Welcome to our Medical Weight Loss Program!

We are excited to have you join our program and look forward to assisting you with your weight loss and health goals. We created this booklet to help you get the most out of this program and start some healthy lifestyle changes, which are key to losing and maintaining weight.

You will work with a dietitian to individualize your goals, which may change over time. This booklet is full of general nutrition information, diet tips, recipes, and lifestyle recommendations to help you be as successful as possible.

Starting Points

Focus on health, not diets.
Initiate lifestyle changes that will improve your health and achieve the balance between energy and calories.
Make a plan for change.
When you stray from your plan, don’t get upset. Figure out what got you off track and how you can fix it.
Make small changes “one step at a time”.
Journal your food/fluids, behaviors, emotions, and exercise.
Safe and effective programs for weight loss should include these components:
- Healthy eating plans that reduce calories but do not rule out specific foods or food groups
- Regular physical activity and/or exercise instruction
- Tips on healthy behavioral changes that also consider your cultural needs
- Medical care if you are planning to lose weight by following a special formula diet, such as a low-calorie diet
- A plan to keep the weight off after you have lost it.

Food Journaling

One of the best ways to achieve successful weight loss and maintenance is to keep a food journal. It may take a few extra minutes out of your day, but if you want to see success, this is the route to go. Journaling makes you more accountable for your actions. Journaling can also help your dietitian pinpoint issues with food choices and also help you with planning your meal patterns. It’s also beneficial in identifying behavior changes that need to be made, like trigger foods and emotional eating trends. If you’re technology-phobic, paper journaling with a DietMinder is a great option. The DietMinder is sort of like a Franklin Planner for diet journaling. These can be ordered from Amazon. Most people prefer electronic food journaling on their smartphones as it makes it much easier to tally your calories, carbs, protein, etc. If you are going to do electronic food journaling we ask that you our patient dashboard so that our dietitians can track your progress from our clinic dashboard.

If you feel like you are getting off track, here are some questions you may want to ask yourself that could be answered in your food journal:

Are you skipping meals?
- Skipping meals can cause increased hunger, which can lead to overeating.
Are you overeating at certain times of the day?
- Monitor if you are eating/snacking late in the day. Many people struggle with boredom-eating in the evening after dinner.
Are you eating protein-based meals?
- Protein-based meals keep you full for long periods of time, whereas starchy meals will have you snacking before you know it.
Do you overeat or eat too quickly when you wait too long to eat?
- Keeping meals evenly spaced will help keep your hunger in better control.
Are you eating appropriate foods but too large of a quantity?
- Protein, complex carbohydrates, and healthy fats are the choices you want to focus on. However, too much of even a good choice can end up in weight gain. Pre-portioning your foods can help eliminate this issue.
Do you notice any meal in particular in which you consume too much?
- Journaling can help identify meals in the day where you tend to consume large amounts.
Are you eating a lot of combination foods?
- Combination foods are usually high in fat and carbs, which can lead to weight gain. Examples would be casseroles, soups/stews, boxed meals, etc.

Nutrition 101

In order for you to be successful with medical weight loss you must become an “amateur dietitian!” You need to understand the basics of nutrition and what it takes for your body to “run” on for fuel yet still lose weight in a healthy, steady manner. You will need to learn to look at food labels and know foods that are good or bad for your program. Let’s start out with some of the basics and learn about carbohydrates, protein, and fat.

What is a Nutrient?

A nutrient is a substance the body must take in from the diet for good health, growth, development and other normal body functions. Carbohydrates, proteins and fats are the nutrients that provide energy for the body. Each one performs unique and special functions in your metabolism. Among other nutrients in foods are water, fiber, and various different vitamins and minerals. Some things that may be a part of your diet are not considered nutrients, such as alcohol. Alcohol does provide energy but has no other unique function. Alcohol is not essential for health; therefore, it is not regarded as a nutrient.

Carbohydrates: What are They?

Carbohydrates are the major energy source for the body. Carbohydrates provide energy for normal body functions (such as heartbeat, breathing, digestion, and brain activity) and for intense exercise (like biking, walking, running). Carbohydrates provide 4 calories per gram. A supply of carbohydrates is necessary to maintain health and a must if your goal is to reduce your body fat and enhance your fitness level, however; they must be closely monitored in terms of the amount and types consumed. There are two major groups of carbohydrates; complex carbohydrates and simple carbohydrates.

Complex Carbohydrates

Complex carbohydrates are chains of three or more sugar molecules linked together. Long chains of sugar molecules are called starches. Branched complex carbohydrates are called cellulose. Starches are fairly easy to digest, however, your body doesn’t digest cellulose, which is an important component of dietary fiber. Complex carbohydrates are found in fruits, vegetables, nuts, seeds and grains. Some examples of foods high in starchy complex carbohydrates include:

bread
cereal
pasta
potatoes
dry beans
corn

In contrast, these contain less starch and more fiber:

green beans
broccoli
spinach
asparagus
zucchini

All grains include starchy carbohydrates. However, whole grains, such as whole wheat pasta, are better for you because they also have more dietary fiber. Dietary fiber is only found in plants. We eat plants but we cannot digest the fiber. There are two types of dietary fiber: insoluble fiber and soluble fiber.

Insoluble fiber is the type of fiber found in high fiber foods like whole grains, nuts, wheat bran and vegetables. Insoluble fiber does not dissolve in water so it helps to move material through the colon faster. This can be very helpful to people who suffer from constipation or irregularity. Diets high in insoluble fiber also decrease the risk of diabetes, colon cancer, and heart disease. Many studies also show that fiber can reduce hunger and increase weight loss.

Soluble fiber is also found in many high fiber foods like oats, citrus fruits, apples, barley, flax seeds and beans. Soluble fiber absorbs water and helps to soften the stool. A diet high in soluble fiber has been shown to reduce cholesterol.

