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ReShape® Patient Article Handouts Table of Contents Nutrition and Food Focused 1. Pre-Procedure Guidelines 2. Post Procedure Instructions 3. Day 12 and Beyond 4. Preparing for Removal 5. Drink up! Staying Hydrated 6. Vegetarian Protein Options 7. Protein Drink Or Protein Disaster 8. Food Swaps: Lunch 9. What is a Treat 10. Starchy Vegetables 11. Processed Foods: Go for Whole 12. Low Calories vs. Nutrient Dense 13. Healthy Snacks 14. Cut Calories in cooking 15. Alcohol 16. Diet Plateaus Environmental Strategies 1. Making Changes in Your Home 2. Eating Sitting Down 3. Eating on a Smaller Plate 4. Portion Your Plate 5. Strategies for Eating Out 6. Travel Page 1 of 2 Controlling Hunger 1. Eating Slowly 2. Rule of 20 3. Recognizing Fullness 4. Redefining Hunger 5. Junk Food Cravings Exercise 1. Walking Benefits 2. Aerobic Activity Overview 3. Exertion Levels 4. Physical Activity without Injury 5. Little Activities Add Up 6. Fueling for Workouts 7. Low Impact Workouts Page 2 of 2 • 12 hours before the procedure: stop all food and drink, including water Plan Ahead for Your Recovery • During the balloon insertion procedure, you will be comfortably sedated under light anesthesia. Arrange for a driver to take you home. • Plan to take at least three days or more off from work, school, or other activities to get through any post-insertion symptoms Pre-Procedure Instructions At ReShape®, we take your health very seriously. You may have selected the ReShape Procedure because it’s a non-surgical, non-anatomy-altering way to achieve significant weight loss, but there are still important health and medical considerations to ensuring you enjoy a safe recovery. No Eating Before the Procedure It is important that your stomach is completely empty before the procedure: if there are any food remnants, your doctor won’t be able to insert the balloons. Starting two days before your appointment, adhere to these eating guidelines: • 48 hours before the procedure: eat only soft foods such as milk, eggs, tofu, cheese, custard, strained soups, rice, cooked vegetables, and bread– no fried foods or meat in any form. • 24 hours before the procedure: consume only clear liquids (e.g., broth, Jell-O, tea, apple juice, popsicles) • You should be up and walking around as soon as possible following the procedure. While you’re recovering, sit in an upright position rather than reclining. • It is important to stay hydrated by sipping water. Sip slowly. Warm water is easier on your stomach than cold water. Carbonated drinks and caffeinated drinks are not recommended. • Post –procedure a phased diet approach is recommended for the first ten days to two weeks. Please talk to your nutrition coach. Medications are prescribed for post-procedure symptoms After the insertion of the balloons, soreness and nausea are common side effects. These symptoms typically subside in a few days to a week. Your doctor will prescribe medication to help alleviate the side effects. If you have any concerns, speak with your doctor. Fill all medications prescribed by your doctor before the procedure. The antacid medication, for example, must be started at least 3 days prior to balloon insertion and taken EVERY DAY until the balloon is removed. These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. NFF 1 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 • Don’t drink more than ½ cup (4 ounces) at a time, and wait for 10 minutes between drinks. If you are able to eat the foods listed above without discomfort, you can begin eating the foods listed for days 4-7. Days 4 – 7 Smooth Pureed Foods Post Procedure Dietary Guidelines Days 1 - 3 After the balloons are inserted, you need to give your body a chance to adjust. Following a carefully designed meal plan will help your recovery. Fluids and Clear Liquids Only You can have clear broth, Jell-O, Ice Chips, Small sips of water, diluted juices, sports drinks, herbal and decaffeinated tea and popsicles You should avoid: • Carbonated drinks, such as soda or mineral water, because they may cause gas and bloating • Caffeinated drinks such as coffee and tea as they may produce more stomach acid and cause gastric irritation. Other things to keep in mind: • You must remain upright for 3-4 hours after drinking. Reclining is fine, but avoid lying flat • Begin with small, warm, frequent sips and then increase the amount taken in each sip • Wait a minute or two between sips • • • • • • • • Liquid protein supplements and smoothies Skim or 1% milk Yogurt (without chunks of fruit) Pureed fruit Soft cooked and pureed vegetables Soups (strained or blended) Cream of Wheat or oatmeal, thinned Sugar free pudding Sample Menu* Breakfast • ¼ cup Cream of Wheat, thinned • 2 tablespoons 1% milk • ¼ cup unsweetened, diluted juice Midmorning Snack • ¼ cup plain yogurt • ¼ cup pureed fruit Lunch • ¼ cup strained soup • ¼ cup pureed squash • ¼ cup liquid protein supplement Midafternoon Snack • ¼ cup sugar free pudding Dinner • ¼ cup strained soup or broth • ¼ cup pureed sweet potato • ¼ cup skim milk *Stop eating at first sign of fullness NFF 2 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 Pg. 1 of 2 Days 8 – 12 Soft Foods Between days 8 and 11 after you had the balloons inserted, you may be ready to transition your diet and be able to add more variety and texture to your food options. During this time, focus on soft foods. Remember, while you eat, pay close attention to how your body feels – before, during, and after meals. It is important to eat slowly, chew food thoroughly, and stop eating at the first sign of fullness. Soft Diet Sample Menu* Breakfast • • • ¼ cup soft fruit such banana or melon 1 scrambled egg ¼ cup skim milk Midmorning Snack • ¼ cup sugar free pudding or liquid protein drink Lunch You can have: • • • • • • • • • • • • • Tofu Soft, poached fish Lean ground meats Deli meats, thinly sliced Canned tuna packed in water Canned chicken packed in broth Scrambled eggs Cottage cheese Custard Toast Well-cooked vegetables Soft fruit with skin removed • • ¼ cup canned chicken or tuna prepared with 1 tablespoon low-fat mayo ½ piece toast ¼ cup mango Midafternoon Snack • ½ cup non-fat yogurt Dinner • • • 2 oz. soft, poached fish or ¼ cup lean ground turkey ¼ cup steamed zucchini squash or carrots ¼ cup cottage cheese *Stop eating at first sign of fullness You should avoid sweets and dry meats. Make sure to drink at least 64 ounces of water a day. Keep in mind, the balloon is not magical, it is only a portion control tool to help you feel fuller sooner but may not control hunger. Therefore, be sure to work with your coach to develop strategies that will help recognize your new feelings of hunger and satisfaction. Learning to distinguish between physical hunger and “head” or “emotional” hunger is an important weight control strategy during this time. 2 Weeks and Beyond: Be sure to discuss your specific diet needs, weight loss goals and food history with your nutrition coach Avoid fried foods Avoid sweetened and caloric drinks Avoid alcohol and caffeinated beverages as they may cause gastric irritation Limit fast food and high calorie convenience foods Eat protein and fiber-rich meals to increase satiety These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. NFF 2 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 Pg. 2 of 2 Introduce new foods one at a time to rule out intolerance. If a food is not tolerated, it may cause pressure or pain near your breastbone. If this occurs, you may find it helpful to return to liquids or purees for a couple of days until your stomach feels calm again. If the pressure or pain persists, discuss your symptoms with your dietitian. Remember to always follow the advice of your health care provider. If you are unsure about your dietary needs and requirements, contact your physician. Day 12 and Beyond Dietary Guidelines: Day 12 and Beyond By day 12 you should be able to transition back to a regular diet. This is an exciting time in your procedure! You should feel fully recovered and ready to begin eating your favorite foods again. You will notice that your portion sizes are going to be a lot smaller so you won’t be able to eat as much as you could before you had the balloons inserted. Make sure to monitor your portion size and be cautious of overeating so you won’t get sick. Here are some general guidelines to follow when transitioning back to normal foods: Pay close attention to your body’s sensations before, during, and after meals. Stop eating at the earliest sign of fullness or discomfort under your breastbone. Stop eating when you no longer feel hunger. Do not eat until you are uncomfortably full. Chew slowly and thoroughly. Each meal should take at least 15-20 minutes. These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. NFF 3 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 If there is any food at all in your stomach, your doctor won’t be able to remove the balloons. It is very important to follow the guidelines listed below. • 48 hours before the procedure: eat only soft foods – meat in any form is strictly prohibited • 24 hours before the procedure: consume only clear liquids (e.g., broth, Jell-O, apple juice) • 12 hours before the procedure: stop all food and drink, including water Mentally Preparing Yourself for Life After the Balloons As your removal date nears, you may find yourself asking, “Now what?” Preparing for Removal As you are approaching the six-month mark for your ReShape® Procedure, it’s time to start planning to have the balloons removed. This is a significant milestone! The instructions that follow will help make sure the procedure goes smoothly and maintain your weight loss when the balloons are no longer in your stomach. Eating Requirements Prior to Balloon Removal The process of having the balloons removed will be similar to the balloon insertion process that you experience initially. It will take place in an outpatient setting and you will be comfortably sedated under light anesthesia. Your doctor will then retrieve the balloons during an approximately 20-minute endoscopic procedure. You’ll need to arrange for a driver to take you home after the procedure. There is no need to worry. The ReShape Procedure was designed to help you achieve long-term success. In fact, studies show that the majority of ReShape patients continue to lose weight or maintain weight loss after the balloons have been removed. At this point in the procedure, we enter the last phase, Healthy Living. You’ll receive another six months of personalized coaching to help you maintain your weight loss and continue your success. It’s important for you to continue the healthy choices you’ve been making so far. Make a point to be extra diligent about logging your nutrition, activity, and weight. This will become increasingly useful for staying on track and reinforcing your recent healthy habits! If you have any concerns or questions about life after the balloons have been removed, make sure to share them with your health care team. These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. NFF 4 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 So What’s Enough Water? The 64 ounces/day rule is good to keep in mind. But in general, you don’t want to feel thirsty throughout the day and the color of your urine should be close to clear by the end of the day (lemonade color and not apple juice color!). Need Help Getting a Few Extra Ounces Down? • Take it to go! Keep your water bottle with you at all times! Remember, you need to drink 64 ounces to meet your daily water needs. Drink Up! The Importance of Staying Hydrated! 