Macronutrient
nutrients which provide energy, carbohydrate, protein, fat
Micronutrient
includes macro minerals, organic
acids, trace minerals, and
... [Show More] vitamins
Food plans/patterns
ways of grouping types of food in consistent pattern - Mediterranean diet pattern, DASH plan, ATP III Dietary guidelines, vegetarianism (including vegan)
Nutraceutical
nutrients consumed not within food via supplementation
Functional foods
foods that have had nutrients not normally found or in high quantity added to the food
What study showed the progressive relationship between saturated fat (SF) intake and CVD death was observed
The Seven Centuries Study
Academy of Nutrition and Dietetics has long recommended the emphasis on what?
Total diet and overall food patterns, this keeps foods from being demonized and encourage greater variety, higher nutrients, and increases compliance
External influences on food choices include
cultural context, historical experience, belief systems, food supply, and socioeconomic status.
Internal influences include both
physiological and emotional responses to food. Taste and preference have genetic and environmental origins.
Food choices include
Pattern, Nutrient and Volume
are limited checklists of foods and beverages with a frequency response section for patients to report how often each item was consumed over a specified period of time
Food Frequency Questionnaires (FFQ)
Which tools yield a precise analysis of nutrient content?
diet histories, diet records, and 24-hour recalls
Disadvantages: time intensive, need trained professional
Name examples of tools that measure consistency with a diet plan/pattern that is to be taught or prescribed. These tools are helpful or evaluating diet quality as well as behavior change, compliance, or nutrition education.
MEDAS, MedDietScore, DASH Adherence Score19
Name the advantages of self-administered food frequency questionaires and/or screeners
both brief and extended, may be evaluated by a variety of health care personnel.
Evidence based nutrition recommendations for CVD: fruits and vegetables
-Epidemiological studies indicate an inverse
association between plant-based foods and CVD
-Evidence suggests that the
benefit of fruits and vegetables may be due to:
• Micronutrients, fiber and phytochemicals
• Potentially enhanced bioavailability in food form
• Replacement of less healthy diet components23
______________ are complex
group of secondary plant metabolites. ___________
rich food consumption may offer a protective effect
on CVD and is associated with a reduction of CVD in
humans and animals.
Polyphenols
True or False
Supplementation of Vitamins C and E, Beta-carotene
and Co-enzyme Q-10 demonstrates decreased risk of CVD events.
False
NIH State of Science Conference on Vitamin and Mineral
Supplementation and chronic disease prevention
concluded there is not enough evidence for or
against supplementation of antioxidants
What did the Nurses' Health Study26 find concerning
nut consumption and CHD events.
Women who ate greater than 50 nuts per week had significantly lower risk than non-consumers.
Name the components of nuts thought to be beneficial in reduction of CVD risk:
monounsaturated and polyunsaturated fatty acids, high in arginine and low in lysine, fiber, tocopherols, folic acid, magnesium, copper, flavonoids, and plant sterols.
Nurses' Health Study, Women's Health Study, Cardiac Risk Development in Young Adults Study, N Hanes Survey, and N Hanes follow-up all found what about fiber?
the highest intakes of total or soluble fiber were associated with reduced risk of CHD and CVA.27 The Nurses' Health Study specifically found an inverse relationship between fiber intake and fatal and nonfatal cardiac events.
How does alcohol prolong blood clot formation?
Alcohol beneficially prolongs blood clot formation by lowering levels of fibrinogen and protein type plasminogen activator.
People who drink alcohol at a rate of 1-2 drinks a week have approximately have _____ lower relative risk of CVD death
1-2 drinks approximately have 35% lower relative risk for
persons who consumed various endpoints including
CVN mortality, CVD, fatal and non-fatal MI, and
CHD.28 But in a Danish cohort, consumption of a
larger amount of alcohol (3-5 drinks/day) increased
CVD mortality by 35%.
