Page 196 - Nutrition Counseling and Education Skills: A Guide for Professionals

across the life span.1,2 It has been reported that adults make more than 225 diet-related decisions each day.3
As medical research and technology increase the longevity of our population, new emphasis on the quality of
life is emerging. Public awareness of the role of nutrition in preventive health is increasing. Nutrition
professionals have a wide array of opportunities to disseminate accurate information and deliver innovative
educational strategies to accomplish key goals such as maintaining a healthy body weight through the life
span.4 The purpose of this chapter is to discuss key counseling strategies that are most effective by individual
life span groups, by family groupings, and within the context of chronic diet-related diseases.

Prenatal and Pregnant Women

Nutrition education should ideally begin in the prenatal phase of child-bearing years when women are at risk
or when they are planning to become pregnant. This is an excellent opportunity to assess current food habits
and align to healthy intake goals. This also provides a sound nutrition beginning for the earliest weeks of
gestation when women typically have not confirmed their pregnancy. Women often do not have access to a
nutrition professional at this point. Innovative ways to reach this audience might include partnering with
gynecologists, primary care providers, physician assistants, or nurse practitioners to offer coordinated
preventive health conversations. Community outreach to educate existing mothers prior to their next
pregnancy is also another potential way to reach this audience.

Life span counseling continues with pregnancy. The quality of the diet of the pregnant mother has been
clearly linked to better outcomes for both mother and fetus.5 Long-term effects of nutrient deficits during
gestation are also well known. Nutrition education should focus on the pattern of weight gain and selection of
foods to meet fetal growth goals. Nutrition counseling addressed to these issues can also reduce the incidence
of excessive weight gain during pregnancy that may evolve into gestational diabetes.

Group classes for expectant mothers are common but often are only implemented in later trimesters.
Involvement of husbands and partners in individual and group counseling can help create a healthy
environment setting that can be sustained after the baby is born. Postpartum activity to return to
prepregnancy weight is an important counseling strategy to reduce risk of obesity.6

CASE ANALYSIS 1

Sarah comes to your office for nutrition counseling. She admits she was not very aware of her diet during
her other pregnancies and wants to be more informed during this pregnancy. What are some key nutrition
education and counseling strategies you may want to incorporate in your first session?

Infants up to 2 Years of Age

Parents or caregivers are the primary decision makers in the feeding of infants during the first year of life.
Full-term infants may only require minor adaptations to their food intake to achieve nutrition goals such as
changing from a milk-based to a soy-based formula. Preterm infants may require extensive stepwise
interventions to address both growth and food tolerance issues.7 For example, the feeding may need to be
adapted for nutrient density when the feeding volume is changed. Breast-feeding or commercial infant

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