Heart Disease

High Blood pressure is what triggered us to go see a doctor for Tim's Kidney Failure. His Kidneys caused effusion (fluid) around his heart which triggered his heart to work faster and harder. It made his heart enlarged and also tough.. Although his heart disease is the least of the issues right now and is controlled it was a huge sign to seek medical attention.. infact it was the only symptom Tim had this entire time... the high blood pressure caused his eyes to start bleeding from the back.. If you go into the grocery store near the pharmacy there are blood pressure cuffs. use them. If you blood pressure is higher than 135/85.. go see your doctor.

Love- Jackie

High Blood pressure is what triggered us to go see a doctor for Tim's Kidney Failure. His Kidneys caused effusion (fluid) around his heart which triggered his heart to work faster and harder. It made his heart enlarged and also tough.. Although his heart disease is the least of the issues right now and is controlled it was a huge sign to seek medical attention.. infact it was the only symptom Tim had this entire time... the high blood pressure caused his eyes to start bleeding from the back.. If you go into the grocery store near the pharmacy there are blood pressure cuffs. use them. If you blood pressure is higher than 135/85.. go see your doctor.

Love- Jackie

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Health Topics A-ZHealth Topics by CategoryHealth Topics for Cardiovascular HealthUI Heart and Vascular CareCardiovascular Diseases
High blood pressure and heart disease Blood pressure can change from minute to minute, especially when we are excited or afraid, and cause an increase in pulse and a rise in the pressure inside our blood vessels. It also is affected by changes in posture, exercise, sleeping, and medications. Normal blood pressure falls within a range. Monitoring and treating blood pressure is important because damage to arteries begins at fairly low blood pressure levels. Damaged arteries greatly increase the risk for heart attack, stroke, kidney failure, and atherosclerosis.
Blood pressure of less than 120 systolic and less than 80 diastolic is considered normal. A systolic pressure of 120 to 139 or a diastolic pressure of 80 to 89 is considered prehypertension and needs to be watched carefully. Any blood pressure reading equal to or greater than 140 systolic over 90 diastolic is considered high blood pressure. For people over age 50, systolic pressure is more important than diastolic.
High blood pressure is considered a silent killer, because many people with this disease have no symptoms. Over time, this increase in blood pressure can damage the blood vessels or vital organs. This can lead to strokes, heart disease, or kidney disease. High blood pressure is one of the most common risk factors for heart disease.
When blood pressure goes up, the heart has to work harder than normal. This puts the heart and the blood vessels under a strain. If high blood pressure is not treated, the heart will have to work even harder to pump enough blood and oxygen to meet the body's needs. The heart enlarges when it is forced to work harder than normal for a long time. An enlarged heart may have a hard time meeting the demands put on it.
Blood vessels also suffer the effects of high blood pressure. Over time, they become hardened. This often occurs as people age. High blood pressure speeds this process. Blood vessel damage is bad because hardened or narrowed arteries may be unable to supply the amount of blood the body's organs need. If the organs, especially the heart, do not get enough blood, they cannot function properly.
Treating prehypertension and high blood pressure early can decrease the chances of having heart problems in later life. A healthy low- fat, low-salt diet and healthy lifestyle habits, such as getting more exercise, losing weight, quitting smoking, and managing stress, help control high blood pressure. Regular and heavy use of alcohol can dramatically increase blood pressure. Alcohol intake of more than two ounces daily should be avoided. Weight loss of even 10 pounds can help significantly. Healthcare providers often recommend these methods to control blood pressure before turning to medications.
There are many drugs that can lower high blood pressure. Some rid the body of excess fluids and salt. Others reduce the heart rate and blood pressure by allowing the walls of the blood vessels to widen.
People with prehypertension and high blood pressure should:
follow the advice of their healthcare provider stay on their medication and follow all instructions ose weight if overweight stop smoking eat heart healthy foods and exercise Adults should get at least 30 minutes of moderate aerobic exercise most days of the week, preferably daily. (Children need at least 60 minutes a day.) Doing less than this will minimize your health benefits. Moderate aerobic exercise is generally defined as requiring about as much energy as walking 2 miles in 30 minutes.
Last Reviewed 2005 Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.HIL File CARD4301.RF2 VRS# 6144 Data Version 7.0 Copyright 1999, 2002-2003 McKesson Health Solutions LLC. All rights reserved.
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Colonoscopy-- Help yourself..get checked

Tim has his colonoscopy tomorrow.. Today was a pretty rough day.. trying to get him to drink a gallon of nasty water was rough.. not that he wasnt compliant but he just cant take in that amount of fluid.. it took a long time to get the stuff down. I read up on a colonoscopy and here is a little information.
Wish him luck tomorrow!
Love
Jackie

The truth about colonoscopy prep

MY TURN

Be grateful for procedure's benefits, book an early appointment and stock up on food for afterward.

