My Weight Solution Strategies and tools to take action The Mayo Clinic Healthy Weight Pyramid Contents Throughout this workbook, you’ll use the Mayo For a lifetime of healthier eating, you don’t need Clinic Healthy Weight Pyramid as your guide to to be overly precise about counting calories or making smart eating choices. You’ll find detailed grams of fat. Just set realistic goals and follow information on page 22. But the main message the general pattern of the pyramid. You’ll be well Getting started.................................................................... 3 you need for getting started is simple: Eat most on your way to a healthier you! Are you ready?.................................................................... 5 Introduction Not just another diet............................................................ 2 of your food from the groups at the base of the pyramid and less from the groups at the top. Part 1: Lose It! And, of course, move more. Sweets Add 5 Habits....................................................................... 7 Break 5 Habits..................................................................... 8 Adopt 5 Bonus Habits....................................................... 10 Fats Part 2: Live It! Your Live It! strategies........................................................ 12 Protein/Dairy Strategy 1: Set realistic goals............................................. 14 Strategy 2: Follow the pyramid.......................................... 20 Strategy 3: Burn calories by being active........................... 38 Carbohydrates Bonus section: How to stick with your commitment Change behaviors............................................................. 48 Change your mind............................................................. 50 Fruit Vegetables Daily Physical Activity Stay connected................................................................. 55 Overcome challenges........................................................ 58 Images © Artville, BananaStock, Brand X Pictures, Comstock, Corbis, Digital Vision, EyeWire, Fancy Photography, PhotoAlto, Photodisc, Stockbyte and Veer Introduction Not just another diet The word diet typically refers to a special eating plan designed to reduce weight. But in spite of the promises offered by countless diet plans, few of them work for most people or are effective over the long term. In fact, some can actually harm your health. Most diets focus only on food — what you should and shouldn’t eat. The goal is simply to lose pounds. Unfortunately, as you likely know from personal experience, those lost pounds usually come back. That’s why Mayo Clinic experts have developed an approach to achieving and maintaining a healthy weight. This approach is more than a diet; it’s a lifestyle. Long-term weight management means focusing on lifestyle changes and a tailored eating and fitness plan that’s appealing and healthy — one that you can live with for the rest of your life. As with any weight management approach, see your doctor before beginning an eating or exercise program if you have health issues or any questions about your health. 2 My Weight Solution A personalized approach from Mayo Clinic Using the Mayo Clinic Healthy Weight Pyramid as a foundation, you can develop a personalized weight-loss plan — one that allows you to make choices. Part 1 of this workbook provides a two-week program to jump-start your weight loss, while Part 2 gives you three strategies to make the long-term changes that are most effective for weight loss. Finally, our “Bonus section” shows you how to be your own coach to stick with the changes you’re making. As you begin this process, talk with a trusted adviser or friend, health coach, or other health professional about what motivates you to lose weight. Then take a look at what drives you to make changes with the checklist on the next page. Getting started Find your inner motivation Chances are, you already have a pretty good idea of what you need to do to lose weight — eat less and move more. But knowing the basic calorie equation for weight loss and being ready to make the necessary changes in your life are two different things. To be successful at losing weight, you need to figure out what will give you an ongoing, burning desire to succeed. You need to tap your inner motivation. Motivation lies at the heart of your weightloss plan — it’s what gets you going and keeps you at it. Motivation connects thoughts and feelings to action and provides a sense of purpose. By understanding what motivates you, you’ll be better able to follow through with your eating and fitness plan. Consider all the benefits of losing weight and staying fit listed at right. Rank your top three reasons — from 1 as your most important to 3. Rank more than three if you want, and add your own reasons if they’re not on the list. Consider posting the list where you’ll see it often. Discuss your list with a trusted friend or adviser. What moves you to lose? c Look better c Feel better c Feel comfortable in my clothes c Improve my physical stamina c Manage high blood pressure c Improve my cholesterol c Prevent or manage diabetes c Reduce joint pain c Prevent or reduce lower back pain c Improve my sleep c Increase my energy c Improve my self-image and self-confidence c Improve my outlook on life c Improve my quality of life c Increase my life expectancy c Be a role model for my family c More motivators: Mayo Clinic 3 How to prepare Along with finding your motivation, you’ll want to decide whether now is the right time to begin a weight program. Take these steps to prepare the way. • Make sure you’re ready. Answer the questions on the next page to determine if now is a good time to start a weightloss program. Starting before you’re ready or when you’re distracted by other major events in your life — job stress or marriage problems, for example — can set you up for failure. On the other hand, people with health challenges often feel the need to start a weight-loss program and succeed because of that extra sense of motivation. You’ll know best if the timing is right. • Consider your health. If you have health issues, such as diabetes, heart disease, shortness of breath or joint disease, or are pregnant, see your doctor before starting your weight program. • Get support. Losing weight and keeping it off is a lifelong process. You’ll have to change long-standing habits, which can be difficult. It helps to be accountable to someone. Enlisting the help of coworkers, family or friends is a powerful motivator that can increase your odds of success. See page 55 for tips on rallying your support network. Circle one best answer for each question. Are you ready? • Find out where you stand. To determine your starting point, be sure to record your weight, your body mass index (BMI) and your waist size (see pages 18-19). Save that information so that you can refer back to it as you make progress. Make sure your first weigh-in is at a time you can follow consistently with followup weigh-ins, such as first thing in the morning. ➊ How motivated are you to lose weight? ➎ If you answered yes to the previous question, how often have you eaten like this during the last year? a.Highly motivated b.Moderately motivated c.Somewhat motivated a. About once a month or less d. Slightly motivated or not at all b. A few times a month c. About once a week ➋ Considering the amount of stress affecting your life right now, to what extent can you focus on weight loss and on making lifestyle changes? d. About three times a week or more ➏ Do you eat for emotional reasons — for example, when you feel anxious, depressed, angry or lonely? a. Can focus easily • Choose your approach. Some people benefit from the psychological boost of the two-week jump-start plan in Part 1. Others would rather aim for a steady, moderate weight loss of 1 to 2 pounds a week, outlined in Part 2. • Pick a start date. Before then, become familiar with the dietary and fitness tips in this book. Get ready by stocking up on fruits and vegetables and by planning how you’ll track your progress. b. Can focus relatively well a. Never or rarely c.Uncertain b. Occasionally d. Can focus somewhat or not at all c. Frequently d. Always ➌ People often lose weight quickly at first. But overall, it's best to lose weight at a rate of 1 to 2 pounds a week. How realistic are your expectations about how fast and how much to lose? ➐ How confident are you that you can make changes in your eating habits and maintain them? a Completely confident a. Very realistic (Gradual weight loss is fine.) b.Moderately confident b.Moderately realistic c.Somewhat confident c.Somewhat realistic d. Slightly confident or not at all d. Somewhat or very unrealistic (I want to Once you’ve completed these steps, you’re ready to begin. On your start date, simply jump right in. As you start planning meals in a healthier way and become more active, you’ll feel better and have more energy. lose weight as fast as possible.) ➑ How confident are you that you can exercise several times a week? ➍ Aside from special celebrations, do you a.Completely confident ever eat a lot of food rapidly and feel that your eating is out of control? b.Moderately confident a.No c.Somewhat confident d. Slightly confident or not at all b.Yes If most of your responses are: • a and b, then you’re probably ready to start a weight-loss program. • b and c, consider if you’re ready or if you should wait and take action to prepare yourself. (See pages 48-49 for ideas on how.) • d, you may want to hold off on your start date and take steps to prepare yourself. Reassess your readiness again soon. 4 My Weight Solution Note: If your answer to question 5 was b, c or d, discuss this with your doctor. If you have an eating disorder, it’s crucial that you get appropriate treatment. Mayo Clinic 5 Part 1: Lose It! Designed to help you lose 6 to 10 pounds in 2 weeks Results can be a great motivator. This twoweek phase not only helps you see results quickly but encourages lifelong habits that help you lose weight and keep it off. The program is designed to help you safely lose 6 to 10 pounds and learn to eat healthy. Does rapid weig ht loss stay off? Pounds lost thro ugh rapid weight loss ofte n come back — unless you make the long-term lifesty le changes to keep them off . So after you “Lose It!” se e Part 2 to “Live It! Here’s what it takes: • Add 5 Habits • Break 5 Habits • Adopt 5 Bonus Habits By sticking to these changes for just two weeks, pounds will come off, your health will improve and you’ll feel better. 3 Add 5 Habits Add these 5 habits to your daily routine to make healthy changes that pave the way for weight loss. Eat whole grains Choose whole-grain breads, cereals or pastas, brown rice, barley, and other whole-grain products instead of white, refined and highly processed grain products. They’re packed with vitamins, minerals and fiber and fill you up. Check food labels for the term whole. This tells you the product is not highly processed. 4 Eat a healthy breakfast — but not too much Eat healthy fats 1 Choose olive or vegetable oils, avocado, nuts and nut butters, and the oils that come from Eating breakfast can help you lose weight and nuts. These fats, called monounsaturated and keep you from overeating later in the day. You polyunsaturated, are the most heart healthy. Look don’t need to eat a lot — just something to get for products with little or no saturated fat and you off to a good start, such as whole-grain avoid trans fats. All fats are high-calorie, so even cereal (hot or cold) or toast, low-fat milk, fat-free the healthy ones should be used sparingly; just yogurt, an egg, nuts, seeds, or nut butters. If use a drizzle on a salad or when cooking. you’re not in the habit, start by grabbing a piece of fruit and gradually add other foods. 5 2 Eat vegetables and fruits Move! Walk or exercise for 30 minutes or more every day. The more physically active you are, the more Eat at least four servings of vegetables and three calories you burn. Physical activity and exercise servings of fruits every day. Fresh vegetables and also offer countless health benefits. If you haven’t fruits are the foundation of a healthy diet and been physically active, start slowly and give your successful weight loss. You can eat generous body a chance to get used to increased activity. portions while consuming fewer calories. Eat as many veggies and fruits as you want — they also make a great snack. 6 My Weight Solution Mayo Clinic 7 Successful lose rs No snacks except fruits and vegetables 3 Break 5 Habits Changing habits, especially ones you’ve had for many years, isn’t easy. But breaking these five unhealthy habits can make a difference in your weight. Common snacks typically have a lot of calories and little nutritional value. If you’re hungry between meals, eat only fruits and vegetables and nothing else. Snacking on healthy fruits and vegetables a couple of times a day can help you manage your weight. Stock your home with a variety of ready-to-eat vegetables and fruits. No TV while eating — AND ONLY AS MUCH AS YOU EXERCISE Moderate meat and low-fat dairy Studies show that watching TV (or any other Limit total daily consumption of meat, poultry and “screen time,” such as computer use) is a driver fish to 3 ounces — the size of a deck of cards. If of weight gain. You aren’t moving, and there’s you consume dairy products, use only skim milk a good chance you’re also sipping or nibbling and low-fat varieties, and consume them in mod- on something. So spend only as much leisure eration (about two servings daily). Full-fat dairy time watching TV (or in front of any screen) as products contain saturated fat that can raise your you spend exercising. That way, you’re not only cholesterol. Even lean cuts of meat and skinless breaking a bad habit (mindless eating) but also poultry have some saturated fat and cholesterol adding a good one (being more active). and can be high in calories. No sugar — EXCEPT WHAT’S NATURALLY FOUND IN FRUIT No eating at restaurants — UNLESS THE MEAL FITS THE PROGRAM 1 2 4 All too often, whe n people lose wei ght, they regain it within a few years. But yo u can take your inspiration fro m success storie s of people who’ve lost weigh t and kept it off fo r years. The National Wei ght Control Regist ry has tracked hundreds of these successf ul losers and studied their habits. The regist ry members have sh ed anywhere from 30 to 300 po unds and kept it off an average of 5.5 years. Studies of membe rs’ habits show that they tend to: DDMaintain a low-calor DDBe physically active ie, low-fat diet DDLimit fast food DDEat breakfast DDWeigh themselves DDWatch less than 10at least once a week hours of TV a wee k Nine out of 10 people who lo se weight and keep it off report that they stay physic ally active about an hour a day. Th eir favorite workout: walking . 