8 glasses, 64 ounces, ½ gallon – that’s the daily recommended water intake! This is a lot of water…and a lot of sipping! Each person’s water needs are different, but adequate hydration is important for your health, body and over well-being! Water is actually considered a major nutrient for your body – just like carbohydrates, protein or fat. It’s important to drink enough to keep your body going and to replace water lost throughout the day – which is lost in skin evaporation, sweat, urine, and breathing. Not replacing water can result in dehydration. What Does Water Actually Do? Since your body is over 60% water, it’s a vital component. It aids your body in blood circulation, absorption, digestion, saliva creation, transportation of nutrients, and maintenance of body temperature. It’s also very important to muscle performance. Dehydrated muscles don’t work as well and your performance will suffer! • Pace yourself. Give yourself a time limit to get in all those ounces. Check at each meal to see how you’re doing for the day. • Drink and drive! Water that is! Make it a point to drink water on your way to work and the way home! • Sip with a straw. Research shows that you’ll drink more water if you use a straw. Take Action! Staying hydrated is critical to your weight loss success. Follow the steps below to add it in to your weight loss routine. • Hydrate! Drink at least 64 ounces (8 glasses) of water per day. • Remember to evaluate your goals on a weekly basis to track your progress. These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. NFF 5 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 The key to making a delicious and protein rich meatless meal is to be aware of other protein sources. Try: Food Meatless Proteins: A Quick Guide Meatless meals have been making a big entrance into the healthy eating arena over the last several years. Vegetarianism and even veganism have become much more mainstream. However, many people find it hard to believe that you can consume enough protein without the typical beef, chicken or fish. Do Meatless Meals Provide Enough Protein? Although essential for optimal health, only a portion of your total calorie intake – anywhere from 2035% – should come from protein-based foods. For example, if you consume 1,200 calories per day your protein intake should include approximately 60 – 105 grams of protein. Meatless meals can provide you with more than the adequate amount of protein without having to consume meat, poultry, or fish. In addition, many vegetarian proteins are high in fiber, iron, zinc and B vitamins. Protein Content Tofu 10 g protein per ½ cup Tempeh 15 g protein per ½ cup Sietan 21 g protein per 3 oz. Lentils 18 g protein per 1 cup Skim Milk 8 g protein per 1 cup Soy Milk (almond milk is not a good source) 7 g protein per 1 cup Eggs 6 g per 1 egg (1 egg white = 4 g) Nuts & Seeds 5-8 g protein per ¼ cup Beans & Lentils 15 g protein per 1 cup Quinoa 8 g protein per 1 cup Veggie Burger About 13 g protein per patty Meatless “ground meat” crumbles 8-12 g protein per ½ cup These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. NFF 6 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 Protein Drink or Protein Disaster? Protein drinks are a great meal replacement option after a weight loss procedure. These low-calorie, high-protein supplements will help you reach your daily protein goals, provide energy and fuel your weight loss! However, not every protein drink is a great choice. It can be tricky to choose which protein drinks are good for you or which ones are high-calorie, highsugar disasters. Here are some things to keep in mind: 100% whey protein – whey protein is derived from milk and is a high quality protein. It contains all the essential amino acids your body needs. Casein, soy and egg white protein are good options too. o Avoid collagen protein. It is not an acceptable source of protein since it provides very little nutritional value. Adequate amount of protein per serving – Aim for about 15 to 20 grams of protein per serving. Low sugar – find protein drinks that have about 6 grams of sugar or less per serving. This will help keep the calories low and you won’t end up consuming a lot of added sugar. Moderate calories – since you still need to keep in mind your overall calorie intake, you should pick a protein drink that has less than 200 calories per serving. Avoid smoothies and shakes – generally, words like protein smoothie or shake may mean higher calories and more sugar. Jamba Juice, Naked shakes and Odwalla drinks are examples of meal replacements that are not appropriate protein supplements. Examples – try these brands to get you started: Premier Protein, Isopure, Unjury Protein, Pure Protein, Jay Robb, Atkins or Nectar. Silken Tofu Berry Blast 16 grams protein per cup (makes 3 cups) 1 10.5-oz package silken tofu (soft), drained 1 cup partially thawed unsweetened frozen berries, include liquid Sugar substitute to taste In a blender or food processor, combine all ingredients. Whip until smooth. Serve chilled. Tropical Smoothie 16 grams protein per cup (makes 2 cups) 1 cup frozen, unsweetened fruit 1 cup non-fat sugar free vanilla or plain yogurt 1 tsp. coconut or vanilla extract 1/3 cup non-fat powdered milk or 1 scoop whey or soy protein supplement In a blender or food processor, combine all ingredients. Whip until smooth. Serve chilled or frozen. These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. NFF 7 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 Food Swaps- Lunch You may default to fast foods or heavy restaurant meals at lunch time, especially during a stressful workday. It’s easy to overload on sandwiches, salads, or a greasy burger when you’re rushed, but healthier food will help fuel you through the afternoon without leaving you feeling weighed down. To lighten up your lunch-time munching, check out these swaps: NFF 8 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 Pg. 1 of 2 These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. NFF 8 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 Pg. 2 of 2 What is a Treat Sometimes the thought of giving up all treats on your weight loss journey seems impossible. Fortunately, planned indulgences have a place in your diet and may help you eat healthier. When you feel satisfied with the foods you eat, including the occasional treat, you are more likely to stick to your plan. Overly restrictive diets only work for so long, and once you finally give in, your small indulgence can avalanche into a day-long binge. Instead of thinking about eating perfectly, remember that occasional treats are good for you mentally and will keep you focused on your goals. The key to keeping treats in their place is to balance what, when, and how much you eat. Remember, a treat can still be made healthier – think chocolate covered strawberries or cocoa dusted almonds. Keep treats to no more than 250 calories. What is considered a treat, and how much is an appropriate serving size? 3” chocolate walnut cookie 1/2 cup low-fat ice cream ½ onion bagel with 1 T. light veggie cream cheese 2 pieces bacon 1 individual bag baked potato chips Small nonfat café mocha 1/2 piece of pizza (add veggies) 2” square brownie 1/2 blueberry muffin Pear slices topped with 1 T. chocolate hazelnut spread 1 ounce dark chocolate 2 cups air popped popcorn with 1 T. melted butter Dark chocolate strawberries (2) Protein drink with 1 T. chocolate or peanut butter chips Frozen fruit (berries, bananas) with 2 T. Truwhip NFF 9 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 Pg. 1 of 2 When should I indulge? Treats are an important, yet small part of a healthy diet. Most people do best when limiting indulgences to 1 or 2 times per week. Make healthy foods feel indulgent. Add cocoa powder to a protein shake for a chocolate fix or drink low sugar hot chocolate. Bake chick peas with a sprinkle of salt, garlic powder and 1 T. olive oil for 20 minutes at 350 degrees. Peel and cut 2 large sweet potatoes into sticks, toss in 2 tablespoons coconut oil, season with cinnamon and sea salt, and bake at 375 degrees for 30 minutes or until slightly crispy to make “fries.” Serves 3-4. Make peanut butter sandwiches by smearing 1 teaspoon of peanut butter between two round slices of banana; freeze. Freeze your favorite flavored Greek yogurt for 1 hour and enjoy! These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. NFF 9 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 Pg. 2 of 2 Even though starchy vegetables are more nutrient rich than other carbohydrate options (think: pasta), it’s still important to eat them in moderation. One