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Healthy Signals NUTRITION GUIDE New England Laborers’ Health and Safety Fund 410 South Main Street Providence, Rhode Island 02903-2982 401-621-5355 fax 401-621-5603 www.nelhsf.com e-mail: [email protected] Chairman’s Message Armand E. Sabitoni General Secretary – Treasurer and New England Regional Manager The New England Laborers’ Health and Safety Fund is committed to providing the most up-to-date health information to LIUNA members, their families, and our retirees. In recent years, the importance of good nutrition, and more specifically, weight control, has come to the forefront, not just with our LIUNA members, but also in the American population in general. Over 65 percent of adults in the U.S. are overweight or obese. Even more troubling is the fact that almost one out of every five American children is overweight or obese. In addition, overweight among children is increasing at a much faster rate than overweight among adults. We know that parents’ health habits influence children’s behavior. Many parents want to adopt healthy eating and exercise habits, but are unsure where to begin in the process. With information and guidance, you will be able to achieve a healthier lifestyle. The New England Laborers’ Health and Safety Fund is proud to provide you with this nutrition manual to help you get started. In it, you will find current guidelines for healthy eating for yourself and your family, along with tips on preventing diseases such as type 2 diabetes and cancer. Please, use the manual to make a commitment to eat more healthful. 2–7 Nutrition basics • What’s in food? (about protein, carbs, fat) • How much protein? • Are carbohydrates bad? • Good fat, bad fat • What about alcohol? 8 –13 What’s a serving? • The importance of portion control • A new look at the food guide pyramid 14 –17 How to read the food labels • What to look at first • How to use the label to make choices 18 –23 Supermarket savvy • Best buys for the buck • How to stock a healthy kitchen 24 –29 What to eat when you’re eating out • Simple tips to avoid overeating • Best and worst choices from the lunch truck 30 –37 How to lower your risk of getting cancer Tips from the ACS: • Eat fruits and vegetables • Limit red meat • Take a multivitamin • Caution with alcohol • Load up on fiber 38– 45 The Dash Diet to lower blood pressure • The “dietary approaches to stop hypertension” program • What to eat and why 46– 53 Preventing and controlling type 2 diabetes • What causes diabetes? • What foods should I eat? 54– 59 The basics of weight control • How many calories? • A simple balance • Move it to lose it! • What to avoid 60– 63 How to get your fiber • What’s the recommendation? • Why eat more fiber? • What are the best choices? • What about fiber supplements? 64– 69 Drink up! All about hydration • How much do you really need to drink? • What about soda? • Is juice a good choice? • Is caffeine a problem? 70–79 Calorie content of common foods When you sit down to a meal, or grab a snack as you run out the door, you’re probably thinking “I’m hungry” or “this tastes good (or bad).” Chances are you aren’t thinking about the protein content, carbohydrates, or the source of the fat in the food. But with our high rates of obesity and confusing food advertising, it pays to know what’s in the food you eat. Knowing the sources of the nutrients in food can help you choose the best food for yourself and your family. Foods that are “pure” protein, carbohydrate, or fat are rare. Egg white is 100 percent protein, white sugar is 100 percent carbohydrate, and cooking oil is 100 percent fat, but most of the food we eat is a combination of protein, carbohydrate, and fat. Nutrition basics 3 Calories A calorie is a unit of energy. When we digest food, the energy stored in that food is converted to energy in the body. Protein and carbohydrates contain 4 calories per gram, while fat contains 9 calories per gram, and alcohol supplies 7 calories per gram. A gram is a small amount. The size of a gram varies according to the density of a food, but in general, you can picture a gram as about a 1/2-inch cube. Protein Everyone needs protein to repair tissues and to build healthy muscles, blood, and skin. Protein is also necessary for a healthy immune system. People who don’t get enough protein develop malnutrition, are frequently run down, and get sick often. However, in the United States, most people get more protein than they need. The best source of protein comes from animal products such as meat, eggs, and milk, but it is possible to get all the protein we need from a vegetarian diet. Vegetarian diets have become more popular in recent years, particularly among teenagers and young adults. Vegetarians who eat no animal products (vegans) have to work a little harder to be sure they get all the protein needed for good health. 4 Nutrition basics How much protein do you need? As a general rule, you can determine your protein needs by multiplying your weight by .4 grams. Active people and growing teens may need slightly more protein. Example: A 130-pound sedentary woman would need to get 52 grams of protein from her daily diet. Remember, most foods contain some protein, so it’s not necessary to get all protein from animal sources. 130 pounds X .4 grams=52 grams of protein Here is the average protein content of some common foods: Meat, fish 7 grams per ounce Egg 7 grams Milk 8 grams per cup Yogurt 8 grams per cup Beans 7 grams per 1/2 cup Nuts 5 grams per 1/4 cup Vegetables 2 grams per 1/2 cup Grains 3-4 grams per serving (example: 1 slice bread equals one serving) Nutrition basics 5 Carbohydrate Carbohydrates (carbs) give us energy and supply fiber. Each gram of carbohydrate contains 4 calories, so a 2,000-calorie diet would equal 250 grams of carbohydrates. Recommendations for intake of carbs vary, but a general guideline is for 50 percent of daily calories coming from carbohydrates. The healthiest sources for carbohydrates are whole grains and fruits and vegetables. Sugary carbs, such as candy and other sweets can lead to obesity and type 2 diabetes. Here are the grams of carbohydrate in some common foods: 1 cup pasta 40 grams 12 oz. cola 36 grams 1 potato 32 grams 10 jelly beans 26 grams 1/2 cup rice 25 grams 1 cup corn flakes 21 grams 1 slice bread 15 grams 1 apple 15 grams 1 chocolate chip cookie 7 grams 1/2 cup broccoli 4 grams Fiber (which is also a carbohydrate) can help promote bowel health, keep insulin levels in check, and may reduce the risk of several cancers including colon, breast, and prostate cancers. See the sections on Fiber, Type 2 Diabetes, and Weight Control for more information on carbohydrates. 6 Nutrition basics Fat Over the past few years, fat has received a lot of bad press. According to the media reports, fat causes heart disease, weight gain, and other problems. However, this information is only partly true. Some fats are very healthy and can actually prevent disease. The bad fats are saturated and trans fats. Trans fats and saturated fats significantly increase the risk of heart disease. Saturated fats are found in processed foods and some animal products such as red meat and butter. But the fats in processed foods and fried fast food cause the most health problems. Trans fats are man-made in a process called hydrogenation. You can tell if a product contains trans fats if the label lists “hydrogenated oil.” The good fats are monosaturates (olive oil, nut oils) and polyunsaturated oils (omega-3 fatty acids from fish and nuts). Olive oil and the oils found in nuts and fatty fish can help prevent heart disease and depression, and may help in diabetes treatment. Fats in the diet are also important for the absorption of fat-soluble vitamins such as vitamins A, D, E, and K. Nutrition basics 7 Here is the fat content of some common foods: 1 tablespoon olive oil 13 grams (monosaturated fat) 6 ounces salmon 12 grams (omega-3 fat) 4 ounces hamburger 11 grams (saturated fat) 1 tablespoon butter 8 grams (saturated fat) 10 French fries 7 grams (trans fat) 1 chocolate 5 grams (trans fat) chip cookie Alcohol Alcohol is another source of calories in many diets. Although a moderate amount of alcohol (one 6-ounce drink per day for women and two 6-ounce drinks for men) has been linked to lower rates of heart disease, alcohol can cause many health problems such as weight