5 If you want something sweet, eat fruit. Otherwise, stay away from sugar and sweetened foods, Eating out is associated with weight gain. The including table sugar, brown sugar, honey, jam tantalizing sights and smells of a restaurant, deli and jelly, candy, desserts, and soda. Alcohol counter, bakery display, food court or concession also counts as a sweet. Keep in mind that many stand entice you with high-calorie menu items artificially sweetened foods like candy, cookies, and large portions. If you must eat out, make cakes, ice cream and yogurt can still pack lots of sure you order foods and beverages that fit the calories. Relying on fruit to satisfy your cravings is habits in this book. a healthier, lower calorie habit. 8 My Weight Solution Mayo Clinic 9 Eat mostly fresh or healthy frozen or canned food, and limit processed foods (see pages 24-25). 5 Write down your daily goals Every day write down a goal that motivates you and you can achieve during the day (see pages 16-17). 10 My Weight Solution Part 2 puts you on a path toward healthier weight for a lifetime. TOTALS r daily goals 5. Write you BITS 5 BONUS HA 1. Keep diet records The sample ctivity rcise/aabove 2. Keep exe records demonstrates how ve more! to fi3.llMoout your Habit food Tracker. 4. Eat “real” 5. No eating dairy ate meat and 4. Only moder 3. No snacks 2. No sugar ile eating 1. No TV wh BITS BREAK 5 HA 5. Move! fats 4. Eat healthy ts at restauran grains 3. Eat whole its bles and fru 2. Eat vegeta lthy breakfast 1. Eat a hea S ADD 5 HABIT Day 4 Day 3 Day 2 Day 1 done Check if er Habit Track Total the columns and rows of your Habit Tracker to see which habits you’re having success with and which are a problem for you. reMINDer: TRACKER ToTALS ToTALS Eat ‘real’ food 5. Write down your daily goals things that will help you establish a new direction. 4. eat “real” food to 60 minutes or more (see page 38). 3. Move more! long term. But you have no doubt learned a few 2. Keep activity records Increase your daily exercise from 30 4 Day 14 You might not be able to maintain all 15 habits Day 5 Move more! 1. Keep food records long-term plan for a healthier weight. 5 BoNuS HABITS throughout the day (see page 23). 5. No eating at restaurants It’s a great way to prepare for Part 2 and your 4. only moderate meat and dairy Record all your physical activity 3 HABIT WEEK 1 patterns and discovering what works for you. 3. No snacks Keep activity records 2. No sugar about “catching yourself,” but about identifying 2 1. No TV while eating your habits. Remember that the process is not BreAK 5 HABITS page 23). 5. Move! Be more curious than judgmental as you track 4. eat healthy fats and drink throughout the day (see 3. eat whole grains Keep a record of everything you eat 2. eat vegetables and fruits reasons others were more challenging. WeeK 1 Keep food records 1. eat a healthy breakfast reasons you did well on some habits and the 1 ADD 5 HABITS — what worked well and what didn’t. List the Day 13 at losing weight. Day 12 new patterns. Think about what you learned Day 11 follow, the more likely you’ll succeed Day 10 out of your comfort zone and help you establish Day 9 optional, but the more of them you Day 8 The habits in Lose It! are designed to bump you Day 7 program. These 5 Bonus Habits are Day 6 Pause to reflect before you move forward Day 4 Habits are must-dos for your Live It! Day 3 The Add 5 Habits and Break 5 Day 2 Lose It! phase. Day 1 right and check off your progress throughout the DCheck if done progress. Make a copy of the Habit Tracker at WeeK 2 more likely to succeed if you keep track of your At the end of each day, check off which Add, Break and Bonus habits you have completed. At the end of the week, total the columns and the rows to see how you’ve progressed. When you want to take on healthier habits, you’re Habit Tracker Adopt 5 Bonus Habits Monitor your progress Part 2: Live It! 1 strategy one Set realistic goals Three strategies for reaching a healthier weight. Outcome goals • Process goals • Daily goals The Lose It! phase of your weightloss plan gave you a quick start. Live It! puts you on a path you can enjoy for a lifetime. It all centers on three key strategies that answer the question: “What really works for losing weight?” These strategies build on the habits described in Part 1 and give you the tools and techniques you need to keep your weight-loss momentum going. They’re not complicated. They do take commitment. They’ve been proved time and again to work for the long haul. 2 strategy two Follow the pyramid 3 Find your daily calorie goal. • Know your daily servings goal. • Count servings, not calories! strategy Three Burn calories by being active Wherever you are, start! • Focus on physical activity — not just exercise. • Stick with what motivates you. Welcome to your healthy, effective, commonsense approach to weight loss. Now you can start living it! 12 My Weight Solution Mayo Clinic 13 1 Live it! strategy one Set realistic goals One of the most important ways to succeed at weight control is to establish realistic goals and expectations. Goal setting keeps Remember … Start with outcome goals Stay inspired with daily goals An outcome goal is longer term and focuses on the end result. Examples include, “I would like to lose 20 pounds” or “I would like to weigh 125 pounds.” Each day, it’s important to set both meal servings and physical activity goals. Outcome goals: • Guide your planning • Build the framework for shorter term, process goals • Stretch and inspire you For more on how to set a weight-loss outcome goal that makes sense for you, see the resources on pages 18 and 19. you motivated and helps you stick with your program. You might have a combination of goals: your weight-loss goal, your health goals, your exercise goals, or your daily servings and calorie goals. The key is to make your goals your own. The more aligned they are with your likes and dislikes — your preferences and priorities — the greater your chances of success. It’s also important to set one “inspirational” goal: “Today I will stop eating before I feel full” or “Today I will focus on positive thinking.” Daily goals: • Are the building blocks for weight loss • Provide a daily sense of achievement • Keep you motivated to keep up with your program You’ll learn how to set your daily food goals on pages 20-25. You can brainstorm and record all your goals on page 17. Move ahead with process goals Process goals focus on a specific process or action — such as “I will walk 30 minutes every day” or “I will eat four servings of vegetables each day” — rather than a single outcome. Many people find that when they focus on process goals, the outcomes take care of themselves. Include enjoyment in your goals When setting goals, don’t forget satisfaction. A study of individuals who maintained their Process goals: • Build success one small step at a time • Help you reach your outcome goals • Are the most important type of goal for many people Learn more about how to make your process goals “SMART” on page 16. 14 My Weight Solution weight after completing a weight-loss program found that satisfaction with the amount and quality of daily activities was an important factor in success. Make a commit ment and don’t look to o far ahead. Wha t can you do today to make this weight-loss plan work for you? 1 Live it! STrategy one set realistic goals Make your goals work for you You don’t have to be “goal-oriented” to benefit from setting goals. All you need are some timetested methods for setting the kinds of milestones you can reach. My Goals Worksheet Cast your goals in a positive light. Rather than saying, “I won’t eat any more junk food for snacks,” offer a solution, such as “I’ll have a piece of Be SMART about your goals When setting any type of goal, you’ll be more likely to achieve it if it’s SMART: • Specific. State exactly what you want to achieve, how you’re going to do it and when you want to achieve it. • Measurable. Tracking your progress is easier if you can measure it. A process goal might be to walk 30 minutes a day or jog three miles a day. A similar outcome goal would be to lose 5 pounds over the next three months. • Attainable. Ask yourself whether your goal is reasonable. Set a goal that you have the time and resources to achieve. • Relevant. Set goals that align with your preferences, values and motivations. Make sure they’re more than simply a reflection of what you (or someone else) think you should do. • Time-limited. Set a date — or a series of dates — by which you want to achieve your goal. Again, setting smaller process goals that build on each other is the key for many people. Play to your strengths and challenges Set goals that take advantage of what you do well and what you enjoy. If you know you would never let a friend down, schedule time with a walking partner. If you’re not a morning person, steer clear of an earlymorning “fitness boot camp.” 16 My Weight Solution More examples: • You love to be outdoors. Your goal is a Saturday-morning hike. • You enjoy a bedtime treat. Your goal is to replace that bowl of ice cream with a cup of tasty herbal tea. • You tend to eat everything on your plate. Your goal is to use a smaller plate to reduce your portion sizes. Think about what’s important right now If you’re like most people, you’re more likely to put effort into something you care about than something not connected to your life and priorities. For example: You may know that you need to improve your diet, but your stress level is an even more-urgent concern. By taking initial steps to reduce stress, you may have more motivation and confidence to tackle your diet. Record your goals and refer to them often One of the most effective ways to meet your weight-loss goals is to write them down and track your progress over time. During the process of losing weight — and beyond — periodically take stock of how you’re doing: • Are you still motivated to lose weight? Has your source of motivation changed? • Have new barriers developed (see pages 58-61 for more on barriers)? How can you overcome them? • If you use tracking tools, do they work for you? What other tools might work? fruit ready when I’m hungry between meals.” My outcome goal(s): Example: “I would like to lose 10 pounds by spring.” My process goal(s): Example: “I will snack only on fruits and vegetables.” My daily inspirational goals: Example: “I will stay away from the snack machine today.” Mayo Clinic 17 1 Live it! STrategy one set realistic goals How much should you lose? Find your BMI One common way to estimate your weight-related health risks is to determine your body mass index (BMI). Elevated BMI can predict risk of conditions such as heart disease and diabetes. If you don’t find your exact weight on the chart, or if you’re working in metric equivalents, follow these steps: ➊ Multiply your height by your height in inches or in meters (not centimeters). ➋ Divide your weight (in pounds or kilograms) by the result of the first step. ➌ If you’re working with kilograms and meters, you now have your BMI. ➍ If you’re working with pounds and inches, multiply your results by 703 for your BMI. Example: A 160-pound (72.6-kilo) person, 64 inches (1.63 meters) tall, has a BMI of 27. Normal 24 Overweight BMI 19 25 Height Weight in pounds 4’10” 91 115 4’11” 94 5’0” Obese There’s no right or wrong answer when it comes to how much weight you should lose. The important consideration is to set a goal that is healthy and realistic. It all starts with you and your health — and factors like your body mass index (BMI). BMI and waist size For most people, BMI is a reasonably accurate measure of body composition and whether they’re at a healthy or unhealthy weight. But it’s not perfect. For example, muscle weighs more than fat, so some athletes and other physically fit people have high BMIs without health risks. In contrast, some people may have a BMI in the “healthy” range yet actually have a high percentage of body fat. Waist size indicates whether you carry extra weight around your midsection. Like an elevated BMI, a larger waist measurement is associated with health risks such as heart disease and diabetes. To measure your waist, use a flexible measuring tape. Find the highest point on each hipbone and measure around your body just above those points. 