PINPOINT THE BEST WAY TO ORGANIZE MEAL & DIETARY TIPS FOR CLIENTS WITH REBECCA SNOW

Organizing meal and dietary tips for clients requires cognitive flexibility.   

Why? Each patient is so unique.  

I remember in early practice I really did not like detailed tracking, i.e., counting grams of macros and calories.  I focused on whole foods, meal changes, meal plans, and mindfulness.  But I came to realize that some of my clients really responded to structure.  I needed to adapt my meal planning for each client. 

First step is to assess your patient for a variety of factors.  Assess for: 

• disordered eating

• tracking fatigue

• preference for structure or flexibility

• preference for cooking and knowledge around the kitchen

• household members

• time for meal prep

• capacity for change

I have a questionnaire that I like to use to help ask these questions in a more structured way.  See the link here. 

After I assess the patient and their needs, here are some of the strategies I use…

1. Mindfulness focus – This is the least structured option.  I love using mindful eating guidance and practices for folks with dieting fatigue.  The focus is guiding patients to understand body messages, differentiate between hunger and build awareness around meal timing, practices and the HOW of eating.  I like to use a workbook with clients.  We will work through the workbook together, i.e. Tribole and Resch’s Intuitive Eating Workbook. 

   
   

2. Use the balanced plate diagram.  A picture is worth a 1,000 words.  Balanced plate diagrams provide clients with tactile and visual clues for recommended balance and food choices.  USDA has a plate visual, but you may wish to create your own for the population you work with.  You can change the size of plate, fill half with veggies, portion protein with hand or deck of cards, providing goals and suggestions. 

   
   

3. Single behavior changes – Dr. Huberman says that humans are wired to like “Go or No Go” behavior changes.  This is why so many people love exclusion diets like carnivore, gluten-free, and vegan.  These diets provide black-white thinking.  Eliminating a possible food sensitivity is a great experiment.  But single behavior changes can also be less restrictive and include healthy food swaps and tweaks.  Change a cereal breakfast to one with 30 g protein and 10 g fiber with 3-4 meal ideas.  Make healthy food swaps, like swapping homemade chicken salad or turkey for bologna deli meat or kale for iceberg.

   
   

4. Food exchange plans – Provide more structure without counting calories.  A prime example is the Institute of Functional Medicine’s Core Food Plan.  Exchange plans teach clients ideal serving sizes, modifies macros and calories without counting, modifies food groups eaten. This type of meal plan is harder to use when cooking complex meals.  This is good for folks who like to eat simply i.e. ½ baked sweet potatoe, 1 cup steamed broccoli and 6 oz baked salmon.

   
   

5. Targeted goals for tracking  - For folks that like structure and tracking, you can give them goals to aim for.  I usually recommend clients track in Cronometer since it has nice micro and macro data.  This strategy is useful when a patient is not meeting their health. I go to tracking when I feel that we need to “get into the weeds” to shift the needle.  i.e. boosting minerals in diet for bone health or shifting the protein:energy ratio for weight loss.

   
   

6. Menu with shopping list – This is the most detailed approach.  Provide your clients a week long menu or weeks of menus with shopping lists.  You can access these resources in books. They can be custom created.  AND they are available in apps for meal planning like EatLovePro, That Clean Life, and Real Plans.   These apps are going to produce menus which can be adapted for food sensitivities, therapeutic diets, family-size, ease of cooking and other factors. Keep in mind that this option does not teach your client how to meal plan but models it.  Best for folks with high motivation!

Drop a comment below...as a nutritionist or a dietician, which strategy is the hardest for you to practice with clients?

Rebecca Snow has been a CNS Supervisor for 10 years and a clinical nutritionist for 20. She is owner and founder of the Nutrition & Herbal Collective. As a CNS Supervisor, and nutrition mentor, Rebecca gives generously of her wisdom, experience, meal and dietary tips, to build up new nutritionists for success. She specializes in chronic illness and has worked in academia, group and private practice.  Come meet the supervisors of our internship for nutrition students, and learn about who they are.

Join an upcoming CNS Candidate Q&A Session to learn more about personalized mentorship for nutrition students and nutrition graduates.