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• 1 FSHN 428

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• Eating Disorders: What is mindful eating?

  
  -Eating when you're hungry, and stopping when you're full.
  -Eating for optimal satisfaction and satiety

  • -Awareness of your physical and emotional cues
  • -Recognition of your non-hunger triggers for eating

• How is normal eating disrupted in those with eating disorders?

  Individuals with eating disorders have an unrealistic relationship with food, and their weight that it develops into disordered eating habits such as:
  -Using food as a coping mechanism for uncomfortable and painful emotions to help them feel more in control when feelings seem overwhelming.
  -Preoccupied with food, weight and body, they have a huge fear of gaining weight, refuse to eat unless it's tiny portions
  -Disordered body image
  -Abnormal weight goals
  -Eating alone, or in secret
  -Shame and guilt when eating

• Three characteristics of individuals with EDO's:

  1) Low-self esteem
  -Not feeling good enough, pretty enough, smart enough
  2) Perfectionist
  - They must have the perfect body to feel happiness 
  - Striving to be the best at whatever he or she does
  3) The need to please others
  - Difficult dealing with conflict

• How to translate the science into action plans for cardiac patients?

  -Start with small achievable goals that work towards benefits of regular physical activity, weight control, lowering blood pressure, and ultimately improve cardiovascular health. 
  - Walk 15 min a day, for 30 days.
  - Reduce sodium intake 500 mg per day. 
  - DASH diet: improve blood pressure, reduce lipids, increase fiber. 
  - AHD diet: balance calorie intake, and physical activity to achieve a healthy body weight, diet rich in fruits and vegetables, choose whole grain, high fiber foods, consume fish at least twice a week, minimize intake of added sugars. 

• Role of the dietitian as a behavior change agent to increase fruit and vegetable intake:

  -Determine what fruits and vegetables the patient is already eating. 
  - Set meaningful and achievable goals
  - Encourage, and reinforcement: rewards
  
  -Add dried fruit to cereals or oatmeal
  -make a smoothie with frozen yogurt, fresh or canned fruit
  -Add berries to a salad
  -Make a homemade trail mix with dried fruit, unsalted nuts and whole grain cereal 
  -Add fruit to a dish of ice cream
  -Add salsa to scrambled eggs

• Diabetes: Intervention based upon type of diabetes and individual's needs/goals.

  
  
  
  
  

  • Type 1 diabetes:individual education
    
  • Type 2 diabetes: class and individual initial appt & follow up or individual only
    
  • Gestational diabetes:small group and individual education
    
  • Pre diabetes: Class 
    

• Diabetes: Goal setting: what outcomes will be achieved?

  -Knowledge on self care/ self manage
  -Reading a food label
  -How to add units of insulin
  -Scheduling and attending follow up appointments 

• Diabetes: Individualization of plan based on psychosocial and physiological considerations:

  Enhance physiological well-being:
  -Do not overwhelm them with education
  -Teach them what they want to learn
  
  -Physical activity counters anxiety, depression, and improves mood

• What are the barriers that patients with diabetes experience?

  - Knowledge and skill to manage their diabetes on a day to day basis
  - They must have access to quality medical care, the means to pay for services
  - Education and income may play a significant role 

• Diabetes: giving information, self-care practices:

  -Teach appropriate level for patient
  -Use tools and visual aids
  
  -Empower them to understand more about how diet and lifestyle affect their bodies and glucose control
  -Educate them on how to read a food label 
  -Long term- help clients make sustainable changes that will improve their wellness and quality of life