Eat Well. LIVE WELL. Be Well. A Guide to Healthy Living for People with Disabilities Eat Well. LIVE WELL. Be Well. A Guide to Healthy Living for People with Disabilities The research and preparation of this guide was accomplished through a collaborative effort of the New Jersey Department of Human Services, Division of Developmental Disabilities, Office for the Prevention of Mental Retardation and Developmental Disabilities and the Division of Disability Services, the Disability, Health and Wellness Program. Chris Christie Governor Kim Guadagno Lt. Governor Elizabeth Connolly Acting Commissioner NJ Department of Human Services Joseph M. Amoroso Division Director Division of Disability Services Jonathan Sabin Director Office for the Prevention of Developmental Disabilities Jennifer Shore Author Susannah Combs, Harry Pizutelli, Colleen Roche and Michelle Wheeler Editors Partner Agencies Division of Developmental Disabilities The Division of Developmental Disability (DDD) funds services and supports for eligible individuals with developmental disabilities. These services are offered in the community by more than 250 agencies or by more than 600 individuals and in five residential developmental centers administered by the division. DDD assures the opportunity for individuals with developmental disabilities to receive quality services and supports, participate meaningfully in their communities and exercise their right to make choices. www.state.nj.us/humanservices/ddd/home/index.html Office for the Prevention of Developmental Disabilities The mission of Office for the Prevention of Developmental Disabilities (OPDD) is to reduce the frequency of occurrence of severe chronic mental or physical disabilities that originate during pregnancy or early childhood. Preventing developmental disabilities begins long before a woman gets pregnant and continues long after her children are born. OPDD addresses the many facets of prevention by using the life cycle paradigm including: preconception health; prenatal health; infant and child health. www.state.nj.us/humanservices/opmrdd/home/index.html Division of Disability Services The Division of Disability Services (DDS) is designated as the “single point of entry” for information about and access to services for people with disabilities living and working in New Jersey. DDS administers programs that allow people with different types of disabilities to live more independently in the community, and in many cases, avoid the need to move into an institution. DDS does not have disability specific eligibility criteria and thus operates as the cross-disability, human services organization for state government. www.state.nj.us/humanservices/dds/home/index.html Disability, Health & Wellness The New Jersey Disability Health & Wellness (DH&W) Program is a unit within the Division of Disability Services. The DH&W Program consults and collaborates on projects that seek to promote healthy living and prevention of secondary conditions for people with disabilities. The DH&W Program works with policy makers, health educators, public and private agencies, and experts in the field of health and wellness to brainstorm and implement ways to integrate health and wellness options for people with disabilities into the general health promotion activities in existence within the state. www.state.nj.us/humanservices/dds/projects/dhwi/index.html The DH&W Program encourages individuals with disabilities to be proactive in their healthcare. In taking on a healthier lifestyle, you can elevate your overall health and wellness and possibly prevent secondary conditions. In support of these goals, the “Eat Well, Live Well & Be Well” guide provides multiple wellness resources for individuals with disabilities. For more recipes, tips and adaptive resources join us for “Wellness Wednesday” at: www.Facebook.com/NJDHS Preface Health and Wellness for People with Disabilities: Why is it Important? As they say, a journey of a thousand miles begins with one step. Creating a healthy lifestyle is not an overnight process. For most of us it is a life- long process that requires lots of adjustments along the way. This guide is for people with disabilities who are saying to themselves, “I want to live a healthy life, but it seems so complicated; where should I begin?” In addition to discussing, health, fitness, nutrition and cooking tips, this guide will also provide some information on setting up a kitchen that works well for you and tips to make healthy meal preparation a little easier with quite a few quick and easy recipes thrown in for good measure. Why is wellness so important and what does my disability have to do with any of it? The truth is wellness or making healthy choices in all areas of your life, is really important and your disability can play a big role in your ability to stay well. In fact, this topic is so important, there is a program which sets out to “improve the nation’s health”, called Healthy People 2020 (HP 2020). Healthy People 2020 has four main goals: To live longer, healthier lives To improve the overall health of everyone To create social and physical environments that promote good health for all To promote healthy behaviors throughout a person’s lifetime One of many topic areas within HP 2020 is, “Disability and Health” which specifically focuses on the health and wellbeing of people with disabilities. According to the most recent U.S Census, about 1 in 5 people in this country have a disability. That’s about 50 million people! People with disabilities are more integrated into their communities than ever before. Therefore, equal access to all health related services is important. Such services include: medical care, public health activities, intervention/preventative care, dental care, vision care and reproductive care. People with disabilities often have more difficulty accessing healthcare than their nondisabled peers. As a result, they are more likely: To be overweight To smoke To have high blood pressure To not exercise To have fewer social supports Having a disability may also put you at risk for developing secondary health conditions, which are conditions that are brought on, in part, due to your disability. Conditions like osteoporosis, or weakening of the bones, bed sores, asthma, cardiovascular or heart disease and arthritis are all fairly common secondary health conditions people with disabilities may develop. While there is no known “magic pill” to prevent the onset of these conditions, making the decision to live a healthier life and get your body moving will help in more ways than one. As you look through this guide, remember changing habits can be difficult. No one expects that you will be a chef or fitness instructor by next week. But, if slowly but surely, you incorporate one tip into your meal planning here and there and another into your daily routine every once in a while, you might be surprised at what a difference it makes. Disclaimer The information contained in this wellness guide is for educational purposes only and should not replace the care and/or advice of your doctor and healthcare providers. Talk to your doctor before making any big changes to your diet or physical activity levels. This guide offers health, fitness and nutritional information and is designed to familiarize you with the basics of a healthy lifestyle. It is not medical advice. If you have any concerns or questions about your health, you should always talk with your doctor or healthcare providers. If you think you are having a medical or health emergency, call your doctor, or 911, immediately. “Health is a state of complete physical, mental, and social wellbeing and not merely the absence of disease or infirmity” ~ World Health Organization 1948 Table of Contents Nutrition 101Page 1 Meal PlanningPage 10 Let’s Go ShoppingPage 18 Meal PreparationPage 23 Healthy Eating HabitsPage 32 Healthy Lifestyle Changes and Community Resources Page 39 Emergency PreparednessPage 49 Recipe FinderPage 55 Appendix APage 27 Appendix BPage 29 Editor’s Note: Having the tools and information to make healthy choices and knowing how to prevent illness is a key part of staying well. This book is intended for individuals who may be living on their own for the first time and not know how to set up a kitchen, shop for groceries, or the basics of cooking. The recipes contained in this book are a sample of recipes that contain a limited number of ingredients and steps, to make it relatively easy for individuals to shop and eat healthier. Nutrition 101 Everything You Ever Wanted To Know About Nutrition Eating a balanced diet is an essential part of leading a healthy lifestyle. Regularly eating the right amounts and kinds of foods can help maintain a healthy weight and reduce risk for developing many conditions such as diabetes and heart disease. My Plate is a diagram you can use to help make better food choices. You can find more information at www.choosemyplate.gov. Each food group shown in the photo below provides different nutrients that your body needs to stay healthy. When thinking about a plate; make it your goal to fill half of your plate with fruits and vegetables, a quarter with lean protein and another quarter with whole grains. Then, add a serving of low fat dairy and you have a healthy meal! Protein: building blocks of the body needed for healthy functioning of all major body systems. Calories: amount of food energy contained in a food. Fat: the major storage form of energy in the body. Suggested Daily Intake Fruit: Adults should eat between 1½ to 2 cups of fruit every day. Fruit is great for a snack, side item or dessert. Vegetables: Adults should eat 2½ to 3 cups of vegetables per day. Try to pick a variety of colors when selecting veggies at the store. Protein: Adults should eat 5 to 6 ounces of protein per day. Meat, seafood, beans, nuts and eggs are all considered protein. Grains: Adults should eat 5 to 7 ounces of grains per day. Choose whole grains like whole wheat bread and pasta, brown rice, oatmeal and whole wheat cereal instead of refined (white) grains whenever possible. Dairy: Adults should eat less than 3 servings of low-fat dairy (milk, yogurt, cheese) per day. Water: Adults should drink their total body weight divided by 2 ounces of water per day. Remember there are 8 ounces in one cup. For example, if you weigh 150 pounds 150 / 2 = 75 ounces per water per day. That’s just over 9 cups. 1 What’s In My Food? To make healthy food choices, you need to begin by knowing what is in your food. Food is the fuel for your body. If you put unhealthy foods into your body, they are not going to work as well as they could or should. On the other hand, if you eat healthy foods as much as possible, your body will not only feel better, but look better too. Nutrients in your food help make your hair stronger, skin smoother, fingernails less brittle and have many other benefits. So, what is in your food? This section explores what your food is made of and tips for making better choices for your wellbeing. Fats Most foods contain several different kinds of fat, and some are better for your health than others. It’s wise to choose to eat healthier types of fat— in moderation. “Not All Fats are Created Equal” “Bad” Fats are mostly saturated, which means they are solid at room temperature and contain trans-fat. Saturated fat: This is a type of fat that most often comes from animal sources, such as red meat, poultry and full-fat dairy products and raises total blood cholesterol levels, especially “bad” low-density lipoproteins (LDL). Trans-fat: Most trans-fats are made from oils through a food processing method called partial hydrogenation. Studies show that these partially hydrogenated trans-fats can increase unhealthy LDL cholesterol and lower healthy high-density lipoprotein (HDL) “good” cholesterol. Examples include beef fat, pork fat, butter, shortening and margarine. “Good” Fats are mostly unsaturated which means they are liquid at room temperature. Monounsaturated fat: This is a type of fat found in a variety of foods and oils. Studies show that eating foods rich in monounsaturated fats (MUFAs) lowers blood cholesterol levels. Examples include macadamia nuts, olives, avocados and peanut butter. Polyunsaturated fat: This is a type of fat found most often in plant-based foods and oils. Studies show that eating foods rich in polyunsaturated fats (PUFAs) lowers blood cholesterol levels, which can decrease your risk of heart disease and type 2 diabetes. (For more information on diabetes see page 41) Examples include mackerel, trout and herring. Omega-3 fatty acids: are most often found in fatty fish. Total fat: This includes all types of dietary fat. 2 IPS NOTES AND T t intake to fa l ta to r u o y Limit f your daily o t n e c r e p 5 20 to 3 n a 2,000o d e s a B . s ie r calo this amounts t, ie d y a d a calorie ms of total a r g 8 7 4 4 to about fat per day. Carbohydrates Carbohydrates are an important source of energy for your body. Your digestive system changes carbohydrates into glucose or sugar, and uses this sugar for energy. Low-fat dairyWhole grainsBeansLegumes NutsSeedsFruitsVegetables “Bad” Carbohydrates are simple carbohydrates that are higher in sugar and lower in fiber and only provide your body with quick short bursts of energy. Examples include: SodaCandySugarWhite rice White pasta White bread The 411 on Sugar When it Comes to Sugar – Moderation is the Key On food labels, sugar is part of the amount that makes up a food’s total carbohydrates. Does that make sugar good or bad? Sugar is a perfect example of a food that is not good for you, but can be eaten in moderation. If your diet contains large amounts of it on a regular basis, you may begin to see negative health consequences like obesity, heart disease, and diabetes. (For more information on diabetes see page 41.) Sugar has many names and many forms. Here are some of the names of sugar you may find in an ingredient list: Agave Nectar Evaporated cane juice Malt syrup Brown sugar FructoseMaple SyrupCane crystals Raw sugar Fruit juice concentrates Molasses Cane sugar Glucose Corn sweetener High-fructose corn syrup Sucrose Maltose Corn syrup Crystalline fructose Invert sugar Dextrose Here is a list of artificial sweeteners you may find in ingredient lists: aspartame, aspartame-acesulfame salt, cyclamate, erythritol, glycerol, glycyrrhizin, hydrogenated starch hydrolysate (HSH), isomalt, lactitol, maltitol, mannitol, neotame ,polydextrose, saccharin, sorbitol, sucralose, tangatose and xylitol. Remember: 4 grams of sugar = 1 teaspoon of sugar. Type Total Calories Recommended Per Day Total Calories Per Teaspoon Total Calories Per Gram Women 100 calories 6 teaspoons 24 grams Men 150 calories 9 teaspoons 36 grams *The American Heart Association (AHA) 3 How Much Should I Eat? Portion Sizes Explained With restaurants offering enormous plates of food, huge drink cups and king-sized packages, it can be hard to know how much to eat at any given time. Even at home, the size of dinner plates, muffin tins and pizza pans have grown. As everything gets bigger, bigger starts to seem like the norm, distorting how we think about a serving size. The following are tips to keep the number of calories you eat at one sitting in a healthy range: Know how many calories you should be ingesting every day. A doctor or nutritionist can help you establish the amount you need. Keep track of how many calories you ingest, or eat and how many calories you expend, or burn through normal activity or exercise. When you exercise, you’ll burn more calories than sitting still. It is important to think of any movement as exercise. Walking, gardening, fidgeting, and cleaning are all activities that burn calories. Read labels and only eat the correct serving size. Place the food you intend to eat on a plate and put the rest away. Buy smaller dinner plates. Try to eat off of a 9-10 inch plate. Eat foods that have high nutritional value so your calories count! 100 calories of potato chips offer your body none of the nutrients it needs. 100 calories of blueberries, on the other hand, provide numerous vitamins. An added bonus to eating food with high nutritional value is that you can eat more! 100 calories of blueberries is over 1 ¼ cups of berries. 100 calories of potato chips is only 9 chips. Portion Control at your Fingertips! 1 tsp. = tip of your thumb to the middle joint 1 tbsp. = your whole thumb 1 cup = your fist 4 3oz. of meat = the palm of your hand Waiter, Check Please! Going Out to Eat It is easier to control food choices when you are at home. It’s a whole different ball game when you go out to eat. The food looks great, the portions are huge, and best of all, you don’t have to prepare it! Unhealthy food choices are everywhere and it’s not difficult to be tempted by them. Here are some general guidelines to help you make better choices when eating out: 10 Tips for Eating Out 1. Ask to “triple the vegetables, please”. 