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Q&A with Australian Health Practitioners
Can someone clarify what the right diet for me would be?
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I am 58 years old and 107 kg. I have arthritis in my knees and back , irritable bowel syndrome, fatty liver and I am fructose intolerant. My question is which diet should I follow as I find fruit and nuts give me severe cramps and diarrhea . I am struggling to lose weight. A typical days diet would be a poached egg on 1 slice of toast and a white coffee for breaky . A salad of tomato ,cucumber, olives,mushrooms and tuna for lunch and stir fry veges with either chicken or lean meat for dinner. I am not a snacker so I don't eat morning or afternoon tea and I don't have a sweet tooth. I don't do a lot of exercise due to my arthritis. -
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Dr Simon Easterbrook-Smith
Health Professional
My research interests include immunology and the mechanisms of amyloid formation. The latter has implications for people who are dealing with Alzheimer's Disease, Parkinson's Disease … View Profile
I think that talking with an Accredited Practising Dietitian (APD) would be a good plan.
APDs are evidence-based health professionals who specialise in working with people who have food/diet issues.
An APD will be able to review your diet with you and suggest ways in which it might be improved.
You can find an APD here: http://daa.asn.au/for-the-public/find-an-apd/ .
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Thanks for the reply but I don't have much faith in dietitians I have been to two different ones and found the only thing I lost was my money. They both handed me a food pyramid chart and when I mentioned my ibs and fructose problems I was told to not focus on them just eat less calories. Everyone assumes when your overweight you gorge on the wrong food. I eat very healthy but am confused about low carb etc for the insulin problem.
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Melissa Yip
Dietitian, Nutritionist
Experienced accredited practicing dietitian (APD) with more than 10 years of practice. Happy to help with nutrition issues and chronic disease management. Lover of delicious … View Profile
I'm so sorry to hear that your previous experience with dietitians were not too good! It's a challenge to find a dietitian that can translate "eat less calories" on paper into actual day to day practices without costing you too much money. Keep trying :)
You mentioned an "insulin problem" - is this insulin resistance? Sometimes food and diets can only take us so far (it kills me to say this because I am a dietitian, after all) and especially in the case of insulin resistance, you also do have to look at physical activity.
Talk to your GP about a referral to an accredited exercise physiologist - they are the experts at prescribing exercises after taking into account your injuries and limitations. The best kind of exercise for you would probably be resistance training, which would not only improve insulin sensitivity, but also aid in weight loss.
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Dr Simon Easterbrook-Smith
Health Professional
My research interests include immunology and the mechanisms of amyloid formation. The latter has implications for people who are dealing with Alzheimer's Disease, Parkinson's Disease … View Profile
I am sorry to read that you had a poor experience with APDs - like all health professionals they differ in their clinical skills.
How were your fructose intolerance and irritable bowel syndrome diagosed? Usually this is a job for a specialist gastroenterologist. If so, going back to him/her for more advice would be a good plan.
As far as your "insulin problem" is concerned, this could indicate that you are at risk of Type 2 diabetes.
If I am correct then getting your GP to refer you to a specialist endocrinologist and/or an APD with experience of working with clients who are at risk of Type 2 diabetes are ideas which are worth considering.
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Arlene Normand
Dietitian
Arlene is a registered practising dietitian, with a private practice in the Eastern Suburbs of Sydney, and has built a strong business over the last … View Profile
Your intake appears very good to lose weight. You must remember that when you are 58 years old your metabolism is very slow so portion sizes are extremely important. You might not snack between meals but you may be eating too much at each meal. Following the FODMAP diet is good for you and it appears that you have managed that alone. Do you get any bloating or diarrhoea on the diet you are following?
Do you consume any alcohol? Have you consulted a gastroenterologist to check your Irritable Bowel Syndrome and your fructose intolerance?
I would suggest you add fish to your diet as Omega3’s which are found in fish are very healthy and good for arthritis. You diet looks deficient in calcium which is a worry at this age when bone density tends to drop. You can eat lactose fee yoghurt and drink lactose free milk.
You should try and do some exercise to keep your joints lubricated. With arthritis you should still be moving. Water aerobics is excellent and it is offered at many centres. Tai Chi is gentle and good for joints and balance. Exercise is essential to maintain muscle tone and bone mass and to move your joints.
I suggest you consult an Accredited Practising Dietitian to have the quantities you are eating checked and to ensure you are getting all your nutrients.
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