Fish, Meat, Poultry, Dairy, and Eggs

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Poultry, Dairy, Session 4 Background Information Tips Goals

Assessment In an average WEEK, how many servings of these foods do you eat? Desirable Could be improved Needs to be improved 1. Fish, including canned tuna 2+ 1 0 2. Bacon, sausage, hot dogs or cold cuts like bologna, salami, Spam or deli meats including turkey and beef 0-2 3-4 5+ 3. Chicken or turkey, excluding chicken or turkey cold cuts 3+ 2 0-1 On an average DAY, how many servings of these foods do you eat? 4. Red meat like roasts, steaks, stew meat, ribs, chops, BBQ, ham or hamburger, either alone or in dishes like meatloaf or spaghetti sauce 0-1 2 3+ On average, how many servings of these foods do you eat? 5. Dairy products, such as milk, cheese, and yogurt Number of servings per day or Number of servings per week 6. Eggs, including in cooking? Number of servings per day or Number of servings per week 2017 UNC-CH Center for Health Promotion and Disease Prevention 81

Background Information Why Is Fish Important? Eating fish can reduce your risk for getting heart disease. This is because fish are high in healthy fats. How Much Fish Should I Eat? You should eat fish often. Try to eat fish at least once a week to help lower your chances of heart disease. What Fish Should I Eat? In deciding what fish to eat, pay attention to mercury levels. Eating lots of food high in mercury can be harmful to anyone. Mercury is especially harmful for pregnant or nursing women and for children. Use the following guidelines to plan the types and amounts of fish you eat: ÛÛ Eat as many as 1 to 2 servings (3 ounces) per week of fish low in mercury. These include: Canned light tuna Salmon Atlantic mackerel Catfish Trout Herring Anchovies Sardines ÛÛ Eat no more than 1 serving (3 ounces) per week of fish high in mercury and serve even smaller portions of these fish to children. If you are planning to become pregnant or become pregnant, do not eat fish high in mercury. Fish high in mercury include: King mackerel Shark Tilefish Swordfish Albacore tuna How Should I Prepare Fish? For the healthiest fish, try: ÛÛ Baking, broiling, grilling, sautéing, or frying in vegetable oils. If you need recipe ideas, (see pages 19-25 of the Cookbook). 2017 UNC-CH Center for Health Promotion and Disease Prevention 83

Background Information Why Should I Eat Poultry? Poultry, such as chicken and turkey, is good for heart health. Plus, poultry costs less than meat and fish, so it is a good choice to eat often 3 or more times a week is fine. Also, it is okay to eat the skin if you enjoy it. Chicken skin is high in fat, but the fat quality is good. How Should I Prepare My Poultry? It is fine to bake, broil, barbecue or fry chicken. If you fry chicken, use healthy vegetable oil. For more information on oils for frying, see pages 107-108. Are all Poultry Choices Healthy? Deep fried, battered chicken purchased at fast food restaurants is high in salt and should not be consumed often. Also, spicy chicken, especially at fast food restaurants, is often very high in salt. It should not be eaten often. What Should I Know About Red Meat (Beef, Pork, and Lamb)? Most experts suggest limiting red meat to no more than 1 serving per day (including breakfast, lunch, and dinner.) This is because eating meat often increases the risk of heart disease. Also, people who eat large amounts of red meat have a modest increased risk for colon cancer. 84 2017 UNC-CH Center for Health Promotion and Disease Prevention

Background Information What Should I Know About Processed Meats Like Bacon, Sausage, Hot Dogs, and Cold Cuts (Including Deli Meats, Like Turkey and Beef)? In most studies, processed meats have been shown to increase the risk of getting heart disease. This is likely due to the preservatives (salt, nitrites, phosphates) in processed meats. Thus, it makes sense to limit processed meat to a couple of times per week. What Should I Know About Dairy Products? The Dietary Guidelines for Americans, 2015-2020, recommend fat-free or low-fat dairy products. After looking at how the use of full-fat dairy products affects the risk of heart disease or stroke in large groups of adults in the US and Europe, this program gives a different recommendation because full fat dairy products do not seem to increase the risk of heart disease or stroke. If you enjoy dairy products, it is reasonable to have 2 to 3 servings per day of either full fat or low-fat dairy products, according to your preference. But don t overdo it. Be sure to leave room in your eating plan for foods that lower heart disease and stroke risk, including healthy fats, fruits and vegetables, and whole grains. What Types of Dairy Products Should I Eat? Dairy desserts, such as ice cream, ice milk, and frozen yogurt contain more sugar than other dairy products. Thus, it makes sense to limit this type of dairy product to a couple of times a week. 2017 UNC-CH Center for Health Promotion and Disease Prevention 85

