How to Run Your Own Workplace Weight Management Programme!

How to Run Your Own Workplace Weight Management Programme! WORKPLACE WEIGHT MANAGEMENT This weight management pack has been developed and produced b...
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How to Run Your Own Workplace Weight Management Programme!

WORKPLACE WEIGHT MANAGEMENT This weight management pack has been developed and produced by NHS Forth Valley Community Dietitians. The material used in this pack has been adapted from the Overweight Management Resource Pack, Dietetic Department, NHS Forth Valley. Contact Details: If you have any queries about running this weight management programme or require further details regarding any aspect of this resource, please contact:

Community Dietitians Department of Nutrition and Dietetics NHS Forth Valley Admin Building Falkirk Community Hospital Westburn Avenue Falkirk FK1 5SU Tel: 01324 673710 Email: [email protected]

Kathleen Gilmour Support Officer - Healthy Working Lives Health Promotion Administration Services Building Falkirk Community Hospital Westburn Avenue Falkirk FK1 5SU Tel: 01324 673521 Email: [email protected]

You can also find more information on our website, log on to: www.nhsforthvalley.com/healthpromotion Then choose ‘Nutrition’, ‘Oral Health’, ‘Health Improvement Resource Service’ etc. You may also find our NHS Forth Valley - weight management website - ‘Choose to Lose’ useful. For more information visit www.nhsforthvalley.com/weight 1

Introduction This resource pack has been designed to support workplaces who wish to run a weight management course for their staff. It aims to give those facilitating the course, whether they have a healthcare background or not, the confidence to plan and deliver weight management sessions. The pack provides basic nutritional information and includes a 10 week session planner, which offers the facilitator of the course a step by step outline for each week of the course. The session planner provides a programme outline, this should equip the group leader(s) with ideas of suitable activities to run within the group and ideas for discussion. These are not rigid or set in stone but have been written in a flexible format to ensure they can be used within various group settings. All the material included within this resource pack is photocopiable. Sessions could be condensed and run over a shorter number of weeks if preferred.

Facts and Figures Obesity continues to be a growing problem in the UK. ‘Obesity has grown by 400% in the last 25 years and on present trends will soon surpass smoking as the greatest cause of premature loss of life.’ 1 These types of worrying statistics clearly illustrate that something needs to be done to address this growing problem.

Questions to Consider • • • •

At present what is being done in your workplace to promote healthy living and healthy eating? Could more be done? Are any staff within your workplace keen to lose weight? What initiatives could be carried out in your workplace to address this national epidemic – obesity?

If you have answered YES to any of the above questions then READ ON.

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This RESOURCE PACK is an excellent starting point. It can equip workplaces with the necessary tools to run their own weight management programme.

WEIGHT MANAGEMENT - SOME BACKGROUND INFORMATION

Weight management is an issue for everyone – it’s about keeping control over our weight – striving to be an ideal weight for healthy living. The most effective approach to weight loss is by dietary modification, encouraging healthy eating and by increasing physical activity levels.

GETTING AND KEEPING YOUR WEIGHT BALANCED

If the energy (calories) you eat is more than the energy (calories) you use up, excess energy is converted and stored as fat. If this occurs over some time, weight gain is inevitable. On the other hand if the energy (calories) you eat is less than the energy (calories) you use up, then fat stores are broken down and used, weight loss occurs. If the energy (calories) you eat equals the energy (calories) you use up, your weight remains the same. Just a small increase in the amount of food you eat over and above your needs can result in a significant weight gain over time. • 2 plain biscuits every breaktime for a year can result in a gain of 6-7lbs or 3kgs. • One can of fizzy (non-diet) drink or a packet of crisps every breaktime for a year can result in a gain of 8-9lbs or 4kgs.

MAKING SMALL CHANGES OVER TIME TO INCREASE PHYSICAL ACTIVITY AND EAT MORE HEALTHILY WILL HELP WEIGHT LOSS IS YOUR WEIGHT IN BALANCE?

Two methods can be used to identify individuals whose health is at risk due to their weight. • Calculating the Body Mass Index (BMI). • Measuring waist circumference.

APPENDIX 3 GIVES DETAILS OF HOW TO WORK OUT BMI AND HOW TO MEASURE WAIST CIRCUMFERENCE ACCURATELY. IF OVERWEIGHT, HOW MUCH WEIGHT SHOULD BE LOST?

If BMI is 25 or over or if the waist circumference appears too high then weight loss should be considered. Aim: • to lose between 5-10% of your current weight. For example if you weigh 80 kgs you should aim to lose 4-8 kgs. Refer to conversion charts + 5 - 10% weight loss charts at the end of this document. (Pages 82 - 89) • to lose 0.5-1 kg (1-2lbs) each week. 3

EATING FOR GOOD HEALTH The eatwell plate is a nationally recognized model which should be used as a tool in any healthy eating session. It should be used to promote the concept of a healthy diet. This model was developed to help people understand and begin to enjoy healthy eating.

Fruit and Vegetables

Have at least five portions of fruit and vegetables each day.

Bread, other Cereals and Potatoes

Have 5-9 small portions of bread, cereals, pasta, rice and potato each day.

It visually illustrates the type and proportions of foods required to achieve a healthy and well balanced diet. N.B. This model should not be used for children under the age of 5 years. This picture shows a plate divided into 5 main food groups. • • • • •

Bread, other Cereals and Potatoes Fruit and Vegetables Milk and Dairy Meat, Fish and alternatives Fatty and Sugary Foods

It is important to choose a wide variety of food from the first four food groups in order to ensure our bodies are being supplied with the vital nutrients it needs in order to function properly. Foods from the fifth group, the fatty and sugary food group, are not essential for good health but they can be included in moderation in a balanced diet. Achieving this balance between the various food groups does not have to be at every meal time but ideally should be achieved over the course of each day.

Meat, Fish and Alternatives

Choose 2-3 small servings of meat, fish, eggs, beans, nuts, pulses or soya products each day.

Fatty and Sugary Foods

Take very small amounts of foods containing fats and sugars.

Milk and Dairy

Choose 2-3 small servings of lower fat milk and dairy products each day.

© Public Health England in Association with the Welsh Government, the Scottish Government and the Food Standards Agency in Northern Ireland. 4

Five Food Groups Food Group

Main Nutrients and Functions

Key Messages

• Eat a wide variety of fruit and vegetables. Fresh, frozen, canned or dried. A glass of Healthy gut, reduces cholesterol, fills you • Eat plenty, aim for at least 5 times a pure fruit or vegetable juice also counts. up and can help weight loss. day. Vit C > • Avoid adding fat, sugar or salt in Helps fight infections, improves wound cooking and serving. healing, helps body absorb iron.

FRUIT AND VEGETABLES

Fibre >

Folate >

Reduces risk of heart disease.

Carotenes >

Good vision, growth and tissue repair.

BREAD, OTHER CEREALS AND POTATOES

Breads and rolls (white and wholemeal) pitta breads, naan bread, bagels, tortilla wraps, chapattis, teacakes, cracker biscuits and scones, potatoes, other cereals - pasta, rice, noodles, oats and cous cous.

• Eat something starchy at every meal. • Always have a breakfast. • Try to choose wholemeal, wholegrain, Fibre > brown or high fibre varieties whenever Healthy gut, reduces cholesterol, fills you possible. up and can help weight loss.

Starch (carbohydrate) >

Provides energy, helps brain work.

Calcium >

Healthy bones and teeth, essential for growth.

Iron >

Helps fight infections, healthy blood, growth and development.

Try to avoid:-

Fried foods too often for instance fried rice, chips etc. Adding too much fat i.e. thick spreadings of margarine or butter. Adding rich, creamy or cheesy sauces.

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Five Food Groups Food Group

Main Nutrients and Functions

Key Messages

MILK AND DAIRY PRODUCTS

Protein >

• Eat and drink moderate amounts. • Choose lower fat versions whenever possible.

Milk, cheese, yoghurt and fromage frais.

Growth, maintenance and repair of body tissues.

Calcium >

Healthy bones and teeth, essential for growth.

Vit A >

Helps fight infections, promotes wound healing.

For instance semi-skimmed or skimmed milk, low fat yoghurts or fromage frais and lower fat cheeses - edam, half fat cheddar, camembert, cottage cheese.

Vit D >

Helps body absorb calcium, promotes healthy bones and strengthens teeth.

MEAT, FISH AND ALTERNATIVES

Beef, lamb, pork, offal (liver, kidney) chicken, turkey, eggs, white fish, oily fish - salmon, pilchards, sardines, herring, tuna, fish fingers, fish cakes, baked beans, kidney beans, lentils, nuts, soya, tofu. Sausages, salami, pate and beefburgers may have a high fat content.

Protein >

Growth, maintenance and repair of body tissues.

Iron >

Helps fight infections, healthy blood, growth and development.

Magnesium >

Helps protect against heart disease, lowers high blood pressure.

• Eat moderate amounts. • Choose lower fat versions whenever possible. • Avoid adding too much fat and salt in cooking and serving. • Trim off any visible fat - remove skin from chicken and eat fish without batter.

Vit B12 >

Lowers risk of heart disease, helps to reduce depression.

Other B Vits >

May help improve mood and help lift depression. Help prevent heart disease and strokes. 6

Five Food Groups Food Group

Main Nutrients and Functions

Eating fatty foods frequently, particularly saturated fat can lead to progressive Butter, margarine, low fat spreads and weight gain and can increase the risk other cooking fats and oils and ghee. Salad dressings and mayonnaise, cream, of heart disease and strokes. Saturated chocolate, crisps, biscuits, pastries, cake, fat is usually hard at room temperature and usually from an animal source. puddings, ice cream, rice, sauces and For example lard, butter or the fats off fatty gravies, sweets, jam and sugar, meat or products containing these fats. fizzy drinks (non-diet) and fruit squash Fatty foods contain some vitamins and (non-diet). essential fatty acids.

FATTY AND SUGARY FOODS

Although sugar adds sweetness and flavour to foods and drinks eating sugary foods frequently can lead to excessive weight gain and tooth decay. NB: Diet, No Added Sugar drinks and Fruit Juices contain acids which could lead to dental erosion. The best choices for good dental health are either plain water or milk. Sugar has no nutritive value and is often referred to as an ‘empty’ source of calories.

Key Messages • Eat less fatty and sugary foods. • Watch Out - sugar can be referred to various other names on food labels for instance brown sugar, dextrose, glucose invert sugar etc... They are all types of sugar - so try to limit intake. • Choose lower fat versions whenever possible. Watch out low fat foods and drinks can be rich in calories due to a high sugar content. • There are different types of fat - the main message is to - reduce total fat intake! • Choose fats and oils containing monounsaturates (olive oil or rapeseed oil) or polyunsaturates (sunflower or corn oil) but still use them sparingly, as they are all rich in calories. • Butter and margarine contain the same calories. Use a low fat spread if you wish to save the calories.

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HEALTHY EATING – MAIN MESSAGES • Eat a variety of different foods. • Eat plenty fibre rich, starchy foods at every meal – for instance bread, rice, pasta, potatoes or cereals (choose wholegrain varieties when you can). • Eat 5 fruit and vegetables every day... try fresh, frozen, tinned, dried or juiced! • Eat breakfast every day. • Eat fish more often, particularly oily fish – aim to eat oily fish once or twice a week. • Halt the salt – sprinkle less and taste more! • Drink more water. • Don’t eat too many foods that contain a lot of fat. • Don’t have sugar or sugary foods or drinks too often. • If you drink alcohol, drink sensibly!!!