serving is considered ½ cup, which has the same amount of carbohydrate as a piece of bread. When dishing up dinner, keep starchy veggies to no more than one quarter of your plate. Starchy Vegetables Vegetables are one of the healthiest foods on the planet. Full of vitamins, minerals and diseasefighting phytochemicals (plant chemicals), veggies should make up half of your plate. Not all vegetables are created equal in the weight loss game, however. Starchy vegetables like corn and peas are higher in plant starch and contain more carbohydrate and calories than non-starchy veggies like broccoli and spinach. You don’t have to forego all starchy vegetables – after all, they are packed with nutrients and fiber – but you should be able to identify them and know how to keep your portions in check. Most starchy vegetables taste best cooked. Peel and chop butternut squash, drizzle with olive oil and season with salt and pepper, and roast at 375 degrees for 30-45 minutes or until lightly browned. Parsnips, which look like white carrots, can be sliced into coins, steamed, and enjoyed with a teaspoon of butter and fresh herbs. Below are the most commonly eaten starchy vegetables: Squash – butternut, acorn, winter Potato Sweet potato/yam Pumpkin Parsnip Green pea Corn PN: 04-0174 Reference: American Diabetes Association These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 NFF 10 Highly processed foods can include – deli meat, baked goods like cookies, crackers and some 100 calorie snack packs, frozen meals, cereals, salad dressings and some bread. Picking Out Whole or Unprocessed Foods Whole and unprocessed foods are similar, but not exactly the same. Although there are rarely foods that require no processing whatsoever (even that apple was picked, washed and shipped), whole foods are items that have been minimally processed or are left in their whole form. These can include: Whole grains like brown rice, quinoa or oatmeal Processed Foods: Go for Whole Have you noticed the big push towards more whole or unprocessed foods? Take a step into a grocery store and you’ll see signs, advertising and food packages promoting all-natural, unprocessed, and whole foods! But what do those words really mean? And more importantly, why is there such a huge focus on these types of foods? What is a Processed Food? Processed foods incorporate a very wide range of foods – anything from drive thru hamburgers and potato chips to low calorie, high fiber bread or pre-washed lettuce. What’s most important is understanding the difference between minimally processed foods and highly processed foods. Minimally processed foods can include – prewashed/cut vegetables and fruit, frozen and canned fruits or vegetables, or items that are only processed for convenience. Whole fruits and vegetables – even those that are only canned or frozen! Lean protein (not including deli meat, bacon or processed meats) Dairy products without a lot of added fruit, sugars or other items Highly processed foods (even low calorie ones) are generally stripped of all the good stuff! Fiber, vitamins, minerals and antioxidants are found in abundance in whole and minimally processed foods. They are great choices and should make up the majority of your diet. References: http://www.eatright.org/Public/content.aspx?id=6442471055 http://www.webmd.com/diet/features/the-benefits-of-healthywhole-foods These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. NFF 11 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 Artificial ingredients: real foods taste good, so why eat artificial ingredients? As food is processed and packaged more artificial ingredients such as sugar and preservatives are added to enhance the taste! Low-fat ≠ low-calorie: Low-fat foods often contain added sugar and can be unhealthy. Fat, when eaten in moderate amounts, is important for our health and aids in weight loss, helping to increase our feelings of fullness. However, remember that every 1 gram (g) of fat contains 9 calories, while 1 g of carbohydrate or protein only contains 4 calories; so, it is easy to “overdo” the fat. Low Calories vs. Nutrient Dense Over the years of fad diets, some dieting ideas have stuck around and some have been completely written off (bye-bye cabbage soup diet!). Fat-free and low-calorie foods are still very popular today. You can find anything from 100calorie snack packs, fat free cookies and desserts, and even breads with less than 90 calories a slice – all great options, right? Well…maybe not. While watching your overall calorie and fat intake is important, you also need to consider the nutrient density or nutrition content of those low-calorie or fat-free foods. You want to find foods that have the most nutrition bang for your calorie buck. For Example It’s time for a snack. There’s a choice of low fat baked potato chips or carrots and hummus. Both offer a nice crunchy, savory flavor and are only about 200 calories. But check out the nutrition stats: 1.5-oz baked potato chips 2 g protein 2 g fiber 1 cup carrots & 3 tbsp. hummus 4 g protein 7 g fiber 400% RDA Vitamin A While the calorie count is the same, the nutrient density is vastly different! Carrots and hummus have twice the amount of protein and fiber. Consider the quality of your calories, not just the quantity. Eating more nutrient dense foods will put good for you foods at the center of your plate! Low-fat/low-calorie foods may not be the best choice for your body. Here’s why: References: http://jhmas.oxfordjournals.org/content/63/2/139 http://www.webmd.com/diet/low-fat-diet www.nutrition411.com Empty calories: many times, low-fat items (especially snack foods or processed foods) come with very little nutrition – low in fiber, protein, vitamin and/or minerals. These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. NFF 12 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 Healthy Snacks Who doesn’t love a quick and easy snack idea? We are always looking for more fun, tasty and healthy recipes, especially when it comes to snacks. See below for 10 yummy ways to incorporate healthy snacks into your diet. Snack Ideas 1. Spicy Cucumber Slices Ingredients: ½ cucumber, peeled and sliced, ¼ cup of reduced fat feta cheese, juice of ½ lemon, 1 tsp. olive oil, chili powder, sea salt and pepper to taste Nutritional Information 106 calories, 7 g protein Directions: Slice cucumber and top with feta cheese, lemon juice, oil, chili powder, salt and pepper. 2. Frozen Blueberry Yogurt Bites Ingredients: 25 blueberries; ¾ cup plain nonfat Greek yogurt; ¼ tsp. vanilla extract 128 calories, 19 g protein Directions: Add vanilla to yogurt and stir. Spear a blueberry with a toothpick (don’t poke all the way through) and dip blueberry in yogurt so that berry is covered. Ease onto a cookie sheet covered in wax paper using fork or finger. Freeze for at least 1 hour, then remove and place in a sealed container. Store frozen. 3. Salted Edamame Ingredients: ½ cup shelled edamame with salt 120 calories, 13 g protein Directions: Steam edamame on stove or in microwave. Sprinkle with salt. PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 NFF 13 Pg. 1 of 3 4. Nectarine Wrapped in Arugula and Prosciutto Ingredients: 1 nectarine, 8 - 12 pieces of arugula, 2 slices of prosciutto, and black pepper 146 calories, 9 g protein Directions: Cut nectarine into 4 slices. Wrap each slice with 2- 3 pieces of arugula and ½ slice of prosciutto. Sprinkle each with black pepper to taste. 5. Strawberry Cream Cheese Sandwich Ingredients: 1 slice whole wheat bread, 1 ½ tbsp. light cream cheese, 4 strawberries (sliced) 129 calories, 5 g protein Directions: Spread cream cheese on bread and add strawberries. Try toasting the bread for an extra crunch! 6. Blackberry Peanut Rice Cake Ingredients: 1 brown rice cake, 1 tbsp. peanut butter, 6 blackberries 173 calories, 7 g protein Directions: Spread peanut butter onto the rice cake and top with blackberries. 7. Zucchini Pizza Bites Ingredients: 1 zucchini, 3 tbsp. marinara sauce (divided), ¼ cup shredded mozzarella cheese (divided) 119 calories, 10 g protein Directions: Wash and dry zucchini. Cut into 8 ¼” slices. Spread zucchini on a cookie sheet lightly coated with olive oil spray. Divide marinara sauce and cheese evenly between zucchini slices (cheese tops sauce). Bake 15-20 minutes or until cheese is lightly browned and bubbling. Cool slightly before eating. 8. Warm Spiced Pear Ingredients: ½ cored pear, ¼ cup part-skim ricotta cheese, ¼ tsp. ground cinnamon 136 calories, 7 g protein Directions: Preheat broiler and place cored pear on baking sheet. Broil 10-12 minutes or until tender. While the pear is broiling, combine ¼ cup part-skim ricotta cheese and ¼ tsp. ground cinnamon. Top warm pear with ricotta mixture. PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 NFF 13 Pg. 2 of 3 9. Black Bean Dip w/ Jicama Slices Ingredients: 1 15-oz can black beans, ½ cup salsa, 2 tbsp. lime juice, ½ tsp. cumin 116 calories, 5 g protein Directions: Combine black beans, salsa, lime juice, and cumin in a food processor or blender. Process until smooth. Serve 1/3 cup bean dip with ½ cup fresh jicama slices. 