With Every Heartbeat Is Life:  A Community Health Worker's Manual for African Americans

Session 5
Be Heart Smart: Keep Your Cholesterol in Check


Contents



Objectives

By the end of this session, group members will:

  • Know what cholesterol is and how it affects the body.
  • Know what healthy cholesterol levels are.
  • Learn the steps they can take to lower their blood cholesterol levels.

Materials and Supplies

To conduct this session, you will need:

  • "With Every Heartbeat Is Life" manual and picture cards
  • Blackboard and chalk or several large pieces of paper, markers, and tape
  • How To Make an Artery Model
  • How To Explain the Artery Model
  • One empty paper towel roll
  • Scissors
  • Red construction paper and tape or red felt with sticky backing
  • Red and yellow modeling clay
  • Six paper plates
  • Set of measuring spoons
  • Can of shortening or lard
  • Bottle of vegetable oil*
  • Choice of three of the following foods:*
    • Cooked beans
    • Beef hotdog
    • Orange
    • Regular mayonnaise
    • American cheese
    • Fried chicken (wing and thigh)
    • Snack cakes (packaged cupcakes)

* You can use pictures of these foods.

Handouts

Give group members these handouts during this session:

Prepare this list before the session. You may find information at your local health department, hospital, or clinic.

Session Outline

Introducing the Session

  1. Welcome
  2. Review of Last Week's Session
  3. About This Session

Conducting the Session

  1. Facts About Blood Cholesterol
  2. Cholesterol and Heart Disease
  3. What Are Your Numbers?
    1. What Are Triglycerides?
    2. Metabolic Syndrome and Your Health
  4. Healthy Arteries Activity
  5. (Optional) Make Your Health a Regular Appointment: A Role Play at Ms. Faye's Hair Salon
  6. Facts About Saturated Fat, Trans Fat, and Cholesterol
  7. Food Label Activity—Fats
  8. Guess the Fat Activity
  9. Cooking With Less Saturated Fat Activity
  10. Making Your Favorite Family Recipes With Your Heart in Mind—Recipe Substitutions
  11. Soul Food Makeover—Chicken Gumbo Recipe

Review of Today's Key Points

Weekly Pledge

Closing


Introducing the Session

  1. Welcome
    • Welcome group members to the session.
  2. Review of Last Week's Session
    • Say:
      Last week, we talked about salt and sodium.
    • Ask the questions below, and give the correct answers if group members do not.
    • Q: Who remembers why you should try to limit the amount of salt and sodium in your diet?
      A: You should cut back on salt and sodium to help prevent or lower high blood pressure.
    • To cut back on salt and sodium, you can:
      • Check the food label to choose foods lower in sodium.
      • Use herbs and spices instead of salt to season foods.
      • Eat more fruits, vegetables, and fat-free or low-fat milk products for snacks.
        People who have trouble digesting lactose found in milk products can eat or drink lactose-free products, such as low-fat soy milk.
      • Choose low-sodium or unsalted nuts, pretzels, and popcorn.
    • Say:
      At the end of our last session, you made a pledge to choose foods lower in salt and sodium. Share with the group what you did. What problems did you have? How did you solve them?
    • Note: Allow 5 minutes for group members to respond.
    • Ask:
      Has anyone completed the family health history?
      Note: Give a prize to group members who have completed the family health history.
    • Ask:
      Do any of you want to share what you have learned about your family
      health history?
      Note: Allow 5 minutes for group members to respond.
  3. About This Session
    • Say:
      Sojourner Truth said, "It is the mind that makes the body."
    • Ask:
      What does this quote mean to you?
      Note: Allow 5 minutes for group members to respond.
    • Say:
      Today we are going to talk about high blood cholesterol as a risk factor for heart disease. You will learn what you can do to keep your blood cholesterol levels low. We will also do some group activities that show how much saturated fat is in some foods and how to cook with less saturated fat. We will also learn how to keep trans fat and cholesterol intake low.

Conducting the Session

  1. Facts About Blood Cholesterol
    • Say:
      If a person's blood cholesterol level is too high, he or she is more likely to get heart disease. Here are some facts about blood cholesterol:
      • Nearly half of African American women and more than one in three African American men have a blood cholesterol level that is too high.
      • African American adults are less likely than white adults to have their blood cholesterol checked.
  2. Cholesterol and Heart Disease
    • Note: This section explains what cholesterol is, why the body needs cholesterol, how much cholesterol the body needs, and where cholesterol comes from.
    • Say:
      Cholesterol is a soft, waxy, fat-like substance found in the body. Your body uses cholesterol to produce hormones and some vitamins.
    • Show picture card 5.1.
    • Say:
      Cholesterol comes from two sources:
      • Your liver makes all the cholesterol your body needs to keep you healthy. When cholesterol is produced, it goes into the bloodstream. The cholesterol that travels in your bloodstream is called blood cholesterol.
      • Cholesterol also comes from the food you eat. Foods that come from animals have cholesterol. The cholesterol from foods you eat is called dietary cholesterol. Other types of fat in foods that raise cholesterol are saturated fat and trans fat. Today we will learn how to lower your intake of these fats.

