Health Management

HEALTH MANAGEMENT

NUTRITION PROGRAM

Your personal nutrition program has been scientifically designed to provide a balance of nutrients to fuel your body for optimal health and performance. You will lose excess body fat, feel better, look better and have more energy.

THIS IS NOT A DIET. Diets don't work because they involve deprivation and unnatural eating patterns that can't be sustained. You can achieve weight loss and positive body composition changes through this program, but you will be following a balanced and healthy eating program, which you will learn to incorporate into your lifestyle for lasting results.

Changing old habits is hard work. But your personal nutrition program makes it easy to follow a healthy eating pattern while giving you the freedom to make your own food choices. This program uses a food exchange system, which provides a blueprint for you to follow. Use the food lists on the following pages along with your personalized nutrition printouts to design your daily menus. If you don't understand the exchange systems at first, simply follow the suggested menus until you are comfortable with using the food lists to create you own menus.

Client Name: ______

EXCHANGE LISTS

CARBOHYDRATES

Carbohydrates -- fruits, vegetables, grains, breads and cereals -- are the foundation of a healthy diet. Carbohydrates are not fattening. They provide energy to fuel your body, plus vitamins, minerals and fiber.

FRUITS

Key Points:

1.Choose fresh fruit rather than juice for increased fiber.

2. When choosing juice, drink only pure juice with no sugar or refined sweeteners.

3.For fruits not listed below, assume a serving of fruit is:

1/3 to 1/2 cup of fresh fruit juice

1/4 cup of dried fruit

1 small or medium fresh fruit

1 Exchange: (approximately 60 calories per exchange) 20g carbs, 0g fat, 0g protein

1 apple1 peach (1/2 c. canned)

4 apricots (medium, raw)1c. papaya

½ c. apricots (canned)2 plums

1/2 banana1/2 pomegranate

3/4 c. berries1 small pear (1/2 c. canned)

1/3 cantaloupe (1 cup cubes)3/4 c. Pineapple (1/3 c. canned)

2 ½ dates (medium)3 prunes (medium)

1/2 grapefruit (3/4 c. segments)2 Tbsp. raisins

15 grapes (small)1 ¼ c. strawberries (raw, whole)

1 c. honeydew(1/8 melon)2 tangerines 1 cup strawberries

1 kiwi (large)1 1/4c. watermelon

1 orange

VEGETABLES

Key Points:

1.Choose fresh or frozen vegetables rather than canned vegetables.

2.Eat at least some of your vegetables raw.

3Steam or microwave vegetables to preserve nutrients and flavor.

4.Include dark green and deep orange vegetables several times per week.

5.Starchy vegetables (corn, peas, potatoes) are counted as Starch exchanges.

1 Exchange: (approximately 25 calories per exchange) 5g. Carbs, 2g. Protein, 0g. fat

1 cup raw or ½ cup cooked vegetables or vegetable juice

asparagusmushrooms, cooked

bean sproutsonions

beetspeppers (green)

broccoliturnips

brussels sproutseggplant

carrotsspinach, cooked

cauliflowertomatoes (1 large)

greenswater chestnuts

leekszucchini, cooked

STARCHES

Key Points:

1.Use whole grains whenever possible.

2.Choose cereals with little or no added sugar (2 grams or less per serving).

3.Include legumes -- beans and peas -- several times per week.

1 Exchange Equals: (approximately 80 calories per exchange)

Cereals:1-1/2 c. puffed cereals

1/2 c. flaked cereals

1/3 c. concentrated bran cereals (bran buds)

3 Tbsp. nugget cereals (grape nuts)

1/2 c. cooked hot cereal (oatmeal or cream of wheat)

Breads:1 slice bread2 pancake (4 inch)

1 Pita1 muffin (small, plain)

1/2 bagel 1/2 English muffin

1 tortilla1 croutons, low fat

Grains (cooked):1/2 c. pasta, macaroni or noodles

1/3 c. brown or white rice

1/2 c. hominy, barley or grits

3 Tbsp. wheat germ

1/2 c. millet

Starchy Vegetables:1/2 c. mashed potatoes

1 baked potato, small

3/4 c. squash or pumpkin

1/2 c. corn

Legumes (cooked):1/3 c. lentils or split peas 1/3 c. peas or lima beans

1/3 c. garbanzo or kidney beans 1/4 c. baked beans

Snack Foods:3/4 oz. pretzels

3 graham crackers

3 c. air-popped popcorn

2-4 slices whole wheat crackers (3/4 oz)

PROTEINS

Key Points:

1.Choose lean meats, skin-free poultry or fish.

