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Using Updated Dietary Guidelines, FPs Can Help Patients Change Habits
Guidelines Cover Healthy Foods, Increased Activity
"The family physician's role is helping patients identify a couple of the most relevant steps they can work on in relation to the recommendations," she adds.
Fortunately, the report's four-page executive summary (4-page PDF; About PDFs) is far more digestible and should make that task easier for busy family physicians.
Dietary Guidelines Include Recommendations for Patient Subpopulations
For women or adolescent girls who are pregnant or breastfeeding
- consume 8-12 ounces of seafood per week from a variety of seafood types;
- white, or albacore, tuna should be limited to 6 ounces per week because of its high methyl mercury content, and tilefish, shark, swordfish and king mackerel should be completely avoided; and
- pregnant women should take an iron supplement, as recommended by an obstetrician or other health care provider.
- choose foods that supply heme iron -- which is more readily absorbed by the body -- additional iron sources, and enhancers of iron absorption, such as vitamin C-rich foods; and
- consume 400 mcg per day of synthetic folic acid (from fortified foods and/or supplements) in addition to food forms of folate from a varied diet.
- consume foods fortified with vitamin B12, such as cereals or dietary supplements.
- reduce daily sodium intake to less than 2,300 mg and further reduce intake to 1,500 mg among persons who are 51 or older and those of any age who are black or have hypertension, diabetes or chronic kidney disease;
- consume less than 10 percent of calories from saturated fatty acids by replacing them with monounsaturated and polyunsaturated fatty acids;
- consume less than 300 mg of dietary cholesterol per day;
- consume at least half of all grains as whole grains; and
- only consume alcohol in moderation -- a maximum of one drink per day for women and two drinks per day for men if alcohol is consumed.
However, the updated guidelines, which were jointly developed by the U.S. Department of Agriculture and HHS, differ from AIM-HI's approach in one chief regard -- they emphasize monitoring caloric intake.
"With AIM-HI, we steered away from that (monitoring) because people are not going to count calories for the rest of their lives," says May, adding that the majority of people who struggle with weight issues eat mindlessly or for emotional reasons.
AFP by Topic Pulls Together Multiple Obesity-related Resources
Topics covered include office-based management strategies, counseling overweight and obese patients about physical activity, the use of dietary supplements in weight loss, and evaluating obesity and cardiovascular risk factors in children and adolescents.
Patient education topics range from gaining and maintaining a healthy life balance to practical weight loss tips.
Ideally, says May, family physicians will consider nutrition and physical activity to be part of their prescription or treatment plan in nearly every patient encounter, whether it be for a physical exam or a follow-up visit for a chronic disease.
For example, May says a physician could focus on educating a patient with a family history of cardiovascular disease about the recommendations regarding saturated fats, trans fatty acids and cholesterol. Similarly, a patient with hypertension should be informed about the sodium recommendations and encouraged to take simple steps, such as reading food labels and not salting food at the table.
"Physicians aren't having these conversations because they're too busy or don't feel comfortable with it," says May. "We can't just write more prescriptions for medications and not talk about some of the fundamental lifestyle changes that can have a huge impact.
"We have to figure out a way to get people to do what the guidelines say, and I think family physicians can really make an impact if they choose to."
New Dietary Guidelines Report Focuses on Obesity
Public Comments Accepted Through July 15
Encouraging Healthy Lifestyles: A Special Report on Overweight and Obesity
U.S. Department of Agriculture: ChooseMyPlate.gov