Question 2
The article mentions the carbohydrate restricted diet should be avoided in vulnerable populations (the young, reproductive-aged women, hypertensive individuals, and patients with nutrient deficiencies). If one of these populations came to you for advice on the carbohydrate restrictive diet, how would you handle this session?
posted by Lauren @ 2:30 PM
32 comments
32 Comments:
I would let them know that their delicate circumstances may put them at greater risk for health problems if they were to go on a very restrictive diet. However, this meta-analysis does point out that while this type of diet isn’t recommend for these populations, studies are lacking that prove this would necessarily result in poor clinical outcomes. Depending on their particular health conditions or circumstances that make them vulnerable, I might offer other diet suggestions or ways to make smarter choices to reach their goals.
I would provide them with the research relating to their situation and discuss the precautions. Instead of a restrictive diet I would help the patient find a diet that works for them, which may include slightly lower carbs but not necessarily restricted carbs. I would help them achieve their goal but in a different way than maybe they intended when they first walked into my office.
If I had an individual come to me for advice on carbohydrate-restricted diets, I would definitely discuss this option with them. I would present both the benefits, as well as the risks (overall, and those that are specifically associated with their circumstances). I would then provide them with other options for cutting calories out of their daily routines. Discussing the “healthy eating” approach vs. the “dieting” approach may help the client see what you are talking about. Many time patients are looking for the next big “diet craze”, when all they really need to do is begin living sensibly and eating a balanced, appropriately portioned diet. It is our job as health professionals to make this known to our clients.
Steph, I think you were definitely right in saying that you would discuss what they originally wanted to discuss with you regarding diets, and then you would bring up other types of potential lifestyle and dietary changes individuals can make to lose weight. In the end, it really most likely doesn’t matter to the client how they are getting to their goal, as long as they are losing the weight (and you know it’s in a healthy way) they are going to be happy.
I would simply explain to them that the low carb diet is a fad and is not a healthy or recommended way to achieve weight loss or to sustain weight loss over time.
I would also point out that this diet is not only unhealthy for their situation particularly but it is not possible to sustain that restriction over time and would eventually result in weight gain.
I would also discuss with them more practical methods for losing weight including adding exercise or cutting down on total calories each day.
Annie...
I agree with you in that you do have to explain the practical ways in which individuals can lose weight. FAD diets and other restricted diets are something that can't be sustained and in order to help clients be successful we must show them ways in which they can achieve success!!
Not just the vulnerable populations, but for all populations I would answer all questions they had based on the carbohydrate restrictive diets. Then I would explain to them, like Karlie mentioned already, that diets don't necessarily work, but rather I would suggest eating healthy as an overall lifestyle. I would associate the term diet as short term and that living a healthy lifestyle is something that needs to be maintained throughout life, not just for a period of time. After most people see results, the term diet often disappears into the night and results soon become something of the past too! If you know that you are doing a healthy eating for life plan, then you do not have to worry about any diet crazes!
I agree with most of the posts that have mentioned focusing on healthy eating versus carbohydrate restriction. Carbohydrate restriction is very difficult and can become monotonous after a while and lead to poor compliance. I would inform clients that they would benefit more greatly from a few healthy eating goals that they can tailor to their own situation.
Find out the reasons the vulnerable population wanted to be on the carbohydrate restricted diet and find resources and education on other ways to meet the pt same goals; whatever they might be. Educate pt on healthy complex carbohydrates and why it is necessary for the body to consume them. Educate on heart healthy diet, nutrient dense foods such as whole grains, fruits, vegetables, beans and nuts, etc. and provide solutions and motivation to decrease intake of high caloric, high fat (unhealthy fat such as trimming fat from meat, medium to high fat dairy products) foods.
I would tell the client that they have special needs due to their life-stage and/or nutrient requirements and that the carbohydrate restrictive diet isn't the right choice for them. We could discuss what they like about the results from a CHO restrictive diet and discuss alternatives appropriate to them specifically. I would tell them the benefits of this regimen and work with them to set goals to improve their diabetes.
Katherine McCullah
Karlie, I think your approach to this situation is wise. Discuss the pros and cons of the carbohydrate restricted diet and help them to choose the alternative that is healthiest/most beneficial. This allows the patient to have some sense of control over their health and will hopefully encourage better compliance with the new lifestyle plan.
Katherine McCullah
I would let them know that due to their current state of health, a restrictive carbohydrate diet would not be beneficial at this time. I would then make other diet suggestions depending on their goals for weight loss. I would also discuss their current health condition with them and make diet recommendations based on their condition.
As a dietitian, I would first listen to what the patient has to say regarding their interest in a low CHO diet. I would then explain that lowering your CHO in the diet has some benefits, but potential risks as well. There are different levels of CHO restriction, and I would explain to them that at this time and with their condition, it may not be the best option for them, but that we could find ways to reach their goals by doing other things. I would give education on heart healthy fats, lean protein and the right carbs, and explain that eliminating simple carbs that contain empty calories will probably be the better option for them now. Of course, every case is different, so depending on the situation, I would find the proper diet that fits them.
