Role of the Physician: Evaluate, Educate, Motivate, Repeat!
1) a) Evaluate:
Lab findings: Lipid profile, diabetic status, low iron, B12, anemia;
Patient complaints: general malaise/fatigue, genetic risk factors (e.g., for macular degeneration, diabetes, obesity, dementia), health problems not well managed with conventional medicines, interest in a popular diet, weight problems, psoriasis, osteoporosis, acne, athletic performance, request for resources;
Clinical suspicion of suspected poor diet—too much processed food?
Diets are hard to assess. Adequacy of nutrient intakes are very difficult to measure! Many blood tests are inadequate. RDAs are generalized, with fudge factors built in. there remains disagreement as to what ideal population goals should be. These are not n=1 guidelines: Everyone has different needs, different contexts.
Biomarkers: what are they? What are the current recommendations?
Most people think they have a healthy diet… Where to begin?
Look at the individual nutrients first: CHOs, Fats, and Protein, and their quality.
2) Educate: What do we want to get accomplished? What is possible with meaningful change?
There are many worthy pursuits:
11 common-sense tips healthy eating tips to live healthier: See a quick list at:
http://www.washingtonpost.com/national/health-science/fat-chance-11-common-sense-tips-to-eat-live-healthier/2013/01/25/2682dea0-65bb-11e2-9e1b-07db1d2ccd5b_gallery.html#photo=1
3) Motivate:
Initiate a discussion/gauge interest in aging well, optimizing lifestyle choices
If the patient hasn’t initiated the dialogue, the doctor can, with the “Five ‘A’s”.
Dr. Phil asks, “How is it working for you so far?” If the patient is happy with where they are, just leave the door open to further discussions as interest changes.
Kelowna can be seen as a Lifestyle Retreat including – activity and eating
We are omnivores; Eat more vegetables; Eat less preserved foods; Eat less white foods
Plant based diet not exclusive of other foods
International context of a definition of healthy eating – sugar, meat, fat
Historical context- sugar, meat, fat, refinement, modifications
Diet for everyone- N=1 for each diet recommendation
Flexible
You don’t have to be a vegetarian
Don’t have to be put off by simple eating
Not a focus on weight
We recognize that everyone has unique, culturally sensitive dietary needs.
Limit preserved, processed and refined foods
Local is better
Calculate your energy intake
Variety is important
Be aware of what you eat! Knowledge is power
What diet is best for you? How would you find out?
Vegetable based diet has strong benefits
Meat and Fish can fit