Personalised Weight Loss Programme

Transcription

1 Personalised Weight Loss Programme Nutrition and Dietetic Service This leaflet has been designed to give you important information about your condition / procedure, and to answer some common queries that you may have.

2 Introduction to the Personalised Weight Loss Programme Welcome to the Personalised Weight Loss Programme run by Northern Lincolnshire and Goole NHS Foundation Trust Nutrition and Dietetic Service. The programme is designed to support you to develop healthier eating habits, increase your activity levels and to achieve and sustain weight loss. You will be invited to attend 10 sessions where you and a dietitian or dietetic assistant will set goals and discuss key aspects of healthy eating and weight loss. These sessions are one to one but you can bring along a supporting person if you would find this helpful. This leaflet will be used to support the practical activities and material discussed within the sessions. The leaflet will also enable you to record and track weight loss efforts and set goals. Role of the Dietitian The role of the dietitian in these sessions is to support you to make lifestyle changes and answer any questions you may have. The dietitian and assistant dietitian will you re your waist circumference, weight and height measurements. The dietitian WILL NOT make judgements about you or your life style choices and all goals will be agreed with you. Dietitians are the only nutrition professionals regulated by law and are registered under the Health and Care Professions Council (HCPC). Your Role You will be required to answer an introductory questionnaire, set realistic goals, and complete a food diary for the first week. You will need to bring this leaflet to every session and supplementary information will be provided. You need to be committed to attend the 10 sessions and the dates and times will be agreed. We understand that sometimes appointments need to be rearranged or cancelled but please note that you will be discharged automatically from the programme if you fail to attend an agreed appointment and do not inform us in advance. Content of the 10 Sessions: Session 1: Programme introduction Session 2: Portion sizes & the balance of nutrients at main meals Session 3: Reducing fat & calories Session 4: Weigh in with dietetic assistant only Session 5: Activity & mindful eating Session 6: Sugar and label reading Session 7: Weigh in with dietetic assistant only Session 8: Food swaps & meal planning Session 9: Fluid & alcohol Session 10: Final session summary Session 1: Introduction This personalised weight loss programme is designed to help you develop healthier eating habits, increase your activity and promote weight loss. The information in this pack will provide you with information to support the 10 education sessions and help to track your progress. Following the personalised weight loss programme will help you to work towards

3 losing 0.5-1kg per week (1-2lbs) and promote steady, sustainable weight loss. Initial assessment Current weight: Height: BMI: Waist circumference: 5-10% weight loss / goal weight: Session 1 goals Your dietitian will discuss with you about setting initial goals to promote weight loss. Use the SMART goal tips to help you choose your goals to work on for the first week. For more information setting SMART goals see the British Heart Foundation booklet: Eating Well, pages Ensure you set SMART goals When setting goals to lose weight, try to be SMART about it. SMART stands for: Specific: your goal should be precise: I will walk 5,000 steps 5 times a week, rather than I will exercise more Measurable: I will use a pedometer to track the number of steps I am doing Achievable: break down your overall goal into easy mini-goals. For example today I will aim for 2,000 steps and by the end of the month I will build this up to 5,000 steps a day Relevant: choose a behaviour that will help you meet your goal Time-specific: set yourself a time scale for achieving your goal

4 Food and activity diary to be completed during your first week. For activity try and record the amount of time that you are active during the day; for example: doing housework for 1 hour, walking the dog for 30 minutes, swimming for 40 minutes etc Meal Monday Tuesday Wednesday Breakfast Mid morning Lunch Mid afternoon Evening meal Supper Physical activity Drinks

5 Meals Thursday Friday Saturday Sunday Breakfast Mid morning Lunch Mid afternoon Evening meal Supper Physical activity Drinks

6 Session 2: Portion Sizes and the Balance of Nutrients at Main Meals Controlling portion sizes is important to help with weight loss and work toward achieving a healthy balanced diet. Try portioning your main meal in the kitchen to avoid second helpings and using a smaller plate to help reduce total calorie intake. The dietitian will show you how to portion food out into the recommended food portion sizes. Another method of controlling your portion sizes is to follow the portion size guide in the Eating Well British Heart Foundation booklet provided, pages Appropriate portions of food groups: A meat / fish serving = size of a deck of cards Pasta / rice / noodles = size of a tennis ball Baked potato / mashed = size of a computer mouse Balance of Nutrients at Main Meals To the right is an example of a balanced plate for a main meal showing different food groups. The plate shows the proportions of different food groups to promote weight loss and provide a healthy balanced diet. Aim for vegetables to make up half of your main meal as these are low in calories, high in fibre, vitamins and minerals. The remainder of the plate can be made up of quarter lean protein and quarter starchy carbohydrates. Below are examples of main meals in the suggested quantities to give you an idea of what this looks like. Current weight: Weight change: Session 2 goals: 1) Vegetables, salad or fruit Carbohydrate: bread, rice, pasta, noodles, potatoes & cereals. Protein: lean meat, fish, beans, Quorn, soya, tofu & pulses. 2) 3)

