nutrition 101: how to eat healthy in the real world liz revilla, ms, rd, csp registered dietitian

Nutrition 101:Nutrition 101:How to Eat Healthy in the How to Eat Healthy in the

Real WorldReal World

Liz Revilla, MS, RD, CSPLiz Revilla, MS, RD, CSP

Registered DietitianRegistered Dietitian

Pop QuizPop Quiz

1.1. Which of the following breads are Which of the following breads are alwaysalways whole grain? whole grain?

A.A. Whole wheatWhole wheat

B.B. Multi-grainMulti-grain

C.C. RyeRye

D.D. Pumpernickel Pumpernickel

Pop QuizPop Quiz

2.2. Which of the following foods does Which of the following foods does NOT contain any cholesterol?NOT contain any cholesterol?

A.A. EggsEggs

B.B. Low-fat milkLow-fat milk

C.C. Coconut oilCoconut oil

D.D. Ground turkeyGround turkey

Pop QuizPop Quiz

3.3. True or FalseTrue or False: Food products that : Food products that are labeled as organic must contain are labeled as organic must contain 100% organic ingredients.100% organic ingredients.

A.A. TrueTrue

B.B. FalseFalse

Pop QuizPop Quiz

4.4. Which of the following McDonald’s Which of the following McDonald’s menu items has the menu items has the fewestfewest calories?calories?

A.A. Grilled Chicken Club SandwichGrilled Chicken Club Sandwich

B.B. Quarter PounderQuarter Pounder

C.C. Southwest Salad w/ Crispy ChickenSouthwest Salad w/ Crispy Chicken

D.D. Double CheeseburgerDouble Cheeseburger

Pop QuizPop Quiz

5.5. A typical bagel served at Einstein’s A typical bagel served at Einstein’s Bros. is equal to how many slices of Bros. is equal to how many slices of bread?bread?

A.A. 1 slice1 slice

B.B. 2 slices2 slices

C.C. 3 slices3 slices

D.D. 4 slices4 slices

Nutrition 101Nutrition 101

What is a “healthy diet” anyway?What is a “healthy diet” anyway? Balancing food intake and physical Balancing food intake and physical

activityactivity Eating Healthy at Home and Out on Eating Healthy at Home and Out on

the Townthe Town Eating Healthy on a BudgetEating Healthy on a Budget

What is a “healthy diet” What is a “healthy diet” anyway?anyway?

““Eat Right and Exercise”Eat Right and Exercise”

We’ve all been told that is what we We’ve all been told that is what we should do to promote good health...should do to promote good health...

But:But: WHY is that important?WHY is that important? WHAT does that mean anyway?WHAT does that mean anyway? HOW exactly do I do that?HOW exactly do I do that?

What is “health”?What is “health”?

““A state of complete mental, physical, A state of complete mental, physical, and social well-being and not merely and social well-being and not merely the absence of disease”the absence of disease” World Health OrganizationWorld Health Organization

This does not just happen by accident!This does not just happen by accident! It doesn’t have to be complicated… It doesn’t have to be complicated… BUT it requires knowledge, planning, and BUT it requires knowledge, planning, and

consistency!consistency!

What is a “healthy diet?”What is a “healthy diet?” One that will allow you to be One that will allow you to be

consistent (and flexible) over timeconsistent (and flexible) over time A lifestyle change, not a “fad diet”A lifestyle change, not a “fad diet”

One that provides adequate calories, One that provides adequate calories, macronutrients and micronutrientsmacronutrients and micronutrients Does not exclude any food groupsDoes not exclude any food groups ““Food is fuel”Food is fuel”

And most importantly…One that And most importantly…One that TASTES GOOD!!TASTES GOOD!!

Benefits of a healthy dietBenefits of a healthy diet

Reduce your risk of many chronic diseases Reduce your risk of many chronic diseases – including obesity, cancer, heart disease, – including obesity, cancer, heart disease, stroke, diabetes, and osteoporosisstroke, diabetes, and osteoporosis

Improve your energy levels and immunityImprove your energy levels and immunity Provide the necessary ingredients for Provide the necessary ingredients for

normal cell growth and function (blood, normal cell growth and function (blood, bones, muscles, skin, etc.)bones, muscles, skin, etc.)

Maintain a healthy body weight and Maintain a healthy body weight and support physical activitysupport physical activity

The Old Food Guide PyramidThe Old Food Guide Pyramid

USDA, 1992.

The New Food Guide The New Food Guide PyramidPyramid

The 4 Principles of The 4 Principles of a Healthy Diet:a Healthy Diet: VarietyVariety ProportionalityProportionality ModerationModeration BalanceBalance

USDA, 2005.

VarietyVariety

Eat foods from Eat foods from allall food groups and food groups and subgroupssubgroups GrainsGrains VegetablesVegetables FruitsFruits Milk and DairyMilk and Dairy Meat and BeansMeat and Beans Fats and OilsFats and Oils

ProportionalityProportionality

Eat Eat moremore of some foods: of some foods: Fruits and VegetablesFruits and Vegetables Whole grainsWhole grains Fat-free or low-fat milk productsFat-free or low-fat milk products

Eat Eat lessless of other foods: of other foods: Foods high in saturated or Foods high in saturated or trans trans fats, fats,

added sugars, cholesterol, or saltadded sugars, cholesterol, or salt AlcoholAlcohol

ModerationModeration

Choose forms of foods that limit intake Choose forms of foods that limit intake of saturated or of saturated or trans trans fats, added sugars, fats, added sugars, cholesterol, salt, and alcoholcholesterol, salt, and alcohol Choose leaner cuts of meat to limit Choose leaner cuts of meat to limit

saturated fat and cholesterolsaturated fat and cholesterol Choose less processed foods to limit sodiumChoose less processed foods to limit sodium Consume alcohol in moderation (if desired)Consume alcohol in moderation (if desired)

BalanceBalance

Balance food intake with physical Balance food intake with physical activity by being active most days of activity by being active most days of the weekthe week Calories in = calories out (Weight Calories in = calories out (Weight

maintenance)maintenance) Calories in > calories out (Weight gain)Calories in > calories out (Weight gain) Calories in < calories out (Weight loss)Calories in < calories out (Weight loss)

GrainsGrains

Make half your grains whole.Make half your grains whole. Eat at least 3 ounce-equivalents of Eat at least 3 ounce-equivalents of

whole grain bread, cereal, crackers, rice, whole grain bread, cereal, crackers, rice, or pasta every day.or pasta every day.

Look for “whole” before the grain name Look for “whole” before the grain name on the list of ingredients.on the list of ingredients.

What is a whole grain?What is a whole grain?

Whole grains contain Whole grains contain all the essential parts all the essential parts and naturally-and naturally-occurring nutrients of occurring nutrients of the entire grain seed.the entire grain seed. The BranThe Bran The EndospermThe Endosperm The GermThe Germ

Refined grains are Refined grains are mechanically mechanically processed, and the processed, and the bran and germ are bran and germ are removed.removed.

