Ch 20: Helping Clients Navigate The Real World Flashcards
Some situations that can be challenging when it comes to making healthy food choices include the following:
Navigating the grocery store
Dining out
Holidays, parties, and social events
Food/meal preparation
Travel
Snacking
One of the most important strategies to practice:
Plan and prepare ahead of time
Planning ahead:
Creating a shopping list prior to a grocery trip, selecting recipes for the week ahead, or looking at a restaurant menu ahead of time, can help individuals maintain some control over their food choices
Plan-Ahead Strategies for Healthy Eating in Various Scenarios: Grocery Shopping
Select recipes/meals and foods in advance.
Write a grocery list.
Avoid shopping at busy times.
Avoid shopping when hungry.
Plan-Ahead Strategies for Healthy Eating in Various Scenarios: Dining Out
Look at the menu ahead of time.
Call in advance to request accommodations.
Request substitutions or alternates at the restaurant.
Have an idea of what to order ahead of time.
Plan-Ahead Strategies for Healthy Eating in Various Scenarios: Parties/Holiday Events
Let the host know in advance of any dietary restrictions.
Offer to bring a healthy dish.
Have a light snack prior to the event.
Set a drink limit ahead of time.
Plan-Ahead Strategies for Healthy Eating in Various Scenarios: Travel
Pack heathy, non-perishable snacks for the journey.
Research some restaurants at the destination ahead of time.
Write out a list of healthy meals to stick to at restaurants.
Look up one or two local grocery stores at your destination.
Write a list of healthy foods to obtain at the local store and stock up on arrival.
Plan-Ahead Strategies for Healthy Eating in Various Scenarios: In between Meal Snacks
Write out a list of healthy snacks to stick to: both sweet and savory.
Prepare and pack snacks ahead of time for the week.
Keep a healthy snack (non-perishable) at your desk or in your bag for hunger emergencies.
Grocery Shopping Factors
Time constraints, hunger signals, and the grocery store’s placement of products on shelves and point-of-display areas can influence consumer purchasing decisions
Two important strategies in navigating a grocery store and making healthy food choices:
Recognizing and avoiding common pitfalls
Planning ahead
(making a shopping list and scheduling a day and time to make the trip)
A two-step process that may be helpful for individuals who like to use recipes and/or plan specific meals for the week ahead of time
Organize a grocery list is by recipe and then by food category
-With this approach, individuals may select two or three recipes for the week ahead and note the specific ingredients required for each. These ingredients are then grouped together in one list that is organized by food categories (as in the Sample Grocery List Template). Listing similar items together in specific food categories such as produce, dairy, seafood, etc. can help streamline the shopping experience and make it more efficient.
Some questions that consumers may wish to consider when reviewing a packaged product:
What does the ingredients list look like?
What is the first ingredient in the list? (Remember that ingredients are listed in decreasing order of prevalence on products.)
What is the nutritional value of the ingredients?
What is the product serving size and how many calories does it provide per serving?
How many grams of total fat, saturated fat, carbohydrates, fiber, added sugar, and protein does it provide per serving?
Is this product high or low in added sugar and sodium?
Is this a product that is in line with my health and fitness goals?
Two main considerations for dining out:
The frequency of dining out and the dining occasion
When Possible, Look at the Menu Ahead of Time
.Reviewing the menu in advance can allow an individual to plan ahead and select a few options that fit within their nutrition plan. This can help them to avoid the pressure of having to make a quick decision at the restaurant and reduce the risk of being influenced by the choices of others at the table
a light protein and fiber-based snack (such as some sliced low-sodium deli meat with vegetables or tuna on whole grain crackers) may help to stave off excess hunger prior to dinner.
Lowest in calories and added fats are generally dishes that are
Poached, steamed, roasted, or broiled (without added fats)
Food is sautéed first and then cooked at a lower temperature in liquid.
Braised
Food is cooked by exposing it to a source of radiant heat at a high temperature (higher than for roasting). The heat source may be a grill, oven with a broiler feature, or live coals. The heat source is typically above the food, though not always, and the food is turned during cooking.
Broiled
Food is cooked using convection heat in an oven. It may be precooked and finished in the oven or prepared entirely in the oven. Food may be baked dry or in a liquid/casserole and may or may not include a sauce.
Baked
Food is coated in batter and then deep-fried at a high temperature.
Battered
The food has been prepared by simmering or poaching it in milk or a cream-based liquid.
The food has been prepared by simmering or poaching it in milk or a cream-based liquid.
Typically refers to food that has been fried – It may or may not be coated in a batter. Some crispy foods may be baked rather than fried but this may not always be stated.
Crispy
Food is deep-fried in oil.
Fried
Food has been cooked using dry, radiant heat directly applied to the surface of the food (e.g., on a grill pan or on a grill over coals). Fat may be added to the food during the process.
