/HHHW_English by Heart and Stroke Foundation

Healthy Habits Healthy Weight A Practical Guide to Weight Management

www.heartandstroke.ca

Foreword You’ve been struggling with your weight for years. You’ve gained and lost dozens of pounds, but every pound you lose creeps back and you find yourself anxiously avoiding that bathroom scale.

Will it ever end? It can. You’re off to a good start by reading this booklet. Here, you’ll find strategies to help you keep the weight off for good. Winning the battle of the bulge for the long term means finding an eating and exercise plan you can live with forever — one that satisfies your nutritional needs and provides the energy you need for active living, while pleasing your palate. Constructing such a plan is easier than ever as this booklet is packed with credible information, tips and recipes to make healthy eating happy eating. Here, registered dietitian, author, and nutrition counsellor Rosie Schwartz shares expert advice and the scientific evidence to back it up. Plus, you’ll benefit from her vast experience with clients who have lost weight and kept it off. You may find this booklet is just the foundation you need to get started. We hope you use it time and time again, turning to it as a trusted guide when life throws you a curve and you find the weight creeping up again. Each year, approximately 74,000 Canadians die of heart disease and stroke. And 80% of Canadians have at least one risk factor for heart disease or stroke. We can win the battle against this potentially fatal disease by modifying our lifestyles — starting with weight. That’s why the Heart and Stroke Foundation is so pleased to provide you with this useful source book. If you’re ready, so are we. The Heart and Stroke Foundation

Contents 2

Weight — A growing problem 10 reasons for weight gain

Is your weight healthy? Assess your risk

More than just weight Are you an apple or a pear? Your weight distribution

Goal setting What’s realistic for you? For how long? The battle plan Staying on track

Demon diet detective Why fad diets fail

Record keeping How food and activity logs can help you

What’s on the menu? Your HeartSmart™ eating plan Grain products Vegetables and fruit Fibre Milk products Meat and alternatives

Fat facts Healthy fats Your personal fat budget How to slash the fat

Revamping eating styles At the starting gate Test your appetite controls Breaking the fast

HeartSmartTM supermarket shopping Making healthy choices What’s in a label?

In the kitchen

Eating out

Fast food follies Fast food facts

Liquid benefits Not all liquids are created equal Alcohol advice

Portion distortion

Building an active lifestyle Get physical What do we mean by “active living”? Stress busting How much are you burning?

Keeping on track

Staying motivated 20 things you can do instead of eating

Resources & Support

Weight — A growing problem It’s a big problem and it’s getting bigger. In fact, Canadians are heavier now than they have ever been before.

It’s those 5 pounds you put on over the holidays. It’s the 10 you gained when you lost your job. Or maybe your problem is even bigger than that. You’re not alone. Literally thousands of us struggle with our weight. It is estimated that almost 60 percent of Canadian adults are overweight, with nearly a quarter considered obese. Some experts even call it an epidemic. But perhaps the greatest toll of excess weight is on our health. An increased risk for heart disease and stroke, which are the leading causes of death for Canadian men and women, goes hand in hand with carrying too much body fat — so do diabetes, gall bladder disease, osteoarthritis, and cancers of the colon, breast and prostate. Even reproductive problems in women and erectile dysfunction in men are more likely to occur when a person is extremely overweight. But you probably know all that. You also know that you need to trim a little body fat — the big question is, how. This booklet will give you a good start. Here you’ll find valuable information on how to assess the problem, set realistic goals and achieve them. In this booklet you’ll find a variety of tools to make weight management easier than you thought, and probably even fun.

➥ Need a little motivation? Remember this: even a modest loss of 5 to 10 pounds can make a huge difference to your health, reducing your risk for all sorts of diseases, including heart disease. You’ll feel better, too. So let’s get started.

Healthy Habits, Healthy Weights

Be smoke free! 10 reasons for weight gain Your weight has been creeping up for years. How does it happen? The reason for weight gain is really

Breathe clean without gaining weight. Follow these tips when quitting:

quite simple: when the number of calories eaten is greater than the number of calories used by the body, the surplus is stored as body fat. Knowing that is an important start, and knowing the other factors that may play a part in your weight-loss picture is the next step.

1 2 3 4 5 6 7 8 9 10

Diet. Regularly consuming too many calories, especially from high-fat foods and calorie-laden drinks. Physical inactivity. Inactive people are more likely to carry excess body fat. Genetics. Your risk of obesity increases if one or both of your parents is obese. Age. As we age we lose muscle to fat and our metabolism declines, reducing calorie needs. Gender. Men expend more calories than women, making weight control a tougher challenge for women. Psychological factors. Some people overeat to cope with emotional problems. Pregnancy. A womanâ&#x20AC;&#x2122;s weight can rise 4 to 6 pounds after each pregnancy. Medications. Some corticosteroids and antidepressants can result in weight gain. Illness. Any medical condition that leads to decreased activity can result in weight gain.

Eat several small meals throughout the day. By eating frequently you will keep your mouth busy and prevent the hunger pangs that frequently lead to overeating later in the day. Keep snacks such as carrot and celery sticks, fresh fruit and unbuttered popcorn close at hand. Drink plenty of fluids, but avoid caffeine and alcohol. Cold water will help flush the nicotine out of your system and will keep your mouth busy. Caffeine may make you more agitated, so keep away. Donâ&#x20AC;&#x2122;t worry about your weight. Keep in mind that you would have to gain 80 to 100 lbs. to counteract the health benefits of quitting smoking. Be physically active. Exercise will relieve stress, fuel your metabolism and keep your mind off smoking. For more nutrition tips for exsmokers visit the Dietitians of Canada at www.dietitians.ca

Quitting smoking. Smokers can gain up to 8 pounds when quitting. For great tips to help you quit without gaining, read Be smoke free! on this page.

Is your weight healthy? Use this tool to determine the weight range that’s right for you. Assess your risk The best way to determine if your weight falls within a healthy range is to consult something called the Body Mass Index (BMI). The BMI measures body fat and its potential impact on your health. It’s a ratio of height and weight that allows for a range of weights to be associated with good health instead of just one ideal weight. (To find your BMI, see chart on next page.)

What your BMI means: Under 18.5

18.5 to 24.9

25 to 29.9

This BMI is considered to be underweight and is linked to some health problems.

According to the World Health Organization standard, your weight is in the acceptable range.

A BMI measurement in this range is classified as overweight.

30 or more BMI measurements of more than 30 rank as “obese,” with 30 to 35 being moderately obese, 36 to 40 being severely obese and more than 40 considered very severe.

Guidelines from the World Health Organization (WHO).

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The BMI is accurate for almost everyone but should not be used for anyone under 18, pregnant or breastfeeding. Also keep in mind that it may be less accurate for people who are extremely muscular, like competitive weightlifters. For persons 65 and older the 'normal' range may begin slightly above BMI 18.5 and extend into the 'overweight' range.

Healthy Habits, Healthy Weights

Find your BMI using the chart below: 1. Plot your current weight and draw a horizontal line across the chart. 2. Find your height and draw a vertical line from the top to the bottom of the chart. 3. Find where these two lines cross. 4. This is your current BMI. HEIGHT (in)

104 102 100 98 96 94 92 90 88 86 84 82

WEIGHT (kg)

80 78 76 74 72 70 68 66 64 62 60 58 56 54

59 60

63 64

66 67

68 69

70 71

73 74

75 76 77

232

226

220

45 44

214

43 208

202

41 40

196

39 38 37 36

190 184

178

34 33 32 31

172 166 160

30 29 28 27 26

154 148 142

136

24 23

130

22 21

124

118

18.5

52 50 48 46

WEIGHT (lb)

106

112

17 16

106 15 100

14 13

94 11

88 40 147 149 151 153 155 157 159 161 163 165 167 169 171 173 175 177 179 181 183 185 187 189 191 193 195 197 HEIGHT (cm)

Source: Adapted from Health and Welfare Canada. Promoting Healthy Weights: A Discussion Paper. Ministry of Supply and Services Canada: Ottawa, Ontario. 1988, to reflect the World Health Organization guidelines.

To calculate your BMI online, visit http://www.heartandstroke.ca/healthyweight Heart and Stroke Foundation - A Practical Guide to Weight Management

More than just weight Find out how your shape affects your health. Are you an apple or a pear? If you’ve never thought of your shape as being one or the other, it’s time to start considering where you carry fat as well as how much of it you carry. Studies tell us that those of us who have apple shapes, storing excess body fat around our middles, are at a higher risk for lifestyle-related diseases such as heart disease, stroke and diabetes, even if our BMI falls within a healthy range. Those of us with pear shapes, who tend to carry weight on our thighs and buttocks, have a lower risk for these conditions.