Examples of Whole GrainsExamples of Whole Grains AmaranthAmaranth BarleyBarley BuckwheatBuckwheat BulgurBulgur Corn, including whole cornmeal and popcorn Corn, including whole cornmeal and popcorn MilletMillet Oats, including oatmeal Oats, including oatmeal QuinoaQuinoa Rice, both brown rice and colored rice Rice, both brown rice and colored rice Rye Rye Sorghum (also called milo) Sorghum (also called milo) TeffTeff TriticaleTriticale Wheat, including varieties such as spelt, emmer, farro, einkorn, Wheat, including varieties such as spelt, emmer, farro, einkorn,

Kamut®, durum and forms such as bulgur, cracked wheat and Kamut®, durum and forms such as bulgur, cracked wheat and wheatberries wheatberries

Wild riceWild rice

Whole Grains Council. www.wholegrainscouncil.org

How To Identify Whole How To Identify Whole GrainsGrains

Words you may see on Words you may see on packagespackages

What they meanWhat they mean

whole grain [name of grain] whole grain [name of grain] whole wheat whole wheat whole [other grain] whole [other grain] stoneground whole [grain] stoneground whole [grain] brown rice brown rice oats, oatmeal (including old-fashioned oats, oatmeal (including old-fashioned oatmeal, instant oatmeal) oatmeal, instant oatmeal) wheatberrieswheatberries

YES -- Contains all parts of the grain, so you're getting all YES -- Contains all parts of the grain, so you're getting all the nutrients of the whole grain.the nutrients of the whole grain.

wheat flour wheat flour semolina semolina durum wheat durum wheat organic flour organic flour multigrain (may describe several whole multigrain (may describe several whole grains or several refined grains, or a mix grains or several refined grains, or a mix of both)of both)

MAYBE -- These words are accurate descriptions of the MAYBE -- These words are accurate descriptions of the package contents, but because some parts of the grain package contents, but because some parts of the grain MAY be missing, you are likely missing the benefits of MAY be missing, you are likely missing the benefits of whole grains.whole grains.

enriched or unbleached flour enriched or unbleached flour degerminated (on corn meal) degerminated (on corn meal) bran bran wheat germwheat germ

NO -- These words never describe whole grains.NO -- These words never describe whole grains.

Whole Grains Council. www.wholegrainscouncil.org

VegetablesVegetables

Vary your veggies.Vary your veggies. Eat more dark green veggiesEat more dark green veggies Eat more orange veggiesEat more orange veggies Eat more dried beans and peasEat more dried beans and peas When possible choose fresh, frozen, or When possible choose fresh, frozen, or

“no salt added” canned vegetables.“no salt added” canned vegetables.

““EatEat thethe Rainbow”Rainbow”ColorColor FoodsFoods PhytochemicaPhytochemica

lslsHealth BenefitsHealth Benefits

RedRed Strawberries, Strawberries, raspberries, red raspberries, red apples, blood oranges, apples, blood oranges, cherries, red pears, cherries, red pears, pomegranates, pomegranates, watermelon, red watermelon, red pepper, radishes, red pepper, radishes, red potatoes, rhubarb, potatoes, rhubarb, tomatoes tomatoes

Anthocyanidins,Anthocyanidins,

flavonols, flavones,flavonols, flavones,

proanthocyanidins,proanthocyanidins,

Lycopene, Lycopene,

ellagic acid,ellagic acid,

resveratrol resveratrol

Protects against heart Protects against heart disease and certain disease and certain cancers. Aids in cancers. Aids in memory and urinary memory and urinary tract function. tract function.

Yellow/Yellow/

orangeorangeYellow apples, citrus Yellow apples, citrus fruits, peaches, fruits, peaches, apricots, carrots, sweet apricots, carrots, sweet potatoes, butternut potatoes, butternut squash, summer and squash, summer and winter squash, yellow winter squash, yellow pears, pumpkin, yellow pears, pumpkin, yellow tomatoes, cantaloupe, tomatoes, cantaloupe, lemon, mangoes, lemon, mangoes, papaya, pineapple, papaya, pineapple, tangerines tangerines

Flavonols,Flavonols,

Flavonones, Flavonones,

Alpha-Carotene,Alpha-Carotene,

Beta-Carotene,Beta-Carotene,

Zeaxanthin Zeaxanthin

Protects against heart Protects against heart disease and certain disease and certain cancers. Boosts cancers. Boosts immune system. immune system.

““EatEat thethe Rainbow”Rainbow”ColorColor FoodsFoods PhytochemicalPhytochemical

ssHealth Health BenefitsBenefits

GreenGreen Lettuce, kiwis, broccoli, Lettuce, kiwis, broccoli, green pears, green green pears, green grapes, green beans, grapes, green beans, avocados, honeydew, avocados, honeydew, limes, green peppers, limes, green peppers, peas, spinach, peas, spinach, cucumbers, zucchini, cucumbers, zucchini, Brussel sprouts, Brussel sprouts, artichokesartichokes

ChlorophyllChlorophyll, , flavones, flavones, flavonanones, flavonanones, flavonols, Beta-flavonols, Beta-carotene, lutein, carotene, lutein, zeaxathin, indoles, zeaxathin, indoles, isothiocyanates, isothiocyanates, organosulfur organosulfur compounds compounds

Reduces risk of Reduces risk of certain cancers. certain cancers. Improves vision Improves vision and helps build and helps build bones and teeth. bones and teeth.

Blue/purpleBlue/purple Plums, blueberries, Plums, blueberries, blackberries, black blackberries, black currants, purple grapes, currants, purple grapes, eggplant, raisins, purple eggplant, raisins, purple cabbage cabbage

Flavonols,Flavonols,

anthocyanidins,anthocyanidins,

proanthocyanidins,proanthocyanidins,

Ellagic acid, Ellagic acid, resveratrol resveratrol

Reduces risk of Reduces risk of certain cancers. certain cancers. Helps memory and Helps memory and reduces free reduces free radical damage radical damage during aging during aging process. process.

WhiteWhite Cauliflower, onions, Cauliflower, onions, garlic, bananas, white garlic, bananas, white peaches, white peaches, white nectarines, mushrooms, nectarines, mushrooms, potatoes, shallots, white potatoes, shallots, white corn, soy products corn, soy products

Flavonols, Flavonols, flavonanones, flavonanones, indoles, isocyanates, indoles, isocyanates, organosulfur organosulfur compounds compounds

Protects against Protects against heart disease and heart disease and certain types of certain types of cancer. May cancer. May reduce cholesterol reduce cholesterol levels. levels.

FruitsFruits

Focus on fruitsFocus on fruits Eat a variety of fruitsEat a variety of fruits Choose fresh, frozen, canned, or dried Choose fresh, frozen, canned, or dried

fruitfruit Go easy on fruit juices (limit to 4 ounces Go easy on fruit juices (limit to 4 ounces

for children, 8 ounces for adults per day)for children, 8 ounces for adults per day)

Organic FoodsOrganic Foods

What is an “organic” food?What is an “organic” food? Refers to the way farmers grow and process Refers to the way farmers grow and process

agricultural products, such as fruits, agricultural products, such as fruits, vegetables, grains, dairy products and meat vegetables, grains, dairy products and meat

Must be produced Must be produced without the usewithout the use of: of: AntibioticsAntibiotics Synthetic hormonesSynthetic hormones Most synthetic fertilizers or pesticidesMost synthetic fertilizers or pesticides Genetic engineering and other excluded practicesGenetic engineering and other excluded practices Sewage sludgeSewage sludge Irradiation Irradiation

How do I know a food is How do I know a food is organic?organic?

““100% organic” 100% organic” MustMust contain 100% organic contain 100% organic

ingredients ingredients ““Organic”Organic”

MustMust contain at least 95% contain at least 95% organic ingredients organic ingredients

““Made with organic Made with organic ingredients”ingredients”

Must contain at least 70% Must contain at least 70% organic ingredientsorganic ingredients

May NOT use the organic May NOT use the organic seal seal

““Contains organic Contains organic ingredients”ingredients”

May contain less than 70% May contain less than 70% organic ingredients, not organic ingredients, not counting added water or saltcounting added water or salt

May NOT use the organic May NOT use the organic sealseal

U.S. Department of Agriculture, 2002.

Are organic foods better?Are organic foods better?