2. Order from the “healthy, light, low fat” entrées on the menu. 3. Beware of the low-carb options. They aren’t always low-calorie. 4. Ask the server to box half of your meal to go before it ever gets to the table. Or, split a meal with your dining partner. 5. Order a salad before ordering anything else on the menu. Salads shouldn’t be fatty. Watch the add-ons to vegetable salads such as cheese, bacon, cold cuts etc. 6. Do the fork dip! Get your dressing on the side, in a small bowl. Dip your empty fork into the dressing, then skewer a forkful of salad. 7. Check the menu online before you leave home. Plan what you are going to order ahead of time. 8. Ask the server to skip the bread basket. If you must have something to munch on while you wait for your order, ask for a plate of raw vegetables or some breadsticks. 9. Top a baked potato with veggies from the salad bar. Salsa can be a great potato topper, both in terms of flavor and health. Try to avoid butter and sour cream. 10. Drink water throughout the meal. IPS NOTES AND T tion control is A key to por ct portion e r r o c e th t u at figuring o nly putting th o d n a t, n u o or am ur plate. o y n o t n u o m a 5 SIZE IT RIGHT! A guide most nutritionists follow as to what one serving size should look like = iPod Classic pasta = ice cream scoop = postage stamp peanut butter = golf ball = matchbox DVD fish potato = = mouse checkbook brown rice salad dressing butter = 1 pancake cheese steak = 1oz shot glass beans = lightbulb 6 = baseball dark chocolate = dental floss Reading Nutritional Labels One way you can tell if you are getting the Recommended Daily Allowances (RDA), which is the estimated amount of a nutrient or calories, per day considered necessary for the maintenance of good health, of a particular nutrient, is by checking the food label. The food label is found on every food package and tells you what is in it. The Big “3” Three Things to Check on Every Food Label 1. Serving size: The information on the label is based on one serving. If a serving size is three cookies the nutritional information on the label is for three cookies, not the entire bag. Tip: Check the serving size before you start eating. Take one serving out of the package, put the package away and then start eating. 2. Calories: The unit of energy contained in the food. Most food labels base their percentages on a 2000 calorie a day diet. This is reflected on the label as “% of DV” or “% of Daily Value- the daily percentage of that food component needed to maintain good health. Tip: Individuals with less mobility may expend less calories in a day and may need less calories to meet their body’s needs. You can speak to a nutritionist and find out how many calories you need daily to meet your body’s needs. 3.Fat: Trans Fat and Saturated Fats are the “Bad Fats” you should try to stay away from. Poly unsaturated and Monounsaturated Fats are the “Good Fats” that are acceptable in moderation. See page 2 for more information about fats. Also on the Label Vitamins: Typically, most labels will reflect the vitamins A, C, Calcium and Iron. The RDA of most vitamins and minerals are difficult to get daily without the assistance of a daily multivitamin. A multivitamin is a single tablet that contains the RDA of vitamins and minerals for healthy adults. Proteins: The RDA for protein is not always listed on food labels. Individual needs for protein vary greatly depending on age, gender and physical activity level. Ingredient list: Foods with more than one ingredient must have an ingredient list on the label. Ingredients are listed in descending order by weight. Those in the largest amounts are listed first. This information is particularly helpful if you have food sensitivities, allergies or other dietary restrictions. 7 MY TIPS! Example of a Food Label To the right is an example of what a food label looks like. On the left side is how much fat, sodium, protein, etc. is in each serving. On the right, is the percentage of the RDA for that particular nutrient or vitamin, in each serving you eat. For example, if you ate one serving of the food with this label, you would take in 45% of the iron you need for the entire day. If you were to eat two servings, you would take in 90% of the iron your body needs for the day from this food alone. This is an example of a “nutritionally dense food”, a food that contains a lot of vitamins and minerals per serving. Whole Foods When you choose the foods you are going to eat, whenever possible, you should pick whole foods. Not to be confused with the grocery store of the same name, whole foods as discussed in this guide, means foods that have not been processed or refined, or processed and refined as little as possible, before being eaten. Whole foods usually do not contain added salt, carbohydrates, or fat. When you eat whole foods, they are in their most natural state with all of their vitamins, minerals, and other nutrients remaining intact. It’s the difference between an apple and an apple roll-up, or a baked potato and French fries. Nutrition 101 – Chapter Summary You can be both healthy and a person with a disability. A balanced diet is essential for a healthy lifestyle. Trans Fats and Saturated Fats should be avoided. Carbohydrates can promote good health and are part of a balanced diet. “Good” carbohydrates, or complex carbohydrates provide your body with energy over a long period of time. “Bad” carbohydrates, or simple carbohydrates contain simple-to-digest, basic sugars that only provide your body with short bursts of energy. Reading nutrition labels will tell you what a particular food item is. Additional Resources For more information on nutrition: National Center on Health, Physical Activity and Disability (NCHPAD) www.nchpad.org/ American Association on Health and Disabilities (AAHD) www.aahd.us/ Center for Disease Control (CDC) www.cdc.gov/features/disabilities/ United States Department of Agriculture (USDA) www.choosemyplate.gov/ 8 We have discussed the dangers of foods loaded with trans-fats, chemical additives, extra calories, and added sodium and sugar. Unfortunately, store bought, cream based salad dressings are loaded with all of these things. Try making your own homemade salad dressings and spreads to cut out the harmful fillers. You might be surprised at how easy they are to make, and how delicious they taste. Dijon Mustard Vinaigrette Sesame Ginger Vinaigrette 1 teaspoon Dijon mustard 1 1/2 tablespoons red wine vinegar 1/4 cup olive oil Salt and freshly ground black pepper 1/2 cup extra-virgin olive oil 1/4 cup balsamic vinegar 2 tablespoons low-sodium soy sauce 2 cloves garlic minced or pressed 2 tablespoons honey Method In a small bowl, whisk together the mustard and the vinegar. Slowly whisk in the olive oil. Season with salt and pepper. 2 tablespoons peeled and minced ginger 1 teaspoon sesame oil or 1 tablespoon of sesame seeds Method Combine all the ingredients in a blender. Add 2 tablespoons of water. Blend until smooth Notes: Notes: Never Fail Kale Salad 1/2 cup walnut halves or pieces 1/4 cup dried cherries 1 tablespoon mirin (Asian rice wine) 1 tablespoon water 1/4 cup or slightly coarse homemade breadcrumbs (from a thin slice of hearty bread) 1 tiny clove garlic, minced or pressed 3 tablespoons olive oil 1 bunch Tuscan kale (also known as black or Lacinato kale; this is the thinner, flatter leaf variety), washed and patted dry ½ cup pecorino cheese, grated Juice of half a lemon (save a little zest for extra zing) Black or red pepper flakes, to taste Method Prepare walnuts: Pre-heat oven to 350 degrees. Toast walnuts on a baking sheet in oven for 10 minutes, tossing once. Let cool and coarsely chop. Prepare dried cherries: In a small saucepan over low heat, simmer white wine vinegar, water and dried cherries for 5 minutes, until plump and soft. Set aside in liquid. Prepare crumbs: Toast bread crumbs, garlic and 2 teaspoons of the olive oil in a skillet together with a pinch of salt until golden. Set aside. Prepare kale: Trim heavy stems off kale and remove ribs. I roll them into tubes and cut them like ribbons. It makes it go faster. Some people cut off stems but I like adding the whole thing. Assemble salad: Put kale in a large bowl. Add pecorino, walnuts and dried cherries (leaving any leftover vinegar mixture in dish), add remaining 2 tablespoons of olive oil and lemon juice and toss until all the kale ribbons are coated. Taste and adjust seasonings with salt, pepper and some of the reserved vinegar mixture from the cherries, if needed. Let sit for 10 minutes before serving, if you can, as it helps the ingredients come together. Just before serving, toss with breadcrumbs and 1 teaspoon drizzle of olive oil. 9 Meal Planning I’m Hungry! What Should I Eat? Healthy eating requires thought and planning. It is important to plan for your weekly meals, choose what you want to eat and develop a shopping list. In order to be successful, think about planning a healthy diet as a number of small, manageable steps rather than one big drastic change. If we make the changes a little bit at a time, and stick to them, we will have a healthy diet sooner than we think. When grocery shopping, we need to take into consideration how quickly the food will go bad, the amount of storage space we have in the refrigerator and how quickly we will eat the food. We don’t want the food to go bad before we get around to eating it. Perishable foods-require refrigeration, and go bad in a few days to a week. The best examples of perishables are fresh fruits and vegetables, dairy products like milk, eggs, cheese, meats and cold cuts. Non-perishable foods-have a longer “shelf life” than perishable food. The best examples of non-perishables are canned vegetables, pasta, peanut butter, canned tuna and dried beans and peas. These foods do have expiration dates, but they are usually calculated in years, not days. “My health and well-being is always on a fluctuation continuum, not because I’m disabled, but because I’m a human being.” Perfectly Poached Salmon 6 ounce canned wild salmon (boneless, skinless) 1/2 cup chopped red onion 2 tablespoons extra-virgin olive oil 1 15-ounce can garbanzo beans, rinsed and drained 1/2 cup chopped red bell pepper ~Unknown 2 tablespoons red wine vinegar Method: In a medium bowl, mash the salmon. MY TIPS! Mix in the chickpeas, onion, and red pepper. Add your preferred seasonings. In a separate bowl, whisk together the oil and vinegar. Pour the dressing over the salmon mixture and stir thoroughly. Notes: 10 When preparing food at home, it is important to know how long it can stay safe in the refrigerator without spoiling. Eating spoiled food can cause illness. These basic guidelines will help ensure that you eat food before it goes bad. Refrigerator temperatures should set between 36 and 40 degrees. Freezer temperatures should be between 0 and -5 degrees. The standard time frames for freezing are based on food, taste and quality, not food safety. Food Item Refrigerator Freezer Food Item Refrigerator Freezer eggs, ham, pasta salads 3-5 days do not freeze well hamburger meat 1-2 days 3-4 months hotdogs (opened) 1 week 1-2 months fresh beef, pork or veal 3-5 days 4-12 months hot dogs (unopened) 2 weeks 1-2 months chicken/turkey 1-2 days 9 months cold cuts (opened) 3-5 days 1-2 months soups/stews 3-4 days 2-3 months cold cuts (unopened) 2 weeks 1-2 months leftovers (cooked meat and poultry) 3-4 days 2-6 months bacon/sausage (raw) 1-2 days 1-2 months chicken nuggets or patties 3-4 days 1-3 months bacon/sausage (cooked) 1 week 1 month pizza 3-4 days 1-2 months Tips for Managing Leftovers Refrigerate or freeze leftovers within two hours. Cool leftovers quickly. Before refrigerating or freezing, slice large cuts of meat and store in serving-size packets. Use small containers to store individual servings. Label leftovers with the date you put them in the refrigerator. Check the refrigerator once a week and discard old leftovers. When in doubt, throw it out! Reheat leftovers until piping hot all the way through. Never reheat leftovers in a slow-cooker. The gradual heating promotes bacterial growth. To ensure even reheating in a microwave oven: Use a vented covering. Rotate food halfway through cooking time. Stir food halfway through cooking time (even if oven has turntable). Stir food again after cooking is completed. Allow food to stand for five minutes after cooking. 11 There are many types of foods that do not need to be refrigerated until opened and some that do not need to be refrigerated at all. These types of foods are usually stored in kitchen cabinets or pantries. Storing food in the pantry just means keeping it in cool, clean cabinets. Cabinets tend to be warmer above the range, near the dishwasher, or next to the refrigerator exhaust. These are good places to store dishes, pots, and pans, but are too warm for keeping food safe and at top nutritional quality. Some examples of foods that can be safely stored in a pantry are as follows: Items to Add To Your Pantry Pastas Peanut (and other nut) butters Dried cereals and oatmeal Canned and/or dried beans Rice and other grains Spaghetti sauce and canned tomatoes Spices and dried herbs Olive oil and vinegar Canned soups and vegetables I’ve Never Shopped Before! What Do I Need to Know? Things to Consider When Planning a Shopping Trip When creating your grocery shopping list for the week, remember to cut coupons and look through your local store’s weekly sale circulars. You can save money on food bills by using coupons and buying items on sale. Your shopping list and planning will be affected by how often you get to the grocery store. How often do you go to the grocery store? Do you go weekly or monthly? Consider your transportation method before you plan a large shopping trip. How many bags of groceries can you carry at a time? Do you take transportation that limits the number of bags you can carry onto the vehicle? How much money do you have to spend on groceries? Do you use SNAP/EBT (formally called Food Stamps)? Do you go to a food pantry? Do you have limits on the type of food you can purchase? Compare store brands to brand names. A lot of foods are generally the same, but store brands can often be cheaper. Read the information tags on the supermarket shelf. Learn to read and understand how much the product costs “per item” or “per pound” and compare the cost. For more information see page 18. Don’t shop when you are hungry or tired. You will be more likely to overspend or buy things you do not really need. Stock up on non-perishables when you see a sale. Even though you may be spending a little more money during that shopping trip, you will save money in the long run. 12 Processed and prepackaged foods are typically less healthy and more expensive than making your own dishes from scratch. Remember, with prepackaged foods, you pay for convenience in the form of a higher price and these foods can be high in fat and salt! Examples of prepackaged foods are frozen meals, like T.V. dinners and boxes of macaroni and cheese. Buying in bulk, or from warehouse stores, is not always the best idea. Be careful when buying perishable foods in bulk. Keep in mind how much available room you have in your refrigerator, freezer and cupboard before buying in bulk. Perishables have a shorter “shelf life” than non-perishables. “Shelf life” is the length of time the food is okay to eat before it spoils, or goes bad. Keep in mind how quickly things spoil and how quickly you will be able to eat all your groceries. Healthier foods are usually around the perimeter, or along the outer walls, of the store. Let’s Develop a Weekly Meal Plan: A Roadmap to Health Planning is the most important part of meal preparation and healthy eating. The first step in developing a meal plan is to sit down with a pencil, paper, and a weekly supermarket circular. A quick internet search for “meal planning ideas” “shopping list template” or “meal planning templates” will give you access to many resources. Start with a basic weekly schedule: Step 1 Breakfast Lunch Dinner Snack Monday Tuesday Wednesday Thursday Friday Saturday Sunday Dessert Begin thinking about the week ahead and start plugging in meal ideas. Start with breakfast and try to plan with the My Plate guidelines in mind. Whole grain carbohydrates, fruit, low fat dairy source. Step 2 Breakfast Monday cereal, banana, orange juice Tuesday cereal, banana, orange juice Wednesday cereal, banana, orange juice Thursday cereal, banana, orange juice Lunch Dinner Snack Dessert 13 Friday cereal, banana, orange juice Saturday I am going out with friends no meal needed Sunday whole