Disclosures. Objective. Outline 4/12/13. Nutrition and Your Patient: Practical Strategies to Help Your Patients Eat Right
|
|
- Basil McLaughlin
- 5 years ago
- Views:
Transcription
1 Nutrition and Your Patient: Practical Strategies to Help Your Patients Eat Right Disclosures I have no conflicts of interest to disclose. Beth Gonzales, MSPH, RD Nutrition Specialist and Counselor Cardiovascular Center of Marin Larkspur, CA Objective To present practical approaches to help your patients eat healthier, achieve their nutrition related goals, and improve health outcomes. Outline Nutrition in primary care-why does it matter? Nutrition assessment and goal setting. Which diet is best for weight loss and/or better health. Practical messages and strategies for your patient-the low hanging fruit. 1
2 Nutrition in Primary Care -Why does it matter? The link between diet and chronic diseases, including type 2 diabetes, cardiovascular diseases, metabolic syndrome, and nonalcoholic fatty liver disease is well established. The importance of lifestyle on disease 1/3 of premature deaths in the U.S. are attributable to poor nutrition and physical inactivity. 50% of American adults do not get the recommended amount of physical activity. Only 10% of Americans eat a healthy diet consistent with federal nutrition recommendations. The typical American diet is too high in saturated and trans fat, salt, and refined sugars and too low in fruits, vegetables, whole grains, calcium, and fiber. National Alliance for Nutrition and Activity The Solution: Exercise and Diet are the low cost and effective solution to this epidemic of metabolic disease. Nutrition in Primary Care A Healthy People 2010 objective was to increase the proportion of office visits that addressed nutrition for patients with CV disease, DM, or hypertension to 75%. At midcourse review, the proportion actually decreased from 42% to 40% Barriers cited: Lack of time and compensation Lack of knowledge and resources 2
3 Audience Response How often do you address nutrition for your patients with cardiovascular disease, diabetes, or hypertension? % % % % % Primary Care Providers influence on eating and exercise behaviors Short 3 to 5 minute conversations during routine visits can contribute to patient behavior change. Obese patients who were advised by their PCP to lose weight were three times more likely to try than patients not advised. Patients who were counseled about the benefits of healthy eating and exercise lost weight and exercised more than patients who were not. Reference: Talking with patients about weight loss: Tips for Primary Care Professionals U.S. Department of Health and Human Services Assessing Nutritional Status BMI and weight history Waist circumference Laboratory assessment Diet assessment Assessing Body Mass Index Determine current weight and weight history BMI: Formula: weight (kg) / [height (m)]2 BMI Weight Status Below 18.5 Underweight Normal Overweight Class I Obesity Class II Obesity 40+ Class III Obesity 3
4 The short-coming of only addressing BMI BMI doesn t always reveal the underlying culprit of metabolic diseases: visceral fat As many as 50% of women and 20% of men with a normal BMI have unhealthy amounts of visceral fat. Assessing Metabolic Status Waist Circumference: Increased disease risk is associated with >35 for women, >40 for men. Setting the tone for a productive discussion about nutrition goals and behavior change Assess readiness to change. Many people who are stuck in an unhealthy pattern want to change, but they don't feel that they can. Clinicians can help tip that decisional balance. If your patient is not ready to change, help them identify the important link between disease risk and diet and exercise behaviors. Setting the tone for a productive discussion about nutrition goals and behavior change Meet the patient where he or she is. Ask open-ended questions, listen, and summarize. 4
5 Opening the discussion to address BMI and weight status Patients prefer terms such as weight, excess weight, unhealthy body weight, and BMI instead of obesity and ideal weight. For example, you might say: "Ms. Brown, your BMI is above the healthy range. Excess weight could increase your risk for some health problems. Would you mind if we talked about it?" Examples of open-ended questions for your patient: "What are your goals regarding your weight? What are your goals regarding your diet? Have you tried to lose weight or change your diet in the past? If so, what worked well and what did not work well? Health Effects of Lifestyle Changes-Small changes, Big results Losing 7% of weight and exercising 30 minutes per day cut diabetes risk by nearly 60% in patients at high risk for developing diabetes after 3-4 years of follow-up minutes of walking/week=51% decreased risk of CHD vs. non-regular walkers Goal setting for weight management Agree on a weight goal: losing 5-10% over 6 months at a rate of pounds per week is appropriate for most patients who are ready to lose weight. A goal of maintaining current weight and not gaining weight may also be appropriate for some patients. References: Diabetes Prevention Program, NEJM, 2002; 346 Women s Health Study, JAMA, 2001; 285 5
6 Sample Nutrition Profile Form Initial Current Target Weight 190 lbs 205 lbs 195 lbs BMI Waist <35 women; <40 men Blood Pressure 128/75 135/93 <130/<90 Assess current diet pattern Diet can be assessed with a 24-hour recall, food frequency questions, or by administering a brief food frequency questionnaire (REAP-Rapid Eating Assessment for Patients). Pertinent Labs LDL: 129 Triglycerides: 130 HDL: 39 Glucose: 94 ALT: 35 LDL: 143 Triglycerides: 160 HDL: 35 Glucose: 111 ALT: 40 LDL: <100 Triglycerides<150 HDL: >50 Glucose: <100 ALT: <30 Goal setting for behavior change You might ask: What changes are you willing to make to your eating and physical activity habits right now? Have them identify 1-2 specific changes they will make. For example: -Order a side of fruit or salad instead of fries or potatoes when eating out. -Walk 30 minutes at least 5 days per week and record steps with a pedometer. Weight loss basics To understand what it takes to lose or maintain weight, it often helps patients to understand energy balance, including one s calorie needs, calories consumed, and calories burned. 6