March 09, 2009|By Kathleen Clary Miller

Colonoscopy: The very word sends shudders down the spine of anyone who has drunk "the drink" -- the concoction that cleanses the colon so the doctor can later examine it. I've enjoyed three different procedures with three different preps, and I've made it my mantra to minimize the misery:
The appointment: Just pick up the phone. The test is far better than cancer would be. My first one was early, at age 45, because my mother died of colon cancer. Feel nothing but gratitude that such a preventive procedure exists.

Once you've drummed thanksgiving into your brain, your aura should be one of pride: You are proactive in your plan to remain healthy and cancer-free! You are in control -- but be sure to request enough medication for the procedure to knock you out cold.
And make yours the very first appointment of the day. Trust me on this: When you haven't eaten anything but lemon Jell-O and Gatorade for 24 hours and you've been awake half the night evacuating everything out of your system, you will want to get this over with so that you can go home and take the longest nap of your life.
The prep: I've chugged the concentrate (two 8-ounce drinks so nasty and salty you'd swear you were drinking water from a Morton salt box), I've thrown back the pills (six horse tablets every 15 minutes) and I've faced the two-gallon pre-mixed jug you have to chug. I'd have to say pills were the best: You can't taste tablets.
A friend told me to keep the giant jug refrigerated because cold kills its Great Salt Lake flavor. But my doctor's instructions were specific: Allow it to reach room temperature. When I inquired of the pharmacist about this, he told me my stomach might constrict were I to leave it cold. So much for that idea.
Pretend that you hold in your hand the only antidote to the lethal virus that has been introduced by some foreign monkey into our country. You will die if you do not drink this glass within 10 seconds every 10 minutes. You may not stop, and you may not lose it into the kitchen sink. It is your only hope.
If imagination doesn't do it for you, locate a friend with whom you feel comfortable sharing your innermost rumblings and e-mail your way through the prep. No one should have to do this alone.
Should you need more encouragement to swallow, read the fine print attached to the bottle: If you are unable to hold down the contents, your doctor will introduce it into your system through your nasal cavity. That's right -- up your nose with a rubber hose. That, in my case, was powerful motivation.
My father, on the other hand, took another tack -- he mixed his prep with straight tequila. "It's clear liquid," he protested. "What would Jimmy Buffett do?"
The bathroom: You are going to be there for a while. Light a scented candle and bring a gripping book or some People magazines.
The procedure: A piece of cake! If for you, like me, the most dreaded part is the IV, ask for a numbing agent on the arm followed by a tiny shot of local anesthesia under the skin. One minute I was awake, the next I was awake again, getting rid of gas like a trooper. Don't be shy -- everyone does this. If you don't, there isn't enough Gas-X in the drugstore to soothe your pain.

The recovery: Stock your pantry in readiness: You'll pack in food like a starving bear once this is done -- after your six-hour nap, that is. Have the bed all ready, shutters drawn. Once I slept from noon until the next morning.
The moral: Remember, it's all about perspective. The third time, I woke up from my afternoon beauty slumber knowing that the things I waste time worrying about pale next to the blessings of good health, bounteous food -- and the reassurance that my next colonoscopy appointment is not for five years.

