Page 110 - Nutrition Counseling and Education Skills: A Guide for Professionals

• Fruits—especially whole fruits.
• Grains—at least half of which are whole grains.
• Fat-free or low-fat dairy, including milk, yogurt, cheese, and/or fortified soy beverages.
• A variety of protein foods, including seafood, lean meats and poultry, eggs, legumes (beans/peas); and

nuts, seeds, and soy products.
• Oils

Limitations

• Saturated fats and trans fats, added sugars, and sodium.
• Consume less than 10% of calories per day from saturated fats.
• Consume less than 2,300 mg/day of sodium.
• If alcohol is consumed, it should be consumed in moderation—up to one drink per day for women and

up to two drinks per day for men—and only by adults of drinking age.

Box 5-1 ■ Dietary Guidelines for Americans, 2015 to 2020: Guidelines.

“What was your goal in coming today?
“Which of these alternatives or changes do you think you could try?”
“What would be the easiest?” “The hardest?”
“What foods could you substitute?”
“How will things be better or worse after you make the change?”
“How do you feel about making this change?”
“Do you think you can succeed?”

The client weighs the pros and cons of the options.
The goals we choose determine how we will live. Clients (not the counselor) at the Preparation, Action,

and Maintenance SOC should select one or two priorities or goals for change for the next week or so. An
obesity intervention group, for example, received health information and goal-setting support through group
meetings and newsletters. Results showed participants moving from Contemplation to Action/Maintenance
for the goals of improving diet and physical activity.15

Those who are enthusiastic or unrealistic about making total changes immediately, such as losing 20 lb in a
month, are setting themselves up for frustration and possible failure, which may lead to abandoning the
dietary changes altogether.16 The counselor should guard against this and use other interventions instead.
Slow, steady changes that will persist over time are preferable. Rather than focusing on long-term goals, the
focus should be on achieving short-term behavioral goals of meeting daily food and exercise goals.17

The session with a client needing a meal pattern limited in sodium, for example, may uncover the following
obstacles:

1. Uses salt in cooking and at the table.
2. Snacks include crackers and potato chips.
3. Uses some high-sodium spices and flavorings.
4. Likes bacon, ham, and salami.
5. Eats lunch in a restaurant.
6. Is the only one in the family on a limited sodium diet.

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