I would explain how a carbohydrate restricted diet may not be the right diet for them, clarifying that this might be more harmful than helpful. I would make suggestions for healthier alternatives. Reducing carbs. might not be bad, but I wouldn’t recommend restricting them. Again every client is different, a child and a hypertensive individual both have very different needs. Education is needed on the importance of a balanced diet and exercise.
Samantha McCoy
Joanna- I liked what you mentioned about making this a lifestyle change and not just a diet. This is a great point, I think most people are confused about diets and weight loss. Many people are unsuccessful in this area, because they are not ready for a lifestyle change. I agree about not focusing on the diet fads, but educating on the importance of healthy eating and exercise.
Samantha McCoy
Steph-
I agree with you that it is very important to take into account the precautions with each individual client. You put it very well when you said that you would help them achieve their goal, but maybe in a different way than they initially imagined.
Steph-
You presented an excellent point when you stated that you would assist your pt/client in reaching his/her goals, but do it in a way that may be different from what they had in mind. Giving diet education is one thing, but counseling a pt/client is another. It is important that we know the difference between these two ideas. Also important is letting the patient know there are alternatives to, in this case, CHO restriction in their diet.
I would explain to the individual why this diet isnt recommended for their condition. For example, if the person was nutrient deficient, they should be informed that limiting carbohydrates could mean limiting their opportunity to intake a certain deficient nutrient.
What is their purpose for starting a resricted carbohydrate diet? Is it for weight loss? The dietitian should work with the individual to develop a plan to reach their goals in alternative ways that take into consideration their existing condition.
I would talk to the patient about their individual needs and let them know why this type of diet would not be the best choice for them. I would also emphasize that it's a lifestyle change that will benefit them in the long run, that fad diets are typically not long term.
Karlie
I agree the more options you can give a client the more apt they are to feeling like they can achieve their goal. I also like calling it a "healthy eating" approach rather than a "diet".
I would tell a client like that some of the important ways the body uses carbohydrates (in a non-technical way) and explain to them that there are other dietary ways to reach their goals (ex. weight loss, lower cholesterol). I would encourage them to try other healthy eating options, that I would tailor to them, rather than a supposedly ones-size-fits-all low carb diet.
I would inform the client of the possible consequences of a carbohydrate restricted diet considering their vulnerable state. I would also explain the lack of success that is associated with diets that require extreme circumstances such as carbohydrate restriction or avoidance. Then I would help find a diet that better fits their lifestyle.
Joanna,
I like your choice of words in relation to changing the word diet to healthy lifestyle. The term diet insinuates negative thoughts. People may be more likely to stick with their "diet" if they don't think of it as one.
I would let them know that a carbohydrate restricted diet is not a good idea for everyone. I would let them know that there are serious side effects, including
constipation, diarrhea, dizziness, halitosis, headaches,and insomnia. I would then recommend a diet that is more appropriate for their health conditions.
Britt,
I agree with you when you say that you would tell your patient about avoiding simple carbs. I think that is especially important for those who are wanting to go on a CHO restricted diet to know that they can avoid certain carbs but they should be comsuming the complex, which are much better for them.
I would explain to the pt./client that such a diet is an option, but maybe not the best for their circumstances. Any severly restrictive diet is difficult to maintain and leaves the individual vulnerable to deficiencies, so I would suggest a balanced plan that would offer comparable results with fewer risks.
Annie,
I agree that we need to let our clients know the difference between fad diets and eating patterns that are part of a healthy overall lifestyle. What is the best way to tell a client that a "fad" is not the way to go, even as their friends, co-workers and family members are using the diet and perhaps seeing results? I suppose the best we can do is to offer better solutions as you suggested, however your post brought to mind a defensive client that may be difficult to convince. I'm sure we'll run in to plenty of individuals who are open to and accepting of our suggestions, but this particluar scenario could pose some hazards when attempting to counsel or educate a patient on a prefered method of achieving a particular goal.
I like how many people said that they would stress to the individual that such a diet would be difficult to maintain. If the client was still considering a carbohydrate resrictive diet, the dietitian could provide them with a simplier version of that diet. This version would be less complicated and less restrictive. So throughout the overall process, the client will improve their knowledge, and will be more likely to adapt the less risky option.
Karlie and Steph~
I am going to apply your responses from another question to this one. Both mentioned by restricting carbohydrates for patients, the patient would be consuming a healthy amount of carbohydrates. In the vulnerable population, I would do the same, evaluate their diet, explain pros and cons of the restricted carbohydrate diet,and offer guidance in alternative methods that would be more suitable.
I first would want to know why they want to restrict their carbohydrates, then depending on their answer would provide other effective ways to achieve their goal. I would definitely make sure to educate them on why the body needs carbs.
Tori McRoberts
Steph,
I agree with your suggestion of providing them with current research relating to their situation. Some people read an article and don't take the time to find out if the results are meant for them, or a different population altogether.
Tori McRoberts
Karlie,
I completely agree with your thinking that people should live sensibly. There are many people who don't realize that diet is such a big key factor to overall health. After sticking to a balanced diet, many would realize that overall they would feel more energized, less lathargic, and be able to maintain a health body (not just size but skin, hair, and nails).
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