1. The client/caregiver can list reasons to eat a well-balanced diet.
   1. It provides energy, builds and repairs body tissues, and regulates body processes.
   2. It is essential for preventing disease and for healing of disease.
   3. It is essential for emotional and physical well-being.
2. The client/caregiver can explain the MyPyramid program.
   1. The U.S. Department of Agriculture introduced this program in 2006.
   2. It offers a personal eating plan with suggested foods and amount of food intake.
   3. They are not therapeutic diets for specific health conditions (see therapeutic diets teaching guides for specific health conditions).
   4. The program can track your food intake and physical activity level.
   5. They offer some basic advice when starting the program:
      1. Make wise choices from every food group.
      2. Find a balance between food and physical activity.
      3. Get the most nutrition out of your calories. Avoid empty calories.
      4. Stay within your daily calorie needs.
      5. Make half your grains whole.
      6. Vary your vegetables.
      7. Focus on fruit selections.
      8. Use calcium-rich foods.
      9. Use lean proteins.
      10. Find a balance between food intake and physical activity.
3. The client/caregiver can list methods to evaluate healthy weight.
   1. Body mass index was created to provide a measurement of weight that is not related to height.
   2. It is often used as an indicator of obesity.
      1. A BMI of 25 to 29.5 is considered overweight.
      2. A BMI over 30 is considered obese.
   3. Another method to evaluate a healthy weight is to use one of the height–weight tables. Adults and older children are measured standing. Infants and small children are measured lying on a flat surface.
4. The client/caregiver can list the Dietary Guidelines presented by the Surgeon General of the United States, the U.S. Department of Agriculture, and the U.S. Department of Human Resources (2005).
   1. Eat a variety of foods.
   2. Balance the food you eat with physical activity. Maintain or improve your weight.
      • Engage in 30 minutes of moderate-intensity activity most days of the week.
   3. Choose a diet with plenty of grain products, vegetables, and fruits. Daily suggested amounts per a 2000-calorie diet are
      • 2 cups of fruit
      • 2.5 cups of vegetables
      • 3 or more servings of whole-grain products
      • 3 cups of fat-free or low-fat milk or milk products
   4. Choose a diet low in fat, saturated fat, and cholesterol.
      1. Consume less than 10% of calories from saturated fatty acids.
      2. Consume less than 300 mg/day of cholesterol.
      3. Limit intake of fats and oils high in saturated or trans fatty acids.
   5. Choose a diet moderate in sugars.
      1. Choose and prepare foods/beverages with little added sugars.
   6. Choose a diet moderate in salt and sugar.
      1. Consume less than 2300 mg (approximately 1 teaspoon of salt) of sodium per day.
      2. Choose and prepare foods with little salt.
   7. If you drink alcoholic beverages, do so in moderation. Moderate consumption is considered
      1. One drink per day for women
      2. Up to two drinks per day for men
   8. Avoid foods that are contaminated with bacteria, viruses, parasites, toxins, and chemical or physical contaminants.
5. The client/caregiver can list general nutritional tips for different ages throughout the lifespan.
   1. Recommendations for children are
      1. Engage in 60 minutes of physical activity most days of the week.
      2. At least half of the grains consumed should be whole grains.
      3. Children 2 to 8 years old should consume 2 cups of fat-free or low-fat milk products. Children over 9 years old should consume 3 cups of milk or milk products daily.
      4. Consume most fats coming from polyunsaturated and monounsaturated fatty acids, such as fish, nuts, and vegetable oils.
      5. Obtain sufficient amounts of fiber, but avoid excessive amounts of added sugars.
      6. Do not eat or drink raw milk or raw milk products, raw eggs, raw or undercooked meats, poultry or fish, unpasteurized juice, or raw sprouts.
   2. Women of childbearing age who may become pregnant or are pregnant and breastfeeding women should
      1. Eat foods high in heme iron, iron-rich plant foods, or iron-fortified foods.
      2. Include vitamin C-rich foods to aid in iron absorption.
      3. Consume adequate amounts of folic acid from fortified foods or supplements.
      4. Eat only certain deli meats and frankfurters that have been reheated to steaming hot.
      5. Avoid raw milk or raw milk products.
   3. Older adults should
      1. Consume extra vitamin D from fortified foods.
      2. Increase dietary fiber to prevent constipation.
      3. Limit intake of sodium per day to no more than 1500 mg.
      4. Eat foods with potassium recommendations of 4700 mg/day.

Resources

National Institutes of Health/National Heart, Lung and Blood Institute
www.nhlbi.nih.gov/health/public/heart/obesity/lose_wt/

U.S. Department of Agriculture. MyPyramid/Steps to a Better Healthier You
www.mypyramid.gov/

USDA Dietary Guidelines for Americans 2005
www.health.gov/dietaryguidelines

Nutritionist
Dietician

References

Ackley, B. J., & Ladwig, G. B. (2006). Nursing diagnosis handbook: A guide to planning care. St. Louis: Mosby Elsevier.
Canobbio, M. M. (2006). Mosby’s handbook of patient teaching . St. Louis: Mosby Inc.
Hitchcock, J. E., Schubert, P. E., & Thomas, S. A. (2003). Community health nursing: Caring in action. Clifton Park, NY: Thomson Delmar Learning.
Lutz, C., & Przytulski, K. (2001).Nutrition and diet therapy. Philadelphia: F. A. Davis Company.
Nutrition made incredibly easy. (2003). Philadelphia: Lippincott Williams & Wilkins.
Timby, B. K. (2005). Fundamental nursing skills and concepts. Philadelphia: J. B. Lippincott Williams & Wilkins.