Grilled
Food is baked dry or roasted in the oven.
Oven-Baked/Roasted
Food has been fried in a small amount of oil or other fat in a pan.
Pan-Fried
Food has been cooked in liquid (either water or wine) at a lower temperature than used for simmering and with no added fat.
Poached
Food is cooked at high heat in a small amount of fat in a shallow pan.
Sautéed
Food has been cooked in hot liquid at a temperature below the boiling point of water.
Simmered
Food (usually meat) has been cooked by exposing it to smoke from a burning or smoldering substance (usually wood).
Smoked
Food (usually meat) is browned on the stove and then cooked at low heat covered in gravy in a covered pan
Smothered
Food has been cooked in steam, possibly in a small amount of water, with no added fat.
Steamed
Food is cut into small pieces and then cooked in a small amount of hot oil in a wok while being stirred continuously.
Stir-Fried
Food that is battered and deep-fried.
Tempura
A method of cooking that creates a burnt or blackened crust on the outer surface of a food. Most foods (such as meats and vegetables) can be charred by cooking them over an open flame or at a high temperature on a stove
Charring
Eating out tips
Ask for Sauces, Dressing, and/or Cheese on the Side
Use a Plate for Shared Appetizers
Avoid the Bread Basket or Limit to One Piece
Balance Calories From Alcohol and Dessert
Set a Limit on Alcohol
Calorie count of alcohol
Light Beer
12 oz. (355ml)
110
Regular Beer
12 oz. (355ml)
145
Craft Cider
12 oz. (355ml)
150
Gin or Vodka
1.5 oz. (45ml)
96
Rum
1.5 oz. (45ml)
97
Coffee Liqueur
1.5 oz. (45ml)
137
White Wine
5 oz. (145ml)
121
Red Wine
5 oz. (145ml)
125
Meeting Friends at the Bar
Set a drink limit
Start with water or a non-alcoholic drink
Avoid drinking on an empty stomach or if hungry
Choose protein-based and vegetable appetizers at the bar:
How to Choose a Healthy Meal
- Pick a protein.
- Pick at least two vegetables.
- Pick a healthy, high-fiber starch.
- Pick a healthy fat.
- Pick a healthy fat.
Is fat included in the preparation of the meal?
Is a healthy fat part of the meal?
If not, what options are available–olive oil, avocado, nuts, seeds?
Is the amount a healthy portion? If not, can you request less or request it on the side?
- Pick a healthy, high-fiber starch.
What are the starch options available for the meal?
If grain-based, is it a whole grain or a refined grain?
How much starch does the meal provide?
Is it an appropriate portion? If in excess, can you request a smaller portion or save some for a later time?
Is starch prepared in a healthy manner? Does it contain added fat (oil, butter, or cheese)?
- Pick at least two vegetables.
Are vegetables available with the lunch option? Are they included in the meal?
Can you request additional vegetables either on the side or to be added to the meal?
How are the vegetables prepared? Are they raw or cooked? If cooked, are they prepared in a healthy manner: grilled or roasted versus fried?
Are the vegetables breaded or covered in a sauce? Can you request sauce on the side?
- Pick a protein.
Is it lean?
If not, is there a leaner version that is cooked differently? (Is it grilled or poached versus fried?)
Is it an appropriate portion size? If not, can you request a smaller portion or save a portion for later?
Is there adequate protein? If not, can you request a slightly larger portion?
Nutrient Density
The amount of nutrients provided by a food or meal relative to the total calories in the meal.
Nutrient Quality
Refers to the amount and variety of nutrients provided in a food or meal.
One of the best ways in which to stay on track with healthy eating during the holidays and at social events is to:
Plan ahead.
Holidays and Parties
Contact the host ahead of time
Offer to bring a dish
Eat lightly (but do not starve) on the day of the party or event
Set a drink limit ahead of time
Monitor portions
Prioritize Foods
Prior to Traveling
Make a list of healthy, mostly non-perishable food items to pack such as nuts, fruit and nut protein bars, nut butters, and whole-grain crackers for snacks. If possible, pack the meals for the journey. Food options at airports have expanded in recent years but it may still be better (and cheaper) to pack a small meal for the journey rather than relying on the options available at the airport and en route if traveling by car
Dining at home today can include several different options:
Cooking at home, ordering takeout from a restaurant or food-delivery service, and/or using a meal-prep service that provides all the ingredients and recipes for a fee and allows individuals to prepare a gourmet meal at home.
Some additional benefits of meal prep include the following:
Having meals already prepared or ready-to-prepare, thereby, reducing the chance of ordering out or making less-healthy food choices
Not having to worry about what to eat or prepare on multiple days of the week because the preparation has been done beforehand
Having additional time to engage in other activities (such as exercise, time with family, etc.) during the week
Decide what type of meal prep best suits the client’s lifestyle and preferences.
