3.3. Health behaviors, social and behavioral risk factors: 3.3.1 and 3.3.2

Weight loss • Because there is no "one size fits all" approach to weight-loss, the coach utilizes coaching skills that engage the client to choose a strategy that fits his/her preferences and lifestyle. The NIH resource below offers general tips for choosing a safe and successful weight-loss program

Choosing a Safe and Successful Weight-loss Program Do you think you need to lose weight? Have you been thinking about trying a weight-loss program? You are not alone. More than 70 percent of U.S. adults are overweight or have obesity1 —and many of them try to lose the extra pounds through different kinds of weight-loss programs. A number of these programs are advertised in magazines and newspapers, as well as on the radio, TV, and internet. But are they safe? And will they work for you? Here you'll find tips on how to choose a program that may help you lose weight safely and keep it off over time. You'll also learn how to talk with a health care professional about your weight. Your health care professional may be able to help you make lifestyle changes to reach and maintain a healthy weight. However, if you're having trouble making these lifestyle changes—or if these changes aren't enough to help you reach and stay at a healthy weight—you may want to consider a weight-loss program or other types of treatment. Where do I start? Talking with a health care professional about your weight is an important first step. Sometimes, health care professionals may not address issues such as healthy eating, physical activity, and weight during general office visits. You may need to raise these issues yourself. If you feel uneasy talking about your weight, bring your questions with you and practice talking about your concerns before your office visit. Aim to work with your health care professional to improve your health. Woman talking with a female health care professional Talking with your health care professional about your weight is an important first step. Prepare for your visit Before your visit with a health care professional, think about the following questions: How can I change my eating habits so I can be healthier and reach a healthy weight? How much and what type of physical activity do I think I need to be healthier and reach a healthy weight? Could I benefit from seeing a nutrition professional or weight-loss specialist, or joining a weight-loss program? You can be better prepared for a visit with a health care professional if you write down all of your questions ahead of time record all of the medicines and dietary supplements you take, or bring them with you write down the types of diets or programs you have tried in the past to lose weight bring a pen and paper, smartphone, or other mobile device to read your questions and take notes During your visit, a health care professional may review any medical problems you have and medicines you take to see whether they may be affecting your weight or your ability to lose weight ask you about your eating, drinking, and physical activity habits determine your body mass index (BMI) to see whether you're overweight or have obesity People who are overweight have a BMI between 25.0 and 29.9. People with obesity have a BMI of 30.0 or higher, and those with extreme obesity have a BMI of 40.0 or higher. You can use this online tool or chart to see what your BMI is. If a health care professional says you should lose weight, you may want to ask for a referral to a weight-loss program, dietitian, or weight-loss specialist. If you decide to choose a weight-loss program on your own, consider talking with the health care professional about the program before you sign up, especially if you have any health problems. Ask questions if you don't understand something your health care professional has said, or if you need more information. Questions to ask a health care professional You may want to ask a health care professional the following questions: What is a healthy weight or BMI for me? Will losing weight improve my general health, as well as specific health problems I have? Could any of my medical conditions or medications be causing weight gain or making it harder for me to lose weight? Are there any types or amounts of physical activity I should not do because of my health? What dietary approaches do you recommend I try or avoid? What should I look for in a weight-loss program? To reach and stay at a healthy weight over the long term, you must focus on your overall health and lifestyle habits, not just on what you eat. Successful weight-loss programs should promote healthy behaviors that help you lose weight safely, that you can stick with every day, and that help you keep the weight off. Safe and successful weight-loss programs should include behavioral treatment, also called lifestyle counseling, that can teach you how to develop and stick with healthier eating and physical activity habits—for example, keeping food and activity records or journals information about getting enough sleep, managing stress, and the benefits and drawbacks of weight-loss medicines ongoing feedback, monitoring, and support throughout the program, either in person, by phone, online, or through a combination of these approaches slow and steady weight-loss goals—usually 1 to 2 pounds per week (though weight loss may be faster at the start of a program) a plan for keeping the weight off, including goal setting, self-checks such as keeping a food journal, and counseling support The most successful weight-loss programs provide 14 sessions or more of behavioral treatment over at least 6 months—and are led by trained staff.2 Some commercial weight-loss programs have all of these components for a safe and successful weight-loss program. Check for these features in any program you are thinking about trying. Some weight-loss programs use very low-calorie diets to promote quick weight loss—3 or more pounds a week for several weeks—in people with a lot of excess weight. You should be monitored closely by a health care professional if you are on a very low-calorie diet that provides 800 calories a day or less. Although these diets may help some people lose a lot of weight quickly—for example, 15 pounds in a month—they may not help people keep the weight off long term. These diets also may have related health risks, the most common being gallstones.3 For people who are overweight or have obesity, experts recommend a beginning weight-loss goal of 5 to 10 percent of your starting weight within 6 months.2 If you weigh 200 pounds, that would amount to a loss of 10 