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Ask the RN: Kerri Zemko

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April 30, 2013

Kerri Zemko, R.N., B.S.N., O.C.N., is an oncology research nurse and PCRM Food for Life Instructor. Visit her on Facebook for more information on her upcoming Food For Life classes. Do you have a health related question? Email us at

Q: Ive been talking with a dietitian about a weight loss program that restricts carbs and counts them instead of calories as a weight loss strategy. As Im primarily a vegan were realizing this approach may not work as a lot of vegan sources of proteins are high in carbs. Is there a way to increase protein consumption on a vegan diet and decrease carbs so that I could loose about 20 lbs? Do you have specific recommendations for how I could do this? Or are there other strategies on a vegan diet that could help me loose this weight?

A: First, congratulations on wanting a safe approach to weight loss. By consulting with a dietitian, you're more likely to make sure you're getting all the nutrients you need, and to avoid yo-yo extreme dieting, which may contribute to insulin resistance. Insulin resistance is a contributor to many preventable diseases, not just diabetes.

I think you're right to question the idea of restricting total carbohydrates. In some studies of different approaches to weight loss, the people who did not have to count or measure anything but who learned to choose whole, plant based foods had better long term health outcomes than those on calorie-controlled diets (see the work of Dr. Barnard, Dr. Esselstyn, Dr. McDougall and Dr. Ornish).

While having something to count is helpful to some people, it is truly the quality and source of the carbohydrates, not the total number, which is important. There is quite a difference nutritionally between a bagel and a scoop of brown rice, for example...and large amounts of refined sugar are never your friend! By changing out any highly refined carbohydrates for real, whole, plant foods, you would not only be improving the vitamin, mineral and antioxidant content, but would be getting more fiber, a key aspect of feeling full and satisfied, clearing excess hormones and toxins, and, importantly, staying"regular." If you like the idea of having a numerical goal each day to keep you on track, I would suggest aiming for 40 grams of fiber, as opposed to limiting total carbohydrates.

Please consider that "ideal weight," a number, is only relevant as it relates to your health and well being, and that it is important to be a good friend to your body no matter what number it brings up on the scale. In my own experience, mental, emotional, and spiritual self-care is every bit as important as diet and exercise in maintaining a healthy weight for you.

I encourage anyone concerned about their weight to to delve deeper into the multiple reasons things may be out of balance, and to avoid strategies that feel restrictive, limiting, confining, or otherwise at odds with your sense of your true self.

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