Structured Diet Versus

Plate Method

Pinky Rose Viloria, RNDKristia Lei Reyes, RNDPhilSPEN October 23, 2013

Outline▫Definitions▫Examples of Structured Diet▫Examples of Plate Methods▫Advantages of Both Methods▫Summary▫Conclusion

Structured Diet• Is a calculated diet based on the Food Exchange

List (FEL) used by Dietitians

• Used specifically for meal planning

• “structured” means:▫Food list/food groups▫Number of exchanges per group▫With distributions for the Meals and snacks of the

day

Example of Structured Diet:•Diet Prescription: 1500 kcal, 245-55-35

Food Exchanges

No. Of Exchan

ges

Sample Menu Approximate Size per Serving

BreakfastFruit

Meat/SubstituteRice/Substitute

Milk (for Coffee)Sugar

111

¼ 2

Ripe PapayaBaked Ham

SausagePan Amerikano

Evaporated MilkWhite Sugar

1 slice (10x6x2cm)3 (9cm dia x 0.3cm

thick)2 slices

2 Tablespoons2 teaspoons

Mid-A.M. Snack

Rice/SubstituteMeat

11

Pan de LimonCottage Cheese

1 piece (6x5x4 cm)1/3 cup

Plate Method•Based on the latest USDA Dietary

Guidelines

•Consists of a 9-inch plate

•Plate is divided like pie chart, divided into portions of important food groups

•Uses different colors or pictures of foods

The Plate Model: A Visual Method of Teaching Meal Planning

•A simple alternative to the traditional exchange-based method for teaching meal planning

•serves as a pie chart to show proportions of the plate that should be covered by various food groups

Camelon, Kathryn et. al. J Am Diet Assoc. 1998; 98:1155–1158.

 

Schoeppner, Heidi et. al. The Journal of the Federation of American Societies for Experimental Biologies

The Plate Method is an Effective Education Tool for Overweight Adolescents Objective: To determine if the Plate Method of nutrition

education is an effective approach to teach overweight 10-14 year-old adolescents (BMI > 95th percentile) in West Virginia to choose healthier foods

Result: subjects have increased servings of fruits, vegetables, and whole grains, while servings of soda/sweetened drinks and high fat/sugar foods have decreased.

Conclusion: Using the Plate Method as a nutrition education tool is an effective way to help overweight adolescents make healthier food choices at meal-time(s)

The Healthy Diabetes Plate• The Healthy Diabetes Plate, which used the

plate format to teach individuals about the type and amount of foods they should consume at each meal (by the University of Idaho)

• In 2004, the four-lesson curriculum was taught in three urban and five rural counties

• Participants were able to correctly plan breakfast, lunch, and dinner meals and improved their intake of fruit and vegetables.

Raidl, Martha et. al. Prev Chronic Dis. 2007 January; 4(1): A12. Published online 2006 December 15. PMCID: PMC1832142

How to do it

Step 1Take an average sized dinner plate and divide it

in half. In one half place non-starchy vegetables such as:

• Spinach, Broccoli, Cauliflower, Romaine lettuce, Cabbage, Carrots, Tomatoes, Onions, Cucumber, Beets, Peppers

• About one cup of raw vegetables is considered an appropriate serving size.

• One cup would be about the size of your fist.

Step 2Divide the other half of your plate in half

again. In one quarter place your protein source, such as:▫3 oz. of lean beef or pork▫3 oz. of skinless turkey, chicken or fish▫Tofu▫Eggs▫Cottage cheese▫A 3 oz. serving is about the size of a deck of

cards

Step 3In the other quarter of your plate place

your starchy foods such as:

▫Bread, Potatoes, Corn, Beans, Rice, Tortilla, Cereals, Oatmeal

▫Serving sizes range from ½ cup of rice to a baked potato about the size of your fist.