        When too much cholesterol is in the blood, it leads to increased risk of a heart attack, stroke, and other health problems.
    • Ask:
      Do any of you know someone who has high blood cholesterol?
    • Note: Allow about 2 minutes for group members to respond.
    • Say:
      Several things affect your blood cholesterol level. You cannot change some of these things, such as your age, gender, or family history (having family members with high blood cholesterol). But you can change the types of food you eat, the amount of physical activity you do, and your weight.
    • Say:
      You can help prevent or lower high blood cholesterol by:
      • Eating a heart healthy diet low in saturated fat, trans fat, and cholesterol
      • Being active every day
      • Maintaining a healthy weight
    • Show picture card 5.2.
    • Say:
      Let's look at how cholesterol travels through the blood.
      • Cholesterol travels through the bloodstream in the form of packages called "lipoproteins." These packages are made of fat and protein.
      • Low-density lipoproteins, or LDL, carry the cholesterol to your blood vessels, clogging them like rust in a pipe. This is why LDL cholesterol is often called the "bad" cholesterol.
      • Cholesterol also travels in the blood in high-density lipoproteins, or HDL. HDL helps to remove cholesterol from your body. This is why HDL cholesterol is often called the "good" cholesterol. Picture it this way:
        • The LDL person in the car (bad blood cholesterol) throws fat and cholesterol into the street (blood vessels).
        • The HDL person (good blood cholesterol) cleans up fat and cholesterol deposited by the LDL and puts it in the trash (liver).
        • Just remember the "L" in LDL for Lousy, and the Lower it is, the better. Remember the "H" in HDL for Healthy, and the Higher it is, the better.
  3. What Are Your Numbers?
    • Show picture card 5.3.
    • Ask:
      How do you find out if you have high blood cholesterol levels or too much fat in your blood?
    • Say:
      Your blood cholesterol levels are measured with a blood test. The test can be done at a doctor's office or at a cholesterol screening (for example, at a health fair).
      • A lipid profile is the blood test done at the doctor's office. It is a complete test to measure the levels of each type of fat in the blood. It measures total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides. (We will talk about triglycerides later.) You have to fast for 12 hours before this test. This test is recommended for adults age 20 and older.
      • Screening sites may only test total cholesterol and sometimes HDL cholesterol. If you are an adult age 20 or older, you may need to follow up with the doctor for a complete lipid profile.
    • Ask:
      Have you ever had your blood cholesterol checked? If you have, do you remember your levels?
      Note: Allow a moment for group members to respond.
    • Give group members the "Take Action To Control Your Cholesterol" handout. Review the cholesterol levels.
    • Note: If participants should ask, explain that cholesterol is measured in milligrams per deciliter (mg/dL).
    • Show picture card 5.4.
    • Say:
      Here are what the total cholesterol numbers (mg/dL) mean:
      Less than 200 mg/dL Desirable—Keep up the good work.
      200– 239 mg/dL Borderline high
      • Depending on your other risk factors, you may be at a higher risk for heart disease.
      • It is time to change your eating habits, increase your physical activity, and lose weight if overweight.
      240 or more mg/dL High
      • You are at a higher risk for clogged arteries and a heart attack.
      • Ask your doctor what your risk is for heart disease.
    • Say:
      Here is what your LDL and HDL cholesterol numbers mean:
      LDL (bad) cholesterol: Keep it low!
      Less than 100 mg/dL Desirable
      100–129 mg/dL Near desirable
      130–159 mg/dL Borderline high
      160 or more mg/dL High
      HDL (good) cholesterol:

      The higher the better!

      Keep it above 40 mg/dL.

    • More Information

      Heart Disease Risk and Your LDL Level

      The goal for the LDL (bad cholesterol) level is different for everyone. It depends on the risk factors you have. The number of risk factors—such as high blood pressure, low HDL, family history of heart disease, age, gender, and smoking—affects your LDL goal. The higher your LDL level and the more risk factors you have, the greater your chances of developing heart disease or having a heart attack. Your doctor can help you set a goal for your LDL level.

    1. What Are Triglycerides?
      • Say:
        Have any of you heard of triglycerides?
        Note: Allow 2 minutes for group members to respond.
      • Say:
        Triglycerides are another type of fat in the blood. When you eat too many calories, drink alcohol, or smoke, your body makes more triglycerides. When your triglycerides are high, it puts you at increased risk for heart disease.
      • Say:
        A healthy triglyceride level is less than 150 mg/dL.
      • Say:
        People with high triglycerides often have low HDL cholesterol (good cholesterol). People with diabetes can also have high triglycerides and low HDL cholesterol.
      • Say:
        To have a healthy triglyceride level:
        • Maintain a healthy weight or lose weight if you are overweight.
        • Be physically active on all or most days of the week.
        • Eat a heart healthy diet that is low in saturated fat, trans fat, and cholesterol.
        • Limit candy, sweets, regular soda, juice, and other drinks high in sugar.
        • Avoid smoking cigarettes and drinking alcohol. Smoking raises triglycerides and lowers HDL cholesterol. Excess alcohol also raises triglycerides.
      • More Information

        Here is what your triglyceride number (mg/dL) means:

        Less than 150 mg/dL Normal
        150–199 mg/dL Borderline high
        You may be at an increased risk for heart disease. To lower your level, aim for a healthy weight, and be more physically active.
        200–499 mg/dL High
        Weight control and physical activity are very important to lower your level. Watch out for other heart disease risk factors such as overweight and obesity, diabetes, low HDL, and high blood pressure.
        500 or more mg/dL Very high
        See your doctor immediately! This level requires attention to prevent severe problems with your pancreas.
      • Ask:
        Do you know what your triglyceride level is?
      • Note: Allow a few minutes for group members to respond.
      • Encourage group members to make an appointment to have their cholesterol and triglycerides checked.
        • Tell them to be sure to ask for their results and to write them on their wallet cards.
        • Give group members a list of clinics and hospitals where they can get low-cost or free blood cholesterol testing.
    2. Metabolic Syndrome and Your Health
        • Say:
          • Now, we're going to learn about metabolic syndrome. Metabolic syndrome is a disorder that is made up of a group of five factors that affect heart health.
          • Many people have this health problem and don't know they have it.
          • About one in five African American women has metabolic syndrome.
          • About one in seven African American men has metabolic syndrome.
        • Say:
          Let's name the five risk factors that make up metabolic syndrome. Hold up your fist and raise one finger for each risk factor you have.
        • Show picture card 5.5.
        • Say:
          The five risk factors that make up metabolic syndrome are:
            1. A high waist measurement:
            • Greater than 35 inches for women
            • Greater than 40 inches for men
            2. A triglyceride level of 150 mg/dL or more
            3. A low HDL (good) cholesterol level:
            • Less than 50 mg/dL for women
            • Less than 40 mg/dL for men
            4. A blood pressure of 130/85* mmHg or more (either number that is high counts as a risk)
            5. Higher than normal fasting blood glucose levels (100 mg/dL or more)

          *The blood pressure level considered a risk factor for metabolic syndrome is 130/85 (mmHg). This level is different than the level that defines high blood pressure, which is 140/90 (mmHg).

           

        • Ask:
          How many fingers (factors) do you have raised?
        • Say:
          • If you have at least three of these risk factors, you have metabolic syndrome.
          • Metabolic syndrome raises your chances of developing heart disease, diabetes, or stroke.
          • People with metabolic syndrome should lose weight and become physically active.
        • Say:
          If you think you have metabolic syndrome, talk to your doctor.

         

      1. Healthy Arteries Activity
        • Note: This section uses the picture cards and an artery model to show how cholesterol can collect on the walls of the arteries and slow down and block the flow of blood. Blocked arteries can cause a heart attack or stroke.
        • Show picture card 5.6.
        • Say:
          Blood flows freely to all cells of the body when arteries are normal and healthy.
        • Say:
          When your LDL cholesterol is too high, cholesterol may become trapped in the walls of the arteries, causing them to harden. The opening of the arteries can become clogged and narrowed.
        • Show the artery model.
        • Note: See the next two pages to help you explain the artery model.
        • Pass the artery model around so that group members can look at it closely.
        • Ask:
          Have you ever seen someone fry food with lard and dump the hot lard down the sink?
        • Allow a moment for group members to respond. Then ask them why they should not do this.
        • Say:
          You should not do this because the lard will clog the pipes. Foods high in saturated and trans fat will clog your pipes (arteries). So we want to treat our bodies just as well as we treat our pipes.

