Structured Diet
Versus
Plate Method
Pinky Rose Viloria, RND
Kristia Lei Reyes, RND
PhilSPEN October 23, 2013
Outline
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Definitions
Examples of Structured Diet
Examples of Plate Methods
Advantages of Both Methods
Summary
Conclusion
Structured Diet
• Is a calculated diet based on the Food Exchange
List (FEL) used by Dietitians
• Used specifically for meal planning
• “structured” means:
▫ Food list/food groups
▫ Number of exchanges per group
▫ With distributions for the Meals and snacks of
the day
Example of Structured Diet:
• Diet Prescription: 1500 kcal, 245-55-35
Food
Exchanges
Breakfast
Fruit
Meat/Substitute
Rice/Substitute
Milk (for Coffee)
Sugar
Mid-A.M.
Snack
Rice/Substitute
Meat
No. Of
Exchan
ges
Sample Menu
Approximate Size per
Serving
1
1
1
¼
2
Ripe Papaya
Baked Ham Sausage
Pan Amerikano
Evaporated Milk
White Sugar
1 slice (10x6x2cm)
3 (9cm dia x 0.3cm thick)
2 slices
2 Tablespoons
2 teaspoons
1
1
Pan de Limon
Cottage Cheese
1 piece (6x5x4 cm)
1/3 cup
Plate Method
• Based on the latest USDA Dietary Guidelines
• Consists of a 9-inch plate
• Plate is divided like pie chart, divided into
portions of important food groups
• Uses different colors or pictures of foods
The Plate Model:
A Visual Method of Teaching Meal Planning
• A simple alternative to the traditional
exchange-based method for teaching meal
planning
• serves as a pie chart to show proportions of
the plate that should be covered by various
food groups
Camelon, Kathryn et. al. J Am Diet Assoc. 1998; 98:1155–1158.
The Plate Method is an Effective Education
Tool for Overweight Adolescents
Objective: To determine if the Plate Method of nutrition education
is an effective approach to teach overweight 10-14 year-old
adolescents (BMI > 95th percentile) in West Virginia to choose
healthier foods
Result: subjects have increased servings of fruits, vegetables, and
whole grains, while servings of soda/sweetened drinks and high
fat/sugar foods have decreased.
Conclusion: Using the Plate Method as a nutrition education tool
is an effective way to help overweight adolescents make healthier food
choices at meal-time(s)
Schoeppner, Heidi et. al. The Journal of the Federation of American Societies for
Experimental Biologies
The Healthy Diabetes Plate
• The Healthy Diabetes Plate, which used the plate
format to teach individuals about the type and
amount of foods they should consume at each
meal (by the University of Idaho)
• In 2004, the four-lesson curriculum was taught in
three urban and five rural counties
• Participants were able to correctly plan breakfast,
lunch, and dinner meals and improved their intake
of fruit and vegetables.
Raidl, Martha et. al. Prev Chronic Dis. 2007 January; 4(1): A12. Published online
2006 December 15. PMCID: PMC1832142
How to do it
Step 1
Take an average sized dinner plate and divide it in half.
In one half place non-starchy vegetables such as:
• Spinach, Broccoli, Cauliflower, Romaine lettuce,
Cabbage, Carrots, Tomatoes, Onions, Cucumber,
Beets, Peppers
• About one cup of raw vegetables is considered an
appropriate serving size.
• One cup would be about the size of your fist.
Step 2
Divide the other half of your plate in half again. In
one quarter place your protein source, such as:
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3 oz. of lean beef or pork
3 oz. of skinless turkey, chicken or fish
Tofu
Eggs
Cottage cheese
A 3 oz. serving is about the size of a deck of cards
Step 3
In the other quarter of your plate place your
starchy foods such as:
▫ Bread, Potatoes, Corn, Beans, Rice, Tortilla,
Cereals, Oatmeal
▫ Serving sizes range from ½ cup of rice to a baked
potato about the size of your fist.