26 27 28 29 30 35 40 45 50 119 124 129 134 138 143 167 191 215 239 119 124 128 133 138 143 148 173 198 222 247 97 123 128 133 138 143 148 153 179 204 230 255 5’1” 100 127 132 137 143 148 153 158 185 211 238 264 5’2” 104 131 136 142 147 153 158 164 191 218 246 273 5’3” 107 135 141 146 152 158 163 169 197 225 254 282 5’4” 110 140 145 151 157 163 169 174 204 232 262 291 5’5” 114 144 150 156 162 168 174 180 210 240 270 300 5’6” 118 148 155 161 167 173 179 186 216 247 278 309 5’7” 121 153 159 166 172 178 185 191 223 255 287 319 5’8” 125 158 164 171 177 184 190 197 230 262 295 328 5’9” 128 162 169 176 182 189 196 203 236 270 304 338 5’10” 132 167 174 181 188 195 202 209 243 278 313 348 5’11” 136 172 179 186 193 200 208 215 250 286 322 358 Normal weight <25 Minimal to slightly increased risk* Increased risk 6’0” 140 177 184 191 199 206 213 221 258 294 331 368 Overweight 25 – 29.9 Increased risk High risk 6’1” 144 182 189 197 204 212 219 227 265 302 340 378 Overweight 30 – 34.9 High risk Very high risk 6’2” 148 186 194 202 210 218 225 233 272 311 350 389 6’3” 152 192 200 208 216 224 232 240 279 319 359 399 Obese 35 – 39.9 Very high risk Very high risk 6’4” 156 197 205 213 221 230 238 246 287 328 369 410 Extreme obesity 40 or over Extremely high risk Extremely high risk Source: National Institutes of Health, 1998 Weight-related risk of disease Waist circumference and BMI are both important predictors of disease risk. Increased waist circumference alone can mean elevated risk even in people of normal weight. A BMI of 18.5 to 24.9 is considered a healthy range, but Asians with a BMI of 23 or more may have an increased risk of health problems. If your BMI is higher, see below. If your BMI is less than 18.5, talk with your doctor. You may be at a higher risk of health conditions associated with a low body weight. Weight status IF Your body mass index is & Your waist measurement is Women: 35 inches or less Women: > 35 inches Men: 40 inches or less Men: > 40 inches *There is a slight increase in risk of diabetes and heart disease associated with “intermediate” waist circumferences between 32 and 34 inches for women and 36 and 39 inches for men. Source: National Institutes of Health, 2000 18 My Weight Solution Mayo Clinic 19 Serving goals Food group 2 Know your serving goals Live it! strategy Two Follow the pyramid With your daily calorie goal in hand, find the number of servings from each food group you should eat each day to meet your goal. You can eat as many vegetables and fruits as you like; they’re low in calories and packed with nutrition. Note that some high-carbohydrate vegetables such as corn and potatoes are considered “carbs” when you are following the pyramid. Check out the more-detailed serving sizes in the back of this book. Vegetables* Fruits* † Carbohydrates Starting calorie goals 1,400 1,200 4 or more 4 or more 4 or more 3 or more 5 4 Protein/Dairy † Fats† 3 3 1,600 5 or more 1,800 5 or more 2,000 5 or more 5 or more 5 or more 5 or more 6 7 8 4 5 6 7 3 3 4 5 75 calories a day † Sweets as you like. imums — eat as much and vegetables are min sweets are maximums. and fats iry, /da *The servings for fruits tein pro s, ate ydr boh car for vings † The recommended ser How to count servings The formula for weight loss is clear-cut: If you eat fewer calories than you burn through physical activity, you’ll lose weight. That means decreasing calories. The Mayo Clinic Healthy Weight Pyramid can help you learn to manage your calories and still feel full. Find your daily calorie goal The chart below shows average calorie levels needed for healthy weight loss, based on current weight and sex. You can adjust this goal as you go along. For example, you might consider adding more calories if you are very active and you are losing more than a pound or two a week. Weight Calorie goals Pounds Women Men 250 or less 1,200 1,400 251 to 300 1,400 1,600 301 or more 1,600 1,800 Count servings, not calories Vegetables Calories Visual cue 1 cup broccoli 25 1 baseball You won’t need to memorize a complete inventory of food serving sizes or carry measuring cups with you to meals. Use the visual cues in the table at right — along with the servings guide in the back of this book — to estimate serving sizes on your own. 2 cups raw, leafy greens 25 2 baseballs Fruits Calories Visual cue ½ cup sliced fruit 60 Tennis ball 1 small apple or medium orange 60 Tennis ball Carbohydrates Calories Visual cue ½ cup pasta or dry cereal 70 Hockey puck Tip: Remember that a portion is not the same as a serving. A portion is an amount of food on your plate. A serving is a specific amount of food that equals a certain number of calories. Often the “portion” you eat contains more than one “serving.” ½ small bagel 70 Hockey puck 1 slice whole-grain bread 70 Hockey puck ½ medium baked potato 70 Hockey puck Protein/Dairy Calories Visual cue 3 ounces of fish 110 Deck of cards Use your “pyramid tracker” on page 23 to track 2-2½ ounces of meat 110 ²∕³ deck of cards 1½-2 ounces of hard cheese 110 ¹∕³ deck of cards Fats Calories Visual cue 1½ teaspoons peanut butter 45 2 dice 1 teaspoon butter or margarine 45 1 die what you’ve eaten at each meal and in between. You’ll soon start seeing patterns and discover what you need to do to make the pyramid work for you. These visual cues can help you use the food lists found in the back of this book. 20 My Weight Solution Mayo Clinic 21 2 Live it! STrategy two follow the pyramid A closer look at the pyramid My Pyramid Tracker Let the pyramid be your guide to making smart eating choices. It’s pretty simple to use. The goal is to choose most of your food from the groups at the base of the pyramid and less from the top — and move more. Start each day by setting a realistic, achievable goal. Then record what you eat and drink and your Sweets. This group includes candies, cakes, cookies, pies, doughnuts and other desserts, as well as table sugar. With sweets, keep it small; most are high in calories and fat without any nutrients. Fats. Your body needs small amounts of certain types of fats to function well, but saturated fats and trans fats increase your risk of heart disease. Focus on good fats (see page 7). Protein/Dairy. The best choices are low in fat and calories, such as fish, skinless white-meat poultry, fatfree dairy foods, egg whites and legumes (lentils, beans and peas) — which also happen to be good sources of fiber. Fruits. Almost all fruits fit into a healthy diet. But whole fresh, frozen and canned fruits without added sugar are the best choices. They’re filling and packed with nutrients and fiber. Limit fruit juices and dried fruits; they have more calories and are less filling. 22 My Weight Solution physical activity. Activity should be moderately intense and sustained for 10 minutes or more at a time. A new way to th ink about treat s Seventy-five ca lories a day isn’ t much. So consider th inking of your “s weet” calories over th e course of a week. If you give in to the brownie on Mon day, hold off on any more sweets until the weeke nd — or even longer. Carbohydrates. Most foods in this group are grains or made from grains. Whole grains are best; they’re higher in fiber and other nutrients. Some examples include whole-grain cereal, whole-wheat bread, whole-wheat pasta, oatmeal and brown rice. Look for the term whole as one of the first ingredients on the label. Vegetables. They’re rich in nutrients and fiber and most are low in calories and fat. Focus on fresh vegetables; frozen or canned without added fat or salt also are OK. And try for more dark green, red and orange varieties. Note that starchy, higher calorie veggies such as corn and potatoes count as carbohydrates when following the pyramid. Type (aerobic, stretching, strengthening) My ACTIVITIeS ToDAy: ToDAy’S DATe: Time ToDAy’S goAL: WHAT I ATe ToDAy FroM THe PyrAMID: record what you eat and drink in one day in the table below. Then track your total servings for that day by checking off the circles in the pyramid at right. (you won’t use all the circles each day.) Put an “x” in a circle for each serving you eat in a food group. Number of servings Time Food item Amount V F C PD Ft S Sweets 75 calories a day or 525 calories a week Write in your calories here. Fats D DD Protein/ Dairy DDD DDD Carbohydrates DDDD DDDDD Fruits reCorD your TArgeT NuMBer oF DAILy SerVINgS For eACH FooD grouP Here: V Vegetables PD Protein/Dairy F Fruits Ft Fats C Carbohydrates S Sweets 75 calories/day DDD DDDD Vegetables DDD DDDD Mayo Clinic 23 2 Live it! STrategy two follow the pyramid Tips for using the pyramid Now that you understand the basics of “following the pyramid,” you can discover more ways to make this new approach work for you. It’s about awareness and planning. • Plan each meal around vegetables and fruits. Since they form the base of the pyramid, start with them. Look for ways to serve veggies and fruits whole, fresh and in combination with other foods. Fill half your plate with veggies; have fruit or a salad on the side. • Spread servings throughout the day. And include at least one serving from most food groups at each meal. • If you’re hungry, EAT! Starving yourself can be counterproductive and set you up for overeating later. The pyramid allows unlimited consumption of vegetables and fruits, so focus on those when you’re hungry. • Make pleasure a priority. Losing weight may require you to cut back on some of your favorite foods, but don’t sacrifice enjoyment. Be sure to include flavors, colors and textures you enjoy. • Plan by the week. It’s more efficient than day to day. That way, you can also be sure to have the right foods on hand. Beverages — including alcohol — count When considering calories, don’t forget to count the liquid form. Although some beverages, such as juice and milk, contain important nutrients, they also have a lot of calories. Water is still the best choice when it • Eat ‘real’ food. Limit or even avoid processed foods, such as many canned and most boxed and convenience foods. Highly processed foods often include unwanted fat, sugar, calories and salt. Whole foods, including most frozen fruit and vegetables, haven’t been changed from their natural state and are loaded with nutrients. if you have a drink (much more than 75 calories), plan on fewer sweets the rest of the week. One drink equals: until you have what you think is about ½ cup. Don’t use a measuring cup! Now pour the cereal into a measuring cup. How close did you come? Most people pour considerably more than ½ cup, which is one serving. You can try this exercise with cooked pasta or • Count ‘add-ons’ in servings. Don’t forget to include anything you put on or add to your food — such as dressings and dips for vegetables and fruits and cream, milk or sugar in coffee or tea. • Be flexible with yourself. Every food doesn’t have to be a source of excellent nutrition. The point is to choose foods that promote good health and help you lose weight most of the time. comes to satisfying thirst and cutting the urge to snack. When drinking milk, choose skim. What about alcohol? In the Mayo Clinic Healthy Weight Pyramid, alcohol is in the sweets category. So Try this exercise. Pour dry cereal into a bowl other favorite foods. ➊ ➋ Here are some other strategies for controlling portion sizes: DDEat slowly. When you eat too fast, your brain doesn’t tell you that you’re full until • Look for shortcuts. Buy pre-cut veggies and fruits, precooked meats, and shredded low-fat cheese for quick healthy meals. you’ve already overeaten. DDDon’t eat directly from a container. Seeing food on a plate or in a bowl gives you a better sense of portion size. DDFocus on your food. Reading, watching 5 ounces of wine 120-130 calories 12 ounces of regular beer 150-190 calories 1½ ounces of 80-proof liquor 95-110 calories • Tomorrow is another day. If you didn’t get enough veggies Monday, add extra Tuesday and Wednesday. Try not to get stuck on exact servings each day. TV or working while you eat distracts you and makes it easier to overeat. DDServe smaller amounts. Take slightly less than what you think you’ll eat. Using a smaller plate or bowl makes less food seem like more. DDDon’t feel obligated to clean your plate. Stop eating as soon as — or even before — you feel satisfied. 24 My Weight Solution Mayo Clinic 25 2 Live it! STrategy two follow the pyramid How to eat more and lose weight Low-energy- dense lunch 585 calories How full you feel is determined by the volume and weight of food — not by the number of calories. If you choose foods with low energy density — few calories for their bulk — you can eat more volume but consume fewer calories because of two key factors: DDWater. Most vegetables and fruits Roast turkey breast (3 ounces) contain a lot of water, which sandwich on whole-wheat bread with provides volume and weight but low-fat cheese (1 ounce), lettuce and few calories. For example, half of tomatoes plus an apple, celery sticks, a large grapefruit is 90 percent vegetable soup (1 cup), whole-grain water with just 50 calories. crackers and water with lemon slice DDFiber. The high fiber content in High-energy-dense lunch foods such as vegetables, fruits 595 calories and whole grains adds bulk to Bacon cheeseburger (thick patty) your diet, so you feel full sooner. Low-energy- 640 calories Fiber also takes longer to digest, dense suppe r making you feel full longer. Adults need about 25 to 35 grams of fiber a day, but the average adult consumes much less. Increase your fiber gradually while you increase the fluids in your diet. Most high-fat foods, desserts, candies and processed foods are Whole-wheat spaghetti (1 cup) and high in energy density — so a small fat-free spaghetti sauce (1 cup) topped volume has a lot of calories. If you with broccoli, bell peppers, onions choose your foods wisely, you can and zucchini plus whole-grain roll, side eat more volume but fewer calories. salad (with 2 tablespoons fat-free dressing), strawberries (1½ cups) with High-energy-dense supper fat-free frozen vanilla yogurt (½ cup) 646 calories and water with lemon slice Spaghetti (¾ cup) with cheese sauce (¾ cup) 26 My Weight Solution Mayo Clinic 27 2 Live it! STrategy two follow the pyramid Set yourself up for healthier choices You’ll be more likely to stick with a healthy diet if you have a plan for every meal and snack. With the right ingredients on hand, healthy meals come together from scratch almost as fast as they do with processed, higher calorie convenience foods. Planning that very important breakfast and packing healthy lunches and snacks help you control what you take in all day. You can even come up with a dining-out strategy in advance to stick with your program. In fact, planning ahead is one of your best defenses against the urge to grab some chips or a cookie when you need a break at work or arrive home hungry. Plan meals around the pyramid Plan your menus using the Mayo Clinic Healthy Weight Pyramid, using the daily serving goals for each food group to guide your decisions (see page 21). • Plan multiple meals. It can be a timesaver (and it’s less costly) to plan menus for an entire week instead of day to day. • Adapt your menus to the seasons. Use the freshest foods available for your meals — asparagus, peas and cherries in the spring; peaches, sweet corn and tomatoes in midsummer. Shop your local farmers markets for fresh produce. 