Simple Carbohydrates

Simple carbohydrates are made up of one or two sugar molecules linked together. These carbohydrates are broken down and digested very quickly. Most simple carbohydrates contain very few important vitamins and minerals. Simple carbohydrate foods include table sugar, honey, molasses, maple syrup, brown sugar, and candy. Fruit juice, fruits and milk are also foods that contain simple carbohydrates. However, they also contain some complex carbohydrates, such as dietary fiber, as well as some important vitamins and minerals. Typically there are many simple sugars added to foods and beverages. Although they may enhance the taste and/or texture they also add extra unwanted calories. Here is a list of common “added sugars” to watch for:

Brown Sugar Inverted Sugar Corn Sweetener Lactose Corn Syrup Maltose
Dextrose Malt Syrup Fructose Molasses Raw Sugar Fruit Juice Concentrates

Raw Sugar Glucose Sucrose
Sugar Honey High-Fructose Corn Syrup

Syrup

What to Know About Sugar Substitutes

Sugar substitutes are natural or chemical compounds that provide the sweetness of sugar without as many (or no) calories. Sugar substitutes are much sweeter than sugar and it takes less amounts to create the same sweetness. The following are sugar substitutes approved for use in foods and beverages:

Splenda (sucralose)
Saccharin (Sweet N’ Low)
Aspartame (Equal)
Stevia
Truvia

Sugar alcohols are also sugar substitutes, and they usually end with the letters “-ol”. They occur naturally in a wide variety of fruits and vegetables, but are also produced commercially from other forms of carbohydrates. They are not completely absorbed or metabolized by the body, therefore contribute fewer (or no) calories. Because of the incomplete metabolism, there are possible side effects from the use of sugar alcohols. Such side effects can include abdominal cramping or bloating, gas, and diarrhea. Here are some common sugar alcohols:

Sorbitol
Mannitol
Lactitol
Xylitol
Maltitol
Isomalt

Carbohydrate: Key Recommendations

TRACK YOUR CARBOHYDRATES CLOSELY!

- Your dietitian will give you a carbohydrate goal to stay under each day.
- 40% of your daily calories should come from complex carbohydrates.
- Choose fiber rich fruits, vegetables, and whole grains.
- Consume 25-38 grams of fiber each day.
- Choose and prepare foods and beverages with little or no added sugars.
- Choose whole fruit (fresh, frozen, canned) rather than juice.
- Choose vibrantly-colored vegetables and potatoes.
- Use sugar substitutes sensibly.

Since not all of your carbohydrate intake gets absorbed, you should mainly be concerned about your net carbohydrate intake and this is what you should track. To calculate your net carbs use the following simple formula:

Total Carbs

– Fiber

– Sugar Alcohols

= Net Carbs

Using the label below, you would end up only counting 21 gm/net carbs after subtracting the fiber (3 gm) and sugar alcohols (4 gm). Just remember! SUGAR ALWAYS STAYS IN THE COUNT.

Sample Food Label & How To Read It

Another thing you must analyze on a food label is servings per container. In this example, the label indicates the nutrition info for one container, which is one serving. It may seem obvious in this example, but becomes sneaky when you buy a snack-sized bag of potato chips. You might look at the label and think “it’s not as bad as I thought,” but actually there may be two servings in the bag, which means you have to double everything on the label to get the total amount in the bag.

Food Label Claims

Here are some other food label claims that you might want to think about when reading a food label:

Fat & Cholesterol

Fat Free: This does not actually mean the product has zero fat, rather it means less than 0.5 grams.
Low Fat: This equates to 3 grams of fat or less.
Reduced Fat: At least 25% less than the standard product.
Cholesterol Free: Less than 2 mg of cholesterol and 2 gm of saturated fat.
Reduced Cholesterol: At least 25% less cholesterol than the standard product and 2 gm or less of saturated fat.

Sodium

Sodium Free: Less than 5 mg sodium.
Very Low Sodium: 35 mg of sodium or less.
Reduced Sodium: At least 25% less sodium than the standard product.
Light In Sodium: 50% less sodium than the standard product

Calories

Calorie Free: Less than 5 calories.
Low Calorie: 40 calories or less.
Light or Lite: ⅓ fewer calories or 50% less fat than the standard product, if more than half the calories are from fat. Fat content must be reduced by 50% or more.

Sugar

Sugar Free: Less than 0.5 gm of sugar.
Reduced Sugar: At least 25% less sugar than the standard product portion reference.
Protein: What are Proteins

Proteins are an essential nutrient. Protein provides energy when not enough carbohydrate is available. Like carbohydrates, protein provides 4 calories per gram. Protein is contained in every part of the body: the skin, muscles, hair, blood, body organs, eyes, fingernails and bones. Protein is needed for growth, making muscle, tissue repair and aiding the body in fighting disease and infection. There is no life without protein! Next to water, protein is the most plentiful substance in the body. You will want to track your protein intake, as your dietitian will give you a protein intake goal which you should achieve each day.

Animal Proteins

Most animal proteins contain all the essential, and also plenty of the non-essential amino acids in liberal amounts. Therefore, they are identified as “complete proteins”. They can provide a balanced mixture of amino acids from their proteins that the body can use to meet its own needs. Besides protein, foods from this group supply a varying amounts of other important nutrients, including iron, zinc, magnesium, Vitamin E, calcium and B vitamins (such as thiamin, niacin, B6 and B12). Some of the foods in this group contain higher amounts of fats, saturated fat, and some cholesterol. Choosing the lower fat, lean, or extra lean cuts of red meats, poultry, and fish will promote an optimal cardiovascular health. Choosing a meat reduced in fat will not reduce the amino acid content of the meat, therefore it will not have a negative effect on the overall protein quality consumed.

Here are some helpful tips when making animal protein choices:

Beef:

choose cuts with “loin” or “round” in the name (such as top round, round tip, top sirloin, bottom round, top loin, and tenderloin)
ground beef – choose beef 92-95% lean or, ground round which is the leanest
veal – choose cutlet, blade, arm steak, rib roast, and rib or loin chop
look for “lean or “extra lean” cuts

Pork

choose cuts with “loin” or “leg” in the name (such as tenderloin, top loin roast, top loin chop, center loin chop, sirloin roast, loin rib chop)

Lamb

choose cuts with “loin” or “leg” in the name (such as leg, loin chop, arm chop and foreshanks)

Poultry

choose skinless white meat
ground turkey – choose ground turkey breast

Fish

prepare grilled, baked, roasted, or boiled. Avoid deep fried, choose canned fish in water

Dairy

Choose fat free or low fat. Skim (fat free) or 1% are optimal choices. These products can include milk, cheese, yogurt, creams, and butters

Eggs

Choose egg whites most of the time and only include the yolk sparingly. The egg white contains mostly protein, while the yolk contains fat

Plant Proteins

Proteins from plant sources are mostly “Incomplete proteins” in their natural forms, with the exception of tofu (soy), chia seeds, quinoa, hemp, buckwheat, tempeh, and spirulina. They are considered incomplete because they lack one or two of the essential amino acids. If a single plant protein is eaten by itself, the body can not take full advantage of it as a protein source. However, by combining two or more plant proteins during one meal or throughout the day, a complete mix of all essential amino acids is provided to the body. These are called “complementary proteins”.