grain bagel, low fat cream cheese, grapefruit Now, start plugging snack and lunch ideas into the planning chart. Step 3 Breakfast Lunch Dinner Snack Dessert Monday cereal, banana, orange juice Tuesday cereal, banana, orange juice Wednesday cereal, banana, orange juice Thursday cereal, banana, orange juice peanut butter with apples cookies and milk celery with cream cheese cookies and milk peanut butter ½ grapefruit with apples cookies cookies and milk and milk Friday cereal, banana, orange juice Saturday I am going out with friends no meal needed Sunday whole grain bagel, low fat cream cheese, grapefruit celery with celery with peanut butter cream cheese cream cheese with apples cookies hot chocolate hot chocolate and milk Next, start plugging in lunch and dinner choices. Remember, things you make for dinner can be used as left overs for lunch the next day. Step 4 Breakfast Monday cereal, banana, orange juice Lunch spinach salad kale and white bean soup Dinner kale and white bean soup and a side of spinach salad chicken breast with potatoes and spinach salad chicken breast with potatoes and spinach salad Snack peanut butter with apples cookies and milk celery with cream cheese cookies and milk peanut butter with apples cookies and milk Dessert Tuesday cereal, banana, orange juice Wednesday cereal, banana, orange juice Thursday cereal, banana, orange juice spinach salad Notes: 14 Friday cereal, banana, orange juice Saturday I am going out with friends no meal needed Sunday whole grain bagel, low fat cream cheese, grapefruit chicken salad chicken salad peanut butter left over pizza on ½ bagel on ½ bagel on a bagel with celery sticks left over pizza kale and finish what- order pizza ever left over and salad white bean soup, chicken soup with spinach salad or spinach salad you salad have left ½ grapefruit celery with celery with peanut butter cream cheese cream cheese with apples cookies cookies hot chocolate hot chocolate and milk and milk Step 5 You have just completed your weekly meal plan. Now, you must finalize your weekly shopping list. Your weekly shopping list for this meal plan is as follows: Produce: (fresh fruits, vegetables, herbs and spices) 5 bananas 1 small head of garlic Large bag of spinach salad (enough for 6 servings) Bag of potatoes 1 Bunch of Kale (or any greens like chard or spinach) If you are just not ready to try the Kale or the greens I totally get it! Baby steps… Use 2 cups of chopped broccoli 1 grapefruit 2 apples 1 package of celery Grocery: Box of whole grain cereal (large enough for 6 servings) 1 container of orange juice 2 whole grain bagels Low fat salad dressing Container of chicken broth or vegetable broth (Buy bouillon cubes if you need a lighter load) 1 package of white beans 1 container of low fat low sodium peanut butter (Look for minimal trans- fats or “bad fats”) 1 container of cookies (Look for minimal trans-fats or saturated fats) 1 package of hot chocolate Remember to read your labels Notes: Meats: 4 chicken breasts Dairy: 1 container of low fat cream cheese ½ gallon of low fat milk Step 6 Before you finalize your shopping list, check your cupboards and refrigerator to see if you have any of the items you need. If you already have items, remove them from your list. 15 TIPS A ND TR Beans ICKS! and po tatoes becom e starc wil hier af sit out ter o overnig r are refrige they rated ht. Us e milk to thin or o reheat ut as needed broth ing left overs. , when Recipe Play Book for the Week (All main meal dishes are four servings) “One Pan” Roasted Chicken Breasts with Potatoes Kale (Or Broccoli) and White Bean Soup 1 bunch of kale, or available greens, cleaned and chopped. (You can buy bags of pre washed pre chopped kale in most grocery stores in the produce section). You can substitute the kale for spinach or chard. If the greens are freaking you out, you can substitute 2 cups of chopped broccoli for the kale. 4 skinless boneless chicken breasts 2 tablespoons olive oil 5 medium sized potatoes- cleaned with the skin left on Salt and pepper 9 X 12 baking pan Aluminum foil to cover while baking Optional: Lemon for flavor Optional: Meat thermometer to verify cooking temperature 1 tablespoon extra-virgin olive oil 2 large cloves garlic (You may mash up the cloves in a garlic press, with a knife or buy pre chopped garlic in jar) 3 cups cooked or canned white beans (If using dried beans, follow instructions on bag. Beans normally need to soak overnight and then cook for 2-3 hours.) 3 cups of stock– chicken, veggie or water with bouillon cubes 1 teaspoon salt Black pepper, freshly ground Method: Preheat oven to 375 degrees. Thoroughly wash potatoes and chop into bite sized cubes, about 1 inch cubes. Once cleaned and chopped, add to the bottom of baking pan. Method: Wash kale, remove stems from leaves. Roll up leaves and cut in thin ribbons. Set aside. (If you are using broccoli, chop up one large head into small pieces. Your goal is to have about 2 cups of chopped greens). Add 2 tablespoons of olive oil and with a spoon toss around the potatoes until the oil is evenly distributed on the potatoes. Remove chicken breasts from package and layer on top of the potatoes. It should all fit in your baking pan, but if not move your potatoes around to make room and if you need to, use a larger pan. In a soup pot, heat olive oil and briefly sauté garlic. Add about half the cooked or canned beans and part of the stock. Salt and pepper to taste and if you like extra flavor, squeeze the juice of one lemon and drizzle on the chicken breast. Purée remainder of beans and stock in blender Stir puréed beans into soup. Cover with aluminium foil and bake covered for 45 minutes. After 45 minutes, remove the aluminum foil and bake for an additional 15 minutes without the covering. Use your meat thermometer to check for an internal temperature of 180 degrees. Let the dish sit on the counter covered with aluminium foil to cool, or rest, for 5 minutes before serving. “Leftover” Chicken Salad 2 fully cooked left over chicken breasts 2 tablespoons low fat mayonnaise ¼ cup on chopped onion ¼ cup chopped celery Salt and pepper 1 quart glass bowl with lid Optional ¼ cup chopped apple Mix kale (or broccoli) into soup and simmer until greens are wilted and darker in color (10 to 15 minutes). Season with salt and pepper to taste. Optional: serve topped with grated low fat cheese Method: Cut the cooked chicken breast which is easiest to do when cold, into bite sized, or 1 inch cubes, and set aside in the glass bowl. Mince the ¼ cup of onion and add to the chicken. Chop the ¼ cup celery and add to the chicken. Optional: chop a ¼ cup of apple and add to the chicken. Add the 2 tablespoons of low fat mayonnaise and with a large spoon, mix the mayonnaise into the salad so it is fully incorporated. Salt and pepper to taste. Refrigerate. 16 Sample Menu Planner/ Shopping List S! ICK TIPS AND TR The meal planning exercise above is based on cooking for one person. When you increase the number of people you are cooking for, you need to plan accordingly. lan, it is ekly menu p e w l gha n fi e om th make throu fr e e w e s s d o n a fo c As you and different ers with lids at we reuse in th ta t n n o a c rt o to p im ccess k. Having a planning. out the wee critical to this type of rage. s is iners for sto d ta n freezer bag o c s s a l g an r lastic and/o h as, ½ cup p c u y s u , b m n e a th c You nts on sizes. measureme idual serving If they have tore your food in indiv an s e go. 1 cup, you c meals on th r lanning fo t a re g with menu p recipes This is t is s s a to s e any resourc s devoted to fits. There are m some amazing website NAP bene and o receive S h w e l p for families o e . p lanning for in Section 6 and menu p se sites can be found the The links to Meal Planning – Chapter Summary Eating a healthy well balanced diet requires planning. Perishables are foods that must be eaten quickly to prevent spoiling. Non-perishables are foods that have a longer shelf- life and don’t require refrigeration. Meal planning templates can assist you when you’re making a shopping list. Knowing how to cook and prepare leftovers helps you save money and can make your food choices more interesting throughout the week. Additional Resources For more information on healthy meal planning: For balanced meal plans, recipe index and references: www.letsmove.gov/plan-healthy-meal For template ideas for menu guides and shopping lists: For free printable meal planners: organizedhome.com/printable/ “Good health is not something we can buy. However, it can be an extremely valuable savings account.” ~Anne Wilson Schaef 17 Let’s Go Shopping There are many services out there to assist people with food shopping. The most common services include, volunteer shopper programs for seniors and people with disabilities, electric scooters at the grocery store, and online shopping at local stores or through national internet-based companies. Once you know what your food needs are, follow this simple plan for shopping success; create a menu plan, develop a shopping list, then stick to the list. We have already discussed nutrition goals using the My Plate format, how to read nutrition labels, meal planning and creating a weekly shopping list. All of this information will help you to make better decisions when you buy things at the grocery store. Now, we are going to talk about unit pricing, product selection and meal makeovers. What is a Unit Price? The “unit price” is the cost per pound, quart, or other unit of weight or volume of a food package. It is usually posted on the shelf tag below the food. The shelf tag shows the total price (item price) and price per unit (unit price) for the food item. You can save money when you compare the cost of the same food in different sized containers or different brands. For example, if you want to buy frozen orange juice, you may find a 6-ounce can costs $.64. The unit price for this small can is $3.42 per quart. A 12-ounce can of another brand of frozen orange juice may cost $.89. The unit price for the larger can of juice is listed as $2.38 per quart. Which is a better value? In this example, the larger 12 ounce can of orange juice is cheaper per quart than the 6 once can. The Choice is Up to You TIPS ICKS! AND TR ing ber, buy m e m e r But nly a bulk is o t it in d o o f ea you can value if it spoils! before When you are at the supermarket you will be faced with many choices. The challenge to healthy eating is to replace your current food choices with healthier options. Generally speaking, reduce saturated fats, transfats, cholesterol and sodium and increase fiber, vitamins and minerals. Remember, whole foods and fresh food items are usually located around the perimeter, or outer walls, of the grocery store. If you fill your shopping cart with mostly items from these areas, your kitchen will be well stocked with healthy food options. Avoid these: Look for more of these: Saturated/Trans fatsFiber Sodium Vitamins A, C, & E CholesterolCalcium, Potassium, Magnesium & Iron Notes: 18 Look for These Items While You’re Shopping Food Type Cereal Milk Meat Whole grains Sodium Condiments Solution Choose brands with fewer than 150 calories per cup/ 3 grams of fiber/10 grams of sugar per serving Choose 2% milk to cut back on saturated fat intake from 23% to 15%. ( 1 cup of fat-free milk has 2% saturated fat RDA) Choose lean meat. Look for ground beef or turkey that’s at least 93% fat free. Choose grains with more than 3 grams of fiber per serving Choose low-sodium products when possible Choose vinaigrette or oil-based dressings instead of creamy ones. Also, try low fat mayonnaise. Nuts for Peanut Butter There seems to be millions of types of peanut butter. Which should I choose? First, you will want to eliminate the choices that contain a lot of saturated and/or trans- fats. Here is an ingredient list for a “traditional” peanut butter: Ingredients: Made from roasted peanuts and sugar. Contains 2% or less of: molasses, fully hydrogenated vegetable oils (rapeseed and soybean), mono and diglycerides, salt. Here is an ingredient list for natural peanut butter: Ingredients: Peanuts. What is Natural Peanut Butter? Natural peanut butter doesn’t have any hydrogenated oil added to it. A healthy peanut butter should have no added trans-fats, additional sugars or high fructose corn syrup (HFCS) or excessive salt. When you buy natural peanut butter, the peanut butter will separate and the oil will float to the top. Just stir and it is ready to eat! D TIPS AN TRICKS! between e c n e r e the diff ilk and one cup ’s t a h W m e of whole the sam one cup ilk? Both have inerals, m m of skim f vitamins and tains 2 o on amount f whole milk c t has 1 po cen but 1 cu of fat, 2 per percent s 2 n teaspoo of fat, and 1 / fat free. y n l teaspoo milk are virtua and skim Meal Makeovers You may have heard the term “makeover” when used to talk about the clothes you wear, or changing the curtains and pillows in a room to make it look nicer. In order to make healthy changes in your life, you need to think about making over your meals. Start by making small changes to the types of foods you buy and eat. Breakfast Makeovers: Simply replace whole milk with skim milk, sugary cereal with plain oatmeal, pork bacon with turkey bacon. 19 Lunch Makeovers: Simply replace mayonnaise on your sandwich with mustard, soda with water, white bread with whole wheat bread, whole milk cheese with low fat cheese, potato chips with a pickle. Low fat cheese Contains no more than 3 grams of fat per ounce. Examples include lowfat cottage cheese. Moderate fat cheese Has 4 to 7 grams of total fat per ounce. Examples include light cream cheese, feta, and mozzarella cheese. High fat cheese Has 8 or more grams of total fat per ounce. Examples include cream cheese, cheddar, Colby, Muenster, and Swiss Dinner Makeovers: Simply replace a cream based salad dressing with a vinaigrette, white potato with sweet potato, iceberg lettuce with mixed greens or kale, fried chicken with roasted chicken, full fat ground beef with 97% fat-free ground beef. Here are three traditional easy pre-packaged supermarket meals that have been made over to create healthier more complete meals. Rockin’ Ramen Noodle Hot Dish Simple Salad Soup 2 cups vegetables (carrots, peas, corn, onion, celery, broccoli, green beans, and spinach). You may use 2 cups of frozen mixed vegetables to avoid having to chop) 1 tablespoon olive or canola oil 1 package ramen noodles, any flavor (there are healthier whole wheat versions) ½ cup water 1 (11.5-ounce) can low-sodium tomato based vegetable juice Method: 1 tablespoon each of vinegar and olive oil 1 large chopped cucumber (the pieces need to be small enough to easily fit on a spoon because remember this is a soup) 1 large chopped green or red pepper 1 large juicy (preferable Jersey) tomato Sauté vegetables in oil until tender-crisp (about 5 to 10 minutes). Optional ingredients: ¼ cup chopped cilantro, zest of 1 lime, 1 chopped scallion Salt and pepper to taste Crush ramen noodles and add to vegetables You may add the seasoning packet along with the water. For a healthier option, discard the seasoning packet and add salt and pepper to taste! Method: In a large, bowl add all the ingredients and let sit covered in a refrigerator for about an hour so the flavors meld together. Cover and simmer for about 10 minutes, stirring occasionally, until the water is absorbed and noodles are tender. Serve chilled. If you like a less chunky consistency you can take ½ of the total amount and run through a blender and then stir it back into the bowl. This still gives you some chunkiness, but creates a smoother soupier feel. Notes: Notes: 20 Summer Slaw- Crunchy Ramen Noodle Salad Buy a pre made coleslaw mix (a bag of shredded carrots and cabbage) and put in a large salad bowl and add one package of uncooked ramen noodles broken up by hand. (Set the seasoning packet aside). Optional: Add a chopped up scallion and ½ cup of slivered almonds. Cover and refrigerate for one hour. Dressing: Add the contents of the seasoning packet to a small mixing bowl, ½ cup of canola or olive oil, 1/3 cup of vinegar ( I prefer rice wine or apple cider vinegar), 1 tablespoon of honey or sugar and pepper to taste. Shake and mix thoroughly and toss over salad prior to serving. Notes: Trying New Foods “But I don’t like that specific food?” Really, are you sure? Many times when people say they don’t like a specific vegetable it could be based on one exposure to that vegetable that they didn’t like. Try things in many different ways before you decide you don’t like it. Try things raw, steamed, fried, baked, roasted, pureed, blended or dehydrated. Odds are you will like them in some form. Often it is the consistency or the texture of a food we find unappealing more than the taste. Preparing it in a way that changes the texture may change your experience and your acceptance of the food. “A Bit Cheesy” Chicken and Shells Abuela’s Black Beans and Rice 1 tablespoon vegetable oil 1 onion, chopped 1 (15 ounce) can black beans, (drained) 1 (14.5 ounce) can stewed tomatoes 1 teaspoon dried oregano optional 1 clove of minced or pressed garlic 1 1/2 cups uncooked instant brown rice 8 small boneless, skinless chicken breasts halved widthwise (about 2 pounds) ½ teaspoon garlic powder 1 tablespoon olive oil 3 cups water 1 (24-ounce) package pre-packaged shells and cheese dinner 1 large tomato, chopped 1 cup of chopped spinach (frozen or fresh) Salt and pepper to taste Method: In large saucepan, heat oil over medium-high. Add onion and garlic. Cook and stir until tender. Method: Sprinkle both sides of chicken breasts with garlic powder. Heat oil in a large skillet over medium heat. Add chicken; cook 7-9 minutes on each side or until the chicken reaches an internal temperature of 165 ̊ F; keep warm. While cooking chicken, heat 3 cups water in a pot. Bring to boil. Stir in shell macaroni. Reduce heat to medium-low; cover. Simmer 12 minutes, or until shells are tender. Strain noodles. Stir in tomato, chopped spinach and cheese. Reduce heat to medium-low; cook until cheese sauce is melted and mixture is heated through, stirring occasionally. Add beans, tomatoes and oregano. Bring to a boil; stir in rice. Cover; reduce heat and simmer 5 minutes. Remove from heat; let stand 5 minutes before serving. Notes: Top with chicken. For added color/flavor, try adding other vegetables such as red, green or yellow peppers; broccoli; and onions to oil before adding chicken. 