What shape are you in? Measuring your waist is the quickest and easiest way to determine if your shape is putting your health at risk. To take your measurement: 1. 2. 3.

Get a tape measure (preferably in centimetres); Stand with your feet together; Measure at the narrowest part of the torso — for men that is at the navel, while women should measure midway between the bottom of the ribs and the top of the hipbones.

Your results: H E A LT H Y

U N H E A LT H Y

(your weight distribution poses no increased threat to health)

(your weight distribution poses a threat to your health)

You are male and have a waist measurement of 40", 102 cm or less.

You are male and have a waist measurement in excess of 40", 102 cm.

You are female and have a waist measurement of 35", 88 cm or less.

You are female and have a waist measurement in excess of 35", 88 cm.

To find out more about apple vs. pear shapes and to calculate your waist circumference online, visit http://www.heartandstroke.ca/healthyweight 6

Healthy Habits, Healthy Weights

Goal setting Forget perfection. Concentrate on getting healthy rather than thin. What’s realistic for you? You know your Body Mass Index (BMI), you’ve figured out your body shape and you can’t wait to start losing that excess body fat. But hold on. Before you do anything, it’s important to establish some realistic goals. What’s realistic? You’d be surprised. Too often we give up on weight-loss plans before we begin because the road to perfection seems far too long and far too hard. So forget perfection for a minute. In fact, the amount of weight most of us need to lose to be healthy is a lot less than we need to lose in order to be ‘thin.’ So before you start taking off any pounds, consider that reducing your weight by 5% to 10% is a healthy, and reasonable, goal. Still not convinced? Imagine what a pound of butter looks like. Now imagine how you will look and feel when a similar-sized pound of fat is trimmed from your frame. Get the picture?

For how long? It’s important to be realistic about time frames, too. Studies say that those of us who chip away at our excess weight slowly and steadily, losing about a pound a week, are more likely to lose fat (as opposed to muscle or even water) and lose it for good. And that’s the point, isn’t it? By setting reasonable goals, eating a healthy diet, and adopting an active lifestyle, you have a far greater chance of reaching and maintaining a healthy weight than you would with drastic ‘fad’ diets.

➥

If you weigh 200 pounds, and you’ve determined that your BMI and waist circumference fall in an unhealthy range, a loss of 10 to 20 pounds is a good goal — for your health and for your sense of well-being.

Heart and Stroke Foundation - A Practical Guide to Weight Management

Goal setting continued…

The battle plan Make no mistake about it, losing weight is not easy. Healthy bodies have healthy appetites. That’s not going to change as you lose weight. In fact, as you begin to lose weight you may feel even more hungry than you did before. It makes sense, really. You need to consume fewer calories than you burn in order to lose weight. That may leave you feeling hungry at times. What’s critical is to remember that it’s a normal part of the journey to a healthy weight.

Staying on track One way to stay on track during tough times is to minimize that struggle between mind and body. If your body perceives starvation, it will try to protect itself. If you were denied food for a day or two, you would feel hunger. If you were denied food for a week or more that hunger would become a complete and relentless obsession with food. At the same time, the body lags — feeling fatigued as the metabolism slows. Once food is made available, your incredible hunger combined with a slow metabolism make weight gain inevitable. So avoid starving yourself. Instead, load up on healthy foods that won’t leave you feeling deprived. (See Pages 11-18 for lots of ideas.)

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If your goal is a total loss of 20 pounds, allowing yourself five months to lose it is both sensible and safe.

Healthy Habits, Healthy Weights

Why fad diets fail

Demon diet detective Beware the allure of quick-fixes. The person on the television screen promises their diet discovery will melt away all that excess fat in mere days. Forget it. In our thin-obsessed culture, the lure of quick-fixes can be irresistible. But if long-term change is what you’re looking for, you’ll have to accept that there are no quick fixes. No ‘crash’ diet, supplement or fat-burning tea will give you the permanent change you’re looking for. Despite their promises, all you will lose is water, essential nutrients and a lot of money.

For healthy and sustainable weight loss, you should be following these guidelines: Your daily caloric intake is not less than 1,800 calories (for men) and 1,500 calories (for women).

Your likes and dislikes are taken into account, making the eating plan easy to stick to.

Your diet includes variety from all of the four food groups (see Canada’s Food Guide to Healthy Eating on Page 11).

Your diet doesn’t contain any “forbidden” foods like fat-laden desserts or even the occasional fried food.

Your diet meets the body’s nutrient needs from food sources and doesn’t rely on supplements.

Your weight-loss plan includes regular physical activity as an important part of burning calories and building health. Your eating plan allows for healthy snacks.

Your weight goes up, so you slash and burn calories using the latest ‘crash’ diet — only to gain it all back again. This yo-yo dieting leaves you heavier than you were to begin with and feeling far worse. Fad diets fail for two reasons: Physiologically. Severe caloriereduced diets turn on the body’s starvation mechanism. When in starvation mode, the body uses whatever fuel it can to make up for the shortfall of calories and doesn’t discriminate between muscle and fat. The trouble is, it’s the amount of muscle we have that determines our calorieburning potential, also known as our metabolism. So when we lose muscle we make it extremely difficult to maintain our healthy weight after the diet is over. Psychologically. Drastic reducing diets leave most of us feeling deprived. Sure we lose weight, but none of us can sustain that kind of starvation diet for long. When we go off the diet, as we inevitably do, we treat ourselves to all of the things we missed. We can’t help it.

Heart and Stroke Foundation - A Practical Guide to Weight Management

Record keeping Food and activity diaries are key to spotting patterns that need to be corrected. Keeping food and activity records before and after you start your weight-loss program can be really helpful. Your food log will tell you where your eating problems may lie and what habits you may need to change. Note the time, food choice and portion size and analyze the log once a week to gain insights into your eating habits. Similarly, an activity record will tell you where you could pick up the pace.

Making the most of your records Before you start your weight-loss plan, note the foods you eat after you’ve eaten them so that you get a more accurate picture of your habits. Once you’ve started a healthy diet geared to reducing body fat, start recording food intake before you open the refrigerator door. Taking the time to write your choice down in your log may be the time you need to rethink your choice. Carry your diary with you so that you can make notes throughout the day. Once you have spotted patterns that could be corrected, target only one at a time. Meal-by-meal is a good way to go — you can zero in on any improvements that could be made at breakfast before moving on to lunch. Be sure to note where you are eating. Research shows that many of us overeat when we are distracted — that is, our attention is diverted from the plate. We often eat more when we are in restaurants, for example, or in front of the television.

You can download your food and physical activity logs at http://www.heartandstroke.ca/healthyweight

Healthy Habits, Healthy Weights

What’s on the menu? Remember that variety is the key to healthy eating. Reaching and maintaining a healthy weight goes hand in hand with a sensible, enjoyable eating plan — one that doesn’t leave you feeling physically or emotionally deprived. Try to focus on what is, rather than what isn’t, on the menu. There’s lots to choose from. Healthy eating begins with a variety of foods. No one food can supply all the nutrients you need, so aim for a combination of foods that are rich in nutrition, fight disease and taste great. To create balanced meals that are moderate in size, follow Canada’s Food Guide to Healthy Eating, which includes these four food groups:

GRAIN PRODUCTS

5-12 servings a day

VEGETABLES AND FRUIT

5-10 servings a day

MILK PRODUCTS

2-4 servings for children; 2-4 servings for adults; 3-4 servings for pregnant and breastfeeding women

MEAT AND ALTERNATIVES

2-3 servings a day

Mix and match food groups — try to include at least three of the four groups at every meal. To order your free copy of Canada’s Food Guide to Healthy Eating, log onto http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/index_e.html or call 1-800-OCANADA. Heart and Stroke Foundation - A Practical Guide to Weight Management

Your HeartSmartTM eating plan To achieve and maintain a healthy weight, you must eat moderate amounts of nutrient-rich foods. Here are some sure-fire tips for losing weight and keeping it off:

Choose healthy foods, such as vegetables, fruit, grains, lean sources of protein (fish, beans), low-fat dairy products and lean meats. Reduce fat in your diet and you’ll cut the calories. A healthy diet should include no more than 20-35 percent of total calories from fat. (See page 20 for your personal fat-budget calculator.) Choose high-fibre carbohydrates, such as whole-grain breads and pasta, brown rice and fresh fruit and vegetables. Watch serving sizes. It doesn’t take a lot to reach a single serving. Half a cup of pasta or rice, for example, equals one serving of grain products. One cup equals two servings. Limit sweets, such as candies, cakes, cookies, pies and doughnuts. Opt for lower-fat dessert choices, including angel food cake, fig-bar cookies, frozen yogurt or sorbet.

