Many of my colleagues who are in health care, but who are not registered dietitians (R.D.s), often ask me what general advice they can give to their patients that would be safe and healthy. These colleagues realize they cannot provide nutritional counseling because they are not R.D.s; however, they often get general questions about nutrition.
If the patient requires one-on-one counseling, I definitely tell my colleagues to refer their patients to an R.D. However, here are some good sources they (and you) can use to provide general nutrition advice to some of your clients.
U.S. DEPARTMENT OF AGRICULTURE DIETARY GUIDELINES FOR AMERICANS
The United States (U.S.) Department of Health and Human Services and the U.S. Department of Agriculture (USDA) have jointly published the Dietary Guidelines for Americans every 5 years since 1980.These guidelines offer recommendations to healthy Americans, 2 years of age and older, for making food choices that support good health, a healthy body weight, and prevent chronic diseases such as cardiovascular disease, diabetes mellitus, some cancers, and osteoporosis (these diseases have a strong link with poor diets and lack of exercise). Furthermore, the Dietary Guidelines for Americans serve as the basis for the federal food and nutrition education programs (6).
WHAT DO THE 2010 USDA DIETARY GUIDELINES FOR AMERICANS EMPHASIZE?
The Dietary Guidelines for Americans, 2010, were released on January 31, 2011. They highlight three major goals for all Americans. These three major goals are as follows:
- Balance energy intake with physical activity (energy expenditure) to manage body weight.
- Consume more fruits, vegetables, whole grains, fat-free and low-fat dairy products, and seafood.
- Consume fewer foods with sodium, saturated fats, trans fats, cholesterol, added sugars, and refined grains (6).
HOW CAN I INCORPORATE THE 2010 USDA DIETARY GUIDELINES INTO MY WORK?
The beauty of the Dietary Guidelines is that they are made for the public. They are available online. For those of you who are not R.D.s, and thus, cannot provide nutrition counseling, you can at least refer to the Dietary Guidelines for Americans to your clients who ask you nutrition questions. They are based on science and provide general guidelines for the public. If your clients ask you more detailed questions about nutrition or how nutrition relates to a disease they might have, then you need to refer them to an R.D.
THE DIETARY APPROACHES TO STOP HYPERTENSION DIET
Dietary Approaches to Stop Hypertension (DASH) was originally formulated for a large National Institutes of Health‐funded study. The DASH diet had a significant effect on lowering blood pressure in individuals with hypertension in that study. The DASH diet is rich in fruits and vegetables, and low-fat or non-fat dairy, with whole grains. It is a high-fiber, low- to moderate-fat diet high in potassium, calcium, and magnesium. Although the DASH diet was originally planned for individuals with hypertension, it is a healthy eating plan designed for all individuals and provided the foundation for the 2010 USDA Dietary Guidelines for Americans and the USDA MyPyramid. It is endorsed by the American Heart Association (5).
The DASH Diet is a sound program. It is certainly a program that can be generally recommended to your clients, as well. The DASH Diet Web site (5) provides a great deal of information for the health care provider, as well as the client. The (Table provides a guideline for the DASH Diet eating plan.
THE MEDITERRANEAN DIET
The Mediterranean diet is based on the diets of those individuals living in countries bordering the Mediterranean Sea (in particular, Italy, Crete, and Greece). The Mediterranean diet is based on high consumption of fruits, vegetables, legumes; bread, pasta, rice, and other whole grains; nuts, extra virgin olive oil, as well as a greater consumption of fish. Poultry and lean red meat also is part of the diet but to a lesser extent. In addition, cheese and yogurt are included in the diet, as are moderate amounts of wine (2).
It is easy to incorporate the Mediterranean diet into your own life and to discuss it with your clients. There is a Mediterranean Diet Pyramid (Figure) that helps people to better understand this healthy and enjoyable way of eating, as well as the importance of physical activity. One does not need to live near the Mediterranean Sea to eat as those who live there do!
RESEARCH ON THE MEDITERRANEAN DIET
There have been several studies conducted on the benefits of the Mediterranean diet. Andreoli et al. (1) assessed the effects of a moderately low-calorie Mediterranean diet and exercise program on body composition and cardiovascular disease risk factors in obese women. They reported that body weight, fat mass, total cholesterol, and triglyceride levels in the blood all decreased significantly in the obese women placed on this diet. They also reported that high-density lipoprotein cholesterol, the “good” cholesterol in the blood, significantly increased.
More recently, Sofi and colleagues (3) conducted a meta-analysis on the effects of adherence to the Mediterranean diet on health status. They reported that an increase in adherence to the Mediterranean diet was related to a significant decrease in overall mortality, cardiovascular incidence or mortality, cancer incidence or mortality, and neurodegenerative diseases. The authors concluded, “This updated meta-analysis confirms, in a large number of subjects and studies, the significant and consistent protection provided to the Mediterranean diet in relation to the occurrence of major chronic degenerative diseases” (3). This same group of researchers also focused on a meta-analysis evaluating adherence to the Mediterranean diet and Alzheimer’s disease (4). They reported a significant association between adherence to the Mediterranean diet and reduction of risk to Alzheimer’s disease.
We often hear how difficult it is for people to consume healthy diets. Eating a healthy diet can be a lot easier and less daunting than most people realize. Following some of the basic premises of the 2010 Dietary Guidelines for Americans and/or the Mediterranean diet principles can result in major changes in overall health. Discussing these options with your clients can allow you to provide some overall guidance.
Be sure to check out the Wouldn’t You Like to Know column in this issue to learn more about the specific nutritional updates available in the 2010 USDA Dietary Guidelines for Americans.
1. Andreoli A, Lauro S, Di Daniele N, Sorge R, Celi M, Volpe SL. Effect of a moderately hypoenergetic Mediterranean diet and exercise program on body cell mass and cardiovascular risk factors in obese women. Eur J Clin Nutr
. 2008;62(7):892–7. Epub 2007 May 16.
3. Sofi F, Abbate R, Gensini GF, Casini A. Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review and meta-analysis. Am J Clin Nutr.
2010;92(5):1189–96. Epub 2010 Sep 1.
4. Sofi F, Macchi C, Abbate R, Gensini GF, Casini A. Effectiveness of the Mediterranean diet: can it help delay or prevent Alzheimer’s disease? J Alzheimers Dis
5. The DASH Diet Eating Plan [Internet]. 2011 [cited 2011 Apr 29]. Available from: http://dashdiet.org/