Assessing & Measuring Healthy Eating for PTs

You’re chomping at the bit to be able to support your clients with their eating so they can truly get the best from their awesome effort! And, you should be encouraged to do so. The question is how to work with a client’s diet without putting yourself, or your clients, at risk? You’re not trying to portray yourself as a nutritionist, but you know the benefits of healthful eating and activity together. Yes, lots of PTs are out there telling clients what to eat, giving them diets and potentially working outside of their scope, and some potentially outside of their PT training.
                                 
So where’s the middle ground? What can you say and how can you work with nutrition? We’ve been chatting with our friends over at PT Academy about how we can better serve our PTs with CEC-approved nutrition knowledge to use with clients. And, we have just the thing.

We have an option that can enable you to safely, and effectively, support your clients total wellbeing, including working on their eating.

We've taken a number of grabs from our Fitness Australia approved (7 CECs) Food Groups & Dietary Diversity; Assessing and measuring healthy eating online course to give you a quick insight into how you can work with a client’s eating, to assess patterns and choices, collaboratively create meal plans and offer improved options all of which are far more likely to yield real, long lasting change, especially when combined with their workout programs.

Collaborate and support, rather than give nutrition advice

Telling people what to eat often does little to help them foster healthy eating habits, nor is it recommended unless you have qualifications that enable you to prescribe, diagnose or treat. We know that giving people answers robs them of the opportunity to be the masters of their own lives.
 
We get asked regularly ‘so how can I tell a client what to eat? They ask me all the time’. Simple answer... don’t 'tell' them, work with them to come up with their own solutions. Encourage them through artful questioning to discover this for themselves.

Try asking clients
‘where do you think you can improve on your diet’? ‘
What sorts of things do you eat at the moment that you feel you could swap for better choices’?
'Let's create a list of ideas for you to chose from'

Your client is learning, leading, and solving their own challenges,
they are the ‘captains of their own fate'! 

And, you are not prescribing them a diet.

Can't I give them nutrition information?

Don't get me wrong, you can still offer information and knowledge about nutrition.

For example, you could say things along the lines of ...

“studies have shown us that not all saturated fats are bad, and often if we improve the quality of our food this takes care of things and you don't need to worry about what foods have what fats and in what quantities”. You can also use your knowledge to offer up choices. ‘Have you considered X, Y  and Z? How would you feel about starting with one of these?”

Win:win!!! I can hear a few of you saying 'ok I kind of get it now', you are essentially Food coaching for wellbeing and healthy eating to support clients in making their own informed decisions about theirlifestyle choices.

What is a 'good diet'?

First let's consider quickly what  a ‘good diet’ actually is. There are a whole load of funky theories on this, and just as many books. At Cadence Institute of Nutrition & Health Coaching we are big believers in not overlooking the simple, and often powerful things in life.

So, we’ve boiled ‘a good diet’ down to the following:

1. Variety - so simple, but this course spends time getting you to dig much deeper into this, simple yet VERY effective in creating healthful eating habits. The importance of making sure a diet includes a wide variety of healthy food can’t be overstated. 
2. Quality - another simple yet powerful factor in a good diet. The better the quality of our food the more likely we are to gain nutritional sufficiency and vitality from our diet, and the less we will be challenged by compounds that may do us harm.
3. Quantity - Eating in line with natural cues of hunger and fullness and less by emotion and want. A bit of nutrition psychology comes in here.
4. Individuality - Any meal plan a client creates with your guidance will need to account for their individual factors, yes finances, activity, location, family, stress etc. 

We can use these basic premises to safely work with clients on their eating. It's a bit like building a house, the foundation a house is built on will ultimately affect it now and into the future.

“The food you eat can be the safest,

most powerful medicine

or the slowest form of poison.” Ann Wigmore

Techniques to measure dietary quality

There are a number of ways we can measure a meal for its healthfulness (though this is never going to be an exact science given what is considered ‘healthy’ seems to change regularly). For example, we can assess it for its nutritiousness, energy, variety and diversity, food group coverage and healthy eating rating. For PTs variety, diversity and healthfuness offer you enormous scope and clients huge benefits; you'll cover all of this and more in the Food Groups & Dietary Diversity course.