For delicious low-fat recipes, shopping lists and heart healthy food selections, log on to http://www.heartandstroke.ca/healthyweight

RECIPE 2

Spinach, Orange and Red Onion Salad

⁄ cup

Chock full of heart healthy nutrients like the B vitamin, folic acid. For those who aren’t fans of raw spinach,prepare this salad with baby spinach, a milder versionof the vegetable but comparable to regular varieties in terms of nutrients. From the kitchen of Rosie Schwartz.

small oranges, peeled, quartered and sliced red onion slices salt and freshly ground pepper, to taste

2 125 mL

In a small bowl, mix together olive oil, orange juice concentrate, balsamic vinegar, salt and freshly ground pepper. Place spinach, orange and red onion in a large bowl. Pour dressing and toss. Adjust seasoning with salt and freshly ground pepper, to taste. Serve immediately.

Makes 4 servings 4 tsp 1 tbsp 1 tbsp 1 ⁄ 8 tsp 1 ⁄ 8 tsp 5 cups

extra virgin olive oil frozen orange juice concentrate balsamic vinegar salt freshly ground pepper spinach

20 mL 15 mL 15 mL 0.5 mL 0.5 mL 1.25 L

Nutritional information (per serving): Calories Protein Fat Saturated fat

103 2g 5g 1g

Cholesterol Carbohydrate Dietary fibre Sodium

0 mg 16 g 5g 29 mg

Healthy Habits, Healthy Weights

Grain products Foods in this group offer many nutritional benefits, including cholesterollowering fibre, B vitamins and a host of phytochemicals — disease-fighting compounds from various plant sources. Grain products have recently gained a bad reputation for promoting weight gain, but that’s because we either consume extra-large servings of these foods or we accompany them with excess fat, such as buttery spreads on breads or creamy sauces on pasta. Sometimes we also eat grains, such as pasta, as a meal with nothing else. The key is to choose the right grains, make sure your meal is balanced with foods from the other food groups and exercise a little portion control. Going with grains Choose whole over refined grains. Whole-grain foods are rich in fibre, which may lower cholesterol and protect you against certain cancers. Look for grain products with at least 2 to 4 g of fibre per serving. Try new grain products, such as quinoa, brown rice or whole-wheat couscous, or use grains in different ways (for example, a barley salad). Don’t judge a bread by its colour. Choose products that list whole-grains as the first item in the ingredients. Also, look for key words, such as 100% whole-wheat or whole-grain.

RECIPE South West Tortilla Soup

1 cup 2 tbsp

A satisfying lunch in a bowl! To take it to work, simply reheat the soup and add the garnishes before eating. For a lower-fat version that curbs your appetite in between meals, omit the cheese and tortilla chips. From the kitchen of Rosie Schwartz.

Makes 4 servings 2 tsp 1 ⁄ 2 cup 2 1 tbsp 1 ⁄ 4 tsp 1 ⁄ 2 tsp 4 cups

extra virgin olive oil 10 mL chopped onion 125 mL garlic cloves, minced 2 tomato paste 15 mL ground cumin 1 mL chili powder 2 mL vegetable or chicken broth, 1L home-made or sodium-reduced 1 1 ⁄ 2 cups canned tomatoes, coarsely chopped 375 mL 1 medium zucchini, diced 1 1 cup fresh or frozen corn kernels 250 mL (if using frozen, do not thaw) 2 tbsp fresh lime juice 25 mL salt and freshly ground pepper, to taste

⁄ 2 cup

grated light cheddar cheese chopped fresh coriander or cilantro for garnish, if desired coarsely broken baked corn tortilla chips

250 mL 25 mL 125 mL

Heat oil in a large saucepan over medium-high heat; add onion and garlic and sauté until soft, about 5 minutes. Add cumin, chili powder, vegetable or chicken broth, tomato paste and canned tomatoes; bring to a boil. Reduce heat and simmer for 10 minutes, covered, stirring occasionally. Add zucchini and corn; simmer another 10 minutes. Add lime juice and stir. Season with salt and freshly ground pepper to taste. Ladle soup into bowls or refrigerate until ready to serve. Then bring soup to a boil. Sprinkle with grated cheese and chopped coriander or cilantro, if using, and top with tortilla chips before serving.

Nutritional information (per serving): Calories Protein Fat Saturated fat

209 14 g 6g 2g

Heart and Stroke Foundation - A Practical Guide to Weight Management

Cholesterol Carbohydrate Dietary fibre Sodium

13 mg 26 g 4g 625 mg

Vegetables and fruit Go ahead and load up! Filling up on vegetables and fruit can help keep weight at bay, yet most Canadians fall short on the daily serving requirements. Vegetables and fruit supply a powerhouse of disease-fighting compounds, including antioxidants such as vitamins C and E, beta carotene (which the body converts to vitamin A), folic acid (which may reduce the level of homocysteine, an amino acid in the blood that is linked to heart disease and stroke) and fibre. Antioxidants are substances that may slow or prevent oxidation. Oxidation can lead to the production of free radicals — compounds that can damage the body and are associated with the development of some diseases. But antioxidant activity lasts only for a few hours, making it essential to load up on vegetables and fruit throughout the day. Look for colourful vegetables and fruit for the most nutritional punch. For example, dark, leafy greens, such as spinach and broccoli, as well as yellow and orange vegetables like squash and carrots, are great sources of vitamin A. Red peppers and strawberries are rich in vitamin C. By filling your plate with colour, you increase your odds of beating a variety of diseases.

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Filling up on vegetables and fruit is a great way to lose weight and still feel full. Many people report significant weight loss when they include large amounts of raw fruits and vegetables in their diets.

Getting your daily quota of vegetables and fruit is easier than you think. Here’s how: Make extra servings when cooking with vegetables. Then, toss leftovers with a low-fat dressing and refrigerate for lunch the next day. Consider frozen vegetables and fruit or the canned variety in water as an alternate to fresh foods. They’re preserved at the peak of their nutritional quality.

Go ‘skinny dipping.’ Enjoy cut-up vegetables and fruit with tasty low-fat dips. Try poaching fruit with seasonings like cinnamon. Sliced fruit can also be added to side dishes and salads.

Don’t substitute unsweetened juices for fresh vegetables and fruit. Juices are missing valuable fibre including the soluble type, which lowers cholesterol and takes longer to digest.

Healthy Habits, Healthy Weights

Friendly fibre Dietary fibre is a group of carbohydrates found in plants that your body cannot break down and which, therefore, does not add any calories. There are two basic types of fibre:

Soluble fibre may lower blood cholesterol and help control blood sugar. Oat products (oat bran, oatmeal), legumes (dried beans, peas and lentils) and pectin-rich fruits (apples, strawberries and citrus fruits) are terrific sources of soluble fibre.

Insoluble fibre, also known as roughage, helps promote bowel regularity as well as prevent and control bowel problems and certain cancers. It acts as a natural laxative, moving solid waste through your intestines. Sources include wheat bran, whole-grain foods (such as whole-wheat bread), beans and the skin, stems, leaves and seeds of vegetables and fruit.

â&#x17E;Ľ

Boosting your fibre intake is a great idea, but take it slowly. The daily recommended intake is between 25 and 35 g. Too much fibre all at once can cause abdominal distress. Be sure to drink plenty of water (about 8 glasses or 2 litres a day) when increasing your fibre intake.

Heart and Stroke Foundation - A Practical Guide to Weight Management

Milk products While dairy products can be loaded with fat, there are low-fat options that are both tasty and meet your nutritional needs. Besides, milk products contain a host of beneficial nutrients, such as calcium and potassium, which play a role in maintaining normal blood pressure. Dairy case directives: Read the labels of all dairy products for their milk fat (M.F.) or butter fat (B.F.) content to choose the best low-fat picks. Whole milk, for example, has three times more fat than 1% milk. If you’re opting for soy beverages, be sure to select those that are fortified with calcium and are low-fat. Boost the taste of low-fat cheeses by using condiments, assorted mustards and chutneys.

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For super non-dairy sources of calcium consider 1⁄ 2 cup of salmon with bones, 1⁄ 2 cup of boiled spinach or 1 cup beans.

