Table of Contents What is a healthy weight?.................................... 2 Are you ready to make a change?........................ 7 Goal setting ........................................................... 8 Adopt healthy habits ........................................... 9 The Mayo Clinic Healthy Weight Pyramid..........12 Daily menus and recipes .....................................17 Tips for healthy, low-fat cooking ........................ 30 Stay motivated .................................................... 32 10 tips for eating out .......................................... 35 Get moving .......................................................... 38 Track your progress ............................................. 41 What is a healthy weight? A healthy weight is a weight that allows you to feel energetic, reduces your health risks, helps prevent premature aging and improves your quality of life. The number you see on the scale is only part of the story. You also need to know your body mass index, which estimates body mass, including body fat. And you need to measure your waist, which shows where most of your extra weight is located. Body mass index Body max index (BMI) more accurately determines health risks than does your bathroom scale or standard height-and-weight tables. BMI relates your body weight to health risks associated with being overweight. BMI RESULTS* CLASSIFICATION Below 18.5 Underweight Between 18.5 and 24.9 Normal weight Between 25 and 29.9 Overweight 30 or above Obese Adapted from National Institutes of Health, 2000 *If your BMI is between 18.5 and 24.9, your weight is not likely to have a major effect on your health. However, Asians with a BMI of 23 or above may have an increased risk of health problems. 2 Healthy Weight for Life CALCULATE YOUR BMI Step 1: Multiply your height by your height (in inches). Step 2: Divide your weight (in pounds) by the above result. Step 3: Multiply the answer by 703. The result is your BMI. BMI WORKSHEET BMI for a person who is 66 inches tall and weighs 160 pounds Use your height (inches) and weight (pounds) to calculate your BMI Step 1 66 x 66 = 4,356 (height x height) ___ x ___ = _____ Step 2 160 ÷ 4,356 = 0.0367 (weight ÷ Step 1) ___ ÷ ___ = _____ Step 3 0.0367 x 703 = 25.8 (Step 2 x 703) ___ x 703 = _____ Adapted from National Institutes of Health, 2000 WHAT IS A HEALTHY WEIGHT 3 Waist measurement Extra weight that settles around your waist puts you at increased risk of heart disease, diabetes and some cancers. If you have a pear shape — large buttocks, hips and thighs — you probably have lower health risks than does someone with an apple shape — a large abdomen. Your waist measurement will reveal if you're an apple or a pear. To measure your waist, find the highest point on each hipbone and measure around your body just above those points. CC For women: A waist measurement of more than 35 inches is associated with higher health risks. CC For men: A waist measurement of more than 40 inches is associated with higher health risks. Using your BMI and your waist measurement, you can assess your risk of obesity-related diseases using the chart below. WEIGHT–RELATED RISK OF DISEASE BMI RANGE WAIST MEASUREMENT 35 inches or less (women) 40 inches or less (men) More than 35 inches (women) More than 40 inches (men) Overweight 25 to 29.9 Increased risk High risk Obese 30 to 34.9 35 to 39.9 High risk Very high risk Very high risk Very high risk Extreme obesity 40 or above Extremely high risk Extremely high risk Adapted from National Institutes of Health, 2000 4 Healthy Weight for Life Personal and family history Numbers alone aren't enough to tell you whether your weight is healthy. Take a look at your personal medical history and your family medical history for a complete picture. If you answer yes to any of these questions, shedding pounds may improve your health: CC Do you have a weight-related medical problem, such as high blood pressure, diabetes, osteoarthritis, high blood cholesterol or high blood triglycerides? CC Do you have a family history of any weight-related medical problems? CC Do you overeat, smoke cigarettes, have more than one or two alcoholic drinks a day, or live with uncontrolled stress? Combined with these behaviors, excess weight can have a greater negative effect on your health. You've calculated your BMI, measured your waist, and evaluated your personal and family medical history. If you've found that you need to lose weight, talk to your doctor about how much weight is healthy for you to lose. Your doctor may refer you to a dietitian or someone who specializes in weight loss. WHAT IS A HEALTHY WEIGHT 5 Keep in mind that losing even 5 to 10 percent of your current weight can significantly improve your health. Health benefits from weight loss include: CC Decreased blood pressure in people with high blood pressure and reduced risk of stroke CC Improved lipid profile and lower risk of heart disease CC Reduced risk of breast, uterus, colon, kidney and esophagus cancers CC Decreased blood sugar (glucose) and lower risk of diabetes 6 Healthy Weight for Life Are you ready to make a change? Like most people, you've probably tried diets before only to give up before achieving your goal. That's why it's important to assess whether now is a good time for you to start a weight-loss plan. Ask yourself these questions: CC CC CC Are you ready to make a commitment? If you aren't ready, focus instead on increasing your motivation by making a list of all the good things about losing weight, such as having more energy and improving your health. What else is going on in your life right now? Don't set yourself up for failure by trying to make lifestyle changes when you're distracted by other major problems. If you're having marital or financial problems or if you're unhappy with other