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Look AHEAD Counselor’s Manual Refresher Group 1: Session 6 More About Healthy Eating Objectives: In this session, the participant will: Learn how to substitute low-fat, low-calorie ingredients for high-fat, high-calorie ingredients in recipes. Understand the popularity of high-protein, low-carbohydrate diets and other fad diets. To Do Before the Session: Get materials ready: Print advertising examples of fad diets and gimmicks Keeping Track book Pages for participant notebook Pencils or pens Basket or box (for collecting Keeping Track books). Campaign Tracking Sheets Campaign prizes I. WEIGH EACH PARTICIPANT A goal of the Refresher Group was for participants to lose 1-2 pounds per week. Allow participants to respond to their weight loss for the week and for the Refresher Group as a whole. Give appropriate feedback. Congratulate all participants and provide encouragement to those who have not lost weight at the desired pace. Calculate participants’ weight loss tickets and miles earned in campaigns. Refresher Group 1, Session 6 More About Healthy Eating Page 1 Look AHEAD Counselor’s Manual II. WELCOME AND DISCUSS HOMEWORK A. Keeping Track of Weight, Calories, Fat Grams, and Physical Activity Thank participants for Keeping Track during the Refresher Group. All participants are encouraged to Keep Track on a daily basis, even after the Refresher Group ends. If necessary, review the rationale behind/benefits of Keeping Track. Provide each participant with the appropriate number of Campaign tickets and give a final tally on miles. Let participants know that tickets will be drawn and prizes will be handed out at the end of the session. B. Use of Meal Replacements/Meal Plans Praise participants’ continued use of meal replacements and the Look AHEAD meal plan. They may continue to replace one meal per day, and they are encouraged to use the meal plan and Food Guide Pyramid as guidelines for healthy eating. C. Following the Food Guide Pyramid Determine if participants made any changes to better match the Food Guide Pyramid. How did they modify their meal of conventional foods to increase fruits and vegetables or to decrease fat? D. Overview of Session 6 Today’s session will prepare participants for fewer meal replacements by continuing to focus on healthy eating and by discussing ways to modify the calorie and fat content of recipes. A recommended list of cookbooks and related information was provided in Year 1. The titles of those books are provided again. Optional: A “taste test” may help participants recognize that low-calorie, low-fat foods taste good. Select a recipe that has been or can be modified. Make the modified version ahead of time for the participants to taste during the session. A good source of “before and after” recipes appears in the magazine “Cooking Light” (available at newsstands 10 months of the year) or check out their on-line features at www.cookinglight.com. You may also use recipes that other Look AHEAD participants provided during Year 1. E. Discussion A discussion of popular diets, particularly the high-protein, low-carbohydrate diet plans will show participants why these diets work and why they continue to be popular. Refresher Group 1, Session 6 More About Healthy Eating Page 2 Look AHEAD Counselor’s Manual III. BUILD A BETTER RECIPE A. Introduction Last session discussed the importance of eating healthy and how the Food Guide Pyramid can be used to construct healthier diets. This session will review tips for building a better recipe. Review the list of suggested substitutions on page 1 and ask the participants if they have ever used these substitutions. Inform participants that the process of modifying recipes is sometimes “experimental.” For example, some no-fat cheeses do not melt. If cheese is used in cooking, it may be best to use a “part-skim” cheese and use the no-fat cheeses for recipes that do not require cooking or baking. If participants brought in recipes from home, ask them to circle the high-calorie, high-fat ingredients that can be substituted. Optional: Have the participants taste a food that is made from a modified recipe. Keep in mind that some participants may never cook or someone might do the cooking for them. Encourage participants to share this handout with the person who prepares their food. If participants frequently eat out, this handout may also be helpful for ordering (e.g., ask for low-fat salad dressings, egg-white omelets, skim or 1% milk in coffee). B. Cookbooks Refer participants to the listing of low-calorie, low-fat cookbooks. Indicate that they are good sources of healthy recipes. Ask participants if they have used any of these books or if they can recommend other low-calorie, low-fat cookbooks from their own experience. IV. POPULAR FAD DIETS A. Introduction Begin the discussion by asking the participants if they were able to find any print advertisements for weight loss programs or products. (Have several examples of current weight loss ads as a backup.) Ask the participants about their experiences with these or similar diets