1. Living Well on a Fixed Income
Elizabeth Black, LADC
ODMHSAS Wellness Program Coordinator

2. What do we know?
On Average our consumers with co-occurring disorders die up to 30 years earlier than the general population.
These stats are specific to Oklahoma

3. Causes of Death for BH Population
Nationwide

4. Obesity
Results from the 2013 ODMHSAS consumer survey:

5. Nutrition & Behavioral Health
The Brain is 2% of our body, but accounts for 25% of our metabolic needs (Drake & Haller, 2011).
Nutrient intake impacts
brain chemistry
the functioning of nerves in the brain
levels of neurotransmitters
Nutrition and mental health is interlinked.
Good nutrition is an important component of an improved mood and an increased sense of well being
Why is nutrition important? Well although only comprising 2% of our body, our brain uses 25% of energy needs. So ¼ of everything that we eat is brain juice.
We know that nutrition impacts brain chemistry, the nerves in our brain, and our levels of neurotrasmitters.
And I’m sure as most of us can attest, good nutrition contributes to a sense of wellbeing. If you eat healthy, you feel healthy. If you eat junk, you feel like junk.

6. Healthy Eating
According to the National Institute of Health, a division of the US Department of Health and Human Services:
“Healthy eating is not hard. The key is to:
Eat a variety of foods, including vegetables, fruits, and whole-grain products
Eat lean meats, poultry, fish, beans, and low-fat dairy products
Drink lots of water
Limit salt, sugar, alcohol, saturated fat, and trans fat in your diet”
Simple enough, right?
What are some barriers our folks and us for that matter fact to healthy eating besides finances? All of this to say that helping them to eat well on a budget is a great first step, but they’re likely to need lots of supports along the way, so keep your mind open to think outside the box. These are some great guidelines though

7. Barriers to Healthy Eating
Time
Coping skill
Symptoms
Medication
Low education/Skills
Culture
Cost

8. Maximum Monthly Allotment
Limited Income
SSI: $721
SNAP benefits:
People in Household
Maximum Monthly Allotment 1
$ 194 2
$ 357 3
$ 511 4
$ 649 5
$ 771 6
$ 925 7
$ 1,022 8
$ 1,169
Each additional person
$ 146
*Maximum- they may not receive full benefits.
(October 1, 2014 through September 30, 2015)

9. ChooseMyPlate.gov
Vs. food pyramid

10. Eating Well on a Budget: Portion sizes
Portion Distortion
Example serving sizes:
Deck of Cards= Meat
6 Dice= Cheese
Computer Mouse=Baked potato
Golf ball= nuts/seeds

11. Eating Healthy on a Budget: Budgeting Strategies
Make a Budget
Pace income
Plan ahead
Create a meal plan
Build meals on items you already have
Check store flyers for upcoming promotions/sales
Make a list
Garbage check
According to a study done by the University of Arizona, Americans throw away about $600 in food every year
Garbage check: According to the Univserity of Arizona, Americans on average throw away about $600 every year in food.

13. Eating Well on a Budget: Shopping Strategies
Don’t shop when you’re hungry
Use coupons (but only for items you would normally buy anyway)
Shop Generic or Store Brands instead of Name brands
Shop high and low
Check sell by dates and Pull from the back
Buy in bulk when possible for a better deal

14. Eating Well on a Budget: Shopping Strategies (cont.)
Check out the bakery- items are often cheaper and fresher than commercial brands
Buy versatile ingredients
Stock up on staple foods
Buy in season
Buy whole foods vs. processed foods
Shop the perimeter of the store

15. Eating Well on a Budget: Shopping Strategies

16. Eating Well on a Budget: Cooking Strategies
Cook in large batches
Make easy substitutions (i.e. whole wheat pasta vs. regular pasta)
Look for shortcuts (i.e. using frozen veggies)
Find easy meals
Build a cupboard
Avoid prepared food
Check for basic cooking skills

17. Training Notes:
A clean copy of these handouts can be found on pages 75 – 78 of your group facilitator manual.
Review the following instructions with trainees:
Pass out copies of the “$20 Shopping List” and “Meal Ideas” handouts. There are two different versions of each handout. One is for individuals who eat meat. The other is for vegetarians.
Choose the shopping list you want the group to discuss. Ask them to look at the food items and come up with meals they can make for breakfast, lunch and dinner. For additional meal ideas, review the “Meal Ideas” handout that matches the shopping list you are discussing.

18. Training Notes:
Review this handout with trainees.
This handout provides examples of meal ideas for the “$20 Shopping List”.

