Throughout our medical education, we are inundated with a vast array of knowledge—everything from pharmacotherapy mechanisms of action to anatomical structures. However, one aspect that tends to be overlooked in our education is nutrition and diet, especially when it comes to educating patients. While it may be easy to refer patients to online resources, in many instances, it may be more efficient and effective to take the time to educate them ourselves. Taking those extra few minutes during patient visits can go a long way, and these tips are a great starting point for educating patients on how to approach their dietary habits.
Reading the Nutrition Label
When looking at the back of a food product, it’s fairly easy to glance at the calorie count and immediately assess it, but it may not always be that simple. For one, the serving size may be deceiving. The idea of a cookie being 250 calories does not seem farfetched, however, it becomes concerning when the serving size for said cookie is 1/4 of a single cookie! It is important to look at the labels holistically and see what other components make up the product. For example, things that we would want to be relatively high in content would be protein and fiber, whereas things we would want to keep relatively low are sodium and sugar. Having patients keep note of their dietary intake of different nutrients is a great first step in ensuring that they are reaching their daily intake of essential components.
Misleading Labels
When perusing the grocery aisles, the terms “No Sugar Added” and “Low Sodium” can be understandably interpreted as designating healthy options, but that may not always be the case. “No Sugar Added,” simply states that no additional sugar was added to the product during its processing, but that does not include any natural sugars that were already in the product beforehand. Similarly, “Low Sodium” products are defined as having 140 mg of sodium per serving, which may be deceiving depending on the product’s serving size. Understanding that the labels may not be truly reflective in what they are trying to convey, it is always a good idea to take a quick peek at the nutrition label and be more aware of what is going on behind the scenes.
Using Our Hands
When educating patients, we often like to refer to dietary guidelines with exact numerical measurements (i.e., recommended daily sodium intake is 1500 mg). While factual, this can sometimes be very difficult to practically grasp when one is going out to grocery shop or cook. That is why it can be an immensely helpful tool to measure things on the fly whenever and wherever we can, with our hands! For example, the recommended sodium intake of 1500 mg can be quickly equated to 2/3 of a teaspoon. However, as you may not have a spoon on hand, you can estimate this by using the finger pad of your index finger (tip of the finger to the DIP joint) as a rough estimate for 1 teaspoon. Similar measurements can be made with the finger pad of your thumb (= 1 tablespoon), the palm of an open hand (= 3 oz), and 1 cupped hand (= 1/2 cup). These estimated measurements can be a practical tool in the kitchen to help ensure that we are reaching a good balance of our nutrients in our diet.
Instead of Removing, What Are We Missing Instead?
I have always found it difficult to part ways with some of my favorite food items (i.e., grilled cheese sandwiches) when I become more conscious of my diet, and this sentiment is shared by others as well. While the mainstream may recommend shying away from whole food groups (i.e., low-carb diets), this is a lot easier said than done. Instead of focusing on what we can look to take away from our meals, we can look to focus more on what we are missing from our meals to make them more complete. In the case of my grilled cheeses, instead of removing my white bread, I could look to add in slices of tomatoes and lettuce, both of which are an excellent source of fiber, to help keep me satiated. Adding in an egg and turkey slices, which are great sources of protein, not only helps keep me full, but gives me enough energy to continue on throughout my day. Approaching dietary changes in this manner helps acknowledge our own food preferences, while also ensuring that we are making our meals whole and sustainable.
Slow It Down
One of the biggest problems I struggle with is eating too fast, and that can sometimes lead to my eyes eating way more than my stomach can handle—and I leave the dinner table super full. It takes on average 20 minutes for the satiety signals from a meal to reach the brain, which can be troublesome for people who are fast eaters like me and continue to eat more than we can handle. While it may be easy to state that we just need to slow down our eating, there are different subtle approaches to slow everything down to allow for those signals to reach the brain. Drinking water throughout the meal can help break up the eating patterns. Making sure to consciously chew and take in the flavors of each bite. Placing the utensil down in between each bite. Incorporating these types of tips can add that extra bit of time needed for the patient to achieve that feeling of appropriate fullness, but definitely feel free to experiment with whatever works best for you and the patient!
This Is a Marathon, Not a Sprint
While these suggestions may help address dietary habits in patients’ lives, lifestyle changes are not an easy task, especially if there are different socioeconomic barriers that may hinder their progress, like access to quality produce. However, help them understand that taking little steps here and there can go a very long way, and making any progress is still that—progress!
