Nutrition

4 Nutrition Questions Registered Dietitians Hear All the Time—Answered

grocery basket with milk, carbs, rice, vegetables

At parties, I don’t usually talk about what I do for a living. I’ve quickly realized that a lot of people want to discuss food as soon as they hear I’m a registered dietitian. I tend to get waylaid by advice-seekers, like those who want my thoughts on what they ate for breakfast that day.

While I love talking about nutrition (it’s my job!) and I’m excited to hear that other people are also thinking critically about food, I just don’t feel as comfortable doling out advice at a cocktail party as I do in a more professional setting. That mainly comes down to the fact that everyone is different and many answers to nutrition questions will come down to your unique health, habits, lifestyle, and all that.

But, hey, I sympathize with how confusing it can be to try to understand nutrition. So, I recently asked my social media followers to send me their biggest nutrition questions. Unsurprisingly, they happened to be ones I hear a lot from clients as well. Here are the answers to four common nutrition questions I receive.

1. We should all try to stay away from gluten, right?

Gluten isn’t inherently bad for everyone. You really only need to go gluten-free if it’s medically necessary for some other reason. It’s simply a protein present in wheat, barley, and rye, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

It does make sense for some people to avoid gluten, like those with celiac disease, whose bodies basically hate this protein. In people with celiac disease, gluten can damage the small intestine, leading to crappy symptoms like bloating, abdominal pain, diarrhea, constipation, gas, and vomiting. Then there are people with non-celiac gluten sensitivity (also called gluten intolerance), who do not experience the small intestine damage but can still deal with symptoms like fatigue and stomach pain after having this protein.

It could also be a good idea to avoid gluten if you have a wheat allergy, which is essentially an immune overreaction to gluten or another wheat protein, the Mayo Clinic explains. Symptoms include mouth and throat swelling or irritation, hives, diarrhea, and in severe cases, anaphylaxis (throat tightness that can lead to difficulty breathing). If your wheat allergy doesn’t specifically encompass gluten, you may not need to go gluten-free, but it’s smart to get allergy testing so you know exactly what you’re dealing with.

People with irritable bowel syndrome may also benefit from curbing their gluten intake, as research has indicated that it may help with symptoms like diarrhea. A 2015 paper in Nutrientsexplains that since some people with IBS also have celiac disease or gluten sensitivity, various studies have shown benefits in going gluten-free for certain people with IBS. It appears as though going gluten-free may even help people with IBS who don’t have these conditions. Experts aren’t sure how IBS interacts with gluten. But, hey, anything to make IBS hell easier might be worth it. Although, if you can, talk with someone like a doctor or registered dietitian before eliminating something from your diet.

So, that was a pretty intense list of very valid reasons to at least consider avoiding gluten. But if you don’t have these types of medical issues, there’s no point in cutting gluten out of your diet. A 2018 article in Gastroenterology and Hepatology explained that eating a medically unnecessary gluten-free diet is unlikely to result in substantial health benefits. In fact, as the paper details, it could be financially challenging because gluten-free food can be expensive as hell. It may also cause psychosocial issues for some people since maintaining a gluten-free diet (or any diet) can be emotionally draining and impact your social life. It could even lead to nutritional deficiencies if you cut out too many foods to try to avoid gluten. And, if you’re interested in nixing gluten to avoid calories, know that a food isn’t inherently healthier or less caloric simply because it’s gluten-free.

Take it from me: You don’t need to avoid gluten for no good reason.

2. Do I really need to eat breakfast?

If you find that breakfast is helpful for keeping you full until lunch and boosting your energy levels, by all means, keep at it. However, if you’re the type of person who never eats breakfast and manages fine without it, then there’s probably no reason to start eating it now.

For what it’s worth, research on this topic is mostly inconclusive. For every study that shows breakfast is beneficial for some reason, there’s another that shows the opposite. That’s especially true when it comes to weight, a major focus of breakfast-related research.

One prevailing school of thought is that regularly eating breakfast may help with weight loss by increasing metabolism and boosting satiety (so you don’t eat more later to compensate for your hunger). For instance, a 2011 systematic review in Obesity analyzed 153 studies having to do with eating behavior and weight, noting that some small studies have found a potential link between eating breakfast and weighing less.

