1. Nutritional Wellness Coaching Your Client to Making Nutritional Changes that Last Certified Obesity Management Specialist, COMS The American College of Wellness, Certified Obesity Management Specialist

2. Identify Your Patient  Fast Food/Convenience Eater No time for preparing food No education on nutrition or food preperation  Poor Nutritional Value No fruit or vegetables, high fat, high salt  Mindless Eating and/or Snacker Eating on the run or quickly, snacking with TV  Portion Overloader The American College of Wellness, Certified Obesity Management Specialist

3. Gradual Lifestyle Changes Lead to Health Weight Loss  Awareness.  Motivation.  Commitment  Reasonable goals.  Behavior change  Eat a balanced diet with a wide variety of foods, in the appropriate portions  Exercise The American College of Wellness, Certified Obesity Management Specialist

4. Nutritional Basics  Know what flavors turns you on  Think QUALITY, not quantity  Eat Mindfully Listen & Taste each bite  Pay Attention Ambiance of the meal and its preparation  3-5 vegetable servings per day.  2-4 fruit servings per day. The American College of Wellness, Certified Obesity Management Specialist

5. Food Composition: Carbohydrate  Starch - beans, vegetables, whole grains, pasta  Fiber-beans, vegetables, fruit, whole grains  Sugar-table sugar, soda, candy, cake, pie (low in nutrients) (will raise triglycerides); fruit and fruit juice contain natural sugar but have nutrition value (limit quantity of juice) The American College of Wellness, Certified Obesity Management Specialist

6. CARBOHYDRATES  All carbs are NOT created equal!  Best - Whole grains and Complex Carbs  Whole grain break down over long periods of time keeping a constant flow of Serotonin in your body  To experience maximum effects of carbs on your mood, eat them ALONE  English muffin with jam is fine. No tuna fish or cheese on it!  Fruit & Fat don’t work!  Eating any of the following grains will help you feel more relaxed: Breads, Pasta Rice, Barley Corn, Potatoes Kasha, or Oatmeal  About 30 grams is plenty ( 1 1-2 cereal)  Snack foods help you concentrate better and ward off tension in the middle of the day  Include: Popcorn or Pretzels Bake potato Rice cakes The American College of Wellness, Certified Obesity Management Specialist

7. Dietary Carbohydrates  Simple Carbohydrates or sugars: Monosaccharides and Disaccharides  Sources Include: Refined and processed sugar Carbonated beverages (not sugar-free) Most cookies, cakes, and candy Dried fruit, fresh fruit, some vegetables Milk, yogurt, ice cream Sugar, syrups, molasses, honey Pudding  Complex Carbohydrates or Starches: Polysaccharides  Sources Include: Breads, bagels, cereals, flour (Grains/Grain products), Crackers Macaroni, noodles, other pastas, rice, Couscous Cooked beans and peas, legumes Potatoes, Corn, other vegetables The American College of Wellness, Certified Obesity Management Specialist

8. Dietary Carbohydrates Cont’d  Dietary Fiber: Soluble and Insoluble  Sources Include: Cellulose, hemicellulose whole grains, bran, dried beans, legumes fruits, vegetables The American College of Wellness, Certified Obesity Management Specialist

11. Functions of Carbohydrates  Principal source of energy for all body functions  Normal metabolism of fat  Formation of nonessential amino acids  Fiber keeps us regular, and may lower serum cholesterol levels The American College of Wellness, Certified Obesity Management Specialist

12. “Good Carbs”  Whole grains- oats, wheat, rye, bulgar, barley  Brown rice, whole-wheat pastas, breads and cereals  Dried beans, lentils  Unrefined flours  Fruits  Milk, yogurt  Sweet potatoes, pumpkin, squash  Corn, peas The American College of Wellness, Certified Obesity Management Specialist

13. “Not So Good Carbs”  Cakes, cookies, pies candy, biscuits, pastries, pop-tarts  Refined sugar  Refined breads, rice, and pasta (all white)  Refined cereals and flour  Butter crackers, chips  French Fries  Ice cream, milkshakes  Soda, fruit juice lemonade, other sugary drinks The American College of Wellness, Certified Obesity Management Specialist

