1. food and drink

How to run your own community
weight management programme!
COMMUNITY WEIGHT MANAGEMENT
This weight management pack has been developed and produced by NHS Forth Valley Community Dietitians.
The material used in this pack has been adapted from the Overweight Management Resource Pack, Dietetic Department, NHS Forth Valley.
Contact Details:
If you have any queries about running this weight management programme or require further details regarding any aspect of this resource,
please contact:
Community Dietitian
Department of Nutrition and Dietetics
NHS Forth Valley
Euro House
Wellgreen Place
Stirling
FK8 2DJ
Tel: 01786 431155
You can also find more information on our website, log onto
www.nhsforthvalley.com
click on health services and select health promotion then select preferred department e.g. Nutrition, HIRS, Oral Health etc.
1
INTRODUCTION
This resource pack has been designed to support communities who wish to run a weight management course.
It aims to give those facilitating the course, whether they have a healthcare background or not, the confidence to plan and deliver weight management
sessions.
The pack provides some basic nutritional information and includes a 10 week session planner, which offers the facilitator of the course a step by step
outline for each week of the course. The session planner provides a programme outline, this should equip the group leader(s) with ideas of suitable
activities to run within the group and ideas for discussion. These are not rigid or set in stone but have been written in a flexible format to ensure they
can be used within various group settings. All the material included within this resource pack is photocopiable.
FACTS AND FIGURES
Obesity continues to be a growing problem in the UK. ‘Obesity has grown by 400% in the last 25 years and on present trends will soon surpass smoking
as the greatest cause of premature loss of life.’ 1 These types of worrying statistics clearly illustrate that something needs to be done to address this
growing problem.
QUESTIONS TO CONSIDER
At present what is being done in your community to promote healthy living?
Could more be done?
Are any workers/volunteers keen to lose weight?
What initiatives could be carried out in your community to address this national epidemic – obesity?
2
This RESOURCE PACK is an excellent starting point. It can equip community workers with the necessary tools to run their own weight
management programme.
WEIGHT MANAGEMENT - SOME BACKGROUND INFORMATION
Weight management is an issue for everyone – it’s about keeping control over our weight – striving to be an ideal weight for healthy living. The most
effective approach to weight loss is by dietary modification, encouraging healthy eating and by increasing physical activity levels.
GETTING AND KEEPING YOUR WEIGHT BALANCED
If the energy (calories) you eat is more than the energy (calories) you use up, excess energy is converted and stored as fat. If this occurs over some time,
weight gain is inevitable. On the other hand if the energy (calories) you eat is less than the energy (calories) you use up, then fat stores are broken down
and used, weight loss occurs. If the energy (calories) you eat equals the energy (calories) you use up, your weight remains the same.
Just a small increase in the amount of food you eat over and above your needs can result in a significant weight gain over time.
2 plain biscuits every breaktime for a year can result in a gain of 6-7lbs or 3kgs.
One can of fizzy (non-diet) drink or a packet of crisps every breaktime for a year can result in a gain of 8-9lbs or 4kgs.
MAKING SMALL CHANGES OVER TIME TO INCREASE PHYSICAL ACTIVITY AND
EAT MORE HEALTHILY WILL HELP WEIGHT LOSS.
IS YOUR WEIGHT IN BALANCE?
Two methods can be used to identify individuals whose health is at risk due to their weight.
Calculating the Body Mass Index (BMI)
Measuring waist circumference
APPENDIX 3 GIVES DETAILS OF HOW TO WORK OUT BMI AND HOW TO MEASURE WAIST CIRCUMFERENCE ACCURATELY.
IF OVERWEIGHT, HOW MUCH WEIGHT SHOULD BE LOST?
If BMI is 25 or over or if the waist circumference appears too high then weight loss should be considered.
Aim: to lose between 5-10% of your current weight. For example if you weigh 80 kgs you should aim to lose 4-8 kgs. Refer to weight conversion chart to change
into stones and pounds.
to lose 0.5-1 kg (1-2lbs) each week.
3
EATING FOR HEALTH
Bread, other
cereals and
potatoes
Have 5-9 small
portions of bread,
cereals, pasta, rice
and potato each day.
The ‘Eatwell’ plate is a nationally recognized model
which should be used as a tool in any healthy eating
session. It should be used to promote the concept of a
healthy diet. This model was developed to help people
understand and begin to enjoy healthy eating.
It visually illustrates the type and proportions of foods
required to achieve a healthy and well balanced diet.
N.B. This model should not be used for children under
the age of 5 years.
This picture shows a plate divided into 5 main food
groups.
Bread, other cereals and potatoes
Fruit and Vegetables
Milk and Dairy
Meat, Fish and alternatives
Fatty and Sugary Foods
It important to choose a wide variety of food from the
first four food groups in order to ensure our bodies are
being supplied with the vital nutrients it needs in order
to function properly.
Foods from the fifth group, the fatty and sugary food
group, are not essential for good health but they can be
included in moderation in a balanced diet.
Achieving this balance between the various food
groups does not have to be at every meal time but
ideally should be achieved over the course of each
day.
Fruit and
Vegetables
Have at least five
portions of fruit
and vegetables
each day.
Meat, Fish and
Alternatives
Choose 2-3 small
servings of meat, fish,
eggs, beans, nuts, pulses
or soya products each
day.
Fatty and Sugary
Foods
Take very small
amounts of fat and
sugar containing
foods.
© Crown copyright materials is reporduced with the permission of the
controller of HMSO and Queen’s printer for Scotland
Milk and
Dairy
Choose 2-3
small servings
of lower fat
milk and dairy
products each
day.
4
FIVE FOOD GROUPS
FOOD GROUP
FRUIT AND VEGETABLES
Fresh, frozen, canned or dried.
A glass of pure fruit or vegetable
juice also counts.
BREAD, OTHER CEREALS
AND POTATOES
Breads and rolls (white and
wholemeal) pitta breads, naan
bread, bagels, tortilla wraps,
chapattis, teacakes, cracker
biscuits and scones, potatoes,
other cereals - pasta, rice,
noodles, oats and cous cous.
MAIN NUTRIENTS AND FUNCTIONS
KEY MESSAGES
Fibre > Healthy gut, reduces cholesterol, fills you up and can help
weight loss.
Vit C > Helps fight infections, improves wound healing, helps
body absorb iron.
Folate > Reduces risk of heart disease
Carotenes > Good Vision, growth and tissue repair.
Eat a wide variety of fruit and Starch (Carbohydrate) > Provides energy, helps brain work.
Fibre > Healthy Gut, reduces cholesterol, fills you up and can help
weight loss.
Calcium > Healthy Bones and teeth, essential for growth.
Iron > Helps fight infections, healthy blood, growth and
development.
Eat something starchy at every vegetables
Eat plenty aim for at least 5 times a day.
Avoid adding fat, sugar or salt in cooking and serving.
meal.
Always have a breakfast.
Try to choose wholemeal, wholegrain, brown or high fibre varieties whenever possible.
Try to avoid:Fried foods too often for instance
fried rice, chips etc.
Adding too much fat i.e. thick
spreadings of margarine or butter.
Adding rich, creamy or cheesy sauces.
5
FIVE FOOD GROUPS
FOOD GROUP
MILK AND DAIRY
PRODUCTS
Milk, cheese, yoghurt and
fromage frais.
MEAT, FISH AND
ALTERNATIVES
Beef, lamb, pork, offal (liver,
kidney) chicken, turkey, eggs,
white fish, oily fish - salmon,
pilchards, sardines, herring, tuna,
fish fingers, fish cakes, baked
beans, kidney beans, lentils, nuts,
soya, tofu. Sausages, salami, pate
and beefburgers may have a high
fat content.
MAIN NUTRIENTS AND FUNCTIONS
KEY MESSAGES
Protein > Growth, maintenance and repair of body tissues.
Calcium > Healthy Bones and teeth, essential for growth.
Vit A > Helps fight infections, Promotes wound healing.
Vit D > Helps Body absorb Calcium, promotes healthy bones and
strengthens teeth.
Eat and drink moderate Protein > Growth, maintenance and repair of body tissues.
Iron > Helps fight infections, healthy blood, growth and
development.
Magnesium > Helps protect against heart disease, lowers high
blood pressure.
Vit B12 > Lowers risk of heart disease, helps to reduce depression.
Other B Vits > May help improve mood and help lift depression.
Help prevent heart disease and strokes.
Eat moderate amounts
Choose lower fat versions amounts
whenever possible.
Choose lower fat versions For instance semi-skimmed or
skimmed milk, low fat yoghurts or
fromage frais and lower fat cheeses
- edam, half fat cheddar, camembert,
cottage cheese.
whenever possible.
Avoid adding too much fat and salt in cooking and serving.
Trim off any visible fat remove skin off chicken and eat fish without batter.
