MAYBERRY ATHLETIC CENTER
Nutrition Reference
Guide
“Our food should be our medicine and
our medicine should be our food.”
— Hippocrates
Gwen is a Registered Dietitian with a Master’s Degree in Nutritional Science and has been in
private practice for the past 15 years. She holds a Certificate of Training in Weight Management for
Adults and a Certificate of Training in Weight Management for Teens and Children. For ten years, Gwen
was a Site Dietitian at Stanford University for a large multi-centered breast cancer study, The Women’s
Healthy Eating and Living Study. The results of this study were published in the Journal of the American
Medical Association, July 18, 2007.
She has counseled adults and children with health issues related to heart disease, high blood pressure,
pre-diabetes, cancer, osteoporosis, age-related macular degeneration among other health issues. Gwen
has also consulted to group homes for developmentally disabled children and adults.
Her specialty areas include wellness, cancer, heart disease, autoimmune diseases, weight management,
gastrointestinal issues and sports’ nutrition. Gwen has Active Registration with the Commission
on Dietetic Registration of The Academy of Nutrition and Dietetics (formerly the American Dietetic
Association).
MAC Nutrition Guide
Written by Gwen D’Antoni, M.S., R.D., LD
Mayberry Athletic Center
© 2014 Mayberry Athletic Center
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Preface
The purpose of this Nutrition Reference Guide is to provide you with the most current, up to date information on healthy
eating and making lifestyle changes. The guide is to assist you in making better choices and is by no means an end all or
cure. There are many diets, fads, trends, and information on nutrition. Our goal is to provide you with information based
on the latest research backed by major health institutions such as the National Institutes of Health* (NIH), American Heart
Association (AHA), Academy of Nutrition and Dietetics (AND) (formerly American Dietetic Association), The 2010 Dietary
Guidelines for Americans, and US Guidelines for treatment of high blood pressure among other credible organizations.
This information may help you in your quest to improve your diet and lifestyle through methods that have been shown to
work supported by unbiased research. If you have specific health concerns, medical condition(s), nutrition needs due to a
medical condition, a medical doctor or registered dietitian should be consulted.
This Nutrition Refernce Guide is not a substitute for the services of a trained health professional. Although we provide
nutritional information, the information on this guide is for informational purposes only. No information, services, or
materials offered by or through this guide shall be construed as or understood to be medical advice or care. None of the
information on this guide shall be used to diagnose or treat any health problem or disease. You should consult with a
physician, doctor, or health care provider before taking any product or using any information on this guide. Please discuss
any concerns with your physician or registered dietitian.
*The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the nation’s medical research
agency—making important discoveries that improve health and save lives.
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Table of Contents
Beginning Your Journey
6
Habits
6
Changes
6
Change: Test Your Readiness
7
Common Problem Behaviors
Breaking the Dieting Cycle
Constructive Behavior Changes
9
9
9
Helping Get Started
10
How Many Calories Should I Consume?
10
What Is Considered Safe Weight Loss?
10
Tips to Succeed
11
Portion Trimming Tips
12
Visualizing Appropriate Portion Sizes
12
Picture This: How to Visualize Portion Sizes
13
Little Changes Can Make a Big Difference
14
Top 10 Eating Tips for 2013 and Beyond
15
Secrets of Weight Loss Success
16
16
Specific Habits of Successful Weight Loss
The Best Breakfast For You
17
General Time Saving Strategies
19
Use Your Freezer
19
Lunch and Dinner Ideas
19
Ways to Add Flavor Without Adding Fat
20
Lean Substitutions
21
Lean Cooking
22
Shopping Lean
23
Caffeine25
Gluten-Free Diet
4
Potential Nutrient Consequences Of The Gluten-Free Diet
25
25
Lactose Intolerance
26
Tips for Tolerance
26
Some Combos That Help Ease Digestion and Provide Calcium
26
Bottom Line For Taking Calcium Supplements
27
Bone Health: Looking Beyond Calcium
27
Phosphate
27
Magnesium
28
Vitamin K
28
Vitamin A
28
Copper
29
Manganese
29
Iron
29
Zinc
29
Vitamin D: What’s All the Hype?
30
Other Dietary Considerations
32
Getting the Most Out of Your Workout Through Nutrition
33
The Goals of Recovery Nutrition
35
Goals for Eating on the Road
35
Fast Food Ideas
36
Tips to Take With You
36
Blood Pressure – What You Need to Know
37
Causes of High Blood Pressure
37
At Risk for High Blood Pressure
37
Treating High Blood Pressure
37
The DASH Diet Plan
38
Reducing Salt and Sodium in the Diet
39
Remember These Helpful Tips
39
Heart Disease
40
Foods to Avoid
40
Foods to Choose
40
Do Not Buy Foods Containing These Ingredients
40
Diet Myths That Will Not Die
41
Probiotics and Prebiotics
43
Benefits of Probiotics
43
Foods Containing Prebiotics
43
Best Sources of Probiotics Or Prebiotics
Fish Oil Supplements: Which Ones To Buy
44
46
Nutrition Facts Label Overview
47
Organic Foods vs Conventionally Produced Foods
49
Health Tips For Families
50
51
Snacks: Ideas For The Active Child
Eat Right: 25 Healthy Snacks for Kids
53
Eat Right, Your Way, Every Day
55
Resources56
5
Beginning Your Journey
“Rome wasn’t built in a day” applies to changes made to improve health and fitness. Small changes
result in better adherence and over time greater impact on health and fitness. If you run a marathon
at top speed the first 5 miles you most likely will not finish the race. Pace yourself with these changes.
Small steps climb big mountains. Lifestyle changes don’t happen overnight. “You can lower your
risk of chronic disease by 80 percent through healthy living,” according to David Katz, M.D., M.P.H.,
Director of Yale-Agriffin Prevention Research Center. He also stated the use of forks, feet and fingers
can help eliminate chronic diseases, such as heart disease, diabetes and cancer.
Habits
Make a list of things that you do that improve your health such as “I workout out regularly” or “I eat
most of my meals at home.” Keep the list and add to it as you progress toward healthy living.
Make a list of things you do that you know have a negative impact on your health. Pick one thing from
the list that you are sure you can change. Set that as your first goal. When it is no longer a struggle,
pick another goal. No one is perfect and from time to time a slip may occur such as when traveling,
or going on vacation. When you return you can go back to the goal and start again. Healthy behavior
does not mean you restrict special treats ALL of the time. Use the 80/20 rule. Eat as healthy
as possible 80% of the time and 20% of the time enjoy special treats.
Changes
American culture emphasizes instant results. Our computers are never fast
enough, we eat fast food because meals at home take up too much time.
This approach does not fit into a successful nutrition and fitness program.
Small changes over time equal results!
Eat as healthy as possible
80% of the time
80%
20%
6
20% of the time enjoy special
treats
Pace yourself with
these changes.
Small steps climb
big mountains.
Change: Test Your Readiness
This fast and easy quiz can help you assess your readiness for change.
Write your points
score for each
question in the
circle
a. Which of the following is your first thought when contemplating changing the types of foods
that you eat?
a.
I really dread making this change. I enjoy the foods that I normally eat.
b. I am slightly anxious about it. I will find it difficult, but I think that I can do it.
c.
I am fine with the idea of changing my diet. I am even looking forward to it a little bit.
b. How necessary do you think that it is for you to make some lifestyle changes?
a. I do not think that it is all that important. I think that the media overemphasizes the importance of these things.
b. I do think that it is important, but it is not one of my most pressing priorities.
c.
c.
The idea of preparing home-cooked meals from fresh food makes me feel:
a.
b. OK, but I am used to eating a good many convenience and restaurant meals.
c.
I know that it is extremely important right now. I am willing to make it a priority.
Overwhelmed and unhappy. I do not have the time or desire to do this.
Good. I am looking forward to trying new recipes and techniques.
d. Exercise is:
a.
Torture for me. It is boring, and/or I do not have time for it, and/or I just do not enjoy doing it.
b. OK, but I would rather do other things.
c.
Important for your health and fun once you find something that you like. I am committed to it.
e. Why are you thinking of making these lifestyle changes?
a.
To get other people off of my back. I am sick and tired of hearing about it. Personally, I do not think it really matters whether or not I do this.
b. Mainly for my appearance and/or so that other people will approve of me.
c.
1.
How do you plan on attacking the challenge of changing your lifestyle?
a.
b. I am going to change several specific things at one time. I am just going to wake up on the designated day and start my new life.
c.
I am doing it for myself, my health, my self-esteem, etc.
I am just going to keep trying things and hopefully something will work.
I have chosen a few important steps. I am going to incorporate them into my life one at a time, and then I will move onto the next.
2. What preparation have you done to get ready for these changes?
a.
No preparation is necessary. I am just going to do it.
b. I have had a few ideas about things that will help me.
c.
I have actually gathered or purchased several items that I will need, such as hand weights or cookbooks.
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3. Do you have a support network of people who will help you when your will lags?
a.
I either do not have a support network, or I have many people telling me what to do or making negative remarks about my plans.
b. I think that I have a few people who would help, although I would not want to bother them if it was not very important.
c.
I have several people who I know will help me and encourage me through this.
4. My level of motivation:
a.
Is definitely lacking. I wish that I would just wake up tomorrow with the change already there.
b. Is pretty good, but I still have too many doubts about whether I will succeed.
c.
Is very high. I am ready to do whatever I need to do.
5. Regarding previous attempts to change my lifestyle:
a.
I have never bothered before, or I was a complete failure.
b. I did manage to make some changes, although they did not last.
c.
I have made positive changes in the past and was successful.
Scoring
Score yourself with the following key:
a =
b =
c =
1 point
2 points
3 points
10−16 points You are not yet ready to make this change. Talking to professionals and learning
more about your options might help you. You most likely have long-held negative
associations about the very same changes that you most need to make.
17−23 points You are definitely on the right track, although you should not make any changes
just yet. Try creating a comprehensive list of why you want or need to make these
lifestyle changes. Set goals that are specific, measurable, realistic, attainable, and
have a time requirement (SMART goals). For example: “I want to improve my
diet by eating at least five servings of fruits and vegetables each day for the next
month. I will keep a food diary and a running record of how I am doing.”
24−30 points You are ready to make this lifestyle change! Continue to reinforce the idea by
focusing on why you are doing it. Also continue to gather resources and learn new
ways of doing things. Keep your energy up by rewarding yourself for your progress
toward success.
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Total Points
Breaking the Dieting Cycle
The message is clear - diets don’t work for many people. They may cause temporary weight loss, but
most people will rebound and gain the weight lost, plus more. Restrictive diets force people to focus
on the end result - a number on the scale, instead of paying attention to the real issues that put on the
weight to begin with. If you stop doing something that fails (i.e. diet) which lowers your self-esteem,
and start focusing on the things that can bring real success, you’ll feel better about yourself. When you
feel better about yourself, eating healthier and being more active naturally follow. Taking better care of
yourself will feel so good it will become your way of life. So stop starving yourself or feeling guilty about
eating. Instead, target the problem behaviors and devise strategies to change destructive behavior into
constructive actions.
Common Problem Behaviors
• Not taking time for yourself
• Getting over-hungry
• Eating with distractions
• Categorizing foods into “good” and “bad”
Take better care
of yourself. Stop
starving yourself
and feeling guilty.
Constructive Behavior Changes:
Take time for yourself
You simply can’t afford not to take 10-15 minute blocks of time at least three times a day to fuel your
body. Would you even attempt to drive a long distance on only a quarter of a tank of gas? How would
you expect optimal energy and performance on barely enough fuel? Pack a food bag with high-quality
foods, non-perishable if no refrigeration is available. Examples include fresh fruit and vegetables, dried
fruit, whole grain crackers, nuts, or low-fat cheese and yogurt.
Do not get over-hungry
This is the greatest problem most people face. Eating frequent small meals and listening to your body’s
hunger signals can prevent you from overeating. When you fuel yourself with what your body needs,
your weight will likely reach a more desirable range. The more regularly you feed your body, the less the
thoughts, desires and fixations of food will occur.
Eat without distraction
If you eat your meals or snacks while driving the car, at the computer or in front of the TV, eating
becomes the secondary activity. Pretty soon, you’re reaching for the second half of the sandwich
without realizing you’ve already eaten it. Practice being more mindful while you eat. Turn away from
the computer screen, turn off the TV, park the car and eat your food, tasting every bite and letting your
brain connect with the fact that you’re eating, not doing something else. This can be difficult, but if you
work at it you will enjoy the pleasure of eating, instead of eating with amnesia.
Legalize all foods
If you have the craving for chocolate, don’t pass up lunch to eat the chocolate bar with the idea that
it replaces your lunch. Instead, eat your lunch until you feel comfortably satisfied, then have some
chocolate. Perhaps then you’ll be happy with a junior size bar of chocolate. Eat the chocolate slowly,
savoring every morsel -make it a real tasting experience. By eating whatever the “bad” food is in this
fashion, you won’t overeat it. More importantly, it will squelch the craving for that food and you won’t
9
end up bingeing or feeling out of control. You won’t have to promise yourself not to eat chocolate again,
or say, “Oh, well, I’ll start my diet tomorrow.”
The strategies listed above work, but they take time, patience and effort. Start with realistic, attainable
goals with which you can see progress. Taking the time for yourself, having the right foods available
to fuel the body and allowing yourself treats eaten in a mindful manner will ultimately keep your body
properly fueled, end food cravings and normalize your eating. And once you learn this, why would you
ever need or want to diet again.
© 1999 DGCP, of The American Dietetic Association
Helping Get Started
If you are a meal skipper especially breakfast skipper your first goal may be to start eating breakfast.
