Download Healthy Express - University of Minnesota Extension

Document related concepts

Obesity and the environment wikipedia , lookup

Organic food wikipedia , lookup

Food choice wikipedia , lookup

Overeaters Anonymous wikipedia , lookup

Human nutrition wikipedia , lookup

Dieting wikipedia , lookup

Nutrition wikipedia , lookup

Childhood obesity in Australia wikipedia , lookup

Transcript
Healthy Express
91
92
Healthy Express Overview
Need State Description
Healthy Express is described as eating healthy and quickly, with minimum preparation time.
Defining Needs
"I want to..."

Feel like I am eating responsibly, controlling and limiting calorie intake, spreading calories
across the day, and eating light

Eat quickly and minimize effort in planning, preparation, and clean-up

Energize and care for myself
Benefits Sought in Food
"I want something that..."

Is easy, fast, and ready to eat

Is healthy; low in calories, fat, cholesterol, salt, and carbohydrates; provides fiber,
vitamins, minerals, nutrients, calcium; is natural and organic
Defining Eating Occasions

Eating occasions include breakfast and lunch

Weekdays, alone, at home

Little preparation and eating time – average of 10 minutes
Healthy Express Lessons
Healthy Express lessons focus on strategies for preparing and eating healthy, well balanced
meals quickly. Activities include planning convenient and healthy breakfasts and lunches,
changing home and work settings so convenient, healthy foods are available for breakfast and
lunch, identifying time-saving strategies for food preparation, and strengthening the belief that
eating healthy on the go is worth the effort.
Lesson 1 ....................................................................................................... 94
Lesson 2 ..................................................................................................... 124
Lesson 3 ..................................................................................................... 151
93 
Healthy Express: Lesson 1
Objectives
By the end of this lesson, the participant will be able to:

Identify components of healthy and balanced meals based on recommendations for food
groups, nutrients, and appropriate portion sizes.

Plan menus or components of menus for convenient and healthy breakfasts and lunches.

Identify time-saving strategies for preparing healthy breakfasts and lunches.

Describe ways to modify home and/or work environments to have components on hand
for quick and healthy breakfasts and lunches.

Improve the perception that eating healthy on the go is worth the effort.

Time for this Lesson: 45-50 minutes
Activities in this Lesson
1. Introduction and Review (5 minutes)
2. Learning the Basics of a Healthy Express Meal (10 minutes)
3. Planning On-the-Go Meals (15 minutes)
4. Go Healthy and Keep Going! (7 minutes)
5. Review and Goal Setting (7 minutes)
Preparation and Handouts Needed
Preparation

Print and prepare handouts as indicated below.

Bring felt-tip marker pens in the five MyPlate colors: red for fruits, green for vegetables,
purple for protein, brown for grains, and blue for dairy. Also bring a yellow pen for
fats/oils.
Handouts
94

What's on Your Plate? (Print this double-sided poster on a color printer, if possible.)

Meal Planning with MyPlate (Double-sided)
Healthy Express Lesson 1

MyPlate Serving Equivalents Guide

Fiber FAQs

Creating Breakfast and Lunch Meal Plans

Tips for Healthy Express Meals

Healthy Express Calendar

Goal Setting Worksheet
Healthy Express Lesson 1
95
Activities
1. Introduction and Review (5 minutes)
Review points from the last lesson with the participant. Ask the participant what she remembers
or what was most notable from the last lesson.
2. Learning the Basics of a Healthy Express Meal (10 minutes)
Using information obtained from the participant’s needs assessment, discuss her meal-planning
responses and the benefits of meal planning:

Help ensure a well-balanced diet

Alleviate some of the stress that comes with making on-the-fly meal decisions

Help save money

Save time in the long run
Review the recommendations on the What's on Your Plate? handout (poster), and discuss how
they can be used to eat a well-balanced diet – after making adjustments for calorie needs.
Next, ask the participant to examine the two meal plans for a 1,800-calorie diet on the Meal
Planning with MyPlate handout.
Questions to Guide Discussion

Does anything about this surprise you?

Does this look realistic? (Some participants may think this seems like a lot of
food. Explain that making healthier choices often means more food with fewer
calories.)

Breakfast and lunch are often the most unplanned meals. Why? (Possible
answers: May be less likely to be eating with the rest of the family; time
restrictions; may be away from home at work or running errands; may be more
likely to have the same thing every day)
On the second page of Meal Planning with MyPlate, have the participant use the felt-tip markers
to indicate the food group in the box next to each item. For example, in the food group column
next to 1 cup skim milk, the participant should mark a blue X for dairy. Use the MyPlate Serving
Equivalents Guide for reference.
96
Healthy Express Lesson 1
Optional activity: If the participant is interested
in fiber, have her mark her menus with F’s for
foods that are a good source of fiber. Use the
Fiber FAQs handout as a reference.
On the Meal Planning with MyPlate handout, have the participant record her most recent
breakfast and lunch on the blank menus and mark colored X’s in the food group column for each
food item.
Now read through Creating Breakfast and Lunch Meal Plans and ask the participant to
compare her meals from Meal Planning with MyPlate to these recommendations:

Foods from at least three food groups for breakfast

Foods from at least four food groups for lunch
If her meals fell short of recommendations, have
the participant suggest ways she could meet
them. Commend the participant if her meals
fulfilled recommendations.
3. Planning On-the-Go Meals (15 minutes)
Discuss Tips for Healthy Express Meals with the participant. Ask her to write any additional
strategies she has for quick and healthy breakfasts and lunches.
Any of these tips could be used as strategies for
the Goal Setting Worksheet.
Using Creating Breakfast and Lunch Meal Plans and ideas from Tips for Healthy Express
Meals, have the participant plan one week of breakfasts and lunches by filling out the Healthy
Express Calendar (during the lesson).
As homework for the next lesson, have the
participant complete at least one additional
weekly meal plan on the Healthy Express
Calendar.
4. Go Healthy and Keep Going! (7 minutes)
Have the participant reflect on eating on-the-go.
Healthy Express Lesson 1
97
Questions to Guide Discussion

Do you ever feel like you sacrifice healthy eating for fast eating?

What are the benefits? What are the consequences?

Is it worth it?

What are some barriers to eating well on the go?

What are some reasons that eating well on the go is important to you?
Reinforce the importance of the participant’s commitment to eating healthy while on the go, noting
that:

Doing so keeps the "engine" tuned so she can keep going full speed.

If she is often on the go, she will likely fall short on nutrition if she is not making healthy
choices.

If she is not prepared, it is much easier to make unhealthy choices, such as fast food,
when on the go.
5. Review and Goal Setting (7 minutes)

Ask the participant if she has any questions.

Have the participant discuss one or two things she learned today.

Have the participant set goals for the next two weeks using the Goal Setting Worksheet.

Review the homework assignment to plan at least one week of breakfasts and lunches
with the Healthy Express Calendar. Remind the participant to bring the completed menu
plan to the next lesson.

Schedule the date and time for the next lesson.

Briefly describe the topic and activities for the next lesson to arouse interest:

•
Control portion size for breakfast and snack foods eaten for comfort and relaxation.
•
Use food labels to identify healthier options for breakfasts and snacks.
•
Plan breakfasts and snacks to include convenient foods that are good for you.
•
Choose healthy, convenient or portable foods for breakfast and snacks when looking
for comfort and relaxation at home, work, or on the road.
Thank the participant for coming.
Additional Reading
U.S. Department of Agriculture. (n.d.). Daily food plans. Retrieved from
http://www.choosemyplate.gov/myplate/index.aspx
98
Healthy Express Lesson 1
Healthy Express Lesson 1 99 100 Healthy Express Lesson 1 Meal Planning with MyPlate
Below is an example of two days of meals and snacks for a 1,800 calorie diet.
Day 1
Breakfast
Lunch
Dinner
1 toasted English muffin
1 tbsp peanut butter
2 tsp jam or preserves
4 oz calcium-fortified orange juice
1 ½ c red beans and rice, prepared
without meat or added fat
1 c raw vegetables (peppers,
cucumbers, tomatoes, etc.)
2 plums
4 oz marinated, grilled salmon
1 medium baked sweet potato
1 c steamed broccoli
Large salad with mixed salad greens
and 1 tbsp olive oil-based salad
dressing
Snacks: 6 oz low fat yogurt, ¼ cup almonds, 1 cup skim milk or soy milk, 3 cups air-popped popcorn
Day 2
Breakfast
Lunch
Dinner
1 c oatmeal, prepared with water
topped with:
2 tsp honey
1 tbsp chopped dates
¼ cup skim milk
4 oz calcium-fortified orange juice
Sandwich:
2 slices whole grain bread
3 oz oven roasted turkey
Spinach leaves
Mustard
1 snack-sized bag of pretzels
1 large apple
Mediterranean salad:
2 - 3 c romaine lettuce
Half of a red bell pepper
10 cherry tomatoes
Red onion
3 large black olives, sliced
3 oz grilled chicken breast
1 oz feta cheese
¼ cup chick peas
2 tbsp Greek dressing
1 small slice Italian bread, dipped in
2 tsp olive oil
Snacks: Low-fat string cheese stick, large stalk celery with 1 tbsp peanut butter, 1 c sugar-free hot cocoa, made
with skim milk
Healthy Express Lesson 1
101
For the examples of healthy breakfasts and lunches below, use colored markers to identify the
MyPlate food group for each meal item.
Breakfast
Food Group
Lunch
Food Group
1 ½ c bran flakes (or another highfiber cereal)
¾ c tuna salad:
water packed tuna
light mayo
relish
chopped celery
1 c skim milk
6 whole grain crackers
1 boiled egg
1 medium raw carrot
4 oz calcium-fortified orange juice
½ c mixed fruit, in own juice
Breakfast
Food Group
Lunch
Food Group
1/2 c mixed fruit (banana, kiwi, orange,
strawberries, etc.)
1 6-inch sub on whole wheat bread:
3 oz turkey breast
1 oz Swiss cheese
lettuce, peppers, tomatoes,
cucumbers, vinegar
½ c low-fat vanilla yogurt
1 medium apple
1 low-fat granola bar
1 small bag multigrain chips
Now, recall your last breakfast and lunch and record each food item in the boxes below. Use
colored markers to identify the food group for each meal item.
Breakfast
102
Food Group
Lunch
Food Group
Healthy Express Lesson 1
MyPlate Serving Equivalents Guide
What counts as an ounce equivalent of grains?
In general, 1 slice of bread, 1 cup of ready-to-eat cereal, or ½ cup of cooked rice, cooked pasta,
or cooked cereal can be considered a 1-ounce equivalent from the grains group. The chart lists
specific amounts that count as 1-ounce equivalents of grains toward daily recommended intake.
Food
Applicable varieties
Amount that counts as
1 ounce equivalent of
grains
Bagels
WG* whole wheat
RG* plain, egg
1 mini bagel
Biscuits
RG baking powder,
buttermilk
1 small (2" diameter)
Breads
WG 100% whole wheat
RG white, wheat, French,
sourdough
1 regular slice
1 small slice French
4 snack-size slices rye
bread
Bulgur
WG cracked wheat
½ cup cooked
Cornbread
RG cornbread
1 small piece (2 ½" x 1 ¼”
x 1 ¼")
Crackers
WG 100% whole wheat,
rye
5 whole wheat crackers
2 rye crisp breads
RG saltines, snack
crackers
7 square or round crackers
English muffins
WG whole wheat
RG plain, raisin
½ muffin
Muffins
WG whole wheat
RG: bran, corn, plain
1 small (2 ½" diameter)
Oatmeal
WG oatmeal
½ cup cooked
1 packet instant
1 ounce (1/3 cup) dry
(regular or quick)
Pancakes
WG whole wheat,
buckwheat
RG buttermilk, plain
1 pancake (4 ½" diameter)
2 small pancakes (3"
diameter)
(continued on next page)
Healthy Express Lesson 1
103
(continued from previous page)
Amount that counts
as 1 ounce
equivalent of grains
Popcorn
WG varieties
Ready-to-eat
breakfast cereal
WG toasted oat, whole
1 cup flakes or rounds
1 ¼ cup puffed rice
wheat flakes
RG corn flakes, puffed rice
Rice
WG brown, wild
RG enriched, white,
polished
½ cup cooked
1 ounce dry
Pasta – spaghetti, WG whole wheat
RG enriched, durum
macaroni,
noodles
½ cup cooked
1 ounce dry
Tortillas
WG whole wheat, whole
grain corn
RG flour, corn
3 cups, popped
1 small flour tortilla (6"
diameter)
1 corn tortilla (6"
diameter)
*WG = whole grains, RG = refined grains. These are shown when products
are available both in whole grain and refined grain forms.
104
Healthy Express Lesson 1
What counts as a cup of fruit?
In general, 1 cup of fruit or 100% fruit juice, or ½ cup of dried fruit can be considered 1 cup from
the fruit group. The following specific amounts count as 1 cup of fruit (in some cases equivalents
for ½ cup are also shown) toward your daily recommended intake.
Amount that counts as
1 cup of fruit
Apple
Amount that counts as
½ cup of fruit
½ large (3.25" diameter)
1 small (2.5" diameter)
1 cup sliced or chopped, raw or
cooked
½ cup sliced or chopped, raw or
cooked
Applesauce
1 cup
1 snack container (4 ounce)
Banana
1 cup sliced
1 small (less than 6” long)
1 large (8" to 9" long)
Cantaloupe
1 cup diced or melon balls
Grapes
1 cup whole or cut-up
Grapefruit
1 medium wedge (1/8 of a medium
melon)
32 seedless grapes
16 seedless grapes
1 medium (4" diameter)
½ medium (4" diameter)
1 cup sections
Mixed fruit (fruit cocktail)
1 cup diced or sliced, raw or
canned, drained
1 snack container (4 ounce)
drained = 3/8 cup
Orange
1 large (3-1/16" diameter)
1 small (2-3/8" diameter)
1 cup sections
Orange, mandarin
1 cup canned, drained
Peach
1 large (2 ¾" diameter)
1 small (2" diameter)
1 cup sliced or diced, raw,
cooked, or canned, drained
1 snack container (4 ounce)
drained = 3/8 cup
2 halves, canned
(continued on next page)
Healthy Express Lesson 1
105
(continued from previous page)
Amount that counts as
1 cup of fruit
Pear
1 medium pear
Amount that counts as
½ cup of fruit
1 snack container (4 ounce)
drained = 3/8 cup
1 cup sliced or diced, raw,
cooked, or canned, drained
Pineapple
1 cup chunks, sliced or crushed,
raw, cooked or canned, drained
Plum
1 cup sliced raw or cooked
3 medium or 2 large plums
Strawberries
Watermelon
1 snack container (4 ounce)
drained = 3/8 cup
1 large plum
About 8 large berries
1 cup whole, halved, or sliced,
fresh or frozen
½ cup whole, halved, or sliced
1 small wedge (1" thick)
6 melon balls
1 cup diced or balls
Dried fruit (raisins, prunes,
apricots, etc.)
½ cup dried fruit is equivalent to
1 cup fresh fruit, e.g.,
½ cup raisins
½ cup prunes
½ cup dried apricots
¼ cup dried fruit is equivalent to ½
cup fresh fruit, e.g., 1 small box
raisins (1.5 ounce)
100% fruit juice (orange, apple,
grape, grapefruit, etc.)
1 cup
½ cup
106
Healthy Express Lesson 1
What counts as a cup of vegetables?
In general, 1 cup of raw or cooked vegetables or vegetable juice, or 2 cups of raw leafy greens
can be considered 1 cup from the vegetable group. The chart lists specific amounts that count as
1 cup of vegetables (in some cases equivalents for ½ cup are also shown) toward your
recommended intake.
Amount that counts as
1 cup of vegetables
Amount that counts as ½
cup of vegetables
Red and Orange Vegetables
Carrots
1 cup, strips, slices, or chopped,
raw or cooked
2 medium
1 medium carrot
1 cup baby carrots (about 12)
About 6 baby carrots
Pumpkin
1 cup mashed, cooked
Red peppers
1 cup chopped, raw, or cooked
1 large pepper (3" diameter, 3¾"
long)
1 small pepper
Tomatoes
1 large raw whole (3" diameter)
1 cup chopped or sliced, raw,
canned, or cooked
1 small raw whole (2¼"
diameter)
1 medium canned
Tomato juice
1 cup
½ cup
Sweet potato
1 large baked (2¼" or more
diameter)
1 cup sliced or mashed, cooked
Winter squash (acorn,
butternut, Hubbard)
1 cup cubed, cooked
½ acorn squash, baked = ¾ cup
Beans and Peas
Dry beans and peas (black,
garbanzo, kidney, pinto, or soy
beans, or black eyed peas or
split peas)
1 cup whole or mashed, cooked
(continued on next page)
Healthy Express Lesson 1
107
(continued from previous page)
Amount that counts as
1 cup of vegetables
Amount that counts as ½
cup of vegetables
Dark Green Vegetables
Broccoli
1 cup chopped or florets
3 spears, 5" long raw or cooked
Greens (collards, mustard
greens, turnip greens, kale)
1 cup cooked
Spinach
1 cup, cooked
Raw leafy greens (spinach,
romaine, watercress, dark
green leafy lettuce, endive,
escarole)
2 cups raw is equivalent to 1 cup
of vegetables
1 cup raw is equivalent
to ½ cup of vegetables
2 cups raw is equivalent to 1 cup
of vegetables
1 cup raw is equivalent
to ½ cup of vegetables
Starchy Vegetables
Corn, yellow or white
1 cup
1 large ear (8” to 9” long)
Green peas
1 cup
White potatoes
1 cup diced, mashed
1 small ear (about 6" long)
1 medium boiled or baked potato
(2½" to 3" diameter)
French fries: 20 medium to long
strips (2½" to 4" long);contains
added calories from solid fats
(continued on next page)
108
Healthy Express Lesson 1
(continued from previous page)
Amount that counts as
1 cup of vegetables
Amount that counts as ½
cup of vegetables
Other Vegetables
Bean sprouts
1 cup cooked
Cabbage, green
1 cup, chopped or
shredded, raw or cooked
Cauliflower
1 cup pieces or florets, raw or
cooked
Celery
1 cup, diced or sliced, raw or
cooked
2 large stalks (11" to 12" long)
Cucumbers
1 cup raw, sliced or chopped
Green or wax beans
1 cup cooked
Green peppers
1 cup chopped, raw or cooked
1 large stalk (11" to 12" long)
1 large pepper (3"
diameter, 3¾" long)
1 small pepper
Lettuce, iceberg or head
2 cups raw, shredded or chopped
is equivalent to 1 cup of
vegetables
1 cup raw, shredded or
chopped is equivalent to
½ cup of vegetables
Mushrooms
1 cup raw or cooked
Onions
1 cup chopped, raw or cooked
Summer squash or zucchini
1 cup cooked, sliced or diced
Healthy Express Lesson 1
109
What counts as a cup in the dairy group?
In general, 1 cup of milk, yogurt, or soymilk (soy beverage), 1½ ounces of natural cheese, or 2
ounces of processed cheese can be considered 1 cup from the dairy group. The chart lists
specific amounts that count as 1 cup in the dairy group toward your daily recommended intake.
Amount that counts as a cup in
the dairy group
Common portions and
cup equivalents
Milk
[choose fat-free or
low-fat milk]
1 cup milk
1 half-pint container milk
½ cup evaporated milk
Yogurt
[choose fat-free or
low-fat yogurt]
1 regular container (8 fluid ounces)
1 small container
(6 ounces) = ¾ cup
1 cup yogurt
1 snack size container
(4 ounces) = ½ cup
1 ½ ounces hard cheese (cheddar,
mozzarella, Swiss, Parmesan)
1/3 cup shredded cheese
1 slice of hard cheese is equivalent to ½
cup milk
2 ounces processed cheese (American)
½ cup ricotta cheese
1 slice of processed cheese is equivalent
to 1/3 cup milk
2 cups cottage cheese
½ cup cottage cheese is equivalent to ¼
cup milk
Cheese
[choose reducedfat
or low-fat cheeses]
Milk-based
desserts
[choose fat-free or
low-fat types]
Soymilk
(soy beverage)
110
1 cup pudding made with milk
1 cup frozen yogurt
1 ½ cups ice cream
1 scoop ice cream is equivalent to 1/3
cup milk
1 cup calcium-fortified soymilk
1 half-pint container calcium-fortified
soymilk
Healthy Express Lesson 1
What counts as an ounce equivalent in the protein group?
In general, 1 ounce of meat, poultry or fish, ¼ cup cooked beans, 1 egg, 1 tablespoon of peanut
butter, or ½ ounce of nuts or seeds can be considered a 1 ounce equivalent from the protein
foods group. The chart lists specific amounts that count 1 ounce equivalent in the protein group
toward your daily recommended intake.
Amount that counts as 1 ounce
equivalent in the protein foods
group
Common portions and ounce
equivalents
1 ounce cooked lean beef
1 small steak (eye of round, filet) = 3½ to 4
ounce equivalents
1 ounce cooked lean pork or ham
1 small lean hamburger =
2 to 3 ounce equivalent
1 ounce cooked chicken or turkey,
without skin
1 small chicken breast half =
3 ounce equivalent
1 sandwich slice of turkey
(4 ½ x 2 ½ x 1/8”)
½ Cornish game hen =
4 ounce equivalent
1 ounce cooked fish or shell fish
1 can of tuna, drained =
3 to 4 ounce equivalents
1 salmon steak =
4 to 6 ounce equivalents
1 small trout = 3 ounce equivalent
Eggs
1 egg
3 egg whites = 2 ounce equivalent
3 egg yolks = 1 ounce equivalent
Nuts and
seeds
½ ounce of nuts (12 almonds, 24
pistachios, 7 walnut halves)
½ ounce of seeds (pumpkin, sunflower or
squash seeds, hulled, roasted)
1 tablespoon of peanut butter or almond
butter
1 ounce of nuts or seeds =
2 ounce equivalent
¼ cup of cooked beans (such as black,
kidney, pinto, or white beans)
¼ cup of cooked peas (such as chickpeas,
cowpeas, lentils, or split peas)
¼ cup of baked beans, refried beans
1 cup split pea soup =
2 ounce equivalent
1 cup lentil soup =
2 ounce equivalent
1 cup bean soup =
2 ounce equivalent
¼ cup (about 2 ounces) of tofu
1 ounce tempeh, cooked
¼ cup roasted soybeans 1 falafel patty
(2 ¼”, 4 ounces)
2 tablespoons hummus
1 soy or bean burger patty =
2 ounce equivalent
Meats
Poultry
Seafood
Beans and
peas
Healthy Express Lesson 1
111
How much is my allowance for oils?
Some Americans consume enough oil in the foods they eat, such as:

Nuts,

Fish,

Cooking oil, and
 Salad dressings.
Others could easily consume the recommended allowance by substituting oils for some solid fats
they eat. A person’s allowance for oils depends on age, sex, and level of physical activity. Daily
allowances are shown in the chart.
Daily Allowance*
Children
Girls
Boys
Women
Men
2-3 years old
3 teaspoons
4-8 years old
4 teaspoons
9-13 years old
5 teaspoons
14-18 years old
5 teaspoons
9-13 years old
5 teaspoons
14-18 years old
6 teaspoons
19-30 years old
6 teaspoons
31-50 years old
5 teaspoons
51+ years old
5 teaspoons
19-30 years old
7 teaspoons
31-50 years old
6 teaspoons
51+ years old
6 teaspoons
*These amounts are appropriate for individuals who get less than 30
minutes per day of moderate physical activity, beyond normal daily
activities. Those who are more physically active may be able to
consume more while staying within calorie needs.
112
Healthy Express Lesson 1
Fiber FAQs
What is fiber? Fiber is a type of carbohydrate (like sugars and starches) found in plant foods.
Unlike sugar and starches, fiber is not digested (broken down) by the human body, and therefore
does not contribute any calories. There are two types of fiber: insoluble, or “roughage,” found in
fruit and vegetable skins, whole grain husks, and nuts; and soluble, found in citrus fruits, apples,
barley, oatmeal, oat bran, peas and beans.
What can fiber do?

Absorb water in the intestine and help relieve constipation (insoluble fiber)

Help lower blood cholesterol level (soluble fiber)

Aid in weight loss (the added bulk helps you feel full with less food)
Do I need to take a fiber supplement? No. A diet containing a variety of fruits, vegetables, and
whole grains should provide adequate fiber as well as essential vitamins and minerals.
How should I increase the fiber in my diet?
Eat at least 5 servings of vegetables and fruits and at least 2 servings of whole grain products
each day. The recommended goal for daily fiber intake is 25-35 grams. Increase the amount of
fiber in your diet slowly over several weeks to allow your body to adjust and avoid stomach
discomfort. Be sure to drink more water as you increase fiber in your daily diet. Following are
some examples of high fiber fruits, vegetables, and grains.
High Fiber Fruits (serving size is ½ cup fresh unless otherwise noted):
Over 3 grams fiber per serving: prunes (5 dried), raisins, apple (unpeeled), pear, blackberries
2-3 grams fiber per serving: blueberries, orange, apple (peeled), raspberries, banana
High Fiber Vegetables (serving size is ½ cup fresh unless otherwise noted):
Over 3 grams fiber per serving: Brussels sprouts, canned pumpkin, potato with skin, kidney
beans
2-3 grams fiber per serving: mushrooms, carrot (1 large), spinach (2 cups), broccoli, green peas
Bread, Cereal, Rice, and Pasta (check the Nutrition Facts label on food packaging for fiber
content):

High fiber choices: bran, including oat and wheat bran; brown rice, buckwheat, oatmeal;
foods made with whole oats, rye flour, wild rice, or whole-wheat flour

Cereals that contain 5 grams of dietary fiber or more per serving are considered high
fiber.

Whole-grain breads that list whole wheat, whole-wheat flour or another whole grain as
the first ingredient on the label and have at least 2-3 grams of dietary fiber per serving
are good sources of fiber.
Healthy Express Lesson 1
113
Adapted from University of Wisconsin Health Services. (2011). Fiber. Retrieved from
http://www.uhs.wisc.edu/health-topics/digestive-system/fiber.shtml
114
Healthy Express Lesson 1
Creating Breakfast and Lunch Meal Plans
Step 1: Available Food
Write the names of foods in your refrigerator or cupboards that will need to be eaten soon. Items
such as fresh fruits and vegetables and dairy products tend to spoil fastest. Keep these items in
mind when you are thinking about menus for each meal.
Step 2: Sale Items
Take into consideration the weekly sales at your grocery store or coupons for items you
frequently purchase. Don’t clip the coupon if you and your family won’t eat it. Record these items.
Step 3: Make a Calendar
Create a list of foods that you like to eat for breakfast and lunch. Then, on the calendar, plan out
what you will eat each day. Aim to eat a variety of foods from day to day. Are there some days
that are especially busy? If so, plan leftovers or simple meals for these days.
Breakfast Plan: Don’t skip breakfast! It can help give you a better start to your day. Breakfast
also gives you a good opportunity to get nutrients like fiber and calcium that may be lacking in
your diet.

Try to create a breakfast that includes foods from three of the five food groups.

Try to include one whole-grain item in most of your breakfasts.

Cereals with 5 or more grams of fiber per serving are considered high fiber.

A healthy breakfast does not have to be cooked or even include traditional "breakfast
foods."

Quick and healthy ideas for breakfast: yogurt mixed with whole grain cereal and sliced
fresh fruit; whole grain frozen waffles or toast topped with peanut butter and a glass of
milk; a boiled egg over an English muffin with a glass of vegetable juice

Lunch Plan: Skipping lunch may set you up for low energy or overeating later. Lunch gives you a
good opportunity to get in a serving or two of vegetables.

Try to create a lunch that includes foods from four of the five food groups.

Leftovers make a quick and easy lunch.

