Tailoring your Patients Diet

Expecting anyone to follow an impersonal printed diet that they've simply been handed is ridiculous.

Have you ever tried a diet that's not for you?  It's like buying a suit and not even trying it on till the day you are going to wear it, chances are high that neither will fit.

I am sure all of us have given a patient a diet or meal plan that we ourselves could not follow. Most of us have special foods we like and our patients are no different. In addition our patients make choices based on restaurant menus, travel plans and income levels. Many of these are not even controllable by the patient.

We routinely tell people with diabetes exactly what they should and should not eat, but how many of us could follow the same plan. Then when we see the patients on a return visit we complain that they are not following their diets.

Food is a cultural thing.  Our patients tend to eat the foods traditionally associated with their ethnic or national backgrounds, the foods their parents made for them. As an example, Type 2 diabetes is a particular problem among people of color, and yet we usually hand our patients diets that have none of their cultural foods included. So rather than ask people to eat healthier versions of the foods they love, we ask them to totally change. It's not realistic or fair, and it's a plan that is doomed to failure.

A good diet is important, and you need to tailor it for each patient.

We should work with our patients to arrive at a meal plan that is good for them and relatively easy for them to follow.  Sit down together and discuss the total caloric intake your patient needs, factor in how exercise affects that number, and how much of each food group should be in their diet, Spend a considerable amount of time finding out what your patient likes to eat and then identify how those foods fit into the plan and what might be substitutable 

Try to teach your patient some new shopping and cooking techniques that are in line with these basic premises. Many cookbooks are aimed at people with diabetes. Take the time to find some recipes, and try them yourself. If you hand your patient a low glycemic sugar-free cookie you baked, then it is more likely they will do the same. Learning to cook the kind of meals you want your patients to eat is a great idea. If you can do it so can they. 

Negotiate with your patient to ensure success. For example most desserts are still high in calories without offering much nutrition. If you add low glycemic fruits like cantaloupe or strawberries you get a much healthier dessert.

 A healthy diet is not so much about eliminating particular foods as it is about choosing from the foods that your patient likes, ones that can offer the greatest benefits to the patient

Put yourself in your patient's shoes. Try following the preprinted diet you hand out for 7 days, and see how hard it is. Then try a custom plan that gives you some of the foods you like while meeting the goals you set. 

We all know that the most proven technique to achieve vitality and a trim and toned body is a good diet coupled with an exercise program. Find out from your patient which exercises they can do and build a program from that. Teach them that even a little bit worked into their other activities can make a difference

I am sure that together you can form a unique plan that will work for your patient with diabetes

Dave Joffe, R.Ph., Editor

Diabetes In Control.com