Ending Type 2 Diabetes One Exercise, Nutrition, and Gardening Class at a Time

Posts Tagged ‘Weight Loss Goal’

Come Exercise with Us! FHCHC DPP’s Exercise Class Video!

In Fitness Class on March 29, 2012 at 4:39 PM

Check out the FHCHC DPP’s latest video, and do the health-enhancing exercise video with us! No fancy equipment or space needed!


FHCHC DPP Partners with Wholesome Wave and City Seed to Provide Farmer’s Market Vouchers to Patients!

In About the Program on March 28, 2012 at 3:07 PM

This summer, FHCHC’s Diabetes Prevention Program is partnering with City Seed and the Wholesome Wave Foundation to provide farmer’s market vouchers to our patients. The program is called the Fruit and Vegetable Prescription Program (FVRx), and aims to improve health through access to farmer’s markets.  Medical facilities across the country will be participating this year in the program, and measuring the effects on patient health through the 4-month market season.

Frederico Corazzini - Photographer

The FVRx program is perfectly aligned with our commitment to utilize innovative and practical strategies for improving the health of our patients. Obese children constitute the index patient – however, each of the index patients’ fellow household members receive $1/day each as well for use at the farmer’s markets. This feature of the program further supports the FHCHC DPP’s commitment to treating the entire household unit, and strays from traditional medical models that focus exclusively on the individual patient. Because diet-related chronic diseases often develop in the home, programs that include all household members tend to produce better results!

For more information on the FVRx Program, go to: http://wholesomewave.org/fvrx/

For more information on FHCHC’s farm-based activities, check out New Haven Farms: newhavenfarms.org

The One Main Use of Food Diaries in Diabetes Prevention Nutrition Education

In Nutrition Class on July 1, 2010 at 1:10 PM

For clinicians, food diaries have one essential role: to guide curriculum development. Every single aspect of the food diary, from dissemination to evaluation, can be utilized as a teaching opportunity.

When Elizabeth asks who likes to read or write before handing out the food diaries, she gains insight into her patients’ literacy rate. Knowing participants’ literacy rate then informs how she might teach the segment on Nutrition Facts, for example.

When people fail to fill out or bring in their food diaries, Elizabeth can see that as an indication of a barrier that, if overlooked, could prevent them from accomplishing their healthy living goals. Non-participation, in other words, is an opening for providing extra support where needed.

Elizabeth uses the food diary content to influence the flavor of subsequent classes as well. For instance, imagine a participant writes, ‘1.5 cups rice with beans’ for lunch 5 days in a row. Elizabeth will talk about diversifying ones diet, especially in the direction of fresh fruits and vegetables.

If a participant is not loosing weight and their food diary indicates a responsible diet, Elizabeth then has a platform on which to inquire into their other habits that may be preventing them from accomplishing their weight loss goals.

At the close of programs, Elizabeth will use the food diary to track trends. “I have never seen a grapefruit in someone’s diary” she declares in an interview. People generally do not report snacks, nor does their fresh fruit and vegetable intake general rise above 33% per week. Understanding these constraints enables the Diabetes Prevention Program’s Nutrition Class to continually evolve to meet the needs of its participants.

How to Introduce Food Diaries to Diabetes Prevention Program Participants

In Nutrition Class on June 23, 2010 at 5:25 PM

Elizabeth begins cultivating Diabetes Prevention Program participants’ investment in using Food Diaries from Session I.

“Not knowing exactly what you eat or how much you exercise every day is like trying to buy a bicycle without knowing how much money you have in the bank; you wouldn’t know how much to spend, save, or borrow! Being aware of what you ate yesterday, however, makes it possible for you to know what would be wise for you to eat today. Knowing how much you exercised yesterday makes it easy for you to decide how to exercise today.”

People’s interest is peaked at this point, but owning the Diary as their personal tool for healthy living is not yet present.

“What did you eat for breakfast yesterday, Lucy?”

“A piece of toast.”

Elizabeth nods solemnly. ” Thank you! A piece of toast. Anything else?”

“Um, a cup of coffee also.”

“Thank you!” Elizabeth smiles. ” Anything else?”