        How To Make an Artery Model

        What you will need:

        • one empty paper towel roll
        • scissors
        • red construction paper and tape or red felt with sticky backing
        • red modeling clay
        • yellow modeling clay

        What you need to do:

        1. Cut construction paper or felt to fit around the outside of the roll.
        2. Tape construction paper or stick felt around the outside of the roll.
        3. Roll out thin pieces of yellow and red clay into doughnut-shaped figures.
        4. Make one small round ball of the red clay.

        How To Explain the Artery Model

        1. Place the doughnut-shaped pieces of red clay on the outside edge of both ends of the roll.
          Say:
          This is a healthy artery. The blood can flow through the opening easily.

        2. Add pieces of the yellow clay to the inside edge of the red clay on one end of the roll.
          Say:
          This is the beginning of a clogged artery. Cholesterol is starting to build up.

        3. Continue to add pieces of yellow clay to this end of the roll. Add pieces until you almost fill in the opening completely.
          Say:
          The opening of the clogged artery is getting smaller. Blood cannot flow through easily.

        4. Put a red ball in the small opening that is left at the end of the roll.
          Say:
          When the inside of an artery becomes narrowed, a blood clot may block an artery going to the heart. This may cause a heart attack. If the blood clot blocks an artery going to the brain, it may cause a stroke, or "brain attack." Other problems caused by narrowed arteries are angina (chest pain) and poor blood circulation.

      2. (Optional) Make Your Health a Regular Appointment: A Role Play at Ms. Faye's Hair Salon
        • Note: Ask for two volunteers to be the actors in the role play. Give these two group members the "Make Your Health a Regular Appointment: A Role Play at Ms. Faye's Hair Salon" handout (pages 157). As the trainer, you can read the introduction.
        • Ask:
          • What are some of the lessons you learned from this role play?
          • Is there any part of the role play that you can use in your own life?
            Note: Allow 5 minutes for group members to respond.
      3. Facts About Saturated Fat, Trans Fat, and Cholesterol
        • Say:
          Today, we will talk about the different types of fat and how they affect heart health.
          • There are two main types of fat—saturated fat and unsaturated fat. Most foods contain some of both types. The total fat found in foods is its saturated fat plus its unsaturated fat.
          • Saturated fat is found in foods that come from animals, such as high-fat meat, cheese, milk, and butter.
          • A type of unsaturated fat called trans fat also raises cholesterol. Trans fat is found in a variety of baked goods (such as cookies, pies, and pastries), fried foods, stick margarine, and vegetable shortening. Choose light margarine (soft tub) instead of stick (hard) margarine and look for trans fat-free spreads.
          • Eating too much saturated fat and trans fat will raise your blood cholesterol level more than anything else you eat. This will increase your chances of developing heart disease.
        • Say:
          It is important to limit the saturated fat and trans fat you eat, but you need some dietary fat to be healthy. Fats are necessary because they are used by the body to:
          • Store and provide energy.
          • Help carry vitamins A, D, E, and K throughout the body.
        • Ask:
          What types of fat do you use to cook your food?
        • Note:Allow 3 minutes for group members to respond. Write their answers on the blackboard or on a large piece of paper taped to the wall.
        • Show group members a stick of butter (or a can of lard).
        • Say:
          • Butter, shortening, and lard are examples of foods high in saturated fat.
          • Saturated fat is usually solid at room temperature.
          • Saturated fat is usually found in foods from animals.
        • Show picture card 5.7.
        • Say:
          Here are some foods that are high in saturated fat:
          • Whole milk and products made from whole milk (regular cheeses, sour cream, and evaporated whole milk)
          • Ice cream and whipped cream
          • Fatty cuts of meat, such as chuck steak, regular ground beef, ribs, pork chops,
            bacon, pork sausage, beef oxtail, Polish
            sausage (kielbasa), and liverwurst
          • Skin of chicken, turkey, and pig
          • Smothered meat and poultry dishes, such as smothered chicken or pork chops, made with animal fat or grease gravies
          • Chitterlings, which are also called chitlins (pork intestines); pickled pig's feet; and hog maws (hog stomach)
          • Beef or pork hotdogs
          • Foods fried in grease or lard (such as chicken, fish, shrimp, and french fries)
          • Butter
          • Shortening
          • Lard
          • Oils such as coconut, palm, and palm kernel
          • Doughnuts, pastries, cakes, and cookies
          • Cornbread, hushpuppies, spoonbread, biscuits, and other breads made with lard, butter, or shortening
        • Show picture card 5.8.
        • Say:
          Here are foods that are lower in saturated fat:
          • Lean meats such as loin, round, and extra lean ground beef
          • Fish and seafood
          • Turkey bacon
          • Poultry without the skin
          • Beans
          • Rice
          • Tub margarine
          • Fat-free and low-fat milk, cheese, yogurt, and evaporated milk (or lactose-free products for people who have trouble digesting lactose found in milk products)
          • Vegetable oil
          • Breads (made without butter or lard)
          • Fruits and vegetables
        • Say:
          You want to limit the amount of saturated fat in your diet.
        • Show group members a bottle of vegetable oil.
        • Say:
          Unsaturated fats are usually liquid at room temperature. As mentioned before, a few oils (coconut, palm, and palm kernel) are high in saturated fat.
        • (Optional) Say:
          The types of unsaturated fats are polyunsaturated and monounsaturated.
        • More Information

          Polyunsaturated fat is found in:

          • Vegetable oils
            • Safflower oil
            • Corn oil
            • Sunflower oil
            • Soybean oil
          • Some types of fish

          Monounsaturated fat is found in:

          • Vegetable oils
            • Canola oil
            • Olive oil
            • Peanut oil
          • Avocados
          • Nuts
        • Give group members the "Fats and Oils To Choose" handout.
        • Say:
          The graph will quickly show you which products have the least amount of saturated fat.
        • Ask:
          What three oils have the least amount of saturated fat?
        • Say:
          Canola, safflower, and sunflower oils have the least amount of saturated fat.
        • Say:
          Although polyunsaturated and monounsaturated fats are better for our health than saturated fat, we need to eat less of all types of fat. Fats are high in calories, and all fats have the same number of calories. Cutting back on calories helps us lose weight. We will talk about this at the next session.
        • Show picture card 5.9.
        • Say:
          Foods high in cholesterol can also raise your blood cholesterol and increase your risk of heart disease. Dietary cholesterol is found only in foods that come from animals. Foods that are highest in cholesterol are:
          • Egg yolks
          • Organ meats, such as liver, gizzards, and chitterlings (chitlins)
          • Pig's feet
          • Whole milk products including butter, cream, ice cream, and cheese
          • Shrimp
        • Show picture card 5.10.
        • Say:
          Foods that come from plants do not contain cholesterol. Foods that do not contain cholesterol include:
          • Fruits, such as bananas, pineapples, mangos, and apples
          • Vegetables, such as tomatoes, green peppers, lettuce, and corn
          • Beans of all varieties
          • Rice, such as brown rice
          • Grains, such as those in corn tortillas and whole-grain bread
          • Cereals, such as oatmeal
        • Say:
          Plant foods that are prepared with an animal product (for example, greens cooked with fatback or bacon grease) have cholesterol.
        • Say:
          Plant foods are generally lower in saturated fat and don't have cholesterol. They also contain a type of dietary fiber (soluble) that is beneficial for lowering cholesterol.
        • Show picture card 5.11.
        • Say:
          Soluble fiber is found in foods such as oats, barley, fruits, vegetables, and cooked dry beans and peas. So this gives you one more reason to
          eat a variety of fruits and vegetables in addition to some whole-grain cereals such as oatmeal and oat bran.