7 How many Calories does one need? Mifflin St Jeor Equation 10*wt(kg) *Ht(cm) - 5*Age(yrs) + 5 = resting energy expenditure (male) 10*wt(kg) *Ht(cm) - 5*Age(yrs) -161 = resting energy expenditure (female) This estimates resting energy expenditure (REE). Multiply REE by an "activity factor : 1.3=sedentary 1.4=walking/standing, no exercise 1.5=exercise 1.6=walking&exercise 1.8=heavy lifting For weight loss, subtract calories Quick estimate for calorie needs -To estimate calories for weight maintenance: If you are moderately active, multiply current weight (pounds) x 15 -To estimate calories for weight loss: Subtract calories to lose approximately pounds per week; usually 7-10 calories per pound of current weight Calorie intake shouldn t be <1200 for women or <1500 for men. How Many Calories do we Consume? According to the Dietary Guidelines Advisory Committee, calorie consumption in the U.S. has increased 30% over the past 4 decades. Year , ,674 Average calories consumed Extra calories from eating away from home Public Health Nutr.16: 87, 2013 Calories/meal at home Normal Weight Overweight/Obese Calories/meal at a restaurant 7
8 4/12/13 Top sources of calories in the U.S. 1. Grain-based desserts 2. Yeast breads 3. Chicken and chicken-mixed dishes 4. Soda, energy drinks, and sports drinks 5. Pizza 6. Alcoholic beverages 7. Pasta and pasta dishes 8. Mexican mixed dishes 9. Beef and beef dishes 10. Dairy desserts What in our diet is making us fatter and sicker? Too many refined grains: Federal guidelines recommend six 1 ounce servings per day for a 2000 calorie diet, and half should be whole grain. The average person eats 8 servings of grains per day, and 7 of the 8 are refined. Source: Report of the Dietary Guidelines Advisory Committee, 2010 What is a serving of grain? 1/2 cup cooked rice or other cooked grain 1/2 cup cooked pasta 1/2 cup cooked hot cereal, such as oatmeal 1 six inch tortilla 1 slice of bread (1 oz.); ½ bun 1 very small (1 oz.) muffin ½-1 cup ready-to-eat cereal A primary contributor to the rise in visceral fat and metabolic syndrome Way too much added sugar The average person consumes 30 teaspoons of sugar and sweeteners per day (~ 15% of calories). The AHA recommendations < 6 teaspoons (24 grams) of added sugar per day for women, and < 9 (36 grams) for men. A 20 oz soda has twice that. (½ cup = ½ a baseball) Nutrition Action Health Letter, CSPI, March,
9 Added sugar is found in much more than just sodas Sugar has many names: cane and beet sugar, high fructose corn syrup, corn syrup, dextrose, honey Weight loss basics Thermodynamics says that a calorie is a calorie, regardless of its source, so to lose weight, you simply eat less and exercise more. Yet emerging research suggests that some foods and eating patterns may make it easier to keep calories in check, while others may make people more likely to overeat. Dietary Reference Intakes for Macronutrients Protein: 10% to 35% Carbohydrate: 45% to 65% Fat: 20% to 35% Institute of Medicine AUDIENCE RESPONSE Which diet is most effective for weight loss? Is it..?? A. High protein, high animal fat, low carbohydrate (Atkins, Paleo/Caveman) B. Low glycemic (Zone, South Beach) C. High protein, moderate fat, moderate carbs (Biggest loser) D. Very Low fat, Vegetarian (Ornish) E. Plant based, high unsaturated fat, low saturated fat (Mediterranean Style) F. Flexible but Calorie controlled (Weight Watchers) 9
10 Studies suggest that the type of diet is less important than total calories for Weight Loss JAMA, 2005; 293 Perhaps the best weight loss diet is the one you can adhere to? N Engl J Med. 2009; 360 Diet/%Completed Diet Characteristics Weight loss at 1 year (pounds) Atkins/ 53% grams of carbs/day 4.8 Zone /65% 40% carb, 30% protein,30% fat 6.0 Weight Watchers/65% calories 4.9 Ornish/50% 10% fat, vegetarian 7.3 Diet Composition % fat % protein % carbs Weight loss at 2 years (lbs) Low fat, average protein Low fat, high protein High fat average protein High fat high protein Is a calorie a calorie? When people eat controlled diets, the proportion of calories from fat, protein, and carbohydrate do not seem to matter for weight loss. When people can freely choose what they eat, there may be some benefits to a higher protein, lower carbohydrate approach. For chronic disease prevention, the quality and food sources of nutrients matter. Healthy Solutions to Lose Weight and Keep it Off. A Harvard Medical School Special Health Report, 2012 Effect of dietary and lifestyle factors on long-term weight gain N Engl J Med 2011; 364 Participants followed prospectively gained an average of 3.35 pounds per 4-year period, or 17 pounds over 20 years. Weight gain was most strongly associated with intake of potato chips, potatoes, sugar sweetened beverages, red meats, and processed meats. Weight loss or maintenance was associated with vegetables, whole grains, fruits, nuts, and yogurt. Other factors associated with weight change were sleep, smoking, TV watching, physical activity and alcohol. 10
