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Efficient and highly educated Registered Dietitians who focus on continuous quality improvement and program development.

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An invaluable resource of nutrition consultants that follow the trends in healthcare and changes in regulatory requirements.

Claxton Dietetic Solutions Articles

Fuel to Move!
Registered dietitians are typically known as the “food and nutrition experts.” Here on the blog, topics usually center around food, nutrients, weight, eating habits, etc. But did you know that dietitians have a knowledge about exercise as well? I do want to be clear though, that registered dietitians are not exercise experts. We are not exercise physiologists, personal trainers and those of the like. But we do have a general knowledge of physical activity and understand the importance of implementing physical activity into a person’s life to not only achieve and maintain a healthy weight but attain an overall sense of wellbeing. There are many different types of exercises. Examples include but are not limited to: aerobic, strength training, low intensity, high intensity, stretching, interval and circuit training. As a clinician, it’s important to assess your patient or client’s current views towards exercise, current exercise habits and his/her attitude towards increasing physical activity (if deemed appropriate). Promoting increased physical activity should be in line with the person’s ability and affinity as well as within their desired schedule. Keep in mind we want to work within our scope of practice so if a patient/client is wanting a specific exercise regimen, it would be best to refer them to a local exercise specialist to meet those needs. One of the best ways we can help our patients/clients as they embark on an increased physical activity journey is to educate them on how to properly fuel their body for that exercise. A simple education on pre and post exercise foods will be immensely helpful to them. Here are a few tips to communicate to them during this time. Tips: 1) Overall, it’s important to utilize the “buddy system”- that being carbs + protein. Balanced meals and snacks will help keep a person fueled and satisfied not only through an exercise period but the rest of the day as well. 2) Pre Exercise: Utilize the “buddy system,” but focus more on the carbohydrates. Examples of good pre exercise snacks include a banana with 2 TB peanut butter, ½ cup grapes with one stick of string cheese, or a yogurt parfait with fresh berries and granola. 3) Post Exercise: Utilize the “buddy system,” but focus more on the protein. Examples of good post exercise snacks include 1 piece of fruit with a handful of nuts, whole grain wrap with turkey/cheese/veggies, or 1 piece of whole wheat toast with 2 scrambled egg whites. Again, these are just examples and the specific amounts of each food will be determined by you (the RD) for each patient/client to help meet their individual estimated needs and health goals. Remember to be specific and incorporate his/her personal food preferences to ensure compliance and sustainability! Head on over to the recipe page for an example of a great pre OR post exercise snack!
Food First Philosophy
Working as a dietitian in long term care or within a skilled nursing facility is a special job. You are getting to work with a population that has very real nutrition needs and most likely has nutritional deficiencies and/or weight loss. In fact, the most common issue you will see within this population is weight loss. How can we fight against this? Even prevent it? The answer- food first. The food first philosophy aims at increasing calorie/protein/nutrient intake while preserving quality of life; something that is very important in all stages of life, but especially this stage. So, what does “food first” mean? Well, it means exactly what it says. When trying to increase calorie/protein/nutrient intake utilize real food first before turning to oral supplements. Dietitians can sometimes come under the stereotype “supplement pushers.” But we are so much more than that. And yes, oral nutrition supplement have a very real place in our job and in some cases are the most appropriate option. But the food first philosophy encourages us to exhaust all real food options first (if appropriate) before recommending an Ensure, Boost, Magic Cup, etc. Below are some tips to help you implement the food first philosophy in your facilities: Food Preferences: Don’t neglect collecting food preferences for all new patients. This is crucial. This ensures the patient is getting foods and beverages he/she actually likes, getting them off on the best food possible. If your CDM gathers the food preferences, make sure and references these when making a recommendation for a patient. You don’t want to add fortified oatmeal at breakfast if the patient dislikes oatmeal. Fortified Foods: Speaking of fortified oatmeal… Utilize the fortified foods offered at your facility (or talk with the CDM/FSM about adding some to the menu). Fortified foods are simply foods with a little extra bang for their buck. Examples include cheesy eggs, fortified potatoes (made with butter, sour cream, etc.), fortified oatmeal (made with butter, brown sugar, etc.), fortified soup (usually a cream based soup with added protein). Energy Dense Foods: Educate the patient on energy dense food choices and/or make recommendations on how they can add them to their daily meal plan. Two examples of energy dense foods include nuts/nut butters and full fat dairy foods/butter. If a patient still has poor PO intake or is still losing weight after utilizing all real food options, then you move to oral nutrition supplement choices. These include but are not limited to Ensure/Boost, Magic Cup, Ensure pudding, MedPass 2.0, or  TF if medically appropriate. Be sure and consult the patient before making a recommendation for a certain supplement. Always be sure they are on board! The good news is, we have a lot of tools in our tool box when it comes to helping fend off weight loss and increase PO intake in the geriatric population; it’s just important to know which tools to use first.
Why Meal Plans Don't Work
If I have heard it once, I have heard it 100 times…” Can you make me a meal plan? I want to lose 10 lbs.” “I need to be healthier. Can you make me a meal plan?” “Can you make me a meal plan? I was just diagnosed as a type 2 diabetic.” It never fails. And do you know what my answer always is to them? My answer is always “No!” Normally this leads to a confused face on the other end, so I always follow my answer with an explanation. You see, people are always looking for an easy way out. They want someone else to do the work for them. And I get it. I am a busy woman. I work full time and have a three-year-old and a one year old. Not to mention a grocery shopping list, laundry to do, dishes to washes, etc. I get it. An easy way out sounds nice. But when it comes to making healthy lifestyle changes, the easy way out can actually slow the progress of true lifestyle change. It’s important to communicate this to your client prior to your first session or at the very latest during your first session with them. As RDs we are tasked with the responsibility of cultivating change in the way people eat, drink and even exercise. Cultivating long lasting, sustainable change takes time, effort and lots of input from the client’s perspective. Giving them a preset meal plan may help them lose weight in the short term, but they have not learned how to make healthy choices on their own and independence is key for the client to experience lifelong change.   Once they are on board with your “No Meal Plan” plan you can both begin the process of setting SMART goals (as talked about in a previous blog post). If you are having a hard time getting your client or prospective client to ditch the idea of a preset meal plan, try discussing the benefits of following a more flexible or intuitive eating plan instead of focusing on the negatives of a preset meal plan. I have posted some of those benefits below. Benefits of an Intuitive Eating Plan:- You will be getting rid of the diet mentality forever! - You will learn to not only recognize you hunger and fullness but honor it as well. - There will no longer be “good” and “bad” foods. - You will learn that meal satisfaction is a full circle experience involving not only the taste and texture of food, but also qualities of the environment around you. - You will learn to honor and respond to your feelings without using food. I believe intuitive eating leads to an overall healthier relationship with food and harnessing these techniques will ultimately lead to healthier and happier clients. Good luck!