Quick and healthy ideas for lunch: pita pocket stuffed with lean turkey, low-fat cheese
and tomatoes; left-over chili with half of a whole-grain tortilla and red pepper strips;
chicken salad with grapes and cucumbers on whole-grain crackers
Healthy Express Lesson 1
115
Step 4: Compare to MyPlate
Check if each breakfast and lunch has foods from the recommended number of food groups.
Does your plan include a variety of foods?
Adapted from University of Nebraska-Lincoln. (2011.). Nebraska’s Nutrition Education Program: Meal planning and
shopping. Retrieved from http://liferay.unl.edu/web/nep/meal-planning-and-shopping-lesson
116
Healthy Express Lesson 1
Tips for Healthy Express Meals

Stock the refrigerator and your desk with healthy and portable snacks, such as small
bottles of flavored low-fat milk, easy-to-eat yogurt tubes, cubed cheese, whole grain
cracker packs, low-fat string cheese, snack bags of mini carrots and pre-measured bags
of nuts. These can be combined for emergency on-the-go meals.

Make a batch of smoothies with fruit and low-fat milk, and freeze in individual containers.
Thaw one out for breakfast while you are in the shower.

Pack lunches the night before.

Form a lunch group with three or four other health-minded co-workers, with each member
taking turns bringing a nutritious, low-calorie lunch for everyone once a week.

Keep pre-cut fruits, ready-to-eat vegetables, and a small bowl of low-fat dip on the most
visible shelf in the refrigerator to quickly complement your lunches.

For faster, healthier lunches, stock no-fuss bagged salads, individually frozen poultry
pieces, and plenty of canned and frozen vegetables.

Consider grilling extra chicken at dinner to slice and freeze for quick chicken quesadillas
or barbecue chicken sandwiches, or to add to soup.
Your Own Ideas
Healthy Express Lesson 1

__________________________________
__________________________________
____________

__________________________________
__________________________________
____________

__________________________________
__________________________________
117
Healthy Express Calendar
118
Healthy Express Lesson 1
Healthy Express Lesson 1
119
120
Healthy Express Lesson 1
Healthy Express Lesson 1
121
Date: _______________
Goal Setting Worksheet
Short-term goals are specific and intended to be accomplished in a short timeframe. Short-term
goals should be:

Clear and specific;

Something you can accomplish in about 1-2 weeks;

Something you really want to do;

Personal (creating expectations of yourself and not other people);

Positive;

Stated in the present tense; and

Brief enough to commit to memory.
Write one or two short-term goals along with several strategies to help you meet these
goals. The following example may help you.
Example
Goal: Replace two of my usual snacks this week with fruit or vegetables.
Strategy 1: Buy baby carrots and cut-up broccoli and vegetable dip at the store.
Strategy 2: Set out a bowl filled with apples on the counter.
Strategy 3: Don’t buy cookies or chips for snacks.
Short-Term Goal #1: ________________________________________________________
__________________________________________________________________________
Strategy 1: _________________________________________________________________
__________________________________________________________________________
Strategy 2: ________________________________________________________________
__________________________________________________________________________
Strategy 3: _________________________________________________________________
__________________________________________________________________________
122
Healthy Express Lesson 1
Short-Term Goal #2: ________________________________________________________
__________________________________________________________________________
Strategy 1: _________________________________________________________________
__________________________________________________________________________
Strategy 2: ________________________________________________________________
__________________________________________________________________________
Strategy 3: _________________________________________________________________
__________________________________________________________________________
For each goal, think about how you would answer the following questions:
•
How will you keep your goals on your mind (post on refrigerator, write on calendar, etc.)?
•
Who will support you in meeting your goals?
•
What roadblocks can you anticipate and how will you get around these?
4. How will you reward yourself for taking action?
Date of next counseling lesson: _____________________
Please bring this worksheet to your next lesson.
Healthy Express Lesson 1
123

Healthy Express: Lesson 2
Objectives
By the end of this lesson, the participant will be able to:

Assess current food choices made on the go from fast-food restaurants, convenience
stores, and the like, for ways to improve their healthfulness (nutritional value).

Examine convenience items, such as meal replacement bars and beverages, for
healthfulness.

Recognize how beverage choices and portion size affects daily calorie and nutrient
intakes.

Practice making healthy choices for foods eaten quickly, at home and away from home.
Time for this Lesson: 50-60 minutes
Activities in this Lesson
1. Introduction and Review (7 minutes)
2. Stop-n-Go Eating (7 minutes)
3. Adding It Up (10 minutes)
4. Fast Food – Beyond Fast-Food Restaurants (7 minutes)
5. Bar Exam (5 minutes)
6. Rethink Your Drink (7 minutes)
7. Review and Goal Setting (7 minutes)
Preparation and Handouts Needed
Preparation
124

Print and prepare handouts as directed below.

Bring fake money, including bills in $1, $10, $20, and $100 denominations. NOTE: You
can make $100 bills by printing out the $100 InSNC bills included in the Fake Money
handout in the Basic Nutrition Lesson. You can make the other bills by revising the
denominations on the $100 InSNC bills, then printing out what you need.
Healthy Express Lesson 2

After reviewing the participant's needs assessment form to determine which fast-food
restaurant menus are relevant, print out them out (including nutrition information) from
http://www.bd.com/us/diabetes/hcp/main.aspx?cat=3066&id=3285.

Bring a calculator.

For the "Rethink Your Drink" activity, bring:

About a half pound of sugar;

Three 8-ounce plastic cups;

One-teaspoon measuring spoon; and

A clear, 20-ounce soda bottle without the soda, but filled with 14 teaspoons of sugar
(before the lesson).
Handouts

Goal Setting Worksheet

Stop 'n Go Eating (Print double-sided with Adding It Up Worksheet.)

Adding It Up Worksheet (Print double-sided with Stop 'n Go Eating.)

Thinking Outside the Kitchen: Healthy Choices

Frozen Meals Purse Card (Print sheet and cut out individual cards on card stock or on
regular paper and laminate.)

Vending Machine Purse Card (Print sheet and cut out individual cards on card stock or
on regular paper and laminate.)

Energy and Snack Bar Comparison Chart (pdf and available from
http://www.runnersweb.com/running/EnergySnackBarChart.pdf

Snack and Meal Replacement Bars Purse Card (Print sheet and cut out individual
cards on card stock or on regular paper and laminate.)

List of Common Drinks

Rethink Your Drink (optional)
Healthy Express Lesson 2
125
Activities
1. Introduction and Review (7 minutes)
Review points from the last lesson. Ask the participant what she remembers or what was most
notable from the last lesson.
Use Goal Setting Worksheet to record responses.
Questions to Guide Discussion

How did you do with your goals from the last lesson? (insert goals)

What went well?

What did you struggle with?

What were some of the barriers?
2. Stop 'n Go Eating (7 minutes)
First discuss the nutritional differences between foods made at home and those consumed when
eating out. Also talk about what instances would be considered eating out.
Here’s what the latest literature says about the nutritional differences between meals prepared
and eaten at home and meals eaten away from home. Meals eaten away from home usually
contain:
1

More calories, saturated fat, sodium and cholesterol, and

Less fiber, calcium and iron.
1
Eating on the go not only includes meals eaten away from home, but also things, such as snacks
and beverages, that “tide you over” until the next meal.
Talk with the participant about the importance of being aware of these on-the-go eating
behaviors, i.e., what she’s doing and how often she’s doing it, because these bites and sips often
add up to an unexpectedly high number of calories.
Have the participant think about the times she eats on the go (when time is a priority).
Question to Guide Discussion

In general, what is the most important thing to you when eating on the go?
(For the facilitator: Because this is the Healthy Express need state, the participant may
typically value health. This probing gives the participant the opportunity to re-state that
focus or to reveal discrepancies.)
126
Healthy Express Lesson 2
Next, read through the examples on the Stop 'n Go Eating handout and ask the participant to
write information about at least one recent or habitual stop 'n go eating occasion. (If necessary,
use the information from the participant’s needs assessment to prompt for places she frequents
when eating outside the home.)
As homework for the next session, have the
participant complete the remainder of Stop 'n
Go Eating. Suggest she keep the handout in a
handy spot, such as her purse or car.
3. Adding It Up (10 minutes)
First, distribute fake money for a 1,800 or 2,000 calorie diet (depending on the participant’s
needs) with 1 calorie equaling $1 (one dollar). Then, using the fast food menus and nutrition
information you printed out, have the participant complete the Adding It Up Worksheet. Once
completed, have her count out what her fast food meal “cost” her.
Discuss with the participant the stresses that fast-food meals can put on a day's “food budget,”
particularly since according to one survey, 75 percent of individuals eat out at least once a week
2
and 25 percent eat out 2-3 times per week.
Ask the participant to recall the composition of optimally healthy breakfasts and lunches.
A healthy breakfast includes:

Foods from three of the five food groups

One whole-grain item

Fiber and calcium
A healthy lunch includes:

Food from four of the five food groups

A serving or two of vegetables
Using the Thinking Outside the Kitchen: Healthy Choices handout, have the participant
identify a healthier choice from the fast-food menu to replace her original choice named on the
Adding It Up Worksheet. Then have her re-do the math.
Healthy Express Lesson 2
127
4. Fast Food – Beyond Fast-Food Restaurants (7 minutes)
Talk with the participant about where her stop 'n go eating occurs in addition to fast food
restaurants. If she needs prompting, suggest vending machines, convenience stores, and coffee
or smoothie shops.
Review the pertinent sections of Thinking Outside the Kitchen: Healthy Choices with the
participant. Have her write down two or three strategies that she will try to incorporate in her daily
eating occasions and write them on the “Personal Summary” page of the handout.
Give the participant a Frozen Meals Purse
Card and a Vending Machine Purse Card.
5. Bar Exam (5 minutes)
Ask participant if she purchases snack and meal
replacement bars or drinks. If not, you may want
to review the content, but skip the activity in this
section.
Discuss the advantages and disadvantages of snack or meal replacement bars or drinks; inform
the participant of the need to know what to look for in these kinds of products given the wide
variety available.

Advantages of such bars include:

Portion controlled

Easy and portable

Can provide a well-balanced snack with fiber and protein

Disadvantages include:

Expense

Potential for such bars to be glorified candy bars, with high sugar and fat content, i.e.,
empty calories
Whole foods, such as fruit, vegetables and whole grains, are always a better nutrition bet than
bars, especially for meals.
Review the "Choosing Snack and Meal Replacement Bars or Drinks" section of Thinking
Outside the Kitchen: Healthy Choices. Next, explain the 5:100 Rule: Add the total grams of
fiber and total grams of protein, using a calculator, if necessary. If the sum equals 5 grams or
more per 100 calories, the bar should satisfy hunger.
128
Healthy Express Lesson 2
Using the Energy and Snack Bar Comparison Chart, have the participant choose a bar she
often buys (or a type of bar she might choose) and apply the 5:100 Rule.
Give the participant a Snack and Meal
Replacement Bars Purse Card.
6. Rethink Your Drink (7 minutes)
Talk with the participant about the importance of choosing healthy beverages. Mention that:

A study reported in the Journal of the American Medical Association found that higher
intake of sugar-sweetened beverages was associated with increased weight gain and risk
3
of type 2 diabetes in women.

Drinking one sugar-sweetened beverage per day, without cutting back on calories, for a
4
year could cause a weight increase of 15 pounds.
Use the following activity to visually demonstrate the amount of sugar in soda and other drinks.
Explain that for a 2,000-calorie diet, the Dietary Guidelines for Americans recommends that
added sugars and solid fats (called SoFAS) amount to no more than 13 percent of total daily
5
intake. That is roughly 65 grams, or15 teaspoons. Tell the participant that this activity assumes
that the allotted calories for SoFAS are consumed solely through added sugars.
Next, place 15 teaspoons of sugar in one of the 8-ounce plastic cups. Now show the participant
the 20-ounce clear soda bottle pre-filled with sugar. Explain that the bottle contains 14 teaspoons
of added sugar, about the same amount in a 20-ounce bottle of regular (not diet) soda – with 1
teaspoon of sugar equaling 4.2 grams.
Have the participant pick a beverage she drinks from the List of Common Drinks and repeat the
activity, measuring out the number of teaspoons of added sugar for that beverage into another 8ounce cup. Compare it to the first cup containing the maximum amount of SoFAS that should be
consumed daily (15 teaspoons). Help her understand that if a 20-ounce bottle of regular soda
contains 13-14 teaspoons of added sugar, drinking just one bottle uses up nearly all the
recommended daily allowance of SoFAS.
Finally, show the participant an empty 8-ounce cup, and say it represents the amount of added
sugar in any amount of water, milk and 100 percent fruit juice, i.e., zero. This leaves her free to
consume more SoFAS, if she wishes, from more healthful foods.
You may also want to provide the participant with the Rethink Your Drink handout. This is
optional.
Healthy Express Lesson 2
129
7. Review and Goal Setting (7 minutes)

Ask the participant if she has any questions.

Have the participant discuss one or two things she learned today.

Have the participant set goals for the next two weeks using the Goal Setting Worksheet.

Review homework for Stop 'n-Go Eating, if applicable, and remind the participant to
bring it to the next session.

Schedule the date and time of the next lesson.

