DanielleH_RD’s Posts

DanielleH_RD
on 9/5/07 1:50 pm
Topic: RE: Are my two friends nutritionally nuts?

Yeah, nuts! For the fellow eating 30 g of protein a day - are you sure those calculations are correct?  I am always suspicious that the less obvious sources of protein might be overlooked - those in bread, vegetables, and legumes.  If it is an accurate accounting then I would also be concerned. Protein malnutrition is a real, and problematic thing.  If he is exercising vigorously then the body will work hard to maintain skeletal muscle and the diaphragm, but the protein has to come from somewhere.  His body is probably not maintaining its immune function and other systems to keep up with the demand of his exercise and poor diet.  The end result is, when he gets sick, he will get really sick.  If he has an injury, he will have a hard & long time healing.  The body is amazingly adaptable and overt signs of protein malnutrition may not be evident even with routine lab work.  One of the clinical markers of protein malnutrition is a normal albumin level. If he doesn't like meat so much, there are a zillion alternatives out there.  A large part of the world eats minimal animal protein, instead they eat beans/legumes, soy, and dairy foods.  It is very possible to eat adequate protein without meat, it simply requires a little more attention to detail. On to friend number two.  500 calories a day is low, but not unusual for recent RNY patients.  If his 500 calories a day comes mostly from protein (I would ballpark that his protein needs are around 100 g per day, multiply that by 4 kcals/g, and that makes 400 kcals of his 500).  His activity will help to speed up his weight loss, and yes, the body will still reduce its resting energy expenditure to compensate for the lower calorie intake.  He is actually doing the right thing - while eating a very low calorie diet, maintaining his activity to force the body to burn the stored fat and not reduce metabolism too much.  Very low calorie diets and inactivity are a bad combination - the body will dial down its metabolism and weight loss will be very slow.  As far as his plateau, sometimes it is the body seeking a balance.  If he is not retaining a lot of fluid (indicating an alteration in protein balance, electrolyte disturbance, or other medical problem) he is going to have to wait it out.  If he is eating a lot of carbs, he may want to up his protein intake. Our bodies will hold on the the fat, to a degree.  Women's fat cells are particularly good at hanging around - especially those on our hips & butt.  Men usually have a higher amount of abdominal fat and that type of fat is more transient - this is why abdominal fat is associated with higher cardiac risks.   It goes back to our biology (and sociology too) - men were designed to go out, slay the beast, and bring it back to the tribe to eat. Men burn their fat in quick spurts and they will perish long before the famale of the species under adverse cir****tances. Women were designed to carry a baby to term while not eating and dragging ourselves across the Sahara - our fat is stubborn because it is a sustained source of energy.  The body will use the fat as it needs to for energy, but it will reduce its needs first (reduced metabolism). So slap those two around a little!  And let me know if I gave you all the ammo you need to let them have it! Danielle Halewijn RD eNutritioncare.com

DanielleH_RD
on 9/5/07 1:22 pm
Topic: RE: Random question about calories
Zinc and smelly feet is a new one for me!  Someone out there may know more than me, but I have never heard of that.  Usually smelly feet is from sweat in the shoes and the bacteria that grow in that warm, moist environment.  Zinc deficiency is more often associated with taste changes and poor wound healing Zinc is one of the nutrients 'enriched' into processed grain products.  The Daily Recommended Intake for women is 8 mg, for men it is 11 mg.   Zinc is present in meats, shellfish, poultry, milk and milk products.  Zinc in foods cannot lead to toxicity but zinc from supplements can.  In RNY and othe WLS zinc may be malabsorbed. The foods which are considered high in zinc: 3 oz oysters 72 mg, 3 oz beef steak 4.9 mg, 1 cup plain yogurt 2.2 mg, 1 cup enriched cereal 3.8 mg, 3 oz pork chop 2 mg, 3 oz shrimp 1.5 mg Danielle Halewijn RD eNutritioncare.com
DanielleH_RD
on 9/4/07 1:33 pm
Topic: RE: Please advise amount of calories, and protien for 1.5 y post op?