Coping with End Stage Renal Failure

Coping with end stage renal failure

There is an old saying that the fear of something is often worse than the reality and this is frequently the case with renal failure.
All of us have our life planned out in our minds. There are the immediate things which we know we will be doing in the next few hours, days and weeks. There are the things we plan to do over the next few months - the family wedding, the annual will do once we have the time!
When something as life threatening such as renal failure comes along to rock our boat, it is natural that we feel anxious, afraid and worried over what the future holds for us. All of a sudden, there is a big question mark over the life we had planned and an uncertainty over what will replace it.
There is much research to show that no matter what we lose, be it our keys, someone close to us, part of our body or body function, we, as humans, respond in the same way.
Initially, when the loss is discovered, there is a sense of numbness which may last for a few seconds, hours or even days and then we often go through a period of denial - you; know the feeling, "maybe if I really stick to the diet my kidneys: will get better".
Eventually the reality sinks in, however - this is for real - this is happening to me. Some of us continue the denial, go about life as if nothing has changed, some of us panic, seek reassurances that all will be well and many of us just take each day as it comes and decide to worry about it when "tomorrow" comes.
All this is fine and part of the adjustment process, but eventually we have to move on because all too often "tomorrow" does come, and we are faced with the reality that change is inevitable and life will never be quite the same again.
Some of us become sad, some angry, and a few of us become very controlled and decide to keep our feelings to ourselves. Once again, this is fine - it's all part of the adjustment process, but remember, it's not only you, the patient, who feels the effects of approaching renal failure, all the uncertainties, worries and anxieties. These are also felt by those nearest to you. They also worry about you and how this will affect their future. Change is around for everyone.
What you are feeling right now is a natural reaction to what you have been going through for the past weeks, months or maybe years. There is much uncertainty around, uncertainty that we somehow have to learn to live with. Some patients feel they have lost control of their lives and that suddenly someone else is "pulling the strings".
Try not to keep things to yourself. A problem shared is a problem halved. Often with a little bit of information many things suddenly fall into place and we begin to see that little bit of sunlight.
So ask. Speak to the doctor at the clinic; ask to see one of the Unit social workers, anyone you feel at ease with. All of us have many years experience working with kidney patients and there are few situations we have not coped with before. Share your concerns and we will do our best to help.

Sexuality and Chronic Kidney Failure

Sexuality and Chronic Kidney Disease

Many people think that sexuality refers only to the act of sexual intercourse. Sexuality includes many factors, such as how people feel about themselves, how they communicate with others and how willing they are to build a relationship. In addition, sexuality involves a wide range of pleasurable sexual activities that may or may not include intercourse, such as touching, hugging and kissing. Being a sexual person is healthy. Lovemaking may provide a way of feeling "normal" for people who are chronically ill.

How can kidney disease affect sex life?

Kidney disease can cause physical and emotional changes that may affect your sex life. The chemical changes that occur in your body with kidney disease affect hormones, circulation, nerve function and energy level. These changes usually lower sexual interest and/or sexual ability. Physical changes may cause people with kidney disease to feel less attractive sexually. Many of the medicines used to treat high blood pressure may affect sexual functioning.
Use of steroids may cause weight gain, acne, and unwanted hair growth or loss. Surgical scars can cause patients to feel unattractive. Medical changes and changes in self-image may affect sexual interest and functioning.

Is sexual intercourse safe for kidney patients?

Patients and their partners may worry that sexual activity could cause the patient's death or harm the dialysis access or transplanted kidney. No limitations need to be placed on kidney patients sexually. If sexual activity does not place pressure or tension on the access site, it will not cause damage. After receiving a transplant, it is important to wait until the scar has begun to heal. Once the doctor says it is all right to resume sexual activity, there is no reason to worry about damaging the transplanted kidney. Fear can cause people to avoid sexual activity needlessly.
For some couples, sexual intercourse is not possible. Some may feel that sex is not as important as it once was. Activities such as touching, hugging, and kissing provide feelings of warmth and closeness even if intercourse is not involved. Professional sex therapists can recommend alternative methods.

Will a child's sexual development be affected by kidney failure?

This depends on the child's age when kidney failure occurs. Young children with kidney disease are usually smaller than other children their age. They are also slower to develop sexually. Children who are on dialysis probably will have slower growth and sexual development than children who have kidney transplants. If a teenager has kidney disease, sexual development may slow down or even stop. For example, teenage girls may not have periods. Changes due to kidney failure and treatment may make the teenager feel different from his or her friends. Parents should express their concerns about growth and sexual development to the doctor. Parents of a child or teenager who is ill must fight the impulse to protect their child from the pain of growing up. Self-worth, independence, and sexual identity are important for teenagers. Parents need to talk openly with their children about physical, emotional, and sexual issues. Support groups for children and teenagers with kidney disease can be helpful. Contact a renal social worker or the National Kidney Foundation to find out if support groups are available near you.

