Can we HALT obesity following lung transplant? A Dietitian and Physiotherapy directed pilot intervention

15 patients recruited into control group within the first two weeks of their transplant whilst still an inpatient. Once those 15 patients had finished their 3 month rehabilitation, the next 15 participants were recruited into the intervention group in the same fashion. Intervention group The intervention group will receive usual nutrition care and as part of the study (see Control group), will attend four 30 minute group education sessions within the first 3 months of transplant. Sessions include a powerpoint presentation, provision of resources and educational activities. The following topics will be covered at the (additional) intervention group education sessions by the Lung Transplant Dietitian: Session 1: General healthy eating based on the Australian Dietary Guidelines (NHMRC 2013b). • Discuss the different food groups, what one serve equivalent is, and how many serves are needed each day • Activities: guessing which food group a food belongs too; developing a day’s meal plan • Resource: Australian Guide to Healthy Eating booklet, blank meal plan template Session 2: Portion control and energy density. • Discuss energy content of fat, alcohol, carbohydrate and protein; discuss opting for less refined/processed carbohdyrates; discuss how to label read; discuss concept of energy in vs energy out through exercise • Activities: guessing which meal a) would take longer to prepare b) which is cheaper c) which provides more nutrition; guessing how long it takes to walk to burn the equivalent energy in different foods • Resource: ‘How to understand food labels’ from Australian Government website www.eatforhealth.gov.au Session 3: Exercise (by Respiratory Physiotherapist). • Discuss reasons why exercise is important after lung transplant, benefits of physical activity and recommended targets. Session 4: Mindfulness • Discuss how to calculate body mass index and healthy range, discuss waist circumference and healthy measurements, discuss benefits of being in healthy weight range, discuss SMART goals (specific, measureable, achieveable, relevant, timed), discuss monitoring of hunger, food intake and anthropometric measures, discuss rewards, discuss mindful eating • Activities: calculating their own body mass index; mindfulness activity (eating raisin) • Resources: Australian Government Department of Health “My Goals”, “My Physical Activity Planner”, “My Meal Planner” This group will then receive follow up with the Lung Transplant Dietitian via phone coaching at 4, 5, 6 and 9 months (approx. 30min each), with a face-to-face consultation at 12 months (approx. 60min). If participants within the intervention group require more intensive nutrition input (as per clinical judgement of lung transplant dietitian), they can also be seen on an individual basis in the lung transplant clinic, as per usual nutrition care.