21 King Neptune’s Spicy Baked Fish 1 pound of fish (about 4 fillets) (flounder, tilapia, cod) Juice of 1 lemon (add zest for extra flavor) 1 tablespoon olive oil 1 tablespoon of capers ¼ cup of green olives stuffed with pimentos sliced ¼ cup of salsa Method: Spray a large piece of heavy duty aluminum foil (approximately 12 x 18 inches) with cooking spray. Add the following ingredients to the aluminum foil cooking packets: 6 servings of fish (approximately 1-1/2 pounds),1 tablespoon of olive oil, 2 tablespoon of lemon, 2 tablespoons of capers, 1/4 cup of green olives with pimentos, and 1/2 cup of salsa. Fold foil over and seal sides to prevent leaking. Let the fish absorb the marinade while you preheat the oven or grill to 450 degrees. Place foil packet on grill over medium heat or place packets in the oven (450 degrees) and cook for 10-15 minutes depending on the thickness of your fillets. Measure the thickness of the fish at its thickest part and bake for about 10 minutes per inch. Shopping for Healthy Foods – Chapter Summary Developing a shopping list from a menu plan is critical for effective shopping. Stick to your list! This is easiest to do if you do not go to the market hungry. Look at the Unit Price on the shelves to assist you in picking the least expensive brand. Look at the nutrition label to assist you in picking the healthiest brand. Pick brands with low amount of Trans Fats and Saturated Fats. Pick brands with high amount of fiber and whole grains. Pick products with less than 300-400 milligrams of sodium per serving. Choose low fat and no fat products when offered. Additional Resources More information about getting food access assistance: Government programs about food access: www.nutrition.gov/food-assistance-programs For locating food pantries: www.foodpantries.org/ New Jersey Hunger Prevention and Nutrition Assistance Program: www.endhungernj.org “A healthy outside starts from the inside.” ~Robert Urich 22 Meal Preparation Safety first While planning ahead saves time, money and hassle for every home cook, it is crucial when it comes to cooking safely and preventing accidents. This section explores safety precautions for handling and preparing foods, storing foods and preventing kitchen accidents. They are most likely to happen when you are rushed, distracted, or under pressure. Even when no one gets hurt, kitchen accidents waste both food and time. Below are five tips to prevent both minor and major accidents in the kitchen: 1. Choose the right-sized pot for the job. 2. Keep your floor and working space clear. 3. Cook when you have minimal distractions. 4. Tie up long electric cords with a rubber band to keep them out of the way. Turn pots so that the handles are on the side of the stove and not sticking out in the front, where someone could walk into them. 5. Protect yourself with proper clothes, shoes, gloves, or oven mitts, especially when working with boiling water or hot oil. When it comes to handling and preparing foods, here are some basic steps you should follow to keep safe while making a meal. This was adapted from the Home Food Safety website www.homefoodsafety.org Clean, Separate, Cook, and Chill •Wash your hands, utensils, cutting boards, and other surfaces before and after handling meat and poultry. •Thoroughly wash fresh fruits and vegetables. •Don’t allow meats to contaminate surfaces and other foods, such as produce, by placing them in locations where cross-contamination could occur. •Don’t wash meat, poultry, and eggs! This can actually spread Salmonella to other foods. •Cook meat, poultry, and eggs thoroughly to safe temperatures. •Avoid unpasteurized dairy products (including soft cheeses) and juices. •Make sure shellfish are cooked or treated for safe eating. •Report suspected food poisoning to your local health department. •Never prepare food for others if you have diarrhea or are vomiting. Notes: 23 A kitchen thermometer (a special thermometer to be used for cooking food only) is an important tool for an inexperienced cook. It is one thing to cook something “wrong” and not like the way it tastes and another thing to undercook meat and get food poisoning. How to use a kitchen thermometer: •For roasts, steaks, and thick chops, insert the thermometer into the center at the thickest part, away from bone, fat, and gristle. •For whole poultry, insert the thermometer into the inner thigh area near the breast but not touching bone. •For ground meat (such as meat loaf ), insert the thermometer into the thickest area. •For thin items such as chops and hamburger patties, insert the thermometer sideways. *For more kitchen utensils see pages 27-28. How Hot is Too Hot? Cooking at the Right Temperature After you remove meat from a grill, oven, or other heat source, allow it to rest for the specified amount of time listed below. During the rest time, its temperature remains constant or continues to rise, which destroys harmful bacteria. Below is a guideline of temperatures for various foods: Beef, Pork, Veal & Lamb (steaks, chops, roasts) Ground meats Ham, fresh or smoked (uncooked) Fully Cooked Ham (Reheat cooked hams packaged in USDA-inspected plants) Fully Cooked Ham (Reheat all others) All Poultry (chicken parts) Eggs 145 °F (62.8 °C) and allow rest time of at least 3 minutes 160 °F (71.1 °C) 145 °F (62.8 °C) and allow rest time of at least 3 minutes 140 °F (60 °C) 165 °F (73.9 °C) 165 °F (73.9 °C) 160 °F (71.1 °C) Egg is firm and the yolks are solid 145 °F (62.8 °C) 165 °F (73.9 °C) Fish and Shellfish Leftovers and Casseroles Notes: 24 Good Food Shouldn’t Make You Sick Safe steps in food handling, cooking, and storage are essential to prevent foodborne illness. You can’t see, smell, or taste harmful bacteria that may cause illness. Always follow the following steps when purchasing, handling, cooking and storing food: Safety Tips for Food Handling Purchase refrigerated or frozen items towards the end of your shopping trip after selecting your non-perishables so they are not sitting in your cart un-refrigerated for long. Never choose meat or poultry in packaging that is torn or leaking. Do not buy food past the “Sell-By,” “Use-By,” or other expiration dates. Always refrigerate perishable food within 2 hours. Check the temperature of your refrigerator and freezer. The refrigerator should be at 40 °F (4.4 ºC) or below and the freezer at 0 °F (-17.7 ºC) or below. Cook or freeze fresh poultry, fish, ground meats, and variety meats within 2 days; other beef, veal, lamb, or pork, within 3 to 5 days. Perishable food such as meat and poultry should be wrapped securely to maintain quality and to prevent meat juices from getting onto other food. To maintain quality when freezing meat and poultry in its original package, wrap the package again with foil or plastic wrap that is recommended for the freezer. Throw away cans that are dented, rusted, or swollen. Check the expiration dates on your non-perishable pantry items once a year and get rid of anything that’s expired. Always wash hands with warm water and soap for 20 seconds before and after handling food. Don’t cross-contaminate. Keep raw meat, poultry, fish, and their juices away from other food. After cutting raw meats, wash cutting board, utensils, and countertops with hot, soapy water. Cutting boards, utensils, and countertops can be sanitized by using a solution of 1 tablespoon of unscented, liquid chlorine bleach in 1 gallon of water. Marinate meat and poultry in a covered dish in the refrigerator. Refrigerator: The refrigerator allows slow, safe thawing. Make sure thawing meat and poultry juices do not drip onto other food. Placing the item in a dish or bowl can help. 25 The Zen of Cooking Like everything discussed in this guide, the key to successful food preparation is to plan ahead and think about what you need to do. This is true of all would be chefs but people with disabilities need to add in additional strategies to ensure success in the kitchen. Planning the meal and anticipate issues that may occur: Make sure you have all the ingredients needed for the recipe. If you have difficulty remembering when things are done cooking, use a kitchen timer or get an alarm to remind you of the next step if need be. Evaluate the cooking process: It is important for every cook to read the entire recipe from top to bottom and decide what adjustments should be made before cooking. Know your strengths and limitations and be patient: Vary activities, rest frequently and stop/limit doing things that cause you pain. For example, if you have difficulty cutting vegetables into small pieces, buy pre-cut frozen vegetables instead of fresh ones. Prevent kitchen accidents: Remember, accidents are most likely to happen when you are rushed, distracted, under pressure, or don’t have the right sized pots and pans for the recipe. KS! TRIC D N A S TIP s! eat Gift r G s e k t Ma quipmen g into a new E g in k Coo re movin wa If you a t/house, thro a gift n te e apartm arty and crea such p rming list gifts at a y w r t e s is u g o e e h that r pans, m In d . y n r a t is s , t reg owls, po er, chef knives b g in ix rain ic as m eter, st d smal electr m o m r e n a th utensils, blender cooking es, such as a applianc electric grill. or Appreciate the process: Cooking should be enjoyable, not a burden. Relaxing while cooking will make it more enjoyable. Listen to music and take your time. If you cook when you are hungry or expecting people for dinner you may feel pressured or rushed. Notes: 26 Appendix A: Cooking Equipment Essentials Checklist There are lots of gadgets you can purchase for your kitchen but not all of them are needed to cook well. Below, is a list of several basic items to look for overtime as you begin to create a kitchen that works for you. You can buy all of these items at a department store, thrift store or garage sale. Ladle Look for a large “bowl” that makes it easy to serve soups. Also, a bent handle at the top allows you to hook the ladle on the side of a pot without it falling in. Food Thermometer A food thermometer is the only reliable method to ensure your food is cooked to the minimal temperature to ensure food safety. (See page 24) Metal Spatula An offset thin blade will allow you to get under delicate items like cookies and pancakes. A medium-length blade will prevent flipping or picking up foods at an awkward angle. Rubber Spatula Should be sturdy enough to maneuver heavy dough but flexible enough to get into jar corners. Silicone models are heat-resistant and can be used in pots. Slotted Spoon Pick a sturdy spoon with a stainless steel handle that won’t get too hot. Whisk Look for a thin wired type (not thick, heavy ones) to make sure it’s well-balanced when whipping egg whites or cream. Chef’s Knife Look for an 8- to 9-inch blade with a thick bolster (the metal that extends from the handle to the edge of the blade and acts as a finger guard while you’re chopping). The knife should feel comfortable in your hand. Garlic Press A nice shortcut to chopping: one that works on unpeeled cloves and is dishwasher-safe. Grater A box grater is the most versatile. Many have up to six different grate option surfaces (shred, shave, dust, and zest) Choose one with a sturdy comfortable handle. Paring Knife The blade should be between 3 to 4 inches for small, fine cutting- like coring tomatoes and peeling fruits and vegetables. A sturdy model’s blade will extend through the handle. 27 Appendix A: Cooking Equipment Essentials Checklist (continued) Can Opener (If an electric can opener is easier for you, that’s fine for non-emergency circumstances. Just remember to have a back-up plan for emergencies or power outages- such as cans that have a tab for opening and/or a manual can opener) A safe-cut, or smooth-edge, can opener cuts around the outside of the can, rather than the lid; produces smooth edges; and will never lower the lid into your food. Measuring Cups You’ll want two sets of measuring cups one for wet ingredients and one for dry. For dry ingredients, you’ll also need at least 1-cup and 4-cup measuring tools on hand for measuring things in larger quantities like flour and sugar. Watermelon Yogurt Ice 1/4 cup water 1/4 cup sugar 4 cups diced seedless watermelon, (about 3 pounds with the rind) 1 cup low-fat vanilla yogurt 1 tablespoon lime juice Optional: 2 tablespoons chopped fresh mint Method Combine water and sugar in a small saucepan. Cook, stirring, over high heat until sugar is dissolved. Transfer to a glass measuring cup and let cool slightly. Puree watermelon in a food processor or blender, in 2 batches, pulsing until smooth. Transfer to a large bowl. Whisk in the cooled sugar syrup, yogurt and lime juice until combined. Pour into a shallow metal pan and freeze until solid, about 6 hours or overnight. Remove from freezer to defrost slightly, 5 minutes. Break into small chunks and process in a food processor, in batches, until smooth and creamy. Measuring Spoons Timer Look for a digital model that allows for multiple timekeeping, so you can track a roast in the oven, potatoes on the stovetop, and dough in the refrigerator— at the same time. Wire Mesh Colanders 2 Cutting boards- one for meat, one for everything else 3 Mixing bowls- different sizes Cookware set that includes the following: 8” Frying pan 2-quart Saucepan with lid 10” Frying pan 3-quart Sauté pan with lid 1-quart Saucepan with lid 6-quart Stockpot with lid Help is On the Way - Adaptive Equipment Options Adaptive equipment is anything that makes doing a specific task easier. For example, there are cutting boards with a spear-like devices built into them that helps secure the food to the board while you’re cutting it, rocker knives, silverware with built-up handles, and more. Check medical supply stores and catalogs, or talk to an occupational therapist for suggestions. Push cart: A push cart on wheels, like the kind you can get at a hardware store, is a good secret weapon. You can use it if you have difficulty carrying foods, and it can also slide ingredients, pots, pans and dishes from the fridge, to the counter or stove and back again. Cutting boards: There are many adaptive cutting boards available to accommodate various disabilities. Hook on a stick: A tool that can be used to reach items on low/high counters. Pizza wheel: A pizza wheel may allow for more ease when cutting than a knife. 