Research shows people who eat breakfast eat fewer calories throughout the day. Start with eating a
light breakfast then increase calories until you eat about 1/4 of your calories in the morning. Eating
before an early morning workout may be difficult for some but even 100 calories consumed before a
workout can be beneficial. In this case, eat breakfast after the workout but remember you have already
consumed some calories. Your stamina will improve with some nutrition within a couple of hours of a
workout.
Satiety (feeling satisfied) last longer when approximately 20 - 25 grams of protein are eaten at breakfast.
What does 25 grams look like?
• Milk or Yogurt - 8 grams in 1 cup
• Egg or 1 ounce of lean meat or meat substitute - 7 grams of protein
• Breads 1 slice or 4 ounce bagel ~3 grams of protein
• Cereals vary so look at the nutrition label and serving size
How Many Calories Should I Consume?
Calculating calories needed in a day for an individual is based on so many factors that general guidelines
do not work. To calculate calories needed, height, weight, gender, age, activity level, injury factor (if any)
and whether that person wants to gain, lose or maintain their body weight are all needed. A Registered
Dietitian can help you calculate.
What is Considered Safe Weight Loss?
Safe weight loss is 1% of your body weight per week. If you weight 100 pounds, then 1 pound a week is
safe weight loss. If you weight 200 pounds, then 2 pounds per week is safe weight loss.
Weight that is loss too quickly may mean loss of water or loss of muscle. The scale is only an indication
of body weight and will vary a little from day to day. Hydration status changes according to the body’s
needs. How clothes fit is a better indication of weight. You want to lose body fat not muscle or water
weight. It takes time.
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Tips to Succeed
• Keep food and beverage records. Write down everything you eat and drink.
• Go to parties and enjoy yourself. Moderation is the key. The day after the party you can eat a little
less but no meal skipping.
• Plan ahead when attending a special function involving celebrations with food and alcohol.
Imagine BEFORE you arrive how you will be successful at limiting some foods and alcohol in
excess. ALCOHOL MODERATION is 1 drink (1 12 ounce beer, 5 ounces of wine or 1.5 ounces hard
liquor) for women. For men MODERATION is 2 drinks (24 ounce of beer, 10 ounces of wine or 3
ounces of hard liquor).
• Alcohol and weight loss do NOT go together. But if you can’t give it up, better choices are wine
and beer in moderation. Calories in margaritas and pina coladas can exceed 500 to 800 calories.
• Exercise a little more to offset the added calories you may eat.
• Don’t skip meals but eat less at other meals. Skipping meals will make you ravenous at the party.
• Get some rest as it is easier to eat more when you are tired.
• Chat with everyone at the party. It is difficult to eat while talking.
• Position yourself as far away from the food as possible.
• Curb your appetite by eating a small meal before you arrive at the party.
• Alcohol tends to stimulate the appetite, opt for club soda or diet soft drinks or sparkling water.
• Good choices at a party can be pretzels, shrimp cocktail, string cheese (low fat mozzarella),
veggie sticks with low fat yogurt dips, and corn chips with salsa dip. Dessert choices like Angel
Food Cake with fresh fruit, oatmeal or ginger snap cookies and fresh fruit are good choices.
• Share a dessert instead of eating the whole thing.
• Order a small size instead of a large and don’t feel guilty.
• Eating a small bowl of brothy soup before a meal helps to increase satiety as does eating a salad
about 15 minutes before a meal.
• Whether at home or out, chew, chew, chew your food. Savor the flavors and chew until nothing is
left. If you eat with a slower eater, try to pace yourself to keep up with slowing down your eating.
• Eat with all your senses and in no less than 20 minutes, which is the time required for the brain
to interpret the satiety signal.
• If you are eating for 20 minutes at 100 calories a minute, that is a lot. However if you are eating
for 20 minutes at 20 calories a minute, that is not a lot and it gives the body time to realize it is
full.
• Brush and floss teeth immediately after the evening meal. It will discourage snacking in addition
to helping them stay pearly white.
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Portion Trimming Tips
Here are some ways to make portions of food smaller. Pick one or two that you are willing to try.
Put meals and snacks on smaller plates and serve drinks in smaller cups or drink water. Low fat dairy (1%
or fat free) can be a healthy choice.
Pre-measure your cups, glasses and bowls by filling them with water and then pouring that water into a
measuring cup to check the volume. This way, you know exactly how much your dishes hold.
Let everyone in the family practice the right-sized portion. Then, when foods are passed around,
everyone can help themselves.
Choose snacks like yogurt and crackers in single-serving containers.
Read food labels and compare serving sizes for different foods and drinks. Everyone in the family should
practice label reading.
Order the smallest size when eating at fast food restaurants.
Visualizing Appropriate Portion Sizes
One reason kids may not be eating appropriately sized portions based on the recommended MyPlate
serving sizes is that they may not recognize what a reasonable portion looks like. What does one-half
cup of pasta look like? What about three ounces of chicken or two tablespoons of peanut butter?
The good news is that kids don’t need a measuring cup or scale to measure the portions they should eat
– instead, they can visualize them by using familiar objects, such as a tennis ball or CD, that are similar
in size to recommended serving sizes. Before they eat or drink, they can think of the relevant object and
choose a portion that matches its size.
The table on the next page will give you some tips to help you and your kids visualize portion sizes.
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Picture This: How to Visualize Portion Sizes
Portion Size
A Portion is About the
Size of a . . .
Bread
1 ounce or 1 regular slice
CD cover
Dry cereal
1 ounce or 1 cup
Baseball
Cooked cereal, rice or pasta
1 ounce or ½ cup
½ baseball
Pancake or waffle
1 ounce or 1 small (6 inches)
CD
Bagel, hamburger bun
1 ounce or ½ piece
Hockey puck
Cornbread
1 piece
Bar of soap
Orange, apple, pear
1 small (2½ inches in diameter)
Tennis ball
Raisins
¼ cup
Golf ball
Baked potato
1 medium
Computer mouse
Vegetables, chopped or salad
1 cup
Baseball
Fat-free or low-fat milk or
yogurt
1 cup
Baseball
Cheese
1½ ounces nature cheese or 2
ounces processed cheese
9-volt battery
Ice cream
½ cup
½ baseball
Lean beef or poultry
3 ounces
Deck of cards
Grilled or baked fish
3 ounces
Checkbook
Peanut butter
2 tablespoons
Ping-pong ball
Tub of margarine
1 teaspoon
Standard postage stamp
Oil or salad dressing
1 teaspoon
Standard cap on a 16-ounce
water bottle
Food
Grains Group
Fruits Group
Vegetables Group
Dairy Group
Protein Foods Group
Oils Group
Resources
For more information about portion sizes, visit these Web sites:
My Pyramid (http://wwwmypyramid.gov)
Portion Distortion! (http://www.nutrition.gov) –type “portion distortion” in the Search Box, then choose link for
Portion Distortion! Quizzes.
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Little Changes Can Make a Big Difference
It is neither necessary nor recommended to severely restrict food intake or exercise obsessively. It’s
often the little things we do or don’t do in a day that can ultimately impact our health. For example,
walking up one extra flight of stairs a day results in the loss of a half-pound of fat in a year, on average.
Eating one less donut per week can produce approximately three pounds of weight loss annually.
The chart below will help you appreciate the caloric consequences of making little changes. If you are
patient and make changes gradually and consistently, you can become fitter and leaner!
Consequences of Little Changes
Note: daily calories burned will vary from person-to-person and food items also vary by type so the
above numbers represent averages only. Yearly caloric impact based on 365 days.
As you now may realize, little changes can add up to big results over time. Below, list 5 of these little
changes you can incorporate in your “personal action plan” You will find positive results.
Daily Caloric
impact
Little Changes
Yearly Impact
Annual
Weight
Loss (lb)
Substitute evening snack of ice cream or candy w/fruit
140
51,000
14.6
Replace one fatty food with one carbohydrate-rich food
100
36,500
10.4
Eat one less donut per week
29
10,429
3.0
Reduce intake of regular salad dressing by 5 tbsp/week
43
15,643
4.5
Climb one extra flight of stairs
5
1,825
0.5
Manually operate your TV
6
2,190
0.6
Park 100 extra yards away from your work entrance
5
1,825
0.5
Rise up and stretch 5 times a day
8
2,920
0.8
Walk one minute after each meal
5
5,475
1.5
Walk 8 extra minutes a day
40
14,600
4.0
Walk 12 extra minutes a day
60
21,900
6.25
Walk 15 extra minutes a day
80
29,200
8.3
© 1999 DGCP of The American Dietetic Association
Daily Caloric
impact
My Little Changes
1.
2.
3.
4.
5.
Total
14
Yearly Impact
Annual
Weight
Loss (lb)
Top 10 Eating Tips For 2013 and Beyond
(Environmental Nutrition Newsletter, January 2013)
1 Choose healthy carbs. These are unrefined grains, unsweetened fruits, and vegetables. Limit refined carbs
such as refined grains and flours. Instead of breads, bagels and cookies made with white flour and sugar fill
your plate with nutrient-rich whole grains such as whole wheat, quinoa, wheat berries, amaranth, barley or
oatmeal.
2 Put legumes on the menu every week. Replace meat at least one day a week with beans, peas, or lentils
and three times a week as a side dish. They have been linked to lower blood cholesterol levels and body
weight, and reduced risk of heart disease, hypertension and some types of cancers. One-half cup serving
provides at least 20% Daily Value (DV) for fiber, folate and manganese; 10% DV for protein, potassium, iron,
magnesium and copper; and 6 – 8% DV for selenium and zinc. For the Meatless Monday movement, visit www.
meatlessmonday.com.
3 Eat smaller portions. Portions in restaurants, supermarkets and at home have increased dramatically over the
past few decades directly feeding into the obesity epidemic and its health fallout. Smaller portions will allow
you to eat a wider variety of foods without feeling deprived. It is suggested that you measure out one-half
cup of pasta, rice or cooked grains and consider that a serving. A three-ounce serving of meat or chicken
should be the size of a deck of cards.
4 Eat fish at least twice a week in place of red meat. Including more fish in your diet is linked to lower rates of
disease. Eat cold-water fatty fish like salmon, halibut, tuna or sardines at least twice a week for a total of 12
ounces per week. Wild fish is better but farm raised is better than no fish!
5 Eat a fruit or vegetable every time you eat, even at breakfast. This increases the likelihood you will get the
fruits and vegetables you need. For additional credit, double up on those vegetables at lunch and dinner—
have a soup or salad and a serving of fresh or cooked vegetables.
6 Eat a healthy food BEFORE you indulge. Nuts or fruit can be a good choice and may fill you up, satisfy you
and help meet your quota for fruit. Nuts provide healthy fats and you may eat less of the treat you are craving.
7 Drink eight glasses of water every day. In hot, dry weather more may be needed. Check hydration by
monitoring urine color. It should be a light yellow color. In addition to hydrating your body with life-giving
fluids needed for maintaining your body functions, you will stay away from sugary beverages, including sodas
and sports drinks, which have been linked to obesity. Keep a water bottle handy and track how much you
consume.
8 Add nuts and seeds to your daily diet plan. Munch on a handful (about 1 ½ ounces) of nuts, such as walnuts,
almonds, pecans or peanuts, or add seeds (about two tablespoons), such as flaxseeds, chia, hemp, sesame or
sunflower seeds to your diet every day. Nuts and seeds provide heart healthy fats, fiber and a host of vitamins,
and minerals. An added bonus is walnuts, ground flaxseed, chia and hemp that are rich in omega-3s and
linked with heart health benefits.
9 Meet your fiber goal every day. Fiber has been linked with lower risk of heart disease, certain types of cancer,
diabetes, and obesity. Only five percent of Americans meet their fiber goal: 25 grams per day for women and
38 grams for men. Think fiber everyday by choosing whole grain breads, cereals and pasta, as well as fruit,
veggies, beans, nuts and tofu.
10 Stop eating at least 2 hours before going to bed. Give your body time to digest the food. You can’t expect
a good night’s rest if you have just loaded your body up with energy. A good night’s rest will help you keep
your exercise and nutrition resolutions.
15
Secrets of Weight Loss Success
The National Weight Control Registry (NWCR) was established by Rena Wing, Ph.D., of Brown Medial
School and James O. Hill, Ph. D., of the University of Colorado and is the largest investigation of longterm weight maintenance in the US. By tracking more than 10,000 individuals who have lost significant
weight and kept it off (average of 66 pounds for over five years) they have identified common
characteristics of long-term weight loss. Their successes provide potential strategies that may help
others maintain weight loss. Anyone who is at least 18 years of age with at least a 30 pound weight loss
maintained for one year or more is eligible to join the registry at www.nwcr.ws.
NWCR finds the variables linked with long-term weight loss are a low-calorie diet with moderate fat
intake, limited fast food and high levels of physical activity.
Specific Habits of Successful Weight Loss
• A proven habit is eating breakfast every day. Regular breakfast eaters tend to make better food
choices and eat fewer calories during the day. When breakfast is skipped, appetite and blood
glucose alterations may leave cravings for refined carbohydrates such as donuts, cookies and
snack foods. Seventy-eight percent (78%) of those successful at maintenance ate breakfast daily.
• Daily exercise is another maintenance strategy of Registry members – 90% exercise at least an
hour every day. Some bouts of higher intensity exercise may also be advantageous. Keeping a
written record is advised. Use a calendar and if there are a lot of blank spaces, increase activity.
• Successful people (75%) weight themselves at least once a week. This strategy enables early
detection of weight gain and correction is easier. Cut back on food intake until the weight is back
to maintenance. Keep a written record of weigh-ins.
