Checklist Konseling Gizi Penderita Hipertensi dan Hiperlipidemia No 1 2.

Langkah/ Tugas Memperkenalkan diri Assess -Food intake and diet habits in the context of health risks -Current physical activity -Readiness to change behavior -From WAVE Nutrition Counseling Tool; W= Weight : Review BMI, blood pressure, lipid, blood sugar to screen for metabolic syndrome A= Activity: Conduct physical activity assessment. Ask about : Moderate physical activity? Goal-30 minutes/ day or more V= Variety E= Excess: For hypertention: Based on DASH- sodium diet: - Number of low-fat dairy foods? Goal: 2 to 3 servings/ day - Number fruits and vegetable? Goal: 8 to 10 servings/ day - Salt added to food? Goal : no salt added at the table, only half the usual amount in cooking - Use of frozen, canned, or dried processed foods (soup, spaghetti sauce, frozen dinners, helper mixes)? Goal: reduced sodium from processed foods - Alcohol intake? Goal: no more than one drink/ day for women and two drinks/ day for men For Hyperlipidemia: Conduct brief diet assessment. Ask about: - High saturated-fat foods like cheese, ice cream, butter, fatty meats? Goal-low fat dairy, lean meat, vegetable oils - High-fiber foods like oats, barley, or legumens? Goal-daily or several times/week - Number of fruits and vegetable? Goal-at least five/day - Number of meals and snacks? Goal-at least three meals/day - Use of sweetened beverages? Goal-if triglycerides high, eliminate or reduce significantly Advise Give clear, specific, and personalized behavior change advice. You might say: - Diet changes, exercise, and weight loss can reduce your blood pressure as much as medicine. Or Changes in your diet and exercise habit can lead to significant improvement in your blood fats and reduce your risk of heart disease. - For patients taking medication for diabetes, lipids, or hypertension: diet choices are important even if you are taking medication, since eating carefully helps the medicine do a better job. You may be able to save money by cutting down on the amount of medicine you take. - For patients NOT ready to change behavior, add: Id like to help you when you are ready to make changes in your diet and be more active. Agree -Collaborate with patient to select treatment goals and methods -Base goals on readiness to change behavior

-For patient NOT ready to change behavior: Is it okay if I ask you again at our next visit? Possible goals for patient ready to change: Return for registered dietitian visit. Keep food and exercise records to increase awareness, if patient willing refer for registered dietitian visit. Assist -Help patient acquire knowledge, skills and support for behavior -Provide hand-outs and web resources, based on patient interest and need -Provide lists and recommendations for community resources (exercise and diet programs, health clubs, etc) Arrange -Schedule follow up appointment Tambahan: Sumber sodium dalam bahan makanan Garam dapur Baking powder Bumbu penyedap Saos Selai Makanan dari mentega Terasi Keju Ikan asin Sosis Tauco Soft drink Soda kue MSG Pengawet makanan Kecap Jelli Obat mengandung sodium Petis Biskuit Sardencis Cornet beef Peanut butter

Sumber lemak dalam bahan makanan Minyak kelapa Lemak hewan Daging sapi Limpa Whole milk Daging babi

Kambing Kepiting Udang Coklat Kelapa dan hasil olahannya Mentega Hati

Jeroan Kuning telur Daging kerbau Ginjal Kerang Cumi-cumi Yoghurt

Anjuran: 1. Konsumsi susu skim 2. Kuning telur 3 butir dalam seminggu 3. Lebih sering mengkonsumsi tahu, tempe, dan jenis kacang-kacangan 4. Batasi konsumsi gula berlebihan 5. Lebih banyak mengkonsumsi sayuran dan buah-buahan 6. Lemak tak jenuh: minyak jagung, minyak kedelai, minyak kacang tanah, minyak biji bunga matahari, ikan, dan minyak ikan.