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Setting up Your Workplace Weight Management Programme Points to Consider WHO SHOULD FACILITATE THE PROGRAMME?

Anyone in your Workplace who has an interest in weight management could run this 10 week programme. The facilitator does not have to have a healthcare background but would be beneficial if they have completed the ‘Food and Health’ or REHIS Elementary course. Visit www.nhsforthvalley.com/healthpromotion - choose Nutriton’ then ‘Training’ for training opportunities available. This programme outlines a plan for 10 sessions - it contains ideas of activities to run and details of the resources and materials required. A group of friends in your workplace could even get together and run with the programme – in this case it is best that someone takes the lead and co-ordinates the sessions.

LOCATION AND TIME • • • • •

If time permits, arrange for the group to go for a 10 minute walk at the end of each session. Each session takes around 30-45 mins to deliver and could be run either weekly or fortnightly. Schedule sessions at a time and location that suits all participants. Ensure participants are well informed about the location and time of the course. Allow adequate time to run each session and ensure you have enough time to set up the room.

GROUP SIZE

• Ideally there should be between 6-10 people in the group.

PLAN AHEAD

• Be realistic – it can take several weeks to order and receive relevant resources to run a session. So take time and plan ahead.

COST

• Consider charging a small fee to attend each session. This could either be donated to charity or used as an incentive – the person who loses the most weight over the duration of the programme wins all the money – Lose lbs to gain ££££’s!!!! • As an incentive, charge group members £10 on week 1 then at the end of the 10 sessions give back £1 for each week of attending, for instance if someone attends for 8 out of the 10 weeks they would get £8 back. Any remaining money could be donated to charity.

PROMOTION

• Allow enough time to promote the course. • Advertise the course through posters, flyers, via email or by word of mouth. 9

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Session 1

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SESSION 1 INTRODUCTION OVERVIEW Introduction Welcome

Ground Rules No more than 2 absences Confidential Buddying Scheme

Ice Breaker

My Favourite Food

Group Activity

Why do I want to lose weight? What influences my food intake - H Diagram A1 Poster on Wall (Appendix 2 - Page 18)

Next Week Handout blank Food Diaries (Appendix 4 - Page 21) to be completed and brought back next week. Waist - Weigh-In

Display Appendix 3 next to scale and tape measure. (Pages 19/20) Handout Weight Record Card

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Subject Introduction

WEEK 1 - INTRODUCTION

Overview of 10 Weeks/ The Contract/ Commitment

Give a brief outline of the programme.

Introduce yourself to the group.

State that you need everyone’s commitment to the programme.

Resources Yourself. Give a programme as a handout.

Nobody is to have more than 2 absences. Ask if anyone can foresee any difficulties with that. Check that everyone understands the importance for the whole group, of their regular attendance, and is ‘signed up’ to their contract with you. That is they MUST attend at least 8 of the 10 sessions.

Set Ground Rules

Emphasize the importance of setting ground rules.

Responsibility

Explain to the group that their decision to attend the programme and whether or not it works for them is in their own hands. Nobody else can be blamed for any apparent failures be it partners, family members, friends, other group members or indeed the facilitators.

Emphasise all information is confidential and anything discussed within the group should remain unrepeated. Group members should arrive promptly, should be encouraged to listen to others, avoid interupting, involve everyone and should not be judgmental or condescending.

Equally everyone is responsible for their own successes so they can congratulate themselves when things go well.

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Subject Buddying Scheme

WEEK 1 - INTRODUCTION Support and Encouragement

Resources

Ice Breaker

Ice Breakers

See Appendix 1 ‘Ice-Breaker’ (Page 17)

This is a key element of losing weight. It is a good idea to swap names and phone numbers or buddy up with a friend or work colleague.

These can help people introduce themselves and may make them feel less anxious about speaking aloud within the group.

Group Activity Reasons to lose weight maybe: Why Do I Want to Lose Weight?

See Appendix 2 You are keen to feel fitter and healthier, have more energy, feel more comfortable How confident am I about in your clothes, drop a size, get into a new outfit, play more with the children, want making healthy choices. to look better in swimwear for a holiday coming up, improve self-confidence. (Page 18) Ask group members to take 5 minutes to write on post its or use flipchart. After 5 minutes pull group back together - ‘How confident am I about making healthy choices’. This can be quite personal - ask people to share any ideas they have with the rest of the group, only if they wish.



What influences your food intake?

Flipchart for brainstorming. Flipchart epns, post-it pads/ pens/pencils.

Make sure you are losing weight for the right reasons and for yourself, not because someone else thinks you should.

Divide group into smaller groups of 2 or 3. Ask them to take 5 minutes to think about things that influence their food intake - use the ‘H’ Diagram. What makes it easy - what makes it difficult.

See Appendix 2 - H Diagram. What influences food intake? (Page 18)

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Subject Group Activity

WEEK 1 - INTRODUCTION Ask group to feedback on the ideas they gathered on what factors they feel influence their food intake.

Factors which influence food intake maybe:

Resources ‘Appendix 2’ - H Diagram either on wall or individual. (Page 18)

Here are some ideas to share with the group after their brainstorming session:boredom, stress, anxiety, anger, comfort, tiredness, habit, availability, sight and/ or smell of food, to be sociable, time of day, advertising, hunger, hormones, depression - feeling down, greed, alcohol, laziness i.e. to prepare healthy foods.

Most people don’t tend to eat because of hunger, but they eat in response to other feelings mentioned above. If people are more aware of the reasons why they overeat then they can concentrate on these and try to combat them, which in turn should help prevent them from continuously reaching for food when in reality they are not even hungry. Next Week

Ask group members to carry out a dietary recall excercise and bring it along next week. Ask them to record everything that they ate or drank yesterday i.e the day before starting their new healthier eating regime. Note a typical days dietary intake up until now. Analysing this next week should help give a true picture of what you were eating and drinking, as well as ideas of what you could change. During this first week try to make a few changes to your dietary intake. Refer to the Eatwell leaflet for general tips on healthier eating.

Writing down what you eat helps you become aware of your actual dietary intake. People are often surprised to see in ‘black and white’ what they have actually eaten in a day. Becoming aware of what you are eating and how much you are eating is an excellent starting point for losing weight. Buy a small notebook and jot it down as you go or write it up at the end of a day. NB: Remember to try to be honest with yourself and remember the odd snacks you had!

‘Appendix 4’ - A blank diary for each group member. (Page 21) Handout ‘Eatwell: Your Guide to Healthy Eating’ available from HIRS Code NUT 07/L See Resources Table (Pages 79 - 81) ‘Eatwell Flier’ available from HIRS Code NUT 79/L See Resources Table (Pages 79 - 81) 15

Subject Waist and Weigh In

WEEK 1 - INTRODUCTION Discuss with group members the procedures of the weekly weigh in. Point out where scales and tape measures will be set out each week. Encourage group members to weigh themselves either weekly, fortnightly or on week 1, 4, 6 then week 10. This encourages group members to take responsibility for their own weight and also helps evaluate the success of the programme. Some individuals may wish to be weighed by the facilitator - they may feel that this would increase their motivation.

The facilitator should record individuals weights on week 1 and 10 as a measure of success.

Resources ‘Weight Record Card’ Available from HIRS Code NUT 08/L See Resources Table (Pages 79-81) ‘Appendix 3’ for materials required. (Pages 19/20)

‘Laminated A3 poster’ Appendix 3 If you lose a pound in a week this is equivalent to a 500g tub of butter. - Pin up on wall next to scales and tape measure. Explain to the group that in order to lose weight you need to burn off more calories (Pages 19/20) than you take in. So eating less food and increasing your physical activity levels work well together and help you lose weight.

‘Appendix 4’ - A blank Refer to instructions on Appendix 3 - A laminated A3 poster of Appendix 3 has been diary for each group included in this pack. This should be displayed in a prominant position - beside the member. (Page 21) scales - for those who wish to weigh themselves. It provides a step by step guide to calculating Body Mass Index (BMI) and taking weight and waist measurements.

Butter - 500g Tub

Take individuals’ weights, calculate Body Mass Index, take waist measurement and calculate the amount of weight they should aim to lose (10%). Record all these details in the weight record card. Encourage group members to bring their Weight Record Card each week.

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APPENDIX 1 MY FAVOURITE FOOD This ice breaker acknowledges that everyone enjoys eating and sets the scene for talking openly about indulgent foods.

PURPOSE/AIM: To give participants an opportunity to: • introduce themselves to each other • speak • reveal something about themselves.

MATERIALS AND PREPARATION: A blank sticky label or post-it plus coloured pens/pencils for each member of the group.

THE ACTIVITY: (15 mins) Each person is given a sticky label/post-it and are then asked to write their first name on it and to draw a picture of their favourite food. Participants are then asked to introduce themselves and explain what they have attempted to draw.

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H Diagram

How confident am I about making healthy choices?

What makes it easy to choose a healthier lifestyle?

APPENDIX 2 What makes it difficult to choose a healthier lifestyle?

How much control do we have over what we eat and physical activities. No Control 0

Full Control 10

Can you identify changes you could make towards healthier choices? 1. 2. 3. 4.

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APPENDIX 3 THE MOMENT OF TRUTH – WAIST/WEIGH IN Have To Hand:

Set of Scales (same scales each week). BMI Chart (on back of Weight Record Card). Weight Record Cards for each group member.

Weight and Height Conversion Charts (included at end of this pack). Tape Measure. Calculator.

WEIGH–IN 1. Weigh yourself on the scales provided (remove your shoes first). 2. Convert your weight into kilograms using the conversion chart. 3. Convert your height into metres using the conversion chart. 4. Take your weight in kilograms and divide by height in metres - then divide by the height again – this will reveal your Body Mass Index (BMI). 5. Record your Weight and BMI in your Weight Record Card – remember to put the date next to your weight. 6. What category do you fit into?



Underweight Okay Overweight Obese Very Obese

BMI less than 18.5 BMI of 18.5 to 24.9 BMI of 25 to 29.9 BMI of 30 to 39.9 BMI of 40 and over

BODY MASS INDEX (BMI)

This is used to determine how much you weigh in relation to your height. There is a BMI Chart on the back of your Weight Record Card. To find out your BMI on the chart draw a line horizontally across the chart at your height and a line vertically up from your weight. Where the two lines intersect - this will reveal your BMI.

• Try not to weigh yourself too often – once a week at the same time of day (mornings are best) is enough. • Aim to lose 1-2lbs (0.5-1Kg) each week, but do remember some weeks you’ll do better than others.

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APPENDIX 3 WAIST COUNTS 1. Measure your waist using the measuring tape. Measure midway between your hips and ribs making sure the tape measure is straight and snug not ‘digging in’ to the skin. Measure after breathing out. 2. Record your waist measurement on your Weight Record Card. 3. What category do you fit into?



Women - Ideal

Increased Health Risk High Risk

Less than 80cm (32 inches) 80cm (32 inches) or more 88cm (35 inches) or more



Men -

Ideal Increased Health Risk High Risk

Less than 94cm (37 inches) 94cm (37 inches) or more 102cm (40 inches) or more



ARE YOU AN APPLE OR A PEAR? It is not just the quantity of body fat that counts but also how it is distributed in our bodies. Waist size is a good indicator of your general health and your exposure to health risks such as heart disease, diabetes and high blood pressure. People who are pear-shaped with excess fat on their hips and thighs seem to be less at risk of heart disease than people who are apple-shaped and carry their weight around their abdomen.

