Healthy lifestyle choices

Healthy food choices

Ask

  • How much fruit and vegetables person eats each day
  • How often person buy’s take-away food
  • How much soft drink person has in a day
  • How often person has bush tucker
  • Does person know how to read labels on packaged food — dietitian can help
  • About family and social factors that influence food choices

Do

Assess

  • Home environment and financial concerns
  • Access to healthy food and recreational facilities

Encourage people to  

  • Think about portion size — choose smaller serve (of soft drink etc)
  • Eat a variety of foods each day with lots of vegetables, lean protein, healthy grains and make sure foods on the plate are as colourful as possible
  • Eat more bush foods and locally grown food
    • Plant and animal bush foods are fresh and have plenty of nutrients
    • Most are low in fat, salt and sugar
    • Fruit and vegetables grown in the community are often cheaper, fresher
  • Eat fruit and lots of different types and colours of vegetables every day. Eat with lunch and dinner
  • Eat some wholegrain and wholemeal breads, cereals, rice, pasta with every meal
  • Choose water when thirsty

Eat less fatty food and fried food

  • Eating too much fatty or fried food can make people put on too much weight, increases risk of diseases like diabetes, heart disease
  • If buying take away food — choose salad, sandwich/roll, meat and vegetable dish
  • Eat more lean meat and bush foods
  • Cut all fat off meat before cooking, take skin off chicken
  • Eat up to 2–3 serves of fish a week. Use fresh or canned in water
  • Use canola or olive oil, polyunsaturated/monounsaturated oils or margarine. These are better fats, but still fats — only use small amounts

Eat and drink less sugar

  • Try not to add sugar to tea and cereal. Don’t add to Milo
  • A lot of sugar is hidden in foods and drinks
  • Too much sugar can cause tooth decay, weight gain

Eat less salt and salty foods

  • Try not to add salt to your food
  • Avoid foods with lots of salt added — tinned meats, sausages, hams, sauces, gravies, pies, sausage rolls, crisps, instant noodles

Follow-up

  • Refer to dietitian
  • Regularly assess goals and give nutrition education

Regular physical activity

Ask

  • How often person exercises or is physically active, and for how long — including strength based activities
  • What sort of physical activity person enjoys. How can they do it more often
  • Who person could exercise/be active with on a regular basis
  • What person would like to achieve and set realistic goals
  • Consider a range of social and contextual factors that may influence an individuals level of physical activity

Do

Explain

  • Doing any physical activity is better than doing none
    • If not doing anything now — start by doing a little bit, build up over time to recommended amount
  • Be active on most, preferably all, days to reduce risk of diabetes, stroke, heart disease and some cancers. Can also help with emotional wellbeing
    • To reduce risk of diabetes, heart disease or stroke — do at least 30–60 minutes of moderate activity (like walking) 5 days a week
    • "That’s like walking to (name a place in community) and back"
  • Also do some activity to keep your muscles strong at least twice a week (eg weights, push-ups)
  • Lots of ways to keep physically active — walking, dancing, hunting, gardening, swimming, cleaning
  • Sitting down for a long time (eg for painting, storytelling, playing cards, watching TV) can lead to increased risk of diabetes and other diseases
    • Break up long periods of sitting as often as possible
    • Stand up and walk around at least every 20 minutes
  • Pregnant women should be encouraged to be active 
    • To improve muscular strength and cardiovascular function 
    • Reduce rates of hypertension and pre-eclampsia  
    • Reduce pelvic and back pain, gestational weight gain, stress and depression, and delivery-related complications

Set achievable goals with person for more daily physical activity, consider  

  • Using an action plan, review at next health check 
  • Cognitive behavioural support and follow-up 
  • Additional social support (eg buddy system, involvement in a group activity) 
  • Brief discussion to decide on reasonable, attainable goals, and a follow-up consultation 
  • Review options for community sports and support (eg buddy system, contracts for exercise, group activities)

Healthy weight

  • Advise people with healthy weight to avoid weight gain by
    • Staying active — aim to exercise at moderate intensity for about 1 hour a day
    • Choose amounts of nutritious food and drinks to meet their energy needs

Losing weight/overweight/obese

  • For overweight or obese adults, even a small weight loss (3–5kg or 5–10% of body weight) can have health benefits
  • Refer overweight/obese adults with a chronic disease to visiting dietitian to help with nutrition information and develop a weight management plan
    • Set realistic targets for weight loss — if target too hard to reach the person may not try
    • Weight loss can be quite slow — 0.5kg/week is good progress. Even stopping more weight gain is a step in the right direction
    • Overweight pregnant women should exercise and eat healthy foods but not try to lose weight until after the baby is born
  • The best way to lose weight is to reduce energy intake and exercise more. Discuss a person’s readiness for behavioural change by talking about the person’s interest and confidence in making changes, as well as the benefits and difficulties of weight management
  • Advise to
    • Cut back on food and drinks that have no nutrients (eg soft drinks) or high energy foods (eg deep fried foods)
    • Start some moderate intensity exercise (eg walking). Progressively increase to about 1 hour a day, at least five days a week
    • Sit less
  • Remember: People often try to lose weight a few times before changing their behaviours

Ask, Assess, Advise, Assist, Arrange (5A’s approach) 

Using diet and exercise as example 

Ask 

  • About diet, exercise and changes in weight, previous diets 
  • How often person exercises or is physically active, and for how long including strength based activities 
  • What sort of physical activity person enjoys. How can they do it more often
  • Who person could exercise/be active with on a regular basis
  • About what person would like to achieve and set realistic goals 
  • Consider a range of social and contextual factors that may influence an individual’s level of diet and physical activity 

Assess 

  • Readiness to change diet and exercise — see Stages of change
  • Degree of overweight/obesity and associated risks and other comorbidities 

Advise 

  • Give advice in a positive way to all people who need to improve their diet and exercise 
  • Reducing at least 5% of body weight is one of the most important things a person can do to protect their health now and in the future 
  • Give advice that means something to person — talk about how it makes their health problems worse, have more energy to play with kids and grandkids 
  • Use additional information such as flip charts, pamphlets, other written or pictorial materials 

Assist 

  • Offer support and treatment based on readiness to change and comorbidities 
  • Diet and exercise plan 
  • Counselling and support (eg dietitian) 

Arrange follow-up 

  • Congratulate and be positive about decision to reduce weight, remind them of good things about improving their diet and increasing exercise 
  • Review progress, problems, encourage to them continue to improve their diet and exercise more 
  • Encourage them to keep trying