Can you get AIDS from a transplant and risk giving AIDS to your sex partners?

Kidneys for transplantation and blood transfusions are now routinely tested for the AIDS virus. The risk of getting AIDS from a transplant or transfusion in the last few years is very small. Therefore, the risk of giving AIDS to a sex partner is small as a result of a transplant. Most health departments and health clinics can do a simple confidential blood test for HIV. Until the results of this test are known, use of a condom lowers the risk of passing the AIDS virus to a sex partner. Practicing safe sex is important for everyone.

Can a kidney transplant from someone of the opposite sex affect me sexually?

No. The sex of the kidney donor has no physical effect on the recipient's ability to function sexually or on sexual preference (heterosexual, homosexual, or bisexual).

Do transplant patients have fewer sexual problems than dialysis patients?

Generally, transplant patients have fewer sexual problems than dialysis patients because they may have fewer physical problems that affect their sex life like fatigue or anemia. But, having a transplant does not make them less prone to sexual concerns. The level of interest in and ability to have sex varies with things like the quality of the relationship, age, stress level, and physical conditions.

Will sexual problems get worse the longer dialysis continues?

This depends on the person. Having kidney failure, like any other chronic diseases, means that the body is in a weaker overall state of health. However, as the body adjusts to the treatment, the kidney patient should feel better physically and emotionally, and interest in sex may return to its earlier level. It is important to be patient and allow time to get used to the kidney disease and treatment. Being flexible and having a positive attitude about yourself and about sex may lower the chances of having severe sexual problems.

Can you tell whether sexual problems are due to physical or emotional causes?

Yes. This requires a complete medical, psychological and sexual history of the patient and his/her partner. Medicines should be reviewed for sexual side effects and changed if possible. Blood tests should include hormone levels and blood sugar levels to check for diabetes. Men can be checked to see if nerve and blood supply to the penis are good and if they can have an erection. If no physical problem is found, an emotional cause must be considered.

What can be done if the problem is physical?

Several options are available for men whose penis will not get or stay hard (erection). Penile implant surgery places inflatable or semi-rigid rods into the penis. In some cases, surgery can improve blood flow to the penis. If the man does not want surgery, male hormones may be given. Oral and injectable medications can cause an erection. External suction devices can make the penis hard enough for intercourse, but they require time and hand strength. Doctors with special training in impotence can give information on all options as well as their advantages, disadvantages, and side effects.
Women patients usually have less vaginal wetness and may have pain during sexual activity. Lower hormone levels can cause vaginal dryness. Use of a water-soluble vaginal lubricant can lower or stop pain associated with intercourse. Do not use petroleum jelly because it can increase the risk of infection. Some women may be unable to have a climax or may need more time to get "turned on" because of loss of energy, hormone changes, or medications for high blood pressure. A change in blood pressure medicine or extra hormones may be needed. Your doctor can provide information on options.

What can be done if the problem is psychological?

Feeling worried, anxious and depressed is normal when faced with a serious loss such as kidney failure. These emotions can cause loss of energy and lower interest in many activities including sex. If a sexual problem does occur, embarrassment and guilt often follow. Fear that the problem will happen again may cause the person to shy away from sexual situations. Relaxation exercises can help to control these fears. Regular physical exercise and activity help keep the mind busy and can improve physical condition and body image. If sexual problems continue, sex therapy can help. Even if the problem is psychological, some of the treatment options mentioned for physical problems may be helpful.

Can sex therapy help?

Sex therapy deals with the sexual problems of couples and individuals. The first step in sex therapy may be sexual education for the individual or couple. The therapist may assign activities to be done at home. These include communication exercises, stress reduction activities, and practicing ways of improving skills in giving and receiving enjoyable touches. Sex therapy can help with problems such as low sexual interest, trouble in reaching climax or reaching climax too soon, pain during sexual activity, and erection difficulties. Therapy also can help a person work through the effects of chronic illness on sexual functioning.
A sex therapist can be a psychiatrist, psychologist, physician, or social worker. Look for someone who is licensed and who has advanced training and experience in sexuality and sexual problems. Charges vary and may be covered partly by insurance.