28 Ways to Open Rigid Plastic Containers Check the back of the package for an opening before you proceed- there may be slits, perforations, and other starting points for opening rigid plastic containers on the back. Also, look around the sides to see if there are any pop-together tabs that can simply pull apart. You can also open containers like this as if they were cans. The sharp wheels of a can opener will cut the plastic without cutting your hands. If you can get your hands on them, aviation snips, also referred to as tin snips, are designed for cutting thin metal and will work on rigid plastic as well. The compound hinge gives extra leverage and can open these annoying containers quite easily. Appendix B: Basic Cooking Terms If you are new to cooking, you might be a little nervous about following a recipe and cooking a dish from scratch. In order to follow a recipe there are certain basic cooking terms that you should be familiar with. Below are some of those terms and their descriptions. Bake - To cook in an oven Beat - To mix ingredients using a fast, circular movement with a spoon, fork, whisk or mixer Blend - To mix ingredients together gently with a spoon, fork, or until combined Boil - To heat a food so that the liquid gets hot enough for bubbles to rise and break the surface Broil - To cook under direct heat (The Broiler may be the “drawer” at the bottom of your oven) Brown - To cook over medium or high heat until surface of food browns or darkens Chop - To cut into small pieces Dice - To cut into small cubes Drain - To remove all the liquid using a colander, strainer, or by tilting the container Grate or Shred - To scrape food against the holes of a grater making thin pieces Grease - To lightly coat with oil, butter, margarine, or non-stick spray so food does not stick when cooking or baking Knead - To press, fold and stretch dough until it is smooth and uniform, usually done by pressing with the heels of the hands Marinate -To soak food in a liquid to tenderize or add flavor to it (the liquid is called “marinade”) Mash - To squash food with a fork, spoon, or masher Mince - To cut into very small pieces, smaller than chopped or diced pieces Mix - To stir ingredients together with a spoon, fork, or electric mixer until well combined Preheat - To turn oven on ahead of time so that it is at the desired temperature when needed (usually takes about 5 to 10 minutes) Sauté - To cook quickly in a little oil or butter Simmer - To cook in liquid over low heat so that bubbles just begin to break the surface Steam - To cook food over steam without putting the food directly in water Stir Fry - To quickly cook food over high heat while constantly stirring until it is crisply tender (usually done with a wok)garage sale. 29 “Not So Fancy” Lentil and Spinach Soup 1 medium chopped onion 3 cloves minced garlic 3 stalks chopped celery 2 grated carrots 1 ½ cup dried lentils (rinsed) 1 cup spinach 1 small can of tomato paste 6 cups of water or broth 1 lemon Method: This recipe is great in a crock pot, but it can be done in a soup pot on the stovetop. Cook until all the veggies and lentils in a large soup pot or a crock pot until the ingredients are tender and thickened. (Approx. 45 minutes to an hour) Add 1 cup of finely chopped spinach greens to hot soup about 15 minutes prior to serving. Add the juice of 1lemon for added flavor. Garnish with chopped tomatoes if you want a splash of color. Salt and pepper to taste. Leftover management: A serving size of lentil soup is 1 cup. This is confusing to people because a can of soup is usually 2 or more cups. One of the many benefits of making your own soup, in addition to the lower sodium content and the better taste, is that you will have leftovers and you have better control over portion sizes. You can store your soup in the refrigerator for 3-4 days. If you plan that you need 3 one (1) cup servings for the week, you can refrigerate that exact amount and then freeze the rest in individual serving freezer bags. Culinary Apps There are many different apps available both online and on cell phones that can be helpful if you are looking to learn how to make new foods, prep foods to make for the week, and learn different healthy tips for choosing healthy foods and the right amount of portions to eat daily. Some of these apps are free, while others may cost a few dollars. Check out the internet and your cell phone or tablet’s app store to see all of the different apps available, and choose the ones that best suit you. Chicken Stir (No) Fry Quick Quinoa Pizza Bites 1 cup cooked quinoa 1 egg 1/2 cup shredded mozzarella cheese plus more, to taste, for topping 2 tablespoons parmesan cheese 1/4 cup chopped roasted red peppers 1/2 teaspoon salt 1 teaspoon basil 1 teaspoon Italian seasoning 1/4 cup marinara plus more for dipping Pinch red pepper flakes Stir frying is a type of cooking style that cooks foods quickly at high heat. This method is said to be healthier because the food cooks quickly and retains the vitamins and nutrients in the vegetables that can be lost during a longer cooking process. 2 tablespoons olive oil 2 cloves minced garlic 1 teaspoon grated ginger OR 1 teaspoon of powdered ginger 1 tablespoon of crushed red peppers 2 cups of broccoli florets ¼ cup chopped onion 1 cup sliced carrots 2 chopped and thinly sliced chicken breasts ¼ cup water ¼ cup of low sodium soy sauce Method: Preheat oven to 350 degrees. Place all ingredients in a mixing bowl and mix until fully combined. Method: Grease a mini muffin tin and fill 12 slots evenly with the mixture. Add oil to a large frying pan over a medium heat and add garlic, ginger and red pepper. Mix around gently for about 2-3 minutes. Add raw chicken (you may coat lightly with flour or cornstarch if you want a thicker sauce) and brown in the oil for about 5 minutes (if the pieces are larger you need to cook longer) Add the vegetables, water and soy sauce and cover the pan and cook for 5 to 8 minutes. Stir to ensure all vegetables are cooked and chicken is fully browned. Bake for 20-22 minutes, until golden brown. When there are about 3 minutes remaining, top the bites with a few shreds of mozzarella cheese and return to the oven to finish baking. Serve with marinara. 30 Meal Preparation – Chapter Summary Remember the following advice to ensure safe food handling; Clean, Separate, Cook and Chill. Your refrigerator should be set for 40 degrees or slightly below to ensure safe storage. Your freezer should be set for 0 degrees or below to ensure safe freezing of food. When cooking meat you need to ensure all parts of the meat cook to a minimal internal temperature to prevent the spread of disease and bacteria. Refer to chart for specific temperature. Before cooking a recipe read it thoroughly and make sure you have all needed equipment and you understand all the terms used. Don’t leave perishable foods out from refrigeration for more than 2 hours (1 hour if temperature is over 90 degrees). Additional Resources Food Safety: For chart of cooking times and resting times: www.foodsafety.gov/keep/charts/mintemp.html Cooking Terms and Resources: For beginner recipes and easy to follow dishes: For overview of cooking terms: www.food.com/recipes/beginner-cook www.d.umn.edu/~alphanu/cookery/glossary_cooking.html Adaptive Cooking Resources: Use the internet to search for adaptive cooking aids. “Early to bed and early to rise makes a man healthy, wealthy and wise.” - Benjamin Franklin 31 Healthy Eating Habits Brains are Beautiful Composed of approximately 75% water and weighing in at just about three pounds, the human brain is quite a compact little powerhouse! It uses about 20% of the body’s oxygen and blood to function. So, it stands to reason that the food you put into your body also has an impact on your brain and its ability to function well. First and foremost, one of the most important things you can do to keep your brain functioning well is to stay hydrated. As mentioned before, making a simple change from drinking soda to drinking only water will have a tremendously positive impact on your overall wellbeing. Similarly, the food we eat also provides energy to our brains. Foods that increase our mental function and capacity are often called brain builders and those foods that decrease mental function and capacity are called brain drainers. It’s important to remember, that dehydration can cause you to feel hungry, when you’re actually thirsty. Before you head to the fridge for that late night snack, have a glass of water and see if you’re still hungry 20 minutes later. Below, you will find a list of brain drainers and brain builders. Try to stay away from items on the brain drainers list and make an effort to try new foods that may be unfamiliar to you on the brain builders list. Brain Builders: Avocado Cantaloupe Collard Greens Oranges Soybeans Yogurt Brown Rice Bananas Eggs Peas Spinach Milk Cheese Lean Beef Flax Seeds Potatoes Tuna Peanut Butter Chicken Brewer’s Yeast Beans Romaine Lettuce Turkey Brussels sprouts Broccoli Oatmeal Salmon Wheat germ Brain Drainers: Artificial sweeteners Soda Corn syrup (HFCS) Frosting JuicesSports drinksEnergy DrinksWhite bread NicotineAlcoholRefined sugarsFried foods Cheers! A Toast to Your Health Poor drink choices can sabotage your dieting efforts. Soda is a prime example of a food product with no nutritional value that contains a lot of calories. An 8 ounce cup of soda contains about 100 calories. Most large drinks from restaurants are 16 ounces and contain 200 calories. Juice is not much better! An 8 ounce cup of cranberry juice cocktail contains about 130 calories and is also loaded with sugar. Eliminating empty calories from your diet by minimizing high calorie, low nutrient laden drinks is critical to a healthy lifestyle. Compare the Following: Juice: 8 ounces of apple juice has 107 calories, no protein, no fiber and 25 grams of sugar. 1 apple has: 90 calories, .5 grams of protein, 4.0 grams of fiber and 17 grams of sugar. The healthier choice is to eat an apple and have an 8 ounce glass of water. Vitamin water: 8 ounces of vitamin water has 50-60 calories, no protein, no fiber and 13 grams of sugar. A multi-vitamin has: No calories, sugar The healthier choice is to drink a glass of water and take a daily multi vitamin. 32 KS! Wet Your Whistle – Drinks Ok, so soda and sugary drinks are out. You’re thinking, what am I supposed to drink now? Ditching soda and other unhealthy drinks is often the most difficult part of beginning a new diet. No one expects you to go from drinking 10 cups of coffee to drinking only water in a day. Here are some great alternatives to soda when you’re looking to drink something a little more flavorful than water. Juice Spritzers: In a pitcher, add equal parts juice to equal parts seltzer water. As you get more comfortable with the taste and decrease in sugar, change the recipe to 3 parts seltzer to one part juice. Combine different kinds of seltzer and juice until you find your favorite flavor combination. Lemon seltzer with orange juice is delicious! TRIC D N A S TIP is year h t n io t no esolu e one r diet. There is t k a m y l c n If you o oda from your stronger impa s a e da t e o elimina that can hav ating s in m i l e n ia a one are eral health th r. From a nutr v e o t d a n r to you cing it with w al tea a b r e h a g l r and rep ndpoint, drinkin s towards you t a n t its u s u o l tiona it in it c plore eating fr o u r f h it water w of water. Ex ter content t wa . ake daily int ables with high r consumption e t t e a and veg your overal w e s a incre Iced Herbal Teas: Black, white and green teas all contain caffeine. Red teas and herbal teas do not. If you are sensitive to caffeine or are trying to reduce your daily caffeine intake, pick a tea that is low in, or free of caffeine. In a large pitcher, add seven (7) glasses of water, five (5) tea bags of your choice and 2 tablespoons of sugar or honey to taste. Refrigerate. Flavored Waters: Fill a pitcher ¾ of the way with water and add any of the following finely chopped ingredients; sliced lemon, sliced lime, orange segments, fresh raspberries, sliced cucumber, mint leaves, basil leaves, ginger slices. What about Diet Soda? Good question! In many ways, diet soda is more dangerous than regular soda. They contain all the chemical ingredients of regular soda and artificial sweetener as well. Juice is something that may seem healthy on the surface but it’s loaded with calories and sugar. Bad Foods and Bad Habits Here is a short list of foods and habits that should be eliminated, or dramatically reduced if you are looking to improve your health: • Alcohol during pregnancy! No amount is safe for a developing fetus. Alcohol also interacts with most medications. • Eating after 10 pm. This is a bad habit and makes weight loss difficult. Always ask yourself “Why am I getting something to eat?”, or “Am I actually hungry, or is it something else?” Many of us eat when tired, bored, upset or lonely. • Soda!! This is the largest source of wasted calories for most people. Every time you drink soda, it’s a missed opportunity to give your body something it really needs - water. • Margarine. This highly processed food is loaded with trans-fats. • Store bought mayonnaise and creamy salad dressings. These dressings are loaded with fats and sugars and, once added to your salad, make a healthy meal unhealthy. • Processed lunch meats (they are expensive too!) • Eating without paying attention- Conscious eating is important! • Eating directly out of the bag and not exercising portion control. • Going to the grocery store while hungry and without a list/plan. 33 “Hakuna Matata” Frittata (Easy Omelet) A frittata, is like an omelet. Instead of making a thin egg crepe and folding over the egg mixture like in an omelet, a frittata is all blended together, and then put, skillet and all, under the broiler. Filling options are limitless! For purposes of healthy eating, sticking with vegetables is your best bet. Custard Mixture Combine all ingredients in a large bowl 6 large eggs 3 cups ricotta cheese 2 tablespoons stone ground mustard, salt and pepper Beat mixture until frothy and set aside Recipe Variations Green Goddess: Sauté 1 bunch of chopped green onions and 1 bunch of greens in 2 tablespoons olive oil. Cook until green and wilted. Add white wine, broth or lemon juice – just enough to keep moist. Add custard mixture to skillet and cook over medium heat on the stove top for 5-7 minutes. Add crumbled feta cheese and sundried tomatoes. “I’m a Fun-gi” Mushroom and Asparagus: Sauté 1 medium chopped onion, 1 1/½ cups chopped asparagus tips and stems, and 1 cup sliced mushrooms in 3 tablespoons of olive oil. After cooked, add custard mixture to skillet and cook on stove top over medium heat for 5-7 minutes. Add gruyere or Swiss cheese. Finish by placing skillet in pre-heated oven (450 degrees) and cook under high heat 5-7 minutes until eggs set and cheese is melted. Garnish with fresh herbs and tomatoes. Chef’s Notes: Making individual frittatas in a muffin tin sprayed with cooking oil is a way to ensure a correct serving size. On Sunday night I spray 12 muffin tins with cooking spray and add sautéed spinach, onion and mushrooms to the bottom of the muffin tins. I blend 8 eggs and ½ cup of low fat milk and pour the custard mixture over the spinach and bake at 375 degrees for about 12-15 minutes. I remove the muffins from the tin, cool, store in the refrigerator and grab two for my breakfast each morning. Groovy Granola Granola is a food associated with healthy eating. Most supermarket granolas have too much sugar, partially hydrogenated oils, refined flours and grains. Read the labels before buying, or make your own. It’s easy and cheaper to make on your own. Basic Base Recipe: 6 cup old fashioned oats 1½ cup wheat germ 1½ cups dried milk Mix in a bowl and set aside In a small saucepan: Heat 1/3 cup honey, 2 tablespoons apple juice concentrate, and 1¼ cup coconut oil. Heat until the ingredients are dissolved and thin. Mix into dry ingredients until all dry ingredients are coated. Pre heat the oven to 350 degrees. Spread granola thinly and evenly over cookie sheets sprayed with cooking oil or parchment paper and bake until dry, about 10-15 minutes. Add any of the following combinations to make your own granola: Cherry Vanilla Granola: When making above, add 1 tablespoon of vanilla to wet ingredients prior to baking. Add 2 cups dried cherries, 1 cup slivered or chopped almonds, and ½ cup pumpkin seeds to the dry ingredients. Tropical Granola: Add ¾ cup dried pineapple, ¾ cup shredded, unsweetened coconut, 1/3 cup macadamia nuts, ¼ cup sesame seeds. Double A Granola: Add 1 cup chopped dried apricots, 1 cup almonds (whole or sliced), ¼ cup dried cranberries, and ¼ cup flax seeds. Traditional Granola: 1 cup of raisins, 1 cup of walnuts, ¼ cup sesame seeds, ¼ cup chopped dates. Have it your way: Any dried fruit, such as, apricots, banana chips, shredded coconut, cranberries, figs, dates, apple rings, and any nuts, such as peanuts, cashews, macadamia, and walnuts; and any seeds; additional ingredients such as carob or chocolate chips, cinnamon, nutmeg, or pretzels. 