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council on
health promotion
Practical tips for nutritional counseling
n January 2011 the General Prac- when, where, why, and how” with how much of them, should appear on
tice Services Committee (GPSC) regard to food consumption can help our plates.5 Created by the Harvard
IPersonal Health Risk Assessment significantly in modifying their eating School of Public Health, the visual
Fee (G14066) came into effect, sup- behavior and provides a useful frame- aid features a plate divided into sec-
porting physicians in providing pre- work for a physician-led discussion: tions for vegetables, fruits, healthy
1
vention services to patients. One of Who: Do you sit and eat with others protein, and whole grains, and shows
the patient populations targeted by this when possible? the relative portions of each. Healthy
initiative is those with unhealthy eat- What: Do you select healthy foods in oils and water are also highlighted as
ing behaviors, such as the consump- the amounts that meet your needs? important components of a healthy
tion of excess calories, fat, or cho- diet.
lesterol, or low fibre intake. Family In January 2011
physicians can now initiate a personal the Small Plate Movement
health risk assessment visit with this the general Practice Dish size has increased 36% since
4
patient population, or book an assess- Services committee 1960. The Small Plate Movement
ment in response to a patient’s request Personal health risk suggests that using a smaller plate for
for preventive care. Assessment Fee came the largest meal of the day will help
Physicians can have a significant into effect, supporting decrease the amount of food con-
4
impact when engaging in health pro- physicians in providing sumed. Modifying our environments
motion, and should encourage pa- by using smaller dishes or repackag-
tients to focus on health goals. When prevention services ing larger food packages into small-
addressing weight concerns with pa- to patients er single-serve portions can help us
4
tients, physicians should avoid using avoid mindlessly overeating.
stigmatizing terms. Research sug-
gests that patients prefer terms such When: Do you trust your body to let the 5-2-1-0 concept
as “weight” or “excess weight” as op- you know when you need food? Sustainable Childhood Obesity Pre-
posed to “fat” and “obese.”2 Where: Do you turn off the computer, vention through Community Engage-
Outlined below are current trends cellphone, and TV when you eat? ment (SCOPE) is a nationally recog-
and concepts physicians can discuss Why: When you eat, do you eat for nized, community-based childhood
with patients to help them adopt hunger? obesity prevention plan. SCOPE has
healthier eating habits. How: When you eat, do you eat di- developed the 5-2-1-0 concept to
rectly out of a bulk-sized box or bag provide clear messaging to families
Mindful vs mindless eating or do you take a single portion and eat and children. This concept promotes
Vancouver Coastal Health recently it from a plate or bowl? a daily routine of five or more veg-
produced a two-page summary for etables and fruits, no more than two
healthy eating entitled “Fueling Your Why we eat hours of screen time, at least one hour
Mind and Body,” which emphasizes Cornell University researcher Dr of play activity, and zero sugar-sweet-
that how we eat is just as important Brian Wansink has written a book on ened drinks. For more information on
as what we eat.3 Being mindful of changing eating behaviors entitled SCOPE and the 5-2-1-0 concept, visit
the environmental factors of eating Mindless Eating: Why We Eat More www.childhood-obesity-prevention
(rather than eating mindlessly) means Than We Think. His emphasis is on .org.
that patients are more aware of both making changes to environment and Unhealthy eating behaviors can
what food they are consuming and routine to help people get in the habit be a sensitive topic for many patients.
how they are consuming it. Having of eating the right amount of the foods While there are many approaches phy-
4
patients ask themselves “who, what, they enjoy. sicians can take to address unhealthy
eating, a simple and clear message
This article is the opinion of the Council on the Healthy eating Plate concept that focuses on lifestyle modification
Health Promotion and has not been peer The Healthy Eating Plate is a new should be provided. This can include
reviewed by the BCMJ Editorial Board. guideline showing which foods, and Continued on 433
b c m e d i c a l j o u r n a l v o l . 55 n o . 9, n o v e m b e r 2013 www.bcmj.org
430
worksafebc cohp advertiser
SafeBC, concurrent treatment may Continued from 430 index
be deemed acceptable in certain referrals to other community servic-
circumstances. For example, the es, such as appropriate nutritional
same disability may require treat- and exercise programs, counseling, The BC Medical Association
ment by a general practitioner and and support. Patients can also con- thanks the following advertisers
a specialist, by multiple specialists, tact a registered dietitian for addi- for their support of this issue of
or by a qualified practitioner (e.g., a tional information by calling 8-1-1 the BCMJ.
chiropractor), with concurrent mon- or visiting www.healthlinkbc.ca/
itoring by the attending physician. healthyeating/emaildietitian.html. BC Association of
If concurrent treatment is denied, —Kathleen Cadenhead, MD Clinical Counsellors ............... 419
patients will be paid benefits to the Chair, Nutrition Committee
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For more information
For more information about chiro- References Carter Auto ....................................... 444
practic services for injured work- 1. General Practice Services Committee,
ers, contact WorkSafeBC Health GPSC Personal Health Risk Assess Haughton Art .................................. 409
Care Services at 604 232-7787, or ment Initiative Information and FAQs.
for clinical questions, contact jeff 2011. Accessed 1 October 2013. www Interior Health ................................ 441
advertsing-ad-pr3.qxp:Layout 1 9/18/13 5:37 PM Page 7
rey.quon@worksafebc.com or 604 .gpscbc.ca/billingfees/highlights.
279-8128. 2. Volger S, Vetter ML, Dougherty M, et al. MD Physician Services ............ 448
—Jeffrey Quon, DC, MHSc, Patients’ preferred terms for describing Pacific Centre for
PhD, FCCSC their exceed weight: Discussing obesi Reproductive Medicine ...... 417
WorkSafeBC Chiropractic ty in clinical practice. Obesity (Silver
Consultant Spring), 2012;20:147150. Pollock Clinics .................. 412, 414
3. Vancouver Coastal Health. Fueling Your
references Mind and Body. 2013. Accessed 1 Oc Sea Courses Cruises ................... 435
1. Dagenais S, Tricco AC, Haldeman S. tober 2013. http://vch.eduhealth.ca/
Synthesis of recommendations for the PDFs/BB/BB.200.F952.pdf. Speakeasy Solutions .................. 413
WanttoreachBCdoctors?
assessment and management of low 4. Wansink, B. Mindless Eating: Why We
back pain from recent clinical practice Eat More Than We Think. New York, NY:
We’vegotyoucovered—inprintandonline. Ultima Medical
guidelines. Spine J 2010;10:514529. Bantam Dell; 2006. Services Inc. ................................ 439
2. Rubinstein SM, van Middelkoop M, 5. Harvard School of Public Health, Healthy
For all your display Kashmira Suraliwalla
Assendelft WJJ, et al. Spinal manipula Eating Plate. 2011. Accessed 1 October
advertising requirements, 115-1665 West Broadway, Westgen .............................................. 442
tive therapy for chronic lowback pain. 2013. www.hsph.harvard.edu/nutrition
please contact: Vancouver, BC V6J 5A4 • 604 638-2815
journal@bcma.bc.ca • www.bcmj.org
Cochrane Database System Rev source/healthyeatingplate.
2011;16:CD008112.
WanttoreachBCdoctors?
We’vegotyoucovered—inprintandonline.
For all your display Kashmira Suraliwalla follow
advertising requirements, 115-1665 West Broadway, the BCMA
please contact: Vancouver, BC V6J 5A4 • 604 638-2815 on twitter
journal@bcma.bc.ca • www.bcmj.org
www.bcmj.org vol. 55 no. 9, november 2013 bc m e d i c a l j o u r n a l
433
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