*Most commercial plant-based protein powders, shakes, and bars contain a mix of plant sources to create a complete protein*

Complementary Proteins

Fats: What are Fats?

Fats occur naturally in food and play an important role in nutrition. Fats and oils provide a concentrated source of energy for the body. Fats provide 9 calories per gram, more than two times the calories you get from carbohydrates and protein. Fats are used to store energy in the body, insulate body tissues, and transport fat soluble vitamins through the blood. They also play an important role in food preparation by enhancing food flavor, adding mouth-feel, making baked products tender, and conducting heat during cooking.

Oils

Oils are fats that are liquid at room temperature, like the vegetable oils used in cooking. Oils come from many different plants and from fish. Some common oils are:

canola oil
corn oil
olive oil
safflower oil
soybean oil
sunflower oil

Solid Fats

Solid fats are fats that are solid at room temperature, like butter and shortening. Solid fats come from many animal foods and can be made from vegetable oils through a process called hydrogenation. Some common solid fats are:

butter
pork fat (lard)
beef fat (tallow, suet)
shortening
chicken fat

Not All Fats and Oils Are Created Equally

Fats and oils are composed of basic units called fatty acids, each type of fat or oil is a mixture of different fatty acids

Saturated Fatty Acids

Saturated fatty acids are found in animal sources such as meat and poultry, whole or reduced-fat milk, and butter. Also, some vegetable oils like coconut, palm kernel oil, and palm oil contain saturated fats. Saturated fats are usually solid at room temperature.

Monounsaturated Fatty Acids

Monounsaturated fatty acids are found mainly in vegetable oils such as canola, olive, and peanut oils. They are liquid at room temperature

Polyunsaturated Fatty Acids

Polyunsaturated fatty acids are found mainly in vegetable oils such as safflower, sunflower, corn, flaxseed, and canola oils. Polyunsaturated fats are also the main fats found in seafood. They are liquid or soft at room temperature. Specific polyunsaturated fatty acids, such as linoleic acid and alpha-linolenic acid, are called essential fatty acids. They are necessary for cell structure and making hormones. Essential fatty acids must be obtained from the foods we choose.

Trans Fatty Acids

Trans fatty acids are formed when vegetable oils are processed into margarine or shortening. Sources of trans fats in the diet include snack foods and baked goods made with “partially hydrogenated oil” or “vegetable shortening.” Trans fatty acids also occur naturally in some animal products such as dairy products. Avoid or limit products containing these oils.

Fat and Cholesterol Key Recommendations

The guidelines for fat intake are well known: for healthy Americans, consume no more than 20 percent of total calories from fat.The “20 percent” guideline means:
7-10 percent of total calories from saturated fats

About 10-15 percent of total calories from monounsaturated fats
About 10 percent from polyunsaturated fats
For cholesterol, one should limit intake to less than 300 milligrams per da

Fluid Intake

Water

You should drink at least eight – 8 oz. glasses of water to equal a minimum of 64 oz. of fluid daily. If you are exercising strenuously you may require more. You may also have other beverages as long as they are sugar-free and less than five calories per serving, in addition to your 64 oz. of water. Diet soda does not count towards your daily fluid goal and is best to be eliminated completely from your diet. Water is an essential nutrient and makes up more than 50% of our body weight. Not drinking enough water can result in problems including everything from muscle cramps, headaches, and fatigue (especially at the end of the day) to constipation, kidney stones, and urinary-tract infections. Changes in exercise, altitude, heat or cold can increase your need for water.

Alcohol

If you choose to have an alcoholic beverage, men should limit consumption to two or fewer drinks at a time, and women to one drink, a maximum of twice a week. A 5 oz glass of wine, 12 oz of beer, or 1 ½ oz of distilled spirits all contain approximately the same amount of alcohol, approximately 15 grams, and are considered to be one alcoholic drink.

Carbonated Beverages and Caffeine

Caffeine should be limited as it is a stimulant, and can increase your heart rate, blood pressure, and appetite. It can also interfere with many medications. If you are currently consuming multiple caffeinated beverages a day, try to wean yourself from them to reduce headache pain.

If you have had weight loss surgery or not, carbonated beverages can take up too much room in the stomach and make you feel uncomfortable. It is best to focus on non-carbonated beverages so that you can get adequate fluid intake throughout the day.

Exercise

While on the medical weight loss program our preference is to keep it simple when it comes to exercise. A step-based program is good, as this will capture activity from most types of exercise plans with reasonable accuracy (with the exception of cycling). In order to accurately track your steps you will need a tracker. We recommend our Patient Dashboard that integrates directly with our dietitian’s dashboard so they can follow your exercise progress. The typical recommended daily step goal is 10,000, however we recognize that some patients may be lucky to get half that initially. The important thing is to start somewhere, and as your weight loss continues, increase your step goal accordingly. Your daily step goal needs to be met at least 5 out of 7 days per week.

Emotional Eating

A note from psychologist Dr. Charles Buhrman

Emotional eating is typically a response to affective distress such as depression, anxiety/stress, boredom, loneliness, etc. It is a maladaptive behavior, conditioned from a repetitive pattern, often for many years (i.e. even a lifetime). This consumption of food as a reaction to emotional distress has become a habit. Habits are “learned automatic acts” (i.e. behaviors) and although difficult to break, can be unlearned, and eliminated as they are not inherent. The emotional eating behavior can be changed through the application of cognitive behavioral coping strategies. This process is bidirectional in that change needs to occur in two ways.

The first is termed cognitive modification or restructuring. Cognitions are our automatic thoughts (i.e. self-statements) that follow a stressful event (a precipitant). As noted above, these are automatic and lead to emotions (i.e. depression, anxiety, loneliness, etc.) which in turn trigger behavioral responses (i.e. food consumption). The task is to make ourselves aware of these cognitions or “self-statements,” to intervene quickly to stop them by distraction, and to modify them to become positive thoughts (or at least more realistic). In this manner, we can reduce the level of affective distress (feeling such as anxiety) which will lead to behavioral changes.