34 Fiesta White Chili with Quinoa 2 tablespoons of olive oil 1 medium chopped onion 2 stalks of chopped celery 1 chopped bell pepper 4 cloves of minced garlic 3 pound lean ground turkey or chicken breast 14-ounce can crushed tomatoes 8-ounce can of tomato sauce 15-ounce can white cannellini beans, rinsed and drained Optional: 1 teaspoon of cumin, and ¼ cup of fresh chopped cilantro Salt and pepper to taste Method In a large soup pan sauté the onion, garlic, peppers and celery in olive oil until translucent. Crumble in the meat and continue to brown with the vegetables 5-8 minutes. Add the tomatoes, tomato sauce, beans and seasoning. Reduce to low medium heat and cook covered for 30 minutes stirring as needed to avoid burning and ensure even cooking. In a separate saucepan, prepare 1 cup of quinoa according to package directions. Prior to preparing, rinse the quinoa to remove any bitter/soapy taste. Place the quinoa in a bowl and ladle the chili on top. Chef’s Notes: This chili recipe is called “White Chili” because it features white beans and white meat. By substituting lean white meat (pork, chicken or turkey) instead of the more traditional red meat, you create a dish with less saturated fat. Quinoa is a protein powerhouse that contains no gluten, but carries all essential amino acids. Rinse the quinoa well before cooking, or it will have a soapy flavor. Birdseed Meatloaf This recipe contains actual red meat! As mentioned earlier, red meat contains saturated fat and, as a result, is a food to be eaten in moderation. In an attempt to make this traditional meatloaf healthier add grains, seeds and some vegetables. 1 1/2 pounds lean beef or turkey (you can mix the two if you prefer) in a mixing bowl 3/4 cup uncooked quick cook oats 1/2 cup chopped onion 1 minced or pressed garlic clove 1/2 cup shredded carrots, (the smaller the pieces the less noticeable they become in the meatloaf) 1/4 cup chopped celery 2 eggs 1 tablespoon soy sauce D 2 tablespoons of flax seeds TIPS AN Salt and pepper to taste TRICKS! Method: Mix together in a large bowl and form into a loaf. Bake at 375 degrees for about 45 minutes while covered with aluminum foil. Optional: add tomato sauce on top. Bake without foil for 10 more minutes. Let sit to cool for about 5 minutes and then serve warm. 35 at tes gre This tas afy green ig le with a b or the Kale d/ n a salad coli) (or broc Feather and Leaf Lasagna This is an interesting lasagna because it substitutes the pasta based noodles with zucchini slices. This substitution decreases the bad carbohydrates found in traditional white flour based pasta and increases the amount of vegetables in the dish. 4 medium sized zucchinis 3 cloves minced or pressed garlic ½ cup grated carrots ½ cup chopped onion ½ cup chopped fresh or frozen spinach 1 pound of ground chicken 1 can of tomato sauce (6 fluid ounces) 2 tablespoons olive oil 16 ounces low or no fat ricotta cheese 2 cups shredded low fat or no fat mozzarella cheese Method Preheat oven to 475 degrees. Cut zucchinis into ¼ inch slices, preferable length-wise as these are going to be your lasagna noodles, then lay zucchini slices out on baking sheet. Drizzle zucchinis with olive oil and season with salt and pepper. Cook for 5-7 minutes on each side. Put on a plate to cool. Sauté garlic and onion in olive oil. Cook until translucent. Add ground chicken and cook until no longer pink. (Approximately 10 minutes) Add 1 can of tomato sauce and let simmer over medium heat for about 10 minutes to let flavors blend. Set aside. In a mixing bowl, add low fat ricotta cheese, eggs, spinach and carrots. Preheat oven to 375 degrees. Assemble the lasagna in a 9 X 13 inch baking dish in the following order; zucchini, ricotta cheese, tomato sauce with chicken, and mozzarella. Try to do two or three layers depending on the depth of your pan, always ending with the shredded mozzarella. Bake at 375 degrees for 45-50 minutes. This dish is even better the next day after the flavors have blended. Notes: Do You Know the Way to Santa Fe? Salad This is a bean based salad that uses a vinaigrette dressing as opposed to a mayonnaise base like many traditional potato salad or macaroni salads. Not only does that reduce the amount of fat, sugar and salt in your diet, it also reduces the overall calories of the dish. The only appliance this recipe requires is a can opener. A traditional potato salad (serving size 1 cup) has approximately 320 calories, 4 grams of sugar, 5 grams of protein and 14 grams of fat (3 grams from saturated fats). A traditional black bean and corn salad (serving size 1 cup) has approximately 220 calories, 0 grams of sugar, 9 grams of protein and 9 grams of fat (1.5 grams from saturated). 1 can of corn, (drained) 1 can of black beans (drained) 1 jar of salsa 1 jar of marinated red peppers (cut into bite sized strips). 1 tablespoon of olive oil Juice of one lime (Zest if you want a little extra lime taste) 1 tablespoon of white wine vinegar Method: Pour contents of all the cans and jar into a large serving bowl. Spice with cumin, salt and pepper to taste. If you don’t have or like cumin, don’t use it. Let sit at room temperature for ½ hour so the flavors blend together. If you want to add fresh produce or herbs chop and add the following: 3 scallions or chives, ¼ cup of cilantro, 2 stalks of celery, 1 green pepper and 1 medium sized tomato. 36 Snacking Saves the Day Having a variety of healthy snacking options is important if you are going to stay on the path of healthy eating. Snacking between meals is often a particularly hard habit for people to break. Ironically, snacks and drinks are the two areas of our diet where the most “empty” calories can be found. Empty calories are calories that contain very little nutritional value, but can pack on the pounds if you’re not aware of how many you eat. Because most of us love to snack, it’s important to have healthy snack options available to you when you have that irresistible urge to munch. If you like to snack on potato chips and a sour cream dip, for example, try some simple alternatives instead. Snack Substitutions Corn Chips and Salsa Celery with Low Fat Cream Cheese Corn Chips and Guacamole Whole Wheat Pita Chips with Hummus Carrots and Celery with Hummus Apples with Peanut Butter Recipes for Healthy Dip Alternatives Desserts and Snacks Desserts are something you need to explore if you are going to eat well and stick to a diet. One thing to remember is, even when you eat healthy foods, you still need to take portion control into consideration. Overeating nutritious food is still overeating. Gotta Have It - Guacamole 1 medium sized ripe avocado Juice of 1 lemon or lime (add some zest from the outside if you want an extra citrus taste) 1 chopped medium sized tomato or 8 grape tomatoes (or if you are lucky enough to find them, ½ cup of husked and chopped tomatillos) 1 clove pressed or minced garlic 1/8 cup of chopped cilantro Optional: Chop about a tablespoon of a jalapeno pepper for a spicy salsa Monkey Sticks: Frozen Banana Treats These are a healthy alternative to popsicles. They contain fiber, vitamins and nutrients. Mash with a fork for chunkier guacamole, or run through a food processor for a smoother blend, add salt and pepper to taste. Peel 12 ripe, yet firm, bananas Insert a Popsicle stick in the bottom of the banana to use like a Popsicle Hummus a Tune Spread room temperature peanut butter, almond butter or honey on the bananas 1 can of chickpeas 1 clove pressed or minced garlic 1 tablespoon sesame oil or olive oil Juice of 1 lemon (add some zest if you want an extra citrus taste) Optional: Add 1 roasted red pepper chopped, ¼ cup chopped Kalamata olives, 2 tablespoons minced dill, 1 tablespoon sesame seeds Roll them in any of the following: Chopped Nuts, Granola, Cereal–like bran or corn flakes Chopped dried fruits like raisins, apricots, dates, shredded coconut, Carob chips/ dark chocolate chips When the banana is covered with topping, lay it on wax paper and place in freezer After letting them freeze, eat one and put the others in a plastic storage bag and refreeze Run through a blender, or a food processor and blend until smooth Remember: They are healthy, but one banana Popsicle is one serving 37 Decadent Dessert Nachos with Strawberries and Chocolate Sauce Get a bag of whole wheat cinnamon pita chips and lay out on a serving plate Add 2 cups of chopped strawberries to the chips Drizzle with chocolate syrup Optional: Add low or no fat whipped cream and sprinkle of cinnamon Healthy Habits – Chapter Summary Keeping track of the calories we consume and expend allows us to plan to gain weight or lose weight. Read labels to make sure you are eating the appropriate serving size. Overeating nutritious food is still overeating. All calories are not created equal. You want to make sure the calories you ingest have a high nutritional value. “Empty Calories” are foods that provide nothing for your body but calories. Soda is a food that provides empty calories to our body. All calories no nutrition. Diet soda is also unhealthy and offers no nutrition to the body. Additional Resources Tracking Calories: My Fitness Pal (a free app) is a website and an iPhone app that allows you to set your weight loss goals and assists you in tracking your calorie intake and calorie expenditures www.loseit.com/ “We are what we repeatedly do. Excellence then, is not an act, but a habit.” - Aristotle 38 Healthy Lifestyle Changes and Community Resources Everyone can agree that we could, and should, be healthier. If we ate better, exercised more, reduced stress, quit smoking we would feel better, look better, have more energy, and get those weight, blood pressure, and cholesterol numbers where they should be. And that’s all true. When it comes to your wellness journey, everyone starts from a different place. But, for each of us, recognizing the importance of an accurate baseline is truly the first step in that journey. The key is to start where you are now; this is called your baseline. Your current baseline is shaped by your medical, social and family history and is constantly being influenced by everyday life. It is important to have an understanding of your current health status. There are two major components to good health: treatment for current conditions and/or illness and preventative care to reduce illness in the future. Taking appropriate preventative health-care steps may help you avoid the need for more prescription medications, hospitalizations and procedures and can lead to a healthier life. Many wellness goals start with changes in diet, exercise and stress reduction. Your healthcare provider can help you figure out how to start making these changes in a safe way. These are just a few of the many things that can be assessed and addressed as part of your health baseline. After reading this wellness guideline, together with your healthcare provider, you can begin to prioritize your health and wellness goals and the steps you will need to take in order to achieve them. Stress What is stress? Stress is your body’s way of responding to any kind of demand. It can be caused by both good and bad experiences. When people feel stressed by something going on around them, their bodies react by releasing chemicals into the blood. People under large amounts of stress can become tired, sick, and unable to concentrate or think clearly. Everyone experiences stress and manages stress. The question becomes, is your method for handling stress healthy? Unmanaged stress, or distress, can lead to an increased risk of both mental and physical problems. Symptoms of distress include increase in blood pressure, rapid breathing and generalized tension. Drinking alcohol, smoking cigarettes, overeating and bad sleep habits are all ways we handle stress, but all of those methods are unhealthy. The American Heart Association offers the following suggestions to address stress in positive ways that do not negatively impact health. 1. Talk with family and friends. A daily dose of friendship is great medicine. Call or write friends and family to share your feelings, hopes and joys and ask them to share theirs. 2. Engage in daily physical activity. Regular physical activity can relieve mental and physical tension. 3. Embrace the things you are able to change. While we may not be able to do some of the things we once enjoyed, we are never too old to learn a new skill, work toward a goal, or love and help others. 4. Remember to laugh. Laughter makes us feel good. Don’t be afraid to laugh out loud at a joke, a funny movie or a comic strip, even when we’re alone. 5. Give up the bad habits. Too much alcohol, cigarettes or caffeine can increase blood pressure. 39 6. Slow down. Try to “pace” instead of “race.” Plan ahead and allow enough time to get the most important things done without having to rush. 7. Get enough sleep. Try to get six to eight hours of sleep each night. 8. Get organized. Use “to do” lists to help you focus on your most important tasks. Approach big tasks one step at a time. For example, start by organizing just one part of your life — your car, desk, kitchen, closet, cupboard or drawer. 9. Practice giving back. Volunteer your time or spend time helping out a friend. Helping others helps you. 10. Try not to worry. The world won’t end if your grass isn’t mowed or your kitchen isn’t cleaned. You may need to do these things, but right now might not be the right time. Time for Bed: Healthy Sleeping Habits The recommended amount of sleep per night for adults is between 6 -8 hours. This is total consecutive, uninterrupted sleep. If you can’t sleep, (insomnia) try establishing a standard wake and sleep time. Going to bed and waking up at the same time every day helps your body establish a standard sleep schedule. Develop nighttime routines that your body associates with going to bed. Do not read or watch TV in bed if you suffer from insomnia. Stop ingesting caffeine several hours before bed. Make sure you are not drinking or eating caffeine without knowing it. Chocolate, energy drinks, weight loss supplements, some desserts, teas, all contain caffeine. Talk to your doctor about possible remedies to your insomnia. Smoking Smoking is bad for your health and harms nearly every organ of the body. Cigarette smoking causes most lung cancer deaths. It is also responsible for many other cancers and health problems. These include lung disease, heart and blood vessel disease, stroke and cataracts. Women who smoke have a greater chance of certain pregnancy problems or having a baby die from sudden infant death syndrome (SIDS). The second-hand smoke you create is also bad for non-smokers around you – by breathing in the smoke you exhale, they too are at risk for developing many of the same dangerous heath complications smokers do. The percentage of adults who smoke cigarettes is higher among people with disabilities than people without disabilities. (2011 National Health Interview Survey). The only proven way to protect yourself from harm is to never smoke, and if you do smoke or use tobacco products, to quit. 40 Jersey Cranberry Spicy Salsa 1 tablespoon fresh lime juice ½ cup canned corn 1 tablespoon honey 3/4 cup halved cranberries 1 minced jalapeno Salt and ground pepper taste 1/4 cup red onion, finely chopped Tortilla chips 2 ripe avocados cut into chunks Method In a large bowl, whisk together the lime juice, honey, jalapeno and onion Add avocados, cranberries, and corn Salt and pepper to taste Toss gently to combine Serve with Pita Crisps or tortilla chips, as desired Notes: An Ounce of Prevention Is Worth a Pound of Cure Preventative Health Screenings Be proactive about your health by staying on top of necessary screenings and health care visits. This schedule is a suggested timeline for routine screenings. The following recommendations are intended as general guidelines only. Other resources may offer different recommendations. Please consult your health care provider to determine which screenings and exams you need. Physical examinations: should be scheduled once a year and include height, weight, and blood pressure and skin cancer screening. You should contact your primary care physician to find out if you are due for your annual physical. Cholesterol screening: A baseline total cholesterol measurement, as well as a measurement of bad (LDL) and good cholesterol (HDL), should be obtained for all adults between 18 and 20 years of age. If within the normal range, the test should be repeated every 5 years. Individuals at higher risk, including children with a strong family history of hyperlipidemia (high cholesterol), may be screened at an earlier age, and more frequently. Diabetes screening: Hemoglobin A1C screening. A Hemoglobin A1C screening, which measures the concentration of sugar in the blood, should be performed at least twice a year if you have diabetes. A healthy A1C should be below 7. If you are 45 or older, and have a family history of diabetes, you should be screened every three years. Diabetes: No Need to Sugar Coat It Diabetes is a disease of the pancreas. People who have diabetes are unable to make healthy amounts of blood glucose (sugar). Type 2 diabetes is the most common form of diabetes. People with