10. Roast Beef Cheese Rolls Ingredients: 1 small spreadable cheese wedge (such as Laughing Cow brand), 4 thin slices of nitrate-free roast beef (2oz total), 1 slice of red bell pepper 121 calories, 14 g protein Directions: Spread cheese on roast beef slices. Top with 1 slice of red bell pepper each and roll into a pinwheel. These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 NFF 13 Pg. 3 of 3 Cut Calories in Cooking The best way to keep your nutrition in check is to make your own food. Restaurant meals can be loaded with calories, fat and salt, but if you’re not careful at home you may find yourself eating poorly. Keep your at-home cooking low-calorie without losing flavor by following these simple kitchen inspirations: Steam, bake, roast or sauté veggies or proteins instead of frying in oil. Use fresh or dried herbs and a bit of sea salt to add flavor without fat. When baking, cut white or brown sugar in half without losing sweetness or consistency. Cook with fruit – citrus pairs especially well with chicken and fish. Substitute nonfat plain Greek yogurt for sour cream and mayonnaise in recipes Replace half of ground beef or turkey with chopped mushrooms, beans, or veggie (soy) crumbles. Use zucchini as pasta, either sliced thin in lasagna or formed into a noodle using a spiralizer. Lighten up meatloaf, meatballs and casserole with shredded veggies such as spinach, carrot, zucchini, peppers, and/or onion. Steam vegetables in a basket over simmering water or microwave steamer. They’ll retain more flavors and won’t need any butter or salt. Use a broth-based or bean soup as a side dish instead of rice or pasta. Use broth, water, oil spritzers, or nonstick cooking spray instead of oil when sautéing vegetables or proteins. Make baked goods moist by using applesauce or pureed pumpkin in place of oil. Use lean meat cuts, like skinless chicken breast, turkey, or beef tenderloin, whenever possible. Choose low-fat dairy in recipes that call for milk, sour cream, cheese or cottage cheese. NFF 14 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 Pg. 1 of 2 Enjoy mashed steamed cauliflower with a bit of butter, salt, garlic and pepper and skip the mashed potatoes. Choose strong cheese like sharp cheddar, Parmesan or feta in place of mild varieties and use half of what the recipe requires. Cook chicken with the skin on to keep it moist – simply remove it before eating. Chicken skin contains 1/3 calories and 1/2 fat of chicken portion. Make your own “light” vinaigrette with 2/3 vinegar, 1/3 olive oil and your favorite herbs, pepper and salt. Blend in berries or add citrus (lemon, orange, lime) for additional tang. When you prepare and cook meals at home, you have control over the nutritional content and the overall healthfulness of the foods you eat. Bonus: You can also save money! These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. NFF 14 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 Pg. 2 of 2 Also, your body burns alcohol before any other fuel. As a result, your fat burning efforts take a backseat until all of the alcohol is metabolized. Finally, alcohol is a physiologic toxin. Consuming alcoholic drinks may reduce your decision-making capability and may lead to overeating food you wouldn’t normally choose. So even if you eat less in order to have a drink, you may make up for it by eating more later. Alcohol You may like an occasional glass of wine after work or enjoy a cocktail with friends or coworkers. You may have heard an occasional drink may be good for you. Alcohol certainly is not all bad; but how does drinking alcohol affect your weight loss and overall maintenance? If you understand how alcohol can impact your efforts, you can make informed decisions the next time you’re heading out on the town, grabbing a glass with a friend, or opening a bottle of wine with dinner. The Downsides of Alcohol It’s important to note that alcohol can contribute considerable calories to your daily intake – up to 500 for certain cocktails. Plan your intake ahead of time and decide when and how much you’ll drink. Here are some examples of calorie counts for common drinks: 5-oz red wine = 125 calories 12-oz beer = 150 calories 1 shot hard liquor (1.5-oz) = 120 calories 12-oz margarita (rocks) = 250 calories Frozen drinks = 300-400 calories. PN: 04-0174 How to Incorporate Alcohol in a Successful Weight Loss Plan If you decide to have the occasional drink, consider the following precautions: 1. Do not skimp on food. Make sure to have a meal with your cocktail. 2. Do not overconsume and be mindful of how much you’re drinking. One drink equates to 12-oz beer, 5-oz wine, or 1.5-oz liquor. 3. Drink plenty of water before and after your cocktail. 4. Know how many calories are in your drink. Stick to lower calorie options such as light beers, wine, or liquor with soda water. Be careful of mixers! Sugary cocktails like liquor mixed with juice, syrups, soda or tonic water can contain more calories than a meal. 5. Sip slowly. Take your time to finish the drink. When possible, try not to use a straw because that will make you drink faster! 6. Plan when and how much you’ll drink. Account for the calories on your food log. ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 NFF 15 Pg. 1 of 2 Drinking alcohol is an individual choice. It’s always best to be mindful when consuming alcohol and know your limits. References: http://pubs.niaaa.nih.gov/publications/AA72/AA72.htm These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. PN: 04-0174 NFF 15 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 Pg. 2 of 2 Fewer calories. As you lose weight, your body will require fewer calories. A smaller body is much easier to move and therefore requires less calories to fuel and keep going. Decreased muscle mass. Some muscle mass is lost as you lose weight along with fat mass. Less muscle mass means a slightly lower metabolism and a decreased calorie burn. Diet Plateaus Losing weight is an exciting process! You feel good, have more energy and are seeing your body change. But at some point along the weight loss journey, many people hit a wall. Their weight just won’t budge – even when their healthy diet and higher activity levels remain the same. This frustrating part of the journey is known as a weight plateau. What is a Weight Plateau? Weight plateaus are common and in fact, they are expected in any long-term weight loss attempt! Typically, these plateaus can last for anywhere from two to six weeks. During this time, dieters may see the same number on the scale for weeks, or see their weight bounce up and down a few pounds. This is due to your body “readjusting” to your initial weight loss, lifestyle and diet. Why the Plateau? A weight plateau can happen for a variety of reasons. The most common are: Nutrition slips. Over time, old habits can sneak back into your lifestyle – maybe you’re drinking more calories or snacking a little more than you should. These extra calories can also cause your weight loss to slow or stall. Moving Past the Plateau When the numbers aren’t budging on the scale, it’s time to take a step back and reevaluate. Keep a food/exercise journal. Take notes for a few days, you might catch a few “slip ups”! If you do, make the corrections and keep on going! Change up your exercise routine. Studies have shown that your body adapts to your exercise routine. Keep changing it up – do more high intensity exercise, adding different types of exercises, or add in more strength training to keep increasing your muscle mass will burn those calories! Don’t second guess yourself. If you’re sticking to a healthy diet and are being physically active have faith! Trust yourself and your knowledge that you’re doing everything right. The key is not to give up! These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. PN: 04-0174 NFF 16 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 Making Changes in Your Home Your home environment can make or break your weight loss efforts. If your fridge is empty and your workout clothes are buried, healthy habits may fall by the wayside. Don’t let your space sabotage all of your hard work! Clear your pantry of cookies and chips, and stock it with healthy eats in individual packages that are easy to grab on the go. Smart options include dry roasted almonds, freeze dried fruits and veggies, and turkey jerky. To stay hydrated, refrigerate a pitcher of your favorite unsweetened tea or fruit-infused water, and pre-fill water bottles each night so they’re ready for a full day of smart sipping. ReThink Your Fitness Make exercise easy by setting out your workout gear – or packing your gym bag – before bedtime. Stash light dumbbells by your TV and flex your muscles while you watch your favorite guilty pleasures. Stand while talking on the phone or watching TV. Take an extra trip up and down your stairs just for fun. De-stress Your Mess A messy house will make you stress, and keeping your cool is critical to your overall health and weight loss efforts. Small Changes Go a Long Way Think: What foods would you be successful around every day? Would healthy fruits, veggies and lean protein make you healthier, or would junk food and fried food be helpful in the house? The healthy foods of course! Create an environment which increases healthy items and limits your exposure to unhealthy or tempting foods. Start with Your Kitchen Store washed, peeled and chopped produce in transparent containers at eye level in your fridge and push less healthy options to the back of your shelves or in drawers. Put aside ten minutes each day to cleaning up, starting with the areas that bug you most, like your kitchen, bedroom or laundry room. You’re more likely to stay home and cook when your kitchen is in tip-top shape, so wash dishes as you go and use parchment paper or foil to make cleanup a breeze. Dusting and scrubbing are not only therapeutic, but they’re also a great workout that will make you happy to come home each day. These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. ES 1 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 Give Your Body A Chance! Did you know your body devotes energy, blood and oxygen to your digestive system the instant food enters your mouth? If you are moving around as you eat instead of sitting, your body is unable to devote enough resources to digesting your food. This can make you feel bloated, constipated or have diarrhea – which is not pleasant. Eating Sitting Down You could probably come up with a ton of excuses as to why you eat on the run. Late meetings, long commutes, and lack of energy are serious contenders when you’re hungry. Even breakfast and lunch are often eaten in the car or crammed in between work meetings. Mindless Eating is Thoughtless Eating When you eat mindlessly…let’s say throwing back a coffee and a granola bar as you hop onto the metro for work…eating goes on autopilot. Not paying attention to what goes in your mouth is dangerous! You can make poor food choices or eat at times when you aren’t hungry. This is how those excess calories sneak in. Why Don’t You Sit for A Bit? Sitting down to a meal is a good habit to put into