The amount of calories and protein you need are based first upon your height and weight, second on your activity level, and third on your medical history. (this information may be more private than you want to share here) Another good place to start is where you are now.  Calculate what your current calorie & protein levels are (keep a daily diary and punch it in to one of the on-line trackers).  Look at an average over 3-5 days, since people don't eat exactly the same thing every day.  Take your current intake and drop it by 3-500 calories per day.  Try to maintain the protein level the same if you can.  Try substituting very lean meats, reduce the amount of oil or butter you use, cut out unnecesary snacks, etc. And my favorite - don't change your eating at all just increase the intensity of your workouts.  Walk a little faster, go 10 minutes longer, etc. Danielle Halewijn RD eNutritioncare.com

DanielleH_RD
on 9/3/07 12:03 pm
Topic: RE: carb counts in post ops
Absolutely - let me clarify. The carb levels I was talking about are based on a carbohydrate controlled diet which is a typical "diabetic diet".  Now, without leading anyone into a conversation about diabetes - the purpose here is to find a way to control carbs. So without reinventing the wheel, it is easiest to use an established eating plan like "Carb Counting". OK here are the basics - one carb serving is equal to 15 g of carbohydrate.  This equals one slice of bread, 1/2 c of pasta, 1 small banana, 1/2 cup of corn, etc.  15 g of carbs is considered one serving, so it is also a way to determine a recommended serving of a starch, fruit, starchy vegetable, or grain. For those who have used diabetic meal planning, weigh****chers, or another diet plan this is a pretty standard amount. Now, when I teach this, I tell people that 12-18g equals one serving because some foods don't fit nicely into the 15 g guideline.  A 8 oz. serving of milk has 12 g of carbs, that counts as a serving. So that explains servings. For the calorie level and number of portions.  I take the recommended amount of calories and allow 50% to be used for carbs.  So if you eat a 1200 calorie diet, 600 calories can come from carbs.  A carbohydrate has 4 calories per gram and we are allowing 15 g per serving. 600 calories divided by 4 calories per gram = 150 grams 150 grams divided by 15 g per serving = 10 servings That explains the number of servings. To get a list of carbs you can look up diabetic meal plans, exchange lists, or carb counting and find just about any food you can think of. Did that help? Danielle Halewijn RD eNutritioncare.com
DanielleH_RD
on 9/3/07 11:39 am
Topic: RE: Random question about calories
Let me clarify a little - lycopene and beta carotene can be separated out, but beta carotene is one of a family of carotenoids (there are 400 or so of these related compounds).  They just can't get all 400 into pill form - that's where food is better than vitamins!  Lycopene can also be separated out, but does anyone know what other compounds are present in tomatoes that also promote prostate health (for the men in our lives). Some phytochemicals can be separated out, but they can never reproduce the complexity of fruits & vegetables. (I sound like I'm in love or something!) Happy Labor Day! Danielle Halewijn RD eNutritioncare.com
DanielleH_RD
on 9/3/07 3:45 am
Topic: RE: Random question about calories
Is there a healthy cheesecake? Well it has "cheese" and "cake" right there in the name to give you fair warning!  You can adjust a recipe to lower the fat and sugar content - but I don't know if you ever make it "healthy".  These types of foods are meant to be enjoyed as a treat.  There are no bad foods! But, there are bad habits!  If you have a slice of cheesecake occasionally as a treat, that's fine.  If you eat cheese cake every day because you like it, that's a bad habit.  If you eat the entire cheesecake over a weekend, that is just a bad idea! (or binge-eating behavior) Food should not just provide you with calories, it should also provide you with nutrients.  Sure, you can take a daily vitamin pill to get your nutrients but it is a well known fact that the nutrients in foods are better absorbed than supplements.  Fruits and vegetables provide more than just vitamins, there are also 'phytochemicals' that promote other body functions - a well known phytochemical is beta-carotene another that is getting alot of attention these days is lycopene.  These aren't vitamins or minerals but are health promoting substances all the same.  There are thousands of these compounds in our food (especially in fruits & veggies) which cannot be reproduced in pill form. Now, supplement producers are going to tell you about soil depletion, on & on and how our food doesn't contain the nutrients it once did.  Well, all you botanists out there (or gardeners for that matter) know that a plant won't grow unless it has what it needs in its soil.  With this fact in mind, I have faith that the fruits & veggies I eat have more nutrients than the vitamin producers can put in a pill. So for all the WLS people out there reading this (and who want to tell me that they can't tolerate fruits & veggies with their new pouch), as soon as you can tolerate them - fruits and veggies should be a part of your life. Long answer for a short question... Danielle Halewijn RD eNutritioncare.com
DanielleH_RD
on 9/2/07 2:01 pm
Topic: RE: Random question about calories