pounds, which is 5 percent of starting weight, to 20 pounds, which is 10 percent of starting weight, in 6 months. Changing your lifestyle isn't easy, but adopting healthy habits that you don't give up after a few weeks or months may help you maintain your weight loss. Read how to change your habits for better health. What if the program is offered online? Many weight-loss programs are now being offered partly or completely online and through apps for mobile devices. Researchers are studying how well these programs work on their own or together with in-person programs, especially long term. However, experts suggest that these weight-loss programs should provide the following: organized, weekly lessons, offered online or by podcast, and tailored to your personal goals support from a qualified staff person to meet your goals a plan to track your progress on changing your lifestyle habits, such as healthy eating and physical activity, using tools such as cellphones, activity counters, and online journals regular feedback on your goals, progress, and results provided by a counselor through email, phone, or text messages the option of social support from a group through bulletin boards, chat rooms, or online meetings Whether a program is online or in person, you should get as much background as you can before you decide to join. Woman holding a laptop and sitting on the floor with outstretched legs Many weight-loss programs are now being offered online and through apps for mobile devices. Weight-loss programs to avoid Avoid weight-loss programs that make any of the following promises: Lose weight without diet or exercise! Lose weight while eating as much as you want of all your favorite foods! Lose 30 pounds in 30 days! Lose weight in specific problem areas of your body! Other warning signs to look out for include very small print, asterisks, and footnotes, which may make it easy to miss important information before-and-after photos that seem too good to be true personal endorsements that may be made up You can report false claims or scams by weight-loss programs to the Federal Trade Commission. What questions should I ask about a weight-loss program? Weight-loss program staff should be able to answer questions about the program's features, safety, costs, and results. Find out if the program you're interested in is based on current research about what works for reaching and maintaining a healthy weight. A first and very important question to ask of commercial weight-loss programs is, "Has your company published any reports in peer-reviewed, scientific journals about the safety and effectiveness of your program?" If the response is "yes," ask for a copy of the report or how you could get it. If the answer is "no," the program is harder to evaluate and may not be as favorable a choice as programs that have published such information. If you have questions about the findings, discuss the report with your health care professional. Here are some other questions you may want to ask: What does the program include? Eating Am I expected to follow a specific meal plan? Am I encouraged to write down what I eat each day? Do I have to buy special meals or supplements? If so, what are the daily or weekly costs? Does the program offer healthy meal-plan suggestions that I could stick with? If the program requires special foods, can I make changes based on my likes, dislikes, and any food allergies I may have? Physical Activity Does the program include a physical activity plan? Does the program offer ways to help me be more physically active and stay motivated? Counseling Does the program offer one-on-one or group counseling to help me develop and stick with my healthier habits? Does the program include a trained coach or counselor to help me overcome roadblocks and stay on track? Weight Maintenance Does the program include a plan to help me keep off the weight I've lost? What does that program include? Will there be ongoing counseling support? Other Features How long is the actual weight-loss program? How long is the weight-loss maintenance program? Does the program require that I take any kind of medicine? Can I speak with a doctor or certified health professional if I need to? Can I change the program to meet my lifestyle, work schedule, and cultural needs? Will the program help me cope with such issues as stress or social eating, getting enough sleep, changes in work schedules, lack of motivation, and injury or illness? Is the program in person? Is there an online part to the program? Group of men and women in an exercise class Find out if the program offers ways to help you be more physically active. What kind of education or training do staff members have? These questions are especially important if you are considering a medically supervised program that encourages quick weight loss (3 or more pounds a week for several weeks): Does a doctor or other certified health professional run or oversee the program? Does the program include specialists in nutrition, physical activity, behavior change, and weight loss? What type of certifications, education, experience, and training do staff members have? How long, on average, have most of the staff been working with the program? Does the program or product carry any risks? Could the program cause health problems or be harmful to me in any way? Is there ongoing input and follow-up to ensure my safety while I'm in the program? Will the program's doctor or staff work with my health care professional if needed—for example, to address how the program may affect an ongoing medical issue? How much does the program cost? What is the total cost of the program, from beginning to end? Are there costs that are not included in that total, such as membership fees or fees for weekly visits food, meal replacements, supplements, or other products medical tests counseling sessions follow-up to maintain the weight I've lost What results do people in the program typically achieve? How much weight does the average person lose? How long does the average person keep the weight off? Do you have written information on these and other program results? Are the results of the program published in a peer-reviewed scientific journal? What if I need more help losing weight? If a weight-loss program is not enough to help you reach a healthy weight, ask your health care professional about other types of weight-loss treatments. Prescription medicines to treat overweight and obesity, combined with healthy lifestyle changes, may help some people reach a healthy weight. For some people who have extreme obesity, bariatric surgery may be an option.