place as you practice mindful eating. Take it a few steps further – completely unplug! Do not multitask while you are eating. Being distracted by television, your cell phone, the computer or the latest magazine can lead you to eat far more than you otherwise would. Turn off the TV Shut off your phone Get off Facebook Mindfully Check In How hungry am I on a scale of one to ten? Gauging your hunger level is a little like taking your temperature. Each time you eat, ask yourself “Am I physically hungry?” Aim to eat until you are satisfied, leaving yourself neither stuffed nor starving. Take Action! If you eat on the go then begin to make it a point to eat sitting down. Eating while sitting down is critical to your weight loss success. Here are some tips to get started: 1) Sit down, unplug and focus. Make it a point to do this on a daily basis, even if you just start with one meal. You’ll get in the groove of this soon enough and you’ll be a lot more satisfied in the long term. 2) When you eat, just eat. 3) Choose one or two areas at home and at work that are only used for eating and eat only there. For example, do not eat while standing over the sink, peering into the refrigerator. Instead, make the kitchen table a place to eat your meals and snacks. These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. ES 2 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 Eating on a Smaller Plate You are probably eating much less than you did before your ReShape® procedure. Even though your body is receiving the benefits of your new healthy habits, your eyes may not be used to seeing less on your plate. To make matters worse, plate sizes continue to grow, making it easy to serve yourself much more than your stomach can handle. . Measure Your Plates! The best way to eat less is portion control and resizing your plate. A smaller plate tricks your brain and makes your main course look larger as well as more appetizing. We overeat from larger portions because we have a tendency to “clean our plate” – so make that plate a smaller one. Measure how much your bowls, glasses, cups and plates normally hold. For example, see what 1 cup of cereal looks like in your bowl or 1 cup of juice in your glass As A General Rule, Eat Off A Plate NO LARGER THAN 9” for EVERY MEAL Swap your usual serving ware for smaller sizes and watch your waistline shrink. Use A Smaller Plate At home, serve your meals on smaller plates. Your plate will look full, but you'll be eating less. Eat from a smaller dish, bowl, or saucer such as a luncheon or salad plate. Even kids bowls work great. The Science Behind the Plate Most people serve themselves bigger portions and eat more food when using larger plates1. They attribute our poor judgment of serving size to an illusion. This illusion occurs when comparing a pile of rice on a big plate to the exact same amount of rice on a small plate. Even when we know that the portions are equivalent, we see one on the larger plate as much less satisfying. ES 3 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 Pg. 1 of 2 Use the Power of Color Another easy way to fool yourself into eating less is to dine off a plate that contrasts with the color of your food. Mashed potatoes, cauliflower and chicken may be tasty, but their colors easily blend into a white plate, making you think you ate less. Red plates have been shown to slow down eating speed. Make sure to let your stomach and not your eyes tell you when you’re done. Slow Down and Skip Second Helpings Eat one reasonable serving and don't immediately go back for seconds. Give yourself time to digest – at least 10 minutes and serve yourself more food only if you are still hungry. Divide the Plate and Fill Up On Fruits and Veggies Divide your plate in half. Fill one half with fruits and vegetables. Then leave the rest of the plate for equal parts lean protein and whole grains. Increasing your vegetables and fruits will keep you satisfied longer. Take Action: Eating on a smaller plate is critical to your weight loss success. 1. Ittersum, Koert Van, and Brian Wansink. "Plate Size and Color Suggestibility: The Delboeuf Illusion's Bias on Serving and Eating Behavior." JSTOR. University of Chicago PressChicago, IL, 04 Jan. 2013. These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. ES 3 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 Pg. 2 of 2 Portion Your Plate Portion control is one of the best ways to lose and maintain weight in the long term. Measuring out each meal might sound tedious, but it helps you stay on track and eliminates those extra bites of food that add up. The portion plate provided in your Patient Starter Kit helps make portion control exceptionally easy! Portions Within Your Portion In addition to serving up your standard-sized portion, you should be aware of the portions of each food group within your meal. You can then introduce a healthy variety when eating. It’s important to eat a variety of foods from each food group, but there are some specific guidelines on how much. The numbers below correspond to the numbers on the image of the portion plate above, and help explain how and why foods are portioned on the plate: 1. Fruits and Vegetables – approximately half of your meal, or about 1 cup of your food, should be nonstarchy produce. Vegetables and fruits are low in calories, high in fiber, and are packed with vitamins, minerals, and antioxidants. These foods are nutrition powerhouses – no wonder 50% of your plate should contain these! 2. Protein – about a quarter of your meal, or 2 to 6 ounces, should contain lean protein. Whether it’s grilled chicken, baked salmon or stir-fried tofu, lean protein provides the essential building blocks to your body, so it’s important to prioritize these foods. Protein-based foods are also high in B vitamins, minerals and can help suppress that nagging hunger. 3. Grains – the last quarter of your meal, or 1/2 to 3/4 cup, can be filled with whole grains – oatmeal, brown rice, whole wheat pasta, or quinoa. Whole grains are generally high in fiber, folate, and B Vitamins. However, not all of your meals will contain grains – so adding in more produce or lean protein is a great substitute. 4. Condiments/Sauces – condiments or sauces are generally packed with calories and sodium and should be limited to about 1/8 cup. When used in the right amounts they can still be part of a healthy diet, so they still have a home on your plate. Following these guidelines can help each of your meals contain of variety of foods from each food group. A balanced and well-portioned diet does wonders for your health! These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. ES 4 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 Strategies for Eating Out Restaurants are notorious for serving huge portions of rich, calorie-laden foods. Since eating away from home is inevitable for most people, it’s important for you to be able to analyze the menu and choose nutritious options that will support your weight loss. Arm yourself with these restaurant-ready strategies: Investigate the menu online before you go. You will feel more confident and relaxed when you already know what to expect. Focus on your entrée and skip the appetizers. Often fried, accompanied by a creamy dip, or served in endless supply (we’re looking at you, bread, chips, and salsa), these are often calorieheavy and leave you hungry for more. Stick to a balanced plate. It’s easy to keep a plate portioned to 50% veggies or fruit, 25% protein, and 25% whole grains if you plan your order. Ask for extra steamed veggies! Look out for sneaky calories. They typically appear in sauces and dressings and are hidden in sneaky words on a menu. Be on the lookout for terms that indicate a high fat and calorie content, such as: buttered, creamed, sautéed, smothered and fried. Ask for the sauce or dressing on the side and use it for dipping instead. Don’t be afraid to modify! Ask for sauce on the side or light cheese on your pizza. Rethink your drink. Water with lemon, unsweetened ice tea, or sparkling water will quench your thirst better than a soft drink, juice, or a cocktail. Keep portion size in mind. Restaurant portions are getting bigger and bigger. Stay on the path to a smaller and smaller you by setting aside part of your plate. Bonus: leftovers make a great second meal! Craving dessert? Pick something decadent to split with the table and savor one or two small bites. A bowl of berries with a drizzle of chocolate sauce will also satisfy that sweet tooth. ES 5 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 Pg. 1 of 2 Salads aren’t always healthy. Croutons, dried fruit, dressings, nuts can increase the calories on the salad. Order a side salad with dressing on the side or a vegetable-based salad with lean protein. Take deep breaths and enjoy your meal! What’s the point of eating out – and trying new foods – if you’re too worried about what you’re eating to actually savor it? Choose Limit Beans, lentils Breaded, fried Chili, turkey or regular Cheese sauce or dips Plain sandwiches Panini sandwiches Chicken breast, turkey, tofu, plain tuna Biscuits, croissants, donuts, muffins Extra veggies, potatoes (baked, sweet) Cream soups Vinegar, mustard, salsa, balsamic, Creamy salad dressings spices/herbs, chili sauce French fries Hot sauce, yogurt sauces Juice Broth-based soups, bean soups Gatorade, pop Sweet potatoes, baked potatoes Frozen alcoholic drinks Spinach salad (dressing on side) Dried fruit Sushi (no mayo or tempura) Candy-coated nuts Flat out or flatbread wraps Skinny sandwiches, lettuce wraps Whether you are going out to eat, going to a drive through, or ordering in; eat slowly, enjoy your meal, consider splitting an entrée with someone, and don’t hesitate to leave food on your plate. Here’s What You Can Do: 1) Plan your meals out ahead of time and look up the menu. 2) Calories = $. Think about how you want to spend your calories. 3) Ask for gravy, sauces, dressings, and butter on the side and use sparingly. 