1 / 24

A Workshop on Obesity and Pregnancy A Dietary History in TWO Minutes! (Can it be done?)

A Workshop on Obesity and Pregnancy A Dietary History in TWO Minutes! (Can it be done?). Susan van Maanen Dietitian, Diabetes in Pregnancy Nutrition Services Auckland City Hospital August 2011. What do Pregnant Women Eat in NZ?. Eat more than recommended:

loring
Download Presentation

A Workshop on Obesity and Pregnancy A Dietary History in TWO Minutes! (Can it be done?)

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. A Workshop on Obesity and PregnancyA Dietary History inTWO Minutes!(Can it be done?) Susan van Maanen Dietitian, Diabetes in Pregnancy Nutrition Services Auckland City Hospital August 2011

  2. What do Pregnant Women Eat in NZ? Eat more than recommended: • Fat, especially saturated fat and sugar Eat less than recommended: • Vegetables & fruit leading to less fibre and folate eaten than recommended • Calcium, Iron, Zinc and Selenium 504 pregnant women, 1x24hr diet recall, 3x1 day food records, 2 day activity record, Ht, Wt, skinfolds, blood sample at mth 5, demographic, medical and lifestyle details Nutrition in Pregnancy- Report to MoH.Watson P. 1999

  3. What do Pregnant Women Eat in Australia? • Women (52%) are piling on extra weight & keeping on the weight gained, post-natally • Choosing fatty food over vegetables & fruit • Iron, calcium & folate requirements not met 50 overweight and obese pregnant women, diet history at 12, 28, 36 wks, food frequency questionnaire, Ht, Wt – prepregnancy, 12, 28, 36 wks and 6 weeks P/N Nutrition and Dietetics. De Jersey et al. Vol. 68, No 1,P 53-59 March 2011

  4. My Clinical Observations: • Women are shocked at how little weight gain is recommended in pregnancy & that no-one had told them sooner what was appropriate • Women want to do well for their baby & family but don’t know how to eat well • They feel they will never achieve weight loss post-natally • Embarrassment & feelings of hopelessness

  5. Observations: • Eating too much! • Poor food choices (finances) • No exercise • Skipping meals, hunger, then over eating

  6. Diet history Food record Food frequency questionnaire 24 hour dietary recall The Challenge: How to give personally relevant advice?

  7. Taking a Diet History: Compared to giving out a generic pamphlet, personally relevant advice has been shown to: • Be remembered • Effect change more readily • Build confidence and rapport so that disclosure is more likely

  8. A Diet History will Identify: • The adequacy of the woman’s usual food/ nutrient intake • Frequency of eating: regular meals and snacks? • Takeaways? • Excess energy from added sugars/drinks, cooking & spreading fat • Portion sizes? • Who cooks?

  9. Easy Portion Measures:

  10. Healthy Eating Plate:

  11. Dietary History- Advantages: • Identify where changes can be made • Negotiate ‘actual’ change • See through their ‘outside’ layer Disadvantages: • Relies on honesty • Underestimates intake • Not precise

  12. What is the goal? To gain enough information to advise the woman on achieving: Nutritionally adequate diet Appropriate weight gain in pregnancy Encourage weight loss post-natally & future disease prevention - Diabetes, Cardiovascular Disease Healthy baby Positive attitude to health - now & for the future.

  13. A Dietitian’s Request to Midwives:Please weigh women every visit if you can (including out of pregnancy if appropriate), so they know how they are progressingFailing to receive any weight gain advice during pregnancy favours excessive weight gain! Remember PREVENTION is easier than CURE

  14. Food for a Healthy Mother and Baby:Lean Meat, Chicken, Fish etc- 2 servings/dayBread & Cereals - 6 servings/dayVegetables & Fruit - 6 servings/dayMilk & Milk Products - 3 servings/dayDrink plenty of fluids every day - 9 cupsChoose & prepare foods low in Fat, Salt & SugarKeep ActiveFood SafetyEating for Healthy Pregnant Women. MoH. August 2010.

  15. So - do you think you can do a Dietary History in TWO minutes

  16. Self completed questionnaires: Advantages: • Save health professionals time • Bring to clinic completed or complete while waiting in clinic Disadvantages: • Needs to be short and simple or women will lose interest • Literacy barriers

  17. Handbook for Lead Maternity Caregivers. Canterbury District Health Board. 2004

  18. A Nutrition Guide for Health Professionals, Resources Tool Kit, ADHB. 2011.

  19. A Nutrition Guide for Health Professionals, Resources Tool Kit, ADHB. 2011.

  20. Time Well Spent:Whatever method you use,I recommend spending as much time as you can, getting information on the woman’s usual eating habits and giving sensible nutrition advice.Your time will never be wasted!

  21. Websites/ Resources Available:www.dietitians.org.nzwww.moh.govt.nzwww.healthpoint.co.nzEating for Healthy Pregnant WomenHealthy Eating for South Asian People

  22. Thank You

More Related