2.You do not need to avoid red meat as long as it is lean. Red meat is a good source of iron and zinc -- minerals which many people do not consume enough of.

3.If you choose to avoid animal meat, you can use low fat cheeses, eggs and legumes to meet your protein needs.

4.Use cooking methods that don't add fat: baking, broiling or grilling. Use wine or broth for poaching and stir-frying.

1 Exchange Equals: (55 to 100 calories) (See following pages)

1 oz. meat, poultry or fish (lowfat cooked)

1 oz. hard cheese (1" x 1" cube)

1 egg

3 egg whites

1 Tbsp. peanut butter

1/3 c. cooked legumes (peas, beans, lentils, etc.)

1/4 c. cottage or ricotta cheese

1/4 c. tuna (packed in water)

4 oz. tofu

Examples of common serving sizes are:

2 oz. =1 chicken leg or thigh

1/2 c. low fat cottage cheese or water-packed tuna

1/2 of chicken breast

3 oz. = 1 med. pork chop

1 small hamburger patty

1/2 of a whole chicken breast

Any cooked meat the size of a deck of playing cards

LEAN PROTEINS: (Choose more often) (55 calories) 0g CARBS, 7g. Protein, 3g. fat

Meat: Lean beef (top round, eye of round, round tip, top loin, sirloin, tenderloin, flank stake, extra-lean ground beef; fresh ham, Canadian bacon, veal (except cutlet), venison, rabbit.

Poultry: Chicken, Cornish hen, turkey (without skin).

Fish: All fresh or frozen fish, water-packed tuna.

Cheese: Nonfat or low fat cottage cheese, diet cheeses.

Other: Egg whites or egg substitute, legumes.

DAIRY PRODUCTS / SUBSTITUTES

Key Points:

1.Dairy products provide calcium and protein, but can be high in fat.

2.Use low fat or nonfat dairy products whenever possible.

3.Tofu and most cheeses are high in fat and should be used in moderation.

1 Exchange Equals: (approximately 90 to 150 calories per exchange)

2g. Fat, 12g. Carbs, 8g. protein

1 c. nonfat or 1% milk

1 c. low fat or nonfat yogurt

1 c. low fat buttermilk

1/2 c. evaporated skim milk

1/3 c. Nonfat dry milk

1 oz. low fat cheese

1/4 c. low fat or nonfat cottage cheese*

1/4 c. part-skim ricotta cheese

2 Tbsp. parmesan cheese

½ c. tofu (made with calcium)

1 c. low fat or nonfat soy milk*

*Low in calcium. Use in moderation along with calcium-rich foods or include a calcium supplement.

BEVERAGES

Caffeine and alcohol are not encouraged but may be consumed in moderation. Fruit and vegetable juices and post-work-out beverages such as the Break Through Energy Drink provide calories and are included in your food exchanges.

1. Drink at least eight glasses of water every day.

2.You may include up to two caffeinated beverages per day (coffee, tea, soda).

3.You may include up to two alcoholic drinks per week. (If you consume more than this, your wellness coordinator will adjust your meal plan accordingly.) One drink contains about 100 calories and is equal to: 8 oz. beer, 12 oz. light beer, 4 oz. wine, or 1-1/2 oz. hard liquor.

4.You may also include the following non-caloric beverages:

Diet soda (in moderation), Decaffeinated coffee or Herbal tea.

FATS

Key Points:

1.All fats are high in calories and should be consumed in moderation.

2.Cutting your fat intake is the single most important dietary change you can make.

3.Eating a low fat diet allows you to consume more calories while losing weight and body fat. (Use sparingly)

1 Exchange Equals: (approximately 45 calories per exchange) 5g. fat

1 tsp. margarine or butter

1Tbsp. diet margarine

1 tsp. mayonnaise

1 Tbsp. reduced-calorie mayonnaise

1 tsp. oil

1 Tbsp. salad dressing

2 Tbsp. reduced-calorie salad dressing

1 Tbsp. cream cheese

2 Tbsp. light or Neufchatel cream cheese

2 Tbsp. sour cream

4 Tbsp. light sour cream

2 Tbsp. coffee creamer (liquid)

1 slice bacon

1/8 avocado

5 olives, large

6 almonds

10 peanuts, large

1 Tbsp. sunflower seeds

BREAKDOWN OF THE EXCHANGE FOODS

(These numbers are averaged for each food group.)