7 Session 3: Reducing Fat & Calories Fat is an important part of the diet. The body needs it to help absorb fat-soluble vitamins A, D, E and K. Essential fats are needed in the diet to help the body reduce inflammation and improve heart health. Why Reduce Your Fat Intake? There are different types of fats, including saturated and unsaturated fats. It is important to maintain a healthy balance of these fats to help reduce the risk of developing heart disease, by opting for plantbased unsaturated fats over animal-based saturated and trans fats. Fat is very energy dense and contains more than twice as many calories per gram, compared to carbohydrates and protein. For this reason, it is important to control the amount of fat in the diet to avoid taking in too many calories and thus prevent weight gain. How do I reduce my fat and calorie intake? To help reduce total calorie intake, try making food swaps, for example: choosing tomato based sauces instead of creamy or cheese pasta sauces and swapping full fat dairy products for low or reduced fat products e.g. whole milk to semi-skimmed milk. It is beneficial to reduce your intake of highfat snacks such as biscuits, cakes and crisps and swapping for healthier snacks such as diet yoghurts and fruit. Try changing your cooking methods from frying to grilling, boiling, and steaming as this can also help to control the amount of fat in your diet. Benefits of Weight Loss Making food swaps and reducing calorie and fat intake in your diet can help promote steady weight loss e.g kg (1-2lbs) per week. There are a number of benefits to losing weight. For example, if somebody who weighs 100kg loses 10kg, (10% of their body weight) this could result in: period pain. It can help improve your mood and selfesteem A 10% drop in cholesterol levels, which will reduce the risk of heart disease and stroke A reduction in risk of developing diabetes Improvements in mobility, mood and selfesteem. Please see your BDA Food Fact Sheet on Fats for more information, as well as pages of your British Heart Foundation Eating Well booklet. Current weight: Weight change: Session 3 goals: 1) 2) 3)

8 Session 4: Weight Measurement Current weight: Weight change: Session 5: Activity & Mindful Eating Benefits of Increasing Physical Activity: Any type of exercise that uses your cardiovascular system (your heart and blood vessels) to provide energy for an activity will help to promote weight loss through burning calories. Other benefits of regular exercise include: a reduction in heart disease risk, 50% reduction in risk of developing colon cancer, a 50% reduction in risk of type 2 diabetes and improvements in mental health. Examples of moderate intensity cardiovascular exercise include: brisk walking, cycling and swimming. To reach the peak fat burning stage during exercise you should feel slightly out of breath, but still be able to hold a conversation. Evidence suggests that you should build up gradually and aim to reach 150 minutes (2 and a ½ hours) a week of moderate intensity exercise. The 150 minutes can be split into a minimum of 10 minutes at a time. Keep a physical activity log, or you could try using an activity tracker App to monitor your progress. If you are unable to undertake cardiovascular activity try to increase your activity through everyday activities such as house work or gardening. Calories Burned Through Exercise: Using the British Heart Foundation exercise calculator online, a 100kg 40 year old man doing 30 minutes of the following activities would burn: Fast walking = 415 calories Playing golf = 240 calories Cycling = 400 calories Dog walking = 150 calories Mowing the lawn = 275 calories Vacuuming = 175 calories Use the online calculator to see what you could burn! Try writing down potential barriers to physical activity on a piece of paper and think of solutions to help plan and overcome them. Current weight: Weight change: Session 5 goals: 1) 2) 3)