Organic foods have Organic foods have lessless pesticide residues pesticide residues 23% of organic vs. 73% of conventional foods23% of organic vs. 73% of conventional foods Likely due to cross-contaminationLikely due to cross-contamination

Usually produced using more environmentally Usually produced using more environmentally friendly practicesfriendly practices

No nutritional difference between organic and No nutritional difference between organic and conventional produceconventional produce SomeSome organic foods have been shown to have higher nutritional organic foods have been shown to have higher nutritional

value (ex: higher Vitamin C and/or antioxidant content in green value (ex: higher Vitamin C and/or antioxidant content in green leafy veggies)leafy veggies)

Organic produce Organic produce maymay be better than conventional be better than conventional produce, but conventional produce is better than produce, but conventional produce is better than none!none!

U.S. Department of Agriculture, 2002.

Organic vs. conventional Organic vs. conventional foodsfoods

Choose organic when Choose organic when possible, especially for possible, especially for foods you eat often!foods you eat often!

Avoid the “dirty Avoid the “dirty dozen” to reduce your dozen” to reduce your pesticide exposure by pesticide exposure by up to 80%!up to 80%!

Eat a variety of fruits Eat a variety of fruits and vegetables!and vegetables!

Wash all produce well Wash all produce well with water and a scrub with water and a scrub brush!brush!

Environmental Working Group - www.foodnews.org

DairyDairy

Get your calcium-rich foodsGet your calcium-rich foods Go low-fat or fat-freeGo low-fat or fat-free

For adults and children over the age of 2For adults and children over the age of 2 If you don’t or can’t consume milk, If you don’t or can’t consume milk,

choose lactose-free products or other choose lactose-free products or other calcium sourcescalcium sources

Dairy AlternativesDairy Alternatives

1 cup of milk provides about 300 mg calcium1 cup of milk provides about 300 mg calcium Some other options:Some other options:

Calcium-fortified soy, almond, or rice milk (1 cup)Calcium-fortified soy, almond, or rice milk (1 cup) Calcium-fortified orange juice (1 cup)Calcium-fortified orange juice (1 cup) Calcium-fortified breakfast cereals (1 cup)Calcium-fortified breakfast cereals (1 cup) Canned fish with bones (3 ounces)Canned fish with bones (3 ounces) Sesame seeds (1 ounce)Sesame seeds (1 ounce) Tofu (4 ounces or 1 cup cubes)Tofu (4 ounces or 1 cup cubes) Dried figs (1 cup)Dried figs (1 cup) Blackstrap molasses (2 Tbsp)Blackstrap molasses (2 Tbsp) Dark leafy greens, especially spinach (1 cup cooked)Dark leafy greens, especially spinach (1 cup cooked)

Meat and BeansMeat and Beans

Go lean on proteinGo lean on protein Choose low-fat or lean meats and Choose low-fat or lean meats and

poultrypoultry Bake it, broil it, or grill itBake it, broil it, or grill it Vary your choices – with more fish, Vary your choices – with more fish,

beans, peas, nuts, and seedsbeans, peas, nuts, and seeds

Which meats are the Which meats are the leanest?leanest?

BeefBeef Round eyeRound eye Top roundTop round Bottom roundBottom round Round tipRound tip Top loinTop loin Top sirloinTop sirloin Chuck shoulderChuck shoulder Extra lean ground beef* Extra lean ground beef*

(look for 90% lean or (look for 90% lean or higher)higher)

PorkPork Pork loinPork loin TenderloinTenderloin Center loinCenter loin HamHam

PoultryPoultry Skinless chicken breastSkinless chicken breast Ground chicken*Ground chicken* Skinless turkey breastSkinless turkey breast Turkey cutletsTurkey cutlets Ground turkey*Ground turkey*

Other optionsOther options

Eat fish twice a week!Eat fish twice a week! Salmon, tuna, trout, and herring are especially Salmon, tuna, trout, and herring are especially

high in omega-3 fatty acidshigh in omega-3 fatty acids Pregnant women, nursing mothers, and young Pregnant women, nursing mothers, and young

children should avoid Shark, Swordfish, King children should avoid Shark, Swordfish, King Mackerel, or Tilefish due to high mercury contentMackerel, or Tilefish due to high mercury content

Go meatless once a week!Go meatless once a week! Lowers saturated fat intakeLowers saturated fat intake Promotes more fruit and vegetable intakePromotes more fruit and vegetable intake Can inspire you to be more creative and try some Can inspire you to be more creative and try some

new foodsnew foods

Fats and OilsFats and Oils

Know your fatsKnow your fats Make the most of your fat sources from Make the most of your fat sources from

fish, nuts, and vegetable oilsfish, nuts, and vegetable oils Limit solid fats like butter, stick Limit solid fats like butter, stick

margarine, shortening, and lard margarine, shortening, and lard

Are all fats created equal?Are all fats created equal? CHOOSE MORE OFTENCHOOSE MORE OFTEN::

Polyunsaturated Fat:Polyunsaturated Fat: Function: lowers total blood Function: lowers total blood

cholesterol levelscholesterol levels Sources: Safflower, sunflower, Sources: Safflower, sunflower,

sesame, soybean, corn, sesame, soybean, corn, cottonseed oils, as well as nuts cottonseed oils, as well as nuts and seeds and seeds

Omega-3 fatty acids Omega-3 fatty acids A type of polyunsaturated fats A type of polyunsaturated fats Function: anti-inflammatory, Function: anti-inflammatory,

lowers the risk of heart diseaselowers the risk of heart disease Sources: fatty fish, fish oil, Sources: fatty fish, fish oil,

flaxseeds and flaxseed oil, and flaxseeds and flaxseed oil, and walnutswalnuts

Monounsaturated Fat:Monounsaturated Fat: Function: tends to lower LDL Function: tends to lower LDL

cholesterol (the "bad" cholesterol (the "bad" cholesterol)cholesterol)

Sources: Olive, canola, peanut Sources: Olive, canola, peanut oils, as well as avocadosoils, as well as avocados

CHOOSE LESS OFTEN:CHOOSE LESS OFTEN: Saturated Fat:Saturated Fat:

Function: increases total and Function: increases total and LDL (“bad”) cholesterol levels LDL (“bad”) cholesterol levels

Sources: Animal products (such Sources: Animal products (such as meat, poultry, seafood, as meat, poultry, seafood, eggs, dairy products, lard and eggs, dairy products, lard and butter), and coconut, palm and butter), and coconut, palm and other tropical oils other tropical oils

TransTrans Fat: Fat: Function: increases total and Function: increases total and

LDL (“bad”) cholesterol levels LDL (“bad”) cholesterol levels Sources: Partially hydrogenated Sources: Partially hydrogenated

vegetable oils, commercial vegetable oils, commercial baked goods, fried foods, baked goods, fried foods, shortening and margarine shortening and margarine

Cholesterol??Cholesterol?? Function: May increase blood Function: May increase blood

cholesterol levels in certain cholesterol levels in certain people, but not as much as people, but not as much as saturated and saturated and transtrans fats fats

Sources: Found only in animal Sources: Found only in animal productsproducts

Choosing “healthy fats”Choosing “healthy fats”

Choose vegetable oils and margarines with:Choose vegetable oils and margarines with: Liquid vegetable oil as the first ingredientLiquid vegetable oil as the first ingredient As little As little transtrans fats as possible fats as possible No more than 2 grams of saturated fat per No more than 2 grams of saturated fat per

tablespoon tablespoon Examples: tub margarines, canola, corn, Examples: tub margarines, canola, corn,

safflower, soybean, sunflower, and olive oilssafflower, soybean, sunflower, and olive oils Need to limit saturated Need to limit saturated andand transtrans fats fats

Example: Krispy Kreme doughnutsExample: Krispy Kreme doughnuts

American Heart Association.