major aspects of your life, you may be less likely to follow through on your good intentions. How confident are you that you can make changes in your eating and exercise habits? It takes a lot of mental and physical energy to change habits. Invest some time thinking about what has and hasn't worked for you in the past. Build on previous successes and brainstorm ways to overcome obstacles. ARE YOU READY TO MAKE A CHANGE 7 Goal setting Changing the way you approach weight loss can help you be more successful. Most people who try to lose weight focus on only one thing — how much weight they want to lose in the long term. However, it's also good to set shorter term goals to help you get to that magic number. Having an outcome goal can be useful, but it's a good idea to also have shorter term process goals. A process goal focuses on actions that will help you achieve your outcome goal. Here are some examples of process goals: CC CC I will walk 30 minutes every day this week. I will eat only fruit or vegetables for my snacks. Write down your goals and each day evaluate whether you met them. Celebrate successes. If you don't succeed, it may mean you need to try a different approach. 8 Healthy Weight for Life Adopt healthy habits It's not enough to eat healthy foods and exercise for a few weeks or even several months. Achieving and maintaining a healthy weight is all about learning to live a healthier lifestyle. To do that, you have to change the behaviors that made you overweight in the first place. Lifestyle changes involve taking a good look at your eating habits and daily routine. Were you taught to clean your plate? If so, do you still feel compelled to eat everything, even when you're full? Assess your eating style. Do you eat fast? Do you take big bites? When do you eat? While watching TV? Assess your shopping and cooking habits too. Then try working out a strategy to gradually change the habits and attitudes that may have sabotaged your past efforts. Make a healthier lifestyle — not the number of pounds — your primary motivation. Learning to enjoy healthier foods Fad diets aren't your answer to long-term weight control and better health. Instead, get in the habit of eating well. Some foods contain many calories in just a small serving. They're described as high in energy density. Foods that are high in energy density include most high-fat foods, simple sugars, alcohol, fast foods, sodas, candies and processed foods. For example, a regular candy bar typically contains 270 calories. Eating one candy bar provides a lot of calories and it may not fill you up. ADOPT HEALTHY HABITS 9 Foods such as vegetables and fruits have fewer calories in greater volume. These types of foods are considered low in energy density. In contrast to the 270 calories in a regular candy bar, a cup of cubed cantaloupe has about 60 calories. So if you choose to eat a generous portion of cantaloupeinstead of a candy bar, you can consume fewer calories and walk away from the table feeling full. 10 Healthy Weight for Life Getting more active Decreasing calories alone can help you lose weight. Cutting 500 calories from your daily diet can help you lose a pound a week (3,500 calories = 1 pound of fat). If you burn another 500 calories a day through exercise, you can lose another pound a week. Exercise also adds unique benefits. Physical activity promotes loss of body fat and development of muscle. Muscle burns more calories than fat does. So the more muscle mass your body has, the more calories it will burn, even when you're at rest. All physical activity you do throughout the day, even if it's not structured exercise, can help you lose weight. The more active you are, the more calories you burn. But it's important to start with activities that match your current fitness level and build up. Aerobic activities are activities that increase your breathing and heart rate and can be sustained for a period of time. These activities are great for weight loss, because their intensity is low enough that you can do them for a relatively long time, increasing calories burned. Brisk walking is an excellent choice. Other options for aerobic activities are swimming, bicycling, jogging and dancing. Also consider adding strength training activities, which help increase muscle mass — allowing you to burn a few more calories even at rest. Even though regularly scheduled exercise is ideal, any extra activity helps burn calories. Start to park at the far end of the lot, take the stairs instead of the elevator, or get off the bus a few stops early. Look for small ways to increase your daily physical activity. ADOPT HEALTHY HABITS 11 The Mayo Clinic Healthy Weight Pyramid The Mayo Clinic Healthy Weight Pyramid can guide you in making smart eating choices. Vegetables and fruits — which are packed with nutrition but low in calories — form the foundation of the pyramid. The number of daily servings for each food group is determined by your calorie goals. (See "Daily calorie goals for healthy weight loss" on page 14.) Notice too that physical activity is at the center of the pyramid. Using the Mayo Clinic Healthy Weight Pyramid can help reduce your risk of weight-related diseases. But if you're following a prescribed diet for a medical condition, ask your doctor how this program might work for you. The Mayo Clinic Healthy Weight Pyramid Sweets Up to 75 calories 75 Fats 3 to 5 servings Protein/Dairy 3 to 7 servings Carbohydrates 4 to 8 servings Fruits Unlimited, minimum 3 12 Healthy Weight for Life Daily Physical activity Activity Vegetables Unlimited, minimum 4 Using the Mayo Clinic Healthy Weight Pyramid is as easy as counting to five: 1 Calories. Identify a daily starting calorie level that's right for you. For most women, a good starting goal is 1,200 calories, and for most men it's 1,400. (See the chart on page 14.) 