Nutrition Counseling Session

good afternoon Miss John O my name is good afternoon my name is j Al nobly and I will be leading you through our nutrition and education counseling meeting today okay uh just a little bit about myself I am a nutrition and dietetic student at lominda University and will be sitting for my Rd exam next June fantastic so um I just wanted to let you know I got into this field because I just really wanted to enhance and improve People's Health through making advantageous uh dietary choices so that's great um before we get started would you

like a bottle of water I'd love to have a bottle of water okay thank you very much there you go can I start drinking now yes go for it all right um so in today's session I would just like to hear about some of your personal goals uh why you came to the session today obstacles you may be facing in regards to nutrition um and just figure out some ways to overcome challenges that you may be facing okay well uh number one I'm really really happy to have this opportunity to sit down with you and

U discuss my really horrible eating habits especially by you know recently I have been actually struggling with wanting to lose the weight um I would say for about a good six seven months now and all that I have seen so far is that I've been basic fluctuate basically fluctuating between 199 and 206 sometimes even 208 um the struggle today has been um the frustration level of when I get on this okay I'm going to get on this quote unquote diet and I'm going to lose the weight something amazing happens I actually end up eating more

I'm tired in the morning I'm stressed because we started this whole new business that we have here and I'm totally out of control um I feel that I'm totally out of control um when it comes to eating I think a lot of it has to do with not eating uh quote unquote properly or systematically okay so I'm a big bad problem for you you just threw a lot at me so I would like to go back and recap um some of the things that you were saying to make sure that I'm understanding everything clearly okay

so in January of 2010 you started a meal plan um that was very strict and you were able to maintain it for a few years no few months few months excuse me few months and um then you started to um travel and you know kind of things kind of went a little bit astray from there yes um you went from this strict dieting All or Nothing kind of plan to not really knowing how to um make food for yourself or compose a meal for yourself because you were um but it was you know it's interesting

to say that because that meal plan that I was on that diet plan was called the no decision plan that is funny yeah so says it's a no decision diet which means you don't have to make any decisions about anything this is the prescription and you live with that prescription you'll be all right and it works I cannot deny that it didn't work it did work so you almost um kind of missed out on the education portion of how to eat when you're on your own yes which is what in the longterm um we want

to achieve is for you to be able to make um healthy food choices when someone isn't there to tell you what to do to be able to critically think for yourself in regards to nutrition yeah so um some other things that you mentioned was that um you're just feeling frustrated and kind of out of control control um in regards to your weight loss um initiatives um which I can which is very it seems very frustrating if you want to be losing weight and you're not not seeing it and then you said that you were um

tend to be eating more so those are all very frustrating things and not and then you also said that during your day um you're not really eating consistently at all you're kind of all over the place and um kind of looking for more of a you know consistent meal planed day in which you're not you know starving and then overeating later I do that kind of like keeping it's like I wish I had one person walking behind me this fairy or whatever that says okay meal time here it is you know it's like preparing it

here it is you know so that because I Le I lead such a stressful and such a work driven environment so let's talk about where you get most of your meals from I would literally stop at the supermarket or I would stop at a 7-Eleven or I would stop at couple of times I did not a lot of times I stopped at Dunkin Donuts right I pick up donuts um or at the other dut shop I would pick up because it's fast a lot of times I'm eating out and it's not you know the best

thing in the world okay um so I'm hearing that you get most of your meals from outside of the home yes and um not typically cooking meals and kind of go for those more convenience convenience meals that are easy yes um so how would you feel about um going over some tips for when you're dining out then if that's if you're very busy and like that's the option that you're doing right now um just making some little tweaks because cooking at home may not be an option for you at this moment that's very true probably

I would say yes so making little changes yes in regards to the restaurant May there is a way of making changes yes yes there definitely are some some tips that you can Implement when you're at the restaurant okay so um some of the things that I would like to talk about so when you're ordering food from a restaurant you want to stay away from words such as like fried or um just like also deep fried and kind of go for those um words like booil bake and steam okay so um recently you told me that

you went to a restaurant um and I have the menu printed out here and I will give you a copy of that yes and um and you told me that you ordered the New York uh strip steak yes and you had bread and butter for your meal yes I did um so just looking at the options here we do have a fresh fish option at the top yes and it says it's simply grilled with olive oil or you could get it pans seared baked or blackened with lemon shallot butter so I would probably say um

maybe to stay away from the um lemon shallot butter choice and maybe steer towards the simply grilled with olive oil um or the uh maybe the baked and the not ped um you could do the paner but the other ones are are better option so that's um they have so I would have enjoyed the tilapia for example okay so that's what I like to eat actually chil and sea bass I would have enjoyed that too so that's an option that you would be en willing to change so going for those um terms and maybe doing