11 Effects of Dietary Composition on Energy Expenditure During Weight-Loss Maintenance JAMA, 2012; overweight and obese adults tried 3 isocaloric diets for 4 weeks each time, after a 10-15% weight loss: low fat: 60% carbohydrate, 20% fat, 20% protein low-glycemic: 40% carbohydrate, 40% fat, 20% protein very low carb: 10% carbohydrate, 60% fat, 30% protein Results: The low-glycemic index diet had the best results, with regards to changes in resting energy expenditure and favorable changes in lipids and inflammatory markers. Which diet is best for health? JAMA, 2005;294(19): OmniHeart - Optimal Macronutrient Intake Trial to Prevent Heart Disease tested 3 variations of the DASH diet in people with HTN Higher carb (58% carb, 15% protein, 27% fat) Higher protein (48% carb, 25% protein, 27% fat) Higher unsaturated fat (48% carb, 15% protein, 37% fat) All 3 diets were low in saturated and trans fat (7% calories), sodium (2300mg), and added sugar (2-5 tsp/day). Results of the Omni Heart Trial After six weeks all 3 variations: Lowered systolic BP by 13 to 16 points. Lowered LDL by 20 to 24 points. Lowered triglycerides by 9 to 16 points. Partial substitution of carbohydrate with protein or unsaturated fat further reduced blood pressure, improved lipids, and reduced estimated cardiovascular risk. Mediterranean Diet-Healthy Fats and good carbs with a big side of fruits and vegetables 11
12 Primary Prevention of Cardiovascular Disease with a Mediterranean Diet NEJM, Feb. 25, 2013 Participants: Men and women without CV disease at enrollment, but with type 2 diabetes or at least 3 risk factors. Randomly assigned diets: a Mediterranean diet supplemented with 4 Tbsp/day of olive oil; or with 1 ounce of nuts/day; vs. a low fat diet (the control) Results: 7,447 participants were followed for a median of 4.8 years. Drop out rates for the control were 11.3% and for the Mediterranean diets 4.9%. 288 primary outcome events occurred: 3.8% in the olive oil group, 3.4% in the nut group, and 4.4% in the control group. (P=0.015) Practical Messages for Your Patients-The Low Hanging Fruit Nutrition advice you can deliver in less than 5 minutes. Eat at least 5 servings of Vegetables and Fruits every day Aim for at least 2 fists (2 cups) of vegetables and 1 fist of fruit each day. More is better! Eat about 1 ounce of nuts most days 1 ounce of nuts=1/4 cup or a small handful But be aware of the calories! 1 ounce= calories 12
13 Select whole grains Look for whole in the first ingredient on the label. Aim for total carbs/fiber = <10 for bread and <5 for cereals. Eat your calories, don t drink them! Eat fiber-rich whole fruit, not fruit juice. Drink calorie free beverages (especially water) or low sugar, nutrient dense beverages such as nonfat or low fat milk, almond milk, or soy milk. Know what you re eating! Read labels! Estimating Portion Sizes of Food 13
14 Beware of the Calories in Restaurant Foods Source: Center for Science in the Public Interest, 2012 Extreme Eating is not always obvious-know the nutrition facts! Reference: Center for Science in the Public Interest, 2012 The Cheesecake factory s Bistro Shrimp Pasta: 3,120 calories and 89 grams of saturated fat. It's the nutritional equivalent of three orders of Olive Garden's Lasagna Classico plus an order of Tiramisu Watch the Sodium < 2300 mg/day is recommended (<1500 mg for higher risk patients) Americans consume an average of 4000 mg/day, with 70% from processed food The leading source of sodium is bread 2400 mg of sodium=1 tsp of table salt Aim for sodium to not exceed calories per serving Shop on the perimeter of grocery stores What We Eat in America, National Health and Nutrition Examination Survey, To help regulate appetite, go for lean protein and/or heart healthy (unsaturated) fat, plus high fiber with each meal or snack Lean Protein Egg (up to 4/week) or Egg whites Chicken breast or Pork tenderloin Plain, non-fat Greek-style yogurt Black beans Fiber Fresh fruit and whole grain toast with a spread that is free of trans fats and <2.5 grams of saturated fat per Tbsp Green salad with olive oil and vinegar, quinoa or lentils Berries and kashi go lean crunch Stone ground corn tortilla, salsa and avocado 14
15 4/12/13 Let the plate be your guide and make it a small plate! Make the easy choice the healthy choice Set up your environment for success Eat from smaller plates Make healthy food accessible and unhealthy food inaccessible Keep it simple. Eat Food, not too much, mostly plants. Michael Pollan, The Omnivores Dilemma Track your diet Diet tracking Diet Journals Computer based and Mobile apps Lose it, My Fitness Pal 15
16 Summary Do address diet and exercise with your patientseven brief messages and small, gradual behavior changes can be effective. For weight loss, the most effective diet is the one your patient can adhere to long-term. To prevent weight gain and to decrease disease risk, the quality of the diet is important. Eat food, mostly plants, not too much. 16
Principles of a Healthy Diet
: How Do We Know What To Eat? Robert Baron MD MS Professor of Medicine Associate Dean for Graduate and Continuing Medical Education Acknowledgements Katie Ferraro, MPH, RD, CDE Beth Gonzales, MSPH, RD
More informationNutrition Tips to Manage Your Diabetes
PATIENT EDUCATION patienteducation.osumc.edu As part of your diabetes treatment plan, it is important to eat healthy, stay active and maintain a healthy body weight. This can help keep your blood sugar
More informationHot Topics in Clinical Nutrition
Hot Topics In Clinical Nutrition Disclosure Robert Baron, MD MS Professor of Medicine Associate Dean for Graduate and Continuing Medical Education No Relevant Financial Relationships I would describe my
More informationeat well, live well: EATING WELL FOR YOUR HEALTH
eat well, live well: EATING WELL FOR YOUR HEALTH It may seem like information on diet changes daily, BUT THERE IS ACTUALLY A LOT WE KNOW ABOUT HOW TO EAT WELL. Eating well can help you improve your overall
More informationHow Do We Know What To Eat, Drink (and Take)?
