“What Can I Add?” The Question a Dietitian Wishes More Patients Asked

The question Eva Tolchinsky, M.S., RDN, hears most often from patients is simple: “What am I allowed to eat?” But the dietitian at Old Bridge Medical Center and Raritan Bay Medical Center in New Jersey said she consistently tries to shift that framing. Instead of starting from restriction, she encourages patients to ask what they can add, whether that’s more fiber, more protein, or another nutrient that supports their goals. The aim, she said, isn’t to take things away from a patient’s diet but to build onto it.

The serving size detail patients often miss

Tolchinsky pointed to a common gap in how people read nutrition labels: Many patients focus on sugar content alone and overlook total carbohydrate count and serving size. Since label values are based on a single serving, not necessarily the amount someone actually eats, the math can be easy to miss. A label listing 15 grams of total carbohydrates per serving actually means 30 grams if someone eats two servings, a distinction Tolchinsky said gets lost more often than people realize.

No question is a silly question

Tolchinsky said she wishes more patients asked the questions they worry are too basic, since those moments often become the most valuable part of a nutrition conversation. More specifically, she wishes patients led with “What can I add?” rather than “What should I restrict?”

Teaching mindfulness, not restriction

For patients managing diabetes or any nutritional condition, Tolchinsky said her goal is to build mindfulness and intuition around eating, helping people notice what they’re adding to a meal rather than fixating on what to cut out. She’s especially mindful of food’s social and cultural role, whether it’s dinners with friends, family gatherings, or cultural traditions, and said nutrition guidance should never strip that away.