like maybe a fish option every once in a while as opposed to doing a steak yes okay um some other um tips so when you're ordering if you want to order a salad um instead of um ordering um the salad and getting kind of like a a caesar dressing or something like that they typically kind of put a lot of dressing on salads so maybe ordering it on the side um is a better option because then you can be in control of how much you um would like to add onto the salad okay and typically

um going for maybe like a balsamic dressing is good or you could do a balsamic and olive oil dressing um typically most restaurants will have that option yes and I like balsamic vinet so um also in regards to restaurants portion sizes are typically very large and you had mentioned earlier that you know sometimes you just like don't know when to stop eating or you you think you're hungry than you are and you just eat a lot at once yes when you when you give that example with the bread yes so um a good tip is

to kind of ask for to go box in the beginning um when you get to the restaurant um after your meal comes and just put half of the food in the Box and don't open the box take it home it's kind of bang for your buck too right because then you can eat another meal later yes and you could if you do choose a healthy option you can take it to work the next day and you'll have a lunch option for you here sure at the office yes um also when it comes to salads you

really don't so here they have um the chopped spinach salad for example there's bacon egg radishes mushrooms and warm bacon dressing MH just because a menu item um has all these things included does not mean that you have to get it with all those things in it okay so you can easily tell them oh can I have the chopped chicken or chopped spinner salad without the bacon right I don't like bacon so well then that's that is something that you could ask for for that salad because I mean spinach is great mushrooms are great radishes

are great egg um is great you can always take out EG whites or I mean the egg yolk if you don't want the egg yolk or anything like that so um a lot of restaurants I think nowadays are accommodating because they want to have your they want to have your business yes so they're going to try their best to make the customer happy yes so um for me personally I often ask for changes in my um in my orders unless they specifically specify please do not make Chang es um to the order or we can't

make a change to this order um I typically change majority of my orders um because the foods that you eat or foods that are commercially made are not necessarily the healthiest yes they're made to appease the pallet right um so they usually um have lots of fat and you know sugar and sodium and those kinds of things added to it to appeal to a wider variety of individuals um I have a um little handout here um so we can talk about some like portion sizes okay so a fist um would be considered like a cup

of rice or pasta MH um or fruits or vegetables so it's about the size of your fist is one serving size now that's cooked rice I hope um yes cooked rice mm not yes cooked rice um the palm of your hand is about 3 oz so that would be for fish meat or poultry so that's about the size some people say like a deck of cards is about 4 o um so around there and then if you're going to have nuts or raisins a handful is about 1 oz so like a little handful so one

thumb would be 1 oz of hard cheese or peanut butter and you said you eat a lot of cheese wow I love cheese yeah and then for your thumb um is a a teaspoon of or a thumb tip is a teaspoon of cooking oil or margarine or butter and sugar teaspoon is a teaspoon why don't we try and start setting some goals for you in regards to some food okay of what would work let's see so we're going to put some gos okay one so what is what is one goal that you want would like

to accomplish for let's say eating out that I want to accomplish for eating out yeah so would you um would a goal be that you want to um choose um grilled options oh I see what you mean okay um would you be willing to do that choose grilled options you know it's sometimes that would be a goal way so how do you feel about journaling it was uh difficult to do but it was very exciting mhm because it is making me um uh it helps me actually meet an objective okay so that seems like something

that we can that you can start do I usually get up reallyy early 6 o'clock in the morning and would you have time to journal then uh yeah I can make the time for that okay so um how many days a week would you say you could Journal I can technically journal every day okay so why don't we give a range of times so why don't we say um four to seven times a week in the mornings for um we can say until um our next session so we can we can go back and recap

how the journaling is going for you what am I journaling um just if I'm going to do it in the morning journaling how you're feeling um physically um maybe the food reflect on the food choices that you had made the day before um maybe set some you said you like setting little objectives um maybe little mini goals for yourself for the day um things like that okay so in regards to restaurants mhm um would you be willing to choose a grilled baked or broiled option that is easy for me to choose actually okay that's great

so um why don't we just make sure we're doing that um let's say um 75% of the time you're eating out okay that is really uh very doable for me okay um we because I do it every lunchtime when I go that's exactly what I do okay we try and um a good idea is living by kind of like an 80 20% rule so 80% of the time you're making healthy choices 20% of the time you can kind of you know um feel like you're not as restricted because it seemed like in the past being

on a very strict diet doesn't work in the long run because that's not how life works yeah and things are thrown at you and you have to be a little bit valuable to to your different situations yes so um those are some good goals um now I would like to talk talk a little bit um maybe about some physical activity yes so I'd love to be to use my gy cost me too much money yes so um I'm understanding that you do want to become more physically active and you've had experience in the past being

