Title: Nutrition News Dee Sandquist, MS, RD Southwest Washington Medical Center Vancouver Director, Center
1Nutrition NewsDee Sandquist, MS, RDSouthwest
Washington Medical Center VancouverDirector,
Center for Weight ManagementAmerican Dietetic
Association Spokesperson
2Objectives
- Simplify strategies for patients to help them
decrease 100 calories per day and increase
physical activity by 2000 steps - Answer your questions
- Provide how to strategies for you to use with
patients
3Questions for Patients
- 1. Why are you here today
- 2. What are your barriers
- (What is keeping you from _____)
4- Using the most accurate data available, it is
estimated that 36 of all children born in the
year 2000 will be diabetic sometime in their
lives - among Hispanics, 50 will become diabetic.
- Source Aldana, Steven G., The Culprit and the
Cure How Lifestyle is the Culprit Behind
Americas Poor Health and How Transforming that
Lifestyle Can be the Cure. 2005, Maple Mountain
Press.
5Priorities
- We do not hesitate to pay 3.19 for a
- bag of chips, but we wont spend that much
on a bag of oranges. - Physical activity in small quantities is ok.
6Movies - POPCORN
20 Years Ago
Today
270 calories 5 cups
630 calories11 cups
Calorie Difference 360 calories
7Quiz Bagel Breakfast
350 calories
8Calories In Calories Out
If you walk 1 hour and 20 minutes, you will burn
approximately 305 calories.
Based on 130-pound person
9Calories In Calories Out
If you walk 1 hour and 20 minutes, you will burn
approximately 305 calories.
Based on 130-pound person
10Calories, Calories
- Increase in average food energy intake between
1971 and 2000 - Among men, the average energy intake has
increased from 2450 to 2618 calories per day. - Among women, the increase was from 1542 to 1877
calories per day. - (NHANES - MMWR 2004)
11Yo-yo Math
- Lose weight (fat and water) rapidly
- Regain as fat
- It takes fewer calories to feed fat than muscle
- A person who previously lost weight on 1500
calories may not because the yo-yo lost and gain
replaced muscle with fat.
12How did this happen?
Weight gain
Energy Out
13What has changed?
- We are eating more calories
- Portion sizes have increased
- Consumption of sugar and soft drinks has
increased - Increased availability and affordability of high
calorie foods
Source dietz
14How did this happen?
- The gap
- Environment
- Genetics
Source Dietz 04
15Where to start
- Prevent weight gain
- Small steps
- Decrease calories 100/day
- Increase steps 2000/day
16Choose a diet rich in plant-based foods.
- Whole grains,
- Fruits, and
- Vegetables
- Using the plate method think of ¾ of your
dinner plate contents as being of plant origin
and ¼ animal or other protein source.
17The Goal
- Maintain a Healthy Weight and be Physically
Active - A body mass index (BMI) of 18.5 25 is
recommended - Healthy weight results from a balance of calories
(energy) in and energy expended.
l
18Select Foods Low in Fat and Salt
- The US Dietary Guidelines recommend 2.4 gms (2400
mg) sodium or less per day - Reduce animal fats and hydrogenated fat
sources, limiting total fat to 30 of calories.
19Prepare and Store Foods Safely
- Use safe storage methods and promptly chill or
freeze leftovers. - Do not eat charred food.
- Avoid burning of meat juices.
- Consume only occasionally meat and fish grilled
in direct flame cured and smoked meats.
20Educating the Patient
- Survival skills
- Social and emotional issues
- Plan strategies
- Face the challenge with a positive outlook
- Fine tune
21Associations between excess weight and disease
- Depression
- Poor self-esteem
- Eating disorders
X
X
X
- Heart failure
- Heart disease
- High cholesterol
- Sleep apnea
- Exercise intolerance
- Asthma
X
X
X
X
- Digestive problems
- Several cancers
- High blood pressure
- Kidney problems
X
- Osteoarthritis
- Joint problems
- Flat feet
- Insulin resistance
- Diabetes Type 2
- Polycystic ovary syndrome
X
X
X
X
Source Adapted from Lancet 02, CDC
22Food Allergen Labeling and Consumer Protection Act
- Effective January 1, 2006, food labels must
clearly state if the product contains any of 8
major food allergens -
- Milk Fish
- Eggs Shellfish
- Peanuts Wheat
- Tree Nuts Soy
-
23Counseling Philosophy
- What are your barriers?
- Food Log
- Do you cook?
- Keep it basic
- Keep it positive
- Plan strategies
24Educating the Patient
- What do you want to learn?
- Do you use the internet?
- Eating out/label reading
- Resources
25Limit Alcohol Intake
- Limit alcohol
- lt2 drinks for men, 1 for women
- 1 drink is 12 oz beer, 5 oz wine, 1.5 oz liquor
- When is a moderate intake too much?
26Limit Salt
- Ability to taste salt changes over time
- 8 weeks.
- High salt foods dont taste salty
27Limit Salt
- Salt does still matter, although some people are
more sensitive to it than others - Avoid adding salt at the table
- Rule of thumb the more processed the food, the
higher the sodium content
28DASH diet resources for patients
- www.nhlbi.nih.gov/health/public/heart/hbp/dash
- Complete DASH diet info
- www.nhlbi.nih.gov/hbp/index.html
- General hypertension treatment/prevention info
(includes DASH)
29Tips to Help With Changes
- Start with half the meat at a meal.
- Add extra vegetables, rice, pasta and dry beans
in meals. - Go meatless once a week.
