Lose and Win Facilitator Guide - uhctools.com Facilitator Guide.pdf · Session 1: Facilitator guide...

Lose and Win

Facilitator Guide

Session 1: Facilitator guide

Lose and Win

Overview 1

Introduction 3

On your way to a healthy weight 13

Move to lose 23

Planning ahead for healthy eating 33

Healthy habits 46

Overcoming exercise barriers 55

Eating healthy – in and out 64

Stress management and problem solving 73

Staying positive 82

Appendix 91

Table of contents


Lose and Win

1

Overview

Session Objectives Topics covered

Kick-off } Review attendance

}Motivate and encourage healthy behaviors

} Collect baseline data

} Program components

} Expectations for success

} Food & activity journal

On your way to a healthy weight

} Discuss the importance of a healthy weight

} Explain the key components of weight loss

} Discuss everyday tips to eat fewer calories and move more

} Provide resources that help participants determine a healthy weight and daily calorie needs

} Benefits of a healthy weight

} Body Mass Index and healthy weight

} Calorie balance for weight loss

} Portion sizes

Move to lose

} Discuss the benefits of exercise

} Review the exercise recommendation for weight loss

} Define moderate intensity exercise

} Encourage participants to develop and adhere to an exercise plan

} Provide tips and resources to help participants move more every day

} Benefits of physical activity

} Short bouts of activity to meet recommendation

} Issues to consider when developing exercise plan

} Everyday ways to move more

Planning ahead for healthy eating

} Promote healthy eating

} Encourage participants to plan meals

} Provide sample healthy meal plans

} Demonstrate how to read the nutrition labels

}Meal planning steps

} Healthy on-the-go snacks

} Grocery store shopping

} Reading nutrition labels

} Saving time by preparing ahead

2

Session Objectives Topics covered

Healthy habits

} Encourage participants to be mindful eaters

} Help participants recognize cues and triggers that lead to unhealthy behaviors

} Discuss how to create healthy environments at home and work

} Encourage participants to develop new healthy habits

}Mindless eating

} Hunger scale

} Identifying triggers

} Setting up cues for healthy behaviors

} Planning ahead for challenging situations

Overcoming exercise barriers

} Identify participants’ barriers to exercise

} Discuss the importance of prioritizing a healthy lifestyle

} Encourage participants to find support systems

} Provide examples of ways to be active when on-the-go

} Common exercise barriers

}Making time to exercise

} Staying motivated

} Support systems

} On-the-go activities

Healthy eating – in and out

} Review key components of a healthy diet

} Provide substitutions and healthy tips to help participants prepare better meals at home

} Discuss strategies to help participants make better choices when dining out

} Healthy eating guidelines

}Whole grain examples

} Ingredient substitution

} Eating out healthy tips

} Better choices for every cuisine

Managing stress

} Help participants identify sources of stress

} Discuss the health consequences of stress

} Provide strategies to reduce and manage stress

} Demonstrate how problem solving can be used to reduce stress

} Signs of stress

} Sources of stress

} Healthy ways to deal with stress

} Problem solving steps

} Identifying possible solutions

Staying positive

} Encourage participants to use positive self-talk

} Discuss best practices and help participants find ways to overcome ongoing challenges

} Review keys to success

} Encourage participants to re-assess progress and set new realistic goals

} Collect post-intervention data

} Positive self-talk

} Realistic expectations

} Argument against excuses

} Assessing progress


Lose and Win

3

Introduction

Introduction:

Facilitator guide

Participant guide


4

Kick-off

Suggested time for session:

60 minutes

} 10 minutes for welcome and introductions

} 15 minutes to review program

} 20 minutes for motivation or open dialogue

} 15 minutes to take questionnaire

Objectives:

} Review attendance

}Motivate and encourage healthy behaviors

} Collect baseline data

Preparation:

} Read through all modules and become familiar with content

} Prepare ice breakers and class activity

} Send reminder to participants with time, date and location

Lose and WinIntroduction session: Facilitator guide

5

Session — Introduction

}Welcome participants and congratulate them on making a decision to achieve a healthier lifestyle

} Verify attendance

} Conduct ice breaker to help build rapport among participants. Choose one of the ice breakers below:

• Ask participants if they had to pick a theme song, what would it be and why?

• Ask participants to choose one word that describes them

• Ask participants to partner with a co-worker. Have the pairs introduce each other including at least one interesting fact.

• Ask participants to share their first job or odd/most interesting job

} Review the components of the program:

1. Group session: Provide participants with a schedule of dates, times, and location for each of the classes. Encourage participants to attend all the sessions and to openly share experiences.

2. Participant materials: Encourage participants to review materials before attending group session. Let them know how to access materials or pass out materials at the opening session.

3. Food and activity journal: Stress how important it is to track the food consumed and the amount of activity each day. Refer participants to the template provided.

4. Resources and tips: Encourage participants to take advantage of tools and resources available through UnitedHealthcare.

5. Pre and post questionnaire: Explain that individual results will be kept confidential and are not shared with the employer including the facilitator. Aggregate results will be used to measure the success of the program at the individual worksite.

6

} Review participant expectations:

•Attend at least 6 out of the 8 sessions

•Complete pre and post questionnaire

•Keep a food and activity journal

•Be respectful of others in the class

•Attend each session and be on time

•Encourage active participation and sharing

•Remind participants not to judge one another and respect individual opinion

•No cell phones or texting during class

•Use discretion — what happens in the group, stays in the group!

} Facilitate open discussion or plan to have someone come in and give a testimonial about losing weight or overcoming a health challenge. Sample open dialogue questions:

1. Why did you want to join this weight loss program? What do you hope to accomplish?

2. Why is managing your weight important to you?

3. Have you tried to lose weight before? What have been the challenges? What will you do differently this time?

} Collect email address for each participant.

1. Email questionnaire link to each member.

2. Participant should complete questionnaire by end of first session.

Lose and Win

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Introduction session: Participant guide

Kick-off

Welcome and congratulations on your decision to make a positive change in your life.

The Lose and Win program was designed to help you understand the many benefits that you will win when you lose unwanted pounds, including reducing your risk for disease and disability, increasing self-esteem and living a longer healthier life. The Lose and Win program will give you the fundamentals of weight loss and offer you practical everyday tips on how to lose pounds or maintain a healthy weight.

Program components:

} Participant workbook

}Group sessions

} Food and activity journal

} Healthy resources and tips

} Pre and post questionnaire (Optional)

One of the key components of Lose and Win is the support you will receive from others in the program. That’s why it’s so important to attend and participate in all the group sessions. Take this opportunity to learn from others and share your own personal challenges and successes.

8

Ready to get started?

Adopting a healthy new lifestyle will require diligence and patience. Changing old habits and learning new skills are not always easy. Think about why you are ready to change and challenges that you may encounter. Answer these questions.

What do you hope to achieve by participating in this program? How would you define success? __________________________________________________________________________________

What are some of your reasons for wanting to change? ______________________________________

__________________________________________________________________________________

What are some of the disadvantages of staying the same? ____________________________________

__________________________________________________________________________________

What are some disadvantages of making changes? __________________________________________

How confident are you that you can make lifestyle changes? __________________________________

What changes do you think you will need to make? ________________________________________

What changes are you most likely to make? _______________________________________________

How would you feel if you achieved your ideal weight? ______________________________________

What are some things that you could see yourself doing once you begin losing weight? _____________

__________________________________________________________________________________

What kind of challenges may come up when making these changes? ___________________________

__________________________________________________________________________________

How could you overcome these challenges? _______________________________________________

__________________________________________________________________________________

Who will you turn to for support as you make changes? _____________________________________

__________________________________________________________________________________

Where is taking care of yourself on your list of priorities? ____________________________________

__________________________________________________________________________________

What can you do to create more time for taking care of yourself ? ______________________________

__________________________________________________________________________________

9

Keys to success

You probably already know that regular activity and eating a balanced diet is the key to achieving a healthy weight. Here are some other key behaviors that will help you succeed:

} Track everything you eat or drink and record calories and fat

}Weigh yourself at least once a week

} Engage in regular structured activity at least 5 days a week

} Find everyday ways to move more

} Decrease your portion sizes

} Eat regularly timed meals and snacks throughout the day

} Plan ahead

}Manage stress

10

Food & activity journal

Keeping a food and activity journal is one of the keys to successful weight loss. However, many people find this challenging. Don’t get caught up trying to keep a ‘perfect’ journal. You want this to be a helpful tool. Food journals can help you identify your eating patterns.

} Do you find that you always eat on the run?

} Do you eat when you are bored, upset, stressed?

} Do you skip meals or eat regularly throughout the day?

} Do you eat at the same time everyday or is your eating schedule sporadic?

} Do you eat out or from vending machines or take time to prepare meals at home?

} Do you eat a large portion of your calories at a certain time of day?

} Do you tend to overeat when you are alone or with friends?

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Other things to keep in mind as you begin your weight loss journey:

} You can succeed!

} Small changes really add up

} Take it one step at a time

} Set backs are normal

} Stay positive

}Welcome changes, but know they are not always easy

} Lean on family and friends for support

} Keep your goals within reach

} Always remember your motivation

} Track your progress

} Celebrate your success along the way

Be safe

If you are planning to become much more physically active than you are now, start by answering these seven questions.

1. Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?

2. Do you feel pain in your chest when you do physical activity?

3. In the past month, have you had chest pain when you were not doing physical activity?

4. Do you lose your balance because of dizziness or do you ever lose consciousness?

5. Do you have a bone or joint problem that could be made worse by a change in your physical activity level?

6. Is your doctor currently prescribing drugs for your blood pressure or heart disease?

7. Do you know of any other reason why you should not do physical activity?

If you answered YES to one or more questions, talk to your doctor by phone or in person before you start a new physical activity program.

We recommend that you talk to your doctor before beginning any type of weight loss program.

12

Try some of these tips to help you jumpstart your weight loss.

Burn 100 calories* Cut 100 calories

Walk upstairs for 10 minutes Drink a diet soda in place of a regular soda

Jump rope for 10 minutes Skip the cheese on your burger or sandwich

Play with kids for 25 minutes Leave a few bites on your plate

Dance for 15 minutes Trim the fat from meat before cooking

Work in the garden for 20 minutes Bake or grill foods instead of frying

Mow the lawn for 20 minutes Skip the bread or appetizer when dining out

Stretch or do yoga for 20 minutes Share a dessert with a friend

Walk for 25 minutes Choose a side of veggies instead of fries

Clean the house for 25 minutes Ask for dressings and sauces on the side

Race walk for 15 minutes Drink skim milk instead of whole milk

* Calories burned vary by individual depending on your weight.

Lose and Win

13

Session 1

On your way to a healthy weight:

Facilitator guide

Participant guide

Lose and Win

14




60 minutes

} 30 minutes reviewing content

} 30 minutes for group discussion and activity

Objectives:

} Discuss the importance of a healthy weight

} Explain the key components of weight loss

} Discuss everyday tips on how to eat fewer calories and move more

} Provide resources that help participants determine a healthy weight and daily calorie needs

Preparation:

} Read module and become familiar with content before the session

} Prepare class activity and any handouts for the session


Special note: Remember to send pre-questionnaire link to participants after session 1.

15

Session 1 — On your way to a healthy weight }Welcome participants and review objectives for the session

} Send pre-questionnaire link to new participants

} Check in with participants to make sure everyone is recording their food and activity every day

} Review the key points from the module

1. Achieving and maintaining a healthy weight can help reduce the risk of many chronic conditions.

2. Body Mass Index (BMI) is a measure used by health professionals to assess healthy weight. It is based on your height and weight. The higher the BMI, the greater risk for illness and disease.

3. Weight is a direct relationship of the amount of energy (calories) one eats and drinks to the amount of energy used. Weight loss will occur when the calories one eats and drinks are less than the calories used. Daily calorie needs vary by individual depending on age, sex, and activity level.

4. Slow and steady weight loss leads to sustainable weight loss. Individuals should aim for 1 – 2 pounds per week.

5. The best method for weight loss is to use more calories by being more active and eat or drink fewer calories.

6. Any movement counts and it all adds up. Look for everyday ways to move more.

7. To eat fewer calories, one can eat smaller portions, substitute lower calorie foods for higher calorie foods, or eat high calorie foods less often. Skipping meals is NOT recommended.

8. It is important to set realistic and achievable weight loss goals.

} Encourage group discussion. Sample questions:

1. Ask participants to share why they wanted to participate in the program.

2. Ask about participants’ previous weight loss efforts. What have been the challenges? How will this weight loss effort be different?

3. Ask participants to share ways they can move more and eat less in their everyday life.

} Facilitate a class activity

} Provide resources and any additional handouts to participants

} Encourage participants to set a goal

} Close by having one of the participants read the Tip of the Week*

* May be used as a handout or emailed after each session as a reminder to engage in healthy lifestyles

16

Class activity suggestions

Food & activity journalObjective Encourage participants to use the food & activity journal

Materials needed Sample journal

Steps 1. Share what a sample day would look like including times eaten, amounts, thoughts, activity, etc.

2. Ask how many participants have been keeping a food & activity journal.3. Discuss some of the challenges and how the journal has helped.4. Ask participants to share an entry that they are either proud of or want help from

the group on how to make better choices.

Special notes If funding permits, purchase journals for each participant

MyPlateObjective Show participants how to determine how many calories they need each day

Materials needed Computer access with Adobe and projector

Steps 1. Go to www.chosemyplate.gov2. Pick "Weight Management and Calories"3. Click SuperTracker4. Click on "Get Started" and "Create My Profile"

Special notes UnitedHealthcare members may also access the Weight Loss Online Health Coach program. This online program provides sample meal plans for their calorie needs. To access, click on ‘Health & Wellness’ from myuhc.com, then select ‘Online Health Coach.’

Portion sizesObjective Help participants visualize appropriate portion sizes

Materials needed Food models and standard dinner plate OR deck of cards, checkbook, pair of dice, baseball, golf ball, and tennis ball

Steps Food Models1. Set up a display and show participants various serving sizes of everyday foods

— juice, cereal, rice, etc. 2. Ask a volunteer to make a meal from the food models.3. Talk about how the food looks on the plate and encourage participants to use this

visual when eating.Everyday Items1. Ask participants to name which item is a serving size of meat, fish, cheese, fruit

or vegetable, peanut butter, pasta or rice, or cereal.

Special notes Food models may be purchased through Nasco Nutrition or HealthEDCO. Visit www.enasco.com or www.healthedco.com.

Lose and Win

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Session 1: Participant guide


The healthy advantage

You probably already know that there are many good reasons to maintain a healthy weight including lowering your risk for type 2 diabetes, heart disease, high blood pressure, and even certain types of cancer.

There are likely many other reasons why you want to lose weight. It’s important to keep these reasons top of mind as you reach towards your goal.

What’s your motivation?

} Feel better

}More energy

} Fit in your favorite clothes

} Play with kids or grandkids

} Sleep better

} Decrease medication

} Fewer doctor visits

} _______________________

} _______________________

} _______________________

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Find your healthy weight

Many of us may rely on the bathroom scale or how our clothes fit to judge whether we’re at a healthy weight. For a more reliable tool, health professionals use the body-mass index (BMI). The BMI is a mathematical formula that uses your height and weight to determine if you are in a healthy weight range. The higher your BMI, the greater your risk for health problems.

Use the chart below to determine your healthy weight range. 1. Find your height on the left hand column.2. Look at the numbers in the lightest shade for your healthy weight range.

Example: A healthy weight range for someone 5'8" would be 125 – 158 lbs.

My healthy weight range is: ________________________________________________________

Healthy Weight Overweight Obese

BMI 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40

Height Body Weight (pounds)

4' 10" 91 96 100 105 110 115 119 124 129 134 138 143 148 153 158 162 167 172 177 181 186 191

4' 11" 94 99 104 109 114 119 124 128 133 138 143 148 153 158 163 168 173 178 183 188 193 198

5' 0" 97 102 107 112 118 123 128 133 138 143 148 153 158 163 168 174 179 184 189 194 199 204

5' 1" 100 106 111 116 122 127 132 137 143 148 153 158 164 169 174 180 185 190 195 201 206 211

5' 2" 104 109 115 120 126 131 136 142 147 153 158 164 169 175 180 186 191 196 202 207 213 218

5' 3" 107 113 118 124 130 135 141 146 152 158 163 169 175 180 186 191 197 203 208 214 220 225

5' 4" 110 116 122 128 134 140 145 151 157 163 169 174 180 186 192 197 204 209 215 221 227 232

5' 5" 114 120 126 132 138 144 150 156 162 168 174 180 186 192 198 204 210 216 222 228 234 240

5' 6" 118 124 130 136 142 148 155 161 167 173 179 186 192 198 204 210 216 223 229 235 241 247

5' 7" 121 127 134 140 146 153 159 166 172 178 185 191 198 204 211 217 223 230 236 242 249 255

5' 8" 125 131 138 144 151 158 164 171 177 184 190 197 203 210 216 223 230 236 243 249 256 262

5' 9" 128 135 142 149 155 162 169 176 182 189 196 203 209 216 223 230 236 243 250 257 263 270

5' 10" 132 139 146 153 160 167 174 181 188 195 202 209 216 222 229 236 243 250 257 264 271 278

5' 11" 136 143 150 157 165 172 179 186 193 200 208 215 222 229 236 243 250 257 265 272 279 286

6' 0" 140 147 154 162 169 177 184 191 199 206 213 221 228 235 242 250 258 265 272 279 287 294

6' 1" 144 151 159 166 174 182 189 197 204 212 219 227 235 242 250 257 265 272 280 288 295 302

6' 2" 148 155 163 171 179 186 194 202 210 218 225 233 241 249 256 264 272 280 287 295 303 311

6' 3" 152 160 168 176 184 192 200 208 216 224 232 240 248 256 264 272 279 287 295 303 311 319

6' 4" 156 164 172 180 189 197 205 213 221 230 238 246 254 263 271 279 287 295 304 312 320 328

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Achieve a healthy weight

Your weight is a direct relationship to the amount of energy (calories) you eat and the amount of energy you use.

Maintaining weight

Your weight will stay the same when the calories you eat and drink equal the calories you burn.

Losing weight You will lose weight when the calories you eat and drink are less than the calories you burn.

Gaining weight You will gain weight when the calories you eat and drink are greater than the calories you burn.

Source: Center for Disease Control and Prevention

You will lose weight when the calories you eat and drink are less than the calories you burn.

To lose one pound, you would need to use 3500 more calories than you take in. Let’s say you wanted to lose one pound a week. You would need to use 500 calories more than you take in each day. This could be accomplished by any one of the following ways:

} Eat 500 fewer calories each day } Burn 500 calories by being more active each day } Eat 250 fewer calories and burn 250 calories by being more active each day

The best method is to eat fewer calories AND be more active.

Move more!

A regular exercise routine can help you burn more calories. You don’t have to belong to a gym to be more active. Walking is a great form of exercise that almost anyone can do. And there’s no special equipment to buy — you just need a good pair of shoes.

In addition to regular exercise, look for everyday opportunities to move more. It all counts and can really add up!

} Park your car a block or two away and walk }Get off one or two bus stops early and walk the rest of the way } Use the stairs } Dance around the house to your favorite tunes

}Walk to a co-workers desk instead of using the phone or e-mail } Clean the house }Walk the dog } Play with the kids

Energy In = Energy Out

Energy In < Energy Out

Energy In > Energy Out

In Out

In

In

Out

Out

In Out

In

In

Out

Out

In Out

In

In

Out

Out

20

Sometimes it’s difficult to know the right portion size. Use these everyday items to help you approximate a serving.

Eat fewer calories

It’s important to know that eating fewer calories doesn’t mean that you will go hungry. Your diet should consist of a variety of foods including fruits and vegetables, whole grains, lean meats and fish and low-fat dairy while minimizing your intake of saturated and trans fat, cholesterol, and sodium. Regularly timed meals eaten throughout the day will help you from feeling over-hungry. Try these 3 ways to eat fewer calories:

1. Eat smaller portions2. Eat lower calorie foods 3. Eat high calorie foods less often

How many calories do you need?

Calorie needs vary by individual depending on your sex, age, and activity level. Use this chart to determine your calorie needs. Sedentary means a lifestyle that includes only the light physical activity associated with typical day-to-day life. Active means a lifestyle that includes physical activity equivalent to walking more than 3 miles per day 3 to 4 miles per hour, in addition to the light physical activity associated with typical day-to-day life.

Eat smaller portions

In the past 40 years, portion sizes have dramatically increased. A typical cheeseburger had about 300 calories years ago. Today’s cheeseburgers can have 600 calories or more.

Try these tips to help keep your portion size in check:

} Use smaller plates, bowls, and glasses at home

} Don’t go back for seconds

} Look for foods packaged in individual servings

} Eat only half of restaurant size portions and take the rest home

}Order kid sized portions

Deck of cards = 3 ounce serving of meat

Checkbook = 3 ounce serving of fish

4 dice = 1 ounce of cheese

Baseball = 1 serving of fruits or vegetables

Golf ball = 2 tablespoons of peanut butter

½ of a tennis ball = ½ cup of rice or pasta

Medium fist = 1 cup of cereal

Calorie range

Children Sedentary " Active 2 – 3 years 1,000 " 1,400Females

4 – 8 years 1,200 " 1,8009 – 13 1,600 " 2,200

14 – 18 1,800 " 2,40019 – 30 2,000 " 2,40031 – 50 1,800 " 2,200

51+ 1,600 " 2,200Males

4 – 8 years 1,400 " 2,0009 – 13 1,800 " 2,600

14 – 18 2,200 " 3,20019 – 30 2,400 " 3,00031 – 50 2,200 " 3,000

51+ 2,000 " 2,800

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Eat more fruits and veggies

Most fruits and vegetables are naturally low in calories. Because fruits and vegetables are also good sources of fiber, they can help you feel full. Try adding more fruits and vegetables into each meal.

