Reducing Illnesses through Nutritional Counseling
Nutritional education and counseling involve
educating the client about the importance of healthy living by providing
information that is vital in supporting a healthy eating lifestyle and teaching
people the importance of making a dietary change. The information gathered
during nutrition assessment provides the necessary data on which eating disorders
can be addressed during the instructional and counseling sessions.
Before beginning the counseling process, the person
involved is first assessed on the knowledge he/she has on nutritional and
eating disorders, their readiness to adopt new eating behaviors, learning
barriers which might be encountered during the counseling session that includes
but not limited to language and possible learning barriers.
It is a well-known fact that four out of ten leading
causes of death in the United States – Cancer, stroke, coronary heart disease,
and type 2 diabetes are all associated with poor and disorderly eating
lifestyles which predispose the individuals to an unhealthy diet. More than
half of all deaths recorded in the year 1994 were directly linked to these four
mentioned diseases (Nawaz, 2001). This situation is likely to have been caused
by poor eating habits which led to the development of high cholesterol levels
in the body, high blood pressure, and overweight. These medical conditions are
associated with high medical expenses and premature deaths, thus, it is
essential to guide and counsel individuals on ways and means of avoiding them.
The United States Preventive tasks force recommended
the introduction of intensive dietary counseling for people with lipid disorders
also known as hyperlipidemia together with other risk predisposing factors for
cardiovascular and disorderly eating related chronic diseases. Counseling of
such individuals was to be delivered by specialists such as dieticians and
nutritionists. The taskforce found out that, counseling alone had the capacity
to produce medium to large changes in the summed average daily intake of the
vital components of a healthy diet (Nawaz, 2001).
Controlled clinical trials have been conducted with
the results showing that intensive counseling interventions reduce the risks of
acquiring poor eating related diseases. The trials constituted the combination
of nutritional education with behavioral dietary counseling which was solely
provided by a chosen nutritionist and a dietician. This led to the conclusion that counseling
programs were likely to improve vital health outcomes with its benefits
outweighing their potential harms.
The taskforce recommendation led to the introduction
of dietary guidelines intended to be used by the general population. The
Department of Agriculture and the Department of Health and Human services
adopted the guidelines which were outlined as the nation's objectives and
published in the Health People 2010 journal.
American Heart associations also issued some guidelines which focused on
the diets which reduces the risk of acquiring a heart disease. All dietary
control agencies recommended fruits, vegetables, and grains as the less risk
type and should be taken at a specified amount to reduce risks associated with
disorderly eating.
The relationship between eating habits and healthy
outcomes has been examined in a wide range of studies which entails observing
eating habits of individuals. The majority of the observed studies showed that
people who took diets low in fat content, saturated fat, trans-fatty acid,
vegetables had lower rates of morbidity and deaths from heart diseases and
possibly, many forms of cancer as compared to the control population which
consumed unhealthy diets. As a matter of fact, four out of ten main causes of
death were associated with unhealthy and disorderly eating lifestyle.
Coronary heart disease can be prevented through
dietary counseling. The cardiovascular disease which is mainly caused by the
thickening and hardening of arteries (arteriosclerosis) often leads to angina
pectoris, heart attack or a combination of both and ultimately leading to the
dead of an individual. It is estimated that 1.5 million Americans die each and
every year due to a heart attack. An additional 13.9 million people have got a
history of coronary heart disease, and it is estimated that one person dies
every minute due to the cardiovascular disease. It essential to make the
general public know that arteriosclerosis is particularly vulnerable to
increasing lipid levels in the body. Thus, counseling aids to change the eating
habits which could lead to acquiring the disease.
To reduce the risk of morbidity and mortality from
cardiovascular disease, it is necessary to maintain a healthy diet and to
balance the consumed calories with some physical exercise. A healthy eating
plan should be given by the counselor and should emphasize diet consisting of
fruits, vegetables, whole grains, fish, beans, and eggs. The diet mentioned
above has low-fat content, cholesterol, and serves to balance calorific intake
with the required calorific needs.
The federal publication, Nutrition, and Your Health:
Dietary Guidelines for Americans gives out an important source of healthy
eating advice. They recommend that an individual should consume a wide variety
of nutrient-dense foods while minimizing the intake of saturated fatty foods.
The individual should meet the recommended daily required calories through the
adoption of a balanced eating pattern as this is associated with a considerate
risk reduction of chronic disease mortality and morbidity.
