Your Heart, Your Life: A Community Health Worker's Manual for the Hispanic Community

Manual Contents

Session 8 Make Heart Healthy Eating a Family Affair

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Objectives

By the end of this session, group members will learn:

  • How to plan and prepare traditional Latino meals in a heart healthy way
  • How to choose foods for a heart healthy diet

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Materials and Supplies

  • “Your Heart, Your Life” manual and picture cards
  • Set of measuring cups (1 cup, ½ cup, ¼ cup)
  • Blackboard and chalk or several large pieces of paper, a marker, and tape
  • Enough pairs of scissors and glue for group members to use during the activity

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Handouts

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Introducing the Session

  1. Welcome
  2. Review of Last Week's Session
  3. About This Session
  1. Welcome
    Welcome group members to the session.
  2. Review of Last Week's Session
    • Say:
      At the last session, we talked about what you need to know about diabetes.
    • Ask these questions, and review the answers with group members.
      • What is diabetes?
        Diabetes results when the body does not make enough insulin or cannot make it well, causing glucose (sugar) to build up in the blood. As a result, the body does not function well.
      • What are risk factors for diabetes?
        • Overweight
        • Family members with diabetes
        • Aged 40 or older
        • Physically inactive lifestyle
        • Being Latino, African American, American Indian, Asian American, or Pacific Islander
        • History of gestational diabetes or giving birth to at least one baby weighing 9 pounds or more
        • High blood pressure
        • Cholesterol levels are not normal: HDL cholesterol is low, or triglycerides are high
      • What are the ABCs of diabetes?
        • A is for the A1C test. This simple lab test reflects a person's average blood glucose level over the past 3 months. The A1C number to aim for is below 7.
        • B is for blood pressure. The higher your blood pressure, the harder your heart has to work. High blood pressure increases your risk for a heart attack, stroke, and damage to your kidneys and eyes. Your blood pressure should be below 130/80 mmHg (millimeters of mercury).
        • C is for cholesterol. Keep cholesterol at normal levels. Bad cholesterol or LDL can build up and clog your arteries. It can lead to a heart attack or stroke. People with type 2 diabetes need to keep their LDL cholesterol below 100 mg/dL (milligrams per deciliter).
      • How does diabetes affect your body?
        Diabetes can cause damage to the heart, brain, kidneys, and eyes. It can cause nerve damage, which reduces feeling in your feet. Diabetes may also affect blood flow in your legs and feet. This can lead to sores that don't heal and amputation.
    • Say:
      At the end of our last session, you made a pledge to do something to help you prevent or control diabetes. What problems did you have? How did you deal with any problems?
      Note: Allow 2 minutes for each group member to respond.
  3. About This Session
    Say:
    What you choose to eat can make a difference in your heart health. During this session, you will learn how to:
    • Choose a variety of foods for heart health.
    • Identify serving sizes and the number of recommended servings for each food group.

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Conducting the Session

  1. Eat a Variety of Heart Healthy Foods
  2. The Latino Diet
  3. A Heart Healthy Eating Plan for Latino Families
  4. How To Choose Heart Healthy Foods
  5. Cooking With Children
  6. Maria's Veggie Wrap Recipe
  1. Eat a Variety of Heart Healthy Foods
    • Ask:
      Why is it important to eat a variety of heart healthy foods?
      Note: Allow about 5 minutes for group members to respond. Write their answers on the blackboard or on a large piece of paper taped to the wall.
    • Add the answers below if the group members do not say them.
      • Eating a variety of foods that are lower in saturated fat, trans fat, cholesterol, sodium, added sugar, and calories can help you have a healthy heart.
      • One food cannot give all the nutrients in the amounts your body needs.