CHECK YOUR CHEESE RATINGS CHEESE PER OUNCE (28 G) OR 1-INCH (2.5 CM) CUBE

PERCENTAGE MILK FAT OR BUTTER FAT

FAT (GRAMS)

Cheddar

Light cheddar

Mozzarella

Part-skim mozzarella

Processed cheese slice

4.5

less than 1

Processed skim milk slice Cottage cheese Cottage cheese (1%)

Healthy Habits, Healthy Weights

Meat and alternatives This food group is an important part of your nutritional mix. While meats, especially untrimmed red meat, can be high in saturated fat (the kind that increases cholesterol), if you skip them and other foods in this group you’ll be missing out on protein. Our bodies need adequate amounts of protein to build and maintain muscles and body tissue. Lean cuts of meat and other foods in this group are also a source of iron. A low supply of iron can cause fatigue and limit the supply of oxygen to working muscles — hardly what you want if you’re aiming for more physical activity. Protein pointers: Redesign your dinner plate so that meats are not the star attraction. Choose leaner, well-trimmed cuts of meats and you’ll cut fat by as much as half. Go fishing. Fish and seafood, such as salmon, sardines and mackerel, provide very little saturated fat and a healthy dose of omega-3 fatty acids. These fats may prevent blood clots, decreasing the risk of a heart attack or stroke. Go meatless at some meals. Try dried peas, beans or lentils, all of which contain almost no fat and are packed with soluble fibre, the type that lowers bad cholesterol levels. Add chick peas or kidney beans to your spaghetti sauce instead of meat or enjoy a spicy lentil soup. Or try soy foods, such as tofu, which are rich in protein and may defend against cardiovascular disease and certain cancers.

RECIPE So simple, yet so tasty a way to include heart healthy omega3 fatty acids. The leftovers are terrific cold the next day. From the kitchen of Rosie Schwartz.

In a small bowl whisk together mayonnaise and Dijon mustard until mixed well. Add honey and soy sauce; mix well. Place salmon skin-side down in a large baking dish. Coat with mayonnaise mixture. Place in oven and roast for 15 to 20 minutes or until fish is cooked through. Sprinkle sesame seeds over the salmon and serve.

Makes 4 servings

Nutritional information (per serving):

Roasted Asian Salmon

1 tbsp 2 tsp 1 tbsp 1 tbsp 4, 4-6 oz 1 tbsp

light mayonnaise Dijon mustard honey sodium-reduced soy sauce salmon fillets sesame seeds, toasted

15 mL 10 mL 15 mL 15 mL 4, 100-150 g 15 mL

Calories Protein Fat Saturated fat

230 28 g 10 g 1g

Cholesterol Carbohydrate Dietary fibre Sodium

79 mg 5g 0g 285 mg

Preheat oven to 425˚F/ 230˚C.

Heart and Stroke Foundation - A Practical Guide to Weight Management

FAT BUDGETING FOR LEANER MEATS AND FISH CHANGE FROM THIS (HIGHER FAT)

TO THIS (LOWER FAT)

AND SAVE (TSP OF FAT)

Beef, lean, untrimmed (100 g)

Beef, lean only (100 g)

Chicken, light meat plus skin (100 g)

Chicken, light meat (100 g)

Chicken, dark meat (100 g)

Chicken, light meat (100 g)

1 1⁄ 2

Lamb, untrimmed (100 g)

Lamb, lean (100 g)

Tuna, light, canned in oil (213 g)

Tuna, white, canned in water (213 g)

Fat facts All fats are not created equal. Fat-laden foods, especially those with hidden fats, can supply a surprising number of calories. In fact, fat has double the calories of protein and carbohydrates — 9 calories per gram of fat versus 4 calories per gram — and too much fat, particularly saturated and trans fats, can be damaging to your health. But what you may not know is that fat is essential to good nutrition: it helps food taste better, it gives you energy, it protects your vision and organs, and it helps the body produce essential hormones and absorb certain fat-soluble nutrients, such as vitamins A, D and E. The trick is to choose the right kinds of fat and monitor your overall fat consumption. According to nutritional guidelines, a healthy diet should contain between 20 and 35 percent of total daily calories from fat. For women, this means about 45-75 grams/day and for men, this means about 60-105 grams/day. Which kinds of fat? The next page will help you find the healthy fats and steer clear of the other ones.

Healthy Habits, Healthy Weights

SATURATED FAT… is solid at room temperature and gets harder when chilled. It’s found in animal products (such as butter and meat), in certain vegetable oils like coconut oil and palm oil, and in hydrogenated vegetable oils. These fats can raise low-density lipoprotein (LDL) or “bad” cholesterol in the blood.

TRANS FAT… is produced during the process of hydrogenation in which hydrogen is added to liquid vegetable oil, changing it into a solid, which is more saturated and has a longer shelf life. Trans fats, like saturated fats, increase LDL levels, but are more harmful because they also lower the levels of “good” cholesterol or high-density lipoprotein (HDL). You may find trans fat in processed foods, such as cookies, cakes and crackers, as well as in fried snacks and fried food from fast-food outlets.

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MONOUNSATURATED FAT… is liquid at room temperature and is found in olive and canola oils, as well as in avocados and some nuts. This fat may lower LDL cholesterol levels, which is a good thing.

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POLYUNSATURATED FAT... is liquid at room temperature and is found in oils such as corn, safflower, soybean and sunflower, and many nuts (walnuts, pinenuts) and seeds (sesame, sunflower). This fat can lower LDL cholesterol levels and provide your body with essential fatty acids.

Heart and Stroke Foundation - A Practical Guide to Weight Management

Fat facts continued…

To estimate your personal fat budget, take these 4 easy steps: *To convert pounds to kilograms, multiply the number of pounds by 0.45.

Find your desirable body weight by using the range in the BMI chart on page 5. Desirable body weight =

Calculate how many calories you need per day by multiplying your desirable weight by your activity factor:

• If you are sedentary, multiply your desirable weight by 30. • If you are moderately active, multiply your desirable weight by 35. • If you are very active, multiply your desirable weight by 40. Desirable weight

kg x

• Divide the calories needed per day (Step 2) by 30. grams of fat

Calculate your fat budget in teaspoons:

• Divide your fat budget in grams (Step 3) by 5. grams of fat /5 =

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calories

Calculate your fat budget in grams:

calories / 30 =

Your personal fat budget is

teaspoons of fat teaspoons of fat per day.

For example, Susan weighs 165 lbs (75 kg) and is moderately active. She calculated her BMI and determined her healthy weight to be 155 lbs (70 kg). By multiplying her desirable weight in kilograms by 35 (70 kg x 35), we see that she should consume 2,450 calories per day. That’s no more than 82 g of fat, or 20 teaspoons per day, to maintain a healthy weight. For Susan to lose those 10 lbs at a healthy rate, she should reduce her original calorie intake (based on her weight of 165 lbs) from approximately 2,600 to 2,100 calories per day (that’s 500 calories per day over the course of 10 weeks). That will enable Susan to lose one pound per week.

Healthy Habits, Healthy Weights

How to slash the fat Cut down on the amount of fats and oils you use when stir-frying foods. Use a non-stick pan and spray with vegetable oil. Or use chicken or vegetable broth instead of oil, or a mixture of both. Use flavourful oils in small amounts for the most taste per spoonful. For example, add a splash of a fruity extra virgin olive oil to your pasta or a dark sesame oil to your stir-fry. If you’re cooking with cheese, mix together a lower-fat version with a stronger-tasting cheese. Increase the amount of vegetables and decrease the amount of meat in stews and casseroles. Always pour oil onto a teaspoon before adding to food to keep track of the amount. High-fat foods like avocados, nuts and seeds should only be consumed in moderation. Substitute applesauce, mashed banana and prune purée for the fat in many baked goods. Replace some of the oil in salad dressings with seasoned rice vinegar, vegetable stock or even water. Choose low-fat versions of fried foods such as baked tortilla and potato chips. Sauté in water, vegetable stock, wine or dry sherry instead of fat.

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Incorporate ground flax seed into your diet. Besides containing heart healthy omega-3 fatty acids, the soluble fibre in flax will help lower your cholesterol and regulate your blood sugar. Flax also contains lignans, which may offer protection against breast, colon and prostate cancers. Add ground flax to salads, cereal and yogurt.

Heart and Stroke Foundation - A Practical Guide to Weight Management

Revamping eating styles Developing a healthy eating plan isn’t as complicated as you might think. Managing your weight starts with developing a healthy eating plan. That means eating when you’re hungry and stopping when you’ve had enough, instead of eating out of habit.

At the starting gate Losing weight means changing food habits. It may take a while, but over time your new, healthy eating habits should become second nature. And nature dictates eating when we are hungry and quitting when we are full. Adopting a commonsense approach to appetite regulation, along with food choices that keep you physically and emotionally healthy, makes it easier to maintain a healthy weight over a lifetime. Responding to your body’s hunger pangs with good food choices is nature’s way, and soon it can be your way too. TAKE THIS SHORT QUIZ TO TEST YOUR APPETITE CONTROLS.

Occasionally

Often

I can easily skip meals. I can go for many hours without eating. I tend to eat more when I’m angry. I tend to eat more when I’m sad. I eat non-stop at social occasions. I look for something to eat when I’m bored.