          Fruits and vegetables that are a good source of soluble fiber are citrus fruits (oranges and grapefruits), pears, apples, peaches, bananas, brussels sprouts, green beans, broccoli, cauliflower, peas, baked or sweet potatoes (with skin), corn, okra, cabbage, spinach, collard and mustard greens, and carrots.
        • Say:
          For great sources of soluble fiber, try to include a variety of cooked dry beans. Avoid canned beans that contain high amounts of salt and sodium. Prepare beans at home, flavoring them with celery, garlic, and spices instead of salt.
      4. Food Label Activity—Fats
        • Give group members the "Read the Food Label To Choose Foods Lower in Saturated Fat, Trans Fat, and Cholesterol" handout and the "Pam's Breakfast Choices" handout.
        • Point out on the food label where to find saturated fat, trans fat, and cholesterol.
        • Show picture card 5.12.
        • Say:
        • For a healthier heart, use the Nutrition Facts labels to choose the foods with a lower Percent Daily Value for saturated fat and cholesterol. If you have high cholesterol, you may need to aim for a lower amount of saturated fat and cholesterol. Try to keep trans fat as low as possible. A doctor or registered dietitian can help you with this.
        • Show group members where the Percent Daily Value for saturated fat, trans fat, and cholesterol is found on the food label for whole milk.
        • Say:
          Look at the bottom of the "Read the Food Label To Choose Foods Lower in Saturated Fat, Trans Fat, and Cholesterol" handout. Look at the Percent Daily Value for whole milk and fat-free milk. Which is lower in saturated fat?
        • Say:
          Fat-free milk is lower in saturated fat. One cup of fat-free milk has no saturated fat. One cup of whole milk has 25 percent, or one-fourth, of the Percent Daily Value of saturated fat.
          Note: If group members should ask, explain that people who have trouble digesting milk products may use lactose-free products (such as soy milk). Although some of these alternatives may be lower in fat, they may not provide all of the other nutrients found in milk products. Recommend that they use calcium-fortified, lactose-free products.
        • Say:
          Trans fat is now listed on all food labels. It is listed on a line below saturated fat, as seen here. Compare labels to choose the food lowest in saturated fat, trans fat, and cholesterol.
        • Say:
          Now look at "Pam's Breakfast Choices." We are going to use the food label to practice choosing foods that are lower in fat. First, I am going to tell you about a problem for many busy people. Then we will use food labels to find some solutions.
        • Pam's Problem

          Pam has little time in the morning to prepare breakfast. She often has a
          honey bun or a doughnut. Look at the food labels. Help Pam select some breakfast foods that are lower in saturated fat than her usual choices. Which should she choose? It is important to also compare labels for trans fat and cholesterol amounts.

          Note: The correct answer is underlined.

          • A honey bun or a plain bagel?
          • A jelly doughnut or an english muffin?
          • A banana muffin or a banana?
          • Toast with butter or toast with light, soft tub margarine?
          • Canadian bacon or pork sausage links?
          • Low-fat American cheese or regular American cheese?

