Supported by: National Center for Minority Health and Health Disparities Native Navigators and the Cancer Continuum (NNACC) [NCMHD R24MD002811] OBJECTIVES By the end of this segment, the learner will be able to: 1. Identify at least five traditional foods that contribute to AIAN health 2. Identify how to read food labels 3. Identify foods that are recommended for healthy daily diets (5 a day, food pyramid, low fat, high fiber) 2 Yesterday and Today AIAN Ancestors Traditional Behaviors During traditional times, American Indians and Alaska Natives rarely had: Cancer Heart Disease Diabetes Obesity 4 QUESTION: What did our AIAN Ancestors Use to Measure a Serving Size? A handful Choosing Traditional or Healthy versus Fast Foods A traditional fast food was a piece of fruit or a handful of pemmican 5 6 1
Food Choices of Our Ancestors Our Ancestors ate foods that were: Low in fat like fish, buffalo and game meats (deer, elk) High in fiber, like vegetables They ate many different kinds of food Varieties in foods provide many nutrients for good health Foods were Selected Below the ground (onions, potatoes, carrots) Above the ground (chokecherries, acorns, corn, asparagus, milkweed) The four-legged (buffalo, deer, antelope, prairie dog, rabbit) The finned (fish, eel, turtle) The winged (turkey, pheasant, grouse, duck) 7 8 Traditional Foods Preparation Traditional Foods Preparation Slow Cooked (rotisserie) Smoked Dried Broiled Boiled Baked Less fat used to cook foods than is used today No fat added to foods that were boiled or dried Foods did not sit in fat 9 10 Traditional Foods and Ceremony Dances, prayers, art and ceremonies that honor traditional foods (like corn) In some tribes, foods have special meanings, such as Corn as the mother, protection and nurturing Other tribes, limited to no corn in diets Giving back some food to Mother Earth or to Fire (as offering and thankfulness) What are Examples of Foods Our Ancestors Ate that are Available today? Corn, squash, beans (3 Sisters / Holy Trinity of foods) Almost all of the foods are still present, just not eaten as often as contemporary foods 11 12 2
Selected Nutrients Calories Calories = measure of energy provided by the food Recommended Daily Calories for Women: 1600-1800 calories Recommend Daily Calories for Men: 1800-2200 calories 14 Fats - Functions Fats = Provide: Provide energy (calories) (~9 grams) Provide padding for bones and body organs Maintain body temperature Add flavor to foods Carry fat-soluble nutrients Fats - Types Fatty Acids Saturated Naturally found in foods made from animals Rarely in plants (coconut and palm oils are exceptions) Raise blood cholesterol 15 16 Fats - Types Fatty Acids Saturated On average, Naturally Americans found consume in foods 4-5 made times from as much saturated animals fat as trans fat in their diets. For example, if you eat 2,000 total calories a day, your Rarely in plants (coconut and palm daily limits should be less than 16 grams (less than oils are exceptions) 140 of those calories) from saturated fats. Raise blood cholesterol Source: http://www.americanheart.org/presenter.jhtml?identifier=3046155 Fats - Types Monounsaturated Naturally found in olive and peanut oils, lean meats, nuts, avocados May lower blood cholesterol Polyunsaturated Naturally found in vegetables (safflower oils, sunflower, corn, soybean) and in fish Lower blood cholesterol 17 18 3
Fats - Types Trans-fats (not identified for health effects until late 1990s) Definition (American Heart Association) Trans fats (or trans fatty acids) are created in an industrial process that adds hydrogen to liquid vegetable oils to make them more solid. Trans-fats Another name for trans fats is partially hydrogenated oils or shortening. Look for them on the ingredient list on food packages Give foods a desirable taste and texture Many restaurants and fast-food outlets use trans fats to deep-fry foods Oils with trans fats can be used many times in commercial fryers 19 20 Trans-fats American Heart Association recommends less than 2 grams of trans-fat a day Zero trans-fat on label does not really mean zero FDA labeling allows a food with less than 0.5 grams of trans-fat to be called zero trans-fat For fry oils, baking shortenings, margarines, and doughnut fry oils, 1 serving = 1 tablespoon. Trans-fats Health Impacts Increases bad LDL cholesterol (see next slides) Increases risks for heart disease and stroke Decreases good HDL cholesterol Contributes to diabetes 21 22 Cholesterol A soft, waxy substance Found among fats circulating in your bloodstream and in all of your body s cells Your body needs cholesterol to produce cell membranes and certain hormones Comes from Your body Foods you eat 23 Cholesterol It is in animal products you eat such as: Meat Chicken (Poultry) Fish (especially shell fish ) Eggs Butter Cheese Whole and 2% milk It is not in foods made from plants 24 4