} Order a side salad, side of fruit, or steamed veggies instead of chips, fries, or baked potato

} Add veggies to casseroles, soups, and stews

} Toss fresh fruit into your cereal or granola

} Dip cut vegetables instead of chips in hummus, salsa, or cottage cheese

} Ask for extra veggies on your pizza or sandwiches

} Snack on whole fruit or fresh cut vegetables

Cut the Fat

While all foods contain calories, fat has more calories per gram than protein and carbohydrates. That’s why eating lower fat foods will help you eat fewer calories. Decreasing your intake of fat will also help reduce your risk for heart disease.

Try some of the substitutions to help you lower your fat intake:

Instead of… Try…

Fried chicken Grilled or baked chicken or fish

Ground beef Ground sirloin or lean ground turkey

Salami, bologna Sliced turkey or chicken deli meat

Whole eggs Egg whites

Whole milk Skim or 1% milk

Cheddar cheeseLight cheddar or other light cheese varieties

Ice cream Frozen yogurt

Cookies Ginger snaps or graham crackers

French Fries Baked potato

Chips Baked chips or whole wheat crackers

Cream sauces and soups

Vegetable based sauces and soups

TIP You don’t have to completely give up the less healthy foods you enjoy — just eat them less often.

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Ready. Set goals!

As you think about your weight loss goal, remember that slow and steady weight loss is the best. It’s important to set realistic goals that are in reach, but still challenging. Aim for a 1 – 2 pound weight loss each week. This may not seem like a lot, but if you lost one pound a week for a year, you would be 52 pounds lighter. Remember to take it one step at a time. Small changes really do add up.

My current weight is: ______________________ My weight loss goal: ______________________

By what date: ______________________________________________________________________________________________________

Focus on healthy lifestyle changes that will help you reach your goal such as getting more activity and eating less.

List how you will include activity in your everyday life:

1. ______________________________________________________________________________________________________________________

2. ______________________________________________________________________________________________________________________

3. ______________________________________________________________________________________________________________________

List specific ways you will eat less every day:

1. ______________________________________________________________________________________________________________________

2. ______________________________________________________________________________________________________________________

3. ______________________________________________________________________________________________________________________

Did you know?Losing just 10% of your body weight can lower your risk for chronic conditions.

Lose and Win

23

Session 2

Move to lose:

Facilitator guide

Participant guide

Lose and Win

24


Move to lose


60 minutes



Objectives:

} Discuss the benefits of exercise

} Review the exercise recommendation for weight loss

} Define moderate intensity exercise

} Encourage participants to develop and adhere to an exercise plan

} Provide tips and resources to help participants move more everyday

Preparation:




25

Session 2 — Move to lose }Welcome participants and review objectives for the session

} Check in with participants to make sure everyone is recording their food and activity


1. Exercise has many health benefits including: reduces the risk of heart disease or high blood pressure, lowers high blood pressure and blood glucose levels, reduces feelings of stress and anxiety, promotes healthy bones and helps individuals achieve and maintain a healthy weight.

2. Individuals should talk to their doctor about exercise. 3. It is important to start slow without overdoing it to prevent injury and burn out. 4. Individuals should take caution during exercise. If breathing is too fast to catch a breath,

individuals should stop and take a break. If one feels any pain in the chest, feel really sick to the stomach, or dizzy and lightheaded, they should STOP immediately, get help and call the doctor.

5. National guidelines recommend 60 minutes of moderate intensity exercise on most days of the week to achieve weight loss. This means structured planned activity, but this time can be broken into 10 minute short bouts throughout the day.

6. Moderate intensity exercise means that individuals should be feeling warm, breathing hard with an elevated heart rate, and possibly sweating, but still able to carry on a conversation. Moderate intensity activities include brisk walking like you were trying to catch a bus or running late to a meeting. Other forms of moderate activity include jogging, biking, swimming, hiking, aerobics, dancing, or gardening.

7. Exercise can fit into even the busiest lifestyles with planning. It is important to build a plan that fits a person’s lifestyle and interests.


1. Ask participants to list some of the benefits of exercise.2. Ask participants to share how they make time for exercise. How do they fit it into their

schedule? What helps them stick to a routine? 3. Ask participants if there are ways to increase physical activity during the workday. 4. Ask participants if exercising with a buddy would help. Would the class like to set a buddy

system for exercising? What other solutions may help participants be more active?



} Encourage participants to set an exercise plan


* May be used as a handout or emailed after each session as a reminder to engage in healthy behaviors.

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True or false exercise quiz

Objective Address common exercise myths

Materials needed True or False Exercise Quiz (in participant manual)

Steps 1. Read the quiz questions and ask participants for answers.

2. Review answers as a group.

3. Award prizes to the participants that achieved 100% or raffle off one prize if limited resources.

Special notes Suggested prizes: aerobic DVD, 3 – 5 lb hand weights, exercise bands, pedometer, water bottle, t-shirt or sport towel

Fitting in 60 minutes of activity

Objective Help participants find time to be active throughout the day

Materials needed Flip chart/white board and markers

Steps 1. Break the participants into groups of 3 – 4.

2. Ask each group to come up with a plan on how to fit 60 minutes of activity into a day.

3. Have one member of each group share the plan with the class.

Special notes Encourage the groups to come up with solutions that can be done throughout the workday

Active lifestyles. No gym membership required.

Objective Stress that no special equipment or gym membership is required for an active lifestyle


Steps 1. Ask group to come up with everyday ways to move more without having special equipment or going to the gym.

2. Come up with at least 20 ways as a group.

3. Ask participants which of these ideas will they do.

Special notes Provide a list of local parks, recreational centers, tracks and other places where individuals can be active in the community

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Move to lose

Your weight depends on the amount of calories or energy you eat and drink and the amount of energy you use. To lose weight, you must use more calories than you take in. This can be accomplished by eating fewer calories, being more physically active, or both.

While you could just focus on eating fewer calories, you’d be missing the other benefits of an active lifestyle. One of the single best predictors of successful long-term weight loss is developing a regular exercise program.

Benefits of physical activity

Regular physical activity can improve your health in many ways.

} Reduces the risk of premature death

} Reduces the risk of developing heart disease or having a stroke

} Lowers bad cholesterol and raises good cholesterol

} Lowers the risk of developing high blood pressure and helps reduce blood pressure in people who already have hypertension

} Lowers the risk of developing type 2 diabetes

} Reduces the risk of certain cancers

} Helps you achieve and maintain a healthy body weight

} Reduces feelings of depression, anxiety and stress

} Promotes mental well-being

} Helps build and maintain healthy bones, muscles, and joints

Source: CDC

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Before you get started, test your exercise IQ.

True or false?

1. If I exercise, I can eat whatever I want. True False

2. If I have no energy for physical activity, it’s best to rest. True False

3. To lose weight, I should only focus on aerobic exercise. True False

4. I should push myself to my limits to get any benefit After all, ‘no pain, no gain.’ True False

5. I should drink a sports drink when I exercise. True False

6. I shouldn’t bother unless I can exercise for at least 30 minutes. True False

7. Regular physical activity can reduce the need for some types of medication. True False

Answers:

1. False. It’s common for people to overestimate the number of calories used during exercise. A 175 pound person burns about 140 calories on a 30 minute walk while an energy bar has about 250 calories. Remember that to lose weight you need to use more calories than you take in.

2. False. Physical activity can actually help you feel more energetic. Plan physical activities for times of the day when you tend to feel more energetic. Go to bed earlier to make sure you’re getting enough sleep. Take it slow — start with a walk around the block, not a marathon.

3. False. While aerobic exercises help you burn calories, strength training helps you reduce your body fat, increase your lean muscles mass and burn calories more efficiently. It’s also important to stretch and exercise your core muscles for flexibility, balance and good circulation.

4. False. Exercise shouldn’t hurt. A little muscle soreness when you do something new isn’t unusual, but soreness doesn’t equal pain. If it hurts, you’re probably pushing yourself too hard.

5. False. It’s important to stay hydrated when you exercise. Zero calorie water is often the best choice. You don’t need electrolytes and carbohydrates (calories) found in sports drinks unless you are doing vigorous exercise for an extended period of time.

6. False. Studies show that doing multiple 10 minute continuous bouts of moderate-intensity activity throughout the day can add up to big health benefits.

7. True. Physical activity can help individuals with type 2 diabetes or hypertension lower blood sugar levels and blood pressure. For some people, physical activity is enough to reduce the need for medication. You should continue to take your medication as directed unless your doctor tells you otherwise.

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Getting started

You’re motivated and ready to begin your exercise routine. Be careful not to overdo it. Start out slow and work up to your target goal. If you go too far or too fast in the beginning, you may hurt yourself or lose interest.

Exercise for weight loss

For weight loss, national guidelines recommend getting 60 minutes of moderate intensity activity on most days of the week.

Sound like a lot? You don’t have to get 60 minutes in at one time. You can break the time into several 10 minute continuous stretches throughout the day. Look at the examples below.

Example 16:30 a.m. Brisk walk 30 minutes9:00 a.m. Take the stairs instead of elevator to the office 10 minutes5:30 p.m. Briskly walk the dog 20 minutes

60 minutesExample 2

12:00 p.m. Brisk walk during lunch 30 minutes6:30 p.m. Circuit training 30 minutes

60 minutesExample 3

7:30 a.m. Brisk walk 30 minutes12:00 p.m. Climb the stairs at work 10 minutes6:00 p.m. Active play outside with kids 20 minutes

60 minutesExample 4

7:00 a.m. Mop the floors 10 minutes7:30 a.m. Jump rope 10 minutes12:00 p.m. Aerobics class 30 minutes5:30 p.m. Dance to your favorite song 10 minutes

60 minutes

Remember to start slow and work up to your goal. Aim for 30 minutes of moderate intensity physical activity most days of the week. Gradually increase your time and frequency until you’ve reached your goal.

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Gradual exercise program

Weeks Days/Week

Minutes/Day

Minutes/Week

1 3 20 60

2 4 20 80

3 – 4 5 20 100

5 – 8 5 30 150

9 – 12 5 40 200

13+ 5 60 300

Be safe! If you are breathing too fast, cannot catch your breath, or get a cramp, stop and take a break. Drink some water. If you feel any pain in your chest, feel really sick to your stomach, or feel dizzy or lightheaded, STOP immediately, get help and call your doctor. If you are just beginning an exercise program, talk to your doctor about activities that are best for your health status.

Plan your exercise program

Finding time to exercise can be challenging. That’s why it’s important to schedule activity into your life.

} Set aside at least 30 minutes a day that you can be active

} Block out this time on your calendar or include on your to-do list

} Keep to the schedule just like you would a doctor’s appointment, lunch date, or work meeting

} Track your activity so that you can measure your progress

Choose activities that works for you

You’re more likely to stick to an exercise routine if you choose activities that work for your schedule and lifestyle. Answer these questions to help you choose activities that are right for you.

} How much time do you have?

} Do you enjoy group or solo activities?

} Do you prefer to exercise in private (home) or public (gym, parks) places?

}Would you rather be inside or outside?

} Do you have access to special equipment needed for certain activities?

} Do you like variety or prefer to master one type of activity?

Most important — choose activities that you enjoy!

TIP Use a pedometer to help track your everyday activity. For every 2000 steps you track, you burn about 100 calories.

Find ways to fit structured activity into your lifestyle on most days of the week. Remember that 10 minute short bouts of activity counts and can really add up.

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Moderate-intensity activities

What type of activities do you enjoy?

Look for everyday ways to move more

Moderate intensity activity helps you burn more energy in less time and lowers your risk for developing certain illnesses. But any opportunity to move more is an opportunity to burn more calories.

Try some of these ways to move more.

} Park and go into the restaurant or bank instead of using the drive-thru

}Walk to the convenience store, post office, or dry-cleaner to accomplish nearby errands

}March in place when you’re watching television

}Walk to the restroom or vending machine furthest away from your office

}Walk around the restaurant parking lot while waiting to be seated

} Plan active family outings such as hiking, biking, or swimming

} Tour the local museum, nature center or zoo

} Volunteer for community clean-up days

What are other ways you can move more?

__________________________________________________________ __________________________________________________________

__________________________________________________________ __________________________________________________________

__________________________________________________________ __________________________________________________________

What is moderate intensity exercise? Moderate intensity means you should be feeling warm, breathing hard with an elevated heart rate, and possibly sweating, but still able to carry on a conversation. You should feel like you are trying to catch a bus or running late to a meeting.

}Walking

} Jogging

} Biking

} Swimming

}Water aerobics

} Hiking

} Circuit training

}Gardening

} Exercise class

} Active play with kids

} Raking the leaves

} Dancing

Did you know?Standing burns 20% more calories that sitting. Try standing next time you’re on the phone.

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My exercise plan

I will exercise for ________ minutes on ________ days of the week.

Time of day Activity Minutes

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Additionally, I will look for ways to move more including: __________________________________________________

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

Ready, set, go!

Now that you have a plan, you’re ready to go. Remember to:

} Be safe


} Schedule activity into your life

} Choose something you like to do

}Go at your own pace

} Small changes add up

} Some activity is better than none


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Session 3

Planning ahead for healthy eating:

Facilitator guide

Participant guide

Lose and Win

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60 minutes



Objectives:

} Promote healthy eating

} Encourage participants to plan meals

} Provide sample healthy meal plans

} Demonstrate how to read the nutrition labels

Preparation:




35

Session 3 — Planning ahead for healthy eating

}Welcome participants and review objectives for the session

} Check in with participants about their progress. Discuss any challenges. Encourage the group to share best practices and successes.


1. Planning ahead helps individuals make better choices.

2. Individuals can plan to bring healthy snacks and lunches instead of relying on less healthy convenient options.

3. Using a meal planner is a great strategy to help individuals make better choices.

4. Preparing foods or meals on the weekends or other less hectic days can make it easier to have ready-to-eat foods available on those busy days.

5. Going to the grocery store several times a week or when an individual is hungry or tired may result in less healthy impulse purchases.

6. Healthy eating doesn’t have to be expensive. Using coupons, buying in-season, or purchasing in bulk can help save money.

7. Nutrition labels provide information to help individuals make better choices. Calories and other nutrients listed on the nutrition labels are per serving not for the entire package.

8. Foods that contain common recognizable ingredients are generally more wholesome.


1. Ask participants to share some of the challenges with healthy eating. Discuss ways that planning ahead could help overcome some of these challenges.

2. Ask if any participants currently use a meal plan. What are the benefits?

3. Ask participants to share ways they save money on healthy foods. Do they look for specials, or coupons or buy store brands?




* May be used as a handout or emailed after each session as a reminder to engage in healthy lifestyle behaviors.


Reading labelsObjective Demonstrate how to read labels

Materials needed Bring in samples of packaged food items

Steps 1. Break the participants into groups of 3 – 4.2. Give each group sample food items.3. Ask groups to find the calories per serving, calories per container, total fat grams,

total fiber and total sodium.4. Ask groups to read the ingredient labels out loud.5. Discuss as a group healthier alternatives to the food choices brought in.

Special notes Look for foods that people may eat in one serving but that contain more than one serving

Planning meals

Objective Help participants develop a healthy meal plan

Materials needed Sample healthy meal plan from module and blank worksheet, healthy cookbooks and cooking magazines, flipchart/white board and markers

Steps 1. Ask participants to think about their upcoming week and create a meal plan that would work with their schedule.

2. Give participants time to look through recipes to get ideas.3. Ask the group to share examples and write a sample plan on the board or flipchart.

Special notes Encourage participants to look for support from each other — eat together, share favorite new foods, etc.

Healthy potluck lunch

Objective Give participants the opportunity to sample healthy food options

Materials needed Plates, napkins, serving utensils

Steps 1. Ask participants to bring in a healthy dish to share along with the recipe.2. Collect recipes and copy for participants.3. Have the group vote for a favorite dish and give the winner a prize such as a gift

card to the grocery store, healthy cooking magazine subscription, or healthy cookbook (optional).

Special notes If resources exist, provide a healthy lunch for the participants. Ask local caterers about healthy meal options. Be sure to include fruits, vegetables, lean protein, and healthy grains.Sample menus:

} baked chicken, brown rice, mixed vegetables, fruit salad } turkey breast, whole grain bread, sliced veggies or green salad, vegetable soup, whole fruit } salad bar with a variety of vegetables, diced turkey or chicken, beans, low-fat cheese, light dressing, fruit smoothies

If you are not able to have food, simply compile healthy recipes to share as a group. Ask participants to try the recipes at home and report back to the group.

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With any weight loss program, it is important to make healthy food choices and get regular exercise. You are motivated and excited about living a healthier life, but sometimes it can be challenging.

Read about Joan’s experience.

“I’m trying hard to eat healthier, but my work schedule is so hectic that I often don’t have time for lunch. I’ll plan to run out for lunch and even schedule lunch dates, but then I get tied up in a meeting and can’t get away. Before you know it, I’ve missed lunch and I'm so hungry I’ll eat anything in sight. This is when I usually head to the vending machine and grab a candy bar and bag of chips. I know this is not a good choice, but I’m not sure what to do in those situations.”

It is sometimes challenging to make healthy choices. But with a little planning, it’s easier than you think.

Think about Joan’s story. She knows that her days often get packed and that she is not able to get away for lunch. Here are three things she can do if she plans ahead:

1. Pack her lunch and bring it with her.

2. Keep healthy snacks in her desk so that she is less likely to visit the vending machine.

3. Ask a co-worker friend to grab lunch for her and bring it back.

“ Those who fail to plan, plan to fail.”

38

Planning ahead for healthy meals

Planning meals in advance can make it easier to incorporate healthy eating into your busy day.

Meal planning steps

1. Write out a meal plan for the week.

2. Make a grocery list.

3. Shop smart.

4. Prepare ahead of time.

When you sit down to write out a meal plan, think about your schedule for the upcoming week. Ask yourself the following questions:

} How busy will your week be?

} How much time will you have to prepare food?

} How many meals will you need to prepare each day?

Match your meals with your available time. If you know you have a busy week, you may not want to plan a four-course, fancy meal. Instead, think about meals that can be made ahead of time or that are quick to prepare. Plan to use leftovers to save time. Make sure to keep your portion sizes small.

Meal planning

Breakfast Lunch Dinner

Sunday Frozen waffles, turkey sausage, blueberries

Family pot-luck Vegetable lasagna, green salad

Monday Whole grain cereal, low-fat milk, bananas

Left-over lasagna Grilled chicken, green beans, baked sweet potato

Tuesday Banana nut smoothie Lunch meeting at work Bean burrito, salsa

Wednesday Scrambled egg whites, whole grain toast, tomato slice

Turkey sandwich on whole grain bread, pretzels, fruit

Tuna patties, mashed sweet potatoes, steamed vegetable medley

Thursday Whole grain cereal, low-fat milk, blueberries

Black bean soup, green salad

Pizza party with baseball league

Friday Yogurt, granola, almonds Lunch with co-worker Salmon, pasta, asparagus

Saturday Scrambled egg whites, whole grain toast, tomato slice

Grilled salmon sandwich, fresh fruit

Dinner with in-laws

The meal planning step helps you think about meals ahead of time so that you can plan to have those foods on hand making meal times more manageable.

Remember that it is also important to think about the amount of food you will eat. You want to stay within your daily calorie range and choose appropriate portion sizes.

