Clients At Risk 1 – 2

1. Pregnant & Lactating Women

• A pregnant woman is at a higher risk of Gestational Diabetes
• There is also an increased risk of the baby becoming overweight or developing metabolic syndrome later in life
• The right amount of weight gain during pregnancy will depend on whether you were at you most healthy weight before pregnancy
• The Institute of Medicine (2010) recommendations for total and rate of weight gain during pregnancy, by pre-pregnancy Body Mass Index.

Healthy Eating When You’re Pregnant or Breastfeeding

Calcium intake: a mother has increased capacity to absorb dietary calcium so no need for extra intake.

Multi-vitamins: a mother will need doctor’s advice. At-risk may be vegans or vegetarians or anyone with inadequate food intake, substance misusers ( including alcohol and nicotine), overweight already and trying to prevent further weight gain.

Vitamin A: excessive intake can cause birth deformities. Plenty in available food sources – milk, fish, eggs, margarine.

Iodine: important mineral needed for thyroid hormone production. Inadequate iodine – increased risk of mental impairment and cretinism in newborns. Common food sources include seafood, seaweed ( nori, kelp), eggs, meat, dairy, iodised salt.

Iron: a foetus draws iron from the mother to last 5-6 months after birth. Iron losses are reduced during pregnancy due to lack of menstruation. Iron rich foods include – meat, chicken, seafood, dried beans, lentils and green leafy vegetables. The mother needs to discuss with her doctor as large amounts of iron can be toxic

Folate: folic acid – B group vitamins – protects against neural tube defects in developing foetus. Many products in Australia are fortified with folic acid – bread, breakfast cereal and some fruit juice.

Alcohol: can increase the risk of miscarriage, low birth weight, congenital deformities, effects on baby’s intelligence.

Listeria: eating foods contaminated by this bacteria can lead to the risk of miscarriage, stillbirth & premature labour.

Listeria (listeria monocytogenes bacteria) – susceptible foods include:

• Soft cheeses (safe if served cooked and hot)
• Undercooked meat
• Chilled pre-cooked meat
• Pate, meat spread
• Pre-cooked or pre-prepared foods that won’t be reheated – salad, pate, ham, salami, quiche
• Raw and smoked seafood
• Unpasteurised foods – pre-prepared or pre-cut fruit and vegies, soft-serve ice-cream.

Salmonella: can cause food poisoning and can trigger miscarriage. Danger foods include; raw eggs, undercooked meat and poultry.

Mercury: high levels can be harmful to a developing foetus – 1-2 serves of fish per week should be ok.

Important!

• Pregnancy is not the time to eat anything you like but needs to be a time when optimal nutritional is beneficial for mother and baby
• Breastfeeding takes energy, so maintenance of a good nutritional diet is enough
• Pregnant women need to boost nutritional intake
• Good food hygiene is essential.

In all the cases of specific or at risk populations mentioned above, you must ensure that clients are referred to an appropriately qualified allied health or medical professional including but not limited to; Dietitians or Sports Dietitians for Nutrition advice.

2. Overweight / Obese Client

Behavioural and psychological issues need attention: not all weight issues are due to laziness and gluttony.

What are their triggers for eating?

• Knowledge is important but people need to want to change – only then does knowledge become important to them
• The knowledge provided needs to be simple and goals need to be short term and achievable
• Focus on what they can have not on what they can’t. This is not about restriction and starvation.

In all the cases of specific or at risk populations mentioned above, you must ensure that clients are referred to an appropriately qualified allied health or medical professional including but not limited to; Dietitians or Sports Dietitians for Nutrition advice.