For more informationFor more information

Food Guide PyramidFood Guide Pyramid www.mypyramid.govwww.mypyramid.gov

Food GroupsFood Groups www.wholegrainscouncil.orgwww.wholegrainscouncil.org www.fruitsandveggiesmorematters.orgwww.fruitsandveggiesmorematters.org www.nationaldairycouncil.orgwww.nationaldairycouncil.org

Balancing food intake and Balancing food intake and physical activityphysical activity

Lifestyle ModificationLifestyle Modification

Practice portion control and/or intuitive Practice portion control and/or intuitive eatingeating

Utilize behavioral strategies to deal with Utilize behavioral strategies to deal with food cravingsfood cravings

Increase your physical activityIncrease your physical activity

Who cares about portion Who cares about portion size?size?

According to the National Center for According to the National Center for Health Statistics, 2006 data:Health Statistics, 2006 data: 66% of American adults are overweight 66% of American adults are overweight

or obeseor obese 20% of American children and 20% of American children and

adolescents are overweight or obese adolescents are overweight or obese This has almost This has almost doubleddoubled in the past 20 in the past 20

years!years!

What’s your Body Mass What’s your Body Mass Index?Index?

BaBackground ckground

The possible advantage for weight loss of a diet that emphasizes protein, fat, or The possible advantage for weight loss of a diet that emphasizes protein, fat, or carbohydrates has not been established, and there are few studies that extend beyond 1 carbohydrates has not been established, and there are few studies that extend beyond 1

year.year.

MethodsMethods

We randomly assigned 811 overweight adults to one of four reduced-calorie diets; the We randomly assigned 811 overweight adults to one of four reduced-calorie diets; the targeted percentages of energy derived from fat, protein, and carbohydrates in the four targeted percentages of energy derived from fat, protein, and carbohydrates in the four

diets werediets were20, 15, and 65%; 20, 25, and 55%; 40, 15, and 45%; and 40, 25, and 35%.20, 15, and 65%; 20, 25, and 55%; 40, 15, and 45%; and 40, 25, and 35%.

ConclusionsConclusions

Reduced-calorie diets result in clinically meaningful weight loss Reduced-calorie diets result in clinically meaningful weight loss regardless of whichregardless of whichmacronutrients they emphasizemacronutrients they emphasize..

Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates

Frank M. Sacks, M.D., George A. Bray, M.D., Vincent J. Carey, Ph.D., Steven R. Smith, M.D., Donna H. Ryan, M.D., Stephen D. Anton, Ph.D., Katherine McManus, M.S., R.D., Catherine M. Champagne, Ph.D., Louise M.

Bishop, M.S., R.D., Nancy Laranjo, B.A., Meryl S. Leboff, M.D., Jennifer C. Rood, Ph.D., Lilian de Jonge, Ph.D., Frank L. Greenway, M.D., Catherine M. Loria, Ph.D., Eva Obarzanek, Ph.D., and Donald A. Williamson, Ph.D.

Published in New England Journal of Medicine on February 26, 2009.

National Weight Control National Weight Control RegistryRegistry

The largest prospective investigation of long-term The largest prospective investigation of long-term successful weight loss maintenance (since 1994) successful weight loss maintenance (since 1994)

Tracks over 5,000 individuals who have lost an Tracks over 5,000 individuals who have lost an average of 66 pounds and have kept it off for 5.5 average of 66 pounds and have kept it off for 5.5 yearsyears

Common Themes:Common Themes: 98% monitor their portion sizes and/or calorie intake98% monitor their portion sizes and/or calorie intake 78% eat breakfast every day78% eat breakfast every day 75% weigh themselves at least once a week75% weigh themselves at least once a week 62% watch less than 10 hours of TV per week (1.5 hours 62% watch less than 10 hours of TV per week (1.5 hours

per day)per day) 90% exercise an average of 1 hour per day90% exercise an average of 1 hour per day

National Weight Control Registry – www.nwcr.ws

Creeping portion distortionCreeping portion distortion

How food portion

sizes have changed in 20 years.

How food portion

sizes have changed in 20 years.

Slides marked by are adapted from “Portion Distortion” by the

National Heart, Lung and Blood Institute at http://hin.nhlbi.nih.gov/portion

http://hin.nhlbi.nih.gov/portion

Guess the calorie difference!Guess the calorie difference!

Bagel

350 calories 140 calories

210 calories!

20 Years Ago

3-inch diameter

Today

6-inch diameter

Larger portions add upLarger portions add up100 extra

calories per day

10 pound weight gain

per year

Maintaining a healthy weight is a balancing actCalories In = Calories Out

Maintaining a healthy weight is a balancing actCalories In = Calories Out

*Based on 130-pound person

How long would you have to rake leaves to burn about 210210 calories*?

Increased size: 210210 MORE calories

50 minutes


Cheeseburger

590 calories

20 Years Ago Today

333 calories

257 calories!


How long would you have to lift weights to burn about 257257 calories*?


1 hour and 30 minutes


Spaghetti and Meatballs

1,025 calories 500 calories

525 calories

!

20 Years Ago Today

1 c. spaghetti with sauce &3 small meatballs

2 c. spaghetti with sauce &3 largemeatballs


How long would you have to clean house to burn about 525525 calories*?


2 hours and 35 minutes


French Fries

610 calories 210 calories

400 calories!

20 Years Ago Today

2.4 ounces 6.9 ounces


How long would you have to walk leisurely to burn approximately 400400 calories*?

Increased size:400400 MORE calories

1 hour and 10 minutes

SodaSoda


85 calories

20 ounces

Today

6.5 ounces

20 Years Ago

250 calories

165 calories!


How long would you have to garden to burn about 165165 calories*?


35 minutes

Keep an Keep an “eye” on “eye” on

your your food portion food portion

sizessizes

Avoid portion distortion!

Food journalsFood journals One of the best ways to find out what you are One of the best ways to find out what you are

REALLY eating is to keep a food journalREALLY eating is to keep a food journal Record Record everythingeverything you eat or drink for 7 days you eat or drink for 7 days

Different options:Different options: Written food journalWritten food journal Calorie King book and websiteCalorie King book and website WebsitesWebsites

www.sparkpeople.comwww.sparkpeople.com www.fitday.comwww.fitday.com www.dailyplate.comwww.dailyplate.com

Look for patterns: which food groups you over or Look for patterns: which food groups you over or under-eat, how balanced your meals are, which under-eat, how balanced your meals are, which times of the day you tend to eat more, etc.times of the day you tend to eat more, etc.

Hollis et al. Am J Prev Med. 2008 Aug;35(2):118-26

http://www.sparkpeople.com/

http://www.fitday.com/

http://www.dailyplate.com/

Portion ControlPortion Control Remember, it’s not only Remember, it’s not only

whichwhich foods you eat foods you eat that can lead to weight that can lead to weight gain…gain…

It’s It’s how muchhow much of those of those foods you eat!foods you eat!

Typical serving sizes Typical serving sizes have increased 2-5 have increased 2-5 times in the past 20 times in the past 20 yearsyears

Use this easy guide for Use this easy guide for proper portion sizes and proper portion sizes and enjoy all of your favorite enjoy all of your favorite foods!foods!

GrainsGrains

Eat 6 ounce-equivalents of grains per day (for Eat 6 ounce-equivalents of grains per day (for a 2,000 calorie diet).a 2,000 calorie diet).

1 ounce-equivalent equals:1 ounce-equivalent equals: 1 slice of bread1 slice of bread 1 cup of ready-to-eat cereal1 cup of ready-to-eat cereal ½ cup of cooked rice, cooked pasta, or cooked ½ cup of cooked rice, cooked pasta, or cooked

cereal cereal 1 “mini” bagel (2 ½ inch diameter)1 “mini” bagel (2 ½ inch diameter) 1 pancake (4 ½ inch diameter)1 pancake (4 ½ inch diameter) 3 cups popcorn3 cups popcorn

USDA. www.mypyramid.gov

http://www.mypyramid.gov/

VegetablesVegetables

Eat 2 ½ cups of vegetables per day (for a Eat 2 ½ cups of vegetables per day (for a 2,000 calorie diet).2,000 calorie diet).