The second part of the process is to initiate the behavioral changes. We need to become aware of the entire pattern within the context in which the maladaptive behavior occurs. It is often helpful to keep a log of when this behavior occurs that includes time of the day, events, feelings, and behaviors that preceded the emotional eating. The goal then becomes not only to eliminate the maladaptive but to substitute new behaviors (i.e. exercise, reading, computers, work, etc.) in an attempt to break the pattern. This often leads to a reduction in affective distress (i.e. depression) which in turn helps us to form more positive thoughts. In psychological literature, this has at times been referred to as forming a positive addiction to replace a negative addiction.

This process can be done quite effectively through some short-term counseling with a psychologist who is trained in cognitive behavioral therapy. The skills are then applied in an independent manner to implement lifestyle changes.

APPENDIX

General Goal Setting

GOALS (WHY DO YOU WANT TO LOSE WEIGHT)	CONCERNS (WHAT ARE YOUR CONCERNS IF YOU DO NOT LOSE THE WEIGHT)	SUCCESSES (WHAT HAVE YOU ACCOMPLISHED IN YOUR PROGRAM)

Step Goals

Visit 1
Visit 2
Visit 3
Visit 4
Visit 5
Visit 6

Carbohydrate Goals and Recommendations

1.________________________________________________________________

2.________________________________________________________________

3.________________________________________________________________

4.________________________________________________________________

5.________________________________________________________________

Protein Goals and Recommendations

1.________________________________________________________________

2.________________________________________________________________

3.________________________________________________________________

4.________________________________________________________________

5.________________________________________________________________

Fat Goals and Recommendations

1.________________________________________________________________

2.________________________________________________________________

3.________________________________________________________________

4.________________________________________________________________

5.________________________________________________________________

Vitamin and Mineral Recommendations

1.________________________________________________________________

2.________________________________________________________________

3.________________________________________________________________

4.________________________________________________________________

5.________________________________________________________________

Fluid Goals and Recommendations

1.________________________________________________________________

2.________________________________________________________________

3.________________________________________________________________

4.________________________________________________________________

5.________________________________________________________________

Additional Comments and Recommendations

______________________________________________________________________

Behavior Changes For Long-Term Success

Do not skip any meals—eat three meals per day, focusing on meal timing.
1-2 low-carbohydrate, low-fat, high-protein snacks if needed.
Take 20-30 minutes to eat meals, and at least 10 minutes to eat snacks.
Pay attention to portion sizes!
Limit eating fast food.
Decrease saturated fat in your diet.
Exercise at least 150 mins per week.
Decrease caffeinated and/or carbonated beverages.
Drink 64 ounces of water per day.
Practice chewing foods thoroughly before swallowing.
Keep a food and activity record

____________________________________________________________________________

Guide to Eating Away from Home

Whether you’re at the office cafeteria or a fine dining restaurant, you can eat the nutrient-rich way. It’s easy to do when you make the following choices:

In the Office Cafeteria…

Omelet filled with tomatoes, mushrooms and spinach (or any veggie)
Lean roast beef, ham or turkey with veggies
A salad bar creation of dark greens and other colorful veggies, avocado slices, sunflower seeds, and lean protein. Top with low-carb dressing.

When Dining Out…

Salads made with deep greens such as spinach, arugula and romaine lettuce.
Lean entrees such as beef sirloin, pork tenderloin, skinless turkey breast, fish or seafood. Ask for sauces on the side.
Stir fries loaded with broccoli, carrots, cabbage and peppers plus lean beef, lean pork, skinless chicken breast or tofu.

Eating on the Go

It’s easy to eat the nutrient-rich way, even when you’re in a time crunch. Try these ideas the next time hunger strikes when you’re on the go.

Fast Snacks in a Flash

Low carb granola mixed into low sugar yogurt.
Lean roast beef, ham or turkey rolled up in a low carb tortilla plus a handful of cherry tomatoes.
A scoop of low-fat or fat-free cottage cheese with sliced strawberries or cantaloupe cubes.

Smart Picks From the Vending Machine or Convenience Store

Protein-packed beef jerky.
Packages of baby carrots, broccoli florets or celery sticks.
Mozzarella cheese sticks.
Low Carb protein bars

Make-it-through-the-Day Desk Drawer Stashes

Instant protein oatmeal packets.
Small packs or cans of water-packed tuna and small cans of veggies (don’t forget the can opener).
Light microwave popcorn. Bonus: Popcorn is a whole-grain food.
Beef Jerky
Nuts (almonds, peanuts, walnuts, sunflower seeds, pistachios)

Quick List of Low Carb Fast Food

There are times when fast food is the only option. The following are some recommendations for a healthier choice:

Entrée salads with grilled chicken and low-calorie dressing.
Grilled chicken or steak tacos with lots of lettuce and tomato.
Any burger, without bun or ketchup.
Grilled chicken sandwiches, no bun.
Caesar salad with grilled chicken. (no croutons)
Bacon ranch salad w/ grilled chicken. (no croutons)
Any breakfast sandwich, without biscuit/bread.
Naked Egg Taco which comes with sausage at Taco Bell.
Low carb breakfast at Taco Bell, Mini Skillet. (no potatoes)
Power Menu Bowl at Taco Bell. It comes with steak or chicken, pico de gallo, cheese, guacamole, sour cream, avocado ranch dressing, and romaine lettuce. (no rice and beans, go lite on dressing).
Chili from Wendy’s, Gold Star or Skyline

Low Carb Snack Options

Easy grab-and-go options:

Lean lunch meats
Nuts/seeds
Peanut butter and Celery
Beef jerky
Salami roll ups (can add banana peppers for a kick)
Hard boiled egg (can stuff with chicken/tuna/guacamole salad.)
Deviled eggs
Raw veggies and dip Laughing Cow
Cheese on celery or approved cracker
Radishes and guacamole
Hummus and veggies
Edamame Hummus
Low carb yogurts
Gelatin bites (Kroger brand in refrigerated Jello section)
Sugar-free popsicles
Sugar-free fudgsicles
No-sugar-added or sugar-free pudding packs
Pepperoni chips (just bake at 350 degrees until crispy)
Dill pickles or no-sugar-added sweet pickles and cheese
Mini peppers with string cheese (eat them cold or broil for 10 minutes)
¼ cup berries and ½ cup cottage cheese
Edamame
Lettuce wraps with lunch meat, chicken or tuna salad
Apple and peanut butter (or any nut butter)
Approved pre-made protein shakes
Approved protein bars
Seaweed

Caprese Bites:

On a toothpick put: grape tomato, 1 small piece fresh mozzarella cheese, basil leaf. Then drizzle with olive oil and balsamic vinaigrette.

