Health and Nutrition Creating a healthy diet from local foods Where do Zambian traditional foods fit? Trainer’s Notes: This is a topic that can be discussed with everyone!! It’s fun to have the learner name off foods that they like and to determine which category that food falls into! In this way, the learner can discover whether their preferred diet is really healthy! Notice that alcohol and beer are NOT on this chart!! This is a good time to discuss that beer is full of energy and calories BUT doesn’t have good nutritional value. Alcohol damages the liver and the brain and people living with HIV and women who are pregnant or nursing SHOULD ABSTAIN from drinking beer! This is also a good place to talk about smoking. Smoking kills – plain and simple! It causes cancer, lung disease, stunts growth and harms the fetus. Women who are pregnant should never smoke and adults should never smoke when holding babies or children, or in closed rooms where children are present! People living with HIV should NEVER SMOKE!! There is no healthy limit - only NOT SMOKING! The Classic “Food Pyramid” Suggests we base our diet on grains, but also get veggies, protein and some fats A “Zambian” food pyramid! 1

Health and Nutrition Creating a healthy diet from local foods What MAKES a balanced meal? All 3 foods: starch, protein, vegetable!! More than just starch! Nshima alone is NOT a balanced meal! Daily sources of protein and vegetable Beans, ground nuts, egg, milk Meat, chicken, kapenta, mopane worms Daily sources of fruit or vegetable Pumpkin leaf, tomatoes, onions, squash, mangos, papaya, banana WHY eat a balanced meal? Kids need protein to grow healthy brains, internal organs and muscles There’s 4 TIMES as much protein in beans as there is in nshima! Roasted ground nuts have 12 times the protein of nshima! Kids need fruit and vegetables which have vitamins and minerals needed for: Good eyesight (Vit A – in pumpkin, squash and sweet potatoes, carrots) Healthy teeth (Vit C, in tomatoes) Strong bones (Calcium, in dark green leaves) Men AND Women need these too! Folic acid, found in dark green leafy vegetables, prevents spinal birth defects EXTRA calcium, protein and fats are needed to make healthy breast milk for growing babies Iodine, found in fish and iodine-treated salt, helps reduce mental retardation of babies and gives adults healthy thyroids glands – the gland that controls our energy levels! Trainer’s Notes: Nshima is really not a great single food source. It has only about 6% protein by dry weight. When prepared, it’s mostly water and starch. Eating roasted maize is more healthy, but it’s still not really considered a source of good protein when eaten alone. It’s particularly important to discuss how food is shared amongst family members. This page, and the next one, are good tools for that. More information about the individual nutrients found in food can be found in a handout from FAO and is available in full at their website. Healthy Tips! Fruit and vegetables that are dark colored are more nutritious than pale ones! Vegetable fats (like those in beans and corn) are more healthy than fats found in meats (like the fat on t-bone!) 2