Arthritis (anti-inflammatory diet)

2. Get Fishy Certain types of fish are rich in inflammation-fighting omega-3 fatty acids, which reduce C-reactive protein (CRP) and interleukin-6, two inflammatory proteins in your body. How much: At least 3 to 4 ounces, twice a week Best sources: Salmon, tuna, sardines, anchovies and other cold-water fish 3. Eat Your Fruits and Veggies Fruits and vegetables are packed with antioxidants, which support the immune system - the body's natural defense system - and may help fight inflammation. How much: At least 1½ to 2 cups of fruit and 2 to 3 cups of veggies per meal Best sources: Colorful foods such as blueberries, blackberries, cherries, strawberries, spinach, kale and broccoli 4. Try a Handful of Nuts or Seeds Nuts are full of inflammation-fighting monounsaturated fat, protein and filling fiber, too - a bonus if you're trying to lose a few pounds. How much: Eat 1.5 ounces of nuts daily (about a handful) Best sources: Walnuts, pine nuts, pistachios and almonds 5. Break out the Beans Beans have several antioxidant and anti-inflammatory compounds. They're a low-cost source of fiber, protein, folic acid and minerals such as magnesium, iron, zinc and potassium. 6. Pour on the Olive Oil Olive oil contains heart-healthy monounsaturated fat, antioxidants and oleocanthal, a compound that can lower inflammation and pain. How much: Two to three tablespoons per day for cooking or in salad dressings or other dishes Best sources: Extra virgin olive oil is less refined and processed. It retains more nutrients than standard varieties 7. Peel Some Onions Onions are packed with beneficial antioxidants. They may also reduce inflammation, heart disease risk and LDL, or "bad" cholesterol. Try them sautéed, grilled or raw in salads, stir-fries, whole-wheat pasta dishes or sandwiches. 8. Nightshades or Not? Nightshade vegetables - eggplant, tomatoes, peppers and potatoes - are central to Mediterranean cuisine. Some people believe they trigger arthritis flares, but there's limited scientific evidence to support this theory. Try cutting nightshades from your diet for two weeks to see if symptoms improve. 9. Fill up on Fiber Fiber lowers C-reactive protein (CRP), a substance in the blood that indicates inflammation. Getting fiber from foods lowers CRP levels more than taking fiber supplements. Foods that have carotenoids, the antioxidants that give carrots, peppers and some fruits their color, are quite good at lowering CRP. 10. Avoid Processed Food Processed foods such as cookies, chips and other snacks can be high in unhealthy fats, which are linked with inflammation. Opt for fresh fruit instead. Canned goods - vegetables and soups - are often high in sodium, which boosts blood pressure. Look for low sodium options, or go with fresh or frozen vegetables. 11. Cut the Salt There are conflicting reports about just how bad excess salt is for us. We know it causes fluid retention - one of many factors that can lead to high blood pressure. Also, corticosteroids, often used to treat RA, can cause the body to retain more sodium. So play it safe and hold the salt when possible. 12. Drink in Moderation Resveratrol, a compound found in red wine, may have anti-inflammatory effects. However, people with RA should limit alcoholic drinks - especially when they are taking medications like methotrexate. Your doctor can let you know what amount of alcohol, if any, is appropriate for you. 13. Fill Your Plate The Food Pyramid many of us grew up with has been replaced with a colorful plate that emphasizes proper proportions. One important message: Fill half your plate with vegetables. Learn more at www.choosemyplate.gov.

