pas are in a unique position to be leaders in nutrition management on behalf of their patients. for example, we can say things like ‘many people struggle with skipping meals or snacking frequently – is that something we can work on?’ a discussion of lifestyle intervention can help to remove some of the burden of blame and help patients understand we are on their team.” smith generally starts with open-ended questions about a patient’s meals during a typical day. and that helps me gauge where they are in their nutritional education and any efforts they’ve tried to augment their nutrition. i start off with open-ended questions and that helps direct our conversation.” following the initial conversation, pas may recommend that patients complete a dietary recall for 24 or more hours. the dietary recall is most helpful when it reflects a typical day and is not adjusted to make the diet seem healthy.
tell patients to be honest and that they won’t be judged for their choices.” beyond asking patients about skipping meals and snacking during the open-ended questions, smith also discusses protein intake. i want to be sure my patients are avoiding this relative malnutrition where they’re cutting back too much and missing key nutrients.” smith suggests that setting expectations for follow-up appointments is important to help patients succeed. the pilot study from abbott followed patients who remained on their typical or real-life diet and were asked to replace their usual breakfast and one afternoon or nighttime snack with diabetes-specific nutrition shakes. the study found that the use of diabetes-specific nutrition shakes to replace breakfast and as an afternoon or evening snack improves glycemic response. create a free account to read more stories, or become a member for more access to exclusive benefits!
whether the focus is to lose weight, treat an eating disorder or improve a chronic medical condition, nutritional counseling offers an ongoing process to help enhance an individual’s health and wellness. the first step to successful nutrition counseling should be information gathering. make sure to ask your client about his medical and nutritional history and inquire about his current eating patterns. if that is not feasible, obtain a 24-hour diet recall at the time of the session to get a sense of what foods the patient is normally eating. and “tell me about your past dieting experience.” molly kellogg — a psychotherapist, nutritionist, life coach and author of “counseling tips for nutrition therapists: practice workbook” — says that instead of trying to guess your client’s meaning during counseling, it is important to reflect first.
to kellogg, reflection means listening carefully for what sounds important and then reflecting it back in your own words. for example, try to highlight important statements using phrases. for example, if you tell a diabetic patient that one serving of rice is 1/2 cup, you can help the patient visualize this by measuring out 1/2 cup of rice in front of her. it’s important for your client to feel like he is in a safe space during your counseling session. the patient should be able to provide information about diet and nutrition habits — both good and bad — without fear of judgment or being ridiculed. a better strategy is to listen with a neutral ear and help the client explore her thoughts around food and eating. jones has worked as a clinical dietitian at kings county hospital in brooklyn and as a senior nutritionist for the nyc department of health.
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