Counseling patients on healthy dietary patterns is challenging Academy of Nutrition and Dietetics Get the right nutrients The US Department of Agriculture DASH diet Mediterranean diet

1. Evidence-Based dietary tips
Dr. Arun Sharma

2. In light of the ever growing mountain of
information from social media, counseling
patients on healthy dietary patterns is one of
the most challenging task for the physician

3. Evidence-based
Diet tips

4. 1. GET THE RIGHT NUTRIENTS

5. Nearly one half of all cardio metabolic deaths (i.e.,
deaths from heart disease, stroke, and type 2 diabetes)
among adults in the United States were found to be
associated with suboptimal intake of vegetables, fruits,
nuts, seeds, and omega-3 fatty acids

6. Evolution of the USDA*
food guides
*The US Department of Agriculture

7. 1992: Food
Guide
Pyramid
https://www.choosemyplate.gov/brief-history-usda-food-guides

8. 2005:
MyPyramid
Food Guidance
System
https://www.choosemyplate.gov/brief-history-usda-
food-guides

9. (USDA) replaced its
food pyramids with
MyPlate in 2011
https://www.choosemyplate.gov/brief-history-usda-food-guides

10. MyPlate illustrates balance and portion size
that are evident at a glance
• The plate is divided into four, roughly equal parts:
• Fruits
• Vegetable
• Grains
• Proteins
• The fifth food group is dairy & can consist of glass of
milk, cheese, or yogurt
https://www.choosemyplate.gov/brief-history-usda-food-guides

11. Advice from the USDA
1. Fill half the plate with a variety of fruits and vegetables
2. Ensure that half of grains consumed are whole grains
3. Shift to low-fat and fat-free dairy products
4. Regularly switch proteins to include such choices as seafood, lean
meats and poultry, eggs, nuts, legumes, and seeds
https://www.choosemyplate.gov/brief-history-usda-food-guides

12. 2. COOK MEALS AT HOME

13. Processed foods and
beverages should be eaten
only occasionally
https://www.choosemyplate.gov/2015-2020-dietary-guidelines-answers-your-questions

14. Less than 10% of
calories should come
from added sugar
https://www.choosemyplate.gov/2015-2020-dietary-guidelines-answers-your-questions

15. Less than 10% of calories
should come from
saturated fats
https://www.choosemyplate.gov/2015-2020-dietary-guidelines-answers-your-questions

16. Less than 2300 mg of
sodium should be eaten
per day
https://www.choosemyplate.gov/2015-2020-dietary-guidelines-answers-your-questions

17. To decrease consumption of added sugars,
saturated fats, and sodium, preparing foods at
home is key, with premade sauces, mixes, and
instant products used sparingly
Academy of Nutrition and Dietetics Complete Food & Nutrition Guide.

18. 3. CHOOSE REALISTIC & BALANCED DIET
FOR WEIGHT LOSS

19. Specific diets that have proven effective at
weight loss plus reduction in BMI
• DASH (Dietary Approaches to Stop Hypertension) diet
• Mediterranean diet
• Nutrisystem®
• Weight Watchers®
• Jenny Craig®
http://www.dynamed.com/topics/dmp~AN~T316887/Diets-for-weight-loss

20. The Mediterranean Diet
• Heavy in vegetables; fruits; nuts; whole grains; and healthy
unsaturated fats
• Focuses more on fish and poultry, and less on lean red meat and
dairy
• Correlated with lower risks for cardiovascular disease, cancers,
type 2 diabetes, Parkinson disease, and death
Academy of Nutrition and Dietetics Complete Food & Nutrition Guide.

21. The DASH diet*
• Focuses on meeting daily and weekly nutritional goals
• Convenient because no special foods are required
• Works well for vegetarians and people who require gluten- or
allergen-free foods
• Promotes general healthy eating
*Academy of Nutrition and Dietetics Complete Food & Nutrition Guide.
# Effects of comprehensive lifestyle modification on blood pressure control: main results of the PREMIER clinical trial. JAMA. 2003;289:2083-2093
6 months on the DASH diet plus counseling results in significantly
lower levels of hypertension in addition to weight loss#

22. Intermittent fasting has been gaining popularity
• An obese person has 8 hours of unrestricted eating followed by 16
hours of water fasting for 12 weeks
• Results in mild calorie restriction
• May help with weight loss and blood pressure
• Although it's not for every patient, this type of diet may appeal to
some
Nutr Healthy Aging. 2018;4:345-353.

23. 4. CHOOSE FATS WISELY

24. Spend your fat calories wisely
• Substitute with healthier fats to reduce the intake of saturated
and trans fats
• When cooking, liquid oils can be used instead of solid fats
• Oils also add key nutrients, such as vitamin E
• Another healthy substitution involves swapping out whole-milk
products with low-fat or fat-free milk, cheese, or yogurt
Academy of Nutrition and Dietetics Complete Food & Nutrition Guide.

25. 5. EAT PLENTY OF FIBER

26. Dietary fiber is the best known prebiotic
• Prebiotics balance the composition and activity of the gut flora to
benefit health
• Consumption of dietary fiber improves cardiovascular health and
lower body weight
• Fiber laxatives can help with issues of gastrointestinal motility
• Fiber is found in fruits, vegetables, legumes, nuts, and whole and
fiber-enriched grains
Nutrients. 2013;5:1417-1435

27. Diet experts have focused on shifting
patient perceptions regarding food

28. Instead of drastic changes, gradual
changes should be made