Presentation on theme: "Structured Diet Versus Plate Method"— Presentation transcript:
1 Structured Diet Versus Plate Method Pinky Rose Viloria, RND Kristia Lei Reyes, RNDPhilSPEN October 23, 2013
2 Outline Definitions Examples of Structured Diet Examples of Plate MethodsAdvantages of Both MethodsSummaryConclusion
3 Structured DietIs a calculated diet based on the Food Exchange List (FEL) used by DietitiansUsed specifically for meal planning“structured” means:Food list/food groupsNumber of exchanges per groupWith distributions for the Meals and snacks of the day
4 Example of Structured Diet: Diet Prescription: 1500 kcal,Food ExchangesNo. Of ExchangesSample MenuApproximate Size per ServingBreakfastFruitMeat/SubstituteRice/SubstituteMilk (for Coffee)Sugar12Ripe PapayaBaked Ham SausagePan AmerikanoEvaporated MilkWhite Sugar1 slice (10x6x2cm)3 (9cm dia x 0.3cm thick)2 slices2 Tablespoons2 teaspoonsMid-A.M. SnackMeatPan de LimonCottage Cheese1 piece (6x5x4 cm)1/3 cup
6 Plate Method Based on the latest USDA Dietary Guidelines Consists of a 9-inch platePlate is divided like pie chart, divided into portions of important food groupsUses different colors or pictures of foods
7 The Plate Model: A Visual Method of Teaching Meal Planning A simple alternative to the traditional exchange-based method for teaching meal planningserves as a pie chart to show proportions of the plate that should be covered by various food groupsDietitians from Canada, Finland, France, and Sweden have explored methods of teaching meal planning to persons with diabetes and dyslipidaemias in the Diabetes Atherosclerosis Intervention Study. The Plate Model, a method commonly used in Europe, is a simple alternative to the traditional exchange-based method for teaching meal planning. In this visual method, a dinner plate serves as a pie chart to show proportions of the plate that should be covered by various food groups. Portions of foods and appropriate food choices can be depicted for meals and snacks in assorted forms of the model. Methods of presenting the model range from professional photography to hand-drawn sketches and displays of food replicasCamelon, Kathryn et. al. J Am Diet Assoc. 1998; 98:1155–1158.
8 The Plate Method is an Effective Education Tool for Overweight Adolescents Objective: To determine if the Plate Method of nutrition education is an effective approach to teach overweight year-old adolescents (BMI > 95th percentile) in West Virginia to choose healthier foodsResult: subjects have increased servings of fruits, vegetables, and whole grains, while servings of soda/sweetened drinks and high fat/sugar foods have decreased.Conclusion: Using the Plate Method as a nutrition education tool is an effective way to help overweight adolescents make healthier food choices at meal-time(s)The number of overweight adolescents in the United States continues to increase and effective methods of treatment intervention need to be established. The objective of this study was to determine if the Plate Method of nutrition education is an effective approach to teach overweight year-old adolescents (BMI > 95th percentile) in West Virginia to choose healthier foods. Twenty-four adolescents were recruited through schools, physician's offices, and community programs to attend a two-week residential lifestyle-modification camp with three follow-up weekends over the next 12 months. Prior to attending the initial camp session, subjects were asked to complete a three-day diet record. Three-months later subjects were asked to complete a three-day diet record before coming to the first follow-up weekend. While attending the camp session, subjects participated in four, 50 minute nutrition education lessons focusing on the Plate Method and 'Always' food choices vs. 'Sometimes' or 'Sparing' food choices. Twenty-three subjects participated in the two-week camp session and 19 subjects attended the first follow-up session. Diet records prior to camp indicated that on average subjects were not meeting recommendations for servings of fruits, vegetables, milk, or whole grains, but were exceeding recommendations for soda/sweetened drinks and high fat/sugar foods. Diet records at follow-up indicate that on average subjects have increased servings of fruits, vegetables, and whole grains, while servings of soda/sweetened drinks and high fat/sugar foods have decreased. Using the Plate Method as a nutrition education tool is an effective way to help overweight adolescents make healthier food choices at meal-time(s).Schoeppner, Heidi et. al. The Journal of the Federation of American Societies for Experimental Biologies