2 Servings. Identify the number of servings you should eat each day from each food group. (See "Daily serving recommendations" on page 15.) 3 Serving size. Become familiar with serving sizes for a wide variety of foods in the five key groups. Distribute the servings evenly throughout the day to best control your appetite. 4 Record keeping. Record your progress. Carefully note what you eat each day, using the daily dining record on page 42. And record your activity in the exercise log on page 43. 5 Variety. Choose foods from each food group and vary your choices within groups too. This helps ensure that you eat many types of foods and get as many different nutrients as possible. It also adds variety in taste and appearance to your meals. THE MAYO CLINIC HEALTHY WEIGHT PYRAMID 13 Calorie goals and serving sizes The following daily calorie goals often work well for weight loss. If you feel exceptionally hungry despite eating a lot of fruits and vegetables, or if you lose weight too quickly, consider moving up to the next calorie level. DAILY CALORIE GOALS FOR HEALTHY WEIGHT LOSS STARTING CALORIE GOAL WEIGHT IN POUNDS WOMEN MEN 250 or less 1,200 1,400 251 to 300 1,400 1,600 301 or more 1,600 1,800 14 Healthy Weight for Life DAILY SERVING RECOMMENDATIONS FOOD GROUP DAILY CALORIE GOALS 1,200 1,400 1,600 1,800 2,000 Vegetables 4+ 4+ 5+ 5+ 5+ Fruits 3+ 4+ 5+ 5+ 5+ Carbohydrates 4 5 6 7 8 Protein/Dairy 3 4 5 6 7 Fats 3 3 3 4 5 SAMPLE SERVING SIZES FRUITS* 60 calories per serving VEGETABLES* 25 calories per serving Apple, 1 small Broccoli, 1 cup florets Banana, 1 small or ½ large Carrots, 1 medium or ½ cup sliced Blueberries, ¾ cup Cauliflower, 1 cup florets Grapefruit, ½ large or ¾ cup sections Cucumber, 1 medium or 1 cup sliced Grapes, 1 cup Green beans, ²⁄³ cup Mixed fruit cocktail, ¾ cup Green or red pepper, 1 medium or 1 cup sliced Orange, 1 medium or ¾ cup sections Lettuce, 2 cups Peach, 1 medium or ¾ cup slices Mushrooms, ½ cup whole Pear, 1 small or ½ cup slices Spinach, 2 cups raw or ½ cup cooked Strawberries, 1½ cups whole Tomato, 1 medium *Can be fresh or frozen THE MAYO CLINIC HEALTHY WEIGHT PYRAMID 15 Calorie goals and serving sizes SAMPLE SERVING SIZES CARBOHYDRATES 70 calories per serving PROTEIN/DAIRY 110 calories per serving Bread (whole-grain), 1 slice Beans or lentils, ½ cup Cereal (bran-type), ½ cup Beef (90-95% lean), 2 ounces Crackers (whole-grain), 8 small Cheese, hard (low-fat), about 2 ounces Pasta (whole-grain, cooked), ½ cup Chicken or turkey (skinless), 2 ½ ounces without bone Potato (baked), ½ medium, ½ cup mashed Fish (broiled or grilled), 2 to 3 ounces Rice (brown, cooked), ¹⁄³ cup Milk (fat-free or 1%), 1 cup Squash (winter, cooked), 1 cup Seafood (shrimp, crab), 4 ounces Yogurt (fat-free, unsweetened or reduced-calorie), 1 cup SAMPLE SERVING SIZES FATS Almonds, 7 whole or 4 teaspoons slivered Cream cheese or sour cream (fat-free), 3 tablespoons Oil (olive, canola or peanut), 1 teaspoon Olives, 9 large or 12 small Peanut butter, 1½ teaspoons Salad dressing, Italian, regular, 1 tablespoon Tub margarine (not stick), 1 teaspoon Walnuts or pecans, 4 halves 16 Healthy Weight for Life Daily menus and recipes The sample menus and recipes that follow are based on the Mayo Clinic Healthy Weight Pyramid approach to eating. Three days of menus are offered at the 1,200-calorie level and three days of menus at the 1,400-calorie level. If you don't care for a specific food item, substitute something else. The idea is to learn to enjoy a variety of foods. SAMPLE MENUS FOR 1,200 CALORIES: DAY 1 BREAKFAST SERVINGS/GROUP 1 small banana 1 fruit 2 slices whole-grain toast 2 carbohydrates 1½ teaspoons peanut butter 1 fat Black coffee --- LUNCH SERVINGS/GROUP Tuna salad sandwich (½ cup water-packed tuna, 4 tablespoons fat-free or 1 tablespoon low-fat mayonnaise, ½ teaspoon curry powder, chopped celery as desired, lettuce, 2 slices whole-grain toast) 2 carbohydrates 1 protein/dairy 1 fat* ½ vegetable 1 cup baby carrots, jicama and bell pepper strips 2 vegetables 1 small apple 1 fruit Herbal tea --- DINNER SERVINGS/GROUP Mediterranean-style grilled salmon (see next page) 2 protein/dairy ²⁄³ cup steamed green beans 2 cups baby lettuce with ½ cup cherry tomatoes, 1 teaspoon olive oil and a splash of balsamic vinegar 1 vegetable 1 cup cubed melon (honeydew, cantaloupe or mix) 1 fruit Sparkling water with lemon --- FOOD GROUP TOTALS ACTUAL GOAL Vegetables 5 4+ Fruits 3 3+ Carbohydrates 4 4 Protein/Dairy 3 3 Fats 3 3 1½ vegetables 1 fat *Although fat-free spreads and dressings contain minimal fat, they still contain calories, so count as one fat. 18 Healthy Weight for Life Mediterranean-style grilled salmon Instead of the usual breaded and fried fish, this fish is grilled, Mediterra- nean style. You may substitute halibut, cod, sea bass or any other whitefish, and the calorie values are similar. Preparation: 10 minutes CC CC CC CC CC CC CC CC Cooking: 8 to 10 minutes Serves: 4 4 tablespoons chopped fresh basil 1 tablespoon chopped fresh parsley 1 tablespoon minced garlic 2 tablespoons lemon juice 4 salmon fillets, each 5 ounces Cracked black pepper, to taste 4 green olives, chopped 4 thin slices lemon 1. Prepare a hot fire in a charcoal grill or heat a gas grill or broiler. 2. In a small bowl, combine the basil, parsley, minced garlic and lemon juice. Spray the fish with cooking spray. Sprinkle with black pepper. Top each fillet with equal amounts of the basil-garlic mixture. 3. Place the fish herb-side down on the grill. Grill over high heat. When the edges turn white, after about 3 to 4 minutes, turn the fish over and place on aluminum foil. Move the fish to a cooler part of the grill or reduce the heat. Grill until the fish is opaque throughout when tested with the tip of knife and an instant-read thermometer inserted into the thickest part reads 145 F (about 4 minutes longer). 