If you’ve checked off the ‘often’ box more than once, you may need to get back to basics. Getting your appetite regulation back on track will help you guard against weight gain. Start by eating at regular times throughout the day. If you learn to recognize when you’re hungry and fuel up with nutritious meals, you’ll be better able to control your portions.

Healthy Habits, Healthy Weights

Breaking the fast How many times have you heard that breakfast is the most important meal of the day? Well, it’s true. Eating breakfast is one of the most important things you can do to lose weight. During the night, your metabolism slows down and your blood sugar level drops. Eating a balanced breakfast sets the body to burn fuel during the day. A good breakfast will also regulate your appetite, helping to fill you up so you can avoid those late-afternoon energy slumps and unhealthy cravings. Craving a sweet or a snooze in the middle of the afternoon? Or maybe you can’t stop nibbling after dinner. What’s on the menu, or not on the menu, may be to blame. For proper appetite regulation, it’s important to get back in touch with your hunger and that means eating a balanced breakfast every day — even if you don’t feel hungry. If breakfast foods don’t tempt you in the morning, be adventurous. There are lots of options beyond the standard cereal and toast. The trick is to choose foods that aren’t so fat-laden they leave you yearning for your bed, or so quickly digested you feel hungry an hour later. Include foods from all the four food groups in whatever combination appeals to you.

RECIPE Cottage Cheese Pancakes A super way to start your day and boost your protein intake! (Adapted from The Enlightened Eater by Rosie Schwartz)

Makes 12-14 pancakes 1 cup 1 2 3 tbsp 1 ⁄ 3 cup 1 ⁄ 2 tsp 1 ⁄ 8 tsp 1 tbsp

1% or 2% cottage cheese egg egg whites wheat germ whole wheat flour cinnamon salt vegetable oil

250 mL 1 2 45 mL 75 mL 2 mL 1 ⁄ 2 mL 15 mL

Process the cottage cheese, eggs and egg whites in a food processor or blender until smooth. Combine the wheat germ, flour, cinnamon and salt in a medium-sized bowl; mix well. Add to food processor bowl or blender and process until blended. Heat oil in a non-stick skillet over medium heat. Drop 2 tablespoons (25 mL) of batter at a time into the skillet with 1 a spoon. Cook the pancakes on each side, for about 1 ⁄ 2 minutes, or until golden brown.

Nutritional information (per pancake): Calories Protein Fat Saturated fat

45 3.9 g 1.7 g 0.3 g

Heart and Stroke Foundation - A Practical Guide to Weight Management

Cholesterol16 mg Carbohydrate Dietary fibre Sodium

3.5 g 0.6 g 106 mg

Break the fast continued…

Making the most of breakfast Don’t limit your morning meal to ‘breakfast foods.’ Try a chicken-fruit salad or a Mexican omelette. Eat from at least three food groups. A slice of toast or a muffin and a cup of coffee won’t do it. Stay away from fat-laden options, such as doughnuts and some muffins, which will leave you hungry an hour or two later. Choose whole foods over refined ones. Have fruit over fruit juice and whole-grain toast over white or refined, to leave you feeling more satisfied. Include small servings of slowly digested protein-rich foods (low-fat cheese, eggs, lean cuts of meat, fish or poultry).

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Don’t keep nibblies in plain sight. To avoid temptation, keep them out of sight and out of mind.

RECIPE Bagel Thins Great as a crunchy snack and a lower-fat alternative to many commercial options. If the bagels are oversized, slice them into 8 slices. But be sure to adjust portions accordingly. (Adapted from The Enlightened Eater by Rosie Schwartz)

Nutritional information (per serving): Calories Protein Fat Saturated fat

125 4g 4g less than 1 g

Makes 4 servings

Garlic Thins

Plain Thins

2 1 tbsp 1

2 1 tbsp

regular sized bagels 2 vegetable oil 15 mL salt and freshly ground pepper to taste

Cholesterol Carbohydrate Dietary fibre Sodium

regular sized bagels extra virgin olive oil clove garlic, minced

0 mg 19 g 1g 190 mg

2 15 mL 1

Follow method for Plain Thins.

Nutritional information (per serving): Thinly slice each bagel into 6 rounds; set aside. Mix other ingredients; brush onto rounds. Place rounds on a baking sheet and bake in a preheated 200 °F/ 95°C oven for 45 minutes or until bagel thins are crisp.

Calories Protein Fat Saturated fat less than

127 4g 4g 1g

Cholesterol Carbohydrate Dietary Fibre Sodium

0 mg 19 g 1g 190 mg

Plan for snacks If your meal times are too far apart, plan a nutritious snack to stave off hunger and to keep your metabolic rate up. By planning a snack instead of spontaneously snacking you won’t be as tempted to head for the vending machine or coffee cart. Try a few of these: a fruit-and-yogurt smoothie (or low-fat yogurt) low-fat cheese crackers and fruit whole-grain cereal with dried fruit mixes air-popped or light microwave popcorn slices of fruit and cut-up veggies (plastic pouches make it easy to carry these around with you) vegetable or tomato juice rice cakes (thinly spread with peanut butter or light cream cheese) bagel thins and low-fat dip (try our recipes on this page and Page 24)

RECIPE Spinach Tofu Dip Even non-tofu eaters will love this creamy dip. Enjoy with cut up veggies, baked tortilla chips, pita triangles or bagel thins. (Adapted from The Enlightened Eater by Rosie Schwartz)

package frozen chopped spinach, thawed 6 oz soft or silken tofu, pressed to remove water 2 shallots, quartered 1 1 ⁄ 2 tbsp grainy mustard 1 tbsp fresh lemon juice 1 ⁄ 3 cup light mayonnaise

⁄ 3 cup

low-fat plain yogurt 75 mL Salt and freshly ground pepper to taste

Squeeze spinach to remove excess liquid. Process all ingredients in a food processor or blender until smooth. Season to taste with salt and freshly ground pepper.

Makes 6-8 servings as an appetizer (about 21⁄ 2 cups/625 mL) 1, 10-oz

300 g 175 g 2 20 mL 15 mL 75 mL

Nutritional information (per serving): Calories Protein Fat Saturated fat

64 3g 4g 1g

Heart and Stroke Foundation - A Practical Guide to Weight Management

Cholesterol Carbohydrate Dietary fibre Sodium

0 mg 4g 1g 167 mg

HeartSmart™ supermarket shopping Navigating your way through supermarket aisles looking for healthy foods can be daunting. Store shelves are a minefield of sodium, fat and calories. Your best defense is to create a list and follow some smart shopping strategies.

Keep an ongoing list as you run out of healthy foods. Plan meals for the week so you’re sure to have all the ingredients on the list. If making a list is too time consuming, create a ‘master’ shopping list that you can photocopy and check off items as you need them. Don’t go shopping when you’re hungry or you’ll be tempted to buy calorierich snack foods. Buy seasonal fruits and vegetables, which are tastier and less expensive. Read all nutrition labels and ingredient lists before buying packaged foods. Look for products with the Health Check™ symbol.

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When you hit the inside of the store, bear in mind that the outside aisles often contain the most nutrition-packed basics. The middle ones are where you’ll find more label and ingredient list reading required. Start off with the produce section — that’s where you should make the most purchases. And if you find the snack food aisle tempting, skip it altogether.

Health Check™ Making healthy choices at the grocery store has just been made easier. Health Check™ is a food information program brought to you by the Heart and Stroke Foundation to help you make wise food choices.

Every food product participating in the program displays the Health CheckTM logo, an explanatory message describing how the food is part of a healthy diet and a nutrition facts panel. Foods that display the logo have been reviewed by the Foundation and meet specific nutrient criteria.

For more information about Health CheckTM visit www.healthcheck.org

Healthy Habits, Healthy Weights

What’s in a label? If you want to eat healthier and make wise food choices, be sure to review product labels before selecting items at the supermarket. Often, labels can be confusing. That’s why the government is proposing changes to how foods are labeled. However, these changes won’t happen right away — companies have two to three years before they must change their labels.

Food labels can supply you with a snapshot of a food’s nutritional makeup in three ways:

THE INGREDIENT LIST:

Items are listed in descending order by weight, so the product contains more of the ingredients at the top of the list. Often, ingredients such as fat, sugar and salt can be disguised. For example:

fats may be labeled as lard, shortening, hydrogenated vegetable oils, coconut/palm oil or tallow. sugars may be labeled as honey, molasses, dextrose, sucrose, fructose (and other words that end in –ose), dextrin or syrup. salts may be labeled as monosodium glutamate (MSG), anything with the word sodium, baking soda, baking powder, brine, kelp or soy sauce. 2 THE NUTRITION FACTS TABLE: This part of the label gives you detailed nutrition information based on a typical serving size. It provides you with the calorie content of the food plus the amounts of important nutrients such as fat, saturated fat, trans fat, cholesterol, sodium, carbohydrates, fibre, sugars, protein, vitamin A, vitamin C, calcium and iron. The new labels will also help you track whether you’re getting a little or a lot of a particular nutrient.