    More Information – Nutrients in the foods we eat include:

    • Carbohydrates
    • Protein
    • Fats
    • Fiber
    • Vitamins
    • Minerals
  2. The Latino Diet
    • Note: This session will help group members think about the foods they eat. Some of their favorite traditional Latino foods are very nutritious. Other dishes can be prepared in more heart healthy ways.
    • Ask:
      What are some traditional Latino foods?
      Note: Allow about 5 minutes for group members to respond. Write their answers on the blackboard or on a large piece of paper taped to the wall.
    • Say:
      Traditional Latino foods are nutritious for you and your family. These include:
      • Bread
      • Corn tortillas
      • Beans
      • Rice
      • Vegetables
      • Fruits
      • Meat and poultry
      • Milk
      • Cheese
    • Say:
      The traditional Latino diet is as varied as the cultural heritage of the Latin American region. Heart healthy foods are part of the rich culinary diversity that is a key to good health.
      The traditional healthy Latino diet included:
      • Daily preparation of meals in the home, using mostly homegrown foods
      • A variety of plant foods, especially maize, root vegetables, cassava, potatoes, sweet potatoes, grains, rice, cornbread, tortillas, beans, nuts, and seeds
      • Plenty of fresh fruits and vegetables, which were eaten during main meals
      • Poultry and fish, which were eaten weekly
      • Limited intake of oils. Fat intake came from foods such as avocados, walnuts, cashews, peanuts, and palm oil.
    • Say:
      Red meats, sweets, and eggs used to be luxuries consumed only at special meals. In the past, people worked in labor-intensive jobs and were very physically active each day. Today, many of these healthy traditions have been replaced by a lack of physical activity and a high-fat diet. Let's bring back the tradition of healthy eating and active living so that we can say, “ïQué viva la tradición!”
    • Say:
      Some Latinos have adopted cooking and eating habits that can lead to health problems such as heart disease. What are some examples of these habits?
      Note: Allow about 3 minutes for group members to answer.
    • Add these habits if they are not mentioned:
      • Cooking foods with too much saturated fat, such as lard and shortening
      • Eating fried foods often, such as refried beans, french fries, fried chicken, fried tacos, and fried cheese
      • Eating foods higher in saturated fat, such as fatty meats, high-fat cheeses and creams, whole milk, and flour tortillas made with lard
      • Eating foods that are higher in calories, such as pastries, candy, and chocolate
      • Drinking high-calorie beverages such as regular soft drinks
      • Eating fewer fruits, vegetables, corn tortillas, and beans
      • Eating meats high in saturated fat instead of lean meats
      • Eating foods high in trans fat such as cookies, crackers, doughnuts, baked goods, and french fries
  3. A Heart Healthy Eating Plan for Latino Families
    • Say:
      We can take steps to improve the way we eat and still enjoy our traditional foods. The first step is to learn which foods we should eat more often. The second step is to learn the amount of these foods that we should eat each day.
    • Show picture card 8.1. (Keep it in view throughout this activity.)
    • Say:
      This heart healthy eating plan is a helpful tool. It shows both the types and amounts of foods we can choose for better health.
    • Give group members the “Heart Healthy Eating Plan” handout.
    • Say:
      The food choices you make each day affect your health. We will talk about ways to choose healthy foods from the food groups in the heart healthy eating plan.
      • Grains (6 to 8 servings a day)
        Say:
        • Make at least half of your grains whole grains. Eat at least three servings of whole-grain cereals, breads, rice, or pasta every day. Remember, one ounce of grains is a serving. In general, 1 ounce of grains is one slice of bread, about 1 cup of ready-to-eat cereal, or 1/2 cup of cooked rice, cooked pasta, or cooked cereal.
        • Look at the food label, and choose grain products that have whole grains as the first ingredient. Some examples of whole-grain ingredients are whole wheat, whole oats, oatmeal, and whole rye.
        • For a change, try brown rice or whole-wheat pasta instead of white rice or pasta.