How Do We Know What To Eat, Drink (and Take)? Robert Baron, MD MS Professor of Medicine Associate Dean for Graduate and Continuing Medical Education I would describe my diet as: Balanced, healthy Not as
More informationHow to treat your weight problem
Behavioral changes for losing weight Changing your behaviors or habits related to food and physical activity is important for losing weight. The first step is to understand which habits lead you to overeat
More informationHistory of the. Food Guide Systems
History of the Food Guide Systems 1940 A guide to good eating, the basic 7 Focus on nutritional adequacy, specific servings from each food group 1956-1970 Food For Fitness: Daily Food Guide Basic 4 1979
More informationMy Diabetic Meal Plan during Pregnancy
My Diabetic Meal Plan during Pregnancy When you have diabetes and are pregnant, you need to eat small meals and s throughout the day to help control your blood sugar. This also helps you get in enough
More informationCoach on Call. Thank you for your interest in My Daily Food Needs. I hope you find this tip sheet helpful.
It was great to talk with you. Thank you for your interest in. I hope you find this tip sheet helpful. Please give me a call if you have more questions about this or other topics. As your UPMC Health Plan
More informationDietary Guidelines for Americans & Planning a Healthy Diet. Lesson Objectives. Dietary Guidelines for Americans, 2010
Dietary Guidelines for Americans & Planning a Healthy Diet NUTR 2050 NUTRITION FOR NURSING PROFESSIONALS MRS. DEBORAH A. HUTCHEON, MS, RD, LD Lesson Objectives At the end of the lesson, the student will
More informationMeal Menu Approximate Amount Eaten
Meal Menu Approximate Amount Eaten Myself 16 Year Old Active Male Teen 3 Year Old Female Child ¼ cup 1 slice 70 Year Old Female Breakfast Special K Cereal(red berries) 1 cup 1 Banana (slices) ¼ cup ¾ cup
More informationNutrition for Rehab Patients
Nutrition for Rehab Patients Michelle Ray, RD Michelle Ray, RD Michelle Ray MS, RD, LDN Making healthcare remarkable Why is nutrition important for our patients? Adequate nutrition protects quality of
More informationThe University of North Texas Dining Services White Paper: Wanting to Gain Weight
The University of North Texas Dining Services White Paper: Wanting to Gain Weight Contents Wanting to Gain Weight What is Underweight? Complications of Being Underweight Possible Causes of Underweight
More informationCHOOSE HEALTH: FOOD, FUN, AND FITNESS. Read the Label!
POSTER 1-1: REPLACE SWEETENED DRINKS Read the Label! Nutrition Facts 20 oz. cola Serving Size: 1 bottle (591mL) Servings Per Container: 1 Amount Per Serving Calories 240 Calories from Fat 0 % Daily Value
More informationDiabetes Management: Meals and More
Diabetes Management: Meals and More Welcome! This webinar will begin shortly. KP Nutrition Services (303) 614-1070 How Does Your Lifestyle Affect Blood Sugar? The following can affect your blood sugar
More informationProve You Are Ready For Healthier Living - Kick the Fat, Sugar, and Salt Food Trifecta
Adult food challenge Prove You Are Ready For Healthier Living - Kick the Fat, Sugar, and Salt Food Trifecta If you are serious about improving your health and life span, you are ready to kick the treacherous
More informationKnowing How Much to Eat
MINTO PREVENTION & REHABILITATION CENTRE CENTRE DE PREVENTION ET DE READAPTATION MINTO Knowing How Much to Eat About This Kit In previous kits you learned about what to eat. Choose a variety of grains,
More informationHEALTHY EATING. What you need to know for a long and healthy life. March National Nutrition Month
HEALTHY EATING What you need to know for a long and healthy life March National Nutrition Month 890246 This presentation is for informational purposes only. Material within this presentation should not
More informationChapter 2. Planning a Healthy Diet
Chapter 2 Planning a Healthy Diet Principles and Guidelines Diet Planning Principles Adequacy Sufficient energy Adequate nutrients for healthy people Balance Enough but not too much kcalorie (energy) control
More informationSNAP-Ed Webinar Series Dietary Guidelines
SNAP-Ed Webinar Series 2015-2020 Dietary Guidelines Joan Doyle Paddock, MPH, RD Senior Extension Associate Division of Nutritional Sciences Cornell University jed36@cornell.edu Pre-recorded webinar Send
More information1 ONE MY FUEL UP PLATE. LESSON
MY FUEL UP PLATE LESSON 1 ONE Explain how physical activity impacts nutritional needs. Identify appropriate number of servings for each food group and recommended caloric intake based on a personal needs
More informationDisclosure. Nutrition and Weight Management. No relevant financial relationships. Robert B. Baron MD MS
Nutrition and Weight Management in Office Practice Robert Baron, MD MS Professor of Medicine Associate Dean for Graduate and Continuing Medical Education Founding Director, UCSF Adult Weight Management
More informationNutrition and Heart Disease. by Rachel Kay, MS, RDN, CD Clinical Nutrition Specialist at Swedish Medical Center
Nutrition and Heart Disease by Rachel Kay, MS, RDN, CD Clinical Nutrition Specialist at Swedish Medical Center Objectives 1. Be able to identify recommended diet changes for patients with cardiovascular
More informationCase Study #4: Hypertension and Cardiovascular Disease
Helen Jang Tara Hooley John K Rhee Case Study #4: Hypertension and Cardiovascular Disease 7. What risk factors does Mrs. Sanders currently have? The risk factors that Mrs. Sanders has are high blood pressure
More informationSTAYING HEART HEALTHY PAVAN PATEL, MD CONSULTANT CARDIOLOGIST FLORIDA HEART GROUP
STAYING HEART HEALTHY PAVAN PATEL, MD CONSULTANT CARDIOLOGIST FLORIDA HEART GROUP What is Heart Disease Cardiovascular Disease (CVD): Heart or Blood vessels are not working properly. Most common reason
More information1 Learning ZoneXpress
1 Food portion sizes have changed over the past 20 years. Slides marked by are adapted from Portion Distortion by the National Heart, Lung and Blood Institute at http://hin.nhlbi.nih.gov/portion 2 Typical
More informationPower Hour (Nutrition 101) User Guide
Power Hour (Nutrition 101) User Guide Time: 60 minutes with client (One Time Consult) Your goals with client: ü Determine their baseline and strategic behavior modification strategies need to be put into
More informationLecture 4 Nutrition Part 2 Nutrition 1. Healthy Diet 2. Sugar 3. Consumer Concerns
Lecture 4 Nutrition Part 2 1 Nutrition 1. Healthy Diet 2. Sugar 3. Consumer Concerns 2 1 Healthy Diet! 3 Four basic behaviors that constitute a "healthy lifestyle" 1. A good diet, 2. Moderate Exercise,
More informationReady, Set, Start Counting!