LDL and HDL Cholesterol Fats have different effects on the cholesterol levels in your body Saturated fats and trans fats raise bad cholesterol (LDL) levels in your blood Monounsaturated fats and polyunsaturated fats can lower bad cholesterol levels and are beneficial when consumed in moderation Good Cholesterol High-density lipoprotein (HDL) HDL carries cholesterol away from your arteries Takes the cholesterol to your liver The Liver removes the cholesterol from your body 25 26 Good Cholesterol High levels of HDL protect you from heart attacks Higher than 60 mg/dl may help protect you against heart disease Low levels of HDL may increase your risk for heart attacks Less than 40 mg/dl for men Less than 50 mg/dl for women Bad Cholesterol Low-density lipoprotein (LDL) High levels of bad cholesterol: Clog your arteries Increase your risk of heart attack and stroke Slowly builds up in the walls of the arteries in your heart and brain 27 28 Bad Cholesterol (LDL) Combines with other substances to form plaque, which can narrow your arteries and make them less flexible (atherosclerosis) If a blood clot forms and blocks an artery narrowed by plaque, you could have a heart attack or stroke Keep your LDL low (below 100 mg/dl) for good health 29 Triglycerides A form of fat that s made in your body People who have high levels of triglyceride often have: Low levels of good (HDL) cholesterol High levels of bad (LDL) cholesterol Triglyceride levels of 150 mg/dl or higher may increase your risk for heart disease Many people with heart disease, diabetes or both have high triglyceride levels. 30 5
Learning About your Cholesterol Levels Blood tests Looks for HDL ( good ) cholesterol LDL ( bad ) cholesterol Triglycerides Need to not eat or drink liquids ( fasting ) for 12 hours before having blood drawn to check for triglycerides How Often Should Cholesterol be Checked? All adults age 20 and older At least once every five years Even if your cholesterol levels are unhealthy, you may not feel sick That s why it s important to have your levels checked regularly 31 32 Fat = Energy Dense Foods (high calories) A single tablespoon of any oil contains 120 calories - which means even a little fat has a lot of calories Energy Dense, High Fat Foods QUESTION: What are examples of energy dense (high calorie), high fat foods? Baked goods (Cookies, commercial products like HoHo s, Cup Cakes) Candies Crackers Deep fried foods Yes, including Fry Bread 33 34 Energy Dense, High Fat Foods Fact or Myth? Fry Bread is not a traditional food if it contains lard; fry bread is a common contemporary food One serving of fry bread typically has 3 days worth of recommended dietary fat intake All fats are bad The body needs some fats Low in fat means the same as low in calories Likely to mean that more refined sugar was added to the food to give it some flavor 35 36 6
Fact or Myth? Butter has more calories than margarine Same number of calories Butter has more cholesterol and saturated fat Trans-fat is used by most Fast Food Businesses = YES Carbohydrates Complex carbohydrates are high in nutrients (naturally found in beans, peas, vegetables, wheat, whole grain products) Simple carbohydrates naturally in fruit, milk Refined carbohydrates are high in calories and typically are low in nutrients 37 38 High Fructose Corn Syrup Added to the diet since 1970 s Fructose may affect the body s metabolism not burn off as many calories as compared to someone with a diet that does not have fructose corn syrup Increase consumption in 1980 s corresponds with increase in overweight and obesity Proteins The body needs to build bones and tissues Proteins make the body function (amino acids, enzymes) Protein foods include meats, chicken (poultry), eggs, cheeses, nuts, milk products QUESTION: What is an example of a low fat, high protein food? 39 40 Dietary Fiber Helps the body get rid of wastes and poisons Estimates from 18-25 grams of fiber a day (for someone on a 2,000 calorie program) Bran muffin usually has less than 4 grams so eating one muffin does not meet the goals Which food is higher in fiber? Which is native to the Americas? Canned applesauce: fresh apple Bean burrito: beef burrito Potato chips: baked potato with skin Raisin bran: fruit loops Chili without beans: chili with beans Whole wheat tortilla / Whit flour tortilla 41 42 7
