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Pennington Biomedical Research Center
Awesome.2Cents! Healthy Lifestyle Curriculum for Teens….

Grades 8-12

Lesson 2: Healthy Diet Plan

Content outline
  1. Definition of a healthy diet
  2. An overview of the Dietary Guidelines
  3. How to read food labels
  4. An overview of the MyPlate
  5. Food groups in a plan
  6. Exercise recommendations
  7. Computing energy needs
  8. Navigating MyPlate

Standards of Education
Louisiana content standards:

1-M-2, 2-M-1, 2-M-3, 3-M-1, 3-M-2, 4-M-3, 4-M-4, 5-M-4, 5-M-5
1-H-1, 1-H-4, 3-H-1, 3-H-2, 3-H-4, 5-H-6, h-H-1

Objectives/Expected Learner Outcomes:
Students will master food groups, portions within food groups, how to calculate energy needs,
understanding of exercise recommendations.

Lesson and Strategies
Student group targeted
8-12th grade

Time required
Teacher Preparation: 15-20 minutes
Assessment: 10 minutes

Materials and Resources
Power point presentation: What defines a “Healthy Diet”?
Projector
Screen
Laptop/Computer
MyPyramid Handout
24-hour Dietary Recall Handouts
MyPyramid Assignment
Calculators
Scrap paper for calculations




Copyright Pennington Biomedical Research Center 2012                                            1
Teacher Preparation
Make copies of MyPyramid Servings, MyPyramid Food Groups, MyPyramid Serving Sizes,
MyPyramid Assignment Rating, Personal Contract, 24-hour Dietary Recall Handout for
students and Calculating Energy Needs.
--------------------------------------------------------------------------------------------------------------------

                                                     PART I
                                                     (Day 1)

The first part of this lesson will require students to interview a person of choice (mother, father,
grandparent, friend, etc) in order to collect one days’ worth of meals that this person consumed.
The 24-hour dietary recall should include all food and all beverages that the person consumed
on the previous day. Using the 24-hour dietary recall form, students will need to collect some
additional information from the person they are interviewing, such as: their age, height, weight,
and activity level. This will be necessary in order to calculate their energy needs in class the
next day. After collecting the 24-hour recall, students will need to bring the information to class
with them for the following class period. From calculating the calorie (energy) needs of the
person that each student interviewed, students will be able to compare what the dietary
guidelines tell us that person should be eating (from MyPlate assignment) with what they
actually ate.

--------------------------------------------------------------------------------------------------------------------

                                                    PART II
                                                     (Day 2)

Slide     Lesson Plan
1         Dietary Guidelines for Americans

2         Say: This lesson will cover:
                     Computations for energy needs
                     Dietary Guidelines
                     Definition of a healthy diet
                     An overview of the MyPlate Plan
                     Exercise recommendations

3         Determinants of a healthy diet
               Plant based (fruits and vegetables)
               Avoids excessive calorie intake
               Minimizes solid fats and added sugars
               Lean meats
               Plant proteins
          Poor diet and physical inactivity are the most important factors contributing to an
          epidemic of overweight and obesity affecting men, women, and children in all
          segments of our society.
          Healthy eating encompasses two overarching concepts:


Copyright Pennington Biomedical Research Center 2012                                                              2
1. Maintain calorie balance over time to achieve and sustain a healthy weight.
              People who are most successful at achieving and maintaining a healthy weight
              do so through continued attention to consuming only enough calories from
              foods and beverages to meet their needs and by being physically active. To curb
              the obesity epidemic and improve their health, many Americans must decrease
              the calories they consume and increase the calories they expend through
              physical activity.
           2. Focus on consuming nutrient-dense foods and beverages. Americans currently
              consume too much sodium and too many calories from solid fats, added sugars,
              and refined grains. These replace nutrient-dense foods and beverages and make
              it difficult for people to achieve recommended nutrient intake while controlling
              calorie and sodium intake. A healthy eating pattern limits intake of sodium,
              solid fats, added sugars, and refined grains and emphasizes nutrient-dense foods
              and beverages—vegetables, fruits, whole grains, fat-free or low-fat milk and
              milk products, seafood, lean meats and poultry, eggs, beans and peas, and nuts
              and seeds.

    4   What is a healthy diet?
        A healthy diet is one that emphasizes fruits, vegetables, whole grains, fat-free or low
        fat milk, and milk products. It includes lean meats. Poultry and fish and vegetable
        proteins such as beans, seeds and nuts.
        Nutrient Density. Nutrient dense foods are those that provide a lot of nutrients
        (vitamins and minerals) and only a few calories. Nutrient-dense foods are the opposite
        of “energy-dense” foods. Energy-dense foods are those foods which are packed with
        calories (energy), but are not very nutritious (meaning that they have a lot of calories
        but not many vitamins or minerals).
        Can you think of any foods which might be nutrient-dense? What about energy-
        dense?
        Encourage students to answer. [Possible answers could include: candy (sugary
        sweets), French fries, potato chips, hamburgers, hot dogs, sodas, cake, many
        desserts, and added fats (like regular mayonnaise, salad dressing, vegetable oil).]
        Say: Fruits, vegetables, and whole grains are rich sources of important vitamins and
        minerals. They also include complex carbohydrates. We are always encouraged to
        choose complex carbohydrate food sources (whole grains) over foods that are highly
        processed, like refined grains. This is because extra sugars and fats are often added to
        refined grains during processing. Also, important vitamins and minerals are lost.
        Refined grains are more likely to be described as “energy-dense” than “nutrient-dense”
        foods in most cases.
        Two other components of a healthy diet are diets that: include lean meats, poultry,
        fish, beans, eggs, and nuts; and are low in saturated fats, trans fats, cholesterol,
        salt (sodium), and added sugars. We’ll go into more depth in later topics, but know
        that saturated fats and trans fats are fats that we want to minimize in our diets. When
        consuming fats, we want to consume “good” fats as often as possible, like
        monounsaturated and polyunsaturated fats.

5       American Institute for Cancer Research


Copyright Pennington Biomedical Research Center 2012                                           3
Say: No single food or food component can protect you against cancer by itself. But
       strong evidence does show that a diet filled with a variety of plant foods such as
       vegetables, fruits, whole grains and beans helps lower risk for many cancers.
       Foods Can Fight Cancer Both Directly …
       In laboratory studies, many individual minerals, vitamins and phytochemicals
       demonstrate anti-cancer effects. Yet evidence suggests it is the synergy of compounds
       working together in the overall diet that offers the strongest cancer protection.
       … And Indirectly
       According to AICR/WCRF’s second expert report and its updates, carrying excess
       body fat increases the risk of seven cancers (esophagus, pancreas, colon and rectum,
       endometrium, kidney and breast). Vegetables and fruits are low in calories, which help
       us get to and stay a healthy weight. Whole grains and beans are rich in fiber and
       moderate in calories, which also help in weight management efforts.
       That is why AICR recommends filling at least 2/3 of your plate with vegetables, fruit,
       whole grains and beans.

6      Recommendations for cancer prevention
          1. Be as lean as possible without becoming underweight.
          2. Be physically active for at least 30 minutes every day.
          3. Avoid sugary drinks. Limit consumption of energy-dense foods.
          4. Eat more of a variety of vegetables, fruits, whole grains and legumes such as
              beans.
          5. Limit consumption of red meats (such as beef, pork and lamb) and avoid
              processed meats.
          6. If consumed at all, limit alcoholic drinks to 2 for men and 1 for women a day.
          7. Limit consumption of salty foods and foods processed with salt.
          8. Don't use supplements to protect against cancer.
          9. Breastfeed exclusively for up to 6 months
          10. After treatment, cancer survivors should follow the recommendations for cancer
              prevention.

