s a practicing clinical and sports nutritionist for 20 years, I am experiencing a substantial increase of patients from varied backgrounds seeking nutritional counseling. Individuals with a very basic nutritional understanding are coming in as a result of side effects from prescribed medications or abnormal lab results from a recent blood test and are being told by their doctor to change their eating habits. Usually, they are handed a generic diet sheet and require more guidance.
A significant segment of our practice consists of professionals, athletes and perfectionists, who are working harder than ever to achieve success and are turning to food for stress reduction, comfort or reward. Due to “long hours” and obsessive-compulsive behavior (OCD) they are searching for the “optimal” diet. Often their personal relationships or business affairs are in disarray, so they turn to food and /or exercise for control.
Both types of patients are highly motivated to learn what to eat and are spending close to $800 to $1,000 out of their pockets (credit cards) for nutritional counseling. Do not let these patients slip by in your practice by not having screening tools such as surveys and a program that addresses how to eat whole healthy foods that are adaptable for each patient’s background, food preferences, and lifestyle based on their metabolic, nutritional and medical needs. By providing a program that focuses on food, you can offer a less expensive counseling program that is 50% the cost for most commercialized programs that are not medically supervised.
The American Psychological Association found that more than half of America's population actually eats a lot more whenever they are feeling stressed. Most comfort foods are high caloric items like Grandmother’s apple pie, which most people remember eating during happy times. Hershey’s and Cadbury’s sales are up and, according to the industry experts, candy store sales are at a record high. Clients report “sugar is comforting” because there is a small temporary increase in serotonin and dopamine which are relaxing neurotransmitters. McDonald's and Burger King report their sales are up. In my practice, the average stress eater gains approximately 20-30 pounds and many are being told by their doctors they need counseling for high blood sugar or pre-diabetes.
Research conducted at California State University shows that, when stress levels are increased, so does one’s craving for carbohydrate rich food. Cortisol increases insulin and insulin resistance, which is associated with metabolic syndrome and pre-diabetes. In a stressful situation, the body does not stop producing cortisol and that is when a person starts to crave carbohydrate dense food in order to replenish their energy. A recession is a long term event and people are under stress for days, weeks and even months at a time. As a result, many individuals turn to counting calories, and can become obsessed with food and are generally always hungry, regardless of whether or not they have eaten.
Here are some guidelines for fine tuning or introducing nutrition counseling for your practice:
• Consider using surveys and questionnaires to screen your patients to find out which patients are interested in nutritional counseling, especially if implementing a new service within your practice.
• Have the patient commit contractually & economically to a series of 4-12 nutritional visits in which they focus on different specific topics weekly. Provide an economic incentive for patients to add more nutritional sessions if necessary.
• Utilize diagnostic equipment to measure lean body mass and metabolic rate to more accurately determine the type and amount of food to provide a patient. Carbohydrate, fat and protein percentages should be a sliding scale—the more lean body mass, the higher the metabolic rate and activity level, the higher the carbohydrate intake. ACCURATE BODY COMPOSITION IS IMPERATIVE.
• Provide specific written out goals & shopping lists (with name brands) each week that focus on different foods and behaviors, i.e. breakfasts, snacks, proteins, carbohydrates, healthy desserts, salad dressings, stress reduction, exercise, etc.
• Try not to give out generalized food lists that omit specific foods. Concentrate on the solution, not the problem to eating—this provides a more positive uplifting experience.
• Concentrate on managing blood sugars and preventing or reversing disease with the correct food combinations rather than calorie counting or food weighing.
• Give specific examples of meals and snacks that have a low glycemic load and that focus on higher lean protein contents with more fiber. Provide salty, crunchy sweet examples and volumetric foods that fill patients’ bellies up with a low caloric density. Review restaurant eating.
• Provide a program for your patients that is 50% the cost of commercialized non-medically supervised programs.
Christopher Fuzy, M.S., R.D., L.D., has a Masters degree in Clinical & Sports Nutrition with offices in Fort Lauderdale and Boca Raton, Florida. He has implemented & trained over 700 physicians nationwide with the Lifestyle Nutrition Counseling Program in the past 19 years. The program incorporates a metabolic analyzer & software to provide customized nutrition and exercise programs. For more information or a practice consultation, visit www.PhysicianWellnessProgram.com or call 1-800-699-8106.