9 Session 6: Sugar & Label Reading Although sugar is not the only cause of weight gain, high sugar intakes are associated with being overweight and obesity. The added sugars contained in many manufactured food products are not needed in a healthy balanced diet, and provide excess calories which can contribute to weight gain. Added sugars include; table sugar (sucrose), honey, glucose, fructose, syrups and fruit juices. Added sugars should not make up more than 5% of your daily calorie intake (around 30g daily). If you have type 2 diabetes it is important to remember that added sugars can affect your blood glucose levels and contribute towards weight gain. Although whole fruits and milk / milk products contain natural sugars, these are not counted as added sugars; however is it still important to watch our portion sizes of these foods. Please refer to your BDA Food Fact sheet on Sugar for further details. Tips to Reduce Added Sugar and Calorie Intake: If you add sugar to food and drink, try swapping this for sweeteners Swap to diet or light versions of yoghurts as low fat yoghurts are generally high in sugar Look at food labels of products to compare sugar content per 100g: if the item s sugar content is over 22.5g this is high and if it is under 5g it is low Many breakfast cereals are high in sugar. By swapping to plain porridge or whole wheat cereals this could dramatically reduce added sugar intake Try to make pasta sauces from chopped tomatoes and herbs, as many bought sauces are high in sugar Swap chocolate bars for snack sized portions to reduce sugar and calories Swap chocolate biscuits for plain biscuits Your dietitian will show you how to successfully read food labels using the British Heart Foundation Food Label Decoder along with examples of everyday food packaging. This will help you make healthier food choices when deciding between products. Current weight: Weight change: Session 6 goals: 1) 2) 3)

10 Session 7: Weight Measurement Current weight: Weight change: Session 8: Food Swaps & Meal Planning Making food swaps is a good way to reduce your total calorie intake for the day and helps promote weight loss. If you can make just 5 food swaps (each about 100kcal) daily to your diet you would lose about 0.5kg (1lb) of fat in a week and in 1 year 23.5kg (52lbs)! Here are a few ideas on how to save 100kcal by making swaps and small changes to your diet: Instead of this 1 medium bowl of cornflakes with whole milk 1 handful of peanuts (25g) 50g hard cheese on 2 slices toast 2 chocolate biscuits Swap to save 100kcal 2 wheat biscuits with semi-skimmed milk 1 snack bag of sweet popcorn (25g) 50g light soft cheese on 2 slices of toast 2 plain biscuits 1 glass of cola 1 glass of diet cola Tips for Meal Planning: Plan meals ahead. Write a shopping list and stick to it to avoid impulse purchases Eat before you go food shopping Use the Change For Life website and look at the meal mixer section for ideas on cooking healthy meals Stock up on tinned and frozen fruit and vegetables as these will last longer than fresh products and count towards your 5 a day Planning meals before you get to the supermarket can help save you money and choose healthier foods to promote weight loss If you normally snack in between meals, plan to buy lower calorie healthier snacks such as diet yoghurt, sugar free jelly, fruit and fruit ice lollies Current weight: Weight change: Session 8 goals: 1) 2) 3)

11 Session 9: Fluid and Alcohol Why is fluid important? An adequate intake of fluid is essential for our health and for many body functions. The human body is made up of around 70% water. Therefore, drinking enough is vital to help keep you healthy, maintain healthy bowel function, help prevent kidney stones and reduce the risk of any urine infections. The recommended daily intake of fluid is ml glasses per day (1.6-2 litres) but this can vary depending on temperature and activity levels. Please see your BDA Food Fact Sheet on Fluid for more information. What counts towards my fluid intake? Suitable drinks to help meet this fluid requirement include water, juice, squash, tea and coffee. Milk can be included; however, it is important to opt for lower fat milks such as skimmed / semi-skimmed milk to help reduce calorie intake. High calorie drinks, such as: sweetened fizzy drinks and syrup-laden coffees are becoming increasingly available these days. These high calorie fluids don t make us feel as full as if we have eaten the same amount of calories from solid food. Alcohol It is important to remember that alcohol has no role in a healthy diet. The recommended daily amount of alcohol is no more than 14 units per day for men and women and ensure you have alcohol free days. Please see your BDA Food Fact Sheet on Alcohol. Bear in mind that alcoholic drinks can be high in calories and therefore can contribute to weight gain. For example drinking 5 pints of lager a week adds up to 44,200 calories extra a year! A glass of wine (175ml) = 126 calories A pint of beer = 215 calories A pint of lager = 233 calories A single measure of vodka and diet cola = 55 calories Current weight: Weight change: Session 9 goals: 1) 2) 3) Session 10: Final Session and Summary Well done for completing the 10 weight management sessions. Hopefully you will now have the knowledge and skills needed for you to lead a healthier and fitter lifestyle. Your dietary and lifestyle changes don t stop here; the weight management programme has given you the tools in order for you to make, and sustain, lifestyle changes to improve your health. Look at how far you have come in the last 10 sessions and reflect on the changes you have already made.