7      American Diabetes Association dietary recommendations
       Say: Five Easy Steps to Create Your Plate
       It's simple and effective for both managing diabetes and losing weight. Creating your
       plate let's you still choose the foods you want, but changes the portion sizes so you are
       getting larger portions of non-starchy vegetables and a smaller portion of starchy foods.
       When you are ready, you can try new foods within each food category.
       Try these five simple steps to get started:
       Using your dinner plate, put a line down the middle of the plate.
       Then on one side, cut it again so you will have 3 sections on your plate.
       Fill the largest section with non-starchy vegetables such as: spinach, carrots, lettuce,
       greens, cabbage, bok choy, green beans, broccoli, cauliflower, tomatoes, vegetable
       juice, salsa, onion, cucumber, beets, okra, mushrooms, peppers, turnip.
       Now in one of the small sections, put starchy foods such as: whole grain breads, such
       as whole wheat or rye, whole grain, high-fiber cereal
       cooked cereal such as oatmeal, grits, hominy, or cream of wheat, rice, pasta, dal,


Copyright Pennington Biomedical Research Center 2012                                            4
tortillas, cooked beans and peas, such as pinto beans or black-eyed peas, potatoes,
       green peas, corn, lima beans, sweet potatoes, winter squash, low-fat crackers and snack
       chips, pretzels, and fat-free popcorn.
       And then on the other small section, put your meat or meat substitutes such as:
       chicken or turkey without the skin, fish such as tuna, salmon, cod, or catfish, other
       seafood such as shrimp, clams, oysters, crab, or mussels, lean cuts of beef and pork
       such as sirloin or pork loin, tofu, eggs, low-fat cheese.
       Add an 8 oz glass of non-fat or low-fat milk. If you don’t drink milk, you can add
       another small serving of carb such as a 6 oz. container of light yogurt or a small roll.
       And a piece of fruit or a 1/2 cup fruit salad and you have your meal planned. Examples
       are fresh, frozen, or canned in juice or frozen in light syrup or fresh fruit.

8      American Heart Association Dietary recommendations
       Say: Heart disease is the No. 1 killer of Americans. We can reduce heart disease by
       promoting a healthy diet and lifestyle. Getting information from credible sources can
       help you make smart choices that will benefit your long-term heart health.
       For the first time, the American Heart Association has defined what it means to have
       ideal cardiovascular health, identifying seven health and behavior factors that impact
       health and quality of life. We know that even simple, small changes can make a big
       difference in living a better life. Known as “Life’s Simple 7,” these steps can help add
       years to your life:
       don’t smoke;
       maintain a healthy weight;
       engage in regular physical activity;
       eat a healthy diet;
       manage blood pressure;
       take charge of cholesterol; and
       keep blood sugar, or glucose, at healthy levels.

       In terms of a healthy diet, do the following:
       Fruits and vegetables: At least 4.5 cups a day
       Fish (preferably oily fish): At least two 3.5-ounce servings a week
       Fiber-rich whole grains: At least three 1-ounce-equivalent servings a day
       Sodium: Less than 1,500 mg a day
       Sugar-sweetened beverages: No more than 450 calories (36 ounces) a week
       Other Dietary Measures:
       Nuts, legumes and seeds: At least 4 servings a week
       Processed meats: No more than 2 servings a week
       Saturated fat: Less than 7% of total energy intake
       The American Heart Association recommends that you eat a wide variety of nutritious
       foods daily. Remember, even simple, small changes can make a big difference in
       living a better life.


9      Dietary Guidelines for Americans
       Say: The next thing on the agenda for today is to discuss the Dietary Guidelines for


Copyright Pennington Biomedical Research Center 2012                                              5
Americans. We’ll talk about what they are and what they tell us and also why they are
       important. The Dietary Guidelines for Americans were created by the United States
       Department of Agriculture (USDA) in order to give us an easy-to-follow guide on how
       Americans should be eating in order to improve their health and reduce the risk of
       disease. There are so many studies which show that people who eat healthy diets have
       some of the lowest risks for chronic diseases, such as diabetes, heart disease, and
       cancer. It’s very important that we learn these healthy lifestyles as young adults or even
       as a child since early eating patterns usually follow us into our adulthood.
       The Dietary Guidelines tell us that we can improve our health and lower our risk for
       disease by changing our food choices (meaning making healthy choices more often),
       the way that we handle food (in relation to food safety), and by changing our physical
       activity patterns (increasing our activity). These guidelines are updated every 5 years,
       with the most recent version being from 2010.

10     Dietary Guidelines for Americans
       Say: It’s important for you to know that the Dietary Guidelines are:
       Recommendations for healthy Americans, ages 2 years and over.
       The government’s key nutrition message on how to choose a healthful diet and increase
       activity.
       Incorporated into an eating plan making it easy for Americans to follow these
       guidelines.
       Does anyone know what the newest meal plan (2010) is called?
       Do: Encourage students to answer. (Answer = MyPlate)

11     Based on a 2000 calorie diet
       Say: One difference between the old food guide pyramid and the new one is that
       servings here are based on cup and ounce equivalents. The number of servings that you
       should consume for each group depends on what your recommended calorie level is.
       For example:
       For a 2,000 calorie diet, for example, the plan tells us that we should consume:
       6 ounces of grains
       2 cups of fruit
       2.5 cups of vegetables
       3 cups of milk and
       5.5 ounces from the meat/beans group
       With the calorie needs now calculated for each person interviewed, we will be able to
       figure up the number of servings from each food group that that person should be
       consuming based on their energy needs. I am going to hand out several pages on the
       MyPlate Plan. Once I hand them out, we’ll go over each one individually. After we go
       over the MyPlate Plan, I’ll let you assess the 24-hour dietary recall that you collected
       based on what we have learned.
       Do: Hand out the MyPlate Assignment.

12     Food group servings
       Say: The first sheet that we will go over is the serving size sheet. This sheet tells us the
       number of servings that a person should be eating from each food group based on their


Copyright Pennington Biomedical Research Center 2012                                              6
recommended calorie intake. As you can see, calorie levels are in increments of 200,
       meaning that if you calculated an energy need of 1,750 calories for your person, you
       would have to round this to the next closest kcal amount, which is 1800 kcal.
       On the sheet, servings for the fruits, vegetables, grains, lean meat and beans, and milk
       groups are listed. Amounts of oils and discretionary calorie allowances are also listed,
       but this is something that we will get into later. As you can see, the vegetables and
       grains groups are broken down further than the fruits, lean meat and beans and milk
       groups.
       For vegetables, the top row is the number of servings that should be consumed per day
       based on a specified calorie level. The specifications for dark green vegetables, orange
       vegetables, etc are based on the number of servings that you should be consuming per
       week. For this assignment, we won’t look at these—only the top row of servings of
       vegetables per day will we pay attention to. For grains, we will look at both types. The
       top row shows the total number of servings of grains per day based on a specified
       calorie intake. The subdivisions simply show that half of your grain intake for the day
       should be whole grain and the other half can be other.
       Can anyone tell me the number of servings that should be consumed per day for:
       grains, fruit, vegetables, milk, meat, and beans based on a 1,800 calorie diet?
       (Answer= 6 ounces of grain; 1.5 cups of fruit; 2.5 cups of vegetables; 3 cups of milk;
       and 5 ounces of lean meat and beans).

13     Food groups – food selection
       Say: When choosing foods from the fruit, vegetable, and grains groups, you always
       want to strive to choose those foods without added fats and sugars. These are the most
       nutrient-dense foods in each group. I had mentioned just a moment ago about
       discretionary calorie allowances. Discretionary calorie allowances are extra calories
       that you consume if you eat a lot of nutrient dense foods. You can eat a lot of calories
       or less calories depending on the types of foods you consume. For example, from the
       grains group you can choose a croissant, a honey bun, cheese grits, macaroni and
       cheese in a day. Those would all be from the grain group but very high in calories, or
       you could choose a bagel, a low fat muffin, plain grits, and pasta salad instead for
       much fewer calories. Of course, the discretionary calorie allowance isn’t huge (maybe
       100-300 calories)—since most people override it by choosing high fat meats, cheeses,
       whole milk, or sweetened bakery products.
       This leads me to the milk and meat group. When choosing foods in these groups, you
       always want to choose lower- fat versions. For example, in the milk group, choose fat-
       free or low-fat milk and yogurt when possible over whole milk. The lower fat versions
       offer the same amount of nutrients with fewer calories. And, when choosing meat,
       always try to choose lean cuts of meat. Replacing red meat with fish, peanut butter,
       tofu, nuts, and seeds is a good practice to try occasionally. Also, another good tip is
       when consuming poultry; always try to remove the skin. This makes the poultry lower
       in fat and calories, and for meat especially—be cautious of the way your prepare it.
       Choose methods like grilling, baking, or sautéing over deep-frying. This greatly
       decreases the calorie load that you consume.