6
FIVE FOOD GROUPS
FOOD GROUP
FATTY AND SUGARY
FOODS
Butter, margarine, low fat spreads
and other cooking fats and oils
and ghee. Salad dressings and
mayonnaise, cream, chocolate,
crisps, biscuits, pastries, cake,
puddings, ice cream, sauces and
fatty gravies, sweets, jam and
sugar, fizzy drinks (non-diet) and
fruit squash (non-diet).
MAIN NUTRIENTS AND FUNCTIONS
KEY MESSAGES
Eating fatty foods frequently, particularly saturated fat can lead to
progressive weight gain and can increase the risk of heart disease
and strokes. Saturated fat is usually hard at room temperature and
usually from an animal source. For example lard, butter or the fats
off meat or products containing these fats. Fatty foods contain
some vitamins and essential fatty acids.
Eat less fatty and sugary foods.
Watch out - sugar can be Although sugar adds sweetness and flavour to foods and drinks
eating sugary foods frequently can lead to excessive weight gain and
tooth decay.
NB: Diet, No Added Sugar drinks and Fruit Juices contain acids
which could lead to dental erosion. The best choices for good
dental health are either plain water or milk.
Sugar has no nutritive value and is often referred to as an ‘empty’
source of calories.
referred to various other names on food labels for instance brown sugar, dextrose, glucose invert sugar etc... They are all types of sugar - so try to limit intake.
Choose lower fat versions whenever possible. Watch out low fat foods and drinks can be rich in calories due to a high sugar content.
There are different types of fat - the main message is to - reduce total fat intake!
Choose fats and oils containing monounsaturates (olive oil or
rapeseed oil) or polyunsaturates
(sunflower or corn oil) but still use
them sparingly, as they are all rich in calories.
Butter and margarine contain the same calories. Use a low fat spread if you wish to save the calories.
7
HEALTHY EATING – MAIN MESSAGES
Eat a variety of different foods.
Eat plenty fibre rich, starchy foods at every meal – for instance bread, rice, pasta, potatoes or cereals.
Eat 5 fruit and vegetables every day... try fresh, frozen, tinned, dried or juiced!
Eat breakfast everyday.
Eat fish more often, particularly oily fish – aim to eat oily fish once or twice a week.
Halt the salt – sprinkle less and taste more!
Drink more water.
Don’t eat too many foods that contain a lot of fat.
Don’t have sugar or sugary foods or drinks too often.
If you drink alcohol, drink sensibly!!!
8
SETTING UP YOUR COMMUNITY WEIGHT MANAGEMENT PROGRAMME
POINTS TO CONSIDER
WHO SHOULD FACILITATE THE PROGRAMME?
Anyone in your Community who has an interest in weight management could run this 10 week programme. The facilitator does not have to have a healthcare
background but would be beneficial if they have completed the ‘Food and Health’ course. There is a programme outline for each of the 10 sessions – containing
ideas of activities to run and details of the resources and materials required.
A group of friends in your community could even get together and run with the programme – in this case it is best that someone takes the lead and co-ordinates the
sessions.
LOCATION AND TIME
If time permits, arrange for the group to go for a 10 minute walk at the end of each session.
Each session takes around 30-45 mins to deliver and could be run either weekly or fortnightly.
Schedule sessions at a time and location that suits all participants.
Ensure participants are well informed about the location and time of the course.
Allow adequate time to run each session and ensure you have enough time to set up the room.
GROUP SIZE
Ideally there should be between 6-10 people in the group.
PLAN AHEAD
Be realistic – it can take several weeks to order and receive relevant resources to run a session. So take time and plan ahead.
COST
Consider charging a small fee to attend each session. This could either be donated to charity or used as an incentive – the person who loses the most weight over
the duration of the programme wins all the money – Lose lbs to gain ££££’s!!!!
As an incentive, charge group members £10 on week 1 then at the end of the 10 sessions give back £1 for each week of attending, for instance if someone
attends for 8 out of the 10 weeks they would get £8 back. Any remaining money could be donated to charity.
PROMOTION
Allow enough time to promote the course.
Advertise the course through posters, fliers, community newsletters or by word of mouth.
9
Session 1
10
SESSION 1 - INTRODUCTION OVERVIEW
Introduction
Welcome
Ground Rules
Confidential
Buddying Scheme
Ice Breaker
My Favourite Food
Group Activity
Why do I want to lose weight?
What influences my food intake - H Diagram A1 Poster on Wall (Appendix 2)
Next Week
Handout blank Food Diaries (Appendix 4) to be completed and brought back next week.
Waist - Weigh In
Display Appendix 3 next to scale and tape measure.
Handout Weight Record Card
11
Subject
Week 1 - INTRODUCTION
Resources
Introduction
Introduce yourself to the group.
Yourself
Overview
of 10 Weeks/
Give a brief outline of the programme.
Give a programme as a
handout.
Commitment
Nobody is to have more than 2 absences. Ask if anyone can foresee any difficulties with that.
The Contract/
State that you need everyones commitment to the programme.
Check that everyone understands the importance for the whole group, of their regular
attendance, and is ‘signed up’ to their contract with you. That is they MUST attend at least 8 of
the 10 sessions.
Set Ground
Rules
Emphasize the importance of setting ground rules.
Responsibility
Explain to the group that their decision to attend the programme and whether or not it works
for them is in their own hands. Nobody else can be blamed for any apparent failures be it
partners, family members, friends, other group members or indeed the facilitators. Equally
everyone is responsible for their own successes so they can congratulate themselves when things
go well.
Emphasise all information is confidential and anything discussed within the group should
remain unrepeated. Group members should arrive promptly, should be encouraged to listen to
others, avoid interupting, involve everyone and should not be judgmental or condescending.
12
Subject
Week 1 - INTRODUCTION
Buddying
Scheme
Support and encouragement is a key element of losing weight. It is a good idea to swap
names and phone numbers or buddy up with a friend or work colleague.
Ice Breaker
Ice breakers can help people introduce themselves and may make them feel less anxious about
speaking aloud within the group.
See Appendix 1 ‘Ice-Breaker’
Reasons to lose weight may be: you are keen to feel fitter and healthier, have more energy,
feel more comfortable in your clothes, drop a size, get into a new outfit, play more with the
children, want to look better in a bikini for a holiday coming up, improve self-confidence.
See Appendix 2 How confident am I
about making healthy
choices.
Group
Activity
Why Do I Want
to Lose Weight?
Ask group members to take 5 minutes to write on post its or use flipchart.
After 5 minutes pull group back together - ‘How confident am I about making healthy
choices’. This can be quite personal - ask people to share any ideas they have with the rest of
the group, only if they wish.
What influences
your food intake?
Resources
Flipchart for
brainstorming.
Flipchart pens, post-it
pads/pens/pencils.
Make sure you are losing weight for the right reasons and for yourself, not because someone
else thinks you should.
Divide group into smaller groups of 2 or 3s. Ask them to take 5 minutes to think about things
that influence their food intake - use the ‘H’ Diagram. What makes it easy - what makes it
difficult.
See Appendix 2 - H
Diagram. What
influences food intake?
13
Subject
Week 1 - INTRODUCTION Group
Activity
Ask group to feedback on their ideas they gathered on what factors they feel influences their
food intake.
Factors which influence food intake may be:
Here are some ideas to share with the group, after their brainstorming session:- boredom, stress,
anxiety, anger, comfort, tiredness, habit, availability, sight and/or smell of food, to be sociable,
time of day, advertising, hunger, hormones, depressed - feeling down, greed, alcohol, laziness i.e.
to prepare healthy foods.
Next
Week
Resources
‘Appendix 2’ - H
Diagram either on wall
or individual.
Most people don’t tend to eat because of hunger, but they eat in response to other feelings
mentioned above. If people are more aware of the reasons why they overeat then they can
concentrate on these and try to combat them, which in turn should help prevent them from
continuously reaching for food when in reality they are not even hungry.
Ask group members to carry out a dietary recall excercise and bring it along next week. Ask
them to record everything that they ate or drank yesterday i.e the day before starting their new
healthier eating regime. Note a typical days dietary intake up until now. Analysisng this next week
should help give a true picture of what you were eating and drinking, as well as ideas of what
you could change. During this first week, try to make a few changes to your dietary intake. Refer
to the Eating for Health handout for general tips on healthier eating.
Writing down what you eat helps you become aware of your actual dietary intake. People are
often surprised to see in ‘black and white’ what they have actually eaten in a day. Becoming
aware of what you are eating and how much you are eating is an excellent starting point for losing weight. Buy a small notebook and jot it down as you go or write it up at the end of a day.
NB: Remember to try to be honest with yourself and remember the odd snacks you had!
‘Appendix 4’ - A
blank diary for each
group member.
Handout
‘Eatwell. your guide to
healthy eating’ available
from HIRS.
See Resources Table.
