Community Dietitians, Community Dietitians, Community Nutrition & Dietitian Community Nutrition & Dietitian

Service,Service,HSE SouthHSE South

1515thth October 2014 October 2014

Carbohydrate Awareness –Carbohydrate Awareness – Portion size & Type Portion size & Type

Today’s WorkshopToday’s Workshop Why focus on Carbohydrates?Why focus on Carbohydrates? Size matters! Weight management & Size matters! Weight management &

Portion size in Type 2 DiabetesPortion size in Type 2 Diabetes Educating patients on CarbohydratesEducating patients on Carbohydrates

What patients need to knowWhat patients need to know Amount?Amount? Type? Type?

Quiz – carbohydrate Quiz – carbohydrate Supporting information/training/materialsSupporting information/training/materials

Carbohydrates (carbs.) Carbohydrates (carbs.) - what’s all the fuss?- what’s all the fuss?

most important nutrient in diabetes control as directly most important nutrient in diabetes control as directly manages blood glucose levelsmanages blood glucose levels

+++ myths around ‘carbs.’:+++ myths around ‘carbs.’:‘bread/pasta fattening’, ‘no grapes/ bananas’‘bread/pasta fattening’, ‘no grapes/ bananas’ ‘cut ‘cut out carbs. to lose weight’out carbs. to lose weight’

‘‘having diabetes requires a sugar free diet’having diabetes requires a sugar free diet’ Size matters! Size matters!

Excess carbohydrate portions lead to raised blood Excess carbohydrate portions lead to raised blood glucose AND weight gainglucose AND weight gain

WEIGHT management is the biggest issue!......WEIGHT management is the biggest issue!......

National Weight Management National Weight Management AlgorithmAlgorithm

(HSE/ICGP 2011)(HSE/ICGP 2011)

National evidence based resources Goal: healthy lifelong weight management for all.

Different info available at:www.hse.ie/weightmanagement/www.healthpromotion.iewww.icgp.ie - supplementary info pack

Valuable to review all websites.

www.icgp.ie/weightmanagement

Understanding Energy BalanceUnderstanding Energy Balance

Excess FOOD including Carbs increases ‘calories in’

Giving Advice on CarbohydratesGiving Advice on Carbohydrates

Giving Advice on CarbohydratesGiving Advice on Carbohydrates

• What foods contain Carbohydrates?

Where do we get Carbohydrate?

Giving Advice on CarbohydratesGiving Advice on Carbohydrates

• QUANTITY ? VS.QUANTITY ? VS. QUALITY ?QUALITY ?

Amount Amount / Portion size / Portion size Vs.Vs. TypeType (GI) (GI)

Giving Advice on CarbohydratesGiving Advice on Carbohydrates

Day 1Day 1 Day 2Day 2

Bowl of porridgeBowl of porridge

1 slice brown bread1 slice brown bread

1 slice of white bread1 slice of white bread

Carbohydrate: Type (GI)Carbohydrate: Type (GI)

Giving Advice on CarbohydratesGiving Advice on Carbohydrates

Educate on foods containing carbohydrateEducate on foods containing carbohydrate Amount Amount / Portion size/ Portion size – most important to BGL – most important to BGL

TypeType (GI)(GI) – modest additional benefit – modest additional benefit Distribution throughout the day – meal timesDistribution throughout the day – meal times Consistency from one day to nextConsistency from one day to next Fibre ContentFibre Content Fruit – amount, types – dried, juice, tinnedFruit – amount, types – dried, juice, tinned Checking blood glucose – 2hr postprandial Checking blood glucose – 2hr postprandial

levelslevels

Using the Food Pyramid…Using the Food Pyramid…

Food pyramid servings are NOT equal in Food pyramid servings are NOT equal in carbohydrate or calorie content carbohydrate or calorie content

Need to watch portions & choose wisely Need to watch portions & choose wisely for wt mngt. (lower calories) & BG control for wt mngt. (lower calories) & BG control (slower absorption)(slower absorption)

~ 200 calories:

~100 calories:

Week 3 of X-PERT? Week 3 of X-PERT?

Carbohydrate Awareness QuizCarbohydrate Awareness Quiz

So to summarise….So to summarise….What do patients need to know?What do patients need to know?

Value in regular Value in regular nourishingnourishing meals everyday meals everyday What part of their meal is actually CHOWhat part of their meal is actually CHO Importance of portion sizes/amounts Importance of portion sizes/amounts Value in increasing veg. at lunch/main mealValue in increasing veg. at lunch/main meal Role of activity, weight, alcohol, meds on BGRole of activity, weight, alcohol, meds on BG What will influence their weightWhat will influence their weight How they can put it all into practiceHow they can put it all into practice

Supports for patients & health professionalsSupports for patients & health professionals

Refer to Community Dietitian – X-PERT /1-1Refer to Community Dietitian – X-PERT /1-1 Referral via online form www.hse.ie/xpert to 3 Referral via online form www.hse.ie/xpert to 3

HSE areas - HSE South, Dublin North East, HSE areas - HSE South, Dublin North East, Dublin Mid-Leinster (not HSE West)Dublin Mid-Leinster (not HSE West)

www.digp.ie – supporting info being addedwww.digp.ie – supporting info being added Poster for waiting roomPoster for waiting room Referral flyerReferral flyer Health profile formHealth profile form Tips on dietary treatment for patientsTips on dietary treatment for patients

Training from HSE Community DietitianTraining from HSE Community Dietitian

Supports for patients & health professionalsSupports for patients & health professionals

www.weigh2live.safefood.eu online wt loss supportwww.weigh2live.safefood.eu online wt loss support www.indi.ie (Irish Nutrition & Dietetic Institute) www.indi.ie (Irish Nutrition & Dietetic Institute)

factsheets, private dietitians…factsheets, private dietitians… www.www.carbsandcals.comcarbsandcals.com (user friendly resources to count (user friendly resources to count

carbohydrate & calorie content of common foods, APP)carbohydrate & calorie content of common foods, APP)

www.getirelandactive.ie www.getirelandactive.ie apps, physical activity apps, physical activity recommendations, tips, whats on. recommendations, tips, whats on. E-learning module: E-learning module: http://www.icgp-education.ie/physical-activity/http://www.icgp-education.ie/physical-activity/

www.healthpromotion.iewww.healthpromotion.ie training calender, order health training calender, order health literatureliterature

www.icgp.ie/weightmanagement www.icgp.ie/weightmanagement wt wt mngt. algorithm, BMI charts, support info..mngt. algorithm, BMI charts, support info..

Any queries: Any queries:

Community Dietitian Team in Cork/KerryCommunity Dietitian Team in Cork/Kerry Cork City: 021-4921641Cork City: 021-4921641 North Cork via Mallow: 022-58700North Cork via Mallow: 022-58700 West Cork via Clonakilty: 023-8832749 West Cork via Clonakilty: 023-8832749 Kery via Killarney: 064- 6670763 or Kery via Killarney: 064- 6670763 or

Tralee: 066-7195617Tralee: 066-7195617