NUT SCI 485 NUTRITION DIAGNOSES FOCUSED ASSESSMENT & CARE PLAN FORM Student: Amanda Thomas Date:

11/28/2013 and 12/07/2013

I. CLIENT DEMOGRAPHIC INFORMATION Age: 51 Sex: Female Marital Status: Married

II. CLINICAL: BIOCHEMICAL (NC 2.1-2.3) Medical History:

Past medical/surgical history: (include positive family history as appropriate)

Medication History: DRUG NAME

PURPOSE/USE

Citalopram

Anit-Aniexty and Anti-panic

Omeprazole

Antiulcer Antigera

POSSIBLE FOOD/NUTRIENT INTERACTION Avoid tryptophan supplement may increase drug side effects also increase weight and appetite May decrease absorption of Fe, B12, Ca

Laboratory & Metabolic findings: (If available)

LAB

NORMAL

Calcium Phosphorus Glucose BUN Cholesterol Protein Albumin Bilirubin Alk Phos (ALP) LDH AST (SGOT) Na K Magnesium Amylase Lipase CPK Hg/Ht Creatinine

9-11 mg/dl 2.5-4.5 " 70-110 " 7-22 " < 200 " 6.0-8.0 g/dl 3.5-4.8 " .3-1.2 mg/dl 42-121 U/L 94-172 U/L 1-55 U/ml 135-145 mEq/L 3.6-5.6 " 1.6-2.4 " 19-110 U/L

DATE 11/18/ 2013 9.3 N/A 92 N/A 185 N/A N/A N/A N/A N/A N/A 144 5.3 N/A N/A

DATE

DATE

REASONS FOR ABNORMAL

20-190 IU/L N/A 30-180 " 12-16 g/dl 35-50 % .5-1.5 mg/dl N/A N/A 0.81

Triglyceride

40-150 mg/dl 121

III.

CLINICAL: FUNCTIONAL (NC 1.1-1.4) Problems with chewing or swallowing? Y/N (possible cause and duration): No Problems with nausea and/or vomiting? Y/N (possible cause and duration): No Problems with diarrhea and/or constipation? Y/N (possible cause and duration): No Other: No

IV.

CLINICAL: WEIGHT (NC 3.1-3.4) Anthropometric Data: Weight (stated/actual): 197 pounds; 89.36 kg Height: 62 inches; 162.56 cm BMI: 33.8 Ideal/Desirable Body Weight (IBW/DBW): 120/197 %IBW: 60.91%

Adjusted body weight (use to determine estimated needs if present weight for men >125% IBW; women >130% IBW): n/a How long has client been at present weight? (+/- 5 lb) 4 yr Has client lost or gained weight before? Yes_x_ No____ ( _________intended; ___x___unintended)

Weight change (loss/gain): 50 pounds; loss ( % of UBW 25% ) Time period of weight change: 6 months If there has been a weight change, describe the reason or cause: Wanted to have a healthy lifestyle that included going for walks daily (anywhere from one or two times), consuming more fruit and vegetables, making more homemade meals and staying or limited amount of consuming processed foods (chips, crackers, cookies, and other boxed products).

V.

BEHAVIORAL-ENVIRONMENTAL: PHYSICAL ACTIVITY AND FUNCTION (NB 2.1-2.6) Physical activity: describe types and duration of physical activity in typical day/week She does little to no physical activity during a typical day or week. At her job she does a lot of standing and walking around instead of sitting and also she always parks in the last stall in the parking lot

Are there any problems with mobility? Y/N (possible cause and duration): No Problems with senses (vision, hearing, smelling etc)? Y/N (possible cause and duration): Yes she has had problems with tasting foods. This has been this way for the last 3 or 4 years and she believes this is due to aging and the medication that she is taking. Condition of skin/hair/nails/oral cavity: Skin- is normal there are no signs of paleness in the skin color or dehydration when I asked the client if I could pinch her skin. Hair- the hair altogether is healthy. Nails- the nails are normal shape they are not spoon shape so no sign of iron deficiencies and there is no central longitudinal ridge. Oral- the oral cavity was also healthy there was no signs of bleeding or inflamed gums or erosion or yellowing of the teeth. I asked the client if they went to the dentist and they stated that they went every six months.

