Nutrition: One Size Does Not Fit All
By Carol Guarino, MS, RD, CDE, Clinical Dietitian, Helen Hayes Hospital
During a meeting with a patient, I once again heard, “I don’t know what I am allowed to eat.”
This is a sad statement. We are adults. We are allowed to eat as we choose. However, I do understand the confusion with the overwhelming advice from the cardiologist, the endocrinologist, the gastroenterologist, and, of course, family, friends and advertisements. Each piece of advice is just that: a piece. We have neglected to treat the individual as a whole. I believe a more accurate statement would be, “I am confused as to what is best for me.”
Of course, medical diagnoses should play a part in food choices, but we also need to be mindful of lifestyle, culture and willingness to receive education. Our patients have been through a life-altering experience. Some are afraid to eat while others are stress eating.
DASH, Mediterranean, plant-based and Choose My Plate are all nutritionally sound meal plans, but will these fit into an individual’s
life? Are they sustainable? Can we mix and match? Encouraging small frequent meals to an individual with a food addiction and constant thoughts of eating might not be the best solution. You just may lose the interest of the cattle farmer when you mention plant-based.
My advice? Listen, advise and repeat as needed.
Work with your patient to make small sustainable changes. Let them try it on for size, and if it doesn’t fit, try on another. Collaborate with your patient to find what will work with their life and their body.
Here is a starting point for an individual plan:
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- Begin with the basics: the food label. Narrow down what is important for that individual. Is it sodium? Carbohydrates? Calories?
- Encourage home cooked meals. Review favorite recipes. Assess if modifications are needed and how they can be made (and accepted). If one is culinary challenged, offer simple recipes or meal kits now widely available in supermarkets.
- Review portion sizes. No food is off limits, but try to set limits with portions.
- Focus on what should be eaten as opposed to what should not.
- Encourage your patient to enjoy their life’s journey.