Greek Salad Bites:

12 grape tomatoes

4 ounces feta cheese, cut into 12 (1/2-inch) cubes

1 mini cucumber sliced into 12 pieces

12 pitted kalamata olives

2 tablespoons extra-virgin olive oil

1 ½ teaspoons Mediterranean spice

12 4-6” wooden skewers

Directions:

Thread the skewers starting with a tomato, then a piece of feta cheese, a cucumber and an olive. Repeat with the remaining ingredients.
Just before serving, arrange skewers on a platter, drizzle with olive oil and sprinkle with Mediterranean spice.

Baked Edamame

This is a nutrient-packed, crunchy alternative to traditional party mix that saves you 7 grams of carbohydrates per 1/2 cup serving and has four times as much fiber. It keeps well in the refrigerator, but it’s also good to eat on the go.

Ingredients:

3 cup shelled edamame beans

1 tablespoon extra virgin olive oil

2 teaspoon curry powder 1 dash of salt and pepper

Directions: Preheat oven to 375 degrees. Toss edamame beans, olive oil, curry powder, salt, and pepper together in a bowl until the beans are thoroughly coated. Spread out on a baking sheet and roast for 15 minutes.

Servings: 6 (1/2 cup)

Kale Chips

Toss two large handfuls of chopped and washed kale in a bowl with extra virgin olive oil, salt, and pepper. Line a baking sheet with tin foil and bake at 300 degrees for 20 minutes. One cup of fresh chopped kale only contains 35 calories and 7 grams of carbohydrates.

Parmesan Cheese Chips

Ingredients:

1 cup grated hard cheese (such as Parmesan) – NOT the dried powdery stuff!

Directions: Preheat oven to 350 F.

Note on type of cheese: You can use any kind of hard cheese, but the results will be different depending on the type. Hard cheeses, such as Parmesan, Romano, Asagio, etc, will make a crisp “shell,” whereas cheddar will be more chewy and “lacey” (the fat separates out), though still firm. Softer cheeses such as mozzarella will not work well.

Toss cheese with any seasonings you’d like — garlic powder (about half a teaspoon for a cup of cheese), hot pepper powder, even cinnamon. Or leave plain.

Pile 1 to 4 Tablespoons of cheese (depending on the size you want) on a baking sheet covered with a silicone mat or parchment paper oiled on both sides. Flatten the tops so they are in more or less an even pile. There should be at least two inches between smaller mounds, 4 inches between larger ones.

Bake 5 to 6 minutes until they are a light golden brown (they will be a little darker at the edges). It happens fast, so watch carefully.

Baked Sesame Crackers:

Ingredients:

1 cup almond meal

¼ cup sesame seeds

4 oz. shredded cheese (at least half should be a hard cheese such as Parmesan)

1 egg white

2 teaspoon prepared mustard

1 teaspoon garlic powder

¼ teaspoon salt

Directions: Preheat oven to 325 F.

Combine all ingredients. A food processor makes it really easy, but you can use a spoon, or even your hands. Keep combining until the ingredients cling together into a ball.
Using your hands, roll dough into a cylinder about 1.5 inches in diameter. Slice with a sharp knife, about three to an inch.
Put rounds on a baking sheet covered with a silicone baking mat or parchment paper. Leave enough space between each to flatten.
Using something with a flat bottom such as a measuring cup, flatten until the rounds are a little over 2″ wide. Smooth out the edges with fingers.

Bake for about 14-18 minutes, though you might want to check before to see how they are coming along. When they begin to brown, remove from oven and cool. Makes approximately 24 crackers.

High Protein Veggie Dip:

Ingredients:

16 oz plain greek yogurt 1 packet ranch dip mix

Blend and serve with fresh veggies!

Cinnamon Almond Fruit Dip

Ingredients:

1 cup ricotta cheese (recipe here)

2 tbsp almond butter

1/2 tsp cinnamon

1 tsp raw honey

1 tsp low fat milk

Fruit of your choice, cut into bite size pieces

Directions:

Place all of the ingredients except the fruit in a food processor and process until smooth. If the dip is a little too thick add another teaspoon of milk. Serve with fruit and dip in!

Nutritional Info: ¼ cup is 1 serving and makes approx. 1 cup of the dip total.

Carbs: 4 net carbs and 9 grams of protein per serving

Low Carb Cheat Sheet

These are some good alternatives for when you are trying to decrease your carb intake. If you want to know what stores near you carry this product, go to the product website and they should give you an option to do a retail search or have a store locator.

Pasta:

Journeylite Pasta (JourneyLite offices or E-store)
Miracle Noodles (most grocery stores, usually in the organic refrigerated section)
Edamame Pasta or Black Bean Pasta, made by Explore Asia, (Costco, Jungle Jim’s, Meijer)
Zucchini Noodles (use vegetable shredder)

Tortillas: (Some of these products could be located in the deli section.)

Mission Brand Tortilla’s “Carb Balance”
Tumaro’s “Low in Carbs” Tortilla’s (Kroger/Jungle Jim’s)
LaTortilla Factory (Kroger/Meijer/Walmart)
Flat Out’s Lite

Ice Cream:

Blue Bunny “Sweet Freedom” No sugar added (Kroger, Remke Bigg’s, Walmart (not all)
Edy’s Slow Churned: No Sugar Added (Kroger, Meijer)
Breyer’s Carb Smart Ice Cream
So Delicious Coconut Milk Ice Cream No Sugar Added (Kroger, Whole Foods) usually located in the Organic section in the freezer.
Arctic Zero Ice Cream
Halo Top Ice Cream (Kroger – only sold in pint sizes)

Granola/Granola Bars:

McCabe’s Granola (Remke/Bigg’s, Kroger, Whole Foods)
Bear Naked Peak Protein Granola (Organic Section)
Nature Valley Protein Granola Bars (Granola Bar Section)
Kellogg’s Fiber Plus Protein Bars (Granola Bar Section)

Yogurt:

Dannon Light & Fit Greek
Kroger Greek Lite
Kroger Carbmaster Yogurt
Kroger Carbmaster Protein Yogurt Smoothie
Oikos Triple Zero
Elli Quark (Target or Whole Foods)