4. Remove the salmon and place on warmed plates. Garnish with green olives and lemon slices. DAILY MENUS AND RECIPES 19 SAMPLE MENUS FOR 1,200 CALORIES: DAY 2 BREAKFAST SERVINGS/GROUP Omelet with chopped fresh chives (½ cup egg substitute, chopped chives as desired) 1 protein/dairy 2 slices whole-grain toast 2 carbohydrates 1 teaspoon soft margarine 1 fat Black coffee --- LUNCH SERVINGS/GROUP Greek salad (Salad: 1 tomato, ½ green pepper, ½ cucumber. Dressing: ½ teaspoon dried basil, ½ teaspoon dried oregano, 2 teaspoons olive oil, 2 tablespoons red wine vinegar) 2 vegetables 2 fats 1 small crusty whole-grain roll 1 carbohydrate 1 small pear 1 fruit Sparkling water with lime --- DINNER SERVINGS/GROUP Orange-rosemary roasted chicken (see next page) 2 protein/dairy ½ cup mashed potatoes (seasoned with chicken broth and chives) 1 carbohydrate 1 cup sautéed spinach with onion 2 vegetables ²⁄³ cup cherries Hot tea 1 fruit --- FOOD GROUP TOTALS ACTUAL GOAL Vegetables 4 4+ Fruits 3 3+ Carbohydrates 4 4 Protein/Dairy 3 3 Fats 3 3 20 Healthy Weight for Life Orange-rosemary roasted chicken Rosemary — an herb with a piney flavor — can season a variety of foods, including roasted potatoes, mushrooms, stuffing, ripe melon, poultry and meats. Use the herb with care, however. Too much can be overpowering. Preparation: 10 minutes CC CC CC CC CC CC CC Cooking: 40 to 45 minutes Serves: 6 3 skinless, bone-in chicken breast halves, each 8 ounces 3 skinless, bone-in chicken legs with thigh pieces, each 8 ounces 2 garlic cloves, minced 1 ½ teaspoons extra-virgin olive oil 3 teaspoons fresh rosemary or 1 teaspoon dried rosemary, minced ¹⁄ 8 teaspoon freshly ground black pepper ¹⁄ 3 cup orange juice 1. Preheat the oven to 450 F. Lightly coat a baking pan with cooking spray. Rub each piece of chicken with garlic. Dab fingers in oil and rub with oil and sprinkle with rosemary and pepper. 2. Place the chicken pieces in the baking dish. Pour the orange juice over the chicken. Cover and bake for 30 minutes. Using tongs, turn the chicken and return to the oven until browned, about 10 to 15 minutes longer. Baste the chicken with the orange juice from the pan as needed to prevent it from drying out. 3. Transfer the chicken to individual serving plates. Spoon orange juice from the pan over the top of the chicken and serve. DAILY MENUS AND RECIPES 21 SAMPLE MENUS FOR 1,200 CALORIES: DAY 3 BREAKFAST SERVINGS/GROUP 1 small banana 1 fruit ½ cup bran cereal 1 carbohydrate 1 cup skim milk 1 protein/dairy Black coffee --- LUNCH SERVINGS/GROUP Apple and raisin salad with slivered almonds (1 apple, 2 tablespoons raisins, 1 celery stalk, 2 tablespoons lemon-flavored yogurt, 7 almonds) 2 fruits 1 fat 8 small whole-wheat crackers 1 carbohydrate 1 cup fat-free, reduced-calorie lemon-flavored yogurt 1 protein/dairy Iced tea --- DINNER SERVINGS/GROUP Pasta primavera (see next page) 1 protein/dairy 3 vegetables 2 carbohydrates 1 fat 2 cups mixed salad greens 1 vegetable 2 tablespoons fat-free salad dressing 1 fat Sparkling water with lemon --- FOOD GROUP TOTALS ACTUAL GOAL Vegetables 4 4+ Fruits 3 3+ Carbohydrates 4 4 Protein/Dairy 3 3 Fats 3 3 22 Healthy Weight for Life Pasta primavera Traditional pasta primavera includes pasta topped with sautéed vegetables in a heavy cream sauce with butter. This lighter version is much lower in calories, fat and sodium, and is fresher tasting. It isn't intended to be saucy like its traditional counterpart. Preparation: 10 minutes CC CC CC CC CC CC CC CC CC CC CC CC Cooking: 20 minutes Serves: 6 2 cups broccoli florets 1 cup sliced mushrooms 1 cup sliced zucchini or yellow squash 2 cups sliced red or green peppers 1 tablespoon extra-virgin olive oil ½ cup chopped onion 2 garlic cloves, minced 1 teaspoon butter 1 cup evaporated fat-free milk ¾ cup freshly grated Parmesan cheese 12 ounces whole-wheat pasta (angel hair or spaghetti) ¹⁄ 3 cup finely chopped fresh parsley 1. In a large pot fitted with a steamer basket, bring about 1 inch of water to boil. 2. 3. 4. 5. Add the broccoli, mushrooms, zucchini and peppers. Cover and steam until tender-crisp, about 10 minutes. Remove from the pot. In large saucepan, heat the olive oil and sauté the onion and garlic over medium heat. Add the steamed vegetables and stir or shake to coat the vegetables with the onion and garlic mixture. Remove from heat but keep warm. In another large saucepan, heat the butter, evaporated milk and Parmesan cheese. Stir over moderate heat until somewhat thickened and heated through. Stir continuously and don't scald. Remove from heat but keep warm. In the meantime, fill a large pot ¾ full with water and bring to a boil. Add the pasta and cook until al dente (tender), about 10 to 12 minutes, or according to package directions. Drain the pasta thoroughly. Divide the pasta evenly among individual plates. Top with vegetables and pour the sauce over the vegetables and pasta. Garnish with fresh parsley and serve immediately. DAILY MENUS AND RECIPES 23 SAMPLE MENUS FOR 1,400 CALORIES: DAY 1 BREAKFAST SERVINGS/GROUP 1 cup old-fashioned oatmeal 2 carbohydrates ²⁄³ cup cherries 1 cup skim milk 1 fruit Black coffee --- LUNCH SERVINGS/GROUP Cottage cheese and fruit salad on lettuce (²⁄³ cup low-fat cottage cheese, ½ cup fresh pineapple, 1 medium sliced peach, red and green lettuce) 2 fruits 1 protein/dairy 2 triple-crisp rye crackers 2 carbohydrates 8 ounces vegetable juice 2 vegetables DINNER SERVINGS/GROUP Sweet peppers stuffed with scalloped corn (see next page) 2 vegetables 1 carbohydrate 1 fat ½ protein/dairy ¾ cup steamed summer squash 1 vegetable 1 teaspoon soft margarine 1 fat 1 cup raspberries 1 fruit 1 cup skim milk 1 protein/dairy SNACK SERVINGS/GROUP 1 cup fat-free, reduced-calorie flavored yogurt 1 protein/dairy 7 almonds 1 fat 1 protein/dairy FOOD