Are there any difficulties with obtaining foods? _____yes __X_no. Explain:

(transportation financial, time etc)

Who usually prepares the food eaten at home? The two people that usually prepare meals at the home are her daughter and her.

Who usually goes grocery shopping for the household? Her daughter and she do the grocery shopping every week.

Activities of Daily Living and Functional Status: She goes to work five days a week from 8:00am till 3:30pm at Alta Resource in Neenah, WI. She also takes care of her family and animals seven days a week. She makes sure the animals are feed twice a day and most days she prepares supper for the family. On the weekend that is when she does most of her relaxing. This is also the time that she does the laundry and goes grocery shopping for the week.

VI.

BEHAVIORAL-ENVIRONMENTAL: KNOWELDGE AND BELIEFS (NB 1.1-1.7) Education history, Etc: Has client tried to change his/her diet in any way? If so, what type of changes? Yes the client has tried to change her diet especially within the last six months. The two changes that she made were not eating at fast food restaurants and stopped drinking soda.

Are there any other members of your household on a modified diet _____yes __X__no. Explain: Previous education (when/by whom): No one has received any nutritional education based on a modified diet in the household. If there has been previous education, briefly describe your experience (positive, negative, helpful, etc) There has been none.

Are there any issues or special needs associated with educational level or literacy? There are no issues or special needs associated with educational level or literacy.

Does the person who shops read labels? If so what part of the label influences a purchase? Yes both people that do the shopping read the food labels. The part of the food labels that influence what types of food are purchased is nutritional label and the ingredient list.

Appetite and food preferences: How would you describe your appetite? __X__good _____fair _____poor

Has there been a recent change in appetite: _____yes, __X__no Explain:

What factors most often influence what foods and when you eat? (Hunger, habit, stress, boredom, etc.) The three facts that often influence when and what foods she eats is boredom, stress, and hunger. What are your favorite foods? Her favorite types of foods to eat are cheese, bread, dark chocolate, popcorn, and coffee.

What foods do you strongly dislike? There arent any foods that she strongly dislikes.

Do you have any food allergies or intolerance? She has an intolerance for acidic and spicy foods that is why she takes Omeprazole.

Do you take any vitamin and/or mineral and/or herbal supplements? If so, what form and what amount? What is the purpose? She takes two chewable multi vitamins daily for her general health.

Meal Patterns What is your usual meal pattern/day? (# of meals and snacks) During the week she doesnt eat breakfast and will have one or two snacks at work. When she comes home around 3 she will have a big meal which she considers her lunch. Then throughout the evening she will have two or three snacks.

Where do you eat most of your meals and with whom? She eats most of her meals at home by herself or with her family.

How often in a week do you eat out? Specify types of restaurants. She goes out to eat one or two times per week and the places she usually goes is a bar or sit down restaurant.

VII.

NUTRITION INTAKE (NI) Food Preparation: What is the most common method of cooking meats, poultry and fish? (Bake, broil, grill, fry etc) The most common method of cooking meats, poultry, and fish is frying them in pan on the stove top.

What kind and amount of fat do you usually use in cooking? The kind of fat that she usually uses for cooking is olive or canola oil. She uses anywhere from 1-2 tablespoons.

What kind and amount of fat do you usually add to vegetables, potatoes and breads, etc before eating? She doesnt add any fat products to the vegetables, potatoes, and breads before eating them.

DIETARY INTAKE: 24-hour recall or typical daily intake Time of Day Meal or Snack Place Detailed Description of Food or Beverage Amount

7:30am

Meal

Home

Cranberry English muffin with peanut butter, coffee with creamer, and ginger snap cookies

1-english muffin 1-tbsp peanut butter 3-8oz coffee 3-tbsp of creamer 3-small cookies 1-12oz

10:30am 1:00pm

Snack Meal

Starbucks Tall Skinny pumpkin spice latte Home Black beans, salsa, pumpkin seeds, and sweet potatoes

cup black beans cup of pumpkin seeds cup of salsa 1 cup of sweet potatoes 3- small cookies

4:00pm

Snack

Home

Gingersnap cookies

6:00pm 8:00pm 4:00am

Snack Snack Snack

Home Home Home

Coffee (black) 2 8 oz cups Coffee (black) 2- 8 oz cups Pecan praline cookies 3 cookies

How does the amount of food you described compare with the amount that you usually consume for that day of the week? __________ _____ _____ much more than usual usual _________ ____X___ dont know much less than usual

B.