14. Fad Diets  May offer rapid weight loss initially  Usually extremely low-calorie plans  Overemphasize one particular food or type of food  Restrictive and monotonous  Effortless  Nutrition Confusion  High calorie food readily available  Emotional eating  Society attaches attention to physical appearance  Unattainable goals The American College of Wellness, Certified Obesity Management Specialist

15. Low Carbohydrate Diets Advantages:  Rapid weight loss  Decreased appetite  Red meat allowed  Reduces triglycerides  Reduces blood glucose Disadvantages  Rapid weight rebound  Ketosis  Headaches  Dehydration  Electrolyte loss  Calcium depletion  Weakness and fatigue  Nausea  Kidney damage  Vitamin deficiencies  Mineral deficiencies  Gout  Constipation from lack of fiber  Limited food variety  Not designed for lifelong eating  Atherosclerosis The American College of Wellness, Certified Obesity Management Specialist

16. Low Carbohydrate Diets  The long-term effects on the risk of heart disease, stroke, cancer, and osteoporosis has not been tested  May not lead to greater weight loss after the first six months  Lack of variety/monotonous  Importance of exercise may be overlooked in the prevention of weight regain  Ketosis  Choose chicken, turkey, fish, pork tenderloin more often than red meat  Choose lean cuts of red meat  Egg whites, low-fat cheese, low-fat cottage cheese  Light margarines  Don’t skimp on veggies The American College of Wellness, Certified Obesity Management Specialist

17. Food Composition: Protein  Lean meat, fish, poultry  Beans  Peanut butter  Soy products  Eggs  Milk products The American College of Wellness, Certified Obesity Management Specialist

18. PROTEINS  If you’re feeling sluggish, protein power can produce the effect you want!  Protein encourages the production of Dopamine and Norepinephrine, which produces mental alertness, energy, and fast reaction times  The effects of eating proteins last about 2-3 hours  To maximize the arousal effects of protein, limit the intake of fat and carbs while eating protein  Remember - Don’t eat protein for several hours before bedtime or you may experience difficulty falling asleep The American College of Wellness, Certified Obesity Management Specialist

19. Food Composition: Fat  Monounsaturated fat (best for heart) -olive oil, peanut oil, peanuts, avocado, canola oil  Saturated fat-butter, stick margarine, bacon, beef fat, cocoa butter, chocolate  Polyunsaturated fat-sunflower oil, corn oil, safflower oil The American College of Wellness, Certified Obesity Management Specialist

20. Added Fat  Monounsaturated Fat  Polyunsaturated Fat  Saturated Fat  5 grams of fat per choice The American College of Wellness, Certified Obesity Management Specialist

21. “Free” or Negligible Foods  Mustard  Salsa  Vinegar  Broth  Catsup  Sugar-free gum  Water  Sugar-free Kool-aid  Crystal Light  Sugar-free gelatin  Decaffeinated tea  (1 serving of an item with less than 20 calories per serving) The American College of Wellness, Certified Obesity Management Specialist

22. Plate Method: Fruit Milk Vegetables Starch Meat/ Protein (Low Carb) The American College of Wellness, Certified Obesity Management Specialist

23. Quarter Plate Method  Mentally divide plate of food in fourths  Pause after a fourth of food is eaten. Ask yourself: Am I comfortably full?  If not eat another fourth.  Repeat. The American College of Wellness, Certified Obesity Management Specialist

24. Hunger/Fullness Record Satiety 10--Stuffed to the point of feeling sick 9--Very uncomfortably full, need to loosen your belt 8--Uncomfortably full, feel stuffed 7--Very full, feel as if you have overeaten 6--Comfortably full, satisfied Neutral 5--Comfortable, neither hungry nor full 4--Beginning signals of hunger 3--Hungry, ready to eat 2--Very hungry, unable to concentrate Hunger 1--Starving, dizzy, irritable The American College of Wellness, Certified Obesity Management Specialist