1 cup of vegetables equals:1 cup of vegetables equals: 1 cup of raw or cooked vegetables or vegetable 1 cup of raw or cooked vegetables or vegetable

juicejuice 2 cups of raw leafy greens2 cups of raw leafy greens 12 baby carrots12 baby carrots 1 medium potato or sweet potato1 medium potato or sweet potato



FruitsFruits Eat 2 cups of fruit per day (for a 2,000 Eat 2 cups of fruit per day (for a 2,000

calorie diet)calorie diet) 1 cup of fruit equals:1 cup of fruit equals:

1 cup of fruit or 100% fruit juice1 cup of fruit or 100% fruit juice ½ cup of dried fruit ½ cup of dried fruit 1 medium whole fruit (3-4 inches diameter)1 medium whole fruit (3-4 inches diameter) 32 seedless grapes32 seedless grapes 8 large strawberries8 large strawberries



DairyDairy

Consume 3 cups of milk, or an equivalent Consume 3 cups of milk, or an equivalent amount of yogurt or cheese, per dayamount of yogurt or cheese, per day 2 cups per day for children 2-8 years old2 cups per day for children 2-8 years old

1 cup of milk (or dairy) equals:1 cup of milk (or dairy) equals: 1 cup of milk or yogurt1 cup of milk or yogurt 1 ½ ounces of natural cheese1 ½ ounces of natural cheese 2 ounces of processed cheese 2 ounces of processed cheese 1/3 cup shredded cheese1/3 cup shredded cheese 2 cups cottage cheese2 cups cottage cheese

Meat and BeansMeat and Beans

Eat 5 ½ ounce-equivalents of meat per Eat 5 ½ ounce-equivalents of meat per day (for a 2,000 calorie diet).day (for a 2,000 calorie diet).

1 ounce-equivalent of meat equals:1 ounce-equivalent of meat equals: 1 ounce of meat, poultry or fish1 ounce of meat, poultry or fish ¼ cup cooked dry beans¼ cup cooked dry beans 2 ounces (or ¼ cup) tofu2 ounces (or ¼ cup) tofu 1 egg1 egg 1 tablespoon of nut butter1 tablespoon of nut butter 2 tablespoons of hummus2 tablespoons of hummus ½ ounce of nuts or seeds ½ ounce of nuts or seeds

Fats and oilsFats and oils

Consume about 2 Tablespoons of oils per Consume about 2 Tablespoons of oils per day (for a 2,000 calorie diet).day (for a 2,000 calorie diet).

1 Tablespoon of oil equals:1 Tablespoon of oil equals: 1 Tablespoon oil, margarine, butter, or 1 Tablespoon oil, margarine, butter, or

mayonnaisemayonnaise 2 Tablespoons salad dressing2 Tablespoons salad dressing ½ medium avocado½ medium avocado 2 Tablespoons nut butter2 Tablespoons nut butter 1 ounce of nuts1 ounce of nuts

AlcoholAlcohol Moderate alcohol intake = 1 drink per day for Moderate alcohol intake = 1 drink per day for

females, 2 drinks per day for males (or less)females, 2 drinks per day for males (or less) 1 drink is defined as:1 drink is defined as:

12 ounces of beer12 ounces of beer 5 ounces of wine5 ounces of wine 1.5 ounces of liquor1.5 ounces of liquor

Benefits – reduced risk of heart attack and Benefits – reduced risk of heart attack and strokestroke

Risks – increased risk of several cancersRisks – increased risk of several cancers Recommendations:Recommendations:

If you choose to drink, do so in moderationIf you choose to drink, do so in moderation If you choose not to drink, you do not need to If you choose not to drink, you do not need to

start just for health reasonsstart just for health reasons

The Plate MethodThe Plate Method

No need to measure or No need to measure or count calories!count calories!

Use a 9 inch plateUse a 9 inch plate Smaller than standard 11 Smaller than standard 11

inch dinner plateinch dinner plate Visual reminder of Visual reminder of

proper portion sizesproper portion sizes Add a serving of fruit Add a serving of fruit

and low-fat dairy for and low-fat dairy for perfectly balanced mealperfectly balanced meal

Can also buy pre-made Can also buy pre-made plates ($10-20 each)plates ($10-20 each)

Intuitive (or Mindful) EatingIntuitive (or Mindful) Eating

Young children are natural intuitive eatersYoung children are natural intuitive eaters They eat when they are hungry and stop They eat when they are hungry and stop

when they are fullwhen they are full They eat exactly what they want and can They eat exactly what they want and can

not be persuaded to eat something they not be persuaded to eat something they don’t wantdon’t want

Although intake can vary from meal to Although intake can vary from meal to meal, over time they consistently eat the meal, over time they consistently eat the same number of calories each daysame number of calories each day

Birch LL. N Engl J Med. 1991 Jan 24;324(4):232-5.


So what happens??So what happens?? As they grow older and enter school, children As they grow older and enter school, children

learn to eat based on learn to eat based on externalexternal cues rather cues rather than their own than their own internalinternal hunger and fullness hunger and fullness signalssignals ““It’s time to eat!”It’s time to eat!” ““Do I smell doughnuts?”Do I smell doughnuts?” ““Clean your plate!”Clean your plate!” ““I want what Johnny has!”I want what Johnny has!” ““Don’t eat any more, you don’t want to get fat!”Don’t eat any more, you don’t want to get fat!”

What Influences our Diet?What Influences our Diet?

Internal CuesInternal Cues Hunger (physical and/or Hunger (physical and/or

psychological)psychological) FullnessFullness TasteTaste TextureTexture Food preferencesFood preferences

External CuesExternal Cues The clockThe clock ConvenienceConvenience EmotionsEmotions AvailabilityAvailability Advertisements Advertisements Health ConcernsHealth Concerns Weight ControlWeight Control PeersPeers Nutritional ValueNutritional Value CostCost Family/Cultural BeliefsFamily/Cultural Beliefs


Eat whenever you are Eat whenever you are trulytruly physically physically hungryhungry

Eat only what you want, not what you Eat only what you want, not what you think you “should”think you “should”

Eat consciously and enjoy every Eat consciously and enjoy every mouthfulmouthful

Stop when you even think you are fullStop when you even think you are full

Hunger/Satiety ScaleHunger/Satiety Scale

1-----2-----3-----4-----5-----6-----7----8-----9-----10

1 = Famished, starving2 = Headache, weak, cranky, low energy3 = Want to eat now, stomach growls and feels empty4 = Hungry - but could wait to eat, starting to feel empty but not there yet5 = Not hungry, not full6 = Feeling satisfied, stomach feels full and comfortable7 = Feeling full, definitely don’t need more food8 = Uncomfortably full9 = Stuffed, very uncomfortable10 = Bursting, painfully full

Rate how your stomach feels before, during and after each meal or snack. Be sure to put a number to your hunger and fullness each time you eat to help you develop an understanding of eating based on your internal physical cues.