What types of foods should be avoided (protein):
Processed Meats
When specific types of meat were examined, processed meats were associated with higher CVD risk, even when SFA content was controlled. Meats (processed and unprocessed)
were associated with higher CVD risk than when
these foods replaced low fat dairy, nuts, and fish
What types of foods should be avoided (grains):
Refined Carbohydrates
Sugar may increase blood pressure and weight gain, both risk factors for heart disease, or it may raise bad cholesterol and triglycerides and lower good cholesterol. Sugar may also increase insulin resistance, a factor in diabetes, or increase fat accumulation in the liver
What types of food should be avoided (fats):
The Dietary Guidelines for Americans 2010 and the
Institute of Medicine recommend that individuals
keep trans fatty acid consumption as low as
possible.
Natural Trans Fats (nTFA)
found in small amounts in the fatty parts of meat and dairy products.
Artifical Trans Fats (rTFA)
comes from foods that contain partially hydrogenated oil and is formed when hydrogen is added to liquid oil turning it into solid fat. Food manufacturers use rTFA in food products because it is inexpensive and it increases the food's shelf life, stability, and texture
Polyunsaturated fatty acids (PuFa N-3 and N-6)
There is an inverse relationship observed in patients
who consumed N-3 PUFA in foods: a 30−45%
reduction in fatal myocardial infarctions.
The data also suggest that
higher intakes appear to be safe and may be even
more beneficial (as part of a low-saturated-fat,
low-cholesterol diet)
What trial sought to compare Mediterranean diet and low fat diet in relation to major cardiac events.
The PREDIMED trial sought to compare Mediterranean diet and low fat diet in relation to major cardiac events. The "low fat" diet in reality was not low fat (approximately 30% calories from fat)although participants were advised to consume low fat foods. When the consumed diets were compared, the addition of plant sterols to the olive oil and nuts demonstrated the most significant reduction CV events.
Dietary Approaches to Stop Hypertension (DASH) diet plan
have been proposed and studied; the most recent versions have decreased carbohydrates to 40% of total calories and increased poly- and monounsaturated fats or protein. The recommended plan has very low levels of sodium content.
The China Study
demonstrated a correlation between plant-based diet and less incidence of heart disease (and cancer)
Vegetarians exhibited a ____ reduction
in ischemic heart disease mortality
Vegetarians exhibited a 25% reduction in ischemic heart disease mortality
Japanese diet (specifically soy, seaweed, vegetable,
fruit and green tea, and some fish) was shown to be
associated with decreased risk of CVD mortality.43
Okinawan diets include root vegetables, leafy greens,
seaweed, and herbaceous plants. Okinawans also
experienced some of the lowest rates of CVD in the
world
Evidence Based Nutrition Recommendations for Dyslipidemia
...
True or False
The types of fats consumed appear to be far more relevant for CVD risk reduction than the proportion of calories consumed from fat.
True
True or False
High levels of LDL circulating in the blood are susceptible to lipid peroxidation that results in oxidized LDL being scavenged by microphages lining certain arteries particularly around the heart leading to atherosclerosis
True
The reduction of _____ cholesterol caused by a decrease in SFA appears to be specific to larger more buoyant particles. These particles contain a greater proportion of cholesterol.
LDL
Reducing saturated fat lowers both LDL-C and HDL-C; but the
absolute effect tends to be greater for LDL-C than HDL.
The length of the carbon chain in saturated fats may be related to toxicity.
Medium chain SFA increase total serum cholesterol primarily through an increase in LDL. Shorter chains SFA have been found to have important antiviral and antimicrobial and immune
response functions. Medium or long chain fatty acids have different effects: stearic acid has been shown to have a neutral effect on LDL, but palmitate has the more harmful influence on increasing LDL and may enhance thrombogenesis when substituted for stearate
________ are shown to increase
serum levels of LDL, apoprotein(a), and lower HDL.
This type of fat has the strongest adverse relationship
with CVD risk factors and their consumption should
be as close to zero as possible
Trans Fats
________ are dietary triglycerides that contain fatty
acids with two or more double bonds. The most
common are alpha-linolenic (ALA), an
omega-3 fatty acid, and linoleic (LA), an omega-6
fatty acid, (3 or 6 refers to the placement of the
double bond on the fatty acids chain). They are not
synthesized by humans and thus are considered
essential dietary nutrients.