Elizabeth teaches Diabetes Prevention Program participants how to use Food Diaries

“No. I don’t think so.” Lucy responds quickly.

The whole group is now listening intently, suspicious of Elizabeth’s grin and apparent enthusiasm.

“Was there anything else you had for breakfast yesterday?” She asks.

Lucy, somewhat surprised, takes a moment to think. “Ah yes, I had a glass of orange juice. I think I also tasted my mom’s torta.”

Elizabeth turns to the rest of the group, and declares with compassion and intensity, “It is difficult to remember what we eat, isn’t it? For that reason, it is sometimes easy to fool ourselves when it comes to our own health. But you ladies are committed to living long and vital lives, no?” Everyone concurs. “I am going to therefore provide you with a tool to use for the next 12-weeks of the program and on an ongoing basis as well. It’s called the Food Diary.”

Elizabeth then gages one of the more important factors influencing the efficacy of the Food Diary tool: participant literacy rate. Although their ability to use the Food Diaries will become abundantly clear within the next few weeks, she likes to get a general sense of people’s comfort levels from the start. “Who here likes to read or write?” A few people raise their hands. Elizabeth, in true form, thanks them for their candor.

At this point everyone is given a Food Diary, and Elizabeth proceeds to describe how to fill it out. Because the assignment is so unfamiliar and often jarring for people in the beginning, Elizabeth requests that they simply document the contents of their meals and physical activities from day to day. She coaches them to ignore portions and nutrition facts for the time being.

Elizabeth closes that component of the class with a reminder that using the Food Diary is central to avoiding diabetes, and their participation is correlated closely with their success in the program.

Food Diaries – What are They and Why are They Important in Diabetes Prevention?

In Nutrition Class on June 18, 2010 at 6:37 PM

A food diary is a simple notebook that participants use to declare their short-term physical fitness and dietary goals, daily exercise regimen, and food and beverage intake. Distinct from the recall method, where subjects chronicle their activities on a weekly or even monthly basis, studies have shown that lifestyle interventions are more effective when subjects account for their performance on a daily basis.

It is important to note here that the Food Diary does not single handedly change dietary and physical fitness behavior; nor is it presented as such by the program administrators. Indeed it is one of a series of interventions, the combination of which make the Diabetes Prevention Program as successful as it is.

The following english version of a food diary comes directly from the NIH:

Elizabeth explains how to use a Food Diary to DPP participants

Accountability – A Key to Changing Behavior

In Nutrition Class on June 10, 2010 at 9:54 PM

Elizabeth starts at the left end of the row, and asks the woman sitting attentively,” Did you bring your food diary?” The program participant opens a notebook, whose pages are clearly empty, and with a sheepish smile says yes. Without hesitation Elizabeth understands that something about the process got lost in translation. She moves swiftly from the front of the classroom and takes a seat casually next to the participant.

” Que comiste hoy? What did you eat today?”

” Nada.” The woman replies, simply.

” Nada?!”

” Only some snacks. And water.”

” Perfect! You write the specific snacks, quantity, and time eaten here, in this space. The drinks go over here.”

When Elizabeth is confident that the communication has been received, she takes her place at the blackboard again.

” Did you bring your food diary?” She asks the next woman in the row.

The woman replies affirmatively, and Elizabeth adds a check under the informal ‘food diary’ column she’s drawn on the elementary school music room’s blackboard. This is one of the providers’ ways of holding the program participants to account, as well as a way to track their progress. Elizabeth never fails to use it as a teaching moment either.

The next question is how many times they exercised that week. One woman has a question about whether the walking she did could be considered exercise. Instead of attempting to describe what distinguishes recreational from aerobic walking, Elizabeth demonstrates her answer. A fast walk around the classroom, arms moving deliberately back and forth with each stride, for up to 30 minutes consecutively, counts. A stroll from your bedroom to your car, however, does not.

The questions and answers continue, from pounds lost this week to overall weight loss goals. Elizabeth celebrates each reported minute exercising, and uses every instance when a participant failed to meet their goal as an opportunity to discuss common barriers and possible solutions. She thanks them for their participation and candor.

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