Let me know if this answer is good enough - these are tough questions! How long does it take to gain weight?  Well, weight is not just fat, it's also water, protein, and a host of other things.  Weight can fluctuate 3-5 lbs in a day under normal cir****tances.  If you are talking about fat tissue only - then it takes 3500 extra calories to make one pound of fat.  How long does it take? Every body is different. Most food takes 1-2 days to transit through your gut and be broken down into it's component parts.  The further metabolism of those food components may take a week or more. How long does it take for the calories to register on the scale? The volume of food will register on the scale immediately.  If you don't eliminate anything (urine, feces, vomit) then the volume of food will register on the scale.  After eating anything, your body will process the food and any calorie that is above the body's needs for operation (breathing, moving, metabolizing, etc) will be put away in storage (fat) for a later day. Is there any food so rich... When your body metabolizes a food, some of that food will not be absorbed or will be spent in fueling the processes of digesting it.  Your body is efficient at getting most of the calories out of food, but there's a reason our intestines are 26+ feet long - so that we can get the maximum calories out of food.  But some of the food will be wasted (percentage-wise) in the process of breaking it down.  So, no, there is no food that packs on more pounds than it weighs alone. (at least not that I know of...if there is, someone please let me know!) Danielle Halewijn RD eNutritioncare.com
DanielleH_RD
on 9/2/07 1:43 pm
Topic: RE: Question from a new DS'er
It wasn't very nice of the dietitian not to be more specific!  I would first have to know the amount of calories you are taking in to give you specifics.  A low fat diet is usually expressed in terms of a percentage of calories from fat.  For instance, the American Heart Assoc. recommends less than 30% of calories from fat, other diets recommend less than 25%. Knowing that a gram of fat has 9 calories, you can work backward. If you are eating a 1200 calorie diet 25-30% of cals from fat would be 33-40 g fat per day Right now your 80-100 g protein are 30-33% of your calories using 1200 cals per day That would leave 40% of calories from carbohydrates.  You should try to eat as much whole, unprocessed fruit, vegetable and grains as you can tolerate. Coincidentally this is a 40-30-30 ("Zone") type of diet.  If you were to reduce the calories from this level, reduce from the carbs & fat first. It's no problem to use that broth as a fluid. Let me know if this helps! Danielle Halewijn RD eNutritioncare.com
DanielleH_RD
on 9/2/07 1:29 pm
Topic: RE: Protein Amounts
As always, check with your doctor & follow their advice first.  If it were up to me, I would put your minimum protein closer to 75g per day.  The protein probably isn't your problem.   If you are not losing as fast as you would like, you need to take a closer look at your diet.  Keep a food diary for a couple of days (yes, I know it's hard to do - but very useful!) and look at your habits.  Are there high calorie foods you could do without? Could you add more fruits, vegetables, or grains? Can you increase the frequency or intensity of your workouts? Danielle Halewijn RD eNutritioncare.com
DanielleH_RD
on 9/2/07 10:34 am
Topic: RE: Different form of B-1?
Are you dissolving it in water or vinegar? It should go a little faster in vinegar - it is a weak acid but is used in this instance to illustrate the effect of stomach acid on pills.  Different pills will break down at different rates.  I think it is wise of you to consider that in your choice of pills. As far as the timing, I say 30 minutes, but most tablets will dissolve in 5-10 minutes if they are going to at all.  5 minutes is pretty fast.  The idea is you want the pill broken down before it gets to the area where it will be absorbed.  Since absorption is altered with the type of surgery that you have, you are wise to consider the stomach's effects of the pill and give it the best chance possible for absorption. The original question was for B1, but you are right in knowing that all of your supplements need to follow the rule of dissolving quickly.  It is for this reason that so many people recommend chewable vitamins and supplements.  A pill that dissolves quickly can be a better choice for some people - i.e. those who don't like the taste of chewables, can't afford more expensive forms of vitamins, etc. My choice of 30 minutes comes from a person who develops supplements for a living.  I didn't make it up - I'm sure there are others out there that believe that quicker is better. Danielle Halewijn RD eNutritioncare.com
DanielleH_RD
on 8/30/07 2:12 pm
Topic: RE: Nutritional Guidelines
Hello Jennifer, In case it wasn't obvious, these answers are coming from NUTs or better Registered Dietitians. I hear what you are saying that a person's surgeon should be the final answer on nutrition questions.  I think it is clear in our answers that we defer to the surgeon's recommendations.   Unfortunately, in some parts of the country there is limited support from Dietitians (or NUTs if you prefer).  Some physicians don't use them, others don't have RDs available, and some have dietitians with limited experience in WLS. I have heard from so many people that they received limited or NO information on their diet post-op.  Each individual who has had WLS has their own unique experiences, but also some commonalities to others.  Some of the benefits of belonging to a support community such as this is to get answers, information, and opinions.  While we recognize that some of the information isn't "hard" science, we can appreciate the value of sharing various perspectives.  While moderating this board, we are hoping to dispel some of the myths and misinformation and provide useful guidelines for those on their journey to a healthier weight. If we say something that you don't agree with, let us know.  But try to recognize what we are trying to accomplish. Regards, Danielle Halewijn RD eNutritioncare.com
DanielleH_RD
on 8/23/07 1:51 pm
Topic: RE: Ask a Dietitian!

