Posted on 10/01/2012 at 12:30:48 PM by Student BloggerBy Chris Sovey
1. What is a good strategy to suggest to a patient who desires to increase vegetable intake, but has had difficulty doing so?
People want quick and easy. Green smoothies may be a sensible way of getting more veggies into the diet. I was first introduced to green smoothies by author Victoria Boutenko. Green smoothies involve selected green leafy vegetables with appropriate fruits and water. Ice is optional. Combinations are endless. Here's an example:
1. Place about a handful or two of spinach in the bottom of a blender.
2. Add about 1.5 cups of frozen berries to the blender.
3. Add 1 cup of water.
4. Blend thoroughly.
5. Ignore the color and enjoy.
There's a yummy, healthy serving of fruit and veggies in minutes. Easy clean-up, too. See what I mean? Simple solution.
But what if they still can't stand veggies after several attempts? Keep trying. The body adapts. In the therapy world, this is known as “adaptation to imposed demand.” Our bodies change according to how we interact with our environment and what we put it through.
2. Assess and assist when someone is ready for change.
Don't push. I relate this back to the Transtheoretical Model of Behavior Change, which states that people go through defined stages of changing behavior patterns. Many linger in what is known as the Contemplation stage, where someone is considering to change, but has not yet taken action. If they are in this stage, don't overload the client. Suggest one or two nutritional interventions that will bring noticeable results. This may be all it takes to bring them into the next stage.
3. Provide evidence appropriate to the population.
Speak to your population. Some clients don't care about the latest or greatest research. (i.e. the constant back and forth about whether or not fish oil supplements really are beneficial for reducing the incidence of cardiac disease.) A lot of folks just want to know how much time it will take out of their day, and how will the benefits apply to them individually. Solutions must be streamlined, easy to use, and idiot-proof. Let the results speak for themselves.
4. Help patients identify their personal goals. How much time and money will a client realistically spend related to food?
Try to get a truthful response about this question and then do less. As a physical therapy student, I know that if I ask how much time a patient would be willing to spend on exercise, they will probably tell me a skewed number in the positive direction to appease me. The same thing applies to nutritional interventions. If a patient claims they will spend 30 minutes/day cooking and $20/month on appropriate supplements, then suggest strategies that will take 15 minutes/day and cost $15/month.
5. What are the priorities of the individual?
I personally believe that a lot of the dietary issues in the United States are related to backwards priorities. The average consumer is not in a place where he/she can consciously appreciate the magnitude of impact related to dietary choices. It is our job as front-line medical professionals to assist in this transformation. As author Michael Pollan says, food was never meant to be convenient. It does take time and effort. But it doesn't have to be a total drag. Make simple suggestions to raise the awareness of patients regarding the impact of dietary choices. It is quite interesting that many consumers will spend thousands of dollars on the latest flat-screen TV, but claim they have no money for fruit or whole foods. It is all about perspective and priorities.
6. When in doubt, refer out.
Deficiencies and complicated cases may require additional assistance. Do the right thing and refer when necessary. Don't put a professional license at risk.
Chris Sovey is the founder of www.healthyconsumer.com, a premiere website for practical tips on healthy living and integrative health practices.
Adams, K., Lindell, K., Kohlmeier, M., & Zeisel, S. (2006). Status of nutrition education in medical schools. American Society for Clinical Nutrition,83(4), 941S-944S. Retrieved from http://ajcn.nutrition.org/content/83/4/941S.full