39

Sample menus for 1600 calories

Day 1 Day 2 Day 3

Breakfast Breakfast burrito1 whole wheat flour tortilla

(7" diameter)1 scrambled egg (in 1 tsp soft, no trans fat

margarine)1/3 cup black beans2 tbsp salsa1/2 cup orange juice1 cup fat-free milk

Cold cereal1 cup bran flakes1 cup fat-free milk1 small banana1 slice whole wheat toast1 tsp soft, no trans fat

margarine1/2 cup orange juice

1 whole wheat English muffin1 tsp soft, no trans fat margarine 1 tbsp jam or preserves1/2 medium grapefruit1 hard-cooked egg1 unsweetened beverage

Lunch Roast beef sandwich1/2 whole grain sandwich bun3 ounces lean roast beef2 slices tomato1/4 cup shredded romaine lettuce1/8 cup sauteed mushrooms (in 1 tsp oil)1 ounce part-skim mozzarella cheese1 tsp yellow mustard1/2 cup baked potato wedges1 tbsp ketchup1 unsweetened beverage

Tuna fish sandwich1 slice rye bread3 ounces tuna (packed in water, drained)1 tsp mayonnaise1 tbsp diced celery1/4 cup shredded romaine lettuce2 slices tomato1 medium pear1 cup fat-free milk

White bean-vegetable soup1 1/4 cup chunky vegetable soup1/2 cup white beans2 ounce breadstick; whole

grain if possible8 baby carrots1 cup fat-free milk

Dinner Stuffed broiled salmon5 ounce salmon filet1 ounce bread stuffing mix1 tbsp diced celery2 tsp canola oil1 ounce slivered almonds1/2 cup steamed broccoli1 tsp soft, no trans fat

margarine1 cup fat-free milk

Roasted chicken breast3 ounces boneless skinless chicken breast1 medium baked sweet potato1 tsp soft, no trans fat

margarine1 ounce whole wheat dinner roll1 tsp soft, no trans fat

margarine1 cup leafy greens salad2 tsp olive oil and vinegar

dressing

Rigatoni with meat sauce1 cup rigatoni pasta; try whole

grain pasta (2 ounces dry)1/2 cup tomato sauce 2 ounces extra lean cooked ground beef (sauteed in Canola oil pay spray)1 tbsp grated Parmesan

cheeseSpinach salad1 cup baby spinach leaves1/2 cup tangerine slices1/2 ounce chopped walnuts2 tsp olive oil and vinegar

dressing1 cup fat-free milk

Snacks 1 cup cantaloupe 1/4 cup dried apricots1 cup low-fat fruited yogurt

1/2 cup low-fat fruited yogurt

Source: MyPlate.gov

40Source: MyPlate.gov

Sample menus for 2000 calories

Day 1 Day 2 Day 3

Breakfast Breakfast burrito1 whole wheat flour tortilla

(7" diameter)1 scrambled egg (in 1 tsp soft, no trans fat

margarine)1/3 cup black beans2 tbsp salsa

Cold cereal1 cup bran flakes1 cup fat-free milk1 small banana1 slice whole wheat toast1 tsp soft, no trans fat

margarine1 cup orange juice

1 whole wheat English muffin2 tsp soft, no trans fat margarine 1 tbsp jam or preserves1 medium grapefruit1 hard-cooked egg1 unsweetened beverage

Lunch Roast beef sandwich1 whole grain sandwich bun3 ounces lean roast beef2 slices tomato1/4 cup shredded romaine lettuce1/8 cup sauteed mushrooms (in 1 tsp oil)1 1/2 ounce part-skim mozzarella cheese1 tsp yellow mustard3/4 cup baked potato wedges1 tbsp ketchup1 unsweetened beverage

Tuna fish sandwich2 slices rye bread3 ounces tuna (packed in water, drained)2 tsp mayonnaise1 tbsp diced celery1/4 cup shredded romaine lettuce2 slices tomato1 medium pear1 cup fat-free milk

White bean-vegetable soup1 1/4 cup chunky vegetable soup1/2 cup white beans2 ounce breadstick; whole

grain if possible8 baby carrots1 cup fat-free milk

Dinner Stuffed broiled salmon5 ounce salmon filet1 ounce bread stuffing mix1 tbsp diced celery2 tsp canola oil1/2 cup saffron (brown) rice1 ounce slivered almonds1/2 cup steamed broccoli1 tsp soft, no trans fat

margarine1 cup fat-free milk

Roasted chicken breast3 ounces boneless skinless chicken breast1 large baked sweet potato1/2 cup peas and onions1 tsp soft, no trans fat

margarine1 ounce whole wheat dinner roll1 tsp soft, no trans fat

margarine1 cup leafy greens salad3 tsp olive oil and vinegar

dressing

Rigatoni with meat sauce1 cup rigatoni pasta; try whole

grain pasta (2 ounces dry)1/2 cup tomato sauce 2 ounces extra lean cooked ground beef (sauteed in 2 tsp vegetable oil)3 tbsp grated Parmesan cheeseSpinach salad1 cup baby spinach leaves1/2 cup tangerine slices1/2 ounce chopped walnuts3 tsp olive oil and vinegar

dressing1 cup fat-free milk

Snacks 1 cup cantaloupe 1/4 cup dried apricots1 cup low-fat fruited yogurt

1 cup low-fat fruited yogurt

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My meal plan

Think about your schedule for the upcoming week. Use the table below to plan your meals.

Breakfast Lunch Dinner

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Watch your portion sizes.

Read the nutrition label to figure out how many servings are in a package. Then, portion out foods and measure instead of eating straight from containers. Use everyday items to help you estimate a serving size. Or try using smaller plates that hold less food.

42

“A successful trip

to the grocery store

is one in which

you make healthy

food choices!”

Shop smart

Grocery stores are filled with “cues” to eat — aisles of food, colorful displays, free samples, and check out areas lined with candy.

Follow these helpful tips to reduce the temptations:

} Keep a shopping list on the refrigerator door to write down items you need to purchase the next time you go shopping

} Limit the number of grocery visits to one a week

} Use your shopping list

} Don’t shop when you’re hungry because you are more likely to buy unhealthy impulse items

} Focus shopping around the perimeter of the store where you find fresh produce, dairy, seafood, meats, and bread

} Check the label for serving size, calories and fat per serving and ingredients that you recognize

} Choose products that are more wholesome with fewer additives, coloring, or preservatives

Next, make a grocery list

After you have a plan, make a grocery list of the items that you need for the week.

Remember to include plenty of fruits and vegetables, whole grains, lean protein and low-fat dairy. Add any staples that you may need. Plan to pick up healthy snacks that you can keep at home, at the office or with you when you’re on-the-go.

TIPHealthy eating doesn’t have to be expensive. Choose fresh produce that is in season. Use canned and frozen vegetables and fruit when fresh produce costs more. Instead of buying pre-packaged, pre-seasoned foods,

buy the plain version and season yourself. Use coupons and look for weekly specials at your local store. If on sale, stock up on foods that have a long shelf life. Try store brands. Purchase fewer expensive ‘junk food’ items.

43Answer: peanut butter crackers

Practice

Look at the Nutrition Facts provided. How many calories would you consume if you ate the entire container?

a. 125 calories

b. 250 calories

c. 500 calories

d. 750 calories

Answer: c. 500 calories

1. Look at the serving size. Serving size = I cup

2. Determine how many servings you ate. Entire container = 2 servings

3. Multiply the calories per serving by the number of servings ate. 250 calories per serving x 2 servings = 500 calories

Know what you are eating

Take time to read the ingredient list of the foods you buy. You want to look for ingredients that you know. See if you could recognize the food simply by reading the ingredient list. Can you name this food?

Answer: __________________________________________________________________________

Read labels

Reading the Nutrition Facts is a great tool to help you make better choices. Remember that the nutrients listed are per serving, not for the entire package.

Start here }

Check calories }

Limit these nutrients

Get enough of these nutrients

Quick Guide to % DV

} 5% or less is low

} 20% or more is highSource: FDA/CFSAN

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Prepare ahead of time

Busy schedules can leave little time for preparing food.

} Try and schedule time at the beginning of the week to prepare food ahead of time

} Get organized. Make sure ingredients you need are easy to find in the pantry or the fridge.

} Cut up fruits and vegetables so they are ready to eat or can be easily thrown into meals

} Assemble or pre-cook portions of the meal if possible

} Remember to place frozen meats and fish in the refrigerator to thaw the morning or day before you plan to use

} Portion out individual snack size servings of crackers or nuts so you can just grab and go

} Keep pre-made foods in the freezer so that you can just heat and serve

Healthy on-the-go snacks

Snacks or mini-meals eaten throughout the day will help keep you fueled and prevent you from becoming over hungry. Try to keep some of these grab-and-go snacks at your desk, in your bag, or nearby.

} Granola bars

} Light cheese sticks

} Whole-wheat crackers

} Whole fruit such as apples, pears, oranges and bananas

} Popcorn

} Mixed nuts or trail mix

} Dark chocolate covered raisins

TIPWorried about fresh produce going bad? Frozen fruits and vegetables are often just as nutritious as fresh and last a lot longer. Add frozen vegetables to soups, casseroles, or stir-fry. Use frozen fruit in smoothies and baked goods.

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My challenges with healthy eating

What are some of the challenges you face when trying to make healthier choices? How can planning ahead help you with these challenges?

My healthy eating challenge:

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

How I can plan ahead:

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

Lose and Win

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Session 4

Healthy habits:

Facilitator guide

Participant guide

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47


Healthy habits


60 minutes



Objectives:

} Encourage participants to be mindful eaters

} Help participants recognize cues and triggers that lead to unhealthy behaviors

} Discuss how to create healthy environments at home and work

} Encourage participants to develop new healthy habits

Preparation:




48

Session 4 — Healthy habits


} Check in with participants to make sure everyone is recording their food and activity everyday


1. Choices are often tied to environmental cues or daily habits.

2. Recognizing triggers or cues that lead to unhealthy behaviors is the first step in making positive changes.

3. Keeping a food and activity journal is a good way to help identify unhealthy habits.

4. Using a hunger scale can help prevent individuals from overeating. On a scale of 1 to 10, individuals should aim to keep hunger levels between 4 and 6 — not too hungry, not too full.

5. Having a plan in place for challenging situations can make it easier to make healthy choices when faced with difficult times.

6. Individuals should think about their behaviors and the potential consequences before making a decision to act.

7. Replacing unhealthy cues with positive ones can help create an environment that encourage healthy behaviors.


1. Ask participants for examples of triggers or cues that cause them to make unhealthy choices. Are they aware of these triggers at the time of action?

2. Ask participants if they can think about everyday cues that exist. Think about television commercials, product placement at grocery stores, work policies, etc.

3. Ask participants to share some of the healthy habits they have developed to help them manage their weight. What has been challenging? How long did it take to adopt this new healthy habit? What helps them succeed?






Identifying triggers

Objective Have participants identify some of the cues used by marketing to sell products


Steps 1. Break participants into groups of 3 – 4.

2. Ask them to think about how marketing uses cues or triggers to sell products.

3. Have each group list cues for less healthy products and for healthy products. Eg. coupons, advertisements, product placement, cross marketing.

4. Ask the group to discuss their reaction to these types of cues. Do they work? Why or why not?

5. Discuss as a group.

Special notes Consider bringing in magazines, newspapers, direct mail or other examples of how marketers use cues/triggers to entice individuals to act

Mark and Michelle’s healthy habits

Objective Help participants identify their own challenges and develop new healthy habits

Materials needed Copy of the Mark and Michelle examples in the participant manual

Steps 1. Read the examples for Mark and Michelle found in the participant manual.

2. Ask the group if they can identify with these situations. What similar situations do they face?

3. Ask the group to come up with a list of healthy alternatives for Mark and Michelle.

4. Discuss as a group healthy alternatives that can be used in everyday life to overcome individual challenges.

Special notes Develop additional situations that may be more relevant to the workplace or to individuals in the group

Healthy habits

Objective Encourage participants to develop new healthy habits


Steps 1. Break participants into groups of 3 – 4.

2. Ask each group to write down the healthy habits that they can adopt.

3. What will be the challenges in keeping these new habits? What can help keep these new habits?

4. Have groups share with the larger group.

Special notes Encourage participants to use each other to keep healthy habits

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Healthy habits

Do you always grab candy at your co-workers desk because it’s there? Do you eat popcorn every time you go to the movies because it smells so good? Do you plop down on the sofa as soon as you get home because that’s what you always do?

Your behaviors and the choices you make are often tied to environmental cues or established habits. For example, the smell of food may trigger you to eat even if you’re not hungry. Or you may turn on the television when you first walk in the door out of habit. It’s important to recognize the triggers and habits that keep you from making healthy choices. Then, you can take positive steps towards more healthy behaviors.

Try these strategies to help you succeed.

} Think before you eat. Ask yourself, “Am I really hungry?” “Do I really need that dessert, second helping, or snack?” “Do I even want it?”

} Keep a journal. Record everything that you eat and log your activity. You may find that you are less likely to eat something if you know you have to record it. You may also feel motivated to move more if you are tracking your progress. Journals can also help you identify triggers. Look for patterns. Are you more likely to overeat certain foods in certain situations?

} Plan ahead. What will you do if faced with challenging situations? Have a plan in place so you’ll be less tempted to eat that extra serving or skip your workout.

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} Anticipate feelings. Think about how you will feel if you miss your workout. Think about how good you will feel after you have exercised. How proud will you be if you say no to that piece of cake or extra serving?

} Create a healthy environment. Make sure your home and work environments are healthy to help you reach your goals.

• Place fruits, vegetables and other healthy foods in plain sight or easy to reach places while storing less healthy food items out of sight.

• Keep exercise shoes and equipment in sight to help remind you to be active.

• Subscribe to a healthy magazine to encourage you each month.

• Keep healthy snacks available at your desk or nearby to avoid vending machine visits.

• Keep a pair of walking shoes at your desk so you’ll be ready for a quick walk during lunch.

• Track your activity on a calendar that you see everyday.

Adopt new healthy habits. Replace some of your less healthy habits with healthy ones.

} Instead of eating food from the package, take out a serving to help you manage your portion size.

} Choose a designated eating place away from distractions. Enjoy your food and then when you’re done, go back to what you were doing before.

} Put on your workout clothes when you first get up or first get home from work and head out for a walk instead of turning on the television.

} Bring your own healthy snack next time you visit the movies or watch the credits first. Then decide if you really want that popcorn or other snack.

Did you know?

Thirst can sometimes be confused with hunger. Make sure you drink plenty of water throughout the day to stay hydrated. It may even help keep your hunger away.

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Mark works in a social office that likes celebrations. It seems as though each week there is a party with cake, donuts, ice cream or other sweets. Mark likes to attend the parties and enjoys the fun, but is trying to watch what he eats.

Mark discovered that he can still enjoy the celebrations without sabotaging his diet. If he knows there is going to be a celebration, he makes sure that he leaves room in his diet for a special treat. He asks for a small portion and doesn’t go back for seconds to make sure he doesn’t eat too much. Sometimes, he realizes he doesn’t even really like what is being served. In those cases, he just skips the sweets and socializes with co-workers. He also suggested to the planning committee a healthy potluck where everyone brings in healthier options such as fresh fruit and trail mix.

Michelle’s job is very stressful. One of her favorite things to do when she gets home from work is sink down into her favorite chair and ‘veg out’ in front of the television. She continually struggles to fit her workout in and even purchased a treadmill for home to help encourage her, but has it stored away until she’s ready to use it.

Michelle decided to change her environment so that she’d be less tempted to just sit around and watch television when she got home. She moved her favorite chair into her bedroom away from the television and put the treadmill in its place. She now has a rule that as soon as she comes home, she puts her walking shoes on. She started subscribing to a health magazine that she reads through while she’s walking on the treadmill. To her surprise, walking after work really helps reduce her stress.

Mark and Michelle’s healthy habits

Look at the scenarios below. Read how Mark and Michelle use the strategies to make better choices.

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Get control of mindless eating. A food journal is one of the best ways to identify situations where you may be eating even when you are not hungry. These impulse eating sessions can contribute to excess calorie intake and weight gain. Keep your food journal nearby so that it is easy to record. Think about why you are eating. Are you bored? Are you tired? Are you stressed? Instead of reaching for that comfort food, go for a walk or call a friend. Drink some water or chew gum.

Eat with awareness. Paying attention to how you eat helps you become aware of how much you eat. Think about these questions to become more aware of your eating style.

} Do you always eat on the run or when you’re driving?

} Are you a fast or slow eater?

} Do you eat what is served or pay attention to your hunger?

} Do you take large or small bites of food?

}What do you typically eat first? Vegetable, protein, starch?

} Do you go back for seconds if a food tastes good regardless of your hunger level?

} Do you wait until you are overly hungry before eating?

} Do you set aside a time and place to eat or continue what you’re doing (watching television, talking on the phone, working, etc.)

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My healthy habits

Now, think about your own challenges. How can you use some of the strategies to help you succeed?

What triggers you to overeat or choose less healthy foods? How can you change this behavior?

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

What habits prevent you from exercising or moving more? How can you change this behavior?

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

What can you do to create a healthy environment at home? At work?

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

What healthy habits can you adopt to help you succeed?

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

Did you know?

Studies show that people who keep a food journal are more likely to lose weight and keep that weight off.

Lose and Win

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Session 5

Overcoming exercise barriers:

Facilitator guide

Participant guide

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60 minutes



Objectives:

} Identify participants’ barriers to exercise

} Discuss the importance of prioritizing healthy lifestyles

} Encourage participants to find support systems

} Provide examples of ways to be active when on-the-go

Preparation:




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Session 5 — Overcoming exercise barriers




1. The first step to overcoming barriers is identifying road blocks that keep individuals from engaging in healthy behaviors.

2. Being too busy to exercise is one of the most common reasons individuals say they don’t exercise.

3. Individuals may be able to find time by re-prioritizing daily activities or looking for ways to add activity while still accomplishing other tasks.

4. It’s common to lose motivation after several weeks of beginning a new program. Changing routines or exercising with others are strategies to stay motivated.

5. Planning ahead for exercise is just as important as planning ahead for healthy eating. Planning alternative exercise schedules or activities can help overcome anticipated or expected challenges.

6. Family, friends, or co-workers may not always be supportive of new lifestyles. Inviting others for support may not be easy, but a support system is one of the keys to achieving success.

7. Traveling on vacation or for business can make it challenging to stick to an exercise routine. Fitness activities that encourage movement no matter where you go.

8. Walking is a great activity that almost anyone can do anywhere.


1. Talk to participants about their exercise routines. How many have been successful adding activity to their daily lives? What helps them succeed?

2. Ask participants about their exercise challenges. What are some of the challenges? How will planning ahead help overcome some of these challenges? Brainstorm as a group ways to help everyone succeed.

3. Talk to participants about activities that can be done when traveling. Ask participants to share ways they are active when away from home. Share best practices.





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Exercise demosObjective Demonstrate strength training exercises and stretching

Materials needed Video and DVD player with monitor

Steps 1. Purchase an exercise DVD or rent one from the library that demonstrates proper ways to do basic stretch training exercises and stretching.

2. Look for videos that require little to no special equipment.3. Show the video in class.

Special notes Encourage participants to talk to their doctor about exercises that are safe for their health status

Prioritizing time

Objective Help participants find time in their day for exercise

Materials needed Where can you find time? chart in the module

Steps 1. Ask participants to think about their day.2. Have them fill out the chart with the activities and prioritize each with a high,

medium or low priority designation.3. Encourage participants to look at the low priority activities and determine where

physical activity could be added.4. Ask for volunteers to share ways they are going to replace a low priority activity

with physical activity.

Special notes Encourage individuals to stay organized by keeping a to-do list and assigning a priority each day for the activities on the list. Things with the highest priorities should be accomplished first.

Finding support

Objective Help participants identify support systems

Materials needed Flipchart/white board and markers

Steps 1. Break participants into groups of 3 or 4.2. Ask participants to identify their existing support systems.3. Have each group develop ways that others could help them succeed (e.g. ask me

to go for a walk instead of meeting for coffee).4. Ask groups to role-play a discussion with someone who has not been as supportive.5. Share as a group ways to help them succeed.

Special notes Encourage participants to use each other as a support system


An active lifestyle helps you achieve and maintain a healthy weight. It can sometimes be challenging to adopt new behaviors. Different barriers can keep you from your good intentions to exercise. For example, you may think, “I really should exercise, but I just don’t have time today.” It’s important to identify the things that prevent you from being active and develop ways to overcome these roadblocks.

Make time

The perception of being too busy is one of the most common reasons individuals say they don’t exercise. You may think you don’t have the time, but you can find the time if you make physical activity a priority.

Think about your day-to-day routine. Are there things you could give up or ways to reschedule your day? Could you spend less time watching television? Or maybe wake up a little earlier? Could you take a shorter lunch break?

Look for ways to add activity while doing other activities. } Do jumping jacks or march in place while you’re watching television

}Walk while you catch up with friends and family on the phone

} Circle the track or field when you drop your kids off at practice

}Walk or ride your bike to run local errands

Find ways to make physical activity part of your daily life.

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Common exercise barriers

What keeps you from being active? } Lack of time }Weather } No support

} Too tired/low energy } Travel schedule } ______________________________ } ______________________________

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Where can you find time?

Children, work, volunteer activities, and other commitments can often get in the way of exercise. Use this chart below to help you find time to be more active.

1. Record your activities for a typical day.

2. Assign a priority to the activities (H=high: M=medium: L=low).

3. Look at the low priority activities.

4. Determine where you can substitute physical activity.

Time of Day Tasks Rank

6:00 am – 10:00 am

10:00 am – 2:00 pm

2:00 pm – 6:00 pm

6:00 pm – 10:00 pm

10:00 pm – 2:00 am

2:00 am – 6:00 am

TIP Find time in your day by organizing your time. Write down the things you need to get done. Distinguish between the things that you have to do, would like do, or things that you will do if you have time. Mark the things that need to be done the highest priority. Assign your top-priority items a specific time of the day to be completed.

Did you know? There are 168 hours in a week. If you exercised 30 minutes, six times of week, this would still leave you 165 hours for sleep, work, caring for loved ones, and other commitments.

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Stay motivated

It’s easy to be motivated when you first set goals or start a new activity. But after time, you may not feel as motivated. Try to reward yourself as you reach short term goals. Think, “If I exercise 4 days this week, I’m going to treat myself to ___________.” Choose non-food rewards such as a manicure, a night at the movies, new workout clothes, a new cookbook, or other small treat.

Other helpful hints to help you stay motivated:

} Remember your goal

} Revisit your reasons for wanting to change

} Try a new activity

}Mix up your exercise routine

} Find a new walking route for a change of scenery

} Train for an event such as a 5K race walk/run

} Invite others to exercise with you

Plan ahead

If you usually exercise outside, changes in weather may keep you from exercising. Too hot? Too humid? Too cold? Too wet? Plan ahead so you can stick to your exercise routine.

If the weather forecast calls for rain late in the day, plan to get your activity in early in the day. Middle of summer? Try to be active early in the day before it gets too hot. Middle of winter? Plan indoor activities. Put in an aerobics DVD. Walk at the local mall. Climb the stairs at work or other indoor location.

Find support

You may feel that not everyone is supportive of your new healthy habits. This may make it more difficult to exercise. Instead of giving in, challenge those that are working against you to participate in exercise with you. Invite these individuals to enjoy the fun and benefits of becoming more active.

} Find support in others that also want to make physical activity a part of life

} Start a walking club at work

}Meet up with neighbors that walk or exercise at the same time as you

} Join local fitness groups

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Stay active on-the-go

Whether you’re traveling on business or enjoying a vacation, it can be difficult to keep your exercise schedule when you’re away from home.