28 My Weight Solution • Be adventurous. Explore new cuisines. Some intriguing ingredients — quinoa, edamame, bok choy, bulgur — are as healthy as they are delicious. Willpower vs. a plan for success You may think that you can reach a healthy Instead of relying on your willpower (which is weight if you simply exert enough willpower. You almost never reliable), help yourself make healthy just won’t eat those foods that cause you to gain choices the easy choices. By planning ahead, weight. This can, unfortunately, set you up to fail you can rely on self-control instead of willpower. as your willpower inevitably cracks. This is when These examples show the difference: • Go for health and convenience. Some convenience foods are designed to be healthy and lower in calories. A healthy frozen entree or side dish is an option on busy days. Read labels for calories, fat and sodium. Stock healthy versions of quick foods like instant brown rice. many people give up: “I already broke the rules, • Plan for leftovers. Making enough food for two meals at once saves time. • Look for shortcuts. Simplify your meal prep and save time by buying pre-cut vegetables and fruits, precooked meats, shredded low-fat cheeses, packaged salads, and frozen or canned vegetables. There’s nothing quicker than fresh fruit. But fruit canned in its own juice (not sugary syrup) is also OK. Rinse canned vegetables with water to remove excess sodium. so I might as well keep eating.” The key is to set yourself up for success by planning ahead. Willpower Set up for success I’ll buy that bag of chips for my family, but I just won’t eat any of them. I’ll pick up healthier snacks such as grapes, popcorn, baby carrots and apples instead. We’ll go to the buffet, but I’ll just have salad. We’ll go to a restaurant that offers small portions and low-fat or vegetarian items. I’ll bring my favorite chocolate dessert for my co-workers, but I won’t have any. I’ll bring a tasty healthy dessert for my co-workers, so that I can have some, too. • Keep a list of simple menu ideas. Recipes that include common staples and take 20 minutes or less come in handy on days when you’re rushed. Mayo Clinic 29 2 Live it! STrategy two follow the pyramid Be a smart shopper These strategies will help ensure that you have the right foods to follow your healthyeating plan. Take inventory Use menus you’ve developed as part of your healthy-eating plan to guide your shopping. Take an inventory of your staples, such as lowfat milk, fresh fruits and whole grains. Make a list A list makes your shopping trip more efficient and helps you avoid impulse buys. But don’t let your list prevent you from looking for or trying new healthy foods. When making your list, use your weight-loss menus as your guide. Make sure your list includes healthy and convenient snack foods. To make things go faster, organize your list according to where foods are located at your favorite store. Shop the perimeter of the store for fresh foods The fresh produce, dairy case, poultry and seafood sections of most grocery stores are all located on the perimeter. That’s where to focus your shopping when using the Mayo Clinic Healthy Weight Pyramid. Fresh foods are generally better than ready-to-eat foods because you can control any ingredients that you add. s m e it y h lt a e h e s e th n o p u Stock Fruits and vegetables DDFresh fruits er) DDCanned fruits (packed in their own juice or wat DDFrozen fruits DDFresh vegetables DDPre-cut fresh vegetables DDFrozen vegetables (no sauce) DDSalad in a bag DDFat-free tomato sauce DD100% fruit juice, including calcium-fortified (but limit juice intake to 4 ounces Don’t shop when you’re hungry It’s harder to resist buying higher fat, higher calorie snack items when you’re hungry. So set yourself up for success and shop after you’ve eaten a good meal. If you do find yourself shopping on an empty stomach, drink some water or buy a piece of fruit to munch on. Read nutrition labels Check nutrition labels for serving size, calories, fat, cholesterol and sodium. Remember, even low-fat and fat-free foods can pack a lot of calories. Don’t be fooled. The label will list calories, fat, sodium and cholesterol for one serving — but it’s always tempting to eat more than one serving. Make sure to compare similar products so that you can choose the healthiest options. a day) Dairy DDFat-free or 1% milk DDLow-fat or fat-free yogurt DDLow-fat or fat-free cheese Whole grains DDWhole-grain breakfast cereal DDRice (brown, wild, blends) DDOatmeal DDWhole-grain bread DDWhole-grain pita bread DDWhole-grain pasta Protein DDLow-fat refried beans DDBlack, kidney or navy beans DDLow-sodium water-packed tuna DDOther fish with omega-3 fatty acids DDSkinless white-meat poultry DDSoy cheese DDTofu How to get the most out of reading nutrition labels Nutrition Facts Serving Size 16 Crackers (31 g) Servings Per Container About 9 a Check the serving size Amount Per Serving How many servings are in the container? Calories 170 a Check the calories in one serving Calories from Fat 55 Serving sizes can be deceptively small; 9% Saturated Fat 1 g 6% Trans Fat 1 g multiply calories per serving by how much Polyunsaturated Fat 2 g you’re really likely to eat. Monounsaturated Fat 2 g Cholesterol 0 mg a Check the % Daily Value* • 5% or less is low • 20% or more is high % Daily Value* Total Fat 6 g† Sodium 270 mg 0% 11% Total Carbohydrate 21 g 7% Dietary Fiber 1 g 4% Sugars 3 g Protein 8 g *Percent Daily Value (DV) in one serving is based on a 2,000-calorie diet for adults. For example, the recommended goal for dietary fiber is 25 grams, so 1 gram is 4% DV. Your DV may be higher or lower, depending on your calorie needs. Adapted from FDA, Center for Food Safety and Applied Nutrition, 2010 30 My Weight Solution Limit nutrients shown in orange. Vitamin A 4% Vitamin C 2% Calcium 20% Iron 4% Get enough of nutrients shown in green. Keep intake of saturated fat and trans fat as low as possible. All fats are high in calories. † Mayo Clinic 31 2 Live it! STrategy two follow the pyramid Practice healthy cooking Healthy cooking doesn’t mean you have to become a gourmet chef or invest in special cookware. Sometimes, using healthier cooking techniques is quicker and more convenient. ➊ Try these healthier cooking methods. • Use oil sparingly. Choose olive, canola or peanut oils. • Use nonstick cookware. Or try cooking sprays, low-sodium broth, water or wine instead of oil or butter. • Try baking. It’s a healthier way to cook seafood, poultry and lean meat. You can even bake vegetables (splashed with a bit of olive oil) and fruit. • Learn how to braise. Brown meat or poultry in a pan on top of the stove, and then slowly cook it covered with a small amount of water or broth. Use the leftover cooking liquid for a flavorful, nutrient-rich sauce. • Grill or broil. Fat will drip away. • Add vegetables. Chop them and mix into lean ground beef, for example, to reduce the portion size of the meat. • Poach. This works especially well with fish, where you gently simmer in low-fat broth or wine and fresh herbs. • Roast. For poultry, seafood and meat, place a rack inside a roasting pan so that the fat can drip away while food cooks in the oven. • Saute. It’s a quick way to cook small or thin pieces of food. 32 My Weight Solution • Steam. Place your food in a perforated basket suspended above simmering liquid. Add seasonings to the water and flavor vegetables or meats as they cook. • Stir-fry. You can quickly cook food using only a small amount of oil or cooking spray. ➍ Find tasty alternatives to meat. • Make meat-free entrees, such as wholewheat pasta with tomato sauce and lots of vegetables, red beans and rice, split pea or lentil soup, or three-bean chili. • Try a veggie burger or veggie hot dog. • Stir-fry tofu or scramble it like an egg. • Try textured soy or vegetable protein. ➋ Find new ways to add flavor. • Season foods with a variety of herbs, spices and low-fat condiments. • Top chicken breast with fresh salsa. • Make meats more flavorful with low-fat marinades or spices, such as bay leaf, chili powder, dry mustard, garlic, ginger, oregano or thyme. • To bring out the sweetness in baked goods, use a bit more vanilla, cinnamon or nutmeg. ➎ Don’t forget about fish. • Two servings a week (about 3 ounces each) of fish rich in omega-3 fatty acids can reduce your risk of heart disease as part of a heart-healthy diet. • Anchovies, bluefish, herring, salmon, sardines, trout (rainbow and lake), light canned tuna and whitefish* are good choices. • Broil, grill, bake or steam your fish for the healthiest benefits. ➌ Choose lean meat and smaller portions. • Use lean meat, poultry and fish in amounts no larger than a deck of cards. • Trim all visible fat from meat before cooking and drain off all fat drippings after cooking. • Focus on main dishes that include a balance of vegetables and meat, such as soups, stews, casseroles and stir-fry. Serve meat dishes over brown rice or whole-wheat pasta instead of alone. • Choose beef with the least marbling; ask for cuts from the round and loin. Lean ground beef, turkey or chicken breast also are good choices. • If you eat pork, choose lean cuts, such as pork loin and tenderloin. *Due to mercury levels, pregnant women, nursing mothers and young children should avoid shark, swordfish, king mackerel and tilefish (golden bass or golden snapper) and eat no more than 6 ounces of albacore (white) or bluefin tuna a week. Get a supply of chopped veggies ready on Sunday. Then add them to lean ground beef or into ovenbaked meals on busy weekdays. You’ll increase your veggie intake and decrease the portion size of meat in your meals. Mayo Clinic 33 2 Live it! STrategy two follow the pyramid Eating out: Test your habits Adapting recipes If the recipe calls for Try substituting DDFor sandwiches, substitute tomato slices, ketchup or mustard. DDFor stove-top cooking, saute food in broth or small amounts of Butter Margarine Shortening Oil healthy oil, like olive, canola or peanut, or use cooking spray. DDIn marinades, substitute diluted fruit juice, wine or balsamic vinegar. DDIn cakes or bars, replace half the fat or oil with the same amount of applesauce, prune purée or commercial fat substitute. DDTo avoid dense, soggy or flat baked goods, don’t substitute oil for butter or shortening, and don't substitute diet, whipped or tub-style margarine for regular margarine. DDKeep it lean. In soup, chili or stir-fry, replace most of the meat with Meat Whole milk (regular or evaporated) Whole egg (yolk and white) Sour cream Cream cheese beans or vegetables. As an entree, keep it to no more than the size of a deck of cards — load up on vegetables. DDFat-free or 1% milk, or evaporated skim milk. DD¼ cup egg substitute or two egg whites for breakfast or in baked goods. White flour and toppings. Note that fat-free, low-fat and light varieties do not work well for baking. half without affecting texture or taste, but use no less than ¼ cup of sugar for every cup of flour to keep items moist. DDReplace half or more of white flour with whole-grain pastry flour or regular whole-grain flour. DDUse herbs (1 tablespoon fresh = 1 teaspoon dried = ¼ teaspoon Salt 34 My Weight Solution ➊ How often do you eat out? powder). Add toward the end of cooking and use sparingly — you can always add more. DDSalt is required when baking yeast-leavened items. Otherwise you may reduce salt by half in cookies and bars. Not needed when boiling pasta. a. b. c. d. On occasion Once or twice a week Three or four times a week Every day or almost every day The special may not be the healthiest item. Items listed as healthy or that are prepared or served in a healthier manner tend to be your best bet. ➍ How often do you order an appetizer? The more you eat out, the more important it is to have a plan, make wise selections and not be tempted by foods that aren’t part of your plan. ➋ Where do you generally eat out? Appetizers often aren’t the healthiest items on the menu, and they tend to be a source of hidden fat and calories. DDFat-free, low-fat or light varieties in dips, spreads, salad dressings DDIn most baked goods, you can reduce the amount of sugar by oneSugar Eating out is convenient, efficient and — let’s face it — fun. By adopting some healthy habits, you can enjoy eating out without packing on extra pounds. Get started by assessing your restaurant habits with these questions: a. b. c. d. Restaurants that specialize in healthy foods Restaurants that include a mix of foods, including healthy entrees Restaurants with a few healthy items Restaurants without any healthy items, except salad Where you eat out can make a big difference in whether you’re able to eat healthfully and stick to your meal plan. ➌ What do you generally order? a. One of the items marked as healthy on the menu b. A food that appears to be somewhat healthy c. A favorite food prepared or served more healthfully d. Whatever is on special a.Never b. Once in a while c. Occasionally, in place of a meal d. Frequently or always ➎ How do you deal with large portions? a. b. c. d. Take half of it home in a carryout bag Split a meal with someone else Stop eating only when you feel full Eat it all Portion sizes in restaurants — even lunch size — are typically too large. It’s better to share or ask for a carryout bag than to rely on If most of your answers are: yourself to stop • a and b, you’ ve developed go od eating when habits when dini ng out, or you’re served a you’re on the righ t track. large amount. • c and d, thin k about how yo