Presentation is loading. Please wait.

Presentation is loading. Please wait.

1 Completing Your PAL Forms 1. PAL Forms PAL: Personal Awareness Log Paperwork you will be COMPLETING and TURNING IN on a weekly basis during Stage I.

Similar presentations


Presentation on theme: "1 Completing Your PAL Forms 1. PAL Forms PAL: Personal Awareness Log Paperwork you will be COMPLETING and TURNING IN on a weekly basis during Stage I."— Presentation transcript:

1 1 Completing Your PAL Forms 1

2 PAL Forms PAL: Personal Awareness Log Paperwork you will be COMPLETING and TURNING IN on a weekly basis during Stage I of the Dr. Dean Ornish Program for Reversing Heart Disease. 2

3 The Benefits of PAL and Other Forms Research shows that self-monitoring is one of the most important tools used for succeeding at lifestyle change. Self-monitoring using PAL and other forms helps you: –Outline clear goals for nutrition, exercise, group and stress management. –Self-assess how you are doing on a daily basis. –Recognize and celebrate the areas in which you’re doing well. –Identify the areas in which you need to focus. 3

4 Is all this paperwork necessary? The PAL forms assist the Ornish team in: –identifying any barriers –helping you reach goals –customizing the Program to meet your needs Careful monitoring will ensure good nutrition and safe and effective participation in all four elements as well as ensure maintenance to lifestyle change. The PAL forms are a tool to help the Ornish team help you. –They are not meant to be judgmental. 4

5 How to Complete Your Nutrition PAL Form and Weekly Food Diary 5

6 Step 1: Identify the foods you have eaten and the amount consumed. Sample Dinner Meal –1 Boca Burger on 1 Whole-Wheat Bun 1 Tbsp ketchup, 1 lettuce leaf, 1 tomato slice –½ cup Vegetarian Baked Beans –1 cup Field Green Salad 2 Tbsp fat-free French dressing –1 cup Fresh Cubed Melon 6

7 Step 2: Determine corresponding food groups based on the Reversal Food Pyramid. Food EatenFood Group Boca BurgerProtein Whole-Wheat BunWhole Grain Lettuce, TomatoVegetable Vegetarian Baked BeansProtein Field Green SaladVegetable Fat-free French DressingFree Food MelonFruit 7

8 SERVING SIZE reference found on back of Nutrition PAL Form. Step 3: Determine the amount of servings eaten. Food EatenFood Group# Servings Boca BurgerProtein1 burger = 1 svg Whole-Wheat BunWhole Grain1 bun = 2 svg Lettuce, TomatoVegetable 1 piece lettuce, 1 tomato slice = < 1 svg Vegetarian Baked BeansProtein½ cup = 1 svg Field Green SaladVegetable1 cup = 1 svg Fat-free French DressingFree Food2 Tbsp = 1 svg Fresh Cubed MelonFruit1 cup = 1 svg 8

9 Step 4: Record information on food diary. Food Eaten Food Group # Servings WW BunWhole Grain1 bun = 2 svg Lettuce, TomatoVegetable 1 piece lettuce, 1 tom. slice = < 1 svg Field Green SaladVegetable1 cup = 1 svg Fresh MelonFruit1 cup = 1 svg Boca BurgerProtein1 burger = 1 svg Veg. Baked BeansProtein½ cup = 1 svg FF French DrsgFree Food2 Tbsp = 1 svg WEEKLY FOOD DIARY Grains (6+ whole grains) 1 whole wheat bun (2) Vegetables (3+) 1 lettuce, 1 tomato slice (<1) 1 cup field greens (1) Fruits (2-4) I cup melon (1) Full Fat Soy (1) Other Protein (1-3) I Boca Burger (1) I/2 cup veg baked beans (1) Nonfat Dairy (0-2) Sweets (0-2)/Alcohol (0-1) Free Food: 2 T FF French dressing (1) Record all meals and snack. 9

10 Step 5: Transfer servings to Nutrition PAL Form. Protein Sources Food Group Servings Whole Grains 6 or more Veggie 3 or more Fresh Fruit 2 to 4 Full Fat Soy Food 1 Other Protein Foods* 1 to 3 Nonfat Dairy 0 to 2 Sweets 0 to 2 Mon Tues Wed Thurs 10

11 Food Group Servings Low-Fat Foods <3g Fat** 0 to 3 Suppl √ for all NO Caffeine LIMITED Alcohol FOOD GROUP TOTAL Mon 1  00 Tues Wed Thurs Step 5: Continued MAJOR GUIDELINES: Please indicate if you were able to follow the nutrition guidelines with a Y (YES) or N (NO). NO ADDED FAT AND OIL NO MEAT FISH POULTRY DIETARY GUIDELINE TOTAL YY 11

