There is often much confusion regarding how much information you can provide your client on nutrition. You should not be writing dietary plans or prescribing supplements to treat clinical conditions or their symptoms. So this includes the attempting to manage blood sugars in diabetic clients, or treating poly cystic ovary syndrome or reducing cholesterol levels. If a client is suffering with a medical condition it is vital that you refer them to a registered dietitian and do not try to manage their nutrition yourself.
You can however provide nutrition advice to a client in order to improve their general health. This should follow closely to the government guidelines on nutrition, these can be found on Public Health England’s and at www.gov.uk . So although you cannot prescribe a set diet to treat a client’s obesity, you can educate them about the principles of healthy eating and share some healthy eating ideas. Although you cannot treat a client’s high blood glucose levels, youcan discuss some low sugar, high fibre, moderate protein meals with them. Although you cannot prescribe someone calcium supplements, you can provide the client with research to show that calcium supplementation in a calcium deficit diet will improve bone health. So ultimately it is about how you communicate the nutrition information to your client.
Although you have your individual opinion regarding nutrition, when it comes to working with clients and professional boundaries it is important to understand the government guidelines, this way you can provide the necessary information to their client when required.
The governments’ healthy eating recommendations include;
It would benefit the client to be advised ways to do this, if they are currently having only one or two portions this could seem daunting. You should come up with easy examples such as snacking on a piece of fruit, adding a side salad to lunch and mixing in three tablespoons of vegetables with an evening meal such as chicken with rice and peas or adding aubergine and spinach to a lasagne.
Many clients will not know what starchy foods or fibre are, so educating them that choosing either oats, wholegrain bread or pasta, quinoa, long grain rice or potatoes with their skins on at two or three meals per day will be adequate information for some. Some clients may ask about portion sizes, however this is very dependent on their goal, age, weight and gender so you should direct them to the government dietary reference values (see table 2.1) and can discuss with them the amount of carbohydrates in common starchy foods. For example, a 200g potato contains approximately 40g carbohydrate, two slices of bread contain approximately 45g carbohydrates. They should also be aware of the carbohydrates in vegetables, fruit, dairy and legumes as this will all contribute to the advised carbohydrate daily intake.
The government recommendation for protein intake is much lower, normally less than half of what many fitness industry professionals consume personally and often advocate to their clients. Although it is beyond your scope of practise to prescribe a certain amount of daily protein to a client, you can present their client with evidence that individuals that do exercise training have a higher requirement for dietary protein than a sedentary individual.
You should advise the client to consume lean protein choices, especially if weight loss is the goal. You could discuss recipes together on how best to cook chicken, turkey, cod and other white fish. The client can also be recommended to eat at least one portion of oily fish per week to provide them with essential fatty acids that must be obtained from the diet. Government guidelines recommend a portion size is 140g.
You can advocate the daily use of dairy products according to the guidelines which state that options lower in fat, sugar and salt should be chosen. This is a good opportunity for you to educate the client about how to read labels to ensure they understand what is in their foods.
Comparing the labels of hard cheese with the label of 0% fat Greek yoghurt would show the client vast contrast in the amount of calories and fat in two dairy products. Using visual examples can help the client understand this further. You can prepare a 30g block of hard cheese and a 220g yoghurt and discuss that they both provide similar energy but if the client experiences hunger regularly it would be more beneficial to choose the Greek yoghurt as they can consume a higher food volume for the same amount of calories.
You should emphasise that it is not optimal for health to regularly consume high fat, high salt and high sugar processed foods. Generally, if a processed food is high in fat, it will be high in either salt or sugar as this enhances to the flavour. These foods include ice-cream, chocolate, cakes, pastries, salted nuts and bacon.
It is important that you do not ban foods, but just suggest to limit them realistically according to how often the client currently consumes them. If these foods are banned completely then it could result in the client feeling restricted and binging on those foods, causing feelings of shame and guilt and leading to further restriction and binging and the cycle continues.
If the client is currently consuming biscuits with their tea in the morning and afternoon rather than remove them completely the biscuits could be reduced in quantity or an alternative could be provided. A natural sugar source such a small pot of Greek yoghurt topped with berries would allow the client to still satisfy their taste buds with something more nutritious. Simple swaps such as swapping a full size chocolate bar to a fun sized one or swapping roasted peanuts to natural almonds are a good starting point to reduce the intake of processed foods.
You should encourage the client to increase their fluid intake mainly from water but if this is disliked adding a squeeze of lemon or low sugar cordial can help increase daily fluid intake.
It should be made clear to the client that juices and fizzy drinks are not an optimal way to increase fluid intake as these drinks are high in sugar and can damage teeth.
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