Nutrition, Physical Activity, and Occupational Engagement

Nutrition

a cornerstone of chronic disease prevention and management, encompassing meal planning, preparation, grocery shopping, and food-related routines

Poor ____ quality is associated with obesity, type 2 diabetes, cardiovascular disease, cancer, and mental health decline

diet

People with severe mental illness have 2-3 times higher _______ prevalence compared to the general population, partly due to medications, poor diet quality, and barriers such as low motivation, limited cooking skills, and reliance on fast food

obesity

Barriers include environmental (food deserts, affordability, access to facilities) and ____ (stigma, knowledge skills) challenges 

personal 

From an OT perspective, nutrition falls under _____ _______ and instrumental ADLs, positioning OTs to address integration food-related occupations into routines

health management

Use _____ to screen for dietary patterns and identify at-risk areas

REAP-S

Skill-building strategies in OT nutrition interventions

• Meal planning aligned with cultural context, budget, and routines

• Grocery shopping training (e.g., navigating store, budgeting, online ordering)

• Cooking and preparation practice; using adaptive strategies for those with sensory, cognitive, or physical impairments

• Portion control and budgeting techniques to make healthy eating realistic and sustainable

How do OTs collaborate with dieticians?

OTs focus on habits, routines, and applying dietitian recommendations to real-life contexts

OTs bridge the gap between knowing what to eat and embedding nutrition into ________ everyday occupations

meaningful

Physical activity includes structured exercise, play, leisure, and _______ ______

incidental movement

Inactivity worsens fatigue, pain, depression, obesity, and functional decline, creating a cycle of _____ ______ and poorer quality of life 

reduced participation

Evidence strongly supports physical activity for _____ ______ in cancer survivorship, MS, and chronic pain conditions

improving outcomes

Physical activity fosters identity, mood improvement, and resilience, positioning it as a meaningful occupation rather than a ______ _______

medicalized prescription

Use ______ to evaluate baseline physical activity and track changes

IPAQ

OT role in routine development (physical activity)

embed PA into clients’ daily lives (stretching at work, leisure walking, gardening)

OT role in adaptive physical activity

modify activities, equipment, or environments to enable participation

OT role in graded engagement

introduce activity gradually, aligned with fatigue self-management and pacing strategies

OT role in advocacy for physical activity

address community barriers, promote inclusive leisure programs, and connect clients to adaptive sports or exercise groups

clinical example of client and physical activity 

A client with MS reintroduces swimming using pacing strategies, building confidence and endurance

Occupational engagement goes beyond occupational performance. It encompasses active involvement, meaning, ______, and _____ experience

motivation, subjective

Occupational engagement includes _______ and _____ aspects of being immersed in an activity, not just physical doing

emotional and cognitive

________ ________ sustains identity and well-being, especially when illness reduces function

occupational engagement

Vrkljan and Miller-Polgar (2001) found that women with breast cancer maintained occupations like gardening and cooking to prove that “______”

life goes on 

Vrkljan and Miller-Polgar (2001) found that _______ served as evidence of being alive and capable

occupations

Vrkljan and Miller-Polgar (2001) found that doing ______ normalcy, control, and dignity

restored

Vrkljan and Miller-Polgar (2001) found that engagement became a _______ ______ during illness

resilience mechanism

It is important to ask clients…..

“which occupations make you feel most alive and connected?” 

Occupational engagement is a human right. A lack of access creates _______ ________

occupational injustice

_____ _____ must be preserved; OE should be offered as opportunity, not prescription

client choice

Barriers to occupational engagement

• stigma

• systemic inequities

• illness burden

• limited community resources

How do OTs address barriers to occupational engagement?

• Advocate 

• Adapting environments

• Creating inclusive opportunities 

Integrated OT strategies in nutrition

Develop routines for grocery shopping, cooking, and meal prep

Integrated OT strategies in physical activity

establish engaging, realistic activity routines and adaptive opportunities

Integrated OT strategies in occupational engagement

anchor interventions in client values and identities

Integrated OT strategies in lifestyle redesign 

a structured OT approach to rebuilding health-promoting routines through occupation 

Integrated OT strategy example

Gardening= access to fresh produce (nutrition), daily movement (physical activity), and joy/purpose (occupational engagement)