Manual of Clinical Nutrition

Calorie Controlled Diet for Weight Management

Manual of Clinical Nutrition Management C- 39 Copyright © 20 13 Compass Group, Inc.

Planning the Diet
The dietitian should plan an energy-controlled diet to meet the individual needs and lifestyle of the client.
Suggestions to reduce daily energy intake include (1-5,13):

 Reduce intake of foods with high-energy density (eg, alcohol and fat). Follow the US Dietary Guidelines of
less than 30% energy from fat, 10% to 20% from protein, and 50% to 60% from carbohydrates.
 Reduce the total amount of food consumed by decreasing portion size and frequency of consumption.
Employ behavior modification techniques to improve control over the food selection process and the act
of eating.
 Establish self-management training techniques that will enhance the satiety of meals but reduce the
energy intake. For example, encourage the patient to eat slowly so that the brain can register that the
stomach is full, or recommend eating ample amounts of low-energy density vegetables (eg, salads with
small amounts of salad dressing or fat-free dressing) to provide chewing satisfaction and fill the stomach.

*The Academy of Nutrition and Dietetics has assigned grades, ranging from Grade I (good/strong) to Grade V (insufficient evidence), to
evidence and conclusion statements. The grading system is described in Section III: Clinical Nutrition Management A Reference Guide,
page III-1.

References

1. Adult Weight Management Evidence-Based Nutrition Practice Guideline. Academy of Nutrition and Dietetics Evidence Analysis
   Library. Academy of Nutrition and Dietetics; 2006. Available at: http://www.andevidencelibrary.com. Accessed August 1, 2006.


2. Position of the American Dietetic Association: weight management. J Am Diet Assoc. 2009;109:330-346.


3. National Heart, Lung, and Blood Institute Obesity Education Initiative Expert Panel. Clinical Guidelines on the Identification,
   Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report. Bethesda, Md: National Institutes of Health;
   1998. NIH publication No. 98-4083. Available at: http://www.nhlbi.nih.gov/nhlbi/htm.


4. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection,
   Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001;285:2486-2497. Available
   at: http:// nhlbi.nih.gov/guidelines/cholesterol/index.htm.


5. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr, Roccella EJ, and
   the National High Blood Pressure Education Program Coordinating Committee. Seventh Report of the Joint National Committee on
   Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003; 42:1206-1252.


6. Diabetes Type 1 and 2 Evidence- Based Nutrition Practice Guideline for Adults. Academy of Nutrition and Dietetics Evidence Analysis
   Library. Academy of Nutrition and Dietetics; 2008. Available at: http://www.andevidencelibrary.com. Accessed December 10, 2008.


7. Festi D, Colecchia A, Sacco T, Bondi M, Roda E, Marchesini G. Hepatic steatosis in obese patients: clinical aspects and prognostic
   significance. Obes Rev. 2004;5:27-42.


8. Kennedy ET, Bowman SA, Spence JT, Freedman M, King J. Popular diets: correlation to health, nutrition, and obesity. J Am Diet
   Assoc. 2001;101:411-420.


9. Barlow SE, Dietz WH. Obesity evaluation and treatment: Expert Committee recommendations. Pediatrics. 1998;102:1-11.


10. Subcommittee on Nutrition Status and Weight Gain During Pregnancy, Committee of Nutritional Status During Pregnancy and
    Lactation, Food and Nutrition Board, Institute of Medicine. Nutrition During Pregnancy. Washington, DC: National Academy Press;
    1990.


11. Kennedy ET, Bowman SA. Assessment of the effect of fat-modified foods on diet quality in adults, 19 to 50 years, using data from
    the Continuing Survey of Food Intake of Individuals. J Am Diet Assoc. 2001;101:455-460.


12. Foster GD, Wyatt HR, Hill JO, McGuckin BG, Brill C, Mohammed BS, Szapary PO, Rader DJ, Edman JS, Klein S. A randomized trial of a
    low-carbohydrate diet for obesity. N Engl J Med. 2003;348:2082-2090.


13. Fabricatore AN, Wadden TA. Treatment of obesity: an overview. Clin Diabetes. 2003;21:67-72.