14     Serving sizes


Copyright Pennington Biomedical Research Center 2012                                              7
Say: The last handout that we will refer to is the MyPyramid Serving Sizes sheet. This
       sheet simply lists each food group and what counts as either 1 cup or ounce equivalent.
       The fruit, vegetable, and milk groups all have their servings as cup equivalents;
       whereas, the grains and lean meat and beans group have their servings as ounce
       equivalents. When you are calculating how many servings from each group a person
       ate, you may have to multiply.

       For example, if Ashley ate 2 slices of bread, looking on the handout, we would see that
       1 serving (or 1 ounce equivalent) equals only one slice of bread. Because Ashley ate 2
       slices of bread, then she consumed 2 servings from the grain group.

       Does everyone understand that? Now, we’ll do a few more examples.

       Could anyone tell me how many servings (same as ounce equivalents) one 3 ounce
       muffin would be? (Answer= 3 servings (or 3 ounce equivalents)

       Now, here is a harder example. Remember, that 1 cup is equal to 8 ounces. Could
       anyone tell me how many cup equivalents it would be if I consumed 12 ounces of
       fruit juice? (Answer = 1 ½ cups) What about servings? Remember, that 1 cup
       equivalent for fruit and vegetable is equal to two servings, so for every 1 cup
       equivalent you have; you have 2 times more servings. (Answer = 1.5 cup equivalents
       x’s 2 = 3 servings)

       Here is the last one. What about if I ate ½ a cup of cooked dry beans. How many
       ounce equivalents from the meat and beans group would I have consumed?
       Remember that ¼ cup cooked is 1 ounce equivalent and that I’m consuming ½ cup.
       (Answer: ¼ cup = 1 ounce; ½ cup = twice more, so 2 ounces)


15     Serving sizes
       Say: We’ll have one last example. Using scratch paper, I want everyone to work
       through this example and total up the number of cup or ounce equivalents from each
       group: grains, fruits, vegetables, meat and beans, and milk. Then we’ll go over how
       many cup or ounce equivalents of each food group were consumed at this meal.

       For lunch on Monday, Josh ate the following:
              1 whole wheat sandwich (2 slices bread) with
              3 ounces of deli turkey and 1 teaspoon of mustard, and
              1 slice (2 ounces) of American cheese
              1 salad that had 1 cup of salad greens,
              ½ cup of cooked pasta, and fat-free dressing
              And 1 glass of low-fat milk (8 ounces)

       Everyone try to work this out. And, remember that some food groups are listed more
       than once, so you’ll have to total the number of equivalents that Josh ate.



Copyright Pennington Biomedical Research Center 2012                                         8
Do: Give students time to work through the example. Leave the slide up for the
       students to refer to while working the example.

       Say: You don’t have to account for mustard or the fat-free dressing. But, had he eaten
       regular mayonnaise on his sandwich, this would go into the oils category. We won’t be
       figuring up servings from the oils category though, so you won’t have to worry about
       calculating that. Just know that you should always choose lower-fat versions of all
       salad dressings and mayonnaises, while limiting oils and added fats.

       ----------------------------------------------BREAK-------------------------------------------------

       Do: When it looks like all students are done, continue with the following questions:

       Say: So, who can tell me how many ounce-equivalents he had from the grains
       category? Remember that both the bread and the pasta came from the grains group.

       Do: Encourage students to provide answers. (Answer = 3 ounce equivalents or 3
       servings; 2 slices of bread (2 ounces) + ½ cup cooked pasta (1 ounce) = 3 oz equiv.).

       Say: Who can tell me how many cup equivalents of fruit he had?

       Do: Encourage students to provide answers. (Answer = Zero)

       Say: Josh didn’t eat any fruit for lunch on this day. What about vegetables—how
       many cup equivalents (not servings) did Josh eat?

       Do: Encourage students to provide answers. (Answer = ½ cup or 1 serving; because 1
       cup equivalent of leafy salad greens equals 2 cups of greens—Josh only ate 1 cup total)

       Say: What about meat and beans—how many ounce equivalents did he eat?

       Do: Encourage students to provide answers. (Answer = 3 ounce equivalents; 3 ounces
       of lean meat equal 3 ounce equivalents)

       Say: And, finally--- what about the milk group—how many cup equivalents did
       Josh eat? Remember that he had both cheese and milk during this meal.

       Do: Encourage students to answer. (Answer = 2 cups or 2 servings; 1 slice of
       processed cheese + 1 cup of milk = 2 cup equivalents or 2 servings)

16     Exercise recommendations
       Say: The plan recommends that along with eating a healthy diet– we engage in regular
       physical activity. For children (< 12 years) and adolescents (about 12 to 19 years of
       age), the plan recommends engaging in at least 60 minutes of physical activity on
       most, but preferably all, days of the week. One important thing that I must bring to
       your attention is that the 60 minutes of activity that the plan recommends does not all



Copyright Pennington Biomedical Research Center 2012                                                      9
have to occur in one session. It can be broken up throughout the day, so long as the
       total of activity for the day is at least 60 minutes.
       Can anyone give me examples of some type of activity that they normally do—
       whether it be sports-related or an activity they enjoy outside of school or sports?

       Do: Encourage students to provide examples of physical activity that they engage in.
       Write the activities down on the board for students to see. (Examples could include:
       walking, jogging, swimming, running, track, basketball, baseball, cheerleading,
       football, etc).

17     Aerobic activity- what counts?
       Aerobic activity or "cardio" gets you breathing harder and your heart beating faster.
       From pushing a lawn mower, to taking a dance class, to biking to the store – all types
       of activities count. As long as you're doing them at a moderate or vigorous intensity for
       at least 10 minutes at a time.
       Intensity is how hard your body is working during aerobic activity.
       How do you know if you're doing light, moderate, or vigorous intensity aerobic
       activities?
       For most people, light daily activities such as shopping, cooking, or doing the laundry
       doesn't count toward the guidelines. Why? Your body isn't working hard enough to get
       your heart rate up.
       Moderate-intensity aerobic activity means you're working hard enough to raise your
       heart rate and break a sweat. One way to tell is that you'll be able to talk, but not sing
       the words to your favorite song. Here are some examples of activities that require
       moderate effort:
       Walking fast
       Doing water aerobics
       Riding a bike on level ground or with few hills
       Playing doubles tennis
       Pushing a lawn mower

18     Vigorous intensity exercise
       Vigorous-intensity aerobic activity means you're breathing hard and fast, and your
       heart rate has gone up quite a bit. If you're working at this level, you won't be able to
       say more than a few words without pausing for a breath. Here are some examples of
       activities that require vigorous effort:
       Jogging or running
       Swimming laps
       Riding a bike fast or on hills
       Playing singles tennis
       Playing basketball
       You can do moderate- or vigorous-intensity aerobic activity, or a mix of the two each
       week. A rule of thumb is that 1 minute of vigorous-intensity activity is about the same
       as 2 minutes of moderate-intensity activity.
       Some people like to do vigorous types of activity because it gives them about the same
       health benefits in half the time. If you haven't been very active lately, increase your


Copyright Pennington Biomedical Research Center 2012                                           10
activity level slowly. You need to feel comfortable doing moderate-intensity activities
       before you move on to more vigorous ones. The guidelines are about doing physical
       activity that is right for you.

19     Muscle strengthening exercises – what counts?
       Muscle-strengthening activities – what counts?
       Besides aerobic activity, you need to do things to strengthen your muscles at least 2
       days a week. These activities should work all the major muscle groups of your body
       (legs, hips, back, chest, abdomen, shoulders, and arms).
       To gain health benefits, muscle-strengthening activities need to be done to the point
       where it's hard for you to do another repetition without help. A repetition is one
       complete movement of an activity, like lifting a weight or doing a sit-up. Try to do 8—
       12 repetitions per activity that count as 1 set. Try to do at least 1 set of muscle-
       strengthening activities, but to gain even more benefits, do 2 or 3 sets.