(pages 76-78)
14
Subject
Waist and
Weigh In
Week 1 - INTRODUCTION Discuss with group members the procedures of the weekly weigh in.
Point out where scales and tape measures will be set out each week. Encourage group members
to weigh themselves either weekly, fortnightly or on week 1, 4, 6 then week 10. This encourages
group members to take responsibility for their own weight, and also helps evaluate the success
of the programme. Some individuals may wish to be weighed by the facilitator - they may feel
that this would increase their motivation.
The facilitator should record individuals weights on week 1 and 10 as a measure of
success.
If you lose a pound in a week this is equivalent to a 500g tub of butter.
Explain to the group that in order to lose weight you need to burn off more calories than you
take in. So eating less food and increasing your physical activity levels work well together and
help you lose weight.
Refer to instructions on Appendix 3 - A laminated A3 poster of Appendix 3 has been included
within this pack. This should be displayed in a prominant position - beside the scales - for those
who wish to weigh themselves. It provides a step by step guide to calculating Body Mass Index
(BMI) and taking weight and waist measurements.
Resources
‘Weight Record Card’
- Available from HIRS
- See Resources Table
(pages 76-78)
‘Appendix 3’ for
materials required.
‘Laminated A3 poster’
- Appendix 3
- Pin up on wall next to
scales and tape measure.
‘Appendix 4’ - A blank
diary for each group
member.
Butter - 500g Tub
Take individuals weights, calculate Body Mass Index, take waist measurement and calculate the
amount of weight they should aim to lose (10%). Record all these details in the weight record
card.
Encourage group members to bring their Weight Record Card each week.
15
APPENDIX 1
MY FAVOURITE FOOD
This ice breaker acknowledges that everyone enjoys eating and sets the scene for talking openly about indulgent foods.
PURPOSE/AIM:
To give participants an opportunity to:
introduce themselves to each other
speak
reveal something about themselves.
MATERIALS AND PREPARATION:
A blank sticky label or post-it plus coloured pens/pencils for each member of the group.
THE ACTIVITY: (15 mins)
Each person is given a sticky label/post-it and are then asked to write their first name on it and to draw a picture of
their favourite food. Participants are then asked to introduce themselves and explain what they have attempted to draw.
16
H Diagram
What makes it
easy to choose a
healthier lifestyle?
How confident am I about
making healthy choices?
How much control do we have
over what we eat and physical
activities.
No Control
0
APPENDIX 2
What makes it
difficult to choose a
healthier lifestyle?
Full Control
10
Can you identify changes
you could make towards
healthier choices?
1.
2.
3.
4.
17
THE MOMENT OF TRUTH – WAIST/WEIGH IN
Have To Hand:
Set of Scales (Same scales each week)
BMI Chart (on back of Weight Record Card)
Weight Record Cards for each Group member
Calculator
APPENDIX 3
Weight and Height Conversion Charts (Included within this pack)
Tape Measure
WEIGH – IN
1.
2.
3.
4.
5.
6.
Weigh yourself on the scales provided (Remove your shoes first)
Convert your weight into kilograms using the conversion chart.
Convert your height into metres using the conversion chart.
Take your weight in kilograms and divide by height in metres, then divide by the height again - this will reveal your Body Mass Index (BMI).
Record your Weight and BMI in your Weight Record Card – Remember to put the date next to your weight.
What Category do you fit into?
Underweight
Okay
Overweight
Obese
Very Obese
BMI less than 18.5
BMI of 18.5 to 24.9
BMI of 25 to 29.9
BMI of 30 to 39.9
BMI of 40 and over
BODY MASS INDEX (BMI) is used to determine how much you weigh in relation to your height. There is a BMI Chart on the back of your
Weight Record Card. To find out your BMI on the chart draw a line horizontally across the chart at your height and a line vertically up from your
weight. Where the two lines intersect - this will reveal your BMI.
Try not to weigh yourself too often – once a week at the same time of day (mornings are best) is enough.
Aim to lose 1-2lbs (0.5-1Kg) each week.
18
WAIST COUNTS
APPENDIX 3
1. Measure your waist using the measuring tape. Measure midway between your hips and ribs, making sure the tape measure is straight and
snug but not ‘digging in’ to the skin. Measure after breathing out.
2. Record your waist measurement on your Weight Record Card.
3. What category do you fit into?
Women - Ideal Increased Health Risk
High Risk
Less than 80cm (32 inches)
80cm (32 inches) or more
88cm (35 inches) or more
Men -
Ideal
Increased Health Risk
High Risk
Less than 94cm (37 inches)
94cm (37 inches) or more
102cm (40 inches) or more
ARE YOU AN APPLE OR A PEAR?
It is not just the quantity of body fat that counts but also how it is distributed in our bodies.
Waist size is a good indicator of your general health and your exposure to health risks such as heart disease, diabetes and high blood pressure.
People who are pear-shaped with excess fat on their hips and thighs seem to be less at risk of heart disease than people who are apple-shaped
and carry their weight around their abdomen.
As your waist gets bigger, your risks to health increase.
Remember any reductions in your waist measurement - is a step in the right direction!!
19
FOOD DIARY
Write down everything you ate or drank yesterday?
APPENDIX 4
Be honest with yourself!! – Remember to note down all the little extras you had!
Be as accurate and descriptive as possible – For example if you had toast at breakfast was it one or two slices – was it white or wholemeal bread and
what did you put on it.
TIME
FOOD + QUANTITIES
DRINK + QUANTITIES
Early Morning
Breakfast
During Morning
Midday
During Aternoon
Evening Meal
During Evening &
Before Bed
Extras During Night
20
Session 2
21
SESSION 2 - EATING FOR HEALTH AND FOOD DIARY OVERVIEW
Welcome
Weigh - In - Appendix 3
Group Activty Set Personal Goal(s)
Food Diary and Handout Empty Plate (Appendix 5 & 6)
Next Weeks Reminder
What to do and what to bring?
22
Subject
Week 2 - FOOD DIARY & EATING FOR HEALTH
Resources
Welcome
Welcome everyone back to the session.
Weigh-In
As each group member arrives, ask if they wish to weigh themselves. Ask group members to log
their weight and waist circumference in their Weight Record Card.
‘Weight Record Card’
Group
Activity
Writing down what you eat helps you become aware of your actual dietary intake. People are
often surprised to see in ‘black and white’ what they have actually eaten in a day. Becoming
aware of what you are eating and how much you are eating is an excellent starting point for losing weight. Buy a small notebook and jot it down as you go or write it up at the end of a day.
‘Appendix 5 - Food
Diary’
Food Diary
NB: Remember to try to be honest with yourself and remember the odd snack you had!
‘Appendix 6 - Empty
Plate’
Ask group members to analyse their diet diaries.
They should go through their food diary and put each food and drink into the appropriate food
group section on Appendix 6.
For example a bowl of Fruit and Fibre with semi-skimmed milk at breakfast write Fruit and
Fibre in cereal section and the milk in the dairy section and so on.......
Allow approximately 10 minutes for this exercise.
23
Subject
Week 2 - FOOD DIARY & EATING FOR HEALTH
Resources
Group
Activity
Once everyone has their plate completed - individuals can review their own dietary intake and
see how many times in the day they’ve eaten something from the fruit and vegetables section or
how many times in the day they’ve eaten a starchy food and so on.
Handout
‘Are you getting the
balance right? What is
a portion? - Available
from HIRS - Refer to
Resources Table (pages
76-78)
Questions to raise to the group, (no need to answer)
Have you all reached at least 5 portions of fruit and vegetables in the day?
How many foods do you have in the fatty and sugary food section?
Did you eat something starchy at each meal?
Were there any sections blank at the end of the exercise?
Eating for
Health
Eatwell plate model is a nationally recognised model - it should be used to illustrate a well
balanced diet. This model was developed to help people understand and begin to enjoy Health
Eating. It illustrates the five different food groups. Those people trying to lose weight often find
it difficult to gauge portion sizes, the ‘what is a portion?’ leaflet should help as a guide.
Comparing food diaries with this model should help highlight areas of our diet which could
change for the better! For example if you have 4-5 items in the fatty sugary section this maybe
an area you should focus on - limit to 1 treat a day! Or maybe you only had 2 portions in the
fruit and vegetable section - aim for 5 each day.
Make
S.M.A.R.T
Changes
Keeping food and activity diaries can make individuals more aware of their current habits and
can help individuals focus on their lifestyle and highlight areas which could be changed for the
better.
Optional
‘Eating for Health
Floor Mat and Food
Models’ - Available
from HIRS - Refer to
Resources Table.
(pages 76-78)
‘Eating for Health
Poster’ - Available from
HIRS - Refer to
Resources Table.
(pages 76-78)
Handout
‘Just what you have
been weighting for’
- Available from HIRS
- Refer to Resources
Table. (pages 76-78)
24
Subject
Week 2 - FOOD DIARY & EATING FOR HEALTH
Make
S.M.A.R.T.