• According to research published in the September 2000 journal Obesity, the longer the weight
loss is maintained, the fewer maintenance strategies are needed, making it easier to keep the
weight off over time.
• Television watching can be a time of mindless eating. Eating should occur ONLY at the dining
room table with no television or other distractions such as computers, I pads, etc. Children should
learn this habit early on. Sixty-two percent (62%) of those that are successful watch less than 10
hours of TV per week.
• Meals in restaurants provide large serving sizes and usually more sodium and fat than home
cooked meals. Share a dish with someone or ask the waiter to serve only half and put the other
half in a box to take home.
• Plan menus for the week. It only takes about 15 or 20 minutes. Make a shopping list as you plan
your menu. Shop for the week.
• When cooking, plan to have leftovers for sandwiches or items that can be added to a salad. Use
leftovers and bring a lunch instead of eating out. Always include a fruit and some veggies.
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The Best Breakfast for You
Give your body and brain the fuel they need, whether you work out, don’t have much
appetite, or are running out the door in the a.m.
By Jessica Girdwain
What you eat after rolling out of bed has the power to banish cravings, turbo-charge energy, and keep
your waistline in check. Breakfast munchers eat 12 percent healthier throughout the day, according to
data from the app Eatery (by Massive Health), which tracks users’ daily chow-down habits. “Skipping
breakfast makes you more likely to overindulge at your next meal or eat mid-morning snacks that are
high in calories and sugar to ward off hunger until lunch,” says Amari Cheffer, R.D., owner of Eat Chic
Chicago.
And if the a.m. is your time to exercise, you especially need to nosh. When you wake up, blood sugar
levels and carb stores are way down, explains sports dietitian Michele Macedonio, R.D. Breakfast
provides what your brain needs to feel alert and what your muscles need to perform at their best—so
you feel zippy on the treadmill instead of fatigued and, well, just blah.
Don’t reach for just any cereal or oatmeal, though. Different morning routines call for different morning
meals. Whether you’re trying to drop 10 pounds or rip through an a.m. Body Pump class, one of these
eight yummy, satisfying breakfasts will start your day on a high note.
2. The best breakfast if you . . . are trying to lose weight
Repeat after us: A grande skinny caramel macchiato is not a breakfast. For the same wake-you-up
buzz of caffeine and healthful antioxidants and no calories, have green tea. Then make one or two
eggs—the whole thing, not just the whites since more than half of the fill-you-up protein is in the
yolk—with a piece of fruit such as an apple or a cup of raspberries. This all clocks in between 135 to
240 calories and has 7 to 14 grams of protein and 4.5 to 8 grams of fiber to provide staying power
until lunch, Cheffer says.
3. The best breakfast if you . . . still feel full from dinner
First things first: Eat! “That will keep your metabolism going,” Cheffer says. Nibble on something
light within an hour of waking up such as a piece of fruit. And next time push back dinnertime.
Eating two to three hours before going to sleep—including snacks—will give your body ample time
to digest everything before the a.m.
4. The best breakfast if you . . . do cardio in the a.m.
Your muscles run on carbs as their main source of fuel when your heart’s pumping while you run,
spin, or sweat on an elliptical, so eat an hour before your exercise to boost energy and allow your
body time to break down your meal. Swirl plain fat-free or low-fat yogurt into oatmeal and top with
fresh fruit or raisins. (If you have less time, a fruit and milk or yogurt smoothie wins points for easy
digestibility.)
Post-workout enjoy a mix of carbs to replenish glycogen stores and protein to maximize muscle
repair, ideally within 30 minutes of your cool down—this is the prime time when muscles are like
a sponge, absorbing all those powerhouse nutrients. A 100-calorie whole-wheat sandwich thin
spread with a thin layer of peanut butter and topped with a bit of honey or jelly is an easy choice,
Macedonio says.
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5. The best breakfast if you . . . will have a late lunch
Slow-digesting fiber and protein are your best friends when you want to quash stomach rumblings.
Shoot for 7 to 10 grams of fiber and 15 to 20 grams of protein, which can deliciously be reached
with a pseudo-parfait of a cup of plain fat-free or low-fat Greek yogurt, a serving of high-fiber
cereal (look for those that pack at least five grams per serving), and fresh or frozen blueberries.
6. The best breakfast if you . . . can’t stomach a lot of food
The last thing you want is something that sits like a rock in your gut, so an easy-to-digest smoothie
is the way to go. Keep it healthy by blending frozen fruit and milk or a non-dairy alternative. Or buy
a bottled one that contains less than 30 grams of sugar per serving and protein to slow the rate
that your body absorbs that sugar and keep you fuller longer, Cheffer says. Either way, sip slowly
through the morning for a dose of important vitamins and minerals.
7. The best breakfast if you . . . are on the go
On Sunday, prep Macedonio’s favorite eat-on-the-run option for the week: Mix a whole grain, highfiber, low-sugar cereal (she likes Mini Shredded Wheat, Cheerios, or Chex); nuts (soy nuts, peanuts,
or almonds); and dried fruit (raisins or cranberries), and portion out one-cup servings into sandwich
bags. On your way out the door in the morning, grab a bag and a single-serving carton of low-fat
milk. Or bake up a half-dozen fiber-rich breakfast muffins and freeze. Take one out the night before
to thaw, or defrost it in the toaster oven when you wake up. Both options offer that perfect combo
of carbs and protein that helps kick your brain into gear and satisfies your hunger.
8. The best breakfast if you . . . practice yoga in the a.m.
Breakfast isn’t one-size-fits-all for yogis. Intense, athletic-style classes call for any of the options
listed previously for cardio or strength workouts. Since milder versions of yoga typically don’t burn
as many calories, Macedonio recommends a piece of fruit or a container of applesauce before
heading to the studio to pump up energy without weighing you down during an inversion.
Following any type of downward dog session, chopped fruit stirred into a container of fat-free or
low-fat plain yogurt is a good bet, as it delivers (say it with us) carbs and protein to recharge your
body.
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General Time Saving Strategies
• Use quick cooking methods such as a microwave, crock pot cooking, pressure pot, or stir fry.
• Purchase time-saving equipment such as a food processor, salad spinner
• Do some preparation ahead of time such as marinate or chop
• Use recipes with few ingredients and requiring few cooking pots and pans
• When you cook, make enough to put in the freezer for a more hurried time
Use Your Freezer
• Divide food into small quantities before freezing; two separate pints will defrost more quickly
and evenly than one quart.
• Store freezer items that will be cooked or reheated in glass containers to go directly into the
oven.
• Label items with date, how much time needed to cook or reheat and what is in the container.
• If you choose a commercial frozen meal, be aware that many are high in sodium and lack
vegetables. Consider supplementing such a meal with vegetables and/or salad.
Lunch and Dinner Ideas
• Add canned beans to salads and sauces for extra protein and fiber.
• Stir canned beans into canned tomatoes or tomato sauce. Season to taste with parsley, chili
powder, cumin, oregano and hot sauce. Serve with whole grain bread,
barley or rice and a mixed green salad.
• Stir-fry tofu with vegetables. Season with soy sauce and
serve over brown rice.
• Purchase lean ground turkey meat; add tomato
sauce, canned corn and beans and favorite
herbs.
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Ways to Add Flavor Without Adding Fat
The flavor of your food comes from these six tastes . . .
Taste Examples
Sweet
Onions, squash, sugar, fruits (mango, banana, melon, apples, berries . . .)
Salty
Salt, soy sauce, pickles, fish sauce, capers, miso, ham, salami . . .
Sour
Tomatillos, lemons, limes, Kumquats, vinegar . . .
Bitter
Watercress, parsley, bitter greens (mustard greens, chicory, collards,dandelion . . .)
Pungent
Garlic, horseradish, daikon, mustard, ginger, turnips, many herbs/spices . . .
Foods Have Different Degrees of Flavor Within The Six Categories Above:
For example . . .
Honey is SWEETER than table sugar, corn syrup, or apple juice.
Table Salt has a different SALTY flavor than soy sauce.
A Yellow Onion is both SWEET and PUNGENT compared to a mostly pungent, white onion.
A Lemon has a mostly SOUR taste, where a lime has both a SWEET and SOUR taste.
In addition to the six tastes described above, Flavors in Food Result From . . .
TIME - Time may mellow or intensify flavors.
For example, in a salsa, many tastes combine to make a balance of:
Sweet (tomato) . . . Bitter (cilantro) . . . Sour (tomato and lime) . . . Pungent (raw onion/garlic) . . .
Many salsas with hot peppers become “hotter” over time as the peppers add flavor throughout.
COOKING - Cooking may mellow or intensify flavors.
For example, many recipes call for sauteed onions and garlic. Sautéing will mellow the Pungent
taste and increase the Sweet characteristics.
COMBINING FOODS - Combining foods in proper proportions can balance flavors.
For example, a stir-fry can a variety of balanced flavors. There may be a Pungent/Sweet onion,
garlic and ginger, balanced with other Sweet vegetables, like carrots and snow peas. There may
also be meats and some type of Sour vinegar.
The combination of flavors and techniques creates a balance of mellow and intense flavors
Examples of BALANCING FLAVORS
Mixed Green Salad with Vinegar-based Dressing
Most basic salads use some type of greens, usually with a slightly Bitter flavor. When dressed, the
Sour flavor of the vinegar (or slightly Sweet flavor of rice wine vinegar), provides a good balance
for the bitter lettuce.
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Mixed Spices
Chinese Five-Spice Powder, Curry Powder, and Garam Masala all combine a variety of pungent, but
not pepper-hot, spices. Each is unique, and when used properly, is well balanced.
Bay Area Project LEAN (Low-Fat Eating for America Now)
Funded by the California Department of Health Services, Chronic Disease Control Branch.
Contract Number: 93·18063
LEAN SUBSTITUTIONS
When you are thinking of making a substitution, ask yourself the following questions:
“What is it about the product that is pleasing?”
“What role is fat playing in the product?”
Then, think about acceptable substitutions.
Here are some suggestions and guidelines about how you might create leaner meals using your
favorite recipes. Remember, these substitutions might require a try or two to be perfect!
BAKING Recipe or Food Item
Try Substituting . . .
Muffins and Quick Breads
Applesauce
Substitute applesauce for half of the fat in your recipe. For example, when your recipe calls for 4
ounces of butter or margarine, replace 2 ounces with 1/4 cup applesauce, and notice how moist your
muffins are!
Boxed MixesApplesauce
Substitute applesauce for all of the fat. For example, when the recipe calls for 1/2 cup oil, replace it
with 1/2 cup applesauce.
Brownies Prune Paste
Substitute prune paste (you can make prune paste by pureeing pitted prunes) for 1/2 or all of the fat
in your recipe. Remember to add 1/4 to 1/2 cup boiling water to reach the needed consistency of your
batter.
In many recipes, especially baked goods, you can substitute 2 egg whites or 1/4 cup of egg substitute
for EVERY egg in the recipe, OR use 2 egg whites and 1 yolk for every 2 eggs in the recipe.
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GENERAL COOKNG Recipe or Food Item
Try Substituting:...
Ground Meats
Beans (whole/pureed)
Substitute cooked beans for all or part of the meat in a recipe. If you are using meat, cook it first and
drain the excess fat before adding the beans and other ingredients.
CheeseLow-fat cheese
Substitute low-fat cheese for regular cheese in sandwiches and spreads. Try different brands until you
find one you like.
Salad Dressing
Starch (to thicken)
Thicken 1 cup fruit or vegetable juice with 1 tablespoon cornstarch (add starch and bring to a boil) or
arrowroot (dissolved in 1 tablespoon cold water). Cool mixture, and add a little vinegar and herbs and
spices. Your mouth will think it is oil and vinegar dressing!
Mayonnaise, Salsa, Mustard,
Substitute all or part of the mayonnaise with one of these choices. Ricotta, Yogurt
You may want to season the non-fat or low-fat yogurt or ricotta with herbs and/or spices.
Lean Cooking
INSTEAD OF:TRY:
FryingBaking
Dunk chicken or fish into egg white or buttermilk, roll in seasoned breadcrumbs, flour or crushed corn
flakes (season with garlic and onion powder) then bake at 400 degrees on a rack.
Bake russet potatoes by slicing potatoes into thin wedges, toss it with 1 tsp of oil per potato and
sprinkle with salt and pepper. Bake until brown at 450 to 475 degrees.
INSTEAD OF:TRY:
Thickening with butter and flour
Pureed Fruits/Vegetables
Thicken sauces and soups with leftover vegetables or “riper” pureed fruits. Soups and sauces can also
be thickened by mixing flour into hot soup or base.
INSTEAD OF:TRY:
Cooking with solid fat
Oil
When sautéing foods, use a small amount of oil in place of other solid fats (such as butter, lard,
Crisco). Finish cooking with flavored oil (olive oil, etc).
After making a STOCK or SOUP, refrigerate it until the fat becomes solid at the top, and then remove
fat and toss it out.
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Shopping Lean
To stay fit, learn how to shop for the BEST in flavor and nutrition and the LOWEST fat!
Here are some tips for LEAN shopping....
Shop for foods that are IN SEASON and use the Food Guide Pyramid as a guide .
•PLAN AHEAD. Bring a shopping list with you to the store, and
remember to eat before you shop to avoid buying extra food.
•BUY FRESH. Take the time to find the best and freshest foods.
Fresh foods give you the best flavor and nutrition.
•BUY LOW-FAT. Look for the best low-fat ingredients;
good ingredients give the best flavor.
•READ LABELS. The nutrient labels tell us a lot about the
nutrient and fat content of foods . Learn to use labels to buy LEAN .