Try these tips to help you be active no matter where you go.

} Always pack your exercise shoes and workout clothes

} Book hotels that have fitness equipment or swimming pools

} Explore a new place by foot — ask about nearby safe walking routes

} Plan active outings such as hiking, biking, skiing, or walking tours

} Find a fitness class on the television and follow along

} Pack an exercise band and use it to stretch and do light exercises in your room

} Find stairs to climb or walk around the parking lot a few times

You can also do strength training exercises such as push ups, sit ups, calf raises, lunges or squats. Make sure you know the proper technique so that you do not hurt yourself. Ask a trainer at your local gym or check-out an exercise video from your local library.

Did you know? Caffeine and sugar may give you a temporary energy boost, but the effect is short lived. Instead, eat small frequent meals and snacks throughout the day to keep you fueled and feeling energetic all day long.

Feel energized

Even the most dedicated individuals have a hard time being active when energy levels are low. Next time you feel too tired; remind yourself that exercise can actually increase your energy.

If your regular exercise routine still sounds like too much, try something low key such as stretching or yoga. Or go for a short walk. It may just give you just the energy you need to keep going.

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My personal challenges with exercise

What prevents you from being more active? What can you do to overcome these barriers?

Personal barriers to exercise Ways to overcome

1.

2.

3.

What motivates you to be active?

(Examples: music, training for a race, nice weather, work-out partner, beach vacation, fit of clothes, etc.)

1.

2.

3.

Lose and Win

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Session 6

Eating healthy – in and out:

Facilitator guide

Participant guide

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Eating healthy – in and out


60 minutes



Objectives:

} Review key components of a healthy diet

} Provide substitutions and healthy tips to help participants prepare better meals at home

} Discuss strategies to help participants make better choices when dining out

Preparation:




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Session 6: Eating healthy – in and out




1. Whether cooking at home or eating out, individuals can make healthy choices.

2. Always remember to keep portion sizes in check — use smaller plates.

3. Add fruits and vegetables to each meal for added volume with few calories. Start a meal with vegetable soup instead of bread or other heavy appetizer.

4. Cooking at home is often less expensive and healthier than eating out. Make meals ahead of time that you can heat and serve for when you are short on time.

5. Read the food labels for products eaten at home or look for healthy icons when dining out.

6. Choose baked, broiled, grilled or steamed dishes to cook at home or eat out.

7. Keep dishes simple with few ingredients and go easy on sauces, dressing and condiments.

8. If you know you are going to eat a bigger meal later in the day, make sure the rest of your meals and snacks are low in calories, but don’t skip meals. This will likely only result in overeating during your next meal.

9. Think about what you will order before you arrive at a restaurant. Get familiar with the menu ahead of time. Look at the nutrition information, if provided.


1. Ask how many participants regularly cook and prepare meals at home. How have they tried to make meals more nutritious?

2. Ask participants to share how they make better choices when dining out.

3. Ask participants about the challenges they face when cooking at home and eating out. What are ways to overcome these challenges?





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Better fast food choicesObjective Help participants make better choices when eating at chain restaurants

Materials needed Menus with nutrition information from 4 – 5 chain restaurants, such as PFChang’s, Chili’s, Ruby Tuesdays, McDonalds, KFC, Boston Market, Red Lobster, On the Border, Pizza Hut.

Steps 1. Break the participants into groups of 3 – 4.2. Give each group one of the menus/nutrition information.3. Ask each group to choose a meal they would normally eat and record

the total calories, fat, and sodium; then to choose a meal that is more healthy and includes at least one fruit or vegetable.

4. Have each group share with the class information for the less healthy version and then the more healthy version.

Special notes Look for fast food restaurants that are most popular for the participants; many popular chain restaurants have downloadable nutrition information on the company’s Web site

Recipe remix

Objective Give participants the opportunity to make favorite meals more healthy

Materials needed Recipes for common family favorites; ask participants ahead of time to bring favorite recipes or make copies from web site or personal cookbook

Steps 1. Break participants into groups of 3 – 4.2. Have them pick a favorite recipe and write down the ingredients.3. Ask the group to rewrite the recipe using healthy substitutions, omitting

ingredients, and/or adding fruits or vegetables.4. Share the recipes with the group.

Special notes Ask for volunteers to try the revised recipes and report back to the group; plan a potluck lunch where participants bring in the healthier versions for everyone to try.

Healthy choices for every cuisine

Objective Demonstrate healthy choices for different cuisines

Materials needed Menus from different restaurants: Italian, Chinese, Pizza, Mexican, Delis, Buffets

Steps 1. Break participants into groups of 3 – 4.2. Give each group a menu from one of the cuisines.3. Have each group choose healthier menu items from each restaurant.4. Share the choices as a group.

Special notes Encourage participants to follow the guidelines in the participant manual

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Eating healthy – in and out:

Whether you are cooking meals at home or eating out, you can take steps to eat healthy.

Healthy eating checklist

Watch your portion sizes

Eat colorful including plenty of fruits and vegetables

Choose whole grains more often than less nutritious refined carbohydrates

Read the food label to make sure you know what you are eating

Limit your intake of saturated fat, trans fat, cholesterol, sodium and sugar

Make sure your diet consists of a variety of foods

Pay attention to cooking methods; select baked, broiled, grilled or

steamed dishes

Skip the heavy, white cream-based sauces, dressings and condiments

Did you know?Not all brown bread is whole wheat. Look at the ingredient list. Only bread that lists whole wheat flour is considered whole wheat bread.

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Healthy Cooking

It is easier to eat healthy when you eat at home. That’s because you control the ingredients used and the cooking method.

Try these tips to make healthier meals at home:

} Add vegetables to casseroles, soups, and stews

} Use fruit in smoothies, cereals, and baked goods

} Cook with healthier fats such as olive oil or canola oil

} Try whole wheat pasta, brown rice, sweet potatoes instead of the traditional white varieties

} Use smaller plates to keep your portion size smaller

} Use leaner cuts of meat and poultry

} Include salmon, albacore tuna, trout and other fish high in omega-3

} Trim excess fat off of meat before cooking

} Add fresh or dried herbs and spices instead of salt

} Use healthy substitutions in your recipes when possible

Healthy substitutions

Try these substitutions in some of your favorite recipes.

Instead of… Use...

Whole milk 1% milk, skim milk or soymilk

Cream Low-fat half & half

Creamed soups

½ can of soup and ½ can of 1% milk, skim milk or soymilk

Sour cream Reduced fat sour cream

Cheese Reduced fat or light cheese or reduce the amount of cheese

Mayonnaise Half of the amount or light mayonnaise

Vegetable oil Canola oil

Shortening or lard

Butter

Whole egg Two egg whites

Salt No salt or ½ the amount

TIP The leanest cuts of beef include round, chuck, sirloin or tenderloin. The leanest cut of pork includes loin chops and tenderloin. The leanest part of poultry is found in the breast meat.

Whole grain examples

Whole wheat pasta

Buckwheat pasta

Brown rice

Whole grain bread

Oatmeal

Quinoa

Bulgar

Whole cornmeal

Whole grain cereal

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Eating out

You may think that it’s difficult to eat healthy when you’re eating out. It can be challenging, but if you follow the healthy eating checklist, you’re on your way.

Additionally, these strategies can help you make better choices.

} Start with a vegetable based soup or salad instead of bread or appetizer

} Order an appetizer portion to help keep portion sizes small

} Order the foods you want a la carte to keep you from eating the additional foods that may come with a meal

} Ask for condiments (butter, sour cream, mayo), dressings and sauces on the side

} Don’t worry about ‘getting your money’s worth’ and focus on the savings you will get for improving your health

} Split an entrée with a friend or ask the server to box up half before bringing you the meal

} Share dessert with the table or order a bowl of fresh fruit or small serving of ice cream

} Choose water, unsweetened tea, soda water, diet soda or other non-calorie beverages

} Ask for healthy substitutions such as steamed vegetables instead of mashed potatoes or fresh fruit instead of fries

} Order simple dishes with few ingredients as these are more likely to be healthy

} Look for symbols on the menu to help you determine healthier items or ask your server for suggestions

Perhaps most importantly, plan ahead! If you know you are going to go out for a big meal, make sure the rest of your meals

and snacks are low in calories, but don’t starve yourself. You don’t want to arrive at the

restaurant so hungry that you’ll eat anything in sight.

Call the restaurant ahead of time or visit their web site to see what types of healthier

options are available. Think about what you will order before you arrive at the restaurant

so you’ll be less tempted by unhealthy choices. Suggest another restaurant if you think

you’ll have a difficult time choosing a healthy option.

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Let’s eat

You can still eat at your favorite restaurants. Use this guide to help you make better choices when you eat out.

Italian

} Choose sauces made with tomatoes and other vegetables

} Stay away from white or butter sauces

} Skip the bread basket

Asian

} Choose steamed or stir-fry dishes

} Ask for extra vegetables with your meal

} Choose steamed white or brown rice instead of fried rice

} Keep away from fried dishes and heavy sauces

Mexican

} Try grilled fajitas, chicken tacos, or vegetarian dishes

} Skip the chips and cheese dip

} Order á la carte to keep portions smaller

} Stay away from fried or extra cheesy dishes and sour cream

Pizza

} Try the vegetarian pizza

} Ask for light cheese

} Choose thin crust if available

} Avoid adding fatty meats such as sausage, pepperoni; choose chicken or shrimp instead

Fast food

} Choose salads with grilled meats and low calorie dressing

} Try grilled chicken sandwiches, but skip the cheese, mayo and special sauces

} Order a kid’s size meal

Delis

} Choose sliced bread instead of rolls

} Ask for extra veggies — lettuce, tomato, the works

} Leave off the cheese and mayo

} Limit mayo based salads such as chicken salad, tuna salad, egg salad, and pasta salad

Buffets

} Use an entrée plate for your salad and a salad plate for your entrée

} Choose plenty of fresh vegetables and fruits

} Look for grilled, baked, or broiled meats

} Avoid creamy and fried foods

} Don’t go back for seconds

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My healthy eating plan

Three things I will do to help me eat healthier at home:

1.

2.

3.

Three things I will do to help me eat healthier when I eat out:

1.

2.

3.

Did you know?Cooking at home is often less

expensive than eating out.

You may think you don’t have time

to cook. Try making meals ahead

of time and place in the freezer. Next

time you need something fast, just heat and

serve. You’ll likely save time and money too.

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Session 7

Stress management and problem solving:

Facilitator guide

Participant guide

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Stress management and problem solving


60 minutes



Objectives:

} Help participants identify sources of stress

} Discuss the health consequences of stress

} Provide strategies to reduce and manage stress

} Demonstrate how problem solving can be used to reduce stress

Preparation:




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Session 7 — Stress management and problem solving

} Welcome participants and review objectives for the session



1. Stress can weaken the body’s immune system, may worsen or contribute to some health conditions, or contribute to weight gain.

2. Identifying stress early can help keep it from becoming a bigger problem.

3. Prioritizing things in life and staying organized can help reduce some forms of stress.

4. Problem solving is one strategy that can be used to help manage and reduce stress.

5. There are several stages involved in the process of problem solving: define the problem; develop possible solutions; make a decision; and take action.

6. It’s important to think about all possible solutions to a problem even those that don’t seem feasible. Using a pro and con list will help sort out realistic and possible solutions.

7. Exercise is a great way to manage stress and release tension.

8. Finding healthy ways to deal with stress can help individuals achieve good health.


1. Ask participants to discuss how stress impacts their weight loss goals. How does stress get in the way of weight loss efforts? What happens to eating habits when stressed? What about exercise routines?

2. Ask participants if anyone is familiar with the problem solving steps. Have any participants used problem solving to help manage stress or to overcome a weight loss barrier?

3. Ask participants how they deal with stress. What would be a healthy way to deal with stress?





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Relaxation exercise #1Objective Help participants relax

Materials needed None

Steps 1. Tell participants to try and relax all the muscles in the body — from head to toe. 2. Ask participants to tense the hand and arms making a tight fist and tense the

biceps muscle. Have them hold for 10 seconds, then release. Walk through all the muscle groups, tensing for 10 seconds, then releasing.

3. Face: Close eyes tight, wrinkle nose, make an exaggerated smile.4. Neck: Bend chin forward. Tilt head back. Roll head from side to side.5. Thigh: Bend toes forward and tense the thigh muscles.6. Chest, shoulders, and back: Arch shoulders back, push chest out. Bring arms

forward and touch elbow to elbow.7. Calves and feet: Bend toes backwards towards knees, tense calf muscles.

Special notes Ask participants if this activity helped them feel relaxed

Relaxation exercise #2 Objective Help participants relax

Materials needed Soothing music/sound CD and CD player

Steps 1. Dim the lights.2. Ask participants to close their eyes think of a happy place.3. Play the music/sound CD.4. Remind participants to think of a happy place and let go of daily tasks or things

that need to get done.5. Have participants sit with eyes closed and listen for 5 minutes.

Special notes Pick a CD that might appeal to a wide audience such as the sound of waves or purchase a DVD or CD that walks participants through a relaxation exercise

Problem solving activity Objective Walk through the problem solving activity as a group


Steps 1. Ask for participants to select a problem they are experiencing.2. Ask the group to think about all aspects of the problem.3. Have them develop solutions. Encourage the group to use their imagination.

Write down all solutions, even those that seem obscure. Then, list all the pros and cons for each of the solutions.

4. Ask participants if there are any solutions they may use to help with a similar problem.

Special notes

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Stress management and problem solving

Sources of stress are everywhere — including worries about finances, jobs, relationships or the future. No matter what causes the stress, the results are much the same. Stress can weaken the body’s immune system, may worsen or contribute to some health conditions, or get in the way of you meeting your weight goals.

Don’t let stress keep you from your goals. Stay on track:

} Know how you react to stress

} Identify the things that cause you stress

Some forms of stress may be out of your control, such as the illness of a loved one. But other things you can control. For example, instead of saying yes to everything and everyone, you can prioritize the things in your life that are most important to you and only commit to those activities. Sometimes you may recognize the signs of stress before you even realize you are stressed. Once you recognize the things that cause stress, you can make a plan to reduce that stress.

What makes you feel stressed?

}Worries about money or finances

} Your job

}Worries about your children or family

} Problems in your relationships

} A sick family member or friend

} Your health

} Think and plan ahead to reduce stress

} Learn how to better cope with stress

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Identifying stress

Identifying stress early can help keep it from becoming a bigger problem. Do you know how to tell when you’re stressed? What happens when you feel stressed?

}Get headaches

} Have a bad temper

} Can’t sleep

} Feel tired all the time

} Feel sad and down

}Want to eat constantly

} Don’t want to eat at all

} Stomach is upset

}Want to be alone

} Drink or smoke more

} Become a couch potato

} Can’t get anything done

Healthy ways to deal with stress

Even though you can reduce your stress by using some of these techniques, it will be hard to avoid stress all the time. Having healthy ways to cope with or manage stress is important.

Breathe deeply. Take a slow, deep breath, hold it for five seconds, and then slowly exhale. As you exhale, feel the stress flow out of your body.

Take a mental health break. Devote some time each day to something you like to do, such as reading, listening to music, talking with a friend, or taking a walk — even 10 to 30 minutes can make a difference.

Be good to your body. Regular exercise can help direct your attention away from daily stress. Eating a low-fat, low-sugar diet with plenty of fruits and vegetables can boost your physical and mental health as well.

Tips to help you reduce stress:

}Manage your time by staying organized

} Share some of the work load with others

} Set goals you can reach one step at a time

} Reach out to people for help or just to talk

} Try not to get upset about things that do not matter

} Think about the good things in your life

}Go for a walk or get your body moving

} Accept things you cannot change

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Problem solving to reduce stress

Another stress reducing strategy is problem solving. There are five general stages involved in the process of problem solving:

1. Recognize that problems are normal. 4. Make a decision.

2. Define the problem. 5. Take action.

3. Develop possible solutions.

What is causing your stress?

} You are continually given new tasks at work and not sure what to do first.

} You have different views from your manager on how to complete a task that often causes tension.

} You participate in many committees and attend meetings keeping you from your work.

You also want to ask, “Are there other reasons I’m not able to stick to my exercise routine?”

} You have primary responsibility for caring for children so are responsible for feeding, bathing, transporting, and helping with homework; and that takes time.

} You go to bed late and get up early so always feel tired.

} You are so hungry that you want to eat dinner first, but then you are too full and too tired to exercise.

} Sometimes you plan to go to the gym after work, but then something comes up.

Problematic situations are part of normal everyday life. Sometimes you may feel that a problem cannot be solved. It is important to look at all aspects of a problem before giving up on a solution.

Example: Let’s say you feel so stressed that you have no energy left at the end of the day to maintain your exercise routine. The problem may be that you are not exercising, but it is important to look at all the aspects of the problem.

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Possible solutions Pros Cons

Ask manager to help prioritize when given new projects

Could result in reduced workload and less stress

Only a partial solution

Talk to your manager about conflicts

May help develop a better working relationship

May be difficult to do

Quit job Eliminate work stressNeed income; cause financial stress

Give up voluntary extra-curriculum activities

Would free up timeFeel like I would be letting people down

Ask to be re-assignedCould be a better work situation

Could increase tension with manager

Ask spouse to help more with kids

Would free up timeSpouse also has busy schedule

Go to bed 60 minutes earlier Would feel more rested May be difficult to do

Work out in the morningLess likely for things to get in the way

Don’t like to get up early

Have a snack in the afternoon Would feel more energeticWould need to make room in diet

Plan family activities or go for a walk after dinner

Good way to get exercise and still spend time with family

Spouse may push back

After you have selected and tried your solution(s), determine if it worked. If not, choose another solution(s). Don’t give up. You can succeed.

Next Steps: Develop a solution, weigh your options and act

Once you’ve clearly defined all aspects of the problem, you’re ready to develop some solutions. This is your opportunity to brainstorm. Write down all the possible solutions even if they seem unrealistic. List all the pros and cons and weigh your options. Then, make a decision and follow through.

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Activity: Problem solving

Pick a problem related to your weight loss efforts. Follow the five stages of problem solving:

1. Recognize that problems are normal.

2. Identify and define the problem

Clearly identify the problem: _____________________________________________________________________________________

List all components of the problem:

__________________________________________________________ __________________________________________________________

__________________________________________________________ __________________________________________________________

__________________________________________________________ __________________________________________________________

3. Develop possible solutions and list the pros and cons

Possible solutions Pros Cons

4. Weigh the options and make a decision.

5. Carry out the solution. Remember to re-evaluate the problem. If the solution you chose is not effective, choose another solution.

What strategies will you use to deal with stress?

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

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Session 8

Staying positive:

Facilitator guide

Participant guide

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Staying positive


60 minutes



Objectives:

} Encourage participants to use positive self-talk

} Discuss best practices to help participants find ways to overcome ongoing challenges

} Review keys to successful weight loss

} Encourage participants to assess progress and set new realistic goals

} Collect post-intervention data

Preparation:




Special note: Remember to send post-questionnaire link to all participants after session 8. Please send to all participants that took the pre-questionnaire.

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Session 8 — Staying positive

}Welcome participants and review objectives for the session. } Check in with participants about their progress. Discuss any challenges. } Encourage the group to share best practices and successes. } Review the key points from the module.

1. It is common to have negative thoughts or feel frustrated when trying to change behaviors. These thoughts can sabotage efforts.

2. Learning how to turn negative thoughts into positive thoughts can help individuals succeed.

3. Individuals should avoid extreme or all-or-nothing thinking.

4. Expectations need to be realistic. Big goals should be broken down into short, obtainable goals to achieve long-term success.

5. No one is perfect and individuals shouldn’t expect the unexpected from themselves.

6. Many people make excuses for unhealthy behaviors. Thinking of arguments for these excuses can help individuals stay on track.

7. Reflecting on one’s progress can help identify additional areas for improvements. Ask, “What continues to be challenging? What changes can you make to succeed?”

8. Success can be achieved! Remember small changes really add up; take it one step at a time; set backs are normal; stay positive; welcome changes, but know they are not always easy; lean on family and friends for support; keep your goals within reach; always remember your motivation; track your progress; and celebrate your success along the way.


1. Ask participants if they have negative feelings about their progress or their efforts. How does that make them feel?

2. Ask the group to share any positive self talk they use. What do they say to themselves when things get tough? How do they stick to an exercise routine? How do they continue to make healthy food choices?

3. Ask participants about ongoing challenges. What can they do differently to help them meet their goals? Have they adopted healthy habits?

} Facilitate a class activity } Provide resources and any additional handouts to participants } Send post-questionnaire link to all participants } Close by having one of the participants read the Tip of the Week*


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Healthy mantraObjective Have the participants develop a healthy mantra that they can use as positive

self talk


Steps 1. Read the definition of a mantra.2. Ask participants to think of a short phrase that they can say to themselves that

will help them succeed.3. Give examples if necessary, “Just do it!” “I think I can, I know I can.” 4. Write down all the suggestions. Ask participants to commit to using a mantra to

help them achieve their goals.

Special notes Mantra definition: A short sacred phrase, often chanted or used in meditation

Retrain your brain Objective Let participants practice using positive self talk to challenge excuses


Steps 1. Break participants into groups of 3 – 4.2. Ask each group to write down a list of negative thoughts they may have and

some common excuses they use to rationalize unhealthy behaviors.3. Have the groups think of positive thoughts or arguments against

common excuses.4. Ask groups to share some of the examples.

Special notes

Setting new realistic goals Objective Encourage participants to assess progress and set new goals

Materials needed Participant module worksheet for session 8

Steps 1. Ask each participant to think about their original goal. Did they reach this goal? Does this goal need to be refocused? Remind participants to set realistic goals.