Hydration o Water and nutrition

Basics Woman Drinking water and laughing. Getting enough water every day is important for your health. Healthy people meet their fluid needs by drinking when thirsty and drinking with meals. Most of your fluid needs are met through the water and beverages you drink. However, you can get some fluids through the foods that you eat. For example, broth soups and foods with high water content such as celery, tomatoes, or melons can contribute to fluid intake. Water helps your body: Keep your temperature normal Lubricate and cushion joints Protect your spinal cord and other sensitive tissues Get rid of wastes through urination, perspiration, and bowel movements Your body needs more water when you are: In hot climates More physically active Running a fever Having diarrhea or vomiting If you think you are not getting enough water, these tips may help: Young boy looking at a glass of water. Carry a water bottle for easy access when you are at work of running errands. Freeze some freezer safe water bottles. Take one with you for ice-cold water all day long. Choose water instead of sugar-sweetened beverages. This can also help with weight management. Substituting water for one 20-ounce sugar sweetened soda will save you about 240 calories. For example, during the school day students should have access to drinking water, giving them a healthy alternative to sugar-sweetened beverages. Choose water when eating out. Generally, you will save money and reduce calories. Add a wedge of lime or lemon to your water. This can help improve the taste and help you drink more water than you usually do. More Information CDC. Plain Water, the Healthier Choice CDC. Water Access in Schools CDC. Toolkit: Increasing Access to Drinking Water in Schools[PDF - 54 pages] Nutrition.gov. Nutrition Information for You

Hypertension (DASH)

DASH is a flexible and balanced eating plan that helps create a heart-healthy eating style for life. The DASH eating plan requires no special foods and instead provides daily and weekly nutritional goals. This plan recommends: Eating vegetables, fruits, and whole grains Including fat-free or low-fat dairy products, fish, poultry, beans, nuts, and vegetable oils Limiting foods that are high in saturated fat, such as fatty meats, full-fat dairy products, and tropical oils such as coconut, palm kernel, and palm oils Limiting sugar-sweetened beverages and sweets. Based on these recommendations, the following table shows examples of daily and weekly servings that meet DASH eating plan targets for a 2,000-calorie-a-day diet. Daily and Weekly DASH Eating Plan Goals for a 2,000-Calorie-a-Day Diet Food Group Daily Servings Grains 6-8 Meats, poultry, and fish 6 or less Vegetables 4-5 Fruit 4-5 Low-fat or fat-free dairy products 2-3 Fats and oils 2-3 Sodium 2,300 mg* Weekly Servings Nuts, seeds, dry beans, and peas 4-5 Sweets 5 or less *1,500 milligrams (mg) sodium lowers blood pressure even further than 2,300 mg sodium daily. When following the DASH eating plan, it is important to choose foods that are: Low in saturated and trans fats Rich in potassium, calcium, magnesium, fiber, and protein Lower in sodium

Arthritis (anti-inflammatory diet)