Briefly describe the topic and activities for the next lesson to arouse interest:

130
•
Find nutrition information online and print it out for guidance on controlling calorie
intake and consuming all necessary nutrients daily.
•
Make a recipe or menu file of healthy foods or meals that can be prepared and eaten
quickly.
•
Understand the benefits of eating organic foods and "superfoods."
Thank the participant for coming.
Healthy Express Lesson 2
Sources Cited
1. Lin, B., Frazão, E., & Guthrie, J. (1999, January). Away-from-home foods increasingly
important to quality of American diet (Agriculture Information Bulletin No. 749). Washington,
D.C.: Economic Research Service, U.S. Department of Agriculture.
2. Stewart, H., Blisard, N., & Jolliffe, D. (2006, October). Let’s eat out: Americans weigh taste,
convenience, and nutrition (Economic Information Bulletin No. 19). Washington, D.C.: U. S.
Department of Agriculture, Economic Research Service.
3. Schulze, M.B., Manson, J.E., Ludwig, D.S., Colditz, G.A., Stampfer, M.J., Willett, W.C., & Hu,
F.B.. (2004). Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in
young and middle-aged women. Journal of the American Medical Association, 292(8), 927934.
4. Harvard School of Public Health. (n.d.). Sugary drinks or diet drinks: What’s the best choice?
Retrieved from http://www.hsph.harvard.edu/nutritionsource/healthy-drinks/sugary-vs-dietdrinks/index.html
5. U.S. Department of Agriculture, U.S. Department of Health and Human Services. (2010,
December). Dietary guidelines for Americans, 2010 (7th ed.). Washington, D.C.: U.S.
Government Printing Office.
Healthy Express Lesson 2
131
Date: _______________
Goal Setting Worksheet
Goal Check-In
Think about your goals from last time and answer the following:
1. Which goals did you achieve?
2. What did you find easy to do?
3. What roadblocks did you encounter and how did you cope with these?
4. If you didn’t reach your goals, how might you revise them to make them more
manageable?
New Goals for Next Lesson
Write down one or two short-term goals you would like to work on before your next
nutrition counseling lesson related to the topics you discussed today.
Short-Term Goal #1: ________________________________________________________
__________________________________________________________________________
Strategy 1: _________________________________________________________________
__________________________________________________________________________
Strategy 2: ________________________________________________________________
__________________________________________________________________________
Strategy 3: _________________________________________________________________
__________________________________________________________________________
132
Healthy Express Lesson 2
Short-Term Goal #2: ________________________________________________________
__________________________________________________________________________
Strategy 1: _________________________________________________________________
__________________________________________________________________________
Strategy 2: ________________________________________________________________
__________________________________________________________________________
Strategy 3: _________________________________________________________________
__________________________________________________________________________
Date of next counseling lesson: _____________________
Please bring this worksheet to your next lesson.
Healthy Express Lesson 2
133
Stop 'n Go Eating: What? Where? When? How
Often?
Fill out this worksheet to record the times you buy something to eat while on the go. Examples
are in italics. Start making your entries in the empty boxes.
Where did you
stop?
What did you get?
What was going on/
what were you
doing?
What time of
day was it?
Was this
planned?
How many
days per
week do you
make these
types of
stops?
Gas station
Snickers bar
Bottle of green tea
Stopped for gas while
running errands
Afternoon
No, I was
hungry
because I
skipped lunch
1
Coffee shop
Small vanilla skim
latte
Bran muffin
On my way to work
Morning
Yes, it’s my
breakfast
ritual
3-4
When you're done, circle the occasion you think is least healthful in red. Circle the occasion you
think is most healthful in green.
134
Healthy Express Lesson 2
Adding It Up Worksheet
Name a place where you sometimes catch a quick bite to eat:
__________________________________________________________________________
List the food or menu items (including beverages) that you usually get at this place:
Food Item
Calories
Total Meal Calories:
Now, do the math:
1. Total calories recommended per day for you (1,800 or 2,000):
2. Total meal calories (recorded in the chart above):
Subtract Line 2 from Line 1 to obtain the remaining calories you can eat that day and stay within
your recommended limit.
List some healthier foods you could choose next time you grab a bite at this place so you
spend less on your daily calorie "budget" and can eat more later in the day.
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
Healthy Express Lesson 2
135
Thinking Outside the Kitchen: Healthy Choices
At Fast-Food Restaurants

Choose small (or even children’s) sizes. Is the good “value” really worth all those extra
calories?

Choose simple. A regular hamburger has 250-300 calories and 9-12 grams fat.

Choose the chicken. When in doubt, order grilled, baked or broiled — not fried or
breaded.

Go for whole-wheat. Whole-wheat buns have more fiber than regular white bread. Some
restaurants (including McDonald’s) offer wheat buns as an alternative — all you have to
do is ask.

"Veg out" on the sandwich. Ask for tomato, lettuce, onion, or other veggies on your
sandwich.

Thin crust it. Go for a thin-crust pizza with veggies instead of a thick-crust with meats.

Avoid double meat and bacon. A serving size of meat (2-3 ounces) is about the size of
a deck of cards.

Go light on the sauce, or skip it altogether. There are lots of hidden calories in mayo,
sour cream, salad dressing and other “special” sauces. Mustard, catsup, and barbecue
sauce are better bets.

Skip the sides. Eating a burger or sandwich by itself is often filling enough. If you do
want a side dish, consider ordering a fruit cup or small salad. Most fast-food restaurants
now offer these options.

Swap out the fries and onion rings. Order a side salad, with light dressing, or baked
potato instead.

Pass on the regular soda and shakes.

Treat yourself. Go for low-fat frozen yogurt, fruit popsicles, sorbets, and sherbets, rather
than ice cream or cookies. Sprinkles are lower in calories than caramel or chocolate
sauces.

Know before you go. Most chain restaurants post their nutrition information online, and
it is also available at the counter. Keep the information handy in your car’s glove
compartment.
At Smoothie Places
136

Order the smallest size available. Order a child’s size if available.

Order smart. Ask to see the nutrition information for each type of smoothie and pick the
one with the fewest calories.
Healthy Express Lesson 2

Hold the sugar. Many smoothies contain added sugar in addition to the sugar naturally in
fruit, juice, or yogurt. Ask that your smoothie be prepared without added sugar.

In general, smoothies purely made of fresh fruit and ice contain fewer calories than those
made with milk or yogurt; those made with fat-free milk contain fewer calories than those
made with fat-free yogurt.

At Coffee Shops

Go "skinny." Request that your drink be made with fat-free or low-fat milk instead of
whole milk.

Order the smallest size available.

Forgo the extra flavoring. The flavor syrups are sugar-sweetened and mean extra
calories. Or try sugar-free syrups now offered by many places.

Skip the whip. The whipped cream on top of coffee drinks adds calories and fat.

Get back to basics. Order a plain cup of coffee with fat-free milk or drink it black.

Try tea. It’s calorie-free and there are many different flavors to tempt you.

At Continental Breakfast Buffets

Fill up on a variety of fresh fruit. Try fruit you wouldn’t normally buy.

Enjoy a small serving (1/2 cup or less) of granola. This contains significant calories
and fat, so eat in moderation — golf-ball size or small handful. Mix granola with low-fat
yogurt or milk.

Sneak in a serving of vegetables by ordering tomato or vegetable juice.

Pick up a cup of low-fat yogurt and top it with granola, whole-grain cereal, or fresh fruit.

Enjoy low-fat or fat-free milk with whole-grain and fiber-filled (at least 3 grams per
serving) cereal.

Go for the oatmeal. It is almost standard in breakfast bars and even the instant kind
provides some whole grains and fiber.

A hard-boiled egg is a good source of protein that will help keep you satisfied longer.

Choose an English muffin over a bagel. The average gourmet bagel contains over 400
calories.

Top it with protein. A small cup of peanut butter is portion-controlled and a good source
of satisfying protein (5 grams protein and 120 calories in ¾ ounce).

Avoid bear claws, pastries, and make-your-own waffles. All these are high in fat and
calories; they are also mainly refined carbohydrates, setting you up for a blood sugar high
and a crash soon after.
Healthy Express Lesson 2
137

Watch out for croissants. Even a small croissant contains almost 9 grams of fat and
170 calories.

Skip the big muffins. Large muffins can easily have 300-400 calories. Enjoy a single
mini-muffin instead.
At Salad Bars
138

Color your plate. The richer the colors, the higher the antioxidants. Start with darker
greens, such as spinach or romaine lettuce, and add reds, oranges, yellows, and purples,
as well as more greens.

Be adventurous! Use the opportunity to try new vegetables or fruits.

Fresh is best. Undressed vegetables or fruit should make up ½ to ¾ of your salad.

Avoid pre-dressed salads, such as coleslaw, tuna, potato, and pasta salads. The
mayo or oil-based dressing tips the scales for fat and calories. If you must have a predressed salad, take only a condiment-size serving.

"Power up" with smart protein choices. Balance out your salad with healthy protein
sources, such as grilled chicken or shrimp, tuna, beans, or low-fat cottage cheese.

Love legumes. Beans and chickpeas are a terrific high-fiber addition to your salad.

Dress smart. Two tablespoons of regular dressing can contain over 160 calories and 16
grams of fat. One salad bar ladle can contain over 4 tablespoons of dressing.

Avoid creamy dressings. Types like Ranch and Caesar tend to be higher in saturated
fats. Use dressings made with heart-healthy fats, such as an olive or canola oil.

Do-it-yourself dressing. Try a splash of seasoned vinegar and olive oil. Use low-fat
cottage cheese and fresh pepper if you prefer creamier dressings.

Dip, don’t dress. Place dressing on the side and dip the tip of your fork in it. You get the
flavor punch with fewer calories.

Go for the good fats. Avocado, olives and nuts can enhance a salad with flavor and
"good" monounsaturated fats. Just remember that a little bit of these toppings goes a
long way.

Watch the last-minute toppings. Cheese, nuts, seeds, bacon, olives, croutons and fried
chow mein noodles can rack up the calories and fat. Pick one or two and use sparingly.

Don’t be too cheesy. Use a sprinkle of a stronger-flavored cheese, like sharp cheddar,
parmesan or feta cheese; bigger flavors require smaller portions.

Soup it up. Broth or vegetable-based soups (rather than cream-based ones) make a
filling and healthy accompaniment to your salad.

Start smaller. If you have a tendency to overdo it at salad bars, as well as any kind of
buffet, try using a smaller plate or container. It helps you eat less and still feel satisfied.
Healthy Express Lesson 2
At Convenience Stores and Vending Machines

Buyer be aware: Think about what you really need: a snack or a meal.
•
If you're looking for something to keep you going for awhile, try choosing from a
variety of food groups. Include some protein and fiber.
•
For a snack, look for between 100 and 250 calories.
•
Always check serving size and calories per serving on the label.

Don't get snack amnesia. Later in the day, it's easy to forget about that fresh
convenience store cookie you ate. Write down what you eat to jog your memory.

Choose water or no-calorie beverages. Calories put the "energy" in energy drinks.

Control the crave. Buy a small or single pack if nothing will satisfy you except a bite of
your favorite treat; eat only 100 calories or less.

Be snack savvy. At vending machines you can’t usually read labels, so stick with items
you know are healthy and calorie-controlled.

Use the chart below for help making healthy choices.
Snack Options: Convenience Stores and Vending
Machines
Foods
Healthiest
Healthier
Once-in-Awhile
Nuts and seeds—plain or with spices
Sugar coated or honey roasted nuts
Chocolate or yogurt-covered nuts
Trail mix—Whole grain cereals (with
no added sugars) and dried fruit (no
added fat)
Popcorn/nut mix with no salt or butter Trail mix with chocolate, yogurt, or
candy
Fresh fruit, canned or single-serve
fruit cups with natural juices only
Canned or single-serve fruit cups in
light syrup
Canned or single-serve fruit cups in
heavy syrup
Unbuttered, no salt popcorn
Light popcorn
Popcorn—butter or "movie style"
Granola bars, whole-grain fruit bars
Animal crackers, graham crackers
Cookies (including low-fat)
Dried fruit—raisins, dried cranberries,
100% fruit leather
Whole-grain pretzels
Chocolate or sugar-coated dried fruit
Pretzels
Low-fat beef jerky
Chocolate- or yogurt-covered pretzels
Sausages, pork rinds
Yogurt, preferably non-fat, low-fat, or
light
Mozzarella string cheese, reduced-fat Regular cheese
cheese cubes
Fat-free pudding
Sugar-free gelatin
Pudding made with whole milk
Chart adapted from YMCA of Greater San Antonio. (2002, December). Healthy vending guidelines: A Fit
City initiative. San Antonio, TX: Fit City: The Health Collaborative.
Healthy Express Lesson 2
139
Choosing Snack and Meal Replacement Bars or Drinks

Feed your need.

As a meal replacement, choose bars with at least 250-300 calories and 10 to 15
grams protein.

For a light snack, look for a bar with 100 to 200 calories and at least 3 grams of fiber.

Bars with 5 grams of protein or more should satisfy your hunger.

Use the 5:100 rule. Add the grams of fiber to the grams of protein in the bar. If they add
up to 5 (for every 100 calories), the bar will keep you satisfied longer.

Avoid trans fat. A company can list a product as having zero grams of trans fat even
when it has up to 0.5 grams per serving. If you see partially hydrogenated oils or
shortening listed in the ingredients of a meal replacement bar, choose another kind.

Limit saturated fat. Look for less than 2 grams.

Look for whole grains, such as rolled oats, whole wheat, or barley, listed as one of the
first ingredients.

Substitute for low protein. If the bar you choose is low in protein, try eating it with a few
nuts or some low-fat dairy.

Beware of too much of a good thing. Many bars are fortified so you could end up with
too much iron and vitamin A. Look for bars with no more than 100 percent of your RDA.

Add a "side." Make a bar into a more nutritious meal by eating it with a piece of fruit,
which contains fiber, and/or a low fat dairy item that contains protein and calcium.

Rethink your drink. In general, meal replacement drinks and shakes are going to be
lower in fiber and other nutrients than the whole foods, such as raisins, nuts, or oats that
some bars provide.
Choosing Frozen Meals

Buyer be aware. Decide what you are looking for.

A light frozen dinner with no more than 300 calories and 8 grams of fat.

A regular frozen dinner with 360-500 calories and 25 grams of fat or less.

Ideally, you want no more than 500 calories and no more than 15 grams of fat in a
frozen dinner.

Add a side salad and/or a serving of fruit to round out your meal. This is even more
important if you're having a light frozen meal. Adding salad or fruit will boost the vitamin;
mineral and fiber content, and help fill you up. What good is a portion-controlled serving if
you‘re still hungry after you eat it?

Choose meals with less than 5 grams saturated fat and no trans fats.
140 Healthy Express Lesson 2 
Choose meals with less than 700 milligrams sodium.

Select meals with at least 2-5 grams of fiber.

Look for meals that include plenty of vegetables. They tend to be lower in calories and
higher in vitamins, minerals, and fiber.

Opt for meals with brown rice and other whole grains whenever possible.

Choose lean meat, fish, or chicken.

