Ching Siew Mooi
Universiti Putra Malaysia, Malaysia
Scientific Tracks Abstracts: Primary Health Care
Literature shows that discussion of specific weight loss targets with the children and family is not usually helpful and may causes them to withdraw from weight loss program. Instead of weight loss goals, we prefer to emphasize behavior goals for specific dietary habits and activities during discussions with the patient and family. Nonetheless, it is appropriate for the provider to keep weight targets in mind to ensure that a patient??s weight trend is safe and realistic. Weight loss goals are a function of a patient??s age and degree of overweight or obesity. For diet, healthcare providers need to be flexible by focus on healthy eating behaviors rather than prescribing a specific structured diet. A dietitian can be helpful in providing this type of counseling, particularly if the emphasis and content are coordinated with and consistent with that of the healthcare providers. Details on the approaches to common diet-related problems encountered in children will be outlines in the lecture. Counseling tools can be used in view of time constraint in the real clinical setting e.g. the ??balanced plate? or ??My Plate? was developed to teach balanced nutrition. Website like ??Choose My Plate? is an interactive useful tool to teach healthy dietary patterns. Using this plate as a starting point, the clinician can then guide the patient easily in discussions of nutrient quality within each food group, examples include: Skim or 1 percent milk instead of whole, whole grains instead of simple carbohydrates and lean proteins instead of higher fat choices. As an example, clinicians can use the traffic light format as a teaching tool, grouping foods based on their nutrient quality and calorie density and then explaining which foods should be eaten most often (Red: Eat rarely; Yellow: Eat less often; Green: Eat more often). Regarding activity, healthcare providers should encourage the children to increase physical activity and reduce the sedentary lifestyle including activities related to television, video games, internet and computer and other media. Substituting healthier behaviors and entertainment is helpful in achieving these goals. It may have varied according to the different age group. Increasing child and family levels of physical activity is a key focus in obesity treatment. It is generally recommended that children and adolescents participate in 60 minutes or more of physical activity a day. Regarding sleep, study show that shortened sleep duration is associated with obesity. Appropriate goals include good sleep hygiene and or aiming for adequate amounts of sleep is important in the weight management among children. Guidelines suggest preschool ages require 10 to 13 hours a night and teens require 8 to 10 hours. Role of allied health care provider is to have a brief counseling session by using a checklist. These brief counseling sessions can be repeated at each subsequent follow-up visit to provide continuity and reinforce the message. If progress has been made the nurses should praise the family and encourage additional work; if no progress has been made the nurses should engage in further problem-solving and/or work with the family to identify other goals that seem more achievable.
Ching Siew Mooi is an Associate Professor in the Department of Family Medicine at the Universiti Putra Malaysia. She has obtained her Master’s degree in Family Medicine at University of Malaya. Her research interests lie in the area of non-communicable disease like blood pressure, obesity, diabetes and addiction. She has published more than 50 manuscripts in peer review journal at the national and international level.
E-mail: sm_ching@upm.edu.my