GROUP TOTALS ACTUAL GOAL Vegetables 5 4+ Fruits 4 4+ Carbohydrates 5 5 Protein/Dairy 4½ 4 Fats 3 3 24 Healthy Weight for Life Sweet peppers stuffed with scalloped corn For extra flavor, use roasted red bell peppers for the shells. To roast, place the bell peppers on a baking sheet lined with aluminum foil. Broil (grill), turning frequently with tongs, until the skin blackens all over, about 10 minutes. Transfer the peppers to a bowl, cover and let steam until the skin loosens, about 10 minutes. Peel if desired. Cover and refrigerate until needed. Preparation: 10 minutes CC CC CC CC CC CC CC CC CC CC Cooking: 30 minutes Serves: 4 4 red or green bell peppers 1 tablespoon olive oil ½ onion, chopped (about ¼ cup) 1 green bell pepper, chopped 2 ½ cups fresh corn kernels, cut from about 4 large ears of corn ¹⁄ 8 teaspoon chili powder 2 tablespoons chopped fresh cilantro or parsley 3 egg whites ½ cup fat-free milk ½ cup water 1. Preheat the oven to 350 F. Lightly coat a baking dish with cooking spray. Cut the tops off the bell peppers and remove the seeds. Place in the prepared baking dish and set aside. 2. In a medium skillet, heat the olive oil over medium heat. Add the onion, chopped green pepper and corn. Sauté until the vegetables are tender, about 5 minutes. Stir in the chili powder and cilantro or parsley. Reduce heat to low. 3. In a small bowl, whisk together the egg whites and milk. Add to the corn mixture and stir. Increase heat and continue stirring until egg whites begin to set, about 5 minutes. The mixture should be moist, not dry. 4. Spoon ¼ of the corn mixture into each pepper. Add the water to the bottom of the baking dish. Cover the peppers loosely with aluminum foil. Bake until the peppers are tender, about 15 minutes. Transfer to individual plates and serve. DAILY MENUS AND RECIPES 25 SAMPLE MENUS FOR 1,400 CALORIES: DAY 2 BREAKFAST SERVINGS/GROUP 1 small (3-inch diameter) whole-grain bagel 2 carbohydrates 1½ tablespoons low-fat cream cheese 1 fat* 2 plums 1 fruit Black coffee --- LUNCH SERVINGS/GROUP Turkey sandwich (2 ½ ounces turkey, 1 tablespoon low-fat mayonnaise, lettuce leaves, tomato slices, 2 slices wholewheat bread) 2 protein/dairy 2 carbohydrates 1 fat* ½ vegetable 1 cup mixed fresh melons (watermelon, cantaloupe, honeydew) 1 fruit 8 ounces spicy vegetable juice 2 vegetables DINNER SERVINGS/GROUP 3 ounces grilled beef tenderloin, shaved into strips 2 protein/dairy Spicy Oriental snow peas (see next page) 1 vegetable 1 carbohydrate 2 cups romaine lettuce 1 vegetable 2 tablespoons fat-free salad dressing 1 fat* ¾ cup blueberries 1 fruit Hot tea --- SNACK SERVINGS/GROUP 1 small apple 1 fruit FOOD GROUP TOTALS ACTUAL GOAL Vegetables 4½ 4+ Fruits 4 4+ Carbohydrates 5 5 Protein/Dairy 4 4 Fats 3 3 *Although fat-free spreads and dressings contain minimal fat, they still contain calories, so count as one fat. 26 Healthy Weight for Life Spicy Oriental snow peas Snow peas are long and flat and contain tiny lentil-sized peas. Sugar snap peas look like shelling peas but are smaller and have completely edible pods. Use either of these in this quick side dish. Preparation: 5-10 minutes CC CC CC CC CC CC CC CC CC Cooking: 5 minutes Serves: 4 1 pound snow peas, washed and trimmed of stems and strings (about 7 cups) 3 tablespoons reduced-sodium soy sauce 4 tablespoons rice vinegar 2 tablespoons brown sugar 1 tablespoon cornstarch ½ teaspoon Chinese five-spice powder 1 teaspoon sesame oil 1 garlic clove, chopped Crushed red pepper, optional 1. Bring a large saucepan ¾ full of water to a boil. Add the peas, reduce heat and simmer for 2 minutes. Drain the peas then plunge them into a bowl of ice water to stop the cooking. Drain again thoroughly and set aside. 2. To prepare the sauce, combine the soy sauce, rice vinegar, brown sugar, cornstarch and five-spice powder in a small bowl. Stir until the cornstarch and seasonings have dissolved. 3. In a large skillet, heat the sesame oil over medium heat. Stir in the garlic and peas. Increase the heat to high, stirring frequently. Pour in the soy sauce mixture and cook until thickened, 1 to 2 minutes. Sprinkle with crushed red pepper, if desired. Serve immediately. DAILY MENUS AND RECIPES 27 SAMPLE MENUS FOR 1,400 CALORIES: DAY 3 BREAKFAST SERVINGS/GROUP ½ cup orange juice 1 fruit 1 small muffin 1 carbohydrate 1 fat 1 ½ cup whole strawberries 1 fruit 1 cup fat-free, reduced-calorie flavored yogurt 1 protein/dairy LUNCH SERVINGS/GROUP Pita stuffed with vegetables and feta (1 whole-grain pita, lettuce, tomato, cucumber, ¼ cup feta, 2 tablespoons fat-free dressing) 2 carbohydrates 1 protein/dairy 1 vegetable 1 fat* 1 medium nectarine 1 fruit 1 cup skim milk 1 protein/dairy DINNER SERVINGS/GROUP 2 ½ ounces baked chicken breast 1 protein/dairy ¹⁄³ cup brown rice with parsley Sautéed zucchini coins (see next page) 1 carbohydrate Tossed salad (2 cups salad greens, ½ cup shredded carrots, 1 teaspoon olive oil, 1 teaspoon red wine vinegar) 2 vegetables 1 fat Hot tea --- 1 vegetable ½ fat SNACK SERVINGS/GROUP 1 cup grapes 1 fruit 1 triple-crisp rye cracker 1 carbohydrate FOOD GROUP TOTALS ACTUAL GOAL Vegetables 4 4+ Fruits 4 4+ Carbohydrates 5 5 Protein/Dairy 4 4 Fats 3½ 3 *Although fat-free spreads and dressings contain minimal fat, they still contain calories, so count as one fat. 28 Healthy Weight for Life Sautéed zucchini coins Instead of breaded and fried, these zucchini slices are lightly sautéed and tossed with herbs. This reduced-fat version also features olive oil, which is mainly monounsaturated fat. Preparation: 5 minutes CC CC CC CC CC CC CC Cooking: 5 minutes Serves: 4 1 tablespoon olive oil 2 cups thinly sliced yellow zucchini 2 cups thinly sliced green zucchini 1 teaspoon dill weed 2 tablespoons fresh cilantro 2 scallions, chopped 2 tablespoons lemon juice 1. In a large, nonstick frying pan, heat the oil over medium heat. Add the zucchini slices and sauté until their colors intensify, about 5 minutes. 