We are moderating the forum and checking for topics and general information on this specific sticky post - but since you're here, let me see if I can help. Your post-op healing and success is in a large part determined by your health going in to the procedure.  Specific protein needs would need to be individualized for you, your weight, the intensity of the procedure, and your current nutritional status.  You also mention IBS and recent (?) weight gain which could change the recommendations I would give you.  Without your specific information I can only give general recommendations. For an average adult going in for surgery, I would recommend 1.0-1.3 g protein per Kilogram of body weight. (To get your weight in kilo, take your weight in pounds and divide by 2.2)  Compare this number to the amount of protein you are currently getting, and see where you are.  This should give you an idea of the recommended amount of protein for healing.  Also for healing, be sure to supplement your B vitamins as these are used in cell division.  Adequate vitamin C is also important to support collagen formation - don't get crazy with the vit C!  Your body can only absorb about 65-100 mg at a time, so megadoses of 500-1000 mg or more is not necessary. I hope this gives you a good start!

Danielle Halewijn, RD,CNSD
Director of Nutrition, eNutritionCare.com
eNutritionCare.com
http://www.enutritioncare.com
DISCLAIMER: Any information contained within is meant to be general nutrition advice. Please consult your Registered Dietitian about your specific problem!

DanielleH_RD
on 8/23/07 1:39 pm
Topic: RE: Carbonation?
It could vary depending on where they place the band - but safely, I would say , yes.
Danielle Halewijn, RD,CNSD
Director of Nutrition, eNutritionCare.com
eNutritionCare.com
http://www.enutritioncare.com
DISCLAIMER: Any information contained within is meant to be general nutrition advice. Please consult your Registered Dietitian about your specific problem!

DanielleH_RD
on 8/22/07 2:11 pm
Topic: RE: Carbonation?
Let me get the question correct - are you talking about sodas post op from a Gastric bypass? If so, if you look at some of the other boards you will see many others with the same dilemma.  Some people will let the soda go flat and then drink it. The issue is primarily with the carbonation.  Anatomically, your stomach is altered by the surgery.  The upper section of your stomach acts as a sort of gas collection area, when it's full, you burp.  After bypass surgery and the formation of your pouch, you no longer have this area and so you no longer have an effective way of eliminating the gas from your system.  The gas will leave - and you may end up with some reflux as a result. There are a lot of fantastic beverages that are not carbonated.  And water isn't so bad either. Danielle Halewijn RD eNutritioncare.com
DanielleH_RD
on 8/18/07 10:29 am
Topic: RE: Cost of Protein
Nonfat dry milk powder is inexpensive, but you will have to use a bit more than some of the super-supplemented protein powders.  In 1/4 cup of powder, there is 6g of protein.  Dried buttermilk (if you can find it) is a little better at 10g.  The protein supplement "shakes" have the benefit of flavors (like chocolate, vanilla, etc), they are often controlled for carbohydrates (which you may or may not tolerate), and they taste pretty good. There are many protein powders out there that are very expensive.  Read the labels - you will find that most of the cheaper, store brand versions are just as good as the big name products.  For example, I have a patient (with a milk allergy) who needed a soy based protein.  She shopped all over and found a wonderful product at Henry's (sister company of Whole Foods - I believe) that was half the price of the major brands.  It was labeled under the store name.  My husband loves the chocolate powder available at Costco by EAS (whey and soy protein source) - per serving it has 3 g carbs, 27 g protein and costs about $24 for a 6 lb. bag Keep in mind also that when you first have the surgery, your intake is going to be less - so the protein supplement will last longer. Your use will increase over time, but your tolerance to other protein sources will also improve (so you can use cottage cheese instead of powder). Also, you won't be buying as much regular food because you won't be eating that at all. (Just a fact, I'm not trying to be mean) I hope this helps - and good luck Tuesday!
Danielle Halewijn, RD,CNSD
Director of Nutrition, eNutritionCare.com
eNutritionCare.com
http://www.enutritioncare.com
DISCLAIMER: Any information contained within is meant to be general nutrition advice. Please consult your Registered Dietitian about your specific problem!

