of Sir Tanktimus the Encourager!" - Jarl Rurik Harrgath

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10 hours ago, aramis said:

I wouldn't scratch out another try, but this time under supervision of someone who knows what is doing. I don't say keto WILL help - I'm just saying not to demonize it. 

I'm not demonizing it, I'm saying that unless approached with medical supervision (especially in a case where the last implementation resulted in negative symptoms eg. 'made seizures go haywire'), it's not always a good option when there are pre-existing medical conditions to consider.

 

I would also suggest that unless a qualified and knowledgeable dietician or neurologist recommends the keto diet for a specific case, it's not necessarily superior to other eating habits which simply emphasize less refined foods.

 

In some cases, yes, a ketogenic diet can absolutely be the best option - but that's something that should be determined by a medical professional, not us strangers on the internet. ;) 

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2 hours ago, Defining said:

that should be determined by a medical professional, not us strangers on the internet

Bullseye!

I absolutely CAN run on caffeine and hatred. But only with a dash of milk.

Challenges' status: 

Spoiler

Not gonna Challenge anymore for now. I took Steve's words and started thinking in days and years. Challenges are just short-term distractions. 

 

#16 | #15 (Xmas mini) |  #14 | #13 | #12 | #11 | #10 | #9 | #8 | #7 | #6 | #5 | #4 | #3 | #2 | #1

 

Other activities: Bike build

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8 hours ago, jenna-hines said:

I'm 31 years old. I live with my parents due to my situation.

My apologies. We have a minimum age of 18 and many people under that create accounts anyway. I was simply making sure you were at least 18. I was asking as an admin.

Current Challenge Original 1,2,3, R 1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51

52,53,54

"By the Most-Righteous-and-Blessed Beard of Sir Tanktimus the Encourager!" - Jarl Rurik Harrgath

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My bachelor's degree was in Sports and Exercise Nutrition and I also know quite a few dietitians. Honestly, I would be very hesitant to take any nutritional advice from any of my classmates or dietitians I know. My best advice would be to educate yourself BEFORE seeking further advice.

 

Interestingly the keto diet was largely developed to reduce the occurrence of seizures. It was introduced for Nazy Seals to prevent them from experiencing seizures and drowning during strenuous diving tasks! However, if the keto diet is increasing your prevalence of seizures then do not use it.

 

Personally, I would take a look into the research that exists for seizures and begin to find solutions from there. 

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The most common answer to this is that nutritionists and dietitians serve different roles. Dieticians are generally individuals who specialize in the delivery of food as treatment, whereas professionals in the field of "nutrition" may not have specific qualifications in this area. So maybe, a dietician is the right choice for you.

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