2. Add the dill, cilantro and scallions, and stir until evenly mixed. Transfer to a serv- ing bowl. Sprinkle with lemon juice and serve immediately. DAILY MENUS AND RECIPES 29 Tips for healthy, low-fat cooking Changing your eating habits — really changing them — involves more than following the healthy menus. Eating to lose weight and maintain the loss may mean learning to enjoy different foods and cooking familiar foods in different ways. Try these tips to cut fat, sugar and salt: 1 2 3 1. Stock a low-fat, high-flavor kitchen. Keep a ready supply of these items: onions, fresh garlic, other herbs and spices, salsa, Dijon mustard, fresh lemons and limes, flavored vinegar, evaporated skim milk, plain fat-free yogurt and vegetable cooking spray. It's also good to keep the following items on hand: whole-grain pasta, brown rice, beans and low-sodium, water-packed tuna. 2. Expand or revamp your culinary habits. CC Sauté vegetables, such as onions, mushrooms or celery, in a small amount of water, broth or wine. CC Use nonstick cookware for foods that require some fat, such as pancakes or browned meats. Or use cooking sprays (negligible fat per one-second spray). CC Trim visible fat from lean meats; then stir-fry with cooking spray or broil, roast or bake on a rack to allow fat to drip away. 3. Save with substitutions. To save fat and calories, substitute: CC 1 cup fat-free sour cream for 1 cup regular sour cream CC 1 cup skim milk for 1 cup whole milk CC 1 cup evaporated skim milk for 1 cup cream 30 Healthy Weight for Life The good and the bad Monounsaturated fats: These "good fats" help lower total and low-density lipoprotein (LDL) cholesterol. Found mainly in olive, canola and peanut oils, as well as most nuts and avocados. Polyunsaturated fats: These ”good fats” help lower total and LDL cholesterol. Found mainly in vegetable oils, such as safflower, corn, sunflower, soy and cottonseed. Saturated fats: These "bad fats" raise total and LDL cholesterol, increasing the risk of heart disease. Found mainly in red meats, most whole-fat dairy products (including butter), egg yolks, milk chocolate, as well as coconut, palm and other tropical oils. Trans fats: These "bad fats" raise LDL cholesterol and lower high-density lipoprotein (HDL) cholesterol, increasing the risk of heart disease. Found mainly in stick margarine and shortening, which are often used in cookies, pastries and other baked goods, as well as most crackers, many candies and commercially prepared snack foods. Look at the ingredient list on food labels — the term "partially hydrogenated vegetable oil" indicates that trans fat is present. TIPS FOR HEALTHY, LOW-FAT COOKING 31 Stay motivated Even with a good plan and the best of intentions, you'll run into roadblocks now and then. When that happens, don't give up. Instead take a moment to analyze what happened so you can be better prepared the next time. Here are some tips for getting and staying on track. Step 1: Know your triggers. Do you tend to eat when you're bored, angry, tired, anxious, depressed or socially pressured? If you do, try these tips: CC Before eating anything, ask yourself if you're really hungry. CC Learn to say no gracefully. CC Do something to distract yourself from your desire to eat — telephone a friend or run an errand. CC Direct emotional energy from stress outward. This is a good time for a brisk, 30-minute walk or cleaning your closet. CC If all else fails, have a snack of fruit or vegetables. If you have trouble identifying emotional or environmental reasons for eating, try keeping a notebook. List what, when and why you eat. See if any relationships or patterns emerge. Step 2: Practice, practice, practice. Whether you're focusing on one habit or immersing yourself in making many changes at once, be specific about how you're going to change. Then continually practice these new behaviors to turn them into habits. 32 Healthy Weight for Life Step 3: Recruit support. Ultimately only you can help yourself lose weight, but that doesn't mean you have to do everything alone. Ask for support from your partner, family and friends. Step 4: Stay positive. Don't dwell on what you're giving up to lose weight. Concentrate on what you're gaining. Instead of thinking, "I really miss eating a doughnut at breakfast," tell yourself, "I feel a lot better when I eat whole-wheat toast or cereal in the morning." Step 5: Plan ahead. Your old habits may be so ingrained that you may do them instinctively. Mentally rehearsing new habits can help. Imagine yourself at a party. Envision yourself taking a small portion of a few items, leaving space between them on your plate, or taking only fresh fruits and vegetables. Mentally rehearse this plan until you're more likely to remember it — and do it — the next time you need it most. STAY MOTIVATED 33 Liquid calories Many people don't realize just how many calories beverages can contribute to their daily intake. To cut calories, try these tips: CC CC CC Switch to low-fat or fat-free milk. Dilute juices with plain or sparkling water. Add a twist of lemon or lime to perk up your water. BEVERAGE SERVING SIZE CALORIES* Water 8 ounces 0 Coffee or tea (plain) 8 ounces 0 Milk, whole 8 ounces 150 Milk, 2% 8 ounces 120 Milk, 1% 8 ounces 105 Milk, fat-free 8 ounces 90 Fruit punch 12 ounces 192 Soda, regular 12 ounces 130-150 Soda, diet 12 ounces 0 Beer, regular 12 ounces 150 Wine 5 ounces 100 *Average calories. Values for specific beverages may vary. Check the label. 34 Healthy Weight for Life 10 tips for eating out 1. Keep hunger under control (by eating). CC Don't skip a meal on the day you're going out to eat. CC Consider eating a light, healthy snack an hour or so before the meal to avoid overeating at the restaurant. 