Changes
When individuals are setting themselves personal goals to reach - encourage them to make
S.M.A.R.T. changes. That is changes which are S (Specific), M (Measurable), A (Achievable),
R (Realistic), T (Time-limited).
Resources
Bear in mind people need help to prepare and set realistic goals. The process of change is not
an easy process.
Making changes for a few weeks can start off well but maintaining the changes needs continued
effort. This is where the value of group support comes in.
If people fail to reach a set goal, it is important to look at the reasons why they haven’t managed
to achieve it and address these issues. Relapses should not be seen as a catastrophe - it is
perfectly normal.
Setting
Personal
Goals
Ask group members to take a few minutes to think carefully about setting 1 personal goal for
the week - bearing in mind the group activity carried out in this weeks session.
This setting personal goals exercise will be done at the end of each weekly session.
At the end of the 10 week programme, individuals will have a set of 10 personal goals. The idea
being that these could be expanded or built upon over time.
Appendix 2 - The H
Diagram from last
week could be revisted
to prepare for goal
setting.
25
Subject
Week 2 - FOOD DIARY & EATING FOR HEALTH
Setting
Personal
Goals
Examples of Goals
I will eat a piece of fruit instead of a biscuit every morning at breaktime.
I will park my car at the furthest away parking space from the office and walk more everyday this week.
Next Week
Resources
People often find they stick to a goal more easily if it is personal to them, if they actually write it down and make it quite specific. For example don’t just plan to cut down on biscuits write down
exactly how many you’ll have each day or week, in what situation and which more nutritious foods
you’ll choose instead. It can also help to plan a non food reward for yourself once you have achieved
say a few small goals. For example a manicure, a trip to the cinema.....
Remind group members to bring their copies of ‘Just what you’ve been weighting for!’ and
‘Weight Record Card’ next week.
26
FOOD DIARY
Write down everything you ate or drank yesterday?
APPENDIX 5
Be honest with yourself!! – Remember to note down all the little extras you had!
Be as accurate and descriptive as possible – For example if you had toast at breakfast was it one or two slices – was it white or wholemeal bread and
what did you put on it.
TIME
FOOD + QUANTITIES
DRINK + QUANTITIES
Early Morning
Breakfast
During Morning
Midday
During Aternoon
Evening Meal
During Evening &
Before Bed
Extras During Night
27
Br
ea
d,
Ce
re
es
l
b
a
t
ge
t
ui
Fr
nd
als
Ve
an
dP
ot
Drink
ato
e
a
Me
Al at, F
te ish
rn
ati and
ve
s
APPENDIX 6
s
Fatty and Sugary
Foods
iry
a
D s
d
n uct
a
ilk rod
M P
Session 3
29
SESSION 3 - PRACTICAL SESSION


Quick and easy snacks, tips etc.
To be arranged and discussed by group - either a demonstraton, participatory or at least discussion or ways of changing foods.
A Quick Pizza
Base: use pitta bread, baguettes, naan bread,
bagels, scone.
Spread: use tomato puree or chopped
tomatoes and sprinkle with mixed
herbs or spices.
Toppings:
use pineapple, sweetcorn, mushrooms,
peppers, spring onions.
Select additional toppings eg cooked ham,
tuna, pepperoni, cooked chicken.
Grated cheese: 2 dessertspoons of grated
edam or cheddar.
To Make It: preheat oven to gas mark 7 or
220 degrees celsius. Spread puree on to the
base. Top with vegetables and small amount
of meat. Sprinkle with grated cheese on top.
Cook in oven for 10-15 minutes.
Quickie Lentil Soup
2 mugs hot water
½ ham stock cube
2 dessertspoons of lentils
1 small potato chopped
½ mug of frozen mixed vegetables
To Make It : put water into a medium sized pot and
dissolve stock cube, add lentils and allow to boil for
5-10 minutes. Chop the potato and add to the pan
with the rest of vegetables. Simmer for about 30 minutes till vegetables are well cooked. Leave chunky or
mash with a potato masher.
Tips: you could use fresh chopped vegetables eg
chopped carrot, turnip and leek.
Spicy Salsa
4 medium tomatoes, skinned and chopped finely or ½
tin (400g) of tomatoes.
3 inch piece of cucumber chopped finely.
2 spring onions, chopped finely .
1 red chilli, de-seeded and chopped finely or 1 teaspoon
of chilli paste.
1 teaspoon of lemon juice.
Potato Wedges
1 medium/large potato
1 dessertspoon of olive oil
To Make It: preheat oven to gas mark 7 or 220
degrees celsius. Cut potato lengthways into 4-6
wedges. Place in a tub, small pot with lid or food
bag. Add oil, give a good shake (you could add
garlic, herbs or chilli powder at this stage). Place
on a baking tray and cook in hot oven for about
30 minutes.
Fruity Crumble Tumbles
3 pieces of tinned fruit in own or fruit juice
(drained) try pears, peaches, pineapple, apricots
2 dessertspoons of greek style natural yoghurt
2 dessertspoons of cereal e.g. shreddies,
cornflakes, rice krispies
To Make It: chop the fruit into small chunks, place
in the bottom of a small bowl or cup. Spoon greek
style yoghurt on top of the fruit. Top with cereal
(can be crushed if you like)!
To Make It: mix it all together, leave for a short while in
the fridge to let the flavours mix.
30
Session 4
31
SESSION 4 - PHYSICAL ACTIVITY OVERVIEW
Welcome
Waist and Weigh - In - Appendix 3
Feedback /Reflection
Group Activty Set Personal Goal(s)
Benefits of physical activity
Barriers to exercising
Ways to increase activity levels at work
Next Weeks Reminder
What to do and what to bring?
Bring in 1 or 2 food labels
Weight Record Card
32
Subject
Week 4 - PHYSICAL ACTIVITY
Welcome
Welcome everyone back to the session.
Congratulate group members on attending half of the 10 week course.
Resources
‘Get fitter is easier
than you think’
‘Hassle free exercise’
‘Walk more feel the
difference’ - Leaflets
Refer to Resources Table
(pages 76-78)
Weigh-In
As each group member arrives, ask if they wish to weigh themselves. Ask group members to log
their weight and waist circumference in their Weight Record Card.
‘Weight Record Card’
Feedback on
Personal
Goals
Ask people to reflect back to last weeks personal goals - did they manage to stick to their goals any difficulties and how did they overcome these obstacles. Encourage group members to share
their experiences.
Refer to H Diagram if
appropriate - Appendix
2
Group
Activity
Divide group into smaller groups of 2 or 3’s and ask groups to think firstly about the many
benefits that can be gained from being more active.
Flipchart and pen for
brainstorming.
Benefits of
After 5 minutes bring group back together and brainstorm as a group.
‘Appendix 7 - Physical
Activity’
Exercise
May want to share these ideas below after the groups have thought for themselves:
Exercise helps improve suppleness, stamina, sleep patterns, helps control stress and anxiety improves relaxation, increases energy levels, makes you feel more alert, improves self
confidence, tones up muscles and helps improve body shape, can speed up weight loss, helps
reduce blood pressure and helps prevent heart disease and reduce your risk of bowel cancer and
osteoporosis, it can also be fun!
33
Subject
Week 4 - PHYSICAL ACTIVITY
Group
Activity
Divide group into the same smaller groups - ask them to jot down a few barriers or obstacles
they face when thinking about exercising and then think of ways they could increase their
physical activity levels without attending a leisure centre or exercise class.
Resources
Flipchart and pen for
brainstorming exercise.
May want to share these ideas with the group after their individual brainstorming
sessions:
Barriers to
Exercising
Despite all the benefits associated with exercising most people don’t exercise enough. There are
many reasons for this:- lack of time, lack of confidence, lack of appropriate leisure facilities and
equipment, self consciousness about body shape, no money, nowhere to leave the children, cultural barriers, too tired, bad weather, dark nights, boring, not co-ordinated.
People should be encouraged to become more physically active in their everyday living, its
never too late to start and the benefits to your health are enormous.
May want to share these ideas with the group after their individual brainstorming
sessions:
Ways to Increase
Activity Levels
Go for a walk with a friend.
Get out with the kids - chase the kids around the garden/park or have a kick around.
Get off the bus a couple of stops early and walk the rest of the way.
When you pop to the local shop, walk rather than taking the car.
Get out into the garden - planting, weeding, digging are good forms of exercise.
34
Subject
Group
Activity
Week 4 - PHYSICAL ACTIVITY Ideas to get the group active:
Set up a walking/jogging group.
Run a competition - use pedometers - who walks the most in your group.
Setting
Personal
Goals
Aim to burn at least 1000 calories a week through extra activities - this equates to 30
minutes brisk walking everyday. If trying to lose weight aim to build up to 60 minutes of
moderate activity on most days of the week.