Food Frequency

Food Item & Frequency: # of times per d,w,m,or not at all 1. Breads, Starches Bread 2-3 times per week Cereal not at all bagel, muffin 7 times per week Other n/a 2. Dairy Products

Food Item & Frequency: # of times per d,w,m,or not at all 6. Meats, Fish, Poultry, Eggs Beef 1 time per week Pork 1 time per week Chicken 2-3 times per week Fish 1-2 times per week Tuna not at all Pizza 1 time per week Lentils not at all Eggs 3-4 times per week 7. Sweets, Desserts, Snacks ice cream not at all Doughnuts not at all Cakes not at all Pie not at all Cookies 10-15 times per week Candy 3-5 times per week chips, pretzels 5-7 times per week 8. Alcohol Wine not at all Beer not at all

Milk 1-2 times per week Cheese 10-12 times per week cottage cheese not at all Other yogurt 2-3 times per week 3. Fruits and Juices

Oranges not at all Bananas not at all Apples not at all Other n/a 4. Vegetables

dark yellow or orange 2-3 times per week dark green 2-3 times per week Potatoes 3-4 times per week Other n/a

5.

Pasta, Rice

liquor not at all

Spaghetti, noodles 2-3 times per week Lasagna not at all Rice 3-4 times per week Other n/a 9. Other n/a

C. Evaluation of nutrient intake 1. Based on Exchange System: Food Group Starch Fruit Milk Sweets Meat Fats # of Exchanges 1 0 1.5 9 0 0 CHO grams 15 0 18 135 0 0 PRO grams 0-3 0 12 varies 0 0 FAT grams 0-1 0 2-5 varies 0 0 CALORIES 80 0 150 varies 0 0

TOTALS:

11.5

168

12-15

0-5

230

2. Based on MY PLATE Guide: Food Group Portion/Servings 1 serving (1 ounce) Grains 1-1/4 cup Vegetables 0 cups Fruits 1.5 cups Dairy 16 oz Protein 0 Oils 9 cookies Sweets No recommendation 9 cookies 1 tsp per day 1 5 ounces per day 11 oz 3 cups per day 1.5 cups 1.5 cups per day 1.5 cups 2.5 cups per day 1-1/4 cup Portion/Servings recommended 6 ounces per day Difference 5 ounces

D. Estimated needs: (calories/protein/) - indicate method of calculation Mifflin-St. Jeor B.E.E= (10*89.36)+(6.25*162.56)+(5*51)-161 B.E.E= 2003.6 Protein= Stress level/normal Condition/healthy protein (g/kg/d) = 0.8*89.36 Protein= 71.488 grams

E. Evaluation of present dietary practices: Identify: 1) Present practices that support nutrition goal Her present practices right now do not support her nutrition goal of losing weight. The only practices that supports her nutritional goal is her readiness to change and lose the 50 pounds in six to nine months.

2) Present practices that are not consistent with nutrition goal Her energy intake and lack of consuming fruits are major practices that are not consistent with her nutritional goal of losing weight. Also her lack of exercising is not consistent with her goal.

3) Potential barriers to patient making changes One potential barrier is that she might not see the weight come off right away and give up. Another barrier is that other members of the household are not supporting her in her nutritional goal.

4) Supportive factors for patient A big supportive factor is just the client willingness to change. She is setting a goal and is determined to meet it. Another supportive factor is her daughter. She is willing to help her mother make this change and help her in anyway possible.

PATIENTS STAGE OF READINESS FOR BEHAVIOR CHANGE (reasons for your assessment) My client is in the preparation stage. She has stated that she want to make this change if weight and she will do anything to make this happen. The client is committed to take action. STUDENTS LEARNING ISSUES: What topics or information do you need to research further to complete this care plan? Describe how you obtained this information. Right now I would not have to do any research because the clients questions and goals are very basic. Once the client want to know more details about specific items I may potential would have to do some research. When looking for the information I would look at peer reviewed or evidence based research articles. Also I would look at the Academy of Nutrition and Dietetics.

