Hart Susan, Marnane Claire, McMaster Caitlin, Thomas Angela
Nutrition Services, St Vincent's Health Network, Darlinghurst, 2010 Australia.
2The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Camperdown, 2006 Australia.
J Eat Disord. 2018 Apr 1;6:6. doi: 10.1186/s40337-018-0192-4. eCollection 2018.
There is limited evidence to inform nutrition and dietetic interventions for individuals with eating disorders even though it is recommended as an essential part of multidisciplinary management. There is minimal guidance, an absence of standardised nutrition educational material, and no research on how best to educate patients on healthy eating and how to achieve nutrition adequacy. Therefore the REAL Food Guide was developed.
The REAL Food Guide is a pyramid with four layers and key nutrition messages beside each layer that was conceived to address gaps in nutrition education and intervention for individuals with eating disorders. Written and verbal consumer feedback was obtained from consumers receiving treatment regarding the acceptability and usefulness of the REAL Food Guide. A unique database was developed to reflect the types of foods and realistic portion sizes that patients are likely to select. This database was used for nutrition modelling to assess the nutrition adequacy of three meal patterns (meat containing, vegetarian and semi-vegan) for both weight maintenance and weight regain. Each meal pattern was compared to the Nutrient Reference Values for Australia and New Zealand.
Nutritional analysis demonstrated nutritional adequacy of meal patterns for energy, macronutrients and most micronutrients when the recommended number of serves from the REAL Food Guide were assessed. All meal patterns were adequate in micronutrients except for the semi-vegan meal pattern that was inadequate in vitamin D. Feedback from individuals with eating disorders demonstrates the nutrition education tool was acceptable to them as they felt it was more helpful for their recovery than general nutrition guidelines.
The REAL Food Guide is a comprehensive and user-friendly guide that clinicians can use to educate patients about components of a balanced and healthy diet. The guide can educate all eating disorder clinicians, including those who are new to the field, about the basics of nutrition. Clinicians using the guide can be confident that, if followed, patient's energy and nutritional requirements will be met and important nutrition education messages are reinforced, that are tailored to the beliefs and concerns of individuals with eating disorders.
尽管营养和饮食干预被推荐为多学科管理的重要组成部分，但针对饮食失调患者的此类干预措施的证据有限。相关指导极少，缺乏标准化的营养教育材料，也没有关于如何最好地教育患者健康饮食以及如何实现营养充足的研究。因此，制定了《REAL食物指南》。
《REAL食物指南》是一个有四层的金字塔，每层旁边都有关键的营养信息，旨在弥补饮食失调患者营养教育和干预方面的空白。从接受治疗的消费者那里获得了关于《REAL食物指南》可接受性和实用性的书面及口头反馈。开发了一个独特的数据库，以反映患者可能选择的食物类型和实际份量。该数据库用于营养建模，以评估三种膳食模式（含肉、素食和半纯素食）在维持体重和恢复体重方面的营养充足性。将每种膳食模式与澳大利亚和新西兰的营养素参考值进行比较。
营养分析表明，当评估《REAL食物指南》推荐的份数时，膳食模式在能量、宏量营养素和大多数微量营养素方面具有营养充足性。除了半纯素食膳食模式的维生素D不足外，所有膳食模式的微量营养素都充足。饮食失调患者的反馈表明，他们认为这种营养教育工具是可接受的，因为他们觉得它比一般营养指南对他们的康复更有帮助。
《REAL食物指南》是一份全面且用户友好的指南，临床医生可用于教育患者关于均衡健康饮食的组成部分。该指南可以让所有饮食失调临床医生，包括该领域的新手，了解营养基础知识。使用该指南的临床医生可以放心，如果遵循该指南，患者的能量和营养需求将得到满足，并且强化了重要的营养教育信息，这些信息是根据饮食失调患者的信念和关注点量身定制的。