Resources
See www.pathsforall.org.
uk/pathstohealth/
pedometesr.asp for
suggestions on where to
obtain pedometers.
Ask group members to take a few minutes to think carefully about reviewing or setting new
personal goals for the week - bearing in mind the group activity carried out in this weeks session.
Ask group to write down 1 S.M.A.R.T. goal they wish to focus on.
Write todays date + goals..
Examples of Goals
I will get off the bus 2 stops earlier.
I will walk to the shops to collect the morning papers.
Next Week
Remind clients to bring their ‘Weight Record Card’ next week.
35
APPENDIX 7
BENEFITS OF EXERCISING
BARRIERS AGAINST EXERCISING
WAYS TO INCREASE PHYSICAL ACTIVITY
36
Session 5
37
SESSION 5 - PHYSICAL ACTIVITY WALK
To be arranged with group.
For ideas of local walking routes go to your local council’s website or:www.walking-routes.co.uk
www.thefalkirkwheel.co.uk/visit/walkingroute.html
www.walkswithbuggies.com
www.braveheart.uk.net
www.feetfirstcanalwalks.com
www.pathsforall.org.uk
Next Week
Ask group members to bring along their favourite restaurant or take away menu.
38
Session 6
39
SESSION 6 - EATING OUT / TAKEAWAYS / ALCOHOL OVERVIEW
Welcome
Weigh - In - Appendix 3
Feedback /Reflection
Group Activty Set Personal Goal(s)
Eating Out Made Healthier - Takeaways - Appendix 8
Takeaway Game - Appendix 9
Alcohol Questionnaire - Appendix 10
Next Weeks Reminder
What to do and what to bring?
Bring in a recipe or packaging of your favourite dish.
Weight Record Card
40
Subject
Week 6 - EATING OUT - TAKEAWAYS- ALCOHOL Welcome
Welcome everyone back to the session.
Weigh-In
Take weights of all those who wish to be weighed - direct others to the scales to weigh
themselves. Remind individuals to record their weight in their Weight Record Card.
Feedback on
Personal
Goals
Ask people to reflect back to last weeks personal goals - did they manage to stick to their goals any difficulties and how did they overcome these obstacles. Encourage group members to share
their experiences.
Group
Activity
Eating Out
Made Healthier
Resources
‘Weight Record Card’
Modern lifestyles involves more eating ‘on the run’. Eating out and takeaway are eaten regularly
by some. If it’s a one off occasion you should eat what you want and enjoy it. Eating out can
cause quite a problem as you don’t know exactly what’s in the meal or how it has been cooked.
In reality alot of takeaways are likely to be rich in fat particularly saturated fat. Don’t be afraid
to ask about ingredients and cooking methods. If you find you are eating out regularly think of
a few strategies that might help you eat or drink less but still enjoy yourself.
Divide the group into smaller groups of 2 or 3’s and ask them to think of some ways to make
eating out a bit healthier.
‘Appendix 8 - Takeaways’
Ideas to share with the group after their individual brainstorming sessions:
Skip a course, avoid creamy, cheesy, fatty dishes, take a small snack before you go out, so you’re
not absolutely starving when you get there, fill up on salad and vegetables, if your drinking
alcohol ask for some water as well, add soda to wine - a long drink lasts longer, choose potatoes
instead of chips or boiled rice instead of fried. Ask waiter for sauce or salad dressings or oils to
be served separately then you can add the amount you want, avoid puddings too often or try a
fresh fruit salad or sorbet.
41
Subject
Week 6 - EATING OUT - TAKEAWAYS - ALCOHOL
Group
Activity
Refer to Appendix 10
Place the cards on a table, so everyone can see, with the name of the meal face up. Give
everyone a blank piece of paper and ask them to write down the meals ranking them 1 to 13. 1
having the most calories and 13 having the least calories.
As a whole group, discuss responses and try to get a consensus. Place cards in the true order and
distribute the handout showing the full list. The calorie values are interesting when
considered in the context of someones daily meal plan/allowance of say 1500 or 1700 calories.
Choose
At the Indian
Plain Naan Bread
Drier dishes - tandoori, karia
and bhuna
Plain boiled rice
Avoid
Creamy dishes - Korma, masala
and dhansak
Deep fried dishes - bhaji, samosa,
pakhora
Pilau rice, biryani, fried rice
Resources
Blank Paper + Pens
Using the material in
‘Appendix 9’ make a set
of 13 individual cards
each with the name of
the takeaway meal on
one side and showing
the calorie and fat intake
on the other.
Have a copy of the full
list for everyone to keep.
At the Chinese
Won-ton soup
Deep fried dishes
Stir fried dishes - vegetables,
Sweet and sour dishes
chicken in black bean sauce
Lemon chicken
Plain rice or noodles
Crispy fried beef or duck
Friend rice, prawn crackers or
sesame prawn roll
At the Mexican
Chicken fajitas
Cajun chicken
Tomato based salsa sauces
and dips
High fat enchaladas
42
Subject
Week 6 - EATING OUT - TAKEAWAYS - ALCOHOL
Group
Activity
Choose
Avoid
At the Italian
Plain crusty bread
Mixed salads/tomato salads
Pasta with tomato, onion and
basil based sauces
Thin based pizzas with
vegetable topping
Creamy or cheese sauces
High fat meats like salami or
pepperoni
Too much cheese such as parmesan
At the Cafe
Homemade soup
Crusty roll
Baked potato (no butter) with
baked beans, vegetable chilli,
curry, tuna(no mayo) or
cottage cheese and order a
side salad
Scone with jam - no butter
Sweeten drinks with artificial
sweeteners
Water is the best option
Too much cheese, coleslaw and rich
meat sauces
Fresh cream cakes, rich pastries or
chocolate cake
Sugar in tea and coffee
High calorie fizzy drinks e.g.
cola, irn bru, lemonade
People often forget the impact that alcohol can have on weight gain. Alcohol is loaded with
Alcohol
calories
1 pint of beer = 180 calories.
1 small glass of white wine = 94 kcals
1 large glass of white wine = 187 kcals A 25ml serving of spirit e.g. whisky = 55 kcals.
Then add calories from mixers e.g. ½ a can of cola contains 70 kcals.
Therefore cutting back on your alcohol consumption means you’ll cut back on your calorie
intake.
Resources
Optional
ALCOFACTS
A Guide to Sensible
Drinking Available from
HIRS - See Resources Table
(pages 76-78)
Sensible Drinking
Available from HIRS - See
Resources Table (pages
76-78)
43
Subject
Week 6 - EATING OUT - TAKEAWAYS - ALCOHOL
Resources
Alcohol
Sensible Drinking
Men - should drink no more than three to four units per day. Consistantly drinking four or
more units per day is not advised. Try to have at least 2 drink free days.
What’s in a drink? The
straight facts about
alcohol. Available from
HIRS - See Resources
Table (pages 76-78)
Women - should drink no more than two to three units per day there. Consistantly drinking
three or more unites per day is not advised. Try to have at least 2 drink free days.
Divide the group into smaller groups of 2 or 3’s again and ask them to answer the7 questions
from Appendix 10. They should answer either TRUE or FALSE. This activity will take around
5-10 minutes. Once everyone has completed bring group together and discuss the answers.
The answers are written in Appendix 10.
Setting
Personal
Goals
‘Appendix 10’ - Alcohol
Questionnaire.
Photocopy Appendix 10
Questions only to
distribute to group
members.
Ask group members to take a few minutes to think carefully about reviewing or setting new personal goals for the week - bearing in mind the group activity carried out in this weeks session.
Ask group members to write down 1 S.M.A.R.T. goal they wish to focus on.
Write todays date + goal.
Examples of Goals
Drink less alcohol this weekend - no more than 3 white wine and sodas.
Only have takeaways once a week and choose healthier options - no chips!!
Next Week
Everyone to bring in a recipe of your favourite dish. Going to be looking at adapting the recipes
to make them healthier.
Remind clients to bring ‘Weight Record Card’ next week.
44
APPENDIX 8
WAYS TO MAKE EATING OUT HEALTHIER
STARTERS TO AVOID
STARTERS TO CHOOSE
MAIN COURSES TO AVOID
MAIN COURSES TO CHOOSE
PUDDINGS TO AVOID
PUDDINGS TO CHOOSE
45
APPENDIX 9
TAKEAWAY GAME
Using the material overleaf, make a set of 13 individual cards each with the name of a takeaway
meal on one side, and showing the calorie and fat values on the other.
Place the cards on a table, with the name of the meal face up. Give everyone a blank sheet of
paper and ask them to write down the 13 takeaway meals in rank order, by calorie content.
That is, write the MOST calorific as number 1 and the LEAST calorific as number 13.
In the whole group, dicuss responses and try to get a consensus.
Place the cards in the true order and distribute the handout overleaf showing the full list.
The calorie values are interesting when considered in the context of someones daily meal plan
of say 1,500 or 1,700 calories.