Milk:

Carbmaster Milk (Original, Vanilla, and Chocolate) Kroger only
Almond Breeze Unsweetened Almond milk
Silk Unsweetened Cashew milk
Soy Slender Soy Milk
Unsweetened Coconut Milk

Low Carb Breads

Label Reading Guidelines:

10 grams Net Carbohydrate or less per serving

Brand	Variety	Serving SIze	Net Carbs
Arnold Sandwich	Fill’ems	½ bun	8
Thins	Honey Wheat Multigrain 100% Whole Wheat	½ bun ½ bun ½ bun	8.5 8.5 8.5
Aunt Millies	5 Grain	1 slice	7
Healthy Goodness	Potato Whole Grain White	1 slice 1 slice 1 slice	7 7.5 7.5
Healthy Life	Whole Grain	1 slice	5
Pepperidge Farm	Very Thin 100% Whole Wheat Oatmeal	1 slice ½ “flat” 1 slice	7.5 7 8.5
Light Style	7 Grain Soft Wheat	1 slice 1 slice	7 7
Sara Lee Thin	100% Whole Grain	½ bun	8
S. Rosens	Dark Jewish Rye	1 slice	8
Thin Sliced	Dill Rye Jewish Rye	1 slice 1 slice	8 8
Trader Joe’s	Sprouted 7 Grain	1 slice	4
Wonder	Smart Wheat Smart White	1 slice 1 slice	6 4

Carb-Controlled Crackers

Label Guidelines: 2-3 grams of fat or less per serving

15 grams carbohydrate or less per serving

Brand	Variety	Serving SIze	Net Carbs
Angonoa Breadsticks	Garlic Garlic Sesame Plain Sesame	1 1 1 1	4 3 4 3
Bremer Wafer	Wafer	3	4
Capeachio’s	Org. Water Cracker	3	9
Crunch Master	Multi Grain Sea Salt	4 4	6 6
Devonshire	Melba Toast (all) Melba Rounds	2 3	7 7
Kashi	Pita Crisp Original 7 Grain	4 4	7 5
Keebler	Club-red fat Town House-red fat Town House-flatbread crisp Italian Herb Sea Salt & Olive Oil Roasted Garlic Zesta (saltines)	3 3 4 4 4 3	6 6 6 6 6 7
Maries Gone Cracker	All Varieties	4	6
Nabisco	Prem Saltines (all) Red Fat Ritz Soup & Oyster Wheat Thins Triscuits (all)	3 3 10 4 4	7 7 5 7 7
Old London	Melba Toast	2	8
Rutherford & Meyer	Gourmet Wafers (all)	4	4
Brand	Variety	Serving SIze	Net Carbs
Ry-Krisp	All Varieties	2	10
34 Degree	Savory Crisp (all)	4	4
Sunshine	Krispy Saltines (all) Krispy Soup & Oyster	3 10	7 7
Shur Good	Soup & Chili Crackers	10	3
Skyline	Oyster Crackers	10	6
Venus Fat Free Crackers	Cracked Pepper Garden Vegetable Garlic & Herb Multi Grain	4 4 4 4	4 10 4 10
Wellington Water Cracker	Cracked Pepper Toasted Sesame Traditional	3 3 3	9 8 9
Wasa	All Varieties	1	10

Protein

Function: Protein has many important functions. It helps to repair muscles, tissues and cells, allows metabolic reactions to take place, provides structure, helps with immunity and provides energy.

Deficiency: The symptoms of protein deficiency include: brittle skin and nails, feeling weak and or hungry, muscle loss, weakened immune system, edema (swelling), anemia.

Toxicity: The symptoms of too much protein include: nausea, headache, mood changes, fatigue, low blood pressure, diarrhea, slow heart rate, weakness, and fatigue.

Food Sources

FOOD SOURCES	AMOUNT	# of Grams

Meats, Poultry and Fish
Chicken, Turkey, Pork, Lamb	1 ounce	7
Fish, tuna	1 ounce	7
Seafood (crab, lobster, shrimp)	1 ounce	6
Egg	1	6
Beef or Turkey Jerky	1 oz dried	10-15

FOOD SOURCES	AMOUNT	# of Grams

Dairy Products
Cow’s Milk, non- fat	1 cup	8
High protein, ultra-filtered milk, fat free or 1%	1 cup	13
Greek yogurt, plain, nonfat light	6 ounces	12-18
Plain, low fat yogurt	6 ounces	5
Cottage cheese	½ cup	13
Sugar Free Pudding (made with skim or 1% milk)	½ cup	4
Cheese, hard (low fat)	1 ounce	7
Almond milk	1 cup	1

FOOD SOURCES	AMOUNT	# of Grams

Legumes and Nuts
Sunflower seeds	1 ounce	5
Almonds, dry roasted	1 ounce	6
Cashews, dry roasted	1 ounce	4
Peanuts, dry roasted	1 ounce	7
Peanut Butter, smooth	2 tablespoons	7
Peanut Butter powder (PB2)	2 tablespoons	8
Hummus	⅓ cup	7
Lima Beans	½ cup	7
Beans (kidney, black, cannellini, navy)	½ cup	8
Refried beans	½ cup	6

FOOD SOURCES	AMOUNT	# of Grams

Whole grains
Whole wheat bread	1 ounce slice	3
Brown rice, cooked	⅓ cup	3
Cereal	½ cup hot or ¾ cup cold	7-15
Quinoa cooked	½ cup	6

FOOD SOURCES	AMOUNT	# of Grams

Vegetable and Soy Protein
Soy milk, plain or vanilla	8 ounces	7
Tofu	1 ounce	3
Edamame, dry roasted	1 ounce	13

*Work with your dietitian to calculate your individual protein needs.

Healthy Lifestyle Eating Plan

The goal of this dietary program is to provide a structured program that will help maximize weight loss. This plan focuses on lean proteins and whole fruits and vegetables. Nutritional needs are different for men and women.