Let’s check out some examples of these.

Let’s get to some nitty gritty!

1. Dietary diversity (DD)

Dietary diversity (DD) assesses an diet based on the diversity of food groups consumed during a given period.  DD’s are nice and easy to apply, they can be as simple as having clients ticking off each food group so it’s been ‘covered’ at some point during the day, right through to drilling down into what level has been consumed in comparison to current recommendations for health.
 
Now we’re not talking about the standard food groups, a DD uses a more detailed list of food groups, some use up to 22, right from cereals, tubers, green leafy veg, fruit, flesh meat, eggs, fish, legumes, oils, sweets, condiments and more. Arrr, yes now your eyes are lighting up, you can see where the scale might be in this!

DD is explain and demonstrated with tools and templates in detail in the course, so you can quickly apply with your clients.
 

Have a go!
 
Check out the diet summary below
 
Breakfast – Two poached eggs on white toast; a coffee with milk, no sugar
Snack – 200g strawberry natural yoghurt; water
Lunch – Turkey, avocado and potato salad
Snack – Plane scone and butter
Dinner – Lamb chops, beans, mashed potato; white wine
 

Even without knowing the exact DD tool to apply
can you potentially see any food groups missing?


What ideas might you discuss with the client in order to
help them move towards a more healthful diet?
 

2. Healthy eating indices

Awesome tools for anyone keen to check a diet or meal. The one we use in the course is completely free and online. You can use with clients to review their diets as well as provide client's with charts, nutrient reports, and graphics to help them make great choices and changes. All within scope. You'll be zinging along with clients eating in no time.

3. Dietary variety assessments

The reality is most often people when they go grocery shopping tend to go down the same aisles, filling trollies with fairly much the same food week after week. You will have seen many repetitious diet diaries, which of course we know isn’t the ideal eating pattern.   There are so many simple yet effective tools to support clients in assessing their dietary variety, many of them are interactive and fun, so they engage the client in their process of change. You'll be provided with  a bunch of useful tools and templates in the course materials.
 

4. Simple colour checker

Sounds like such a simple concept! How many clients come to you with yellow diets (chips, sausages, pasta, bread etc)? The variation of colour in a diet can reflect the biological compounds that it contains and its diversity. In the berry family, strawberries differ from raspberries. Similarly, kale differs from broccoli, wheat differs from oats and so on. Visual checks like this can provide very clear feedback to clients about where they are consuming, what needs changing and how far they have come.
 

Have another look!
 
Check out the diet summary below
 
Breakfast – Two poached eggs on white toast; a coffee with milk, no sugar
Snack – 200g strawberry natural yoghurt; water
Lunch – Turkey, avocado and potato salad
Snack – Plane scone and butter
Dinner – Lamb chops, beans, mashed potato; white wine
 

What's the variety like?
What is the colour richness like?
Is there an overriding colour theme?
Along with DD is there scope for improvement?

Like they say ‘a picture paints a thousand words’.

Balancing your view

We understand that there's considerable, and ongoing controversy, over food pyramids and the like. However, using groupings of foods can be a useful tool for clients to assess their meal quality. Nutrition knowledge is ever changing, and just as our diet must be dynamic, so must the models and theories we use. Take the best parts and get the best from them! But, ensure you stay up-to-date with what is happening in the field.
 
Assisting a client to self-assess their diet, providing them with relevant knowledge and tools, and collaboratively creating steps forward doesn't have to be overly technical and full of jargon, they can be simple and effective tools that look at the big picture. Your client's will love you for allowing them to be involved, and will be raving about your nutrition support in no time.


If in doubt... refer on!

Remember, if a client needs a specific diet, or their dietary needs require expertise beyond your scope refer on and work collaboratively with your referral network. You can help clients stay on track with dietary regimes they are prescribed, and who knows you may even find that everyone benefits.

Remember, prescribe (that's diets too), diagnosing and treating are in the realm of health care professionals who are suitably qualified, suitably registered and insured.

Work smart, work safe!

Words by Leanne Cooper
Registered Nutritionist and Founder, Cadence Health

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