gain, alcoholism, and cancer. Talk to your doctor about alcohol and health concerns. Remember that alcohol is a source of “empty” calories, meaning it supplies no other nutrients. “ Did you know? Countries with the highest rates of sugar consumption also have the highest rates of depression. ” As restaurants, supermarkets, and movie theaters “supersize” everything from French fries to soft drinks, Americans are becoming supersized themselves. For some, a serving size is whatever comes in the package or is on their plate. But it doesn’t have to be that way. Once you know appropriate serving sizes, you can decide how much you want to eat at one sitting and either share your food or save the rest for later. Controlling portion size is the first step to controlling weight. What’s a serving 9 The United States Department of Agriculture (USDA) has researched the amount of food and types of food we all need for good health. The USDA Daily Food Guide Pyramid is a good way to determine how many servings you need of foods in each category. Serving sizes that promote good health and weight control tend to be much smaller than those served in restaurants. If you choose to eat more than the amount listed for each food, you would need to count it as more servings. Refer to the serving sizes below and use the pyramid as an easy guide to count the number of servings you need each day. Children and women need fewer servings than teens and men. For example, a 35-year-old woman would need 6 servings from the grain group, whereas a 35-year-old man might need closer to 11 servings, based on his activity level. Serving sizes compared to size of common objects 1/2 cup = a tennis ball 1/4 cup = one large egg 1 oz = a pair of dice 2 Tbsp = a ping pong ball 3 oz serving of meat = deck of cards 10 What’s a serving What Counts as One Serving for 7-Year-Olds to Adults? Milk 1 cup Cheese 1 1/2 ounces Meat, poultry, fish 2–3 ounces Beans 1/2 cup* Egg 1 egg* Nuts 1/4 cup* Vegetables 1/2 cup cooked, 1 cup for lettuce Fruit 1 medium Juice 6 ounces Bread 1 slice Cereal 3/4 cup dry, 1/2 cup cooked Rice 1/2 cup Food Guide Pyramid Fats, Oils & Sweets Use Sparingly Milk, Yogurt, & Cheese Group 2–3 Servings Vegetable Group 3–5 Servings Meat, Poultry, Fish, Dry Beans, Eggs, & Nuts Group 2–3 Servings Fruit Group 2–4 Servings Bread, Cereal, Rice, & Pasta Group 6–11 Servings Key Fats (naturally occurring & added) Sugars (added) These symbols show fats & added sugars in foods insert from http://www.nal.usda.gov:8001/py/pmap.htm * 1/2 cup beans, one egg, or 1/4 cup nuts count as 1 ounce of meat What’s a serving 11 What Counts as One Serving for 2- to 6-Year-Olds? Grain Group • 1 slice of bread • 1/2 cup of cooked rice or pasta • 1/2 cup of cooked cereal • 1 ounce of ready-to-eat cereal Vegetable Group • 1/2 cup of chopped raw or cooked vegetables • 1 cup of raw leafy vegetables Fruit Group • 1 piece of fruit or melon wedge • 3/4 cup of juice • 1/2 cup of canned fruit • 1/4 cup of dried fruit Milk Group • 1 cup of milk or yogurt • 2 ounces of cheese Meat Group • 2 to 3 ounces of cooked lean meat, poultry, or fish • 1/2 cup of cooked dry beans, or 2 tablespoons of peanut butter counts as 1 ounce of meat Fats and Sweets Limit calories from these 4- to 6-year-olds can eat the above serving sizes. Offer 2- to 3-year-olds less, except for milk. 2- to 6-year-old children need a total of 2 servings from the milk group each day. • 12 What’s a serving Food is fun, and learning about food is fun, too. Eating foods from the Food Guide Pyramid and being physically active will help you grow healthy and strong. Food Guide Pyramid for Young Children A Daily Guide for 2- to 6-Year-Olds Fats & Sweets Eat Less Milk Group 2 Servings Vegetable Group 3 Servings Meat Group 2 Servings Fruit Group 2 Servings Grain Group 6 Servings What’s a serving 13 Tips to help manage serving sizes* • For a balanced meal, use the two-thirds, one-third rule. Vegetables, grains, and fruits should occupy about two-thirds of the plate and meat, poultry or fish the remaining one-third. • Measure serving sizes at home with a food scale and measuring cups until you become comfortable estimating the sizes of portions. • Write down what and how much you eat. Research shows people will stick to a diet if they make this effort. • Use smaller size plates. • Read food labels which list the number of servings. If the package contains more servings than you need, save the extra for another meal. • To cut impulse eating, plan menus in advance. • Notice serving sizes in restaurants. Frequently, they are very large. Either share a meal with a companion, or ask for a “doggie bag” and take a portion home for the next day. *(Adapted from University of Kentucky College of Agriculture News) The labels on packaged foods can help you choose the best products, but you have to know what to look for! Here’s a stepby-step guide to reading the food label. The label is most useful when you’re checking for calories, fat, sugars, protein, and fiber in food. How to read the food labels 15 1 1 Start Here Get Enough of these nutrients Footnote Quick Guide to % Daily Value 5% or Less is Low 20% or More is High 16 How to read the food labels & The first thing to check is serving size. If you look at the label and look at calories only, you would think you were getting 250 calories in this food. This food has 250 calories per serving, and contains two servings in the package. Be sure to check serving size, how many servings are in the package, and then compare it to how much you actually eat to get the true number of calories and nutrients. Check how much fat is in the food and the sources of the fat. See section 1 of this manual for a discussion of the types of fat. Food manufacturers must tell you how much saturated fat and trans fat is in the food. Look at the ingredients on the label. If it lists “hydrogenated” it contains trans fat. Trans fat is dangerous and has been associated with health problems, including heart disease. Remember, a healthy diet contains no more than 25-30% of calories coming from fat. Carbohydrates are broken down into fiber and sugars. Try to avoid foods high in sugars and choose foods high in fiber. Depending on your needs and health concerns, you may want to look at the cholesterol and sodium content of the food. Many processed foods contain a lot of sodium. The recommendation for daily intake of sodium is less than 2,400 milligrams per day. How to read the food labels 17 Most packaged foods are not great sources of vitamins and minerals. The exceptions are juices for vitamins A and C, and dairy foods for calcium. The percent (DV) will tell you whether a food is high or low in a nutrient. It’s based on a 2,000 calorie diet, but you can use it as a general guide even if you eat more or less than 2,000 calories each day. For example, in the label on page 15, one serving of this food would provide 20 percent of the daily limit for sodium. The Daily Values are based on a 2,000 calorie diet. “ Did you know? Children’s taste buds are more sensitive than those of adults. That’s why many children won’t eat foods with a bitter or strong taste, such as brussels sprouts and spinach. ” “ Did you know? According to FDA labeling guidelines, a ‘healthy’ food must be low in fat, saturated fat, cholesterol, and sodium, and must contain at least 10 percent of the Daily Value for vitamin A, vitamin C, iron, calcium, protein, or fiber. ” Years ago, people shopped at neighborhood markets. There were few products to choose from, and many families had food delivered to their homes directly from the local grocer. Today’s supermarkets carry more than 40,000 items, making a trip to the “grocery store” overwhelming and confusing. Supermarket savvy 19 It wouldn’t be so bad if we could be assured of getting our money’s worth with every purchase, but there is perhaps no place where “buyer beware” applies more than at the supermarket. The shelves at markets today are stocked full of many quality and convenient products. However, alongside the healthful products are equal numbers of unhealthy “rip-offs.” The quest for the consumer is to sort out which products are good for both the budget and the body. A good place to start is with a grocery list. It’s almost a guarantee that if you go shopping with no list, you will spend more and buy more than you really intended. Take a quick inventory of your kitchen shelves before you head for the supermarket. 