SELF-ASSESSMENT OF INTERVIEW/EDUCATION: Comments regarding: Receptiveness and interest of those interviewed; what went well, what didnt go so well The client was very open about the information I asked her about. She was also very committed in making a change and losing the weight in the time frame of six to nine months. Also she was very open to ideas and suggestions to help her in this weight loss goal. It was very important to give her concrete numbers for her energy intake. The education was very basic and easy for her to understand and incorporate into her daily routine. A big item that didnt go well was the 24 hour recall. As stated earlier she eats much less during the weekend so that was not very accurate of what she is eating during the week. So would ask her to do a 24 hour recall of a week day and weekend to compare numbers. Besides that the patient information was very accurate and she was eager to start making changes to a healthier life.

B. Step #2 NCP Nutritional Diagnosis 1. PES Statements a. Overweight/obese related to excessive energy, fat, and sugar intake as evidence by BMI (33.8). b. Inadequate carbohydrate intake related to inadequate intake of fruits and vegetables as evidence by 24 hour recall 2. Prioritization of nutritional problems a. Overweight/Obese related to excessive energy, fat, sugar intake as evidence by BMI (33.8). i. The reason why this is number one priority because the client stated that they wanted to lose weight. They said that they know that they are overweight and they would like to change the number on the scale to a more appropriate and healthy number for their height and activity level. So the number one goal for this client is to lose weight. b. Inadequate carbohydrate intake related to inadequate intake of fruits and vegetables as evidence by 24 hour recall. i. When looking at the patient 24 hour recall and food frequency sheet I saw that the client was not taking in many fruits in vegetables. I would like to help the client to start incorporating more fruits and vegetables into their diet. I would suggest that they would exchange a sweet item (such as the cookies) for a fruit or vegetables as a snack. This will also aid in their weight loss goal since they are lower in calories and they help a person stay fuller longer. C. Step #3 NCP Nutrition Intervention 1. Appropriate behavioral, intake and clinical goals based on the eithology and signs and symptoms including PES statements a. After the 24 hour food recall the client said that this was much less then what they normally ate. She said this was for two reasons the first was that it is the weekend and she usually doesnt eat as much compared to during the week when she is more stressed out. Also she is busy on the weekends doing household items so she is not as bored compared to when she comes home after work on the week days. After she told me this I knew the 24 hour recall could not be considered what she has in a typical day. So I would ask her do one again for a week day and then one for a weekend. Based on what my plate said and the calorie estimator tool if she wanted to lose weight she should aim for eating anywhere from 1800-2000 calories a day. I would advise her to replace her snacks of cookies with fruit and vegetables. This will to cut back on excessive amount of energy and sugar intake. When it comes to consuming fruits and vegetables I would set the goals for the

client to consume three cups of vegetables a day and two cups of fruit a day. Finally I would also recommend that the patient start incorporating exercise into her daily routine. I would suggest starting out getting thirty minutes of exercise everyday and that could include just walking outside. Overtime I would start to increase the amount. The reason for this is a client is going to see the greatest result when they combine a healthy food intake and exercise. I would work with this client to see when they wanted to meet to track their progress. I would suggest at first meeting every two weeks. As the client gets more confident in their ability to lose the weight and maintaining this healthy lifestyle I would suggest just meeting with her once a month. 2. Interventions a. Goal setting- Since weight loss is this client number one goal I would use goal setting as a way to check the progress. Some of these goals would be consuming 1800-2000 calories a day, include three cups of vegetables a day and two cups of fruit a day, thirty minutes of exercise each day to start out with, and finally the patient would like to loss fifty pounds in 6-9 months. b. Stress management- When doing the assessment the client stated that one of the factors that most often influence what foods and when you eat is stress. Knowing this I would give her tips of ways to deal with stress besides eating foods. This could be one of the ways that she incorporates her thirty minutes of exercise each day. c. Nutritional education- When it comes to nutritional education I would first ask her what she already knows and go from there. The main topics that I would talk to her about is that she needs to have a healthy well rounded diet that includes eating fruits, vegetables, lean meats, dairy, and whole grains. If she wanted to know about a specific food group I would go into more detail and give her education material to take home. I would also talk to her about the importance of exercise and making that part of her daily routine. d. Modified diet and amount of food 3. Lesson plans and educational materials a. Lesson Plan i. Nutritional Education ii. Target Audience: Judy T. iii. Duration: 4-5pm iv. Goal: By the end of the session the client will be able to track food intake and start incorporating more fruits and vegetables into diet. 1. Objective: The client will know how to properly track what kinds of food she is eating and the amount in order to track energy, fat, and other nutrients.