Background Information What Should I Know About Eggs? Not too long ago, people were told to avoid eggs. However, eggs are a very good source of protein and vitamins and contain reasonable amounts of healthy fats. Though eggs are high in cholesterol, we now know that cholesterol in the diet does not increase the risk for heart disease. So, it is okay to eat eggs. How Many Eggs Should I Be Eating? If you enjoy eggs, eating 1 to 2 a day is fine. How Should I Prepare My Eggs? Here are some heart healthy ways to prepare eggs: ÛÛ Try hard-boiling eggs. Hard-boiled eggs can be great on salads or as a healthy snack. ÛÛ Scramble your eggs or fry them in heart healthy oils. Summary Here is a summary of key points about. ÂÂ You should aim to consume fish 1 or more times a week, as fish contain heart healthy fats. ÂÂ Poultry is an inexpensive food that is good for your heart. Eating the skin is fine if you enjoy it. ÂÂ Avoid processed meats and eat red meat in moderation, up to 1 serving per day. ÂÂ Dairy products and eggs are other good choices. 86 2017 UNC-CH Center for Health Promotion and Disease Prevention

Tips Check the goals you want to work on for the next contact. 1. Choose fish more often. Aim for 1 or more servings of fish per week. Try baked, broiled, grilled, or fried fish. Try these Tasty Fish Recipes on pages 19-25 in the Cookbook. When frying fish, use vegetable oils instead of shortening or lard. Try some fish that have healthy fats, like canned tuna, herring, canned or fresh salmon, or trout. When you eat canned tuna, choose light tuna (most albacore or white tuna is higher in mercury). Some fish contain mercury, which can be harmful if large amounts are eaten. So eat fish with low levels of mercury, such as salmon, catfish, and canned light tuna. 2. Cut down on bacon, sausage, hot dogs, and cold cuts. Aim for 2 times a week or less. Try having breakfast without meat on some days. Try sandwiches made with: Sliced fresh beef, pork, chicken, or turkey are better choices than processed meats (cold cuts). Chicken, egg, or tuna salad (these salad sandwiches usually contain mayonnaise, which has healthy fats that are good for your heart). Peanut butter or other nut butters. Also, try these other ideas for lunches: Healthy leftovers. Soups (low salt/sodium). Salads with dressing. Continued 2017 UNC-CH Center for Health Promotion and Disease Prevention 87

Tips 3. Eat chicken and turkey often. It is reasonable to eat 3 or more servings of poultry each week. Bake, broil, or barbecue chicken. Try these Chicken Recipes on pages 16-18 of the Cookbook. Fried chicken is also okay, if fried in healthy vegetable oils. Do not fry chicken in shortening as most shortening still has trans fats. Fresh chicken or turkey is better for sandwiches than chicken or turkey cold cuts. 4. If you like eating red meat, like beef, pork, or lamb, aim for no more than 1 serving per day. A serving size of meat is 3 to 4 ounces, about the size of a pack of cards. It is fine to bake, grill, and broil meat. A great option is to sauté strips of meat with vegetables. 5. Dairy products, like milk cheese and yogurt, are good choices. If you like dairy, 2-3 servings a day is fine, full or reduced fat. A serving size of cheese is 1 ounce or 1 slice if pre-cut. Most flavored yogurt are high in sugar: Consider having only a couple times a week. Or, mix flavored yogurt with plain yogurt. Or, add chopped fruit or nuts to plain yogurt. Dessert dairy products, like ice cream, ice milk, and frozen yogurt are high in sugars and it is best to save these treats for a couple of times a week. 6. Eggs are also a good choice. 1 or 2 a day are fine. Eggs are great plain or mixed with other foods, like chopped vegetables. Try whole grain toast, with a bit of butter or tub-margarine, with your eggs. Boil eggs ahead of time for breakfast or a quick snack. 88 2017 UNC-CH Center for Health Promotion and Disease Prevention

My Goals and First Steps My Goals and First Steps To make changes, it is important to make goals and keep track of your progress. Enter the 2 goals you selected to work on today. Then enter your First Steps for achieving these goals. First Steps should be specific and realistic to get you started. To plan First Steps, think about: When you will start working towards this goal. What you need to get started. If you can actually reach the goal. Finally, keep track of your progress using the tables provided. 2017 UNC-CH Center for Health Promotion and Disease Prevention 89

My Goals and First Steps Date: Goal 1: First Steps: Goal 2: First Steps: Place this sheet where you will see it often (refrigerator or bathroom mirror). You may monitor goals by the week (left side of table) or by the day (right side of table). GOAL 1: Did you meet your goal? (Check for Yes, or for No) Week Weekly Goal Daily Goal Monday Tuesday Wednesday Thursday Friday Saturday Sunday 1 2 3 4 5 GOAL 2: Did you meet your goal? (Check for Yes, or for No) Week Weekly Goal Daily Goal Monday Tuesday Wednesday Thursday Friday Saturday Sunday 1 2 3 4 5 90 2017 UNC-CH Center for Health Promotion and Disease Prevention