Intuitive Eating ResearchIntuitive Eating Research

Intuitive eating is associated with an increase Intuitive eating is associated with an increase in the enjoyment and pleasure of food, lower in the enjoyment and pleasure of food, lower BMI scores, and fewer dieting behaviors and BMI scores, and fewer dieting behaviors and food anxietiesfood anxieties Smith and Hawks, 2006Smith and Hawks, 2006

Resources:Resources: ““Intuitive Eating” by Evelyn Tribole and Elyse Intuitive Eating” by Evelyn Tribole and Elyse

Resch, 2003 (Resch, 2003 (www.intuitiveeating.comwww.intuitiveeating.com)) ““Mindless Eating: Why We Eat More Than We Mindless Eating: Why We Eat More Than We

Think” by Brian Wansink, 2006 (Think” by Brian Wansink, 2006 (www.mindlesseating.orgwww.mindlesseating.org) )

http://www.intuitiveeating.com/

http://www.mindlesseating.org/

Intuitive (or Mindful) Eating Intuitive (or Mindful) Eating

Now it’s time for YOU to practiceNow it’s time for YOU to practice

with a mindful chocolate meditation…with a mindful chocolate meditation…

Managing Food CravingsManaging Food Cravings

Use the hunger/satiety scale to rate your Use the hunger/satiety scale to rate your hunger on a scale of 1-10:hunger on a scale of 1-10: If you are below 5, and/or are experiencing If you are below 5, and/or are experiencing

physical signs of hunger (stomach growling, physical signs of hunger (stomach growling, feeling weak or tired, haven’t eaten recently)feeling weak or tired, haven’t eaten recently)

EAT SOMETHING!EAT SOMETHING! If you are at 5 or higher, and you have eaten If you are at 5 or higher, and you have eaten

within the past few hourswithin the past few hours Try drinking some water firstTry drinking some water first USE THE 5 D’s!USE THE 5 D’s!

Managing Food CravingsManaging Food Cravings Disarm your cravings with the 5 D'sDisarm your cravings with the 5 D's::

DelayDelay at least 10 minutes before you eat so that at least 10 minutes before you eat so that your action is conscious, not impulsive. your action is conscious, not impulsive.

DistractDistract yourself by engaging in an activity that yourself by engaging in an activity that requires concentration.requires concentration.

Are you bored?Are you bored? DealDeal with the emotions that make you want to with the emotions that make you want to

eat. eat. Are you lonely, sad, angry, frustrated, tired?Are you lonely, sad, angry, frustrated, tired?

DetermineDetermine how important it really is for you to eat how important it really is for you to eat the craved food and how much you really want it.the craved food and how much you really want it.

DecideDecide what amount is reasonable and what amount is reasonable and appropriate, eat it slowly and enjoy! appropriate, eat it slowly and enjoy!

Benefits of physical activityBenefits of physical activity

Reduced risk for heart disease, cancer, Reduced risk for heart disease, cancer, stroke, obesity, Type 2 diabetes, and stroke, obesity, Type 2 diabetes, and osteoporosisosteoporosis

Increased energy levels and self-esteemIncreased energy levels and self-esteem Decreased rates of anxiety and Decreased rates of anxiety and

depressiondepression Strength training improves lean body Strength training improves lean body

mass and bone mineral densitymass and bone mineral density

ACSM RecommendationsACSM Recommendations

Cardio – Cardio – Do moderately intense cardio 30 minutes a day, five days a Do moderately intense cardio 30 minutes a day, five days a

weekweek Examples: walking, swimming, dancingExamples: walking, swimming, dancing

OrOr Do vigorously intense cardio 20 minutes a day, 3 days a weekDo vigorously intense cardio 20 minutes a day, 3 days a week Examples: jogging, high-impact aerobics, bicycling uphillExamples: jogging, high-impact aerobics, bicycling uphill

Strength – Strength – Do eight to 10 strength-training exercises, eight to 12 Do eight to 10 strength-training exercises, eight to 12

repetitions of each exercise twice a weekrepetitions of each exercise twice a week

Flexibility – Flexibility – Do 10 minutes of stretching 10 minutes a day twice or week Do 10 minutes of stretching 10 minutes a day twice or week

(plus a few minutes after each cardio session)(plus a few minutes after each cardio session)

American College of Sports Medicine, 2007.

““But I’ve never worked out But I’ve never worked out before…”before…”

Choose an activity you Choose an activity you enjoyenjoy!! Walking is the most common form of physical activity, is low impact, Walking is the most common form of physical activity, is low impact,

and requires very little equipmentand requires very little equipment

Start slowly!Start slowly! Start with 10 minutes per day, and each week add another 5 minutesStart with 10 minutes per day, and each week add another 5 minutes

Find a fitness partner!Find a fitness partner! People who work out with a partner are much more likely to be People who work out with a partner are much more likely to be

consistent with their programconsistent with their program

Pick a goal!Pick a goal! Sign up for a race or choose a cause that is important to you to Sign up for a race or choose a cause that is important to you to

support!support!

Reward yourself!Reward yourself! Put stickers on your calendar for each day you work out, and give Put stickers on your calendar for each day you work out, and give

yourself a reward each week or month you meet your goalyourself a reward each week or month you meet your goal

““But I don’t have time…”But I don’t have time…” Do a little at a time!Do a little at a time!

Fit in 10 minutes of activity 3 times per day!Fit in 10 minutes of activity 3 times per day!

Mix it up!Mix it up! Walk, run, bike, swim, dance/aerobics, lift weights, do yoga or pilates, Walk, run, bike, swim, dance/aerobics, lift weights, do yoga or pilates,

etc!etc!

Set your schedule!Set your schedule! Choose a time that will make it easy for you to be consistent!Choose a time that will make it easy for you to be consistent!

The gym isn’t a necessity!The gym isn’t a necessity! Walk around the neighborhood or to the park, work out with DVD’s inside Walk around the neighborhood or to the park, work out with DVD’s inside

your house, etc!your house, etc!

Make it a family affair!Make it a family affair! Take your spouse, your children, or a friend with you during exercise to Take your spouse, your children, or a friend with you during exercise to

add some fun to your routine!add some fun to your routine!

Eating Healthy at Home Eating Healthy at Home and Out on the Townand Out on the Town

Tips for Shopping for Tips for Shopping for Healthy FoodsHealthy Foods

Eat before you go!Eat before you go! Take the time to make a list!Take the time to make a list!

This will save you time This will save you time andand money also money also Shop the perimeter!Shop the perimeter! Read the labels!Read the labels!

““Shop the Perimeter”Shop the Perimeter”

Fresh fruits and vegetablesFresh fruits and vegetablesWhole grain breadsWhole grain breads

Fresh meatsFresh meatsMilk and dairy productsMilk and dairy products

How to Read Food LabelsHow to Read Food Labels

Useful tool for evaluating the health Useful tool for evaluating the health benefits of food products and benefits of food products and comparing different brandscomparing different brands

Made up of two parts:Made up of two parts: The Nutrition Facts labelThe Nutrition Facts label The Ingredients listThe Ingredients list

http://www.cfsan.fda.gov/~dms/foodlab.html







Ingredients ListIngredients List Listed in descending order of weight (from Listed in descending order of weight (from

most to least)most to least) The more ingredients you can recognize, the The more ingredients you can recognize, the

less processed the foodless processed the food Useful for avoiding certain ingredientsUseful for avoiding certain ingredients

Hidden sugars (HFCS, words ending in –ose)Hidden sugars (HFCS, words ending in –ose) TransTrans fats (partially hydrogenated oils) fats (partially hydrogenated oils)

Does “0 grams” really mean that?Does “0 grams” really mean that? Check the ingredients list!Check the ingredients list!

Food allergens (peanuts, milk, eggs, etc.)Food allergens (peanuts, milk, eggs, etc.)