        • Ask for a volunteer to describe:
          • What he or she usually eats for breakfast
          • Which foods are higher in fat
          • What lower-fat foods can be chosen to replace them
        • Note: Write the answers on the blackboard or on a large piece of paper taped to the wall. Help the volunteer select some substitutes, if needed.
      5. Guess the Fat Activity
        • Before the session
          1. Buy a can of shortening or a stick of margarine. Also buy paper plates and three foods from this list (or use pictures of the food).
            • 2 ounces American cheese (about the size of a 9-volt battery)
            • 2 tablespoons regular mayonnaise
            • 2 pieces of fried chicken (wing and thigh)
            • 1 beef hotdog
            • 1 cup cooked beans
            • 1 orange
            • 2 snack cakes (1 package)
          2. Foods Teaspoons of Fat (Grams of Fat)
            2 ounces American cheese (about the size of a 9-volt battery) About 5 teaspoons (20 grams)
            2 tablespoons regular mayonnaise (about the size of a ping-pong ball) About 2½ teaspoons (10 grams)
            2 pieces of fried chicken (wing and thigh) About 8½ teaspoons (34 grams)
            1 beef hotdog (1.5 ounces) About 4 teaspoons (16 grams)
            1 cup cooked beans About ¼ teaspoon (1 grams)
            1 orange None
            2 snack cakes (1 package) About 4¼ teaspoons (18 grams)
          3. Write the name of each food you bought on a separate plate.
          4. Look at the following chart. Find the amount of fat for each food you bought.
            Note: You do not have to use all the food in the chart. Choose the foods that are eaten most often in your community.
          5. Using the can of shortening, spoon the amount of fat listed in the chart onto the plate labeled for that food.
          6. Take the remaining plates, and place each food item (or picture of food) on the separate plates.
          7. Put all the plates away until you are ready to do the activity.
        • Group activity
        • Say:
          We are going to play a guessing game that will help you learn about the total fat content of several foods. Learning which foods are higher in fat and how to replace them with foods that contain less fat will help you make healthier choices. Decreasing your total fat intake can help you reduce your saturated fat, trans fat, and calorie intake.
        • Give group members the "Guess the Fat Activity" handout.
        • Show group members the plates of foods (or pictures of food) you prepared ahead of time.
        • Say:
          Guess the number of teaspoons of fat that are found in one serving of each of these foods. Write your guess on the "Guess the Fat Activity" handout.
        • Ask group members to tell you the amount of fat they guessed for the first food item. After group members have shared the amount they guessed, tell them the actual number of teaspoons of fat the food contains. Tell them to write this amount on their handout, too. Bring out the plate of fat you made ahead of time for that food to show them how much it is. Then do this for the other foods.
        • Say:
          As you can see, it is easy to go over the limit for fat when we eat foods higher in fat, such as fried foods, some fast foods, hotdogs, chips, and ice cream. Eating foods lower in total fat will also help you reduce your saturated fat, trans fat, and cholesterol intake. To make it easier to cut back on fat, eat more foods that are lower in fat, such as fruits, vegetables, rice, whole-grain cereals and breads, beans, and fat-free or low-fat milk products. People who have trouble digesting lactose found in milk products should eat lactose-free products.
        • Ask:
          How do you feel about the true amount of fat in the foods you guessed?
        • Note: Allow 3 to 5 minutes for group members to talk about their reactions.
        • Say:
          There are lower-fat substitutes for some of the higher-fat foods we often eat.
        • Review the following list.
        • Foods Lower-Fat Substitutions
          Regular Cheese Fat-free or low-fat cheese*
          Whole milk Fat-free or low-fat milk*
          Regular Sour cream Fat-free or low-fat sour cream or plain yogurt*
          Pork rinds Low-salt crackers
          Beef hotdog Low-fat hotdog
          *Or lactose-free products
        • Say:
          You can also reduce the amount of fat you eat by simply eating foods higher in fat less often or in smaller amounts.
      1. Cooking With Less Saturated Fat Activity
        • Note: This section gives information to help group members cut back on the amount of saturated fat in their diets. This activity will help them understand that they can cut back on the fat in their diets without giving up their traditional foods.
        • Ask:
          Before we do the next activity, can you tell me what you can do to cook with less saturated fat?
        • Note: Allow 3 minutes for group members to respond. Write their answers on the blackboard or on a large piece of paper taped to the wall.
        • Say:
          The next activity shows how to prepare foods with less saturated fat.
        • Give group members the "Cooking With Less Saturated Fat" handout. Review each of the dishes listed. Ask volunteers to read each recipe out loud.
        • Ask:
          Why are the recipes on the handout lower in saturated fat?
        • Note: Allow a few minutes for group members to respond.
        • Add the following reasons if they are not mentioned:
          • Beans are naturally low in fat, and no fat (lard, shortening, or oil) is added.
          • Boiled rice is naturally low in fat, and no fat is added.
          • The potato salad is made with low-fat or fat-free mayonnaise. A little mustard is added for great flavor.
          • The meats selected are lean and are loin or round cuts. Before cooking, the poultry skin is removed and all visible fat is trimmed. The meat and poultry dishes are baked, broiled, stewed, roasted, or grilled instead of fried or prepared with fat such as lard or grease.
          • The fish and seafood dishes are baked, braised, stewed, or grilled without using fat such as lard or grease.
          • The fat is drained from the cooked ground meats.
          • The fruit shake is made with fat-free milk instead of whole milk.
      2. Making Your Favorite Family Recipes With Your Heart in Mind—Recipe Substitutions
        • Say:
          Many of us have favorite recipes that have been in our families for generations. We don't have to give up cooking these recipes altogether if we want to be heart healthy.
        • Give each group member the "Recipe Substitutes" handout.
        • Say:
          Let's read the recipe substitutions that provide some heart healthy options for ingredients and measurements common to many recipes.
        • Ask for a volunteer to read the handout aloud.
        • Try these substitutions the next time you are preparing one of your
          favorite dishes.
      3. Soul Food Makeover—Chicken Gumbo Recipe
        • Give group members the "Soul Food Makeover—Chicken Gumbo Recipe" handout.
        • Ask:
          How has saturated fat been reduced in this recipe?
          Note: Allow a moment for group members to respond.
        • Add the following answers if they are not mentioned:
          • The dish is made with chicken without the skin.
          • It uses chicken breasts, which are lower in fat than chicken thighs.
        • Say:
          Remember that foods lower in fat still contain calories. Check the portion size. If you eat these foods in large quantities, you may gain weight.
        • Ask if there are any questions. Encourage group members to try this recipe at home this week.

      Review of Today's Key Points

      • Say:
        Let's review what you've learned today.
      • What may cause your arteries to become clogged?
        • Cholesterol buildup will clog the arteries.
      • What is considered a desirable total blood cholesterol level?
        • Less than 200 mg/dL
      • What steps can you take to keep your cholesterol level low?
        • Eat foods lower in saturated fat, trans fat, and cholesterol.
        • Maintain a healthy weight.
        • Stay physically active.
        • Eat a variety of whole grains, fruits, and vegetables.
      • Can you name some foods that are high in saturated fat?
        • Fatty meat, including certain types of meat or animal cuts such as fatback, beef oxtail, and chitterlings (also called chitlins); poultry with skin; whole milk and cheese; butter; lard; and shortening
      • What are some things you can do to make foods lower in fat?
        • Trim the fat from meat before cooking.
        • Take the skin off poultry and throw it away.
        • Bake, boil, broil, or grill food instead of frying it.
        • Skim the fat off soups before serving.
      • Can you name some foods that are high in soluble fiber?
        • Oats, cooked dry beans, and peas
        • Fruits and vegetables such as citrus fruits (oranges and grapefruit), pears, apples, peaches, bananas, broccoli, baked or sweet potato (with skin), carrots, and collard greens

      Weekly Pledge

      • Say:
        You have learned a lot today about preventing high blood cholesterol and how to eat less saturated fat, trans fat, and cholesterol. 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 keep your blood cholesterol in check. 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 take the skin off chicken and throw it away.
        • I will bake fish instead of frying it in lard or grease.
        • I will try low-fat milk or fat-free, lactose-free products, starting this week.
          Note: Allow 5 minutes for group members to think of a pledge.
      • Say:
        Write your pledges on the "Take Action To Control Your Cholesterol" handout. Keep this handout in a special place so you can review your
        pledges and keep your goals in mind.
      • 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 changes in your everyday life to prevent and control high blood cholesterol. Remember that a personal value is a quality that you consider important.
      • Today, the value is self-control. Before making lifestyle changes, it helps to prepare mentally to take control of your health. This is stated in today's quote, "It is the mind that makes the body." Self-control increases your ability to make healthy choices and to take responsibility for the habits you need to change. Self-control also helps you improve your eating habits. For example, it can help you limit portion sizes and stop yourself from going back for second servings.

      • Ask:
        How could you use self-control, 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. Remember to continue to work on your pledge to be physically active and to reduce salt and sodium in your diet. Please continue to work on your family health history.

      Closing

      • Say:
        Thank you for coming today. What did you think of today's session?
      • Note: Wait to see if group members have a response.
      • Say:
        I am looking forward to seeing you at the next session. The next session will be about maintaining a healthy weight.
      • Note: Think about today's session. What worked and what didn't work? Have you decided to make any changes in your own life based on what was covered in today's session?

      Handouts

      Take Action To Control Your Cholesterol

      Do you know your cholesterol numbers?

      Get Checked

      • A lipid profile is a blood test that measures your cholesterol and triglyceride levels.
      • Adults aged 20 and older should have a lipid profile test at the doctor's office.

      Take Action

      • Eating foods lower in saturated fat, trans fat, and cholesterol can help you reduce your blood cholesterol level, reduce your weight, and prevent heart disease.

      Here is what your cholesterol numbers mean.