Different Models
of the Plate Method
Harvard Healthy Eating Plate
US Department of Agriculture (USDA) MyPlate
Idaho Plate
UK Eatwell Plate
Population /group specific plate models
In addition to the Plate graphic itself, the new icon is accompanied
by the following nutritional guidelines that offer more information
for healthy eating.
•Enjoy your food, but eat less.
•Avoid oversized portions.
•Make half your plate fruits and vegetables.
•Make at least half your grains whole grains.
•Switch to fat-free or low-fat (1%) milk.
•Compare sodium in foods like soup, bread and
frozen meals—and choose the foods with lower
numbers.
•Drink water instead of sugary drinks.
Advantages of Structured Diet
• More accurate calorie counting
• Includes all food groups such as fats/oils, sugar
• Time and meal distribution is indicated
• Indicates number of servings or exchanges per
food group
Advantages of Plate Method
 Enhancement of the connection between dietary theory and
practice
 Promotion of memory retention and understanding through
visual messages
 Experience of a positive approach to nutrition counselling
 Various cuisines and festive foods can be incorporated into the
model
 Offers a meal planning approach that is simple and versatile
 Easier to understand
J Am Diet Assoc. 1998; 98:1155–1158.
Diabetes Plate Method offers many invaluable benefits to
the diabetic people:
1. The blood sugar level of a diabetic individual can be managed
under the required level every day since carbohydrates are
distributed evenly.
2. The consumption rate of starches, fat or cholesterol can
easily be maintained.
3. A diabetic individual will be able to get plenty of fiber,
antioxidants, phytochemicals and proteins which forms a
healthy diet.
4. Another notable benefit is the weight loss without extra
effort. As we know, excess body weight minimizes insulin
sensitivity.
Recording and Recall
Comparative List of High Nutrient and Low Nutrient Foods
High Nutrient Food
Low Nutrient Foods
Whole Grains, Breads, and Rice
Whole grains (wheat, oats, barley)
Whole grain breads, rolls, bagels, crackers and muffins
Whole grain and high-fiber cereals
Whole grain pasta
Brown rice
Croissants
Fried rice
Doughnuts and pastries
Sweet rolls
Cookies
Cakes
Egg noodles and pasta
Vegetables
Bean Sprouts, broccoli, Brussels sprouts, cabbage, carrots,
cauliflower, corn, cucumbers, green beans, leafy vegetables,
mushrooms, potatoes, summer and winter squash, tomatoes,
sweet potatoes, yams
French-fried potatoes, fried vegetables
Vegetables packed in sauce
Fruits
All fresh fruits, especially apples, oranges, apricots, bananas,
berries, cantaloupe, citrus fruits, peaches, pears
Canned or frozen fruits, unsweetened or packed in water or their
own juice
Canned or frozen fruits, sweetened packed in syrup
Fruit rolls
Fruit drinks
High Nutrient Food
Low Nutrient Foods
Proteins and Protein Substitutes
Eggs, egg whites, egg beaters, fish, chicken, turkey, round or loin
beef, round or loin pork, legumes, tofu, lean luncheon meats, nuts &
seeds
Hot dogs, luncheon meats, sausage, bacon, fried
fish, fried poultry, spareribs, prime cuts of meat.
Dairy Products
Nonfat, skim, and 1% milk
Nonfat products such as buttermilk, cottage cheese, and yogurts
Soy milk
Nonfat ice milks and sherbets
Fat Free or low fat cheeses
Whole milk
Whole milk products such as cheese, cottage
cheese, custard, milk shakes, pudding,
and ice cream
Beverages
Water
Herbal teas
Non caloric beverages
Sugared soft drinks
Alcoholic beverages
Caloric beverages
Fats
Vegetable oils (olive oil, canola oil, flaxseed oil, safflower oil)
Fat free sour cream, cream cheese
Nuts and seeds, flaxseed
Avocados, olives, dark chocolate
Butter, margarine, lard
Cream cheese, sour cream
High fat salad dressings
Cakes, cookies, high fat desserts
In Summary…
Variations among healthy diet plans
• Most healthy diets are built on the same general principles, but there are key differences that reflect
dietary preferences, food availability and cultural eating patterns.