Different Models of the Plate Method

Harvard Healthy Eating Plate

US Department of Agriculture (USDA) MyPlate

Idaho Plate

UK Eatwell Plate

Population /group specific plate models

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=ti0pQXH6kNx_SM&tbnid=Z7wv06nSLLzMAM:&ved=0CAUQjRw&url=http%3A%2F%2Fblog.diabetesms.com%2F%3Fcat%3D3&ei=9ydIUr_PNqyUiAe33YDQAg&bvm=bv.53217764,d.aGc&psig=AFQjCNF7VG4umq3oDgs5T6bPecyzpL7OIg&ust=1380546850526368

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=ti0pQXH6kNx_SM&tbnid=Z7wv06nSLLzMAM:&ved=0CAUQjRw&url=http%3A%2F%2Fblog.diabetesms.com%2F%3Fcat%3D3&ei=9ydIUr_PNqyUiAe33YDQAg&bvm=bv.53217764,d.aGc&psig=AFQjCNF7VG4umq3oDgs5T6bPecyzpL7OIg&ust=1380546850526368

In addition to the Plate graphic itself, the new icon is accompanied by the following nutritional guidelines that offer more information for healthy eating.

• Enjoy your food, but eat less.• Avoid oversized portions.• Make half your plate fruits and vegetables. • Make at least half your grains whole grains. • Switch to fat-free or low-fat (1%) milk. • Compare sodium in foods like soup, bread and

frozen meals—and choose the foods with lower numbers.

• Drink water instead of sugary drinks.

Advantages of Structured Diet•More accurate calorie counting

•Includes all food groups such as fats/oils, sugar

•Time and meal distribution is indicated

•Indicates number of servings or exchanges per food group

Advantages of Plate MethodEnhancement of the connection between dietary theory and practicePromotion of memory retention and understanding through visual messagesExperience of a positive approach to nutrition counsellingVarious cuisines and festive foods can be incorporated into the modelOffers a meal planning approach that is simple and versatileEasier to understand

J Am Diet Assoc. 1998; 98:1155–1158.

Diabetes Plate Method offers many invaluable benefits to the diabetic people:

1. The blood sugar level of a diabetic individual can be managed under the required level every day since carbohydrates are distributed evenly.

2. The consumption rate of starches, fat or cholesterol can easily be maintained.

3. A diabetic individual will be able to get plenty of fiber, antioxidants, phytochemicals and proteins which forms a healthy diet.

4. Another notable benefit is the weight loss without extra effort. As we know, excess body weight minimizes insulin sensitivity.

Recording and Recall

High Nutrient Food Low Nutrient Foods

Whole Grains, Breads, and Rice  Whole grains (wheat, oats, barley) Whole grain breads, rolls, bagels, crackers and muffins Whole grain and high-fiber cerealsWhole grain pasta Brown rice  

 Croissants Fried rice Doughnuts and pastries Sweet rolls Cookies Cakes Egg noodles and pasta  

Vegetables  Bean Sprouts, broccoli, Brussels sprouts, cabbage, carrots, cauliflower, corn, cucumbers, green beans, leafy vegetables, mushrooms, potatoes, summer and winter squash, tomatoes, sweet potatoes, yams  

 French-fried potatoes, fried vegetables Vegetables packed in sauce  

Fruits  All fresh fruits, especially apples, oranges, apricots, bananas, berries, cantaloupe, citrus fruits, peaches, pears Canned or frozen fruits, unsweetened or packed in

water or their own juice  

 Canned or frozen fruits, sweetened packed in syrup Fruit rolls Fruit drinks  

Comparative List of High Nutrient and Low Nutrient Foods

High Nutrient Food Low Nutrient Foods

Proteins and Protein Substitutes  Eggs, egg whites, egg beaters, fish, chicken, turkey, round or loin beef, round or loin pork, legumes, tofu, lean luncheon meats, nuts & seeds  

 Hot dogs, luncheon meats, sausage, bacon, fried fish, fried poultry, spareribs, prime cuts of meat.  