Ready, Set, Start Counting! Carbohydrate Counting a Tool to Help Manage Your Blood Glucose When you have diabetes, keeping your blood glucose in a healthy range can help you feel your best today and in
More informationDelivering the Diet Information Your Patient Needs. April 6, 2019 Lynda Hesse RD
Delivering the Diet Information Your Patient Needs April 6, 2019 Lynda Hesse RD Dietary Assessment Tools Dietary assessment help clinicians formulate an individualized treatment plan for patients Self
More informationLecture 4 Nutrition, Part 2 Nutrition 1. What is a Healthy Diet? 2. Food Labels 3. Sugar 4. Consumer Concerns
Lecture 4 Nutrition, Part 2 1 Nutrition 1. What is a Healthy Diet? 2. Food Labels 3. Sugar 4. Consumer Concerns 2 1 Healthy Diet? 3 Four basic behaviors that constitute a "healthy lifestyle" 1. A good
More informationMaking Meals Matter. Tips to feed 6-12 year olds. Healthy eating for your school-age child
Making Meals Matter Tips to feed 6-12 year olds Healthy eating for your school-age child Your child learns healthy eating from you. Your elementary- school child needs you to guide them and to model healthy
More informationEat Well, Live Well Nutritional Guidelines for those 50+ April 10, 2014 Laura Vandervet, Registered Dietitian
Eat Well, Live Well Nutritional Guidelines for those 50+ April 10, 2014 Laura Vandervet, Registered Dietitian Outline Benefits of healthy eating Meeting your nutritional requirements Using Canada s Food
More informationCHOLESTEROL GUIDELINES
CHOLESTEROL GUIDELINES High cholesterol and lipid levels can significantly increase a person's risk of developing chest pain, heart attack, and stroke. Fortunately, a number of effective treatment options
More informationBeverage Guidelines: 1 up to 3 Years
Beverage Guidelines: nutritionally-equivalent nondairy beverages like soy, rice, or lactose-free milks with medical permission). nutritionally-equivalent nondairy beverages like soy, rice, or lactose-free
More informationYouth4Health Project. Student Food Knowledge Survey
Youth4Health Project Student Food Knowledge Survey Student ID Date Instructions: Please mark your response. 1. Are you a boy or girl? Boy Girl 2. What is your race? Caucasian (White) African American Hispanic
More information25* or higher Underweight. 240 mg/dl and above High (More than twice the risk as desirable level.) OK, but higher is better
Biometrics Screening Biometric Health Indicators The charts below provide a summary of the ranges for each of the biometric screening tests. Be sure to check with your doctor if your results are outside
More informationYou Bet Your Weight. Karah Mechlowitz
You Bet Your Weight Karah Mechlowitz What to Expect for Today n Introduction to macronutrients n Breakdown of each macronutrient n Ways to track macronutrients n Wrap up What are the macronutrients? Carbohydrates
More informationInstructions for 3 Day Diet Analysis for Nutrition 219
Name Instructions for 3 Day Diet Analysis for Nutrition 219 1. Keep a record of everything you eat and drink for 3 days. Be specific. Was it white or wheat bread, 1% or 2% milk, 1 cup or 1½ cups, did you
More informationStudent Book. Grains: 5 10 ounces a day (at least half whole grains) Self-Check
ETR Associates Middle School I read and followed directions. My work is neat and complete. This is my best work. HealthSmart Actions Lesson at a Glance Student Book The HealthSmart Actions student book
More informationOnline Nutrition Training Course
Expert advice, Excellent results Online Nutrition Training Course Module 23: Dyslipidaemia www.diet-specialist.co.uk Notice of Rights All rights reserved. No part of this publication may be reproduced,
More informationChoose Health! STRATEGIES TO CREATE A MODEL MENU FOR HEALTH
Choose Health! STRATEGIES TO CREATE A MODEL MENU FOR HEALTH Thomas Thaman, CDM, CFPP Director of Food and Nutrition Margie Fougeron, MS, RDN, CD Culinary Nutrition Specialist Who are Our Customers? Patients,
More informationPromoting Healthy Kids After School: Tips, Tools and Strategies. Wendy Wolfe, PhD Division of Nutritional Sciences Cornell University March 14, 2017
Promoting Healthy Kids After School: Tips, Tools and Strategies Wendy Wolfe, PhD Division of Nutritional Sciences Cornell University March 14, 2017 Webinar Overview Nutrition issues of 9-12 year olds Behaviors
More informationFitness and Food. By: Sara Zook, RD-CD
Fitness and Food By: Sara Zook, RD-CD Fitness & Food 1. Why should we exercise? 2. What is metabolism? Define BMR How to calculate your BMR 3. Nutrition Recommendations Eating pre- and post-exercise Protein
More informationStep Up and Celebrate
Step Up and Celebrate Physical Activity Physical Activity Healthy Eating Goals Met Rewards Goals Met 1. 1. Handout 12-1 Healthy Eating Rewards 2. 2. 3. 3. 4. 4. 5. 5. 6. 6. Choose an appropriate reward
More informationPart 1: Obesity. Dietary recommendations in Obesity, Hypertension, Hyperlipidemia, and Diabetes 10/15/2018. Objectives.