2. Objective: The client will know how to properly read and use a food label. This will be examined when going over examples during the session. 3. Objective: The client will be given a variety of ways to start incorporating more fruits and vegetables into her diet. v. Specific Lesson Plan 1. Introductions 2. Label reading explanation with examples 3. How to track foods that she is eating in order to see how many calories and other nutrients she is in taking 4. Going over how she can incorporate more fruits and vegetables into her diet and finding out what she does and doesnt like b. Educational Material i. Food Tracker 1. Excel spread sheet ii. Fruit and vegetable handouts 1. http://www.co.orange.nc.us/health/FruitsAndVeggies.asp 4. Counseling and learning theories a. The counseling/ learning theory that most appropriate for this client is motivational interviewing. Motivational interviewing is a counseling technique that allows the patient to recognize that they want to change something. So my patient stated on her own that she wants to lose weight. Along with that it allows the client to state ways that they can make this change happen. Being patient centered is important in this counseling technique because only the patient truly knows their body and in what ways change works for them. D. Step #4 NCP Nutrition Monitoring and Evaluation 1. Tools and forms used to monitor and evaluate a. In order to monitor and evaluate the effectiveness of the counseling I would have the patient bring in her food tracker that she fills out and document it in an excel spreadsheet. This will be a way to monitor her energy intake, fat, sugar, fruit, and vegetable. Also when she comes in we will weigh her to see if she has lost any weight and that will be documented. By having this on an excel spread sheet it will allow me to show the patient there progress in meeting her goals.

E. Summary and Self Evaluation of Learning Issues 1. What I learned from working with this patient is that they need to state they want to change something there life. Also along with saying that they want to change that they are

able to come up with ways that are going to fit within their lifestyle. For my patient I gave her a variety of techniques to try as examples. She believed that a food tracker would be the best way to monitor her intake of energy and fat. This would also allow her to make sure she is getting the proper amounts of fruits and vegetables. One way that I would improve my educational skill is I would have given the client recipes to take home and try in order to incorporate more fruits and vegetables into her diet. Also I would have liked to give her more education about the importance of coupling healthy eating and exercising. When it comes to counseling I would have liked the patient to come up with some ideas in how they could make this change fit in their life. I believed the counseling part went very well because the patient stated that they want to make the change and set a goal. Once that has happened I proved her with numbers for her energy intake and fruit and vegetables.

24 Hour Recall (My Fitness Pal)

Breakfast English Muffin Thomas - Cranberry 150 English Muffin, 1 muffin Nancy's Peanut Butter - Natural 90 Creamy Peanut Butter, 1 Tb Coffee - Brewed from grounds, 3 7 cup (8 fl oz) International Delight Sugar Free Caramel Machiatto - Coffee Creamer, 3 Tbsp Cookies - Gingersnaps, 3 cookie 87 394 16 55 2 17 1 11 137 446 4 10 60 3 6 0 0 0 0 0 1 14 0 4 8 4 65 0 32 1 5 230 6 Calories Carbs Fat Protein Sodium Sugar

Lunch

Calories Carbs
Dinner Bush's - Black Beans - Reduced Sodium 105 Updated 12/2/13, 1/2 cup David - Pumpkin Seeds Roasted and Salted (With Shell) - Net Carbs, 1 serving 1/4 cup (30g kernel) 1/3 cup in shell Pace Chunky Salsa(Net Carb - Salsa - Mild, 8 40 Tbls Wildfire Sweet Potato (Baked - Sweet Potatoes 180 Baked In Skin, 1 cup 41 12 190 1 23

