Eating Smart and Working Out More

Preventing Preventable Diseases

Maintaining your weight can be a tricky task and may sometimes feel like a chore. A lot of us as healthcare professionals, especially pharmacists, have busy lives that consist of more important things to worry about rather than exercising and counting calories.

According to the CDC, in 2017–2018, the age-adjusted prevalence of obesity in adults was 42.4%, and there were no significant differences between men and women among all adults or by age group.

Obesity is linked to numerous comorbidities and sometimes can result in death. For example, an obese/overweight patient who is living a sedentary lifestyle is at risk for developing metabolic syndrome. Metabolic syndrome is a bundle of disorders that can increase the risk of developing cardiovascular disease (CVD), diabetes, and stroke.

We all would like to have the “perfect patient” that complies to their medication regimen, eats clean and attends every gym session. In reality, the “perfect patient” is not totally exempt from illness. As pharmacists, we should be following all of the advice we give to patients and be that “perfect patient” ourselves. In this article, my goal is to help you educate patients and yourself from developing any preventable comorbidities.

What’s Cooking in the Kitchen? MyPlate Method

MyPlate is an easy method to teach patients about what they should eat and how much. It consists of a standardized plate split into the categories of fruits, vegetables, grains, protein and dairy. It is an easy colorful visual that you can provide to your patients and help guide them on portion sizes. For adults, they should be receiving about 1 and 1/2 to 2 cups of fruits, 2 and 1/2 to 3 cups of vegetables, 5 to 8 ounce-equivalents of grains, 5 and 1/2 to 6 and 1/2 ounce- equivalents of protein and 3 cups of dairy on a daily basis. These portion sizes may vary depending on daily calorie intake, physical activity, age and gender. Each recommendation should be specific to each patient to meet their specific daily requirements.

Some patients may find it difficult to measure portion sizes. However, there is an easy solution to measuring portion sizes by using their hands.

— An average fist measures about 1 cup which can help with measuring the adequate amount of vegetables.

— A scooped handful measures about a 1/2 cup and equals to 1-ounce equivalent for grains, such as pasta or rice.

— The palm of the hand measures about 3 ounce-equivalents, which is adequate to measure protein such as chicken, fish or beef.

— The size of a thumb measures about 1 tablespoon which can be appropriate to use to measure portion size for peanut butter.

— The index finger can be used to measure the appropriate amount of oils or other fats.

Diet Restrictions and Chronic Diseases

Patients with chronic diseases such as hypertension or diabetes can potentially require a strict diet. Dietary approaches to stop hypertension (DASH) is a common diet that should be recommended for hypertensive patients to limit their daily salt intake. They should be encouraged to eat foods low in sodium as well as take their antihypertensives to manage their blood pressure appropriately. The recommended daily intake of sodium for hypertensive patients should be limited to 1500 mg. For diabetics, their diet should be balanced among the major macronutrient groups and their intake of saturated and trans fats should be limited.

Working Out More

Some patients may think if they eat smarter they can neglect physical activity. This is where healthcare professionals can intervene and educate them on the importance of having a healthy diet and engaging in daily moderate intensity aerobic activity. It is recommended that adults engage into some sort of physical activity for 150 minutes/week and muscle strengthening activities on 2 or more days/week. This does not require a gym membership or exercising equipment. You can recommend they start out slow and increase intensity as they become comfortable. This includes simple activities like walking, cleaning up around the house and yard work. When they are comfortable to increase the intensity to vigorous aerobic activity they can begin to participate in running/jogging, biking, playing basketball or swimming. Kindly advise your patients that the recommended time for vigorous activity is 75 minutes/week.

Conclusion

A combination of diet and exercise is vital to maintaining an appropriate weight and can aid in preventing diseases.

It is our due diligence as healthcare professionals to provide this type of information to our patients and practice what we preach.

The same effort we put into treating patients should be reciprocated in the prevention phase.

References:

1. Hales CM, Carroll MD, Fryar CD, Ogden CL. CDC. Prevalence of obesity and severe obesity among adults: United States, 2017–2018. Available at:https://www.cdc.gov/nchs/products/databriefs/db360.htm. Accessed April 7, 2020.
2. U.S. Department of Agriculture. What is MyPlate? Available at:https://www.choosemyplate.gov/eathealthy/WhatIsMyPlate. Accessed April 7, 2020.
3. Eat Right Academy of Nutrition and Dietetics. Serving Size vs Portion Size Is There a Difference. Available at:https://www.eatright.org/food/nutrition/nutrition-facts-and-food-labels/serving-size-vs-portion-size-is-there-a-difference. Accessed April 7,2020.
4. National Heart, Lung, and Blood Institute. DASH Eating Plan. Available at: https://www.nhlbi.nih.gov/health-topics/dash-eating-plan. Accessed April 8, 2020
5. CDC. How much physical activity do adults need?. Available at:https://www.cdc.gov/physicalactivity/basics/adults/index.htm. Accessed April 8, 2020.