Diet counseling - Definition, Skills for a dietitian, steps in diet counselling

1. DIET
COUNSELLING
G.SARANYA
DIETITIAN

2. DEFINITION
Diet counselling is a process by a health professional trained in nutrition,
make people to choose healthy food choices by that making them to follow
healthy eating habits.
Healthy Eating Habits helps to
 Recover from disease conditions
 Prevent diseases
 Weight Loss
 Weight Gain

3. SKILLS
 BE EMPHATHETIC – Thinking from Patient’s point of view and
helping them to recover from disease condition
 BE PATIENCE – Treat patients with lot of tolerance.
 KNOWLEDGE – Keep updating in the subject is very important.
 BUILD TRUST AND RAPPORT – Patient should believe without
any doubts whatever suggested. Bringing closeness is also should be
there
 COMMUNICATION – Effective communication is required. It
includes both verbal and non- verbal communication.

4. SKILLS
 Verbal Communication includes
 Confirm which language is comfortable for patient
 Use clear language
 Tone of voice should not be too low or too loud.
 Non – verbal communication – It includes sitting and standing posture,
body gestures, facial expression and eye contact.
 PROBING OR QUESTIONING : questions are asked to get more
information. In Diet counselling the questions should be
 Asked with cautions
 Don’t ask too many small questions
 Always ask open questions than closed questions

5. SKILLS
 ACTIVE LISTENING : Active listening is important in counselling. When
a person involved both physically and mentally in a conversation is called
active listening. It helps to avoid distraction and can get all information
required.
 SUMMARIZING : summarizing means accurately reflecting back to the
client, to understand what was discussed in the counselling process. Making
a short note on entire conversation.

6. STEPS INVOLVED IN
DIET COUNSELLING
 EVALUVATION
 SUGGESTION
 MODIFICATION
 FOLLOW UP

7. EVALUVATION
 Evaluation is done to know the nutritional status, disease condition and
eating pattern about the patient using nutrition assessment sheet.
 Nutrition assessment sheet consists of personal history, medical history,
life style, sleep pattern, stress management, food frequency and 24 hrs.
recall.
 All the questions asked in nutrition assessment sheet asked for reasons.
 24 hours recall must be filled along with timing of the meal, food items
and quantity.

8. SUGGESTION
 Suggestion is the main part of the counselling. In this going to
suggest what are all the changes going to make in their eating
pattern
 Always start suggestion with appreciation. Ex : Appreciating
their good habits like drinking proper amount of water.
 Tell the changes in a positive way and with proper reason for
changing that habit.
 Never stop any habit immediately. Gradually reduce the quantity
and stop.

9. MODIFICATION
 Modification is planning of menu
 The menu plan should consist of 2 columns
 1st column – Meal name with Timings
 2nd column – Food items with quantity
 All the quantity must be mentioned in grams, ml, numbers
 Menu plan should be precise and options need to be given

10. FOLLOW UP
 Follow up is done 15 days or 1 month after prescribed the diet.
 Follow up is done to know the progression of the patient’s health
 During follow up we must ask How much they followed the diet,
what are the difficulties they had when following the menu plan and
how far they are doing in recovery state.
 Counselling to be done and menu plan to be altered according to
patient’s requirement.

11. BMI – BODY MASS INDEX
 BMI is a measurement of fat using height and weight values applicable
only for the adults.
 BMI = Weight (in kgs) / Height (in m2)
CLASSIFICATIONS VALUES
UNDERWEIGHT <18.5
NORMAL 18.5 – 24.9
OVER WEIGHT 25 .0- 29.9
OBESE 1 30.0- 34.9
OBESE 2 35.0- 39.9
OBESE 3 > 40

12. BASAL METABOLIC RATE
 Basal metabolic rate is the minimum calorie requirement for an
individual to do normal day- today activities for 24 hours when
resting.
 There are certain equations are there to calculate BMR.
 HARRIS –BENEDICT EQUATION has been used to calculate
from1900.
 After 1990’s MIFFLIN- ST.JEOR has done research on this and
come up with new formula. Called MIFFLIN-ST.JEOR
EQUATION

13. BASAL METABOLIC RATE
HARRIS – BENEDICT EQUATION
 FOR MEN = 66.47 + (13.75 * weight [kg]) + (5.003 * height [cm]) − (6.755
* age [years])
 FOR WOMEN =655.1 + (9.563 * weight [kg]) + (1.85 * height [cm]) −
(4.676 * age [years])

14. BASAL METABOLIC RATE
MIFFLIN-ST.JEOR EQUATION
 FOR MEN = (10 × weight in kg) + (6.25 × height in cm) - (5 × age in years) +
5
 FOR WOMEN = (10 × weight in kg) + (6.25 × height in cm) - (5 × age in
years) - 161