Diet and Lifestyle

I am going to make a summary in regards of patient education for diet and lifestyle.

1. Exercise
CDC recommends 30-60 minutes of moderate (brisk walking, bicycling, vacuuming, gardening, or anything that causes small increases in breathing or heart rate) to vigorous (running, aerobics, heavy yard work, or anything else that causes large increases in breathing or heart rate) physical activity per day at least 5 days per week in all children.
Almost all patients should be able to incorporate recommended levels of physical activities in their lifestyle.

Barriers: Bad weather, lack of time and access to facilities or equipment etc. Attempts to further characterize and eliminate these barriers. PE classes are currently inadequate to meet physical activity recommendations.

2. Effect on Adolescents (all positive health-related behaviors)
- Decreased smoking
- Decreased drug use
- Increased fruit and vegetable consumption
- Decreased risk of pregnancy and STD
- Decreased anxiety, stress and depression
- Decreased illicit drug use
- Increased seat belt use
- Increased academic performance

3. Food
Plenty of fresh fruits and vegetables (5 servings) and less than 30% of total calories as fat
Fruit juice (can take only 10-12 ounces) is often an unrecognized culprit in childhood obesity and is not a substitute for fresh fruits.
Parents play a part as model since children will learn by example.

4. Others...
Avoid all diet fads and diet "revolutions"
Avoid anorexic drugs
Change composition of the diet
Attend multiple office visits to establish a baseline and to motivate continual weight loss
Decrease caloric intake to approx 500kcal/day less than energy expenditure --> loss 1 pound/week
Positive reinforcement from a support group etc.
Treat comorbid conditions

Hypercholesterolemia diet management:
Begin with Step 1 diet of AHA: no more than 300mg cholesterol, no more than 30% total fat and no more than 10% saturated fat.
Continue for at least 6 months. If cholesterol levels do not normalize, consider AHA step 2 diet: no more than 200mg cholesterol, no more than 30% total fat, and no more than 7% saturated fat.