3/6/19 February 2019 HEALTHY EATING LIFESTYLE CHANGES Viola Holmes, MS, RD, CDE Presented to you by your Diabetes Care Team: Virginia Center for Diabetes Prevention & Education UVA Diabetes Education & Management Program Class Handouts List: • Healthy Eating Slide Handout • Meal Preparation & Planning handout • Eating Behavior Diary • Lifestyle Change Goals form 1 3/6/19 OBJECTIVES: § Learn strategies to improve overall food choices § including meal preparation & planning, portion control, & shopping tips § Problem-solve strategies for making positive behavior changes in different scenarios § Set a personal goal for improving your food choices or eating behaviors HEALTHY EATING STRATEGIES 1) Focus on Foods to Increase: § Make half your plate vegetables & have fruit § More whole grains & high fiber foods § Switch to fat-free or low-fat dairy or plant-based alternatives § Less & lean protein, and plant-based 2 3/6/19 HEALTHY EATING STRATEGIES 2) Focus on Foods to Reduce: § Refined starches § Unhealthy fats § High sodium & processed foods § Empty calories § Sugar-sweetened beverages Photo courtesy of National Cancer Institute Eat more nutrient- dense foods 6 6 3 3/6/19 NUTRIENT-DENSE FOODS INCLUDE: Ø Vegetables/fruits Ø Whole grains Ø Seafood Ø Eggs Ø Dry beans/peas Ø Unsalted nuts/seeds Ø Fat-free/low-fat dairy products Ø Lean meats/poultry Fill half your plate with vegetables & include fruit 4 3/6/19 At least half your grains should be whole grains HOW DO I KNOW IF IT’S A WHOLE GRAIN? Look for these words and ingredients on food labels: § Whole grains § Whole (oat, bran, barley) § Whole wheat § Brown rice § Stoneground whole wheat § Oats, oatmeal 5 3/6/19 BELOW IS A LIST OF BREADS AND GRAIN ITEMS. CIRCLE THE ITEMS YOU EAT MOST OFTEN. Whole Wheat Bread OR White Bread White Rice OR Brown Rice White Pasta OR Whole Wheat Pasta Grits OR Oatmeal Flour Tortillas OR Corn Tortillas Add/Use Healthy Fats: Unsaturated Fat Saturated Fat Trans Fat Preferred fat sources, in small amounts Limit these fat sources Avoid these fat sources Partially hydrogenated Monounsaturated Meat vegetable oil Oil (olive, canola, peanut) Cheese (may be found in Olives Egg yolk vegetable shortening, Avocados Whole milk some margarines, Peanut butter 2% milk crackers, cookies, snack Nuts (peanuts, cashews, almonds) Ice cream foods) Butter Ø ↓ LDL cholesterol Bacon Ø ↑ LDL cholesterol Polyunsaturated Sour cream Ø ↓ HDL cholesterol Oil (Corn, Safflower, Soybean) Fatback Margarine Coconut oil Mayonnaise Shortening Walnuts Hydrogenated Sesame Seeds vegetable oil Omega fatty acids in fish Poultry skin Ø ↓ LDL cholesterol Ø ↑ LDL cholesterol 6 3/6/19 SWITCHING TO FAT-FREE OR LOW-FAT (1%) MILK MAKES A DIFFERENCE! Whole 2% 1% Fat-free 165 125 100 85 calories calories calories calories Calories 40 65 80 saved 13 Ideas for Avoiding Extra & Add-on Fats Instead of: Try: Gravies and Creamy Sauces Fat-free gravy, cream of chicken soup, seasoned yogurt, parmesan cheese Cheese Sauce Marinara sauce Ranch, Blue Cheese Dressing Lite or oil-based dressing Butter, lard Margarine, oil, oil-based butter spreads Luncheon meats, hot dogs Left-over home-cooked meat Ice cream Yogurt, Lite ice cream, sugar-free pudding Cookies, cake Home-made items modified for fat & sugar Chips Baked tortilla chips, pretzels, lite popcorn 7 3/6/19 Photo courtesy of National Cancer Institute Limit foods high in sodium, added sugars, and refined grains 15 How much sodium is in a teaspoon of salt? A. 1,300 mg B. 2,300 mg C. 3,300 mg 16 8 3/6/19 Sodium recommendation is <2300mgs/day: Ways to reduce sodium: Ø Check labels; Look for lightly salted, lower sodium, or no salt added products Ø Avoid adding salt (an exception may be when baking yeast breads) Ø Eat fresh foods, frozen veggies Ø Request salt be left off when eating out Ø Use other seasonings & spices to add flavor Ø Avoid/limit - fast foods, processed meats, rice/noodle mixes and boxed meals, canned foods, salty snacks 17 GET CREATIVE IN THE KITCHEN TO REDUCE FAT & SODIUM ü Use other seasoning in place of salt such as pepper, garlic, onion, herbs (basil, oregano), and spices (cinnamon, nutmeg) to flavor foods ü Try new cooking methods: baking fish, broiling chicken, steaming veggies in water or low sodium broth, grilling produce ü Use cooking spray or small amounts of olive or canola oil instead of butter. ü Remove the skin and trim any visible fat off of meat before cooking. ü Refrigerate soups, stews and gravy. Skim the fat off the surface before serving. ü Drain & rinse canned vegetables before cooking. 