What can kidney patients do to help themselves?

Take an active role in learning about kidney disease and treatment. Follow the prescribed diet and fluid limits. Take all medications properly and tell the doctor of any side effects. Ask for an exercise program to help muscle tone, strength, and endurance. Your doctor and dietitian can suggest a weight gain or loss program, if needed. Lead a healthy lifestyle. Be aware of other things that could affect your sexual functioning, such as drinking too much alcohol and smoking.

CKD information to munch on

The National Kidney Foundation suggests guidelines for renal dietitians who are preparing and teaching special diets for persons with kidney disease. This article will help you plan your meals and eating in order to slow or halt the progression of kidney disease. Specifically, if the amount of protein eaten is limited, it may help alleviate the symptoms of uremia, such as nausea, vomiting, bad taste and weight loss.
PROTEIN
Protein may be limited to 0.6 grams per kilogram ideal body weight per day. If the patient simply cannot adhere to this restriction, then 0.75 grams per kilogram ideal body weight per day. For your information, the Recommended Dietary Allowance (RDA) for protein in healthy persons is 0.8 grams per kilogram body weight per day. One can see there is very little difference in the normal diet for healthy individuals and the diet that is recommended to delay the progression of kidney disease. People probably eat twice the amount of protein needed to be healthy.
Here is an example of how the protein in the diet would be figured:
A man 5’7” tall and 150 pounds (70 kilos)
0.6  grams X 70 kilos = 42 grams protein per day
0.75 grams X 70 kilos = 52 grams protein per day
Here are some samples of protein in foods:
1 egg                          =          7 grams protein
1 chicken thigh          =          14 grams protein
8 ounces skim milk   =          8 grams protein
1 slice bread              =          2 grams protein
1 cup cooked rice     =          4 grams protein
1/2 cup corn               =          2 grams protein
CALORIES
According to the National Kidney Foundation Guidelines, calories in this special diet should be 35 calories per kilogram per day for those less than 60 years of age and 30 calories per kilogram per day for those over 60 years of age. Calories are found in carbohydrates, protein, fats and alcohol. As alcohol is not a necessary nutrient, it is not recommended. People with diabetes may need to eat more calories from carbohydrates to prevent weight loss. The medication to control blood sugar may need to be adjusted and/or increased.
POTASSIUM
Potassium is not usually restricted until urine output begins to decrease. Sometimes people with diabetes may need to have potassium limited.
Foods high in potassium are:
Bananas, Oranges, Orange Juice, Milk, Prunes, Prune Juice, Tomato Juice, Tomato Sauce, Nuts, Chocolate, Dried Peas and Beans
SODIUM AND BLOOD PRESSURE
High sodium foods can increase blood pressure. High blood pressure is one of the major causes of kidney disease. New research tells us strict blood pressure control is important. Ask your doctor what your target blood pressure should be. A person may require more than one high blood pressure medicine. The first line of high blood pressure medication is called an “ace inhibitor.”  This may improve a condition known as “proteinuria” or protein in the urine. This can affect diabetics and non-diabetics with high blood pressure. Some persons need a diuretic or “water pill” to help control high blood pressure.
High sodium foods to avoid include:
Salt, Bacon, Ham, Corned Beef, Pepperoni, Sausage, Pizza, Chinese Food, Fast Foods, Pickles, Cheese, Soy Sauce, Canned Soups, Potato Chips, Fritos, Cheetos
FLUID RESTRICTION
There is usually no restriction in the amount of fluids you can drink until severe kidney disease (Stage 4 or 5) is reached. The amount of urine your kidneys can make will usually not decrease until it is almost time to begin dialysis. It is called “kidney failure” because eventually the kidneys fail to make urine.