• As your waist gets bigger, your risks to health increase. • Remember any reductions in your waist measurement is a step in the right direction!!

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APPENDIX 4 FOOD & DRINK DIARY Write down everything you ate or drank yesterday. • Be honest with yourself!! – Remember to note down all the little extras you had! • Be as accurate and descriptive as possible – For example if you had toast at breakfast was it one or two slices – was it white or wholemeal bread.

Time

Food & Drinks - Quantities Consumed

Thoughts & Feelings

Early Morning Breakfast During Morning Midday During Afternoon Evening Meal During Evening & Before Bed Extras During Night 21

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Session 2

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SESSION 2 EATING FOR HEALTH AND FOOD DIARY OVERVIEW Welcome Weigh-In (Appendix 3 - Pages 19/20) Group Activity

Food Diary and Handout Empty Plate (Appendix 5 & 6 - Pages 29/30)

Set Personal Goal(s) Next Week’s Reminder

What to do and what to bring?

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Subject

WEEK 2 - FOOD DIARY & EATWELL FOR GOOD HEALTH

Welcome

Welcome everyone back to the session.

Weigh-In

As each group member arrives, ask if they wish to weigh themselves. Ask group members to log their weight and waist circumference in their Weight Record Card.

Resources

‘Weight Record Card’

Group Actvity Food & Drink Diary

Writing down what you eat helps you become aware of your actual dietary intake. People are often surprised to see in ‘black and white’ what they have actually eaten in a day. Becoming aware of what you are eating and how much you are eating is an excellent starting point for losing weight. Buy a small notebook and jot it down as you go or write it up at the end of a day.

‘Appendix 5 - Food & Drink Diary’ (Page 29) ‘Appendix 6 - Empty Plate’ (Page 30)

NB: Remember to try to be honest with yourself and remember the odd snack you had! Ask group members to analyse their Food and Drink diaries. They should go through their food and drink diary and put each food and drink into the appropriate food group section on the blank plate in Appendix 6 (Page 30). For example a bowl of Fruit and Fibre with semi-skimmed milk at breakfast write Fruit and Fibre in bread, cereals and potatoes section and the milk in the dairy section and so on....... Allow approximately 10 minutes for this exercise.

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Subject

WEEK 2 - FOOD DIARY & EATWELL FOR GOOD HEALTH

Group Activity Once everyone has their plate completed - individuals can review their own dietary intake and see how many times in the day they’ve eaten something from the fruit and vegetables section or how many times in the day they’ve eaten a starchy food and so on. Questions to raise to the group, (no need to answer) • Have you all reached at least 5 portions of fruit and vegetables in the day? • How many foods do you have in the fatty and sugary food section? • Did you eat something starchy at each meal? • Were there any sections blank at the end of the exercise?

Eatwell for Good Health

Handouts ‘Are you getting the balance right? What is a portion? - Available from HIRS Code NUT 76/L Refer to Resources Table (Pages 79-81)

Optional Eatwell plate model is a nationally recognised model - it should be used to illustrate ‘Eatwell Floor Mat and Food a well balanced diet. This model was developed to help people understand and Models’ - Available from begin to enjoy healthy eating. It illustrates the five different food groups. Those HIRS Code NUT 78/K1 people trying to lose weight often find it difficult to gauge portion sizes, this should Refer to Resources Table help as a guide. (Pages 79-81) Comparing food diaries with this model should help highlight areas of our diet which could change for the better! For example if you have 4-5 items in the fatty sugary section this maybe an area you should focus on - limit to 1 treat a day! Or maybe you only had 2 portions in the fruit and vegetable section - aim for 5 each day.

Make S.M.A.R.T Changes

Resources

Keeping food and activity diaries can make individuals more aware of their current habits and can help individuals focus on their lifestyle and highlight areas which could be changed for the better.

‘Eatwell Poster’ - Available from HIRS Code NUT 21/P - Refer to Resources Table (Pages 79-81)

Handout ‘Just what you have been weighting for’ - Available from HIRS Code NUT 80/L - Refer to Resource Table (Pages 79-81) 26

Subject

WEEK 2 - FOOD DIARY & EATWELL FOR GOOD HEALTH

Make S.M.A.R.T Changes

When individuals are setting themselves personal goals to reach - encourage them to make S.M.A.R.T. changes. That is changes which are S (Specific), M (Measurable), A (Achievable), R (Realistic), T (Time-limited).

Resources

Bear in mind people need help to prepare and set realistic goals. The process of change is not an easy process. Making changes for a few weeks can start off well but maintaining the changes needs continued effort. This is where the value of group support comes in. If people fail to reach a set goal, it is important to look at the reasons why they haven’t managed to achieve it and address these issues. Relapses should not be seen as a catastrophe - it is perfectly normal.

Setting Personal Goals

Ask group members to take a few minutes to think carefully about setting 1 personal goal for the week - bearing in mind the group activity carried out in this week’s session. This ‘setting personal goals exercise’ will be done at the end of each weekly session.

Appendix 2 - The H Diagram from last week could be revisited to prepare for goal setting. (Page 18)

At the end of the 10 week programme, individuals will have a set of 10 personal goals, the idea being that these could be expanded or built upon over time.

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Subject

WEEK 2 - FOOD DIARY & EATWELL FOR GOOD HEALTH

Setting Personal Goals

Examples of Goals

Resources

• I will eat a piece of fruit instead of a biscuit every morning at breaktime. • I will park my car at the furthest away parking space from the office and walk more every day this week.

People often find they stick to a goal more easily if it is personal to them, if they actually write it down and make it quite specific. For example don’t just plan to cut down on biscuits write down exactly how many you’ll have each day or week, in what situation and which more nutritious foods you’ll choose instead. It can also help to plan a non food reward for yourself once you have achieved say a few small goals. For example a manicure, a trip to the cinema.....

Next Week

Remind group members to bring their copies of ‘Just what you’ve been weighting

for!’ and ‘Weight Record Card’ next week.

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APPENDIX 5 FOOD & DRINK DIARY Write down everything you ate or drank yesterday. • Be honest with yourself!! – Remember to note down all the little extras you had! • Be as accurate and descriptive as possible – For example if you had toast at breakfast was it one or two slices – was it white or wholemeal bread and what did you put it on.

Time

Food & Drinks - Quantities Consumed

Thoughts & Feelings

Early Morning Breakfast During Morning Midday During Afternoon Evening Meal During Evening & Before Bed Extras During Night 29

APPENDIX 6

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Fatty and Sugary Foods

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30

Session 3

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SESSION 3 PRACTICAL SESSION • Quick and easy snacks, tips etc. • To be arranged and discussed by group - either a demonstraton, participatory or at least discussion or ways of changing foods. • Don’t worry if you don’t have access to cooking facilities, just skip this session and go onto the next one.

Lentil Soup - Ingredients ½ mug lentils 2 carrots ¼ turnip 2 medium potatoes 1 small onion or leek 4 or 5 mugs water 1 stock cube (ham, vegetable or chicken) black pepper to taste

How to...

Wash, peel, chop vegetables. Rinse lentils in a sieve under cold water. Place large pot onto a high heat, add chopped vegetables, water and stock cube. Bring to the boil, reduce heat to medium and cook until all vegetables are soft. Soup can be served chunky or use a hand blender to make smooth. Add black pepper to taste.

Spicy Salsa - Ingredients

A Quick Pizza - Ingredients

4 large tomatoes 1 red onion, ½ pepper and 1 spring onion 1 teaspoon chilli powder or chilli flakes 1 teaspoon dried mixed herbs black pepper to taste

Base - choose from french stick, naan bread,pitta bread, tortilla wrap or bagel

How to...

Spread - a thin layer of tomato pureé and a sprinkle of dried mixed herbs

Peel, chop vegetables. Mix ingredients together. Leave for short while in fridge or cool box to let flavours mix.

Toppings - choose from chopped peppers, mushrooms, sweetcorn, pineapple, tuna, cooked ham or cooked chicken

Potato Wedges - Ingredients

2 dessertspoons grated mature cheddar black pepper to taste

3 or 4 medium baking potatoes or sweet potatoes black pepper to taste 2 dessertspoons olive or vegetable oil

How to...

Preheat oven to 180°C or gas mark 4. Wash potatoes, cut into 8 to 12 wedges. Place wedges into deep bowl, add oil, black pepper (any spices) - mix together. Place on non-stick baking tray in oven for 30 minutes or until soft, turning once.

How to...

Preheat oven to 220°C or gas mark 7. Spread tomato pureé on to base of choice. Add selection of toppings, remember not to overload pizza. Sprinkle cheese on top. Add black pepper to taste. Cook in oven for 10-15 minutes. 32

Session 4

33

SESSION 4 PHYSICAL ACTIVITY OVERVIEW Welcome Waist and Weigh-In - Appendix 3 (Pages 19/20) Feedback/Reflection Group Activty Benefits of physical activity

Barriers to exercising Ways to increase activity levels at work

Set Personal Goal(s) Next Weeks Reminder



What to do and what to bring? Bring in 1 or 2 food labels Weight Record Card

34

Subject

WEEK 4 - PHYSICAL ACTIVITY

Resources

Welcome

Welcome everyone back to the session.

‘Getting Fitter is easier than you think’ HIRS Code PAC 01/L ‘Hassle Free Exercise’ HIRS Code PAC 05/L Refer to Resources Table (Pages 79-81)

Congratulate group members on attending almost half of the 10 week course.

Weigh-In

As each group member arrives, ask if they wish to weigh themselves. Ask group members to log their weight and waist circumference in their Weight Record Card.

‘Weight Record Card’

Feedback on Personal Goals

Ask people to reflect back to last weeks personal goals - did they manage to stick to their goals - did any difficulties arise and how did they overcome these obstacles? Encourage group members to share their experiences.

Refer to H Diagram if appropriate - Appendix 2 (Page 18)

Group Activtiy Divide group into smaller groups of 2 or 3’s and ask groups to think firstly about the many benefits that can be gained from being more active.

Benefits of Exercise

After 5 minutes bring group back together and brainstorm as a group.

May want to share these ideas below after the groups have thought for themselves:

Flipchart and pen for brainstorming.

‘Appendix 7 - Physical Activity’ (Page 38)

Exercise helps improve suppleness, stamina, sleep patterns, helps control stress and anxiety - improves relaxation, increases energy levels, makes you feel more alert, improves self confidence, tones up muscles and helps improve body shape, can speed up weight loss, helps reduce blood pressure and helps prevent heart disease and reduce your risk of bowel cancer and osteoporosis, it can also be fun! 35

Subject

WEEK 4 - PHYSICAL ACTIVITY

Group Activity Divide group into the same smaller groups - ask them to jot down a few barriers

or obstacles they face when thinking about exercising and then think of ways they could increase their physical activity levels without attending a leisure centre or exercise class.

Resources Flipchart and pen for brainstorming exercise.

May want to share these ideas with the group after their individual brainstorming sessions: Barriers to Exercising

Despite all the benefits associated with exercising most people don’t exercise enough. There are many reasons for this:- lack of time, lack of confidence, lack of appropriate leisure facilities and equipment, self consciousness about body shape, no money, nowhere to leave the children, cultural barriers, too tired, bad weather, dark nights, boring, not co-ordinated.

People should be encouraged to become more physically active in their every day living, its never too late to start and the benefits to your health are enormous.