        • Snack on ready-to-eat, whole-grain cereal such as toasted oat cereal. Also try popcorn with little or no salt or butter as a snack.
      • Vegetables (4 to 5 servings a day)
        Say:
        • Eat more dark green vegetables, such as broccoli, spinach, and other dark leafy greens.
        • Eat more orange vegetables, such as carrots and sweet potatoes.
        • Stock up on frozen vegetables for quick and easy cooking in the microwave.
        • Buy fresh vegetables in season. They cost less and are likely to be at their peak flavor.
        • Plan some meals around a vegetable main dish, such as vegetable stir-fry or soup.
        • Choose no-salt-added canned vegetables.
      • Fruits (4 to 5 servings a day)
        Say:
        • Choose fresh, frozen, canned, or dried fruit.
        • Limit fruit juices, because they contain a lot of calories and added sugar. Try to choose whole fruit instead of fruit juice most of the time.
        • Keep a bowl of whole fruit on the table or counter or in the refrigerator.
      • Fat-free or low-fat milk and milk products (2 to 3 servings a day)
        Say:
        • Get your calcium-rich foods.
        • Choose fat-free or low-fat milk, yogurt, and other milk products.
        • If you usually use whole milk, switch gradually to fat-free milk. Try reduced-fat (2%) milk, then low-fat (1%) milk, then fat-free milk.
        • Have a fat-free or low-fat yogurt for a snack.
        • If you are lactose intolerant, try lactose-free products, such as yogurt, cheese, or lactose-free milk.
      • Lean meats, poultry, and fish (2 or fewer 3-ounce servings a day)
        Say:
        • Choose low-fat or lean meats and poultry. Select meat cuts that are low in fat and ground beef that is extra lean.
        • Eat a variety of foods with protein. Choose fish more often.
        • Choose lean turkey, roast beef, or ham, instead of fatty lunch meats such as regular bologna or salami.
        • Bake, broil, or grill meat.
      • Nuts, seeds, and legumes (4 to 5 servings a week)
        Say:
        • Choose cooked and dry beans, nuts, seeds, and peas for rich sources of protein and fiber.
      • Fats and oils
        Say:
        • Get most of your fat from food sources such as fish, nuts, and vegetable oils.
        • Limit solid fats such as butter, stick margarine, shortening, and lard, as well as foods that contain these fats.
      • Sweets and added sugars (5 or fewer servings a week)
        Say:
        • Choose foods and beverages that are low in calories and added sugar. Use the Nutrition Facts label to compare the calorie and sugar content of foods and beverages.
        • Choose water, fat-free milk, or other unsweetened beverages most often.
        • Select unsweetened cereal and add fruit.
    • Ask these questions, and hold up the correct measuring cup for each answer.
      • What is one serving of a cooked vegetable?
        ½ cup
      • How much milk or yogurt is considered one serving?
        1 cup
      • How much cheese is considered one serving?
        1.5 to 2 ounces
      • Can you give an example of a 1-ounce serving from the grains group?
        1-ounce servings from the grains group include:
        • One slice of bread
        • About 1 cup of ready-to-eat cereal or ½ cup of cooked cereal, such as oatmeal
        • ½ cup of cooked rice or pasta
      • What counts as one serving of fruit?
        • One medium apple, banana, or orange
        • ½ cup of raw or canned fruit or 100 percent fruit juice
        • ¼ cup of dried fruit
      • What is a serving of cooked beans?
        • ½ cup
  4. How To Choose Heart Healthy Foods
    • Say:
      We are going to do another group activity. During this activity, we will learn how to make better food choices.
      Note: Write Virginia's breakfast on the blackboard or on a large piece of paper taped to the wall. Fill in the Virginia's Breakfast and Portion Size columns. Leave the Food Group and Better Choices columns blank. (Optional) Repeat the game with the lunch and dinner meals.
    • Ask:
      To which food group does each food belong? What changes would make Virginia's breakfast more heart healthy?
      Breakfast
      Virginia's Breakfast Food Group(s)
      (leave blank for activity)
      Portion Size Better Choices
      (leave blank for activity)