12 Tips to Keep Motivated: Make use of the knowledge you have learnt and refer back to this leaflet Set SMART goals for yourself and make sure you reward your efforts with nonfood treats Monitor your weight regularly (no more than once a week) Keep your activity levels up and, if it helps, track your progress and use an activity diary or a smart-phone App If you go off track don t worry about the slip-ups as these are normal. Try to start afresh with the changes you previously made. To boost your confidence, reflect on all the positive changes you have already made to your diet and focus on the positives, not the negatives! Make a note of all the things you want to achieve and set realistic timescales. Remind yourself of the positive reasons for change Useful contacts for further information: For further support losing weight look up the NHS Weight loss pack and the Change4Life website. Walking your way to Health for local short walks around Lincolnshire, call Christine Johnson on For advice on getting more active look up the NHS Couch to 5k. For more support on getting active, making behaviour changes and advice on cooking contact the Health Trainers on: for Scunthorpe and for Goole. If you are interested in walking and meeting new people contact the Scunthorpe Ramblers on or Goole Ramblers on Reference Section British Dietetic Association (2015) Food Fact Sheets home British Heart Foundation (2015) Calories calculator British Heart Foundation (2015) Eating well booklet British Heart Foundation (2015) Food labelling booklet Harvard School of Public Health Healthy Eating Plate National Health Service (NHS) (2015) Calories in alcohol National Health Service (NHS) (2015) Change4Life Cooking & meal ideas National Health Service (NHS) (2015) Losing weight, getting started- week 1 LOSS-PACK/all-weeks.pdf National Health Service (NHS) Photo Library National Institute for Health and Care Excellence (NICE) (2014) Weight

13 management: lifestyle services for overweight or obese adults National Institute for Health and Clinical Excellence (NICE) (2015) Preventing excess weight gain Concerns and Queries If you have any concerns / queries about any of the services offered by the Trust, in the first instance, please speak to the person providing your care. For Diana, Princess of Wales Hospital Alternatively you can contact the Patient Advice and Liaison Service (PALS) on (01472) or at the PALS office which is situated near the main entrance. For Scunthorpe General Hospital Alternatively you can contact the Patient Advice and Liaison Service (PALS) on (01724) or at the PALS office which situated on C Floor. Alternatively you can nlg-tr.pals@nhs.net Confidentiality Information on NHS patients is collected in a variety of ways and for a variety of reasons (e.g. providing care and treatment, managing and planning the NHS, training and educating staff, research etc.). Everyone working for the NHS has a legal duty to keep information about you confidential. Information will only ever be shared with people who have a genuine need for it (e.g. your GP or other professionals from whom you have been receiving care) or if the law requires it, for example, to notify a birth. Please be assured however that anyone who receives information from us is also under a legal duty to keep it confidential. Zero Tolerance - Violent, Threatening and Abusive Behaviour The Trust and its staff are committed to providing high quality care to patients within the department. However, we wish to advise all patients / visitors that the following inappropriate behaviour will not be tolerated: Swearing Threatening / abusive behaviour Verbal / physical abuse The Trust reserves the right to withdraw from treating patients whom are threatening / abusive / violent and ensuring the removal of those persons from the premises. All acts of criminal violence and aggression will be notified to the Police immediately. Risk Management Strategy The Trust welcomes comments and suggestions from patients and visitors that could help to reduce risk. Perhaps you have experienced something whilst in hospital, whilst attending as an outpatient or as a visitor and you felt at risk. Please tell a member of staff on the ward or in the department you are attending / visiting. Moving & Handling The Trust operates a Minimal Lifting Policy, which in essence means patients are only ever lifted by nursing staff in an emergency situation. Patients are always encouraged to help themselves as much as possible when

14 mobilising, and if unable to do so, equipment may be used to assist in their safe transfer. If you have any questions regarding moving and handling of patients within the Trust, please speak to a member of staff in the ward or department you are visiting. Northern Lincolnshire and Goole NHS Foundation Trust Diana Princess of Wales Hospital Scartho Road Grimsby Scunthorpe General Hospital Cliff Gardens Scunthorpe Goole & District Hospital Woodland Avenue Goole Date of issue: February, 2016 Review Period: February, 2019 Author: Dietitian IFP-899 NLGFT 2016