46
APPENDIX 9
FACTS ABOUT TAKEAWAY MEALS
MEAL (Standard Portion)
Fish and chips
Sweet and sour chicken (battered) and fried rice
Vegetarian pizza (small)
Chicken tikka massala and pilau rice
Fried chicken and chips
Cheeseburger and chips
Bean burger in bun
Baked potato with cheddar cheese and butter
Chicken Deli Sandwich
Donor kebab
Chicken Chow Mein
kcalories
1134
970
936
860
814
663
589
533
410
405
384
Fat (grams)
52
50
27
47
45
29
20
27
11
21
22
Baked potato, cottage cheese and salad
374
5
47
ALCOHOL QUESTIONNAIRE
APPENDIX 10
Answer the following questions either TRUE or FALSE.
1.
Five pints of beer has the same calories as a cheeseburger and fries?
2.
A “beer belly” is only caused by downing too many pints?
3.
Alcohol is measured in units with the recommended maximum intake for men being 3-4 units per day?
4.
If you’re trying to lose weight a good choice is non-alcoholic beer?
5.
When you consume alcohol, you lose more water in your urine than you take in, in the drink itself ?
6.
Switching between beer, wine and spirits will lead to intoxication more quickly than sticking to one type of
alcohol beverage?
7.
There are no health benefits to drinking alcohol?
8.
Write down a few ways that you think you could enjoy drinking without adding to the waistline.
48
ALCOHOL QUESTIONNAIRE
APPENDIX 10
1.
FALSE
The five pints is equivalent to almost 1 and a half cheeseburgers and a portion of fries. With a pint of beer containing about
180 calories per pint or 900 in total whereas the cheeseburger and chips totals about 600 calories.
2.
FALSE
A “beer belly” is caused by eating or drinking too much therefore you don’t need to drink beer to get one but it certainly won’t help it.
3.
TRUE
Currently the recommended intake for men is 3-4 units of alcohol per day. It is also recommended that you have at least one or
two alcohol free days per week. One unit of alcohol is equivalent to:
Men - if you drink 3 or 4 units a day or less, there should be no significant health risks.
Women - if you drink 2 or 3 units a day or less there should be no significant health risks.
4.
FALSE
Non-alcoholic beer actually has the same calories as alcoholic beer: 148 calories in a pint. If you drink a light beer you’ll only take
in around 99 calories per pint. Take care with your choice - a can of extra strong beer or lager is equal to two pints of ordinary
strength beer or lager, or four units of alcohol.
 half a pint of ordinary strength beer or lager
 a small glass of wine
 a single pub measure of spirits
49
ALCOHOL QUESTIONNAIRE
APPENDIX 10
5.
TRUE
Alcohol affects the hormones responsible for fluid balance. As a result, it causes you to pee frequently, losing body fluids. You then feel thirstier so you have another alcoholic drink and so it goes alcohol - pee - thirst and so on. The only way to break the cycle is to have water or another non-alcoholic beverage. Along with the fluids drinkers lose, they excrete important nutrients
as well. It’s one of the main reasons that after a lot of drink you wake up suffering from what is known as a “pain in the hair
roots” in Sweden, “wailing of the cats” in Germany or “a hangover” in Britain.
6.
FALSE
Remember that a standard drink or beer, wine, or spirits contains equivalent amounts of alcohol. Alcohol is alcohol and a drink is a drink.
7.
FALSE
There is some evidence that alcohol taken in moderation may have some health benefits. For men over 40, drinking 1 or 2 units
of alcohol a day may help prevent coronary heart disease. For women who have been through the menopause, drinking 1 or 2
units of alcohol a day may help prevent coronary heart disease.
8.
Suggestions may include:
 Drink Spirits with a diet or low calorie mixer e.g. swap Bacardi and Cola for a Bacardi and Diet Cola.
 Alternate between Alcoholic and Non-alcoholic drink.
 Be careful of the choice of non-alcoholic drink.
 Order half pints instead of pints.
 Add soda water to wine - a longer drink can last longer.
50
Session 7
51
SESSION 7 - MAKING GOOD CHOICES / FOOD LABELS OVERVIEW
Welcome
Waist and Weigh - In - Appendix 3
Feedback /Reflection
Group Activty Set Personal Goal(s)
Food Label Quiz - Guess the Food Game (Appendix 11)
Handout - Your Guide to Food Labels
Next Weeks Reminder
What to do and what to bring?
Weight Record Card
52
Subject
Week 7 - MAKING GOOD CHOICES / FOOD LABELS
Welcome
Welcome everyone back to the session.
Weigh-In
As each group member arrives, ask if they wish to weigh themselves. Ask group members to log
their weight and waist circumference in their Weight Record Card.
Feedback on
Personal
Goals
Ask people to reflect back to last weeks personal goals - did they manage to stick to their goals any difficulties and how did they overcome these obstacles. Encourage group members to share
their experiences.
Group
Activity
Guess the Food
Game
So much of what we buy and eat is now pre-prepared so we simply have to reheat it in the
microwave or put it in the oven for 20 minutes. This means we don’t know exactly what is in it.
Nutritional information printed on food labels sets out the amount of each key nutrient in an
individual food or drink product. This can help you keep track of what your eating.
Handout the quiz and ask people in pairs to guess the food or drink item by looking at the
ingredients list. Explain that the ingredients list is always written in descending order, so the
main ingredient is the first one.
Resources
‘Weight Record Card’
‘Appendix 11 - Food
Label Quiz’
‘Check the Labels’ Refer to Resources Table
(pages 76-78)
Bring group back together and give out the answers to the quiz.
Handout the booklet - ‘Check the Labels’. Hopefully once the booklets have been read the
complex issue of food labelling may become a bit clearer.
53
Subject
Week 7 - MAKING GOOD CHOICES / FOOD LABELS
Group
Activity
Divide the group into smaller groups of 2 or 3’s and ask them to assess the food labels on the
items brought in, using the ‘Check the Labels’ - leaflet. Each small group should have 2 or 3
labels to assess.
Assess Food
Does your food/drink items contain A little or A lot of sugar, fat, fibre?
Labels
Setting
Personal
Goals
Ask group members to take a few minutes to think carefully about reviewing or setting new personal goals for the week - bearing in mind the group activity carried out in this weeks session.
Resources
May be useful to have a
few other labels to hand
just in case some people
forget to bring any in.
This credit card can be stored in your purse or wallet and when out shopping it can be used
as a quick guide to assess the nutrition labels. Remember to use the amounts per 100gms on
the food labels, to compare with the amounts on the credit card - ‘Your Guide to Food Labels’.
Ask group members to write down 1 S.M.A.R.T. goal they wish to focus on.
Write todays date + goals.
Examples of Goals
Pay particular attention to food labels when shopping - take ‘Your Guide to Food Labels’ credit card and compare labels.
Write a shopping list and stick to it. Plan ahead meals for each night of the week.
Next Week
Remind group members to bring and ‘Weight Record Card’ next week.
Also bring in a copy of their favourite recipe.
54
FOOD LABEL GAME
APPENDIX 11
GUESS THE FOOD / DRINK GAME
Look at the following ingredients lists, which have been taken from the labels of various foods and drinks. Try to guess the food or drink and write your answer on the dotted line.
1. INGREDIENTS: Carbonated Water, Sugar (carbohydrate), Colour (caramel E 150d), Phosphoric Acid, Flavourings (including caffiene)
………………………………………………………………................
2. INGREDIENTS: Water, Sweetcorn (3%), Potato Starch, Creamer [Contains Hydrogenated Vegetable Oil, Glucose Syrup Solids, Milk Proteins, Acidity
Regulator (Monopotassium Phosphate) and Emulsifier (E471)], Glucose Syrup, Chicken (1%), Onion, Salt, Flavourings (contain Wheat), Flavour Enhancers
(E621, E635), Parsley, Stabiliser (Xanthan Gum), Colour (Beta-Carotene), Natural Flavourings.
………………………………………………………………................
3. INGREDIENTS: Meat and Animal Derivatives (Turkey min 4%, Chicken min 4%), Cereals, Minerals, Various Sugars.
…………………………………………………………………...........
4. INGREDIENTS: Cereals (34%)(Wheat Flour, Whole Oats, Wheat Bran), Glucose-Fructose Syrup, Apples 8%, Sugar, Vegetable Oil, Humectant (Glycerol),
Maltodextrin, Honey, Dextrose, Stabalisers (Sodium Alginate, Cellulose, Xanthan Gum, Carrageenan, Locust Bean Gum), Calcium Carbonate, Modified Stach,
Dried Skimmed Milk, Salt, Flavourings, Cinnamon, Raising Agent (Potassium Hydrogen Carbonate), Malic Acid, Calcium Phosphate, Citric Acid, Colour Caramel
(E150d), Emulsifier (E472e, E471, Wheat Gluten Starch, Niacin, Iron, Vitamin B6, Riboflavin (B2), Thiamin (B1), Folic Acid, Vitamin B12.