9 3/6/19 TRY DIFFERENT SEASONING THEMES Mexican – salsa, chilli powder, oregano, garlic, onion, crushed pepper flakes, cilantro Italian – Italian seasoning, oregano, basil, bay leaves, garlic, olive oil, parmesan Asian – lite soy sauce, ginger, garlic Indian – cumin, turmeric, cardamom, nutmeg Traditional – Pepper, lemon pepper, lemon juice, pepper, onion & garlic (powder), paprika, Mrs. Dash blends, lime Have low-fat and light dressings, sauces, & toppings on-hand. Have lower sodium broths and soups on-hand for cooking bases. Reduce sugar-sweetened beverage intake: Ø Drink water, unsweetened coffee and tea, and other beverages with few or no calories Ø Drink fewer sugar-sweetened beverages Ø If drinking a sweet beverage, have a smaller portions 20 10 3/6/19 Healthy Eating Strategy: Reduce Portion Sizes The bigger the portion, the more people tend to eat Keep an Eye on Your 11 3/6/19 PORTION CONTROL IDEAS FOR EATING OUT ü Choose healthier options (baked, grilled, broiled) ü Look at the restaurant’s menu ahead of time ü Share an entrée or order half portion ü Start your meal with fluid and/or high-fiber foods ü For example, drink a glass of water & have a raw vegetable salad or piece of fresh fruit Slow Down & Enjoy Your Food It takes about 20 20 minutes minutes for stomach to tell your brain you’re full 24 12 3/6/19 BEWARE OF THE COST OF EXTRA CALORIES 25 Putting it together: Meal Makeovers BEFORE AFTER 13 3/6/19 Meal Preparation and Planning Idea - Lunch Example Steps Monday Tuesday Wednesday Thursday Friday Pick your food category Wrap: (salad, soup, sandwich/wrap, smoothie) Pick your vegetable(s) Spinach leaves Sliced tomatoes Pick your fruit Lite peach yogurt 2 slice deli ham Pick your protein 1 slice swiss cheese Pick your carb 1 whole wheat wrap Spicy mustard Seasonings/Sauces Combine ingredients Preparation Method for wrap Meal Preparation and Planning Idea – Dinner Example Steps Monday Tuesday Wednesday Thursday Friday Pick your food category Plate: (plate, bowl, casserole, salad) Pick your vegetable ½ plate salad with avocado Pick your fruit Blueberries w/cool whip Pick your protein Black beans 1-oz low-fat cheese Pick your carb Rice Seasonings/Sauces Lite balsamic vinaigrette, salsa Preparation Method Open beans & heat Microwave rice 14 3/6/19 NOW IT’S YOUR TURN TO PRACTICE Use the Meal Preparation and Planning Guide to come up with a lunch or a dinner menu. Grocery Shopping Tips Never shop when you are hungry Make a shopping list AND stick to it Navigating Your Grocery Store: 1. Start with the perimeter, or the walls, of the store 2. Work your way into the middle aisles 3. Read labels! 15 3/6/19 Break TRICKY TRAPS ACTIVITY SCENARIO # 1 – AT HOME Mike works really hard and feels like he deserves to relax in the evening. The first thing he does when he gets home at 3pm is grab a large bag of chips and a couple meat & cheese sandwiches. He then heads to the couch to eat and relax. A little later he has a couple of beers and peanuts or trail mix. He never eats dinner before 8pm because his wife works late. Dinner is usually some kind of meat and potatoes. After dinner he plays video games, and on his way up to bed he grabs a few cookies from the cookie jar on the counter. 16 3/6/19 PROBLEM-SOLVING – SCENARIO # 1 Eat in a designated eating place §Kitchen or dining room table Portion out snacks instead of eating from original containers ‘Out of sight, out of mind’ rule §Remove cookie jar from kitchen counter or replace it with healthy choices (sugar-free gum, dried fruit, low-fat, high-fiber cookie or cracker, fruit bowl) Have a healthier snack (fresh fruit, frozen yogurt) Eat vegetables with dinner Add a non-calorie beverage to help TRICKY TRAPS ACTIVITY SCENARIO #2 - EATING OUT Bill and Judy are empty nesters now that their 4th child has gone away to college. After years of shopping in bulk and cooking for a big family, they are tired of cooking so they eat out or get takeout most evenings. Additionally, they don't pack their lunch either but grab something quick from fast food or a vending machine. When Bill and Judy do prepare meals at home they find that they cook way too much and end up with leftovers that eventually get thrown away. Either way, they find that they are spending way too much money on food, and they are also noticing their weights are creeping up too. 17 3/6/19 PROBLEM-SOLVING: SCENARIO # 2 Get out of the habit of buying food in bulk Make a grocery shopping list and limit the amounts purchased Cooking doesn’t have to be 100% from scratch. Incorporate some easy to prepare foods such as steam-able veggies, minute brown rice; and buy a rotisserie chicken to go along Carry leftovers for lunch Check out food magazines, websites for new meal ideas and strategies for cooking for two Set a limit on the number of times/week they eat out When they do eat out, make healthier food choices; divide meal in half for lunch the next day.