      Fried egg Meats (eggs) 1 egg Boiled or poached egg, 1/2 cup egg substitute, or 2 egg whites. Scramble eggs with vegetable oil spray instead of using fat.
      Chorizo Meats 1 link Lean turkey sausage
      White toast with guava paste and cream cheese Grains, fruit, and fats 1 slice Whole-grain toast with low-fat tub margarine and an orange
      Butter Fats 1 teaspoon 1 teaspoon of low-fat tub margarine or jam with no added sugar
      Orange juice Fruit 1/2 cup One orange
      Coffee with whole milk Milk 1 cup of coffee, 1 tablespoon of milk Coffee with fat-free milk (or 1 tablespoon of evaporated fat-free milk)
    • Write the suggestions beside the foods they are replacing on the blackboard or on a large piece of paper taped to the wall. Fill in the correct answers for any items not mentioned by group members.
    • (Optional meals: lunch and dinner)
      Lunch
      Virginia's Lunch Food Group(s)
      (leave blank for activity)
      Portion Size Better Choices
      (leave blank for activity)
      Large cheeseburger with mayonnaise Meats, grains, milk, vegetables, fats 1 large cheeseburger Small hamburger or grilled chicken sandwich with mustard or ketchup
      Super-size french fries Vegetables, oils 1 large serving of fries Small order of fries or a side salad with reduced-calorie salad dressing
      Large soft drink Sweets 1 large soft drink Water, diet soft drink, or fat-free milk
      Dinner
      Virginia's Dinner Food Group(s)
      (leave blank for activity)
      Portion Size Better Choices
      (leave blank for activity)
      Chicken quesadilla Meats, grains, milk, vegetables 2 oz. chicken
      2 flour tortillas
      2 tbsp. cheddar cheese
      1 plum tomato
      2 oz. mushrooms
      Use skinless chicken breast, corn tortilla, low-fat and low-sodium cheese, and fat-free vegetable oil spray. Bake instead of frying.
      Refried beans Nuts, seeds, and legumes; fats 1/2 cup beans Use cooked dry beans or rinsed canned beans, and saute beans with a small amount of oil in a nonstick pan.
      Vanilla shake made with whole milk Milk, sweets 1 cup Homemade shake with fat-free milk, ice, vanilla, and sugar substitute
      Flan Fats, sweets, milk, meats (eggs) 1 small bowl Fresh fruit cup or low-fat frozen yogurt
    • Ask:
      What are some ways to eat less saturated fat, trans fat, cholesterol, sodium,
      and calories?
    • Add the following answers if they are not mentioned:
      • When shopping:
        • Choose a variety of whole grains, fruits, and vegetables.
        • Choose low-fat or fat-free milk products, salad dressings, and mayonnaise.
        • Choose lean cuts of meat. Trim away extra fat.
        • Use food labels to choose foods lower in saturated fat, trans fat, cholesterol, sodium, sugar, and calories.
      • When cooking:
        • Use vegetable oil or soft tub margarine instead of butter or lard.
        • Cook with low-fat methods, such as baking, broiling, or boiling (without added fat), rather than frying.
      • When eating:
        • Eat foods that are low in saturated fat, trans fat, and added sugars.
        • Remove skin from poultry. Throw away the skin, and do not eat it.
        • Choose low-fat or fat-free milk products, salad dressings, and mayonnaise.
        • Eat no more than four egg yolks each week.
        • Eat fewer high-calorie foods with little added nutrition value, such as high-fat lunch meats, pies, cakes, cookies, crackers, and chips. Drink fewer sodas.
        • Eat smaller portion sizes.
    • Say:
      Put the “Heart Healthy Eating Plan” handout on your refrigerator to remind you to eat in a heart healthy way.
    • Say:
      Thank you for participating in this activity! You did great! Now you can make healthier choices for you and your family.
  5. Cooking With Children
    • Give group members the “Cooking With Children” handout.
    • Ask volunteers to read the handout out loud.
    • Say:
      As parents, you can teach your children healthy eating habits that will last
      a lifetime.
    • Say:
      For good health and proper growth, children need to eat a variety of different foods every day. When children are offered a balanced diet every day, they will develop good eating habits.
    • Ask:
      Can you think of other ways to get children involved in helping to prepare healthy meals?
    • Write group members' suggestions on the blackboard or on a large piece of paper taped to the wall.