      Total cholesterol

      Less than 200 mg/dL Desirable. Good for you! Keep up the good work!
      200—239 mg/dL Borderline high. Depending on your other risk factors, you may be at a higher risk for heart disease. It is time to change your eating habits, increase your physcal activity, and lose weight if overweight. Ask your doctor what your risk is for heart disease.
      240 mg/dL or higher High. You are at a higher risk for clogged arteries and a heart attack.
      Ask your doctor what your risk is for heart disease.

      LDL (lousy, bad) cholesterol: Keep it low!

      Less than 100 mg/dL Desirable
      100—129 mg/dL Near desirable
      130—159 mg/dL Borderline high
      160 mg/dL or more High

      HDL (healthy, good) cholesterol (mg/dL): The higher the better! Keep it above 40.

      Write Your Numbers Here

      Triglycerides: Keep your triglycerides below 150 mg/dL.

      How I switched my family from whole milk to fat-free milk

      I slowly changed the milk my family drinks from whole milk to fat-free milk. The first month I served reduced-fat (2%) milk. During the next month I served low-fat (1%) milk. Finally, I made the switch to fat-free milk. The change was so slow that they couldn't even taste the difference.

      Ms. Diane has learned that it's not difficult to get one's family to eat foods lower in saturated fat, trans fat, and cholesterol.

      Try some of these simple changes

      When Shopping

      1. Buy fat-free or low-fat (1%) milk and cheese.*
      2. Buy vegetable oil spray. Spray it on baking pans and skillets instead of using a lot of fat to grease pans.
      3. Use the food label to help you choose foods lower in saturated fat, trans fat, and cholesterol.

      When Cooking

      1. Trim the fat from meat, and remove the skin and fat from chicken and turkey before cooking.
      2. Cook ground meat, drain the fat, and rinse with hot tap water. This removes half the fat.
      3. Cool soups, and remove the layer of fat that rises to the top.

      When Eating

      1. Use fat-free or low-fat salad dressing, mayonnaise, or sour cream.
      2. Use small amounts of tub margarine instead of butter.
      3. Choose fruits and vegetables instead of high-fat foods like chips or fries.

      * Or lactose-free products

      Pam has learned that eating foods high in saturated fat can raise her blood cholesterol level. So she's modified her favorite cobbler recipe by using soft margarine and fat-free milk. Now the cobbler is lower in saturated fat, trans fat, and cholesterol, and it still tastes great.

      Make your personal pledge to do what Pam has done! Look at these examples.

      Breakfast

      Use fat-free or low-fat milk in coffee or on cereal.

      Lunch

      Use leftover roasted turkey to make a sandwich. Eat it with some raw carrots and a banana for dessert.

      Dinner

      Steam fish with allspice, garlic powder, cayenne pepper, lemon, and tomatoes.

      Snack

      Eat an apple instead of tortilla chips that are high in fat.

      The health of you and your family is priceless.
      Make an investment in it!

      Make Your Health a Regular Appointment

      A Role Play at Ms. Faye's Hair Salon

      Ms. Faye is a community health worker and the owner of a hair salon. Ms. Faye talks to Pam, a family friend, while she styles her hair. Pam has an appointment with Ms. Faye every Saturday morning.

      Faye: Are you coming to my cholesterol screening next Sunday at the church's health fair? I'll be giving a talk about eating foods lower in fat and cholesterol.

      Pam: I don't know if I believe all the fuss about high cholesterol. I think what's really hurting us is all the chemicals put into foods.

      Faye: I had my doubts, too. Then I learned where cholesterol comes from. It comes from our body, the types of foods we eat, and the way we cook food. I also learned that high cholesterol can clog your arteries, and that can cause a heart attack.

      Pam: How do you know whether you have high blood cholesterol?

      Faye: That's what Sunday's screening is about. We do a simple blood test to measure your total blood cholesterol level. When I was screened, I found out that my cholesterol level was too high. That's when I started making changes in my diet.

      Pam: Is that why you switched from your regular sausage, egg, and cheese biscuit to a bagel with low-fat cream cheese and a banana? I was wondering why you stopped asking me to pick up the breakfast special on the way to my appointments with you.

      Faye: That's right. I started eating foods with less fat and cholesterol and being more physically active to keep my weight down. At first, I also had to take medicine prescribed by my doctor. Now I've lowered my cholesterol enough that my doctor said I could stop taking the medicine——as long as I keep up the healthy eating and physical activity.

      Pam: Okay, Ms. Faye. I'll get my cholesterol checked, and I'll even listen to your healthy eating tips.

      Faye: Now you can look good on the outside, and be healthy on the inside.

      Fats and Oils To Choose

      When you do use fats and oils, choose those with less saturated fat.

      Lower in Saturated Fat—Choose More Often

      • Canola, corn, olive, safflower, soybean, and sunflower oils
      • Tub margarine (especially light margarine)

      Higher in Saturated Fat—Choose Less Often

      • Butter
      • Solid shortening
      • Lard
      • Fatback
      • Stick margarine

      Read the Food Label To Choose Foods

      Lower in Saturated Fat, Trans Fat, and Cholesterol!

      Percent of Saturated Fat

      Use this handy graph to help you choose products with the least amount of saturated fat. Look for the ♥

      ♥ Canola Oil 7%
      ♥ Safflower Oil 10%
      ♥ Sunflower Oil 12%
      ♥ Corn Oil 13%
      ♥ Olive Oil 15%
      ♥ Soybean Oil 15%
      ♥ Margarine (tub) 17%
      ♥ Peanut Oil 19%
      Margarine (stick) 20%
      Cottonseed Oil 27%
      Chicken Fat 30%
      Lard 43%
      Fatback 48%
      Bacon Grease 50%
      Palm Oil 51%
      Butter 68%
      Coconut Oil 91%

      Source: Adapted from the Canola Council of Canada. "Canola Oil Dietary Fat." (http://www.canolacouncil.org/PDF/dietarychart.pdf#zoom=100) July 19, 2007.

      Read the Food Label To Choose Foods Lower in Saturated Fat, Trans Fat, and Cholesterol

      Food labels tell you what you need to know about choosing foods that are lower in saturated fat, trans fat, and cholesterol. Here's a food label for a carton of whole milk. The label tells you:

      Whole Milk

      Nutrition Facts
        Whole Milk
      Serving Size 1 cup (fl. oz)
      Servings Per Container 8
      Amount Per Serving Calories 150
      Calories from Fat 70
      Nutrient % Daily Value*
      Total Fat 8g = 12%
      Saturated Fat 5g = 25%
      Trans Fat 0g
      Cholesterol 35mg = 12%
      Sodium 125mg = 5%
      Total Carbohydrate 12g = 4%
      Dietary Fiber 0g = 0%
      Sugars 11g
      Protein 8g
      Vitamin A 6%
      Vitamin C 4%
      Calcium 30%
      Iron 0%
      Vitamin D 25%

      Amount Per Serving
      The nutrient amounts are for one serving. So, if you have more than one serving, you need to add nutrient amounts. For example, if you drink 2 cups of whole milk, you are drinking two servings. You would need to double the amount of calories, saturated fat, trans fat, and cholesterol.