type 2 diabetes have difficulty maintaining their blood sugar levels. Factors that can increase your risk for diabetes include a personal history of gestational diabetes, obesity, inactivity, high blood pressure or race/ethnicity. African Americans, Hispanic/ Latino Americans, American Indians and Asian Americans and Pacific Islanders are at particularly high risk for pre-diabetes and diabetes. Seven percent of the U.S. population has diabetes. Hemoglobin A1C screenings can help lead to an early diagnosis of diabetes, as elevated sugar levels may not always produce symptoms. You can cut your risk of developing type 2 diabetes by losing weight, eating a balanced diet, getting adequate sleep, and exercising more. (For more information on sugar, see page 3.) Colon Cancer Screening A colonoscopy is a screening exam that checks the overall health of your intestines, and should be done annually after age 50, or sooner if there is a family history of colon cancer. A flexible sigmoidoscopy is recommended every 3 years after age 50 (earlier or at more frequent intervals for individuals at higher risk); colonoscopies, which are probably a better screening test than flexible sigmoidoscopy, only needs to be repeated every 5 to 10 years if your last colonoscopy was clear. Blood pressure should be checked annually. Weight should be checked annually unless there are notable weight losses or gains. Dental examinations and cleaning should be routine, every 6 months or so. 41 OK… Some Guy Talk Testicular self-examination (TSE) should be taught during adolescence and continued on a monthly basis throughout a man’s life. If you do not know how to do a TSE contact your healthcare provider and ask them to teach you how to do one. It is a quick a painless way to spot abnormalities in their earliest stages. Prostate cancer screening: Prostate health should be evaluated by performing an annual digital rectal examination for men over 40. Prostate Specific Antigen (PSA) tests may also be used to screen for prostate cancer, but they are not specific and may indicate benign growth of the prostate (benign prostatic hypertrophy) as a man gets older. Screening may begin earlier if there is a strong family history. Resource: U.S. National Library of Medicine, the National Institutes of Health (www.nlm.nih.gov) A Section for the Ladies Pap smear: Sexually-active female adolescents and women over age 20, regardless of sexual activity, should have an annual Pap smear for cervical cancer screening. A Pap smear is a quick swab test to check the health of your cervix. After three negative, annual Pap smear tests in a row, women who are celibate or not sexually active, or monogamous which means you have only one partner, and younger than 40 years of age may decrease Pap smear testing to every 2 to 3 years. Women over the age of 40, women with multiple sexual partners and women who take oral contraceptives should have an annual Pap smear. Women with a medical history of Human Papilloma Virus, or genital warts should have a Pap smear every 6 months. Breast self-examination (BSE): BSE should be taught during adolescence and continued on a monthly basis throughout a woman’s life. If you do not know how to conduct a BSE make an appointment with your primary care physician and ask them to give you the information you need to conduct your monthly self-exam at home. Fiberlicious Lentil Salad “Going Bananas About Berries” Yogurt 3 cups dry brown lentils 1 tablespoon minced flat leave parsley 3 tablespoons chopped unsalted mixed nuts 2 sprigs fresh thyme (optional) 1 clove garlic, minced 2 tablespoon unsalted seeds such as pumpkin or sunflower 1 cup finely diced carrots Juice of 1/2 lemon (zest of one lemon) 1 sliced banana 1 cup finely diced red pepper 2 tablespoons olive oil 1 cup of berries (raspberry, blueberry and or blackberry) 1 cup finely diced celery 1 teaspoon kosher salt 1 cup low fat Greek style yogurt 1/2 cup finely diced red onion Ground black pepper Method Put the yogurt in a bowl and add the additional ingredients. Serve. Method Notes: Cook lentils according to package directions and drain well. Add the remaining ingredients in a large bowl and add the warm lentils and thoroughly mix. Let the salad sit and marinate for about an hour. Refrigerate and serve cold. Notes: 42 Mammography: A Mammography is an X-ray evaluation of the breast tissue. A baseline mammogram is recommended for women at age 40 and should be repeated every 2 years for women between 40 and 50 years old, if the baseline test is clear. An annual mammogram is recommended for women over 50. A mammogram may be done at an earlier age, or at more frequent intervals if problems are suspected or the woman is at increased risk, for instance, if a first-degree relative has had breast cancer. Folic Acid Folic Acid is a B-vitamin that helps build healthy cells. It is essential for women of childbearing age to get the daily recommended allowance of folic acid, 400 micrograms, every day whether or not they plan on becoming pregnant. Nearly half of all pregnancies in the US are unplanned. So, don’t wait until you know you’re pregnant to begin taking folic acid supplements. Though there are nutritional sources of folic acid, called folate, it is hard to get the RDA through diet alone. You can eat leafy greens, legumes (beans) and whole grain cereal fortified with folic acid in addition to your daily multivitamin supplement. Urological Health Urological Health is important for us all, but is particularly important for anyone with kidney issues and those who catheterize regularly. Drinking plenty of water helps to flush your kidneys and keep them healthy. Try to stay away from foods that irritate the kidneys such as highly acidic foods and caffeine. Preventing a Urinary Tract Infection (UTI) Urinary tract infections are one of the most common types of infections people with disabilities have to deal with on a regular basis. A urinary tract infection (UTI) is an infection that occurs anywhere in the urinary tract which consists of the kidneys, bladder, urethra and ureters. Symptoms of UTI may include: increased urgency to urinate, urine with a strong odor and cloudy appearance and failure to fully empty your bladder when you go to the bathroom. Here are a few tips to help prevent UTIs: Healthy Beginnings Salad 1 cup fresh raspberries, 4 cups baby spinach leaves 1/8 cup extra-virgin olive oil 1 ripe diced mango 1/8 cup rice wine vinegar 1 small ripe avocado, diced 1 tablespoon honey 1/2 cup thinly sliced red onion 1 small clove garlic, Optional coarsely chopped 1/8 cup toasted sliced almonds Salt and pepper to taste ¼ cup cooked black beans Method Puree 1/2 cup raspberries, oil, vinegar, honey, garlic, salt and pepper in a blender until combined. Combine spinach, mango, avocado and onion in a large bowl. Pour the dressing on top and gently toss to coat. Add remaining raspberries and sprinkle with nuts and or beans. Notes: 1. Wash hands before catheterizing. This greatly reduces the chance of infection. Completely empty the bladder to the best of your ability. Urine left in the bladder for long periods of time is more likely to grow bacteria, which can lead to infections. 2. Maintain good hygiene by following regular bowel and bladder programs. 3. Drink plenty of liquids. Water is best. Adults should try to drink six to eight 8-ounce glasses per day. 4. Avoid drinks with carbonation, caffeine and sugar. 5. At the first sign of a UTI call your doctor and drink more liquids. Stay away from very acidic foods like citrus and foods with a high sugar content- choose less acidic foods like cranberries, pomegranate, blueberries or purple cabbage. Do not drink cranberry cocktail- it has a ton of sugar in it! 43 Skin Breakdown/Pressure Sores Did you know that your skin is your largest organ? When skin is healthy and unbroken, it protects us from a wide variety of viruses and bacteria on a daily basis. Even the tiniest, cut or open blister is big enough to let infection causing bacteria into our bodies. Preventing skin breakdown requires a daily commitment. It is important to stay as dry and clean as you can, so infections don’t take hold. Performing daily skin checks is a good way to spot skin breakdowns before they become a problem. There are many devices with mirrors you can purchase to help you see all parts of your body. Skin that experiences pressure is more likely to breakdown (buttocks, top of the back of your thighs, bottom of your feet, anywhere that comes into contact with braces). The type of mattress and wheelchair cushion you use and moving your body at regular intervals (weights shifts) can help prevent skin breakdown. Staying hydrated, being physically active on a daily basis, practicing good hygiene, and eating a diet high in fruits and vegetables all reduce the risk of skin breakdown. The vitamins and minerals found in fresh fruits and vegetables are important for skin health. If you have skin breakdown/pressure sores, you can help your body’s natural healing ability by eating foods high in protein, low in fat and, as always, stay away from excess sugar. The Final Frontier: Physical Activity Diet is important, but it is very hard to achieve optimal wellness and maintain a healthy weight without some physical exercise. Exercise is defined as any movement of the body that burns, or expends, additional calories. Sports and physical activity has been linked to improvements in self-confidence, social awareness and self-esteem. Please consult your healthcare provider before beginning a new exercise routine to make sure it is right for you. According to the Center for Disease Control’s (CDC) website section on Health Promotions for Persons with Disabilities, exercise is critical for overall health and wellness. Here are some key points from the site: www.cdc.gov/nccdphp/sgr/disab.htm Physical activity need not be strenuous to achieve health benefits. Significant health benefits can be obtained with a moderate amount of physical activity, preferably daily. The same moderate amount of activity can be obtained in longer sessions of moderately intense activities, such as 30-40 minutes of wheeling oneself in a wheelchair, or in shorter sessions of more strenuous activities, such as 20 minutes of wheelchair basketball. People who are previously sedentary, or unable to walk or move much, who begin physical activity programs should start with short intervals of physical activity, about 5-10 minutes, and gradually build up to the desired level of activity. Amazing Smoothie Recipes If you do start working out, it is important your body gets the protein it needs to help convert fat into muscles. You can make smoothies before you go to the gym and save some to reward yourself after your work out. You really don’t need a recipe to make a smoothie. You can just get creative and throw in what you like. If you use too much fruit you will have a smoothie that is very high in sugar, so try to keep fruits in equal balance to vegetables or protein. “The Great Pumpkin” Pie Smoothie: ¼ cup pumpkin puree, 1 cup almond milk, 1 teaspoon pumpkin pie spice, 1 tablespoon honey and ½ cup of ice. Blend and serve. Green Machine: This is a two serving recipe-make one and save one for later; they keep well in the refrigerator for one day. 1-very unripe banana, 1-one large pear and or green apple, 1 cup of spinach, 1 cup of romaine lettuce (I prefer kale), juice of 2 lemons, 1-cup of celery, 1 tablespoon honey to sweeten and 1 cup of very cold water. Blend and serve. Banana Berry Smoothie: 2 bananas, 1 cup assorted berries (I prefer strawberries), 1 cup low fat Greek yogurt, 2 tablespoon honey. Blend and serve. Vanilla Date Smoothie: Blend 4 pitted Medjool dates, 1 1/2 cups of almond milk, a sprinkle of cinnamon, 1/2 teaspoon of vanilla extract. Add 1 cup of ice to the blender and blend on the ice crush, or puree setting. Serve cold. Green Tea Frappacino: 2 tablespoons powdered green tea, 1 teaspoon vanilla extract, 1 tablespoon honey, 1 cup coconut milk, 1 cup of ice in a blender on ice crush, or puree setting and serve cold. 44 Benefits of Physical Activity Aerobic activities like boxing, swimming, bike riding and dancing provide many benefits to your mind and body. Improving your physical fitness can reduce the risk of dying from coronary heart disease and developing colon cancer and diabetes. Additional benefits of regular exercise include controlling joint swelling and pain, associated with arthritis and reducing blood pressure in some people with hypertension. Regular exercise can also improve your stamina and muscle strength while at the same time lowering anxiety and depression. Physical activity has been shown to make us feel happier. The most important thing to remember is any increase in physical activity will have health benefits. Any type of movement no matter how small will have a positive impact on your health. You don’t need to run a mile tomorrow; start with a walk around the block today. Do you have limited mobility and wonder what kind of exercises you can do to improve your health? Something as basic stretching your arms out and rotating them in circles will even tone muscles and burn calories if you do it regularly enough! Passive vs. Active Range of Motion Range of motion is the amount of movement you have at each joint, or how far your joints can be moved in different directions. It is related to flexibility and is an important part of an exercise program. Understanding both active and passive ranges of motion and their importance can help you improve your flexibility and performance. Passive range of motion exercises helps keep your joints flexible, even if you cannot move by yourself. These are done with a friend or caregiver. Your limbs and joints are moved by your helper. This type of exercise will help you maintain good flexibility and motion. Active range of motion means you move a joint through its range of motion by yourself. Anytime you are moving your body, you are using active range of motion. What kind of activity? What is your fitness goal? Do you want to lose weight, build muscle, participate in a competitive sport or perhaps all three? Here are a few activities you might want to try out. If you’re not interested in a particular activity, try something different. Cardiovascular exercise Stretching exercises: • swimming • wheelchair sprinting, in a studio • Chair Yoga • Range of motion exercises • using a rowing machine You can find videos, clips and websites that will walk you through numerous exercise options. or at a track adapted for wheelchair use • wheelchair sports, such as basketball, netball and badminton Muscle-strengthening • Gyms with equipment adapted for wheelchair users are a great place to do musclestrengthening activities. • Free weights • Some wheelchair users also find that they can do muscle-strengthening exercises at home, using resistance bands. 