“One of the biggest pieces of nutrition advice I can give is: If you’re looking for answers, you should be asking the questions to the right people,” says Mary Cain. “And that’s not your favorite athlete’s Instagram account. It’s not even going to your favorite runner’s Instagram and seeing like, ‘Oh, they’re kind of, they look sort of similar to me, they say they’re healthy.'” Instead, Cain wants you to see the right people: Dietitians.
Answers about how to dial in your nutrition are never one-size-fits-all, and with all the fads and diets in the space lately, it can be harder than ever to determine what’s right for you. “Nutrition has just become this strange—I don’t even know how to describe it—but it’s something that has become more complicated,” she says. Should you be doing low-carb, high-fat, high-protein? Depending on who you ask, it’s only gotten more confusing, but it doesn’t need to be.
It can be tempting to look at athletes who embody either a performance or aesthetic “ideal” and decide that we should follow what they do. But Cain emphasizes that’s the last thing we should do: “Don’t come to me. Don’t come to Instagram. Don’t go to another athlete. Find a registered dietician who you can sit down with and make a plan.”
For Cain, who has recovered from an eating disorder—something up to 47 percent of female athletes in sports such as running have experienced—seeing a dietitian was key to her recovery. She credits Lindsey Cortes, a registered sports dietitian and founder of Rise Up Nutrition in New York City, for changing a lot of her mindset about food and eating.
“She’s somebody who I think really, really helped my journey. It was my experience that I reached a point where I was eating enough, but I was very self loathing about that,” Cain says. “How you see your relationship with food was something that [Cortes] was able to help me with, and kind of reframe my thoughts of like, ‘Why am I feeling sad eating a pizza?’ That negates the whole point of pizza night!”
Dietitians can not only help you nail down the nuts and bolts of fueling your body, but also start to help put your feelings into perspective.
What to Expect When Seeing a Dietitian
We spoke to Cortes about why female runners can benefit from seeing a dietitian even if they have a healthy relationship with food—and what to expect when you find one.
Why You Might Want to See a Dietitian
“Anybody can benefit from learning nutrition from a registered dietitian. Even if you don’t have anything ‘wrong,’ the truth is, most of us never properly learned about food or how to eat in any of our schooling,” says Cortes. “And unfortunately, there are a lot of mixed, harmful, or conflicting nutrition messages and opinions among friends, peer groups, and media.”
If you want to up your nutrition game—something that can really improve your performance—a dietitian is great for learning how to create balanced meals, how to easily create grocery lists and meal prep plans, or for finding tasty and nutritious snacks
A lot of Cortes’s clients are athletes who want to boost performance. “Often, [they] are struggling with low energy, repeated injuries, and lack of recovery,” she says. “Many are having micronutrient and hormonal imbalances and have exhausted the help of medical doctors, and they’re finally turning inward and realizing it may be nutritional.”
There are also lots of medical reasons to see a dietitian: problems with energy, gastrointestinal health, nutrient deficiencies, hormone imbalances, performance goals, body composition goals, and eating disorders. Nutrition also plays a huge role in medical conditions like kidney disease, diabetes, ulcerative colitis, even cancers. A dietitian can help you tackle all of the above.
Cortes also works with her clients on having a good mindset and approach to fueling. It’s more psychological (and Cortes notes that the help of a therapist or psychologist may be warranted), but incredibly foundational.
“Regardless of somebody’s actual nutritional status, people experience feelings of confusion and insecurity around their food choices, maybe guilt or shame after eating, or even anxiety and fear around food,” she says. “Working with a dietitian who specializes in disordered eating and building healthy relationships with food and body is incredibly helpful for those who struggle with the mental aspect of food and nutrition as well.”
Finding the Right One for You
First, make sure you’re hiring someone who is properly trained and credentialed. Look for a registered dietitian (RD). You don’t want to see somebody with a degree in nutrition or a self-claimed “nutritionist,” but rather a registered dietitian who is nationally board-certified.
After RD there are additional specialties. Cortes is a “CSSD,” or board-certified specialist in sports dietetics; there are also board-certified specialists in oncology nutrition, pediatric nutrition, pediatric critical care nutrition, renal nutrition, obesity and weight management, and gerontological nutrition.
Within these specialties, every dietitian may have a different approach or method; when working with a dietitian, it’s important that you build a relationship of trust. Cortes recommends finding the right “fit” to your personal needs, goals, and preferences. “Even though I think I’m a great dietitian, I’m not great for everybody,” she says. She recommends asking these questions before you sign up with someone:
- What is your nutrition philosophy?
- Do you prescribe meal plans or calorie goals?
- Do you take blood work?
- Do you coordinate with my doctor?
- How often can we have sessions/communicate with each other?
You may not know what you need (“many people don’t!” says Cortes), but working with a dietitian includes a lot of nutrition counseling and coaching, much like a therapy session or working with your running coach, so you want to make sure you are on the same page with your goals and nutrition plan. Cortes offers one or two free consultations with every client before mutually deciding that they want to work together.
Your First Appointment
The first time you meet with an RD, you should bring some info with you, including your goals, your usual dietary intake, and medical history. Cortes also recommends being prepared with a “want, willing, won’t” list: what you want to change, are willing to change, and won’t change. This helps your dietitian make effective recommendations to you.
“I’ve had vegans that won’t change their dietary preference no matter what feedback I give them, and others that are willing to consider it if I have reason to believe their health or performance will improve,” Cortes says. “Thinking of what you want to get out of your nutrition journey is important.”
Short-Term or Long-Term Treatment
You might be wondering if seeing a dietitian is something you’ll have to do for forever, or if it’s more of an acute, short-term treatment. This depends on the dietitian, their approach, and your needs. The hope is that your dietitian will teach you how to nourish and fuel on your own so that you don’t need to see them long-term.
“At the same time, only so much can be accomplished in just one or two sessions,” says Cortes. “Personally I work with clients for a minimum of 12 weeks, with the goal that they do not need me after that time.”
Three months is great amount of time for people to learn, implement, get feedback, see results, and adjust if needed, says Cortes. For athletes, Cortes provides ongoing coaching programs, because often runners want somebody to check in with/get support/hold them accountable/address race day tactics/or change the plan when training changes.
For effective results with a dietitian, plan on investing a couple of months to set goals and accomplish them, then re-assess if ongoing nutrition support is needed—whether its monthly check-ins or as-needed.