2. Ask participants to list things that continue to be a challenge. Ask them to write down what they can do differently to succeed.

3. Ask participants to write down someone they can reach out to for support when they need it.

4. Ask participants to write down why they want to succeed. Is this the same reason as before?

5. Ask if anyone wants to share a motivating story or success story.

Special notes Encourage participants to continue to use each other for support; determine if the group wants to continue meeting to share stories and challenges or engage in healthy behaviors together.

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Staying positive

Do you ever feel frustrated with your weight loss efforts? Do you find yourself thinking negative thoughts? Do you ever feel like you want to give up?

It’s common to have these negative thoughts, but you can succeed.

} Retrain your brain to change negative thoughts into positive ones.

} Focus more on developing healthy eating and exercise habits instead of your weight.

} Be realistic. Set goals that are reachable. Don’t expect the unexpected from yourself.

} Don’t give up. Remind yourself that you can succeed no matter how difficult it may seem.

} Think about your efforts. What could you do differently for better results?

} Remind yourself daily on why you want to succeed. What’s your motivation?

Keep expectations realistic

If you have goals that are too hard to reach, you will only feel disappointed and frustrated if you don’t succeed. Try not to think about your longer term goals. Instead, focus on getting through one day a time. By setting short-term goals you will achieve long-term success.

Find a diet and exercise routine that works for you and your lifestyle. Learn to eat and exercise in moderation. For instance, it’s not very realistic to say that you’ll never eat sweets again. Instead, your healthy eating plan should allow you to occasionally eat a few of your favorite, less healthy foods. Likewise, exercising for hours a day is not realistic. Plan an exercise routine that fits your lifestyle and fitness level. Start out slow and build up to your goal so that you don’t overdo it or get discouraged.

TIP Aim for a realistic

weight loss goal of

1 – 2 pounds per week.

Just a 10% decrease

in weight can lower your

risk for certain diseases

and illnesses.

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Retrain your brain

Learn how to turn those negative thoughts into positive ones. Avoid extreme thinking.

For example, instead of thinking, “I ate that piece of cake. I’ve blown it. I might as well forget it. I’ll never succeed;” say to yourself, “I ate that piece of cake and really enjoyed it. I’m proud of myself for only eating one piece. I’ll make sure that I eat a little less at dinner to stay within my daily calorie range for the day.”

Turn these negative thoughts into positive ones.

Negative thought Think again

“I always eat too much. I’ll always be overweight.”

“I ate too much today. I need to go for an extra long walk and remember that tomorrow is another day.”

“I’m not losing as much weight as everyone else. I’m a failure.”

“Wow. Jen has really lost a lot of weight, but I’ve lost weight too and am feeling good. Maybe I’ll talk to Jen about what she’s doing and see if it is something I can do too.”

“I just can’t get up in the morning to exercise.”

“This is a lot harder than I thought it was going to be, but I know I can do it. Maybe I’ll ask someone to meet me so I’ll be more likely to exercise if someone is counting on me.”

“There’s no way I can eat healthy and exercise while I’m on vacation. I’ll just have to start again when I get back.”

“I can still eat healthy and exercise on vacation. I’ll just choose healthy menu items and focus on walking a lot. Then I’ll feel completely recharged after vacation — healthy eating, exercise, adventure, and rest.”

“If I make another mistake, I should just give up.”

“I know I can do this. I just need to try a little harder. I’m going to have a plan in place so that next time I’m tempted, I can make better choices.”

“I gained a few pounds. I’m never going to reach my goal.”

“I know that set backs are normal and that I can’t be perfect. What can I do to increase my efforts?”

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No excuses

Many people rationalize their unhealthy choices. Do you use any of these excuses?

} “I have been good all week; indulging for one night isn’t going to hurt.”

} “After the day I’ve had, I deserve to skip my workout.”

} “It’s not fair to my family if I don’t buy the treats I normally do.”

} “Everyone else is eating it. It will look funny if I don’t.”

} “I can always do double tomorrow if I skip my exercise today.”

} “I’m going to offend the cook if I don’t try everything and have seconds.”

} “As long as I eat a little less, I won’t have to exercise.”

Think of an argument against your excuses and stick to your plan.

Instead of … Think …

“I have been good all week; indulging for one night isn’t going to hurt.”

“I have been good all week. Why give up now?”

“After the day I’ve had, I deserve to skip my workout.”

“After the day I’ve had, I can’t imagine skipping my workout. I need to burn off some steam and feel energetic for my family when I get home.”

“It’s not fair to my family if I don’t buy the treats I normally do.”

“My family deserves the best. In our house, we eat healthy foods and set good examples for others. I don’t want my children to struggle with weight like I have.”

My top excuses or rationalizations:

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

What I’ll say to myself instead:

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

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Be honest with yourself

If you’re not reaching your goals, ask yourself why.

} Am I keeping a journal of everything that I’m eating and tracking my exercise?

} Am I eating smaller portions and trying to stay within my daily calorie range?

} Am I mindful of everything that I am eating?

} Am I getting enough activity each week?

} Do I have a plan in place to help me eat healthier and exercise more?

} How often do I stick to my plan?

} Am I able to overcome the barriers that keep me from succeeding?

} Am I making my new lifestyle a priority in my life?

} Have I adopted healthy habits that help me reach my goal?

} Have I reached out for support from my family and friends when I need it?

} Am I letting self-defeating thoughts get in my way of success?

} Do I try to problem solve to help me through challenging situations?

} Have I identified the things that trigger me to make less healthy choices?

} Do I continually remind myself of why I want to succeed?

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Think about your responses to these questions.

Have you met your goal? Do you need to refocus your goals?

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

What continues to be a challenge for you?

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

What changes can you make to help yourself succeed?

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

Who can you reach out to for support when you need it?

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

Why do you want to succeed?

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

Success! Keep these things top of mind as you continue your weight journey.

} You can succeed!

} Small changes really add up


} Set backs are normal

} Stay positive

} Welcome changes, but know they are not always easy

} Lean on family and friends for support

} Keep your goals within reach

} Always remember your motivation


} Celebrate your success along the way

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Appendix

Recruitment & attendance 91

Healthy tips 95

UnitedHealthcare Resources 119

Other Resources 121

Food & activity journal – sample template 123

Food & activity journal – example 124

My weight tracker 125

Healthy recipes 126

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Sign-up sheet

Sign up for the Lose and Win weight loss program.

Location: ______________________________________________________________________________________________________________

Date: ___________________________________________________________________________________________________________________

Time: ___________________________________________________________________________________________________________________

1. Name: ________________________________________________ E-mail: ______________________________________________

2. Name: ________________________________________________ E-mail: ______________________________________________

3. Name: ________________________________________________ E-mail: ______________________________________________

4. Name: ________________________________________________ E-mail: ______________________________________________

5. Name: ________________________________________________ E-mail: ______________________________________________

6. Name: ________________________________________________ E-mail: ______________________________________________

7. Name: ________________________________________________ E-mail: ______________________________________________

8. Name: ________________________________________________ E-mail: ______________________________________________

9. Name: ________________________________________________ E-mail: ______________________________________________

10. Name: ________________________________________________ E-mail: ______________________________________________

11. Name: ________________________________________________ E-mail: ______________________________________________

12. Name: ________________________________________________ E-mail: ______________________________________________

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13. Name: ________________________________________________ E-mail: ______________________________________________

14. Name: ________________________________________________ E-mail: ______________________________________________

15. Name: ________________________________________________ E-mail: ______________________________________________

16. Name: ________________________________________________ E-mail: ______________________________________________

17. Name: ________________________________________________ E-mail: ______________________________________________

18. Name: ________________________________________________ E-mail: ______________________________________________

19. Name: ________________________________________________ E-mail: ______________________________________________

20. Name: ________________________________________________ E-mail: ______________________________________________

21. Name: ________________________________________________ E-mail: ______________________________________________

22. Name: ________________________________________________ E-mail: ______________________________________________

23. Name: ________________________________________________ E-mail: ______________________________________________

24. Name: ________________________________________________ E-mail: ______________________________________________

25. Name: ________________________________________________ E-mail: ______________________________________________

26. Name: ________________________________________________ E-mail: ______________________________________________

27. Name: ________________________________________________ E-mail: ______________________________________________

28. Name: ________________________________________________ E-mail: ______________________________________________

29. Name: ________________________________________________ E-mail: ______________________________________________

30. Name: ________________________________________________ E-mail: ______________________________________________

M45002-A 1/11 Consumer © 2011 United HealthCare Services, Inc.

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Attendance sheet

Day: ____________________________________________________________________________________________________________________

Time: ___________________________________________________________________________________________________________________

Location: ______________________________________________________________________________________________________________

Kick-off Session 1

Session 2

Session 3

Session 4

Session 5

Session 6

Session 7

Session 8

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

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Introduction

Announcing the Lose and Win program,

an 8 week onsite program designed to help you manage your weight.

Learn how to:

} Read nutrition labels

} Plan healthy meals

} Add structured exercise

} Recognize emotional eating

}Manage stress

Plus much more ...

Join other co-workers that are ready to make a positive change. To sign up, please contact:

M44781-A 1/11 Consumer © 2011 United HealthCare Services, Inc.

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Tip of the week

Plan ahead

With a little planning, it’s easy to eat healthy and be active. Try these tips to help you get started.

} Schedule physical activity as part of your day — in the morning, at lunch, after work, or any time that works for you

} Lay out your excercise clothes and sneakers the night before or pack a gym bag for after work, so you’ll be ready to go when you wake up

} Pack your lunch for the next day the night before so you can just grab and go. Same goes for breakfast if you eat on the run.

} Go to bed and get up 20 to 30 minutes earlier so that you will have time to eat breakfast, pack lunch, or go for a quick walk

} Cook several meals on the weekends and store in the refrigerator or freezer for easy, quick weekday meals

} Always have healthy snacks around — at the office, in your car, at home — so that you’re less likely to choose unhealthy foods when hunger strikes

} Think ahead about what you will order before you get to the restaurant avoiding temptations

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Tip of the week

Move to your own groove

Physical activity is an important component of any weight loss program. The more you move, the more calories you burn. You don’t have to go to the gym or buy expensive equipment to move more, just find something you enjoy. Whether you choose to dance, walk the dog, garden, bike, or do yoga — have fun!

Ten ways to burn 150 calories*

1. Bicycling 5 miles in 30 minutes

2. Climbing stairs for 15 minutes

3. Dancing for 30 minutes

4. Gardening for 30 to 45 minutes

5. Jumping rope for 15 minutes

6. Running 1.5 miles in 15 minutes

7. Swimming laps for 20 minutes

8. Walking 2 miles in 30 minutes

9. Cleaning the house for 35 to 40 minutes

10. Active playing with children for 30 to 35 minutes

We recommend that you talk to your doctor before beginning a physical activity routine.

* The actual calories you burn may vary based on your sex and weight.

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Tip of the week

Skip the second helping, but don’t skip meals

You may think that skipping meals is a good way to reduce calories, but this strategy can often backfire. That’s because when you are really hungry, you’re more likely to make unhealthy choices and overeat. Plus, your body needs constant energy in the form of calories to run efficiently. Instead of skipping meals, eat smaller portions and lower-fat foods to reduce calories. Try eating smaller meals throughout the day to keep your hunger away.

Sample meals Sample 1 Sample 2 Sample 3

8:00 am Oatmeal with almonds, raisins and honey

One whole egg and one egg white on whole wheat toast

Frozen waffle with peanut butter and banana

10:30 am Apple or banana Dried fruit with nuts Low-fat yogurt with berries

12:30 pm Vegetable soup with turkey sandwich on whole grain bread

Slice of veggie pizza Green salad with tuna or chicken, whole grain crackers

3:00 pm Carrot sticks, whole wheat crackers, low-fat cheese slice

Apple with peanut butter

Hummus, pretzel sticks, and celery

6:30 pm Spinach salad with grilled chicken, pasta and broccoli

Shrimp and vegetable stir fry with brown rice

Turkey and low-fat Swiss burger on whole wheat bun with cucumber and tomato salad

8:30 pm Graham crackers with glass of skim milk

Low-fat frozen yogurt with chocolate chips

Popcorn

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Tip of the week

Find support

As you reach for your goals, you may find that you are changing many of your current behaviors. These lifestyle changes may affect those around you. Some may be more supportive than others. For instance, some families may support your decisions but not want to change themselves.

Think about who you rely on for support — family members, friends, co-workers, others? Are they supportive of your new lifestyle changes? It can be more difficult to change without a strong support system. Find a good support system and let others know how they can support your healthy lifestyle.

Ways to help me eat healthy and move more

} Choose and eat healthy foods with me

}Go for a walk with me or ask me to do other physical activities with you

} Don’t tempt me with less healthy foods as a reward or gift

} Plan social events around being active

} Don’t offer me second helpings

} Encourage me to cook or try new foods

} Help me with my other responsibilities so I can prepare healthy foods and be more active

} Encourage me to go for a walk when I’m feeling stressed or overwhelmed

} Praise my efforts to change

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Tip of the week

Stay motivated

You likely have noticed how important motivation is in helping you reach your goals. As time goes by, you may find that your motivation is not as strong as it was in the beginning. Use some of these techniques below to help you stay focused and energized.

}Write down the reasons why you want to achieve your goal and post it where you can see it on a daily basis

} Stay aware of the benefits you’ve achieved so far

} Recognize and celebrate your successes, no matter how small

} Come up with a saying that helps you stay motivated and repeat it to yourself regularly

} Set short term goals to keep you motivated. Keep them realistic and obtainable, but challenging.

} Add variety to your routine. Take a healthy cooking class or sign up for a race.

} Tell people about your goals so they can help you stay motivated

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Tip of the week

Re-think your drink

Are you drinking your calories? These calories can really add up. You don’t have to give up your favorite beverages, just be sure to count the calories you are drinking. Try switching to low- or no-calorie beverages or a smaller size if you’re trying to cut calories. And remember to drink plenty of water, the natural zero-calorie beverage.

Instead of … Try … Calories saved

Breakfast 1 cup whole milk on cereal 1 cup of skim milk on cereal

60

Mid-morning 20 oz of orange fruit drink 8 oz of 100% orange juice 176

Lunch Large sweet tea Large low-calorie sweet tea

209

Afternoon Medium specialty coffee-drink

Medium coffee with Tbsp of cream and sugar packet

140

Drive home 12 oz can of regular soda 12 oz can of diet soda 135

Dinner 8 oz glass of red wine 4 oz glass of red wine 98

Total Calories Saved 818

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Tip of the week

Manage stress

Almost everyone experiences some sort of stress on a regular basis. Whether it’s driving in traffic, arguing with a loved one, or having too much to do; life can be pretty stressful.

Did you know that stress can prevent you from reaching your goals? Think about what happens to your eating habits and exercise schedule when you’re stressed. Are you able to stay on track? Learn strategies that help you better manage and deal with stress.

Try these stress-reducing techniques:

} Take a few deep breaths to relax your muscles

} Exercise — go for a walk and move your body to release excess energy

} Don’t get overwhelmed — practice saying ‘no’ to things that are not as important to you

} Think about stressful situations and strategize ahead of time about how to handle them

} Clean your house or your desk to feel more organized and in control

} Eat nutritious meals and get plenty of sleep

} Practice yoga or meditate

} Share some of your responsibilities or work load with others

} Reach out to people for help or just to talk

} Try not to get upset about things that do not matter as much

} Keep an upbeat attitude and focus on the good things in your life

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Tip of the week

Stay on track

Change is never an easy process. Yet, it seems so easy to fall back into old habits. Relapses are common. Don’t let set-backs sabotage your efforts. Stay positive and pick up where you left off. Transition negative thoughts into positive ones and keep going strong.

Negative thought Think again

“I’ll never be able to this. This is too hard.” “It may not be easy, but I can do this.”

“I only have 10 minutes to exercise — why bother.”

“A quick walk will help me feel energized. Plus it’s better to do something than nothing.”

“I just ate an entire bag of cookies. I might as well eat the fries and pizza, too.”

“I wish I wouldn’t have eaten that entire bag of cookies, but I can still eat healthy the rest of the day and get back on track.”

“I can’t believe she lost so much weight when I’ve barely lost any. I must have bad genes so there’s nothing I can do about it.”

“If she can lose that much weight, so can I. It may just take me longer. As long as I’m headed in the right direction, I’m on the right track.”

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Tip of the week

Small changes = Big results

Original Better choice Healthy alternative

Breakfast

Sausage, egg, & cheese biscuit; large orange juice

Egg & cheese English muffin, small orange juice

Multigrain frozen waffle, natural peanut butter, fresh blueberries

Snack

Large mocha coffee drinkSmall coffee with cream & sugar, granola bar

Low-fat string cheese with apple, hot tea

Lunch

Double cheeseburger, large fry, large regular soda

Regular hamburger, small fry, side salad, small diet soda

Turkey sandwich on whole wheat bread, side salad, small diet soda

Snack

King size candy bar3 bite size candy bar pieces

2 graham crackers, 2 pieces of dark chocolate

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Original Better choice Healthy alternative

Dinner

Caesar salad, chicken & broccoli pasta with white sauce, two dinner rolls with butter

Garden salad, chicken & broccoli pasta with marinara red sauce, one dinner roll

Shrimp & veggie stir fry, brown rice

Dessert

½ pint ice cream½ pint low-fat frozen yogurt

Yogurt cup with half banana

Total calories & fat

Calories: 4,291Fat (g): 257



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Tip of the week

Fresh Produce

Apples Bananas Lemons Limes Other fruit in season Carrots Celery Onion Mushrooms Broccoli Garlic Peppers Zucchini Potatoes Sweet potatoes Lettuce Spinach Tomatoes Other veggies in season Fresh herbs (cilantro,

parsley, basil)

Grains

Whole wheat bread Oatmeal Brown rice Pasta Quinoa or couscous Whole wheat crackers Whole wheat or corn

tortillas

Canned foods

Canned tomatoes Tomato sauce Black beans Garbanzo beans Kidney beans Tuna Salmon Coconut milk

Frozen foods

Berries Corn Broccoli Green beans Peas Multigrain waffles Veggie pizza Shrimp Tilapia

Lean Protein

Chicken Sliced turkey Ground turkey Pork loin Flank steak Salmon Eggs Lentils and other

dried beans

Stocking a healthy kitchen

Include these items in your grocery cart and you’re sure to have healthy foods to choose from all week long.

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Low-fat Dairy

Low-fat yogurt Low-fat sour cream Soy milk Skim milk Low fat Swiss cheese Feta cheese Part skim mozzarella

cheese Cottage cheese String cheese

Spices

Chili powder Cumin Adobe seasoning Italian seasoning Curry Oregano Paprika Cinnamon

Staples

Salsa Natural peanut butter Flour Brown sugar Honey Butter Olive oil Canola oil Low-fat cooking spray Balsamic vinegar White vinegar Tea Ketchup Light mayo Low-sodium soy sauce Mustard Light salad dressing Salt Pepper Raisins Molasses

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Tip of the week

Include these 10 foods in your diet

Want to improve your health and help fight disease? Having a nutritious diet is the first step in the right direction. In general, fruits, veggies, beans, fish, nuts and whole grains should be the cornerstone of any health eating plan.

The following 10 foods fall into one of thee categories. They are particularly rich in certain nutrients, such as healthy fats, fiber and/or antioxidants. Add them to your shopping list, then serve them to your loved ones on a regular basis.

1. Avocados

Benefit: Many people avoid them because they are high in fat. Avocados can help reduce cholesterol, and decrease the risk of cancer and diabetes. They also contain antioxidants.

Nutrients: Vitamins E, C and B6, potassium, fiber, vitamin K and folate.

Recipe tip: Spread on toast and melt low-fat cheese on top. Add sliced tomato.

2. Apples

Benefits: Apples are loaded with antioxidants. They have vitamin C, which keeps your blood vessels healthy and helps you absorb iron. That means a reduced risk of cancer and heart disease, especially if you eat the skin.

Nutrients: Fiber and vitamin C.

Recipe tip: Chop and toss into a green salad.

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3. Berries

Benefits: All berries are highly nutritious. Eating blueberries regularly may improve short-term memory and slow the aging process. They may also help people with many diseases, including Alzheimer’s, Parkinson’s, diabetes and heart disease. Studies show that blueberries fight cancer better than other fruits.

Nutrients: Fiber, vitamin C, vitamin K and manganese.

Recipe tip: Mix with yogurt or cottage cheese. Add a small handful of crushed nuts.

4. Broccoli

Benefit: Broccoli is part of a family that includes spinach, cabbage, cauliflower, Brussels sprouts, kale and collard greens. It is highly nutritious and may help prevent diabetes, heart disease and some cancers.

Nutrients: Calcium, potassium, folate, fiber, iron, magnesium, phosphorus, potassium, B vitamins, vitamin C, vitamin K and manganese.

Recipe tip: Sauté with a small amount of olive oil, garlic and chicken broth.

5. Salmon

Benefit: Try to eat at least two fish meals per week, especially wild salmon, herring and sardines. They provide the most heart-healthy omega-3 fats. Eating fish helps cut your risks for heart disease, cancer, Alzheimer’s, stroke, diabetes and arthritis. It may also help with depression.

Nutrients: B vitamins, phosphorus, protein, selenium and omega-3 fats.

Recipe tip: If possible, choose wild salmon. It is less likely to contain chemicals like mercury. Brush fish with a mixture of orange juice and orange marmalade. Bake until done.

6. Beans (includes beans, split peas and lentils)

Benefits: Beans provide energy that lasts for hours. They are high in fiber, which can lower your risk for heart disease and help control your blood sugar. They also may help fight cancer. All legumes — especially soy — are important in vegetarian diets because they are high in protein.