4) Track your goal on a weekly basis to evaluate your progress. These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. ES 5 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 Pg. 2 of 2 Assess accommodations before you leave. If possible, stay in a room with a kitchenette or small refrigerator. Ask hotel staff to remove snacks and alcohol from the mini bar, and locate the nearest grocery store so you can stock up once you arrive. Opt for a hotel with a gym or access to walking paths. Sip smart. Buy a large bottle of water after going through airport security, or place a few gallon jugs of H2O in your back seat if driving. Tote along your favorite reusable bottle so you can refill it throughout the day. Having your own water will prevent you from reaching for sweetened beverages and keeps costs down. Choose protein every morning. Skip the continental breakfast pastries and bagels and select eggs, plain Greek yogurt, milk, oatmeal with milk, or lean breakfast meats, and add fruit. Your blood sugar will thank you. Food isn’t everything. Vacation may bring out the gourmand in you, but there are many more things to do in a new destination than eat or drink. Ask the concierge about must-see landmarks, visit local museums, or lace up your sneakers and go on a walking tour. Travel Healthy habits can be more difficult to maintain when you’re on a trip and out of your element. Prior to your new lifestyle, you may have gained weight whenever you headed to a new destination; after all, most people see travel as an opportunity to eat too much and move too little. Whether you go away for work or have an upcoming vacation, it’s important to plan for how you will tackle travel so you can come home feeling just as great as when you left. Pack to be active. Stash athletic shoes, workout clothes and your favorite workout DVD or resistance band in your luggage. Find out if where you are going has access to a gym or if there is a workout facility close by. Pack your snacks. Portion out protein powder in small sandwich bags, and keep healthy, non-perishable snacks with you at all times. Other snacks include: individual peanut butter packs, protein bars, fruit, freeze dried fruit, string cheese. It is possible to enjoy your vacation or traveling trip, and the local food, without packing extra pounds for the trip home. The secrets: choose foods wisely, make "moderation" your vacation mantra, bring healthy foods with you, and stay as active as possible during your trip. These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. PN: 04-0174 ES 6 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 chewing the last bite. As soon as they swallow, the next mouthful is ready to go. Instead, try slowing yourself down by: Taking a bite of food and then putting your fork down to enjoy and savor each bite. Drink plenty of water in between bites. Chewing your food for at least 20 times before you swallow. Being chatty – we all know it’s rude to talk as you chew! Eating Slowly Did you know it takes 20 minutes for your stomach and brain to communicate during a meal? This means it takes a whole 20 minutes before you realize you’re full! Most of us are already done with the meal by then – and may be walking away feeling too full! Ignoring our natural fullness signals can be dangerous – leading to bigger portions and way too many calories. Slow It On Down Eating slowly can do wonders for your weight. When you take at least 20 minutes to eat your entire meal, you may actually eat less. You’ll be more aware of the subtle signals your body gives you – making it easier to recognize when you are full. A gentle pressure near your breastbone may be a sign that you need to stop eating. Let’s Try It Slow down the speed at which you eat by refilling your fork only after you swallow – even try putting it down in between bites. It’s common for people to put more food on their fork while they are still Make “Slow” A Habit The more and more you practice eating slowly, you’ll probably notice that you eat less at meals and feel satisfied with a smaller amount of food. Both of which are great! Practice this with every meal and snack time so you and your body are perfectly in tune! Take Action! Slowing down while you eat is critical to recognizing fullness and to helping support your weight loss success. Follow the steps below to learn how to make this a part of your weight loss routine: 1) Visit the goals section on the portal and select “Eat slowly at every meal” as one of your personal goals. 2) Remember to take your time when you eat. Putting your fork down between bites is an easy way to remember to slow down. Make it a point to do this at every meal. 3) Evaluate your goal on a weekly basis to track your progress. These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. CH 1 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 20 Minutes Per Meal Take an entire 20 minutes to eat your meal. It takes just about 20 minutes for your brain and stomach to communicate that you’ve had enough food. If you eat too fast, your body won’t have a chance to tell you if your meal was too much or too little. It takes time to trigger the signal from your brain that you are full, and feeling full translates into eating less. The 20/20/20 rule takes some getting used to, but it will quickly become just another habit as you sit down to meals! Rule of 20 The 20/20/20 rule is a simple tool to help you eat a bit more mindfully. With the 20/20/20 rule, you eat a little slower, chew a few more times and take a short rest between bites. This way you can sit down and enjoy your meal. Chew 20 Times Many of us chew our food only a few times before swallowing it – barely breaking it down. If you count out 20 chews for each bite of food, it will slow calorie consumption and lengthen the time you spend eating your meal. In addition, the more masticated (or well chewed) your food is, the easier time your stomach will have digesting your food. Set Your Fork Down For 20 Seconds This may be challenging, especially if you’re eating alone or at your desk during your lunch break. Setting your fork down for 20 seconds between bites, again, helps you slow down. It will also allow you to mentally and physically enjoy your food, which has been shown to help you eat less. Take Action! Practicing the 20/20/20 rule by chewing, putting your fork down and taking 20 minutes per meal is a great way to help you reach your weight loss goals and achieve success. Take the following steps to incorporate the rule in your weight loss routine. 1) Make it a point to use the rule at every meal. If you forget, don’t be hard on yourself. It takes time and practice to make this a habit. 2) Set a reminder on your phone or write the rule on a note card and keep it where you eat (at your desk, kitchen counter, dining room table, etc.). It will act as a helpful reminder to use the rule as you eat. 3) Set a timer for meals and see how long it takes you to eat each meal. 4) Evaluate this goal on a weekly basis in order to track your progress. These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. CH 2 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 What Should You Listen For? There are a few simple tips that will help you figure out if you’ve had enough to eat. Here are a few things to keep in mind: Understand what it means to be satisfied. Remember, you can be satisfied, full or stuffed! Satisfied means you’re no longer hungry, you could eat more, but are choosing not to. You may feel more content, and may lose that intense feeling of hunger or interest in food. A slight pressure or stretching feeling in your stomach is another signal that says your stomach is almost full. The amount of food consumed will keep you satisfied for about 3-4 hours or until your next planned snack or meal. Recognizing Fullness Ask yourself this: when do I typically stop eating during a meal? Is it when you’ve cleared your plate? When your stomach feels physically full? Or do you stop when your body is satisfied? Many people find it hard to know exactly when to stop eating. If you learn to actively listen to your body, then you will realize when you have had enough food. Your body has a unique communication system – the feeling of hunger and fullness are regulated by the hypothalamus in your brain. It takes about 20 minutes for your stomach to send signals to the hypothalamus to register as “I’m full!”. If you are distracted, eat mindlessly or even too fast, you can override the communication system and unconsciously eat too much. Try to practice recognizing the signals your body sends you to let you know when you’re full, it will make a noticeable difference in your weight loss success! Here’s What You Can Do: 1) Practice recognizing if you are full vs. satisfied during and after eating. 2) Stop before you are uncomfortable or full and pay attention to how you feel. 3) Evaluate this goal on a weekly basis in order to track your progress. These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. CH 3 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 Still not sure? Answer these questions: 1. When was my last meal or snack? If it was less than 2 hours ago, you’re probably not truly hungry. 2. Am I craving a specific food? Would anything make me feel better? If you’re craving a specific food, that’s generally “head hunger,” or a craving. 