9 The Healthy Diabetes Plate The Healthy Diabetes Plate, which used the plate format to teach individuals about the type and amount of foods they should consume at each meal (by the University of Idaho)In 2004, the four-lesson curriculum was taught in three urban and five rural countiesParticipants were able to correctly plan breakfast, lunch, and dinner meals and improved their intake of fruit and vegetables.BackgroundDiabetes education presents two major challenges to the U.S. Cooperative Extension System. The first is that the majority of diabetes education services are provided in more populated areas, resulting in large nonurban areas being underserved. The second is that many individuals with diabetes find the meal-planning component of diabetes education confusing.ContextThe University of Idaho, a land-grant institution, includes teaching, research, and extension as part of its mission. Extension means "reaching out," and in Idaho, the Extension Service provides research-based programs on agricultural, natural resources, youth, family, community, and environmental issues in 42 of Idaho's 44 counties, making it accessible to most Idahoans.MethodsThe University of Idaho Extension Service collaborated with dietitians and certified diabetes educators to develop and test materials that simplify the meal-planning component of diabetes education. The result was a four-lesson curriculum, The Healthy Diabetes Plate, which used the plate format to teach individuals about the type and amount of foods they should consume at each meal. In 2004, the four-lesson curriculum was taught in three urban and five rural counties. Surveys, hands-on activities, and note-taking of participants' comments were used to collect data on participants' characteristics, their ability to plan meals, and changes in eating habits.ConsequencesParticipants were able to correctly plan breakfast, lunch, and dinner meals and improved their intake of fruit and vegetables.InterpretationQuantitative and qualitative evaluation information gathered from class participants helped identify which components of The Healthy Diabetes Plate curriculum were effective.Raidl, Martha et. al. Prev Chronic Dis January; 4(1): A12. Published online 2006 December 15. PMCID: PMC
11 Step 1Take an average sized dinner plate and divide it in half. In one half place non-starchy vegetables such as:Spinach, Broccoli, Cauliflower, Romaine lettuce, Cabbage, Carrots, Tomatoes, Onions, Cucumber, Beets, PeppersAbout one cup of raw vegetables is considered an appropriate serving size.One cup would be about the size of your fist.
12 Step 2Divide the other half of your plate in half again. In one quarter place your protein source, such as:3 oz. of lean beef or pork3 oz. of skinless turkey, chicken or fishTofuEggsCottage cheeseA 3 oz. serving is about the size of a deck of cards
13 Step 3In the other quarter of your plate place your starchy foods such as:Bread, Potatoes, Corn, Beans, Rice, Tortilla, Cereals, OatmealServing sizes range from ½ cup of rice to a baked potato about the size of your fist.
18 The Idaho Plate Method works by visualizing how much space each of the major food groups should occupy on one’s plate. At breakfast, one fourth of the plate should have a protein or meat, half of the plate should have a starch, and one-fourth of the plate would be empty. The meal should be completed with a milk, yogurt, or fruit. At lunch and dinner, the plate should show a similar pattern: one fourth of the plate should have a starch, one-fourth should have a protein or a meat source, and half should be filled with low-calorie vegetables (not “starchy” vegetables, such as potatoes, corn, or peas). On the side of the plate there should be either 1 cup of milk or yogurt or a half-cup of pudding or ice cream, as well as one small piece of fruit. Using low calorie seasoning to flavor food, the Plate Method provides approximately 1,200–1,500 calories. This approach is not only easy to use, but also works well when eating outsidethe home, such as in a restaurant or at a family gathering.Idaho Plate
20 UK Eatwell Plate The recommended percentages are: Fruit and vegetables: 33%Bread, rice, potatoes, pasta: 33%Milk and dairy foods: 15%Meat, fish, eggs, beans (protein) :12%Foods and drinks high in fat and/or sugar: 7%The guide recommends that you try to get this balance every day, or over several days or a week. Based on the recommendations you should eat:Lots of fresh fruit and vegetables (at least five portions every day).Lots of whole grain rice, potatoes, cereals, bread, pasta and other starchy foodsSmall amounts milk and dairy foods (low fat varieties preferred)Restricted amounts of fish, meat, eggs, beans and other non-dairy proteinsVery small amounts of foods and drinks that are high in sugar and/or fatTry to choose options that are lower in salt when you can.Conclusion The Eatwell Plate is a much better image as it conveys a simpler message and gives a better indication of proportions.UK Eatwell Plate
29 In addition to the Plate graphic itself, the new icon is accompanied by the following nutritional guidelines that offer more information for healthy eating.Enjoy your food, but eat less.Avoid oversized portions.Make half your plate fruits and vegetables.Make at least half your grains whole grains.Switch to fat-free or low-fat (1%) milk.Compare sodium in foods like soup, bread and frozen meals—and choose the foods with lower numbers.Drink water instead of sugary drinks.
