QHow Do You Personalize a Diet Plan for Unique Dietary Restrictions?

Each and every client presents with a unique set of dietary needs, preferences, and restrictions. As dietitians, we need to be able to accommodate clients' needs in a very individualized approach. One size does not fit all. The first things I look at when sitting down with a client include height, weight, gender, activity level, and body fat percentage to help determine caloric needs.

When a client presents with a need to eliminate a specific food, food group, or nutrient, I assess what gaps in the diet this may present. Elimination of foods over a long period of time can create nutritional deficiencies. We work together on substituting other foods into the diet or adding supplementation to ensure the client is getting everything they need nutritionally.

Clients benefit from being able to understand how recommendations play out in real life. When someone has unique or various restrictions to their intake, translating options that accommodate those into real food examples is step one. For example, someone with lactose intolerance might understand they need to limit lactose in their diet, but what does that mean in reality? Create a list of familiar and preferred foods, and then review where sources of lactose might come from.

Step 2 is to then see where the diet might be lacking due to food avoidances and provide specific examples of foods that could fill those gaps. For example, often vitamin D intake is limited when dairy foods are restricted. Identifying specific vitamin D-fortified options that are lactose-free, or other food sources like fatty fish, is critical.

In my practice, I see many individuals with gut health issues. Due to the extent of their gut health, food groups may need to be eliminated to reduce inflammation and improve symptoms. Commonly, dairy is a culprit. Eliminating dairy for some individuals can feel very overwhelming; therefore, I set them up with meal plan suggestions based on this elimination. Here is one example:

• Breakfast: 3-4 eggs, 1/2 cup oatmeal, 1/4 cup berries, 2 TB almond/peanut butter
• Lunch: 4-5 oz taco meat, 1/2 cup rice, 1 cup cooked veggies, 10 olives, 1/4 avocado
• Dinner: 5-6 oz salmon, 1/2 cup quinoa, 1-2 cups sautéed veggies, 1 TB butter

Almost every single client will have some unique dietary preferences. This can range from not liking a food due to its texture to having an allergy to a food or food group. Any time I am personalizing a meal program for a client, I make sure that if I am removing a food or food group, I am including or emphasizing a food or food group that provides a very similar nutrient profile.

This is why working with an RD is so important. The public has wrongfully assumed that you can just stop eating a food group and be healthy. The aim is to avoid any nutrient deficiencies and also provide education for eating a balanced meal pattern most days. For example, if someone is lactose intolerant (the most common food allergy), they are losing out on a protein and calcium source, so I add more calcium- and protein-rich foods to their meal program, like beans and dark leafy greens.

As a gut health dietitian, many of my clients have IBS or other digestive issues that are associated with numerous dietary restrictions. I may recommend a short-term low-FODMAP diet followed by a structured reintroduction in order to identify food intolerances. In these cases, I create a personalized diet plan that accommodates the client's food preferences, nutrition needs, and recommended dietary restrictions in order to achieve symptom improvement and move forward with the FODMAP reintroduction process.