Dietary recommendations in Obesity, Hypertension, Hyperlipidemia, and Diabetes Stephen D. Sisson MD Objectives To review dietary recommendations in the following conditions: Obesity Hypertension Diabetes
More informationLive the Mediterranean Lifestyle with Barilla. The Mediterranean Nutrition Model
Live the Mediterranean Lifestyle with Barilla The Mediterranean Nutrition Model Whole Grains Legumes Live the Mediterranean Lifestyle with Barilla Table of Contents: MEDITERRANEAN NUTRITION MODEL Health
More informationDisney Nutrition Guideline Criteria
Disney partners with parents to inspire kids to lead healthier lifestyles. In 2006, Disney became the first major media company to establish nutrition guidelines, which associate its brands and characters
More informationCoach on Call. Thank you for your interest in understanding the new Nutrition Facts labels. I hope you find this tip sheet helpful.
Coach on Call It was great to talk with you. Thank you for your interest in understanding the new labels. I hope you find this tip sheet helpful. Please give me a call if you have more questions about
More informationLose the Goose! 3 Day Sampler
Lose the Goose! 3 Day Sampler Day 1 Breakfast 7:00 AM egg, hard boiled 1 large 78 cal blueberries 1/2 Cup(s) 41 cal plain greek yogurt, nonfat 4 oz 67 cal Calories 186 cal / Carbs 15 g (33%) / Protein
More informationSession 21 Leader Guide: Heart Health
Session 21 Leader Guide: Heart Health Objectives In this session, the participants will: Identify the leading cause of death in American adults. Define heart disease. Learn the risk factors for heart disease.
More informationSupplemental Table 1: List of food groups
Supplemental Table 1: List of food groups Food groups names Food groups description Serving size definitions - Examples Fruits and vegetables Vegetables Fruits Whole vegetables All vegetables but soups,
More information3 Day Diet Analysis for Nutrition 219
Name 3 Day Diet Analysis for Nutrition 219 Keep a record of everything you eat and drink for 3 days. Be specific. Was it white or wheat bread, 1% or 2% milk, 1 cup or 1½ cups, did you fry it in oil or
More informationStaying Healthy with Diabetes
Staying Healthy with Diabetes Note to the Health Care Provider: Topics in this handout are discussed in Chapters 6 and 13 of the American Dietetic Association Guide to Diabetes Medical Nutrition Therapy
More informationEducator Self-Assessment Supervisor Assessment Fidelity Team Assessment. Educator(s) Name (s): Sub-Contractor: Region: County: Date of Lesson:
Washington State Snap-Ed Curriculum Fidelity for Continuous Improvement Lesson Assessment Tool for Eat Healthy, Be Active Community Workshops: Workshop 1 Enjoy Healthy Food That Tastes Great Educator Self-Assessment
More informationFollowing Dietary Guidelines
LESSON 26 Following Dietary Guidelines Before You Read List some things you know and would like to know about recommended diet choices. What You ll Learn the different food groups in MyPyramid the Dietary
More informationDietary recommendations in Obesity, Hypertension, Hyperlipidemia, and Diabetes. Stephen D. Sisson MD
Dietary recommendations in Obesity, Hypertension, Hyperlipidemia, and Diabetes Stephen D. Sisson MD Objectives To review dietary recommendations in the following conditions: Obesity Hypertension Diabetes
More informationFOCUS ON CONTROLLING WHAT YOU CAN CONTROL AND ACCEPTING WHAT YOU CANNOT CONTROL.
Nutrition Guide Disclaimer: Please discuss with your physician or healthcare provider before starting this program. The information provided does not intend to replace the advice of a medical professional.
More informationMEDITERRANEAN EATING GRANT CEFALO RD, MDA, CD, CNSC
MEDITERRANEAN EATING GRANT CEFALO RD, MDA, CD, CNSC OBJECTIVES Why is it needed? Current trends Review the Mediterranean Lifestyle Discuss application of this lifestyle MANY OF AMERICAN S EATING PATTERNS
More information10/3/2016. SUPERSIZE YOUR KNOWLEDGE OF the CARDIAC DIET. What is a cardiac diet. If it tastes good, spit it out!!
SUPERSIZE YOUR KNOWLEDGE OF the CARDIAC DIET What is a cardiac diet If it tastes good, spit it out!! 2 1 Heart healthy diet includes: Limiting saturated fat Including unsaturated fats Including omega 3
More informationCoach on Call. Thank you for your interest in The Mighty Mediterranean Diet. I hope you find this tip sheet helpful.