       Learn how to strengthen your muscles
       •at home
       •in the gym
       You can do activities that strengthen your muscles on the same or different days that
       you do aerobic activity, whatever works best. Just keep in mind that muscle-
       strengthening activities don't count toward your aerobic activity total.
       There are many ways you can strengthen your muscles, whether it's at home or the
       gym. You may want to try the following:
       Lifting weights
       Working with resistance bands
       Doing exercises that use your body weight for resistance (i.e., push ups, sit ups)
       Heavy gardening (i.e., digging, shoveling)
       Yoga

20     Energy needs
       Energy needs depend on several factors such as age, gender, height, activity level.
       Total daily energy requirements are made up of basal energy expenditure, thermic
       effect of food and energy expended in physical activity (most variable component).

21     Calculating calorie needs
       Say: We will be calculating how many calories (or energy) the person that you
       interviewed should be consuming. This is important because it not only will tell us how
       much energy he/she should be consuming in order to maintain their current weight (at
       their present level of activity), but also allow us to see what their eating plan should be.
       We are going to do this using the Harris-Benedict equation. It is important to know
       that calorie needs are different for each individual when using this equation, and these
       needs are based on a person’s:
               Gender
               Age
               Height
               Weight and


Copyright Pennington Biomedical Research Center 2012                                            11
Activity Level


       In just a moment, you will all calculate the energy needs of the person you interviewed.
       But, first—I’ll work through an example.
22     Calculating calorie needs
       Say: The Harris-Benedict equation has two forms. One equation is specific for females;
       the other for males. So, depending on the gender of the person that you interviewed,
       you may use a different equation than the person sitting next to you. The Harris-
       benedict equation calculates a persons BEE or basal energy expenditure. The BEE is
       the number of calories that a person should consume (based on his or her age, gender,
       height and weight) in order to maintain their current weight at rest. It is important that
       you know that the BEE is the minimal number of calories that a person could consume
       to maintain their weight when the person is at complete rest. The BEE does not take
       into account physical activity. The BEE is the calories needed to maintain your weight
       when doing no additional physical activity. So, once we calculate the BEE, we’ll then
       need to take into account the level of physical activity that the person you interviewed
       typically does.
23     The Harris Benedict Equation
       Say: Here are the two equations that I told you about. As you can see, the equations are
       set up the same way; however, one is different from the next numerically. To calculate
       the BEE for a person, we will need their weight, their height, their age, and, of course,
       their gender.
24     An example calculation
       Say: Here is an example that we can work through. Ashley is a 25 year old female. She
       is 5 foot 5 inches tall and weighs approximately 135 pounds. Ashley is pretty active,
       jogging on most days of the week. What’s Ashley’s energy needs (not accounting for
       physical activity)? So, the first thing that we would do is calculate her BEE using the
       Harris-Benedict equation.
       As you can see in the equation here, weight is not in pounds, but rather in kilograms.
       Therefore, we will first need to do a conversion from pounds to kilograms. There are
       2.2 kilograms per pound. In order to calculate her weight in kilograms, we must divide
       weight in pounds by 2.2.

       Do: Write 1 lb = 2.2 kg on the board. Next, write 135 pounds divided by 2.2 kg/pound.

       Say: Everyone go ahead and work this in your calculator. For the answer, two decimal
       places will be fine. Has anyone calculated her weight in kilograms? If so, tell me the
       answer. (answer = 61.36 kg)
       Next, we need to convert her height into centimeters, since this is the unit of height
       used in the equation. Can everyone see the abbreviation for cm in the equation?

       In order to convert height into centimeters, we must do 2 conversions.
       The first is to convert her height into inches only. According to the example, she is 5
       foot 4 inches. But, how many inches is that total? Can anyone tell me how many
       inches there are in one foot?


Copyright Pennington Biomedical Research Center 2012                                             12
Do: Encourage students to answer. Write 1 foot= 12 inches (on the board.)

       Say: Since we know this, we can do the conversion. 12 inches per foot times 5 (which
       is her height in feet) gives us 60 inches. If she were 5 foot even, this would be all that
       we have to do, but since we know she is 5 foot 4 inches tall, we add the extra 4 inches
       for a total of 64”.

       Do: Write height = 64 inches (on the board.)

       Say: Next, we must convert inches into centimeters. Because there are 2.54 centimeters
       in every inch, we can calculate how tall she is in centimeters simply by multiplying her
       height in inches (64 inches) by 2.54.

       Do: Write 1 inch = 2.54 centimeters. Then, write 64 inches times 2.54 cm/inch =
       162.56 cm

       Say: Does anyone know what the answer is? (Answer = 162.56 centimeters.)

       Do: Encourage students to answer. Write the correct answer on the board.

25     Calculating BEE
       Say: The numbers in red represent those values specific to Ashley used in the equation.

       Do: Rewrite the formula on the board, including the numbers we inserted.

       Say: When calcualting the answer, remember that we must do what is inside of the
       parentheses first. Once that is done, addition and subtraction should be the only things
       left in the equation. Once we get to that point, all that’s left is working the equation
       from the left side to the right. I’ll give you all a moment to try and solve the equation
       on your own. Then, I’ll work through it and show you how to get the answer.

       Do: (wait and say): Does anyone have the answer? (Answer = 1232.608096 or 1233)

       Now, write the following on the board:
       655.1 + (9.563 x 61.36) + (1.850 x 162.56) – (4.676 x 25)
       655.1 + 586.78568 + 300.736 – 116.9
       1048.772096 + 300.736 – 116.9
       1349.508096 – 116.9
       B.E.E.= 1232.608096 or 1233 kcal

       Say: Ashley’s basal energy expenditure (BEE) or basal metabolic rate (BMR) is 1233,
       meaning that this is the number of calories she needs to eat to maintain her body
       weight if she was doing no physical activity. However, she is active. She needs more
       than that to maintain her weight at her current activity level. Next, we have to multiply
       her BEE by an activity factor.



Copyright Pennington Biomedical Research Center 2012                                            13
26     Calculating energy needs
       Say: Here is a table which shows us the different activity factors. In our earlier
       example, we said that Ashley was moderately active jogging on most days of the week.
       From looking at the table, can anyone guess which activity factor we would use?

       Do: Encourage students to give answers. (Answer = 1.55)


       Say: Yes, 1.55 is correct. Ashley’s BEE was 1233 kcal, so we would multiply her
       calorie needs of 1233 by 1.55. This gives us a final answer of 1911.15 kcal. We round
       this down to about 1900 kilocalories. This tells us that in order to maintain her current
       weight at that activity level, Ashley needs to consume about 1900 kilocalories a day.

       Now, I am going to start handing out some sheets so that you can do your own
       calculations on the person that you interviewed. If you have any questions or any
       difficulty doing the calculations or estimating activity levels, just let me know. And,
       remember, there is a certain formula that has to be used if you interviewed a male and a
       certain formula that has to be used if you interviewed a female.

       Do: Hand out the Calculating Energy Needs activity sheet. Allow all students time to
       calculate the energy needs for the person that they interviewed. Walk around the room
       to answer any possible questions that students may have.

       ----------------------------------------------BREAK-----------------------------------------------

       Only proceed with the rest of the powerpoint once all students have completed this part
       of the assignment.

27     Summary
       Say: Healthy diets are those that:
                   Emphasize fruit, vegetables, whole grains, and fat-free or low fat dairy;
                   Include lean meats more often than high fat meats;
                   Replace meat with beans, eggs, nuts and seeds occasionally;
                   Are low in saturated fat, trans fat, cholesterol, salt and added sugars

28     Say:
           Energy needs are different from one person to the next and based on:
                Gender
                Height
                Weight
                Activity level

            Healthy Diet + Exercise = the key to healthy living and lowering your risk for
             disease later in life




Copyright Pennington Biomedical Research Center 2012                                                    14
21
       Authors:
       Heli Roy, PhD, RD
       Shanna Lundy, MS

       Division of Education
       Phillip Brantley, PhD, Director
       Pennington Biomedical Research Center
       Steven Heymsfield, MD, Executive Director

       The Pennington Biomedical Research Center is a world-renowned nutrition research
       center.