12 Leave shaded areas blank. For staff use. Know Your PAL Form 12

13 Low-Fat Foods ≤ 3 grams Fat Per Serving LOW-FAT FOOD = An Ornish-friendly food with 3 grams of fat or less per serving, which also contains trace amounts of unsaturated fat(s) as a minor ingredient. 0-3 SERVINGS ALLOWED/DAY. Veggie Penne Nutrition Facts Serving Size: 1 package (300g) Calories 220 Calories from Fat 15 Total Fat 1.5g Saturated Fat 0g Cholesterol 30mg Sodium 730mg Total Carbohydrate 36g Dietary Fiber 4g Sugars 7g Protein 12g INGREDIENTS: WATER, TOMATOES, ENRICHED PENNE PASTA (DURUM SEMOLINA, NIACIN, FERROUS SULFATE (IRON), THIAMINE MONONITRATE, RIBOFLAVIN, FOLIC ACID), ROASTED RED PEPPERS, ONIONS, TEXTURED SOY PROTEIN (NON-GMO), TOMATO PASTE, BURGUNDY WINE, TEXTURED WHEAT PROTEIN, ROASTED GARLIC, SALT, ORGANIC EVAPORATED CANE JUICE, CORNSTARCH, SPICES, EXPELLER PRESSED OLIVE OIL, NATURAL FLAVOR, MALT EXTRACT, CITRIC ACID, GARLIC POWDER, ONION POWDER, CARRAGEENAN (FROM SEAWEED), SESAME OIL. 13

14 INGREDIENTS: WATER, SOY PROTEIN CONCENTRATE, WHEAT GLUTEN, CONTAINS LESS THAN 2% OF NATURAL FLAVOR, SALT, MALTODEXTRIN, DRIED ONION, YEAST EXTRACT, SESAME OIL, DEFATTED WHEAT GERM, CARAMEL COLOR, HYDROLYZED CORN, SOY AND WHEAT GLUTEN, SOY SAUCE (WATER, SOYBEANS, WHEAT, SALT), AUTOLYZED YEAST EXTRACT, NATURAL AND ARTIFICIAL FLAVOR (CONTAINS COTTONSEED), METHYLCELLULOSE, DISODIUM GUANYLATE, DISODIUM INOSINATE, SUCCINIC ACID Nutrition Facts: Serving Size: 1 burger (71g) Servings Per Container: 4 Amount Per Serving Calories 90 Calories from Fat 10 Total Fat 1g Saturated Fat 0g Cholesterol 0mg Sodium 350mg Total Carbohydrate 6g Dietary Fiber 4g Sugars 0g Protein 13g 14

15 3 1 Weekly Food Diary Name: ________________ Monday Food & Amount: Other Grains 1 cup Yves Veggie Penne ** Vegetables (3+) ½ cup tomato sauce Fruits (2-4) Full Fat Soy (1) Other Protein (1-3) 1 Boca Burger (1) * Nonfat Dairy (0-2) Low fat Foods (0-3) 1 Boca Burger (1) 2 servings Yves Veggie Penne Sweets (0-2) / Alcohol (0-1) 1 15

16 Tips for Nutrition PALs: Always include accurate amounts for all foods and beverages recorded. Don’t forget snacks or drinks. Save food labels and bring them to the next session if unsure of a packaged food. Always refer to the serving sizes listed of the back of the Nutrition PAL form when estimating servings. Write legibly. Be as accurate and descriptive as possible, using “FF” for fat-free foods, “WG” or “WW” for whole-grains and whole- wheat foods. Indicate whether vegetables are cooked or raw, and fruits are fresh or canned.

17 Stress Management, Exercise and Group Support PAL Forms

18 Sample Week PAL Form MONDAY 30 minutes meditation 30 minutes yoga poses 45 minutes swimming TUESDAY – CLASS 60 minutes – Ornish yoga class 50 minutes treadmill WEDNESDAY – BAD DAY! 15 minutes deep breathing THURSDAY – CLASS 60 minutes Ornish yoga class 45 minutes treadmill FRIDAY 15 minutes imagery 15 minutes deep relaxation 15 minutes yoga poses 40 minutes biking SATURDAY 60 minutes relaxation/yoga CD 30 minutes resistance band SUNDAY 60 minutes relaxation/yoga CD

19 01/02/ treadmill treadmill sitting in traffic Relax CD minutes bike swim bands minutes yard 30 yard Ornish yoga class           Relax CD Leave shaded area blank. For staff use.

20 More PAL Tips Total your weekly minutes for stress management and exercise. Don’t forget to record exercise and stress management done during weekly class time. Add comments about encounters or stressful situations you may have had during the day/week. Write down any questions or concerns you may have during the week on the back of any one of your forms for the staff to address. 20

21 21 Questions 21


Download ppt "1 Completing Your PAL Forms 1. PAL Forms PAL: Personal Awareness Log Paperwork you will be COMPLETING and TURNING IN on a weekly basis during Stage I."

Similar presentations


Ads by Google