Nutrition and Diet
- It is projected that 35% of all cancer could be prevented with an improved diet recommended by the National Cancer Institute.
- A low-fat, high-fiber diet is recommended.
- Fat should account for no more than 30% of calories.
- Fiber content should be 20 to 30 g daily.
- Five servings of fruits and vegetables should be included daily, especially those rich in vitamin C and those rich in beta-carotene, such as carrots, sweet potatoes, cantaloupe, broccoli, spinach, and collard greens.
- Six servings of breads, cereals, and legumes should be included daily.
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- Similar guidelines, in addition to calorie restriction and increased energy expenditure, can be used to promote optimal weight, energy, and well-being. More than 60% of American adults are overweight (body-mass index [BMI)] 25 or greater) and 38.8 million American adults meet the criteria for obesity (BMI 30 and greater). Obesity has almost tripled among children in the past 25 years. One of the Healthy People 2010 objectives is to reduce the prevalence of obesity among adults to less than 15%.
- These guidelines- with additional restrictions of substances such as sodium and saturated fat- are also necessary to treat and prevent chronic diseases, such as hypertension, type 2 diabetes mellitus, coronary artery disease (CAD), and hyperlipidemia.
- Educate patients about the five basic food groups and their placement on the food pyramid, optimum weight, calorie requirements, and ways to increase fiber and decrease fat in the diet.
- Total fat content can be reduced by cutting down on red and fatty cuts of meat; bacon and sausage; cooking oils; whole dairy products; eggs; baked goods; cookies and candy; and sauces, soups, and dressings made with cream, eggs, or oil. Also teach patients to save high-fat foods for a special treat, reduce portion size, use fat substitutes, and prepare dishes at home using low-fat recipes.
- Teach patients to add fiber to the diet by choosing whole grain breads and cereals; raw or minimally cooked fruits and vegetables (especially citrus fruits, squash, cabbage, lettuce and other greens, beans); and any nuts, skins, and seeds. Fiber can also be increased by adding several teaspoons of whole bran to meals each day or taking an over-the-counter fiber supplement such as psyllium (Metamucil), as directed.
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- Encourage patients to keep food diaries and review them periodically to determine if other adjustments should be made.
- If weight loss is desired, have the patient weigh in monthly, and review the diet and give praise or constructive criticism at this visit. Many people, especially women, respond to group therapy that focuses on education, support, and expression of feelings related to overeating.
NURSING ALERT
Encourage all patients to follow-up closely with their health care providers if they are following high-fat, restricted carbohydrate diets. Any diet that is unbalanced may require vitamin supplementation and alter biochemical processes such as cholesterol metabolism and fluid balance.
