The scope of dietary nutrition guidance includes

The core scope of dietary nutrition guidance covers four major areas: nutritional support throughout the physiological stages of the life cycle, disease-related medical nutrition intervention, nutrition adaptation for special scenarios, and dietary behavior and cognitive guidance. It covers almost all dietary-related needs of ordinary people from daily meals to disease treatment. It is not as narrow as everyone thinks, and it is not only necessary to seek nutritional guidance when you are sick or pregnant.

I just picked up a 28-year-old girl who was preparing to become pregnant last week. When she arrived, she memorized half a page of the "Must Eat List to Prepare for Pregnancy" copied online. Folic acid, DHA, and black soy milk were clearly listed. The results showed that her BMI was 26.2, indicating she was overweight. She also had a history of Hashimoto's thyroiditis. I had no idea before that I had to control my intake of added sugars. I even secretly added honey to the freshly squeezed soy milk I had been drinking for three months. I just want to mention here that different schools of thought currently have different opinions on whether Hashimoto’s patients should strictly abstain from gluten: the standard of evidence-based nutrition is that only patients with celiac disease need to completely avoid it. As long as ordinary Hashimoto’s patients do not have obvious symptoms of gastrointestinal discomfort or fatigue after eating pasta, they do not need to quit completely. However, most nutritionists in the functional medicine field will recommend doing a food intolerance test first, and adjusting the proportion of gluten intake based on the results. We generally explain the pros and cons of both options clearly, allowing users to choose the more acceptable one. Not only for pregnancy preparation, from babies who have just turned 6 months old and need complementary feeding, to students who need to grow during adolescence, to women with hot flashes and insomnia during menopause, and even elderly people in their 80s who have pressure sores and need high protein support, the physiological stage needs of all age groups are within the guidance range, and the focus of different stages is not even a bit different.

Oh, by the way, many people’s understanding of nutrition guidance is that “only when you are sick should you adjust your diet.” This part is actually the scope of medical nutrition intervention, and it is also the most common need for hospital nutrition departments. A 62-year-old type 2 diabetic came to me a while ago. I heard from my neighbor that diabetics should completely cut out staple foods and only eat vegetables and boiled eggs. As a result, last month when I went out to buy vegetables, I fainted due to hypoglycemia. After he retired, he walked and picked up his grandson every day, and did not have much activity. However, when we calculated it for him, daily carbohydrates still accounted for about 45% of the total energy. However, he had to give priority to low-GI (glycemic index) staple foods such as oatmeal and quinoa, and only ate an amount the size of his fist each time. There is currently no unified "optimal solution" in the academic community regarding the dietary pattern of diabetics: the low-carb diet is quick to control sugar, but long-term adherence is prone to constipation and hair loss problems; the Mediterranean diet is gentler and friendly to blood lipids, but the blood sugar-raising effect is not as obvious as low-carbohydrate. We will not forcefully recommend any one. We first ask users about their daily eating habits and choose a plan that they can stick to for a long time.

Don't mention it, there are many scenes that don't seem to have anything to do with "sickness", but in fact they also require special nutrition guidance. This part is the adaptation to special scenes. Last month, a young man who ran a half-marathon came to me and said that his legs would cramp every time he ran about 15 kilometers. The energy gel he bought blindly was so sweet that it made him nauseous after eating it. We calculated his running volume and body fat percentage, adjusted his carbohydrate loading plan for the week before the race, and recommended energy gels that were suitable for his gastrointestinal tolerance and had a more reasonable electrolyte ratio. He just finished the Northern Marathon half marathon last week and sent me a message saying that he had no cramps throughout the race and that his pace was 2 minutes faster than before. Recently, many parents have come to me to adjust the diet of their children who are taking the physical examination for the high school entrance examination. They first ask whether they should give their children protein powder and functional drinks. In fact, most children usually consume enough meat, eggs, and milk. Instead, they should be careful not to eat too much cold food or too oily food before the examination to avoid gastrointestinal discomfort. Indiscriminate supplementation of protein powder will easily increase the burden on the kidneys, which is not worth the gain.

To be honest, in the five years I have been working as a nutrition coach, the most common problem I have encountered is not "What should I eat?" but "What should I do if I know what I should eat but can't control my mouth?" This is the scope of dietary behavior and cognitive guidance, and it is also the part that many people tend to ignore. A girl came to me to lose weight before. She said that every time she couldn't help but eat fried chicken, she felt guilty and would induce vomiting after eating. Instead, she lost weight and gained weight. Different nutrition schools have quite different views on this point: some schools advocate completely quitting "junk food" with high oil and sugar, and eliminating temptation at the root; but most of us who practice it will prefer a flexible diet, such as arranging a "casual meal" once a week, and eating whatever you want. As long as the overall calorie gap is not large, it will not be easy to overeat. After all, the ultimate goal of nutrition guidance is to let you develop healthy eating habits, not to make you live with your favorite food for the rest of your life.

In fact, these sections do not have such clear boundaries. For example, for a pregnant diabetic patient, you must not only consider her physiological nutritional needs during pregnancy, but also provide medical nutrition intervention for diabetes. You must also adjust her recipes based on her usual situation of bringing meals to work, and correct her misconception that "she should eat more fruits to supplement vitamins during pregnancy." Several contents are interspersed together. To put it bluntly, as long as it is related to your eating problems, whether you want to eat healthier every day, or you need to adjust your diet when you are sick, or you have special needs for exercise or exams, they are actually covered by nutrition guidance, and it is not as out of reach as everyone thinks.