Ways to Increase Activity Levels

May want to share these ideas with the group after their individual brainstorming sessions: • Go for a walk with a friend. • Get out with the kids - chase the kids around the garden/park or have a kick around. • Get off the bus a couple of stops early and walk the rest of the way. • When you pop to the local shop, walk rather than taking the car. • Get out into the garden - planting, weeding, digging are good forms of exercise.

36

Subject

WEEK 4 - PHYSICAL ACTIVITY

Group Activity Ideas to get the group active: • Set up a walking/jogging group. • Run a competition - use pedometers - who walks the most in your group.

Resources See www.pathsforall.org then choose ‘Walk at Work’ - they have pedometer packs available.

Aim to burn at least 1000 calories a week through extra activities - this equates to 30 minutes brisk walking every day. If trying to lose weight aim to build up to 60 minutes of moderate activity on most days of the week.

Ask group members to take a few minutes to think carefully about reviewing or Setting Personal Goals setting new personal goals for the week - bearing in mind the group activity carried out in this week’s session.

Ask group to write down 1 S.M.A.R.T. goal they wish to focus on. Write todays date + goals..

Examples of Goals • I will get off the bus 2 stops earlier. • I will walk to the shops to collect the morning papers.

Next Week

Remind clients to bring their ‘Weight Record Card’ next week.

37

APPENDIX 7 BENEFITS OF EXERCISING BARRIERS AGAINST EXERCISING WAYS TO INCREASE PHYSICAL ACTIVITY

38

Session 5

39

SESSION 5 PHYSICAL ACTIVITY WALK To be arranged with group. For ideas of local walking routes go to your local council’s websites or:

www.activescotland.org.uk www.walking-routes.co.uk www.thefalkirkwheel.co.uk/visit/walkingroute.html www.walkswithbuggies.com www.braveheart.uk.net

www.feetfirstcanalwalks.com

www.pathsforall.org.uk Next Week Ask group members to bring along their favourite restaurant or take away menu.

40

Session 6

41

SESSION 6 EATING OUT/TAKEAWAYS/ALCOHOL OVERVIEW Welcome Weigh-In - Appendix 3 (Pages 19/20) Feedback/Reflection Group Activty

Eating Out Made Healthier - Takeaways - Appendix 8 (Page 47) Takeaway Game - Appendix 9 (Pages 48/49) Alcohol Questionnaire - Appendix 10 (Pages 50/52)

Set Personal Goal(s) Next Weeks Reminder

What to do and what to bring? Bring in a recipe or packaging of your favourite dish. Weight Record Card.

42

Subject

WEEK 6 - EATING OUT - TAKEAWAYS - ALCOHOL

Welcome

Welcome everyone back to the session.

Weigh-In

Take weights of all those who wish to be weighed - direct others to the scales to weigh themselves. Remind individuals to record their weight in their Weight Record Card.

Resources

‘Weight Record Card’

Ask people to reflect back to last week’s personal goals - did they manage to stick Feedback on Personal Goals to their goals - any difficulties and how did they overcome these obstacles. Encourage group members to share their experiences.

Group Activity Eating Out Made Healthier

Modern lifestyles involve more eating ‘on the run’. Eating out and takeaway are eaten regularly by some. If it’s a one off occasion you should eat what you want and enjoy it. Eating out can cause quite a problem as you don’t know exactly what’s in the meal or how it has been cooked. In reality a lot of takeaways are likely to be rich in fat particularly saturated fat. Don’t be afraid to ask about ingredients and cooking methods. If you find you are eating out regularly think of a few strategies that might help you eat or drink less but still enjoy yourself. Divide the group into smaller groups of 2 or 3 and ask them to think of some ways to make eating out a bit healthier.

‘Appendix 8 - Takeaways’ (Page 47)

Ideas to share with the group after their individual brainstorming sessions:

Skip a course, avoid creamy, cheesy, fatty dishes, take a small snack before you go out, so you’re not absolutely starving when you get there, fill up on salad and vegetables, if you’re drinking alcohol ask for some water as well, add soda to wine - a long drink lasts longer, choose potatoes instead of chips or boiled rice instead of fried. Ask the waiter for sauce or salad dressings or oils to be served separately then you can add the amount you want, avoid puddings too often or try a fresh fruit salad or sorbet. 43

Subject

WEEK 6 - EATING OUT - TAKEAWAYS - ALCOHOL

Resources

Group Activity

Refer to Appendix 10

Blank Paper + Pens

Place the cards on a table, so everyone can see, with the name of the meal face up. Give everyone a blank piece of paper and ask them to write down the meals ranking them 1 to 13. 1 having the most calories and 13 having the least calories. As a whole group, discuss responses and try to get a consensus. Place cards in the true order and distribute the handout showing the full list. The calorie values are interesting when considered in the context of someone’s daily meal plan/allowance of say 1500 or 1700 calories.

Using the material in

‘Appendix 9’ (Pages 48/49)

make a set of 13 individual cards each with the name of the takeaway meal on one side and showing the calorie and fat intake on the other.

Choose

Avoid

At the Indian

Plain Naan Bread. Drier Dishes - tandoori, karia and bhuna. Plain boiled rice.

Creamy dishes - korma, Have a copy of the full list for everyone to masala and dhansak. Deep fried dishes keep. bhaji, samosa, pakhora. Pilau rice, biryani fried rice.

At the Chinese

Won-ton soup. Stir fried dishes vegetables, chicken in black bean sauce. Plain rice or noodles.

Deep fried dishes. Sweet and sour dishes. Lemon chicken. Crispy fried beef or duck. Fried rice, prawn crackers or sesame prawn roll.

At the Mexican

Chicken fajitas. Cajun chicken. Tomato based salsa sauces and dips.

High fat enchaladas.

44

Subject

WEEK 6 - EATING OUT - TAKEAWAYS - ALCOHOL

Group Activity

Alcohol

Choose

Avoid

At the Italian

Plain crusty bread. Mixed salads/tomato salads. Pasta with tomato, onion and basil based sauces. Thin based pizzas with vegetable topping.

Creamy or cheese sauces. High fat meats like salami or pepperoni. Too much cheese such as parmesan.

At the Cafe

Homemade soup. Crusty roll. Baked potato (no butter) with baked beans, vegetable chilli, curry, tuna (no mayo) or cottage cheese and order a side salad. Scone with jam - no butter. Sweeten drinks with artificial sweeteners. Water is the best option.

Too much cheese, coleslaw and rich meat sauces. Fresh cream cakes, rich pastries or chocolate cake. Sugar in tea and coffee High calorie fizzy drinks e.g. cola, irn bru, lemonade.

Resources

People often forget the impact that alcohol can have on weight gain. Alcohol Optional ALCO-FACTS is loaded with calories.

1 pint of beer = 180 calories. 1 small glass of white wine = 94 kcals 1 large glass of white wine = 187 kcals A 25ml serving of spirit e.g. whisky = 55 kcals. Then add calories from mixers e.g. ½ a can of cola contains 70 kcals. Therefore cutting back on your alcohol consumption means you’ll cut back on your calorie intake.

A Guide to Sensible Drinking Available from HIRS Code ALC 28/L - See Resources Table (Pages 79-81) Sensible Drinking Available from HIRS - See Resources Table (Pages 79-81) 45

Subject

WEEK 6 - EATING OUT - TAKEAWAYS - ALCOHOL

Welcome

Sensible Drinking

Resources

What’s in a drink? The straight facts about Men - should drink no more than three to four units per day. Consistantly drinking alcohol. Available from four or more units per day is not advised. Try to have at least 2 drink free days. HIRS Code ALC 05/L Women - should drink no more than two to three units per day there. Consistantly See Resources Table drinking three or more units per day is not advised. Try to have at least 2 drink free (Pages 79-81) days.

Divide the group into smaller groups of 2 or 3 again and ask them to answer the 7 questions from Appendix 10. They should answer either TRUE or FALSE. This activity will take around 5-10 minutes. Once everyone has completed, bring group together and discuss the answers. The answers are written in Appendix 10.

‘Appendix 10’ - Alcohol Questionnaire (Pages 50/52) Photocopy Appendix 10 Questions only to distribute to group members. (Pages 50/52)

Ask group members to take a few minutes to think carefully about reviewing or Setting Personal Goals setting new personal goals for the week - bearing in mind the group activity carried out in this week’s session.

Ask group members to write down 1 S.M.A.R.T. goal they wish to focus on. Write today’s date + goal.

Examples of Goals

• Drink less alcohol this weekend - no more than 3 white wine and sodas. • Only have takeaways once a week and choose healthier options - no chips!!

Next Week

Everyone to bring in a recipe of your favourite dish. Going to be looking at adapting the recipes to make them healthier. Remind clients to bring ‘Weight Record Card’ next week.

46

APPENDIX 8 WAYS TO MAKE EATING OUT HEALTHIER STARTERS TO AVOID

STARTERS TO CHOOSE

MAIN COURSES TO AVOID

MAIN COURSES TO CHOOSE

PUDDINGS TO AVOID

PUDDINGS TO CHOOSE

47

APPENDIX 9 TAKEAWAY GAME Using the material overleaf, make a set of 13 individual cards each with the name of a takeaway meal on one side and showing the calorie and fat values on the other. Place the cards on a table with the name of the meal face up. Give everyone a blank sheet of paper and ask them to write down the 13 takeaway meals in rank order, by calorie content. That is, write the MOST calorific as number 1 and the LEAST calorific as number 13. In the whole group, discuss responses and try to get a consensus. Place the cards in the true order and distribute the handout overleaf showing the full list. The calorie values are interesting when considered in the context of someone’s daily meal plan of say 1,500 or 1,700 calories.

48

APPENDIX 9 FACTS ABOUT TAKEAWAY MEALS

MEAL (Standard Portion) kcalories Fat (grams)



Fish and chips

1134

52



Sweet and sour chicken (battered) and fried rice

970

42



Vegetarian pizza (small)

936

27



Chicken tikka massala and pilau rice

860

47



Fried chicken and chips

814

45



Cheeseburger and chips

663

29



Bean burger in bun

589

20



Baked potato with cheddar cheese and butter

533

27

Chicken deli sandwich 410 11 Donor kebab 405 21

Chicken chow mein

384

22



Baked potato, cottage cheese and salad

374

5

49

APPENDIX 10 ALCOHOL QUESTIONNAIRE Answer the following questions either TRUE or FALSE. 1.

Five pints of beer has the same calories as a cheeseburger and fries?

2.

A “beer belly” is only caused by downing too many pints?

3.

Alcohol is measured in units with the recommended maximum intake for men being 3-4 units per day?

4.

If you’re trying to lose weight a good choice is non-alcoholic beer?

5.

When you consume alcohol, you lose more water in your urine than you take in, in the drink itself?

6.

Switching between beer, wine and spirits will lead to intoxication more quickly than sticking to one type of alcohol beverage?

7.

There are no health benefits to drinking alcohol?

8.

Write down a few ways that you think you could enjoy drinking without adding to the waistline.

50

APPENDIX 10 ALCOHOL QUESTIONNAIRE 1.

FALSE The five pints is equivalent to almost 1 and a half cheeseburgers and a portion of fries. With a pint of beer containing about 180 calories per pint or 900 in total whereas the cheeseburger and chips totals about 600 calories.

2.

FALSE A “beer belly” is caused by eating or drinking too much therefore you don’t need to drink beer to get one but it certainly won’t help it.

3.