u can improve your eating-out habits. Review the tips on pages 36-37. Mayo Clinic 35 2 Live it! STrategy two follow the pyramid Tips for dining out With all the choices for dining out, it’s hard not to take advantage of the fun and convenience of restaurant food once in a while. But eating out a lot is a quick way to put on pounds. Make the most of dining out in a healthy way with these tips: Keep hunger under control — eat. • Don’t skip a meal on the day you’re going out to eat. • Eat a light, healthy snack (such as a piece of fruit or a glass of fat-free milk) an hour before your meal to avoid eating too much at the restaurant. Don’t give up Cut out or cut back on the condiments. Approach buffets with a plan. • Taste your food before adding salt, butter, sauces and dressings. • Order sauces and dressings on the side; even small amounts add up. • Substitute healthier condiments. Use mustard instead of mayonnaise. Use pepper or lemon juice in place of salt. • Don’t be tempted to get more than your money’s worth by overfilling your plate. Instead, survey the entire buffet line and choose healthier options. • Make salad your first course, with plenty of veggies, fruit, and no-fat or low-fat dressing. Then go back for the entree or just eat more salad. Choose restaurants that offer variety. • Choose a restaurant that offers lots of variety, with low-fat options. • Call the restaurant ahead of time to ask about healthy menu items. Or go online to check its website to see if nutrition information is posted. Control fat. • Order baked or broiled. Avoid fried. • Ask for smaller portions of fatty foods — such as meats and fatty sauces — or ask for substitutions. it’ll help you cut calories. • Eat slowly for better digestion. You’ll feel full before overeating. • Don’t gulp your food; chew thoroughly. • Order food that requires work and slows your eating, such as crab legs. • Share your meal with a companion. Order beverages with few Order more plant-based foods. • Try an exotic fruit — kiwi or papaya for example — for variety. • Order your favorite vegetables, but don’t smother them in rich, high-fat dressings or cream sauces. • Order items that include whole-grain foods to get your fiber. Mind your manners — Get the facts firs t or no calories. • Order water or sparkling water with a twist of lemon — it’s healthy, filling and has no calories. • For a hot drink, try black decaf coffee or hot tea, minus sugar and other extras. Many chain rest aurants, including fast-f ood franchises , post their men us and nutritio n information on their websites. So before you go , you can look for healthy opti ons and decide what to order. etizers, Avoid app aded especially bre or fried. so 36 My Weight Solution ased y. ups, not cream Go for broth-b When you find yo urself caught in a situ ation with mostly unhealth y options, don’t throw in th e towel. Instead, eat th e healthiest food you can fin d and do your best to contro l portion size. • Be aware that alcoholic beverages may have more calories than you’d expect, and alcohol may stimulate your appetite and weaken your willpower. Wait before ordering dessert. • Finish the main dish. By the time you’re done, you may not want dessert. • If you do order dessert, split it with a friend or take half of it home. Control portion size. • Leave food on your plate. • If you’re tempted to clean your plate, ask your server to remove it. • Take a carryout bag — it gives you two meals for the price of one. Order your salad dressings on the side; skip crouto ns and cheese. Skip the brea d, or choose whole-gra in. Pick veggies as d ea your side inst of fries, chips or salads with ased mayonnaise-b dressings. Mayo Clinic 37 3 Live it! strategy three Burn calories by being active The fastest way to lose weight is to reduce calorie intake and burn more calories with daily physical activity. The benefits of this powerful combination include more than weight loss. Physical activity improves your overall well-being and helps prevent or manage heart disease, high blood pressure, stroke, diabetes, osteoporosis, some types of cancer and depression. If you’ve never Wherever you are, start! Stick with what motivates you For most people, getting started on a more active lifestyle is the hardest part. Here are some things to consider as you embark on your plan to get more active: When it comes to physical activity, by all means go for enjoyment. (See page 42 for a starter list of ideas.) Here are some examples of how to make your routine work for you: • Start with easy activities to avoid burnout or injury. • Gradually build up your endurance. • Schedule specific times to be active — and make moving a priority. • Track your progress. • Find a buddy to walk or work out with. • Get the support of family who can help you rally on days you’re feeling sluggish. • Set weekly goals and gently evaluate what worked and what didn’t. • Be realistic and fit in activity when it works for you. If you aren’t a morning person, exercising at 4:30 a.m. isn’t going to work. Try right after work instead. Focus on activity and exercise All physical activity — including mowing the lawn, playing ball with the kids or taking the stairs at work — burns calories. More structured exercise, such as brisk walking, swimming laps and lifting weights, can help you burn even more calories. The key is making a plan that is varied and lively. started down a healthier path. 38 My Weight Solution nds off, move! Studies show th at people who lo se more than 30 po unds and keep it off for five ye ars are physical ly active an hour ea ch day. The mos t common activity is walking. That may sound like a lot of time if yo u haven’t been ph ysically active, bu t you can work yo ur way up. Talk to your doctor before increasing your physical activity if: DDYou are middle-aged or older DDYou are significantly overweight DDYou have been inactive for several years DDYou smoke or have a heart condition or other chronic health problem been physically active, even a brisk walk a few times a week is a great way to get To keep the pou • Pick activities that help you build a healthy and fun habit for a lifetime. • Remember that 10 minutes of activity three times a day has many of the same benefits of a 30-minute session. • When in doubt: Walk! DDAre taking medicines that might need to be adjusted with increased activity Mayo Clinic 39 3 Live it! STrategy three burn calories by being active How you can step into fitness When it comes to getting more active, take it one day at a time and add more challenge as you’re ready. Walk for fitness and weight loss Follow these tips to start a walking program and prevent pain and injuries: • Start slow and easy. Unless you’re a seasoned walker, give yourself several weeks to work up to a schedule of 30 minutes or more five days a week. • Dress appropriately. Wear comfortable walking shoes that fit well along with loosefitting clothing and layers to adjust to any change in temperature. Try this 10-week walking schedule • Warm up. Spend five to 10 minutes walking slowly (or walk in place) to reduce your risk of injury. • Stretch. After warming up, stretch your muscles for about five minutes before walking. • Maintain good posture. Hold your head high, swing your arms naturally, and gently tighten your stomach muscles, with feet shoulder-width apart. • Assess your intensity. If you’re so out of breath that you can’t carry on a conversation, you’re probably walking too fast and should slow down. • Track your progress. Track how many steps or miles you walk and how long it takes — a pedometer is a great tool. • Make walking fun. Plan several different routes for variety. Listen to your favorite music. Invite friends or family to join you. This 10-week walking schedule can start you on the path to better fitness and health.* Aerobic activities The three pillars of fitness why Balance your physical activity routine To get the best results, your routine should include all of the following types of exercise. Aerobics Aerobic or cardiovascular (cardio) activity is a great choice for weight loss. Aerobic means “with oxygen.” These activities increase your breathing and heart rate and ultimately help you use oxygen more efficiently. Aerobic exercise increases your stamina and burns more calories than other types of activity. Examples of aerobic activities: • Walking • Jogging • Bicycling • Swimming • Dancing • Exercising with fitness equipment, such as an elliptical machine or treadmill • Water aerobics • Rowing • Cross-country skiing *Before starting this walking plan, you may need to talk with your doctor. Suggested times do not include warm-up and cool-down time. For heart and lung health and to lose weight or maintain a healthy weight At least 30 minutes on m ost days; how often more if trying to lose weight or maintain weight loss Stretching For better flexibility and joint health A few minutes before and after aerobic activities Strength training For bone health and to get stronger and leaner Two or three days a week, but not on consecutive days Make sure to warm up for five to 10 minutes before your aerobic activity by doing a low-intensity version, such as walking slowly before a brisk walk or jog. After your aerobic activity, cool down for five to 10 minutes to allow your heart rate to return to normal. It’s a good idea to stretch your muscles after cooling down. Stretching and flexibility Stretching is an important part of any exercise program. Regular stretching: • Improves range of motion of your joints • Improves circulation • Helps your posture • Helps relieve stress by relaxing muscles • May help prevent injury by maximizing joint range of motion Strength training: Not just for athletes Improving your muscle strength can boost metabolism, relieve arthritis pain, improve balance and Week 1 15 minutes, 2 days 30 minutes a week Week 2 15 minutes, 3 days 45 minutes a week 40 My Weight Solution Week 3 20 minutes, 3 days 60 minutes a week Week 4 25 minutes, 3 days 75 minutes a week relieve depression symptoms — all for a relatively small time investment. Just two to three workouts Week 5-6 30 minutes, 3 days 90 minutes a week Week 7-8 Week 9-10 a week provide significant benefits. And for most people, a single set of repetitions with a weight that 30 minutes, 4 days 120 minutes a week 30 minutes, 5 days 150 minutes a week the different parts of the body — your legs, hips, back, chest, stomach, shoulders and arms. Heavy tires the muscles after 12 to 15 repetitions is enough to build strength. Choose activities that work all gardening, lifting weights, push-ups, sit-ups and working with resistance bands can help keep variety in your routine. Mayo Clinic 41 3 Live it! STrategy three burn calories by being active n when you enjoy Exercise is more fu d help getting Nee what you’re doing. ese options. th started? Consider Choose activities you enjoy Go solo cAerobics c Bicycling: stationary or outdoors c Canoeing, kayaking or rowing c Elliptical training cHiking c Horseback riding c Jogging or running c Jumping rope c Skating: ice or in-line (rollerblading) c Skiing: cross-country, downhill or ski machine cSnowshoeing c Stair climbing cSwimming cWalking cWeightlifting Take a class cAerobics cDancing cKickboxing c Martial arts cPilates c Spinning (indoor cycling) cStep c Strength training c Tai chi c Water aerobics cYoga Bring a friend cBadminton cCatch c Dancing cFrisbee c Frisbee golf cGolfing cRacquetball cSquash c Table tennis c Tandem bicycling cTennis c Video games that require physical activity Be safe and active Most fitness injuries result from trying to do too much too soon. You can protect yourself as you start to burn those extra calories. Start with less intense activity before attempting more intense exercise. To build up, increase your exercise in this order: • Frequency — number of days a week • Duration — length of activity session • Intensity — how hard you’re working If you’re interested in burning even more calories and are physically capable of the effort, higher intensity exercise may help. This involves repeated bursts of intense activity separated by short recovery periods, such as walking or cycling fast for several minutes, then slowing down and repeating. Strengthen your core The area around your trunk and pelvis is known as your “core.” Because virtually all movement in your body originates here, it’s important to keep your core strong. When you have good core stability, the muscles in your pelvis, lower back, hips and abdomen work in harmony and provide support to your spine. Find a team cBaseball cBasketball cBowling cBroomball cFootball cHandball c Hockey: field or ice cLacrosse cRugby cSoccer cSoftball cTennis c Ultimate Frisbee cVolleyball Abdominal bridges and planks are classic core exercises. Try crunches on a fitness ball for added challenge. Since body position and alignment are important for these types of exercises, consult a trained professional before you start. Warning signs: When to stop Moderate activity should cause you to breathe faster and feel like you’re working. Mild muscle soreness following exercise is common. This is especially true when you are trying something new. But pain during exercise can signal an impending injury. If you have any of the following signs and symptoms during exercise, stop and seek medical help immediately: 42 My Weight Solution DDChest pain or tightness DDDizziness or faintness DDPain in an arm or your jaw DDSevere shortness of breath DDExcessive fatigue DDBursts of very rapid or slow heart rate DDAn irregular heartbeat DDSevere joint or muscle pain DDJoint swelling Mayo Clinic 43 3 Live it! STrategy three burn calories by being active Boost your everyday activity The key to keeping physically active is making it convenient. Whether at work or on the road, plan ahead how you’ll squeeze in all the activity you can get. To fit physical activity into your home life: • Wake up early. Get up 30 minutes earlier than you normally do. Use the time to walk on your treadmill or