20 Supermarket savvy What foods stock a healthy kitchen? Food staples for every kitchen Bread Look for bread with whole grains to increase fiber intake. If your family isn’t used to whole grain, start off with a “wheat” bread and gradually change to 100% whole grain breads. Eggs Over the past few years, eggs have gotten a bad rap for being high cholesterol and bad for the heart. Most nutritionists don’t buy this assessment. Eggs are perfectly healthy and can be eaten every day, if desired. Eggs are versatile and high in protein. If your doctor has recommended a low cholesterol diet, you can substitute two egg whites instead of a whole egg. Dairy Skim or low fat milk is the best choice for children over age 2 and adults. (It is important not to limit fat for children under the age of 2. They need fat to build brain tissue.) Other dairy products to have on hand include yogurt and low fat cottage cheese. Supermarket savvy 21 Frozen vegetables and canned fruit Many people don’t buy fruits and vegetables because they spoil quickly. The solution to this problem is to buy frozen and canned so you will always have a steady supply on hand. Studies have shown that frozen products are equal to (and sometimes superior to) fresh produce in vitamin and mineral content. Beans Beans are inexpensive, loaded with protein, low fat, and can help keep blood sugar stable. Canned beans can be transformed into a healthy dinner in a matter of minutes. Add chickpeas to a salad with canned tuna and you have a complete meal ready in 10 minutes. Canned fish Canned fish, such as tuna, sardines, and salmon can be a timesaver for busy cooks. You can make delicious casseroles or quick and easy snacks and sandwiches using canned fish. Peanut butter Peanut butter can be used for sandwiches, spread on toast, and also used as a flavoring for sauces. Buy the brand with no sugar and no added fat. Many popular brands add hydrogenated oils to peanut butter. This type of fat has been linked to heart disease and other health problems. 22 Supermarket savvy Frozen “heart-healthy” dinners These products are very expensive, but for days when you’re pressed for time, they can be lifesavers. Check the labels for fat and sodium content. Whole grain cereals Oatmeal, cream of wheat, shredded wheat, and other whole grain cereals can serve as breakfast, snacks, and in a pinch—even dinner. Also keep white rice and brown rice on hand. Brown rice is a good choice because it has fiber. Nuts Walnuts, almonds, peanuts, pecans—all are good for the heart and contain healthy fats. Nuts are a great snack because they keep well, are easy to carry to work or school, are high protein, and help to keep blood sugar stable. The downside: they are high in calories, so keep serving sizes small. One serving of nuts is 1/4 cup (a large handful). Supermarket savvy 23 People in the United States go to the grocery store on average more than twice a week and spend a good portion of the family budget on food. Making wise choices can keep the cost down. Here are some suggestions for stretching your food dollar: Compare prices using the “Unit Price.” By law, every food in the supermarket must have a unit price. You can check how much an item costs in a standard amount. For example, the unit price will tell you how much the item costs per pound. That way, you can decide which brand is the best buy. • Buy store brands. They are usually good quality and a better bargain. • Buy fruits and vegetables in season. Strawberries in February can be twice as expensive as they are in June. Apples are freshest when bought in the fall. Always look for weekly specials, but be aware that sometimes food is on sale because the “sell by” date is about to expire. • Buy large cuts of meat and whole chickens and cut them up at home.You’ll save dollars and also have the convenience of packaging meats in serving sizes for your needs. • Buy bread on sale and freeze an extra loaf. Bread keeps exceptionally well in the freezer. • Never shop when you’re hungry! You’ll be tempted to buy high priced snacks. • On average, the typical American household spends $2,116 on food away from home, according to a recent National Restaurant Association’s Restaurant Spending report, an analysis of the recently published Bureau of Labor Statistics’ Consumer Expenditure Survey. That works out to about $846 per person. The fact that we’re eating out more often affects more than our wallets: eating out can cause weight gain. What to eat when you’re eating out 25 There are good reasons for the super sizing of the American public, starting with fast food and huge portion sizes. You may have noticed that portions are getting bigger: french fries that could serve a family of four, two-burgers-in-one (with cheese!), and 20ounce soft drinks. It seems like a bargain— that is, until you step on the scale and get your reality check. “Economy” or super sizing—in packaged food as well as in fast food—is cheaper for the food producer. Believe it or not, packaging of food sometimes costs more than the food itself. Economy” or super sizing—in packaged food as well as in fast food—is cheaper for the food producer. The producer can charge more for the product by packing more food into fewer units (thus saving on packaging costs). This makes a good profit for the producer, and also makes the customer happy because he is getting bigger portions. The downside to this “bargain” occurs when super sizing encourages us to overeat.” “ Did you know? Sugar-sweetened soft drinks have been linked to obesity in both children and adults. By eliminating one 12-ounce cola per day and making no other changes to the diet, a person can lose 10 pounds in one year. ” 26 What to eat when you’re eating out If you eat out a lot, there are some simple tricks to help protect yourself from overeating and gaining weight: Tips for making healthy restaurant choices • Ask for dressing on the side. Remember, most salad dressing contains about 200 calories in a 2 Tbsp serving. • Tell your server to hold the bread and butter. • Ask to split an order. Some restaurants will charge a small plate fee. • Ask for a “doggie bag.” Bag 1/2 of your dinner before you start eating and enjoy it for lunch the following day. • Request that your fish be grilled or baked “dry, no bread crumbs.” • The highest calorie dishes are those that are sautéed in butter or prepared with sauces or cheese. • Choose baked or grilled meats for lower calories. • Watch serving sizes of meat! A 10-ounce steak is 2 1/2 servings. • Order one dessert for the table and share. Sometimes all you need is a taste! • Ask for two vegetables instead of a potato. What to eat when you’re eating out 27 Now consider this: a 125-pound woman can drink a chocolate milk shake in less than 15 minutes. But she would need to walk for 3 hours to burn off the calories! The sad truth is, it’s a lot easier to eat than it is to exercise. That’s why it’s important to know calorie counts. Read food labels; ask for nutrition information at fast food restaurants. Remember that any weight loss plan must include both exercise and watching calories. Check out the following charts for calorie counts of popular foods and calories burned during common activities. Calories in common food: Food Calories Whopper w/cheese 860 Medium milkshake 780 Hot fudge sundae 650 Ice cream cone, 1 scoop 340 3 oz hamburger with bun 310 Small french fries 210 1/4 cup nuts 200 1cup skim milk 80 Medium apple 95 28 What to eat when you’re eating out Calories burned for a 125 lb person Calories burned Activity for 125 lb person Bicycling 15mph 600 calories per hour Running 12 min mile 480 calories per hour Digging ditches 438 calories per hour Step aerobics 420 calories per hour Soccer 420 calories per hour Swimming 360 calories per hour Construction 330 calories per hour Walking 15 min miles 270 calories per hour Heavy cleaning 270 calories per hour Yoga 240 calories per hour Watching TV 68 calories per hour Ordering from the lunch truck Unfortunately, many choices at the lunch truck are high in fat and calories and low in nutrients. You’re better off bringing lunch from home, but when you must order from the truck, here are the best choices: Turkey sub • Pretzels • Fresh fruit • Nuts • 100% fruit juice • Coffee and tea • Ask the truck owner if he would be willing to offer more fresh