•THINK LOW-FAT. Look for low-fat alternatives to the foods you love that are high in fat.
CREATE a pantry of flavor and nutrition
Many delicious and nutritious options can be found in your grocery store’s dry goods section to help
you create LEAN and tasty meals!
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SHOPPING LEAN
For the best flavor and nutrition and the lowest fat, look for these items in your grocery store.
Vegetables
Fruits
Dry Goods
Potatoes
Lemons
Dry Beans/Canned Beans
Greens (all types)
Limes
Rice/Whole Grains
Corn
Bananas
Pasta
Peppers
Papaya
Pretzels
Tomatoes
Mango
Baked Tortilla/Potato Chips
Tomatillos
Berries
Corn / Low-fat Flour Tortillas
Fresh Herbs
Watermelon
Canned Chiles
Onions
Pineapple
Crushed/Pureed Tomatoes
Garlic
Pears
Rice Paper
Dry Bean Curd Sheets
Meats
Salsa
Meats Labeled “95% Fat-Free”
Low/Non-fat Salad Dressing
Meats Labeled “LEAN”
Loin Cuts of Pork or Beef
Trimmed Meats (with less visible fat)
Reduced fat Cookies/Desserts
Herbs and Spices
Poultry
Seafood
Skinless Chicken or Turkey
Tuna (packed in water)
Ground Chicken or Turkey
Clams
Poultry Labeled “93% Fat Free” or
Most types of white fish
“96% Fat Free”
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Low/Non-fat EvaporatedMilk
Caffeine
The beverage market is exploding with stimulating beverages such as double espresso macchiato,
smoothie with energy boost, or a two-ounce energy shot. Most experts agree that moderate caffeine
consumption is about 200 to 300 mg (two to four cups) of brewed coffee. For adults, some health
benefits are found in products like coffee, tea and chocolate. Caffeine can boost alertness and memory,
ward off Alzheimer’s and Parkinson’s diseases, protect against heart disease and diabetes. During
physical activity it may even jumpstart speed and endurance.
The negative side of caffeine (heavy use) is more than 500 to 600 mg per day can
cause negative effects such as restlessness, sleep disturbance, nervousness, irritability,
uneven or quickened heart rhythm, headache and stomach upset in some individuals.
Consumed in excess, it can lead to dependence and intoxication, amplify above effects
and even lead to fever, tremors, and sensory disturbances.
Data from two studies in the journal Pediatrics in 2009 and 2010 indicate that children
aged five to seven consumed about 52 mg of caffeine each day, those aged eight to 12
doubled intake to 109 mg and 12 to 18 year-olds averaged 144 mg each day.
Gluten Free Diet
Many people are following the gluten-free diet as a fad. For those individuals with celiac disease (CD)
or non-celiac gluten sensitivity (NCGS), the gluten-free diet is a medical requirement. Foods that need
to be absolutely avoided are wheat, barley and rye and to a lesser extent oats.
Best practices for diagnosis are a thorough physical examination, including serological blood tests for
gluten antibodies. The second step is a health care practitioner performing a small bowel biopsy. The
diagnosis is confirmed when symptoms subside and the intestinal lining normalizes while the patient is
on a gluten-free diet. There is no standard diagnostic approach or validated blood tests available for
the diagnosis of non-celiac gluten sensitivity. The diet is pretty overwhelming and a patient is usually
supported by help from a registered dietitian.
Potential Nutrient Consequences of the Gluten-Free Diet
Decreased grain consumption includes a decreased intake of fiber, iron, folate, niacin, Vitamin B-12 and
zinc. Additional potential consequences include increased fat intake due to decreased intake of glutenfree grains and an increased consumption of foods high in fat that are frequently substituted for grain
foods. Beans contain some of the nutrients commonly lacking in the gluten-free diet: folate, calcium,
iron, and fiber.
Don’t follow a gluten-free diet unless it is medically necessary and recommended by your physician.
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Lactose Intolerance
Lactose intolerance occurs when the body is lacking enzymes (lactase) that are needed to digest the
sugar in milk called lactose. Studies have shown that even if you are lactose intolerant, in most cases it
does not mean giving up milk. Milk and milk products provide many important vitamins and minerals
for good health.
Tips for Tolerance
Drink milk with a snack or meal instead of on an empty stomach. Solid foods slow down digestion, which
helps your body handle the lactose more easily.
Try small, frequent portions of milk and milk products throughout the day. This allows the lactase to do
the job of digesting the lactose before there is a problem.
Purchase lactose-free milk and milk products. Lactase enzymes drops can be bought at the pharmacy
and added to your milk.
Cheese has half the lactose that milk has because the lactose is removed when cheese is made. Aged
hard cheeses like Cheddar, Colby, Swiss and Parmesan are particularly low in lactose and easy to digest.
Cultured milk products such as yogurt contain “friendly” bacteria. The bacteria help your body digest
lactose.
Don’t like milk? Add chocolate to your milk!
Whole milk and 2% milk contain saturated fat and can raise serum cholesterol level and increase the
“bad cholesterol”. Healthy children over age 2 and adults should drink 1% or fat-free milk. When making
dishes that call for cream (even more saturated fat), substitute whole milk or 2% milk for cream and save
on the amount of saturated fat consumed while not totally altering flavor.
Some combos that help ease digestion and provide calcium are:
• Add milk to creamy-style soup instead of water
• Enjoy a cheese and mushroom omelet.
• Grab a yogurt for breakfast or a snack.
• Have a treat with a thick milk-fruit smoothie or use yogurt-fruit for a smoothie.
• Use plain yogurt in party dip recipes
It is better to get calcium from natural sources than from fortified sources. Research suggests an increase
in heart problems when calcium is supplemented or fortified in large amounts.
Keep calcium intake from both food and supplements at or below 2000 mg a day.
Dairy foods provide other bone building minerals and are one of a few foods that contain Vitamin D.
Compare 300 mg of calcium in 1 cup of milk with these other sources of calcium
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Bok Choy
1 cup 160 mg calcium need to eat ~ 2 cups
Broccoli (boiled)
1 cup
72 mg need to eat ~ 3 cups
Collard Greens (boiled)
1 cup
358 mg Less than 1 cup
Goal for calcium intake is:
Birth-6 months 210 mg
7-12 months 270 mg
1-3 years 500 mg
4-8 years 800 mg
9-18 years 1300 mg
19-50 years 1000mg
50+ years 1200 mg
Bottom Line for taking Calcium Supplements
There is no question that our body needs calcium. It is involved in everything from nerve signal
transmission to blood vessel health. Calcium builds and strengthens bones - something that is especially
critical after menopause. A European study found an increase risk for heart attacks in addition to
development of kidney stones in those that supplement too much calcium.
Get your calcium from food however if you are unable to get enough through diet then estimate how
much calcium you get from food and add the amount of calcium you need to supplement to reach your
goal for calcium.
Bone Health: Looking Beyond Calcium
We know that calcium is important for bone health, and most of us know about the role of vitamin D as
well. However, your skeletal health is affected by many other vitamins and minerals in your diet, many
that you probably do not even think about.
Phosphate
A proportional amount of both phosphate and calcium is necessary for bone mineralization. If too much
phosphorus is consumed with a concurrent low intake of calcium, bone loss is thought to result. This is
referred to as nutritional secondary hyperparathyroidism, and contributes to a loss of bone density and
mass. Individuals who consume many phosphorus-containing foods should make sure they consume an
adequate amount of calcium, as well.
Phosphorous is found in:
• Meat
• Milk
• Poultry
• Nuts
• Fish
• Legumes
• Eggs
• Cereals
• Milk Products
• Grains
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Magnesium
More than 50% of the total magnesium in your body is found in the bone, mostly in bone fluids.
Magnesium is found in:
• Seeds
• Cabbage
• Nuts
• Turnip greens
• Legumes
• Dark lettuces
• Milled cereal grains
• Milk
• Broccoli
• Dark-green leafy vegetables, such as:
Spinach
Vitamin K
Vitamin K is very important for bone health and acts as a modifier of bone matrix proteins. It also may
reduce urinary calcium excretion and aid intestinal calcium absorption. It seems that a low intake of this
fat-soluble vitamin increases the risk for bone fracture.
Vitamin K is found in dark-green leafy vegetables, such as:
• Spinach • Dark lettuces
• Broccoli
Also found in:
• Cabbage
• Dairy products
• Turnip greens
• Meat • Eggs
Vitamin A
For many years, vitamin A was considered beneficial for skeletal health. However, in the past several
years, fears have arisen that too much retinal (not derived from the carotenoids found in plant sources)
may contribute to hip fractures, especially in postmenopausal Caucasian women.
Preformed vitamin A is found in:
• Liver (not recommended for food consumption due to possible toxins). Once a year maybe
• Milk fat
• Fortified skim milk
• Eggs
Carotenoids are found in:
Dark-green leafy vegetables, such as:
Yellow-orange vegetables and fruit, such as:
• Spinach
• Carrots
• Broccoli
• Oranges
• Cabbage
• Sweet potatoes
• Turnip greens
• Cantaloupe
• Dark lettuces • Butternut squash
• Brussels sprouts
• Peaches
• Tomatoes
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Copper
Copper is integral to the process of cross-linking of collagen and elastin molecules, and may have other
roles in bone cells as well.
Copper is found in:
• Meat
• Nuts
• Poultry
• Cereal grains
• Shellfish
• Dried legumes
• Organ meats
• Dried fruits
• Chocolate
Manganese
Manganese is necessary for the formation of bone matrix.
Manganese is found in:
• Whole grains
• Instant coffee
• Nuts
• Fruits
• Legumes
• Vegetables
• Tea
Iron
Iron is important for collagen maturation, and has other roles in osteoblasts and osteoclasts. Osteoblasts
deposit bone and osteoclasts breaksdown bone.
Iron is found in:
• Organ meats, such as liver, kidney, heart
• Fortified and whole-grain cereals
• Seafood
• Milk
• Lean meat
• Milk products
• Poultry
• Shellfish
• Dried beans
• Liver
Zinc
The enzymes in osteoblasts require zinc to synthesize collagen.
Zinc is found in:
• Meat
• Fish
• Poultry
• Dry beans
• Nuts
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Vitamin D: What’s All The Hype?
A deficiency of Vitamin D has become epidemic for all age groups in the United States and Europe.
Sufficient levels are essential to maintain bone strength in children and adults. Severely deficient
amounts of Vitamin D cause rickets (bowed legs) in children and osteomalacia (a softening of bones) in
the spine, pelvis and lower extremities in adults.
The Institute of Medicine increased the recommended daily allowance (RDA) of Vitamin D to:
Ages birth to 12 months
400 IU
Ages 1 to 70 years
600 IU
Ages 71 and above
800 IU
The Upper Safe Limit is now set at 4,000 IU/day for individuals older than nine years of age.
Many studies have identified an insufficiency of vitamin D in a number of chronic diseases: Multiple
sclerosis, type 1 and 2 diabetes, osteoporosis, cardiovascular disease, hypertension, metabolic syndrome,
cancer, and autoimmune diseases.
The amount of vitamin D found in fortified foods is small.
Milk = 115 - 124 IU vitamin D
Yogurt = amount varies in different brands ~ 80 IU
Other sources of Vitamin D:
Egg yolks = 1 large = 40 IU
Salmon (sockeye, cooked, 3 oz) = 447 IU
Sardines, canned in oil, drained, 2 sardines = 46 IU
Tuna fish, canned in water, drained 3 oz = 154 IU
Exposing the skin to the sun is the most reliable mechanism for the body to synthesize its own vitamin
D, yet to reduce the risk of skin cancer many people apply sunscreen prior to sun exposure, which in turn
blocks up to 99% of vitamin D biosynthesis.
At northern latitudes (37 degrees north of equator, north of Los Angeles, CA and Atlanta, GA),
insufficient vitamin D is produced by the skin during the winter months (November through March)
even when sunscreen is not used.
Obese individuals require greater doses of vitamin D to raise their serum vitamin D levels.
67% of the United States population over the age of 20 years are overweight or obese.
New guidelines: Serum (Blood) Levels
30
25 Hydroxy vitamin D level less than 20 ng/mL
DEFICIENCY
25 Hydroxy vitamin D level 21 – 29 ng/mL
INSUFFICIENCY
25 Hydroxy vitamin D level greater than 30 ng/mL
GOAL
To maintain the goal above 30 ng/mL, a supplement may be needed.
Adults may need to supplement in the winter months or year round based on skin color and the amount
of sun exposure. African Americans may need to supplement 2,100 – 3,100 IU/day of vitamin D3 year round.
Caucasians recommended supplementation may need 1,000 – 1550 IU/day of vitamin D3 during the
winter months or year round depending on serum level.
Before supplementing women and especially men should have a blood test (25 hydroxy vitamin D test)
done to determine their level and then decide on the amount of vitamin D supplement needed to reach
goal. Men are more susceptible to adverse effect if serum level increases too much.
Keep serum level below 50 ng/mL.
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Other Dietary Considerations
Dietary fiber: A high intake of dietary fiber may interfere with calcium absorption. This is generally
not an issue for Americans. This may impact vegans, who consume 50 or more grams
of fiber/day.
Protein: Excessive animal protein consumption may cause an increase in urinary calcium
excretion.
Sodium: Excessive consumption of sodium increases the excretion of calcium from the body.
Soy: Soy seems to protect against osteoporosis and hip fractures.
Alcohol: Some studies refer to alcohol as a major contributor to bone loss. However, heavy
alcohol consumption also is linked to tobacco usage and poor dietary habits, and these
are possibly the reasons for the skeletal problems currently attributed to the alcohol
usage.