Food Label ClaimsFood Label Claims Regulated by the Food and Drug Regulated by the Food and Drug

Administration (FDA)Administration (FDA) ““Organic”Organic”

Must meet the standards set by the Department of Must meet the standards set by the Department of Agriculture (USDA) for the way it is grown or producedAgriculture (USDA) for the way it is grown or produced

““Natural”Natural” The product does not contain synthetic or artificial The product does not contain synthetic or artificial

ingredients ingredients ““Healthy”Healthy”

The product must meet certain criteria that limit the The product must meet certain criteria that limit the amounts of fat, saturated fat, cholesterol, and sodium, amounts of fat, saturated fat, cholesterol, and sodium, and require specific minimum amounts of vitamins, and require specific minimum amounts of vitamins, minerals, or other beneficial nutrients minerals, or other beneficial nutrients

My Favorite Example…My Favorite Example… Nutrition FactsNutrition Facts – Cherry Garcia – Cherry Garcia

Serving Size: 1/2 cupServing Size: 1/2 cup Servings per Container: 4Servings per Container: 4

Amount Per ServingAmount Per Serving::

Calories 250Calories 250 Calories from Fat 126Calories from Fat 126 Total Fat 14 g Total Fat 14 g (22% DV)(22% DV) Saturated Fat 10 g Saturated Fat 10 g (50% DV)(50% DV) Cholesterol 60 mgCholesterol 60 mg (20% DV)(20% DV) Sodium 50 mgSodium 50 mg (5% DV)(5% DV) Total Carbohydrate 26 gTotal Carbohydrate 26 g

(9% DV)(9% DV) Dietary Fiber 1 g Dietary Fiber 1 g (4% DV)(4% DV) Sugars 22 gSugars 22 g Protein 4 gProtein 4 g Vitamin A Vitamin A

10% DV10% DV Vitamin C Vitamin C

0% DV 0% DV Calcium Calcium 15% DV15% DV Iron Iron 4% DV 4% DV

Eating Healthy during Busy Eating Healthy during Busy DaysDays

Don’t skip meals – especially breakfast!Don’t skip meals – especially breakfast! Make time to Make time to sit downsit down for several meals and for several meals and

snacks each day (depending on your schedule)snacks each day (depending on your schedule) Plan ahead to have healthy options Plan ahead to have healthy options

available when you are hungry!available when you are hungry! If you don’t bring it home, you can’t eat it!If you don’t bring it home, you can’t eat it! Plus, you don’t end up at the drive through…Plus, you don’t end up at the drive through…

Balance your meals to keep you full longer!Balance your meals to keep you full longer! Include carbohydrates, proteins, healthy fats, Include carbohydrates, proteins, healthy fats,

and some fruits and veggies to provide the and some fruits and veggies to provide the energy and nutrients you need to get through energy and nutrients you need to get through the daythe day

Eating Healthy at HomeEating Healthy at Home

Make healthy substitutions:Make healthy substitutions: Use whole-wheat grains instead of enriched grains Use whole-wheat grains instead of enriched grains

(bread, pasta, rice)(bread, pasta, rice) Use low-fat dairy products (milk, cheese, sour cream)Use low-fat dairy products (milk, cheese, sour cream) When baking, reduce the amount of butter or oil by When baking, reduce the amount of butter or oil by

half and replace with applesauce, mashed bananas, half and replace with applesauce, mashed bananas, or pureed prunesor pureed prunes

Use less salt when cooking, and add more flavor with Use less salt when cooking, and add more flavor with fresh or dried herbs, lemon or lime juice, or garlicfresh or dried herbs, lemon or lime juice, or garlic

Prepare meats by baking, broiling, poaching, grilling, Prepare meats by baking, broiling, poaching, grilling, or pan-sauteeing for less fat than fryingor pan-sauteeing for less fat than frying

Use extra lean ground beef, ground chicken or turkey Use extra lean ground beef, ground chicken or turkey breast, tofu, or veggies instead of regular ground breast, tofu, or veggies instead of regular ground beefbeef

Recipe Makeover – Recipe Makeover – Beef LasagnaBeef Lasagna

The Lady and Sons The Lady and Sons Lasagna (Paula Lasagna (Paula Deen)Deen) Makes 8 servingsMakes 8 servings Per serving:Per serving:

770 calories770 calories 48 grams fat (27 48 grams fat (27

grams saturated fat)grams saturated fat) 34 grams carbohydrate34 grams carbohydrate 50 grams protein50 grams protein 1230 mg sodium1230 mg sodium

Better Beef Lasagna Better Beef Lasagna (Ellie Krieger)(Ellie Krieger) Makes 8 servingsMakes 8 servings Per serving:Per serving:

400 calories400 calories 12 grams fat (5 grams 12 grams fat (5 grams

saturated fat)saturated fat) 46 grams 46 grams

carbohydratecarbohydrate 26 grams protein26 grams protein 1150 mg sodium1150 mg sodium

Recipes available at: www.foodnetwork.com

Recipe Makeover – Recipe Makeover – Chicken EnchiladasChicken Enchiladas

Creamy Chicken Creamy Chicken Enchiladas (original Enchiladas (original recipe)recipe) Makes 8 servingsMakes 8 servings Per serving:Per serving:



Cheesy Chicken Cheesy Chicken Enchiladas (Cooking Enchiladas (Cooking Light)Light) Makes 8 servingsMakes 8 servings Per serving:Per serving:



Recipes available at: www.cookinglight.com

Eating Healthy in Eating Healthy in RestaurantsRestaurants

When possible, look up nutrition information in When possible, look up nutrition information in advance and find several healthy choices that are advance and find several healthy choices that are appealing to youappealing to you Healthy ideas for many types of cuisine available at Healthy ideas for many types of cuisine available at

www.americanheart.orgwww.americanheart.org

Share an entrée with a friend OR ask for a to-go Share an entrée with a friend OR ask for a to-go container at the beginning of the meal, and container at the beginning of the meal, and automatically take half of your meal home with automatically take half of your meal home with youyou You will eat fewer calories and save money!You will eat fewer calories and save money!


http://www.americanheart.org/

Eating Healthy in Eating Healthy in RestaurantsRestaurants

Decide what’s most important to you!Decide what’s most important to you! Splurge on one item, and go lighter on the other itemsSplurge on one item, and go lighter on the other items Have an appetizer OR dessert, but not bothHave an appetizer OR dessert, but not both

Make sensible substitutions:Make sensible substitutions: Choose foods that are steamed, broiled, baked, grilled, Choose foods that are steamed, broiled, baked, grilled,

poached or roasted poached or roasted Instead of foods that are Fried, au gratin, crispy, scalloped, Instead of foods that are Fried, au gratin, crispy, scalloped,

pan-fried, sautéed or stuffed pan-fried, sautéed or stuffed Substitute a baked potato, rice, or vegetablesSubstitute a baked potato, rice, or vegetables

Instead of French friesInstead of French fries Ask for gravy, sauces, and dressings on the sideAsk for gravy, sauces, and dressings on the side Ask for items to be prepared without extra butter or oilAsk for items to be prepared without extra butter or oil


Eating Healthy in a Mexican Eating Healthy in a Mexican RestaurantRestaurant

Instead of:Instead of: Try:Try:Flour tortillasFlour tortillas Corn tortillasCorn tortillas

NachosNachos Grilled shrimpGrilled shrimp

Carnitas (fried beef or pork) or chorizo Carnitas (fried beef or pork) or chorizo (sausage)(sausage)

Grilled fish or chicken breast with salsa on topGrilled fish or chicken breast with salsa on top

Refried beansRefried beans Black or pinto beans and Spanish rice or Black or pinto beans and Spanish rice or grilled vegetablesgrilled vegetables

Full-fat sour cream and cheeseFull-fat sour cream and cheese Salsa, pico de gallo, cilantro, jalapeno Salsa, pico de gallo, cilantro, jalapeno peppers, guacamole peppers, guacamole

Quesadillas (flour or corn tortilla, filled with Quesadillas (flour or corn tortilla, filled with meat and cheese and fried)meat and cheese and fried)

Chicken fajitas (marinated chicken grilled with Chicken fajitas (marinated chicken grilled with onions, green peppers, lettuce, diced onions, green peppers, lettuce, diced tomatoes with a soft corn tortilla)tomatoes with a soft corn tortilla)