DanielleH_RD
on 8/17/07 9:53 am
Topic: RE: does suich a vitamin exist?
None that I know of - and since you shouldn't take calcium and iron together, it wouldn't be a good idea to have an "all-in-one" with those minerals. The number and amount of supplements post-operatively can be very challenging.  Believe me when I say, it is important to take your supplements and to be very regimented about it.  A lot of the long-term data coming out in the literature about post-operative complications mentions again and again how 'bad things' could have been avoided if supplements were used - I'm talking fractures that have led to amputation, permanent nerve damage, and other complications that can be linked back to nutritional deficiencies. As far as a multi. Some docs suggest prenatal vits - but these are not appropriate for women past child bearing age.  A good high potency multi from any brand will work.  You don't have to spend a fortune on your multivitamin.  There are fantastic vitamin preparations available in "plain wrap", store brand, or generic forms.  I personally am a big fan of Trader Joes - good vitamins and good $$$ value. I hope this helps!
Danielle Halewijn, RD,CNSD
Director of Nutrition, eNutritionCare.com
eNutritionCare.com
http://www.enutritioncare.com
DISCLAIMER: Any information contained within is meant to be general nutrition advice. Please consult your Registered Dietitian about your specific problem!

DanielleH_RD
on 8/1/07 6:15 am
Topic: RE: Different form of B-1?
The B's can be pretty confusing. B12 is different than all of the other B vitamins.  In only shares the "B" in the name because it was once thought to be a similar compound - it's not.  B12 requires stomach acid and another chemical called "intrinsic factor" in order to be converted to it's usable form.  B12 is absorbed in the distal ileum.  Most people with WLS still have the ileum intact, just the mechanism for converting the vitamin is altered.  The end result is that B12 is usually supplemented. None of the other B vitamins require conversion before absorption. 
DanielleH_RD
on 8/1/07 6:02 am
Topic: RE: carb counts in post ops
I'm one of the dietitians at eNutritioncare.com - so yes, I'm for hire! I'm also here on the nutrition board. Looking at the postings, there is a need for information.  It's also unfortunate, not all of the dietitians working in bariatrics have the same amount of expertise.  It's a big country and dieitians are in short supply just like most other healthcare professionals. I'm happy to help when I can! Danielle
DanielleH_RD
on 8/1/07 3:04 am
Topic: RE: Different form of B-1?
Take that pill and put in a glass of water and set it on your counter.  Check it in about 30 minutes and again at 1 hour.  The tablet should be dissolved when you stir the glass. This gives you an idea of what that little pill can do in your stomach. You can also do the same thing but add a capful of vinegar (it is a weak acid, but can approximate the acid in your stomach). If it dissolves, then feel comfortable that the pill is digesting just fine.  B1 is very readily absorbed by your body.  If the pill works - why switch to a more expensive, alternate form of the same nutrient?
DanielleH_RD
on 8/1/07 2:57 am
Topic: RE: Colonic Hydro Therapy
Why do you want to get a colonic? I know that the practitioners of these procedures talk about the benefits - but there is absolutely NO scientific evidence that this is beneficial or necessary. If a person is constipated and they use an enema - that's very understandable.  If a person has slow gut motility, they may need to change their diet (add fiber & water), use a stool softener, or use a stimulant such as reglan (by Rx).   I had a professor in college that used to say - "if we were meant to have colonics, we would have come equipped with a hose up our butts" I recognize that this is an opinion, stated in a rather harsh way - but it ties to the fact that our bodies are amazing things with many protective and balancing mechanisms.  It already has a system for elimination, why do we need to fix it if it isn't broken?
DanielleH_RD
on 8/1/07 2:46 am
Topic: RE: carb counts in post ops
If you are doing okay on 12-1300 calories a day, that's probably fine.  If I based your carbs on 1200, I would calculate 10 servings.  Using your nutritionist's (dietitian??) it would be 12. If you are calculating that in grams of carbohydrate that would be a minimum of 120 g per day to about 215 g.  That's a pretty big range.  To be on the safe side, I would recommend not going over about 180 g per day.  In food terms that is 15 cups of milk or 12 small apples or 6 cups of pasta (I am not recommending that you eat these - but just illustrating my point) About good carbs - good is relative and it doesn't just mean 'taste good'.  "Good Carbs" contain vitamins and minerals - think carbs from milk (12 g per cup) or from servings of fresh fruit (12-18 g).  Milk has calcium, phosphorus, zinc, and magnesium - all nutrients that you need after GBS.  Fruit has loads of the B vitamins, potassium, vitamin C, fiber and phytochemicals (these are chemicals that are related to the color of foods and have great health promoting benefits).  Your carbs should come with more than just calories, they should also have nutrients. I hope this helps! Danielle