Unhealthy eating habits contribute to many diseases
that impose a heavy financial burden to employers and employees. Productivity
losses due to disorderly eating- associated morbidity from heart diseases,
cancer, and stroke costs $9.3 as of the year 1995. Also, an estimated 39
million working days were being lost each year as a result of obesity-related
illnesses. In a study done by Massachusetts Dietetic Association aimed at analyzing
the effect of counseling on diet-related illnesses, results showed that
counseling of hypercholesterolemia by a registered specialist saved a whopping
$1300 per patient in that given year.
In the year 2004, the cost of preventive medicine
done by a physician in the private sector averaged $39 per session which was
approximated to be 95% of the total paid claims falling between the range of $0
and $130 per session. On the contrary, nutritional counseling by a dietician
was averaged $61 which was approximately 95% of the total paid claims falling
within the range of $0 and $150 per session. Nutritional education helped
limited population acquire the knowledge, attitude, and skills which were
essential to behavioral change necessary for nutritionally healthy living. The
benefits derived from nutritional counseling by far outweighed that of private
sector counseling done by a physician. This is because nutritional counseling
was cost effective and produces a significant return on investment.
Behavioral counseling helps individuals who are at
high risk of heart disease and other diet-related diseases improve their eating
habits which ultimately tends to reduce the risk of the acquiring complications
and outcomes related to obesity, heart disease, and lipid disorders. Behavioral
interventions produce consistent and sustained changes in the dietary
consumption of saturated fats and fibers. Effective interventions of such
diseases should combine educating the people, behavior-oriented counseling, and
a follow-up to ensure that the person sticks with the outlined guidelines.
There are no known possible harms of dietary
counseling. Most researchers have suggested that the focus of reducing the
total fat intake while maintaining the calorific intake could lead to an
increased intake of carbohydrates which in turn could lead to weight gain,
insulin resistance, or an increased triglyceride levels. Little is known about
effective counseling for children and adolescence since most studies, and
nutritional advice in this subset focuses on non-clinical settings.
All decisions made concerning behavioral counseling
should always take into consideration the risk for acquiring the coronary
disease. Some of the effective modes of counseling include individual or group
counseling, which should be delivered by a specialist such as a dietician or a
nutritionist. This kind of interventions should align with the behavioral
counseling framework which stresses the need to assess, advise, agree, assist,
and arranging for a regular follow-up if needed ( Alters, 2003).
The initial assessment and a follow-up monitoring
can be done using brief nutritional assessment questionnaires, which should be
validated for use in any primary setting. These assessment tools should
identify dietary counseling needs, guide interventions, and also should monitor
and evaluate the changes in the patient's eating patterns. Patients in
diet-changing programs are known to exaggerate their adherence to the laid
nutritional guidelines, thus, counselors should not entirely rely on the brief
assessment of the diet (Croll, 2001).
The American Dietetic Association suggests that the
primary the nutritional specialists should check all patients for diet-related
illnesses and, for patients who are found with positive indications of the
disease, a diet prescription is given and at the same time giving the patient
preliminary counseling on the needed diet change. The patient should also be
referred to the relevant professional in the dietetic field where necessary.
There should also be one or two goals during a
counseling session as this would make it reasonable to work towards its
achievement. Setting many goals at one instant reduces the chances that the
patient can meet all the specified goals and may seem overwhelming. Each goal
set should be agreed upon by the counselor and the patient and should accompany
the strategies which need to be employed to achieve the desired goals. Follow
up sessions should be more frequent so as to ensure that feedback and progress
are being monitored (Alters, 2003). Health specialist needs to give careful
thought to the type of nutritional messages given to the patients since many
may perceive that good diets meant eating food that doesn't have a pleasant
taste.
In conclusion, diseases associated with disorderly
eating rank among the leading causes of illnesses and death in the world. The
relationship between some nutritional elements such as saturated fat and
specific healthy outcomes have been researched and well understood. Similarly,
the main role of nutritional specialists in arranging for nutritional
counseling has been largely explored, though controversy still exists
concerning the level of change that can be scored through such counseling
sessions, it is still important in changing the behavioral aspects of eating
behaviors. The change of eating plan through counseling aids in minimizing
occurrences of lifestyle diseases.
References
Nawaz,
H. & Katz, D. (2001). American College of Preventive Medicine policy
statement: weight management counseling of overweight adults.
Croll,
J. & Neumark, D. (2001). Healthy eating: what does it mean to adolescents?
Alters,
S., & Schiff, W. (2003). Applying concepts for healthy living: A
critical-thinking workbook. Sudbury, Mass: Jones and Bartlett Publishers.
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