Sound nutritional advice or quackery

Nutrition Q&A [Moderated]
1

Hello,

I live in a country where there’s very few nutritionists available and where there doesn’t seem to be proper regulation in terms of what they offer. I booked a consultation with a nutritionist, who had gone to some private nutritional school here (no idea if that has any validity). This already ringed many alarm bells, but since it was recommended by a physician (after a quick research) I decided to try it. I wanted to improve my well-being, because getting ill constantly is getting on the way of my training and lifting regime.

Medical background in TLDR form: 2-3 yrs of health problems, prostatis and frequent urination are the most disturbing ones, IBS that comes and goes with mostly diarrhea, anxiety, many viral and bacterial infections in the last 2-3 years; but immunglobulins are okay. One specific IG was lower than usual, but a vaccine fixed that. Many neurological and metabolic diseases in the family from my mothers side. Thyroid fine, kidneys fine, liver great and heart great. 30 years old, normal weight. Some history with back problems, but nothing serious at the moment.

The nutritionist was using a lot of fancy words and talking about cell-level stuff and for the most part I really wasn’t following what she was saying. She asked about my diet, I admitted to eating dinner way too late and eating sweets especially if I haven’t had time to eat. I was mostly looking for support in regards to finding a suitable dietary balance, but she immediately made me a list of things that I should quit indefinitely, which included all non-fruit sweets, alcohol, caffeine, spicy foods (whatever that means), indian and chinese foods (because of MSG), acidic foods like tomatoes, ketchup, vinegar and anyhthing that is inflammatory. I understand that sometimes an elimination diet might be necessary for some months, but after that you should start reintroducing different foods. Indefinite bans rarely work. She also told me to avoid GMO, because there’s so many chemicals (this made me laugh) and pesticides (not true, organic farming requires more pesticide use).

There was also a bunch of rather expensive supplements and tests I was recommended from the get-go. She said I might have gluten or milk intolerance (I have had a gastroscopy as well: no signs of celiac disease in the villi or stomach lining, calprotectine not indicative of celiac)

The tests included:
Gluten and casein peptides from urine (to check for gluten or milk “sensitivity”)
Urinary hormone metabolites (to check for cortisol levels)
Some expensive DNA test

Both of these damn tests cost over 200 euros per piece. On top of these I should apparently be taking: omega 3 fish oil, quercetine, one extremely expensive probiotic mix, s. boulardii capsules and magnesium with phospholids. After being bombed with all of this she said, it’s obviously my own choice what I choose to take…

Writing this, I realize I’ve answered my own question for the most part, but I still have some specific questions to ask. I’ll put them in order here:

  1. Can cortisol be too high in the mornings due to anxiety disorders or other neurological or neuro-psychiatric issues? Wouldn’t a simple blood test be enough to check for this?
  2. Is there such a thing as non-celiac gluten intolerance or sensitivity? I tried googling it, but couldn’t recgognize sound evidence from bullshit. There seems to be contradictory claims in this?
  3. Do any of the above supplements have any actual studied benefits for digestion or digestive problems? From your podcasts I’ve understood, that for the most part supplements are unnecessary with a few rare exceptions.
  4. Inflammatory foods. This gets thrown around a lot and I understand that alcohol and too much sugar can cause issues, but to say that there are foods that cause inflammation “in the body” is a bit vague. Is this a scientific term or just more quack.

There’s a lot of questions and issues here and I don’t expect you to address them all. The podcasts have been super beneficial to help me identify health bs from sound advice.

Thanks!

2

That is interesting. How did you find this “nutritionist”? In the US, anyone can call themselves a nutritionist, but registered dieticians (RD) are the licensed professionals. Not sure how it is in Europe, but this is concerning…depending on why and how you came to be in this nutritionist’s office.

To your questions:

  1. Not really, no. Cortisol is typically maintained quite well unless there is adrenal insufficiency, which is a serious condition. Anyone talking about cortisol from a dietary standpoint might as well be quacking.

  2. Yes, that is considered real.

  3. Outside of very specific conditions that I’m guessing you don’t have, those supplements are worthless.

  4. A little bit of both. There is an inflammatory index foods can be measured on, but the degree of inflammation is highly variable and ultimately, not clinically significant as they typically don’t cause disease or symptoms outside of specific food allergies or autoimmune conditions.

1 Like
3

Thank you very much. This clarified a lot and strengthened what I already sort of knew.

I currently live in Estonia, but I’m from Finland originally, where registered dietician is also protected by law. I don’t know how the laws are here, but at I guess there’s no university training for that here, at least not one that I know of. It’s a small country and is dragging behind on specialists.

Thus far, moderation, activity and excersise have seemed to be the best medicines. And regular contact with actual doctors.

4

Oh, one more thing. Is there any actual clinical test for non-celiac gluten sensitivity? I honestly feel that this is one of the major issues in terms of my problems based on self-evaluation and anecdotal evidence.

5

So again, I’m not sure why you were evaluated by a professional with all these tests in the first place, which makes it hard to correlate anything clinically, you know?

As far as non-celiac gluten sensitivity, it is a syndrome of symptomatic response to gluten ingestion in folks with no laboratory or histologic evidence of celiac disease. The most common complaints are abdominal pain, bloating, and/or change in bowel patterns, but some patients complain of symptoms unrelated to the GI tract. The onset is typically within hours or a few days of ingesting gluten. This time course distinguishes NCGS from the rapid onset of symptoms in wheat allergy (minutes to hours) but can overlap with the delayed onset of symptoms in celiac disease (days to weeks).

Testing should be done for celiac or wheat allergy to potentially diagnose non-celiac gluten sensitivity, which does not have its own test.

6

Alright, this clears a lot of things up. I was confused about all of this myself. I think there could be a nocebo effect going on with non-celiac gluten sensitivity as well, at least partly.

But yeah, this “nutritionist” was absolute bullshit and I’m not planning to go there again.