take a brisk walk around the neighborhood. • Make household chores count. Mop the floor, scrub the tub, mow the lawn with a push mower or do other chores at a pace fast enough to get your heart pumping. • Be active while watching TV. Use hand weights, ride a stationary bike or stretch during your favorite shows. Or take advantage of video exercise technology like fitness or dance games. • Involve the whole family. Take group walks before or after dinner. Play catch. Ride your bikes. • Get your dog into the act. Take daily walks with Fido. If you don’t have a dog, offer to walk your neighbor’s dog. (Or get your neighbor out, too!) To fit in more physical activity while you’re on the job: Calories burned in 1 hour Calorie expenditure for a variety of activities varies widely depending on the type of exercise, intensity level and individual. If you weigh less than 160 pounds, your calories burned would be somewhat less than shown, and if you • Make the most of your commute. Walk or bike to work. If you ride the bus, get off a few blocks early and walk the rest of the way. weigh more than 240 pounds, calories burned would be somewhat more. Activity (one-hour duration) Weight of person and calories burned 160 pounds (73 kilograms) 200 pounds (91 kilograms) 240 pounds (109 kilograms) • Schedule physical activity as an appointment. Don’t change your plans for physical activity unless you absolutely have to — this is important to your health. Aerobics, low impact 365 455 545 Aerobics, water 292 364 436 Basketball game 584 728 872 Bicycling, < 10 mph, leisure 292 364 436 Bowling 219 273 327 • Take the stairs. If you have a meeting on another floor, get off the elevator a few floors early and use the stairs. Better yet, skip the elevator entirely. Dancing, ballroom 219 273 327 Football, touch, flag, general 584 728 872 Golfing, carrying clubs 329 410 491 Hiking 438 546 654 Ice skating 511 637 763 Jogging, 5 mph 584 728 872 Racquetball, casual, general 511 637 763 Rope jumping 730 910 1,090 Rowing, stationary 511 637 763 Running, 8 mph 986 1,229 1,472 Skiing, cross-country 511 637 763 Skiing, downhill 365 455 545 Softball or baseball 365 455 545 Stair treadmill 657 819 981 Swimming, laps 511 637 763 Tennis, singles 584 728 872 Volleyball 292 364 436 Walking, 2 mph 183 228 273 Walking, 3.5 mph 277 346 414 Weightlifting 219 273 327 • Take fitness breaks. Rather than hanging out in the lounge with coffee or a snack, take a short walk. • Start a lunchtime walking group with your co-workers. The regular routine and the support of your co-workers may help you stick with the program. • If you travel for work, stay physically active. Choose a hotel that has fitness facilities or just get out and walk when you have the chance. Based on Ainsworth BE, et al., Medicine & Science in Sports & Exercise, 2000 44 My Weight Solution Mayo Clinic 45 Bonus section: How to stick with your commitment You’ve learned how to set goals and make a plan for healthier eating and burning more calories. You’ve discovered the value of tracking your progress and you’ve made adjustments as you go along. Now, how do you keep it up? Even with the best of intentions, many people stay on a diet for only a week or two before giving up. Learning new habits takes more than willpower — it takes a commitment to change. It requires ongoing inspiration and motivation. It means picking yourself up when you’ve fallen off track. The following pages are designed to help you refine your change strategies, get beyond the occasional lapse and keep up your motivation. With a little help, you can keep up your resolve, enlist support, solve problems and get back on track when you have a lapse. Change behaviors Studies of human behavior have uncovered some tested approaches to adopting new habits. You can be your own coach as you try some of these strategies for “changing for good.” In the pages that follow, you’ll learn about four methods to try for yourself. If one doesn’t work for you, move on to another. Or combine aspects of several methods until change starts to come naturally. As always, be patient with yourself as you learn more about how you approach and respond to change. Change your mind To succeed at weight loss, you’ll need to check your inner thoughts for patterns that 46 My Weight Solution sabotage your efforts. Negative self-talk, stress, inflexibility, “all-or-nothing thinking” — many people are surprised to find that their inner voice works against their efforts. You can “unlearn” these habits and switch to new ways of thinking that strengthen your resolve and move you toward your goals. Overcome challenges We all experience setbacks when embarking on a weight-loss program. So learn to expect them! And be prepared in advance with tricks and methods for moving beyond them. This section of your book is full of tools and ideas for revisiting your goals, brainstorming solutions to problems, overcoming barriers and breaking through plateaus. Stay connected We’re social beings. And our friends, coworkers and family have a major influence on our habits. So when the going gets tough, it’s important to surround yourself with people who can help. A support network not only energizes your weight-loss journey but keeps you accountable when you can’t do so for yourself. Keeping friends and family involved in your healthier lifestyle has the added benefit of encouraging them to adopt healthier habits. Ready to learn more? Read on! Change behaviors To lose weight, you may need to change habits you’ve developed over many years — often without thinking about them. It may feel like trying to move a mountain. It can be discouraging when cravings get the best of you or when you can’t seem to stick with your physical activity goals. Go easy on yourself as you strive to make big lifestyle changes. It takes time for new habits to feel natural. But you can do it if you keep a positive attitude, stay committed and focus on small, doable changes. Below are four approaches to changing behaviors. Choose one that makes sense for you. If that doesn’t work, think about trying a different approach. You’ll find many ideas in the bonus section that follows. ABC approach Heading off problems before they develop is the crux of this approach. A stands for antecedent, B stands for behavior and C stands for consequence. Most behaviors have an antecedent — or cause. And causes lead to consequences. By addressing antecedents (causes) first, you can prevent unwanted consequences. You might decide not to buy ice cream, because keeping it in the freezer (antecedent) leads you to eat most or all of it in one sitting (behavior), which disrupts your weight program (consequence). 48 My Weight Solution How to make new habits last All of us approach the process of personal change a little differently. But anyone can take a cue from these key principles as you work to adopt new habits: Build confidence. Focus on strategies that play to your strengths and your skills. Consider how you have succeeded in the past and build your plan from there. Create a routine. An eating or activity schedule can create a better sense of control. Make sure your schedule is one that truly works for your life and not one you can follow only short-term. Distraction approach This is a way to change unhealthy eating habits by focusing your attention on something else when food cravings start. To use this approach, when you feel a craving coming on, remind yourself it will last for 20 minutes at most. Then do something — call a friend, read a book, revisit your goals, take a walk — anything that will distract you until the feeling passes. Focus on what you’re adding to your life. And try not to fixate on what you’re giving up. Recognize and celebrate success as you notice even the smallest positive changes in how you look and feel. Confrontation approach This approach to behavior change requires that you confront yourself mentally about the negative impact of your behavior. For example: If you’re craving cookies, think about the unnecessary calories and fat you’ll be consuming — how tired and sluggish you’ll feel afterward. Remind yourself this isn’t what you want to do with your life. Make your program your own. Take a day off from exercise, or enjoy one of your favorite foods once in a while. The more you make your program work for you, the less likely you are to rebel against it. Shaping approach Try changing your behavior gradually, one step at a time. Instead of eliminating evening snacks altogether, start with a rule of no snack one night a week. Increase that to two nights a week. Eventually you might be able to scale back to a snack one evening a week. As you succeed with step-by-step changes, you’ll build confidence and start fueling even more successes. Mayo Clinic 49 Change your mind The best motivation comes from within. But several common problems can sidetrack your intentions, sap your motivation and keep you from reaching your goals. Negative beliefs and self-talk The internal dialog you have with yourself influences your actions. Thoughts such as “I’ll never lose weight” or “I’m no good at exercising” can weaken your self-esteem and stall your progress. Replace these thoughts with positive statements. Instead of: “I can’t stick with an exercise program,” tell yourself: “I can meet one realistic goal today.” Unrealistic expectations Many people imagine that losing weight will solve all their problems. Your life will likely change with weight loss — but probably not in all the ways you imagine. Losing weight doesn’t guarantee a better social life or more satisfying job. Keep your expectations focused on those very real benefits like more energy and higher self-esteem. Inflexibility Words such as always, never or must place undue pressure on you. Telling yourself you’ll never eat chocolate again or you must walk two miles a day can lead to guilt-ridden lapses. Be flexible. Treat yourself now and then in ways that make sense — when you’re out to dinner with friends, not when you’re feeling sad. 50 My Weight Solution All-or-nothing thinking Emotional eating One setback doesn’t mean failure. If you eat too much one day, you haven’t blown your plan. Counteract this kind of thinking with moderation — no “good” and “bad” foods, for example, and it’s OK to have dessert once in a while. Remind yourself you can get back on track tomorrow. Many people turn to food for comfort when they’re dealing with problems or to suppress negative feelings, which can lead to eating too much, especially high-calorie, sweet, salty and fatty foods. Depression and anxiety You can learn to separate food from mood. Accept occasional lapses without judgment and try some of these steps: Disorders such as depression and anxiety can make it difficult to lose weight. If you have signs of a mood disorder — sleeping more or less than usual or feeling down a lot of the time — talk to your doctor about your symptoms and possible treatment options. Stress When you’re faced with stress, you may overeat to ease your anxiety. How to cope? • Manage your time by planning, pacing and prioritizing your activities. • Learn to say no to new responsibilities. • Set aside one night each week for fun; take a day off with no set plans. • Organize work and living spaces so that you know where things are. • Keep up your daily physical activity. • Learn to delegate responsibility. • Practice relaxation techniques, such as deep breathing and meditation. • Have a good laugh. • Seek professional help if necessary. • Soothe yourself with healthier “comfort” food alternatives like a bowl of tomato soup or a cup of tea. • Distract yourself from eating, call a friend, run an errand or take a walk. • Monitor your mood; learn to distinguish true hunger from emotional eating. • When you feel down, try to replace your negative thoughts with positive ones. DDPhysical factors. Does skipping breakfast cause you to lose control of your eating? When you’re tired, do you turn to junk food for energy? DDFoods. Are there some DDActivities. When you watch TV or read, do you always have a snack at hand? Do you eat at your desk while you work or while you’re preparing dinner? foods that you can’t eat in moderation? Do you find that the sight or smell of certain foods tempts you to overeat? DDTime of day. Are there certain times of the day when you’re more susceptible to overeating? DDSocial situations. Do DDEmotions. Do certain feelings cause you to snack — boredom, loneliness, stress or anxiety? What are your eating triggers? Identifying situations that cause you trouble can help you develop strategies to overcome them. Track these items in your food record or journal to become more aware of your patterns. you eat more when you’re around certain people? Do you snack anytime your partner does? Mayo Clinic 51 Answer these questions to assess how mindfully (or mindlessly) you’re eating. Be mindful: Most of us find ourselves in the habit of mindless eating — eating on the run or in front of the TV, eating when bored or distracted, or eating just because the food is there. This unconscious eating can often lead to an equally unconscious, creeping weight gain. The antidote to mindless eating is mindful eating. This approach to eating and weight loss stems from the practice called mindfulness — a state of being aware in the present moment in a particular way: on purpose and without judgment. Mindfulness pulls you out of your habitual patterns of thinking, feeling and acting. Mindful eating allows you to notice each bite or sip you take. It helps focus your senses on exploring, savoring and tasting your food. It puts you in touch with your eating triggers and helps you become more conscious of what and how much you eat and drink. Savor every moment How mindful are you? ➊ What else are you doing while DDMindful eating means being fully aware of you’re eating? what you’re doing. Pay attention to your a. Watching a movie or TV breathing and how your body feels as you b. Reading start to eat. Enjoy each bite, appreciating the c. Preparing food sensory qualities of the food. d. Sitting at the table and focusing on eating ➍ How do you know when you’ve DDEating while you do other things can be eaten enough? distracting and lead to eating more calories a. When I feel so full I can't eat more than you intended to. You may even begin to b. When I’ve cleaned my plate feel the need to eat whenever you do these c. When my body says to stop activities. Break the link — enjoy your food d. I don’t know “mindfully,” without distraction. DDEat slowly and stop before you’re full. Try ➋ How long does it generally take putting down your fork periodically. Breathe you to eat a meal? and stay relaxed as you tune in to your body’s a. Less than five minutes signals. It may take some time to learn to be b. Five to 10 minutes mindful of the difference between eating c. 10 to 20 minutes because you are truly hungry and eating for d. More than 20 minutes other reasons like boredom or stress. DDThe longer it takes you to finish a meal, the ➎ How do you respond when you make an eating choice that wasn’t OK? more time your senses can take to fully experience your meal — to feel the fork in your hand, to notice the aromas, textures and a. Frustrated and angry with myself b. Quickly put it out of my mind tastes. You eat less as you notice more and c. Feel like giving up leave time for your body to feel satisfied. d. Accepting and curious ➌ Where is your attention as you eat? DDPart of mindfulness is observing feelings and a. Too busy to notice much behaviors as they happen — and being simply b. On how many calories are in my food curious about them. If you’ve overeaten, just c. Zoned out, almost as if I’m in a trance accept what happened with compassion for d. On how my food looks, smells and tastes yourself and with no judgment. Bring your awareness back to the present, breathing and becoming conscious of what's happening in the moment. What can you learn? 