19. Eating Well on a Budget: Fruits and Veggies
Fruit makes for quick portable healthy snacks
Buy only the amount of fresh fruit and veggies you can use before it spoils
Considering buying frozen and canned fruit and veggies
Can be cheaper than fresh
Usually packaged at peak of freshness
Longer shelf life
Easy to add to meals for additional nutrition
Look for veggies with “Low sodium” or “no salt added”
Look for fruits canned in 100% fruit juice or water (no syrup)
Buy fresh fruit and veggies in season

20. Seasonal Produce Guide
Fall
Winter
Spring
Summer
Apples X
Bananas
Bell Peppers
Blackberries
Blueberries
Broccoli
Carrots
Cantaloupe
Corn
Lemons
Lettuce
Onions
Oranges
Peaches
Pears
Pineapple
Pumpkin
Potatoes
Raspberries
Spinach
Strawberries
Sweet Potatoes
Tomatoes
Turnips

21. Potatoes Good staple product and meal builder
Versatile; can be prepared in a variety of ways.
They are affordable at about $.19/lb
Excellent source potassium, fiber, and vitamin C
Cheapest to buy by the sack vs. individually
Can be frozen up to 3 months

22. Grains Grains are full of fiber which helps to fill us up faster
Buy whole grain versions of the foods you already love:
Cereal
Pasta
Rice
Bread
Crackers
Look for store bands to save money on expensive packaging
To tell if a food is a whole grain, look for the word “whole” as the first ingredient on the ingredients list (i.e. whole wheat, whole oats, etc.)

23. Protein
Save money by supplementing meat proteins with plant proteins (seeds, nuts, soy, beans, etc.)
Eggs are one of the most affordable sources, at about $.15/ea
Choose lean proteins (fish/birds) more often than red meat or pork products
Substitute ground beef or bacon for turkey/veggie alternatives
Buy proteins in bulk during good sales and freeze what you won’t use right away
Try grilling, broiling, roasting, or baking vs. frying
Avoid canned meat (except tuna) due to high sodium content

24. Dairy
Dairy is high in calcium which is important in building and maintaining bones.
Choose low fat (2% to 1%) or nonfat (skim) milk products
Buy a block of cheese and shred it on your own
Replace sour cream with plain low fat yogurt
Alternatively, you can try plant based milk which includes soy, almond, or rice milk
Check expiration dates (don’t buy more than you can use)
Ice cream doesn’t count

25. Staples
Build a pantry by stocking up on staples, which are items that you will use frequently for a variety of different dishes.
Some items might be costly in the beginning (i.e. Spices) but buy them as they go on sale and eventually you build a variety to choose from.
Staples may include:
Spices Vanilla extract
Baking powder/soda Flour
Cooking Spray Pasta
Cornmeal Soups
Cornstarch Sugar (brown, table, confectioners)
Canned vegetables Tomato sauce
Rice Beans
Condiments Vegetable Oil

26. Feel Great, Hydrate Our bodies are made up of 70% water
Save money by drinking water
Drink out of tap vs. bottled
Invest in a filter if necessary
Invest in a water bottle to drink on the go.
If the average 12 pack of coke cost $4.00 and you drink 2 per day, you spend almost $250 per year.
It adds up quickly!

27. When eating out Limit eating out, but when you do:
Drink water when possible. At most places water is free vs. drinking soda or alcohol.
Ask about specials.
Skip the appetizer and/or dessert
Stick to 15% tip and make sure the tip isn’t already included
If you typically don’t finish the entire meal, ask if you can order a smaller portion for a reduced price.
Take a doggy bag home with any uneaten food so you can make another meal out of it.

28. A couple more things
The easiest way to make change is to start small (baby steps)
Add to your diet/not subtract
There are no good or bad foods
Find nutritious foods that taste good to you
Food can be a coping skill and a source of shame
Relationship with food = Love/hate
Emotional vs. Physical hunger
Food Diary

29. Food Diary Time/Date Meal Food/Beverage Amount Mood Monday Tuesday
Time/Date
Meal
Food/Beverage
Amount
Mood
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

30. PB&J
Meeting them where they are

31. Resources SNAP Farmer’s Markets School programs
Offers financial assistance for food items
Program participants can also purchase seeds and plants to grow their own food
Farmer’s Markets
Support local farmers while getting fresh foods
School programs
Offers free or reduced cost meals to families with limited finacial means
County Extension Offices
Offers nutrition education and resources
WIC
Offers financial assistance for mothers with young children

32. Physical Activity on a Budget
People with behavioral health problems are overall less physically active than the general population.

33. Physical Activity on a Budget
The CDC recommends that the average adult get 2.5 hours of exercise each week
Physical activity does not have to be formal.
May include gardening, cleaning, riding a bicycle to the store, etc.
The most popular form of physical activity is walking
Due to it’s affordability, accessibility, and low-impact.
Small changes result in long term maintenance
Something is always better than nothing

34. Low cost physical activity ideas
Swimming in a lake
Frisbee golf
Walking/jogging/running
Dancing
Throwing a football
Shooting hoops
Strength exercises (push ups, sit ups, etc.)
Hiking
Running/walking stairs
Stretching
Workout videos

35. Resources Used sporting good stores YMCA
Oklahoma Tourism and Recreation Department
Community Events (Walks, Festivals, etc.)
Local resources
Your facility

36. Fostering Change Is it will or skill? Evolution, not resolution
Set realistic, measurable goals
Start small
Focus on one thing at a time
Promoting intrinsic motivation
Find support
Record progress
Reinforce success
Develop a routine
Foster patience and self-acceptance

37. Thank you! Questions? Elizabeth Black, LADC