Today, as health care practitioners, we can help reduce this narrow view on food by using words like new eating lifestyle, better food choices or “good diabetic meal plan for Mr. So and So. It is just simply making people more informed food consumers. Go for the pleasure and taste value of the meal rather than just for the health promotion and disease prevention benefit they give.

The Simpler the Better – The 3 I’s

Diet prescription can be translated to our patients, and they don’t mind following it as long as they understand what you want them to do. There are three I’s that I use in my counselling practice depending on individual needs: 1) Inspire – inspire them to follow your advice by your friendly and caring attitude; 2) Inform – inform them of its medical benefits and disadvantages if food plans are not followed; 3) Instruct – instruct them in the simplest words and most realistic way they can do and follow.

With the proliferation and accessibility of diet information from a number of sources, among them books, magazines, family and friends, the patient is left in a quandary. To prevent information overload, focus on the most important and relevant information based on the patient’s needs be it medical or to reduce risk factors detrimental to health.

Some Counselling Strategies You Can Try

1. Emphasize improvement, not perfection. It is unrealistic to expect 100% compliance to dietary changes everyday of the week. When there is better adherence, you can increase commitment. Short-term goals can lead to long-term success. For example, skipping desert in the first week; taking water instead of soft drinks the second week; switching to decaffeinated coffee in the third week; and starting to exercise on the fourth week are simple changes though small but significant.


2. Provide action-oriented tips. Do not just tell WHAT to do. Tell them HOW to do it. For example, rather than telling patients to “limit fresh fruits,” tell them to “eat only 1 medium mango for breakfast, 1 slice of papaya for lunch and 10 pieces of lanzones for supper or glass of fresh fruit juice in lieu of a fruit.” Radical words like avoid, restrict, do not eat, or it’s bad for you, should be changed to eat less, choose more, and enjoy your favorites.


3. Prioritize changes. Help patients to set at least two clear, attainable short-term goals; let the patient decide where to start and which strategies to try. Together, gradually increase the number and complexity of goals with each success. Example: for an overweight diabetic lady, a moderate amount of weight loss to improve her blood sugar level is more important than the weight she wants to lose to look thinner. Even a moderate weight loss of 5-10 percent of initial weight will show a big improvement on blood sugar control. Having your clothes fit better or enjoying your 30-minute walk are signs of success.


4. Put together a winning team. Work with family and significant others like yayas and grandparents so they can support dietary changes. Peer support groups may also be very helpful. Involve the cook or whoever prepares the food. Sit down and review with them if routine instructions were followed such as grill, steam, boil or roast is better than frying. Buy your favorite vegetables and fruits. It’s more enjoyable to have your “comfort foods” around. Again, a small slice of your favorite cheesecake will not make the blood sugar level shoot up so high for as long as you forego your fresh mango dessert. Learn the art of food exchanges and variation to minimize boredom and monotony of dietary regimens.


5. Positively reinforce and reward success. Teach patients how to reward themselves for successful changes as well. Prod them to enjoy their new healthy weight or how great it is to have a normal blood pressure. Reward themselves with non-food items like new clothes, new shoes, a special outdoor trip, a massage or a movie with a friend.


6. Provide written material. Studies show that patients forget more than half of what they are told within a few minutes after leaving your clinic. Written materials serve as constant reminders of dietary instruction and these materials guide patients when eating out, buying and preparing meals. The Food Guide Pyramid is a striking visual teaching material on what to eat more and eat less of. You can supplement it with the Activity Guide Pyramid and other handouts they can use.


7. Arrange for follow-up visits. One visit is NOT enough. Learning how to change life-long eating habits takes more than 30 minutes or even three to five visits to the clinic. Frequent therapeutic contact is essential for long-term compliance. Each visit is a learning experience. Bring a member of the family who can be of help when fall-out happens.

For best results, patients should see the same counsellor at each visit. This will help establish rapport and build trust. Their cases are better monitored to suit individual needs. Counsellor should treat patients like friends. Dig deeper, more than just casual “ask and tell.” The better you know your clients/patients, the easier you can modify their eating binges and food trips.