foods such as salads and fruit. What to eat when you’re eating out 29 Tips for ordering at specialty restaurants Chinese • Ask your server to stir-fry using less oil • Limit serving sizes of white rice • Avoid fried entrees Italian • Ask for a side dish of pasta rather than a full order • Ask for sauces on the side so you can control amounts • Skip the bread—have a salad instead • Request salad dressing on the side Thai • Order brown rice, if available • Ask for steamed rather than sautéed vegetables • If ordering a tofu dish, request steamed rather than fried tofu Mexican • Skip the nachos with cheese appetizer • Ask for extra salsa instead of cheese • Order a whole bean dish instead of refried beans • Ask for extra lettuce and tomatoes on burritos and tacos How to lower your risk of getting cancer 31 Cancer is second only to heart disease as a major cause of death in Americans. Although most people think of cancer as one disease, it is actually a term used to describe many diseases that are caused by uncontrolled growth of cells in the body. There are many risk factors for cancer, including heredity, environment, gender, and age. Obviously, we have no control over many of the risk factors for cancer, but there are some health behaviors that significantly affect cancer risk. Researchers don’t have all the answers about what causes cancer, but there are some good recommendations to help lower your risk. “ Did you know? Anywhere from 30 to 40 percent of all cancers can be prevented by eating healthy foods, exercising, and not using tobacco. ” 32 How to lower your risk of getting cancer Cancer Prevention Guidelines Don’t smoke Tobacco use is the number one cause of cancer deaths in the U.S. By now, everyone knows that tobacco use isn’t healthy. But quitting is not always easy. Most people make several unsuccessful attempts at quitting before they quit for good. Research shows that support programs combined with nicotine replacement therapy (nicotine patch or gum) have the best success rates. Maintain a healthy weight Overweight is now a major cause of cancer. About two thirds of the American population are overweight, and about one third of overweight people fall into the obese category. Until recently, doctors thought that overweight was a risk factor primarily for diabetes and heart disease, but recent findings show that being overweight can cause high levels of hormones and substances called growth factors, which can encourage cells to divide more rapidly. When cell growth gets out of control, cancer can develop. Overweight people with high insulin levels are at the highest risk, but there is no way to predict who will develop cancer. The best prevention for obesity-related cancer is to lose weight, keep it off, and to get regular physical activity. How to lower your risk of getting cancer 33 Limit alcohol Although alcohol consumption in moderation is good for the heart, alcohol significantly increases the risk of cancers of the mouth, throat, and voice box, particularly in smokers. For women, even moderate alcohol consumption increases breast cancer risk. Moderate alcohol consumption is defined as one drink per day for women, and two for men. Drinking more than moderate amounts of alcohol is associated with overweight, alcoholism, depression, dementia, domestic violence, diabetes, heart disease and stroke. If you drink alcohol, you may want to review your personal health history and talk it over with your doctor. Eat fruits and vegetables Eating seven to nine servings of fruits and vegetables every day is the closest we have to a magic pill for cancer prevention. There are chemicals in fruits and vegetables called phytochemicals that help to neutralize cancer cells or prevent cancer from growing. Lycopene, beta-carotene, vitamin C, sulforaphane, quercetin, and flavonoids are all examples of phytochemicals that may help reduce the risk of cancer. It isn’t possible to get all of these chemicals in a pill form because no one has discovered the exact blend that works best. Eating a variety of fruits and vegetables in a variety of colors (the color is where the phytochemicals are found) is the best way to protect yourself and your family from developing cancer. 34 How to lower your risk of getting cancer Limit red meat and processed meats Red meat has been associated with higher rates of colon, prostate, breast, and uterine cancer. Researchers aren’t sure exactly why this is so, but some theories point to the type of iron in red meat, preservatives used in curing meats, and/or cooking methods. Other facts about meat and cancer include: Preservatives called nitrites found in bacon and hotdogs have been linked to stomach cancer. • Several research studies show an increase in childhood brain cancers among children whose mothers ate cured meats during pregnancy. • Charring meats on the grill causes carcinogens (cancer causing chemicals) to develop on the cooked surface. • The best methods of cooking meats for cancer risk reduction are baking, boiling, and stir-frying. • Try to limit red meat to two servings a week. Substitute other meats such as fish and chicken, or experiment with vegetarian dishes using grains, beans, and other vegetables. • Omega-3 fatty acids in fish are thought to be protective against cancer. • How to lower your risk of getting cancer 35 Take a multivitamin with folic acid Folic acid is a vitamin found in fruits and vegetables, whole grains, and beans. Several studies have shown that folic acid can help prevent birth defects and can also reduce the risk of getting colon cancer. It is difficult for the body to extract the folic acid from foods, so taking a multivitamin is good insurance that you’ll get enough of this important vitamin. Look for a multivitamin with 100 percent of the recommended daily value (DV) of vitamins and minerals, and 400 micrograms (DV) of folic acid. Be physically active! Exercise is not only a great stress reliever, it can also help to control weight and reduce the risk of cancer and heart disease. Most experts recommend one hour of physical activity each day. Remember, you don’t have to do it all at once: climbing stairs, doing heavy housework, and walking the dog all count towards the one hour daily total. 36 How to lower your risk of getting cancer Eating to reduce your risk of cancer Not so fast! (eat rarely or not at all) • Cured meat (hot dogs, bacon) • Red meat (beef, pork) • Charcoal grilled meats • Alcohol Slow Down! (eat in moderation) • Turkey, chicken, other meats • High-calorie sweets (weight control) • Refined flours (white bread, bagels, crackers) Go for it! • Vegetables-dark green and orange are best choices • Fruits-berries, watermelon, apples, tomatoes • Whole grains-wheat, brown rice, oatmeal, rye • Beans and other legumes • Omega-3 fatty acid fish such as salmon, mackerel, sardines, bluefish • Multivitamin • One hour of daily exercise to help control weight How to lower your risk of getting cancer 37 Notes: The DASH Diet to lower blood pressure 39 High blood pressure (hypertension) affects about 1 in 4 Americans. It is more common among African Americans and people over age 60. More than half of people over 60 have hypertension. High blood pressure is dangerous because it causes the heart to pump too hard, and this pressure on artery walls can cause damage that leads to heart attacks, kidney disease, and strokes. Medication is sometimes prescribed to lower blood pressure, but many people can lower their blood pressure by following a healthy diet, thus avoiding the side effects and expense of medication. Researchers, sponsored by the National Heart, Lung, and Blood Institute (NHLBI), have conducted many studies on the best diet to prevent and treat high blood pressure. The “Dietary Approaches to Stop Hypertension” (DASH) eating plan has been clinically proven to significantly reduce blood pressure. The DASH plan is based on a delicious low-sodium diet that includes lots of fruits and vegetables, whole grains, and low fat dairy foods. The diet is naturally lower in sodium (salt) because it avoids processed foods. 