FRUITSVEGETABLES

Calories80Calories30

Carbohydrates20 gCarbohydrates7.5 g

Fat.00 gFat.00 g

Protein.00 gProtein.00 g

GRAINS / STARCHESFATS / OILS

Calories80Calories40

Carbohydrates15 gCarbohydrates.00 g

Fat< 1 gFat4.5 g

Protein2 gProtein.00 g

PROTEIN / MEATSDAIRY / SOY

Calories55Calories80

Carbohydrates.00 gCarbohydrates11 g

Fat3 gFat< 1 g

Protein7 gProtein8 g

EXCHANGES FOR COMBINATION FOODS

Not all foods fall exactly into one exchange list or another. Many of the foods we eat are combination foods. Use the following guide to count the exchanges of the combination foods in your diet.

Bean burrito:2 burrito = 4 starch, 2 protein, 2 fat

Casseroles:1 cup = 2 starch, 2 protein, 2 fat

Cheese pizza:1/4 of 10" pizza = 2 starch, 2 protein, 1 fat

Chili with beans:1 cup = 2 starch, 2 protein, 2 fat

Garden burger (with bun):1 item = 3 starch 1 protein

Macaroni and cheese:1 cup = 2 starch, 1 protein, 2 fat

Spaghetti:1 cup = 2 starch, 1 protein, 1 fat

Soup: Chunky

or bean :type 1 cup = 2 starch, 1 protein, 1 vegetable

Cream 1 cup = 1 starch 2 fat

Chicken Nuggets6 nuggets = 1 starch, 2 protein, 2 fat

A DOZEN SNACK IDEAS

Since fat takes twice as long to digest as carbohydrates or protein, low fat eating usually means eating more often. If your personal nutrition plan calls for snacks, you'll probably want to get used to snack packing. One trip to a vending machine can undermine all of the healthy food choices you make during the day. The following snack suggestions can be packed along with you in a cooler, lunch box, briefcase or brown bag.

1.2 oz low fat cheese2 protein (or dairy)

4 Ry-Krisp crackers1 starch

1 c. assorted raw vegetables1 vegetable

2.1 apple1 fruit

4 ak-mak crackers1 starch

1 Tbsp. peanut butter1 protein

3.1/2 C. fruit salad1 fruit

1 oz. rice cakes1 starch

4.7/8 oz. Health Valley Fat-Free

Cookies (6 small or 2 large)1 starch + 1 fruit

5.2 Tbsp. raisins1 fruit

12 almonds2 fat

6.1 Fiber (Natural Nectar)1 starch + 1 fat

7.1 c. assorted raw vegetables1 vegetable

2 Tbsp. low-calorie ranch dressing (dip)1 fat

8.2 oz. Guiltless Gourmet tortilla chips2 starch

1/4 c. salsa1/2 vegetable

9.2 fig bars1 starch + 1 fruit

1 apple1 fruit

10.3 c. air-popped popcorn1 starch

2 tsp. butter2 fat

11.1 c. low fat yogurt1 dairy

1 banana1 fruit

12.1 whole wheat bagel2 starch

2 Tbsp. light cream cheese1 fat

1/2 c. grapes1 fruit

SUGGESTED GROCERY LIST

DAIRY & EGGS

Low or nonfat milk

Partskim mozzarella cheese

Lowfat or nonfat mayonnaise

Lowcalorie margarine

MEATS, POULTRY AND FISH

Choose white fish

Chicken breast skinned

Flank steak or lean beef

VEGETABLES AND FRUITS

Broccoli, carrots, tomatoes, potatoes, onions, green peppers, lettuce(romaine). Since vegetables are free calories, you can eat more of them.

Oranges, apples, grapefruit, bananas, cantaloupes.

Try to eat less of very sweet fruits such as grapes,

pineapples, watermelon.

CEREALS, GRAINS, PASTAS & MISC.

All bran cereals, Grape Nuts, Shredded Wheat and like cereals.

Spaghetti, brown rice, or long grain white rice.

Unbleached white or wheat flour, corn tortillas, popcorn, whole wheat or low-fat pancake mix, light pancake syrup

Fig bars

Try to use frozen foods instead of canned foods, as they are much fresher, thereby maintaining more nutrients.

CANNED & BOTTLED GOODS

Natural style almond butter or peanut butter

Lowsugar juices and jams

Red wine vinegar

Lemon juice, spaghetti sauce

Salsa, mustard, lowcal. catsup

Tuna fish, water packed

Honey

Canned black, red or garbanzo beans

Tofu

FROZEN FOODS

Frozen Vegetables low sodium

Lowfat or nonfat deserts

Orange Juice.

Frozen fruits

Lowfat and lowcalorie frozen dinners

HERBS AND SPICES

Saltfree seasonings with garlic

Paprika, cinnamon, dried herbs

(parsley, dill etc.)