       Mission:
       To promote healthier lives through research and education in nutrition and preventive
       medicine.

       The Pennington Center has several research areas, including:

           Clinical Obesity Research
           Experimental Obesity
           Functional Foods
           Health and Performance Enhancement
           Nutrition and Chronic Diseases
           Nutrition and the Brain
           Dementia, Alzheimer’s and healthy aging
           Diet, exercise, weight loss and weight loss maintenance

       The research fostered in these areas can have a profound impact on healthy living and
       on the prevention of common chronic diseases, such as heart disease, cancer, diabetes,
       hypertension and osteoporosis.

       The Division of Education provides education and information to the scientific
       community and the public about research findings, training programs and research
       areas, and coordinates educational events for the public on various health issues.

       We invite people of all ages and backgrounds to participate in the exciting research
       studies being conducted at the Pennington Center in Baton Rouge, Louisiana. If you
       would like to take part, visit the clinical trials web page at www.pbrc.edu or call (225)
       763-3000.



       Copyright Pennington Biomedical Research Center 2012




Copyright Pennington Biomedical Research Center 2012                                           15

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Healthy diet plan Unit 2 teen curriculum

  • 1. Pennington Biomedical Research Center Awesome.2Cents! Healthy Lifestyle Curriculum for Teens…. Grades 8-12 Lesson 2: Healthy Diet Plan Content outline 1. Definition of a healthy diet 2. An overview of the Dietary Guidelines 3. How to read food labels 4. An overview of the MyPlate 5. Food groups in a plan 6. Exercise recommendations 7. Computing energy needs 8. Navigating MyPlate Standards of Education Louisiana content standards: 1-M-2, 2-M-1, 2-M-3, 3-M-1, 3-M-2, 4-M-3, 4-M-4, 5-M-4, 5-M-5 1-H-1, 1-H-4, 3-H-1, 3-H-2, 3-H-4, 5-H-6, h-H-1 Objectives/Expected Learner Outcomes: Students will master food groups, portions within food groups, how to calculate energy needs, understanding of exercise recommendations. Lesson and Strategies Student group targeted 8-12th grade Time required Teacher Preparation: 15-20 minutes Assessment: 10 minutes Materials and Resources Power point presentation: What defines a “Healthy Diet”? Projector Screen Laptop/Computer MyPyramid Handout 24-hour Dietary Recall Handouts MyPyramid Assignment Calculators Scrap paper for calculations Copyright Pennington Biomedical Research Center 2012 1
  • 2. Teacher Preparation Make copies of MyPyramid Servings, MyPyramid Food Groups, MyPyramid Serving Sizes, MyPyramid Assignment Rating, Personal Contract, 24-hour Dietary Recall Handout for students and Calculating Energy Needs. -------------------------------------------------------------------------------------------------------------------- PART I (Day 1) The first part of this lesson will require students to interview a person of choice (mother, father, grandparent, friend, etc) in order to collect one days’ worth of meals that this person consumed. The 24-hour dietary recall should include all food and all beverages that the person consumed on the previous day. Using the 24-hour dietary recall form, students will need to collect some additional information from the person they are interviewing, such as: their age, height, weight, and activity level. This will be necessary in order to calculate their energy needs in class the next day. After collecting the 24-hour recall, students will need to bring the information to class with them for the following class period. From calculating the calorie (energy) needs of the person that each student interviewed, students will be able to compare what the dietary guidelines tell us that person should be eating (from MyPlate assignment) with what they actually ate. -------------------------------------------------------------------------------------------------------------------- PART II (Day 2) Slide Lesson Plan 1 Dietary Guidelines for Americans 2 Say: This lesson will cover: Computations for energy needs Dietary Guidelines Definition of a healthy diet An overview of the MyPlate Plan Exercise recommendations 3 Determinants of a healthy diet  Plant based (fruits and vegetables)  Avoids excessive calorie intake  Minimizes solid fats and added sugars  Lean meats  Plant proteins Poor diet and physical inactivity are the most important factors contributing to an epidemic of overweight and obesity affecting men, women, and children in all segments of our society. Healthy eating encompasses two overarching concepts: Copyright Pennington Biomedical Research Center 2012 2
  • 3. 1. Maintain calorie balance over time to achieve and sustain a healthy weight. People who are most successful at achieving and maintaining a healthy weight do so through continued attention to consuming only enough calories from foods and beverages to meet their needs and by being physically active. To curb the obesity epidemic and improve their health, many Americans must decrease the calories they consume and increase the calories they expend through physical activity. 2. Focus on consuming nutrient-dense foods and beverages. Americans currently consume too much sodium and too many calories from solid fats, added sugars, and refined grains. These replace nutrient-dense foods and beverages and make it difficult for people to achieve recommended nutrient intake while controlling calorie and sodium intake. A healthy eating pattern limits intake of sodium, solid fats, added sugars, and refined grains and emphasizes nutrient-dense foods and beverages—vegetables, fruits, whole grains, fat-free or low-fat milk and milk products, seafood, lean meats and poultry, eggs, beans and peas, and nuts and seeds. 4 What is a healthy diet? A healthy diet is one that emphasizes fruits, vegetables, whole grains, fat-free or low fat milk, and milk products. It includes lean meats. Poultry and fish and vegetable proteins such as beans, seeds and nuts. Nutrient Density. Nutrient dense foods are those that provide a lot of nutrients (vitamins and minerals) and only a few calories. Nutrient-dense foods are the opposite of “energy-dense” foods. Energy-dense foods are those foods which are packed with calories (energy), but are not very nutritious (meaning that they have a lot of calories but not many vitamins or minerals). Can you think of any foods which might be nutrient-dense? What about energy- dense? Encourage students to answer. [Possible answers could include: candy (sugary sweets), French fries, potato chips, hamburgers, hot dogs, sodas, cake, many desserts, and added fats (like regular mayonnaise, salad dressing, vegetable oil).] Say: Fruits, vegetables, and whole grains are rich sources of important vitamins and minerals. They also include complex carbohydrates. We are always encouraged to choose complex carbohydrate food sources (whole grains) over foods that are highly processed, like refined grains. This is because extra sugars and fats are often added to refined grains during processing. Also, important vitamins and minerals are lost. Refined grains are more likely to be described as “energy-dense” than “nutrient-dense” foods in most cases. Two other components of a healthy diet are diets that: include lean meats, poultry, fish, beans, eggs, and nuts; and are low in saturated fats, trans fats, cholesterol, salt (sodium), and added sugars. We’ll go into more depth in later topics, but know that saturated fats and trans fats are fats that we want to minimize in our diets. When consuming fats, we want to consume “good” fats as often as possible, like monounsaturated and polyunsaturated fats. 5 American Institute for Cancer Research Copyright Pennington Biomedical Research Center 2012 3
  • 4. Say: No single food or food component can protect you against cancer by itself. But strong evidence does show that a diet filled with a variety of plant foods such as vegetables, fruits, whole grains and beans helps lower risk for many cancers. Foods Can Fight Cancer Both Directly … In laboratory studies, many individual minerals, vitamins and phytochemicals demonstrate anti-cancer effects. Yet evidence suggests it is the synergy of compounds working together in the overall diet that offers the strongest cancer protection. … And Indirectly According to AICR/WCRF’s second expert report and its updates, carrying excess body fat increases the risk of seven cancers (esophagus, pancreas, colon and rectum, endometrium, kidney and breast). Vegetables and fruits are low in calories, which help us get to and stay a healthy weight. Whole grains and beans are rich in fiber and moderate in calories, which also help in weight management efforts. That is why AICR recommends filling at least 2/3 of your plate with vegetables, fruit, whole grains and beans. 6 Recommendations for cancer prevention 1. Be as lean as possible without becoming underweight. 2. Be physically active for at least 30 minutes every day. 3. Avoid sugary drinks. Limit consumption of energy-dense foods. 4. Eat more of a variety of vegetables, fruits, whole grains and legumes such as beans. 5. Limit consumption of red meats (such as beef, pork and lamb) and avoid processed meats. 6. If consumed at all, limit alcoholic drinks to 2 for men and 1 for women a day. 7. Limit consumption of salty foods and foods processed with salt. 8. Don't use supplements to protect against cancer. 9. Breastfeed exclusively for up to 6 months 10. After treatment, cancer survivors should follow the recommendations for cancer prevention. 7 American Diabetes Association dietary recommendations Say: Five Easy Steps to Create Your Plate It's simple and effective for both managing diabetes and losing weight. Creating your plate let's you still choose the foods you want, but changes the portion sizes so you are getting larger portions of non-starchy vegetables and a smaller portion of starchy foods. When you are ready, you can try new foods within each food category. Try these five simple steps to get started: Using your dinner plate, put a line down the middle of the plate. Then on one side, cut it again so you will have 3 sections on your plate. Fill the largest section with non-starchy vegetables such as: spinach, carrots, lettuce, greens, cabbage, bok choy, green beans, broccoli, cauliflower, tomatoes, vegetable juice, salsa, onion, cucumber, beets, okra, mushrooms, peppers, turnip. Now in one of the small sections, put starchy foods such as: whole grain breads, such as whole wheat or rye, whole grain, high-fiber cereal cooked cereal such as oatmeal, grits, hominy, or cream of wheat, rice, pasta, dal, Copyright Pennington Biomedical Research Center 2012 4