40 The DASH Diet to lower blood pressure What is the definition of high blood pressure? The NHLBI recently released new blood pressure definitions: 1. Normal – 120/80 or less 2. Prehypertension – 120-139/80-89 3. Stage 1 hypertension – 140-159/90-99 4. Stage 2 hypertension – at or greater than 160/100 The guidelines do not recommend drug therapy for those with prehypertension unless it is required by another condition, such as diabetes or chronic kidney disease. But the report advises them, and those with normal blood pressures, to make any needed lifestyle changes. Recommendations include weight loss, physical activity, limiting alcoholic beverages, and following a low salt/sodium heart-healthy eating plan (DASH).The DASH plan is also helpful for weight loss and cancer risk reduction because of its emphasis on low calorie fruits and vegetables. The DASH Diet to lower blood pressure 41 How do I make the DASH plan work for me? The chart below lists the number of servings of foods on a 2,000 calorie DASH diet. You will need to adjust the number of servings up or down for higher or lower calorie levels. The Dash plan may include more servings of fruits and vegetables and whole grains than you are used to eating. These foods are high in fiber and may cause gas and other intestinal upset until your body gets used to new levels of healthy foods. So take it slow and gradually increase to the recommendations. Dash number of servings for 2,000 calorie diet Food Group Servings/day Grains 7-8 Vegetables 4-5 Fruits 4-5 Low fat or fat free dairy 2-3 Meats, poultry, fish 2 or less Nuts, seeds, beans 4-5 per week Fats & oils 2-3 Sweets 5 per week (See the chapter “What’s a Serving” for serving sizes. A serving of “sweets” equals: 1Tbsp sugar, 1Tbsp jelly or jam, or 1/2 oz jelly beans. Sweets should be low in fat.) 42 The DASH Diet to lower blood pressure Sodium If you want to make the DASH, you’ll need to also watch for salt (sodium) in your diet. Food processors add salt to foods because sodium is a good preservative, and because sodium can give flavor to otherwise bland foods. A healthy adult under normal conditions (not during exercise) needs only 500 milligrams (mg) of sodium per day, which equals about 1/4 tsp of table salt. The average American gets seven to eight times that amount each day. Foods as found in nature are naturally very low sodium, but most processed foods contain very high levels of sodium. For example, one cup of canned soup contains about 900 mg of sodium—nearly twice the amount needed daily for health! DASH researchers tested two levels of sodium in the diet. The diets were identical, except one contained 1,500 mg of sodium, and the other contained 2,400 mg. Both were effective in lowering blood pressure, but the biggest reductions were seen in people following the 1,500 mg sodium diet. If you want to follow the Dash plan, you will need to check labels of foods for sodium content. After a few weeks of tracking sodium levels, you will know which foods to avoid. At first, low sodium foods will seem to lack flavor, but as your taste buds adjust to the change, processed foods will begin to taste too salty! The DASH Diet to lower blood pressure 43 Here are some tips to lower salt in your diet: • Buy sodium reduced or no-salt-added products. • Use fresh meats rather than canned, smoked, or cured products. • Choose naturally low-salt cereals such as oatmeal. • Use spices for flavoring instead of salt. • Rinse canned tuna to remove some of the salt. Eating out can sometimes be tricky on the DASH plan. Ask your server how foods are prepared and request that no salt be added in preparation. Casserole dishes, soups, and sauces have the highest levels of sodium. An example of a DASH restaurant meal would be 6 ounces of broiled fish (no breadcrumbs), a plain baked potato, and a salad with oil and vinegar. 44 The DASH Diet to lower blood pressure The DASH plan can significantly lower blood pressure. But you have to watch intake of processed and fast foods. Use this handy guide to choose the best foods. Not so fast! (avoid on the DASH plan) • Canned soup • Soy sauce • Condiments, such as ketchup, relish, pickles • Salted nuts • Potato chips • TV dinners • Pizza • Spaghetti sauce Slow down! (eat in moderation) • Reduced sodium foods (check labels) • Homemade soups and broths • Homemade spaghetti sauce (use low sodium products) • Packaged cereals (check labels for sodium) • Fresh meats, poultry and fish • Nuts and beans • Heart healthy oils such as canola and olive oil Go for it! (enjoy often) • Fresh fruits and fruits canned in juice • Fresh, frozen, and no-salt-added canned vegetables • Whole grains and cereals • Low fat and fat free dairy products The DASH Diet to lower blood pressure 45 For more information on the DASH eating plan, and to download a free version of the workbook or order by phone, go to: http://www.nhlbi.nih.gov Here are some suggestions for seasoning foods without salt. • Beef – Try fresh mushrooms, onion, garlic, pepper, sage, and thyme. • Chicken – Lemon juice, marjoram, mushrooms, poultry seasoning, and pepper work well with chicken. • Fish – Use dry mustard powder, green pepper, lemon juice, marjoram, or mushrooms instead of salt. • Lamb – Try curry powder, garlic, mint, mint jelly, pineapple, rosemary, and pepper. • Veal – Marjoram, oregano, bay leaf, curry powder, ginger, apricot, and pepper all go well with veal. • Vegetables – Garlic, lemon juice, and vinegar can be used instead of salt on many vegetables. • Potatoes –Try pepper, parsley, onion, green pepper, chives, or pimento. • Rice – Use onion, green pepper, or chives. You may have overheard someone say, “he has a little sugar” when describing a relative’s health problems. What used to be called “sugar diabetes” is really a group of diseases that results in high blood sugar. Some forms of diabetes include types 1 and 2, and gestational diabetes (which occurs during pregnancy). The causes and treatment for each form of the disease differ, but the effects of the disease are the same: diabetes can result in heart disease, stroke, high blood pressure, blindness, kidney disease, dental disease, amputations, and other complications. The American Diabetes Association estimates the costs of diabetes to be $132 billion per year. Preventing and controlling type 2 diabetes 47 What is diabetes? As we digest food, the glucose (sugar) from that food enters the blood stream. Insulin is a hormone that grabs on to the excess sugar and moves it into cells for energy. Diabetes occurs when insulin levels are either too low, or when the body can’t use its own insulin even though levels of the hormone are normal or high. Although we all need some sugar in our blood at all times to supply energy and keep the body functioning, when sugar levels rise too high, the excess sugar can cause damage to blood vessels and capillaries, which eventually leads to organ damage. This is why so many people with diabetes lose their sight or develop numbness in their hands and feet, or even need to have amputations of limbs. There are several types of diabetes, but the most common and well-known types are type 1 diabetes, which was previously called juvenile-onset diabetes because it is usually diagnosed in childhood, and type 2 diabetes which was previously called adult-onset diabetes. “ Did you know? A 10 percent weight loss and walking about 2 1/2 miles per week can prevent or delay the onset of type 2 diabetes. ” 48 Preventing and controlling type 2 diabetes About 17 million people in the Unites States suffer from diabetes. Type 1 diabetes accounts for about 5 to 10 percent of all cases of diabetes. It is usually caused by genetic, autoimmune, or environmental factors. (An autoimmune factor is when the body’s immune system overreacts and starts to fight itself.) Type 2 diabetes is by far the most common form of the disease, accounting for 90 percent of all cases of diabetes. It usually starts with a condition called insulin resistance, which happens when the body can’t use insulin properly. There may be plenty of insulin circulating in the bloodstream, but for unknown reasons, the cells don’t respond to it. Eventually, the body stops producing enough insulin, which results in high blood sugar and symptoms of diabetes. Symptoms in adults include: • Excessive thirst • Frequent urination • Fatigue • Weight loss • Blurred vision • Yeast infections (in women) • Itching • Tingling in the hands or feet (These symptoms can also be caused by other illnesses, so it’s important to check with your doctor to find the cause.) Preventing and controlling type 2 diabetes 49 Type 2 diabetes is associated with aging, obesity, low levels of activity, and family history of diabetes. Aging and family history cannot be controlled, but doctors tell us that many cases of type 2 diabetes can be prevented or controlled with weight loss and increased physical activity. Studies show that even a 10 percent weight loss and/or walking about 2 1/2 miles per week can prevent or delay the onset of type 2 diabetes. Over the past few years, researchers have noticed a rise in the number of young adults and even children with type 2 diabetes. This is alarming because 20 years ago, type 2 diabetes was almost never seen in young people. Our national rates of overweight and obesity and lack of physical activity appear to be the cause of the dramatic rise in type 2 cases in the United States. Together, a healthy diet and regular exercise is the cornerstone of diabetes prevention and treatment. (It’s always important to check with your doctor before starting a new diet or exercise program, but it is especially important for people with diabetes to do so. Diabetics have much higher rates of heart disease than non-diabetics.) 