Wellness Protocol: Cholesterol Control

PHILOSOPHY:   For persons who feel they can change their eating habits and lower their cholesterol on their own, without attending a formal class or seeing a dietician. This counseling is designed to address the client's individual needs and increase their chances for success.

FORMAT:   The Wellness Counselor will be available during posted office hours. The client can come in weekly or a schedule can be worked out as needed. The sessions will consist of a review of approved dietary material, and periodically checking the client's cholesterol.

Session I. Initial Contact

1. Recheck cholesterol. Complete Follow-up Form.



2. Inquire about physician contact if cholesterol is still high. Encourage all clients to make an appointment if they have not seen a physician. Offer to call while the client is in the office.



3. Go over the American Heart Association (AHA) diet with client and have them pick one item they feel can be changed for one week that would make their eating healthier. Have client commit to a date when she/he will implement the change.



4. Give wallet card to client and explain its use.



5. Set an appointment for next visit.

Materials:

• Step By Step
• Wallet card (developed by the University of Michigan Worker Health Program).
• Follow-Up Form (developed by the University of Michigan Worker Health Program).

Session II. Second Week

1. Go over material given during first session



2. Discuss changes made and have client choose others.



3. Help client understand the difference between saturated and unsaturated fats. Show client how to read labels.



4. Explain that triglyceride levels affect total cholesterol, and that the amount of sugar and alcohol consumed affect triglyceride levels. Review safe drinking guidelines.



5. Emphasize importance of daily physical activity such as walking, swimming, biking, simple aerobics, etc.



6. Set an appointment for the next visit.

Materials:

• Key Aspects of the New Nutrition Label (FDA Consumer, 1993 or more recent)

Session III. Fourth Week

1. Recheck cholesterol and continue review of approved dietary materials.



• If readings are high or borderline, ask about intake of saturated fats and of alcohol. If either needs lowering, encourage this. If both seem to be within recommended limits, suggest that client ask his/her physician to check triglyceride levels. Suggest it is possible that client should avoid all alcohol and/or cut down sharply on other intake of sugars.



• If readings are high, recheck at 3 and 6-month intervals.



• If readings were borderline at screening and have not changed, or have gone into the high category, recheck again in 3 months.