  • 5. tortillas, cooked beans and peas, such as pinto beans or black-eyed peas, potatoes, green peas, corn, lima beans, sweet potatoes, winter squash, low-fat crackers and snack chips, pretzels, and fat-free popcorn. And then on the other small section, put your meat or meat substitutes such as: chicken or turkey without the skin, fish such as tuna, salmon, cod, or catfish, other seafood such as shrimp, clams, oysters, crab, or mussels, lean cuts of beef and pork such as sirloin or pork loin, tofu, eggs, low-fat cheese. Add an 8 oz glass of non-fat or low-fat milk. If you don’t drink milk, you can add another small serving of carb such as a 6 oz. container of light yogurt or a small roll. And a piece of fruit or a 1/2 cup fruit salad and you have your meal planned. Examples are fresh, frozen, or canned in juice or frozen in light syrup or fresh fruit. 8 American Heart Association Dietary recommendations Say: Heart disease is the No. 1 killer of Americans. We can reduce heart disease by promoting a healthy diet and lifestyle. Getting information from credible sources can help you make smart choices that will benefit your long-term heart health. For the first time, the American Heart Association has defined what it means to have ideal cardiovascular health, identifying seven health and behavior factors that impact health and quality of life. We know that even simple, small changes can make a big difference in living a better life. Known as “Life’s Simple 7,” these steps can help add years to your life: don’t smoke; maintain a healthy weight; engage in regular physical activity; eat a healthy diet; manage blood pressure; take charge of cholesterol; and keep blood sugar, or glucose, at healthy levels. In terms of a healthy diet, do the following: Fruits and vegetables: At least 4.5 cups a day Fish (preferably oily fish): At least two 3.5-ounce servings a week Fiber-rich whole grains: At least three 1-ounce-equivalent servings a day Sodium: Less than 1,500 mg a day Sugar-sweetened beverages: No more than 450 calories (36 ounces) a week Other Dietary Measures: Nuts, legumes and seeds: At least 4 servings a week Processed meats: No more than 2 servings a week Saturated fat: Less than 7% of total energy intake The American Heart Association recommends that you eat a wide variety of nutritious foods daily. Remember, even simple, small changes can make a big difference in living a better life. 9 Dietary Guidelines for Americans Say: The next thing on the agenda for today is to discuss the Dietary Guidelines for Copyright Pennington Biomedical Research Center 2012 5
  • 6. Americans. We’ll talk about what they are and what they tell us and also why they are important. The Dietary Guidelines for Americans were created by the United States Department of Agriculture (USDA) in order to give us an easy-to-follow guide on how Americans should be eating in order to improve their health and reduce the risk of disease. There are so many studies which show that people who eat healthy diets have some of the lowest risks for chronic diseases, such as diabetes, heart disease, and cancer. It’s very important that we learn these healthy lifestyles as young adults or even as a child since early eating patterns usually follow us into our adulthood. The Dietary Guidelines tell us that we can improve our health and lower our risk for disease by changing our food choices (meaning making healthy choices more often), the way that we handle food (in relation to food safety), and by changing our physical activity patterns (increasing our activity). These guidelines are updated every 5 years, with the most recent version being from 2010. 10 Dietary Guidelines for Americans Say: It’s important for you to know that the Dietary Guidelines are: Recommendations for healthy Americans, ages 2 years and over. The government’s key nutrition message on how to choose a healthful diet and increase activity. Incorporated into an eating plan making it easy for Americans to follow these guidelines. Does anyone know what the newest meal plan (2010) is called? Do: Encourage students to answer. (Answer = MyPlate) 11 Based on a 2000 calorie diet Say: One difference between the old food guide pyramid and the new one is that servings here are based on cup and ounce equivalents. The number of servings that you should consume for each group depends on what your recommended calorie level is. For example: For a 2,000 calorie diet, for example, the plan tells us that we should consume: 6 ounces of grains 2 cups of fruit 2.5 cups of vegetables 3 cups of milk and 5.5 ounces from the meat/beans group With the calorie needs now calculated for each person interviewed, we will be able to figure up the number of servings from each food group that that person should be consuming based on their energy needs. I am going to hand out several pages on the MyPlate Plan. Once I hand them out, we’ll go over each one individually. After we go over the MyPlate Plan, I’ll let you assess the 24-hour dietary recall that you collected based on what we have learned. Do: Hand out the MyPlate Assignment. 12 Food group servings Say: The first sheet that we will go over is the serving size sheet. This sheet tells us the number of servings that a person should be eating from each food group based on their Copyright Pennington Biomedical Research Center 2012 6
  • 7. recommended calorie intake. As you can see, calorie levels are in increments of 200, meaning that if you calculated an energy need of 1,750 calories for your person, you would have to round this to the next closest kcal amount, which is 1800 kcal. On the sheet, servings for the fruits, vegetables, grains, lean meat and beans, and milk groups are listed. Amounts of oils and discretionary calorie allowances are also listed, but this is something that we will get into later. As you can see, the vegetables and grains groups are broken down further than the fruits, lean meat and beans and milk groups. For vegetables, the top row is the number of servings that should be consumed per day based on a specified calorie level. The specifications for dark green vegetables, orange vegetables, etc are based on the number of servings that you should be consuming per week. For this assignment, we won’t look at these—only the top row of servings of vegetables per day will we pay attention to. For grains, we will look at both types. The top row shows the total number of servings of grains per day based on a specified calorie intake. The subdivisions simply show that half of your grain intake for the day should be whole grain and the other half can be other. Can anyone tell me the number of servings that should be consumed per day for: grains, fruit, vegetables, milk, meat, and beans based on a 1,800 calorie diet? (Answer= 6 ounces of grain; 1.5 cups of fruit; 2.5 cups of vegetables; 3 cups of milk; and 5 ounces of lean meat and beans). 13 Food groups – food selection Say: When choosing foods from the fruit, vegetable, and grains groups, you always want to strive to choose those foods without added fats and sugars. These are the most nutrient-dense foods in each group. I had mentioned just a moment ago about discretionary calorie allowances. Discretionary calorie allowances are extra calories that you consume if you eat a lot of nutrient dense foods. You can eat a lot of calories or less calories depending on the types of foods you consume. For example, from the grains group you can choose a croissant, a honey bun, cheese grits, macaroni and cheese in a day. Those would all be from the grain group but very high in calories, or you could choose a bagel, a low fat muffin, plain grits, and pasta salad instead for much fewer calories. Of course, the discretionary calorie allowance isn’t huge (maybe 100-300 calories)—since most people override it by choosing high fat meats, cheeses, whole milk, or sweetened bakery products. This leads me to the milk and meat group. When choosing foods in these groups, you always want to choose lower- fat versions. For example, in the milk group, choose fat- free or low-fat milk and yogurt when possible over whole milk. The lower fat versions offer the same amount of nutrients with fewer calories. And, when choosing meat, always try to choose lean cuts of meat. Replacing red meat with fish, peanut butter, tofu, nuts, and seeds is a good practice to try occasionally. Also, another good tip is when consuming poultry; always try to remove the skin. This makes the poultry lower in fat and calories, and for meat especially—be cautious of the way your prepare it. Choose methods like grilling, baking, or sautéing over deep-frying. This greatly decreases the calorie load that you consume. 14 Serving sizes Copyright Pennington Biomedical Research Center 2012 7