50 Preventing and controlling type 2 diabetes The Diabetic Diet There are many approaches to dietary control of type 2 diabetes, and no one plan is accepted by all diabetes authorities. However, most doctors and diabetes organizations advise patients to eat fruits and vegetables, whole grains, moderate amounts of protein, low cholesterol foods, and only heart-healthy fats such as olive oil, nuts, or fish oil. The DASH Diet, which is highly recommended as a treatment for hypertension, can also help control type 2 diabetes. Recent research shows that diets high in some types of carbohydrates increase the risk of developing diabetes. This has led to recommendations to limit what are called “high glycemic foods” in the diet. The Glycemic Index and Glycemic Load Carbohydrates are not all created equal when it comes to their effect on blood sugar. Some can cause a very quick rise in blood sugar, while others have a slow and sustained effect. There are many factors involved in this difference between carbs—including the amount of fiber present in the food, and how refined or processed the food is. Preventing and controlling type 2 diabetes 51 The glycemic index, in simple terms, is a number that refers to how quickly a food causes a rise in blood sugar. To get these numbers, researchers fed a standard amount of different foods to volunteers and then measured their blood sugar. White bread was made the standard at an index of 100. All other foods were compared to this standard. Theoretically, a food with a low index has less effect on blood sugar and a food with a high index can cause a spike in blood sugar. Mashed potatoes, white bread, and white rice are among the foods with the highest glycemic index. However, the glycemic index does not tell the whole story about how much a food will raise blood sugar. You must also take into account normal portion size. All of the foods tested for the glycemic index used as much food as it took to get 50 grams of carbohydrate. “ Did you know? The DASH Diet can help control type 2 diabetes. (See page 38 in this guide for information on the DASH Diet.) ” 52 Preventing and controlling type 2 diabetes By taking glycemic index and considering normal portion size, researchers have developed a better guide to carbohydrate’s effect on blood sugar called the glycemic load. Glycemic load is the true effect a food will have on blood sugar. As an example, it has been reported in some popular books that carrots should be avoided because of their high glycemic index. To get fifty grams of carbohydrate from carrots, a person would need to consume over three cups of carrots. But when carrots are consumed in normal portions, their effect on blood sugar is minimal. A 1/2-cup serving of carrots has a glycemic index of 131, but a glycemic load of 11. The glycemic load is the preferred guide of many nutrition experts. In general, all refined grains and sugars have a high glycemic load and can cause high blood sugar. This is why these foods are not recommended for people with diabetes. Foods high in fiber, such as whole grains, vegetables, and legumes (beans) have lower glycemic indexes and are highly recommended. Preventing and controlling type 2 diabetes 53 Here are some indexes for common foods: Food Amount Glycemic Glycemic index load White rice 1/2 cup 102 45 Mashed potatoes 1 cup 104 38 Pizza 2 slices 86 67 Oatmeal 1 cup 82 21 Sugar 1 tsp 84 34 Apple 1 medium 55 12 Cola 12 ounces 39 35 It is not necessary to know the glycemic numbers of all the foods you eat; rather, it’s more important to avoid refined foods such as white bread, white rice, sugared cereals, soft drinks, and sugary desserts. These are the foods that can cause high blood sugar and can have a negative effect on diabetes. It is also important to remember that a high glycemic food will not have as much effect on blood sugar if it is eaten with other foods containing protein and fat, because protein and fat can slow digestion of carbohydrates. For more information about what you can do to control or prevent type 2 diabetes, contact the American Diabetes Association. We are in the midst of an epidemic of overweight and obesity—both in adults and children. The most recent government statistics put the number of overweight Americans at 65 percent, but many experts believe the actual number today is closer to 80 percent. How did this happen? The Basics of weight control 55 People gain weight for many reasons. For some people, overeating is tied to emotional issues such as depression, anger, or anxiety. Sometimes, getting professional help for emotional issues may be a first step for overweight. But for the majority of Americans, weight gain is the result of a basic imbalance. Maintenance of optimal weight is based on a very simple formula: calories eaten must equal calories used. A lot of press is devoted to fad diets that promise weight loss by eating high amounts of protein, or eating foods in special combinations, but the bottom line remains the same. A calorie is a calorie, whether it comes from carbohydrate, fat, or protein. If a person eats too many calories from any source, he or she will gain weight. The formula is simple, but unfortunately, putting it into practice is not quite so simple. There are many causes of our overweight epidemic, starting with our food environment. The supermarket shelves are loaded with highly processed, high fat, sugared items that contribute very little nutritional value, but provide lots of calories. In addition, “economy” or super sizing—in packaged food as well as in fast food—encourages us to eat much more than we really need. 56 The Basics of weight control And just how many calories do we need? This amount varies for each person, based on age, gender, activity level, and heredity. For a quick ballpark figure of how many calories you need, multiply your ideal weight (what you would like to weigh) by a factor of: • 13 if you get very little activity, • 15 if you are somewhat active, and • 18 if you get at least one hour of exercise every day. This number is just an estimate; the exact number of calories you need each day varies from person to person. After a few weeks of tracking calories, you’ll be able to assess whether the amount is on target or needs to be adjusted. Once you know your caloric needs, spend some time checking labels for serving size and number of calories per serving of your favorite foods. You can also ask for nutrition guides at fast food restaurants. You may be surprised by how many calories are in common foods. (see “Calorie content of common foods” for a calorie guide) The Basics of weight control 57 Information about popular diet plans • • • • High protein diets are all the rage, but scientific studies show that the reason people lose weight on these diets is because they get tired of eating so much protein and eventually just cut down on calories. Few people can tolerate a high protein, low carbohydrate diet long term. For short term, the diet is safe for most people, but long term, it is an unhealthful way to eat. Unfortunately, research also shows that although people quickly lose weight on a high protein diet, the weight is gained back equally as fast once they go off the diet. Food combining is based on the (unscientific) theory that certain foods in special combinations will