Here are the daily guidelines:

64 ounces of calorie-free fluid daily (minimum)
5 servings of protein: (1 serving: 3-4 oz solid meats, 2 oz nuts/seeds, 8 oz low fat dairy, 1 oz low fat cheese)
2 servings of fruits (1 serving: 1 small whole fruit, or ½ c canned)
5 servings of vegetables (1 serving: ½ cup cooked, or 1 cup raw)

This sample menu provides an outline of how your meals will flow daily:

	Guidelines	Sample Menu
Breakfast	1 protein 1 fruit	1 – egg 1 – grapefruit
Mid-Morning Snack	1 vegetable 1 protein	2 – celery stalks peanut butter
Lunch	1 protein 2 vegetables	chicken breast, with green beans and a small salad, with 1 tsp of regular dressing
Afternoon Snack	1 protein 1 fruit	nuts strawberries
Dinner	1 protein 2 vegetables	fish with cauliflower and a small salad, with 1 tsp of regular dressing.

**When using fats such as mayo, salad dressing, and butter you must account for those calories on your food journal.**

The following tables outline food choices that we want to increase in our diet. Also included is a list of foods to use sparingly!

Protein Choices

Ground meats (85% or less fat), pork loin, lean lunch meats, chicken/turkey breast, crab, shrimp, white fish, tuna, salmon, peanut butter, nuts (almonds, pistachios, peanuts, walnuts), cottage cheese, eggs, egg whites, cheese (mozzarella , colby, provolone, swiss cheese, feta cheese, goat cheese), soy protein (tofu soft or firm)

Eat in Moderation: breaded, fried/deep fried protein, bacon, beef (fatty cuts), ground beef (>15% fat), chicken (fried and/or with skin), chicken (buffalo wings), duck, fish sticks, hot dogs (all types), liver, liverwurst, pepperoni, salami, sausage, seafood (canned in oil),

Fruit Choices

FRUITS Count as 15 grams of carbohydrates and 60 calories (Portion sizes listed on next page)

Star fruit, cranberries, watermelon, strawberries, grapefruit, cantaloupe, papaya, peach, pear, plum, honeydew melon, blackberries, raspberries, apples, pineapple, oranges, blueberries.

Eat in Moderation: Dates, Bananas, Passion Fruit, Pomegranate, Grapes, Figs, Sweet Cherries, Mango.

Vegetable Choices

NON STARCHY VEGETABLES count as 5 grams of carbohydrate, 2 grams of protein, 0 grams of fat, and 25 calories

One vegetable exchange: ½ cup cooked or 1 cup raw

Sour pickles, watercress, dill pickles, cucumber, mustard greens, radishes, celery, zucchini, summer squash, lettuce, tomatoes, sauerkraut, swiss chard, bell peppers (all colors). Asparagus, mushrooms, spinach, eggplant, cauliflower, cabbage, arugula, green onions, jalapeños, collard greens, okra, spaghetti squash, green beans, turnip greens, broccoli, onions, carrots, snow peas (snap bean), brussel sprouts, kale, Chinese cabbage, bean sprouts.

Eat in Moderation: Acorn squash, artichokes (Jerusalem), beans (other than green beans), butternut squash, corn, legumes, parsnips, peas, potatoes, sweet potatoes, and yams.

These choices can be taken in any amount since they do not contain sugar. Aim for 48-64 ounces daily.

Water, sugar free beverages such as Crystal Light, Wyler’s Light, sugar-free Kool Aid, sugar- free Tang, Diet Snapple, MIO, Minute Maid Lite(all flavors), Fruit 2 0 or Propel Zero, Powerade Zero, coffee or tea with sugar substitute, broth/bouillon, strained broth soups.
Sugar free popsicle, sugar free gelatin, sugar free gum , sugar free mints

FRUITS Count as 15 grams of carbohydrates and 60 calories

Apple, small 1 (4oz)	Applesauce, Unsweetened ½ Cup
Apples, dried 4 rings	Apricots, diced 8 halves
Apricots, fresh 4 whole	Apricots, canned ½ cup
Banana, small 1 (4 oz)	Blueberries ¾ cup
Cantaloupe 1 cup	Cherries, fresh 12
Grapefruit ¾ cup	Grapes, small 17
Honeydew Melon 1 cup	Kiwi 1
Mandarin oranges ¾ cup	Mango ½ cup
Nectarine 1 (5 oz.)	Orange, small 1
Peach medium 1 (4 oz.)	Peaches, canned ½ cup
Pear, large 1/2	Pears, canned ½ cup
Pineapple, fresh ¾ cup	Pineapple, canned ½ cup
Plum, small 2	Raisins 2 Tbsp
Raspberries 1 cup	Strawberries 1 ¼ cup
Whole Tangerine, small 2	Watermelon 1 ½ cup cubes

Total calories for the meal plan ranges from 1000-1200 calories depending on food choices.

JourneyLite Physician’s 3 & 2 Program

You may feel like you hit a wall from time to time in your weight loss journey. The 3 & 2 program is a sure fire way to get your weight loss on track again!!

Here are the basics of the program:

○ This program is designed to get your weight loss moving again!

○ You will choose 3 boxes of product per week.

3 & 2 Program: You consume 3 supplements (limit 1 bar per day) throughout the day and then have 2 meals that are considered “Lean and Green”. This is basically a lean protein and non-starchy vegetable.

It is essential to keep a thorough food journal while on the program so that you can review it with your dietitian at each visit!

It is also important to exercise 3-5 times per week for a minimum of 30 minutes per session to maximize your results.

1st Choice 2nd Choice 3rd Choice

Lean meat with <6 grams of fat per serving

Lean meat with 6-9 grams of fat per serving

Lean meat with >9 grams of fat per serving

Choose a 7 oz portion and 2 additional fat servings

Choose a 6 oz portion and 1 additional fat serving

Choose a 5 oz portion and NO

additional fat servings

Fish: Cod, Flounder, Haddock, Orange Roughy, Grouper, Tilapia, Mahi Mahi

Shellfish: Crab, Scallop, Shrimp, Lobster

Game Meat: Deer, Buffalo, Elk

Meatless Options:

●14 egg whites

●2 cups of Egg Beaters

●2 soy burgers (Morning Star Farms, Boca Burger) with <6 carbs/serving

Fish: Swordfish, Trout

Chicken: Breast or white meat without skin

Pork Tenderloin

Ground Turkey or other meat 99% lean

Light Meat Turkey

Meatless Options:

●Tofu, extra firm, 15 ounces

●2 whole eggs plus 4 egg whites

Fish: Salmon, Tuna

Lean Beef: Beef steak, roast, and ground beef

Lamb

Pork Chop

Ground Turkey or other meat

80-98% lean

Dark Meat: Turkey or Chicken

Meatless Options:

●3 whole eggs (limit to 1 time per week)

● Tofu, firm and soft variety, 15 ounces

Fat Servings

Each choice below=1 fat serving

Add 0-2 servings daily based on your meat choices

1tsp of canola, flaxseed, walnut, or olive oil
5 black olives or 10 green olives
Up to 2 Tbsp of low carbohydrate dressing (<5gm carb per serving)
1 tsp of trans fat-free margarine

Vegetable Servings

(Select ANY combination of three (3) servings at each of your Lean and Green Meals. So 6 servings total for the day.)

