clinical nutrition assessment dr niikee schoendorfer uq medical school [email protected]
TRANSCRIPT
Clinical NutritionAssessmentDr Niikee SchoendorferUQ Medical [email protected]
Session objectives
1. Understand the role that nutrition and lifestyle play in the development of chronic disease
2. Provide an assessment of patients diet and lifestyle
3. Gain practical skills in the provision of basic nutritional and lifestyle advice
4. Identify useful adjunct patient information resources
What Causes Chronic Disease?
Many chronic diseases are preventable
Adopt healthy behaviours –
controlling body weight
eating nutritious foods
avoiding tobacco use
increasing physical activity
Source: Australian Institute of Health and Welfare (AIHW) 2002. Chronic diseases and associated risk factors in Australia, 2001. Canberra: AIHW.
(a) rheumatoid arthritis(b) osteoarthritis
Chronic conditions
Contributing Factors Tobacco smoking
Physical inactivity
Risky alcohol consumption
Poor diet
Obesity Hypertension High blood fats
Heart disease
Stroke
Diabetes II Kidney disease
Arthritis (a) (b) (b) Osteoporosis Lung cancer
Colorectal cancer COPD
Asthma Depression Oral health
What Causes Chronic Disease?
Source(s): Australian Health Survey: Updated Results, 2011-12Health Statistics in
Australia
Source(s): Australian Health Survey: Updated Results, 2011-12Health Statistics in
Australia
Source(s): Australian Health Survey: Updated Results, 2011-12Health Statistics in
Australia
Source(s): Australian Health Survey: Updated Results, 2011-12Health Statistics in
Australia
Source(s): Australian Health Survey: Updated Results, 2011-12Health Statistics in
Australia
Source(s): Australian Health Survey: Updated Results, 2011-12Health Statistics in
Australia
Source(s): Australian Health Survey: Updated Results, 2011-12Health Statistics in
Australia
Source(s): Australian Health Survey: Updated Results, 2011-12Health Statistics in
Australia
Source(s): Australian Health Survey: Updated Results, 2011-12Health Statistics in
Australia
Source(s): Australian Health Survey: Updated Results, 2011-12Health Statistics in
Australia
Source(s): Australian Health Survey: Updated Results, 2011-12Health Statistics in
Australia
Source(s): Australian Health Survey: Updated Results, 2011-12Health Statistics in
Australia
Source(s): Australian Health Survey: Updated Results, 2011-12Health Statistics in
Australia
Source(s): Australian Health Survey: Updated Results, 2011-12Health Statistics in
Australia
Public Health Campaigns
Cardiovascular Disease/ Diabetes RiskTotal Waist Measurement Waist : Hip Ratio
Additional Weight Loss MeasuresCircumferences –
- thigh- bicep- bust
Taking Measurements
Australian Dietary Guidelines
Recommendations: Fruits and vegetables – variety of colours both
cooked and raw, also include legumes, nuts and
seeds
Cereals – preferably wholegrain
Meat, seafood and alternatives
Milk, Yoghurts and Cheese – reduced fat varieties
Drinking plenty of water
Australian Dietary Guidelines
and take care to: Limit saturated fat and moderate total fat intake
Choose foods low in salt
Limit your alcohol intake if you choose to drink
Consume only moderate amounts of sugars and
foods containing added sugars.
Australian guide to health eating https://www.eatforhealth.gov.au/guidelines
How does your diet measure up?
Taken from the Australian Dietary Guidelines Summaryhttp://www.eatforhealth.gov.au/sites/default/files/files/the_guidelines/n55a_australian_dietary_guidelines_summary_131014.pdf
Recommended Food Servings
Recommended Food Servings
Recommended Food Servings
Recommended Food Servings
Recommended Food Servings
Portion Distortion
38
Creeping portion distortion
Are you aware of how much food
portion sizes have increased in 20
years?
Are you aware of how much food
portion sizes have increased in 20
years?