30Ideas for DASHing Your Diet
- Eat 2 fruits or vegetables at each of 3 meals
then add 2 more as snacks - Use fresh, frozen, canned or dried fruits
- Use fresh, frozen, or no salt added canned
vegetables
31DASH pyramid
- Sweets 5/week
- Beans, Nuts, Seeds-1/day
- Low Fat Dairy-2-3/day
- Grains-
- 7-8/day
Oils, salad dressing,mayo-2-3/day Seafood,
poultry, lean meat- 0-2/day Vegetables/fruit8-10
/day
32DASH Diet
- A diet rich in fruits, vegetables, whole grains,
nuts/seeds/legumes, and nonfat dairy, and low in
saturated fat/red meat. 2,000 cal example - Grains 7-8/day (1 slice bread)
- Vegetables 4-5/day (½ cup cooked vegetable)
- Fruits 4-5/day (1 medium fruit, 6 oz juice)
- Nonfat dairy 2-3/day (1 cup yogurt, 8 oz milk)
- Fish, poultry, lean meat 2 or less/day (3 oz
cooked) - Nuts,seeds,dry beans 4-5/week (1/3 cup)
- Fats Oils 2-3 day (1 tsp vegetable oil)
- Sweets 5 per week (1/2 oz jelly beans)
33The Influence of a Parent
- Children model their parents behavior and eating
patterns. - Treating the parents of obese children is more
effective than directly treating the obese child. - Parents with poor nutrition and exercise habits
cannot expect their children to eat healthy foods
and exercise daily.
34Childrens Nutrition Rights
- Children have the right not to go hungry or
endure deprivation. - Children have the right to choose among the foods
available. - Children have the right to eat as much or as
little as they need. - Children have the right to enjoy their favorite
foods.
35Ask the right questions about
- Ethnic background
- Education level
- Economic status
- Religious beliefs
- Take care to individualize suggestions to a
family rather than giving a template
36How parents can encourage exercise
- Limit TV, video games and computer time.
- Use physical activity as a reward.
- Include children in activities that parents
enjoy. - Let your child win sometimes.
- Plan exercise as a way of life.
- Include physical activity in a vacation.
37How parents discourage exercise
- Allow endless TV, video games and computer time.
- Reward a child with TV.
- Use TV as a babysitter.
- Spending sunny, cool afternoons indoors.
- Make fun of exercise.
- Plan vacations that involve mostly driving,
eating and sitting.
38The Family that eats togetherfrom
ChristianityToday.com
- National Merit Scholars without exception came
from families who ate together three or more
nights a week. - Family meals can make your kids smarter, and
stronger spiritually and emotionally. - Kids who feel close to their families are more
likely to take the familys value system to heart.
39The Family that eats togetherovercoming the top
5 excuses
- Dad or Mom doesnt get home in time for dinner.
- We have too many after-school activities.
- Dinnertime is our only time to talk without kids
around. - The kids wont eat what we eat.
- Our kids arent old enough to sit still.
40Did You Know?
- Anyone can claim they are a nutritionist
- Anyone can write and sell a book
- Anyone can start selling supplements
- Anyone can create a website and post nutrition
statements
41Weight Loss Industry
- 30 -50 Billion Industry
- Poorly Regulated
- Rarely Prosecuted
- Exploits ideal and overweight individuals
- Includes diet programs, Diet books, and
Over-the-counter Pills
42Weight Loss Claims
- Unrealistic!
- Lose 30 in 30 days!
- Use words like Magical, Cure,
- Offers permanent weight loss
- Are unproven
- No need to exercise
- Melts the fat away
- Lose weight forever
- Guaranteed
43Professional Resources
- American Dietetic Association
- www.eatright.org
- American Obesity Association
- www.obesity.org
- Federal Trade Commission
- www.consumer.gove/weightloss
- North American Association for the study of
Obesity www.naaso.org - Shape Up America www.shapeup.org
- WIN Weight-Control Information Network
http//win.niddk.nih.gov
44America on the Move
- www.americaonthemove.org
- Key messages move more, eat less
- 2000 steps,
- 100 calories
45National Weight Control Registry
- People who have lost 30 pounds and have kept it
off 3 years - 1400 calories/day
- Eat breakfast
- Daily physical activity 60-90 minutes
- Portion control
46Nutrition News
- Americans are overweight and undernourished in
several nutrients - Children live in a sensory world that prefers
sweets. This declines in adolescence. - The diet of mothers in pregnancy and lactation
influences the childs acceptance of foods.
47Nutrition News
- The parent is responsible for what, when and
where for feeding - The child is responsible for how much and whether
to eat. - Breakfast is the most important meal of the time
of day. - Inflammation plays a role in many human diseases
48Nutrition News
- Obesity increases the bodys inflammatory
response. - Phytonutrients from plant-based foods help
prevent disease risk. - By the time fruits and vegetables are consumed,
fresh, frozen, and canned are likely to be
nutritionally similar. Canning increases the
bioavailability of beta-carotene and lycopene,
however reduces water-soluble vitamin content for
B and C vitamins.
49Nutrition News
- Emerging reasons to chew gum
- Help focus
- Help feel relaxed
- Chew gum instead of high calorie snack
- Benefits of chewing gum
- Stress relief
- Cognitive performance
- Weight Management
-
50The Role of Protein in Weight Management
- Protein as a percent of weight not calories
- Need the right amount for the right person,
people are different - Protein has more effect on women with weight loss
51Distilled Alcohol Council
- Resources to facilitate patient discussions about
drinking - www.alcoholtoolkit.org
- www.standarddrinks.com
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