      Nutrients
      Here are the amounts of saturated fat, trans fat, and cholesterol in one serving. These amounts are given in grams (g) or milligrams (mg).

      Serving Size and Number of Servings
      The serving size is 8 fluid ounces (1 cup). There are eight servings in this carton.

      Percent Daily Value
      The Percent Daily Value helps you compare products. Choose products with the lowest Percent Daily Value for saturated fat and cholesterol. If you have high blood cholesterol, you should eat less saturated fat, trans fat, and cholesterol. A doctor or registered dietitian can help you with this.

      The Choice Is Yours—Compare!

      Which one would you choose?

      Except for calories and saturated fat, fat-free milk has all the nutrients of whole milk, including the calcium. That makes fat-free milk a better choice! Read food labels, and choose products to keep your heart strong. Calcium-fortified, lactose-free alternatives such as soy milk have lower fat and provide calcium; however, they may not provide the other nutrients found in milk.

      Whole Milk
      One cup of whole milk has 25 percent of the Daily Value of saturated fat. This is one-fourth of the total amount of saturated fat that you should have in 1 day. This is too much!

      Nutrients % Daily Value*
      Amount Per Serving Calories 150
      Calories from Fat 70
      Total Fat 8g = 12%
      Saturated Fat 5g = 25%
      Trans Fat 0g
      Cholesterol 35mg = 12%
      Sodium 125mg = 5%

      Fat-Free Milk
      One cup of fat-free milk has no saturated fat. You can learn a lot from a food label.

      Nutrients % Daily Value*
      Amount Per Serving Calories 90
      Calories from Fat 0
      Total Fat 0g = 0%
      Saturated Fat 0g = 0%
      Trans Fat 0g
      Cholesterol 5mg = 2%
      Sodium 125mg = 5%

      * Percent Daily Values are based on a 2,000-calorie diet. Your Daily Values may be higher or lower depending on your calorie needs.

      Pam's Breakfast Choices

      Pam has little time in the morning to prepare breakfast. She often has a honey bun or
      a doughnut.

      Look at the food labels. Help Pam select some breakfast foods that are lower in saturated fat than her usual choices.

      Which should she choose? Write the number of your choice for each pair in the space between the labels.

        Food 1 Food 2
      Nutrient Honey Bun Plain Bagel
      Serving Size 1 bun (85g) 1 bagel (75g)
      Servings Per Container 6 6
      Amount Per Serving Calories = 360
      Calories from Fat 170
      Calories = 210
      Calories from Fat 5
      Total Fat 19g = 29% 1g = 0%
      Saturated Fat 5g = 25% 0g = 0%
      Trans Fat 0g 0g
      Cholesterol 0mg = 0% 0mg = 0%
      Sodium 280mg = 12% 390mg = 16%
      Total Carbohydrate 43g = 14% 43g = 14%
      Dietary Fiber 1g = 4% 2g = 8%
      Sugars 18g 2g
      Protein 4g 8g
      Vitamin A 0% 0%
      Vitamin C 0% 0%
      Calcium 15% 6%
      Iron 10% 15%



        Food 3 Food 4
      Nutrient Jelly Dooughnut English Muffin
      Serving Size 1 doughnut (85g) 1 muffin (57g)
      Servings Per Container 1 6
      Amount Per Serving Calories = 300
      Calories from Fat 140
      Calories = 130
      Calories from Fat 10
      Total Fat 16g = 24% 1g = 2%
      Saturated Fat 4g = 20% 0g = 0%
      Trans Fat 5g 0g
      Cholesterol 5mg = 2% 0mg = 0%
      Sodium 130mg = 5% 290mg = 12%
      Total Carbohydrate 38g = 13% 25g = 8%
      Dietary Fiber 0g = 0% 1g = 4%
      Sugars 22g 4g
      Protein 3g 4g
      Vitamin A 0% 0%
      Vitamin C 0% 0%
      Calcium 8% 15%
      Iron 8% 8%



        Food 5 Food 6
      Nutrient Banana Muffin Banana
      Serving Size 1 muffin (128g) 1 medium (126g)
      Servings Per Container 1 1
      Amount Per Serving Calories = 420
      Calories from Fat 180
      Calories = 110
      Calories from Fat 0
      Total Fat 20g = 31% 0.5g = 1%
      Saturated Fat 4g = 20% 0g = 0%
      Trans Fat 1g 0g
      Cholesterol 65mg = 22% 0mg = 0%
      Sodium 380mg = 16% 0mg = 0%
      Total Carbohydrate 55g = 18% 29g = 10%
      Dietary Fiber 1g = 4% 1g = 4%
      Sugars 29g 21g
      Protein 5g 1g
      Vitamin A 2% 0%
      Vitamin C 4% 0%
      Calcium 2% 0%
      Iron 8% 0%



        Food 7 Food 8
      Nutrient Butter Light Margarine (Soft Tub)
      Serving Size 1 Tbsp (14g) 1 Tbsp (14g)
      Servings Per Container 32 80
      Amount Per Serving Calories = 100
      Calories from Fat 100
      Calories = 50
      Calories from Fat 50
      Total Fat 11g = 17% 6g = 9%
      Saturated Fat 8g = 40% 1.5g = 8%
      Trans Fat 0g 0g
      Cholesterol 30mg = 10% 0mg = 0%
      Sodium 85mg = 4% 55mg = 2%
      Total Carbohydrate 0g = 0% 0g = 0%
      Dietary Fiber 0g = 0% 0g = 0%
      Sugars 0g 0g
      Protein 0g 0g
      Vitamin A 8% 10%
      Vitamin C 0% 0%
      Calcium 0% 0%
      Iron 0% 0%
      Vitamin E 0% 0%



        Food 9 Food 10
      Nutrient Canadian Bacon Pork Sausage Links
      Serving Size 2 slices (2 oz.) 3 links (2.5 oz)
      Servings Per Container 6 8
      Amount Per Serving Calories = 90
      Calories from Fat 35
      Calories = 190
      Calories from Fat 150
      Total Fat 4g = 6% 16g = 25%
      Saturated Fat 1g = 5% 6g = 30%
      Trans Fat 0g 0g
      Cholesterol 30mg = 10% 20mg = 7%
      Sodium 800mg = 33% 380mg = 16%
      Total Carbohydrate 1g = 0% 1g = 0%
      Dietary Fiber 0g = 0% 0g = 0%
      Sugars 0g 1g
      Protein 12g 10g
      Vitamin A 0% 0%
      Vitamin C 0% 0%
      Calcium 0% 0%
      Iron 2% 4%



        Food 11 Food 12
      Nutrient Low-fat American Cheese Regular American Cheese
      Serving Size 1 oz 1 oz
      Servings Per Container 8 7
      Amount Per Serving Calories = 50
      Calories from Fat 15
      Calories = 120
      Calories from Fat 90
      Total Fat 1.5g = 2% 10g = 15%
      Saturated Fat 1g = 5% 7g = 35%
      Trans Fat 0g 0g
      Cholesterol 0mg = 0% 30mg =1 0%
      Sodium 220mg = 9% 180mg = 8%
      Total Carbohydrate 1g = 0% 0g = 0%
      Dietary Fiber 0g = 0% 0g = 0%
      Sugars 0g 0g
      Protein 8g 6g
      Vitamin A 4% 6%
      Vitamin C 0% 0%
      Calcium 10% 20%
      Iron 0% 0%



      Note: Percent Daily Values are based on a 2,000-calorie diet. Your Daily Values may be higher or lower depending on your calorie needs.