It was great to talk with you. Thank you for your interest in. I hope you find this tip sheet helpful. Please give me a call if you have more questions about this or other topics. As your UPMC Health Plan
More informationSeminar Objectives. Why Eat Well? Webinar: Eating Your Way to Wellness Presented by: Suzanne Ballantyne March 20, Increase energy.
Webinar: Eating Your Way to Wellness Presented by: Suzanne Ballantyne March 20, 2012 Seminar Objectives Recognize the importance of a balanced diet Discuss how the My Plate can aid in choosing the right
More informationWarm up # 76. What do you think the difference is between fruits and vegetables? Warm up # 77
Warm up # 76 What do you think the difference is between fruits and vegetables? Warm up # 77 Which of these are vegetables and which of these are fruits? Apples Tomatoes Onions Pumpkin Lettuce Broccoli
More informationGeneral Food Choices- YOU ARE WHAT YOU EAT!
General Food Choices- YOU ARE WHAT YOU EAT! Currently the best guidelines for food portion and balanced meals follow the my plate diagram. Athletes burn way more calories than people may think and the
More informationBasic Nutrition. The Basics of Nutrition. The Six Basic Nutrients. calories. How it Works. How it works 10/5/16
Basic Nutrition The Basics of Nutrition Nutrition: The study of how your body uses the food that you eat Nutrient: a chemical substance in food that helps maintain the body The Six Basic Nutrients Carbohydrates
More informationNutrition Basics. Health, Wellness & Fitness. Brenda Brown
Nutrition Basics Health, Wellness & Fitness Brenda Brown bbrown9@asu.edu Why do we eat? Building blocks to fuel our bodies Hunger Don t want to starve Socialization Emotional eating or not eating when
More informationPrinciples of the DASH Diet
DASH Diet Lower your blood pressure by changing your eating habits. The DASH diet is based on findings from the "Dietary Approaches to Stop Hypertension" clinical study that found that high blood pressure
More informationGiving Good Dietary Advice to Cardiovascular Patients
Giving Good Dietary Advice to Cardiovascular Patients Carmine D Amico, D.O. Learning objectives Introduction Basic principles Grocery shopping Cooking Eating out Snacking Staying active Summary Overview
More informationEATING AND EXERCISE. goals, whether they are physical fitness, weight loss, or hormonal/fertility improvement.
EATING AND EXERCISE Eating a healthy diet and obtaining regular exercise can be a big part of helping you achieve your goals, whether they are physical fitness, weight loss, or hormonal/fertility improvement.
More informationGrocery Shopping Guidelines
Grocery Shopping Guidelines Here are some tips to help make your grocery shopping experience a healthy one. Do not shop when you are hungry. Have a snack (or meal) before grocery shopping to prevent impulse
More informationWEEK 1 GOAL SETTING & NUTRITION 101. with your Supermarket Registered Dietitian
WEEK 1 GOAL SETTING & NUTRITION 101 with your Supermarket Registered Dietitian Welcome to Week 1! We are excited you have decided to join us on this wellness journey! Please note that you should consult
More informationEatHealthy. SUBJECTS: Health Science English Language Arts listening, speaking, and writing Math. Healthy
Bee you eat, think about what goes on your plate or in your cup or bowl. steps to build a healthy plate: Make half your plate Switch to skim or 1% milk Make at least half your Vary your protein food choices
More informationMagic Potions: Evidence-Based Diet Solutions for Diabetes and Weight Management Monica A. Dixon, Ph.D., R.D.
Magic Potions: Evidence-Based Diet Solutions for Diabetes and Weight Management Monica A. Dixon, Ph.D., R.D. Washington State Dept of Health Cardiovascular, Diabetes, Nutrition and Physical Activity Section
More informationGet off the SoFAS! Solid Fats and Added Sugars
Get off the SoFAS! Solid Fats and Added Sugars Sponsored by: USDA through the Supplemental Nutrition Assistance Program, the School District of Philadelphia and the Department of NutritionSciences, Drexel
More informationHealthyMe DocTalk. A Healthy Diet EATING HEALTHY IN A FAST-PACED, FAST-FOOD WORLD. Brenda Sheehan, MD HealthyMe Medical Clinic Salt Lake County
HealthyMe DocTalk A Healthy Diet EATING HEALTHY IN A FAST-PACED, FAST-FOOD WORLD Brenda Sheehan, MD HealthyMe Medical Clinic Salt Lake County Benefits of a Healthy Diet Healthy eating is important for
More information2010 Dietary Guidelines for Americans
2010 Dietary Guidelines for Americans Mary M. McGrane, PhD Center for Nutrition Policy and Promotion February 25, 2015 Agenda for Commodity Supplemental Food Program (CSFP) Brief history and description
More informationSo how do we get balance back into our meals? Start by consuming a variety of nutrient rich foods and beverages:
It s back to school and that means busier schedules with homework, after-school programs, sports activities and school activities. With today s busy lifestyles, eating has turned from three square meals
More informationDisclosure. No relevant financial relationships. Nutrition Counseling for Office Practice
Nutrition Counseling for Office Practice: Understanding the New Guidelines and the Cacophony of Expert Opinion Robert Baron, MD MS Professor of Medicine Associate Dean for Graduate and Continuing Medical
More informationKnow Your Numbers Handouts
Calculating Your Body Mass Index (BMI) 1. Write down your weight in pounds (example: 190) 2. Multiply that number by 703 (190 x 703 = 133,570) 3. Multiply your height in inches by itself ( 70 x 70 = 4,900)
More informationFresh BaBy s eat Like a MyPlate Super HERO
Audience 3 rd and 4 th Grade Setting Small Group Fresh BaBy s eat Like a MyPlate Super HERO MyPlate Messages Eating a variety of foods provides the body with a variety of essential vitamins, minerals and