Fat

Protein Sodium

Sugar

240

16

10

940

920

72

13

515

77

17

21

2,172

22

Snacks Starbucks - Pumpkin Spice Latte - Tall, 200 Nonfat Milk, No Whipped Cream, 12 fl oz Cookies - Gingersnaps, 3 cookie Coffee - Brewed from grounds, 2 cup (8 fl 5 oz) Sam's Choice - Pecan Praline Cookies, 3 360 cookie 42 21 3 480 24 0 0 1 9 0 87 16 2 1 137 4 38 0 11 0 37

652

96

23

16

626

65

Totals Your Daily Goal Remaining

1,561 1,470 -91 Calories

228 202 -26 Carbs

57 49 -8 Fat

48 55 7 Protein

3,244 2,500 -744 Sodium

97 29 -68 Sugar

My Plate Guidelines My Plan This plan shows your daily food group targets what and how much to eat within your Calorie allowance. Enter your meals in Food Tracker to see how you stack up. client1's PlanYour plan is based on a 1800 Calorie allowance. You can set a personal Calorie goal in My Top 5 Goals. Calories Allowance Total Calories Empty Calories* Food Group Food Group Amount Grains 6 ounce(s) per day 3 ounce(s) 1 per day Whole Grains 1800 per day 161 per day What counts as 1 ounce of Grains 1 slice of bread (1 ounce) cup cooked pasta, rice, or cereal1 ounce uncooked pasta or rice1 tortilla (6 inch diameter)1 pancake (5 inch diameter)1 ounce ready-to-eat cereal (about 1 cup cereal flakes)See more Grain examples

Tips Tips

Eat at least half of all grains as whole grains.Substitute whole-grain choices for refined grains in breakfast cereals, breads, crackers, rice, and pasta.Check product labels is a grain with "whole" before its name listed first on the ingredients list?

Vegetables

2 cup(s) 1 cup of Vegetables: Tips per day 3 1 cup(s) 1 cup raw or cooked Include vegetables in meals and in Dark per week5 vegetables1 cup 100% snacks. Fresh, frozen, and canned GreenRed & cup(s) per vegetable juice2 cups vegetables all count.Add dark-green, OrangeBeans & week1 leafy salad greensSee red, and orange vegetables to main PeasStarchyOther cup(s) per more Vegetable examples and side dishes. Use dark leafy week5 cup(s) greens to make salads.Beans and per week4 peas are a great source of fiber. Add cup(s) per beans or peas to salads, soups, side week dishes, or serve as a main dish. Fruits 1 cup(s) 1 cup of Fruit: Tips per day

1 cup raw or cooked Select fresh, frozen, canned, and fruit1 cup 100% fruit dried fruit more often than juice; juice cup dried fruitSee select 100% fruit juice when more Fruit examples choosing juice.Enjoy a wide variety of fruits, and maximize taste and freshness, by adapting your choices to whats in season.Use fruit as snacks, salads, or desserts.

Dairy
10

3 cup(s) per day

1 cup of Dairy:

Tips

Protein Foods
11

Seafood

1 cup milk1 cup fortified Drink fat-free (skim) or low-fat (1%) soymilk (soy beverage)1 milk.Choose fat-free or low-fat milk cup yogurt1 ounces or yogurt more often than natural cheese (e.g. cheese.When selecting cheese, Cheddar)2 ounces choose low-fat or reduced-fat processed cheese (e.g. versions. American)See more Dairy examples 5 ounce(s) 1 ounce of Protein Foods: Tips per day 8 ounce(s) 1 ounce lean meat, Eat a variety of foods from the per week poultry, seafood1 egg1 Protein Foods group each week.Eat Tablespoon peanut seafood in place of meat or poultry butter ounce nuts or twice a week.Select lean meat and seeds cup cooked beans poultry. Trim or drain fat from meat or peasSee more Protein and remove poultry skin. Food examples

Oils

5 tsp. per day

1 tsp. of Oil:

Tips

13

1 tsp. vegetable oil (e.g. Choose soft margarines with zero canola, corn, olive, trans fats made from liquid soybean)1 tsp. vegetable oil, rather than stick mayonnaise2 tsp. tub margarine or butter.Use vegetable margarine2 tsp. French oils (olive, canola, corn, soybean, dressingSee more Oil peanut, safflower, sunflower) rather examples than solid fats (butter, shortening).Replace solid fats with oils, rather than adding oil to the diet. Oils are a concentrated source of Calories, so use oils in small amounts.