For more detailed information on nutrition labeling, visit Health Canada’s Web site at www.hc-sc.gc.ca/fn-an/ label-etiquet/nutrition/index_e.html Heart and Stroke Foundation - A Practical Guide to Weight Management

Supermarket shopping continued…

While most foods will carry the new labels, you won’t see them on certain foods, such as fruits and vegetables, meat and cheese sold at the deli counter, raw meat and poultry (except when ground), raw fish or seafood, or foods sold in restaurants.

NUTRITION CLAIMS:

These claims, usually in big or bold print, highlight a nutritional feature that can either entice you to buy a product or turn you away. Only foods that meet strict criteria will be allowed to make nutrient content claims under the new labeling regulations.

Here are a few: “Fat free” describes a product that is free of fat (less than 0.5 g of fat per reference amount and per stated serving of food), although it can still be high in calories. Check the sugar content. Products that are “cholesterol free” (less than 2 mg cholesterol and low in saturated fatty acids) or “low in saturated fat” may still be high in fat. For example, vegetable oils contain no cholesterol and are low in saturated fat, but they’re still 100% fat. “Low calorie” (40 calories or less per serving) points to a product that is low in fat and sugar, since many products derive their calories from these two sources. Products with “no sugar added” or “unsweetened” may still be high in natural sugars.

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Premium ice creams may contain much higher amounts of fat compared to supermarket and lower-fat varieties. A small 100 mL scoop of premium ice cream could provide 19 to 20 g of fat. Choose lower-fat frozen desserts like sherbert and yogurt and slash even more than 2⁄ 3 the fat.

Healthy Habits, Healthy Weights

In the kitchen Cutting the fat doesn’t mean you have to sacrifice taste. Here are a few helpful hints to keep the fun in low-fat cooking.

Use fresh herbs, spices and other condiments to boost flavour and nutrition without adding any fat or calories. If you’re short on time, add some bottled condiments, such as chopped ginger, garlic, Dijon mustard, horseradish or a variety of vinegars.

2 3

Instead of frying foods try baking, barbecuing, broiling, braising, microwaving, poaching, roasting or stir-frying. Allow excess fat to drip off while foods are cooking. To make cooking more interesting, treat yourself to a healthy-eating cookbook that includes an assortment of new recipes and preparation ideas you can enjoy even if you’re trying to lose weight. Try these ones: HeartSmartTM: The Best of HeartSmartTM Cooking; HeartSmartTM Cooking for Family and Friends: Great Recipes, Menus and Ideas for Casual Entertaining, all written by Bonnie Stern and published by Random House Canada in co-operation with the Heart and Stroke Foundation of Canada.

Lightly cooked garlic, onions and sweet red peppers do more than add flavour. They are packed with assorted phytochemicals that all promote good health.

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Rinsing canned foods like tuna and chickpeas can substantially reduce the sodium content.

Heart and Stroke Foundation - A Practical Guide to Weight Management

Eating out Whether you’re going to a restaurant for a quick bite for lunch or for a special occasion, be selective about what you order. Small efforts can add up and keep the scales from tipping out of your favour. You can make healthy menu choices with a little know-how:

Ask how various dishes are prepared. Your best options are barbecued, broiled, grilled, poached, roasted, steamed or stir-fried. But, be sure to ask for a “low-fat preparation” since other fats may be added after cooking. Ask for all sauces and dressings on the side. When portions are too large, don’t clean your plate; leave some behind. If you’re uncomfortable asking about the menu while dining with friends or colleagues, call ahead of time and ask about lower-fat options. Don’t skip meals throughout the day and arrive famished. You’ll be sure to dive into the bread basket. Eat slowly and savour every bite. Make a habit of putting your eating utensils down between bites. When you book a flight, request a low-fat meal or fruit plate. All airlines have them now.

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End a meal with a favourite hot beverage, herbal tea or flavoured coffee.

Healthy Habits, Healthy Weights

Keep the fat down

Fast food follies We all do it. Eating at fast food outlets saves time and there are no dishes to wash. But before you pull into the drive-through, remember that there may be a price to pay for convenience — your health. Many fast food chains promote overindulgence — meal deals like “Buy a sandwich and get the oversized soft drink and fries.” Resist the bargain combos. Instead, get to know the nutrition counts of your favourite menu options.

One submarine sandwich chain lists its 6-in (15-cm) tuna sub as containing 24 g of fat. That’s a whopping 48 g or 12 teaspoons of fat for a full-sized sub. An oversized burger with cheese can add up to almost 700 calories, 40 g of fat and more than 1,800 milligrams of sodium. Chicken sandwiches also vary — one outlet offers one with 550 calories and almost 30 g of fat while another lower-fat option supplies 315 calories, 6 g of fat and under 1,000 milligrams of sodium.

Make healthier choices when ordering fast food with these tips: Do a little homework first. Ask for pamphlets containing nutritional information about menu options. If they’re not available at the restaurant, call the head office or check out the company’s website. Consider the method of preparation. Foods that are breaded or fried will likely have a higher fat count. Watch portion sizes. A double burger will have twice the fat of a single patty. Don’t get sauced. Instead, ask for sauces — such as salad dressing or a sandwich garnish — on the side.

Heart and Stroke Foundation - A Practical Guide to Weight Management

Fast food follies continued…

These are average values for typical fast food menu items. See for yourself what a difference your choices can make. (An asterisk* indicates a better food choice.)

CALORIES

FAT (GRAMS)

Deluxe burger — 2 patties, cheese, and sauce

570

Regular hamburger (no cheese)*

300

Veggie burger*

330

Bowl of chili (with meat)*

270

Taco*

195

Pizza with the works — 2 slices

600

Pizza — vegetarian 2 slices*

500

Chicken sandwich — breaded and fried

550

Charbroiled chicken sandwich — no sauce*

315

Salad — 1 packet, regular dressing

150

Salad — 1 packet, light dressing*

Breakfast sandwich — egg, sausage, and cheese

480

Pancake breakfast (no butter, syrup only)*

360

FAST FOOD FACTS

10 32

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Make it a 10! If you’re tempted by delicious food that you know is not nutritious, play this game: take a bite and rate it from one to 10. Finish only if your decadent delight scores a full 10 points.

Healthy Habits, Healthy Weights

Liquid benefits Think a little sip of pop now and then doesn’t really count? Think again. Your drink choices — from water and juices to soft drinks and alcohol — have a great impact on your overall weight. A sugary soft drink a day can add up to 55,000 calories, or 15 pounds, a year. Of course, you need to replenish your body regularly with fluids, especially water. When your body’s temperature rises during exercise, for example, water helps cool the body through perspiration. Water also helps dissolve and absorb nutrients, as well as carry waste products out of your body. Starving your body of fluids can dehydrate you, which can cause nausea, fatigue and a collapse of the circulatory system.

But not all liquids are equal: Beverages containing protein, such as milk, can satisfy your hunger while those containing sugar may only satisfy fluid needs. Hot beverages like coffee or tea contain no calories on their own, but the company they keep — sugar, cream and even whole milk — can be deceptively calorie-laden. Rich, fancier coffee offerings like flavoured lattes or cappuccinos can contribute as much fat and calories as a piece of cake. Also, keep in mind size — a large serving size could be the equivalent of four regular cups of coffee. Too much caffeine — found in coffee, tea and soft drinks — can raise blood pressure and even cause indigestion, which may lead some people to nibble in order to soothe their tummies. So don’t exceed a moderate amount — two to three 5-oz (150 ml) cups of coffee a day. Black and green teas can be good for you. They’re rich in antioxidants, which may offer protection against cardiovascular disease and certain cancers.

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Make sure you drink enough water. People often mistake thirst for hunger.

Heart and Stroke Foundation - A Practical Guide to Weight Management

Liquid benefits continued…

Alcohol advice Moderate amounts of alcohol — which is considered to be no more than one or two standard drinks per day, with a weekly limit of nine standard drinks for women and 14 standard drinks for men — have been shown to offer protection against heart disease and stroke. That’s because in middle-aged and older adults, alcohol may increase HDL (“good”) cholesterol levels and decrease your risk of developing blood clots.