Physically Active what do you feel has prevented you from from being physical active is it time is it being tired it's actually both um time and being tired okay you know what kinds of physical activity do you enjoy doing if you were to do physical activity what do you like do you like walking you like biking swimming recreational activities swi I love swimming okay um I would uh I don't mind actually going on a treadmill on a bicycle I I do enjoy those things because they do revive me okay when when I do it mhm

it's when I don't do it that I'm start the start that's difficult very getting there yes yes okay so um okay so starting is difficult um but just remember that any little changes you're making are are good even if it's going to the gym um for a little just a little bit like 20 15 20 minutes or just walking outside of your house um you know after work or in the morning or on a lunch break just going outside getting some fresh air um how do you feel about maybe parking further I do that okay

you know it's interesting but I don't do it all the time M so um maybe we'd like to set a goal for that so um what about um what what seems good for you how often do you want to do it every time what would you like to park far I should be doing it all the time for a while I did and then I stopped and then I parked like the closest I can it's true so even that alone will give you a little bit more that's physical activity exercise so um maybe parking um

I don't know an exact distance but parking further away if you're going to the grocery store if you're going in and out of places just walking more in general yes um can help but I get the idea though mhm I get the idea typically once um you start something you kind of like and start seeing results yes um you that's I get so that's where your motivation is so your motivation lies in seeing results yes yes okay so then something to remember is that results don't come overnight and that's hard yes to have to stick

to something and constantly remembering that and maybe that's something you could write about in your Journal too saying that results literally writing results don't happen overnight mhm because if you do stick to a plan over time you will see results and it will be exciting for you yes I'm going to write this so maybe getting up in the morning and going on the treadmill how often would you be willing to do that per week you know if realistically week realistically I mean I'd love to do it four times a week four times a week okay

so for how long do you think you can we can go on it I always uh um wanted to be on a treadmill for about 60 Minutes 60 yeah it feels good when I'm on treadmill for 60 minutes is do you think that would be realistic for your schedule now that we're saying that we're going to be journaling to start out you mean mhm to start out probably not okay so why don't we start trying with um 20 minutes okay so or 15 or 10 minutes or 15 what works best for your schedule what is

realistic to tell you that uh I have tried the 10 and 15 minute and it doesn't do much at all it doesn't feel like I I've done much you know what I mean but over time I guess it depends also on how fast I'm I'm I'm using the treadmill M and over time it will help but you also have to couple it with your with um I down ches I I put down 20 minutes 20 minutes start for 20 minutes a day for 4 days a week mhm excuse me on the treadmill and I can

start without doing the inine or anything just to get myself back into doing it okay getting used to it yeah just going through the motions until it becomes kind of second nature right right they say it takes about like 27 or 30 somewhere around there days to develop a habit oh really that's interesting point I'll have to get you the exact number later but yeah so for it to start feeling second nature so it seems like you are really you want to make you're you're preparing to make the changes right so yes you know you

know that you want to make the changes and you feel ready to make do you feel ready to make these changes uh I actually do yes I mean I was really really happy um when you approached me to have this uh this meeting I really was and uh that's why I was sharing with you the details uh it's almost like into confession you know and because because I don't feel good about where I am mhm I really don't yeah um maybe one last thing I can mention for right now um is water reason why it's

I like water and I it's easy for me to drink water is because my throat got used to actually taking in that much water it's not a fight it used to be a fight at the beginning yeah you know that's like me too drinking water for me is a struggle and I have to make myself do it but I know that I'll feel rejuvenated and I'll my body will function better and it'll let my metabolic processes happen like they should and get my food and digestive system going so they're very I mean we're made up

of mostly water so your body your body needs that yes and just keeps you more alert when you're dehydrated do um typically more sluggish and you're Le more likely to make um poor nutrition decisions yes yes so just drinking water so why don't we you said you've done it in the past right how do you feel about drinking five bottles of water I I I honestly would not mind at all especially if I start exercising I think so you know what's really cool is they have apps now oh that you can track how much water

you're drinking oh on um I'll have to um grab the name of the app tell me what for you m yeah and you can track how much water you're drinking on there and there's other we um um sites or apps like my fitness pal that you can track what you're eating and it will track all the calories and things like that for your day so um why don't we go over um why don't we recap some of the goals so I just want to make sure that you're understanding you know what we went through and