Read the label. Don't assume a product is healthy without checking the Nutrition Facts
label.
Healthy Express Lesson 2 141 Thinking Outside the Kitchen: Personal Summary
At Fast-Food Restaurants

___________________________________________________________________

___________________________________________________________________
At Smoothie Places

___________________________________________________________________

___________________________________________________________________
At Coffee Shops

___________________________________________________________________

___________________________________________________________________
At Continental Breakfast Buffets

___________________________________________________________________

___________________________________________________________________
At Salad Bars

___________________________________________________________________

___________________________________________________________________
At Convenience Stores and Vending Machines

___________________________________________________________________

___________________________________________________________________
Choosing Bars and Drinks for Meal Replacement or a Snack

___________________________________________________________________

___________________________________________________________________
Choosing Frozen Meals

142
___________________________________________________________________
Healthy Express Lesson 2
Healthy Express Lesson 2
143
144
Healthy Express Lesson 2
Energy and Snack Bar Comparison Chart
Healthy Express Lesson 2
145
146
Healthy Express Lesson 2
List of Common Drinks
Red Bull
Size: 8.3 oz can
Calories: 110
Fat: 0 g
Sugars: 27 g (about 7 tsp)
Dunkin Donuts Vanilla Bean Coolatta
Size: 16 fl oz
Calories: 500
Fat: 17 g
Sugars: 82 g (20.5 tsp)
Hawaiian Punch Juicy Red
Size: 8 fl oz
Calories: 120
Fat: 0 g
Sugars: 28 g (7 tsp)
Jamba Juice Green Tea Blast
Size: 16 fl oz
Calories: 340
Fat: 0 g
Sugars: 67 g (almost 17 tsp)
Hershey's Chocolate Milk
Size: 1 cup, or 8 fl oz
Calories: 270
Fat: 5 g
Sugars: 45 g (a little more than 11 tsp)
Gatorade Frost
Size: 20 oz bottle
Calories: 125
Fat: 0 g
Sugars: 35 g (almost 9 tsp)
McDonald's McFlurry with M&M's
candies
Size: 12 oz
Calories: 620
Fat: 20 g
Sugars: 85 g (a little more than 21 tsp)
Fuze Green Tea
Size: 8 fl oz
Calories: 60
Fat: 0 g
Sugars: 16 g (4 tsp)
Wendy's Chocolate Twisted Frosty with
M&M's
Size: 16 oz
Calories: 560
Fat: 19 g
Sugars: 72 g (18 tsp)
Glaceau Vitamin Water
Size: 20 oz
Calories: 125
Fat: 0 g
Sugars: about 33 g (a little more than 8 tsp)
Tropicana Fruit Smoothie
Size: 11 fl oz
Calories: 220
Fat: 0 g
Sugars: 44 g (11 tsp)
Starbucks Grande Vanilla Latte (with
nonfat milk)
Calories: 230
Fat: 0 g
Sugars: 38 g (9.5 tsp)
Starbucks Frappuccino Blended Crème,
Double Chocolate Chip Crème (without
whipped cream)
Size: Venti, 24 fl oz
Calories: 550
Fat: 11 g
Sugars: 79 g (almost 20 tsp)
Healthy Express Lesson 2
147
Rethink Your Drink
As you can see in the example below, calories from drinks can add up. The good news is that you
have plenty of options for reducing the number of calories in what you drink. Substituting no- or
low-calorie drinks for sugar-sweetened beverages cuts about 650 calories in the example below.
Eating Occasion
Instead of…
Calories
Try…
Calories
Morning coffee
shop run
Medium café latte made
with whole milk (16 oz)
265
Small café latte made
with fat-free milk (12 oz)
125
Lunch
Bottle of regular cola (20
oz)
227
Bottle of water or diet
cola (20 oz)
0
Afternoon break
Bottle of sweetened
lemon iced tea (16 oz)
180
Sparkling water with
natural lemon flavor (not
sweetened, 16 oz)
0
Dinner
A glass of regular ginger
ale (12 oz.)
124
Water with a slice of
lemon or lime, or Seltzer
water with a splash (2
oz) of 100% fruit juice
0
30
796
Total Beverage
Calories
125-155
Learn to Read Nutrition Facts Labels Carefully
Be aware that the Nutrition Facts label on beverage containers may give the calories for only part
of the beverage in the container. The example below shows the label on a 20-ounce bottle that
contains two and a half (2.5) 8-ounce servings. To figure out how many calories are in the whole
bottle, you need to multiply the number of calories in one serving by the number of servings in the
bottle (100 x 2.5). The entire bottle actually contains 250 calories even though what the label calls
a “serving” only contains 100.
NUTRITION FACTS
Serving Size 8 fl. oz.
Servings Per Container
2.5
Amounts Per Serving
Calories
148
100
Healthy Express Lesson 2
Sugar by Any Other Name: How to Tell Whether Your Drink Is
Sweetened
Sweeteners that add calories to a beverage go by many different names and are not always
obvious to anyone looking at the ingredients list. Some common caloric sweeteners are listed
below. If these appear in the ingredients list of your favorite beverage, you are drinking a sugarsweetened beverage:

High-fructose corn syrup

Fructose, sucrose, and dextrose

Fruit juice concentrates

Honey

Sugar

Syrup or corn syrup
High-Calorie Culprits in Unexpected Places
Coffee drinks and blended fruit smoothies sound innocent enough, but the calories in some of
your favorite coffee-shop or smoothie-stand items may surprise you. Check the website or instore nutrition information for your favorite coffee or smoothie shop to find out how many calories
are in different menu items.
Better Beverage Choices Made Easy

Choose water, diet, or low-calorie beverages instead of sugar-sweetened beverages.

For a quick, easy, and inexpensive thirst-quencher, carry a water bottle and refill it
throughout the day.

Don’t stock the refrigerator with sugar-sweetened beverages. Instead, keep a jug or
bottles of cold water in the fridge.

Serve water with meals.

Make water more exciting by adding slices of lemon, lime, cucumber, or watermelon, or
drink sparkling water.

Add a splash of 100 percent juice to plain sparkling water for a refreshing, low-calorie
drink.

When you do opt for a sugar-sweetened beverage, go for the small size. Some
companies are now selling 8-ounce cans and bottles of soda, which contain about 100
calories.

Be a role model for your friends and family by choosing healthy, low-calorie beverages.
Healthy Express Lesson 2
149
Source Cited
Agricultural Research Service. (n.d.). USDA national nutrient database for standard reference. Retrieved
from http://www.nal.usda.gov/fnic/foodcomp/search/
Chart adapted from Department of Health and Human Services, Centers for Disease Control and
Prevention. (n.d.). Rethink your drink. Retrieved from
http://www.cdc.gov/nccdphp/dnpa/nutrition/pdf/rethink_your_drink.pdf.
150
Healthy Express Lesson 2

Healthy Express: Lesson 3
Objectives
By the end of this lesson, the participant will be able to:

Find and use reliable nutrition information online or in print.

Incorporate foods made from new, healthy, easy recipes into meals.

Understand the benefits of eating organic foods and those promoted as “superfoods.”
Time for this lesson: 30-45 minutes
Activities in this Lesson
1. Introduction and Review (5 minutes)
2. Be Web Aware (5 minutes)
3. Using New Recipes (5-10 minutes)
4. Organic Foods 101 (5-10 minutes)
5. What's Super About Superfoods? (5-10 minutes)
6. Review and Goal Setting (5 minutes)
Preparation and Handouts Needed
Preparation

Print and prepare handouts as indicated below.

Verify Internet access at the counseling location; if no computer is available for use, bring
a laptop, if possible. (If you have no computer or Internet access, follow instructions for
alternative activities.)

Print the Almost Homemade recipe for "Citrus-Poached Snapper with Black Bean Salad"
from the Food Network website at http://www.foodnetwork.com/recipes/sandra-lee/citruspoached-snapper-with-black-bean-salad-recipe/index.html.

Print the Almost Homemade recipe for "Chicken with Peach and Melon Salsa" from the
Food Network website at http://www.foodnetwork.com/recipes/sandra-lee/chicken-withpeach-and-melon-salsa-recipe/index.html.
Healthy Express Lesson 3
151
Handouts
152

Goal Setting Worksheet

Evaluating Health Resources on the Web

Useful Consumer Health Websites

Tips for Healthier Substitutes

Almost Homemade: A Blend of Scratch and Convenience Cooking

Organics Quiz

Organic Foods 101

Organics Flash Cards (Print each sheet on a color printer, if possible. Next, fold each
sheet vertically down the center so the text and photos are on opposite sides. Finally, cut
horizontally between each photo and description, so you can use these as flash cards,
i.e., show the participant the photo side before revealing the text side.)

Dirty Dozen, Clean 15 Purse Card (Print sheet on card stock and cut out individual
cards, or print on regular paper and laminate individual cards. Use a color printer, if
possible.)

What's Super About Superfoods?
Healthy Express Lesson 3
Activities
1. Introduction and Review (5 minutes)
Review points from the last lesson with the participant. Ask her what she remembers or what was
most notable from the last lesson.
Use the Goal Setting Worksheet to record responses.
Questions to Guide Discussion

How did you do with your goals from the last lesson? (Insert goals.)

What went well?

What did you struggle with?

What were some of the barriers?
2. Be Web Aware (5 minutes)
Discuss with the participant how to find reliable nutrition and health information on the Internet.
Question to Guide Discussion

Where do you go for health and nutrition information on the Internet?
Talk about the advantages and disadvantages of using the Internet to find health and nutrition
information; ask the participant why it is important to look at websites with a critical eye. Then
discuss advantages and disadvantages of using the web.


Advantages include:

Information can be easily updated on the web, so it is probably more current than
print materials;

Information is easy to access and print;

Some websites are interactive and can provide customized information; and

You can access different opinions on the web, which improves your ability to assess
what’s right for you.
Disadvantages include:

Some online information can be biased and promote false claims;

Accuracy of some information is not guaranteed; and

Some websites promote extreme views and take partisan stands.
Healthy Express Lesson 3 153 Review Evaluating Health Resources on the Web with the participant and select one of the
activities below based on computer and Internet availability, as well as time.
With computer and Internet access:
Activity 1. Ask the participant if she has a specific nutrition topic she would like to research
online. Using the computer, enter the topic into a search engine and use Evaluating Health
Resources on the Web to evaluate two different health websites. Aim to review one reputable
website and one with less credibility.
Activity 1 (variation). Use the handout to evaluate and compare the following websites:
http://www.nutrition.gov to http://www.dietfacts.com/list.asp.
Activity 2. Review a Medline Plus tutorial on evaluating Internet health information, available
from the National Institutes of Health at:
http://www.nlm.nih.gov/medlineplus/webeval/webeval.html.
Without computer or Internet access:
Activity 3. Ask the participant to complete Activity 1 as homework, using a computer at home, at
a friend's house, or at the public library.
Give the participant the Useful Consumer Health Websites handout for her own reference.
3. Using New Recipes (5-10 minutes)
Ask the participant how often she uses new recipes and how she might benefit from doing this.

Benefits might include reducing boredom and providing a more varied and well-balanced
diet.
Talk about how to determine if a recipe is healthy.


A recipe is the sum of its parts. A healthy recipe contains:
•
More nutritious ingredients, including fruits and vegetables, lean meats, low-fat and
no-fat dairy, whole-grain flours, olive and canola oils, broth or vegetable puree-based
sauces.
•
Fewer less nutritious ingredients, including fatty cuts of meat, full-fat dairy, refined
flours, tropical oils, butter, cream-based sauces and dressings.
The cooking method is also important. Healthy cooking methods include:
•
Broiling, baking, braising, grilling, poaching, roasting, sautéing, steaming, and stirfrying in a small amount of oil.
Give the participant the Tips for Healthier Substitutes handout.
154
Healthy Express Lesson 3
Question to Guide Discussion

What barriers prevent you from trying new recipes?
After determining the barriers that prevent the participant from trying new recipes, have her think
about some solutions. Use the suggestions below if she needs some ideas to get started.

Choose recipes with fewer ingredients and steps.

Use convenient foods like pre-chopped vegetables in recipes.

Keep your recipes together in a folder or expandable file so they are ready when you
need them.

Once a week (or once a month) choose a new recipe to try. Schedule the recipe on a day
where you have extra time and add the ingredients to your shopping list.

Prepare "halfway homemade"’ recipes, using ideas from the Almost Homemade: A Blend
of Scratch and Convenience Cooking handout.
Give the participate Almost Homemade: A Blend of Scratch and Convenience Cooking, and
review the points with her.
Using the Almost Homemade Recipes you printed from the Food Network website, ask the
participant to identify some of the almost homemade strategies and the convenience foods
(prepared or partially prepared) used.
4. Organic Foods 101 (5-10 minutes)
Use the Organics Quiz as a pre- and/or post- test, as needed. Answers and explanations are
provided below.
Organics Quiz Key
Correct answers are in boldface.
13. How do you differentiate between an organic product and a non-organic product?
a. Use the “squeeze test”
b. The cost – organics are usually more expensive
c. The organic label
d. There is no difference
While organics are typically more expensive, the cost of the product is not a good indicator of
organic status. The USDA has strict rules defining use of the term "organic," as well as use of the
1
label.
Healthy Express Lesson 3
155
2. What percent of product content must be organic in order for a package to display the “made
with organic ingredients” label?
a. 15-33 percent
b. 0-15 percent
c. 70-90 percent
d. 33-70 percent
According to USDA rules, a product labeled “made with organic ingredients” must contain 70-90
1
percent organic ingredients.
3. In order to bear the organic label, organic products cannot be subject to:
a. Synthetic pesticides
b. Genetic engineering
c. Antibiotics or growth hormones
d. All of the above
The USDA does not allow use of synthetic pesticide or genetic engineering in crops, nor does it
2,3
allow antibiotic or growth hormone use in meat, poultry or eggs.
4. Organic foods have been proven to be:
a. Healthier
b. Better tasting
c. Safer
d. None of the above
Organic produce has not been proven to be healthier or safer, and taste is usually an individual
2,3
preference.
5. Organic produced foods are more expensive than conventionally grown products because:
a. Higher taxes
b. Grocery stores can make a bigger profit on organic foods
c. Higher production costs
d. None of the above
Higher prices are due to more expensive farming practices, tighter government regulations, and
lower crop yields. Because organic farmers don't use herbicides or pesticides, many
3
management tools used to control weeds and pests are labor intensive.
6. Consumption of non-organic produce can lead to exposure to:
a. Potentially harmful pesticide levels
b. Safe levels of pesticide residue
c. The chilly refrigerated produce section
d. Consumption of non-organic produce has not been shown to have any ill effects on
health
Non-organic produce is still required be below required pesticide tolerance levels set by the
4
Environmental Protection Agency (EPA).
156
Healthy Express Lesson 3
7. Other than purchasing organic produce, pesticide exposure can be reduced by
a. Washing all fruits and vegetables
b. Peeling or trimming fruits and vegetables
c. Eating a wide variety of fruits and vegetables
d. All of the above
Use of all of the above methods will reduce exposure to any one pesticide, remove bacteria and
3,5
ensure you are consuming enough nutrients.
Quiz adapted from Brigham and Women’s Hospital. (2011). Fielding questions on organic foods. Retrieved
from http://healthlibrary.brighamandwomens.org/InteractiveTools/Quizzes/40,OrganicFoodOrganicFoQuiz
Questions to Guide Discussion

Do you choose organic foods? If so, why?