Reference
Anderson JJ. Nutrition and bone health. In: Mahan LK, Escott-Stump S. Krause’s Food, Nutrition, and Diet Therapy.
11th ed. Philadelphia, PA: WB Saunders; 2004:652-654.
Review Date 3/09
Disappointing Results found in more Rigorous Studies of Supplementation
Vitamin E – initially thought to protect the heart and later discovered to increase the risk for bleeding
strokes. May also increase risk for heart attacks.
Folic Acid and other B vitamins were once believed to prevent heart disease and strokes until later
studies not only didn’t confirm that benefit but actually raised concerns that high doses of these
nutrients might increase cancer risk.
Safety of Supplements
From 2007 to 2012, the U.S. Food and drug Administration (FDA) received more than 6,300 reports of
serious adverse events linked with supplements, including 115 deaths. Of particular concern are those
targeted at weight loss, bodybuilding or sexual enhancement; vitamin and mineral supplements that
contain more than 100% of the recommended daily intake. Most manufacturers are not required to get
FDA approval to sell them and supplements must be proven unsafe before they can be taken off the
market. Supplements should NEVER be a substitute for a healthy eating plan.
According to Consumer Reports, supplements may contain active ingredients found in prescription
drugs or high doses of vitamins and minerals that can cause health problems.
The Academy of Nutrition and Dietetics position paper reaffirms the importance of obtaining nutrients
from the consumption of a variety of nutrient-rich foods while acknowledging that nutrient supplements
may be needed to help fill dietary gaps for some.
Popular Sports Supplements Evaluating
The two most important questions to ask: Is the supplement safe? Is it effective?
Review the scientific literature and meticulously examine the quality and quantity of studies that support
32
the safety and effectiveness of the supplement. Supportive research should be published in a reputable
peer-reviewed journal and cited in the National Library of Medicine database (PubMed).
Organizations that test supplements and certify products that pass tests include:
NSF (www.nsf.org/consumer/dietary_supplements)
United States Pharmacopeia (www.usp.org/USPVerified/dietarySupplements)
Consumer Lab (www.consumerlab.com)
Getting the Most Out of Your Workout Through Nutrition
Food is fuel for exercise. Without the right mixture of fuel your body won’t perform at its best, and you
won’t get the results you desire. It doesn’t matter if you are not training for a marathon or other high
endurance sport, it is very important for the average person or non-athlete who is strictly trying to get
in better shape for their overall health and perhaps trying to lose weight as well.
Optimal timing of food intake, macronutrients (Carbohydrates, protein and fats) is not always feasible
however working toward fueling properly can avoid gastrointestinal upsets, maximize energy levels and
enhance performance. Individual preferences and circumstances need to be taken into consideration.
Whole foods are recommended instead of packaged snacks as the main source of fuel.
What can be done to improve energy level during a workout?
Your car won’t run without fuel. The Human Body will run without fueling before exercise however it is at
the expense of performance and recovery. According to Keri Gans, MS, RD, CDN a Nutrition Consultant
“A combination of high fiber carbohydrates and protein is ideal pre and post exercise, the carbohydrates
for quick energy and the protein to build and maintain muscles.”
Complaint: I can’t eat right before I go to my workout, it’s too early. I am not hungry early in the
morning.
Suggestion: THINK SNACK, not meal. Experiment with different light snacks to see what agrees with
you. Carbohydrates are digested quickly and provide energy for the workout. Eat something very simple,
such as a piece of toast or crackers with jam or nut butter, yogurt, low fat granola (few tablespoons), low
fat cottage cheese, or a piece of fruit. Portions should be small and monitored for tolerance. Perhaps a
small amount of fruit smoothie that is not high in fat. (Fat delays absorption and you need the energy
soon.)
Perhaps eating too much at night lessens hunger in the morning.
Complaint: I go straight from work so I don’t have time for eating before the class.
Later workouts in the day should be easier to fuel with a little planning. If you have lunch at 1 PM and go
to the gym at five or six you definitely need fuel to get through the workout.
33
At lunch or 3 or 4 hours before a workout:
• Eat a sandwich such as nut butter, honey or jam and glass of milk
• Fruit and yogurt smoothie and low fat granola
• Lean hamburger on bun with lettuce, tomatoes, side salad, yogurt
• Low fat tuna melt sandwich, fruit or fruit cup, milk or sports drinks
• Turkey sandwich, lettuce, tomato, avocado, water or milk
• Lean roast beef sandwich, salad or fruit, fluids
• Grilled boneless chicken breast, medium baked potato, steamed green beans
• Spaghetti with marinara sauce
If it has been longer than 4 hours since eating, one hour before workout try:
• Plain or vanilla yogurt mixed with a handful of low-fat granola cereal or small amount of nuts
• Plain or cinnamon–raisin bagel with light spread (small bagel) or ½ large bagel
• Hard-boiled egg with toast or small banana
• One-half bagel with nut butter or jam
• Low fat cheese and crackers
• Fresh fruit or fruit cups, pretzel sticks, Fig Newton bars
• 1 ounce serving of nuts and a piece of fruit
• Individual can of tuna (water-packed) on a whole-grain crisp bread cracker
• 3 slices of turkey breast on a small 100% whole grain pita
When talking about fuel for exercise it is important to remember that how you eat the rest of the day
is important. Eating junk food the rest of the day is surely defeating the purpose. An excellent exercise
routine is not enough on its own.
Planning ahead is important. Cook eggs ahead of time, compile a list for grocery shopping, have snacks
available either at your desk or in your car (use insulated bags). Keep it out of sight to avoid mindless
eating.
Pre-Event games/events – A pre-event meal is important to top off the body’s stores of carbohydrate,
especially if the workout or competition is in the morning. It also helps to maintain blood sugar levels
with additional carbohydrate intake during a long game of competition in order to improve performance.
The pre-event meal can keep an athlete from experiencing distracting hunger pains.
Eat 2 to 3 hours before practice or game. The amount of food should contain 200 – 300 grams of
carbohydrates, lean protein, and low fat with 12 to 20 ounces of fluid
Carbohydrates are the preferred fuel for exercise lasting about one hour. Without enough carbohydrate,
athletes lack energy, experience muscle fatigue, lack clear thinking and will be unable to work at high
intensities.
Always experiment with foods before an important event or game. Game or event time is not the
place to try a new snack or food.
34
During Exercise
Hydrate frequently with water if exercise is 60 minutes or less. For exercise lasting greater than 60
minute or for multiple workouts, intake of a sports beverage (15 grams of carbohydrate per 8 ounces)
is recommended. Continue drinking every 15 to 30 minutes to maintain energy levels. Increase fluid
replacement according to sweat rate. Weigh before workout then after. For every 1 pound of weight
lost, drink 16 ounces of 2 cups over the next few hours. Subtract the amount of fluid consumed during
the workout.
The Goals of Recovery Nutrition Include
• Restore fluid and electrolytes (sodium and potassium) lost in sweat.
• Replace muscle fuel (carbohydrate) used during the workout.
• Provide protein to aid in repair of damaged muscle tissue and to stimulate development of new
tissue.
• Begin nutrition recovery with a snack or meal within 15 to 60 minutes following the workout.
• Rehydration fluids such as milk or Gatorade can replenish fluids and electrolytes. Gatorade has
the proper amount of glucose (6%). (This writer has no connection or interest in the Gatorade
Company.)
Coconut Water:
Coconut water is great for rehydration when “sweat rate” is high. It contains high
amounts of potassium and too much potassium can affect heart rate. In addition,
people on potassium sparing diuretics could have a problem. Ask your doctor first
and limit the amount of coconut water.
Other Recovery Snack Ideas:
Smoothie made with yogurt and frozen berries
Graham crackers with peanut butter + low fat chocolate milk +banana
Recovery Meal Ideas:
Whole wheat pita sandwich with turkey and veggies + pretzels + low-fat milk
Rice bowl with beans, cheese, salsa, avocado, + whole grain tortilla chips or
whole wheat tortilla
Stir fry with lean steak, skinless chicken or shrimp, broccoli, bell peppers, carrots + brown
rice
Goals For Eating On the Road
Carbohydrates – consume at each meal and pre- and post-exercise, for fuel and to replenish muscle
energy stores
Protein – moderate amounts of lean protein at each meal, small amounts in pre- and post-exercise
snacks, to speed recovery and repair muscles
Fat – Healthy fats at each meal to meet needs for energy balance and help replace muscle energy
stores. Healthy fats are avocadoes, nuts, seeds, olives, canola and olive oils.
Fluids – enough to maintain hydration and replace fluids lost during exercise and travel
35
Fast Food Ideas
• Familiarize yourself with eateries that provide high performance food options and nutritional
information.
• Mexican: burrito or soft tacos with grilled veggies, chicken, fish, or steak
• Fast food: grilled chicken sandwich, hamburger, or veggie burger with tomatoes, and lettuce or
grilled chicken salad with reduced-fat dressing
• Trail mix with dried fruit, nuts, and seeds
• Fresh fruit, sliced vegetables
• Bagel with nut butter, dry ready-to-eat cereals, sports bar
• Hydrating beverages such as water, low fat milk, 100% fruit juice
• String cheese, yogurt
• Ask for dressing / sauce on the side
Tips To Take With You
• Choose eateries that allow substitutions, such as vegetables and fruit, when menu items do not
meet your performance needs
• Tailor your meals. Specify bake, broil, grill, roast, “on the side”.
• Plan ahead! Prepare a travel pack with snacks and beverages that support your performance
eating plan.
36
Blood Pressure - What You Need To Know
Blood pressure is the force of blood against the walls of your arteries. Your blood pressure is measured
as two numbers, the systolic pressure (as the heart beats) and the diastolic pressure (as the heart
relaxes). Blood pressure is written as systolic/diastolic pressure. For example:
• Optimal—120/80 or lower
• Prehypertension—120-139/80-89
• High—140/90 or greater’
You have high blood pressure if it is 140/90 or higher. High blood pressure also is known as “hypertension.”
If you have high blood pressure, you have more of a risk for developing heart disease and stroke.
Causes of High Blood Pressure
Many different things cause high blood pressure, including:
• Narrowing of the arteries—blood has to move through a narrower space
• A greater than normal volume of blood—too much blood forced through the system
• The heart beating faster or more forcefully—possibly because of heart size, stress, anxiety, etc
• Certain medications
At Risk For High Blood Pressure
Many people develop high blood pressure as they get older. Ninety percent of all middle-aged individuals
develop hypertension. If you have any of the following, you are possibly at risk for developing high
blood pressure:
• Are overweight
• Have a family history of high blood pressure
• Have a high normal blood pressure (130-139/85-89 millimeters of mercury [mm Hg])
• Are African American
Treating High Blood Pressure
To Treat Hypertension, you should:
• Eat healthfully
• Replace non nutritious foods with foods that are rich in magnesium, potassium and calcium
• Lower salt and sodium intake in your diet
• Lose weight if you are overweight
• Keep physically active
• Limit alcohol intake
• Quit smoking
Research shows that the DASH diet (Dietary Approaches to Stop Hypertension) lowers blood pressure
as well as medications. It has been proven to lower blood pressure and cholesterol, and is associated
with lower risk of several types of cancer, heart disease, stroke, heart failure, kidney stones, reduced risk
of developing diabetes, and can slow the progression of kidney disease.
37
In addition to being recommended by your physician, DASH is also endorsed by:
• The National Heart, Lung, and Blood Institute (one of the National Institutes of Health, of the US
Department of Health and Human Services)
• The American Heart Association (AHA)
• The 2010 Dietary Guidelines for Americans
• US guidelines for treatment of high blood pressure
• The 2011 AHA Treatment Guidelines for Women
• The Mayo Clinic.
The DASH Diet Plan
The DASH eating plan has been proven to lower blood pressure in just 14 days, even without lowering
sodium intake. Best response came in people whose blood pressure was only moderately high,
including those with prehypertension. For people with more severe hypertension, who may not be
able to eliminate medication, the DASH diet can help improve response to medication, and help lower
blood pressure. The DASH diet can help lower cholesterol, and with weight loss and exercise, can reduce
insulin resistance and reduce the risk of developing diabetes.
The NY Times Best Sellers, The DASH Diet Action Plan and The DASH Diet Weight Loss Solution, provide
real life solutions to make it easy for people to follow the DASH diet. They each have 28 days of meal
plans, recipes, guidance for weight loss, how to eat at restaurants, fast food places, etc. and still stay on
track. It shows you how to stock up your kitchen for the DASH diet, and how to read food labels to make
good choices. And, of course, the meal plans and recipes are all low sodium/low salt. The book shows
you how to add exercise and other lifestyle changes to help lower blood pressure. The books help you
design your own personal “DASH Diet Action Plan” and your own “DASH Diet Weight Loss Solution.”
Number of servings
for 1600 - 3100
Calorie diets
Servings on a 2000
Calorie diet
Grains and grain products
(include at least 3 whole grain foods each day)
6 - 12
7-8
Type of food
Fruits
4-6
4-5
Vegetables
4-6
4-5
Low fat or non-fat dairy foods
2-4
2-3
Lean meats, fish, poultry
1.5 - 2.5
2 or less
Nuts, seeds, and legumes
3 - 6 per week
4-5 per week
2-4
limited
Fats and sweets
www.dashdiet.com
If these steps fail to lower your blood pressure to what is considered a healthy blood pressure, your
doctor may prescribe a blood-pressure-lowering medication.