…………………………………………………………………...........
5. INGREDIENTS: Wholewheat, Dried Fruit (28%)(Raisins, Coconut, Banana (Flavouring), Apple, Hazelnuts ) Sugar, Salt, Barley, Malt Flavouring, Niacin,
Iron, Vit B6, Riboflavin (B2), Thiamin (B1), Folic Acid, Vitamin B12.
…………………………………………………………………..
55
FOOD LABEL GAME
APPENDIX 11
GUESS THE FOOD / DRINK GAME
ANSWERS
1. Cola Drink
2. Slim A Soup – Chicken and Sweetcorn
3. Cat Food – Sheba – Delicious morsels of turkey and chicken.
4. Kelloggs Nutrigrain Bar – Apple
5. Kelloggs Fruit and Fibre Breakfast Cereal
56
Session 8
57
SESSION 8 - RECIPE ADAPTATION OVERVIEW
Welcome
Weigh - In - Appendix 3
Feedback /Reflection
Group Activty Set Personal Goal(s)
Recipe Adaptation (Appendix 12)
Next Weeks Reminder
What to do and what to bring?
Weight Record Card
58
Subject
Week 8 - RECIPE ADAPTATION Welcome
Welcome everyone back to the session.
Weigh-In
As each group member arrives, ask if they wish to weigh themselves. Ask group members to log
their weight and waist circumference in their Weight Record Card.
Feedback on
Personal
Goals
Ask people to reflect back to last weeks personal goals - did they manage to stick to their goals any difficulties and how did they overcome these obstacles. Encourage group members to share
their experiences.
Group
Activity
Recipe
Adaptation
People often feel dreadfully deprived having to forego their favourite recipe. By doing this
next exercise, people can see that there are some ways around that, by modifying favourite
unhealthy recipes, to make them a little more healthy.
Split the group into 2 or 3’s - The group task is to work out how the recipe could be modified
to make it healthier, but just as tasty. They could also think about accompaniments (breads, veg,
salads) and puddings that could be served alongside to make a complete healthy meal.
Each group should feedback and share ideas with the whole group.
Resources
‘Weight Record Card’
In case the group don’t
bring in their own
recipes - have copies of
popular, recipes to hand.
For example Lasagne,
Spaghetti Carbonara,
Macaroni Cheese.
‘Appendix 12 - Recipe
Adaptation’
59
Subject
Week 8 - RECIPE ADAPTATION Group
Activity
Some Ideas
To reduce fat in a recipe:
use low fat spread instead of butter
use less butter/oil than stated in recipe
use non stick frying pan with a lid and add less or no fat
use skimmed milk instead of whole milk
use low fat creme fraiche or low fat yoghurt instead of cream
use some vegetable stock instead of milk
use reduced fat cheese or less cheddar - grate it - it goes further!
bulk meat dishes out with more vegetables or pulses
Resources
To reduce sugar in a recipe:
cut amount of sugar in recipes by about a half
use tinned fruit in natural juice instead of in syrup
use reduced sugar jams or pure fruit spread in sponges
use nutmeg, mixed spice and cinnamon with fruit for extra flavour
Setting
Personal
Goals
Ask group members to take a few minutes to think carefully about reviewing or setting new personal goals for the week - bearing in mind the group activity carried out in this weeks session.
Ask group members to write down 1 S.M.A.R.T. goal they wish to focus on.
Write todays date + goal.
Examples of goals
Concentrate on making more homemade dishes - focus on lowering the fat and sugar content
Go to Step Class, once this week
Remind clients to bring Weight Record Card’ next week.
Next Week
60
APPENDIX 12
RECIPE ADAPTATION
USING YOUR CHOSEN RECIPE WRITE DOWN WAYS IN WHICH
THE FAT AND/OR SUGAR CONTENT COULD BE LOWERED
Think about healthy accompaniments that could be served along with your
recipe and suitable healthy puddings to make a complete healthier meal.
61
Session 9
62
SESSION 9 - SNACKING OVERVIEW
Optional
Prior to session - Set up Snack Food Model Display
Swap & Save
Welcome
Weigh - In - Appendix 3
Group Activty Set Personal Goal(s)
Beat the Snack Attack (Appendix 13)
Ideas of Healthy Snacks
Next Weeks Reminder
What to do and what to bring?
Weight Record Card
63
Subject
Week 9 - SNACKING
Resources
Prior to
Session Optional
Set up Snack Food Model Display. This display visually illustrates the amount of sugar and fat
found in some everyday snack foods.
‘Snack Food Model
Display - Swap + Save’
- Available from HIRS
(pages 76-78)
Welcome
Welcome everyone back to the session.
Weigh-In
As each group member arrives, ask if they wish to weigh themselves. Ask group members to log
their weight and waist circumference in their Weight Record Card.
Feedback
on Personal
Goals
Ask people to reflect back to last weeks personal goals - did they manage to stick to their goals
- ask about any difficulties and how did they overcome these obstacles. Encourage group
members to share their experiences.
Group
Activity
Beat the Snack
Divide group into smaller groups of 2 or 3’s and ask groups to brainstorm - Ideas of Healthy
Snacks.
Attack
Most of us will probably snack during the day but snacking needn’t be bad news for your waistline.
Snacking on healthy, low calorie foods can help keep hunger pangs at bay.
Focus on healthy snacks. Then think of ways you could introduce healthier snacking into your
day.
‘Weight Record Card’
Flipchart and Pen for
brainstorming.
‘Appendix 13 - Snacking’
‘Healthy Snacks’ fact
sheet - download from
www.bda.uk.com/
foodfacts/07092healthy
snacks.pdf
64
Subject
Week 9 - SNACKING Group
Activity
May want to share these ideas with the group after their individual brainstorming
session:
Resources
Flip chart and pen for
brainstorming.
‘Quick convenient snacks’ - fruit - banana, handful of grapes, chopped melon, small bag
of sultanas, handful of cherry tomatoes, small cucumber sticks, wholemeal scone and low fat
spread or jam, small bowl of wholegrain cereal with semi skimmed milk, rice cake and savoury
spread, half a bagel with low fat cheese spread.
‘Introducing healthier snacking @ home and @ work’
plan ahead and take healthier snacks into work
make smart choices from vending machines or the local shop
join forces with friends or colleagues and take a walk to the local shop for some fruit
Setting
Personal
Goals
Ask group members to take a few minutes to think carefully about reviewing their goals or
setting new personal goals for the week - bearing in mind the group activity carried out in this
weeks session.
Ask group members to write down 1 or 2 additional S.M.A.R.T. goals they wish to focus on.
Write todays date + goals.
Examples of Goals
I will drink a large glass of water at my afternoon break instead of my usual cup of coffee.
Plan ahead - snack times and take them into work from home - to avoid vending machine temptation.
65
Subject
Week 9 - SNACKING Optional
Healthy Snack Tasting Session - choose from the following ideas:-
Resources
fresh fruit - bananas, grapes, apple, pineapple, melon, orange etc
dried fruit - raisins, apricots etc
vegetable sticks - with low fat dip e.g. spicy salsa (see recipe in pack) or cottage cheese
rice cakes/crackers with savoury spread
mini wholemeal pitta stuffed with salad and/or tuna
half a bagel or a few oat cakes with low-fat cheese spread
small wholemeal or fruit scone with a little low-fat spread or jam
diet or low fat yorghurt/fromage frais
66
APPENDIX 13
IDEAS OF HEALTHY SNACKS
WAYS TO INTRODUCE HEALTHIER
SNACKING INTO OUR DAY
67
Session 10
68
SESSION 10 - WEIGHT MAINTENANCE AND FEEDBACK OVERVIEW
Welcome
Waist and Weigh - In - Appendix 3
Feedback /Reflection
Review of Personal Goal(s) - Recognising Achievements and relapses
Feedback
What Next? and moving on... Think about future plans?
Achievements - Calculate overall group weight loss.
Ending / Closing Activity
69
SESSION 10 - CYCLE OF CHANGE
Where are you on the
Process of Changes?
Maintaning
Healthier
Lifestyle
Making
Changes
Maintaining
Changes
Ready to
Change
Relapsing/
Set Back
Thinking
about
Change
Research has shown that there are different stages involved in
the way people make changes. At first, people may not even
be ready to change. They may be not interested in change or
are thinking about change, but not quite sure. These people
may need to set some relevant information about why change
is a good idea. They might need time to think about the pros
and cons involved in changing. Even when people are ready to
change, they need to prepare themselves before they actually
get down to making the changes. Making changes is one thing,
but maintaining the changes over weeks or months - or forever
- is another. Sometimes people relapse. For whatever reason,
they find they can’t keep to their action plan. A relapse doesn’t
mean a permanent failure, just that things didn’t quite go to
plan that time! People can use relapse as a learning experience,
think about why things went wrong, and work out whether and
how they will prepare to take action again. Once people have
maintained changes for many months they may eventually go
out of the circle and become a person who has permanently
changed. For these people, the new way of doing things feels
absolutely normal and they know they will never slip back to
their old ways.