Polyunsaturated Fatty Acids (PUFA)
Eicosanoids
Eicosanoids are a group of hormones intimately
involved in the body's inflammatory and homeostatic
processes, which include the prostaglandins,
leukotrienes, and thromboxanes, among others.
Omega-6 and omega-3 eighteen-carbon
polyunsaturated fatty acids compete for the same
metabolic enzymes, thus the omega-6:omega-3 ratio
of ingested fatty acids has significant influence on
the ratio and rate of production of eicosanoids.
True or False
Humans have a limited ability when
the diet includes the shorter-chain omega-3 fatty
acid to make the longer-chain fatty acids from ALA
and this may be impaired in aging.
True
EPA (inversely)
and ARA (directly) affect inflammation modulation,
platelet aggregation, cell growth and proliferation,
smooth muscle contraction and vasoconstriction
(n-6) and vasodialative (n-3) effects.
The cardiovascular effect of raising total PUFA consumed has been studied extensively due to its beneficial effect upon lowering
lowering LDL and total cholesterol (TC). Omega 6 (n-6) PUFA may reduce inflammation and is associated with lower LDL (yet larger), lower VLDL (size and number), and higher HDL (size and number)
Oleic acid
MUFA -Oleic acid (medium chain
length) is one of the most abundant fatty acids and
is found in high amounts in olive oil and canola oils,
but is also present in modest amounts (20-30%) in
beef fat, palm oil, soybean, and corn oil
Which as a better improvement in lipid profile PUFAs or MUFAs?
When MUFAs replace SFA they
demonstrate a positive influence on the lipid profile
and possible improvement in insulin resistance, but
PUFAs had a greater benefit
Cholesterol
is an organic molecule found in cell membranes and serves as a precursor to biosynthesis of some hormones and Vitamin D.
True or False
85% percent of cholesterol is found in foods.
False
Eighty-five percent of circulating cholesterol is
endogenous and 15% from food.
Does saturated fat consumed with cholesterol potentiate effects on lipids?
True
Saturated fat when consumed with cholesterol may
potentiate its effect on TC and LDL and thus should
be controlled when reviewing studies regarding
cholesterol and diet. The AHA/ACC
recommendations state there is insufficient evidence
that lowering dietary cholesterol reduces LDL-C.
Would lowering dietary cholesterol reduce your LDLs?
The AHA/ACC
recommendations state there is insufficient evidence
that lowering dietary cholesterol reduces LDL-C.
Name the four forms of carbohydrates:
Carbohydrates are hydrates of carbon and are found
in four forms: mono-, di-, oglio- and
polysaccharides.
Simple CHO
Simple CHO refers to mono and disaccharides that are easily absorbed in the GI tract (does not require digestion). Foods are neither exclusively simple nor complex, but a combination of both.
Complex Carbs
Complex CHO refers to oglio and polysaccharides; it does not refer to fiber content. Foods are neither exclusively simple nor complex, but a combination of both.
Glycemic load
refers to the serum glucose-raising capability of an isolated food item.
What increases when you consume greater than 65% of your calories as carbohydrates?
Higher intakes (> 65% of calories consumed) of CHO
lead to increases in plasma triglycerides (TG) and
reductions in HDL.
Consuming whole grains improves
the glucose/insulin homeostasis and endothelial function, and reduces inflammation.
The benefit with replacing SFA with CHO is ______ than that of PUFA
less
Name examples of soluble fiber
glycan, psyllium gums, and pectin
Soluble fiber _______ LDL.
lowers
What combines with fluids and forms a gel which can increase elimination of bile acids stimulating hepatic conversion of cholesterol to new bile acids, increasing hepatic uptake of LDL and reduction serum LDL. Consumption of whole grain oats lowers LDL without lowering HDL.