um some things that we talked about okay you want me to tell you what they are yes please okay so um the first thing you said is how about if I did some journaling and and you said to do it uh between four and seven times per week in the morning um and then uh I should actually indicate also in my journaling how I feel MH uh also you said to reflect on the food choices that I made for the day the day before MH and that should be part of my journaling you said yes

um may be noting some goals for the rest of the day so I want to drink five remember to drink five bottles of water a day as part of my journal things like that just kind of like reminders for yourself mhm okay the second thing there were five things Al together the second thing was we talked about restaurants because I eat out a lot mhm and he said that I really should choose always put in my mind that I should be choosing Roy Baker theme 70% of the time but if I go with the 8020

rule it will be good I can do 80% of the time I should be doing good choices 20% of the time it can be bad choices that's okay because of humans so that's basically what I remember you said well I also want to reiterate that it's you know there's no good food and bad food right so there's no such thing as good food or bad food that's when we we come like portion sizes right so food is food yes but we want to have more you know plant-based foods and lean meats and lowfat dairy and

um whole grains and things like that um and fruits and things um because of all the health benefits that they have and then we want to you know for sweets and other other treats and desserts we want to keep them as treats and desserts and by doing by keeping a portion size small we can also um you know continue our goal of weight loss okay because we don't want to you know deprive you and then all of a sudden oh I want to binge eat all this food right so and you know there's you know

events and parties and things like that that you kind of need to be um you know okay with you know living a little bit yes so uh the okay uh that's very good points and um I noted those things MH uh the third thing is the physical activity mhm he said that I should really begin if I do like can enjoy using the treadmill for example um I ought to consider maybe 20 minutes to start um and um um every 29 to 30 days uh chances are you will develop a habit yeah I don't remember

the exact time frame but um it's somewhere around there okay it helps you develop a habit that's fair enough um so maybe keep it as a goal just to get there just to get to that point yes as a motivator yes mhm and number four was Park far away give yourself as much give yourself as much time uh to you know put in some physical activity even if you go into the office yeah so that's very logic number five the fifth thing you talked about is uh which was more of an educational piece and you

said it was all about calories and you said that would I should be considering is taking in about what would be 500 less calories per day MH and if I did that it would equate a loss of one pound per week yes and U and don't forget to increase your water intake by basically take the five bottles that I that basically I was saying that I used to do so start drinking more water and um maybe the reason why we drink water is because um carbohydrates attach themselves to water and that it is a good

idea to reduce carbohydrates are important for the body but at the same time uh a lower intake of the carbohydrates would probably be helpful in G with weight loss well it will be helpful with water I mean it will result in water weight loss but that's not really fat loss so that will water weight will come back when you drink a bunch of water again so that's not really the weight loss we're looking for we want fat loss okay we want decrease in fat M and increase in lean mass MH so so how mean how

are you going to lose the fat the um yeah the fat loss through your diet and just exercising will will result in fat L better choices that will result in Fat Loss right which which is basically always think Roy Bak steam right that's 3 3500 calories is one pound of fat so 3500 calories oh my God yeah you're reducing your one pound of fat is 3500 calories which is why if you decrease by 500 * 7 is 3500 calories a week oh M so um oh do these all seem like changes that are doable then

they're excited they're doable for they're doable for a start yeah okay so um that's great I'm glad that you are feeling confident in some of the things that we've talked about and just remember that you know every day is a fresh start so even if you didn't do as well as you wanted to the day before it's not the end of the world life continues and you kind of just have to tackle it a day at a time yes and that journaling will help for you to reflect on you know maybe why you you know

if you were wake up upset for some reason about something that happened yes Journal about it and then move on right and kind of let that let that go and don't think oh I had one cookie I'm just going to eat the whole box because I because I messed up or something like that because that's not really how it is you're in control you need to just remember that you're in control and um you are in charge of what you put in your body and you know you have this overarching goal of weight loss and

um you know getting getting healthier and you know being here for the long long ha yes so um I would like to schedule another uh followup session with you okay um in about two weeks if that works for you two weeks is fine okay that's a good idea perfect you know then we can check back in and see how we do it right yes and then we can you know see some other goals or maybe you know increase exercise if you if you want to and things like that so yeah very good thank you very

much really really wonderful appreciate your time thank you oh and I have this hand out for you to take with you oh good thank you and this is just um to choose my plate recommendations of how many um what your plate should look like so take a read on these and then we can discuss them next week or in two weeks excuse me in two weeks okay okay you got it thank you very much