3. Am I thirsty? Try drinking a small glass of water before you grab a snack – thirst can mimic hunger. Redefining Hunger People eat for a variety reasons – boredom, social situations, stress, twinge of habit and of course, because they are hungry. Hunger is the physiological response to a lack of food in the stomach. It’s triggered by chemicals and hormones that act in the hypothalamus (a part of the brain that controls appetite) when there is no longer food or nutrients left in your GI tract. The majority of your meals and snacks should be consumed when you notice that empty feeling in your stomach – physical hunger. However, it can be hard to tell the difference between a craving and actual hunger. Look for these signs: You might feel a physical emptiness in your stomach Hear a rumbling or growling noise from your stomach Have the sensation of hunger pangs Feel weak without eating for a long time The next time you sit down to a meal or grab a snack, pay attention to your body. Tune into your hunger signals and learn what it truly means to be hungry. It’s a great tool to help manage your weight! Reference: Understanding Nutrition 11th Edition Ellie Whitney and Sharon Rady Rolfes These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. PN: 04-0174 CH 434 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 your brain – which means you keep wanting more! Those comfort foods become therapeutic to you – you think you need them to feel better. Overcoming the Cravings Manage your junk food cravings wisely. Try: Indulging moderately. Restricting your favorite foods too much can trigger a binge. Give yourself a limit and enjoy your favorite foods wisely – for example, pick one day per week to have your treat meal and/or snack. Junk Food Cravings Whether it’s chocolate, carbs, salty or crunchy foods, everyone seems to have their own food cravings. These might be foods that are hard to have only one bite of, or the ones you crave when you’re stressed, sad, or even bored. Why We Crave It Many times specific foods are connected to memories. What you grew up with, what your families ate, or things you ate during childhood affect your choices as an adult. That’s part of the reason for the term “comfort foods.” Most of these foods fall into one or more of the following categories: high fat, high sugar/high carb, or calorie dense. These foods affect two very important neurotransmitters in your brain – serotonin and dopamine – which both play an important role in regulating your mood and appetite. When you over indulge in ice cream or a greasy burger, your brain chemistry changes. It will sense pleasure and reward after eating these foods. It makes you feel good (at least temporarily). Indulging in your favorite comfort foods every now and again is not a bad thing. It’s a problem when it becomes a habit. When you emotionally eat, whether in response to depression, loneliness, anger, stress, or boredom, you strengthen the reward pathway in Find a healthy substitute. Crave sweets? Try a sweet fruit like pineapple or mango, drink a cup of low-fat hot chocolate, have a low sugar protein bar, or eat a low fat Greek yogurt. Manage your emotions. Seek out help and support and work on dealing with your emotions in a different way. Relax and de-stress regularly. Find activities like yoga, walking, hot bubble baths, a massage, etc that can help you feel relaxed and calm. Take 10. Cravings are very spontaneous and fleeting. Generally, they’re more intense when they first hit, but will subside over time. Distract yourself for 10 minutes, take yourself away from the situation, drink lots of water, and then revisit that craving (if necessary)! Detoxify your kitchen. Get rid of tempting junk food in your house, workplace, and other environments. If tempting food is not there during a craving, you won’t be able to eat it! References: http://www.webmd.com/diet/the-facts-about-food-cravings https://www.psychologytoday.com/blog/cravings/200906/your-brain-food These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. CH 5 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 Walking Benefits You already know that exercise is important, but sometimes the thought of getting on the stair climber or going to a yoga class makes the couch seem that much more appealing. Fortunately, you don’t have to belong to a gym or own fancy equipment to get an effective workout. The solution is right outside your door – go for a walk! All you need is a good pair of shoes and an outdoor or indoor space to strut your stuff. Regular exercise is good for both the mind and body, but it also has additional benefits. Physical activity can prevent diseases such as diabetes, stroke, osteoporosis and lower blood pressure. Did you know that regular exercise like walking helps improve quality of life? Exercise is also great for your libido, improves sleep duration, dramatically decreases stress in your life and ultimately improves the odds of maintaining weight loss over time. Win-win! Walking Checklist: Lace up – wear supportive shoes with thick rubber soles and good arch support. Consider this your excuse to buy yourself some new kicks! Wear it right – dress in layers if the weather is cold and wear reflective clothing in the dark. Rock out as you walk – load your favorite high-energy music to get you motivated. Stand up straight – Keep your chin level with the ground, shoulders back, and remember to breathe. Buddy up – Recruit a friend or family member to join you on your walk. You will have more fun and will pay less attention to the clock! Take long cuts – Take the stairs, take a few 10-minute walks, walk around while talking on the phone, walk to the store or park farther away from the store, exercise during commercials, etc. How much should I walk? Frequency: o 5-7 days per the week Duration depends on the goal: o At least 10 minutes at one time! o 30 minutes a day to reduce the risk of chronic disease o 30-60 minutes a day to prevent weight gain o 60-90 minutes a day for weight loss E1 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 Pg. 1 of 2 Take Action: Walking is a great way to meet your step goal and help contribute to your weight loss success: 1) Link a pedometer or activity tracker. 2) Lace up your sneakers and head outside or jump on a treadmill. If you’re new to exercise, it’s smarter to start small. 3) Short on time? Break up your exercise into ten-minute strolls throughout the day. 4) Track your progress each week. 5) Are you meeting your goal? If you’re meeting your goal every day, try taking an additional 500 steps daily, per week, and then build up to a long-term goal of 10,000 steps per day. These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. E1 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 Pg. 2 of 2 Aerobic Activity Overview Aerobic exercise, or “cardio,” involves large muscle groups and requires your heart to pump oxygenated blood to the rest of your body. Aerobic activity is very effective in burning calories and strengthening your respiratory and cardiovascular systems. It’s also beneficial to reducing other health risks such as diabetes and high blood pressure, it can improve your mood and even help you live longer! It’s best to do a minimum of 30 minutes a day, 5 days a week to improve health and 40-60 minutes for long-term weight loss. In order to stay consistent, choose a cardio routine you enjoy, and make sure to keep it safe by matching your activity to your fitness level. Which cardio is best for you? Choose from the many options below. Activity Type Benefits Equipment Needed Walking Low impact, can be done anywhere, can be intensified as you get stronger Sturdy athletic shoes Cardio machines (elliptical, stair climber, ski or row machine) Used indoors so weather is not a factor, adjust intensity to fitness level, can watch TV or even read during workout Cardio machine, sturdy athletic shoes Cycling Low impact, easy on joints Bike (stationary or standard), sturdy athletic shoes or cycling shoes, safety gear (helmet if outdoors) Swimming Low impact, engages many muscles, easy on joints; may be difficult to maintain for 30 minutes Swim gear (suit, goggles, swim cap) and access to pool/water E2 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 Pg. 1 of 2 Stairs Low impact, especially on knees. More calorie burn due to vertical component. Stairs, sturdy athletic shoes Jogging Burns more calories than walking, can be done anywhere; not low impact Running shoes Group exercise or exercise videos Match type of exercise to preference – dance, aerobics, step, “boot camp”; may not be low impact depending on activity Sturdy athletic shoes These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. E2 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 Pg. 2 of 2 Exertion Levels It’s time to get moving! Regular physical activity plays a huge part in weight loss. It helps those stubborn numbers on the scale head in a downward trend and keeps them there in the long run! Adults who participate in at least 150 minutes a week (30 minutes, 5 times a week) of moderateintensity physical activity prevent significant weight gain and reduce associated chronic disease risk factors. 250-300 minutes a week (60 minutes, 5 times a week) is needed for significant weight loss. Sedentary behavior – sitting for long periods of time – is distinct from physical activity and has been shown to be a health risk in itself. Meeting the guidelines for physical activity does not make up for a sedentary lifestyle. So, What’s A Moderate-Intensity Activity? Well, that depends on you. Your perceived exertion level (how easy or difficult you find a physical activity) will help you figure it out. It can be anything from walking or jogging, or even taking a fun Latin inspired dance class! Try mixing it up: - Walking briskly - Indoor/outdoor cycling - Swimming - Dancing - Jogging - Using the elliptical - Group aerobics classes - Gardening What’s Moderate for You? (I can talk while I do them, but I can’t sing) What determines whether or not an activity is of moderate intensity will depend on you – your current fitness level, your age, your weight, and any current health conditions you may have. Work somewhat hard. Your heart rate will be faster, you may be sweating slightly and are not able to hold a conversation very easily. If you can belt out your favorite tune then it’s too easy! Everything in Moderation. Use the RPE Scale. When you’re planning out your physical activity, it’s important to think about your exertion level. The Rated Perceived Exertion Scale (RPE) can help you determine what falls into low, moderate, or high-intensity activities. This scale runs from 0 (relaxing or watching TV) to 10 (kicking box or sprinting). It is a psycho-physiological scale, and you have to rely on how your body feels to rate your perception of effort. E3 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 Pg. 1 of 2 0 1 2 3 4 5 6 7 8 9 10 Nothing at all; sitting still or lying down Very light; moving but can hold a conversation easily Light Moderate; slightly out of breath Somewhat heavy; out of breath, sweating, can complete short sentences. Heavy Very Heavy; can’t get more than one or two words out at a time. Maximum effort; too heavy to continue for more than a few moments. 