Nutrients: Fiber, vitamin B6, folate, manganese, protein, copper, iron, magnesium, phosphorus, potassium, thiamine, calcium and zinc.

Recipe tip: Add rinsed, canned beans to your favorite salad.

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7. Spinach

Benefits: Spinach is loaded with disease-fighting antioxidants that help fight heart disease and cancer. Overcooking spinach can decrease some of the nutrients including vitamin C. However, cooked spinach provides a concentrated amount of other nutrients per serving.

Nutrients: Vitamin C, folic acid, vitamin K, iron, fiber and calcium

Recipe tip: Use spinach instead of lettuce to salads and sandwiches or add to soups, casseroles or macaroni & cheese.

8. Walnuts/Almond

Benefits: These nuts are packed with nutrients. They’re also good for your heart. The monounsaturated fat in almonds can help lower your cholesterol if you substitute them for other fats. Walnuts have small amounts of omega-3 fat. Although nuts are high in fat and calories, they can actually help with weight loss. Their protein, fiber and healthy fats provide a feeling of fullness, which can keep you from overeating.

Nutrients: Magnesium, vitamin E, fiber, riboflavin, magnesium, iron, calcium and vitamin E.

Recipe tip: Toast a whole-grain English muffin and spread with low-fat cream cheese. Top with a handful of crushed walnuts or slivered almonds.

9. Tomatoes

Benefits: Tomatoes are known for containing lycopene, a powerful antioxidant that protects against cancer. Tomatoes are also rich in other antioxidants including vitamin C and A that help promote heart health.

Nutrients: Vitamin C, vitamin A, vitamin K, potassium

Recipe tip: Slice, lightly sprinkle with part-skim mozzarella and broil until cheese melts. Top with fresh basil and serve as a healthy appetizer.

10 Eggs

Benefits: Eggs are a great source of protein for only 70 calories. Eggs contain choline that is particularly important for brain function and also reduces inflammation.

Nutrients: Selenium, iodine, vitamin B2, protein, phosphorus, vitamin B5, vitamin B12 and vitamin D

Recipe tip: Hard-boiled eggs are fun to eat and easy to pack for on-the-go lunches. Start or end the day with a huevos ranchero. Add chili peppers to scrambled eggs and serve with black beans and corn tortillas.

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Tip of the week

Fiber facts

A fiber-rich diet may help protect against heart disease, stroke, diabetes, cancer, diverticulosis, constipation and even weight gain. That’s why it is important to get the 25 – 35 g of fiber a day.

Fiber rich foods

Fruits, vegetables, beans, peas, lentils and whole grain provide fiber. Try these tips to include more of these foods in your daily diet:

} Add grapes, mandarin oranges, raisins, chick peas and red onions to a salad

} Puree veggies in a blender and add to soups.

} Blend fruits or veggies with yogurt and fruit juice for a breakfast smoothie.

} Pop a bag of frozen veggies into the microwave or heat on the stove.

} Add vegetables to casseroles, mashed potatoes and macaroni & cheese

}Make lentil or bean soups a frequent meal

} Try hummus, a chickpea-based spread, on a whole-wheat pita or as a vegetable dip

}Opt for brown rice, whole wheat pasta, sweet potatoes instead of the traditional white varieties

} Snack on popcorn instead of pretzels or chips

} Use oats as a casserole fillers and add to baked goods

} Try grains — like quinoa, bulgur or barley — for something different

TIP When you increase fiber in your diet, there are two rules to remember. First, increase fiber gradually to allow your body time to adjust. This reduces bloating and gas. Second, drink more fluids to help keep the body fluids moving. Too much fiber without enough fluids may cause constipation.

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Types of fiber

All fiber-rich foods contain soluble and insoluble fiber, although one type usually dominates.

} Soluble fiber absorbs water like a sponge, forming a gel-like substance. This helps lower your risk of heart disease. Soluble fibers are found in fruits, vegetables, dried beans, peas, lentils, oats and barley.

} Insoluble fiber acts like a broom, sweeping away potentially cancerous substances. Insoluble fiber also relieves constipation. Wheat bran, which is found in bran cereals and whole-wheat bread, is rich in insoluble fibers. Other sources are brown rice, fruits and vegetables.

What is “functional fiber?”

These are non-digestible carbohydrates that are isolated from foods and then added to products to up their fiber content. You may recognize the names maltodextrin, polydextrose, inulin and cellulose. These pop up in the ingredient lists of foods like breads, yogurt and even ice cream. They are different from dietary fibers, which occur naturally in fruits, vegetables, beans/legumes and whole grains. Yet, they are all lumped together on the label under “fiber.”

Although they are safe, it is too soon to say whether these functional fibers have any real benefit. Most studies have been done on people who eat dietary fiber, not functional fiber.

On the other hand, fruits, veggies, beans and 100 percent whole grains have a host of other important vitamins and minerals that contribute to overall health. Eat plenty of these fiber rich foods to make sure you get the benefits.

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Tip of the week

Saturated Fat

Saturated fats are usually described as fats that are solid at room temperature. The most common contributors to saturated fat intake in the American diet are: fat on meats, cheese, butter and products made with butter, ice cream and whole milk.

You will notice in the chart below, that many foods contain both saturated fats as well as healthy fats (monounsaturated fats). Common healthy fats in the American diet include: olive oil, almonds, and salmon. As a general rule, it is best to keep saturated fat intake as low as possible and substitute foods high in healthy fats for foods high in saturated fats. For example, reduce the amount of butter you cook with, substituting olive oil as the fat. Or, use lean ground beef, which will contribute less saturated fat to the diet.

Foods Saturated Fat (g) Monounsaturated Fat (g)

90% lean ground beef, 10% fat 4.0 4.3

1 slice cheddar cheese 5.9 2.6

1 oz roasted almonds 1.1 9.5

1 Tablespoon olive oil 2.0 10.0

5 oz salmon 1.7 3.8

8 oz whole milk 4.5 1.9

8 oz almond milk 0 1.5

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Good and Bad Cholesterol

You’ve probably heard about LDL and HDL cholesterol levels, but may not understand what that means. There are different types of cholesterol in the blood that have different functions. LDL stands for low density lipoprotein. When there is too much LDL cholesterol in the blood, these particles can make deposits on the walls of the arteries. These deposits are often called plaque and can contribute to a heart attack or stroke. Often LDL cholesterol is referred to as bad cholesterol.HDL, the ‘good’ cholesterol, works to remove excess cholesterol from the body. HDL stands for high density lipoprotein. HDL can be a protective cholesterol.

Know your numbers

Total Cholesterol: A good total cholesterol level is below 200mg/dL. LDL Cholesterol: Your LDL level should be below 100mg/dl. Higher levels of LDL increase your risk for heart disease. HDL Cholesterol: High levels of HDL cholesterol are better. Men should strive for 40mg/dL or higher. Women’s HDL should be 50mg/dL or higher. An HDL cholesterol of 60mg/dL or higher gives some protection against heart disease.

Heart Health

As a general rule, it is best to keep saturated fat intake as low as possible by cutting down on foods that are high in saturated fat and substitute foods high in healthy fats where possible. For example, reduce the amount of butter you cook with, substituting olive oil as the fat.

} Recent studies have highlighted that eating up to seven eggs per week was not associated with a higher risk of heart disease if you do not currently have heart disease or diabetes.

}Minimize organ meats and fatty meats.

} Look for leaner meat, fish, poultry and low-fat dairy foods.

} Increase consumption of fruits and vegetables.

} Replace the grains you eat with whole grain options whenever possible. Example: use 100% whole wheat bread instead of white, or brown rice instead of white.

} Increase consumption of whole grain foods and fiber rich foods.

} Consider non-meat sources of protein such as fish, beans and nuts.

} Exercise to help increase your ‘good’ cholesterol.

} Don’t smoke.

} Achieve a healthy weight.

Cholesterol Ratio

Blood cholesterol ratios can also be important risk indicators for heart disease. To lower your risk, keep total cholesterol/HDL ratio below 4.2 and LDL/HDL less than 2.5.

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Tip of the week

Why Whole Grains

You’ve probably heard it from the experts, ‘Eat more whole grains for good health’ but did you ever wonder why? Eating whole grains as part of a healthy diet can help lower your risk for certain diseases and health conditions. That’s because whole grains are a good source of dietary fiber. Health benefits of dietary fiber include:

} Reduce blood cholesterol levels

} Reduce risk for coronary artery disease

} Reduce constipation

} Reduce diverticulosis

} Help achieve and manage a healthy weight

What are whole grains?

Like other grains, whole grains are complex carbohydrates that are low in fat and good sources of vitamins and minerals. However, whole grains are less refined containing more fiber and even better for you. Fiber-containing foods have many health benefits and help provide a feeling of fullness with fewer calories.

Did you know?All carbohydrates — simple and complex, whole grains, refined grains and sugar — have the same amount of calories. Although whole grains contain fiber and provide health benefits, they don’t contain fewer calories.

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Examples of whole grains

} Brown rice

} Buckwheat

} bulgur (cracked wheat)

} Oatmeal

} Popcorn

}Whole wheat cereal flakes

}Muesli

}Whole grain barley

}Whole grain cornmeal

}Whole rye

}Whole wheat bread

}Whole wheat crackers

}Whole wheat pasta

}Whole wheat sandwich buns and rolls

}Whole wheat tortillas

}Wild rice

Finding whole grains

Read the food label to help you choose whole grains. Look for the word “whole” on the package. Try to choose items with at least 3 grams of dietary fiber per serving.

Choose foods that name of the following ingredients first on the label:

Eat more whole grains

Try these tips to add more whole grains to your diet:

} Add beans to soups and salads

} Try new grains like quinoa, barley or wild rice with stir fry

}Make sure cereal and bread purchased has at least 3g of fiber

} Use brown rice or whole wheat pasta in casseroles

} Add oats to cookies, muffins and other baked goods

} Select popcorn as an afternoon or after dinner snack

} Brown rice

} Bulgur

} Graham flour

} Oatmeal

}Whole-grain corn

}Whole oats

}Whole rye

}Whole wheat

}Wild rice

Don’t be fooledFoods labeled with the words multi-grain, 100% wheat, cracked wheat, seven-grain or bran are usually NOT whole-grain products. Color is not an indication of a whole grain. Bread can be brown because of molasses or other added ingredients. Read the ingredient list to see if it is a whole grain.

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Tip of the week

The Skinny on Fat

Fat is a major nutrient in the diet and is essential in the diet for good health. Fat helps us maintain healthy skin, absorb fat-soluble vitamins, regulate body functions, serve as a protective cushion for vital organs and provide an energy reserve. In the foods we eat, fat provides flavor and helps us feel full after eating a meal. It’s okay to have some fat in your diet, up to 20 – 30% of your total calories. But, eating a high fat diet can lead to weight gain, heart disease and other health issues.

Sources of fat

Fat is in many of the foods that we eat. Some fats we add to foods when preparing and some fats are found naturally in food.

Added fat: Butter, no trans fat margarine, vegetable oils, salad dressings, mayonnaise and many other sauces add fat to the meals that we eat. Fats are also mixed into processed foods that we eat such as cakes, chips, crackers, and deli meats. The amount and types of fat found in these foods vary, but the fat calories can add up quickly depending on how much you eat.

Naturally occurring fat: Fat is found in many good sources of protein, such as red meat, chicken, turkey, cheese, nuts, and full or partial-fat dairy products.

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Not all fats are equal

There are many types of fat in the foods we eat. Eating too much of some types of fat can increase your chances of having heart problems. For example, saturated and trans fat have been linked to heart disease and high cholesterol levels. On the other hand, monounsaturated and polyunsaturated fats may help lower the risk of heart disease.

Saturated fats are mostly hard or solid fats. They are the main fats found in foods from animals including:

} Fatty meats — ribs, ground beef, steak, barbecue, salt pork, and fatback

} Processed meats — bacon, sausage, bologna, and hot dogs

} Cheese

}Whole milk

} Ice cream

} Cream

} Butter

} Lard

Hydrogenated fat is made during the process that turns liquid vegetable oils into solid fats like hard stick margarine and shortening. This type of fat contains trans fats. Many of the prepackaged foods contain hydrogenated fat including:

} Processed foods — cakes, cookies, crackers, chips

} Fried foods and biscuits from fast food places and restaurants

} Hard stick margarine

} Shortening Fat calories add up quickly

That’s because fat provides 9 calories per gram, more than double the 4 calories per gram from carbohydrates and protein.

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Monounsaturated and polyunsaturated fats are better for your heart. These are softer, more liquid fats found in plant foods and some kinds of oily fish including:

} Vegetable oils — olive, canola, peanut, corn, soybean and safflower

} Fish — salmon, mackerel, and tuna

} Peanut butter and other nut butters

} Nuts — almonds, pecans, peanuts, and walnuts

} Avocado

}Olives

Keep it simple

Many people are confused about fats, what type and how much to eat. Reducing your overall fat intake is a great way to eat fewer calories and make sure that you get less saturated and trans fat. Try these tips to reduce the fat in your diet:

} Have salad dressing on the side and use as a dip

} Cut fat off meats

} Remove skin from chicken and turkey

} Choose skim, low-fat, or 1% dairy products

} Remove some of the cheese from deli sandwiches

} Use mustard, ketchup, salsa or other low-fat condiments instead of mayonnaise

} Choose baked foods over fried

} Keep food simple without a lot of sauces or gravies

} Choose leaner cuts of meat

How can you lower the fat in your diet? List three ways you will cut the fat:

1. _____________________________________________________________________________________________________________________

2. _____________________________________________________________________________________________________________________

3. _____________________________________________________________________________________________________________________

Omega-3 fatty acids are a type of polyunsaturated fatty acids that help reduce inflammation and protect against heart disease and certain types of cancer. Omega-3s are found walnuts, ground flax seeds and in seafood such as mackerel, albacore tuna, salmon, sardines, and lake trout. Supplements are another source of omega-3s, but food provides a better source of these important fats. Remember that it is important to talk to your doctor about any supplements that you are taking.

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UnitedHealthcare Resources*

Nutrition

Healthy recipes

Try one of the healthy recipes; accessed in the ‘Healthy Eating’ section under ‘Lifestyles’ on the ‘Health & Wellness’ homepage. Try one of the healthy recipes on Source4Women, http://www.uhc.com/source4women/healthy_recipes.htm

Personal health record — Calorie tracker

Keep track of daily calories by entering calories consumed throughout the day; accessed from the myuhc.com homepage

Online health coach: Nutrition

Enroll in the nutrition program to learn how to plan healthy meals and view nutrition related information, tips and interactive tools; accessed from the Health & Wellness homepage

Exercise

Fitness demos

Learn how to properly do strength exercises such as squats, crunches, calf raises, lunges, and more; accessed in the ‘Fitness’ section under ‘Lifestyles’ on the Health & Wellness homepage

Personal health record — Walking tracker

Record walking minutes or steps and use the tracker to visualize your progress; accessed from the myuhc.com homepage

Calories burned calculator

Use this tool to calculate how many calories are used during certain types of physical activities; accessed in the ‘Cool Tools’ section on the Health & Wellness homepage

Online health coach: Exercise

Enroll in the Exercise program to learn proper exercise techniques, how to make exercise a part of a lifestyle, and how to overcome obstacles; access tools such as the exercise tracker, strength training demos, target heart rate calculator, resting heart rate calculator, exercise trivia and much more; accessed from the Health & Wellness homepage

* Members may access these tools plus many other health education articles through www.myuhc.com; new users will be required to set up user ID and password.

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Weight Management

Healthy weight calculator

Use this tool to determine a healthy weight range; accessed in the ‘Cool Tools’ section on the Health & Wellness homepage

Online health coach: Weight loss

Enroll in the weight loss program to learn about good nutrition, the importance of exercise and the obstacles facing individuals; access tools such as the exercise planner/tracker, meals plans, fast food choices, portion sizer, fast food trivia, snack trivia, plus much more; accessed from the Health & Wellness homepage

Personal health record — Weight tracker

Monitor weight by plugging in the date and weight and graph progress; accessed from the myuhc.com homepage

Other Related Topics

Stress quiz

Take the online stress quiz to find out how you manage stress; accessed in the ‘Cool Tools’ section from the Health & Wellness homepage

Online health coach: Stress

Enroll in the Stress program to learn how to manage stress, learn tips on how to relax, and view interactive tools that help you manage time and show you breathing techniques for times of stress; accessed from the Health & Wellness homepage

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Other Resources

Nutrition

Fruits & veggies

Find ways to add more fruit and vegetables in your diet and try one of the healthy recipes http://www.cdc.gov/nutrition/everyone/fruitsvegetables/index.html

National Diabetes Education Program

Read more about how to develop a healthy meal plan specially targeted for those with or at risk for diabetes http://ndep.nih.gov/diabetes/MealPlanner/en_intro.htm

Reading nutrition labels

Learn new skills on how to use nutrition labels to make quick, informed food choices that contribute to a healthy diet http://www.fda.gov/Food/IngredientsPackagingLabeling/LabelingNutrition/ucm274593.htm

Sample healthy eating plan — DASH

Learn about healthy meal planning and helpful tips for those with high blood pressure http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf

Sample healthy eating plan — Myplate

View sample eating plans http://www.choosemyplate.gov/healthy-eating-tips/sample-menus-recipes.html

Calories counter

Find nutrition facts including calories, fat, fiber and more for all types of foods and beverages whether you’re eating in or dining out http://www.calorieking.com/

My calorie counter

Track your calories, carbs and other nutrients and find the calories you burn during exercise http://www.my-calorie-counter.com/ or myfitnesspal.com

Portion distortion

Slides demonstrate how dramatic portion sizes have increased throughout the years http://www.nhlbi.nih.gov/health/public/heart/obesity/wecan/portion/index.htm

Zinczenko, David. Eat This, Not That. 2007. St. Martin Press. New York, NY

Wansink, Brian; Mindless Eating: Why We Eat More Than We Think, 2006, 224 pages, Bantam Books, New York, NY

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Exercise

Overcoming exercise barriers — CDC

Find solutions to common excuses for not exercising http://www.cdc.gov/nccdphp/dnpa/physical/everyone/get_active/ overcome.htm

Strength training for older adults — CDC

Learn strength training basics http://www.cdc.gov/nccdphp/dnpa/physical/growing_stronger/index.htm

American college of sports medicine

Download and print brochures free of charge on exercise basics from home weights to heart rate monitors http://www.acsm.org/access-public-information/brochures-fact-sheets/brochures

Physical activity for everyone — CDC

Find resources, tools, glossary and articles related to being physically active www.cdc.gov/nccdphp/dnpa/physical/everyone/index.htm

America on the move

Find helpful tips to increase your daily steps and resources to help individuals succeed http://aom.americaonthemove.org

American heart association

Learn about Get Moving for a healthier lifestyle. http://www.heart.org/HEARTORG/GettingHealthy/PhysicalActivity/Physical-Activity_UCM_001080_SubHomePage.jsp

Fitness fundaments

Review guidelines for personal exercise programs http://www.fitness.gov/be-active/physical-activity-guidelines-for-americans/

Active at any size

View a variety of exercises appropriate for different levels of fitness http://win.niddk.nih.gov/publications/active.htm

Dietary guidelines for Americans, 2010

View the recommendation for daily physical activity http://www.health.gov/dietaryguidelines/2010.asp

Map my run

Find running/walking paths, map your own running/walking route, meet others in your community also interested in outdoor running/walking http://www.mapmyrun.com/

General information about weight, nutrition and health — CDC

Find resources, tools and articles related to achieving and maintaining a healthy lifestyle http://www.cdc.gov/HealthyLiving/

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Food & activity journal

M44431-C 1/11 Consumer © 2011 United HealthCare Services, Inc.

Date

Time Food/Drink (include amount and type)

Calories Fat Notes (Why certain choices? Am I hungry?)

What I did to be active todayActivity Minutes

Daily thoughts (goals, challenges, feelings, reminders, questions)

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Sample journal example

M44810 1/11 Consumer © 2011 United HealthCare Services, Inc.

Time Food/Drink Calories Fat (g) Notes

8:00 am 1 whole wheat English muffin, 1 whole egg, 1 whole egg white, 1 apple

350 6 Healthy, good choices

10:30 am Mocha Grande 310 12 Wish I would have ordered the smaller version

2:00 pm Double cheeseburger, large fries, milkshake

1640 86 Starving — made it hard to make healthy choices

4:00 pm 5 chocolate pieces 300 16 Wasn’t even hungry

6:00 pm 20 oz bottle of soda 250 0 Needed a pick me up

8:00 pm Spaghetti with marinara sauce, grilled chicken and steamed broccoli

550 11 Passed on the bread — yeah for me! Portion size still too big, but I was really hungry

10:00 pm Pint of ice cream 920 52 Eating while watching television; didn’t realize eaten everything until gone

Total 4320 183

What I did to be active todayActivity Minutes

Brisk walk 20

Daily thoughts(goals, challenges, feelings, reminders, questions)

Very stressful day at work; feel horrible after ice cream — need to be more mindful of what I am eating

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My weight tracker

Goal weight: ________________________________________________________________________

By what date: _______________________________________________________________________

Starting weight:

Week 1:

Week 2:

Week 3:

Week 4:

Week 5:

Week 6:

Week 7:

Week 8:

Ending weight:

TIP Aim for weight loss of 1 – 2 pounds per week

Weighing yourself often and regularly is a key behavior that can help you lose and maintain weight.

