(CDE). A CDE is a professional who has met standards and passed a qualified exam to be designated as someone knowledgeable and experienced in diabetes care. See the box How to Find a Professional for more information on how to find these professionals.
GET THE MOST OUT OF YOUR VISIT TO THE RD
ASK YOURSELF WHAT YOU WANT OUT OF THE VISIT
Do some soul-searching before your appointment and determine what you want to learn from your visit. You will also likely be asked to make some changes; what are you willing to do? You should be in a state of mind to receive suggestions and act on them. If you feel your first RD doesn’t meet your needs, don’t give up; ask for another RD.
STAY POSITIVE
Forget the negatives you’ve heard in the past and start from scratch. If you are anticipating the worst, this negativity will set the stage and will become the inevitable outcome of the visit. Unfortunately, friends, family members, and health care professionals may have said some unkind and hurtful things to you about your weight, food choices, or food behaviors. Start your new relationship by viewing the RD as someone who is there to support you, and remember that it may take a few visits to formulate the right plan.
BE TRUTHFUL
Hiding information about your eating habits or behaviors will make it impossible to develop a personalized meal plan that can work. For instance, if you have a weekly date out with friends at a local restaurant, tell the RD. He or she can help you make the best choices at this restaurant and not force you to give up important parts of your lifestyle. Tell the RD what your favorite foods are—any plan that cuts out these foods completely will be difficult to follow.
SET SHORT-TERM AND LONG-TERM GOALS
Goal planning is an essential part of changing habits. Food habits have taken years to establish and will take time to change. A proper goal should answer three questions:
1. What? What you want to achieve (the change)
2. When? When you plan to achieve it (the timeline)
3. How? How you will achieve it (the strategy)
EXAMPLE: “I will substitute a 15-gram carbohydrate food choice for my mid-morning snack at work instead of a candy bar (1). I will start doing this next Monday (2). I will go to the store on Saturday and select some new things that have about 15 grams of carbohydrate in them (3).”
Without these three elements, it is difficult to initiate change. During your appointment, write down your goal and include these elements to provide a clear concept of your plan. Your goals should be realistic—losing 20 pounds overnight is not a good short-term goal. In setting only a few realistic goals at a time, you will be better able to make changes that will last a lifetime, rather than just a few days.
REMEMBER, NO ONE’S PERFECT
No matter how great your meal plan, there are going to be times when you fall off the wagon. Ask your RD about relapse prevention and strategies on what to do if you get off track. One very important tip: Do not call your plan a “diet.” This word has a negative and short-term implication. Medical literature calls it a “medical nutrition plan,” but most RDs will simply call it a meal or nutrition plan. Another word to drop from your food vocabulary: “cheating.” Instead, you make “choices” with food. Learning how to incorporate your favorite foods into your plan will help you stick with your plan.
BRING IN A FOOD DIARY
A food diary can help you identify some previously unrecognized food behaviors, such as unconscious eating (nibbling while you cook, snacking while watching TV, grabbing a handful of something as you breeze through the kitchen) or nervous snacking (eating while you are stressed or nervous). See the food diary sample in Table 1 for an example.
TABLE 1. SAMPLE FOOD DIARY
TAKE THE SHOPPER AND CHEF WITH YOU
The person who prepares your food should, if possible, accompany you to the RD visit. No, this does not mean you should hunt down Ronald McDonald. But if your wife or husband does the cooking for you, they should learn what you learn. Knowing what to buy and how to prepare the food is an important part of putting together the pieces of a meal plan. Ultimately, though, the responsibility to follow the plan falls on the person who holds the fork.
TAKE MENUS AND EMPTY BOXES WITH YOU
If you visit a particular restaurant on a regular basis, ask for a menu and bring it with you to your RD visit. With this information, you and the RD can identify healthy choices and develop strategies for eating healthier while eating out. The same is true for some of your favorite boxed foods—take in the label. With your real-life tools (menus, labels, etc.), you will be able to individualize your plan and practice making choices.
COMPLETE A NUTRITIONAL ASSESSMENT
Ideally, your RD will have you to complete a nutritional assessment, which should ask for:
ASK FOR A FOLLOW-UP
Determine when