One serving = 1 cup raw salad greens or ½ cup of vegetables (cooked or raw) other than salad greens. So serving size is ½ cup unless specified.

Lowest Carb Choices

Medium Carb Choices

Highest Carb Choices

➤Mustard greens (1 cup)

➤Collards, fresh/raw (1 cup)

➤Romaine Lettuce (1 cup)

➤Endive (1 cup)

➤Lettuce, Butterhead (1 cup)

➤Spinach, fresh/raw (1 cup)

➤Turnip greens

➤Celery

➤Cucumber

➤Mushrooms, white

➤Radishes

➤Sprouts: Alfalfa or Mung

Bean

➤Asparagus

➤Cabbage

➤Cauliflower

➤Eggplant

➤Fennel Bulb

➤Kale

➤Mushroom, portabella

➤Spinach, cooked

➤Summer squash: Zucchini and Scallop

➤Broccoli

➤Cabbage, red

➤Collard or Mustard Greens, cooked

➤Green or Wax beans

➤Kohlrabi

➤Okra

➤Peppers: Green, Red, Yellow

➤Scallions

➤Summer Squash: Crookneck/Straightneck

➤Tomato, red ripe or canned

➤Turnips

➤Winter Squash: Spaghetti

Squash

Free Foods

You can have the following “free foods” in unlimited amounts:

➤Sugar-Free/Calorie Free beverages

➤Sugar-Free gelatin

➤Sugar-Free popsicles

➤Sugar-Free gum or mints

➤Broth or strained broth soups

Optional Snacks

You can have ONE of the following optional snacks daily as needed.

➤3 celery stalks

➤2 dill pickle spears

➤½ oz of nuts: almonds (10 whole), walnuts (7 halves), or pistachios (20 kernels)

➤1 Carbmaster Yogurt (Kroger ONLY carries this)

➤1 Lite String Cheese

Seasoning Options

You have the option to add any of the following ingredients to your Protein

Supplements to add some variety to the flavors or spice them up!!!

Shakes and Puddings: Sugar-free syrups (found in coffee aisle), 1/8 tsp Sugar-free powdered gelatin, Sugar-free baking extracts.

Journeylite Soups: Add broth instead of water to add flavor, use seasonings like garlic powder, onion powder, cumin, curry, Mrs.Dash, etc

Proti Soups: Add the soup base with the flavor pack to make a hearty and delicious soup. Season as needed.

Oatmeal: Add any sugar substitutes, Splenda brown sugar, Sugar-free maple syrup, spray butter (I Can’t Believe it’s Not Butter or Parkay)

Proti Eggs: Follow directions on the box. You can add 1 egg or 2 egg whites to the packet and make scramble or omelet.

Proti Vegetarian Chili: If you like spice, add hot sauce to spice up this flavorful chili. Proti Protein Orzo: Once cooked you can put them in hot broth to make “orzo” soup or use spray butter(I Can’t Believe it’s Not Butter or Parkay) and fresh herbs and a seasoning mix (no sugar added).

Proti Protein Bread: Toast it or eat it plain, you can use spray butter (I Can’t Believe it’s Not Butter or Parkay) , sugar free jelly (1-2 tsp)

Protein Pancakes: Can use Sugar Free syrup and Spray butter.

Sample Menus:

Sample Menu 1

Sample Menu 2

Breakfast: 1st Protein Supplement

➤Maple and Brown Sugar Oatmeal

AM Snack: Sugar Free Gelatin

Lunch: “Lean and Green” Meal

➤7 oz grilled tilapia -1 ½ cup celery sticks -2

Tbsp Ranch Dressing

Afternoon: 2nd Protein Supplement Peanut

Butter Crunch Bar

Dinner: “Lean and Green” Meal

➤6 ounces grilled chicken breast -1 ½ cup of cooked zucchini -1 tsp margarine

Evening: 3rd Protein Supplement

➤Hot Chocolate w/ Marshmallows.

Breakfast: 1st Protein Supplement

➤Cheese and Chives Eggs

AM Snack: Sugar Free Popsicle

Lunch: “Lean and Green Meal”

➤5 ounce pork chop

➤2 cups mixed salad greens, ½ cup total of diced tomatoes and cucumbers

➤2 Tbsp Low Carb salad dressing.

Afternoon: 2nd Protein Supplement

➤Caramel Crunch Bar

Dinner: “Lean and Green” Meal

➤5 oz Sirloin Steak

➤1 ½ cup steamed broccoli

Evening: 3rd Protein Supplement

➤Lemonade Fruit Drink.

Team Contact Info

Toll free: 877-442-2263

Fax: 513-559-1235

If you haven’t already done so, please set up your Patient Dashboard. You can get a link by texting 513-572-1718.

Text: During normal business hours feel free to text us at 513 572-1718

Providers: All providers general email – provider@curryweightloss.com

Dr. Curry – dr.c@curryweightloss.com

Dr. Augusta – dr.augusta@curryweightloss.com

Dietitians: All dietitians general email – RD@curryweightloss.com

For individual dietitian contact info please visit JourneyLite.com/dietitians

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Carbohydrates: What are They?

What to Know About Sugar Substitutes

Sample Food Label & How To Read It

Food Label Claims

APPENDIX

General Goal Setting

Step Goals

Carbohydrate Goals and Recommendations

Protein Goals and Recommendations

Fat Goals and Recommendations

Vitamin and Mineral Recommendations

Fluid Goals and Recommendations

Additional Comments and Recommendations

Low Carb Snack Options

Additional menu

Carbohydrates: What are They?

What to Know About Sugar Substitutes

Sample Food Label & How To Read It

Food Label Claims

APPENDIX

General Goal Setting

Step Goals

Carbohydrate Goals and Recommendations

Protein Goals and Recommendations

Fat Goals and Recommendations

Vitamin and Mineral Recommendations

Fluid Goals and Recommendations

Additional Comments and Recommendations

Low Carb Snack Options