25. Resting Metabolic Rate Percent of resting Organ Calories per day metabolic rate Brain 36521 Heart 180 10 Kidney 120 7 Liver 560 32 Lung 160 9 Other tissues 370 21 The American College of Wellness, Certified Obesity Management Specialist

26. Cells need power  Carbohydrate provides energy for all cells including muscles and brain  Carbohydrate breaks down to glucose The American College of Wellness, Certified Obesity Management Specialist

27. Foods for Energy  Fruit  Vegetables  Whole Grains  Light Yogurt  Skim or 1% Milk The American College of Wellness, Certified Obesity Management Specialist

28. Food with Staying Power  Lean Meat (sirloin, 90% lean ground)  Poultry (remove skin after cooking)  Fish  Beans  Nuts and Seeds (watch the amount) The American College of Wellness, Certified Obesity Management Specialist

29. Functions of fat in the diet  Fat helps with feeling full  Fat helps vitamin A be absorbed  Fat keeps skin and intestines healthy  Fat improves the taste of food The American College of Wellness, Certified Obesity Management Specialist

30. How much fat do I need?  Varies with individual  Consult a Registered Dietitian  In general between 30-60 grams of fat per day would be healthy for most people The American College of Wellness, Certified Obesity Management Specialist

31. 30 % of Calories from Fat  300 calories/100 calories from fat (frozen dinner)  100 calories/30 calories from fat (cheese)  30 calories/10 calories from fat (lunch meat) The American College of Wellness, Certified Obesity Management Specialist

32. Role of the Brain  Neurotransmitters - biochemical messengers of the brain  NT’s most sensitive to diet: Serotonin Norepinephrine Dopamine The American College of Wellness, Certified Obesity Management Specialist

33. Serotonin  Relaxation  Optimism  General states of Well-Being  Ability to focus and concentrate  HIGH levels can make you feel sluggish and tired  LOW levels can make you feel depressed, have difficulty sleeping and concentrating, and increase food cravings The American College of Wellness, Certified Obesity Management Specialist

34. Dopamine and Norepinephrine  Alertness  Excitement  Action  Mental Acuity  High Levels are associated with anxiety and agitation  Low levels are associated with Depressed mood, fatigue, and poor concentration The American College of Wellness, Certified Obesity Management Specialist

35. What do I need to eat?  Tyrosine  Dopamine & Norepinephrine  To increase levels of TYROSINE, eat foods high in PROTEIN  Milk, meat, fish, beans, nuts, soy products  With only 3-4 ounces of protein, you will feel energized, more alert, and more assertive  Tryptophan  Serotonin  Reach for CARBOHYDRATES to boost SEROTONIN  Carbs enhance the absorption of Tryptophan  Within 30 minutes of eating carbs, you will feel more calm and relaxed  These effects can last up to 6 hours The American College of Wellness, Certified Obesity Management Specialist

36. Break-the-fast  Studies show students who eat breakfast score higher on tests.  If not hungry for breakfast, you may be overeating the night before. String cheese and 1 serving of crackers Light yogurt Half bagel w/ light cream cheese or peanut butter (1 T.) Hard boiled egg and 1sl. whole wheat toast Dry cereal (1 serv.) and 1 ounce nuts The American College of Wellness, Certified Obesity Management Specialist

37. Positive Eating Patterns  Eating is OK! 3-6 times per day  There are no “Bad” foods. Instead think of foods as good to eat occasionally or good to eat frequently.  Nourish yourself. Food is fuel. Eat a wide variety of foods such as lean meats, low-fat dairy products, fruits, vegetables and whole grain products. The American College of Wellness, Certified Obesity Management Specialist

38. Physical Hunger  Symptoms: stomach growls, headache, shakiness, weakness, poor concentration, etc.  Blood sugar may be low to cause these symptoms  Time of day- not hungry at breakfast may be due to overeating the night before  Stomach hunger v/s “taste bud desires”  Ask yourself: Am I really hungry? If the answer is no….try alternative activities. The American College of Wellness, Certified Obesity Management Specialist