52 My Weight Solution Mayo Clinic 53 Stay connected How to be a more mindful eater Try these ideas to increase your mindfulness as you prepare and eat meals: • Practice acceptance. Be aware of critical or judgmental thoughts about food, your eating habits and your body. Accept the moment — and your body — as it is. • Make a conscious decision to eat. Before you eat, ask yourself, “How hungry am I right now? Am I eating out of hunger, habit, boredom or emotion?” • Reserve time for your meal. Don’t eat on the run. If you’re eating with others, involve them in preparing the food. • Avoid distractions while eating. Eat at a table. Turn off the TV and put away your phone, work, books and magazines until you are done. • Appreciate your food. Start your meal by saying grace or a prayer or by offering another expression of gratitude. • Breathe. Before and during your meal, consciously take a few deep breaths. • Use all your senses to fully experience your food and drinks. Observe the smells, textures, sounds, colors and tastes. Ask yourself how much you’re enjoying the food and how appealing it is. • Choose modest portions to avoid overeating. Eat small bites, and chew slowly. Appreciate that your food fills you up and makes you healthy. A ‘taste’ of mindful eating Try this exercise to gain a firsthand understanding of mindful eating. 1. Choose one piece of food you like, such as a strawberry. 2. Take a moment to look at the berry. Breathe in and out a few times to help yourself focus. Notice the color, texture and shape. What does it feel like in your fingers? Smell the strawberry. 3. Take a bite of the strawberry. Before you start chewing, notice what it feels like in your mouth. Slowly eat the berry as you focus on the act of chewing and then swallowing. What does it taste like? 4. Savor the taste of the strawberry and immerse yourself in this moment and nothing else — no projects or deadlines, no worries, no past, no future. As you slow down the process of eating to become fully aware of the experience, you connect more closely with your food. If you eat just one mindful bite during a meal, that’s a good start. Mindful eating can help with weight control by increasing your awareness of physical cues that you’re hungry or satiated. It can help you avoid eating when you’re not really hungry and can prevent overeating. It can help you choose food both pleasing to you and nourishing to your body. Getting support for your weight-loss efforts can mean the difference between success and failure. Support can be emotional: a shoulder to lean on when you’re feeling discouraged. It can be practical: someone to watch the kids while you exercise. It can also be inspiring: an exercise partner who encourages you to get out and move on those days when your favorite TV show seems like a better option. Who’s on your support team? If you don’t have one, create one. Tell your family and friends that you would appreciate their help, especially if they’re reluctant. Remember that it’s not uncommon for a partner or other companion to feel threatened as you lose weight. Your mother may feel hurt if you don’t eat her famous dessert, or your friends may beg you to skip a workout to go out for pizza. Remind your loved ones that while you’re changing your lifestyle, you’re not changing your feelings for them. Give them ways to help. Some people fare better with professional support, such as from a dietitian or health coach. A professionally led group may also help. Or ask a friend, family member or coworker to join your weight program to create your own support group. Even if you want to work on your own, it helps to have people in your corner. To build and maintain a support network: • Stay in touch. Answer phone calls, emails and letters, even when you’re feeling down. • Recognize the importance of give and take. Express your appreciation for support and be ready to return the favor. • Learn to say no. Free time for friends and activities that support your efforts. • Find a partner. Find a co-worker to walk with or a friend to plan or cook healthy meals with. • Practice forgiveness. Set aside past differences and approach relationships with a clean slate. • Join in. Take part in neighborhood events, community organizations, local exercise classes or family get-togethers. Cognitive behavioral therapy If you find yourself struggling with self-defeating attitudes and beliefs, you may benefit from cognitive behavioral therapy. This type of therapy is based on the belief that how you feel stems from how you think about yourself and your life. It helps you confront distorted ways of thinking that can sabotage success, such as focusing on the negative aspects of a situation while filtering out the positive ones. A licensed therapist can help you move toward positive, realistic perceptions. 54 My Weight Solution Mayo Clinic 55 Food and fitness: Make it a family affair If your child is overweight ... Parents play a crucial role in helping children who are overweight to feel loved and to achieve a healthy weight. Take opportunities to build self-esteem: One way to make sure your family supports your weight-loss goals is to help them get involved in your plan. The bonus is that they’ll be more healthy — which can be especially important for children who are overweight or at risk of obesity. Healthy eating, family style Your wise choices can influence your family’s eating behaviors. • Keep healthy foods within arm’s reach for snacking. • Avoid stocking large quantities of unhealthy foods — if it’s not in the house, they (and you) won’t be tempted. • Avoid fast-food restaurants. If you do go, focus on healthier choices. • Take your kids grocery shopping. Teach them how to read food labels (see page 31). Give them options so that they can make choices. • Adapt your recipes so they’re healthier (see page 34). Let your children help. Don’t be afraid to get creative. • Make easy-to-fix healthy meals ahead of time. You can freeze them and heat them when needed. 56 My Weight Solution • If your child’s school rarely offers healthy foods, teach your child how to pack a healthy lunch. And consider talking with other parents and the school to try to initiate a healthier lunch program. • Schedule family meals several times during the week. Children who eat with their families tend to have healthier eating patterns. Include your favorites, as well as your children’s. Encourage them to develop a taste for new foods. • Talk to your kids directly, openly and without being critical. Focus on your child with questions such as “What activity would you find most enjoyable?” “What’s been the hardest part about managing your weight this week?” “What can I do to help?” • Celebrate small changes with nonfood rewards, such as going to the local park. • Help your child focus on positive achievements, such as biking for more than 20 minutes without getting tired. Keep it fun To keep your kids interested in fitness, make it fun: Be silly. Let younger children see how much fun you can have while being physically active. Run like a gorilla. Walk like a spider. Hop like a bunny. Get in the game. Play catch, get the whole family involved in a game of tag or have a rope-jumping contest. Set an example Remember, your kids may follow your example if you: • Eat healthy food s and keep acti ve • Don’t eat he althy foods and are sedentary • Constantly complain about your weight and how you look • Focus on a he althy weight inst ead of model-like th inness Whether your child is overweight or not, avoid food-related power struggles. You might unintentionally lay the groundwork for unhealthy behaviors by providing or withholding certain foods (sweets, for instance) as rewards or punishments. An intense focus on your child’s eating habits and weight can lead your child to overeat even more. Make chores a friendly challenge. Who can pull the most weeds in the garden? Who can collect the most litter around the neighborhood? Try an activity party. For your child’s next birthday, schedule a bowling party, take the kids to a climbing wall or set up relay races in the backyard. Put your kids in charge. Let each child take a turn choosing the activity of the Rather than criticize, focus on the positive — such as the fun of playing outside or the adventure of fresh fruits you can get yearround. Emphasize the benefits of exercise apart from helping to manage weight — for example, it makes muscles stronger. day or week. The key is to find things that your children like to do. Mayo Clinic 57 Overcome challenges Check the healthy-eating barriers that apply to you. Then review possible solutions, including ones you create, with a health professional or other supportive friend or family member. Potential barriers Possible solutions Potential barriers Possible solutions c Lack of • • • • • c Lack of time to • Keep it simple. Serve a fresh salad with fat-free dressing, a wholegrain roll and a piece of fruit. • Stop at a deli or grocery store and buy a healthy sandwich, soup or entree that’s low in calories and fat. confidence c Family resistance c Dislike of vegetables and fruits c Cravings for junk food c Too expensive 58 My Weight Solution Focus on skills that have worked for you in the past. Consider your strengths and play to them. Identify what personally motivates you to succeed. Make small changes over time. When you have a setback, start fresh the next day. • Take it slowly. Make a few small changes each week. • Keep fruit in a location where it’s visible and easy to grab. • Prepare one of your favorite dishes using a different cooking method, such as baking chicken instead of frying. • Ask family members which healthy foods they’d like to try. Give them several options so that they might be more willing to experiment. • Find a few that you do like and eat them more often. • Try vegetables you’ve never had. Add them to your favorite soups or replace some of the meat in casseroles or pizzas with vegetables. • Include fresh fruit with your cereal, and stir fruit into low-fat yogurt or low-fat cottage cheese. • Avoid keeping junk food at home. • Have a glass of water or a piece of fruit instead. • If you can’t resist the urge, buy only a small amount, such as a single serving. Have it along with your meal. • Eat healthy foods first; you won’t be as hungry when you get to the favorites that put your weight at risk. • Try healthier versions, such as baked rather than regular chips. • Track in-store specials on healthy foods at your local grocery. • Buy grains such as oatmeal and brown rice in bulk. • In summer, buy fresh produce at the farmers market for some of the lowest prices. • Eat simple meals occasionally; a peanut butter sandwich on wholewheat bread or a bowl of soup doesn’t cost much. make healthy meals c Don’t like to cook • Use shortcuts such as prepackaged salad greens or raw vegetables. • Check your library for cookbooks that focus on easy, healthy meals; copy and save the recipes and ideas that work best. • Base your meals on ready-to-eat fresh fruits and vegetables. • Explore convenient cooking techniques using a slow cooker or your microwave to save time. c Travel a lot • In your car, pack a cooler with sandwiches, yogurt, fruits and veggies. • On a plane, pack nuts and fruits in your carry-on. • At hotels or conferences, ask for healthy or vegetarian meals or seek out a nearby grocery for easy-to-fix items. c Not hungry at • Start by eating breakfast on two mornings at first, then add a healthy morning meal one day at a time. • Prep a box of cereal and bowl the night before or have a ready-made shake in the refrigerator if time is an issue. • Take breakfast in hand by carrying along apples, bananas, whole-grain bagels or single-serve yogurts as you go. breakfast time Solve problems Life doesn’t follow a perfectly smooth The first step is to identify and course. You will inevitably run into define potential roadblocks and obstacles on the weight-loss journey. brainstorm solutions. Use the It’s how you respond that makes the charts on these pages to identify difference. For long-term success, the