38
Reducing Salt and Sodium in the Diet
It is recommended that you eat 2.3 grams (g) or 2300 milligrams (mg) of sodium/day or less. That is
equivalent to about 1 teaspoon (tsp) of table salt/day. Remember though, the 2.3 g of sodium or 1 tsp
of table salt includes the salt and sodium in all the foods you eat, not just the amount that you add to
your foods. If you have high blood pressure, your doctor or dietitian may advise you to eat less salt and
sodium.
The following tips can help you reduce the amount of salt and sodium in your diet:
• Add less salt at the table and in cooking
• Buy fresh or plain frozen vegetables, instead of canned vegetables
• Use fresh poultry, fish, and lean meat, rather than canned or processed varieties
• Cut back on the following foods, which often have large amounts of hidden sodium:
• Frozen and packaged foods
• Mixed dishes, such as pizza
• Packaged mixes
• Canned soups or broth
• Salad dressings
• Buy low- or reduced-sodium or no-salt-added versions of foods, when available
• Choose ready-to-eat breakfast cereals that are lower in sodium
• Limit smoked, cured, or processed beef, pork, poultry, and fish
The following suggestions can help you reduce the salt and sodium content in the foods
that you cook yourself:
• Cook rice, pasta, and hot cereals without the salt
• Rinse canned foods, such as tuna, beans, and vegetables, to remove some of the sodium
• Use herbs, spices, and salt-free seasoning blends in cooking and at the table
• Substitute fresh garlic, onion, or celery for seasonings such as garlic salt, onion salt, and celery
salt
• Make foods from scratch, rather than using prepared foods, whenever possible
• Try to use lemons and limes to season foods
Remember These Helpful Tips:
• Choose low-sodium or salt-free foods
• Do not add salt to foods (it takes about 2 weeks to adjust to a low salt diet)
• Learn to read food labels—look for hidden salt and sodium
• Limit alcohol intake
• Quit smoking
• Keep physically active
• Lose weight, if overweight
• Check your blood pressure frequently
References:
American Dietetic Association. Nutrition fact sheet: get smart about salt. Available at: http://www.eatright.org/ada/
files/Mrs_Dash.pdf. Accessed February 4, 2009.
American Heart Association. High blood pressure. Available at: http://www.americanheart.org/presenter.
jhtml?identifier=4623. Accessed February 4, 2009.
Review Date 3/09
39
Heart Disease
Heart disease is America’s number-one killer, with about 82.6 million people in the United States having some form of
cardiovascular disease. Below are the heart disease risk factors that you can control and take steps to decrease your risk:
• Smoking, including cigarettes, cigars and pipe smoking
• High blood pressure causes the heart to work harder and enlarge and weaken
• High total blood cholesterol and low HDL(good cholesterol) cholesterol levels
• Diabetes. Even if diabetes is under control, people with diabetes have a higher risk of dying from a heart attack
• Being overweight or obese, especially with excess abdominal fat. The excess fat puts strain on the heart, raises
blood pressure, raises total cholesterol and triglyceride levels and lowers HDL cholesterol
• Physical inactivity or living a sedentary lifestyle
Consult your physician to see if you are at high risk for heart disease or already have heart disease, and consult a registered
dietitian in your area.
Foods to avoid
• Bacon
• Stick margarine
• Chocolate
• Ice cream
• Bologna
• Lard
• Potato chips
• Chocolate
• Sausage
• Bakery items
(Danish, croissant,
doughnuts, cake,
cookies)
• Egg yolks
• Potato chips
• Regular ice cream
• Egg yolks
• Coconut
• Regular ice cream
• Fried food
• Coconut
• Fast food
• Fried food
• Chicken skin
• Duck
• Liver
• Whole milk
• Cream
• Butter
• Regular cheese
• Alfredo sauce
• Ice cream
• Regular cheese
• Alfredo sauce
Foods to choose
• Fruits
• Egg Beaters® or egg whites
• Pasta
• Vegetables
• Tub margarine
• Popcorn
• Canola oil
• Walnuts
• Gummy candy
• Olive oil
• Almonds
• Gingersnaps
• Fish
• Oatmeal
• Vanilla wafers
• Skinless poultry
• Shredded wheat cereal
• Sherbet
• Meat with fat cut off
• Raisin bran cereal
• Low-fat ice cream
• Lite yogurt
• Whole-wheat bread
• Beans
• Low-fat cheese
• Brown rice
• Skim milk
• Wild rice
Do not buy foods containing these ingredients
• Coconut oil
• Palm oil
• Cottonseed oil
40
• Partially hydrogenated oil
Review Date 10/10
G-1398
Diet Myths That Will Not Die
Olive oil is the best oil, hands down
Some experts actually state that canola oil might be better, because it is lower in saturated fat and has
more polyunsaturated fat than olive oil. This matters because polyunsaturated fats lower low-density
lipoprotein (LDL), the “bad cholesterol,” more than the monounsaturated fats found in olive oil. Both
are good for you, but do not use olive oil to the exclusion of canola oil. Let them share the spotlight!
Vitamin C boosts your immune system, helping you to fight off illness
Actually, it seems that vitamin C has no effect on one’s ability to fight off the average cold. It may,
however, shorten the common cold by about one half day, but even these results vary among studies.
Contrary to popular belief, no research shows that vitamin C is beneficial to people with any other kind
of illness.
High-fructose corn syrup is worse for you than regular sugar
In the past 30 years, usage of high-fructose corn syrup in our food supply has increased more than
1000%. The rates of overweight and obesity have climbed and climbed in those same years,
but that definitely does not mean that the two are interdependent. Many researchers
are hesitant to place the blame solely on high-fructose corn syrup and in fact
blame diets that are high in all sugars, the increased intake of calories
in any form, and the decreased physical activity done by modern
Americans.
People with diabetes should buy “sugar-free” foods
“Sugar free” does not mean “carbohydrate free.” Many sugar-free
foods contain as many, or more, carbohydrates as “regular” versions.
Your best bet is to carefully scrutinize all food labels. Remember that 15
grams (g) of carbohydrates equals 1 carbohydrate choice. It does not matter,
for the sake of carbohydrate counting, what form those 15 g of carbohydrate
come in—natural sugar, added sugar, grain, etc.
Peanut butter is high in fat—avoid it
Yes, 2 tablespoons of peanut butter do contain 190 calories and 17 g of fat. However, keep in mind that
peanut butter is an excellent source of protein and provides vitamin E, fiber, magnesium, copper, folate,
potassium, and niacin. The fat in peanut butter is the monounsaturated form, which lowers LDL and
total cholesterol levels. Peanut butter also is proven to reduce the risk of diabetes and lower triglyceride
levels.
Drinking wine will save your heart
The studies regarding the beneficial effects of alcohol on heart disease risk remain controversial. The
6000 men who were followed for 20 years showed no beneficial relationship. An increased overall risk
of mortality from all causes was seen in men who drank more than 22 drinks/week. In addition, men
drinking more than 35 drinks/week had twice the risk of dying from stroke.
Grape juice is perhaps more suitable for lowering blood pressure than red wine. Alcohol causes an
increase in triglycerides. At autopsy, the heart of a person who suffered from alcoholism will weigh
twice as much as the heart of nonalcoholics.
Still, some researchers recommend a moderate alcohol intake for reduction of cardiovascular disease,
because of the antioxidants contained in it. At any rate, it is not recommended that a man consume
more than two drinks/day or a woman more than one drink/day.
41
For the best health, buy foods that are labeled as high fiber
Isolated fibers, including inulin, maltodextrin, oat fiber, soy fiber, modified wheat starch, sugarcane fiber,
and polydextrose, may not improve regularity, decrease cholesterol, or improve blood glucose levels the
way that intact, natural fiber does.
Energy bars and drinks help to improve exercise performance and are great to eat before your 30- to
60-minute regular workout
Studies have shown that these supplemental food products are no better for athletes than any other
food containing an equal amount of calories and carbohydrate. They were originally designed for
endurance athletes, such as marathon runners who needed nonperishable and portable food to take
with them. These bars usually contain at least 200 calories, which would take a 150-pound person about
20 minutes of running at 5 miles per hour to burn off.
Vitamin-infused waters are a great choice for healthy, on-the-go people
Any water-soluble vitamins will pass into your urine, if your intake is more than what you need. That is a
waste of money, but not particularly dangerous to you. However, fat-soluble vitamins (vitamins A, D, E,
and K) are stored in your body, and if you consume more than you need, they have the possibility of an
“overdose” with some negative health effects. No solid evidence exists to prove that any vitamins help
to either increase your energy or calm you down when you are feeling frazzled.
Organic food is more nutritious
The Academy of Nutrition and Dietetics states that the vitamin, mineral, and antioxidant levels in organic
foods are no different from the nutritional qualities of conventional foods. A cookie is still a cookie
nutritionally, whether or not it is an organic cookie. If you eat cookies do so in moderation.
References and recommended readings
Day S. Bottled water is still pure, but it’s not simple anymore. Available at: http://query.nytimes.com/gst/fullpage.
html?res=9402E2D9153BF930A3575BC0A9649C8B63&sec=health&pagewanted=1. Accessed September 30, 2009.
Hobbs SH. Don’t put much stock in fancy waters. Available at: http://www.onthetable.net/vitamin-waters.html.
Accessed September 30, 2009.
Jiang R, Manson JE, Stampfer MJ, Liu S, Willet WC, Hu FB. Nut and peanut butter consumption and risk of type 2
diabetes in women. JAMA. 2002;288:2554-2560.
Liebman B, Schardt D. Bar exam: energy bars flunk. Available at: http://www.cspinet.org/nah/12_00/barexam.html.
Accessed September 30, 2009.
Liebman B, Schardt D. H2NO: the scoop on enhanced waters. Available at: http://cspinet.org/nah/06_08/h2no.pdf.
Accessed September 30, 2009.
WebMD. Peanut butter, nuts lower diabetes risk: the more consumed, the more protection for women. Available
at: http://diabetes.webmd.com/news/20021126/peanut-butter-nuts-lower-diabetes-risk. Accessed September 30,
2009.
Zelman KM. Organic food—Is natural worth the cost? Available at: http://www.webmd.com/food-recipes/features/
organic-food-is-natural-worth-the-extra-cost. Accessed September 30, 2009.
Review Date 11/09
G-1179
42
Probiotics and Prebiotics
More than 400 types of microorganisms are in your gastrointestinal tract. Some of these microorganisms
are healthy and others are unhealthy. The healthy bacteria in your gut help digest food. They also
synthesize some vitamins and essential fatty acids.
Probiotics are live microbes that can benefit your health by allowing the healthy bacteria in your
gastrointestinal (GI) tract to thrive while inhibiting or destroying toxins released by other bacteria. While
the research on the positive effects of prebiotics and probiotics is promising, many unknowns still exist,
including what bacteria work best with each condition, what dose is needed to have an effect, and
whether or not probiotic foods and/or supplements lose their effectiveness over time.
Benefits of Probiotics
Scientists still are learning how and why probiotics work. Some of the potential benefits include:
• Synthesizing vitamins (particularly the B vitamins)
• Boosting your immune system by producing antibodies for certain viruses
• Decreasing allergies (particularly in regard to skin reactions, such as dermatitis or eczema)
• Decreasing the risk of developing dental caries
• Speeding recovery from bacterial vaginosis
• Reducing the problems associated with inflammatory bowel disease (particularly related to
pouchitis or ulcerative colitis) and irritable bowel syndrome
• Helping people with lactose intolerance digest dairy products more easily
• Reducing symptoms of diarrhea associated with antibiotic usage or acute illness
Foods Containing Probiotics
Pasteurization kills probiotics, but many fermented-food manufacturers add them back into the food.
Fermented foods and dairy products are the two most common sources. Strict labeling guidelines
do not exist for probiotic-containing foods at this time. The dose needed for probiotics varies widely,
depended on type and formulation.
The following foods contain probiotics:
• Yogurt
• Cottage Cheese
• Buttermilk
• Kefir
• Soy sauce
• Miso
• Tempeh
• Fresh Sauerkraut
Benefits of Prebiotics
Prebiotics are nondigestible substances that feed the probiotics, helping them to thrive in the GI tract.
Not all probiotics consumed will survive, so it is important to consume prebiotics with probiotics.
Prebiotics release short-chain fatty acids, which decrease the pH of the colon and, thereby, enhance
mineral absorption, particularly calcium, iron, and magnesium, possibly decreasing the risk of
43
osteoporosis development. This decrease in pH also leads to the decreased survival of some pathogenic
bacteria. Prebiotics may decrease cholesterol levels and also reduce the risk of colon cancer. Some
forms of prebiotics aid in the relief of constipation. Different strains of prebiotics provide different health
benefits.
Foods containing prebiotics
• Wheat
• Berries
• Barley
• Leafy Greens
• Chicory root
• Honey
• Jerusalem artichoke
• Bananas
• Rye
• Asparagus
• Flax
• Legumes
• Oatmeal
• Leeks
• Onion
• Garlic
Best sources of probiotics or prebiotics*
Condition
Recommended Probiotics/Prebiotics
Diarrhea from antibiotic usage
Lactobacillus rhamnosus GG
Saccharomyces boulardii
Streptococcus thermophilus
Bacillus clausii
Lactibacillus acidophilus
Irritable bowel syndrome
Lactobacillus plantarum
Bifidobacterium infantis
Lactobacillus rhamnosus GG
Saccharomyces boulardii
Weakened immunity
Lactobacillus rhamnosus GG
Lactobacillus plantarum
Lactobacillus salivarius
Bifidobacterium bifidum
Lactose indigestion
Lactobacillus bulgaricus
Streptococcus thermophilus
Constipation (prebiotics)
Lactulose
Oligofructose
*Adapted from Douglas and Kane and the American Gastroenterological Association
Resistant starch
Resistant starch helps to feed probiotics, similar to prebiotics. Resistant starch is found in cooked
starchy products, such as hot cereals and unripe fruit, such as bananas that are still firm to the touch. On
food labels, resistant starch is referred to as starch, modified food starch, cornstarch, or maltodextrin.