READING

AND

USING FOOD LABELS

Nutrition Facts on food labels can help you with food choices. These labels are required by law for most foods and are based on standard serving sizes. However, these serving sizes may not always be the same as the serving sizes in this booklet.

Check the serving size on the label. Is it nearly the same size as the food exchange? You may need to adjust the size of the serving to fit your meal plan.

Look at the grams of carbohydrate in the serving size. (One starch, fruit, milk, or other carbohydrate has about 15 grams of carbohydrate.) So, if 1 cup of cereal has 30 grams of carbohydrate, it will count as 2 starch choices in your meal plan. You may need to adjust the size of the serving so it contains the number of carbohydrate choices you have for a meal or a snack.

Look at the grams of protein in the serving size. (One meat choice has 7 grams of protein.) If the food has more than 7 grams of protein in a serving, you can figure out the number of meat choices by dividing the grams of protein by 7. Meats generally contain fat, too.

Look at the grams of fat in the serving size. (One fat choice has 5 grams of fat.) If one waffle has 15 grams of carbohydrate and 5 grams of fat, it counts as 1 starch choice and 1 fat choice.

Look at the number of calories in the serving size. If there are less than 20 calories per serving, it is a free food. However, if it has more than 20 calories, follow the steps listed above to count the food choices.

Ask your dietitian for help using information on food labels. Some food labels may also give exchanges. These are based on information in this booklet.

The following “sample” label is provided for you to practice reading a food label before you get to the super market.

Chili with beans

Nutrition Facts

Serving Size 1 cup (253 g)

Serving Per Container 2

Amount Per Serving

Calories 260Calories from Fat 72

% Daily Value

Total Fat 8g13%

Saturated Fat 3g 17%

Cholesterol 130mg 44%

Sodium 101mg 42%

Total Carbohydrate 22g 7%

Dietary fiber 9g

Sugars 4g

Protein 25g

BREAKFAST MEALS

EXCHANGE GROUP / # OF EXCHANGES / FOOD

Meal 1

Fruit_____Raisins

Starch_____Oatmeal

Fat_____Margarine or Butter

Dairy_____1% Milk

Meal 2

Fruit_____Apple

Starch_____Whole Wheat Toast

Fat_____Margarine

Dairy_____Yogurt (low fat)

Meal 3

Fruit_____Strawberries

Starch_____Bagel

Fat_____Cream Cheese (low fat)

Dairy_____1% Milk

Meal 4

Fruit_____Peach

Starch_____English Muffin

Fat_____Margarine

Dairy_____Yogurt (low fat)

Meal 5

Fruit_____Blueberries

Starch_____Corn Flakes

Starch_____Whole Wheat Toast

Fat_____Peanut Butter

Dairy_____1% Milk

LUNCH MEALS

EXCHANGE GROUP / # OF EXCHANGES / FOOD

Meal 1 (Chicken Sandwich)

Protein_____Chicken

Starch_____Whole Wheat Bread

Fat_____Mayonnaise (low cal)

Fruit_____Apple

Vegetable_____Mixed Green Salad

Fat_____Salad Dressing (low cal)

Meal 2 (Tuna Salad)

Protein_____Tuna

Vegetable_____Mixed Green Salad

Fat_____Salad Dressing (low cal)

Starch_____Whole Wheat Roll

Fruit_____Orange

Meal 3 (Beef Taco)

Protein_____Shredded Beef or Extra Lean Ground Beef

Starch_____Tortilla

Vegetable_____Lettuce / Tomato

Fat_____Cheese (low cal)

Fruit_____Cantaloupe

Meal 4 (Tuna Sandwich)

Protein_____Tuna

Starch_____Pita Bread

Vegetable_____Sprouts / Onion

Fat_____Mayonnaise (low cal)

Fruit_____Mixed Fruit

Meal 5 (Chicken Roast)

Protein_____Chicken Breast (broiled w/skin removed)

Starch_____Brown Rice

Vegetable_____Broccoli (steamed)

Fat_____Margarine (low cal)

Fruit_____Pineapple Chunks

DINNER MEALS

EXCHANGE GROUP / # OF EXCHANGES / FOOD

Meal 1 (Steak Dinner)

Protein_____Flank Steak (broiled)

Starch_____Brown Rice

Vegetable_____Mixed Green Salad

Fat_____Salad Dressing (low cal)

Fruit_____Cantaloupe

Meal 2 (Spaghetti)

Protein_____Extra Lean Ground Beef

Starch_____Spaghetti / Pasta

Vegetable_____Tomato Sauce (Classico, Healthy Choice or home made)

Vegetable_____Green Salad

Fat_____Salad Dressing (low cal)

