Health Promotion & Disease Prevention

**All names and scenarios are fictional for the purpose of learning education.**

I would start off by commending Mrs. Williams for recognizing that she needs to make a change in her diet and lifestyle. She is aware that her HBA1c levels are close to diabetic and she is motivated to control her sugar rather than become insulin-dependent. I would also encourage her by highlighting the positive aspects in her lifestyle as she does not smoke, drink, or abuse recreational drugs. Moving forward, I believe it is best to implement a strategy that focuses on building healthy habits slowly. The formation of a habit is oftentimes the most difficult aspect in weight loss. To be successful in long-term weight loss, Mrs. Williams should enjoy the changes, easily incorporate these changes into her busy schedule, and maintain these changes for sustainable benefits. I would also give a brief overview on calorie tracking and portion control so that she is fully aware of how much food and energy she requires in a day. However, I do not want her to become preoccupied with counting calories and to first try making healthier adjustments that work well with her current lifestyle.

Week 1:

For the first week, I want to focus on changing Mrs. Williams’ breakfast and snacking habits. At the moment, she grabs a donut on her way to work. A donut is packed with sugar and contains little nutritional value. This is a poor setup for the rest of the day as it will spike her sugar levels and not keep her full. Additionally, snacks can quickly add up up throughout the day. Breakfast and snacks are smaller meals of the day that Mrs. Williams can start adjusting so that the change does not feel so drastic. She can start her day by becoming more mindful of the foods she eats and continue these conscious eating thoughts  with the selection of snacks throughout the day.

• Breakfast: Replace donuts with healthier choices. For example, choose an English muffin breakfast sandwich with eggs from a deli nearby her office. Alternatively, overnight oatmeal with peanut butter and banana is also a quick and inexpensive breakfast that can be prepared at home. 
• Snacks: Make healthier conscious choices. Mrs. Williams does not need to cut out all snacks that she enjoys. For example, eat one serving of chocolate about the size of a thumb and include an apple with nuts. 
• Exercise: Try a ten-minute dance fitness video on YouTube each night. Mrs. Williams mentioned that she enjoyed dancing. Exercise does not need to be grueling and can be comprised of activities she already enjoys. Although ten minutes may seem like a short period of time, it’s best to ease into a new fitness regimen that can be maintained. Also, ten minutes can really work up a sweat!

Week 2:

In the second week, I’d have Mrs. Williams’ continue building additional habits onto the ones she has grown comfortable with in Week 1. This includes spending more time on preparing her foods and amping up her physical activity. 

• Continue Week 1 habits. 
• Meal Prep Dinners: Choose one night of the week to meal prep. Although Mrs. Williams enjoys cooking, it does take a long amount of time. The goal is to cut down on the amount of time while preparing enough food to sustain the week. For example, Mrs. Williams can prep staple foods such as brown rice and steamed veggies to ensure that she is receiving good nutritional value with each dinner of the week. She can switch up the protein source and toppings so that the meal plan does not seem monotonous. Mrs. Williams may also choose to meal prep with her husband and grandchildren so that it doubles as a family activity.
• Exercise: In addition to online workout videos, Mrs. Williams can incorporate steps in her daily activity. For example, she can stick with stairs instead of the elevator at the subway and at work. As she has a busy work schedule, this is a great way to add physical activity into her existing schedule.

Week 3:

• Continue Week 1 habits.
• Continue Week 2 habits.
• Lunch: Now that Mrs. Williams feels more comfortable with making conscious healthy decisions throughout her day, she can make healthier choices for lunch. Lunch is understandably the hardest meal in the day as she is busy at work. I would ask for her to explore dining options around her workplace. Perhaps there is a deli that makes fresh sandwiches that can be a healthier alternative to halal and McDonald’s. If she has grown used to meal prepping, she may enjoy making larger batches so that she can pack lunches to work. 
• Exercise: Implement bike riding on the weekends with her husband. Exercise can be an enjoyable activity that is done with loved ones. This builds the habit of physical activity very naturally into a person’s lifestyle. 

After 1 month, I’d like to see Mrs. Williams again and see if she implemented any of these changes and if there are any signs of weight loss. Adjustments to her meal plan and exercise can be made based on what lifestyle changes she was able to apply. Additionally, as Mrs. Williams is concerned with the use of Statins, I’d also suggest that we reevaluate her cholesterol levels. If they can be resolved with diet and exercise, then Statins can be avoided. However, if her cholesterol levels remain uncontrolled, I would try to explain the use of Statins and ameliorate any concerns she has.