Home > For Consumers > Education and Prevention > Patient Education > Lifescripts

Lifescripts

Lifescripts methodology card: nutrition and weight management

Helping patients eat well for health.

Lifescripts methodology card: helping patients eat well for health (PDF 119 KB)

Hard copies of this document can be ordered from National Mailing and Marketing - see Lifescripts order forms.

html version of nutrition and weight management methodology card

Ask, assess, advise, assist, arrange
Evidence for the benefits of healthy eating

Ask, assess, advise, assist, arrange

Ask

Less intensive (1-5 mins)

Identify patients who would benefit from brief advice on nutrition and/or weight management

• Waiting room checklist and poster
• Patient record prompts: check eating habits at least every two years
• Prompts by practice staff
• Patients with high cholesterol and blood pressure and/or are overweight

Ask: 'How do you feel about your eating habits/weight at the moment?'

More intensive (5-15 mins)

Identify patients who would benefit from brief advice on nutrition and/or weight management

• Waiting room checklist and poster
• Patient record prompts: check eating habits at least every two years
• Prompts by practice staff
• Patients with high cholesterol and blood pressure and/or are overweight

Ask: 'How do you feel about your eating habits/ weight at the moment?' Top of page

Assess

Less intensive (1-5 mins)

Assess current eating habits and weight

• Assess:
  • current eating habits and/or weight - if high risk consider more intensive intervention
  • interest and confidence in changing

Ask: 'Are you interested in changing your eating habits/ losing weight?'

• Assess barriers to change (e.g. 'What would be the hardest thing about changing?')
• Record lifestyle habits in patient's record

More intensive (5-15 mins)

Assess current eating habits and weight

• Assessment tool:
  • eating habits
  • body measurement
  • interest and confidence in changing
• Identify individual barriers to change
• Assess mental health status
• Record lifestyle habits in patient's record Top of page

Is the person ready to attempt change?

If yes, ready to attempt change, continue with the 5As approach

If no, not ready

• Advise on benefits of healthy eating and weight
• Offer information and resources
• Assess interest in changing at later date

Advise

Less intensive (1-5 mins)

Advise on benefits of change

• Provide brief, non-judgemental advice about positive benefits of change
• Advise on recommended eating habits and weight

More intensive (5-15 mins)

Provide tailored advice

• Provide feedback on healthy eating and nutrition
• Provide brief, non-judgemental advice about positive benefits of change
• Discuss individual benefits Top of page

Assist

Less intensive (1-5 mins)

Offer resources and support

• Offer information/ resources
• Encourage social support

More intensive (5-15 mins)

Write nutrition prescription

• Jointly devise strategies for support
• Individualise the prescription (incl. goal setting)
• Make an individual plan to deal with common challenges
• Offer information/ resources
• Encourage social support Top of page

Arrange

Less intensive (1-5 mins)

Arrange follow-up

• Negotiate a separate consultation
• Organise follow-up review

More intensive (5-15 mins)

Arrange referral and follow-up

• Consider referral to an Accredited Practicing Dietician
• Consider referral to a physiotherapist and/or an accredited exercise physiologist
• Consider referral to local services, a weight management or lifestyle modification program
• Organise follow-up appointment in 2-4 months for review Top of page

Evidence for the benefits of healthy eating *

Diet plays a major role in health and in recent decades it has been shown to reduce or increase the risk of various diseases¹.

Health benefits of healthy eating

• Lower risk of early death
• Lower risk of coronary heart disease and stroke
• Lower risk of high blood pressure
• Lower risk of adverse blood lipid profile
• Lower risk of type 2 diabetes
• Lower risk of metabolic syndrome
• Lower risk of colon cancer
• Increases energy and sense of wellbeing.^1,3,4

Health benefits of 5–10% weight loss in overweight patients

• Reduction in blood pressure
• Improvements in dyslipidaemia
• Reduced risk of type 2 diabetes and improved control in those with existing type 2 diabetes
• Improvement or resolution of sleep apnoea
• Improved self esteem and quality of life
• Improved exercise tolerance.^1,3,4 Top of page

Nutrition in Australia

More than half of the Australian population consume fewer than two serves of fruit a day and over 80% consume fewer than five serves of vegetables per day².