Soluble Fiber
Phytosterols
chemically related and structurally similar to cholesterol. They are found to decrease TC and LDL by reducing dietary and biliary cholesterol absorption by being preferentially selected.
Plant sterols lower _____.
lowering TG
What is often added to foods such as milk, margarine, orange juice, olive oil,
cheese, snacks and breads to help lower TG? These foods are examples of . . .
Plant Sterols, Functional foods
What kind of wine should you drink for health benefits
The drier the wine (less sugar),
the less likely it is to raise TG.
A moderate consumption (< 30 mg/day =
approximately 2 drinks) increases HDL but also
raises TG.75 Red wine can have cardioprotective
effects by providing polyphenol (resveratrol) and
reducing LDL, further boosting HDL and inhibition of
clotting mechanisms.
True or False
Studies have conclusively shown no
benefit on lipoprotein profile with supplemental
vitamins. Current evidence is insufficient to
recommend for or against supplement use.
True
What stuff does fish contain that is "good"?
Fish contains high quality protein, unsaturated fats,
and long chain omega 3 (EPA and DHA) fatty acids.
Name types of fatty fish that have highest amounts of omega 3:
Fatty fish (generally ocean fish) such as
anchovies, sardines, trout, white tuna, farmed and
wild salmon
Name the four main benefits of fish:
Fish intake is associated with lower TG, and may
reduce inflammation, improve endothelial function,
and limit platelet aggregation
Should you eat Tilapia? Are all fish equal in nutrients?
Tilapia, an
inexpensive frequently consumed mild fish, contains
a prevalence of long chain omega-6 fatty acids,
which act as a precursor to ARA and may be
proinflammatory.
Name the three things that eating nuts helps lower:
nut consumption reduces TC, LDL, and
apolipoprotein.
Name the kind of nut that is high in LA and are also a source of plant stanols?
walnuts
Name three reasons why fruits and vegetables are beneficial to your health:
Evidence suggests their benefit may be due to:
• Micronutrients, fiber, and phytochemicals
• Potentially enhanced bioavailability in food form
• Replacement of less healthy diet component23
What are the following omega fatty acids: ALA and LA
common PUFAs are alpha-linolenic (ALA), an
omega-3 fatty acid, and linoleic (LA), an omega-6
fatty acid,
What's bad in red meat?
SATURATED FAT and possibly L-carnitine as the agent for
increased CV risk via its influence on artery clogging
HOWEVER L-carnitine supplementation has been shown to be
beneficially associated with 27% reduction in
all-cause mortality
Is white meat better?
"white" has modestly lower cholesterol
than beef and is variable in its saturated fat content
Name the benefits and componenets of low-fat dairy:
Low-fat dairy foods contain calcium, high quality
protein, linoleic acid, vitamins, and other nutrients.
As a component of diet patterns it has been
associated with lower lipids and improved
endothelial function.
Name some diet plans/patterns that have been shown to help CVD
DASH, Mediterranean, vegetarianism, myPlate
The AHA/ACC Lifestyle recommends (strong evidence to
support) a diet plan which emphasizes vegetables,
fruits, whole grains, low fat dairy products, poultry,
fish, legumes, non-tropical vegetable oils, and nuts
and which limits sweets, sugar-sweetened
beverages, and red meat.
Does the DASH plan include alcohol in modest amounts and low fat dairy?
True
Which eating plan is generally higher in total fat (moderate at 32-35% of total calories) and higher in MUFA (due to emphasis of olive oil
Mediterranean Diet
Which plan was also shown to be beneficial in populations, including men, women, African American and non-African American, hypertensive and non-hypertensive. Evidence: strong
DASH
Explain the obesity paradox
The observed paradox is the contradiction that
obese patients have lower mortality than normal
weight individuals. Hypotheses for this unexpected
observation are debated but possible explanations
include visceral fat accumulation in normal weight
individuals causing an increased risk of CVD due to
increasing insulin resistance
Evidence based nutrition recommendations for obesity: name caloric intake for weight loss in men
1500−1800 calorie diet plans for men
Evidence based nutrition recommendations for obesity: name caloric intake for weight loss in women
1200−1500 calorie diet plans for women
How many calories should be reduced per day?