Do you only buy certain organic foods?
Give the participant the Organic Foods 101 handout and review the points, emphasizing the
following:

Organic produce has not been shown to be any more nutritious than non-organic
produce.

Eating a wide variety of produce is most important, whether it is organic or not.

Proper washing and handling of produce can reduce residues and risk of food borne
illnesses.
Using the Organics Flash Cards, review the “Dirty Dozen” and “Clean 15” with the participant.
Give the participant a Dirty Dozen, Clean 15 Purse Card for her own use.
5. What's Super About Superfoods? (5-10 minutes)
Review the What's Super About Superfoods? handout with the participant and discuss the
superfoods she currently eats.
Ask the participant to select a superfood she would like to add to her diet and discuss specific
ways that she could make that happen.
Advise the participant to look up a recipe containing her chosen superfood and add it to her
recipe file.
6. Review and Goal Setting (5 minutes)

Ask the participant if she has any questions.

Have the participant discuss one or two things she learned today.
Healthy Express Lesson 3
157

Have the participants set goals for the next two weeks on the Goal Setting Worksheet.
•

If this is the final lesson, the participant should evaluate her goals on her own in two
weeks.
If applicable, briefly describe the topic and activities for the next lesson to arouse interest.
•
If the participant will be continuing lessons, the facilitator should consult the Need
State Activities Overview to determine the next lesson’s topics and activities.

If she is continuing lessons, remind the participant to bring her paperwork from this
lesson to her next one.

Thank the participant for coming.
Sources Cited
1. Agricultural Marketing Service, U.S. Department of Agriculture. (2010). National Organic
Program: Understanding organic labeling. Retrieved from
http://www.ams.usda.gov/AMSv1.0/ams.fetchTemplateData.do?template=TemplateA&na
vID=NationalOrganicProgram&leftNav=NationalOrganicProgram&page=NOPUnderstandi
ngOrganicLabeling&description=Understanding%20Organic%20Labeling&acct=nopgenin
fo
2. Agricultural Marketing Service., U.S. Department of Agriculture. National Organic
Program: Going organic. Retrieved from
http://www.ams.usda.gov/AMSv1.0/ams.fetchTemplateData.do?template=TemplateN&lef
tNav=NationalOrganicProgram&page=NOPGoingOrganic&description=Going%20Organi
c&acct=nopgeninfo
3. Mayo Clinic. (2011). Organic foods: Are they safer? More nutritious? Retrieved from
http://www.mayoclinic.com/health/organic-food/NU00255#
4. National Pesticide Information Center. (2011). Pesticide residues in food. Retrieved from
http://npic.orst.edu/health/residue.html
5. National Pesticide Information Center. (2011). Minimizing pesticide residue in foods.
Retrieved from http://npic.orst.edu/health/foodprac.html
158
Healthy Express Lesson 3
Date: _______________
Goal Setting Worksheet
Goal Check In
Think about your goals from last time and answer the following:
1. Which goals did you achieve?
2. What did you find easy to do?
3. What roadblocks did you encounter and how did you cope with these?
4. If you didn’t reach your goals, how might you revise them to make them more manageable?
New Goals for Next Lesson
Write down one or two short-term goals you would like to work on before your next
nutrition counseling lesson related to the topics you discussed today.
Short-Term Goal #1: ________________________________________________________
__________________________________________________________________________
Strategy 1: _________________________________________________________________
__________________________________________________________________________
Strategy 2: ________________________________________________________________
__________________________________________________________________________
Strategy 3: _________________________________________________________________
__________________________________________________________________________
Healthy Express Lesson 3
159
Short-Term Goal #2: ________________________________________________________
__________________________________________________________________________
Strategy 1: _________________________________________________________________
__________________________________________________________________________
Strategy 2: ________________________________________________________________
__________________________________________________________________________
Strategy 3: _________________________________________________________________
__________________________________________________________________________
Date of next counseling lesson: _____________________
Please bring this worksheet to your next lesson.
160
Healthy Express Lesson 3
Evaluating Health Resources on the Web
The Internet has made finding health and nutrition information easier and faster. Much of the
information on the Internet is valuable; however, the Internet also allows rapid and widespread
distribution of false and misleading information. Use the following check sheet to decide whether
the health and nutrition information you find on the Internet is likely to be reliable.
Provider
1. Who runs the website?
Any website should make it easy for you to learn who is responsible for the site and its
content. Look under “About Us” or a similarly named link for contact and related information.
2. What is the website's purpose?
To learn about a website’s purpose, look under an “About this Site” or similarly named link to
understand the site's goals and objectives, as well as help verify its trustworthiness. Also
consider motivation. Although many legitimate websites contain advertisements and sell
health, nutrition, and medical products and services, keep in mind that the website owner's
desire to promote these products or services can compromise the accuracy of information on
a site. At the least, this desire to sell something might indicate the omission of important
information. Validate the accuracy of information on a website through an independent and
unbiased source, such as a University Cooperative Extension site.
3. How does the website manage interactions with users?
Websites should always offer a way for users to contact the website owner with problems,
feedback, and questions. If the site hosts a chat room or some other form of online
discussion, it should explain the terms of using the service. For example, the site should
explain whether anyone moderates the discussions and, if so, who provides the moderation
and what criteria the moderator uses to determine which comments to accept and which to
reject.
Funding
4. Who pays for the website?
It costs money to run a website. The source of a website's funding should be clearly stated or
readily apparent. A website's source of funding can influence its content and how it's
presented, depending on the funder's interests. Web address endings may give some
indication on the nature of funding. For example, the U.S. government funds websites with
addresses ending in ".gov," educational institutes maintain ".edu" sites, nonprofit
organizations' addresses often use ".org," and ".com" denotes a for-profit business or other
commercial enterprise.
Healthy Express Lesson 3
161
Quality
5. What is the original source of the website's information?
Many health, nutrition, and medical websites post information that the owner has collected
from other websites or sources. If the person or organization in charge of the site did not write
the material, the original source should be clearly identified.
6. How does the website document the evidence supporting its information?
Websites should identify the medical and scientific evidence that supports the material
presented on the site. Medical facts and figures should have references, such as citations of
articles published in medical journals. Also, opinions or advice should be clearly set apart
from information that is "evidence based" (that is, based on research results). Testimonials
from people who said they have tried a particular product or service are not evidence-based
and usually cannot be corroborated.
7. Who reviewed the information before the owner posted it on the website?
Health-related websites should provide information about the medical or scientific credentials
of people who prepared or reviewed the website material.
8. How current is the information on the website?
Experts should review and update the material on websites regularly. Medical information
needs to be current because research is constantly generating new information about
medical conditions and how to best treat or prevent them. Websites should clearly post the
most recent update or review date. Even if the information has not changed in a long time,
the site owner should indicate that someone has reviewed it recently to ensure that the
information is still valid.
9. How does the website owner choose links to other sites?
Owners of reliable websites usually have a policy governing which links to other sites they
post. Some health and medical websites take a conservative approach and do not provide
links to any other sites; some sites provide links to any site that asks or pays for a link; and
still others provide links only to sites that have met certain criteria. Reviewing a website's
linking policy can help you understand how and why links to other sites are chosen.
Privacy
10. What information about users does the website collect, and why?
Websites routinely track the path users take through their sites to determine what pages
people are viewing. However, many health-related websites also ask users to "subscribe" to
or "become a member" of the site. Sites sometimes do this to collect a user fee or select
relevant information from the user. Some sites also collect personal information about users.
162
Healthy Express Lesson 3
Any website asking you for personal information should explain exactly what the site will and
will not do with the information. Many commercial sites sell "aggregate" data—such as what
percent of their users take dietary supplements—about their users to other companies. In
some cases, sites collect and reuse information that is personally identifiable, such as your
zip code, gender, and birth date. Be sure to read and understand any privacy policy or similar
language on the site and do not sign up for anything that you do not fully understand.
Adapted from Office of Dietary Supplements. (2011, June 24). How to evaluate health information on the
Internet: Questions and answers. Retrieved from
http://ods.od.nih.gov/Health_Information/How_To_Evaluate_Health_Information_on_the_Internet_Questions
_and_Answers.aspx
Healthy Express Lesson 3
163
Useful Consumer Health Websites
Health and wellness
The following websites are sponsored by credible organizations and provide a wide variety of
information, tools and resources on health and health-related topics.
Cancer.gov at http://www.cancer.gov is the official website of the National Cancer Institute, the
federal government's principal agency for conducting and supporting cancer research, training
physicians and scientists, and providing information about cancer detection, treatment, prevention
and more.
Centers for Disease Control and Prevention at http://www.cdc.gov provides resources and
information about a variety of health and safety topics, including diseases and healthy living,
emergency preparedness and response, and more. The site also includes an "Outbreaks" section
on current infectious disease outbreaks.
FamilyDoctor.org at http://familydoctor.org is operated by the American Academy of Family
Physicians, a national medical organization representing more than 100,000 family physicians,
family practice residents and medical students. The site offers health information for the entire
family, including sections on diseases and conditions, prevention and wellness, and more.
Healthfinder.gov at http://www.healthfinder.gov is a health information website provided by the
U.S. Department of Health and Human Services. The site contains information on over 1,600
health topics, as well as personal health tools, such as an online checkups, health calculators,
and activity and menu planners.
KidsHealth at http://www.kidshealth.org provides doctor-approved health information about
children from before birth through adolescence. The site is sponsored by the pediatrician-led
Nemours Center for Children's Health Media, which is part of the Nemours Foundation – a
nonprofit organization.
The Mayo Clinic in Rochester, Minn., sponsors a website at http://www.mayoclinic.com that
provides health education to patients and the general public. The website also includes
interactive tools to assist consumers in managing their health.
MedlinePlus at http://medlineplus.gov is the National Institute of Health's consumer health
website produced by the National Library of Medicine. The website includes information about
more than 900 diseases, conditions, and wellness issues, as well as tutorials, podcasts, videos,
and interactive tools on a wide variety of health-related topics.
New York Online Access to Health (NOAH) at http://www.noah-health.org is a collection of
state, local, and federal health resources. Topics are listed alphabetically in "Health Topics" and
then narrowed to include definitions, care and treatment, and lists of information resources. All
content is in both English and Spanish.
164
Healthy Express Lesson 3
Nutrition
The following websites are sponsored by credible organizations and provide a wide variety of
information, tools and resources on food and nutrition topics.
Nutrition.gov at http://www.nutrition.gov provides access to government information on food and
nutrition for consumers. It serves as a gateway to reliable science-based information on nutrition,
healthy eating, physical activity, and food safety.
Eatright.org at http://www.eatright.org is the official website of the Academy of Nutrition and
Dietetics (formerly the American Dietetic Association). Useful information on nutrition, exercise,
and other food-related topics can be found under the “Public" tab at the top of the home page.
CalorieKing at http://www.calorieking.com is a respected commercial website that provides
nutrition information in a comprehensive database of foods, including brand name and restaurant
foods.
Adapted from Consumer and Patient Health Information Section. (2010). 2010 CAPHIS top 100 list: Health
websites you can trust. Chicago, IL: Medical Library Association.
Healthy Express Lesson 3
165
Tips for Healthier Substitutes
These lower-calorie alternatives provide new ideas for old favorites. When choosing foods, avoid
those that are high in sugar and fat. Instead, select healthier alternatives with a higher proportion
of vitamins and minerals.
Milk and Milk Products
If you usually buy:
Try these instead:
Whole milk
Fat-free (skim), low-fat (1%), or reduced fat (2%) milk
Ice cream
Sorbet and ices, sherbet, or low-fat or fat-free frozen yogurt
Whipping cream
Imitation whipped cream made with fat-free (skim) milk
Sour cream
Plain low-fat yogurt
Regular cream cheese
Neufchatel or “light” cream cheese, or fat-free cream cheese
Regular cheese (cheddar, Swiss, or jack)
Reduced-calorie or low-calorie processed cheeses. Examples
include: Trader Joe’s low-fat, Laughing Cow Light, Jarlsberg
Lite Swiss, Kraft 2% milk cheese, Sargento reduced-fat,
Tillamook reduced-fat, Baby Bell Light, Cabot 50% reduced-fat,
Weight Watchers cheese
Regular American cheese
Fat-free American cheese
Regular (4%) cottage cheese
Low-fat (1%) or reduced fat (2%) cottage cheese
Whole-milk mozzarella cheese
Part-skim, low-moisture mozzarella cheese
Coffee cream (half and half) or non-dairy
creamer (liquid or powder)
Low-fat (1%) or reduced fat (2%) milk; non-fat dry milk powder;
or fat-free half and half
Cereals, Grains and Pastas
If you usually buy:
Try these instead:
Ramen noodles
Rice or other noodles (spaghetti, macaroni, etc.)
Pasta with white sauce (Alfredo)
Pasta with red sauce (marinara)
Pasta with cheese sauce
Pasta with vegetables (primavera)
Granola
Bran flakes or crispy rice, cooked grits or oatmeal, or reducedfat granola
White rice
Brown rice
166
Healthy Express Lesson 3
Meats, Fish and Poultry
If you usually buy:
Try these instead:
Cold cuts or lunch meats (bologna, salami,
liverwurst, etc.)
Low-fat cold cuts (95% to 97% fat-free lunch meats or low-fat
pressed meats)
Regular hot dogs
Reduced-fat hot dogs
Bacon or sausage
Canadian bacon or lean ham
Regular ground beef
Extra-lean ground beef, such as ground round, or ground
turkey (read labels)
Chicken or turkey with skin, duck or goose
Chicken or turkey without skin (white meat)
Oil-packed tuna
Water-packed tuna (rinse to reduce sodium content)
Beef chuck, rib, or brisket
Beef round or loin; trim external fat; choose select grades
Pork (spareribs or untrimmed loin)
Pork tenderloin or trimmed, lean smoked ham
Frozen breaded fish or fried fish
(homemade or commercial)
Unbreaded fish or shellfish, fresh, frozen, or canned in water
Whole eggs
Egg whites or egg substitutes
Frozen TV dinners containing more than
13 grams of fat per serving
Frozen TV dinners containing less than 13 grams fat per
serving and lower in sodium
Chorizo sausage
Turkey sausage, drained well (read label) or vegetarian
sausage made with tofu
Baked Goods
If you usually buy:
Try these instead:
Croissants, brioches, etc.
Hard French rolls or soft brown ‘n serve rolls
Donuts, sweet rolls, scones, or pastries
English muffins, bagels, reduced-fat or fat-free muffins, or fatfree scones
Party crackers
Low-fat, reduced-sodium party crackers, or reduced-sodium
soda crackers
Cake (pound, chocolate or yellow)
Cake (angel food, white, or gingerbread)
Cookies
Fat-free or reduced-fat cookies, such as graham crackers,
ginger snaps, or fig bars; compare calorie levels
Healthy Express Lesson 3
167
Snacks and Sweets
If you usually buy:
Try these instead:
Nuts
Popcorn (air-popped or light microwave), fruits, vegetables
Ice cream, including cones and bars
Frozen yogurt, frozen fruit, or chocolate pudding bars
Custards or puddings made with whole
milk
Puddings made with fat-free milk
Miscellaneous
If you usually buy or make:
Try these instead:
Canned cream soups
Canned broth-based soups (low-sodium)
Homemade gravy with fat drippings and
whole milk or gravy mixes made with milk
Homemade with the fat skimmed off and fat-free milk, or gravy
mixes made with water
Fudge sauce
Chocolate syrup
Guacamole dip or refried beans with lard
Salsa
Adapted from U.S. Department of Health and Human Services. (2005). Tips for healthy
substitutes. Washington, DC: U.S. Government Printing Office.
Baking Substitutes
Instead of:
Try these instead:
Sugar
Substitute with Splenda. Use ½ cup of Splenda for every cup of sugar in the
recipe. Check Splenda’s website for specific recommendations on
1
substitutions: http://www.splenda.com/cooking-baking/granulated
Sugar
Reduce sugar by 1/4 to 1/3. Cookies, quick breads, and cakes can be
successfully baked this way. Substitute flour for the omitted sugar. Do not
2
decrease sugar in yeast breads, because sugar feeds the yeast.
Sugar
Use spices rather than sugar. Adding cinnamon, nutmeg, or vanilla to your
2
recipes instead of sugar will mimic sweeteness.
Butter, shortening or oil
Use applesauce, prune or other fruit puree, or plain non-fat yogurt. Replace up
to half of the butter, oil or shortening with any of these ingredients based on the
flavor of the dish. Keep an eye on your dish once it is in the oven as the baking
2
time may decrease up to 25 percent.
Oil
Reduce oil by 1/3. Avoid this method when baking yeast breads or pie crusts.
Solid fats
Use vegetable oils, such as corn, canola, or peanut, instead of solid fats, such
as shortening, lard, or butter. To substitute liquid oil for solid fats, use about 1/4
2
less than in the recipe.
Sour cream
Swap yogurt for sour cream. If the recipe calls for sour cream, add plain low-fat
yogurt in the same amount. Two other acceptable substitutes are buttermilk or
TM
168
3
Healthy Express Lesson 3
3
low-fat cottage cheese blended in a food processor.
Whipped cream
Refrigerate one 13 ounce can of evaporated skim milk overnight. Combine with
4
1 teaspoon of lemon juice and beat until stiff.
Whipped Cream
Combine 1/2 cup of ice-cold water and 1/2 cup non-fat dry milk and whip until it
forms peaks. While still mixing, gradually add 1/2 cup sugar. Finally, add 2
4
tablespoons of lemon juice and stir until well incorporated.
Eggs
Use egg substitute or egg whites. Replace one egg with two egg whites or 1/4
2
cup egg substitute.
Sources Cited
1. McNeil Nutritionals. (2012). Cooking and baking with Splenda® No Calorie Sweetener. Granulated.
Retrieved from http://www.splenda.com/cooking-baking/granulated
2. Brinkman, P., & Syracuse, C. J. (n.d.). Modifying a recipe to be healthier. Columbus, OH: Ohio State
University Extension (Fact Sheet No. HYG-5543-06).
3. The Cooking Inn. (2012). Modify a recipe. Retrieved from http://www.thecookinginn.com/modify.html
4. Garden-Robinson, J. (1999, July). Ingredient substitutions. Fargo, ND: University of North Dakota (Fact
Sheet No. HE-198).
Healthy Express Lesson 3
169
Almost Homemade: A Blend of Scratch and
Convenience Cooking
"Almost homemade" cooking is a compromise between spending a lot of time making everything
from scratch and using only (usually less healthy) already prepared convenience foods. Almost
homemade cooking can help save time while making meals more nutritious.
Two Halfway-Homemade Options