30 Advantages of Structured Diet More accurate calorie countingIncludes all food groups such as fats/oils, sugarTime and meal distribution is indicatedIndicates number of servings or exchanges per food group
31 Advantages of Plate Method Enhancement of the connection between dietary theory and practicePromotion of memory retention and understanding through visual messagesExperience of a positive approach to nutrition counsellingVarious cuisines and festive foods can be incorporated into the modelOffers a meal planning approach that is simple and versatileEasier to understandJ Am Diet Assoc. 1998; 98:1155–1158.
32 Diabetes Plate Method offers many invaluable benefits to the diabetic people: 1. The blood sugar level of a diabetic individual can be managed under the required level every day since carbohydrates are distributed evenly.2. The consumption rate of starches, fat or cholesterol can easily be maintained.3. A diabetic individual will be able to get plenty of fiber, antioxidants, phytochemicals and proteins which forms a healthy diet.4. Another notable benefit is the weight loss without extra effort. As we know, excess body weight minimizes insulin sensitivity.
34 Comparative List of High Nutrient and Low Nutrient Foods High Nutrient FoodLow Nutrient FoodsWhole Grains, Breads, and RiceWhole grains (wheat, oats, barley)Whole grain breads, rolls, bagels, crackers and muffinsWhole grain and high-fiber cerealsWhole grain pastaBrown riceCroissantsFried riceDoughnuts and pastriesSweet rollsCookiesCakesEgg noodles and pasta VegetablesBean Sprouts, broccoli, Brussels sprouts, cabbage, carrots, cauliflower, corn, cucumbers, green beans, leafy vegetables, mushrooms, potatoes, summer and winter squash, tomatoes, sweet potatoes, yams French-fried potatoes, fried vegetablesVegetables packed in sauceFruitsAll fresh fruits, especially apples, oranges, apricots, bananas, berries, cantaloupe, citrus fruits, peaches, pearsCanned or frozen fruits, unsweetened or packed in water or their own juice Canned or frozen fruits, sweetened packed in syrupFruit rollsFruit drinks
35 Proteins and Protein Substitutes High Nutrient FoodLow Nutrient FoodsProteins and Protein SubstitutesEggs, egg whites, egg beaters, fish, chicken, turkey, round or loin beef, round or loin pork, legumes, tofu, lean luncheon meats, nuts & seeds Hot dogs, luncheon meats, sausage, bacon, fried fish, fried poultry, spareribs, prime cuts of meat.Dairy ProductsNonfat, skim, and 1% milkNonfat products such as buttermilk, cottage cheese, and yogurtsSoy milkNonfat ice milks and sherbetsFat Free or low fat cheeses Whole milkWhole milk products such as cheese, cottage cheese, custard, milk shakes, pudding,and ice creamBeveragesWaterHerbal teasNon caloric beverages Sugared soft drinksAlcoholic beveragesCaloric beverages Fats Vegetable oils (olive oil, canola oil, flaxseed oil, safflower oil)Fat free sour cream, cream cheeseNuts and seeds, flaxseedAvocados, olives, dark chocolate Butter, margarine, lardCream cheese, sour creamHigh fat salad dressingsCakes, cookies, high fat desserts
37 Variations among healthy diet plans In Summary…Variations among healthy diet plansMost healthy diets are built on the same general principles, but there are key differences that reflect dietary preferences, food availability and cultural eating patterns.For example, the Latin American Diet Pyramid might mention tortillas and cornmeal, whereas the Asian Diet Pyramid might include noodles and rice.Other differences include:1. Food groupsThe food groups among healthy-diet plans vary in some ways. For example, some versions have plant-based proteins — soybeans, beans and nuts — in a separate group from animal proteins found in meat, poultry, eggs and dairy products. This is because animal proteins are often higher in fat and cholesterol, and some diets limit or exclude animal proteins.2. Serving recommendationsHealthy-eating plans also vary in the recommended servings of each food group. The Mayo Clinic Healthy Weight Pyramid, for example, recommends a daily number of servings from each food group. Other plans offer more-general guidelines, such as eating particular foods at every meal, or on a weekly or monthly basis. Or that the Mediterranean Diet Pyramid recommends that you eat whole grains, vegetables and fruits at every meal.