TRUE Currently the recommended intake for men is 3-4 units of alcohol per day. It is also recommended that you have at least one or two alcohol free days per week. One unit of alcohol is equivalent to: • • •

half a pint of ordinary strength beer or lager a small glass of wine a single pub measure of spirits



Men - if you drink 3 or 4 units a day or less, there should be no significant health risks. Women - if you drink 2 or 3 units a day or less there should be no significant health risks.

4.

FALSE Non-alcoholic beer actually has the same calories as alcoholic beer: 148 calories in a pint. If you drink a light beer you’ll only take in around 99 calories per pint. Take care with your choice - a can of extra strong beer or lager is equal to two pints of ordinary strength beer or lager, or four units of alcohol.

51

APPENDIX 10 ALCOHOL QUESTIONNAIRE 5. TRUE Alcohol affects the hormones responsible for fluid balance. As a result, it causes you to pee frequently, losing body fluids. You then feel thirstier so you have another alcoholic drink and so it goes alcohol pee - thirst and so on. The only way to break the cycle is to have water or another non-alcoholic beverage. Along with the fluids drinkers lose, they excrete important nutrients as well. It’s one of the main reasons that after a lot of drink you wake up suffering from what is known as a “pain in the hair roots” in Sweden, “wailing of the cats” in Germany or “a hangover” in Britain. 6.

FALSE Remember that a standard drink of beer, wine, or spirits contains equivalent amounts of alcohol. Alcohol is alcohol and a drink is a drink.

7.

FALSE There is some evidence that alcohol taken in moderation may have some health benefits. For men over 40, drinking 1 or 2 units of alcohol a day may help prevent coronary heart disease. For women who have been through the menopause, drinking 1 or 2 units of alcohol a day may help prevent coronary heart disease.

8.

Suggestions may include: • Drink Spirits with a diet or low calorie mixer e.g. swap Bacardi and Cola for a Bacardi and Diet Cola. • Alternate between Alcoholic and Non-alcoholic drink. • Be careful of the choice of non-alcoholic drink. • Order half pints instead of pints. • Add soda water to wine - a longer drink can last longer.

52

Session 7

53

SESSION 7 - MAKING GOOD CHOICES/FOOD LABELS OVERVIEW Welcome Waist and Weigh-In - Appendix 3 (Pages 19/20) Feedback/Reflection Group Activty Food Label Quiz - Guess the Food Game (Appendix 11 - Pages 57/58)

Handout - Your Guide to Food Labels

Set Personal Goal(s) Next Week’s Reminder

What to do and what to bring? Weight Record Card

54

Subject

WEEK 7 - MAKING GOOD CHOICES/FOOD LABELS

Welcome

Welcome everyone back to the session.

Weigh-In

As each group member arrives, ask if they wish to weigh themselves. Ask group members to log their weight and waist circumference in their Weight Record Card.

Resources

‘Weight Record Card’

Ask people to reflect back to last week’s personal goals - did they manage to stick Feedback on Personal Goals to their goals - any difficulties and how did they overcome these obstacles. Encourage group members to share their experiences.

Group Activity

Guess the Food Game

So much of what we buy and eat is now pre-prepared so we simply have to reheat it in the microwave or put it in the oven for 20 minutes. This means we don’t know exactly what is in it. Nutritional information printed on food labels sets out the amount of each key nutrient in an individual food or drink product. This can help you keep track of what you’re eating.

‘Appendix 11 - Food Label Quiz’ (Pages 57/58) ‘Check the Labels’ - HIRS Code NUT 05/L Refer to Resources Table (Pages 79-81)

Handout the quiz and ask people in pairs to guess the food or drink item by looking at the ingredients list. Explain that the ingredients list is always written in descending order, so the main ingredient is the first one. Bring group back together and give out the answers to the quiz. Handout the booklet - ‘Check the Labels’. Hopefully once the booklets have been read the complex issue of food labelling may become a bit clearer.

55

Subject

WEEK 7 - MAKING GOOD CHOICES/FOOD LABELS

Group Activity Divide the group into smaller groups of 2 or 3 and ask them to assess the food Assess Food Labels

labels on the items brought in, using the ‘Check the Labels’ - leaflet. Each small group should have 2 or 3 labels to assess. Does your food/drink items contain A little or A lot of sugar, fat, fibre?

This credit card can be stored in your purse or wallet and when out shopping it can be used as a quick guide to assess the nutrition labels. Remember to use the amounts per 100gms on the food labels, to compare with the amounts on the credit card - ‘Your Guide to Food Labels’.

Setting Personal Goals

Resources May be useful to have a few other labels to hand just in case some people forget to bring any in. ‘Your Guide to Food Labels’ HIRS Code NUT 72/L Refer to Resources Table (Pages 79-81)

Ask group members to take a few minutes to think carefully about reviewing or setting new personal goals for the week - bearing in mind the group activity carried out in this week’s session. Ask group members to write down 1 S.M.A.R.T. goal they wish to focus on. Write today’s date + goals.

Examples of Goals

• Pay particular attention to food labels when shopping - take ‘Your Guide to Food Labels’ credit card and compare labels. • Write a shopping list and stick to it. Plan ahead meals for each night of the week.

Next Week

Remind group members to bring ‘Weight Record Card’ next week. Also bring in a copy of their favourite recipe.

56

FOOD LABEL GAME GUESS THE FOOD/DRINK GAME

APPENDIX 11

Look at the following ingredients lists, which have been taken from the labels of various foods and drinks. Try to guess the food or drink and write your answer on the dotted line.

1. INGREDIENTS: Carbonated Water, Sugar (carbohydrate), Colour (caramel E 150d), Phosphoric Acid, Flavourings (including caffiene)

………………………………………………………………

2. INGREDIENTS: Water, Sweetcorn (3%), Potato Starch, Creamer [Contains Hydrogenated Vegetable Oil, Glucose Syrup

Solids, Milk Proteins, Acidity Regulator (Monopotassium Phosphate) and Emulsifier (E471)], Glucose Syrup, Chicken (1%), Onion, Salt, Flavourings (contain Wheat), Flavour Enhancers (E621, E635), Parsley, Stabiliser (Xanthan Gum), Colour (Beta-Carotene), Natural Flavourings. ………………………………………………………………

3. INGREDIENTS: Meat and Animal Derivatives (Turkey min 4%, Chicken min 4%), Cereals, Minerals, Various Sugars. …………………………………………………………………

4. INGREDIENTS: Cereals (34%)(Wheat Flour, Whole Oats, Wheat Bran), Glucose-Fructose Syrup, Apples 8%, Sugar,

Vegetable Oil, Humectant (Glycerol), Maltodextrin, Honey, Dextrose, Stabalisers (Sodium Alginate, Cellulose, Xanthan Gum, Carrageenan, Locust Bean Gum), Calcium Carbonate, Modified Starch, Dried Skimmed Milk, Salt, Flavourings, Cinnamon, Raising Agent (Potassium Hydrogen Carbonate), Malic Acid, Calcium Phosphate, Citric Acid, Colour Caramel (E150d), Emulsifier (E472e, E471, Wheat Gluten Starch, Niacin, Iron, Vitamin B6, Riboflavin (B2), Thiamin (B1), Folic Acid, Vitamin B12. …………………………………………………………………

5. INGREDIENTS: Wholewheat, Dried Fruit (28%)(Raisins, Coconut, Banana (Flavouring), Apple, Hazelnuts) Sugar, Salt, Barley, Malt Flavouring, Niacin, Iron, Vit B6, Riboflavin (B2), Thiamin (B1), Folic Acid, Vitamin B12. ………………………………………………………………… 57

FOOD LABEL GAME GUESS THE FOOD/DRINK GAME

APPENDIX 11

ANSWERS

1. Cola Drink

2.

Slim A Soup – Chicken and Sweetcorn



3.

Cat Food – Sheba – Delicious morsels of turkey and chicken.



4.

Kelloggs Nutrigrain Bar – Apple



5.

Kelloggs Fruit and Fibre Breakfast Cereal

58

Session 8

59

SESSION 8 - RECIPE ADAPTATION OVERVIEW Welcome Weigh-In - Appendix 3 (Pages 19/20) Feedback/Reflection Group Activity

Recipe Adaptation (Appendix 12 - Page 63)

Set Personal Goal(s) Next Week’s Reminder

What to do and what to bring? Weight Record Card

60

Subject

WEEK 8 - RECIPE ADAPTATION

Welcome

Welcome everyone back to the session.

Weigh-In

As each group member arrives, ask if they wish to weigh themselves. Ask group members to log their weight and waist circumference in their Weight Record Card.

Resources

‘Weight Record Card’

Ask people to reflect back to last week’s personal goals - did they manage to stick Feedback on Personal Goals to their goals - any difficulties and how did they overcome these obstacles. Encourage group members to share their experiences.

Group Activity

Recipe Adaptation

People often feel dreadfully deprived having to forego their favourite recipe. By doing this next exercise, people can see that there are some ways around that, by modifying favourite unhealthy recipes, to make them a little more healthy. Split the group into 2’s or 3’s - The group task is to work out how the recipe could be modified to make it healthier, but just as tasty. They could also think about accompaniments (breads, veg, salads) and puddings that could be served alongside to make a complete healthy meal. Each group should feedback and share ideas with the whole group.

In case the group don’t bring in their own recipe - have copies of popular recipes to hand. For example lasagne, spaghetti carbonara or macaroni cheese. ‘Appendix 12 - Recipe Adaptation’ (Page 63)

61

Subject

WEEK 8 - RECIPE ADAPTATION

Group Activity

Some Ideas To • • • • • • • •

reduce fat in a recipe: use low fat spread instead of butter use less butter/oil than stated in recipe use non stick frying pan with a lid and add less or no fat use skimmed milk instead of whole milk use low fat creme fraiche or low fat yoghurt instead of cream use some vegetable stock instead of milk use reduced fat cheese or less cheddar - grate it - it goes further! bulk meat dishes out with more vegetables or pulses

To • • • •

reduce sugar in a recipe: cut amount of sugar in recipes by about a half use tinned fruit in natural juice instead of in syrup use reduced sugar jams or pure fruit spread in sponges use nutmeg, mixed spice and cinnamon with fruit for extra flavour

Resources

Ask group members to take a few minutes to think carefully about reviewing or Setting Personal Goals setting new personal goals for the week - bearing in mind the group activity carried out in this week’s session.

Ask group members to write down 1 S.M.A.R.T. goal they wish to focus on. Write today’s date + goal.

Examples of goals

• Concentrate on making more homemade dishes - focus on lowering the fat and sugar content • Go to Step Class once this week

Next Week

Remind clients to bring ‘Weight Record Card’ next week.

62

APPENDIX 12

RECIPE ADAPTATION USING YOUR CHOSEN RECIPE WRITE DOWN WAYS IN WHICH THE FAT AND/OR SUGAR CONTENT COULD BE LOWERED Think about healthy accompaniments that could be served along with your recipe and suitable healthy puddings to make a complete healthier meal.

63

64

Session 9

65

SESSION 9 - SNACKING OVERVIEW Optional Prior to session - Set up Snack Food Model Display

Swap & Save

Welcome Weigh-In - Appendix 3 (Pages 19/20) Group Activity

Beat the Snack Attack (Appendix 13 - Page 70) Ideas of Healthy Snacks

Set Personal Goal(s) Next Weeks Reminder

What to do and what to bring? Weight Record Card

66

Subject

WEEK 9 - SNACKING

Resources

Prior to the Session

Optional

‘Snack Food Model Display - Swap + Save’ - Available from HIRS - Code NUT 72/K1 Refer to Resources Table (Pages 79-81)

Welcome

Welcome everyone back to the session.