3 or 4 Are the Magic Numbers! In most cases you should aim for activities that make you feel like you are at a 3 or 4 on the RPE scale. Or you can try a combination of low and high intensity exercises – like a leisurely walk one day and a spin class the next! Shoot for 3-5 times a week. If you’re consistent you’ll start to see the benefits of your hard work pay off! Here’s What You Can Do: 1) Pick an activity that’s easy to fit into your life. 2) Do at least 10 minutes of physical activity at one time. 3) Do moderate activity at least 30 minutes 5 days per week. 4) Track your goal on a weekly basis to evaluate your progress. These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. E3 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 Pg. 2 of 2 of pain or injuries, such as knee pain, shin splints, and neck or shoulder injuries. The recumbent bike is also suitable for those with back pain as well, as long as the sitting position doesn’t make the pain worse. Water Aerobics/Swimming – Performing exercises in the water makes your body feel lighter and easier to move. It lessens the impact for activities such as jumping, walking, or running. This type of exercise is wonderful for most low-grade injuries, lower back pain, joint pain, and general arthritis-related aches and pains. Physical Activity Without Injury Being physically active is an important part of your healthy lifestyle. Exercise helps control weight, improves mood, reduces the risk for all-cause mortality, and can even improve sleep habits. But even with all the benefits of regular activity, less than 50% of Americans meet the guidelines for aerobic exercise1. Many times, the reason for inactivity is chronic pain or injuries that make it difficult to begin or continue exercising. No Pain, No Gain: Pushing yourself through pain is generally not a smart idea, especially if you’re aware of a chronic injury or feel like the pain is worsening. However, there are many types of exercises that are safe (and even therapeutic) for people with injuries or chronic pain. So don’t cut out your activity altogether – just change it up, be safe, and always check with your doctor! • Recumbent (Seated) Bike – These bikes are comfortable, easy to use, and low-impact. However, you can easily increase the resistance and make your workout more challenging. Using this type of bike is great for people with a variety Elliptical – Using the elliptical can help decrease the amount of impact you place on your joints – especially in your knees, ankles, and feet. This low impact workout is ideal for those suffering from general arthritis or joint pain. Be careful with neck and back pain, as the elliptical does move your torso, which can aggravate pain in those areas. Modified Yoga – Various forms of yoga not only strengthen your muscles and core, but can also be relaxing and therapeutic. Modified yoga may be best for those with recovering injuries – like knee or shoulder injuries – and may help improve strength and range of motion. It may also help relax and stretch tight muscles. Make sure to find a qualified yoga instructor. Seated (Chair) Exercises – Start up a safe exercise routine using one piece of equipment – a stable chair. Warm up with a few minutes of light activity such as arm swinging, shoulder rolls, and leg lifts. Chair aerobics can raise your heart rate, and you can perform strength training exercises by using resistance bands, light weights, or anything weighted. These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. E4 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 If you are watching TV, avoid the bother of pesky commercials and do pushups or lunges while they are on. Seek activity in your chores. Don’t hesitate to make several trips when loading and unloading your car, rather than trying to do it all in one go. Be the first to volunteer for yard work – but use a rake and push mower instead of motorized tools. Add activity to your work day. Stand up as often as possible and take a stroll around the office during coffee breaks. Skip the elevator and hit the stairs. Empty your trash can every day so you have an excuse to walk to the dumpster or break room. Stand up or walk around while talking on the phone. Dance! Put on some music and boogie while you cook, shower, or brush your teeth. Walk or bike instead of using your car. You will use more energy while saving on fuel costs. Get off the bus a stop earlier. Play actively with kids or nieces/nephews. Little Activities Add Up Small and mundane bodily movements have the potential to significantly impact your weight in a good way. According to a Mayo Clinic study, people who fidget and move often throughout the day add over two hours of “activity”, which burns 350 extra calories on average when compared to those who are more sedentary. This everyday activity is called NEAT, or nonexercise activity thermogenesis.1 Researchers estimate that this extra calorie burn means a difference of 10 to 30 pounds a year – now that’s neat! If sitting is most of your day, follow these simple steps to increase your NEAT and decrease your waistline: Stop searching for the best parking space. Park on the top floor of the garage and take the stairs, or find a spot on the other side of the mall from your favorite stores. Reference: Levine JA, Lanningham-Foster LM, McCrady SK, et al. Interindividual variation in posture allocation: possible role in human obesity. Science. 2005;307(5709): 584–6. These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. E5 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 During exercise: Sports drinks are not recommended unless you are exercising more than one hour. Water is all you need – sip throughout your workout and ensure that you drink about 8 ounces of fluid (water) every 20 minutes. Fueling for Workouts Eating smart before and after exercise can make or break all of your hard work. Skimp on a preworkout snack and you may not have enough energy to power through your routine. Overdo your post-workout meal and you will lose the calorie-blasting benefit of your exercise. Balancing what you take in with what you expend depends on the type and duration of your exercise, as well as when you last ate. Before exercise: If you are hungry and plan to exercise less than one hour, a small snack will provide enough fuel. Stick to no more than 150 calories. Choose healthy carbohydrates with a little protein, like fruit with a teaspoon of peanut butter or half a piece of whole grain toast and low-fat string cheese. Exercising more than 60 minutes? Fuel up prior to your workout; 3 hours before is best to allow your food to digest. Oatmeal with brown sugar and berries, fruit with cottage cheese, or a peanut butter sandwich with a bit of honey are good options when having a long workout. If you have eaten a meal within three hours, a pre-workout snack is not necessary. After exercise: Eat a meal or snack within two hours of your workout if you are hungry and if your workout was more than 60 minutes. Again, keep a snack to around 150 calories. Carbohydrate and protein are important components of your postworkout fuel, but you don’t have to pound a protein shake to maintain muscle or regulate your blood sugar. Simply keep carbohydrate and protein a part of your meal or snack. Low-fat Greek yogurt with berries, a chicken sandwich, canned tuna on whole grain crackers, or lentil soup are all suitable choices. Don’t forget to hydrate! Source: SCAN fact sheets = http://www.scandpg.org/sportsnutrition/sports-nutrition-fact-sheets/ These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. E6 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374 Low Impact Workouts Does the word “exercise” remind you of work? How about an unpleasant experience? As you continue on your weight loss journey, think about sticking to low impact, enjoyable workouts. After all, moving your body should feel good, but high impact moves can be intimidating. In low impact activity, at least one foot is always on the floor, or your body weight is supported by a machine or water. These options are realistic, safe and effective. Low Impact Options Walking is a convenient low impact exercise. Throw in some lunges and squats or take a walk up a hill. Biking, swimming and free weights are also easy on your joints. At the gym include water aerobics, circuit training with weights, the elliptical machine, or a low impact group exercise class. Pilates and yoga are wonderful physically as well as mentally. If you are looking to increase activity at home, check out online resources such as free barre, yoga, and aerobics videos on YouTube, Vimeo or websites like FitnessBlender.com. Comcast On Demand Exercise and Sit and Be Fit TV (chair exercises) programs work wonders. Aim for at least 30 minutes a day, most days of the week, but start small. Remember: any exercise is better than none, so on days when you’re slammed, consider a ten-minute walk around the office or neighborhood a success. Sample Low Impact Workout Below is a quick low-impact workout that can be done at home and targets many muscle groups. - Warm-up: walk in place, swinging arms: 3 minutes - Pushups against wall or on floor (knees down): 1 minute - Walk in place, swinging arms: 2 minutes - Knees to chest while walking: 2 minutes - Walk in place, swinging arms: 2 minutes - Plank on forearms and knees or toes: 1 minute - Walk in place, swinging arms: 2 minutes - Squats (knees don’t go forward of toes): 1 minute - Sit ups, using your hands to support your neck: 1 minute Repeat twice for a 30 minute workout. Cool down by walking in place, swing arms and breathing for two minutes. These are suggested guidelines. Follow the recommendations of your physician and consult your healthcare providers before modifying your diet and exercise. E7 PN: 04-0174 ReShape Medical, Inc. | 100 Calle Iglesia, San Clemente, CA 92672-7502 | Tel: 844-937-7374