Prescribe 500 kcal/day or 750 kcal/day energy deficit
This deficit is tolerated best by a combination of increased energy expenditure and reduced energy intake.
If fat content is lowered what will be the different outcomes of increasing carbs or increasing protein
If fat content is low (< 20% of total calories), the
macronutrient component selected as a fat
replacement will yield different outcomes. Replacing
fat with simple, high glycemic foods has been shown
to be related to weight gain. Intake of high fiber
carbohydrates was inversely related to body
weight.
Replacing fat with protein or raising the
proportion of protein has not shown consistent effect
on CVD risk likely due to variation in self-selection of
protein from animal or plant sources and simple
versus complex CHO.
hypocaloric target
hypocaloric (500-750 calorie reduction and not more) eating plans
When using portion control and DASH eating plan what is the recommended percent of weight loss to achieve in 6 months?
attain 3-5% weight loss in 6 months
Based on the JNC 7 report, a weight loss of as little
as _____ reduces blood pressure and/or
prevents hypertension in a large proportion of
overweight persons
10 lbs
Name three vitamin and mineral deficiencies that have been implicated in hypertension:
Insufficient intakes of potassium, calcium and
magnesium below DRI have been implicated in
hypertension
What does acute caffeine use do to BP?
raises it, chronic affects have not been studied
How much alcohol intake may reduce BP by 2-3 mmHG? What happens if you drink a lot more?
Alcohol intakes less than or equal to 2 drinks a day
for men and one drink per day for women may
reduce BP by 2-4 mmHg. Patients who consume
chronic high intakes of alcohol may increase the risk
for higher BP one and a half to two times.
What does Diabetes make CVD worse?
The presence of diabetes compounds the risk of
CVD due to insulin resistance and elevated
triglycerides leading to an increase in LDL.
What helps diabetics stay maintain appropriate CHO intake?
Monitoring CHO, whether
by CHO counting, choices, or experience-based
estimation remains a key strategy in achieving
glycemic control.
Protein and diabetic patients:
Protein increases insulin response and has no effect
on blood glucose levels. Therefore protein is an
important component of every meal and should not
be used to treat hypoglycemia.For individuals
without diabetic kidney disease, higher protein
eating patterns (30% of calories) may or may not
improve A1C; however, they appear to improve one
or more CVD risk measures.
High fat diets and A1C:
High
fat diets were positively related to HbA1C and when
the fat was reduced, HbA1C declined. In patients
who take insulin, meals that are high in fat may
require more insulin than low fat meals
Recommendations for weight loss for patients with CVD and diabetes
Weight management (loss of 5-10% of initial body
weight if BMI > 30), increased activity level and diet
plans which support CHO control are essential and
can delay or prevent further disease
progression
Heart Failure (HF)
is characterized by impaired
cardiac output. Acute or chronic heart injury leads to
cardiac remodeling in an effort to sustain blood to
the body. Heart compensates for the loss of cardiac
output by increasing force and rate of contraction
stimulating angiotensin system and sodium and fluid
retention aggravating status
General recommendations for dietary salt and water for HF patients
recommendations are less
than 2000-3000 mg sodium consumed in a day in
conjunction with less than 2 liters of fluid consumed
What's strange that's going on in HF patients and dietary salt?
The AHA/ACC guidelines
recommend further studies evaluating the effects of
sodium restriction on the neurochemical activation
and outcomes in patients optimally treated in heart
failure.
Some studies are showing more salt (2400) is better.
2013 AHA/ACC Guidelines for Heart
Failure suggest a Class II recommendation:
restriction is reasonable for patients with
symptomatic heart failure to reduce congestive
symptoms (Level of evidence C).