Fruit_____Fruit Cup (or consumed as snack)

Meal 3 (Grilled Halibut)

Protein_____Halibut (baked in white wine, garlic and ginger)

Starch_____Brown Rice

Starch_____Whole Wheat Dinner Roll

Fat_____Margarine (low cal)

Vegetable_____Peas and Corn

Fruit_____Orange (or consumed as snack)

Meal 4 (Chicken Stir Fry)

Protein_____Chicken Breast

Vegetable_____Assorted Vegetables

Fat_____Canola Oil

Starch_____Brown Rice

Vegetable_____Mixed Green Salad

Fruit_____Apple (or consumed as snack)

Meal 5 (Tostada)

Protein_____Shredded Flank Steak (broiled)

Starch_____Tortilla

Vegetable_____Mixed Raw Vegetables

Fat_____Salad Dressing (low cal)

Protein_____Cheese

Fruit_____Grapes (or consumed as snack)

DAILY MENU PLANNER

The following Daily Menu Planner Work Sheet is intended to assist you in planning your daily nutrition program. Note that each meal allows for a specific number of exchanges and recommended foods from each food group.

*Please use the following Key to list your Mood at the time you eat:

B - Bored / H - Happy / D - Depressed / S - Stressed

# of Exchanges

MealsAllowed / UsedFood *Mood

BREAKFAST:

Fruit______/ ______

Starch______/ ______

Fat______/ ______

Dairy______/ ______

SNACK:

Fruit______/ ______

Vegetable______/ ______

Starch______/ ______

LUNCH:

Protein______/ ______

Vegetable______/ ______

Fat______/ ______

Starch______/ ______

Fruit______/ ______

SNACK:

Fruit______/ ______

Vegetable______/ ______

Starch______/ ______

DINNER:
Protein______/ ______

Fruit______/ ______

Vegetable______/ ______

Starch______/ ______

Fat______/ ______

Exercise: Strength Training? ______Aerobics? ______

DAILY MENU PLANNER

*Please use the following Key to list your Mood at the time you eat:

B - Bored / H - Happy / D - Depressed / S - Stressed

# of Exchanges

MealsAllowed / UsedFood *Mood

BREAKFAST:

Fruit______/ ______

Starch______/ ______

Fat______/ ______

Dairy______/ ______

SNACK:

Fruit______/ ______

Vegetable______/ ______

Starch______/ ______

LUNCH:

Protein______/ ______

Vegetable______/ ______

Fat______/ ______

Starch______/ ______

Fruit______/ ______

SNACK:

Fruit______/ ______

Vegetable______/ ______

Starch______/ ______

DINNER:
Protein______/ ______

Fruit______/ ______

Vegetable______/ ______

Starch______/ ______

Fat______/ ______

Exercise: Strength Training? ______Aerobics? ______

DAILY MENU PLANNER

*Please use the following Key to list your Mood at the time you eat:

B - Bored / H - Happy / D - Depressed / S - Stressed

# of Exchanges

MealsAllowed / UsedFood *Mood

BREAKFAST:

Fruit______/ ______

Starch______/ ______

Fat______/ ______

Dairy______/ ______

SNACK:

Fruit______/ ______

Vegetable______/ ______

Starch______/ ______

LUNCH:

Protein______/ ______

Vegetable______/ ______

Fat______/ ______

Starch______/ ______

Fruit______/ ______

SNACK:

Fruit______/ ______

Vegetable______/ ______

Starch______/ ______

DINNER:
Protein______/ ______

Fruit______/ ______

Vegetable______/ ______

Starch______/ ______

Fat______/ ______

Exercise: Strength Training? ______Aerobics? ______

DAILY MENU PLANNER

*Please use the following Key to list your Mood at the time you eat:

B - Bored / H - Happy / D - Depressed / S - Stressed

# of Exchanges

MealsAllowed / UsedFood *Mood

BREAKFAST:

Fruit______/ ______

Starch______/ ______

Fat______/ ______

Dairy______/ ______

SNACK:

Fruit______/ ______

Vegetable______/ ______

Starch______/ ______

LUNCH:

Protein______/ ______

Vegetable______/ ______

Fat______/ ______

Starch______/ ______

Fruit______/ ______

SNACK:

Fruit______/ ______

Vegetable______/ ______

Starch______/ ______

DINNER:
Protein______/ ______

Fruit______/ ______

Vegetable______/ ______

Starch______/ ______

Fat______/ ______

Exercise: Strength Training? ______Aerobics? ______

DAILY MENU PLANNER

*Please use the following Key to list your Mood at the time you eat: