You can still dine

In addition, at times people may probably prefer a liberalised diet on occasions such as weddings, anniversaries, and birthday parties; likewise to ensure that individuals enjoy mealtimes, meal managers, caterers, and chefs take the opportunity to prepare tasty local cuisines.

According to the Academy of Nutrition and Dietetics “food is not only critical to one’s physiological well-being, but also contributes to one’s social, cultural, and psychological quality of life; as nutrition aids in promoting health and functionality.” Factors affecting quality of life Factors such as advanced age, intellectual and developmental disabilities, mobility issues, lack of assistance at home, older adults supporting children and grandchildren with their finances and not having sufficient money to buy food and problems with dentition can impact meal preparation at home.

These can also increase the number of challenges the patient/ client might face.

Overall, one’s nutritional status can be affected by medical/ health status, physical/ functional status, cognition and environmental factors (which include but may not be limited to living situation, economics, cultural practices, religious beliefs, environment, lifestyle, as well as access to food and socialisation).

With this in mind, dietary intakes can sometimes be affected not only due these issues, but due to lack of food and nutrition knowledge, food dislikes, poorly prepared meals, as well as due to restricted and non-individualised diet. This of course, can contribute to unintentional weight loss, or lack of compliance with diet prescription. The Academy of Nutrition and Dietetics documented that “multiple disease states and their detrimental effects contributing to morbidity and mortality in the population can be prevented and minimised” through the utilisation of effective and timely diet and healthy lifestyle intervention. Healthcare professionals, stakeholders and community representatives should seek to develop policies and implement initiatives that will more than likely address the contributory factors fostering poor dietary practices and physical activity habits. Hence, nutrition and dietetics professionals should note some of the issues surrounding mealtimes and collaborate with the patient/ client, family members, meal manager, and colleagues in the interdisciplinary team to work together in resolving any issues.

Enjoying mealtimes Just having knowledge of someone’s food preferences can make a big difference regarding the consumption of the meal, avoiding wastage, and helping them to meet daily nutritional requirements.

In work- ing with the patient/ client the registered dietitian or meal manager can ask them to identify some foods that they like for the menu and select of their favourite recipes and snacks.

In some cases, the meal manager may try a few new recipes, modify as needed to suit the diet prescription, and invite the client or their family members to participate in meal preparation.

Also, to increase food and beverage intake and prevent unintentional weight loss, consideration can be given to liberalising the diet to include a variety of foods. Using the Caribbean Food Groups as a guide should be encouraged.

Food choices The diabetic patient/ client can select foods from all of the various food groups such as staples, legumes, foods from animals, vegetables, fruits, and fats and oils.

Personal preferences and metabolic goals should be taken into consideration when recommending the patient/client eating pattern. “For individuals using fixed daily insulin doses, consistent carbohydrate intake with respect to time and amount can result in improved glycemic control and reduce risk for hypoglycemia.” For the quantity of carbohydrate for the diabetic patient/client, the registered dietitians should develop collaborative goals with the individual.

“The amount of carbohydrates and available insulin may be the most important factor influencing glycemic response after eating and should be considered when developing the eating plan. Monitoring carbohydrate intake, whether by carbohydrate counting or experience-based estimation remains an essential strategy in achieving glycemic control.

For good health, carbohydrate intake from vegetables, fruits, whole grains, legumes, and dairy products should be advised over intake from other carbohydrate sources (which may include concentrated sweets, sugary drinks, pastries, etc.) especially those that contain added fats, sugars, or sodium,” according to Evert et al 2014.

The key is choosing nutritious foods, counting carbohydrates (or using the diabetic exchanges), understanding what is a portion, and portion control, taking time to read the food label and checking the ingredient list, and also incorporating foods moderate to high in dietary fibre, healthy fats (such as avocado, nuts, etc), adding more veggies to the menu (limiting carrots, pumpkin, and beetroot), and include only two fruits per day.

You should note that by omitting sugary beverages and foods high in fat and salt can more than likely help to improve your health.

In addition for persons without diabetes, studies show that the DAS H (Dietary Approaches to Stop Hypertension) eating plan is beneficial in assisting individuals in controlling blood pressure levels and lowering one’s potential risk for cardiovascular disease; it is frequently recommended as a healthful eating pattern for the general population.

The meal plan of the DAS H diet include food sources rich in potassium (fruits and vegetables), magnesium (dried beans, tofu, peanuts, potatoes, dark green leafy vegetables, milk, bread, ready-to-eat cereals), calcium (dark green leafy vegetables (spinach, broccoli, dasheen leaves), milk and milk products, dried beans.

It should also include calcium-fortified foods (juices, breakfast cereals, soy milk, almonds), protein (fish, poultry, egg, milk, yogurt, cheese) and dietary fibre (whole grains and whole grain products, legumes, ground provision, starchy fruits); limit lean read meats, concentrated sweets, added sugars, and sugar containing beverages.

Claudette Mitchell, PhD, RD is assistant professor, University of the Southern Caribbean, School of Science, Technology, and Allied Health.