But there are also weighty risks to consuming too much alcohol: It can raise your blood pressure. Individuals with high levels of triglycerides in their blood should not consume alcohol. Calorie counts in alcohol can add up significantly: A 12 oz, (341 mL) bottle of 5% beer with an alcohol content of 5% has 157 calories 1 1⁄ 2 oz, (43 mL) of spirits contains 93 calories A 5 oz glass (142 mL) of red table wine comes in at 102 calories A 5 oz glass (142 mL) of sweet dessert wine can add up to 220 calories Some studies link a larger waist size with alcohol intake. Fat around the waistline can contribute to high cholesterol, which is linked to an increased risk for cardiovascular disease. Alcohol may increase the risk of breast cancer, especially for women who have a family history of the disease.

A standard drink is: 12 oz (341 mL) bottle of 5% beer, 5 oz (142 mL) of 12% wine, or 1 1/2 oz, (43 mL) of 40% spirits or liquor.

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If you don’t already drink alcohol, don’t start.

Healthy Habits, Healthy Weights

Portion pointers

Portion distortion How much is enough? Less than you might think. While gigantic portions are served to us at fast-food outlets, restaurants and supermarkets, a healthy serving size is much smaller and is all that your body needs. Appetizers, for example, should be tummy teasers, not meals on their own. Single servings of pasta needn’t be the size of a platter but should fit onto a side plate. Steak platters are often double or triple the recommended number of ounces, which should roughly resemble a pack of cards. Even oversized bakery goods, such as monster muffins or bagels, can contain more than double the calories of their regular-sized cousins. Eating recommended serving sizes is key to effective weight management. (To become a portion pro, see our chart on Page 36.) Consult Canada’s Food Guide to Healthy Eating to determine the number of daily servings that are right for you.

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Fight the urge to overeat with these tips: When you’re eating out, doggie bag some of your extra-large portions. Use leftover meat, poultry or fish for sandwiches, salads or soup the next day. An uneaten salmon fillet can make a delicious salmon salad. At a restaurant, calculate how much is enough before you start eating. One trick is to use your knife and fork to mark your boundaries. At home, consider the size of the dishes you eat from. Eating cereal in a large bowl can equal a week’s worth of grains in just one sitting. For main courses, switch to a dessert plate and feel free to fill it.

Keep a batch of low-salt, brothbased vegetable soup with lots of vegetables on hand. Studies show that soup can curb the appetite. Try our South West Tortilla Soup recipe on Page 13.

Heart and Stroke Foundation - A Practical Guide to Weight Management

Portion distortion continued…

Use this chart to help you eyeball hard-to-measure foods, determine portion sizes and prevent overeating.

FOOD (RECOMMENDED SERVINGS PER DAY) Grain products (5-12 recommended servings per day)

Fruits and vegetables (5-10 recommended servings per day)

ONE SERVING

WHAT IT LOOKS LIKE

1 slice of bread

CD case

1 30 g cup cold cereal

2 soup ladles

1 medium potato

Computer mouse

Milk products (2-4 recommended servings per day)

⁄ 2 cup fresh, canned or frozen vegetables

Small fist

50 g cheese

4 dice

Meat and alternatives (2-3 recommended servings per day)

Fat

⁄ 4 cup (175 g) yogurt

Tennis ball

50-100 g of meat, poultry or fish

Deck of cards

2 tablespoons (30 mL) peanut butter

Golf ball

1 teaspoon (5 mL) fat

Tip of your thumb

Healthy Habits, Healthy Weights

Building an active lifestyle Get physical! The benefits are too great to ignore. You have a busy life. Like most people, you find it hard enough to fit in the time for a good meal; finding the time to exercise seems harder still. So what if we told you that to reap health benefits you donâ&#x20AC;&#x2122;t have to log long hours in a gym? Research is now telling us that simply leading an active life (see the next page for examples) reaps all sorts of health benefits:

You will help lower your risk for heart disease and stroke by boosting levels of HDL cholesterol (the heart-helping kind) while helping control blood pressure. Active living also plays a vital role in blood-sugar regulation, helping those with type 2 diabetes manage their condition while helping prevent its onset in those without the disease. An active lifestyle also reduces your risk for cancers of the breast, prostate and colon. Regular physical activity can contribute to a more healthy immune system. Weight-bearing activities help guard against the bone-thinning disease osteoporosis. Physical activity increases your energy. If thatâ&#x20AC;&#x2122;s not enough, an active lifestyle burns calories and that will help you lose weight and keep it off.

â&#x17E;Ľ

Remember that when the number of calories eaten is greater than the number used by the body, the surplus is stored as fat. That means that increased calorie burning through activity translates into eating more each day and still losing weight.

Heart and Stroke Foundation - A Practical Guide to Weight Management

What do we mean by “active living”? Active living means incorporating physical activity into your daily life. That activity can be anything from walking up a flight of stairs at the office, to a 10-km jog. The point is to get physical whenever and wherever the opportunity presents itself. Ever wonder why we spend so much money on gym memberships and then waste time driving around parking lots looking for the best possible spot? If we made a conscious effort to spend more time on our feet, we wouldn’t need to spend so much money on our fitness. Start by honestly assessing your daily routines and looking for opportunities where you can be more active and burn a few more calories. Why not walk to the shopping mall? Or simply stroll around the neighbourhood. There are lots of ways we can all be more active every day.

Here are just a few examples: Set the alarm 10 minutes earlier and walk before breakfast. Take the stairs instead of the elevator. Instead of letting your dog play in the yard, take it for a walk around the block. When using public transit, get off the bus a few stops early and walk the last stretch. When shopping, find the parking spot farthest away from your destination or, better yet, leave your car at home and walk, bike or in-line skate to the local store. Instead of talking on the phone to a friend who lives near-by, get caught up by going for a walk. Go out dancing or put on a favourite CD and dance at home. Make a family walk/skate/bike ride part of your weekend routine.

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Getting back in shape won’t happen overnight. Slow and steady is a winning combination for weight loss and for physical fitness. It’s also a strategy that will help you make permanent change. But remember, if you haven’t exercised in a while, talk to your doctor before starting any fitness plan.

Looking for a way to ease into exercising? Try our six week HeartSmart™ walking program available at www.heartandstroke.ca/healthyweight 38

Healthy Habits, Healthy Weights

Stress busting Physical activity is one of the best antidotes to stress — stress being one of the primary reasons many of us overeat and gain weight. Why? Because when we feel stressed our bodies produce adrenaline, which in turn causes muscles to tense, blood sugar levels to rise and blood vessels to constrict. Those stress reactions would be great if we were going into a fight, but most of us don’t want to go through life with our fists up. Over long periods of time, that kind of constant stress may contribute to your risk of disease. And if you’re one of those people who eats to combat stress, it will take a toll on your weight, too. Physical activity helps moderate adrenaline levels, bringing blood sugar levels down. It won’t eliminate the source of your stress, but by boosting endorphins, our “feel good” hormones, it may leave you feeling less upset about the situation.

For more information on physical activity You can access a wealth of information about physical activity online. Check out these web sites for reliable, practical information: Heart and Stroke Foundation: www.heartandstroke.ca. Canadian Fitness and Lifestyle Research Institute: www.cflri.ca Canadian Health Network: www.canadian-healthnetwork.ca (Look under Active Living) Many excellent books are available to help you learn more about active living. Here is a partial listing of resources. Booklets on physical activity available through the Heart and Stroke Foundation by calling 1-888-HSF-INFO (1-888-474-4636) - Fitness Wheel

So walk, cycle or swim when you’re feeling negatively stressed — any exercise that uses muscles in a sustained way.

- Getting Active for Life Booklets available at no cost through Health Canada's web site www.paguide.com or by calling 1-888-334-9769 - Canada's Physical Activity Guide

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Approximately 63 percent of Canadian adults are not physically active enough in their leisure time to reap any health benefits.

- Canada's Physical Activity Guide for Older Adults - Canada's Physical Activity Guide for Children - Canada's Physical Activity Guide for Youth

Heart and Stroke Foundation - A Practical Guide to Weight Management

Building an active lifestyle continued…

How much are you burning? Calories expended are just as important as calories consumed when it comes to weight regulation. Use the chart below to determine how many calories you’re burning with a variety of physical activities. ACTIVITY

CALORIES BURNED/ 30 MIN.

FOOD

Aerobics

246

1 plain bagel

Bicycling (10 mph/16 kph)

201

1.6 oz (50 g) cheddar cheese

Dancing

208

1 cup (237 mL) of pasta

Downhill skiing

272

1 plain croissant 1

Housework

Ice skating

168

2 plain pancakes

Inline skating (roller blading)

163

1 cup (237 mL) frozen yogurt

Jogging (5 mph/8 kph)

268

1 sugar or glazed doughnut

Jogging (8 mph/12 kph)

455

1 submarine sandwich

Swimming (45 yards/.04 k/minute)

279

1 hamburger with the works

Tennis (singles)

205

1 chocolate bar

Walking (2 mph/3 kph)

Walking (4 mph/6 kph)

160

⁄ 2 cup (118 mL) tuna (canned in water)

⁄ 2 medium cantaloupe

1 can beer

These figures are for a person who weighs 140-150 pounds (63-68 kg). The higher your weight, the greater the number of calories you will burn.

