practical lifestyle advice for people with the metabolic ... · © 2017 universitair ziekenhuis...

© 2017 Universitair Ziekenhuis Gent

Practical lifestyle advice for people with the metabolic syndrome

focus on dietary advice

Heyens IsabelleDiëtiste, Centrum voor gezonde voeding en diëtiek

24 oktober 2017

22© 2017 Universitair Ziekenhuis Gent

33© 2017 Universitair Ziekenhuis Gent

Practical lifestyle advice for people with the metabolic syndrome

Let me introduce you to…

Which diet?

Moderate calorie restriction

Change in dietary composition

Moderate increase in physical activity

44© 2017 Universitair Ziekenhuis Gent

Let me introduce you to…

Marleen- age: 52 years old- profession: secretary- Antropometry: L = 1m65, W = 89,3 kg, BMI = 32,8- Dietary history: jojo-effect between 90 kg and 78 kg.- Medical problems: IR and hypercholesterolemia

- Patient request:- “Can you help me? Increasing health problems (physical and

mentally). What kind of diet?

55© 2017 Universitair Ziekenhuis Gent

66© 2017 Universitair Ziekenhuis Gent

WHICH DIET?

IDF (International Diabetes Federation) recommends thatprimary management is a healthy lifestyle!:

Moderate calorie restriction → to achieve a 5 – 10% loss of body weight in the first yearModerate increase in physical activityChange in dietary composition

Secundairy intervention:When life style change is not enough + high risk CVD

→ drug therapy (treating psysician)

77© 2017 Universitair Ziekenhuis Gent

Moderate calorie restriction

88© 2017 Universitair Ziekenhuis Gent

Moderate calorie restriction

Calculate energy requirement

Nutrition historyDietary history (anamnese)Eating diary (awareness → eating behavior)

Negative energy balance → -500 kcal/day

View labels together with your patiënt

99© 2017 Universitair Ziekenhuis Gent

1010© 2017 Universitair Ziekenhuis Gent

1111© 2017 Universitair Ziekenhuis Gent

Change in dietary composition

19/09/2017: new Flemish Food Triangle – FlemishInstitute of Healthy Life

Based on scientific research:impact of food on healthImpact of food on sustainability / planetAverage food intake of the Flemish people (what we eat toomuch and what we eat too less) (https://fcs.wiv-isp.be)

1212© 2017 Universitair Ziekenhuis Gent

1313© 2017 Universitair Ziekenhuis Gent

Bleu zone = waterDark green zone = plant-based foods with a positive effect on health:

Vegetables, fruit, whole grains, legumes, nuts, seeds, plant oils and other fats rich in unsaturated fatsTry to eat the low or unprocessed version as much as possible

Light green zone = foods mainly from animal origin with a positive, neutral or insufficiently proven effect on health:

Fish, poultry, cheese, eggs, milk, yoghurt or soy-based dairy alternativesPreference for low or unprocessed choice

Orange zone = foods from animal or plant-based origin which can have an unfavourable effect on health when consumed in high amounts:

Red meat, butter, coconut oil, palm oil and other fats rich in saturated fatThese foods can contain some useful nutrients eg. fatsolube vitamins, iron,…

Red zone is set apart from the triangle = highly processed foods with high amounts of sugar, fat and/or salt and which have clear unfavourable effects on health consume these rarely and in small portions.

1414© 2017 Universitair Ziekenhuis Gent

Extra attention for:Insulin resistance:

30 En% proteins (max. 1,5 gr protein/kg normal weight)35 En% fat 35 En% carbohydrates (less “fast” sugars, many “complex” sugars) min 30 gr fibres

Hypertension:Use salt in moderation and replace it with iodized salt.Max 5 gr salt/dagAttention for added salt in meats, in ready meals, ….

1515© 2017 Universitair Ziekenhuis Gent

Extra attention for:

Hypertriglyceride and low HDL-cholesterol / high LDL:Use good fats, such as unsaturated fatty acids (olive oil), omega-6 (sunflower oil and soya oil) and omega-3 (canola oil, nut oil and soya oil and fatty fish).Quantity!If hypertriglyceride -> reduce “fast” sugars and alcohol (= calories!) and increase omega 3

1616© 2017 Universitair Ziekenhuis Gent

Example off a low glycemic index meal

Use always hydrocarbonates, proteins and lipids together with fibres.

Fruit breakfast - smoothies

1717© 2017 Universitair Ziekenhuis Gent

Moderate increase physical activity

1818© 2017 Universitair Ziekenhuis Gent

1919© 2017 Universitair Ziekenhuis Gent

Moderate increase physical activity

Sedentary behavior:Sit down at schoolSit down at workSitting in the carWorking before a display (TV, gaming, smartphone, …)Reading a book…

ADVICE : stand up every 30 minutes! (a mix of sitting, standing up and moving is the best for young and old)

2020© 2017 Universitair Ziekenhuis Gent

Moderate increase physical activity

Light intensity of physical activity:Making a call standingSlowly walking, go shoppingYogaLight housekeeping…

breathing and talking is normal, heartrate stays normal

ADVICE : every day! Minimum 30’

2121© 2017 Universitair Ziekenhuis Gent

Moderate increase physical activity

Moderate intensity of physical activity:Cycling to school and workGardeningCleaning windowsTake a staircase…

Breathing is faster but you can talk normal, heartrate goes up

ADVICE: daily

2222© 2017 Universitair Ziekenhuis Gent

Moderate increase physical activity

High intensity of physical activity:JoggingTake a staircase with heavy groceriesSwimming…

Patient is sweating, breathing is faster, high heartrate, …

ADVICE: min 1x/week

2323© 2017 Universitair Ziekenhuis Gent

Questions?