Enhance certain convenient supermarket products by adding ingredients to them.

Use "shortcut" products in homemade recipes to cut down on preparation time.
Helpful Shortcut Products
Here are some prepared or partially prepared "shortcut" products to use in homemade
recipes and meals:

Frozen bread dough. Choose whole wheat options most often.

Whole rotisserie chicken. Remove the skin before using in recipes.

Shredded cheese. Choose reduced-fat types most often.

Bottled marinara sauce.

Bottled salsa.

Reduced-fat Bisquick.

Instant pudding. Choose sugar-free most often.

Reduced-fat cream of mushroom soup, or similar flavors, such as cream of celery. Use
instead of making gravy or cream sauce for casseroles and similar recipes.

Canned broth.

Canned beans and refried beans. Choose fat-free or vegetarian.

Reduced-fat salad dressings. Instead of making your own high-fat dressings or dips, try
light bottled dressings in your recipes.

Frozen chopped spinach. Slightly thaw (don’t cook!) in the microwave and drain.

Seasoning blends. Use them in recipes instead of measuring and mixing separate
seasonings.
Enhancement Ideas
Here are some ideas for making prepared or partially-prepared dishes your own by
dressing them up with extra ingredients:

170
Reduced-fat crescent rolls. Make them into fancy rolls by adding herbs, dried fruit, etc.
Healthy Express Lesson 3

Salad in a bag. Add ingredients to create your own gourmet salads, such as extra
vegetables, nuts, fresh or dried fruit, or lean meats.

Boxed macaroni and cheese. Use half the amount of butter or margarine called for and
add flavorful ingredients, such as green onions, frozen spinach or peas, tomatoes, and
water-packed tuna.

Prepared pizza crust, such as Boboli. Use this as a base for your own "gourmet" pizzas
with marinara sauce and plenty of vegetables.

Reduced-fat Bisquick. Use this as a base for blueberry pancakes or herb biscuits.

Instant pudding. Add ingredients like light-whipped topping or fresh fruit for a mousse or
parfait.

Frozen tortellini and ravioli. Make your own pasta salad by adding cherry tomatoes, light
vinaigrette, grilled chicken breast strips, and so on.

Seasoned tuna. Use it to create sandwiches and wraps by adding the ingredients of your
choice.
Adapted from Magee, E. (n.d.). Halfway homemade: Cooking with convenience foods. Retrieved from
http://www.webmd.com/food-recipes/guide/halfway-homemade
Healthy Express Lesson 3
171
Organics Quiz
Choose the best answer.
_____ 1. How do you differentiate between an organic product and a non-organic product?
a. Use the “squeeze test”
b. The cost – organics are usually more expensive
c. The organic label
d. There is no difference
_____ 2. What percent of product content must be organic in order for a package to display the
“made with organic ingredients” label?
a. 15-33 percent
b. 0-15 percent
c. 70-90 percent
d. 33-70 percent
_____ 3. In order to bear the organic label, organic produce cannot be subject to:
a. Synthetic pesticides
b. Genetic engineering
c. Irradiation
d. All of the above
_____ 4. Organic foods have been proven to be:
a. Healthier
b. Better tasting
c. Safer
d. None of the above
_____ 5. Organic produced foods are more expensive than conventionally grown products
because:
a. Higher taxes
b. Grocery stores can make a bigger profit on organic foods
c. Higher production costs
d. None of the above
_____ 6. Consumption of non-organic produce can lead to exposure to:
a. Potentially harmful pesticide levels
b. Safe levels of pesticide residue
c. The chilly refrigerated produce section
d. Consumption of non-organic produce has not been shown to have any ill effects on
health
_____ 7. Other than purchasing organic produce, pesticide exposure can be reduced by:
a. Washing all fruits and vegetables
b. Peeling or trimming fruits and vegetables
c. Eating a wide variety of fruits and vegetables
d. All of the above
172 Healthy Express Lesson 3 Organic Foods 101
Choosing Organics
Many factors may influence your decision to buy – or not to buy – organic foods. Consider these:

Nutrition – The USDA makes no claims that organically produced foods are safer or
1
more nutritious than conventionally produced foods.

Quality and Appearance – Organic foods are required to meet the same safety and
quality standards as those set for conventional foods. Organic foods differ from
conventionally produced foods in the way they are grown, handled, and processed. You
may find that organic fruits and vegetables spoil faster because they are not treated with
waxes or preservatives. Also, do not be surprised to see less-than-perfect looks –
sometimes organic produce may be oddly shaped, have color variations, or be smaller in
size. But remember – odd appearances do not indicate any problems with safety or
2
quality.

Pesticides – In conventional growing methods, pesticides and fungicides are sprayed on
crops to prevent pest damage, molds and other diseases. These practices can leave a
residue on fruits or vegetables. One reason individuals may purchase organic foods is to
2
limit consumption of these chemicals.

Environment – People may also purchase organic foods to support a healthy, natural
environment. Organic food is produced by farmers who value the use of renewable
resources and the conservation of soil and water to help ensure environmental quality for
1
future generations.

Cost – Organic foods are often more expensive than conventionally grown foods. Higher
prices are due to more expensive farming practices, tighter government regulations and
lower crop yields. Because organic farmers don't use herbicides or pesticides, many
2
management tools that control weeds and pests are labor intensive.

Taste – Some people say they can taste the difference between organic and non-organic
food. Others say they find no difference. Taste is a subjective and personal
2
consideration, so decide for yourself.
Healthy Express Lesson 3
173
Understanding Organic Terminology
When buying organic foods, look for the following USDA-regulated terms on labels3:

“Natural” and “organic” are not interchangeable. Other truthful claims, such as freerange, hormone-free, and natural, can still appear on food labels. However, don't confuse
these terms with "organic.”4