DanielleH_RD
on 8/1/07 2:28 am
Topic: RE: My protein levels dangersly low
The protein was 11, so they were looking at total protein.  Did they have albumin levels too? The facts are that you are losing weight and doing it in a way that forces your body to pull from your reserves in order to provide energy and and building blocks for maintenance.   I am going to digress into a little physiology lesson: The energy you are using to live primarily comes from your fat reserves now because your intake of food is so restricted.  What you are able to eat is immediately converted for energy or maintenance.  The body will spare protein if it needs it for building new muscles, healing, or immunity.  When the only thing you are taking in is protein the body will use some of it for energy but most of it for maintenance of your body.  Protein only has a small amount of energy potential.  Your body prefers to run on glucose (sugar).  Protein is made up of amino acid chains, on the end of that chain is a structure that can be turned into sugar.  Protein is not converted into sugar (just like your fat cannot be converted into muscle) The carb restriction exists for two reasons - one, you may not tolerate carbs well (ex: lactose intolerance or dumping) and two, you will get full fast with the pouch so eating protein first is more important.  Your body can convert fat to glucose relatively easily, so carbs are not as necessary in your intake.  Protein cannot be produced unless your body breaks down some other structure in order to obtain the necessary amino acids (proteins are made up of amino acids, proteins make up your muscles and organs). If you aren't taking in enough protein, your body will steal from itself in order to get the protein - so your body will cannibalize its own muscles to get protein.  The only way to stop or slow this process is to maintain a regular exercise program.  How does that work? If you are using your muscle groups, your body will recognize the need to keep those muscles intact.  It's the "use it, or lose it" rule - if you need the muscle for regular use, your body will maintain it.  If you do not use the muscles, your body thinks it is fair game to break it down and use it for other purposes. Here's my analogy - you are living in a cold place, it's winter and you have no firewood.  You do have an old wood shed out back that you're not using.  Instead of freezing, you cut up that old shed and burn it to keep warm.  That's what your body does with muscles if you don't use them. So back to your protein levels.  Eat your protein first at every meal.  If you are able to sip a protein shake between meals, great.  If boost is the only one you can stand - that's fine as long as you tolerate it and it fits in to your daily calorie goals.  Preferable would be a low-carb protein mixed with water or skim milk.  Eat fish, chicken, cottage cheese or whatever proteins you like at your 6 meals.  Consider stirring a little protein powder in - cottage cheese with some vanilla protein powder and a little splenda in the blender is not a bad little treat (I like it blended rather than stirred to take away any chalky residue from the protein - not everyone is bothered by that.  Stirring works too!)  Supplement protein whenever you can. And most important - MOVE. Keep up your activity, what ever it is.  Use your major muscle groups and give your body a reason to maintain those muscles! Take your supplements every day and don't forget!  If you do these things you will be fine.  Having some of your labs come back low is not unusual. I hope this helps - and good luck!
DanielleH_RD
on 7/31/07 12:29 pm
Topic: RE: My protein levels dangersly low
I would need a little more information. What proteins are dangerously low ? (lab levels if you have them) Have you had any recent infections, illnesses, colds? How many meals a day? Why was boost a no-no?
DanielleH_RD
on 7/31/07 12:25 pm
Topic: RE: carb counts in post ops
Are you looking for a carb count that fits in with your total calories for the day? To just give you a number would almost be irresponsible. In general, if a patient was maintaining a 1800 calorie per day diet, then I would use 15 servings per day (that is 50% of calories from carbs, 4 kcals/g, 15 carbs per serving).  Many people adjust their carbs up or down depending on goals, calorie levels, etc.  I use 15 as a guideline for a serving but teach that anything from 12 to18 g carb counts as that serving.  It requires label reading and measuring - but no one here is unfamiliar with those concepts. Hope that helps - if not, let me know.
DanielleH_RD
on 7/27/07 3:16 pm
Topic: RE: LAB WORK QUESTIONS
Sorry - I just realized how long ago the original post was.  You have probably already given birth! Best of luck, and I hope the information is beneficial to someone else out there!
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