Fact or Myth? Carbohydrates are fattening Not all carbohydrates are equal complex carbohydrates versus refined sugary carbohydrates Too much sugar in the diet causes diabetes Eating excess calories, high-fat foods and no exercise = greater relationship to diabetes than does sugar intake Fact or Myth? Honey is better for you than white sugar Honey has the same chemical structure as white sugar Any food with fructose is bad for you Fructose occurs naturally in fruits High Fructose is not the same as fructose it is a sweetener made from cornstarch to increase the amount of fructose 43 44 Calories in Protein, Carbohydrates, Fats 9 calories in every gram of fat, regardless of what type of fat it is 4 calories in every gram of protein 4 calories in every gram of carbohydrate Reading Labels 45 Start here Note the Size of a single serving Number servings in the package 47 48 8
Check total calories per serving. Look at how many servings you re really consuming If you double the servings you eat =double the calories, nutrients, and Percent Daily Value (% DV). 49 Limit: Total fats (to no more than 56 78 grams a day) Saturated fats (no more than 16 grams a day) Trans-fat (less than two grams a day) Cholesterol (less than 300 mg if you re on a 2,000 calorie diet) 50 Get enough of: Carbohydrates Dietary Fiber Protein Vitamins and nutrients Need to get 100 percent of the fiber, vitamins and other nutrients every day 51 Percentage of Daily Values Tells you the percent of each nutrient in a single serving based on 2,000 calorie diet If you want to consume less of a nutrient (such as saturated fat, cholesterol or sodium), choose foods with a lower % DV: <5 % less is low. 52 If you want to consume more of a nutrient (such as fiber), seek foods with a higher percentage Daily Value (%DV) 20 percent or more is high 53 You may need to consume less or more than 2,000 calories depending upon: Your age Your gender Your activity level Whether you re trying to lose, gain or maintain your weight 54 9
The number of calories in a food per serving (for a 2,000- calorie diet): 40 calories per serving is considered low 100 calories per serving is considered moderate 400 calories or more per serving is considered high 55 No % DV shown for trans fat FDA does not have enough scientific information to set this value 0 g of trans fat on label only means the food contains < 0.5 grams of trans fat per serving. 56 Food can still include partially hydrogenated oil in the ingredient list = <.5 grams per serving If you eat more than one serving, you could quickly reach your daily limit of trans fat. Practice How many servings per container? How large is a ½ cup serving as compared to your closed hand? How much cholesterol? 57 58 Practice What is healthy about this food? What is not-toohealthy about this food? What would you guess is the amount for trans-fat? Which of these foods has the lowest amount of saturated fat? Which of these foods has the lowest calories per serving? Which of these foods has the largest serving size? 59 10
Summary for Reading Labels Other Guidelines 5 to 9 a Day Food Pyramids 62 Eat 5 to 9 Fruits and Vegetables a Day National Cancer Institute s 5 a day campaign Easy way to remember to eat at least 5 servings of fruits and vegetables each day Canada recommends at least 9 a day USDA FOOD PYRAMID 63 Walter Willet MD 2001 64 AIAN Tailored Pyramid s based on USDA Pyramid Willet s Healthy Eating Pyramid Walter Willet MD 2001 65 66 11
Dr. Willet s Pyramid The pyramid is not a carbohydrate freefor-all Need carbohydrates that are whole grain foods etc The USDA pyramid oversimplified the message All carbohydrates are not equal All fats are not bad 67 12