barriers most likely to get in you’ll need strategies in place to solve your way and plan ahead how problems as they arise. you’ll face those challenges. Mayo Clinic 59 Tackle exercise barriers Again, check the barriers that present your biggest challenges. Then consider which solutions would work for you. And don’t hesitate to add your own solutions. Potential barriers Possible solutions Potential barriers Possible solutions c Lack of time • • • • Break activity into shorter periods of time, such as 10-minute walks. Identify current time wasters, such as TV watching or Internet use. Plan exercise into your daily schedule. Reframe your concept of exercise to include many everyday activities. c Travel cBoredom • • • • • • • • • Change your routines occasionally. Do a variety of activities rather than just one or two. Work out with a friend or in a group. Join a health club or take a fitness class. Listen to music, watch TV or read while you work out. Challenge yourself with new goals. Experiment with interval training. Learn more about technique. Get a new gadget or piece of equipment. • Find out what fitness facilities, parks or walking paths are available where you’re going. • Walk around the airport terminal. • Stretch and walk during your flight, or take short walking breaks during a road trip. • Work out in your hotel room, and walk the halls and climb the stairs in your hotel. c Injury or • • • • • Work out at home rather than at a club. Choose activities that require minimal facilities and equipment. Incorporate physical activity into your daily routine. Make use of cues or prompts to remind yourself to work out. Choose activities that don’t depend on good weather or daylight. • Warm up and cool down when you exercise. • Talk to your doctor about how to exercise appropriately for your age, fitness level, skill level and health status. • Choose low-risk or low-impact activities such as water aerobics. • Use the proper equipment and dress for the weather conditions. • If you’ve been injured, ask your doctor what you can still do. Choose physical activities involving uninjured parts of your body. cInconvenience cWeather • Choose activities that you can do regardless of the weather, such as indoor cycling, aerobics, indoor swimming, stair climbing, dancing or mall walking. c Life transitions • Consider a moderate program of physical activity during stressful times. c Self- • Find an exercise class with others trying to lose weight. Or find a friend willing to walk, bike or jog with you. • Ask an expert to demonstrate how to use equipment — or how to stretch and train — to increase your confidence. • Be confident that your discomfort will disappear as exercise becomes more routine. consciousness 60 My Weight Solution sore joints c Illness • Avoid strenuous exercise when you’re sick. But you may be able to work out at a reduced intensity. • Don’t exercise if you have a fever, chest pain, shortness of breath, generalized muscle aches, a hacking cough, vomiting, extreme tiredness, diarrhea, chills or swollen lymph glands. c Fatigue • Regular physical activity increases energy. Begin with just 10 minutes of activity — a little is better than none. • Exercise when your energy is highest, whether it's in the morning, afternoon or early evening. • Keep motivational messages where you'll see them often. c Lack of facilities • Select activities you can do on your own, such as walking, jogging or rope jumping. • Identify inexpensive, convenient community resources, such as park and recreation centers or community education programs. or resources Mayo Clinic 61 How to get back on track Habits for life You were slowly and steadily losing weight, but now the scale refuses to budge. Or you’ve lost your resolve and slipped back to old habits. It’s not unusual to hit a plateau or to experience a lapse in your commitment to your weight-loss program. Rather than be hard on yourself, simply be curious about what’s happening and try some of these strategies to get back on track. With time and regular reinforcement, your new Plateaus It’s normal to hit plateaus. Most people reach one after six months of weight loss. Try these solutions: • Review your food and activity records to make sure you haven’t let yourself get by with larger portions or less exercise. • Reduce your daily calorie intake by 200 calories, unless this puts you in a range that’s too low for good health. • Gradually increase your daily exercise time by 15 to 30 minutes. If possible, also increase the intensity. • Focus on three- to four-week trends in weight loss instead of daily changes. • Reassess your program and goals. If it is too much to decrease calories or increase activity, it is better to be satisfied with the weight you have lost than to throw in the towel and regain it. Dealing with lapses A lapse occurs when you revert to your old behaviors temporarily. If several lapses have occurred in a short time, it’s tempting to think your weight-loss plan is too challenging. 62 My Weight Solution Not to worry; a lapse is just that: a shortterm bump in the road. Following these tips will help you get back on track: healthy behaviors will become habits. In fact, there may come a time that you no longer need to keep detailed records of your food intake or physical activity. • Don’t let negative thoughts take over. Mistakes happen, and each day is a chance to start anew. Eventually you’ll know how to identify healthy foods, how many servings a day meet your needs, and what makes a single serving. You’ll look forward to physical activity • Take another small step. Changing your life doesn’t happen all at once. Keep in mind that changing behaviors in small ways can add up to a big difference in your life. that’s a routine part of your day. You’ll have formed new habits and be well on your way to maintaining a healthy weight for life. • Ask for and accept support. Accepting support from other people isn’t a sign of weakness, nor does it mean that you’re failing. Get support from others when you have difficult days. • Plan your strategy. Clearly identify the problem, and then create a list of possible solutions. If one solution doesn’t work, try another until you find one that does. • Work out your frustration with exercise. Keep it upbeat and even fun — don’t use physical activity as a punishment. • Recommit to your goals. Review them to make sure they’re still realistic. Although lapses can be disappointing, they can also teach you a lot. Perhaps your goals are unrealistic or certain strategies don’t work. Above all, realize that all hope isn’t lost when you lapse. Just recharge your motivation, recommit to your program and return to healthy behaviors. Mayo Clinic 63 ½ cup ½ large ear ½ ½ cup 1 small ½ cup 1, 4-inch diameter ½ cup ½ circle, 6-inch diameter 3 cups Chips, low-fat, baked Corn, fresh or canned Corn on the cob Crackers, low-fat » Triple-rye » Whole-wheat English muffin, whole-grain Kasha (buckwheat groats, cooked) Muffin, whole-grain Oatmeal, cooked Pancake, whole-wheat Pasta, whole-grain, cooked Pita bread, whole-grain Popcorn, microwave, low-fat ¾ cup 1 cup cubed or ¹∕³ small melon ²∕³ cup or about 15 ½ cup (4 ounces) 3 small 2 small 1 small, ½ large, ¾ cup sections ½ cup (4 ounces) Blueberries Cantaloupe Cherries Cranberryjuice,100%† Figs, dried Figs, fresh Grapefruit Grapefruitjuice,100%† ½ cup or 4 sprouts ¾ cup 1 cup ½ cup sliced or baby or 1 medium 1 cup cut-up 1 cup diced or 4 medium stalks 1 cup sliced or 1 medium Brussels sprouts Cabbage, cooked Cabbage, raw Carrots Cauliflower Celery Cucumber † 10 chips Cereal, dry, whole-grain† 1 cup Blackberries 1 cup cut-up Broccoli ¾ cup 1 medium 1 medium or ¾ cup sections ½ cup (4 ounces) about ½ cup ½ cup (4 ounces) 3 2 tablespoons Mandarin oranges, canned Mango Melon balls Mixed fruit, fresh Nectarine Orange Orangejuice,100%† Papaya Peach Pear Pineapple Pineapplejuice,100% Plums Pomegranate Pomegranatejuice,100%† Prunes Raisins Raspberries Strawberries Tangerine Watermelon ½ cup or 3 pods ¾ cup or 8 stalks ½ cup sliced See “Protein/Dairy” group ¹∕³ cup 25 medium ¼ cup 3 tablespoons chopped ½ cup 2 cups ¾ cup sliced ½ cup diced 1 medium 8 or 1 cup ¹∕³ cup ½ cup (4 ounces) ½ cup ¾ cup ¾ cup Okra Onions, green (scallions) Onions, red, white or sweet Peas, green Peas, pod or snap Salsa, vegetable Shallots Spinach, cooked Spinach, raw Squash, summer Tomatillo Tomato Tomatoes, cherry or grape Tomato sauce, fat-free (includes fat-free marinara, pasta, pizza sauces) Vegetable juice Vegetables, canned Water chestnuts Zucchini, cooked or raw Radishes 30 small sticks or 3 twists 1½ cups ¹/³ cup ½ cup 1 small ¾ cup 1 biscuit or ½ cup spoon-sized Pumpkin, cooked, no sugar Rice, brown, cooked Roll, whole-grain Rutabaga, cooked Shredded wheat, unsweetened ½ large 1, 6-inch diameter 1, 4-inch square Sweet potato, baked Tortilla, corn or fat-free flour Waffle, whole-grain Fruit spread 2 tablespoons 2 tablespoons ¼ cup » Half-and-half » Nondairy liquid creamer » Nondairy whipped topping » Cheddar, low-fat, or Colby, low-fat 2 ounces or ½ cup shredded ²∕³ cup 1½ ounces or ¼ cup 1½ ounces or ½ cup shredded ¼ cup or 1 ounce Cheese » Cottage, low-fat » Mozzarella, part-skim » Parmesan, grated » Ricotta, part-skim » Soy or low-fat Swiss Jam 3 tablespoons 1½ tablespoons » Fat-free » Low-fat 4 halves 2 tablespoons 1 tablespoon 1½ tablespoons 1 tablespoon 1 tablespoon 1 tablespoon 4 tablespoons Peanut butter » Reduced-fat or regular Salad dressing » Fat-free » Low-fat or reduced-fat » Reduced-calorie Seeds » Flaxseed, ground » Sesame » Sunflower Sour cream, fat-free 1 cup 1 cup 2 ounces 2 ounces 3 ounces 4 ounces ½ cup ½ cup 3 ounces or ½ cup 3 ounces 3 ounces 3-ounce patty 1 cup 1 cup » Rice, calcium-fortified » Soy, calcium-fortified Milk,2% Peas, green Pork, lean cuts with no fat Salmon Scallops Shrimp Soybeans, green (edamame) Tofu Tuna, fresh or canned in water Turkey, skinless Veal Vegetarian burger, black bean Yogurt, fat-free, plain Yogurt, low-calorie 9 large or 12 small Olives ¾ cup *Blue indicates the best (and least processed) choices. Remember, low-fat doesn’t always mean low-calorie. † Butter is higher in saturated (bad) fat and cholesterol than is soft (tub) margarine. oNe SerVINg IS: Vegetables Unlimited (minimum 4) Unlimited (minimum 3) 4 to 8 daily servings 3 to 7 daily servings 3 to 5 daily servings Up to 75 calories daily Vegetables Fruits Carbohydrates Protein/Dairy Fats FooD grouP My My DAILy SerVINg goALS calorie diet When a range of recommended servings is shown, the lower number of servings is based on 1,200 calories and the higher number is based on 2,000 calories. Mayo Clinic Healthy Weight Pyramid Fruits Carbohydrates Protein/Dairy Fats Sweets *Or limit to about 500 calories a week. ¹∕³ cup 1½ tablespoons ¹∕³ cup 3-ounce bar 1½ tablespoons ¹∕³ cup 1 tablespoon ½ cup 1½ tablespoons 3 tablespoons ½ ounce or ¹∕³ of standard bar 1 small slice (¹∕12 of 12-ounce cake) To make a handy, portable brochure, copy your guide on a front-and-back sheet *Blue indicates the best (and least processed) choices. 1 teaspoon » Corn, safflower or sunflower ¾ cup (6 ounces) 1½ teaspoons 1 teaspoon » Canola, olive or peanut Oil 4 halves ½ cup Lentils » Walnuts 8 whole » Peanuts » Pecans 4 whole » Cashews Lamb, lean cuts with no fat 1 cup (8 ounces) 7 whole or 4 teaspoons slivered » Almonds ¹∕³ cup 2 ounces Garbanzos » Fat-free or 1% 1 tablespoon Nuts about 3 ounces Fish (also see salmon and tuna) Milk 1 tablespoon » Reduced-calorie Egg whites » Low-fat or light Egg substitute 1 cup or about 6 1 large Egg ½ cup Mayonnaise 4 ounces Crab 4 tablespoons 1 tablespoon » Tub (soft), reduced-fat 3 ounces or 9 small Clams » Fat-free Syrup, maple 2 teaspoons » Trans-free Yogurt, frozen, fat-free Sorbet Margarine Juicebar,frozen,100%juice Ice cream, fat-free, vanilla Cream cheese Honey Gelatin dessert ¹∕³ cup 2 ounces » Feta Cranberry sauce Chocolate, dark Cream 2½ ounces Chicken, skinless 1 teaspoon Butter, regular† 2 ounces Beef, lean Angel food cake FoCuS oN LoW-CALorIe Avocado ¹∕6 medium FoCuS oN uNSATurATeD ½ cup Sweets: 75 calories/serving* (eat sparingly) *Blue indicates the best choices. Breads and cereals vary greatly in calories — check the label. 1 cup Squash, winter, cooked » Chicken noodle, tomato or vegetable 1 cup Soup, made with water oNe SerVINg IS: oNe SerVINg IS: ½ cup Pretzels Beans, black, kidney, navy Fats:* 45 calories/serving (eat sparingly) ½ medium Potato, mashed Rice, wild, cooked 3 » Baked 8 1 ½ cup » Baby, red or yellow FoCuS oN LoW-FAT Protein/Dairy:* 110 calories/serving 1¼ cups cubed or 1 small wedge 1 large or ¾ cup sections 1½ cups whole 1 cup 2 ½ cup (4 ounces) ½ cup cubed or 2 rings 1 small or ½ cup sliced 1 medium or ¾ cup sliced ½ medium or 1 cup cubed ¾ cup 1 cup or about 8 *Blue indicates the best choices. Limit fruit juice to 4 ounces a day — it’s high in calories, low in fiber and less filling than fresh fruit. † 1 large Kiwi ½ cup diced 1 cup cubed Honeydew melon 1 cup whole Lettuce Mushrooms 1 cup or 30 small Grapes, red or green ²∕³ cup 2 cups shredded Kale, cooked *Blue indicates the best choices. Starchy, higher calorie vegetables and soups are listed under “Carbohydrates.” † † ½ cup Bulgur, cooked ¾ cup Berries, mixed 1 medium or 1 cup sliced Bell pepper Potato (skin on) 2, 6- to 8-inch long Breadsticks, crispy, low-fat 1 small or ½ large Banana ½ cup sliced Beets Eggplant, cooked (not fried) 1 cup cubed ¹∕³ cup 1 slice Bread, whole-grain† 4 whole Apricots Bean sprouts ½ small, 3-inch diameter Barley, cooked ½ cup Applesauce, unsweetened ²∕³ cup 1 cup Beans, green 6 Bagel, whole-grain oNe SerVINg IS: ½ cup (4 ounces) FoCuS oN WHoLe grAINS Applejuice,100%† ½ cup or 6 spears Asparagus oNe SerVINg IS: Animal crackers Apple ½ bud or ½ cup hearts Carbohydrates:* 70 calories/serving 1 small FoCuS oN FreSH oNe SerVINg IS: Artichoke Fruits:* 60 calories/serving FoCuS oN FreSH Vegetables:* 25 calories/serving† Pyramid Servings Guide and fold between panels .$
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