Self Management of Healthy Eating & Exercise

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1 Self Management of Healthy Eating & Exercise Christine Young, RD March 27, 2014 Belleville and Quinte West CHC RD role in Self Management One on one counseling Health promotion Management of chronic disease Weight management 1

2 RD role in Self Management Group support Nutrition workshops Diabetes support group Living Well RD role in Self Management Hands on cooking group and individual Knowledge of community resources and referring to appropriate agencies or professionals Self Management of Healthy Eating What is needed? Readiness to change Capacity to buy food/food Security Knowledge of healthy food, balanced meals, calorie awareness, understanding nutrition facts labels Skills to prepare and cook food Literacy Tools needed (pots, pans, etc.) A safe place to learn and practice skills 2

3 National Weight Registry Data Data on over 10,000 individuals who have lost significant amounts of weight and kept it off for long periods of time Collection of data found some common habits National Weight Registry What healthy habits do these successful losers have? 78% eat breakfast every day 75% weigh themselves at least once a week 62% watch less than 10 hours of TV per week 90% exercise, on average, about 1 hour per day Most report continuing to maintain a low calorie, low fat diet and doing high levels of activity to keep weight lost off. Best Weight Approach A patient s best weight is whatever weight they can achieve while living the healthiest lifestyle they can truly enjoy. (Canadian Obesity Network, 2010) 3

4 Readiness to Change Consider stage of change I want to lose weight this desire/motivation needs to be turned into an actionable step What is the client ready for and motivated to work on? Readiness to Change Determine if client has pressing concerns to address (issues with secure housing, depression, etc.) Refer to social work, community resource worker if needed Food Security When all people at all times have access to sufficient, safe, nutritious food to maintain a healthy and active life. (World Health Organization, 1996) 4

5 Food Security Can the client afford to make changes at this time? What resources would the client be able to access in order to improve their diet? Food Security Is the client accessing the food bank? Does the client use up everything that they get?(canned beans/chickpeas, diced tomatoes, broth) Here in Trenton, we are lucky to have a community garden that supplies our Care and Share food bank with lots of vegetables in the summer Food Security Special diet allowance for certain health conditions for clients on social assistance Some common eligible conditions: Diabetes/Pre diabetes Hypertension Hyperlipidemia BMI over 40 5

6 Food Security Would the client be interested in the Good Food Box program? Knowledge of Healthy Eating Use resources as a guide, they may not represent the goal for the client Knowledge of Cooking, Recipe Modifications Eating more whole foods Lower salt, sugar, fat Choosing healthier fats Trying/preparing unfamiliar foods 6

7 Food Related Habits Matter! Timing, pattern, composition of meals Rate of eating Emotional eating (loneliness, boredom, stress) Social drinking or eating habits Past history of dieting/weight cycling Sleep adequacy affects eating habits! Mindless Eating Is the client eating in front of the TV? Does the client use standard bowls, plates, and cups that encourage overeating? How often are they eating out? Is the client aware that most restaurant portions encourage overeating? Mindless Eating 7

8 Portion Distortion Chipotle Bacon Penne (Boston Pizza) Nutrition Facts Calories 1470 Fat 88 grams (117% Daily Value) Sodium 2800 mg (121% Daily Value) Carbohydrate 115 grams Fibre 6 grams Portion Distortion The Curse of Cup Size Names Bob always has a medium double double every day. He did not change his order after the cup sizes were shuffled. How much extra sugar is he having each month? a) 20 packets b) 30 packets c) 40 packets How many pounds will that add in a year? a) 3 pounds b) 5 pounds c) 7 pounds 8

9 Calorie Awareness & Food Labels Compare daily calorie needs to budgeting how much can you afford to spend? How can you tell if a packaged food is a good choice or not? Tracking Intake A food journal can be a good way for clients to be more aware of what/when they are eating and emotions related to eating If motivated, free online food intake tracking tools can make it easy to self manage at home MyFitnessPal EaTracker (Dietitians of Canada) Self Management of Exercise We know the benefits of exercise on: Aerobic fitness Insulin sensitivity Blood pressure Heart disease risk reduction Weight management The hardest part is getting motivated to start and maintain an exercise routine! 9

10 Self Management of Exercise Clients should not confuse being active with being busy Clients should be aware that doing extra activity does not warrant extra food! Self Management of Exercise It is important for clients not to over estimate how much exercise they have done so they feel entitled to extra food For example, a 160 lb. person who walks for 30 minutes at 2 mph will burn about 102 calories 10 fluid oz. of apple juice= 140 calories 1 slice of bread= 130 calories Ways to Self Manage Exercise FITT principle Self monitoring and non food rewards Using devices that give instant feedback (treadmills, pedometers) 10

11 FITT Principle F Frequency I Intensity T Type of exercise T Time Self Monitoring Using a calendar or exercise log to track date, type, minutes of exercise Clients can see their progress, which can be motivating Non food rewards can motivate clients For minutes or walks, I get to Devices with Feedback Exercise machines indicate time, activity level, calories burned Pedometer indicate steps taken, some have a stopwatch and calorie counter built in 11

12 Pedometer use At our centre, we have pedometers to lend out to clients (from Stepscount.com) Clients are encouraged to wear it daily, first just to track baseline activity, then increase as able Clients can increase by 500 steps each week to reach their goal number of steps Goal Setting & Action Planning Out of everything that we talked about today, is there something you want to change? Break this down into doable steps... What? How much? When? How many? Goal Setting & Action Planning What? Walk around the house How much? 3 5 minutes When? During TV commercial breaks How many? Every day 12

13 Healthy Eating and Exercise Self Management Resources Living Well with Diabetes or Chronic Conditions Workshops Refer clients to RD, HP Be aware of free/low cost programs in your community that can provide support Examples: YMCA, indoor track, CHC programs like Urban Poling, Healthy Bites workshops, Working on Wellness program References Best Weight: A Practical Guide to Office Based Weight Management (2010) by Dr. Yoni Freedhoff and Dr. Arya Sharma, PDF copy available from weight Food Security World Health Organization at Mayo Clinic Exercise for Weight Loss: Calories burned in 1 hour living/weightloss/in depth/exercise/art Mindless Eating by Dr. Brian Wansink (2010), information available at National Weight Control Registry at Resources Health Canada Estimated Energy Requirements reference guide sc.gc.ca/fn an/food guide aliment/basicsbase/1_1_1 eng.php Health Canada Using the Nutrition Facts Table sc.gc.ca/fn an/label etiquet/nutrition/cons/dvvq/index eng.php Canadian Diabetes Association Alcohol and Diabetes and you/healthy livingresources/diet nutrition/alcohol diabetes 13

14 Resources MyFitnessPal Calorie counter app EaTracker Food and activity tracker Obesity Network Resource How to use a Pedometer Questions? Christine Young, RD Belleville & Quinte West Community Health Centre x 139 youngc@bqwchc.com 14

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