  • 8. Say: The last handout that we will refer to is the MyPyramid Serving Sizes sheet. This sheet simply lists each food group and what counts as either 1 cup or ounce equivalent. The fruit, vegetable, and milk groups all have their servings as cup equivalents; whereas, the grains and lean meat and beans group have their servings as ounce equivalents. When you are calculating how many servings from each group a person ate, you may have to multiply. For example, if Ashley ate 2 slices of bread, looking on the handout, we would see that 1 serving (or 1 ounce equivalent) equals only one slice of bread. Because Ashley ate 2 slices of bread, then she consumed 2 servings from the grain group. Does everyone understand that? Now, we’ll do a few more examples. Could anyone tell me how many servings (same as ounce equivalents) one 3 ounce muffin would be? (Answer= 3 servings (or 3 ounce equivalents) Now, here is a harder example. Remember, that 1 cup is equal to 8 ounces. Could anyone tell me how many cup equivalents it would be if I consumed 12 ounces of fruit juice? (Answer = 1 ½ cups) What about servings? Remember, that 1 cup equivalent for fruit and vegetable is equal to two servings, so for every 1 cup equivalent you have; you have 2 times more servings. (Answer = 1.5 cup equivalents x’s 2 = 3 servings) Here is the last one. What about if I ate ½ a cup of cooked dry beans. How many ounce equivalents from the meat and beans group would I have consumed? Remember that ¼ cup cooked is 1 ounce equivalent and that I’m consuming ½ cup. (Answer: ¼ cup = 1 ounce; ½ cup = twice more, so 2 ounces) 15 Serving sizes Say: We’ll have one last example. Using scratch paper, I want everyone to work through this example and total up the number of cup or ounce equivalents from each group: grains, fruits, vegetables, meat and beans, and milk. Then we’ll go over how many cup or ounce equivalents of each food group were consumed at this meal. For lunch on Monday, Josh ate the following: 1 whole wheat sandwich (2 slices bread) with 3 ounces of deli turkey and 1 teaspoon of mustard, and 1 slice (2 ounces) of American cheese 1 salad that had 1 cup of salad greens, ½ cup of cooked pasta, and fat-free dressing And 1 glass of low-fat milk (8 ounces) Everyone try to work this out. And, remember that some food groups are listed more than once, so you’ll have to total the number of equivalents that Josh ate. Copyright Pennington Biomedical Research Center 2012 8
  • 9. Do: Give students time to work through the example. Leave the slide up for the students to refer to while working the example. Say: You don’t have to account for mustard or the fat-free dressing. But, had he eaten regular mayonnaise on his sandwich, this would go into the oils category. We won’t be figuring up servings from the oils category though, so you won’t have to worry about calculating that. Just know that you should always choose lower-fat versions of all salad dressings and mayonnaises, while limiting oils and added fats. ----------------------------------------------BREAK------------------------------------------------- Do: When it looks like all students are done, continue with the following questions: Say: So, who can tell me how many ounce-equivalents he had from the grains category? Remember that both the bread and the pasta came from the grains group. Do: Encourage students to provide answers. (Answer = 3 ounce equivalents or 3 servings; 2 slices of bread (2 ounces) + ½ cup cooked pasta (1 ounce) = 3 oz equiv.). Say: Who can tell me how many cup equivalents of fruit he had? Do: Encourage students to provide answers. (Answer = Zero) Say: Josh didn’t eat any fruit for lunch on this day. What about vegetables—how many cup equivalents (not servings) did Josh eat? Do: Encourage students to provide answers. (Answer = ½ cup or 1 serving; because 1 cup equivalent of leafy salad greens equals 2 cups of greens—Josh only ate 1 cup total) Say: What about meat and beans—how many ounce equivalents did he eat? Do: Encourage students to provide answers. (Answer = 3 ounce equivalents; 3 ounces of lean meat equal 3 ounce equivalents) Say: And, finally--- what about the milk group—how many cup equivalents did Josh eat? Remember that he had both cheese and milk during this meal. Do: Encourage students to answer. (Answer = 2 cups or 2 servings; 1 slice of processed cheese + 1 cup of milk = 2 cup equivalents or 2 servings) 16 Exercise recommendations Say: The plan recommends that along with eating a healthy diet– we engage in regular physical activity. For children (< 12 years) and adolescents (about 12 to 19 years of age), the plan recommends engaging in at least 60 minutes of physical activity on most, but preferably all, days of the week. One important thing that I must bring to your attention is that the 60 minutes of activity that the plan recommends does not all Copyright Pennington Biomedical Research Center 2012 9
  • 10. have to occur in one session. It can be broken up throughout the day, so long as the total of activity for the day is at least 60 minutes. Can anyone give me examples of some type of activity that they normally do— whether it be sports-related or an activity they enjoy outside of school or sports? Do: Encourage students to provide examples of physical activity that they engage in. Write the activities down on the board for students to see. (Examples could include: walking, jogging, swimming, running, track, basketball, baseball, cheerleading, football, etc). 17 Aerobic activity- what counts? Aerobic activity or "cardio" gets you breathing harder and your heart beating faster. From pushing a lawn mower, to taking a dance class, to biking to the store – all types of activities count. As long as you're doing them at a moderate or vigorous intensity for at least 10 minutes at a time. Intensity is how hard your body is working during aerobic activity. How do you know if you're doing light, moderate, or vigorous intensity aerobic activities? For most people, light daily activities such as shopping, cooking, or doing the laundry doesn't count toward the guidelines. Why? Your body isn't working hard enough to get your heart rate up. Moderate-intensity aerobic activity means you're working hard enough to raise your heart rate and break a sweat. One way to tell is that you'll be able to talk, but not sing the words to your favorite song. Here are some examples of activities that require moderate effort: Walking fast Doing water aerobics Riding a bike on level ground or with few hills Playing doubles tennis Pushing a lawn mower 18 Vigorous intensity exercise Vigorous-intensity aerobic activity means you're breathing hard and fast, and your heart rate has gone up quite a bit. If you're working at this level, you won't be able to say more than a few words without pausing for a breath. Here are some examples of activities that require vigorous effort: Jogging or running Swimming laps Riding a bike fast or on hills Playing singles tennis Playing basketball You can do moderate- or vigorous-intensity aerobic activity, or a mix of the two each week. A rule of thumb is that 1 minute of vigorous-intensity activity is about the same as 2 minutes of moderate-intensity activity. Some people like to do vigorous types of activity because it gives them about the same health benefits in half the time. If you haven't been very active lately, increase your Copyright Pennington Biomedical Research Center 2012 10
  • 11. activity level slowly. You need to feel comfortable doing moderate-intensity activities before you move on to more vigorous ones. The guidelines are about doing physical activity that is right for you. 19 Muscle strengthening exercises – what counts? Muscle-strengthening activities – what counts? Besides aerobic activity, you need to do things to strengthen your muscles at least 2 days a week. These activities should work all the major muscle groups of your body (legs, hips, back, chest, abdomen, shoulders, and arms). To gain health benefits, muscle-strengthening activities need to be done to the point where it's hard for you to do another repetition without help. A repetition is one complete movement of an activity, like lifting a weight or doing a sit-up. Try to do 8— 12 repetitions per activity that count as 1 set. Try to do at least 1 set of muscle- strengthening activities, but to gain even more benefits, do 2 or 3 sets. Learn how to strengthen your muscles •at home •in the gym You can do activities that strengthen your muscles on the same or different days that you do aerobic activity, whatever works best. Just keep in mind that muscle- strengthening activities don't count toward your aerobic activity total. There are many ways you can strengthen your muscles, whether it's at home or the gym. You may want to try the following: Lifting weights Working with resistance bands Doing exercises that use your body weight for resistance (i.e., push ups, sit ups) Heavy gardening (i.e., digging, shoveling) Yoga 20 Energy needs Energy needs depend on several factors such as age, gender, height, activity level. Total daily energy requirements are made up of basal energy expenditure, thermic effect of food and energy expended in physical activity (most variable component). 21 Calculating calorie needs Say: We will be calculating how many calories (or energy) the person that you interviewed should be consuming. This is important because it not only will tell us how much energy he/she should be consuming in order to maintain their current weight (at their present level of activity), but also allow us to see what their eating plan should be. We are going to do this using the Harris-Benedict equation. It is important to know that calorie needs are different for each individual when using this equation, and these needs are based on a person’s: Gender Age Height Weight and Copyright Pennington Biomedical Research Center 2012 11