Foods that fight inflammation Doctors are learning that one of the best ways to quell inflammation lies not in the medicine cabinet, but in the refrigerator. Updated: October 26, 2015Published: June, 2014 Your immune system attacks anything in your body that it recognizes as foreign—such as an invading microbe, plant pollen, or chemical. The process is called inflammation. Intermittent bouts of inflammation directed at truly threatening invaders protect your health.Foods that fight inflammation However, sometimes inflammation persists, day in and day out, even when you are not threatened by a foreign invader. That's when inflammation can become your enemy. Many major diseases that plague us—including cancer, heart disease, diabetes, arthritis, depression, and Alzheimer's—have been linked to chronic inflammation. One of the most powerful tools to combat inflammation comes not from the pharmacy, but from the grocery store. "Many experimental studies have shown that components of foods or beverages may have anti-inflammatory effects," says Dr. Frank Hu, professor of nutrition and epidemiology in the Department of Nutrition at the Harvard School of Public Health. Choose the right foods, and you may be able to reduce your risk of illness. Consistently pick the wrong ones, and you could accelerate the inflammatory disease process. Foods that inflame Try to avoid or limit these foods as much as possible: refined carbohydrates, such as white bread and pastries French fries and other fried foods soda and other sugar-sweetened beverages red meat (burgers, steaks) and processed meat (hot dogs, sausage) margarine, shortening, and lard Inflammation-promoting foods Not surprisingly, the same foods that contribute to inflammation are generally considered bad for our health, including sodas and refined carbohydrates, as well as red meat and processed meats. "Some of the foods that have been associated with an increased risk for chronic diseases such as type 2 diabetes and heart disease are also associated with excess inflammation," Dr. Hu says. "It's not surprising, since inflammation is an important underlying mechanism for the development of these diseases." Unhealthy foods also contribute to weight gain, which is itself a risk factor for inflammation. Yet in several studies, even after researchers took obesity into account, the link between foods and inflammation remained, which suggests weight gain isn't the sole driver. "Some of the food components or ingredients may have independent effects on inflammation over and above increased caloric intake," Dr. Hu says. Foods that combat inflammation Include plenty of these anti-inflammatory foods in your diet: tomatoes olive oil green leafy vegetables, such as spinach, kale, and collards nuts like almonds and walnuts fatty fish like salmon, mackerel, tuna, and sardines fruits such as strawberries, blueberries, cherries, and oranges Anti-inflammation foods On the flip side are foods and beverages that have been found to reduce the risk of inflammation, and with it, chronic disease, says Dr. Hu. He notes in particular fruits and vegetables such as blueberries, apples, and leafy greens that are high in natural antioxidants and polyphenols—protective compounds found in plants. Studies have also associated nuts with reduced markers of inflammation and a lower risk of cardiovascular disease and diabetes. Coffee, which contains polyphenols and other anti-inflammatory compounds, may protect against inflammation, as well. Anti-inflammatory eating To reduce levels of inflammation, aim for an overall healthy diet. If you're looking for an eating plan that closely follows the tenets of anti-inflammatory eating, consider the Mediterranean diet, which is high in fruits, vegetables, nuts, whole grains, fish, and healthy oils. In addition to lowering inflammation, a more natural, less processed diet can have noticeable effects on your physical and emotional health. "A healthy diet is beneficial not only for reducing the risk of chronic diseases, but also for improving mood and overall quality of life," Dr. Hu says.

Nutrition and weight status

Goal Promote health and reduce chronic disease risk through the consumption of healthful diets and achievement and maintenance of healthy body weights. Overview The Nutrition and Weight Status objectives for Healthy People 2020 reflect strong science supporting the health benefits of eating a healthful diet and maintaining a healthy body weight. The objectives also emphasize that efforts to change diet and weight should address individual behaviors, as well as the policies and environments that support these behaviors in settings such as schools, worksites, health care organizations, and communities. The goal of promoting healthful diets and healthy weight encompasses increasing household food security and eliminating hunger. Americans with a healthful diet: Consume a variety of nutrient-dense foods within and across the food groups, especially whole grains, fruits, vegetables, low-fat or fat-free milk or milk products, and lean meats and other protein sources. Limit the intake of saturated and trans fats, cholesterol, added sugars, sodium (salt), and alcohol. Limit caloric intake to meet caloric needs.1 All Americans should avoid unhealthy weight gain, and those whose weight is too high may also need to lose weight.2 Why Are Nutrition and Weight Status Important? Diet and body weight are related to health status. Good nutrition is important to the growth and development of children. A healthful diet also helps Americans reduce their risks for many health conditions,1 including: Overweight and obesity Malnutrition Iron-deficiency anemia Heart disease High blood pressure Dyslipidemia (poor lipid profiles) Type 2 diabetes Osteoporosis Oral disease Constipation Diverticular disease Some cancers Related Topic Areas Adolescent Health Arthritis, Osteoporosis, and Chronic Back Conditions Cancer Diabetes Early and Middle Childhood More Individuals who are at a healthy weight are less likely to: Develop chronic disease risk factors, such as high blood pressure and dyslipidemia. Develop chronic diseases, such as type 2 diabetes, heart disease, osteoarthritis, and some cancers. Experience complications during pregnancy. Die at an earlier age.2, 3, 4, 5 Back to Top Understanding Nutrition and Weight Status Diet Diet reflects the variety of foods and beverages consumed over time and in settings such as worksites, schools, restaurants, and the home. Interventions to support a healthier diet can help ensure that: Individuals have the knowledge and skills to make healthier choices. Healthier options are available and affordable. Social Determinants of Diet Demographic characteristics of those with a more healthful diet vary with the nutrient or food studied. However, most Americans need to improve some aspect of their diet.6, 7 Social factors thought to influence diet include: Knowledge and attitudes Skills Social support Societal and cultural norms Food and agricultural policies Food assistance programs Economic price systems8 Physical Determinants of Diet Access to and availability of healthier foods can help people follow healthful diets. For example, better access to retail venues that sell healthier options may have a positive impact on a person's diet; these venues may be less available in low-income or rural neighborhoods.9 The places where people eat appear to influence their diet. For example, foods eaten away from home often have more calories and are of lower nutritional quality than foods prepared at home.10 Marketing also influences people's—particularly children's—food choices.11 Learn More Dietary Guidelines for Americans CDC Division of Nutrition, Physical Activity, and Obesity CDC Division of School and Adolescent Health Fruits and Veggies Matter FDA Nutrition and Health Information More Weight Because weight is influenced by energy (calories) consumed and expended, interventions to improve weight can support changes in diet or physical activity. They can help change individuals' knowledge and skills, reduce exposure to foods low in nutritional value and high in calories, or increase opportunities for physical activity.3, 12, 13 Interventions can help prevent unhealthy weight gain or facilitate weight loss among obese people. They can be delivered in multiple settings, including health care settings,2, 14, 15, 16 worksites,17 or schools.12, 18, 19 Social and Physical Determinants of Weight The social and physical factors affecting diet and physical activity (see Physical Activity topic area) may also have an impact on weight. Obesity is a problem throughout the population. However, among adults, the prevalence is highest for middle-aged people and for non-Hispanic black and Mexican American women.20 Among children and adolescents, the prevalence of obesity is highest among older and Mexican American children and non-Hispanic black girls.21 The association of income with obesity varies by age, gender, and race/ethnicity.22 Emerging Issues in Nutrition and Weight Status As new and innovative policy and environmental interventions to support diet and physical activity are implemented, it will be important to identify which are most effective. A better understanding of how to prevent unhealthy weight gain is also needed.