2. Choose restaurants that offer variety. CC Choose a restaurant that offers a variety of foods, with low-fat options. CC Call the restaurant ahead of time (during nonpeak hours) to ask about healthy menu items. 3. Order more plant-based foods. CC Start your meal with a salad packed with veggies to help control hunger. CC Choose main dishes that include vegetables, such as stir-fries, kebabs or pasta with tomato sauce. 4. Control fat. CC Order baked, not fried; grilled, not greasy. Skip cheesy toppings. CC Ask for smaller portions of fatty foods — such as meats and fatty sauces — or ask for substitutions. 5. Control portion size. CC Ask your server if you can order a half-size portion. CC If you're tempted to clean your plate, ask your server to remove it. 10TIPS FOR EATING OUT 35 6. Cut out or cut back on condiments. CC Order sauces and dressings on the side — small amounts add up! CC Substitute healthier condiments. For example, use mustard instead of mayonnaise, or pepper or lemon juice instead of salt. 7. Approach buffets with a plan. CC Make salad your first course, with plenty of veggies and fruit, and fat-free or low-fat dressing. CC Fill half of your plate with vegetables, no more than one-fourth with grain or potato, no more than onefourth with protein/dairy. CC Consider ordering from the menu instead of the buffet. 8. Mind your manners — it'll help you cut calories. CC Eat slowly for better digestion. You'll feel full faster. CC Share an entree with your dining companion. 9. Order beverages with few or no calories. CC Order water, sparkling water or mineral water with a twist of lemon — it's healthy, filling and caloriefree. CC For a hot drink, try black decaf coffee or black or green tea, minus sugar or other extras. (See "Liquid calories” on page 34.) 10. Wait before ordering dessert. CC Finish the main dish. By the time you're done, you may not even want dessert. CC If you do order dessert, split it with a friend or take half of it home. 36 Healthy Weight for Life Clues to better menu choices Cooking terms can give you a basic idea of a food's nutritional makeup. Look for descriptions that indicate low-fat preparation. Remember that some low-fat, low-cholesterol foods are high in calories and sodium. Here's a guide to help you decode menus. CHOOSE AVOID Baked Au gratin Broiled (without added butter) Basted Grilled Breaded Poached Broasted Roasted Creamed Sautéed Fricasseed Steamed Fried 10 TIPS FOR EATING OUT 37 Get moving Do you really want to lose fat? Do you want to look and feel better while you do it? Do you want the extra pounds gone for good? Then take a walk. A walking program is an aerobic activity that's easy and effective for burning calories from fat. Regular aerobic walking also conditions your muscles and cardiovascular system. But if you haven't been exercising regularly, check with your doctor before starting a walking program. Start slow and steady Start a regular schedule of walking. Begin with slow, short walks and gradually increase the frequency, time and intensity. Keep a moderately brisk pace — just enough to increase your breathing noticeably. Your ultimate goal is to walk about an hour a day. Consider wearing a pedometer to track your activity. An appropriate long-term goal might be 10,000 steps a day, while an interim goal might be increasing your steps by 2,000 a day. If the first few minutes of walking seem to take the most effort, remember to warm up gradually. Ease into a faster pace after five to 10 minutes. This time allows your muscles to reach the temperature at which they use oxygen most efficiently. Also, your heart needs time to begin pumping enough blood. 38 Healthy Weight for Life Not a walker? If you can't walk or find it boring, don't use that as an excuse for avoiding exercise. Find other activities that you can do and that you enjoy. Exercise bikes, crosscountry ski machines and low-impact aerobic classes are good alternatives. ACTIVITY (1-HOUR DURATION) CALORIES BURNED* BASED ON BODY WEIGHT 160 POUNDS 200 POUNDS Aerobics, low-impact 365 455 Aerobics, water 292 364 Bicycling, <10 mph 292 364 Dancing, ballroom 219 273 Jogging, 5 mph 584 728 Running, 8 mph 986 1,229 Skiing, cross-country 511 637 Stair treadmill 657 819 Swimming, laps 511 637 Walking, 2 mph 183 228 Walking, 3.5 mph 277 346 250 or less 1,200 1,400 Based on Ainsworth BE, et al. Medicine & Science in Sports & Exercise, 2000 *Calories burned are based on estimates of energy expended. The number of calories you burn depends on the intensity and duration of activity, as well as your body weight. GET MOVING 39 Step it up As you progress with your walking program, remember to increase the frequency, duration and intensity of your workout — in that order. If you're comfortable walking briskly for about 30 minutes three or four times a week, try to make it seven days a week. Add time until you're walking about 60 minutes a day. To add intensity, try lengthening your stride, swinging your arms, increasing your speed or walking uphill. To track your progress, use the exercise log on page 44 to record the amount of time you walk each week and the calories burned. Lose fat, gain muscle Strength, endurance, energy and muscle tone are several of the physical rewards you can expect from regular exercise. But if these changes haven't translated into pounds lost on the scale, don't worry. The muscle you're building is denser than the fat you're losing. That means you actually may not lose as much weight as you would like for a while, even though you're losing fat. Remember that how much you weigh is less relevant than achieving physical fitness. One of the best ways to increase your muscle mass is by doing some type of resistance training. Weight training, for example, not only builds more muscle and helps you burn more calories, but also strengthens bones, helps protect your joints, and improves balance, posture and coordination. If you're new to strength training, look for an instructor or class to learn the proper technique. 