To find out how many minutes of your favourite exercises it takes to burn off the foods you love, visit the Food and Fitness Calculator at www.heartandstroke.ca/healthyweight

Healthy Habits, Healthy Weights

Stay motivated

Keeping on track

Cut out these motivational tips and keep them somewhere handy, for those times when you need a helping hand.

Don’t give up. Mere bumps in the road shouldn’t take you off your journey to a healthy lifestyle.

Make sure the diet and exercise changes you make are for you and not to please someone else.

Reaching, and maintaining, a healthy weight means maintaining a healthy lifestyle. It means adopting eating and exercising habits that will

Resolve any issues that may be at the root of an eating problem. In other words, get at what’s eating you so you can make healthy eating a priority.

last you a lifetime. But since our lives are constantly changing — you find a new job, or go on a vacation — it’s really important to allow yourself room for mistakes. If you look at a greasy lunch or an extra dessert

Set small, realistic goals. If you go at this too intensely you are more likely to give it up.

helping now and then as a mere bump on the road to healthy living, you’re more likely to keep your eating on track and your weight on target.

Surround yourself with good examples — pictures of athletes or friends who have succeeded or motivational articles.

And be realistic about expectations. Making the types of changes that will last a lifetime will take longer than a day or two. Like anything, there will be good days and bad. But take heart — as you

Focus on what you can eat, instead of what you can’t. And reorganize the fridge so that tempting options are harder to

move towards a healthy lifestyle, the good days will outweigh the bad. When the hungries hit, here are five ways to curb

get at and healthy choices are readily available.

your appetite:

Get unhealthy food triggers out of view, or out of the house altogether. And try to find healthy alternatives for food triggers. If movie night isn’t the same without a snack, opt for light microwave popcorn.

1. Drink a large glass of water — sometimes people mistake thirst for hunger. 2. Have a bowl of broth-based vegetable soup or a large salad with low-fat dressing. 3. Pamper yourself with a soothing herbal tea. 4. Rinse your mouth with mouthwash or brush your teeth with a strongly flavoured toothpaste.

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5. A small snack, such as a piece of fruit or a piece of low-fat cheese can keep cravings at bay.

Don’t give up. Remember, every pound you lose is a huge step on the road to a healthier you.

Heart and Stroke Foundation - A Practical Guide to Weight Management

20 things you can do instead of eating You may want to post these on the fridge for times when you need a little motivation.

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17.

18. 19. 20.

Call or email a friend. Browse through a favourite magazine. Hit the gym. Go for a walk. Take a long bath or shower. Start, or add to, your weight-loss scrapbook. Include motivational articles, photos and your own thoughts and feelings. Search the web for tidbits on a subject that interests you. Go window-shopping. Play a game with your spouse, children or pet. Tackle a household chore. Start your holiday gift list. Write a letter to an old friend. Work on a craft to keep your hands busy. Work on a puzzle or knit a scarf while watching television. Crank the stereo and dance around the living room. Read a book with your child. Research new (healthy) recipes for the coming week and make a grocery list. Brush your teeth, use a strong mouthwash and pop a piece of minty gum in your mouth. Reorganize your closet. Get outside into your garden. Try on old clothes, starting with the ones that are now too big and finishing with those that you canâ&#x20AC;&#x2122;t fit into. Healthy Habits, Healthy Weights

Resources & Support Health Check™ To assist you with your grocery shopping and for more information on food labeling, visit the Heart and Stroke Foundation of Canada’s Internet site at www.healthcheck.org or call 1-888-473-4636. Heart and Stroke Foundation For more tools, tips and practical information on how to maintain a healthy weight and manage your risk factors for heart disease and stroke, log onto www.heartandstroke.ca or call 1-888-473-4636. Health Canada For a free copy of Canada’s Food Guide to Healthy Eating call toll free 1-800-OCANADA or visit www. healthcanada.ca/foodguide Canada’s Physical Activity Guide to Healthy Active Living For a free guide on information on how to get more physically active, have more energy, move more easily and get stronger, visit www.healthcanada.ca/paguide or call 1-888-334-9769. Dietitians of Canada For more interactive tools and practical tips on how to eat and live well, visit www.dietitians.ca or call (416) 596-0857. If you’re looking for a Registered Dietitian in your area, log onto www.dietitians.ca/ public/content/find_a_nutrition _professional/find_a_dietitian.asp 5 to 10 a day For easy ways to increase your fruit and vegetable intake during the day, plus healthy eating, money-saving and time-saving tips, visit www.5to10aday.com

YMCA/YWCA To find out more about the health and wellness programs at your local YMCA or YWCA, log on to www.ymca.ca or www.ywca.ca Canadian Diabetes Association For recommendations on how people with diabetes should eat to stay as healthy as possible, log onto www.diabetes.ca or call 1-800-226-8464. Canadian Mental Health Association For resources and strategies to help you cope with tension and stress, log onto www. cmha.ca/english/coping_with_stress or call (416) 484-7750. Recommended Reading The HeartSmartTM Shopper, Nutrition on the Run By Ramona Josephson (Douglas & McIntyre 1999) Lighthearted Everyday Cooking By Anne Lindsay (Macmillan Canada, 2002) The New Lighthearted Cookbook By Anne Lindsay (Key Porter, 2005) HeartSmartTM The Best of HeartSmartTM Cooking By Bonnie Stern with the Heart and Stroke Foundation (Random House, 2006)

HeartSmart™ Cooking for Family and Friends By Bonnie Stern with the Heart and Stroke Foundation (Random House Canada, 2000)

Go Smoke Free For your free quit-smoking e-mail program along with health facts concerning tobacco, breaking news and information updates, log onto www.gosmokefree.ca Heart and Stroke Foundation - A Practical Guide to Weight Management

Heart and Stroke Foundation Offices To contact your provincial foundation office toll free, call 1-888-HSF-INFO (473-4636). Visit the Heart and Stroke Foundation of Canada website at www.heartandstroke.ca Heart and Stroke Foundation of Canada 222 Queen St., Suite 1402 Ottawa, ON K1P 5V9 (613) 569-4361

Heart and Stroke Foundation of Saskatchewan 279 – 3rd Ave. North Saskatoon, SK S7K 2H8 (306) 244-2124

Heart and Stroke Foundation of Québec 1434 Sainte-Catherine St. W. Suite 500 Montréal, PQ H3G 1R4 (514) 871-1551

Heart and Stroke Foundation of PEI 180 Kent St., PO Box 279 Charlottetown, PEI C1A 7K4 (902) 892-7441

Heart and Stroke Foundation of BC & Yukon 1212 West Broadway, Vancouver, BC V6H 3V2 (604) 736-4404 Heart and Stroke Foundation of Nova Scotia 5161 George St., 7th Floor Halifax, NS B3J 1M7 (902) 423-7530 Heart and Stroke Foundation of Alberta & NWT/Nunavut 100-119 14 St. NW Calgary, AB T2N 1Z6 (403) 264 -5549

Heart and Stroke Foundation of Manitoba 6 Donald St., Suite 200 Winnipeg, MB R3L 0K6 (204) 949-2000 Heart and Stroke Foundation of Newfoundland & Labrador PO Box 5819 169-173 Water St. St. John’s, NFLD A1C 5X3 (709) 753-8521 Heart and Stroke Foundation of Ontario 2300 Yonge Street, Suite 1300 P.O. Box 2414 Toronto, Ontario M4P 1E4 (416) 489-7111

Heart and Stroke Foundation of New Brunswick 133 Prince William St., Suite 606 Saint John, NB E2L 2B5 (506) 634-1620

Healthy Habits, Healthy Weights

Millions of Canadians will develop some form of heart disease or stroke over their lifetime - and some at a much too early age. As a leading funder of heart and stroke research in Canada, the Heart and Stroke Foundation continues to find the answers that lead to earlier diagnoses, better treatments and new insights into how to prevent and manage these diseases. To protect your health and the health of those you love, the Foundation also provides the most up-to-date healthy living information to Canadians, based on the most current, evidence-based research.

To find more information about heart disease, stroke, how to live a healthy life, as well as how you can offer much needed support in your community, visit

www.heartandstroke.ca or call

1-888-HSF-INFO (1-888-473-4636)