Evidence-Based Nutrition Practice Guidelines and the Nutrition Care Process


7


the DPP intervention was reported in the 15-year follow- up. At this time point, a 27% reduction in diabetes onset was reported in participants in the original lifestyle- intervention arm.25


Other prevention studies have also


reported long-term reductions in diabetes incidence from lifestyle interventions.26


Overweight and Obesity


Overweight and obesity are complex, multifactorial chronic diseases that develop from an interaction between genetics and the environment and are associated with increased morbidity and mortality.27


An individual’s health


can improve with relatively modest weight losses of 5% to 10% of body weight.19


With nutrition therapy interventions


in overweight or obese adults, average weight loss is max- imal at 6 months, with smaller losses maintained for up to 2 years, during which treatment and follow-up usually tapers. Weight loss achieved by lifestyle techniques aimed at reducing daily energy intake ranges from 4 to 12 kg at 6 months. Thereafter, slow weight regain is observed, with total weight loss at 1 year of 4 to 10 kg and at 2 years of 3 to 4 kg.19


Planning Medical Nutrition Therapy Encounters


Multiple encounters between the RDN and a client are required to implement nutrition interventions that will facilitate the goals of nutrition therapy and achieve desir- able outcomes. The EBNPGs for lipid disorders, HTN, diabetes, and weight management also provide encounter guidelines, which are described in the sections that follow. The rating of each recommendation is listed parenthetically after the recommendation (see pages xii–xiv for rating defi- nitions). Note that for clients who present with multiple


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