• For example, the Latin American Diet Pyramid might mention tortillas and cornmeal, whereas the
Asian Diet Pyramid might include noodles and rice.
Other differences include:
1. Food groups
• The food groups among healthy-diet plans vary in some ways. For example, some versions have
plant-based proteins — soybeans, beans and nuts — in a separate group from animal proteins
found in meat, poultry, eggs and dairy products. This is because animal proteins are often higher in
fat and cholesterol, and some diets limit or exclude animal proteins.
2. Serving recommendations
• Healthy-eating plans also vary in the recommended servings of each food group. The Mayo Clinic
Healthy Weight Pyramid, for example, recommends a daily number of servings from each food
group. Other plans offer more-general guidelines, such as eating particular foods at every meal, or
on a weekly or monthly basis. Or that the Mediterranean Diet Pyramid recommends that you eat
whole grains, vegetables and fruits at every meal.
The plate method has been used for diabetes
meal planning. It also works well for weight loss,
teaching good nutrition and in improving blood
glucose and lipids.
Benefits
•Weight loss
•Improved carbohydrate distribution
•More nutritionally sound diet
•Increase intake of fibers
•Decrease fat and cholesterol intake
Try the Plate method for:
•People with busy lifestyle
•Seniors
•Feeling overwhelmed because of a recent
diagnosis or psychological circumstances
•Cognitive difficulties / Low literacy level
•For those with difficulties in using a more
structured approach
•Type 2 diabetes and needs to loose weight
Conclusion:
Whatever tool or principle you as a health professional will use, always
remember the Basic principles of a healthy diet:
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That the diet is appropriate to the needs and condition of the individual .
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Symbols/ tools (computed diets, pyramid & the plate) are educational tools to help us
visualize and understand the diet better, these tools illustrate how the pieces of a healthy
diet fit together.
•
Definitely, no single food provides all of the nutrients that your body needs, so the idea is
to eat a variety of foods from each group in the proper proportions to get all the necessary
nutrients and other substances that promote good health.
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Lastly , a healthy-diet plan/regimen should emphasize the following:
1. Eat more plant foods, including fruits, vegetables and whole grains.
2. Choose lean protein from a variety of sources.
3. Limit sweets and salt.
4. Control portion sizes.
5. Be physically active.
Putting the pyramid, the computed diet or the plate — to work for you
Know the specific needs of the individuals that needs to be addressed.
To see how your eating habits match up to these healthy-diet plans, keep a food diary
for several days. Then compare how much of your diet comes from the various
groups.
To eat healthier, start with gradual changes, such as eating more vegetables, fruits
and whole grains, and limiting fats and sweets.
• Choose a variety of foods
• This ensures that you get all of the calories, protein, vitamins, minerals
and fiber you need.
• Choosing a wide range of foods also helps make your meals and snacks
more interesting.
• Adapt the plan to your preferences
• How to do it?
Explore all possibilities!
• Combine foods any way you like but in the right amount
Sources
American Dietetic Association. "New MyPlate Is a Useful Tool for Consumers to
Follow Dietary Guidelines and Eat Healthfully, Says American Dietetic
Association,"
American Heart Association. "American Heart Association CEO Nancy Brown
Says New USDA Food Icon Is A Positive Step Towards Improving Consumer
Health,"
Hellmich, Nanci. "USDA Serves Nutrition Guidelines on 'My Plate',"
The Journal of the American Medical Association. "New Nutritional Icon Steps
Up to the Plate,"
Khan, Amina . "USDA to Reshape How We See Dietary Nutrition,"
Neuman, William. "Nutrition Plate Unveiled, Replacing Food Pyramid,"
United States Department of Agriculture. "USDA's MyPlate,"
Vastag, Brian. "At USDA, a Plate Usurps the Food Pyramid,"