Dairy Products  Nonfat, skim, and 1% milk Nonfat products such as buttermilk, cottage cheese, and yogurts Soy milk Nonfat ice milks and sherbets Fat Free or low fat cheeses  

 Whole milk Whole milk products such as cheese,

cottage cheese, custard, milk shakes, pudding,

and ice cream  

Beverages  Water Herbal teas Non caloric beverages  

 Sugared soft drinks Alcoholic beverages Caloric beverages  

Fats  Vegetable oils (olive oil, canola oil, flaxseed oil, safflower oil) Fat free sour cream, cream cheese Nuts and seeds, flaxseed Avocados, olives, dark chocolate

 Butter, margarine, lard Cream cheese, sour cream High fat salad dressings Cakes, cookies, high fat desserts

In Summary…

Variations among healthy diet plans• Most healthy diets are built on the same general principles, but there are key

differences that reflect dietary preferences, food availability and cultural eating patterns.

• For example, the Latin American Diet Pyramid might mention tortillas and cornmeal, whereas the Asian Diet Pyramid might include noodles and rice.

Other differences include:

1. Food groups• The food groups among healthy-diet plans vary in some ways. For example, some

versions have plant-based proteins — soybeans, beans and nuts — in a separate group from animal proteins found in meat, poultry, eggs and dairy products. This is because animal proteins are often higher in fat and cholesterol, and some diets limit or exclude animal proteins.

2. Serving recommendations• Healthy-eating plans also vary in the recommended servings of each food group. The

Mayo Clinic Healthy Weight Pyramid, for example, recommends a daily number of servings from each food group. Other plans offer more-general guidelines, such as eating particular foods at every meal, or on a weekly or monthly basis. Or that the Mediterranean Diet Pyramid recommends that you eat whole grains, vegetables and fruits at every meal.

The plate method has been used for diabetes meal planning. It also works well for weight loss, teaching good nutrition and in improving blood glucose and lipids.

Benefits• Weight loss• Improved carbohydrate distribution• More nutritionally sound diet• Increase intake of fibers• Decrease fat and cholesterol intake

Try the Plate method for:

• People with busy lifestyle

• Seniors

• Feeling overwhelmed because of a recent diagnosis or psychological circumstances

• Cognitive difficulties / Low literacy level

• For those with difficulties in using a more structured approach

• Type 2 diabetes and needs to loose weight

Conclusion:Whatever tool or principle you as a health professional will use, always remember the Basic principles of a healthy diet:

• That the diet is appropriate to the needs and condition of the individual .

• Symbols/ tools (computed diets, pyramid & the plate) are educational tools to help us visualize and understand the diet better, these tools illustrate how the pieces of a healthy diet fit together.

• Definitely, no single food provides all of the nutrients that your body needs, so the idea is to eat a variety of foods from each group in the proper proportions to get all the necessary nutrients and other substances that promote good health.

• Lastly , a healthy-diet plan/regimen should emphasize the following: 1. Eat more plant foods, including fruits, vegetables and whole

grains.2. Choose lean protein from a variety of sources.3. Limit sweets and salt.4. Control portion sizes.5. Be physically active.

Putting the pyramid, the computed diet or the plate — to work for you

Know the specific needs of the individuals that needs to be addressed.

To see how your eating habits match up to these healthy-diet plans, keep a food diary for several days. Then compare how much of your diet comes from the various groups.

To eat healthier, start with gradual changes, such as eating more vegetables, fruits and whole grains, and limiting fats and sweets.

• Choose a variety of foods• This ensures that you get all of the calories, protein, vitamins,

minerals and fiber you need. • Choosing a wide range of foods also helps make your meals

and snacks more interesting.

• Adapt the plan to your preferences• How to do it?

Explore all possibilities!

• Combine foods any way you like but in the right amount

Sources

American Dietetic Association. "New MyPlate Is a Useful Tool for Consumers to Follow Dietary Guidelines and Eat Healthfully, Says American Dietetic Association," American Heart Association. "American Heart Association CEO Nancy Brown Says New USDA Food Icon Is A Positive Step Towards Improving Consumer Health," Hellmich, Nanci. "USDA Serves Nutrition Guidelines on 'My Plate'," The Journal of the American Medical Association. "New Nutritional Icon Steps Up to the Plate," Khan, Amina . "USDA to Reshape How We See Dietary Nutrition," Neuman, William. "Nutrition Plate Unveiled, Replacing Food Pyramid," United States Department of Agriculture. "USDA's MyPlate," Vastag, Brian. "At USDA, a Plate Usurps the Food Pyramid,"