Slides marked by are adapted from “Portion Distortion” by the National Heart, Lung and Blood Institute Obesity Education Initiative at
http://www.nhlbi.nih.gov/health/public/heart/obesity/wecan/portion/index.htm
BURGER
20 Years Ago Today
333 calories How many calories are in today’s burger?
Calorie Difference: 257 calories
590 calories
BURGER
20 Years Ago Today
333 calories
Maintaining a Healthy Weight is a Balancing Act
How long will you have to lift weights in order to burn the extra 257 calories?*
*Based on a 60kg person
1 hour and 30 minutes
Calories In = Calories Out
FRENCH FRIES 20 Years
AgoToday
210 Calories How many calories are intoday’s portion of fries?
610 Calories
Calorie Difference: 400 Calories
FRENCH FRIES
20 Years Ago
Today
210 Calories
How long will you have to walk leisurely in order to burn those extra 400 calories?*
*Based on 72kg person
1 hour and 10 minutes
Calories In = Calories Out
85 Calories 250mL
How many calories are in today’s portion?
SOFT DRINK20 Years Ago
Today
Calorie Difference: 165 Calories
250 Calories 600mL
85 Calories 250mL
SOFT DRINK20 Years
AgoToday
How long will you have to work in the garden to burn those extra calories?*
*Based on 72kg person
35 minutes
Calories In = Calories Out
320 calories How many calories are in today’s sandwich?
SANDWICH20 Years Ago
Today
Calorie Difference: 500 calories
820 calories 320 calories
SANDWICH20 Years Ago
Today
How long will you have to ride a bike in order to burn those extra calories?*
*Based on A 72kg person
1 hour and 25 minutes
Calories In = Calories Out
COFFEE
20 Years AgoCoffee (with whole milk and sugar)
TodayMocha Coffee(with steamed whole milk and mocha syrup)
45 calories How many calories are in today's coffee?
COFFEE
20 Years Ago Today
45 calories 350 calories
Calorie Difference: 305 calories
How long will you have to walk in order to burn those extra 305 calories?*
*Based on 60kg person
1 hour and 20 minutes
Calories In = Calories Out
59
Larger portions add up100 extra
calories per day
4.5kg weight gain
per year
Maintaining a healthy weight is a balancing actMaintaining a healthy weight is a balancing act
MUFFIN
20 Years Ago Today
210 calories How many calories are in today’s muffin?
20 Years Ago Today
Calorie Difference: 290 calories
500 calories
MUFFIN
210 calories
How long will you have to vacuum in order to burn those extra 290 calories?* *Based on a 60kg
person
1 hour and 30 minutes
Calories In = Calories Out
CHOCOLATE CHIP COOKIE
20 Years Ago Today
55 calories How many calories are in today’s large cookie?
CHOCOLATE CHIP COOKIE
20 Years Ago Today
55 calories
275 calories
Calorie Difference: 220 calories
How long will you have to wash the car to burn those extra 220 calories?*
*Based on 60kg person
1 hour and 15 minutes
Calories In = Calories Out
SPAGHETTI AND MEATBALLS
20 Years Ago
Today
500 calories1 cup spaghetti with sauce and 3 small meatballs
How many calories do you think are in today's portion of spaghetti and meatballs?
Calorie Difference: 525 calories
1,025 calories 2 cups of pasta with sauce and 3 large meatballs
20 Years Ago
Today
500 calories1 cup spaghetti with sauce and 3 small meatballs
SPAGHETTI AND MEATBALLS
70
Which portion would you choose?
71
You can save 300 calories by choosing the 1 cup portion.
72
Why not fill up on vegetables??!!?
73
Useful web resources Activity calorie comparison http://www.8700.com.au/balance-and-
burn/kj-activity-comparison/
Public Health Resources http://www.eatforhealth.gov.au/Nutrient Reference Values http://www.nrv.gov.au/ Drug and Supplement Information http://
www.nlm.nih.gov/medlineplus/druginformation.html