* Calories from food components such as added sugars and solid fats that provide little nutritional value. Empty Calories are part of Total Calories.

Educational Material

12 Delicious, Easy Ways to Enjoy Fruit Fruit is a double-sweet treat. Its a delicious treat for your taste buds and a nutrition treat for your whole body. Fruits are naturally nutrient-rich. That means they are packed with vitamins, minerals and disease-fighting phytonutrients and are still low in calories. To maximize the health benefits from fruit, nutrition experts suggest 2 to 3 servings per day in a rainbow of colors. All types of fruit are nutritious fresh, frozen, canned and dried so here are a dozen easy ways to treat yourself to good health! 1. Berries, berries, berries: Canned blueberries in muffins, dried cranberries in a salad, or fresh, juicy strawberries for dessert. 2. Citrus fruit: Oranges, pink and white grapefruit, tangerines, tangelos, Clementines, lemons and limes. 3. Melons and more melons: Slices of watermelon, cantaloupe, honeydew or Crenshaw in a fruit cup or for a sweet snack. 4. Bananas: Bananas, natures fast food, come in their own wrapper convenient to take in the car or eat at your desk. 5. Kiwi fruit: Slice kiwi fruit into a mixed fruit or fresh spinach salad or just scoop them out of their thin, brown peel. 6. Pineapple: One of the most versatile fruits, pineapple is perfect fresh, canned, dried, as juice or on a pizza! 7. Tropical fruit: Fresh produce departments and canned food aisles now serve up mangoes, papaya and star fruit. 8. Apples and pears: A fresh, crisp snack, a juicy addition to green salad, and in a tasty pie, tart or cobbler for dessert. 9. Summer tree fruit: Nectarines, peaches and apricots are fabulous when fresh and still quite tasty when canned in their own juice. 10. Plums and prunes: Fresh plums are another juicy taste of summer. Dried or made into juice, prunes are very nice for regularity! 11. Cherries and grapes: Fresh or dried, cherries and grapes make a great snack or addition to salads (mixed fruit or tossed green). 12. Trendy tomatoes: Tomatoes are a fruit and now they come in sweet, fruit-shaped cherry, grape and strawberry varieties. National Nutrition Month - March 2005

12 Delicious, Easy Ways to Enjoy Vegetables From a health standpoint, vegetables are a five-star food group: naturally nutrient rich; better tasting than a vitamin pill; low in calories and fat; cholesterol-free and packed with disease-fighting phytonutrients. To maximize your health with vegetables, nutrition experts suggest at least 3 to 5 servings per day in a rainbow of colors. All types of vegetables can be nourishing and delicious fresh, frozen, canned and juiced. Here are a dozen daily ways to treat yourself to good health! 1. Broccoli and cauliflower: Versatile and very healthful eat them raw (with dip if you like) or cooked, in a salad or even a slaw. 2. Carrots: Sweet, crunchy, good for your teeth, eyes and heart! Perfect raw (as a snack or salad) or cooked in a stew. 3. Peppers: Green, red, yellow, orange or even purple! Enjoy peppers in a salad, stir-fry, or casserole or as a snack. 4. Spinach: A salad of baby spinach leaves with pears or apples can turn anyone into a real spinach lover. 5. Onions: The zesty onion family (scallions, leeks and garlic, too!) offer some powerful antioxidant nutrients. 6. Peas: Fresh, frozen or even canned, peas are a treat to eat and they are very popular with small children. 7. Beets: If youve never liked beets, try them in a new way like roasted, grilled or lightly steamed in the microwave. 8. Sweet potatoes and yams: Switch the color of your usual baked potato and youll get a lot more nutrients, along with great taste. 9. Mushrooms: Just a mushroom or two adds rich flavor to a casserole, soup, stew, stir-fry or even a tossed green salad. 10. Leaf and romaine lettuce: Rule of thumb for a healthy salad the darker green or red the lettuce leaves, the more nutrients you get. 11. Green, yellow or purple beans: Like their pea cousins, beans offer some fiber and a little bit of protein, along with vitamins and minerals. 12. Tomatoes: Cooking increases the availability of some tomato nutrients so enjoy canned sauce, paste and chunks. National Nutrition Month - March 2005