More informationBridges to the Future Transitional Care Program. Nutrition
Bridges to the Future Transitional Care Program Nutrition Fueling Your Body Face the Facts: Junk food is NOT good fuel! Navigating Food Choices: What types of foods are unhealthy? What problems can people
More informationthan 7%) can help protect your heart, kidneys, blood vessels, feet and eyes from the damage high blood glucose levels. October November 2014
October November 2014 Diabetes - the Medical Perspective Diabetes and Food Recipes to Try Menu Suggestions Diabetes - the Medical Perspective Be Heart Smart: Know Your ABCs of Diabetes There is a strong
More informationGrocery Shopping Tips
Grocery Shopping Tips Here are some tips to help make your grocery shopping experience a healthy one. Do not shop when you are hungry. Have a snack (or meal) before grocery shopping to prevent impulse
More informationNAME/ID: SAMPLE PATIENT SEX: FEMALE ACC #: F DATE: NOV 12, 2015 IMPORTANT INFORMATION
Personal Details Name: SAMPLE PATIENT DOB: Jan 1, 19XX Gender: Female Ethnicity: Caucasian Report Date: Nov 12, 2015 Received Date: Nov 2, 2015 IMPORTANT INFORMATION PAGE 3 Test Performed / Method Genotyping
More informationA common sense approach to taking control of your diet
Welcome Wellness Warriors! Carbohydrate Counting: A common sense approach to taking control of your diet Today we will discuss The different food groups and how they affect blood sugar Which foods increase
More informationUsing the Nutrition Facts Table to Make Heart Healthy Food Choices
Using the Table to Make Heart Healthy Food Choices Most packaged food products that you purchase contain a Table on the label. The Table lists information on nutrients that are found in the food product.
More informationMedical Disclaimer. THE 80/20 FAT LOSS PROGRAM 2
Medical Disclaimer The techniques, ideas, and suggestions in this document are not intended as a substitute for proper medical advice. Always consult your physician or health care professional before performing
More informationPersonal Touch Food Service will ensure all consumers have access to varied and nutritious foods consistent with promoting health and wellness.
Nutrition Guidelines It is well accepted that consumer eating habits are greatly influenced by the types and quantities of foods made available to them. Personal Touch Food Service is committed to supporting
More informationHealthy Foods for my School
, y Healthy Foods for my School Schools are an ideal place for children and youth to observe and learn about healthy eating. Children learn about nutrition at school and they often eat at school or buy
More informationControl your weight Exercise. take it as prescribed. possible
University it Pharmacy Eat well Control your weight Exercise If you take medication for diabetes, take it as prescribed Check your blood sugar daily if Check your blood sugar daily if possible Respect
More informationProfessor Popcorn Grade 2, Lesson 1: Visual 2:1A The Professor Popcorn
Professor Popcorn Grade 2, Lesson 1: Visual 2:1A The Professor Popcorn What s Protein Grains Dairy on your plate? Fruits Vegetables ChooseMyPlate.gov Make half your plate fruits and vegetables. Vary your
More informationGUIDE TO HEALTHY SHOPPING WITH DIABETES FOR MORE INFORMATION, VISIT CDIABETES.COM: THE COSTCO DIABETES WEBSITE
GUIDE TO HEALTHY SHOPPING WITH DIABETES Please note: Product selection may vary between Costco Wholesale locations DIVIDE YOUR CART. MAKE HEALTHIER FOOD CHOICES. Apply MyPlate principles to your cart.
More informationBlood Pressure Action Plan
Blood Pressure Action Plan 2 Keeping your blood pressure in the healthy range can be as simple as having a plan and sticking to it. Make sure to work with your health care professional when creating an
More informationSession 21: Heart Health
Session 21: Heart Health Heart disease and stroke are the leading causes of death in the world for both men and women. People with pre-diabetes, diabetes, and/or the metabolic syndrome are at higher risk
More informationWhat s. on your plate? ChooseMyPlate.gov. Vegetables. Fruits. Protein. Grains. Dairy. plate fruits and vegetables. Make half your
What s Protein Grains Dairy on your plate? Fruits Vegetables ChooseMyPlate.gov Make half your plate fruits and vegetables. Vary your protein food choices. Make at least half your grains whole. Before you
More informationLimiting choice as an approach for obesity management. Jenna Crown PDt Nova Scotia Health Authority
Limiting choice as an approach for obesity management Jenna Crown PDt Nova Scotia Health Authority Limiting choice as an approach A healthful lifestyle requires: significant planning proficiency in making
More informationEating in America. Sooyoung Uhm, RD, LD Student Health Services Jan 2019
Eating in America Sooyoung Uhm, RD, LD Student Health Services Jan 2019 American eating habits Standard American diet (SAD): excess consumption of refined carbohydrates, fatty meats and added fats that
More informationThe Food Guide Pyramid
The Food Guide Pyramid In this lesson, you will Learn About n What influences a person s food choices. n How to use the Food Guide Pyramid to make healthful food choices. The Foods You Choose The foods
More informationTips for a Diabetes Diet
Tips for a Diabetes Diet Diet plays an important role in diabetes treatment. Majority of people affected with diabetes are overweight or obese. In fact, your risk of getting diabetes increases the more
More informationABLE TO READ THE LABEL?
ARE ABLE TO READ THE LABEL? A Consumer s Guide to Navigating Food Labels Food and Drug Safety Program Consumer and Environmental Health Services Phone: 609-826-4935 Fax: 609-826-4990 http://nj.gov/health/eoh/foodweb/
More information