The following are some questions to consider:
Do you want to prepare full meals ahead of time or just prepare the ingredients to make cooking easier on weeknights?
Do you like to try new recipes or do you prefer making a few staple dishes that are tried-and-true favorites?
Do you like variety or are you happy eating similar meals on a daily basis and then changing the options for the following week?
Do you want to prepare for a full week or only for a few days and leave some flexibility for dinners out?
Do you want to prepare for dinner only or all three meals?
Meal Prep Guidelines:
- Decide what type of meal prep best suits the client’s lifestyle and preferences.
- Budget and schedule time for meal prep.
- Invest in the right equipment and tools for meal prep
- Decide on the menu for the week (and/or on staple foods to prepare) and write a list of the fresh ingredients that will be required
- Schedule a few hours on a designated day to meal prep and time it
Kitchen Tools and Appliances for Meal Prep: Food Preparation Tools
Knives: chef’s knife, bread knife, paring knife, or small chopping knife
Ladles
Peeler, Grater, Spiralizer
Mixing Bowls
Food Storage Container
Sandwich and freezer bags
Aluminum foil or plastic wrap
Kitchen Tools and Appliances for Meal Prep: Food Processing & Cooking Appliances
Food processor (small and large)
Blender (traditional or high-powered)
Saucepans (1 small, 1 large)
Skillet or frying pan (1 small, 1 large)
Steamer basket
Oven
Baking Sheets
Kitchen Tools and Appliances for Meal Prep: Time-Saving Appliances & Tools
Slow Cooker
Pressure Cooker
Toaster ovens with broilers
Air Fryer
Microwave
Pantry and Refrigerator Staples for Meal Prep: Dry
Olive oil: virgin and extra virgin
Coconut oil for higher heat cooking
Dried or canned lentils and beans
Boxed or canned low-sodium soups
Dried pasta
Whole-grain and white rice
Rolled oats
Vinegars: balsamic and red wine vinegar
Salt: both iodized and a finishing or kosher salt
Black pepper
Spices: dried basil, oregano, dill, thyme, rosemary, paprika, chili pepper, garlic powder, cumin, or mixed seasonings (such as five spice)
Pantry and Refrigerator Staples for Meal Prep: Perishable/Refrigerated Items
Eggs, preferably organic
Grass-fed butter
Milk: dairy or non-dairy
Nut butters: peanut, almond, cashew, or sunflower seed
Grainy or Dijon mustard
Mayonnaise
Teriyaki sauce
Barbeque sauce
Deciding on What to Prepare:
If using or trying new recipes, limit to two or three
Identify the main sources of the macronutrients for meals during the week
The CDC outlines four basic steps for maintaining food safety
Clean, Separate, Cook, and Chill (Keep your refrigerator below 40 degrees Fahrenheit.)
Safe Internal Cooking Temperatures for Meat and Poultry
Meat and Poultry
Minimum Internal Cooking Temperature
Whole cuts of beef, pork, or lamb
145°F (Rest for 3 minutes before carving.)
Fin Fish
145°F (Flesh must be opaque.)
Raw, fresh ham
145°F
Ground meats (beef and pork)
160°F
All poultry (including ground chicken and turkey)
165°F
Casseroles and heating leftovers
165°F
Factors that must be considered with regard to snacking
Overall caloric intake over the course of the day; the size, caloric density, and composition of snacks eaten; and the frequency of eating.
Factors that must be considered with regard to snacking
Overall caloric intake over the course of the day; the size, caloric density, and composition of snacks eaten; and the frequency of eating.
Snacks can contribute to weight gain if
Snacking excessively on energy-dense foods
Mindless and excessive snacking due to boredom or other emotions
Late-night snacking on high-calorie foods
Ask clients about their snacking habits. The following are some questions to consider:
Do they snack between meals and, if so, why? Is it due to hunger or boredom?
What types of foods do they choose for snacks? Do they prepare these ahead of time or rely on what may be available at work or at events?
Do they consider the nutritional value and composition of snacks?
Do they feel that snacking is affecting their weight? Or do the snacks help control their appetite and hunger?