Weigh In

As each group member arrives, ask if they wish to weigh themselves. Ask group members to log their weight and waist circumference in their Weight Record Card.

Set up Snack Food Model Display. This display visually illustrates the amount of sugar and fat found in some everyday snack foods.

‘Weight Record Card’

Ask people to reflect back to last week’s personal goals - did they manage to stick Feedback on Personal Goals to their goals - ask about any difficulties and how did they overcome these obstacles. Encourage group members to share their experiences.

Group Activity

Beat the Snack Attack

Most of us will probably snack during the day but snacking needn’t be bad news for your waistline. Snacking on healthy, low calorie foods can help keep hunger pangs at bay.

Flipchart and pen for brainstorming. ‘Appendix 13 - Snacking’ (Page 70)

Divide group into smaller groups of 2 or 3 and ask groups to brainstorm - Ideas of Healthy Snacks.

‘Healthy Snacks’ Download from: www.bda.uk.com/foodfacts Focus on healthy snacks. Then think of ways you could introduce healthier snacking into your day.

67

Subject

WEEK 9 - SNACKING

Group Activity May want to share these ideas with the group after their individual brainstorming session:

Resources Flip chart and pen for brainstorming.

‘Quick convenient snacks’ - fruit - banana, handful of grapes, chopped melon, small bag of sultanas, handful of cherry tomatoes, small cucumber sticks, wholemeal scone and low fat spread or jam, small bowl of wholegrain cereal with semi skimmed milk, rice cake and savoury spread, half a bagel with low fat cheese spread.

‘Introducing healthier snacking @ home and @ work’ • plan ahead and take healthier snacks into work • make smart choices from vending machines or the local shop • join forces with friends or colleagues and take a walk to the local shop for some fruit

Ask group members to take a few minutes to think carefully about reviewing their Setting Personal Goals goals or setting new personal goals for the week - bearing in mind the group activity carried out in this week’s session.

Ask group members to write down 1 or 2 additional S.M.A.R.T. goals they wish to focus on. Write today’s date + goals.

Examples of Goals

• I will drink a large glass of water at my afternoon break instead of my usual cup of coffee. • Plan ahead - snack times and take them into work from home to avoid vending machine temptation.

68

Subject

WEEK 9 - SNACKING

Optional

Healthy Snack Tasting Session - choose from the following ideas:-

Resources

• fresh fruit - bananas, grapes, apple, pineapple, melon, orange etc • dried fruit - raisins, apricots etc • vegetable sticks - with low fat dip e.g. spicy salsa (see recipe in pack) or cottage cheese • rice cakes/crackers with savoury spread • mini wholemeal pitta stuffed with salad and/or tuna • half a bagel or a few oat cakes with low-fat cheese spread • small wholemeal or fruit scone with a little low-fat spread or jam • diet or low fat yoghurt/fromage frais

69

APPENDIX 13 IDEAS OF HEALTHY SNACKS

WAYS TO INTRODUCE HEALTHIER SNACKING INTO YOUR DAY

70

Session 10

71

SESSION 10 - WEIGHT MAINTENANCE AND FEEDBACK OVERVIEW Welcome Waist and Weigh-In - Appendix 3 (Pages 19/20) Feedback/Reflection Review of Personal Goal(s) - Recognising Achievements and Relapses Feedback What Next? and moving on... Think about future plans? Achievements - Calculate overall group weight loss. Ending/Closing Activity

72

SESSION 10 CYCLE OF CHANGE

Research has shown that there are different stages involved in the way people make changes. At first, people may not even be ready to change. They may

Where are you on the Process of Changes? Maintaining Healthier Lifestyle

Making Changes Maintaining Changes Ready to Change

Relapsing/ Set Back Thinking about Change

be not interested in change or are thinking about change, but not quite sure. These people may need to set some relevant information about why change is a good idea. They might need time to think about the pros and cons involved in changing. Even when people are ready to change, they need to prepare themselves before they actually get down to making the changes. Making changes is one thing, but maintaining the changes over weeks or months - or forever - is another. Sometimes people relapse. For whatever reason, they find they can’t keep to their action plan. A relapse doesn’t mean a permanent failure, just that things didn’t quite go to plan that time! People can use relapse as a learning experience, think about why things went wrong, and work out whether and how they will prepare to take action again. Once people have maintained changes for many months they may eventually go out of the circle and become a person who has permanently changed. For these people, the new way of doing things feels absolutely normal and they know they will never slip back to their old ways.

Not interested in Changing ‘Current Lifestyle’ Adapted from Prochaska and Di Clemente

73

Subject

WEEK 10 - WEIGHT MANAGEMENT - FEEDBACK

Welcome

Welcome everyone to the final session and congratulate everyone for staying on the course.

Waist & Weigh In

Weigh everyone and record final weights.

Resources

‘Weight Record Card’

Measure everyones waists and record results.

Ask people to reflect back to last weeks personal goals - did they manage to stick Feedback on Personal Goals to their goals - did any difficulties arise and how did they overcome these obstacles. Encourage group members to share their experiences.

Remind group members that making lifestyle changes is one thing, but Review of Personal Goals maintaining the changes over weeks or months - or forever - is another.

Recognising Achievements and Relapses

Sometimes people relapse. For whatever reason, they find they can’t keep to their set personal goals. A relapse doesn’t mean permanent failure, just that things didn’t quite go to plan that time! People should use a relapse as a learning experience, thinking about why things went wrong and work out whether and how they will prepare to take action again.

Each person needs a copy of their personal goals with them. Use the ‘Cycle of Change’ diagram on the previous page.

Ask people to form pairs and take it in turns to review all their personal goals. • Notice the things that have gone really well and they now consider an integral part of their lifestyle. • Notice also the things they are still doing but find difficult. Discuss barriers and ways of overcoming these. • Notice goals which have been abandoned and work out together what happened.

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Subject

WEEK 10 - WEIGHT MANAGEMENT - FEEDBACK

Resources

Feedback

Tell the group how important it is for you to get their feedback about how they felt the whole programme went. Stress that this means comments about the good and the not so good things. Their ideas for improving the programme are really welcomed.

Post-it Notes

Give out a batch of post it notes to each person and ask them to respond to the three headings on the flipchart with one comment per post-it. Invite them to stick the post-its on the relevant piece of flip chart paper.

Things I really liked about... the programme

Three sheets of flipchart paper headed:

Things I didn’t particularly like about the programme I think the program would be better if... What Next? Moving on...

Ask the whole group to think about what their future plans are now that this programme has come to an end. Get the group to come to an agreement about future meetings.

Present options: • nothing at all, individuals may wish to carry on by themselves with their personal goals, recording their own weight and resetting a new target weight. • have a room set aside within the workplace where group members can drop in at any time review their weight or the room could be set aside for a drop-in wegh-in session on a particular day and time each week.

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Subject

WEEK 10 - WEIGHT MANAGEMENT - FEEDBACK

What Next? Moving on...

• Have an informal arrangement to stay in touch with other group members/ workmates and get together say once a month, at a regular time, in a specific place.

Resources

• Continue to meet regularly (e.g. weekly) as a self-help group, to keep on track with weight management. • All join another group such as a commercial slimming group or a suitable keep fit or walking group. • Group members may not wish to continue meeting but they may wish to continue to keep in touch with each other. They may wish to swap names, addresses and phone numbers. Ideally 2 people will volunteer to be responsible for co-ordinating a follow-on group.

Achievements

Ask group members to calculate any weight loss they have achieved over the 10 week programme - get them to write it anonymously on a post-it. Gather these in and add them up - reveal to the group - the groups combined weight loss over the 10 weeks. There are 14lbs in 1 stone. Therefore if the group has lost 1st 10lbs between them that is the equivalent of 24lbs or 12 bags of sugar!

Post-it Notes Optional - kilogram bags of sugar equal approximately 2lbs.

1 x 14 = 14 + 10 = 24 lbs ÷ 2 = 12 bags of sugar.

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Subject

WEEK 10 - WEIGHT MANAGEMENT - FEEDBACK

Ending and Closing Activity

Bringing the group to a formal close is important.

Resources

Open it up for each person, if they want to say a few words about their very best moment (in terms of their personal achievements) during the programme. Allow people to speak at random making it easy for those who haven’t anything to say, to remain silent. Congratulate group members for completing the 10 week programme. And wish them every success in the future!

77

WEBSITES For more information on Weight Management, healthy eating and physical activity - check out the following websites... NHS Forth Valley - ‘Choose To Lose’

www.nhsforthvalley.com/weight

British Dietetic Association - Weight Wise

www.bdaweightwise.com

British Dietetic Association - Food Fact Sheets

www.bda.uk.com/foodfacts

British Heart Foundation - Health at Work

www.bhf.org.uk/healthatwork/

Take Life On Campaign

www.takelifeon.co.uk

Active Scotland

www.activescotland.org.uk

Paths for All - Walk at Work

www.pathsforall.org.uk/work

Walking Routes

www.walking-routes.co.uk

Scottish Slimmers

www.scottishslimmers.com

Slimming World

www.slimmingworld.co.uk

Weight Watchers

www.weightwatchers.co.uk

NHS Choices - Lose Weight

www.nhs.uk - search ‘Lose Weight’ 78

Leaflets HIRS Codes Weight Record Card (NUT 08/L)

Brief Description

Available from

Small card to record weight and waist Health Improvement Resource Services measurements each week. Also has a BMI chart (HIRS), Central Supplies Department, to help calculate Body Mass Index (BMI) Colquhoun Street, Stirling FK7 7PX

tel: 01786 433867 email: [email protected] For more information and opening times visit www.nhsforthvalley.com/healthpromotion Choose ‘Health Improvement Resource Service’ ALCOFACTS - A Guide to Sensible Drinking (ALC 28/L)

This booklet gives details about alcohol, what is HIRS as above. a unit, drinking and driving, effects of alcohol and knowing your limit.

Sensible Drinking (ALC 06/L)

Alcohol and sensible limits. How many units are HIRS as above. in a drink? What happens when we drink too much?

What’s in a Drink? The Straight Facts about Alcohol (ALC 05/L)

Alcohol and how it affects us. How much is too much? Alcohol and Scotland Law.

HIRS as above.

Are you Getting the Balance Right? What is a Portion (NUT 76/L)

This leaflet explains what a ‘healthy’ portion of everyday foods should be.

HIRS as above.

Just What You Have Been Weighting For (NUT 80/L)

This booklet gives a step by step guide to losing HIRS as above. weight.

79

Leaflets HIRS Codes Check the Labels (NUT 05/L)

Brief Description

Available from

Guide on how to read the information on food labels and eating healthily to reduce the risk of obesity, heart problems, diabetes, cancer and stroke.

HIRS as previous.

Eatwell Plate: Flyer (NUT ??/L)

A5 flyer has image of Eatwell Plate and tips on how to eat a healthier diet. There is also a South Asian version - Eatwell Plate: Flyer (NUT 72/L)

HIRS as previous.

Eatwell: Your Guide to Healthy Eating (NUT 07/L)

A5 Booklet - attractive, easy to read leaflet explaining the importance of healthy eating. Also includes tips on food shopping and hygiene. Simple recipe suggestions.

HIRS as previous.