45 D TIPS AN TRICKS! nt moveme ill f o e p y al w Any t how sm ct r e t t a pa no m sitive im o p a e hav health. on your 46 Locating Community Resources and Accessing Assistance Programs Every now and then people may experience financial and other types of hardship. Sometimes you just need that little extra help. You should never hesitate to research your local state or county government to see what assistance programs they have and learn about what type of aid they can provide. There are numerous national assistance programs, ways to get help from your local government, community action agencies, and non-profits, as well as charities that offer programs and grants that will assist many families and individuals with bills, living expenses, and debts. You can find assistance to help pay your utility bills, help with medical bills, health care costs, rent, food assistance programs, credit card debt, and many other government assistance programs. Below are just a few of the programs that are available. Types of Programs Supplemental Nutrition Assistance Program (SNAP) or “food stamps” is the largest nutrition assistance program administered by the United States Department of Agriculture (USDA). There is an eligibility criteria and the amount of benefits you get is determined by your personal situation, family size and income level. To access resources in your county contact your County Board of Social Service. www.nj.gov/humanservices/dfd/programs/njsnap/cwa/ Women, Infant and Children (WIC) provides supplemental nutrition coupons for pregnant and nursing woman, infant and children under 5 years of age. Most of the foods provided are milk, eggs, juice and protein sources like peanut butter and beans. www.state.nj.us/health/fhs/ wic/ Food pantries: A food pantry is a non-profit, charitable organization that distributes food to those who have difficulty purchasing enough food to avoid hunger. In addition to food, many pantries offer other services and assistance, such as clothing, counseling, and help applying for other assistance programs. For the last few years, the Division of Disability Services has been working to make more pantries accessible through small grants from the Kessler Foundation. To date, the Division has awarded funds to five (5) pantries across the State to make capital improvements to their facility so that people with disabilities can access the lifesaving services they provide. Community Food Bank of NJ has an interactive website to assist you in locating food pantries in NJ. www.cfbnj.org/food/find-food/ NJ 211- is the statewide information and referral hotline. According to their site, NJ 211 is a universally respected and growing national model that “can help you find solutions to personal needs by informing you of resources in your community like day care facilities, shelters, affordable housing units, social services, employment training programs, senior services, medical insurance, and more”. Dial 2-1-1 on your telephone (referral to local providers in your area). www.nj211.org/ Division of Disability Services Information and Referral Certified Information and Referral Specialists are available to confidentially discuss issues, provide information, assist with problem solving, and to refer individuals to appropriate agencies or services. www.nj.gov/humanservices/dds/home/index.html 47 Online Ordering of Groceries and Home Delivery Ordering groceries or meals online from your local grocery store and having them delivered to your home is a great timesaving option, especially for those who have more difficulty finding transportation. There are grocery delivery companies that allow you to choose healthy food options and deliver them right to your door. A lot of these companies also provide meal prep services that make it easier and quicker to prepare healthy meals. National food delivery services don’t offer options for perishables or accept SNAP, but you can purchase many of your pantry items this way nonetheless. Meals on Wheels is a meal delivery program option for some. While the program is designed for seniors, some regions provide services to people with disabilities, people who are sick, “homebound”, or require a special diet. While some Meals on Wheels programs have certain requirements in order to be a part of the program, others do not. Check with your local program for specific requirements. Lifestyle Changes and Community Resources – Chapter Summary Know your baseline. Stress management, healthy sleep habits, preventative healthcare and physical activity are all part of a healthy life style. 6-8 hours a night of sleep is recommended for adults to obtain optimum health. Bedtime routines and sticking to established bedtimes help decrease insomnia. As you get older it is important you talk to your doctor about needed preventative health screens. Age, family history and other risk factors determine when you need specific health screens. Physical activity does not need to be strenuous to have health benefits. There are many ways for people with disabilities to get exercise. Community resources are available to help people with disabilities access nutrition. Additional Resources Stress Management The American Heart Association: www.heart.org Exercise Resources for People with Physical Disabilities Disabled Sports USA: www.disabledsportsusa.org “I feel pretty good. My body actually looks like an old banana, but it’s fine.” ~ Mike Piazza 48 Emergency Preparedness What is an Emergency? What is an emergency? An emergency is “a serious, unexpected, and often dangerous situation requiring immediate action.” There are two types of emergencies and disasters- natural and man- made. You are likely most familiar with large scale emergencies like, tornadoes hurricanes, earthquakes terrorist attacks and oil spills, however, for a person with a disability a downed power line, broken elevator or house fire are also emergencies that must be prepared for. And, the best time to prepare for an emergency is NOT during the event itself, but rather long before it occurs. This section will briefly discuss how to plan for an emergency, prepare an emergency kit/go bag in the event you need to evacuate your home and, finally, provide some super simple recipes you might want to try after an emergency, when resources, electricity and space to prepare food may be extremely limited. Three Steps to Prepare for an Emergency Be Informed Emergencies and disasters can happen at any time without warning. In an emergency you may not be able to: • Cook • Use equipment that depends on • Access cash • Access services on which you rely • Cool, light, or heat your home power • Shelter in an accessible place • Use regular means of transportation It is also vitally important that you head the warnings that are provided as soon as you hear them, this is particularly the case with evacuation orders. It is a known fact that, here on the east coast, we have had several days warning for most potential natural disasters. If you receive an order to evacuate you should do so as soon as possible. During emergencies, many people think it’s a good idea to “wait out the storm”, or choose not to evacuate because “it doesn’t look that bad out now.” Waiting to evacuate is dangerous for everyone, and is often a matter of life and death. As a person with a disability, the earlier you choose to evacuate, the more likely you will find an accessible place to stay for the duration of the emergency-be it with a friend, family member or even perhaps at your house of worship. Should you choose to wait until the last minute to evacuate, roads may be closed, shelters may be operating at capacity and your ability to bring all of your disability related equipment, may be hampered by the emergent nature of your evacuation. It’s almost always a better choice to get out town days ahead of storm instead of relying on emergency personnel to rescue you when the storm is bearing down on the area. Notes: 49 Make a Plan As a person with a disability, it’s important to make a plan for emergencies that incorporates your disability-related needs. Some questions you should consider asking yourself include: • • • • • • • How does my disability affect me in stressful situations? Am I responsible for assisting others? Do I need assistance to complete activities of daily life? Who’s in my support network? What is my language of choice? Do I have pets or service animals? How, when and where will I evacuate? Once you’ve identified what your disability related needs are, pick a minimum of two people in the places that you most frequently go (work, school, volunteer site, house of worship etc.) to share your plan with so they know what your needs are and how they can effectively assist you in the event of an emergency. Prepare and Maintain a “Go Bag” If an emergency were to occur, the general rule of thumb is that every member of your household and your service animals and pets should have on hand all the essentials to survive for a minimum three days without power, running water or access to food. In order to prepare, each member of your family should have a “Go Bag”. A go bag is a simple backpack/duffel bag that is filled with items you may need in the event of an emergency that’s easily carried on your body. Items to put in your Go bag may include: • Three-day supply of non-perishable food such as tuna, protein bars, peanut butter, fruit cups, canned chili and canned beans • Three-day supply of water – one gallon of water per person, per day • Portable, battery-powered radio or television and extra batteries • Flashlight and extra batteries • First aid kit and manual • Sanitation and hygiene items (moist towelettes and toilet paper) • Whistle • Extra clothing • Can opener • Photocopies of credit and identification cards • Cash and coins • Special needs items, such as prescription medications, eye glasses, contact lens solutions, and hearing aid batteries, catheters • Items for infants, such as formula, diapers, bottles, and pacifiers • Items for service animals • Other items to meet your unique family needs • Sturdy shoes • Hat, mittens, and scarf • Sleeping bag or warm blanket (per person) 50 As important as it is to have an emergency kit, don’t forget to update your kit at least once every 6 months by doing the following to maintain your kit: • • • • • Keep canned foods in a cool, dry place Store boxed food in tightly closed plastic or metal containers to protect from pests Throw out any canned good that becomes swollen, dented, or corroded Change stored food and water supplies every six months Re-think your needs every year and update your kit (especially your medication list and current medical needs) as your family needs change • Keep items in airtight plastic bags and put your entire disaster supply kit in one or two easy-to-carry containers, such as plastic bin, camping backpack, or duffel bag So, What Can I Eat? Even in an emergency it is important to eat healthy. When you purchase supplies in preparation for an emergency, you need to think about items that do not need refrigeration or an oven. Know your home and the impact a power outage will have on your ability to prepare food. Remember perishable food can’t sit without refrigeration for more than a few hours. For basic pantry items see page 12. Here are a few reliable recipe options for a disaster: Peanut Butter Protein Balls No Power Peanut Butter Sandwiches The batter requires refrigeration during the preparation so, you need to make these before a potential power outage or the temperature needs to be cold enough to chill outside. 1 cup (dry) oatmeal 1/2 cup chocolate chips (optional) 2/3 cup toasted coconut flakes 1/3 cup honey 3/4 cup peanut butter 1 teaspoon vanilla extract Whole grain bread Natural Peanut Butter Banana or apple slices Method Take 2 slices of bread and spread approximately 1 tablespoon on peanut butter on each slice of bread. Add the slices of apple or banana to the bread and put the bread together. Method Notes: Stir all ingredients together in a medium bowl until thoroughly mixed. Cover and let chill for ½ hour. Once chilled, roll into balls about an inch in diameter. Store in an airtight container. These protein balls can be refrigerated for up to 1 week. Notes: 51 Tornado Tuna Salad Other suggestions Oatmeal with fruit 1 can (5 ounces) water packed tuna, only (optional) 1 tablespoon Italian seasoning, dried basil, oregano, dill or any herb of your choice 2 tablespoons lemon juice, or more to taste Peanut butter toast Cereal with almond milk 1/2 stalk celery, minced 1 tablespoon extra-virgin olive oil to taste Granola or trail mix 1 finely chopped scallion - green part Salt and pepper to taste Rice cakes with peanut butter Canned soup or chili Method Pour the tuna in a small mixing bowl. Use a fork to break the tuna chunks into very small pieces. Notes: Add the herbs, celery and lemon juice to the bowl. Use the fork to stir all the ingredients together till well mixed. Add extra virgin olive oil. Season with salt and pepper to taste; sea salt and freshly ground pepper are best. Serve in a bowl, over a bed of lettuce or on bread as a sandwich. Emergency Preparedness – Chapter Summary Emergencies require planning. Maintain a list of doctors, medications in original containers, and needed personal supplies that are important to take with you. Create an emergency plan that includes ways to contact caregivers. Do not eat foods that have been unrefrigerated for more than a few hours. Additional Resources American Red Cross: Functional need sheltering: www.redcross.org/prepare/ www.ready.gov/individuals-access-functional-needs “He who has health, has hope; and he who has hope, has everything.” ~Thomas Carlyle 52 My Notes: MY TIPS ! ICKS R T D N A MY TIPS ! KS C I R T D AN 53 “And the Beet Goes On”- Vegetable Pancakes 1 grated red beet 2 grated carrots 3 peeled and grated potatoes 1/4 cup minced onion “Give Peas a Chance” Pasta About ¼ cup of canola oil 2 eggs 1/2 cup flour Salt and Pepper 1 pound spaghetti; preferably whole wheat or gluten free 4 ½ cups water 1 pound mushrooms, thinly sliced 2 zucchini, thinly sliced and quartered Method Add all the vegetables into a colander, lightly salt, cover with a paper towel. Squeeze out all liquid in a colander. In a large bowl, mix vegetables with eggs, flour, 1 teaspoon of kosher salt and pepper to taste. Mix, form into patties (mini pancakes). Fry for two minutes on each side in vegetable oil over medium heat. Drain on paper towel to absorb excess oil. Serve with apple sauce or low fat sour cream. 2/3 cup peas 2 cloves garlic, thinly sliced Optional: 2 sprigs thyme Salt and pepper, to taste 1/3 cup grated Parmesan Method In a large stockpot or Dutch oven over medium high heat, combine spaghetti, mushrooms, zucchini, peas, garlic, thyme and 4 1/2 cups water; season with salt and pepper, to taste. Bring to a boil; reduce heat and simmer uncovered, until pasta is cooked through and liquid has reduced, about 8-10 minutes. Stir in Parmesan. Serve immediately. This recipe is a great vegetarian dish! There is an international movement called “Meatless Monday” that encourages people to forgo eating meat products on Monday to improve personal health, as well as, to benefit the environment. For more information about why the Meatless Monday movement exists and healthy, delicious meatless recipes visit www.meatlessmonday.com/ This recipe calls for beets which are great vegetables to work into your diet. They are a root vegetable which means they grow underground, a good source of natural sugar and vitamins and minerals, make a great side dish and are a nice addition to any salad. Colorful Grilled Vegetable Kabobs 2 medium sized zucchini clean and cut into 2 inch cubes 2 medium sized yellow squash clean and cut into 2 inch cubes 2 red or green bell peppers, seeded, cleaned and cut into wedges 2 medium red onions cut into wedges 16 cherry tomatoes 8 ounces fresh mushrooms Non-stick vegetable oil spray Wood/bamboo skewers Sauce Method Combine the cut vegetables with the tomatoes and mushrooms in a bowl. Mix the vinegar, mustard, garlic, and thyme for the sauce. Toss vegetables in the sauce and thread vegetables onto skewers. (Soak bamboo or wood skewers in water for over an hour before using. This prevents them from catching on fire during cooking.) Before starting the grill, spray it with vegetable oil spray. Place the skewers on the grill, turning onto each side for about 2-3 minutes until done. Notes: ½ cup balsamic vinegar 2 tablespoons mustard 3 cloves garlic, minced or pressed Optional: ¼ teaspoon thyme, ¼ teaspoon crushed red peppers 54 Appetizers: Recipe Finder Gotta Have It - Guacamole (Smashed Avocado Dip) Page 37 Hummus a TunePage 37 Quick Quinoa Pizza BitesPage 30 Soups: Kale (or Broccoli) and White Bean Soup Page 16 “Not So Fancy” Lentil and Spinach Soup Page 30 Simple Salad SoupPage 20 Salads: Summer Slaw —Crunchy Ramen Noodle Salad Page 21 Fiberlicious Lentil SaladPage 43 Healthy Beginnings SaladPage 16 “Leftover” Chicken Salad Page 9 Never Fail Kale SaladPage 36 Do You Know the Way to Santa Fe? Salad Page 52 Tornado Tuna SaladPage 73 Side Dishes: “And The Beet Goes On” Vegetable Pancakes Page 54 Abuela’s Black Beans and Rice Page 21 Colorful Grilled Vegetable Kabobs Page 54 Jersey Cranberry Spicy SalsaPage 40 Main Dishes: “Hakuna Matata” Frittata (Easy Omelet) Page 34 Birdseed MeatloafPage 35 Feather and Leaf LasagnaPage 36 “One Pan” Chicken Breasts with Roasted Potatoes Page 16 Chicken Stir No FryPage 30 “Give Peas a Chance” Pasta Page 54 King Neptune’s Spicy Baked Fish Page 22 No Power Peanut Butter Sandwich Page 51 Perfectly Poached SalmonPage 10 Rockin’ Ramen Noodle Hot Dish Page 20 “The Bit Cheesy” Chicken and Shells Page 21 Fiesta White Chili with Quinoa Page 35 Desserts and Snacks: Decadent Dessert Nachos with Strawberries and Chocolate Sauce Page 38 Monkey Sticks Frozen Banana Treats Page 37 Groovy GranolaPage 34 “Going Bananas About Berries” Yogurt Page 42 Peanut Butter Protein BallsPage 51 SmoothiesPage 44 Watermelon Yogurt IcePage 28 Extras: Dijon Mustard vinaigrette salad dressing Page 9 Sesame Ginger vinaigrette salad dressing Page 9 55 The Disability, Health & Wellness Program encourages individuals with disabilities to be proactive in their healthcare. In taking on a healthier lifestyle, you can elevate your overall health and wellness and possibly prevent secondary conditions. In support of those goals, the “Eat Well, Live Well & Be Well” guide provides multiple wellness resources for individuals with disabilities. Recipes, tips, adaptive resources and so much more - helps you to take control of your health.
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