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Lifestyle Management of Adult Obesity

Diet Plan


A low fat, low calorie, and high fiber diet was prescribed. Emphasis was placed on both short-term realistic goals (0.5 to 1.5 lbs of fat loss per week) and developing a foundation for long-term maintenance of a healthy, palatable diet. Retrospective studies suggest that, long-term, low fat, high complex carbohydrate dietary patterns are most effective for weight loss and maintenance. [63] [64]

Based on measured resting energy expenditure adjusted for light physical activity, and estimated and anticipated caloric expenditure during exercise and increased lifestyle physical activity (PA) after 1-2 months (1100 in exercise and 800 in increased lifestyle PA), a 1400 kilocalorie diet was prescribed. In light of her type 2 DM, particular attention was given to meal planning, high fiber, and low glycemic index foods. A macronutrient distribution of 25% protein, 55% carbohydrate, and 20% fat was prescribed. Since she does not consume alcohol, this was not an issue with respect to calorie distribution.

The caloric distribution was prescribed to be 350 protein (~88 grams), 770 carbohydrate (~192 grams), and 280 fat (~31 grams). A slightly increased dietary protein percentage was suggested to compensate for increased protein needs when sedentary adults initiate a regular exercise program.

Mrs. Jones was advised to consume these calories in three meals and two snacks per day including, in particular, a high fiber breakfast. In addition, it was recommended that she try to consume 75% of calories before 6:00 pm. She also was seen by a certified diabetes educator (CDE) for education about type 2 DM and self-monitoring of blood glucose.

Several recent studies have shown the safety and efficacy of the DASH (Dietary Approaches to Stop Hypertension) Diet on lowering blood pressure in adult men and women of varied ethnicity with Stage 1 hypertension or upper normal levels. [65] [66] [67] [68] One study of the DASH Diet showed that a low sodium diet of 1500 milligrams per day optimized the efficacy of this diet which on average is 26% fat and 6% saturated fat with 143 mgs cholesterol intake per day. [67]

Key components of the DASH diet are clearly compatible with a hypoglycemic diet and include 7-9 servings of fruits and vegetables, 6-11 whole grain servings, 4-6 ounces of lean animal foods, and 2-3 low fat (1% or less) dairy product servings per day.


Pertinent information

Importance of low fat, high complex carbohydrate, high fiber dietary patterns.

Consider

DASH diet for increased success; consultation with Registered Dietitian.



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Last Update: March 6 2013