But the other school of thought is that skipping breakfast could help contribute to weight loss if that means eating overall fewer calories than normal because there’s no guarantee that it will lead to eating more later in the day. A 2019 BMJ meta-analysis of 13 studies found that, overall, those in the included trials who skipped breakfast tended to have a slightly lower weight. They also found no evidence that skipping breakfast was associated with higher overall food consumption.

It’s hard to know where the truth really lies. As the BMJ study authors explained, so much of the evidence on breakfast and weight is low-quality. There are lots of potential flaws with breakfast-related studies, like that many are based on participants self-reporting what they eat rather than researchers actually tracking that information themselves. Many of these studies also don’t account for confounding variables, like that people who eat breakfast or skip it may have other lifestyle habits in common that influence their weight. Then there’s the issue that many of these studies are small and conducted on such select parts of the population (like only men or only women below a certain BMI) that it doesn’t provide a good foundation for extrapolating the results to the general population.

Also, some breakfast-related studies have been funded by companies that have a stake in the game, like those that make cereal. And, in those cases, it’s not a huge surprise when the research finds some great benefits to eating breakfast.

Perhaps the larger issue is that many of these studies focus on breakfast’s effects on weight gain or loss when we know that losing or gaining weight is so much more complicated than whether or not you eat this daily meal. We know that weight is not the be-all, end-all arbiter of health, too.

With that said, if you are going to eat breakfast because it’s your favorite part of the day or it gives you a ton of energy or whatever other reason, it should typically include a lot of filling protein. (I say “typically” because there are those days when all you want is bananas foster French toast at brunch, which is great.) Although this varies based on factors like your weight and activity level, I recommend getting 20 or more grams of protein at breakfast to help keep you full. (That can be hard, but try to get 15 at the very least. Here are some recipes to help you out.) I also love to include some energizing complex carbohydrates (like whole wheat toast or oatmeal) at breakfast, which brings me to the next question I get all the time.

3. Is it OK to eat carbs?

Let me put this in all-caps for you: YES! Carbohydrates are not only delicious, but they’re nourishing as well. Carbs are our bodies’ first-line energy source, the NIDDK explains. You need carbs to function, full stop. However, there are times when it makes sense to modify how many carbohydrates you eat or the type you’re usually including in your diet.

For instance, if you have type 1 or type 2 diabetes, you should work with your doctor to determine how many carbohydrates are safe for your daily consumption since they affect your blood sugar.

Even if you don’t have any type of health condition, if you feel you’re eating too many refined carbohydrates (like if you think they’re the reason why you constantly feel lethargic), cutting back might make sense. You don’t need to remove these from your life entirely, but focusing more on complex carbohydrates can be helpful. Your body takes longer to break down the complex carbohydrates present in foods like whole grains, legumes, and starchy vegetables than it does the refined carbs in foods like cookies and crackers. This keeps you full for longer and provides more long-lasting energy.

I usually recommend my clients get almost half of their calories from carbohydrates, but that’s after I have extensive conversations with them about how their bodies work and what their dietary goals are. Everyone is different. You might need to experiment with the number of carbs you eat to see what level makes you feel and function your best.

4. Why is dairy suddenly bothering my stomach?

You used to be able to go to town on a cheese plate without issue. Now your stomach burbles if you so much as glance at a wedge of brie. If you routinely experience issues like bloating, gas, and abdominal discomfort after eating dairy, you could have lactose intolerance without even realizing it.

Over time, your small intestine can begin to have difficulty digesting lactose, the sugar naturally found in dairy, the NIDDK explains. It’s unfair, I know. And because this can develop over time, it may take a bit for you to figure out exactly why your stomach gets upset every time you have dairy.

If you think you might have lactose intolerance, see a doctor (ideally a gastroenterologist) who can diagnose you for sure. After that, your doctor or a registered dietitian can offer tips for coping with lactose intolerance, like eating hard cheeses that have less lactose than other varieties or using supplements containing the lactase enzyme that will help you digest dairy.

Abby Langer has been a registered dietitian since 1999. Educated at Dalhousie University in Halifax, Nova Scotia and Loyola University in Chicago, Abby has worked extensively both in clinical nutrition, and nutrition media and consulting. She has won awards for her teaching and has served for three years on her regulatory college’s council. Abby is passionate about all aspects of nutrition, from physiology to teaching to cooking. Her approach to nutrition is permissive and relaxed, and she is a true believer in living your best life without dieting. Abby’s counseling and writings focus on body respect and intuitive-style eating. She has written in depth about debunking fad diets and nutrition myths. Follow her on Twitter and Instagram.

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