Health and Nutrition Creating a healthy diet from local foods Group Nutritional Needs Group Nutritional Needs Two mixed meals every day and some snacks. They can get enough energy from a few large meals and from bulky foods. Heavy work like farming and cutting wood may increase needs. At least two large mixed meals and some snacks each day. Boys need a lot of energy. Girls need plenty of iron and calcium. Pregnant teen girls are still growing so they need more food than pregnant adult women. MEN Teens At least two mixed meals every day and some snacks. They can get enough energy from a few large meals and from bulky foods. Women doing heavy field work will need extra protein with extra starch. School-age children need at least two to three mixed meals WITH PROTEIN and some snacks each day. Fruit and vegetable is essential! WOMEN If they are pregnant or nursing, women need as much food as men - especially if they are also doing hard physical work like farming. Women need much more iron, calcium, protein and folate when they are pregnant or nursing. School Kids Children one to five years old need breast milk until they are at least two years old. They need at least three mixed meals and two snacks each day. They cannot eat large bulky meals. They MUST have protein to prevent liver damage, and a mixed diet for essential vitamins and minerals! Trainer’s Notes: Families often try to save the protein-containing foods for the men. In reality, EVERYONE needs protein! From the person doing physical labor – such as farming, digging, carrying water and firewood – or women who are pregnant or nursing – or children who are growing – protein is an important nutrient for healthy life! This may put a heavy demand on a family to produce or acquire protein and may increase the temptation to go poaching or hunting/fishing by illegal or unsustainable means. Reminding them that beans, ground nuts, lentils, eggs, and peas are also great protein sources may help. Start a discussion about what kind of proteins they can raise themselves or get through COMACO that will help them meet the needs of the whole family. You can use this page to write out and add up how many meals are needed for a family every day. Help the person preparing meals to decide how he or she will make this work! There is one exception to the rule of nursing all babies as long as possible – mothers who are HIV+ may be advised by their doctor or nurse not to breast feed in order to reduce the risk of giving HIV to the baby. This is DEFINATLY a topic that pregnant women should discuss with a care giver, and THE MOST IMPORTANT reason to KNOW YOUR STATUS!! HIV+ moms CAN have healthy babies if properly managed during pregnancy, delivery and nursing. Kids in Zambia are often: deficient in Vitamin A – causing blindness Deficient in vitamin C – causing poor disease resistance and bad teeth Calcium – causing rickets (bow legs) Protein – causing bellies to bulge. Remember that parasites also drain the body of nutrients. Kids should be checked for worms or de-wormed regularly and adults should probably consider de-worming annually if they are working in the soil. NURSING PREGNANT Kids 1-5 yrs At least two and maybe more meals each day as they may not eat much at each meal. They need less starch than young people but about the same amount of protein and vegetables. Old people may need soft food because of mouth pain and lost teeth. Babies six to 12 months old need breast milk at least 8-10 times per day. They need small meals, three to five times a day. Babies under six months of age need only breast milk at least ten times each day. ELDERLY Babies 3

Health and Nutrition Creating a healthy diet from local foods Food habits that are BAD for you! Too much salt causes heart disease and high blood pressure. If the food tastes salty – IT’S TOO MUCH!! Too much fat or oil not only makes you fat, it increases your risk of heart attack. Chose vegetable fats, like corn oil, & don’t eat the fat from meats like T-bone or chicken skin. Fried foods are high in fat and less healthy than foods which are roasted or boiled. Use the smallest amount of oil possible for good health!! You’re a better host if you serve healthy food! If you can see the oil on the plate, you’ve used TOO MUCH! Too much sugar is also bad, as it causes tooth decay and weight gain without healthy nutrients! Save it as a rare treat! Never eat meat raw – it can have bacteria and worm eggs! Do NOT give honey to babies under age 6 months – it can have tiny amounts of botulism toxin that won’t hurt the rest of us, but can hurt the baby! HEALTHY TIPS! Boiling takes vitamins out of food and puts them into the water! If you boil veggies, use the water for soup or porridge, or drink it for a healthy boost after it cools! Rather than boiling food in lots of water, try putting on the lid, and steaming foods in just a little water. Roller meal is healthier than breakfast meal because it has more fiber and protein! Brown rice is healthier than white rice for the same reasons! Eat fruit and vegetables raw to get the full food value, but be sure that you’ve washed the dirt off with pure water. Ground nuts are best for you if roasted as soon as they are dry after harvest. Make healthy tea out of many herbs such as lemon grass, mint or wild basil! These are easy to grow and will last a long time. Honey is healthier than cane sugar! Trainer’s Notes: Remind adults that they have to set an example for their kids by eating healthy and serving proper meals! Drinking shake-shake instead of proper eating is a bad lesson for kids! Moldy ground nuts contain poisons called “aflotoxins” which are bad for your liver. Cooking them will NOT remove the toxin, so if they’re moldy, don’t eat them at all. This is why we recommend roasting as soon as they are dried after harvest!!! Many people feel that using lots of oil shows you are well off, and that you are a good host. In fact, too much oil isn’t healthy. People working physically hard can eat some oil, but should focus on vegetable oils rather than lards or fats. It’s important that oils only be used when fresh, and only used once. Oil that’s been used for frying should NOT be saved to use again. Eggs are a great food source – they have protein and energy. They are only healthy if they’re FRESH! Encourage people not to leave eggs in the sun AT ALL and show them how to check for freshness by shaking (only a spoiled egg will slosh) or floating them (only a spoiled egg will float). Honey is better for you than processed sugar because it has small amounts of pollen in it that stimulate your immune system. But NEVER give it to babies – it may have a little bit of botulism toxin in it! Doesn’t bother adults, but kids can get sick. Eating a balanced diet of healthy foods is especially important for people living with HIV!! 4