or Refresher Group 1, Session 6 More About Healthy Eating Page 3 Look AHEAD Counselor’s Manual weight loss products. Have the group generate a list of reasons why these diets and weight loss products are appealing. Point out some commonalities in the ads – words and phrases such as guaranteed, miraculous, breakthrough, new discovery, scientific, phenomenon, secret, eat all you want, just minutes a day, etc. Most likely, the group will identify two key factors that fuel the diet industry: people want to lose weight 1) quickly and 2) without much effort. This is why the diet industry is a $33 billion business. Participants now have at least one year’s worth of experience in Look AHEAD, which has taught them that healthy and sustained weight loss is gradual and requires effort. While people continue to look for a “magic bullet” for weight loss, the tried and true method remains a healthy, balanced diet with regular physical activity. This sounds like the Look AHEAD program! B. High-Protein, Low-Carbohydrate Diets Some fad diets including Atkins and similar high-protein, low-carbohydrate diets such as the Zone or Sugar Busters continue to appear on best sellers’ lists. The appeal of these diets is that they work in the short-term and allow people to lose weight while eating high-fat foods. Ask group members if they or someone they know has ever tried or considered this type of diet. Inquire about the experience. Background information about the Atkins Diet (For purposes of answering potential questions) Dr. Robert Atkins’s diet was first published in 1972. It has been re-released as “Dr. Atkins New Diet Revolution.” Weight loss will occur from eating very few carbohydrates. When the body does not get enough carbohydrates, it starts to use the blood sugar reserves (glycogen) from the liver and muscle tissue. After using up these reserves, the body burns fat. This condition is known as ketosis. Ketones are the by-products of fat digestion and build up in the blood and make it acidic. Some potential complications of ketosis over a long enough period include dehydration, nausea, kidney problems, and coma. Refresher Group 1, Session 6 More About Healthy Eating Page 4 Look AHEAD Counselor’s Manual C. Claims and Truths There are five “claims” related to high-protein, high-fat diets. Participants are likely familiar with these claims, or may remember them from Year 1. You may ask them to list the claims of these diets. Summarize those claims and respond to them with their corresponding “truths.” Most are self-explanatory. The information on insulin resistance may be confusing to participants. Try to provide a simple explanation of this syndrome using the information below or consult with your site’s physician for further explanation. V. The role of insulin is to bring glucose (energy) into the tissues of the body. The condition of insulin resistance occurs when the tissues of the body are not as “sensitive” or resist the insulin. When insulin resistance exists, the body tries to overcome this resistance by producing more insulin from the pancreas. The pancreas eventually cannot keep up these increased levels of insulin secretion. Typically, this is when a person develops type 2 diabetes. Relapse Prevention A. Discuss with participants what kind of meal plan they are going to follow after the Refresher Group ends. Are they planning to continue consuming two meal replacements per day, go on the maintenance plan of one meal per day, or consume a meal plan following the Food Guide Pyramid? B. Have participants develop a plan to follow if they gain a few pounds. Will they return to two meal replacements if they aren't already doing so? Have them discuss the behaviors that they will reintroduce to prevent further weight gain. Remind them that we are always available to them as a resource. VI. HOMEWORK Because Refresher Group #1 has come to an end, there are no assignments to bring to the next group session. Participants should, however, do the following: A. Continue to Keep Track of weight, calories, fat grams, minutes of activity, and steps. B. Participants are encouraged to replace one meal a day with a meal replacement product. They may also wish to maintain a low calorie diet to lose more weight. Refresher Group 1, Session 6 More About Healthy Eating Page 5 Look AHEAD Counselor’s Manual C. Increase their minutes of activity to 175 minutes per week, if not already achieved. VII. CLOSING (Allow 5-10 minutes) A. You don’t need magic to lose weight. Adhering to the meal replacement and meal plans carefully and staying active are the keys to reaching weight loss goals. B. Address questions and concerns about ending the Refresher Group. C. Draw tickets to award prizes in the Lottery Campaign. For the Exercise Campaign, award prizes to every participant who walked > 50 miles in the past 5 weeks. Give an additional prize to the person with the greatest total mileage. D. Thank participants for attending the Refresher Group and wish them the best with continued weight loss and/or weight maintenance. Refresher Group 1, Session 6 More About Healthy Eating Page 6