Practical lifestyle advice for people with the metabolic syndrome focus on dietary advice Heyens Isabelle Diëtiste, Centrum voor gezonde voeding en diëtiek 24 oktober 2017
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Practical lifestyle advice for people with the metabolic syndrome Let me introduce you to Which diet? Moderate calorie restriction Change in dietary composition Moderate increase in physical activity 3
Let me introduce you to Marleen - age: 52 years old - profession: secretary - Antropometry: L = 1m65, W = 89,3 kg, BMI = 32,8 - Dietary history: jojo-effect between 90 kg and 78 kg. - Medical problems: IR and hypercholesterolemia - Patient request: - Can you help me? Increasing health problems (physical and mentally). What kind of diet? 4
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WHICH DIET? IDF (International Diabetes Federation) recommends that primary management is a healthy lifestyle!: Moderate calorie restriction to achieve a 5 10% loss of body weight in the first year Moderate increase in physical activity Change in dietary composition Secundairy intervention: When life style change is not enough + high risk CVD drug therapy (treating psysician) 6
Moderate calorie restriction 7
Moderate calorie restriction Calculate energy requirement Nutrition history Dietary history (anamnese) Eating diary (awareness eating behavior) Negative energy balance -500 kcal/day View labels together with your patiënt 8
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Change in dietary composition 19/09/2017: new Flemish Food Triangle Flemish Institute of Healthy Life Based on scientific research: impact of food on health Impact of food on sustainability / planet Average food intake of the Flemish people (what we eat too much and what we eat too less) (https://fcs.wiv-isp.be) 11
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Bleu zone = water Dark green zone = plant-based foods with a positive effect on health: Vegetables, fruit, whole grains, legumes, nuts, seeds, plant oils and other fats rich in unsaturated fats Try to eat the low or unprocessed version as much as possible Light green zone = foods mainly from animal origin with a positive, neutral or insufficiently proven effect on health: Fish, poultry, cheese, eggs, milk, yoghurt or soy-based dairy alternatives Preference for low or unprocessed choice Orange zone = foods from animal or plant-based origin which can have an unfavourable effect on health when consumed in high amounts: Red meat, butter, coconut oil, palm oil and other fats rich in saturated fat These foods can contain some useful nutrients eg. fatsolube vitamins, iron, Red zone is set apart from the triangle = highly processed foods with high amounts of sugar, fat and/or salt and which have clear unfavourable effects on health consume these rarely and in small portions. 13
Extra attention for: Insulin resistance: 30 En% proteins (max. 1,5 gr protein/kg normal weight) 35 En% fat 35 En% carbohydrates (less fast sugars, many complex sugars) min 30 gr fibres Hypertension: Use salt in moderation and replace it with iodized salt. Max 5 gr salt/dag Attention for added salt in meats, in ready meals,. 14
Extra attention for: Hypertriglyceride and low HDL-cholesterol / high LDL: Use good fats, such as unsaturated fatty acids (olive oil), omega-6 (sunflower oil and soya oil) and omega-3 (canola oil, nut oil and soya oil and fatty fish). Quantity! If hypertriglyceride -> reduce fast sugars and alcohol (= calories!) and increase omega 3 15
Example off a low glycemic index meal Use always hydrocarbonates, proteins and lipids together with fibres. Fruit breakfast - smoothies 16
Moderate increase physical activity 17
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Moderate increase physical activity Sedentary behavior: Sit down at school Sit down at work Sitting in the car Working before a display (TV, gaming, smartphone, ) Reading a book ADVICE : stand up every 30 minutes! (a mix of sitting, standing up and moving is the best for young and old) 19
Moderate increase physical activity Light intensity of physical activity: Making a call standing Slowly walking, go shopping Yoga Light housekeeping breathing and talking is normal, heartrate stays normal ADVICE : every day! Minimum 30 20
Moderate increase physical activity Moderate intensity of physical activity: Cycling to school and work Gardening Cleaning windows Take a staircase Breathing is faster but you can talk normal, heartrate goes up ADVICE: daily 21
Moderate increase physical activity High intensity of physical activity: Jogging Take a staircase with heavy groceries Swimming Patient is sweating, breathing is faster, high heartrate, ADVICE: min 1x/week 22
Questions? 23