39. Alternative Activities  Take a walk  Call a friend  Write in journal  Play with children or grandchildren  Read a chapter in a book  Take a relaxing bath  Sit back and relax  Write a letter to a friend  Listen to music  Make a list of your blessings  Drink a cup of herbal tea  Ask for a hug  Take a walk  Do needlework or other craft  Go fishing  Drink a glass of water  Practice deep breathing  Draw or doodle  Practice stretching techniques  ________________ The American College of Wellness, Certified Obesity Management Specialist

40. Emotional Hunger  Put in a delay  Identify feelings  Use alternative activities  Positive eating style rather than “chaotic” eating style  Seek counseling if needed The American College of Wellness, Certified Obesity Management Specialist

41. Connection between Food & Mood  Relationship has intrigued people for years  About 3000 years ago in India, people described how the body’s natural rhythms were affected by time of day, seasonal changes, and by diets  Morning was the time for clearest thinking  Afternoon & evening were times of irritability and fatigue  Brain synthesizes NT’s from Amino Acids (Building blocks of protein)  Two important AA’s that play a part in the food/mood response: Tryptophan - converted into Serotonin Tyrosine - converted into Dopamine and Norepinephrine The American College of Wellness, Certified Obesity Management Specialist

42. Honoring Fullness  “To-go” boxes  Share meals when able to  Dump the “clean plate” idea  Realize there will be other opportunities to eat when you are hungry again The American College of Wellness, Certified Obesity Management Specialist

43. Reading Food Labels  Clients report longer shopping time due to label reading in the beginning  Most products now have labels The American College of Wellness, Certified Obesity Management Specialist

45. What is important on label for weight control?  Portion size  Servings per container  Calories  Relationship of calories to fat….. The American College of Wellness, Certified Obesity Management Specialist

46. Food Cravings  A Matter of texture, Aroma, and Taste  Craving for FAT is mostly unconscious and has to do with texture, flavor, and aroma  Don’t underestimate the importance of aroma!  Because fat carries many of the best aromas - we are drawn to them!  Sizzling steaks, roast turkey, chocolate  The more turned on you are by smells the more likely you are to struggle with food cravings!  It is very likely that complex smells of food trigger jumps in Serotonin and other brain chemicals (Endorphins)  Also, anticipation of food releases insulin into the blood  People eat more food when endorphins are high  That’s the reason we can’t eat just ONE!  Endorphins are released by fat and sugar The American College of Wellness, Certified Obesity Management Specialist

47. Deficiency  Food cravings are the body’s way of correcting a deficiency  Pica - iron deficiency  Realize you can’t “will away” your cravings  Work with them instead of fighting them!  Pinpoint your TRUE craving Crunchy? Chewy? Creamy?  Ride out the wave!  Remember - A CRAVING IS A FEELING, NOT A COMMAND The American College of Wellness, Certified Obesity Management Specialist

48. Size up your servings  1 teaspoon =  1 cup =  3 ounces = The American College of Wellness, Certified Obesity Management Specialist

49. Healthy Eating when Eating Out  Preplan  Know sources.  Order sauces, dressings, margarine, toppings on the side.  Choose restaurant with variety.  Preview menu.  Call restaurant in advance.  Have a plan.  Obtain nutrition info.  Be assertive and descriptive when ordering.  Ask for substitutions.  Fill up on fat-free foods.  Ask for low-fat items.  Don’t go hungry.  Order “take home plate” in advance.  Eat slowly.  Slow down and taste each bite.  Control environment.  Split dessert. The American College of Wellness, Certified Obesity Management Specialist

50. Food Preparation  Use lower calorie, lowfat cooking/ serving methods  Be creative and aware- Save calories and fat  Try low-fat flavorings during food prep  Trim visible fat from all meats, fish, and poultry  Steam, bake, broil, braise, roast The American College of Wellness, Certified Obesity Management Specialist

51. More Ideas  Keep healthy snacks on hand to avoid snack machines/fast food  Choose fresh or frozen fruits and veggies vs. canned  Always practice portion control The American College of Wellness, Certified Obesity Management Specialist