PHOSPHORUS
Phosphorus is a mineral found in almost all foods. Normal kidneys will balance the amount of phosphorus in our bodies. However, when the kidneys fail to eliminate this in the urine, the phosphorus will increase in the blood. High phosphorus foods will need to be limited and/or avoided. A medication called a phosphate binder (such as Oscal, Phoslo and Tums) may be ordered by your physician to be taken every time you eat. This medication will bind the phosphorus in the food and eliminate it in the stool. Control of phosphorus is very difficult for kidney disease patients. Ignoring this problem can lead to bone disease with pain in the back and joints.  
High phosphorus foods to eliminate are:
Milk (any kind) - Start learning to use a milk substitute like Cremora (powdered) or Coffeemate (liquid) - Beans (red, black, white), Black Eyed Peas, Lima Beans, Nuts, Chocolate, Yogurt, Cheese, Liver, Sardines, Desserts made with milk
ANEMIA
Healthy kidneys make a hormone that helps make red blood cells. One of the symptoms of  kidney disease is anemia, which causes weakness, tiredness and shortness of breath. Your kidney doctor may give you an injection called “Procrit.” This may help improve your anemia. The doctor may also order iron injections because in order to make red blood cells, you will need enough iron. Unfortunately, in some people the special diet will not provide enough iron and iron pills would be taken.
VITAMINS
Diseases of the heart and blood vessels remain the number one health problem in the U.S.  Recently, a new risk factor has been identified in kidney disease patients. It is an amino acid called homocysteine. Over 75 percent of dialysis patients have increased homocysteine levels. Too much homocysteine in the blood has been found to be associated with increased risk of heart disease, stroke and blood vessel disease. Studies have shown that homocysteine levels in the blood are strongly influenced by these specific vitamins: Folic Acid, Vitamin B12 and Vitamin B6. The American Heart Association has indicated that a reasonable therapeutic goal should be less than 10 micromoles per liter. Ask your kidney doctor if you should be taking a special vitamin to help prevent high levels of homocysteine.
DIABETICS
Since about 40 percent of all kidney disease patients are diabetic, it is important to know about good control of your blood sugar. There is a special blood test called a “hemoglobin A1C.” This test tells what your blood sugars have been in the past two to three months. The normal range is 4.5 to 6.0 percent. Poor control of blood sugar contributes to the progression of your kidney disease. Be sure to ask your doctor how you are doing with blood sugar control. It may be necessary to be referred to a diabetes educator for help.
Sample Menu: 40-50 grams protein
(For non diabetic man 5’7” tall and 150 pounds (70 kilos) with CKD)
BREAKFAST
• 1/2 cup (4 ounces) orange juice • 1 English muffin or 2 slices bread
• At least one tablespoon margarine with jelly
• Coffee or tea with non-dairy creamer and sugar
SNACK 
• 2 canned pear halves in heavy syrup
LUNCH
• 2 slices white bread • At least 2 tablespoons mayonnaise with lettuce and tomato
• 1 ounce chicken (such as a small thigh) or 1 hard boiled egg
• 2 canned peach halves in heavy syrup
• 7-UP, lemonade or Hawaiian Punch
SNACK 
• Baked apple with 1/2 cup non-dairy whipped topping
DINNER
• 3-4 ounces steak (weigh after cooking, without bone) , sauté in tablespoons olive oil
• 1 small baked potato with at least 2 tablespoons margarine
• 1/2 cup fresh green beans, carrots or broccoli with margarine
• Lettuce, onions, cucumbers, green pepper
• At least 2 tablespoons olive oil with vinegar or lemon
• 1/8 apple or cherry pie with 1/2 cup fruit sorbet (this is not sherbet)
• Iced tea with sugar and lemon or Sprite
SNACK
• 1 small banana and 10 vanilla wafers
• Coffee or tea with non-dairy creamer and sugar
NOTE: Olive oil, margarine and mayonnaise contain little or no protein