Physical Activity and Weight Loss A5 Booklet - provides information on the benefits of physical activity and how it can help (PAC 09/L)

HIRS as previous.

with weight loss. Suitable activities are highlighted, with issues around safe practice being mentioned.

Getting Fitter is Easier Than You This leaflet encourages the reader to become HIRS as previous. more moderately active for a total of 30 mins or Think (PAC 01/L) more each day.

Hassle Free Exercise (PAC 05/L)

This booklet will help you take the first step by building more activity into daily routines and improving your health.

HIRS as previous.

Your Guide to Food Labels (NUT 72/L)

This credit card sized resource encourages people to read nutrition labels and make healthier, more informed choices.

HIRS as previous.

80

Displays & Banners HIRS Codes Eatwell Banners (NUT 102/103/104/K2)

Brief Description

Eatwell Poster (NUT 21/P - A3 Smallest Size)

This poster is available in 2 sizes - A3 and A2. This poster can be used to help individuals make healthier food choices. Can be displayed in the workplace to promote healthy eating among staff.

(NUT 22/P - A2 Largest Size)

Available from

These three pull up banners should be used as HIRS as previous. a set. They could be used for promoting healthy eating during a staff health awareness event within the workplace.

HIRS as previous.

Eatwell - Floor Mat and Food Models (NUT 73/K1)

A tool for teaching nutrition and healthy eating. HIRS as previous. This kit contains a range of plastic food models from the five main food groups. It also contains a large floor mat which illustrates a plate divided into proportionate food groups.

Snack Food Model Display Swap + Save (NUT 72/K)

This resource contains a wide range of healthy and unhealthy food models. Sugar and fat cubes supplied with this resource can be used to visually illustrate quantities of sugar and fat within individual snacks and drinks. This resource box also contains a swap + save display. This shows how much overall calories can be saved by making more sensible + healthier snack choices. This resource raises awareness of the amount of added sugars in common snack foods and drinks.

HIRS as previous.

This display contains a range of healthy snacks which could be kept in your drawer at work.

HIRS as previous.

Sugar Display (NUT 74/K1) Workplace Desktop + Drawer Display (WKH 12/K)

HIRS as previous.

81

ARE YOU A HEALTHY WEIGHT FOR YOUR HEIGHT? st lb 7.0 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9 7.10 7.11 7.12 7.13 8.0 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12 8.13

kg 44.5 45.0 45.5 45.9 46.4 46.8 47.3 47.7 48.2 48.6 49.1 49.5 50.0 50.5 50.9 51.4 51.8 52.3 52.7 53.2 53.6 54.1 54.5 55.0 55.5 55.9 56.4 56.8

st lb 9.0 9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.8 9.9 9.10 9.11 9.12 9.13 10.0 10.1 10.2 10.3 10.4 10.5 10.6 10.7 10.8 10.9 10.10 10.11 10.12 10.13

kg 57.3 57.7 58.2 58.6 59.1 59.5 60.0 60.5 60.9 61.4 61.8 62.3 62.7 63.2 63.6 64.1 64.5 65.0 65.4 65.9 66.3 66.8 67.2 67.7 68.1 68.6 69.0 69.5

st lb 11.0 11.1 11.2 11.3 11.4 11.5 11.6 11.7 11.8 11.9 11.10 11.11 11.12 11.13 12.0 12.1 12.2 12.3 12.4 12.5 12.6 12.7 12.8 12.9 12.10 12.11 12.12 12.13

kg 70.0 70.4 70.9 71.3 71.8 72.2 72.7 73.1 73.6 74.0 74.5 74.9 75.4 75.9 76.3 76.8 77.2 77.7 78.1 78.6 79.0 79.5 79.9 80.4 80.9 81.3 81.8 82.2

st lb 13.0 13.1 13.2 13.3 13.4 13.5 13.6 13.7 13.8 13.9 13.10 13.11 13.12 13.13 14.0 14.1 14.2 14.3 14.4 14.5 14.6 14.7 14.8 14.9 14.10 14.11 14.12 14.13

kg 82.7 83.2 83.6 84.1 84.5 85.0 85.4 85.9 86.3 86.8 87.2 87.7 88.1 88.6 89.1 89.5 90.0 90.4 90.9 91.3 91.8 92.2 92.7 93.1 93.6 94.0 94.5 95.0

st lb 15.0 15.1 15.2 15.3 15.4 15.5 15.6 15.7 15.8 15.9 15.10 15.11 15.12 15.13 16.0 16.1 16.2 16.3 16.4 16.5 16.6 16.7 16.8 16.9 16.10 16.11 16.12 16.13

kg 95.4 95.9 96.3 96.8 97.2 97.7 98.1 98.6 99.0 99.5 100.0 100.4 100.9 101.3 101.8 102.3 102.7 103.2 103.6 104.1 104.5 105.0 105.4 105.9 106.3 106.8 107.2 107.7

st lb 17.0 17.1 17.2 17.3 17.4 17.5 17.6 17.7 17.8 17.9 17.10 17.11 17.12 17.13 18.0 18.1 18.2 18.3 18.4 18.5 18.6 18.7 18.8 18.9 18.10 18.11 18.12 18.13

kg 108.2 108.6 109.1 109.5 110.0 110.4 110.9 111.3 111.8 112.2 112.7 113.2 113.6 114.1 114.5 115.0 115.4 115.9 116.3 116.8 117.2 117.7 118.1 118.6 119.1 119.5 120.0 120.4

st lb 19.0 19.1 19.2 19.3 19.4 19.5 19.6 19.7 19.8 19.9 19.10 19.11 19.12 19.13 20.0 20.1 20.2 20.3 20.4 20.5 20.6 20.7 20.8 20.9 20.10 20.11 20.12 20.13

kg 120.9 121.4 121.8 122.3 122.7 123.2 123.6 124.1 124.5 125.0 125.4 125.9 126.3 126.8 127.3 127.7 128.2 128.6 129.1 129.5 130.0 130.4 130.9 131.3 131.8 132.3 132.7 133.2

st lb 21.0 21.1 21.2 21.3 21.4 21.5 21.6 21.7 21.8 21.9 21.10 21.11 21.12 21.13 22.0 22.1 22.2 22.3 22.4 22.5 22.6 22.7 22.8 22.9 22.10 22.11 22.12 22.13

© These tables were supplied and reproduced with the kind permission of Counterweight Ltd

kg 133.6 134.1 134.5 135.0 135.4 135.9 136.3 136.8 137.2 137.7 138.2 138.6 139.1 139.5 140.0 140.5 140.9 141.4 141.8 142.3 142.7 143.2 143.6 144.1 144.5 145.0 145.4 145.9

st lb 23.0 23.1 23.2 23.3 23.4 23.5 23.6 23.7 23.8 23.9 23.10 23.11 23.12 23.13 24.0 24.1 24.2 24.3 24.4 24.5 24.6 24.7 24.8 24.9 24.10 24.11 24.12 24.13

kg 146.4 146.8 147.3 147.7 148.2 148.6 149.1 149.5 150.0 150.4 150.9 151.4 151.8 152.3 152.7 153.2 153.6 154.1 154.5 155.0 155.4 155.9 156.3 156.8 157.3 157.7 158.2 158.6

st lb 25.0 25.1 25.2 25.3 25.4 25.5 25.6 25.7 25.8 25.9 25.10 25.11 25.12 25.13 26.0 26.1 26.2 26.3 26.4 26.5 26.6 26.7 26.8 26.9 26.10 26.11 26.12 26.13

kg 159.1 159.5 160.0 160.5 160.9 161.4 161.8 162.3 162.7 163.2 163.6 164.1 164.5 165.0 165.5 165.9 166.4 166.8 167.3 167.7 168.2 168.6 169.1 169.5 170.0 170.5 170.9 171.4

st lb 27.0 27.1 27.2 27.3 27.4 27.5 27.6 27.7 27.8 27.9 27.10 27.11 27.12 27.13 28.0 28.1 28.2 28.3 28.4 28.5 28.6 28.7 28.8 28.9 28.10 28.11 28.12 28.13

kg 171.8 172.3 172.7 173.2 173.6 174.1 174.5 175.0 175.5 175.9 176.4 176.8 177.3 177.7 178.2 178.7 179.1 179.6 180.0 180.5 180.9 181.4 181.8 182.3 182.7 183.2 183.6 184.1 82

ARE YOU A HEALTHY WEIGHT FOR YOUR HEIGHT? st lb 29.0 29.1 29.2 29.3 29.4 29.5 29.6 29.7 29.8 29.9 29.10 29.11 29.12 29.13

kg 184.6 185.0 185.5 185.9 186.4 186.8 187.3 187.7 188.2 188.6 189.1 189.6 190.0 190.5

st lb 30.0 30.1 30.2 30.3 30.4 30.5 30.6 30.7 30.8 30.9 30.10 30.11 30.12 30.13

kg 190.9 191.4 191.8 192.3 192.7 193.2 193.6 194.1 194.5 195.0 195.5 195.9 196.4 196.8

st lb 31.0 31.1 31.2 31.3 31.4 31.5 31.6 31.7 31.8 31.9 31.10 31.11 31.12 31.13

kg 197.3 197.8 198.2 198.7 199.1 199.6 200.0 200.5 200.9 201.4 201.8 202.3 202.7 203.2

st lb 32.0 32.1 32.2 32.3 32.4 32.5 32.6 32.7 32.8 32.9 32.10 32.11 32.12 32.13

kg 203.7 204.1 204.6 205.0 205.5 205.9 206.4 206.8 207.3 207.7 208.2 208.7 209.1 209.6

st lb 33.0 33.1 33.2 33.3 33.4 33.5 33.6 33.7 33.8 33.9 33.10 33.11 33.12 33.13

kg 210.0 210.5 210.9 211.4 211.8 212.3 212.7 213.2 213.6 214.1 214.6 215.0 215.5 215.9

st lb 34.0 34.1 34.2 34.3 34.4 34.5 34.6 34.7 34.8 34.9 34.10 34.11 34.12 34.13

kg 216.4 216.9 217.3 217.8 218.2 218.7 219.1 219.6 220.0 220.5 220.9 221.4 221.8 222.3

st lb 35.0 35.1 35.2 35.3 35.4 35.5 35.6 35.7 35.8 35.9 35.10 35.11 35.12 35.13

kg 222.8 223.2 223.7 224.1 224.6 225.0 225.5 225.9 226.4 226.8 227.3 227.8 228.2 228.7

st lb 36.0 36.1 36.2 36.3 36.4 36.5 36.6 36.7 36.8 36.9 36.10 36.11 36.12 36.13

© These tables were supplied and reproduced with the kind permission of Counterweight Ltd

kg 229.1 229.6 230.0 230.5 230.9 231.4 231.8 232.3 232.7 233.2 233.7 234.1 234.6 235.0

st lb 37.0 37.1 37.2 37.3 37.4 37.5 37.6 37.7 37.8 37.9 37.10 37.11 37.12 37.13

kg 235.5 236.0 236.4 236.9 237.3 237.8 238.2 238.7 239.1 239.6 240.0 240.5 240.9 241.4

st lb 38.0 38.1 38.2 38.3 38.4 38.5 38.6 38.7 38.8 38.9 38.10 38.11 38.12 38.13

kg 241.9 242.3 242.8 243.2 243.7 244.1 244.6 245.0 245.5 245.9 246.4 246.9 247.3 247.8

st lb 39.0 39.1 39.2 39.3 39.4 39.5 39.6 39.7 39.8 39.9 39.10 39.11 39.12 39.13

kg 248.2 248.7 249.1 249.6 250.0 250.5 250.9 251.4 251.8 252.3 252.8 253.2 253.7 254.1

