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Currumbin Clinic – Perfect Meals for patients

Amanda Clark, ( Adv APD) Senior Dietitian, Great Ideas in Nutrition, www.greatideas.net.au

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Australians are getting fatter at a more rapid rate than most other countries- note the steep er curve and the projections to the year 2020

Source: Obesity and The Economics of Prevention, OECD, 2010.

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Here we are in 2014

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• Busier lives• Technology – less exercise• Stress• Lack of sleep• Food advertising• Increasing portion size• Metabolic changes• Food processing

Possible Reasons

+Weight Gain & Psychotropic Medications

• Common side effect

• Poorly understood

• Leads to poorer self esteem

• Common reason for discontinuation of treatment

+Research shows this can be limited

Strategies focus on increased exercise and decreased caloric intake.

A survey of Currumbin Clinic inpatients in 2007 indicated that 73% experienced unwanted weight gain during their stay

+Possible ways to address this:

• High Protein diets• Low Fat diets• Carbohydrate restriction• Low Calorie diets• Energy Density• Portion control• Behavioural approaches• Meal replacements• Exercise

+ Portion control

The approach chosen for Currumbin Clinic

inpatients is portion control. This approach

allows inpatients to still eat the foods they

enjoy but provides guidance on the correct

portion sizes for weight loss. This method

places the least onus on patients and

makes weight control simpler and easy for

patients to understand and achieve.

+Portion Control

This is an example of how portion sizes have changed in the past 20 years. The small coffee on the right is an example of the standard serving size 20 years ago and provides up to 85 cals as a water based instant coffee with 2 sugars and whole milk.. Today serving sizes have ballooned, the picture on the left is a Star Bucks Grande at a whopping 480 Cals and 470ml.

+Portion Control – potato chips

The serving of chips on the left is an example of the standard serving size 20 years ago at 30g (150 cals)

Today 50g (250Cals) and 100g (500 Cals) packets are marketed as a single serving size.

+Cupcakes/muffins

The cupcake on the left is a standard serving size 20 years ago providing 140 cals.

Today portion sizes are much larger, the picture on the right is a Texas muffin providing approx 1000 cals!

+Bigger Serves = Bigger Bodies

Eating larger portion sizes regularly can lead to unwanted weight gain. The picture on the right is a picture of a Super Sized McDonalds fries in 2003 compared to the largest serving size in Australia at the time. The movie Super Size Me altered the plans to introduce this serving to the Australian market in 2004.

+Recipes, plates & bowls

It’s not just processed foods that have increased in portion size. Today recipe books provide larger serving sizes. Plates, cups, bowls and serving spoons are larger – research has shown that eating from larger plates, bowls and using serving spoons can cause us to serve and eat bigger portions without being aware.

+Energy Needs

To maintain weight the average women needs 1800 Cals ( 7600kJ) per day

To maintain weight the average man needs 2200 Cals (9250kJ) per day

To achieve a weight loss of ½ a kg of body fat per week, a calorie deficit of 500 cals is needed

+Calorie Requirements

These are the calorie requirements for men and women to lose or maintain weight. We recommend 1300 calories per day for women and 1600 calories per day for men for weight loss. The second table demonstrates the calories needed in each meal and snack to achieve the desired total calories. (Ref: Portion Perfection – A visual weight control plan 2014)

+Portion Perfection Plate

1. Nutritional Balance The correct balance of carbs, protein and vegetables for healthy brain function.

2. Portion Control Eating meals and snacks in the correct portion sizes for weight control

3. Conscious Eating Being mindful of what you are eating. The words around the outside of the plate guide this process.

The Portion Perfection Plate was introduced to Currumbin clinic in 2008. The plate has 3 main messages:

+Resources

The food, mood and exercise diary was introduced in 2010 and is used in patient group education sessions from dietitians and psychologists. The diary encourages patients to choose 1 change to focus on per week and to monitor their progress in the diary.

+Serving Sizes

This is an example of how meals are portioned. The first meal is an example of a 350 cal serving size – the serving size for women wanting to lose weight. The meal is served within the rim of the plate.

The second picture is an example of a 450cal serving size – the size for women to maintain weight, and for men to lose weight. The meal is served to the words on the rim of the plate.

+Mid meals

These are examples of 100cal snacks served at mid meals.

Inpatients should aim for:• 1 snack per mid meal for weight loss• 2 snacks per mid meal for weight maintenance• 3 snacks per mid meal for weight gain

+Quality Control

Kitchen staff monitor portion sizes to ensure quality control and the correct serving sizes.

+Chefs or Patients Plate Meals according to the plate guide.

+Patient Guides

Information on the program appears in the Patient Information Manual, on posters and also in a brochure in the servery.

+Results

Since 2007 the Perfect Meals for Patients Program has reduced unwanted weight gain during patient stay from 73% to 35%!

+Then what?

Patients wishing to continue the program at home

can purchase the Portion Perfection book, plate and

bowl at Currumbin clinic. The book provides further

information and examples of the correct portion

sizes of meals and snacks.

+Feedback

• How can you encourage patients to opt in to the program?

• What benefits are there for you?• Questions, Suggestions and

Comments?

• Please provide your feedback to info@greatideas.net.au to demonstrate your understanding of this module