WHAM Handouts 1
Comfort Contract What is said in this room stays in this room. No computers or cell phones during class time. Speak from your own experience. Nothing about me without me! Go easy on aftershave and perfume (some of your classmates may be allergic to these). No personal attacks. No side conversations 2
Eating Pattern Assessment (Move Yourself-Cooper Clinic) For each of the food groups in the chart below, circle the foods that you usually eat from that particular category Food Group One Two Three Breads, cereals, and other starchy food Whole grain breads, cereals, crackers and pasta; wild and brown rice; corn tortillas; beans prepared with healthy or limited fats. White bread; presweetened cereal; granola; white rice; regular pasta; cornbread; muffins; regular crackers; flour tortillas; beans prepared with fat Doughnuts; biscuits; croissants; pastries; egg noodles; high-fat crackers; refined beans; potato skins; French fries; pasta, potatoes, and rice prepared with butter, cream or cheese Fruits and vegetables 4 or more servings of vegetables per day; 2 or more servings of fruit per day 2-4 servings per day of combined vegetables and fruit; canned fruit in heavy syrup Less than 2 servings of fruits and vegetables a day, coconut; vegetables cooked with cream, butter or cheese Dairy products Skim or 1% milk; 1% yogurt; low-fat soy milk; nonfat cheese; cheese with less than 3 grams of fat per ounce Reduced fat (2%) milk; 2% yogurt; reduced-fat cheese; light cream cheese; light sour cream Whole milk; whole milk yogurt; custard-style yogurt; Regular sour cream; cream cheese; regular cheeses like ricotta, Swiss, American, cheddar Meats, poultry, fish, eggs Small to moderate portions of lean beef and pork tenderloin; extra lean hamburger; skinless poultry; seafood; fish; egg whites or only a few eggs a week Larger portions of lean beef and pork cuts; lean hamburger; ground turkey; poultry with skin Marbled beef and pork; regular hamburger; bacon; sausage; bologna; hot dogs; fried chicken; fried fish; canned fish packed in oil; more than 6 egg yolks a week Fats and oils Use vegetable oils in moderation when preparing foods; consume moderate amounts of nuts, avocado, and olives; no trans fats Often add fats and oils when preparing foods at home; use soft margarine Always add fats and oils when preparing foods at home. Do not measure the amount of oil used. Frequently eat fried foods and fat foods. Use butter or stick margarine Desserts and snacks Pretzels; angel food cake; fig bars; graham crackers; lowfat crackers and cookies; low-fat popcorn; non-fat plain frozen yogurt without added sugar or fructose; sorbet Low-fat chips; cakes; brownies; regular popcorn; sherbet Regular potato, corn, and cheese chips; ice cream; candy; rich cakes; cookies; pies Beverages Water; less than 1 or 2 cups of coffee a day; 100% fruit juice; 100% vegetable juice; a variety of tea; little or no alcohol. Few alcoholic beverages; sports drinks; fruit punch. More than 2 cups of coffee a day; more than 2 drinks of regular latte drinks, regular soft drinks, and hot chocolate. 3
Interpreting the Results Into which column (one, two, or three) do most of your circled foods fall? If your answers are in Column one: Congratulations. You are enjoying a healthful diet that may help you reduce many of your risk factors for heart disease and stroke. Keep up the good work. Columns one and two: You are doing a good job of eating a healthful diet. Make a few changes so more of your food choices are in column one. Column two: Your diet is moderately healthy. You may have made some steps in the right direction. Keep making changes slowly until most of your food choices are in column one. Columns two and three: Your diet is not as heart healthy as it could be. Try to move away from some foods in column three and eat them only occasionally. Make changes slowly so that more of your choices are in column two, then mostly in column one. Column three: Your diet has room for improvement. Choose one or two food groups and start to slowly make changes toward two, then column one. Save the column three foods for eating on special occasions.
The YOU Diet Crib Sheet (YOU on a Diet by Roizen and OZ) Meal Strategy Waist Foods (eat em) Waste Foods (Trash em) In a Hunger Emergency Substitute Foods Meal Journal Supplements The Team The YOU-Turn Three main meals plus snacks, so you are never hungry. No eating within three hours of bedtime. Consider dessert an every other day treat. Whole-grain carbohydrates; fiber; nuts, which include healthy monounsaturated and polyunsaturated fats; protein, such as lean meats (two-legged preferred) and fish. Added sugars, simple carbohydrates, fructose as in high fructose corn syrup, trans fat, saturated fat, non-whole- grain flour, and enriched and/or bleached flour. Apples, almonds, walnuts, edamame (soybeans), sugarless gum, water, cut-up vegetables, low-fat yogurt and cottage cheese. In any recipe or meal plan, you can replace any fruit or vegetable with another to make recipes to your taste. You can keep track of what you eat at www.mychoicescount.com Once a day, take a multivitamin as an insurance policy against less-than-perfect food choices. Other supplements need to be discussed with your doctor. Don t be afraid to enlist advice from qualified nutritionists and trainers. But one of your most important team members will be your support partner someone who can encourage you and be a deterrent to failure, too. It s OK to make mistakes. The important thing is to catch them, recognize them, control them, and allow yourself the opportunity to get back on the right (waist management) road.
Role Play: Shared Decision Making Getting Ready for your Doctor Appointment and Health Tests An important emerging concept in whole health self-management is shared decision making. In the WHAM training, shared decision making is defined as the collaboration of a medical professional and recipient of whole health services to determine the treatment and self-management actions for maximizing whole health. In this collaboration, both the medical professional and recipient of whole health services should be valued as experts. The doctor may be an expert on medications, tests, and treatment, but equally important is the recipient of whole health services who uses skills like person-centered planning and the eliciting of the Relaxation Response as an expert on self-management. Following are 2 suggested scenarios for role playing: 1. A peer seeks support from a peer leader after learning that his blood pressure was high when taken at a health fair. He did not understand what terms like systolic and diastolic meant and due to his anxiety he is having problems sleeping. The peer leader demonstrates respectful listening and validating the peer s concerns. Then, if appropriate, the peer leader suggests some brainstorming of ideas to provide more information, like support to search on the internet to learn more about high blood pressure and ways to self-manage it. The peer leader shares the concept of shared decision making and becoming an expert on self-management of whole health issues like high blood pressure. The peer leader introduces the handout called Questions to ask about medical tests and offers support on how to fill it out. (Take 10 minutes to role play this scenario using volunteers from the group and/or trainers) 2. In conversation with a peer leader, a peer expresses concern about weight gain and whether medication could be causing the gain. The peer shares how meetings with the doctor are frustrating because the doctor always focuses on mental illness symptoms and how the medications are helping those symptoms, and never seems interested in discussing the weight gain or how gaining weight could negatively be impacting getting a meaningful life. The peer leader demonstrates respectful listening and validation of the peer s concerns. The peer leader shares information on the concept of shared decision making and how that process should be a collaboration with two experts the doctor and the recipient of whole health services. The peer leader introduces the handout called Getting ready for your Doctor appointment and offers support on how to fill it out. (Take 10 minutes to role play this scenario using volunteers from the group and/or trainers)
Questions to ask about medical tests Why is the test being done? What does the test involve? How should I get ready? Are there any dangers or side effects? How will I find out the results? How long will it take to get the results? What will we know after the test?
Reason for visit: Getting ready for your Doctor appointment What am I doing to address? What do I need help with? Life or health changes since last visit: Questions: 1) 2) 3) Challenges with current treatment: Current medications: Medication Questions: Medication refills: Link to an online question generator: http://www.ahrq.gov/questionsaretheanswer/questionbuilder.aspx