Specifically ≤ 1500 mg sodium for Stage A or B
and consideration for less strict (< 3000 mg/day) for
stage C and D for symptom improvement
Dietary sodium recommendations for cardiac rehab patients:
Regardless of the uncertainty attached to specific
amounts of sodium to recommend, a diet high
(> 3500 mg) is to be avoided and thus foods of
very high sodium content are to be avoided. In order
to personalize sodium guidance, the CRP and
dietitian should consider family history, body size,
renal function, comorbidities, and symptomatic
status. Because of unintentional negative
nutritional consequences that may occur with a very
low sodium restriction and the risk of malnutrition in
the heart failure patient, the CRP and RD should
consider the whole diet while educating the
patient.
ACC/AHA Guidelines for HF cite fluid restriction
ACC/AHA Guidelines for HF cite fluid restriction as
being reasonable in Stage D HF: 1.5L to 2L/day.
If the CR patient at any of stage of HF has a fluid
restriction and sweats profusely during exercise
session, the CRP should ask the physician if an
increase in fluid allowance is appropriate.
What should you do to avoid symptomatic hypotension in exercising CR participants?
Weighing
the patient pre and post-exercise and using the
factor 2c H2O/pound of weight lost during the
exercise session may be helpful information for the
physician in order to avoid symptomatic
hypotension.
True or False
Weight loss is not prioritized in the
2013 ACC/AHA Guidelines for HF
Concern that intentional weight
loss may mask cardiac cachexia and subsequent
worse outcomes, weight loss is not prioritized in the
2013 ACC/AHA Guidelines for HF
Recommendations by the patient's physician would
best guide the CRP regarding the benefit of weight
loss in each individual patient
Eating plans for HF patients:
DASH diet or low
sodium Mediterranean diet have been shown to
have beneficial outcomes in HF.
Transtheoretical Model (TTM):
was originally
proposed by Prochaska in 1982. Assessment of
patient readiness for change is a helpful tool for the
CRP to assess how much information, guidance,
and feedback the CR participant is "ready" for. Its
use demonstrates respect for the patient, which
creates a better learning environment.
Environmental reevaluation
Component of TTM, involves having
individuals reflect on how their eating behavior
affects the environment, especially the social environment.
What component of TTM is this an example of?
Example: a father post-MI
recognizes that to provide for his children he
needs to decrease his risk for mortality by setting
a goal of a 100# weight loss.
Environmental Reevaluation
Self-reevaluation
Component of TTM, involves having individuals
reflect on their self-image as it relates to the
target behavior.
What component of TTM is this an example of?
Example: Helping an obese man
with type 2 diabetes see that he can be a positive
role model for his obese wife if he reduces his
dietary fat intake and increases his activity level.
Self-reevaluation
Social liberation
involves increased societal
changes or opportunities that help promote the
healthier behavior.
What component of TTM is this an example of?
Example: inclusion of nutrient
content information on restaurant menus.
Social liberation
Self-liberation
involves making a choice and
commitment to change a behavior.
What component of TTM is this an example of?
Examples: Making a New Year's resolution or
telling a spouse about a decision to keep food
records.
Self-liberation
Stimulus control
involves changing the
environment to promote the healthier behavior
and/or avoid the undesirable behavior.
What component of TTM is this an example of?
Example:
serving the meal from the kitchen and quickly
refrigerating leftovers, or removing ice cream from
the freezer to reduce cues to eat.
Stimulus control
Counterconditioning
involves learning new,
healthier substitutes for the undesirable behavior
What component of TTM is this an example of?
Example: learning to purchase and substitute
healthy snacks for low nutrient dense snacks.
Counterconditioning
helping relationships
involves getting and using
support to help with positive behavior change.
What component of TTM is this an example of?
Example: participation in diabetes, weight-loss, or
heart failure support groups. In addition, well
coaches can be valuable support people in the
change process.
helping relationships
Reinforcement management
involves using
rewards, both tangible and intangible, for positive
changes. Rewards do not need to cost money,
but have meaning for the patient.
What component of TTM is this?
Example:
paying self for each CR session or pound lost,
accumulating the money for new exercise
outfit.