  • 12. Activity Level In just a moment, you will all calculate the energy needs of the person you interviewed. But, first—I’ll work through an example. 22 Calculating calorie needs Say: The Harris-Benedict equation has two forms. One equation is specific for females; the other for males. So, depending on the gender of the person that you interviewed, you may use a different equation than the person sitting next to you. The Harris- benedict equation calculates a persons BEE or basal energy expenditure. The BEE is the number of calories that a person should consume (based on his or her age, gender, height and weight) in order to maintain their current weight at rest. It is important that you know that the BEE is the minimal number of calories that a person could consume to maintain their weight when the person is at complete rest. The BEE does not take into account physical activity. The BEE is the calories needed to maintain your weight when doing no additional physical activity. So, once we calculate the BEE, we’ll then need to take into account the level of physical activity that the person you interviewed typically does. 23 The Harris Benedict Equation Say: Here are the two equations that I told you about. As you can see, the equations are set up the same way; however, one is different from the next numerically. To calculate the BEE for a person, we will need their weight, their height, their age, and, of course, their gender. 24 An example calculation Say: Here is an example that we can work through. Ashley is a 25 year old female. She is 5 foot 5 inches tall and weighs approximately 135 pounds. Ashley is pretty active, jogging on most days of the week. What’s Ashley’s energy needs (not accounting for physical activity)? So, the first thing that we would do is calculate her BEE using the Harris-Benedict equation. As you can see in the equation here, weight is not in pounds, but rather in kilograms. Therefore, we will first need to do a conversion from pounds to kilograms. There are 2.2 kilograms per pound. In order to calculate her weight in kilograms, we must divide weight in pounds by 2.2. Do: Write 1 lb = 2.2 kg on the board. Next, write 135 pounds divided by 2.2 kg/pound. Say: Everyone go ahead and work this in your calculator. For the answer, two decimal places will be fine. Has anyone calculated her weight in kilograms? If so, tell me the answer. (answer = 61.36 kg) Next, we need to convert her height into centimeters, since this is the unit of height used in the equation. Can everyone see the abbreviation for cm in the equation? In order to convert height into centimeters, we must do 2 conversions. The first is to convert her height into inches only. According to the example, she is 5 foot 4 inches. But, how many inches is that total? Can anyone tell me how many inches there are in one foot? Copyright Pennington Biomedical Research Center 2012 12
  • 13. Do: Encourage students to answer. Write 1 foot= 12 inches (on the board.) Say: Since we know this, we can do the conversion. 12 inches per foot times 5 (which is her height in feet) gives us 60 inches. If she were 5 foot even, this would be all that we have to do, but since we know she is 5 foot 4 inches tall, we add the extra 4 inches for a total of 64”. Do: Write height = 64 inches (on the board.) Say: Next, we must convert inches into centimeters. Because there are 2.54 centimeters in every inch, we can calculate how tall she is in centimeters simply by multiplying her height in inches (64 inches) by 2.54. Do: Write 1 inch = 2.54 centimeters. Then, write 64 inches times 2.54 cm/inch = 162.56 cm Say: Does anyone know what the answer is? (Answer = 162.56 centimeters.) Do: Encourage students to answer. Write the correct answer on the board. 25 Calculating BEE Say: The numbers in red represent those values specific to Ashley used in the equation. Do: Rewrite the formula on the board, including the numbers we inserted. Say: When calcualting the answer, remember that we must do what is inside of the parentheses first. Once that is done, addition and subtraction should be the only things left in the equation. Once we get to that point, all that’s left is working the equation from the left side to the right. I’ll give you all a moment to try and solve the equation on your own. Then, I’ll work through it and show you how to get the answer. Do: (wait and say): Does anyone have the answer? (Answer = 1232.608096 or 1233) Now, write the following on the board: 655.1 + (9.563 x 61.36) + (1.850 x 162.56) – (4.676 x 25) 655.1 + 586.78568 + 300.736 – 116.9 1048.772096 + 300.736 – 116.9 1349.508096 – 116.9 B.E.E.= 1232.608096 or 1233 kcal Say: Ashley’s basal energy expenditure (BEE) or basal metabolic rate (BMR) is 1233, meaning that this is the number of calories she needs to eat to maintain her body weight if she was doing no physical activity. However, she is active. She needs more than that to maintain her weight at her current activity level. Next, we have to multiply her BEE by an activity factor. Copyright Pennington Biomedical Research Center 2012 13
  • 14. 26 Calculating energy needs Say: Here is a table which shows us the different activity factors. In our earlier example, we said that Ashley was moderately active jogging on most days of the week. From looking at the table, can anyone guess which activity factor we would use? Do: Encourage students to give answers. (Answer = 1.55) Say: Yes, 1.55 is correct. Ashley’s BEE was 1233 kcal, so we would multiply her calorie needs of 1233 by 1.55. This gives us a final answer of 1911.15 kcal. We round this down to about 1900 kilocalories. This tells us that in order to maintain her current weight at that activity level, Ashley needs to consume about 1900 kilocalories a day. Now, I am going to start handing out some sheets so that you can do your own calculations on the person that you interviewed. If you have any questions or any difficulty doing the calculations or estimating activity levels, just let me know. And, remember, there is a certain formula that has to be used if you interviewed a male and a certain formula that has to be used if you interviewed a female. Do: Hand out the Calculating Energy Needs activity sheet. Allow all students time to calculate the energy needs for the person that they interviewed. Walk around the room to answer any possible questions that students may have. ----------------------------------------------BREAK----------------------------------------------- Only proceed with the rest of the powerpoint once all students have completed this part of the assignment. 27 Summary Say: Healthy diets are those that:  Emphasize fruit, vegetables, whole grains, and fat-free or low fat dairy;  Include lean meats more often than high fat meats;  Replace meat with beans, eggs, nuts and seeds occasionally;  Are low in saturated fat, trans fat, cholesterol, salt and added sugars 28 Say:  Energy needs are different from one person to the next and based on:  Gender  Height  Weight  Activity level  Healthy Diet + Exercise = the key to healthy living and lowering your risk for disease later in life Copyright Pennington Biomedical Research Center 2012 14
  • 15. 21 Authors: Heli Roy, PhD, RD Shanna Lundy, MS Division of Education Phillip Brantley, PhD, Director Pennington Biomedical Research Center Steven Heymsfield, MD, Executive Director The Pennington Biomedical Research Center is a world-renowned nutrition research center. Mission: To promote healthier lives through research and education in nutrition and preventive medicine. The Pennington Center has several research areas, including: Clinical Obesity Research Experimental Obesity Functional Foods Health and Performance Enhancement Nutrition and Chronic Diseases Nutrition and the Brain Dementia, Alzheimer’s and healthy aging Diet, exercise, weight loss and weight loss maintenance The research fostered in these areas can have a profound impact on healthy living and on the prevention of common chronic diseases, such as heart disease, cancer, diabetes, hypertension and osteoporosis. The Division of Education provides education and information to the scientific community and the public about research findings, training programs and research areas, and coordinates educational events for the public on various health issues. We invite people of all ages and backgrounds to participate in the exciting research studies being conducted at the Pennington Center in Baton Rouge, Louisiana. If you would like to take part, visit the clinical trials web page at www.pbrc.edu or call (225) 763-3000. Copyright Pennington Biomedical Research Center 2012 Copyright Pennington Biomedical Research Center 2012 15