Saturday, October 3, 2015

Does this nutritionist count calories, track exercise on a Fit Bit, or limit her gluten, sugar or carb intake? You just might be surprised.

Time for lunch? Thinking about dinner?  I've gathered a bunch more pics to share from my recent meals. But first I need to respond to a couple of comments and questions you've voiced in person and on the last post.

Lean steak which I have infrequently with grilled farm-fresh
potatoes and watermelon.

Do you think about balancing your day's eating depending on what you ate earlier in the day?

Not at all.  I don't think "I shouldn't have bread again since I had some at breakfast" any more than I think "Oh, I had three fruits already so I'd better have something else for snack." I go with what I feel like, when I'm hungry. 

So you don't give any thought to your food choices?

Homemade pizza topped with artichoke and peaches.
That's not the case either. There's a balance between nutrition information and pleasure/preference that informs my decisions about what to eat. I might have lox at a meal but I wouldn't include olives, let's say, as the sodium would be quite high. And since I have high blood pressure I try to be moderate about my intake. Besides, I think it would be disgusting together. I might have pasta--white, low fiber pasta, but I don't eat a pound of it. I'll add veggies and perhaps a protein source such as chicken or tofu for some balance; the protein and fiber impact fullness which helps make the pasta meal more satisfying.  

Similarly, I'll routinely have a large salad with my pizza or I'm apt to eat a lot more pizza than I need, before recognizing that I've had enough. I happen to love fruit and vegetables so I eat them generously. But my favorite food just might be bread which I eat no less than twice a day. My latest favorite is homemade sourdough.

Do you calculate your calories? And if not, how do you know how much to eat?

I never calculate my calories. Okay. Not true. I did it once after a 2 day bike ride at my husband's request, as he was curious about how our constant eating (and cycling) measured up with our calculated need. In fact, it was strikingly right on--but calculated after the fact; I did not count my calories to limit my intake or determine my portions. When you allow your self to acknowledge hunger and not mask it with water or coffee or deny it until you 'deserve it', and respond to it with food for fuel, the system starts to work just fine.

This is a special meal I prepared from Gramercy Tavern cookbook
featuring halibut, zucchini in various forms and corn salsa.
But you also need to be eating regularly to prevent excessive hunger and impulsive eating. And it helps most of us to control the environment--removing food as a visual trigger to eat. Store food behind cabinet doors, in the fridge or freezer instead. And beware of the impact of other triggers such as alcohol, stress, and mood. Feeling a sense of hopelessness about your eating doesn't help either.

A veggie heavy pasta meal.

Do you think some people are born unable to do this and others aren't? Because I think I'm different, and this simply won't work for me.

No. I felt the same way many years ago when I struggled with a cycle of restrictive eating followed by binge eating. It feels like there's no way out. I don't buy into the addiction model for foods ( but I do see that behaviors can be addictive. So focusing on eating behaviors (which I address a great deal on this blog) is key. Search this blog for mindfulness, hunger and fullness to start.

Sure, you can do this because you must exercise a lot. 

Pasta with an indian flare-with some cashews and coconut.
Sometimes I exercise a lot, like when I'm training for my annual fund-raising bike ride. But I usually work out about 3-4 days/week (once is just a walk with you-know-who*), with an additional day of Pilates. In cycling season the rides may be long, but aside from then,  I don't spend more than an hour working out. 

And I don't intentionally adjust my food choices or portions on non-work-out days. I know my body burns calories at rest, even when I'm sitting at my desk for 8 hour days, 4 days a week. 

Hope this helps. Still thinking this is unhealthy? Let's discuss.
And by the way, all the meals above right were dinners, and those below were my lunches. Missing are the frequent PB and P (preserves of all kinds) sandwiches I bring for lunch but neglected to photograph.

A grilled cheese, arugula and tomato. Yes, on sourdough.

That's cheese hidden under the figs, and lox. Admittedly a weird 
mix, but I had little time to make a lunch when I was
running late.
Add caption

Bread and houmous, with yogurt and granola.
Lemony Lentil Stew with goat cheese, served on 2 corn
tortillas. From Drop the Diet


*yes, you know who.


  1. I think it's irresponsible to tell patients that if they tune into their hunger signals, they won't get fat. Doctors/nutritionists told me that for years and years, and now that I've been in real recovery for two years, I'm fat. This is why I stayed trapped in my ED for 30 years. I think it would be a lot more honest (and useful to patients) to tell them yes, they may end up fat (truth), but that being fat is not the end of the world, and that they'll be much healthier, have better energy, clearer thinking, and the chance to have a fulfilling life, rather than to spend all your time avoiding food, calculating values, sneaking food, and trying to add in more exercise.

    In addition to being untrue, saying, "don't worry, you won't get fat" feeds into our cultural stereotype that fat is to be feared. It also implies that those of us who are fat are somehow doing it (eating) wrong. Also not helpful.


    1. My message in this post has to do with health--both physical and mental. Weight was not addressed because it is a less than ideal measure of health. To your point, I am not directing readers--or my patients--to suppress their food intake to maintain a goal weight. Rather, I am attempting to demonstrate a picture of normal, non-diet eating, as a counter message to all the craziness everyone is reading, crazy rules about calorie counting, carb restriction, and monitoring our every movement. Simply not healthy, in my view.
      As I have written about previously, there are times when intuitive eating has no place--
      Hope this help.

    2. Anonymous, I see nothing in this post that says a person will (or will not) get fat by eating in any particular way.

  2. could you maybe post your opinions on the Wahls protocol, and why you've decided not to use it? thanks.

    1. Anecdotal evidence is everywhere and it's easy to get drawn in when there's no cure for your condition. In my early days with MS I did follow a gluten free diet even though there was no evidence. I mean, if the risk is low, why not? Unlike Terry Wahl, rather than a miraculous recovery I developed more new lesions on my brain and spinal column--I think 7--in the 3 months I meticulously followed GF. These anecdotes we don't tend to publicize. While Wahl's protocol is a diet stated to help those with MS, as one doctor summarizes "...neither Dr. Wahls' program, nor any other wellness regimen, regardless of how thoughtfully conceived and well intentioned, has been proven rigorously to alter the MS disease process in randomized, controlled trials such as those required by the FDA for the approval of new therapies. Naturally, we all want people with MS to feel better and do better, but we ought to be cautious about possibly promoting false hope." -- Andrew Goodman, MD, University of Rochester in New York.
      Here's more on the subject:

    2. thank you so much for your (as always) thoughtful reply.

  3. Do you have any thoughts about shakeology ? People say it gives them energy and that it is nutrient dense. Could this be an ok breakfast drink?

  4. I have a moderate amount of experience with weight control. I am a 31 year old female. I only started to make correct diet and exercise choices when my life crashed. I had a mild stroke and severe angina in the same episode which resulted in 3 days in the hospital. The dietitian in the hospital was able to raise my knowledge level and desire to do something. I began blood pressure and statin meds and in 2 years I was able to drop 25 pounds by eating regular portion meals, eliminated sugary snacking, and exercise every day. I have kept the weight off for 15 months. I am considered pre-diabetic but my A1C is 5.5. I don't know what it was before.

  5. I miss your blog posts!