Eating Right-

This is not recommended for the Kidney Diet, but for those who are healthy now and plan to stay that way, I have found this for you!

-Jackie

Who would have thought you could fight cancer, diabetes, heart disease and stroke … with a fork?
Many people don’t know it, but one of the most important things you can do to protect yourself from these diseases is to eat a healthy diet Whether or not you have a family history of cancer, diabetes, heart disease or stroke, what you eat - and how much you eat - can help reduce your risk. As a matter of fact, if you are one of the many Americans who do not smoke, eating well – along with being active and maintaining a healthy weight – is your best defense against disease.
Following a few simple recommendations from the American Cancer Society, American Diabetes Association and the American Heart Association can help you eat your way to a healthier weight – and a healthier YOU!

Make Healthy Choices

Eat at least five servings of vegetables and fruits each day.

• Does “five” sound like a lot? Serving sizes are actually smaller than you might think!
• One medium piece of fruit
• ¼ cup of dried fruit
• ½ cup chopped, canned or frozen fruit
• 6 oz of 100% fruit or vegetable juice
• ½ cup chopped, canned or frozen vegetables
• 1 cup of leafy greens
• Focus on fruits and veggies that have the most color. They’re generally the most nutritious.

Choose whole grains over processed (refined) grains and sugars.

• Choose whole-grain rice, bread, pasta and cereals.
• Not sure if it’s whole grain?  Look for “whole wheat” or another whole grain as the first ingredient on the label.
• Limit consumption of refined carbohydrates, including pastries, sweetened cereals, soft drinks and other foods high in sugar. .

Substitute healthier fats for not-so-healthy fats

• Choose monounsaturated and polyunsaturated fats such as olive oil, canola oil and peanut oil.
• Avoid trans fats, found in many margarines and baked goods.
• Limit your intake of saturated fats and cholesterol found in meats and dairy products.
• Select lean cuts of meat (look for “round” or “loin”).
• Trim excess fat from meats.
• Choose low-fat and fat-free dairy products.
• Choose poultry, fish and beans as alternatives to beef, lamb and pork.
• Add avocados and nuts to your diet. (These are high in healthy fats, but also high in calories, so don’t go overboard!)

Dining Portion Sizes

• Eating out? Restaurant portions are frequently two to three times larger than normal portions. Remember these tips next time you dine out:
• Split an entrée with a friend or save half of it for lunch the next day.
• Have an appetizer and salad or soup as your main course.

• At home, serve appropriate portion sizes, and store the rest for leftovers. Avoid eating directly out of a bag or carton. Think about buying foods packaged in individual serving sizes to help you control portions. Serve dinner on your smaller salad plates instead of your dinner plates!

Watch Your Portion Sizes
No doubt about it – our portion sizes are getting bigger and bigger, and unfortunately, so are our waistlines. Beware of portion distortion, and help trim down the number of calories you eat each day.

• Use these visuals to help you judge what a normal portion size is:
• ½ cup of vegetables or fruit is about the size of your fist.
• A medium apple is the size of a baseball.
• A three-ounce portion of meat, fish or poultry is about the size of deck of cards.
• A single-serving bagel is about the size of a hockey puck.
• 1 ½ ounces of cheese is the size of a pair of dice.
• One tablespoon of peanut butter is about the size of the tip of your thumb.

• Eating out? Restaurant portions are frequently two to three times larger than normal portions. Remember these tips next time you dine out:
• Split an entrée with a friend or save half of it for lunch the next day.
• Have an appetizer and salad or soup as your main course.

• At home, serve appropriate portion sizes, and store the rest for leftovers. Avoid eating directly out of a bag or carton. Think about buying foods packaged in individual serving sizes to help you control portions. Serve dinner on your smaller salad plates instead of your dinner plates!

Choose Foods That Help Maintain a Healthy Weight

In addition to watching your portion sizes, substituting lower calorie foods for higher calorie foods can help influence what your scale says.

Cooking Tips

• Use low-fat cooking methods like roasting, baking, broiling, steaming or poaching. Limit deep-fat frying and sautéing in a lot of oil, butter or margarine. Use a cooking spray, broth or water to sauté meats.
• Substitute vegetables, fruits and other lower-calorie foods – lowfat dairy products, lean meats and cheeses, whole grains, and reduced sugar foods -  for calorie-dense foods such as French fries, cheeseburgers, pizza, ice cream, doughnuts and other sweets

Dairy Substitutions

• Use evaporated (skim or whole) milk instead of higher-fat cream in baked goods, sauces and soups.
• Use reduced-fat or fat-free yogurt to replace all or part of the sour cream or mayonnaise in a recipe. Replace part of ricotta cheese with reduced-fat cottage cheese. Use a puree of cooked potatoes, onion, and celery as a creamy base for soups instead of cream or half-and-half.
• Sharp cheese gives extra flavor so that less can be used. This helps trim the fat.
• Select yogurt or milk products without added sugar or flavorings. Mix in fresh fruit for a flavor boost.