Page 109 - Nutrition Counseling and Education Skills: A Guide for Professionals

specific goals. Nutrition counselors can assist individuals in establishing goals and action plans. Because clients
are responsible for their own care, the nutrition interventions should be based on what the client is willing to
change. This involves clients in their own health care and has them take an active part in their self-care and
treatment.

In diabetes, for example, managing the disease is a daily event. Client-defined behavioral goals are effective
in supporting self-management behaviors. Self-management and self-care goals and action plans for diabetes
or prediabetes management, for example, may lead to improvements in diet, physical exercise, and self-
efficacy.10–12

Before problems are explored and goals are set, it is advisable to discuss with the client, show approval for,
and reinforce those current food choices that do not need changing, that is, what the individual is already
doing right according to the Nutrition Assessment. After problems are identified, talk should turn to possible
solutions.3 Foods that should be limited and foods, or cooking practices, that should be changed may be
discussed next, perhaps starting with what the client is willing to consider.

Goals should be mutually negotiated based on the Nutrition Intervention and desired clinical outcomes. In
the case of normal nutrition, the Dietary Guidelines for Americans (DGA), which uses science-based advice
to promote health and reduce the risk of disease, is appropriate. The DGA provides recommendations for the
prevention of disease and for people who are at increased risk of a chronic disease, as seen in Box 5-1.13,14
After conditions and circumstances surrounding food behaviors are explored, clients need to find solutions to
their problems and develop goals and plans of action with the help of the counselor.

By law, every 5 years an advisory committee of recognized experts in the fields of nutrition and health
review scientific and medical knowledge in providing recommendations for updating the Guidelines. They
provide evidence-based nutrition and physical activity strategies for health promotion and disease
prevention.14

Nutrition counseling should be directed not solely at the client’s knowledge, but also at feelings, attitudes,
beliefs, and values, which have strong and powerful influences on dietary behaviors. Knowledge is a tool only
if and when a person is ready to change and is motivated to change. The counselor may ask any of the
following types of questions:

For example
“Is this the right time to make changes?”

• Follow a healthy eating pattern across the life span.
• Focus on variety, nutrient density, and amount across all food groups.
• Limit calories from added sugars and saturated fats, and reduce sodium intake.
• Shift to healthier food and beverage choices within all food groups.
• Support healthy eating patterns for all: at home, school, and work.
• Meet physical guidelines for Americans.

Key Recommendations A Healthy Eating Pattern Includes:

• A variety of vegetables—dark green, red, and orange, legumes (beans/peas), starchy, and others.

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