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Healthy recipes

Snacks and Munchies

Banana Nut Smoothie Spiced Almonds Zesty Guacamole Mexican Layered Bean Dip Crispy Chicken Nuggets Garlic Shrimp Sizzle

Soups and Salads

Butternut Squash Soup Vegetarian Minestrone Curried Lentil and Spinach Soup Spinach Rainbow Salad Beet Salad Carrot Cumin Salad Creamy Coleslaw

One Dish Meals

Vegetable Fried Rice Turkey Chili Greek Pasta Chicken and Rice Turkey and Bean Burritos Tuna Casserole

Protein

Simple Snapper Creole Baked Salmon Cakes Creamy Baked Salmon Dijon Turkey Stuffed Cabbage Turkey Meatloaf Low-Fat Chicken Parmesan Spicy Barbecued Chicken Sautéed Chicken with

Artichoke Hearts Rosemary and Garlic Pork Chops

Veggies

Sesame Green Beans Spinach and Corn Casserole Savory Greens Roasted Zucchini Roasted Parmesan Tomatoes Baked Broccoli and Cheese Ratatouille White Beans and Pesto Roasted Sweet Potatoes Microwave Garlic Mashed Potatoes

Whole Grains

Whole Wheat Couscous with Parmesan Brown Rice and Vegetable Risotto Wild Rice and Mushrooms Quinoa Pilaf Barley and Black Beans

Sweet Treats

Strawberries with Vinegar Oatmeal Chocolate Chip Cookies Carrot Cake Chocolate Zucchini Cake Pumpkin Spice Muffins

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Banana Nut SmoothieMakes one serving

Ingredients 1 cup vanilla soymilk1/2 frozen banana1 T natural peanut butter2 T vanilla or chocolate whey protein powder3 – 4 ice cubes

Directions } Place ingredients in blender until smooth. } Serve immediately or freeze for later.

Nutritional information per servingCalories: 325kcal; Fat: 9g; Protein: 16g; Carbohydrates: 44g; Sodium: 145mg

Source: USDA

Spiced AlmondsMakes 8 servings

Ingredients 1 cup whole almonds1 tsp extra-virgin olive oil3/4 tsp ground cumin1/4 tsp salt1/8 tsp cayenne pepperDash of onion powder

Directions } Preheat oven to 350 degrees F. } Toss almonds with oil and spices in a pie pan. } Bake, stirring occasionally, until fragrant and lightly toasted, 25 to 30 minutes. } Let cool and serve.

Nutritional information per serving (approx. 2 Tbsp)Calories: 112kcal; Fat: 10g; Protein: 4g; Carbohydrates: 4g; Sodium: 73mg

Source: National Institutes of Health

Zesty Guacamole Makes 6 appetizer-sized servings

Ingredients 2 avocados, ripe1/2 red onion, minced (about 1/2 cup)1 or 2 Serrano chili peppers, stems and seeds removed, minced2 T cilantro leaves, finely chopped1-1/2 T fresh lime juice1/2 tsp coarse saltA dash of freshly grated black pepper1 small, ripe tomato, seeds and pulp removed, chopped

Directions }Cut avocados in half. Remove seeds. Scoop out avocado from the peel, put in a mixing bowl and mash. }Add the chopped onion, cilantro, lime or lemon, salt and pepper and mash some more. Chili peppers vary individually in their hotness. } Start with a half of one chili pepper and add to the guacamole to your desired degree of hotness. } Keep the tomatoes separate until ready to serve. }Cover with plastic wrap directly on the surface of the guacamole to prevent oxidation from the air reaching it. Refrigerate until ready to serve. } Just before serving, add the chopped tomato to the guacamole and mix.

Variations For a very quick guacamole, just take a 1/4 cup of salsa and mix it in with your mashed avocados.

Nutritional information per servingCalories: 120g; Fat: 9g; Protein: 1g; Carbohydrates: 9g; Sodium: 219mg

Source: USDA

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Mexican Layered Bean DipMakes 12 servings

Ingredients 1 (16-ounce) can fat-free or low-fat refried beans 1 (4-ounce) can chopped green chili peppers, drained 2 tsp chili powder 1 tsp ground cumin 3 large avocados, peeled and pit removed 2 cups salsa 1-1/2 cups fat-free sour cream 1 cup shredded lettuce 1-1/2 cups of shredded reduced-fat cheese, any variety 1 (4-ounce) can sliced black olives

Directions } In a medium bowl, mix the refried beans, 1/4 cup of salsa, green chili peppers, chili powder and cumin. } Spread on the bottom of a serving platter or in a dish with sides. }Mash avocados and blend with 3/4 cup of salsa. } Spread mixture on top of beans. Spread sour cream on top of avocado mixture, followed by layers of lettuce, cheese and the remaining salsa. Top with olives. }Distribute a layer of each ingredient on top of sour cream in the following order: lettuce, cheese, remaining salsa and olives. } Serve with your favorite tortilla chips and some crunchy raw vegetables, such as carrots, celery and grape tomatoes.

Nutritional information per serving Calories: 193kcal; Fat: 11g; Protein: 7g; Carbohydrates: 16g; Sodium: 584mg

Source: USDA

Crispy Chicken NuggetsMakes 4 servings

Ingredients 1 lb boneless, skinless chicken breasts 1/4 cup flour 1/2 tsp paprika 1/4 tsp freshly ground black pepper 1 egg white 1/4 cup low-fat buttermilk 1 cup cornflakes, crushed

Directions } Preheat oven to 450 degrees. Coat a baking sheet with nonstick cooking spray. } Prepare three bowls: one with flour and seasonings, one with egg white and buttermilk stirred together, and one with crushed cornflakes. }Cut chicken breasts into 1- to 1-1/2-inch pieces. } Place chicken pieces into bowl and roll in flour mixture. Then, piece by piece, shake off excess flour, dip the chicken into the milk mixture, then coat the pieces with cornflakes. } Place chicken on baking sheet and bake for 10 minutes until golden, turning them halfway through.


Source: USDA

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Garlic Shrimp SizzleMakes 4 servings

Ingredients Marinade and shrimp 3 T lemon juice3 T dry white wine2 tsp olive oil4 cloves garlic, minced1 lb medium shrimp (30 to 40 per pound), peeled and deveined

Sauce Olive oil cooking spray1 tsp olive oil 1 bay leaf1/4 tsp crushed red pepper1/4 tsp salt, or to taste2 T chopped fresh parsley

Directions }Combine lemon juice, wine, 2 teaspoons oil and garlic in a medium bowl. }Add shrimp and toss to coat. }Cover and marinate in the refrigerator for 15 minutes, tossing occasionally. Drain well, reserving marinade. }Heat cooking spray and 1 teaspoon oil in a large nonstick skillet over medium-high heat. }Add shrimp and cook, turning once, until barely pink, about 30 seconds per side. } Transfer to a plate. Add bay leaf, crushed red pepper and the reserved marinade to the pan; simmer for 4 minutes. } Return the shrimp and any accumulated juices to the pan; heat through. } Season with salt, sprinkle with parsley and serve immediately.



Butternut Squash SoupServes 6

Ingredients2 T olive or canola oil2 large leeks, sliced, white part only1 small onion, chopped2 carrots, peeled and diced1 green apple, peeled and sliced1 butternut squash, peeled, seeded, and cut into 1-inch cubes1 tsp allspice1 tsp cinnamon7 cups low-sodium chicken broth1/4 cup orange juice concentrate, thawed

Directions } In a large pot, heat oil over medium heat. }Add onions, leeks, carrots, apple slices and spices. Cook, stirring often, until vegetables start to soften. }Add broth and squash. Turn heat to high and bring to a boil. } Reduce heat and simmer for about 45 minutes, until squash is tender. } Let soup cool for 10 to 15 minutes, then transfer to blender or food processor and blend until smooth. } Return to pot and stir in orange juice. Add more broth and season with a dash of salt if necessary.

Nutritional information per serving Calories: 130kcal; Fat: 3g; Protein: 2g; Carbohydrates: 25g; Sodium: 416mg

Source: USDA

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Vegetarian MinestroneMakes 4 servings Ingredients1 tsp olive oil 3/4 cup chopped onion 3 cups water or low-sodium vegetable broth2 cups diced zucchini 1 cup diced carrot 1 cup canned cannellini beans or other white beans, drained 3/4 cup diced celery 1/2 tsp dried basil 1/4 tsp salt 1/4 tsp dried oregano 1/8 tsp coarsely ground pepper 1 can (14.5 ounce) diced tomatoes, not drained 1 garlic clove, minced 1/4 cup uncooked ditalini (very short tubular macaroni) or elbow macaroni 4 tsp Parmesan cheese, grated

Directions }Heat oil in a large saucepan over medium-high heat. }Add onion; sauté 4 minutes or until lightly browned. }Add water and next 10 ingredients (water through garlic); bring to a boil. Cover, reduce heat to medium-low and cook 25 minutes. }Add pasta; cover and cook an additional 10 minutes. } Ladle into individual bowls and sprinkle with cheese.



Curried Lentil and Spinach SoupMakes 6 hearty servings

Ingredients 2 T olive oil1 large onion, chopped3 large celery stalks, chopped2 large carrots, peeled and chopped3 garlic cloves, minced1 T curry powder 1 tsp cumin1 T minced fresh ginger1 bay leaf1/4 tsp dried crushed red pepper8 cups low-sodium chicken or vegetable broth2 cups water1 bag (16 ounce) dried lentils (about 2-1/2 cups) 1 bag (6 ounce) baby spinach leaves1/2 cup chopped fresh cilantro 1/2 cup plain nonfat yogurt

Directions }Heat oil in a large pot over medium-high heat. }Add onion, garlic, celery and carrots and sauté until golden, about 10 minutes. } Stir in curry powder, ginger, cumin, bay leaf and dried crushed red pepper. }Add broth, water and dried lentils; bring to boil. Reduce heat to medium-low and simmer uncovered until lentils are tender — about 25 minutes. }Add more water to thin out soup (if desired) — 1/2 cup at a time. }Add spinach and cilantro. Simmer until spinach is wilted, about 5 minutes, and remove bay leaf. } Season soup with salt and pepper. }When reheating the next day, add a little water if soup is too thick. } Ladle soup into bowls. Top each serving with spoonful of yogurt.

Nutritional information per servingCalories: 316kcal; Fat: 6g; Protein: 15g; Carbohydrates: 51gSource: National Institutes of Health

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Spinach Rainbow Salad Makes 4 servings

Ingredients1 lb spinach, washed, dried and chopped1 cup canned sliced beets2 medium oranges, peeled and sectioned

Dressing 1/2 cup balsamic vinegar2 T orange juice2 T olive oil1 T water1 T honey1 tsp Dijon mustardSalt and pepper to taste

Directions } Put spinach in a bowl and add oranges and beets. } For the dressing, combine the rest of the ingredients in a saucepan and bring to a boil. } Lower the heat and simmer until the liquid is reduced by about one third. }When done, drizzle on salad.

Nutritional information per servingCalories: 178kcal; Fat: 7g; Protein: 4g; Carbohydrates: 21g; Sodium: 92 mg


Beet Salad Makes 8 servings

Ingredients 3 lbs beets 1/4 cup brown sugar1/4 cup rice or cider vinegar 1/4 cup water 1 tsp dry mustard powder 1 T extra-virgin olive oil 1 large onion, sliced thin Salt to taste

Directions }Cut off the beet tops about an inch above the beet. In a large pot cover the beets with three inches of cold water and bring to a boil. }Cover and boil over medium heat until tender, about 45 minutes. }Drain the beets under cool running water. Slip off their skins. } Trim off stems and root ends and slice the beets thinly. }Combine the sliced beets in a bowl with the other ingredients, add salt to taste, and chill. Stir several times. }This salad will keep for a week in the refrigerator.



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Carrot Cumin Salad Makes 4 servings

Ingredients 6 carrots, coarsely grated1/2 cup chopped fresh parsley1 T lemon juice1 T extra-virgin olive oil1 clove garlic, finely chopped1 tsp ground cuminSalt and freshly ground pepper to taste

Directions }Combine carrots, parsley, lemon juice, oil, garlic and cumin in a medium bowl. } Season to taste with salt and freshly ground pepper.



Creamy Coleslaw Makes 6 servings

Ingredients 4 T reduced-fat mayonnaise4 T nonfat plain yogurt, preferably Greek-style1 T Dijon mustard2 tsp cider vinegar1 tsp sugar1/2 tsp caraway seed or celery seed (optional)Salt and freshly ground pepper to taste2 cups shredded red cabbage (1/4 small head)2 cups shredded green cabbage (1/4 small head)1 cup grated carrots (2 medium or large)

Directions }Combine mayonnaise, yogurt, mustard, vinegar and sugar in a large bowl. }Add caraway seed (or celery seed), if using. } Season with salt and pepper. }Add cabbage and carrots; toss to coat.



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Vegetable Fried Rice Makes 4 servings

Ingredients 1 cup quick brown rice 2 cups vegetable broth, reduced sodium2 eggs, lightly beaten2 tsp canola oil8 ounces asparagus spears, trimmed and cut into 1-inch pieces (about 1/2 bunch)1 large red bell pepper, thinly sliced 4 scallions, cut into 1-inch pieces3 cloves garlic, minced1 T minced fresh ginger4 tsp reduced-sodium soy sauce2 T rice vinegar1 tsp toasted sesame oilHot red pepper sauce, to taste

Directions }Combine rice and broth in a small saucepan. Bring to a boil over high heat. Cover, reduce heat and simmer until the liquid is absorbed, 12 to 14 minutes. } Spread the rice out on a large plate and let stand for 5 minutes. }While the rice is cooling, coat a large nonstick wok or skillet with cooking spray and place over medium heat. } Pour in eggs and cook, stirring gently, until just set, 30 seconds to 1 minute. Transfer to a small bowl. }Heat canola oil in the pan over medium-high; add asparagus and cook, stirring, for 2 minutes. }Add bell pepper, scallions, garlic and ginger; cook, stirring, until the vegetables are just tender, about 2 minutes. }Add the cooked rice, soy sauce and vinegar to the pan; cook until the liquid is absorbed, 30 seconds to 1 minute. } Fold in the cooked eggs. } Remove from the heat; stir in sesame oil and hot sauce.



One Dish Meals

135

Turkey ChiliServes 6

Ingredients1 pound ground turkey breast (ground without skin)2 teaspoons olive or vegetable oil1/2 Spanish onion, chopped (about 1 cup)2 celery stalks, chopped2 garlic cloves, minced2 tablespoons chili powder2 tablespoons minced chipotle in adobo (from 7-ounce can)*1 tablespoon ground cumin1 teaspoon dried Mexican or regular oregano1 28-ounce can crushed tomatoes2 cups reduced-sodium, nonfat chicken broth1 8-ounce can tomato sauce1 15-ounce can red kidney beans, rinsed and drained1 15-ounce can white (cannellini) beans, rinsed and drained1/3 cup chopped fresh cilantro1/2 cup nonfat sour cream (garnish)1/2 cup chopped green onions (garnish)

* Sold with Mexican ingredients in most supermarkets.

Directions } Place a large stockpot over medium-high heat. When pan is hot, add turkey (a hot pan prevents sticking). } Saute turkey until browned and cooked through, breaking up the meat as it cooks. Transfer to a colander to drain. }Meanwhile, heat oil in the same stockpot over medium-high heat. Add onion, celery and garlic and saute 3 to 4 minutes, until tender and golden. } Return turkey to pot. Add chili powder, chipotle in adobo, cumin, and oregano and mix well. }Add tomatoes, chicken broth, tomato sauce, and both beans and bring mixture to a boil. } Reduce heat, partially cover and simmer 30 minutes (and up to 1 hour). } Remove from heat and stir in cilantro. } Ladle chili into bowls and top with sour cream and green onions.

Nutritional information per servingCalories: 353 kcal; Fat: 3g; Protein: 32 g; Carbohydrates: 49g; Sodium: 890 mg

One Dish Meals

136

Greek PastaMakes 4 servings

Ingredients 4 cups cooked farfalle (bow tie pasta) 1 can (7 ounce) albacore tuna 2 cups sliced peeled cucumber 1/2 cup (2 ounces) crumbled feta cheese 1/4 cup chopped red onion 1/4 cup sliced black olives 1/4 tsp freshly ground black pepper 20 cherry tomatoes, halved

Dressing 1/4 cup fresh lemon juice 2 tsp extra-virgin olive oil 1 tsp dried oregano 1/4 tsp freshly ground black pepper1/8 tsp salt

Directions } To prepare salad, cook pasta according to package directions, omitting salt and fat. Drain and rinse under cold water. } Place in a large bowl. Add tuna, cucumber, feta, onion, olives, pepper and tomato. }Combine lemon juice and remaining ingredients, stirring with a whisk. Drizzle over salad, and toss gently to coat.



Chicken and Rice Makes 4 servings

Ingredients 1 pound boneless chicken breasts, cut into strips1 chopped medium onion1 diced green bell pepper2 minced and seeded jalapeno peppers2 minced cloves garlic2 cups low-sodium chicken broth1 14-ounce can diced tomatoes, drained1/2 cup frozen peas and carrots, thawed1 tsp ground chili powder1 tsp cumin3/4 cup long grain brown rice1 T olive oil

Directions } In a medium skillet sprayed with cooking spray, add the olive oil and sauté the chicken strips until cooked thoroughly, about 8 to 10 minutes. Set aside and keep warm. } In a large skillet, bring all remaining ingredients to a boil. Cover and simmer about 30 to 40 minutes, until rice has absorbed broth. }Add chicken to rice and serve.

Nutrition information per servingCalories: 335kcal; Fat: 8g; Protein: 31g; Carbohydrates: 37grams; Sodium: 460mg

Source: USDA

One Dish Meals

137

Turkey and Bean BurritosMakes 6 servings

Ingredients 1 T canola oil1 medium onion, sliced2 cloves minced garlic2 to 3 tsp chili powder1 can (15 ounce) diced tomatoes1 small container green chili peppers (mild or hot)2 T lime juice4 cups shredded turkey or chicken (leftover or rotisserie)1 can (15 ounce) pinto beans3/4 cup low-fat grated cheese, Monterey or mozzarella2 cups shredded lettuce6 10-inch whole-wheat tortillas/wraps

Directions }Heat oil in a large pan. Over medium heat, add onion and garlic until soft, about 2 to 3 minutes. } Stir in chili powder and green chili peppers. }Add tomatoes and lime juice and bring to a boil. Reduce heat to a simmer and cook another 15 to 20 minutes. } Stir in turkey or chicken and beans and heat through, another 3 to 4 minutes. }Divide the mixture evenly among tortillas. } Top with cheese and lettuce. Roll and serve.

Variation Serve turkey mixture over 1/2 cup of brown rice instead of in a tortilla and add the cheese and lettuce to the rice mixture.



Tuna CasseroleMakes 6 servings

Ingredients 6 ounces wide regular or whole-wheat egg noodles1 can (10 ounce) low-fat condensed mushroom soup1/3 cup skim milk1 can (6-1/2 ounce) water-packed tuna (or salmon)1 cup frozen green peas 1 cup dried whole-wheat bread crumbs

Directions } Preheat oven to 350 degrees F. Cook noodles in boiling water until al dente according to package instructions, drain and set aside. }Meanwhile, combine mushroom soup, milk, tuna and peas in a large bowl. Stir the noodles into the tuna and pour into a nonstick casserole dish. } Sprinkle with bread crumbs and bake until golden brown and bubbly, about 30 minutes.



One Dish Meals

138

Simple Snapper CreoleMakes 4 servings

Ingredients1 T trans fat-free spread2 cloves minced garlic¼ tsp cayenne pepper½ tsp paprika1 onion, chopped2 stalks celery, chopped4 red snapper fillets or other white fish (4 ounces to 5 ounces each)2 T chopped fresh parsley

Directions } In a nonstick skillet, melt spread and stir in garlic, cayenne and paprika. }Add onion and celery and sauté until soft, 3 to 4 minutes. }Add fish fillets and cook until fish flakes, about 5 to 7 minutes. } Place fish on a platter and pour pan juices over fish. Top with parsley.



Baked Salmon Cakes Makes 2 servings

Ingredients8 ounces cooked salmon fillet1/4 cup scallions or onions, finely chopped2 tsp dill2 garlic cloves, minced1 egg, beatenSplash of lemon juice1/4 cup wheat germ or whole-wheat bread crumbs

Directions } Preheat oven to 350 degrees F. Separate salmon with a fork in a large bowl. }Add remaining ingredients, and shape into two patties. } Place patties in a nonstick baking dish or baking sheet in oven. } Bake about 15 minutes, until cooked through.


Source: USDA

Protein

139

Creamy Baked Salmon Dijon Makes 6 Servings

Ingredients 1 cup sour cream, light or fat-free 2 tsp dill weed, dried 4 T scallions 2 T Dijon mustard 2 T lemon juice 1-1/2 pounds salmon fillet 1/2 tsp garlic powder 1/2 tsp pepper, black

Directions }Coat baking sheet with cooking spray.

} Stir together sour cream, dill, scallions, mustard and lemon juice in a small bowl. Preheat oven to 400 degrees F. } Place salmon, skin-side down, on prepared baking sheet. } Sprinkle with garlic powder and pepper, then spread with the sauce. } Bake salmon until just opaque in the center, about 20 minutes.



Turkey Stuffed CabbageMakes 5 serving

Ingredients1 head cabbage½ lb lean ground beef½ lb lean ground turkey1 small onion, minced1 slice stale whole wheat bread, crumbled1 tbsp lemon juice1 ¼ cup water1/8 tsp black pepper1 can (16 ounce) diced tomatoes1 small onion, sliced1 medium carrot, sliced1 tbsp lemon juice2 tbsp brown sugar1 tbsp cornstarch

Directions } Rinse and core cabbage. Carefully remove 10 outer leaves, place in saucepan and cover with boiling water. Simmer 5 minutes. Remove and drain cooked cabbage leaves on paper toweling. } Shred 1/2 cup of raw cabbage and set aside.