38 The plate method has been used for diabetes meal planning The plate method has been used for diabetes meal planning. It also works well for weight loss, teaching good nutrition and in improving blood glucose and lipids.BenefitsWeight lossImproved carbohydrate distributionMore nutritionally sound dietIncrease intake of fibersDecrease fat and cholesterol intake
39 Try the Plate method for: People with busy lifestyleSeniorsFeeling overwhelmed because of a recent diagnosis or psychological circumstancesCognitive difficulties / Low literacy levelFor those with difficulties in using a more structured approachType 2 diabetes and needs to loose weight“The Plate Method works particularly well for patients who eat three meals a day, are at a low literacy level, have cognitive difficulties, are elderly, have type 2 diabetes and need to lose weight, or are hospitalized and need “survival” information. It also adapts easily for patients who snack by allowing individuals to move side items to snack time. It does not require math skills or a high reading level.” by Brown MD, Lackey HD, Miller TK, Priest D. Controlling calories — the simple approach. Diabetes Spectr 2001;14(2):110-2.
40 Conclusion:Whatever tool or principle you as a health professional will use, always remember the Basic principles of a healthy diet:That the diet is appropriate to the needs and condition of the individual .Symbols/ tools (computed diets, pyramid & the plate) are educational tools to help us visualize and understand the diet better, these tools illustrate how the pieces of a healthy diet fit together.Definitely, no single food provides all of the nutrients that your body needs, so the idea is to eat a variety of foods from each group in the proper proportions to get all the necessary nutrients and other substances that promote good health.Lastly , a healthy-diet plan/regimen should emphasize the following:Eat more plant foods, including fruits, vegetables and whole grains.Choose lean protein from a variety of sources.Limit sweets and salt.Control portion sizes.Be physically active.The base of the pyramid is typically made up of foods that should be the bulk of your healthy diet. In contrast, foods you should eat in smaller amounts or less frequently are shown in the smaller sections of the pyramid.The same principle applies to the dinner plate — half of the plate consists of fruits and vegetables, which should be the bulk of your diet.
41 Putting the pyramid, the computed diet or the plate — to work for you Know the specific needs of the individuals that needs to be addressed.To see how your eating habits match up to these healthy-diet plans, keep a food diary for several days. Then compare how much of your diet comes from the various groups.To eat healthier, start with gradual changes, such as eating more vegetables, fruits and whole grains, and limiting fats and sweets.Choose a variety of foodsThis ensures that you get all of the calories, protein, vitamins, minerals and fiber you need.Choosing a wide range of foods also helps make your meals and snacks more interesting.Adapt the plan to your preferencesHow to do it?Explore all possibilities!Combine foods any way you like but in the right amountA serving of grains doesn't only mean a slice of bread. It can be wild rice, whole-wheat pasta, grits, bulgur, cornmeal muffins or even popcorn. If you need to avoid milk because of lactose intolerance, try yogurt (lower in lactose) or fortified soy milk instead.
42 SourcesAmerican Dietetic Association. "New MyPlate Is a Useful Tool for Consumers to Follow Dietary Guidelines and Eat Healthfully, Says American Dietetic Association," American Heart Association. "American Heart Association CEO Nancy Brown Says New USDA Food Icon Is A Positive Step Towards Improving Consumer Health," Hellmich, Nanci. "USDA Serves Nutrition Guidelines on 'My Plate'," The Journal of the American Medical Association. "New Nutritional Icon Steps Up to the Plate," Khan, Amina . "USDA to Reshape How We See Dietary Nutrition," Neuman, William. "Nutrition Plate Unveiled, Replacing Food Pyramid," United States Department of Agriculture. "USDA's MyPlate," Vastag, Brian. "At USDA, a Plate Usurps the Food Pyramid,"