Ideal snack
A combination of a high-fiber carbohydrate and a lean source of protein to promote satiety
A small portion of nuts may also be an acceptable snack. Despite being calorie-dense, nut consumption is not associated with significant weight gain and may even be associated with a reduced risk of weight gain
Healthy Snack Examples
Range from 150 to 200 calories and feature two or more macronutrients
- Plain Greek Yogurt with Nuts, Berries or chopped fruit
- Cottage Cheese with Fruit and Nuts
- 1 oz of hard cheese and whole-grain crackers
- Sliced Vegetables with 2-3 tbsp of Hummus
- 1 piece of fruit and 1 Tbsp of nut butter
- 1 or 2 hard-boiled Eggs
- String cheese with 1 piece of fruit
- Half a pita with sliced vegetables and Hummus
- 1 oz baked corn chips and 2-3 tbsp of guacamole
- 1-2 oz of smoked salmon and on 1 slice of toast with sliced tomato and cucumber
- 1 Cup of vegetable soup with 1 tbsp of shredded cheese
- 1/2 sandwich on whole grain bread with lean protein and 2-3 slices of Avocado
- 1 ounce of nuts with a plum or a clementine
- Whole Foods Protein Bar
1 apple, pear, or orange with 1/2 oz of nuts
- 1 oz of fresh mozzarella cheese with sliced tomato
Guidelines to Choosing Healthier Snack Options
Look for least-processed food items.
Look for a lean protein and carbohydrate-based snack.
If a protein source is not available, choose a healthy fat or a minimally processed, low-sugar carbohydrate option.
Coaches should explore other healthy habits that may be substituted in place of food. These may include the following:
- Taking a short walk break from work
- Calling a friend or family member
- Engaging in a new hobby
- Reading and/or research
The following are some situations in which mindless eating may occur:
Eating while watching television in the afternoon or evening
Eating while driving
Snacking or eating a meal while working at a computer
Snacking while at the movie theater
Picking at snack foods and appetizers at a social event or party
Tips for Managing Mindless Eating
- Find an alternative activity or hobby to help deter mindless eating that stems from boredom.
- Ask clients to pause before reaching for food and ask themselves if they are truly hungry or just bored.
- Take a screen break for lunch. Many individuals will eat lunch at their desks or in front of a computer screen without paying attention to their food or their hunger and satiety levels. Taking a short break (even 20 minutes, to pause and enjoy lunch) can help to enhance satiety and promote a greater sense of enjoyment of the meal.
- Make it difficult to eat mindlessly. This may be a helpful strategy for individuals who reach for snacks when they are stressed and have easy access to junk foods. At work, this may mean removing all junk-food items from your desk and storing all foods and snacks in the office refrigerator. At home, this may mean storing snack foods in a hard–to-reach cupboard or at the back of the freezer. In all these cases, it requires effort to go and retrieve the food item and the time and effort required may be sufficient to cause a client to pause and consider if they are truly hungry or just reaching for a snack out of habit, stress, or boredom.
Mindless Eating
Eating without attention to or awareness of the food being consumed.
The collective reasons that drive a person to take action.
Motivation
A trigger or cue that initiates an action or event to occur.
Prompt
B.J. Fogg Behavior Model
in order for a particular behavior to occur, three elements have to come together: there has to be motivation, the ability to perform the behavior, and a prompt (previously referred to as a trigger)
Ability is a factor that can be changed
With education, tools, and resources and this is another area in which a Nutrition Coach may be able to help clients.
Could be a simple note that reminds an individual to perform an activity (for example, a note on a computer reminding an individual to get up and take a 5-minute walk break every hour). It may also be an existing behavior; turning on the television may be a prompt for some individuals to reach for a snack.
Prompt
When working with clients, it may be helpful to use a step-wise process to help them achieve their goals:
Ask clients to list their ultimate or end goal. This may be a general goal (such as eating healthier, losing weight, or start exercising).
Ask them to be more specific about their goals. If the goal is “eat healthier,” ask them to be specific about what changes they want to make. The more specific the goal, the greater the likelihood a client can define the steps needed to achieve it and a timeline for making the changes.
Encourage clients to pick a simple change and identify a specific time or condition when they will implement the change. For example, a client whose goal is to eat more vegetables should identify exactly when and how they will implement this change.
Use the concept of setting SMART goals (Specific, Measurable, Achievable, Relevant, and Time-Bound) to help clients make small, measurable changes that they can achieve and sustain over the long-term.
“Designing for behaviors that lead to an outcome.”
The idea behind this approach is to make small, simple changes that will eventually result in the realization of the end goal.
Fogg’s (2013) behavior model
Small changes should be tied to existing behaviors so that the latter serve as prompts for the new behavior to occur
Over time, the new behavior also becomes a habit and a part of an individual’s lifestyle but the change occurs seamlessly, without the need for overt effort
The success of these small changes eventually leads to the client accomplishing their goal of adding more fruit and vegetables to their diet.
When dining out, certain key words on a menu can indicate how a dish has been prepared. In general, which preparation methods tend to be the healthiest (i.e. prepared with minimal added fat)?
Dishes that are poached, steamed, roasted, or broiled (without added fat)
What does batch prep mean?
Preparing ingredients used in multiple recipes at the same time