} Brown ground beef and turkey and minced onion in skillet. Drain fat. } Place cooked and drained meat mixture, bread crumbs, water, and pepper in mixing bowl. }Drain tomatoes, reserving liquid, and add 1/2 cup tomato juice from can to meat mixture. Mix well, then place 1/4 cup filling on each parboiled, drained cabbage leaf. Place folded side down in skillet. }Add tomatoes, sliced onion, water, shredded cabbage, and carrot. Cover and simmer about one hour (or until cabbage is tender), basting occasionally. } Remove cabbage rolls to serving platter, keep warm. }Mix lemon juice, brown sugar, and cornstarch together in small bowl. Add to vegetables and liquid in skillet and cook, stirring occasionally, until thickened and clear. Serve over cabbage rolls.

Nutrition information per serving (2 rolls)Calories: 257kcal; Fat: 9g; Sodium: 266mg

Protein

140

Turkey MeatloafMakes 5 servings

Ingredients 1 lb lean ground turkey1/2 cup regular oats, dry1 large egg, whole1 T onion, dehydrated flakes1/2 tsp garlic powder2 T grated Parmesan cheese1/4 cup ketchup

Directions }Combine all ingredients and mix well. } Bake in a loaf pan at 350 degrees F for 40 – 50 minutes or to an internal temperature of 165 degrees F. }Cut into five slices and serve.

Nutritional information per servingCalories: 200mg; Fat: 8g; Protein: 23g; Carbohydrates: 9g; Sodium: 235 mgSource: USDA

Low-Fat Chicken Parmesan Makes 4 servings

Ingredients4 boneless, skinless chicken breasts 2 cups tomato/marinara sauce 1/2 cup reduced-fat shredded mozzarella cheese 1/4 cup Parmesan cheese2 tsp dried basil1 – 2 tsp garlic powder

Directions } Preheat oven to 450 degrees F. Spray a baking pan with cooking spray. } Pour 1 cup of tomato sauce on the bottom of the pan and layer the chicken on top. } Pour the other cup of sauce over the chicken and sprinkle remaining ingredients evenly over the top. }Cover with foil and bake for 30 minutes until bubbly.

Nutritional information per servingCalories: 241kcal; Fat: 5.5g; Protein: 44g; Carbohydrates: 44g; Sodium: 375mgSource: USDA

Spicy Barbecued ChickenMakes 8 servings

Ingredients3 lbs. chicken parts (breast, drumstick and thigh), skin and fat removed1 large onion, thinly sliced3 T vinegar3 T Worcestershire sauce2 T brown sugarDash of black pepper1 T pepper flakes1 T chili powder1 cup chicken stock or broth

Directions } Place chicken in a 13 x 9 x 2-inch pan. Arrange onions over the top. } Skim fat from top of chicken stock or broth. Mix together with vinegar, Worcestershire sauce, brown sugar, pepper, hot pepper flakes and chili powder. } Pour over the chicken and bake at 350 degrees F for 1 hour or until done. } Baste occasionally.

Nutritional information per servingCalories: 176kcal; Fat: 6g; Sodium: 240mg


Protein

141

Sautéed Chicken with Artichoke Hearts Makes 4 servings

Ingredients 4 skinless, boneless chicken breast halves (4 ounces to 5 ounces)Fresh ground pepper1 jar (6 ounce) marinated artichoke hearts1 cup low-sodium chicken broth1/2 tsp dried red pepper flakes1-1/2 T lemon juice

Directions } Pound chicken breasts slightly to flatten evenly. Season with pepper. Drain artichoke hearts and reserve the liquid. }Heat 1/4 cup of the artichoke marinade in a large frying pan. Add the chicken and cook over medium heat until lightly browned, about 2 minutes per side. }Add the artichokes, chicken broth and red pepper flakes to the pan. Pour in the remaining marinade. }Cover and cook until chicken is cooked through, but still moist in the center (about 5 minutes). }Add the lemon juice. If you find the sauce is too liquid, boil uncovered for 1 minute to reduce slightly.



Rosemary and Garlic Pork Chops Makes 4 servings

Ingredients4 boneless or bone-in pork loin chops, cut 1/2 inch thick (1 to 1-1/2 lbs.)1/2 tsp kosher salt1/4 tsp freshly ground black pepper1 T finely chopped fresh rosemary or 1 tsp dried rosemary, crushed4 cloves garlic, minced

Directions } Sprinkle chops with kosher salt and pepper; set aside. } In a small bowl, combine rosemary and garlic. Sprinkle rosemary mixture evenly over both sides of each chop; rub in with your fingers. } Place chops on a rack in a shallow roasting pan. Roast chops in a 425 degree F oven for 10 minutes. } Reduce oven temperature to 350 degrees F and continue roasting about 25 minutes — or until an instant-read thermometer inserted through the side of a chop registers 160 degrees F (make sure tip of thermometer does not touch bone).



Protein

142

Sesame Green Beans Makes 4 servings

Ingredients1 T olive oil 1-1/4 T sesame seeds 1 lb fresh green beans cut into 2-inch pieces 1/4 cup chicken broth 1/4 tsp salt Freshly ground black pepper to taste

Directions }Heat oil in a large skillet or wok over medium heat. }Add sesame seeds. When seeds start to darken, stir in green beans. }Cook, stirring, until the beans turn bright green. } Pour in chicken broth, salt and pepper. Cover and cook until beans are tender-crisp, about 10 minutes. }Uncover and cook until liquid evaporates.



Spinach and Corn CasseroleMakes 6 servings

Ingredients 1 (16 ounce) package chopped frozen spinach1/2 cup minced white onion1 (16 ounce) can creamed corn1 (16 ounce) can plain corn (no added sugar or salt)1 T no trans fat margarine1 T vinegar1/8 tsp salt1/2 tsp black pepper

Topping 1/2 cup bread crumbs, preferably whole wheat, or 1/4 cup whole wheat flour and 1/4 cup wheat germ2-1/2 T grated Parmesan cheese1 T trans fat-free spread

Directions } Preheat oven to 400 degrees F. Defrost spinach and drain. }Combine spinach, onion and corn in a casserole dish sprayed with cooking spray. Melt 1 T no trans fat margarine and mix in. }Add vinegar, salt and pepper, and mix. } Spread bread crumbs and cheese over top of casserole. }Melt remaining no trans fat margarine and drizzle over the top. Bake 20 to 30 minutes.


Source: USDA

Veggies

143

Savory Greens Makes 2 servings

Ingredients1 lb greens (mustard, turnip, other)Olive oil cooking spray1 tsp olive oil 1/2 cup chopped onions 2 cloves garlic, minced 1 small red bell pepper, chopped 4 to 6 T low-sodium chicken broth1/2 T cider vinegar 1 tsp sugar Olive oil cooking spray

Directions }Wash greens thoroughly. Pat dry. Cut crosswise into half-inch slices. } Spray a large pan with olive oil cooking spray. Add olive oil. }Over medium heat, sauté onion and garlic, cook and stir for about 3 minutes. } Stir in mustard greens, red bell pepper and chicken broth. } Bring to boil, then reduce heat to low. Cook, covered, for 20 to 25 minutes or until greens are tender. Add more broth if needed. } In a small bowl, combine vinegar and sugar. Stir until dissolved. } Sprinkle over cooked greens and remove from heat. Serve immediately.


Source: USDA

Roasted Zucchini Makes 4 servings

Ingredients3 cloves garlic, minced 1 T extra-virgin olive oil1 T chopped fresh rosemary or 1/2 tsp dried rosemary, crushed1/2 tsp freshly ground black pepper1/4 tsp kosher salt1-1/2 lb zucchini and/or yellow summer squash, sliced 1/2-inch thick

Directions } In a small saucepan, cook garlic in hot oil over medium heat for 30 seconds. Stir in rosemary, pepper and kosher salt. } Place zucchini in a 13x9x2 baking pan; add oil mixture. Toss to coat. } Roast, uncovered, in a 425 degree F oven for about 20 minutes or until crisp-tender, stirring once.



Veggies

144

Roasted Parmesan Tomatoes Makes 4 servings

Ingredients 2 tomatoes2 garlic cloves, minced2 tsp olive oil1 T basil1/8 tsp freshly ground pepper1/4 cup soft bread crumbs1/4 cup wheat germ2 T grated Parmesan cheeseNonstick cooking spray

Directions }Cut the tomatoes in half crosswise. Gently squeeze out and discard the seeds. } Place the tomatoes cut side facing up on a broiler pan prepared with nonstick cooking spray. }Combine garlic, oil, basil and pepper in a small bowl. Brush evenly over the cut surfaces of the tomatoes. } Broil 6 inches from the heat source until hot, about 5 minutes. }While the tomatoes are broiling, combine the crumbs and cheese in a small bowl; sprinkle evenly over the tops of the hot tomatoes. } Return to the broiler until the crumbs are browned, about 2 minutes. Serve immediately.



Baked Broccoli and Cheese Makes 4 servings

Ingredients 1/2 lb cauliflower 1/2 lb broccoli (or 1 lb if not using cauliflower)1/2 cup plain low-fat yogurt 3/4 cup grated reduced-fat cheddar cheese 1 tsp mustard 2 T wheat germ Salt and pepper to taste

Directions } Break the cauliflower and broccoli into florets and cook in lightly salted, boiling water for 10 minutes until just tender. }Drain well and transfer to a baking dish. }Mix together the yogurt, grated cheese and mustard, then season the mixture with pepper and spoon over cauliflower and broccoli. } Sprinkle wheat germ over the top and heat in oven at 350 degrees F for 10 minutes. Serve hot.



Veggies

145

RatatouilleMakes 6 servings

Ingredients 1 large eggplant, cut into 1-inch cubes 4 medium zucchini, sliced ½-inch thick1 tsp salt2 T olive oil2 medium onions, sliced2 medium red, green or yellow bell peppers, chopped2 large tomatoes, chopped3 cloves garlic, minced Freshly ground black pepper to taste1 T chopped fresh thyme or 1 tsp dried thyme1 T chopped fresh oregano or 1 tsp dried oregano1 T chopped fresh basil or 1 tsp dried basil

Directions } Put eggplant and zucchini in a colander, sprinkle with salt and toss lightly. Allow to drain for at least 30 minutes. Rinse and pat dry with paper towels. } In a heavy, nonstick skillet, heat oil over medium-high heat. } Sauté onions until translucent, about 3 minutes. } Stir in peppers, tomatoes, eggplant, zucchini, garlic, salt, pepper, thyme, oregano and basil. } Reduce heat, cover and simmer 30 – 45 minutes, or until vegetables are thoroughly cooked. Stir to prevent sticking. }Uncover and cook another 5 minutes to reduce liquid. } Serve warm or cold.



White Beans and PestoMakes 2 servings

Ingredients 1/2 cup jarred roasted red peppers, cut in strips1 can (15 oz.) cannellini beans, rinsed and drained 2 cloves garlic, minced 2 T prepared pesto

Directions }Mix together red peppers, beans and garlic in a small saucepan. }Cook over low heat until warmed through. } Stir in pesto and serve.



Roasted Sweet PotatoesMakes 6 servings

Ingredients2 lbs sweet potatoes 2 T olive oil 1½ T honey 1½ tsp fresh lemon juice ½ tsp salt

Directions } Preheat oven to 350 degrees F. Peel and cut the sweet potatoes into 1-inch pieces and put in a 9"x13" baking dish. } In a small bowl, whisk together olive oil, honey and lemon juice. Pour mixture over potatoes and toss to coat. } Sprinkle with the salt and bake, stirring occasionally, for about 1 hour, until potatoes are tender.

Nutritional information per servingCalories: 168kcal; Fat: 5g; Protein: 2g; Carbohydrates: 30g; Sodium: 210mgSource: USDA

Veggies

146

Microwave Garlic Mashed Potatoes Makes 4 servings

Ingredients2 large potatoes2 cups skim milk3 cloves garlic1/2 tsp white pepper

Directions } Scrub potatoes. Pat dry and prick with fork. }On plate, cook potatoes in microwave uncovered on 100 percent (high) power until tender (about 12 minutes), turning over once. Let stand five minutes, then peel and quarter. }Meanwhile, in 4-cup measuring glass, combine milk and garlic. Cook, uncovered, on 50 percent (medium) power until garlic is soft (about four minutes). }Add milk-garlic mixture and white pepper to potatoes. } Beat with electric mixer on low speed, or mash with potato masher until smooth.



Whole Wheat Couscous with Parmesan Makes 6 servings

Ingredients 1 can (14 ounce) reduced-sodium chicken broth or vegetable broth1/4 cup water2 tsp extra-virgin olive oil1 cup whole-wheat couscous1-1/2 cups frozen peas2 T chopped fresh dill2 tsp freshly grated lemon zestSalt and freshly ground pepper to taste1/2 cup freshly grated Parmesan cheese

Directions }Combine broth, water and oil in a large saucepan; bring to a boil. } Stir in couscous and remove from heat. Cover and let plump for 5 minutes. }Meanwhile, cook peas on the stovetop or in the microwave according to package directions. }Add the peas, dill, lemon zest, salt and pepper to the couscous; mix gently and fluff with a fork. } Serve hot, sprinkled with cheese.



Veggies and Whole Grains

147

Brown Rice and Vegetable Risotto Makes 6 servings, 1-1/2 cups each

Ingredients 1 T extra-virgin olive oil1 medium onion, diced1/4 tsp salt2 cups instant brown rice4 cloves garlic, chopped 2-1/2 cups vegetable or reduced-sodium chicken broth1 lb asparagus, trimmed and cut into 1/4-inch pieces1 red bell pepper, finely diced1 cup frozen peas, thawed4 ounces reduced-fat cream cheese 1/2 cup grated Parmesan cheese1/4 cup minced chives or scallion greens

Directions }Heat oil in a large nonstick skillet (with a lid) over medium-low heat. }Add onion and salt. Cook, stirring often, about 4 minutes. Add rice and garlic and cook another 30 seconds to 1 minute. }Add broth and bring to a boil; cover, reduce heat to a simmer and cook for 5 minutes. } Remove cover and spread asparagus and bell pepper on top of the simmering rice; do not stir into the rice mixture. Replace cover and continue simmering until the liquid is almost absorbed and the asparagus is bright green but still crisp, about 5 minutes. }Add peas and cream cheese; stir until the mixture is creamy and the cheese is blended in. } Return to a simmer and continue cooking until the liquid has evaporated and the asparagus is tender, about 5 minutes more. } Stir in the Parmesan and serve hot.

Nutritional information per servingCalories: 249kcal; Fat: 9g; Protein: 8g; Carbohydrates: 34g; Sodium: 225mgSource: National Institutes of Health

Wild Rice and MushroomsMakes 6 servings

Ingredients 1 cup dried porcini or shiitake mushrooms 2-1/2 cups water1 cup wild rice 1/2 cup orange juice 1/4 cup dry sherry 1/2 cup sliced carrots 3 T chopped fresh parsley Low-sodium soy sauce to taste 1/2 cup finely chopped walnuts or almonds

Directions } Soak the dried mushrooms in water to cover until they are soft. Squeeze them out, reserving liquid, and slice. }Wash the wild rice in cold water and place in pot with the reserved mushroom liquid (minus any sediment) and enough additional cold water to total 2 cups. }Add the orange juice, sherry and carrots. Bring to a boil, reduce heat, cover and simmer for 30 minutes. }Add mushrooms and continue cooking until rice is tender and all the liquid is absorbed. }Add the chopped parsley and salt or soy sauce to taste. } Stir in the finely chopped nuts.



Whole Grains

148

Quinoa PilafMakes 6 servings

Ingredients1 T olive oil1 medium finely chopped onion1/2 chopped red bell pepper1 clove minced garlic1 T pine nuts2 cups quinoa, rinsed4 cups low-sodium chicken or vegetable broth1/4 cup chopped parsleySalt and pepper to taste

Directions } In a large pot with a lid, heat oil and cook onions, red peppers and garlic over medium heat for 3 to 4 minutes. }Add pine nuts and quinoa, and cook another 1 to 2 minutes. } Stir in broth and bring to a boil. Reduce heat to low. Cover and simmer for 15 to 20 minutes, until all broth is absorbed. }Add salt and pepper to taste. Add parsley when done.



Barley and Black BeansMakes 4 servings

Ingredients 1 cup barley, cooked according to package directions 1 can (15 ounce) black beans, rinsed1/2 cup corn (thawed if frozen)1 large tomato, diced1/3 cup chopped fresh cilantro2-1/2 T lime juice1 T extra-virgin olive oilPinch of cayenne pepperSalt and freshly ground pepper to taste

Directions }Combine all ingredients in a bowl and mix. } Serve warm or cold.



Whole Grains

149

Strawberries with VinegarMakes 4 servings

Ingredients 1 pound ripe, fresh strawberries1-1/2 tsp red wine vinegar2 tsp sugar

Directions }Hull strawberries, slice and place in a medium bowl. }Drizzle vinegar over them and then sprinkle with sugar. } Stir gently to mix. Cover and refrigerate for 3 hours. } Serve chilled.



Oatmeal Chocolate Chip CookiesMakes about 2-1/2 dozen cookies

Ingredients Cooking spray3/4 cup rolled oats1 cup whole-wheat pastry flour1/2 tsp baking soda1/2 tsp salt1/4 cup trans-fat-free spread, softened1/3 cup white sugar1/3 cup brown sugar1 large egg1 tsp vanilla1 cup chocolate chips

Directions } Preheat oven to 350 degrees F. Coat a baking sheet with cooking spray. }Grind oats in a blender or food processor. Transfer to a bowl and stir in flour, baking soda and salt. } Beat trans-fat-free spread in a large bowl with an electric mixer for 1 – 2 minutes. }Add spread, both sugars, egg and vanilla. Beat until creamy. }Add dry ingredients and continue mixing on low speed until dry ingredients are just combined. Stir in chocolate chips. }Drop the dough by heaping teaspoonfuls, one inch apart, onto baking sheet. } Bake until cookies are firm around the edges and golden brown on top, about 15 minutes.



Sweet Treats

150

Carrot Cake9 servings

Ingredients2 cups firmly packed, finely grated carrots (3 large) Juice of 1 large orange 2 tsp vanilla extract 1/4 cup light olive oil 1 cup honey, liquefied in microwave (30 seconds) 1/2 cup crushed or chopped pineapple, drained 1/2 cup wheat germ 2 cups whole-wheat pastry flour 2 tsp baking soda 1 tsp cinnamon 1/2 tsp ground allspice 3/4 cup walnuts, chopped

Directions } Preheat oven to 350 degrees F. In a mixing bowl, stir together the carrots, orange juice, vanilla, olive oil, honey and pineapple until well blended. } In another bowl, stir together the flours, baking soda and spices. Mix in the walnuts. } Blend the dry ingredients into the carrot mixture, stirring until just mixed. } Pour the batter into a nonstick 8-inch-square baking pan and bake for 45 to 60 minutes — until a knife inserted in the center comes out clean. } Remove from oven, let cool slightly and remove from pan.


Source: USDA

Chocolate Zucchini CakeMakes about 24 servings (2"x2")

Ingredients 1 tsp vanilla1/2 cup canola oil1-1/2 cups sugar1 whole egg2 egg whites1/2 cup skim milk1 tsp baking soda2 cups whole-wheat pastry flour1/2 cup wheat germ1/4 cup cocoa powder1/2 tsp cinnamon1/2 tsp nutmeg1/4 tsp salt2 cups grated zucchini

Directions } Preheat oven to 350 degrees F. Combine vanilla, oil, sugar, egg, egg whites and skim milk. } Sift together baking soda, flour, wheat germ, cocoa, cinnamon, nutmeg and salt. Add dry ingredients alternately with zucchini to the first mixture. } Bake for 45 minutes in a 9x13 pan sprayed generously with cooking spray.


Source: USDA

Sweet Treats

151

Pumpkin Spice MuffinsMakes 10 to 12 muffins

Ingredients2 cups whole wheat or whole wheat pastry flour ½ cup sugar 1 tablespoon baking powder ½ teaspoon baking soda ½ teaspoon salt ½ teaspoon cinnamon ¼ teaspoon nutmeg 1 15-ounce can solid-pack pumpkin ½ cup water 1/3 cup raisins (optional)

Directions } Preheat oven to 375°F. }Mix flour, sugar, baking powder, baking soda, salt, cinnamon and nutmeg in a large bowl. }Add pumpkin, ½ cup of water and raisins. Stir until just mixed. } Spray baking cups with cooking spray, then spoon batter into each one. Fill to just below the top of each baking cup. } Bake 25 to 30 minutes, until tops of muffins spring back when touched lightly. } Remove from oven and let stand 5 minutes, then remove from pan and cool on a rack. Once cool, place muffins in airtight container for storage.

Nutritional information per serving (1 muffin)Calories: 131kcal; Fat: 1g; Protein: 3g; Carbohydrates: 31g; Sodium: 236mg

Sweet Treats

152

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M44984-A 12/13 © 2013 United HealthCare Services,

Insurance coverage provided by or through UnitedHealthcare Insurance Company or its affiliates. Administrative services provided by UnitedHealthcare Insurance Company, United HealthCare Services, Inc., or their affiliates. For informational purposes only. UnitedHealthcare does not diagnose problems or recommend specific treatment. The information provided in this document is not a substitute for your physician’s care. Services and medical technologies referenced herein may not be covered under your plan or be available in all states or for all groups.

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