      More Information

      We Can! (Ways to Enhance Children's Activity and Nutrition) is an education program to help children aged 8 to 13 to maintain a healthy weight. The program includes tips for parents on healthy food choices and physical activity. Visit http://wecan.nhlbi.nih.gov.

  6. Maria's Veggie Wrap Recipe
    • Note: This recipe will give group members a chance to try a heart healthy dish at home.
    • Give group members the “Maria's Veggie Wrap Recipe” handout.
    • Say:
      This dish contains beans and tasty vegetables, and it's high in protein and fiber. Try to prepare it at home this week.

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Review of Today's Key Points

  • Say:
    Let's review what we learned today.
  • What is heart healthy about the traditional Latino diet?
    The traditional Latino diet can provide a variety of foods that are lower in fat and sodium, such as bread, corn tortillas, beans, rice, vegetables, fruits, poultry, fish, and milk products.
  • What are some foods that we should eat less often?
    We should limit foods that are high in saturated fat, trans fat, sodium, added sugar, and calories, including:
    • High-fat foods, such as refried beans, fried chicken, fatty meats, and high-fat cheeses
    • Salty foods, such as potato chips and taco chips
    • Foods that are high in saturated fat and added sugar, such as pastries, cookies, and chocolate
    • Foods with added sugar, such as candy and soft drinks
  • How can the heart healthy eating plan be used to choose heart healthy foods?
    Use the heart healthy eating plan to choose foods that are lower in saturated fat, trans fat, cholesterol, sodium, and added sugar from each of the five food groups. The eating plan also shows you the number of servings that you need from each group every day.
  • Why is it helpful to know how much you need to eat from each food group each day?
    When you know the amount of food you need to eat every day, it can help you get the right amount of calories you need.

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Weekly Pledge

  • Say:
    You have learned a lot today about how to make your favorite dishes in a heart healthy way. Now, let's think about how you can apply what you have learned. Please think of one change you can make in your everyday life to eat in a heart healthy way with your family. This will be your pledge for the week.
  • Say:
    Be specific about what you plan to do, how you plan to do it, and when you will start. Here are some examples:
    • I will make baked chicken instead of fried chicken for the next family meal.
    • I will eat one more vegetable and one more fruit each day, starting tomorrow.
      Note: Allow 5 minutes for group members to think of a pledge.
  • Say:
    Would anyone like to share his or her pledge with the group?
    Note: Write down pledge ideas on the blackboard or on a large piece of paper taped to the wall.
  • (Optional) Say:
    Keeping a personal value in mind can help you make heart healthy eating a part of your family life. Remember that a personal value is a quality that you consider important.
    Today's value is fun. Fun can help you stay positive in your efforts to improve your health and the health of your family. It can help you overcome challenges, allowing you to laugh when you want to cry. Fun can also motivate you to turn your pledges into permanent habits.
  • Ask:
    How could you use fun or another value to help you keep your pledge?
    Note: Allow 3 minutes for group members to share their thoughts.
  • Say:
    We will discuss the results of your pledges next week. Don't forget to work on your pledges to be more physically active; to cut back on salt, sodium, saturated fat, trans fat, and cholesterol; to reach and keep a healthy weight; and to prevent or control diabetes.

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Closing

  • Say:
    Thank you for coming today. What did you think of today's session?
    Note: Allow a moment for group members to respond.
  • Say:
    I am looking forward to seeing you again at the next session. We will talk about eating in a heart healthy way – even when time or money is tight.
    Note: Think about today's session. What worked and what didn't work? Have you made any changes in your own life that were covered in today's session?

Go to Session 7

Go to Session 9


Information on this page is taken from the English print version of “Your Heart, Your Life, A Community Health Worker's Manual.” U.S. Department of Health and Human Services, National Institutes of Health, National Heart Lung and Blood Institute, NIH Publication No. 08-3674, Originally Printed 1999, Revised May 2008.




Last Updated March 2012




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