Not interested in
Changing
‘Current Lifestyle’
Adapted from Prochaska and Di Clemente
70
Subject
Week 10 - WEIGHT MAINTENANCE - FEEDBACK
Welcome
Welcome everyone to the final session and congratulate everyone for staying on the course.
Waist &
Weigh-In
Weigh everyone and record final weights.
Feedback on
Personal
Goals
Ask people to reflect back to last weeks personal goals - did they manage to stick to their goals any difficulties and how did they overcome these obstacles. Encourage group members to share
their experiences.
Review of
Personal
Goals
Remind group members that making lifestyle changes is one thing, but maintaining the changes
over weeks or months - or forever - is another. Sometimes people relapse. For whatever reason,
they find they can’t keep to their set personal goals. A relapse doesn’t mean permanent failure,
just that things didn’t quite go to plan that time!
Recognising
Achievements
People should use a relapse as a learning experience, thinking about why things went wrong and
work out whether and how they will prepare to take action again.
and Relapses
Ask people to form pairs and take it in turns to review all their personal goals.
Resources
‘Weight Record Card’
Measure everyones waists and record results.
Each person needs a copy
of their personal goals
with them.
Use the change cycle.
Notice the things that have gone really well and they now consider an integral part of their lifestyle.
Notice also the things they are still doing but find difficult. Discuss barriers and ways of overcoming these.
Notice goals which have been abandoned and work out together what happened.
71
Subject
Feedback
Week 10 - WEIGHT MAINTENANCE - FEEDBACK
Tell the group how important it is for you to get their feedback about how they felt the whole
programme went. Stress that this means comments about the good and the not so good things.
Their ideas for improving the programme are really welcomed.
Give out a batch of post it notes to each person and ask them to respond to the three headings
on the flipchart, with one comment per post it. Invite them to stick the post its on the relevant
piece of flip chart paper.
Resources
Post it Notes
Three sheets of flipchart
paper headed:
Things I really liked
about... the programme
Things I didn’t
particularly like about
the programme
I think the program
would be better if.........
What Next?
Moving
On...
Ask the whole group to think about what their future plans are, now that this programme has
come to an end. Get the group to come to an agreement about future meetings.
Present options:
nothing at all, individuals may wish to carry on individually with their personal goals,
recording their own weights and resetting new target weights.
have room set aside within the community centre where they can drop in at any time to
review their weight or the room could be set aside for a drop-in weigh-in session on a
particular day and time each week.
72
Subject
What Next?
Moving
On...
Week 10 - WEIGHT MAINTENANCE - FEEDBACK
Resources
have an informal arrangement to stay in touch with other group members/workmates and
get together say once a month, at a regular time, in a specific place.
continue to meet regularly (e.g. weekly) as a self-help group, to keep on track with weight management.
all join another group such as a commercial slimming group or a suitable keep fit group.
group members may not wish to continue meeting but they may wish to continue to keep in touch with each other. They may wish to swap names, addresses and phone numbers.
Ideally 2 people will volunteer to be responsible for co-ordinating a follow-on group.
Achievements
Ask group members to calculate any weight loss they have achieved over the 8 week programme
- get them to write it anonymously on a post-it. Gather these in and add them up - Reveal to the
group - the groups combined weight loss over the 10 weeks.
There are 14lbs in 1 stone. Therefore if the group has lost 1st 10lbs between them that is the
equivalent of 24lbs or 12 bags of sugar!
Post - It Notes
Optional - Kilogram
bags of sugar equal
approximately 2lbs.
1 x 14 = 14 + 10 = 24 lbs ÷ 2 = 12 bags of sugar.
73
Subject
Ending and
Closing
Activity
Week 10 - WEIGHT MAINTENANCE - FEEDBACK
Resources
Bringing the group to a formal close is important.
Open it up for each person, if they want to say a few words about their very best moment
(in terms of their personal achievements) during the programme.
Allow people to speak at random making it easy for those who haven’t anything to say, to
remain silent.
Congratulate group members for completing the 10 week programme.
74
WEBSITES
For more information on Weight Management, healthy eating and physical activity - Check out the following websites...
Weight Managament Advice Written by Dietitians
www.nhsforthvalley.com
Weight Management Advice Written by Dietitians
www.bdaweightwise.com
British Heart Foundation
www.bhf.org.uk
Food Standards Agency
www.eatwell.gov.uk
Take Life On Campaign
www.takelifeon.co.uk
British Dietetic Association
www.bda.uk.com/foodfacts/index.html
British Nutrition Foundation
www.nutrition.org.uk
Walking Routes
ww.walking-routes.co.uk
Weight Watchers
www.weightwatchers.co.uk
Walking the Way to Health Initiative
www.whi.org.uk
Scottish Slimmers
www.scottishslimmers.com
Slimming World
www.slimmingworld.com
Active Scotland
www.activescotland.org.uk
75
RESOURCES TABLE
Brief Description
Available From
Weight Record Card
(NUT 08/L)
Small card to record weight and waist
measurements each week. Also has a BMI chart to
help calculate Body Mass Index (BMI)
Health Information and Resources Service
(HIRS), 9 Gladstone Place, Stirling
Tel: 01786-434756 View Catalogue and order via www.nhsforthvalley.com/healthpromotion/hirs/OnlineCatalogue.htm
ALCOFACTS - A Guide to
Sensible Drinking
(ALC 28/L)
This booklet gives details about alcohol, what is a
unit, drinking and driving, effects of alcohol and
knowling your limit.
Sensible Drinking
(ALC 06/L)
Alcohol and sensible limits. How many units are in a
drink? What happens when we drink too much?
HIRS as above.
Alcohol and how it effects us. How much is too
much? Alcohol and Scotland Law
HIRS as above.
Are you Getting the Balance
Right? What is a Portion.
(NUT 76/L)
This leaflet explains what a ‘healthy’ portion of
everyday foods should be.
HIRS as above.
Just what you have been
Weighting For.
(NUT 80/L)
This booklet gives a step by step guide to losing
weight.
HIRS as above.
What’s in a Drink? The Straight
Facts About Alcohol
(ALC 05/L)
HIRS as above.
76
RESOURCES TABLE
Brief Description
Available From
‘Check the Labels’
(NUT 05/L)
Guide on how to read the information on food labels and eating healthily to reduce the risk of obesity,
heart problems, diabetes, cancer & stroke.
HIRS as previous.
Food Labels - More Informed
Choices
Booklet takes a closer look at the information on
food labels.
Eatwell. Your Guide to Healthy
Eating
(NUT 02/L)
A5 Booklet - Attractive, easy to read leaflet
explaining the importance of healthy eating. Also
includes tips on food shopping and hygiene. Simple
recipe suggestions.
Food Standards Agency
email: [email protected]
Tel: 0845 606 0667
HIRS as previous.
Physical Activity and Weight
Loss
(PAC 09/L)
A5 Booklet - Provides information on the
benefits of physical activity and how it can weight
loss. Suitable activities are highlighted, with issues
around safe practice being mentioned.
Getting Fitter is Easier Than You
Think
(PAC 01/L)
This leaflet encourages the reader to become more
moderately active for a total of 30 mins or more
each day.
HIRS as previous.
Hassle Free Exercise
(PAC 05/L)
This booklet will help you take the first step by
building more activity into daily routines and improving your health.
HIRS as previous.
HIRS as previous.
77
RESOURCES TABLE
Brief Description
Snack Food Model Display
Swap + Save
(NUT 72/K)
This resource contains a wide range of healthy and
unhealthy food models. Sugar and fat cubes supplied
with this resource, can be used to visually illustrate
quantities of sugar and fat within individual snacks
and drinks. This resource box also contains a swap +
save display. This shows how much overall calories
can be saved by making more sensible + healthier
snack choices.
Eating for Health - Floor Mat
and Food Models
(NUT 73/K1)
A tool for teaching nutrition and healthy eating. This
kit contains a range of plastic food models from the
five main food groups. It also contains a large floor
mat which illustrates a plate divided into
proportionate food groups.
Available From
HIRS as previous.
HIRS as previous.
78
REFERENCES
1.
2.
3.
4.
House of Commons Health Committee Report on Obesity, HMSO, May 2004
National Audit Office. Tackling Obesity in England, 2001. The Stationery Office
Energising Lives: A Guide to Promoting Physical Activity in Primary Care, NHS Health Scotland, 2008.
Healthy Eating, Active Living: An Action Plan to Improve Diet, Increase Physical Activity and Tackle Obesity (2008 - 2011). The Scottish
Government, 2008.
79