3.3.1. Healthy weight and 3.3.2. Optimal nutrition & hydration

Guidelines around healthy weight, nutrition, and hydration are among the most controversial topics in lifestyle medicine. Thus, in this area, it is particularly important for the coach to follow a client-centered approach, beginning with what the client understands, needs, and wants, and engaging in a partnership that allows the client to access new information and ultimately create new habits. The coach should be familiar with recommendations and resources currently offered by leading government and health agencies. There are differing professional opinions, and many controversies exist that are not always readily apparent within conventional expertise. For example, the CDC recommendation for dietary guidelines (MyPlate) has been contested by some experts in nutrition, and alternative recommendations have been put forth, such as Harvard's Healthy Eating Plate. In this circumstance, the coach should be familiar with both popular resources, even though they may be contradictory. It is widely agreed that there is no "one size fits all" diet, and everything from ethnicity, family history, lifestyle, age, sex, body habitus, overall health, and environment needs to be considered by and for any given individual. How these individual considerations are made varies widely between experts. The coach and client have the unique opportunity to explore together what works best for the client. The coach understands the basics of a healthy diet, which include knowledge of unprocessed (or minimally processed) whole foods, lean proteins, adequate fiber, healthy fats, and the recommended intake of fruits and vegetables. Regarding water intake, the coach recognizes the role of hydration in health, and weight balance in particular, since people sometimes confuse the body's signals for hunger and thirst.

Healthy eating plate

Healthy eating plate o https://www.health.harvard.edu/healthy-eating-plate

MyPlate (current CDC guidelines)