cause the body to burn more calories. Food combining diets, along with diets based on blood type, are not based on scientific fact. Mediterranean diet This type of diet includes lots of fruits and vegetables, whole grains, nuts, and healthy oils such as olive and canola oil. Many studies have shown this is a healthy diet, and can help prevent heart disease, diabetes, and reduce the risk of cancer. High complex carbohydrate diets Many of these diets are vegetarian and very low in fat. They have been proven in many cases to reverse heart disease but like the high protein diet, it is sometimes difficult for people to stick to the diet. 58 The Basics of weight control What’s the best way to lose weight? Studies that have tracked thousands of people who have successfully lost weight and kept it off over many years show people who control their weight have three things in common: • They eat breakfast • They eat lots of fruits and vegetables and whole grains • They exercise 30-60 minutes every day What about exercise? Overeating is only half of the story. The other reason for overweight is that we Americans are slowing down. We have machines—cars, computers, and appliances—to do our work for us. This is why the National Institute of Medicine recently made the recommendation that all Americans get a minimum of 60 minutes of exercise each day. A great way to keep track of how active you are is to use a pedometer or step counter. Most sporting goods stores carry a simple version of this device that will give you instant feedback on activity levels. Experts recommend that 10,000 steps are needed every day to keep weight under control, and about 15,000 steps are needed to lose weight. Step counters can be fun for the whole family and are a great way to get into the habit of moving. If you want to lose weight, first talk to your doctor to get the OK for an exercise program. Then, start by cutting 500 calories from your daily food intake. The Basics of weight control 59 Many people find that by adding fruits and vegetables and whole grains to their diet, they naturally cut down on the “junk.” Eat breakfast. People who don’t eat breakfast almost always overeat during the day. If time is an issue, grab a banana and a handful of nuts for the ride to work or school. Become more active. Take a two-mile walk three times a week to start, and gradually increase to walking most days of the week. Find a partner if you don’t like to exercise alone. Overweight in children The number of overweight and obese children is rising steadily every year: in 2000, the latest year of national statistics, 15 percent of children were too heavy. According to pediatricians, that number is growing every year. Doctors worry that this epidemic of overweight in children will result in many more cases of type 2 diabetes and other health problems later in life. Nutritionists and pediatricians offer the following advice to parents: • Limit television viewing to no more than 2 hours each day. Encourage physical activity. • Limit sugary snacks. Fruit is a healthy substitute. • Limit or eliminate soft drinks and sugared drinks from your child’s diet. It’s best to check with your pediatrician if you have concerns about weight gain and diet for your child. Fiber 61 Most people think fiber is only useful for preventing constipation, but fiber performs many other functions. By helping to keep blood sugar levels down, lowering cholesterol, and decreasing fats in the blood, fiber helps to prevent and control diabetes and heart disease. Research studies are now showing a link between high fiber diets and a lower risk of cancer. Eating a high fiber diet can help control weight because fiber is found in low calorie foods, and also helps you feel full. In 2003, the National Institutes of Medicine released new recom-mendations for fiber intake. Men need 35 grams of fiber, and women and children need 25 grams each day. Most Americans get about 11 grams of fiber each day, or less than half the amount needed for good health. Because of overly processed foods and use of white flour in most baked goods, many people take fiber supplements to avoid constipation. However, by including fruits and vegetables and whole grains in our diets, it is possible to get all the fiber we need from foods. Dietary fiber comes from the peels, seeds, and bran in plant foods. Meat and dairy foods do not contain any fiber. Fiber 62 Fiber is divided into two types: soluble and insoluble. We need both types of fiber in our diets each day. Soluble fiber comes from the inside of beans, fruits, vegetables, and from grains like oatmeal. Soluble fiber soaks up water and has a gummy or mushy texture. Insoluble fiber is found in the bran of grains, and the seeds and peels of fruits and vegetables. It has more of a “sawdust’ type of texture. You can get 30 grams of fiber in your diet by eating: • 7 servings of fruits and vegetables (see “What’s a Serving?”) • 1 1/2 cups oatmeal • 2 slices whole wheat bread • 1/4 cup nuts Fiber 63 Here are some tips on including more fiber in your diet: • Buy whole grain breads and cereals. Check the ingredient lists carefully. “Wheat flour” is white flour. The ingredient must say “whole” for it to contain a whole grain. • Look at the label. Choose products that contain more than 2 grams of fiber per serving. Some whole wheat breads contain as much as 5 grams of fiber per slice. • Buy old-fashioned oatmeal. It takes a few minutes longer to cook, but the finished product is much more tasty and higher in fiber. • It takes a while to get used to going high fiber. Make changes gradually to give your system time to get used to a high fiber diet. • If children have always eaten low fiber foods, they may refuse whole grains. Introduce foods slowly, perhaps starting off with a light wheat bread rather than going right to the whole wheat. • Nuts and beans are a good source of fiber. Add them to salads and casseroles for crunch and variety. Hydration 65 Young men have more water weight than women (women tend to have higher percentages of fat) and as we age, body water content decreases. We all lose about 2 quarts (8 cups) of water each day and need to replace those losses through foods or beverages. In hot weather, more body water is lost through sweat, so it’s important to drink more during the heat. Children and the elderly may need to be reminded to drink more fluids. Although water is the best choice for hydration, the taste of flavored drinks may encourage both adults and children to drink more fluids. Here are some general hydration tips: 66 Hydration For children • Depending on height and weight, children need anywhere from 1-2 quarts (4 to 8 cups) of fluid each day. • Fruits and vegetables have high water content and can be included in the daily totals. • Sugar sweetened soda consumption is associated with obesity in children. • Caffeinated beverages are not a good choice for young children. • Fruit juice is high in calories and may discourage children from eating other healthy foods. Limit juice to 6 ounces per day or dilute juice with water or seltzer water. For the elderly Older adults need the same amount of fluid as younger adults, but older people may have conditions that interfere with good hydration. Medications, kidney problems, and other health problems can upset the fluid balance. • It’s important to be sure that older adults drink enough fluid, especially during hot weather. For teens and adults • Drink 8 cups of fluids each day. Fluid can come from water, tea, coffee, flavored drinks, fruits, and vegetables. • Alcohol can cause dehydration. • During hot weather or exercise, follow the guidelines on the following pages. Hydration 67 Guidelines for hydration during heavy labor or exercise Keeping hydrated on the job or while playing sports is important to prevent fatigue and heat stroke. It’s normal to lose about 2.5 quarts of water each day through sweat and breathing, but on the hottest summer days, if you’re wearing heavy protective clothing, you can lose more than 2 quarts of fluid per hour through sweat. Drinking water before work and frequently throughout the day can keep you well hydrated. Fruit juices and sugar-sweetened sodas are not a good choice during a hot workday or while playing sports because they contain too much sugar, which can cause nausea and intestinal cramping. They also contain a lot of calories, which can lead to weight gain. Thirst is a good indicator that you may be dehydrated. Also, urine color can signal that you aren’t drinking enough fluids. Urine should be clear or pale yellow. A dark color indicates dehydration. (Note: some B vitamins can temporarily impart a deep yellow color to urine.) 