83

HEIGHT CONVERSIONS ft 4 4 4 4 4 4 4 4 4 4 4 4

inches 0 1 2 3 4 5 6 7 8 9 10 11

metres 1.22 1.25 1.27 1.30 1.32 1.35 1.37 1.40 1.42 1.45 1.47 1.50

ft 5 5 5 5 5 5 5 5 5 5 5 5

KG TO LBS CONVERSIONS kgs 1 2 3 4 5 6 7 8 9 10

lbs 2.2 4.4 6.6 8.8 11 13.2 15.4 17.6 19.8 22.0

inches 0 1 2 3 4 5 6 7 8 9 10 11

metres 1.52 1.55 1.57 1.60 1.62 1.65 1.67 1.70 1.72 1.75 1.77 1.80

ft 6 6 6 6 6 6 6 6 6 6 6 6

inches 0 1 2 3 4 5 6 7 8 9 10 11

metres 1.82 1.85 1.87 1.90 1.92 1.95 1.97 2.00 2.02 2.05 2.07 2.10

ADDITIONAL CONVERSIONS 1 oz 1 lb 1 stone 1 stone 1 inch 39.4 inches 1 pint

28.3 g 454 g 14lbs 6.35kg 2.54cm 1m 568ml

© These tables were supplied and reproduced with the kind permission of Counterweight Ltd

84

Start Weight 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79

5% 2.5 2.6 2.6 2.7 2.7 2.8 2.8 2.9 2.9 3.0 3.0 3.1 3.1 3.2 3.2 3.2 3.3 3.4 3.4 3.5 3.5 3.6 3.6 3.7 3.7 3.8 3.8 3.9 3.9 4.0

Goal Weight 47.5 48.4 49.4 50.3 51.3 52.2 53.2 54.1 55.1 56.0 57.0 57.9 58.9 59.8 60.8 61.8 62.7 63.6 64.6 65.5 66.5 67.4 68.4 69.3 70.3 71.2 72.2 73.1 74.1 75.0

Start Weight 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109

5% 4.0 4.1 4.1 4.2 4.2 4.3 4.3 4.4 4.4 4.5 4.5 4.6 4.6 4.7 4.7 4.8 4.8 4.9 4.9 5.0 5.0 5.1 5.1 5.2 5.2 5.3 5.3 5.4 5.4 5.5

Goal Weight 76.0 76.9 77.9 78.8 79.8 80.7 81.7 82.6 83.6 84.5 85.5 86.4 87.4 88.3 89.3 90.2 91.2 92.1 93.1 94.0 95.0 95.9 96.9 97.8 98.8 99.7 100.7 101.6 102.6 103.5

Start Weight 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139

5% 5.5 5.6 5.6 5.7 5.7 5.8 5.8 5.9 5.9 6.0 6.0 6.1 6.1 6.2 6.2 6.3 6.3 6.4 6.4 6.5 6.5 6.6 6.6 6.7 6.7 6.8 6.8 6.9 6.9 7.0

Goal Weight 104.5 105.4 106.4 107.3 108.3 109.2 110.2 111.1 112.1 113.0 114.0 114.9 115.9 116.8 117.8 118.7 119.7 120.6 121.6 122.5 123.5 124.4 125.4 126.3 127.3 128.2 129.2 130.1 131.1 132.0

Start Weight 140 141 142 143 144 145 146 147 148 149 150 151 151 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169

© These tables were supplied and reproduced with the kind permission of Counterweight Ltd

5% 7.0 7.1 7.1 7.2 7.2 7.3 7.3 7.4 7.4 7.5 7.5 7.6 7.6 7.7 7.7 7.8 7.8 7.9 7.9 8.0 8.0 8.1 8.1 8.2 8.2 8.3 8.3 8.4 8.4 8.5

Goal Weight 133.0 133.9 134.9 135.8 136.8 137.7 138.7 139.6 140.6 141.5 142.5 143.4 144.4 145.3 146.3 147.2 148.2 149.1 150.1 151.0 152.0 152.9 153.9 154.8 155.8 156.7 157.7 158.6 159.6 160.5

Start Weight 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199

5% 8.5 8.6 8.6 8.7 8.7 8.8 8.8 8.9 8.9 9.0 9.0 9.1 9.1 9.2 9.2 9.3 9.3 9.4 9.4 9.5 9.5 9.6 9.6 9.7 9.7 9.8 9.8 9.9 9.9 10.0

Goal Weight 161.5 162.4 163.4 164.3 165.3 166.2 167.2 168.1 169.1 170.0 171.0 171.9 172.9 173.8 174.8 175.7 176.7 177.6 178.6 179.5 180.5 181.4 182.4 183.3 184.3 185.2 186.2 187.1 188.1 189.0

85

Start Weight 200 201 202 203 204 205 206 207 208 209

5% 10.0 10.1 10.1 10.2 10.2 10.3 10.3 10.4 10.4 10.5

Goal Weight 190.0 190.9 191.9 192.8 193.8 194.7 195.7 196.6 197.6 198.5

Start Weight 210 211 212 213 214 215 216 217 218 219

5% 10.5 10.6 10.6 10.7 10.7 10.8 10.8 10.9 10.9 11.0

Goal Weight 199.5 200.4 201.4 202.3 203.3 204.2 205.2 206.1 207.1 208.0

Start Weight 220 221 222 223 224 225 226 227 228 229

5% 11.0 11.1 11.1 11.2 11.2 11.3 11.3 11.4 11.4 11.5

Goal Weight 209.0 209.9 210.9 211.8 212.8 213.7 214.7 215.6 216.6 217.5

Start Weight 230 231 232 233 234 235 236 237 238 239

© These tables were supplied and reproduced with the kind permission of Counterweight Ltd

5% 11.5 11.6 11.6 11.7 11.7 11.8 11.8 11.9 11.9 12.0

Goal Weight 218.5 219.4 220.4 221.3 222.3 223.2 224.2 225.1 226.1 227.0

Start Weight 240 241 242 243 244 245 246 247 248 249

5% 12.0 12.1 12.1 12.2 12.2 12.3 12.3 12.4 12.4 12.5

Goal Weight 228.0 228.9 229.9 230.8 231.8 232.7 233.7 234.6 235.6 236.5

86

Start Weight 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79

10% 5.0 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 6.0 6.1 6.2 6.3 6.4 6.5 6.6 6.7 6.8 6.9 7.0 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9

Goal Weight 45.0 45.9 46.8 47.7 48.6 49.5 50.4 51.3 52.2 53.1 54.0 54.9 55.8 56.7 57.6 58.5 59.4 60.3 61.2 62.1 63.0 63.9 64.8 65.7 66.6 67.5 68.4 69.3 70.2 71.1

Start Weight 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109

10% 8.0 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 9.0 9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.8 9.9 10.0 10.1 10.2 10.3 10.4 10.5 10.6 10.7 10.8 10.9

Goal Weight 72.0 72.9 73.8 74.7 75.6 76.5 77.4 78.3 79.2 80.1 81.0 81.9 82.8 83.7 84.6 85.5 86.4 87.3 88.2 89.1 90.0 90.9 91.8 92.7 93.6 94.5 95.4 96.3 97.2 98.1

Start Weight 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139

10% 11.0 11.1 11.2 11.3 11.4 11.5 11.6 11.7 11.8 11.9 12.0 12.1 12.2 12.3 12.4 12.5 12.6 12.7 12.8 12.9 13.0 13.1 13.2 13.3 13.4 13.5 13.6 13.7 13.8 13.9

Goal Weight 99.0 99.9 100.8 101.7 102.6 103.5 104.4 105.3 106.2 107.1 108.0 108.9 109.8 110.7 111.6 112.5 113.4 114.3 115.2 116.1 117.0 117.9 118.8 119.7 120.6 121.5 122.4 123.3 124.2 125.1

Start Weight 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169

10% 14.0 14.1 14.2 14.3 14.4 14.5 14.6 14.7 14.8 14.9 15.0 15.1 15.2 15.3 15.4 15.5 15.6 15.7 15.8 15.9 16.0 16.1 16.2 16.3 16.4 16.5 16.6 16.7 16.8 16.9

© These tables were supplied and reproduced with the kind permission of Counterweight Ltd

Goal Weight 126.0 126.9 127.8 128.7 129.6 130.5 131.4 132.3 133.2 134.1 135.0 135.9 136.8 137.7 138.6 139.5 140.4 141.3 142.2 143.1 144.0 144.9 145.8 146.7 147.6 148.5 149.4 150.3 151.2 152.1

Start Weight 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199

10% 17.0 17.1 17.2 17.3 17.4 17.5 17.6 17.7 17.8 17.9 18.0 18.1 18.2 18.3 18.4 18.5 18.6 18.7 18.8 18.9 19.0 19.1 19.2 19.3 19.4 19.5 19.6 19.7 19.8 19.9

Goal Weight 153.0 153.9 154.8 155.7 156.6 157.5 158.4 159.3 160.2 161.1 162.0 162.9 163.8 164.7 165.6 166.5 167.4 168.3 169.2 170.1 171.0 171.9 172.8 173.7 174.6 175.5 176.4 177.3 178.2 179.1

87

Start Weight 200 201 202 203 204 205 206 207 208 209

10% 20.0 20.1 20.2 20.3 20.4 20.5 20.6 20.7 20.8 20.9

Goal Weight 180.0 180.9 181.8 182.7 183.6 184.5 185.4 186.3 187.2 188.1

Start Weight 210 211 212 213 214 215 216 217 218 219

10% 21.0 21.1 21.2 21.3 21.4 21.5 21.6 21.7 21.8 21.9

Goal Weight 189.0 189.9 190.8 191.7 192.6 193.5 194.4 195.3 196.2 197.1

Start Weight 220 221 222 223 224 225 226 227 228 229

10% 22.0 22.1 22.2 22.3 22.4 22.5 22.6 22.7 22.8 22.9

Goal Weight 198.0 198.9 199.8 200.7 201.6 202.5 203.4 204.3 205.2 206.1

Start Weight 230 231 232 233 234 235 236 237 238 239

10% 23.0 23.1 23.2 23.3 23.4 23.5 23.6 23.7 23.8 23.9

© These tables were supplied and reproduced with the kind permission of Counterweight Ltd

Goal Weight 207.0 207.9 208.8 209.7 210.6 211.5 212.4 213.3 214.2 215.1

Start Weight 240 241 242 243 244 245 246 247 248 249

10% 24.0 24.1 24.2 24.3 24.4 24.5 24.6 24.7 24.8 24.9

Goal Weight 216.0 216.9 217.8 218.7 219.6 220.5 221.4 222.3 223.2 224.1

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ARE YOU A HEALTHY WEIGHT FOR YOUR HEIGHT?

© Reproduced with kind permission of the Food Standards Agency 89

REFERENCES 1.

House of Commons Health Committee Report on Obesity: HMSO, May 2004

2.

National Audit Office. Tackling Obesity in England, 2001: The Stationery Office

3.

Energising Lives: A Guide to Promoting Physical Activity in Primary Care: NHS Health Scotland, 2008

4.

Healthy Eating, Active Living: An Action Plan to Improve Diet, Increase Physical Activity and Tackle Obesity (2008 - 2011): The Scottish Government, 2008.

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