MyPlate is a reminder to find your healthy eating style and build it throughout your lifetime. Everything you eat and drink matters. The right mix can help you be healthier now and in the future. This means: Focus on variety, amount, and nutrition. Choose foods and beverages with less saturated fat, sodium, and added sugars. Start with small changes to build healthier eating styles. Support healthy eating for everyone. Eating healthy is a journey shaped by many factors, including our stage of life, situations, preferences, access to food, culture, traditions, and the personal decisions we make over time. All your food and beverage choices count. MyPlate offers ideas and tips to help you create a healthier eating style that meets your individual needs and improves your health. For a colorful visual of MyPlate and the 5 food groups, download What's MyPlate All About?. Take a look at A Brief History of USDA Food Guides to learn more about previous food guidance symbols. Build a Healthy Eating Style All food and beverage choices matter - focus on variety, amount, and nutrition. Focus on making healthy food and beverage choices from all five food groups including fruits, vegetables, grains, protein foods, and dairy to get the nutrients you need. Eat the right amount of calories for you based on your age, sex, height, weight, and physical activity level. Building a healthier eating style can help you avoid overweight and obesity and reduce your risk of diseases such as heart disease, diabetes, and cancer. Choose an eating style low in saturated fat, sodium, and added sugars. Use Nutrition Facts labels and ingredient lists to find amounts of saturated fat, sodium, and added sugars in the foods and beverages you choose. Look for food and drink choices that are lower in saturated fat, sodium, and added sugar. Eating fewer calories from foods high in saturated fat and added sugars can help you manage your calories and prevent overweight and obesity. Most of us eat too many foods that are high in saturated fat and added sugar. Eating foods with less sodium can reduce your risk of high blood pressure. Make small changes to create a healthier eating style. Think of each change as a personal "win" on your path to living healthier. Each MyWin is a change you make to build your healthy eating style. Find little victories that fit into your lifestyle and celebrate as a MyWin! Start with a few of these small changes. Make half your plate fruits and vegetables. Focus on whole fruits. Vary your veggies. Make half your grains whole grains. Move to low-fat and fat-free dairy. Vary your protein routine. Eat and drink the right amount for you. Support healthy eating for everyone. Create settings where healthy choices are available and affordable to you and others in your community. Professionals, policymakers, partners, industry, families, and individuals can help others in their journey to make healthy eating a part of their lives.

Common evidence-based nutritional interventions for prevalent medical conditions o

The coach recognizes that professional organizations recommend nutrition guidelines for specific medical conditions, and may choose to refer clients to these links. The coach has a conceptual understanding of the diet (e.g., DASH diet for hypertension, reduced sodium intake); however, the coach is not required to memorize specifics of each diet.

Hypertension (DASH)

Three NHLBI-funded trials showed the health benefits of the DASH diet, such as lowering high blood pressure and LDL (bad) cholesterol in the blood, and shaped the final DASH eating plan recommendations. Study Results Three NHLBI-funded trials found the following health benefits of the DASH diet. DASH (Dietary Approaches to Stop Hypertension Trial): The DASH diet lowers blood pressure and LDL (bad) cholesterol compared with a typical American diet alone or a typical American diet with more fruits and vegetables. DASH-Sodium (DASH Diet, Sodium Intake, and Blood Pressure Trial): The DASH diet lowers blood pressure better than a typical American diet at three daily sodium levels. Combining the DASH diet with sodium reduction gives greater health benefits than the DASH diet alone. PREMIER clinical trial: People can lose weight and lower their blood pressure by following the DASH eating plan and increasing their physical activity. DASH Trial This trial included 459 adults, some with and without confirmed high blood pressure, and compared three diets including 3,000 mg daily sodium: Typical American diet Typical American diet plus more fruits and vegetables DASH diet None of the plans were vegetarian or used specialty foods. After 2 weeks, participants who added fruits and vegetables to a typical American diet or those on the DASH diet had lower blood pressure than those who followed a typical American diet alone. However, the participants on the DASH diet had the greatest effect of lowering their high blood pressure. Follow-up reports from the DASH trial showed that in addition to improving blood pressure, the DASH diet also lowered LDL cholesterol levels. High blood pressure and elevated LDL cholesterol are two major risk factors for cardiovascular disease. DASH-Sodium Trial This trial randomly assigned 412 participants to a typical American diet or the DASH diet. While on their assigned diet, participants were followed for a month at a high daily sodium level (3,300 mg) and two lower daily sodium levels (2,300 mg and 1,500 mg). Reducing daily sodium lowered blood pressure for participants on either diet. However, blood pressures were lower for participants on the DASH diet versus a typical American diet. Blood pressure decreased with each reduction of sodium. These results showed that lowering sodium intake and eating the DASH diet is more beneficial for lowering blood pressure than following the DASH diet alone. PREMIER Trial The PREMIER trial included 810 participants who were placed into three groups to lower blood pressure, lose weight, and improve health. The groups included: Advice-only group, did not receive counseling on behavior changes Established treatment plan, including counseling for 6 months Established treatment plan, plus counseling and use of the DASH diet After 6 months, blood pressure levels declined in all three groups. The two groups that received counseling and followed a treatment plan had more weight loss than the advice-only group. However, participants in the established treatment plan who followed the DASH diet had the greatest improvement in their blood pressure.