68 Hydration Hydration tips for hot temperatures and strenuous activity*: • Drink frequently throughout the day. Water, coffee, tea, and diet soda are all good choices. Alcohol is not a good choice for re-hydration. • Food is the best source of electrolytes (sodium and potassium). If you’re eating snacks and meals, you don’t usually need a sports drink. Guidelines for use of sports drinks: • Working more than 6 hours in hot weather if no meals or snacks are eaten. • Working strenuously for more than 3 hours, if no meals or snacks are eaten. • Before a strenuous workday if you haven’t eaten in the previous 4 hours. When to use “energy” drinks: Canned energy drinks are often sold in convenience stores. They contain about the same amount of caffeine as a cup of strong coffee, with added amino acids, vitamins, and sugar. The energy they provide comes from the caffeine. The other ingredients are not proven to provide any beneficial effects on energy levels. Energy drinks are good to keep you alert if you’re tired, and have a similar effect as a cup of coffee. Hydration 69 Quick Hydration Guide (green dot=unlimited use) • Water • Coffee • Tea • Diet soda • Fruits and vegetables (yellow dot=OK) • Sports drinks • Energy drinks • Diluted juice (red dot=limit) • Juice • Sugar sweetened drinks and sodas • Caffeine drinks (for young children) • Alcohol is not appropriate for hydration *(adapted from the US Army Surgeon General’s Guidance for the Field Use of Sports Drinks) “ Did you know? About 60 percent of an adult man’s body is water. Women have more fat than men, so the amount of water in a woman’s body is about 55 percent. ” A calorie is the amount of heat, or energy, that a food provides. Carbohydrate and protein each provide 4 calories per gram (about 1/4-1/2 tsp measurement). Fat provides 9 calories per gram. Alcohol provides 7 calories per gram. Calorie content of common foods 71 Calorie requirements Calorie needs are based on age, gender, and activity levels. Active people need more calories to maintain weight. Most people eat too many calories for their activity levels. As a general guideline, you need: 13 calories per pound of desired weight if you are sedentary 15 calories per pound of desired weight if you are somewhat active 18 calories per pound of desired weight if you are very active You need to burn 3500 calories to lose one pound of body fat. This calorie counter is intended as a general guide. For exact calorie counts, be sure to check labels of the actual food. 72 Calorie content of common foods Foods in the guide are in alphabetical order. Food Amount Calories Almonds Applesauce, unsweetened Apricots in light syrup Asparagus Avocado Bacon Bagel, plain Banana Bass Beans, baked Beef, sirloin, choice Beer, regular Beer, light Beets, canned Blueberries Bread, white Bread, whole wheat Broccoli Brownie from mix Brussels sprouts Butter Cabbage Cake, chocolate w/icing Cake, angel food Cake, cheesecake Cantaloupe Carrots Cashews Cauliflower 1 oz 1/2 cup 1/2 cup 1/2 cup 1 whole 2 strips cooked 1 (3.5 in) 1 peeled 3 oz 1/2 cup 3 oz 12 oz 12 oz 1/2 cup 1/2 cup 1 slice 1 slice 1/2 cup 1 oz 1/2 cup 1 Tbsp 1/2 cup 1/12 of cake 1/12 of cake 1/12 of cake 1/2 cup 1/2 cup 1 oz 1/2 cup 178 86 195 101 340 140 450 Calorie content of common foods 73 Food Amount Calories Celery Cheese, cheddar Cheese, goat Cheese, American Chicken, white meat, broiled Chickpeas Chocolate bar Cod, Atlantic Cookies, chocolate chip, homemade Cookies, Oreo Corn, canned Corn chips Cottage cheese, low fat Crackers, saltine Crackers, whole wheat Cranberry juice Cream, light Cream cheese Cream cheese, whipped Croissant Danish, cheese Dates, whole Doughnut, cake Doughnut, raised Egg English muffin Flour, white French toast Granola bar, plain Grapefruit Grapes 1/2 cup 1 oz 1 oz 1 oz 3 oz 1/2 cup 1 oz 3 oz 1 3 1/2 cup 1 oz 1/2 cup 10 5 large 6 oz 1 Tbsp 2 Tbsp 2 Tbsp 1 (2 oz) 1 (4 inch) 10 1 1 1 1 1 cup 1 slice 1 oz 1/2 fruit 10 266 74 Calorie content of common foods Food Amount Calories Gravy, canned Green beans, canned Haddock Ham, lean Hamburger, lean Hamburger Honey Honeydew melon Ice cream, regular, chocolate Ice cream, light, vanilla Ice cream, rich, chocolate or vanilla Ice cream sugar cone Jam or jelly K Kiwi Lamb, lean Lentils Lobster Margarine Mayonnaise Mayonnaise Milk, skim Milk, 1% Milk, whole Muffin, store bought Mushrooms, sliced Nuts, mixed Oil, canola or olive Orange Orange juice Pancake syrup 2 oz 1/2 cup 3 oz 3 oz 3 oz 2.5 oz w/bun 1 Tbsp 1/2 cup 1/2 cup 25 275 1/2 cup 1/2 cup 1 cone 1 Tbsp 1 3 oz 1/2 cup 3 oz 1 Tbsp 1 Tbsp regular 1 Tbsp light 1 cup 1 cup 1 cup 2 oz 1/2 cup 1 oz 1 Tbsp 1 medium 6 oz 1/4 cup 100 50 65 Calorie content of common foods 75 Food Amount Calories Pancake 1 (4 inch) Pasta 1 cup cooked Peaches, canned 1/2 cup in light syrup Peanut butter 2 Tbsp Peanuts 1 oz Pear 1 medium Peas 1/2 cup Pecans 1 oz Peppers, green 1/2 cup sliced Pickle, dill 1 oz Pie, apple, store bought 1/8 of 9” pie Pie, pumpkin from recipe 1/8 of 9” pie Pizza, cheese 1/8 of 12” pie Pizza, pepperoni 1/8 of 12” pie Popcorn, air popped 1 cup Pork, lean 3 oz Pretzels 1 oz Prunes, dried 4 Pudding, chocolate, 1/2 cup whole milk Raisins 1/4 cup Raspberries 1/2 cup Rice, white long grain 1/2 cup cooked Rice, brown long grain 1/2 cup cooked Salad dressing, 2 Tbsp creamy Italian Salmon, fresh Atlantic 3 oz Salsa 2 Tbsp Sausage, beef 3 oz Shrimp 4 large Soda, cola 8 oz 75 200 98 13 300 316 150 180 111 116 76 Calorie content of common foods Food Amount Calories Sour cream Spaghetti sauce, meatless Spaghetti sauce with meat Spinach Sports drinks Squash Sugar Sweet potato Tofu Tomato, chopped Tomato juice Trout, baked Tuna, white canned in water Turkey, breast Veal, lean Walnuts Watermelon Wine, dry red or white Yogurt, plain Yogurt, fat free w/fruit Zucchini, cooked 2 Tbsp 1/2 cup 1/2 cup 1/2 cup cooked 8 oz 1/2 cup 1 tsp 1/2 cup 1/2 cup 1/2 cup 6 oz 3 oz 3 oz 30 3 oz 3 oz 1 oz 1/2 cup 4 oz 1 cup 6 oz 1/2 cup (source: USDA Handbook No. 456) Calorie content of common foods 77 Notes: 78 Calorie content of common foods Eating out Eating out can be fun for the whole family. But some fast food is so loaded with fat and calories, it can soon put a stop to good health. Use this handy guide to make the best choices. BK=Burger King DD=Dunkin Donuts KFC=Kentucky Fried Chicken Mc=McDonald’s PH=Pizza Hut TB=Taco Bell W=Wendy’s Not so fast! (eat rarely or not at all) BK Whopper w/cheese DD maple walnut scone KFC popcorn chicken, large Mc large shake Mc Super Size fries Mc Big Mac PH stuffed crust pizza slice TB Nachos Bellgrande W Classic Triple 860 calories, 53g fat 470 calories, 22g fat 670 calories, 44g fat 1,150 calories, 32g fat 610 calories, 29g fat 580 calories, 33g fat 470 calories, 25g fat 780 calories, 43g fat 950 calories, 57g fat “ Did you know? Salad dressings can add as much as 250 unwanted calories to a healthy salad. If you are counting calories, be sure to ask for dressing on the side and check calories before adding dressing. ” Calorie content of common foods 79 Slow Down! (Eat in moderation) BK Croissan’wich 320 calories, 19g fat w/egg ‘n cheese BK regular hamburger 310 calories, 13g fat DD english 310 calories, 10g fat muffin sandwich KFC chicken breast 380 calories, 19g fat Mc small fries 210 calories, 10g fat Mc Egg Mcmuffin 300 calories, 12g fat Mc small shake 430 calories, 12g fat Mc sundae 340 calories, 12g fat Mc 4 pc Chicken 210 calories, 13g fat Mcnuggets TB bean burrito 370 calories, 12g fat W 11 ounce soft drink 140 calories, 0g fat Go for it! BK veggie burger KFC Tender Roast sandwich DD iced coffee w/skim & sugar Mc fruit ‘n yogurt parfait Mc grilled chicken caesar salad (without dressing) PH Veggie Lover’s pizza slice TB soft taco W grilled chicken sandwich W small chili W Mandarin Chicken Salad (without dressing) 330 calories, 10g fat 260 calories, 5g fat 60 calories, 0g fat 160 calories, 2g fat 200 calories, 6g fat 220 calories, 8g fat 210 calories, 10g fat 300 calories, 7g fat 200 calories, 6g fat 190 calories, 3g fat 80 Calorie content of common foods Notes: Calorie content of common foods 81