Chalupas, hard tacos, flautas (crisp, rolled Chalupas, hard tacos, flautas (crisp, rolled tortillas stuffed with shredded meat and tortillas stuffed with shredded meat and topped with a sauce); chimichangas (flour topped with a sauce); chimichangas (flour tortillas filled with spicy meat and Monterey tortillas filled with spicy meat and Monterey Jack cheese, fried and topped with tomato Jack cheese, fried and topped with tomato sauce); burritos (large flour tortillas filled with sauce); burritos (large flour tortillas filled with beans or meat, served with tomato sauce and beans or meat, served with tomato sauce and topped with shredded cheese)topped with shredded cheese)

Taco salad or fajita salad (ask for it on a plate Taco salad or fajita salad (ask for it on a plate instead of the fried taco shell), soft tacos with instead of the fried taco shell), soft tacos with grilled chicken or fish, “skinny enchiladas” grilled chicken or fish, “skinny enchiladas” (cooked in water instead of oil) and covered (cooked in water instead of oil) and covered with green or red salsawith green or red salsa

Eating Healthy in an Italian Eating Healthy in an Italian RestaurantRestaurant

Instead of:Instead of: Try:Try:

Caesar saladCaesar salad Caesar salad with low-fat dressing or a Caesar salad with low-fat dressing or a house salad with balsamic vinaigrettehouse salad with balsamic vinaigrette

Fried calamariFried calamari Antipasto (with extra vegetables and fewer Antipasto (with extra vegetables and fewer cheese and meats), tomato bruschetta, or cheese and meats), tomato bruschetta, or minestrone soupminestrone soup

Cheese or meat-filled pastas or casserole-Cheese or meat-filled pastas or casserole-type dishestype dishes

Pasta primavera (with sauteed garden Pasta primavera (with sauteed garden vegetables), grilled chicken or fish with a vegetables), grilled chicken or fish with a side of pasta or vegetablesside of pasta or vegetables

Pasta with butter or cream sauces (such as Pasta with butter or cream sauces (such as Alfredo or Carbonara sauce)Alfredo or Carbonara sauce)

Pasta with tomato-based sauces (marinara, Pasta with tomato-based sauces (marinara, Bolognese, red clam, or puttanesca)Bolognese, red clam, or puttanesca)

Any scallopine or parmigiana (floured, fried Any scallopine or parmigiana (floured, fried and baked with cheese) dishand baked with cheese) dish

Marsala and piccata dishesMarsala and piccata dishes

Italian pastries such as cream cakeItalian pastries such as cream cake Italian ices, sorbet, or gelato (milk-based)Italian ices, sorbet, or gelato (milk-based)

Eating Healthy on a Eating Healthy on a BudgetBudget

Eating Healthy on a BudgetEating Healthy on a Budget

Read grocery ads Read grocery ads beforebefore shopping! shopping! Plan your meals around what’s on salePlan your meals around what’s on sale

Get organized!Get organized! Plan out your meals for the week, make a list of the items you Plan out your meals for the week, make a list of the items you

will need, and stick to it!will need, and stick to it! Know where to look for deals!Know where to look for deals!

More expensive items are often at eye levelMore expensive items are often at eye level Less expensive items are located on the upper and lower Less expensive items are located on the upper and lower

shelvesshelves Give the generic brand a try!Give the generic brand a try!

Most are much less expensive and similar quality to the name Most are much less expensive and similar quality to the name brand productsbrand products


Reconsider convenience foods!Reconsider convenience foods! Pre-cut fruits and vegetables and individually sized snacks are Pre-cut fruits and vegetables and individually sized snacks are

much more expensive, and you can do this yourself at homemuch more expensive, and you can do this yourself at home Plan to make extra!Plan to make extra!

If you’re making dinner, buy enough to make a double batch If you’re making dinner, buy enough to make a double batch and then use the rest for leftovers or freeze for a quick dinner and then use the rest for leftovers or freeze for a quick dinner another nightanother night

Choose foods that are in season!Choose foods that are in season! Fresh fruits and vegetables are usually less expensive when Fresh fruits and vegetables are usually less expensive when

they’re in seasonthey’re in season Choose frozen versions of off season favoritesChoose frozen versions of off season favorites

In Season Produce – Northern In Season Produce – Northern California (late May)California (late May)

Almonds, Apples, Apricots, Apriums, Artichokes , Almonds, Apples, Apricots, Apriums, Artichokes , Arugula, Asian Greens , Asparagus, Avocado, Basil, Arugula, Asian Greens , Asparagus, Avocado, Basil, Beans, Beets, Bell Pepper, Blackberries, Blueberries, Beans, Beets, Bell Pepper, Blackberries, Blueberries, Bok Choy, Boysenberries , Broccoli, Cabbage, Cactus Bok Choy, Boysenberries , Broccoli, Cabbage, Cactus Pads, Cactus Pears, Cardoons , Carrots , Cauliflower, Pads, Cactus Pears, Cardoons , Carrots , Cauliflower, Celery, Chard , Cherimoyas, Cherries , Cucumbers, Celery, Chard , Cherimoyas, Cherries , Cucumbers, Dandelion/Chicory Greens, Dates, Eggplant, Endive, Dandelion/Chicory Greens, Dates, Eggplant, Endive, Fava Beans , Fennel , Garlic, Green Garlic , Herbs, Fava Beans , Fennel , Garlic, Green Garlic , Herbs, Horseradish, Kale , Kohlrabi , Leeks, Lemons, Lettuces, Horseradish, Kale , Kohlrabi , Leeks, Lemons, Lettuces, Loquats, Mushrooms , Mustard Greens, Nectarines, Loquats, Mushrooms , Mustard Greens, Nectarines, Nettles , Olives , Onions , Oranges, Peaches, Peas, Nettles , Olives , Onions , Oranges, Peaches, Peas, Peppers, Pistachioes, Plums, Pluots, Potatoes, Peppers, Pistachioes, Plums, Pluots, Potatoes, Purslane, Radicchio , Radish , Rapini , Raspberries, Purslane, Radicchio , Radish , Rapini , Raspberries, Rhubarb, Scallions, Shallots , Spinach, Strawberries , Rhubarb, Scallions, Shallots , Spinach, Strawberries , Summer squash, Tayberries, Tomatoes, Walnuts Summer squash, Tayberries, Tomatoes, Walnuts

Natural Resources Defense Council. www.nrdc.org


Do the math!Do the math! Compare product cost per ounce to make sure you’re getting Compare product cost per ounce to make sure you’re getting

the best dealthe best deal Learn the tricks of the trade!Learn the tricks of the trade!

When a store advertises a special (such as 10 yogurts for $10), When a store advertises a special (such as 10 yogurts for $10), you don’t have to buy the number of items they’re advertisingyou don’t have to buy the number of items they’re advertising

Only buy what you need!Only buy what you need! Watch the register!Watch the register!

Make sure the cashier rings up your purchases correctly, Make sure the cashier rings up your purchases correctly, including sale discounts and couponsincluding sale discounts and coupons

Final Thoughts…Final Thoughts…

Eating a “healthy diet” means having Eating a “healthy diet” means having variety, moderation, proportionality, and variety, moderation, proportionality, and balance in your food choices (and your balance in your food choices (and your lifestyle)!lifestyle)!

This This isis possible to achieve in the real world, possible to achieve in the real world, but it takes knowledge, planning, and but it takes knowledge, planning, and consistency!consistency!

The benefits of “eating right and exercising” The benefits of “eating right and exercising” will pay of now and for years to come!will pay of now and for years to come!

Thank you for listening!Thank you for listening!

Any questions?Any questions?

nutrition 101: how to eat healthy in the real world liz revilla, ms, rd, csp registered dietitian

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