Organic meat, poultry, eggs, and dairy products come from animals that are given no
antibiotics or growth hormones.1
Buying and Handling Tips
Whether you are already a fan of organic foods or you just want to shop wisely and handle your
food safely, consider these tips:2
1. Buy fruits and vegetables in season to ensure the highest quality. Also try to buy
your produce the day it's delivered to market to ensure that you're buying the freshest
food possible. Ask your grocer what day new produce arrives. Farmers' markets are also
a good source of fresh produce.
2. Eat a variety of fruits and vegetables. This will reduce the chances of overexposure to
any one residue.
3. Read food labels carefully. Beyond the produce section, remember that just because a
product says it is organic or contains organic ingredients does not mean it is healthier
than its conventional counterpart. The calorie, fat, salt and sugar content of organic foods
are often remarkably similar to that of conventional foods.
4. Wash all fresh fruits and vegetables thoroughly. This will help remove most dirt and
bacteria. Use a small scrub brush to clean produce eaten with its skin intact. Examples
include apples, potatoes and cucumbers.
5. To reduce exposure to pesticides, peel fruits and vegetables after washing them and
discard the outer leaves of leafy vegetables. A wax coating is applied to some vegetables
(such as cucumbers) to help retain moisture. Although the wax is considered edible, it
may taste bitter. Keep in mind that peeling your fruits and vegetables may also reduce
the amount of nutrients and fiber. Some pesticide residue also collects in fat, so remove
fat from meat and the skin from poultry and fish.
174 Healthy Express Lesson 3 The Dirty Dozen and Clean 15
The Environmental Working Group, a non-profit organization in Washington, D.C., recommends
going organic on the “Dirty Dozen” – produce that is most susceptible to pesticide residue.
Produce on the "Clean 15" list bears little or no traces of pesticide residue and is safe to consume
5
in non-organic form.
The Dirty Dozen
The Clean 15
Apples
Grapes – imported
Onions
Cantaloupe – domestic
Celery
Sweet bell peppers
Sweet corn
Kiwi
Strawberries
Potatoes
Pineapples
Cabbage
Peaches
Blueberries – domestic
Avocado
Watermelon
Spinach
Lettuce
Asparagus
Sweet Potatoes
Nectarines – imported
Kale & Collard greens
Sweet peas
Grapefruit
Mangos
Mushrooms
Eggplant
Sources Cited
1. Agricultural Marketing Service, U.S. Department of Agriculture. (2010). National Organic
Program: Going organic. Retrieved from
http://www.ams.usda.gov/AMSv1.0/ams.fetchTemplateData.do?template=TemplateN&leftNa
v=NationalOrganicProgram&page=NOPGoingOrganic&description=Going%20Organic&acct=
nopgeninfo
2. Mayo Clinic. (2011). Organic foods: Are they safer? More nutritious? Retrieved from
http://www.mayoclinic.com/health/organic-food/NU00255#
3. Agricultural Marketing Service, U.S. Department of Agriculture. (2010). National Organic
Program: Understanding organic labeling. Retrieved from
http://www.ams.usda.gov/AMSv1.0/ams.fetchTemplateData.do?template=TemplateA&navID
=NationalOrganicProgram&leftNav=NationalOrganicProgram&page=NOPUnderstandingOrga
nicLabeling&description=Understanding%20Organic%20Labeling&acct=nopgeninfo
4. Agricultural Marketing Service, U.S. Department of Agriculture. (2010). National Organic
Program: Understanding organic. Retrieved from
http://www.ams.usda.gov/AMSv1.0/ams.fetchTemplateData.do?template=TemplateA&leftNav
=NationalOrganicProgram&page=NOPUnderstandingOrganic&description=Understanding%2
0Organic&acct=nopgeninfo
5. Environmental Working Group. (2011). Executive summary. Retrieved from
http://www.ewg.org/foodnews/summary/
Healthy Express Lesson 3
175
176
Celery
Buy Organic
Strawberries
Apples
Buy Organic
Buy Organic
Peaches
Buy Organic
Healthy Express Lesson 3
(Imported)
Grapes
(Imported)
Spinach
Nectarines
Buy Organic
Buy Organic
Sweet Bell
Peppers
Buy Organic
Buy Organic
Healthy Express Lesson 3
177
Buy Organic
Buy Organic
178
(Domestic)
Potatoes
Blueberries
Lettuce
Buy Organic
Kale/
Collard Greens
Buy Organic
Healthy Express Lesson 3
Onions
Buy Conventional
or
Locally Grown
Sweet Corn
Buy Conventional
or
Locally Grown
Healthy Express Lesson 3
Avocado
Buy Conventional
or
Locally Grown
Pineapples
Buy Conventional
or
Locally Grown
179
180
Buy Conventional
or
Locally Grown
(Domestic)
Sweet Peas
Mangos
Buy Conventional
or
Locally Grown
Eggplant
Buy Conventional
or
Locally Grown
Cantaloupe
Buy Conventional
or
Locally Grown
Healthy Express Lesson 3
Cabbage
Buy Conventional
or
Locally Grown
Watermelon
Kiwi
Buy Conventional
or
Locally Grown
Buy Conventional
or
Locally Grown
Sweet Potatoes
Buy Conventional
or
Locally Grown
Healthy Express Lesson 3
181
182
Asparagus
Grapefruit
Buy Conventional
or
Locally Grown
Buy Conventional
or
Locally Grown
Mushrooms
Buy Conventional
or
Locally Grown
Healthy Express Lesson 3
The Dirty Dozen
Apples Grapes – I Celery Bell peppers Strawberries Potatoes Peaches Blueberries – D Spinach Lettuce Nectarines – I Kale/Greens I= Imported D= Domestic The Clean 15
Onions Sweet corn Pineapples Avocado Asparagus Sweet peas Mangos Apples Cantaloupe ‐ D Kiwi Cabbage Watermelon Sweet potatoes
Grapefruit Mushrooms The Dirty Dozen
D= Domestic The Dirty Dozen Apples Grapes – I Celery Bell peppers Strawberries Potatoes Peaches Blueberries – D Spinach Lettuce Nectarines – I Kale/Greens I= Imported D= Domestic The Clean 15 Onions Apples Sweet corn Cantaloupe ‐ D Pineapples Kiwi Avocado Cabbage Asparagus Watermelon Sweet peas Sweet potatoes
Mangos Grapefruit Mushrooms The Clean 15 Onions Apples Sweet corn Cantaloupe ‐ D Pineapples Kiwi Avocado Cabbage Asparagus Watermelon Sweet peas Sweet potatoes
Mangos Grapefruit Mushrooms The Dirty Dozen Apples Grapes – I Celery Bell peppers Strawberries Potatoes Peaches Blueberries – D Spinach Lettuce Nectarines – I Kale/Greens I= Imported D= Domestic The Clean 15 Onions Apples Sweet corn Cantaloupe ‐ D Pineapples Kiwi Avocado Cabbage Asparagus Watermelon Sweet peas Sweet potatoes
Mangos Grapefruit Mushrooms Healthy Express Lesson 3 Apples Cantaloupe ‐ D Kiwi Cabbage Watermelon Sweet potatoes
Grapefruit Mushrooms The Clean 15 Onions Apples Sweet corn Cantaloupe ‐ D Pineapples Kiwi Avocado Cabbage Asparagus Watermelon Sweet peas Sweet potatoes
Mangos Grapefruit Mushrooms The Dirty Dozen Apples Grapes – I Celery Bell peppers Strawberries Potatoes Peaches Blueberries – D Spinach Lettuce Nectarines – I Kale/Greens I= Imported D= Domestic The Dirty Dozen Apples Grapes – I Celery Bell peppers Strawberries Potatoes Peaches Blueberries – D Spinach Lettuce Nectarines – I Kale/Greens I= Imported D= Domestic Onions Sweet corn Pineapples Avocado Asparagus Sweet peas Mangos The Dirty Dozen Apples Grapes – I Celery Bell peppers Strawberries Potatoes Peaches Blueberries – D Spinach Lettuce Nectarines – I Kale/Greens I= Imported D= Domestic The Clean 15
Apples Grapes – I Celery Bell peppers Strawberries Potatoes Peaches Blueberries – D Spinach Lettuce Nectarines – I Kale/Greens I= Imported The Clean 15 Onions Apples Sweet corn Cantaloupe ‐ D Pineapples Kiwi Avocado Cabbage Asparagus Watermelon Sweet peas Sweet potatoes
Mangos Grapefruit Mushrooms The Dirty Dozen Apples Grapes – I Celery Bell peppers Strawberries Potatoes Peaches Blueberries – D Spinach Lettuce Nectarines – I Kale/Greens I= Imported D= Domestic The Clean 15 Onions Apples Sweet corn Cantaloupe ‐ D Pineapples Kiwi Avocado Cabbage Asparagus Watermelon Sweet peas Sweet potatoes
Mangos Grapefruit Mushrooms 183 What's Super About Superfoods?
Eating right is more than adding a handful of healthy foods to your diet or eliminating unhealthy
ones, but rather the healthfulness of your entire diet – which should include a variety of foods.
However, a few foods are truly "super" – packing more than their share of nutrients and
phytochemicals that lower risk for diseases such as cancer and heart disease. In addition, many
of these “superfoods” are low in calories and high in fiber, which can help with weight loss and
weight maintenance.
Phytonutrients or phytochemicals are chemicals in plants (apart from vitamins, minerals, and
macronutrients like proteins and carbohydrates) that have a beneficial effect on the body. There
are hundreds, if not thousands, of phytochemicals in foods. Highly colored vegetables and fruits
tend to be highest in these chemicals, but tea and nuts are also excellent sources.
What's one key thing superfoods have in common? They are all "real," i.e., unprocessed, foods.
Garlic
Why it’s super:
1
Studies have shown that garlic may help to reduce cholesterol , have anti-inflammatory and anti2
3
arthritic properties and contain sulfur compounds that may prevent heart disease.
How to include more in your diet and other advice:

Studies have shown that crushing garlic cloves prior to cooking reduces the loss of
4
garlic's healthful properties during cooking.

Fresh garlic may inhibit the development of heart disease more than processed garlic.

Look for cloves that are plump and smooth. Avoid those that have begun to sprout
because they could be spoiled.

Add chopped garlic when sautéing greens, such as spinach, kale, or rapini (also called
broccoli rabe).

Add chopped garlic to soups, stews, and pasta sauces.

Roast potatoes with whole cloves of garlic, then puree them together with a bit of olive oil
for garlic-mashed potatoes.

Add a bit of finely minced garlic to salad dressings.
5
Oats
Why it's super:
6
7
Oats has been found to lower cholesterol and blood pressure, and the phenolic compounds in
oats have been found to inhibit the oxidation of LDL (“bad”) cholesterol, which protects against
8
the development of heart disease.
184
Healthy Express Lesson 3
How to include more in your diet and other advice:

Eat more oatmeal, which tastes better with a toasted flavor. You can enhance this flavor
by cooking oatmeal in a nonstick pan over low heat until it's slightly fragrant and darker.
Take care not to burn it, though.

Garnish oatmeal with raisins, dried cranberries, blueberries, or toasted nuts.
Blueberries
Why they’re super:
9
Studies have shown that blueberries increase insulin sensitivity, protect brain and memory
10
11,12
health, and protect against oxidation, the principal cause of cellular damage.
How to include more in your diet and other advice:

The best of the berries is in the pulp and seeds, so choose the whole fruit, not juice.

Frozen berries are just as nutritious as fresh berries.

Switch from ice cream to frozen blueberries for an after-dinner snack.

Add berries to tossed salads, salsas and muffin batter.

Briefly cook berries with a little sugar or other sweetener, lemon juice, and cornstarch,
and use as a topping for pancakes, French toast, waffles, and ice cream.
Nuts
Why they’re super:
Multiple studies have found a moderate amount of nuts inhibits the development of heart
13,14
Limit yourself to about an ounce of nuts a day – about what fits in one layer on the
disease.
palm of your hand.
How to include more in your diet and other advice:

Use as a crunchy addition to oatmeal, salads, or yogurt.

Because of their high concentrations of fats, nuts have a tendency to go rancid.

In general, whole nuts keep better than pieces; unprocessed nuts keep better than
processed ones; nuts in the shell keep better than shelled.

Keep nuts in a cool place in a sealed container for up to four months. Keep in the fridge
for about six months and in the freezer for up to a year.

Dry-roasted or raw nuts are a good choice. Avoid nuts with added salt, oil or flavors.
Green Tea
Why it’s super:
15
16
17
Green tea may reduce the risk of heart disease , stroke and cancer. Additionally, a
18
compound in green tea called EGCG may support brain health and memory.
Healthy Express Lesson 3
185
How to include more in your diet and other advice:

Aim to drink at least two cups per day. Replace coffee drinks or sugary sodas with tea.

Brewed tea offers more health benefits than instant tea. Brew tea for at least three
minutes.
Sources Cited
1. Reinhart, K. M., Talati, R., White, C. M., & Coleman, C. I. (2009). The impact of garlic on
lipid parameters: A systematic review and meta-analysis. Nutrition Research Reviews,
22(1), 39-48.
2. Ban, J. O., Oh, J. H., Kim, T. M., Kim, D. J., Jeong, H. S., Han, S. B., et al. (2009). Antiinflammatory and arthritic effects of thiacremonone, a novel sulfur compound isolated
from garlic via inhibition of NF-κB. Arthritis Research & Therapy, 11(5), R145.
3. Benavides, G. A., Squadrito, G. L., Mills, R. W., Patel, H. D., Isbell, T. S., Patel, R. P., et
al. (2007). Hydrogen sulfide mediates the vasoactivity of garlic. Proceedings of the
National Academy of Sciences of the United States of America, 104(46),17977-17982.
4. Cavagnaro, P. F., Camargo, A., Galmarini, C. R., & Simon, P. W. (2007). Effect of
cooking on garlic (Allium sativum L.) antiplatelet activity and thiosulfinates content.
Journal of Agricultural and Food Chemistry, 55(4), 1280-1288.
5. Mukherjee, S., Lekli, I., Goswami, S., & Das, D. K. Freshly crushed garlic is a superior
cardioprotective agent than processed garlic. Journal of Agricultural and Food Chemistry,
57(15), 7137-7144.
6. Van Horn, L., Moag-Stahlberg, A., Liu, K., Ballew, C., Ruth, K., Hughes, R., et al. (1991).
Effects on serum lipids of adding instant oats to usual American diets. American Journal
of Public Health, 81(2), 183-188.
7. Saltzman, E., Das, S. K., Lichtenstein, A. H., Dallal, G. E., Corrales, A., Schaefer, E. J.,
et al. An oat-containing hypochaloric diet reduces systolic blood pressure and improves
lipid profile beyond the effects of weight loss in men and women. Journal of Nutrition,
131(5), 1465-1470.
8. Chen, C. Y., Milbury, P. E., Kwak, H. K., Collins, F. W., Samuel, P., & Blumberg, J. B.
(2004). Avenanthramides and phenolic acids from oats are bioavailable and act
synergistically with vitamin C to enhance hamster and human LDL resistance to
oxidation. Journal of Nutrition, 134(6), 1459-1466.
9. Stull, A. J., Cash, K. C., Johnson, W. D., Champagne, C. M., & Cefalu, W. T. (2010).
Bioactives in blueberries improve insulin sensitivity in obese, insulin-resistant men and
women. Journal of Nutrition, 140(10), 1764-1768.
10. Krikorian, R., Shidler, M. D., Nash, T. A., Kalt, W., Vinqvist-Tymchuk, M. R., Shukitt-Hale,
B., et al. (2010). Blueberry supplementation improves memory in older adults. Journal of
Agricultural and Food Chemistry, 58(7), 3996-4000.
186
Healthy Express Lesson 3
11. Hurst, R. D., Wells, R. W., Hurst, S. M., McGhie, T. K., Cooney, J. M., Jensen, D. J.
(2009). Blueberry fruit polyphenolics suppress oxidative stress-induced skeletal muscle
cell damage in vitro. Molecular Nutrition & Food Research, 54(3), 353-63.
12. Ahmet, I., Spangler, E., Shukitt-Hale, B., Juhaszova, M., Sollot, S. J., & Joseph, J. A.
(2009). Blueberry-enriched diet protects rat heart from ischemic damage. Public Library
of Science (PLoS) ONE, 4(6), e5954.
13. Kelly, J. H., Jr., & Sabaté, J. (2006). Nuts and coronary heart disease: An epidemiological
perspective. British Journal of Nutrition, 96(suppl2), S61-S67.
14. Blomhoff, R., Carlsen, M. H., Andersen, L. F., & Jacobs, D. R., Jr. (2006). Health benefits
of nuts: Potential role of antioxidants. British Journal of Nutrition, 96(suppl2), S52-S60.
15. Aneja, R., Hake, P. W., Burroughs, T. J., Denenberg, A. G., Wong, H. R., & Zingarelli, B.
(2004). Epigallocatechin, a green tea polyphenol, attenuates myocardial ischemia
reperfusion injury in rats. Molecular Medicine, 10(1-6), 55-62.
16. Choi, Y. B., Kim, Y. I., Lee, K. S., Kim, B. S., & Kim, D.J. (2004). Protective effect of
epigallocatechin gallate on brain damage after transient middle cerebral artery occlusion
in rats. Brain Research,1019(1-2), 47-54.
17. Chen, D., Daniel, K. G., Kuhn, D. J., Kazi, A., Bhuiyan, M., Li, L., et al. Green tea and tea
polyphenols in cancer prevention. Frontiers in Bioscience, 9, 2618-2631.
18. Haque, A. M., Hashimoto, M., Katakura, M., Tanabe, Y., Hara, Y., & Shido, O. (2006).
Long-term administration of green tea catechins improves spatial cognition learning
ability in rats. Journal of Nutrition, 136(4), 1043-1047.
Healthy Express Lesson 3
187