44
Probiotic and prebiotic supplements
Only live microorganisms are classified as probiotics. Avoid any that are not live.
“The FDA doesn’t regulate probiotics, so probiotic supplements and probiotic foods aren’t required
to label the dosage or the strain of product they contain,” registered dietitian Erin Palinski-Wade said.
So stick with products that list the specific probiotic strains. And look for the CFUs.
“CFUs stand for colony forming units, and it’s basically an estimate of the amount of viable bacteria cells
in a product or supplement,” Palinski-Wade said.
Make sure there are enough CFUs per serving to deliver actual health benefits.
“There is enough evidence in the literature that one needs 3 billion to 5 billion CFUs on a daily basis,”
Dr. Challa said.
Prebiotics are consumed in different ways, including:
• Sprinkled on food
• Stirred into liquid
• Taken in capsule form
• Purchased in prebiotic-fortified foods and beverages, such as sports drinks
Safety
Individuals who are immunocompromised, have compromised gut integrity, or who have allergies or
intolerances to foods containing probiotics or prebiotics should only use these products under the
advisement of a doctor. Otherwise, they appear safe for human consumption.
References and recommended readings
American Gastroenterological Association. Probiotics: what they are and what they can do for you. Available at:
http://www.gastro.org/patient-center/diet-medications/probiotics. Accessed October 21, 2012.
Douglas LC, Sanders ME. Probiotics and prebiotics in dietetics practice. J Am Diet Assoc. 2008;108:510-521.
International Food Information Council Foundation. Functional foods fact sheet: probiotics and prebiotics. Available
at: http://www.foodinsight.org/Resources/Detail.aspx?topic=Functional_Foods_Fact_Sheet_Probiotics_and_
Prebiotics. Accessed October 21, 2012.
National Center for Complementary and Alternative Research. Oral probiotics: an introduction. Available at:
http://nccam.nih.gov/health/probiotics/introduction.htm. Accessed October 21, 2012.
Roberfroid M, Gibson GR, Hoyles L, et al. Prebiotic effects: metabolic and health benefits. Br J Nutr. 2010;104:S1S63.
Sanders ME, Heimbach JT, Pot B, et al. Health claim substantiation for probiotic and prebiotic products. Gut
Microbes [serial online]. 2011;2:127-133. Available at: http://www.landesbioscience.com/journals/gutmicrobes/
Sanders-GMIC2-3.pdf. Accessed August 2, 2012.
World Gastroenterology Organisation. World Gastroenterology Organisation Practice Guidelines: probiotics and
prebiotics. Available at: http://www.worldgastroenterology.org/assets/downloads/en/pdf/guidelines/19_probiotics_
prebiotics.pdf. Accessed October 21, 2012.
Review Date 10/12
45
Fish Oil Supplements: Which Ones to Buy
By now, everyone has heard of the health-boosting powers of fish oil, and many people have a bottle
or two of supplements at home. Before you buy the next bottle, read this to ensure that you are not
wasting your money.
Is it all fish oil?
Make sure that all of the oil is really from fish, containing eicosapentaenoic acid (EPA) and docosahexaenoic
acid (DHA), and not the other omega-3 fatty acid, alpha-linolenic acid (ALA) contained in flaxseed,
soy, canola and vegetable oils, which does not seem to provide the same benefits as EPA and DHA.
Unfortunately, studies are not as clear on the benefits of ALA. In fact, some fear that a high intake of
ALA actually may increase the risk of prostate cancer in men. Many experts believe that a supplement
should contain more EPA than DHA. The exception to more EPA than DHA would be for pregnant
women who should consult with their doctor on what and how much to take.
How much should I take?
If you already have heart disease, make sure that your supplements provides at least 1 gram (g) of fish
oil/day. Healthy people who want to reduce their risk of developing heart disease should take 500
milligrams (mg)/day.
Are larger doses better?
Taking doses larger than 3 g/day can lead to spontaneous bleeding, which sometimes is deadly. Talk to
your doctor before beginning a high-dose regimen or if you are taking blood thinners.
Concerned about overfishing?
If you are concerned about overfishing, you may want to choose a supplement that gets its omega-3
fatty acid, DHA, from algae.
Have you checked out the product online?
Before choosing a supplement, go to the company’s Web site and look for a copy of the certificate of
analysis (COA), which shows whether or not the supplement was tested and proven free of mercury,
polychlorinated biphenyl (PCBs), dioxins, lead, arsenic, and other toxins. The COA also will state
the total oxidation level of the supplement—you want one that does not have a level higher than 17
milliequivalents (mEq)/kilogram (kg). Also look for a product that was molecularly distilled, further
proving that all potentially harmful contaminants are removed.
What else should I look for?
Choose a brand that is pharmaceutical grade. Also look for a supplement that is produced at a
pharmaceutical good manufacturing practices (GMP) facility.
References and recommended readings
Herper M. What you need to know about fish oil. Available at:
http://www.forbes.com/2010/03/09/omega-fatty-acids-lifestyle-health-heart-disease.html. Accessed April 3, 2010.
Nutritional Supplement Nutritional Centre. Benefits of fish oil. Available at:
http://www.nutritional-supplement-educational-centre.com/benefits-of-fish-oil.html. Accessed April 3, 2010.
Review Date 5/10
G-1323
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Nutrition Facts Label Overview
The information in the main or top section of a Nutrition Facts label can vary with each food product. It
contains product-specific information (serving size, calories, and nutrient information).
Always start with the serving size and note the number of servings per container. In several foods, 2 or
more servings are contained in what is generally considered a single-portion package.
The bottom part contains a footnote with Daily Values (DVs) for 2000- and 2500-calorie diets. Ignore
the percent daily value. It is only relevant if you eat 2000 calories per day.
Find the calories and total grams of fat in a serving
Calories
Calories provide a measure of how much energy you get from a serving of this food. The calorie section
of the label can help you manage your weight (i.e., gain, lose, or maintain). Remember that the number
of servings you consume determines the number of calories you actually eat (your portion amount).
General guide to calories
• 40 calories is low
• 100 calories is moderate
• 400 calories or more is high
A low fat food is fat grams less than half the protein grams. You do not always need to eat low-fat, it
depends on what other foods are consumed the same day.
Nutrients
The top of the nutrient section in the sample label shows you some key nutrients that impact your
health. They are separated into two main groups.
Limit these nutrients
The nutrients listed first are the ones Americans generally eat in adequate amounts, or even too much.
Eating too much fat, saturated fat, trans fat, cholesterol, or sodium may increase your risk of certain
chronic diseases, such as heart disease, some cancers, or high blood pressure.
Health experts recommend that you keep your intake of saturated fat, trans fat, and cholesterol as low
as possible, as part of a nutritionally balanced diet.
The body needs some saturated fat so a good rule of thumb is using 12 to 20 grams of saturated fat a
day depending on your size and the amount of food needed for maintaining your weight or weight loss.
Vigorous exercise is no excuse for eating more saturated fat.
Trans-fats may be even worse than saturated fat for blocking arteries. A product is allowed to put 0
trans fat on the label if it has less than 1.0 grams. If you have several of these products in a day, intake
of trans fats can be harmful. You can tell if the product has ANY trans fats by readings the list of
ingredients. If it has any partially hydrogenated oil (soybean, sunflower, etc) find a substitute. Children
should especially stay away from trans fats.
Scientific reports link trans fat and saturated fat with raising blood low-density lipoprotein (LDL) or
“bad” cholesterol levels. Both trans fats and saturated fats increase your risk of coronary heart disease,
a leading cause of death in the United States.
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Get enough of these
Most Americans do not get enough dietary fiber, vitamin A, vitamin C, calcium, and iron in their diets.
Eating enough of these nutrients can improve your health and help reduce the risk of some diseases and
conditions. Eating a diet high in dietary fiber promotes healthy bowel function. In addition, a diet rich in
fruits, vegetables, and grain products that contain dietary fiber, particularly soluble fiber, and that are
low in saturated fat and cholesterol may reduce the risk of heart disease.
Remember that you can use the Nutrition Facts label not only to help limit those nutrients you want to
cut back on, but also to increase those nutrients you need to consume in greater amounts.
Percent Daily Value
The Percent Daily Value (% Daily Value) is based on the Daily Value
recommendations for key nutrients, but only for a 2000-calorie daily
diet—not 2500 calories. But you still can use the % Daily Value as a frame
of reference, whether or not you consume more or less than 2000 calories.
The % Daily Value helps you determine if a serving of food is high or low
in a nutrient.
Note: A few nutrients, such as trans fat, do not have a % Daily Value.
Guide to % Daily Value
5% Daily Value or less is low, and 20% Daily Value or more is high.
For dietary trade-offs: You can use the % Daily Value to help you make
dietary trade-offs with other foods throughout the day. You do not have to
give up a favorite food to eat a healthy diet. When a food you like is high
in fat, balance it with foods that are low in fat at other times of the day.
Nutrients without a % Daily Value
Trans fats, protein, and sugars: No % Daily Value is listed on the Nutrition
Facts label for trans fats, protein, and sugars.
Protein: A % Daily Value is required on the label if a claim is made for
protein, such as “high in protein.” Otherwise, unless the food is meant
for use by infants or children younger than 4 years of age, it is not needed. Current scientific evidence
indicates that protein intake is not a public health concern for adults and children older than 4 years of
age.
Sugars: No daily reference value is available for sugars, because no recommendations are made for the
total amount to eat in a day. Keep in mind, the sugars listed on the Nutrition Facts label include naturally
occurring sugars, such as those in fruit and milk, as well as those added to a food or drink. Check the
ingredient list for specifics on added sugars.
G-1197
Review Date 11/09
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Organic Foods vs Conventionally Produced Food
Organic foods generally don’t deliver more nutrients and aren’t even completely pesticide
free. There are a few exceptions. When picking fruits and vegetables, ripeness may be more
important to nutrient content than whether you choose organic produce. Riper produce
tends to be richer in nutrients.
What About Pesticides?
Dr. Smith-Spangler and colleagues did find a substantial difference in detectable pesticide
residue between conventional and organic produce. While 38% of conventional produce
contained traces of pesticides – almost always below government safety limits, only 7% of
organic fruits and vegetables contained detectable pesticides.
Pesticides can drift from neighboring fields or transfer to produce during transport and
processing so organic does not mean totally free of pesticides. Among those most likely
to be affected by pesticide residue are older adults with chronic health conditions, young
children and pregnant women.
Consider skipping organic produce with fruits and vegetables with thick peels or rinds that
won’t be eaten anyway – like bananas.
Consider buying organic for foods that are found to usually be high in pesticide residue.
Each year the Environmental Working Group (www.ewg.org) produces a Shopper’s Guide to
pesticides that help consumers determine which fruits and vegetables (the “Dirty Dozen”)
are the most contaminated. The produce with the least contamination (the Clean 15) can be
purchased with conventional growing methods.
Buy Organic - Dirty Dozen
1. Apples
5. Strawberries
8. Spinach
11. Blueberries
(domestic)
3. Sweet Bell Pepper
6. Nectarines
(imported)
9. Lettuce
10. Cucumbers
12. Potatoes
4. Peaches
7. Grapes
2. Celery
Lowest in Pesticides (Less Important to Buy Organic)
1. Onions
5. Cabbage
9. Eggplant
12. Sweet Potatoes
2. Sweet Corn
6. Sweet peas
10. Cantaloupe
13.Grapefruit
3. Pineapples
7. Asparagus
(domestic)
14.Watermelon
4. Avocado
8. Mangoes
11. Kiwi
15.Mushrooms
Bacteria and Hormones
Organic produce and organic meats were no less likely than conventional choices to be contaminated by
dangerous bacteria, such as E. Coli. When contaminated with bacteria conventional chicken and pork
were at higher risk of contamination with bacteria resistant to multiple antibiotics compared to organic
produce. Scientist noted that these bacteria would not survive proper cooking.
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Dairy
Some people prefer organic milk because of worries about health effects of bovine growth hormone.
The US Food and Drug Administration (FDA) noted that hormones also occur naturally in cows and
maintains that the use of added hormones does not affect the milk. Organic milk is believed to be
higher in heart-healthy omega -3 fatty acids and lower in omega 6s. A higher ratio of omega-3s to
omega 6s may be associated with a healthier heart and even suggested a benefit against the effects of
aging.
Reference: Tufts University Health & Nutrition Letter, December 2012.
Health Tips For Families
Author of The End of Overeating, David Kessler, MD, UCSF Medical School states the children of today
enter into adulthood 20 lbs heavier than occurred in 1960. According, by the time children reach ages 4
to 5 years, 60% have lost the ability to self-regulate. Fats and sugar stimulate humans to eat more. We
need to change the perception that these foods are giving us satisfaction; the same way we changed
the perception that smoking is fun. Children went home and asked Mom and Dad not to smoke. Kids
need to start asking Mom and Dad not to make them eat fast foods.
Rats fed rat chow maintain a normal weight, but rats fed a supermarket diet rich in sugar, saturated fat
and sodium end up overweight. When that food is taken away, then the rats lose weight.
Tips:
Try a new food each week with no pressure to eat it all. After trying the new item, put it to a formal
vote. If everyone enjoys it, add it to the regular menu.