Reinforcement management
Decisional balance
The patient weighs pros and
cons of change and rating its value to
themselves.
What example of TTM is this?
Example: the CRP offers to the
patient a Likert scale evaluating the likelihood of
performing a certain behavior
Decisional balance
Self-Efficacy
Patient confidence that they can
cope in high-risk situations without relapse or
failure.
Example: The CRP offers a selection of
behavioral tools and the patient selects which
one has been successful and together they
decide how to employ in future.
Self-Efficacy
Temptations
urge the patient to
engage in a specific behavior in difficult
situations. Common types of temptation include
emotional distress, social situations and craving.
TTM component Example: CRP teaches the patient urge surfing or
distraction behaviors
Temptations
Name the stage of change:
not intending to change to
the goal level of a behavior in the foreseeable
future; "I plan to eat out every day from now on"
Precontemplation
Name the stage of change:
intending to change to the goal
level in the foreseeable future (next 6 months), but
not the immediate future (next 30 days): "I really
should eat at home more often, but I travel so
much. Maybe I will after my travel season ends."
Contemplation
Name the stage of change:
intending to change to the goal
behavior in the immediate future and taking behavioral steps in the direction of change; "My
wife and I talked about how we should eat at
home more often: we are going to pre-prepare
meals on weekends together."
Preparation
Name the stage of change:
has made a change to the goal level of
the behavior in the recent past (6 months); "That
wasn't that hard, we have been eating at home
usually 3 nights a week for ages."
action
Name the stage of change:
been at the goal level of the
behavior for 6 months or longer. "Eating at home
is now preferable to us rather than eating out."
Maintenance
True or False
TTM ultilizes the stages of change to determine interventions for cardiac rehab participants
True
Name the theory that builds on the interaction
between personal factors and the environment
suggesting that both influence each other leading to
reciprocal causation in relation to eating behavior.
Social Cognitive theory
Eating behavior is thought to be a function of
modeling or observed learning (environmental). The
CRP or dietitian could use tools such as food
demonstration, grocery tours, healthy food potlucks,
and role-playing to model healthy eating behavior.
Name the theory that is the based on
the premise that reinforcement (positive or negative
and environmental contingencies) is highly effective
in influencing behavior, but must remain in effect
long-term for the behavior to be sustained.
Social Determination theory (SDt)
What theory is often used with motivational interviewing?
Social Determination Theory
What theory includes the following four regulators for the continuum of
extrinsic motivation: External Regulation, Introjected
Regulation, Identified Regulation, and Integrated Regulation
Social Determination Theory
Name the behvaiors that staff should use to promote diet change:
education, goals, self-monitoring, group support, problem solving, well coaching, motivational interviewing, mindful eating, intuitive eating
Define SMART Goal Setting:
Specific: exactly what does the patient intend
to do, eg, I will eat a single portion of cereal in
the morning.
Measureable: how will the patient know if the goal
has been met, eg, documentation on food
record.
Achievable: assess the ability of patient to
achieve the outcome. Requires patient agreement
and CRP may use Likert scale as tool to assess.
Relevant: does the goal align to primary diet
objective?
Time-bound: when will the patient implement?
When will success be evaluated?
What is a is a collaborative
person-centered form of guiding to elicit and
strengthen motivation for change that includes: Understand and explore the patient's own
motivations using patient perceptions, avoid the righting reflex, listen and empower patient
Motivational Inteviewing
What eating practice is this?
-Eat mindfully and consciously be aware of each
bite I take
-Pace not Race: eat slowly with intention
-Eat Less, nourish more: consume high-nutrient,
lower-calorie dense foods.
-Calm without calories: find true comfort and
soothing without food
-When i eat: eat without distraction
Mindful Eating
Inincludes the prescription that no
foods are "bad" and instead patients are encouraged
to eat foods that appeal whenever hunger is
perceived
tuitive Eating
incorporates tools and principles
from the Transtheoretical Model, Motivational
Interviewing, and Mindfulness.
Well-Coaching [Show Less]