      Guess the Fat Activity

      Try to guess the amount of fat (in teaspoons) that is found in each food.

      Write your answers on the "My Guess" line.

      Teaspoons of Fat
      Food My Guess True Amount
      2 ounces American cheese
      2 tablespoons regular mayonnaise
      2 pieces of fried chicken (wing and thigh)
      2 snack cakes (1 package)
      1 beef hotdog
      1 cup cooked beans
      1 orange

      Cooking With Less Saturated Fat

      New Orleans Red Beans

      Don't add oil!

      1. In a 5-quart pot, combine red beans, water, onion, celery, and bay leaves. Bring to boiling, then reduce heat.
      2. Cover and cook over low heat for 4½ hours or until beans are tender.
      3. If desired, stir and mash beans against the side of the pan (New Orleans style). Add green pepper, garlic, parsley, thyme, and black pepper.
      4. Cook uncovered over low heat until creamy, about 30 minutes.
      5. Remove bay leaves before serving.

      Boiled Brown Rice

      Don't add oil!

      1. Bring 2 cups of water to a boil, and add 1 cup of brown rice.
      2. Cover well, and cook over low heat for 20 minutes.

      Potato Salad

      1. Wash 2 pounds of potatoes, cut in half, and place in cold water in a saucepan.
      2. Cook covered over medium heat for 25 to 30 minutes or until tender.
      3. Chop celery, scallion, and red and green bell peppers, if desired.
      4. Chop one hard-boiled egg.
      5. Drain and dice potatoes when cool.
      6. Add vegetables and egg to potatoes, and toss.
      7. Blend together low-fat or fat-free mayonnaise, mustard, pepper, and dried dill weed.
      8. Pour blended mixture over potato mixture and stir gently to coat evenly.
      9. Chill for at least 1 hour before serving.

      Poultry and Meat

      1. Remove the skin from chicken and turkey, and throw it away. Cut off chunks of fat from beef and pork, and throw it away.
      2. Add your favorite seasonings, such as garlic, onion powder, sage, or cracked black pepper.
      3. Cook meat by baking, broiling, or grilling—not frying.

      Fish and Seafood

      1. For fresh seafood and fish, clean as desired. If your seafood or fish is canned, rinse thoroughly to reduce the amount of sodium.
      2. Season with seafood spices such as basil, chili powder, dill, marjoram, parsley, rosemary, and thyme to taste. Lemon juice or fresh lemon wedges will add a nice flavor to many seafood dishes.
      3. Cook fish and seafood by baking, broiling, braising, stewing, or grilling—not frying—and use vegetable oil spray to coat pans.

      Spaghetti With Turkey Meat Sauce

      1. Coat a large skillet with vegetable oil spray. Preheat over high heat. Add ground turkey (1 pound). Cook, stirring occasionally, for 5 minutes. Drain off fat.
      2. Stir in a 28-ounce can of diced tomatoes (low- or no-sodium variety), chopped green peppers, onion, garlic, oregano, and black pepper. Bring to boiling, then reduce heat. Simmer covered for 15 minutes, stirring occasionally.
      3. Remove cover, and simmer for an additional 15 minutes.
      4. Meanwhile, cook spaghetti (or other whole-grain pasta variety) according to package directions, and drain well. Serve sauce over spaghetti with crusty, whole-grain bread.

      Fruit Shake

      1. Cut your favorite fruit—such as bananas, oranges, or strawberries—into chunks.
      2. Place in a blender, along with fat-free milk*, vanilla, and ice.
      3. Blend until smooth.

        *Or use lactose-free alternative.

      Recipe Substitutes

      When the recipe calls for: Use these heart smart picks instead:
      1 whole egg 2 egg whites or 1/4 cup egg substitute
      1 cup butter 1 cup soft margarine or 2/3 cup vegetable oil
      1 cup shortening or lard 1 cup soft margarine or 2/3 cup vegetable oil
      1 cup whole milk 1 cup fat-free milk
      1 cup cream 1 cup evaporated fat-free milk
      1 cup sour cream 1 cup fat-free sour cream

      Soul Food Makeover—Chicken Gumbo Recipe

      1 teaspoon vegetable oil
      ¼ cup flour
      3 cups low-sodium chicken broth
      1½ pounds chicken breast, skinless and boneless, cut into 1-inch strips
      1 cup white potatoes, cubed
      1 cup onions, chopped
      1 cup carrots, coarsely chopped
      ¼ cup celery, chopped
      ½ medium carrot, grated
      4 cloves garlic, finely minced
      2 stalks scallions, chopped
      1 whole bay leaf
      ½ teaspoon black pepper, ground
      2 teaspoons hot (or jalapeno) pepper
      1 cup (½ pound) okra, sliced into ½-inch pieces

      1. Add oil to a large pot.
      2. Heat pot over medium flame.
      3. Stir in flour.
      4. Cook, stirring constantly, until flour begins to turn golden brown.
      5. Slowly stir in all the broth using a wire whisk, and cook for 2 minutes. The mixture should not be lumpy.
      6. Add all ingredients except okra. Bring to a boil, then reduce heat and let simmer for 20 to
        30 minutes.
      7. Add okra and let cook for 15 minutes.
      8. Remove bay leaf.
      9. Serve hot in a bowl or over rice.

      Yield: 8 servings
      Serving size: ¾ cup
      Calories: 165
      Total fat: 4 g
      Saturated fat: 1 g
      Cholesterol: 51 mg
      Sodium: 81 mg
      Total fiber: 2 g
      Protein: 21 g
      Carbohydrates: 11 g
      Potassium: 349 g

      The Makeover

      In the past, the Harris family would have used chicken parts that are high in fat, such as chicken thighs. They also would have used chicken skin, which is very high in saturated fat and cholesterol. This made-over recipe has great flavor, and it uses chicken breasts, which are lower in fat than chicken thighs.


      Go To SESSION 4 Go To SESSION 6



      Last Updated December 2010




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