40 Healthy Weight for Life Track your progress Keep a record of everything you eat and drink throughout the day. This makes it easier to identify potential problems in your eating habits. SAMPLE DINING RECORD SERV- FOOD INGS FOOD GROUPS Oatmeal ½ cup 1 Carbohydrates Skim milk 1 cup 1 Protein/Dairy Banana 1 small 1 Fruits Snack Orange 1 medium 1 Fruits Lunch Greek salad Tomato 1 1 Vegetables Green pepper, cucumber ½ each 1 Vegetables Olive oil 2 tsp 2 Fats Bread (whole-grain) 1 slice 1 Carbohydrates Snack Walnuts 4 halves 1 Fats Dinner Salmon 3 ounces 1 Protein/Dairy Breakfast Snack Salad (lettuce with olive oil) 2 cups, 1 tsp 1 Vegetables/Fats Pasta (whole-grain) ½ cup 1 Carbohydrates Tomato sauce ¹⁄³ cup 1 Vegetables Broccoli 1 cup 1 Vegetables Bread (whole-grain) 1 slice 1 Carbohydrates 2 Fruits Mango (balsamic vinegar) 1 Serving goals for my _______–c alorie diet Sweets (75 calories daily) Fats ( ___ servings) Protein/Dairy ( ___ servings) Carbohydrates ( ___ servings) Fruits ( ___ servings) Vegetables ( ___ servings) Mayo Clinic Healthy Weight Pyramid TRACK YOUR PROGRESS 41 DINING RECORD Serving goals for 1,200–calorie diet Sweets (75 calories daily) 3 servings) Fats ( ___ 3 servings) Protein/Dairy ( ___ 4 servings) Carbohydrates ( ___ 3 servings) Fruits ( ___ 4 servings) Vegetables ( ___ Mayo Clinic Healthy Weight Pyramid Write your starting calorie level and recommended number of servings in the blanks to the right of the pyramid. FOOD Breakfast Snack Lunch Snack Dinner 42 Healthy Weight for Life SERVINGS FOOD GROUPS Throughout the day, record what you eat in your personal dining record, including the foods, amounts, servings and food groups. At the end of the day, check the servings boxes inside the pyramid and compare the servings you ate with your goals. Then congratulate yourself or commit to adjustments tomorrow. Exercise log Keeping an activity record like the one shown below can help you be accountable and establish a regular exercise routine. If you choose walking as your activity and have a pedometer, record the number of steps. EXERCISE LOG Week 1 Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Activity (specify type) Duration (minutes) Week 2 Activity (specify type) Duration (minutes) Week 3 Activity (specify type) Duration (minutes) Week 4 Activity (specify type) Duration (minutes) TRACK YOUR PROGRESS 43 Weight record Weigh yourself at least once a week and write down your results in a log like the one below. If you want to weigh more often, keep in mind that daily fluctuations may be due to changing body fluid levels rather than gains or losses in body fat. But if you notice an upward trend over several weeks and your clothes begin to fit more snugly, review your eating and exercise records to discover where you may be getting off course. WEIGHT RECORD WEEK Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Week 7 Week 8 Week 9 Week 10 44 Healthy Weight for Life DATE WEIGHT References 1.Hensrud DD, et al. The Mayo Clinic Diet. Intercourse, Pa.: Good Books; 2010. 2.Diabetes Prevention Program. National Institute of Diabetes and Digestive and Kidney Diseases. http://diabetes.niddk.nih.gov/dm/pubs/preventionprogram/. Accessed Aug. 25, 2010. 3.Facts about healthy weight. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/prof/ heart/obesity/aim_kit/healthy_wt_facts.htm. Accessed Aug. 25, 2010. 4.Improving your eating habits. Centers for Disease Control and Prevention. http://www.cdc.gov/healthyweight/losing_ weight/eating_habits.html. Accessed Aug. 25, 2010. 5.Identification, evaluation, and treatment of overweight and obesity in adults. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/guidelines/obesity/prctgd_c.pdf. Accessed Aug. 25, 2010. 6.Biggs ML, et al. Association between adiposity in midlife and older age and risk of diabetes in older adults. JAMA. 2010;303:2504. 7.Weight-loss and nutrition myths. Weight-control Information Network. http://www.win.niddk.nih.gov/publications/myths. htm. Accessed Aug. 26, 2010. 8.When delicious meets nutritious. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/public/ heart/other/sp_recip.htm. Accessed Aug. 26, 2010. REFERENCES 45 9. Know your fats. American Heart Association. http:// www.heart.org/HEARTORG/Conditions/Cholesterol/ PreventionTreatmentofHighCholesterol/Know-Your-Fats_ UCM_305628_Article.jsp. Accessed Aug. 26, 2010. 10.Rethink your drink. Centers for Disease Control and Prevention. http://www.cdc.gov/healthyweight/healthy_ eating/drinks.html. Accessed Aug. 26, 2010. 11.Tips for eating healthy when eating out. U.S. Department of Health and Human Services. http://www.mypyramid. gov/tips_resources/eating_out.html. Aug. 26, 2010. 12.Horvath K, et al. Long-term effects of weight-reducing interventions in hypertensive patients: Systematic review and meta-analysis. Archives of Internal Medicine. 2008;168:571. 13.National Cholesterol Education Program. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines. Circulation. 2004;110:227. 14.Calle EE, et al. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. New England Journal of Medicine. 2003;348:1625. 15.Tudor-Locke C, et al. Why do pedometers work? A reflection upon the factors related to successfully increasing physical activity. Sports Medicine. 2009;39:981. 46 Healthy Weight for Life Mayo Clinic Family Health Book, Fourth Edition Completely revised and updated! Mayo Clinic Family Health Book is your reliable, comprehensive guide to thousands of health concerns. With more than 1.5 million copies sold, it has become one of the most popular health books ever published. 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