High body weight is estimated to be responsible for 8% of the total burden of disease in Australia, placing it a close third behind tobacco smoking and high blood pressure². About half of Australian adults are overweight or obese. An estimated 2.5 million Australian adults were obese (19% of males and 17% of females). A further 4.9 million Australian adults were estimated to be overweight but not obese (41% of males and 25% of females), with the highest rates of obesity being among males aged 45–54 years (23.2%) and females aged 55–64 years (21.7%)².

Figure 1: Inadequate consumption of fruit and vegetables by socioeconomic status 2004–05

Top of page
Text version:

	Inadequate fruit intake	Inadequate vegetable intake
Group 5 (low)	50.8	87.0
Group 4	48.8	85.0
Group 3	46.8	85.6
Group 2	44.1	86.2
Group 1 (high)	40.6	86.6

Healthy measurements

For most people a waist measurement higher than the following is associated with increased risk of chronic disease⁵.

Increased risk:

Men: > 94 cm
Women: > 80 cm

Greatly increased risk:

Men: > 102 cm
Women: > 88 cm

Classification	BMI (kg/m2)	Risk of co-morbidities
Underweight	< 18.5	Low (but increased risk of other clinical problems)
Normal range	18.5 - 24.9	Average
Overweight:	25 or more
Pre-obese	25 - 29.9	Increased
Obese I	30 - 34.9	Moderate
Obese II	35 - 39.9	Severe
Obese III	40 or more	Very severe

Top of page

Nutritional guidelines

To help reduce risk of chronic disease⁶, it is important to recommend patients eat a wide variety of nutritious foods, including:

• plenty of vegetables, legumes and fruits
• plenty of cereals (including breads, rice, pasta and noodles), preferably wholegrain
• lean meat, fish, poultry and/or alternatives
• milks, yoghurts, cheeses and/or alternatives. Reduced-fat varieties should be chosen, where possible
• drink plenty of water

and also limit intake of:

• saturated fat
• added sugar
• salt (sodium)
• alcohol (if the patient chooses to drink)

Benefits of physical activity

Physical activity is a necessary component of weight management. It helps reduce abdominal fat and can help to reduce total body fat⁷. A physical activity Lifescripts may be appropriate to complement a healthy eating Lifescripts.

Can general practice make a difference?

Ongoing support is needed for successful weight management. Long term follow-up is vital to monitor the patient's dietary, physical activity and lifestyle behaviours. Supportive follow-up will help the patient resolve set-backs and reinforce any positive changes that have been achieved. Top of page

What referral options are available?

Referral to an Accredited Practicing Dietitian may be necessary for those individuals who are overweight/ obese or require more specific nutritional advice and support. Referral to a physiotherapist or an accredited exercise physiologist may be appropriate for individuals looking at increasing their levels of physical activity to achieve a healthier weight.

The National Heart Foundation of Australia telephone counselling service, Heartline, is staffed by trained health professionals who can provide further information on healthy eating.

Information about local community programs may be available from your local division, local council and/or state government.

Recommended reading

• Access Economics. The growing cost of obesity in 2008: three years on. Diabetes Australia; Canberra: 2008.
• Online Obesity Working Group. Technical Report No 1: Obesity in Australia: a need for urgent action. National Preventative Health Taskforce; Canberra: 2008.
• Booth A, Nowson C, Huang N, Lombard C & Singleton K. Evaluation of a brief pilot nutrition and exercise intervention for the prevention of weight gain in general practice patients. Public Health Nutr; 2006; Dec; 9(8):1055–61.

Useful resources

• NHMRC Nutrient Reference Values for Australia and New Zealand www.nrv.gov.au
• Nutrition Australia www.nutritionaustralia.org
• The Dieticians Association of Australia www.daa.asn.au
• CSIRO Health Heart Program 2008
• A Healthy and Active Australia www.healthyactive.gov.au Top of page

References

See www.health.gov.au/lifescripts

* References in this section are listed in risk factor area evidence references from the practice manual.

Page last reviewed: 18 March 2011