Try exotic fruits or vegetables or an ethnic dish that you haven’t tried before. Sometimes it takes
awhile to accept new foods. It may take 12 to 15 times of trying a new vegetable (food) to accept and
enjoy it.
Eat the rainbow. Keep track of how many colors of fruits or vegetables you eat in a week. Try to have
at least one of the red, orange-yellow, green, blue-purple, and white. Use markers or crayons, or colorful
stickers to keep track.
Appreciate treats. Remind children that dessert or other goody is not something that they need to
have every day, but nothing is wrong with an occasional treat, as long as their overall diet is nutritious.
Give gifts that encourage physical activity. Make it your goal to choose active games or toys that
promote activity for at least three-fourths of the gifts you give.
Stay active by making activity part of everyone’s daily routine. Take a walk after dinner, take the stairs
instead of the escalator at the mall, and park further away from the store you are going into. Don’t call
it “exercise”. Think of it as just a normal part of living.
Don’t make food the focus on festive occasions. Choose to make the food secondary to people and fun.
COOK and SHOP as a family. Children can help prepare meals in the kitchen, and assist parents in
picking out good-tasting and nutritious foods at the supermarket.
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Snacks: Ideas for the Active Child
Parents struggle all the time with busy schedules. The modern-day child has school and homework,
after-school sports, clubs, religious school, jobs, and classes. The few hours that span after school
until bedtime sometimes are demanding and rushed. Weekends are often a busy time of running from
practice to practice. One thing all parents agree on is that children need snacks to make it through until
dinner or the next meal.
Understanding the child will help to determine what to pack for a snack. Many children are too busy with
their social life to eat a well-balanced lunch, making it necessary to have more of an after-school meal
than a snack. On the weekend during sports, lighter snacks work better, because children have less time
to digest a more substantial snack.
Snacks can prepare children to perform their best, but before deciding what to pack, think about what
the snack needs to do. Parents do not want their children eating too much to spoil their next meal, so
they should fuel them up with just enough food to keep their energy levels high.
Children who are running around and very physically active may do well with snacks that are highly
digestible and do not stay in the stomach long. A couple of hours before the activity, children should
eat a well-balanced meal that is rich in protein, fiber, fluid, and carbohydrate. A carbohydrate-rich snack
with water is appropriate just prior to the activity. If the child is working at high intensity for a long
period of time, sports drinks and juices can provide carbohydrate to use as nearly immediate energy.
Snack ideas for the active child (before exercise)
Consider these snack ideas just before exercise, served with water:
• Fresh fruit
• Raisins or dried fruit
• Oatmeal, farina, or Cream of Wheat®
•Applesauce
•Pretzels
•Popcorn
• Canned fruit in juice
• Rice cakes
During exercise
Most children do not require a snack during exercise. However, you do need to encourage them to drink
water and to take sips, not gulps.
Snack ideas for the active child (post exercise)
Generally within 20 minutes after exercise, children will need a more substantial snack. This snack should
contain 150-300 calories, depending on the child’s age, weight, gender, and the intensity of workout.
Consider these snacks ideas just after exercise, served with water:
• High-fiber granola bar
• Yogurt and fruit
• Granola and milk
• Mini bagel with cream cheese
• One half of a peanut butter sandwich
• Hummus and vegetables
• Turkey and cheese roll-ups
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• Cheese and crackers
• ¼ cup of trail mix
• ¼ cup of shelled sunflower seeds
• 3” diameter high-fiber muffin
Snack ideas for children on the go (no refrigeration needed)
Many children on the go need something to tide them over until dinner, but have to pack their snack in
the morning.
These ideas do not require a cooler to keep them safe:
• Peanut butter and jelly sandwich on high-fiber bread
• ¼ cup trail mix with one piece of fresh fruit
• Homemade muffin with one piece of fresh fruit
• Sunflower seeds or nuts with one piece of fresh fruit
• Granola bar with one piece of fresh fruit
• Dried Fruit with ¼ cup of granola
• Raw vegetables with bean dip
• Dried cereal with shelf-stable milk (carton)
Team snacks
If a team snack is required at the end of a game, try some of these healthful options, served with water:
• Homemade muffins
• Fresh fruit—sliced, washed, and ready to eat
• Granola bars
• Graham crackers with applesauce
• Yogurt tubes
•Popcorn
• Mini sandwiches
Review Date 11/10
K-0632
52
Eat Right
Food, Nutrition and Health Tips from the Academy of Nutrition and Dietetics
25 Healthy Snacks for Kids
When a snack attack strikes, refuel with these nutrition-packed snacks.
Easy, Tasty (and Healthy) Snacks
You may need an adult to help with some of these snacks.
1. Parfait: Layer vanilla yogurt and mandarin oranges or blueberries in a tall glass. Top with a sprinkle
of granola.
2. Inside-Out Sandwich: Spread mustard on a slice of deli turkey. Wrap around a sesame breadstick.
3. Rocky Road: Break a graham cracker into bite-size pieces. Add to low-fat chocolate pudding along
with a few miniature marshmallows.
4. Mini Pizza: Toast a whole-wheat English muffin, drizzle with pizza sauce and sprinkle with low-fat
mozzarella cheese.
5. Spread mustard on a flour tortilla. Top with a slice of turkey or ham, low-fat cheese and lettuce.
Then roll it up.
6. Sandwich Cut-Outs: Make a sandwich on whole grain bread. Cut out your favorite shape using a big
cookie cutter. Eat the fun shape and the edges, too!
7. Banana Split: Top a banana with low-fat vanilla and strawberry frozen yogurt. Sprinkle with your
favorite whole-grain cereal.
8. Apple Pie Oatmeal: Make one packet of microwave oatmeal with low-fat milk. Mix in 1/4 cup
unsweetened applesauce. Sprinkle with apple pie spice or cinnamon.
9. Mix together peanut butter and cornflakes in a bowl. Shape into balls and roll in crushed graham
crackers.
10. Microwave a cup of tomato or vegetable soup and enjoy with whole-grain crackers.
11. Fill a waffle cone with cut-up fruit and top with low-fat vanilla yogurt.
12. Sprinkle grated Parmesan cheese on hot popcorn.
13. Peel a banana and dip it in yogurt. Roll in crushed cereal and freeze.
14. Spread celery sticks with peanut butter or low-fat cream cheese. Top with raisins.
15. Stuff a whole-grain pita pocket with ricotta cheese and Granny Smith apple slices. Add a dash of
cinnamon.
16. Mix together ready-to-eat cereal, dried fruit and nuts in a sandwich bag for an on-the-go snack.
17. Smear a scoop of frozen yogurt on two graham crackers and add sliced banana to make a yummy
sandwich.
18. Microwave a small baked potato. Top with reduced-fat cheddar cheese and salsa.
19. Make snack kabobs. Put cubes of low-fat cheese and grapes on pretzel sticks.
20. Toast a whole-grain waffle and top with low-fat yogurt and peaches.
21. Mix together low-fat cream cheese, mixed dried fruit bits and shelled sunflower seeds. Spread on a
toasted English muffin.
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22. Blend low-fat milk, frozen strawberries and a banana for thirty seconds for a delicious smoothie.
23. Make a mini-sandwich with tuna or egg salad on a whole-grain dinner roll.
24. Sprinkle grated Monterey Jack cheese over a corn tortilla; fold in half and microwave for twenty
seconds. Top with salsa.
25. Spread peanut butter on apple slices.
Dip it! Bonus Snacks
• Dip baby carrots and cherry tomatoes in low-fat ranch dressing.
• Dip strawberries or apple slices in low-fat yogurt.
• Dip pretzels in mustard.
• Dip pita chips in hummus.
• Dip graham crackers in applesauce.
• Dip baked tortilla chips in bean dip.
• Dip animal crackers in low-fat pudding.
• Dip bread sticks in salsa.
• Dip a granola bar in low-fat yogurt.
• Dip mini-toaster waffles in cinnamon applesauce.
Find more healthy eating tips at:
www.kidseatright.org
www.eatright.org/nutritiontipsheets
This tip sheet is provided by:
Authored by Academy of Nutrition and Dietetics staff registered dietitians.
©2012 Academy of Nutrition and Dietetics. Reproduction of this tip sheet is
permitted for educational purposes. Reproduction for sales purposes is
not authorized.
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Eat Right, Your Way, Every Day’
with Foods from All Ethnic Traditions: Tips from the Academy of Nutrition and Dietetics
Tuesday, January 29, 2013
CHICAGO – America is a nation of immigrants, with each group adding its cultural traditions, including food, to the country’s
shared multi-ethnic experience. As part of National Nutrition Month®, the Academy of Nutrition and Dietetics offers ways
to “Eat Right, Your Way, Every Day” with foods from all corners of the globe.
“Eating is not a ‘one-size-fits-all’ proposition. RDs make recommendations that accommodate the food preferences,
cultural traditions and customs of the many and diverse groups who live in our country,” Sheth said.
The 2010 Dietary Guidelines for Americans calls a healthy eating pattern “an array of options that can accommodate
cultural, ethnic, traditional and personal preferences and food cost and availability.” They advise making about half your
plate fruits and vegetables; about one-quarter protein, such as lean meats, black beans and tofu chunks; and about onequarter grains, preferably whole grains. With each meal, the Dietary Guidelines recommend fat-free or low-fat milk, yogurt
or cheese.
“With the countless and increasing varieties of foods that are available today, people who live virtually anywhere can follow
the recommendations of the Dietary Guidelines and its MyPlate symbol to eat healthfully within the preferences of any
culture,” Sheth said.
Examples of healthful menus items from ethnic traditions that follow the MyPlate recommendations include:
• Chinese: Stir-fried chicken and vegetables such as bok choy, snap peas, carrots and bean sprouts; brown rice;
and a dish of lychee fruit.
• Italian: Minestrone (a hearty, tomato-based soup with beans, vegetables and pasta) with kidney beans added
for folate, fiber and protein; gnocchi (flour or potato dumplings) with chopped vegetables like spinach mixed
into the dough and served with lycopene-rich tomato sauce.
• Greek: Tzatziki sauce (a creamy dressing of low-fat yogurt, garlic and cucumber) served on pita sandwiches or
as a dip with vegetables; and dolmas (grape leaves stuffed with ground meat, vegetables such as bell peppers,
eggplant and squash, rice, dried fruit and pine nuts).
• Mexican: Jicama (a crisp and slightly sweet root vegetable) peeled, sliced and served on a salad with lime
vinaigrette or chopped for a crunchy addition to salsas; and gazpacho (a cold tomato-based raw vegetable
soup) made with spinach or cucumbers.
Additional menu ideas for ethnic foods that meet the recommendations of the Dietary Guidelines and MyPlate include:
• Fruit chutney (Asian Indian)
• Grilled pineapple as part of a chicken shish kabob (Middle Eastern)
• Mango or other tropical fruit smoothie (Latin American)
• Baked pumpkin sprinkled with cinnamon (African)
• Polish beets (European)
• Stir-fried greens (Asian)
• Cactus salad (Latin American)
• Succotash (Native American or Southern U.S.)
• Couscous (African)
• Quinoa (Latin American)
• Naan bread (Asian Indian)
• Egg noodles (German).
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As part of this public education campaign, the Academy’s National Nutrition Month website includes a variety of helpful
tips, games, promotional tools and nutrition education resources, all designed to spread the message of good nutrition
around the “Eat Right, Your Way, Every Day” theme.
The Academy of Nutrition and Dietetics (formerly the American Dietetic Association) is the world’s largest organization of
food and nutrition professionals. The Academy is committed to improving the nation’s health and advancing the profession
of dietetics through research, education and advocacy. Visit the Academy of Nutrition and Dietetics at www.eatright.org.
Websites
A resource and free interactive online tool created by the US Department of Agriculture’s Center for Nutrition Policy and
Promotion was designed to help individuals apply the healthy eating patterns of the Dietary Guidelines for Americans to
achieve their diet, weight management, and physical activity goals. It also gives diet, recipe and menu analysis.
http://www.choosemyplate.gov/supertracker-tools/supertracker.html
Portion Distortion! Type “Portion Distortion” in the Search Box, then choose link for Portion Distortion! Quizzes
http://www.nutrition.gov
In 2005 the U.S Department of Agriculture (USDA) released a food pyramid called MyPyramid, which was designed to
educate people about the 2005 Dietary Guidelines for Americans. These guidelines were developed jointly by the USDA
and the Department of Health and Human Services (HHS). The dietary guidelines are revised every five years by both
departments. (Currently, there are new guidelines in place, and the government has decided to drop the pyramid shaped
illustration to replace it with a plate model called MyPlate.)
http://mypyramid.gov
Dietary Approaches to Stop Hypertension
www.dashdiet.com
Academy of Nutrition and Dietetics (formerly American Dietetic Association)
The Academy of Nutrition and Dietetics is the world’s largest organization of food and nutrition professionals. The Academy
is committed to improving the nation’s health and advancing the profession of dietetics through research, education and
advocacy.
www.eatright.org
Each year the Environmental Working Group produces a Shopper’s Guide to pesticides that help consumers determine
which fruits and vegetables (the “Dirty Dozen”) are the most contaminated.
www.ewg.org
Find more healthy eating tips at:
www.kidseatright.org
www.eatright.org/nutritiontipsheets
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Think About It
Cutting 100 calories a day can lead to 10 lbs of weight loss a year.
The natural state of your stomach is the size of your fist.
Mayberry Athletic Center
Gwen D’Antoni, M.S., R.D.
Registered Dietitian
8543 White Fir St. Unit D-5
Reno, NV 89523
775-787-3762 Dietitian
775-746-1622 Fitness Center
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