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Joslin’s
Supermarket Smarts                                                               ™


                         Making Heart-Healthy Choices Aisle By Aisle




Copyright © 2010 by Joslin Diabetes Center, Inc.                                      1
(www.joslin.org). All rights reserved.
                                                              Distributed Courtesy of Unilever
About Joslin Diabetes Center
                                                   Joslin Diabetes Center is the world’s preeminent diabetes
                                                   clinic, diabetes research center and provider of diabetes
                                                   education. Joslin is dedicated to ensuring that people with
                                                   diabetes live long, healthy lives and offers real hope and
                                                   progress toward diabetes prevention and a cure for the
                                                   disease. Founded in 1898 by Elliott P. Joslin, M.D., Joslin
                                                   is an independent nonprofit institution affiliated with
                                                   Harvard Medical School.

                                                   For more information about Joslin, call 1-800-JOSLIN-1
                                                   or visit www.joslin.org.




Copyright © 2010 by Joslin Diabetes Center, Inc.                                                                 2
(www.joslin.org). All rights reserved.
Getting Started
Making a few simple changes in your food choices can
help keep your heart healthy and can also help you if
you have diabetes or are controlling your weight. Even
better – what’s good for you is also good for your whole
family. You don’t have to buy special foods or cook
special meals for yourself if the entire family eats the
same way. Healthy eating is good for everyone!

Tips for Easier and Healthier Shopping
One way to get started with healthier shopping
and eating is to have a few goals in mind. The
goals are simple:

•	   Eat the right types of fats. We need fat for overall health. But the type of fat makes a
     difference to heart health, and the total amount of fat we eat is also important. Eating too
     much of some types of fat (saturated fat, trans fat and cholesterol) can increase one’s risk of
     heart disease.

•	   Eat more fiber. Fiber keeps the digestive tract healthy and can help lower the risk for
     heart disease.

•	   Eat less sodium and salt. Too much sodium and salt in the diet can raise blood pressure.

•	   Eat a variety of nutrient-rich foods. Choose a variety of nutrient-rich foods and beverages
     within and among the basic food groups. Examples include: fresh fruits and vegetables, whole
     grain cereals, brown rice and whole grain breads, along with fat-free and lowfat dairy products,
     legumes, poultry, lean meats and fish. Limit your intake of more refined and processed foods
     which tend to be higher in fat, sugar, calories and/or sodium.

How do you do all this? One way is to learn how to read food labels. The second way is to use
this booklet as a guide when making food choices in the grocery store. Let’s get started.




Copyright © 2010 by Joslin Diabetes Center, Inc.                                                        3
(www.joslin.org). All rights reserved.
Label Reading
One of the first steps to healthier eating is learning how to read the Nutrition Facts panel on the food label.
There’s a lot of information on a food label – but the good news is that you don’t have to read all of it! For
heart health, here are some of the most important sections of the food label to pay attention to:

•	   Serving size. Always look at the serving size, which is found right at
     the top of the label, just underneath the Nutrition Facts title. A food
     item’s serving size might be larger or smaller than what you might be
     planning to eat.

•	   Total fat. Fat is an essential nutrient. But eating too much can lead
     to weight gain and increase your risk of heart disease. Reading the
     Nutrition Facts label for total fat can help you limit your fat intake.
     Also, be sure to limit the intake of foods high in saturated and
     trans fat.

     •	   Saturated fat. Saturated fat is an unhealthy fat because it can
          raise blood cholesterol, especially LDL, or “bad” cholesterol. Try
          to limit foods high in saturated fat, such as butter, whole milk dairy
          foods and red meat, as much as possible.

     •	   Trans fat. Like saturated fat, trans fat (made by a process
          called hydrogenation) is an unhealthy fat. Trans fat can raise
          LDL cholesterol and lower HDL, or “good” cholesterol. Some
          margarines and snack foods contain trans fat. Look for 0 grams
          of trans fat on the food label.

     •	   Cholesterol. Saturated fat is more likely to raise your LDL
          cholesterol than the cholesterol found in food. But it’s still a
          good idea to limit your intake of cholesterol to no more than
          300 milligrams (mg) per day. Only foods made from animal
          products contain cholesterol.

•	   Sodium. Aim for no more than 2400 mg of sodium per day (about
     the amount in one teaspoon of salt). Low sodium foods are those
     with no more than 140 mg per serving.

•	   Dietary fiber. Fiber is found in whole grain breads, cereals and
     pasta; fruits and vegetables; and beans and legumes. Aim for 20
     to 35 grams each day. Choose foods with at least 3 grams of fiber
     per serving.




Copyright © 2010 by Joslin Diabetes Center, Inc.                                                                  4
(www.joslin.org). All rights reserved.
Shopping Tips
•	   Shop the perimeter. For the most part, some of the healthiest
     foods in the grocery store are found along the perimeter, or outer
     sections. The produce section, meat, fish and poultry cases, and
     dairy sections are usually found along the perimeter of the store.

•	   Shop from a list. Using a shopping list can make it easier to
     remember to buy healthier foods and can also limit “impulse”
     buying. A list can also help you stick to your food budget.

•	   Shop after eating. If you go grocery shopping when you’re hungry,
     you might find it harder to resist tempting goodies, especially
     sweets and snack foods.

Next, use the following food lists as a guide to making better food choices.



Produce                                                                                     Nutrition Notes:

Fruits, Vegetables, Nuts & Seeds: Choose more                                               Whole fruits have more fiber
The main message for fruits and vegetables? Eat more! In fact, aim to eat 5 to              than fruit juice and contain
9 servings of different fruits and vegetables every day. It sounds like a lot, but          less sugar.
remember that fruits and vegetables are full of vitamins, minerals and fiber –              Choose different colored fruits
and they’re low in calories. Choose fresh or frozen fruits and vegetables whenever          for the best nutrition.
possible. While you’re at it, don’t forget to add dried beans, peas and lentils
to your menu. They’re also high in fiber and other nutrients, including protein.            To save money, buy fruits and
They can add variety to your diet – and save you money at the same time! Nuts               vegetables that are in season.
and seeds are high in calories, so eating smaller amounts is the way to go. But,
they’re full of heart-healthy fat, protein and fiber, too.                                  Dark green and deep orange-
                                                                                            colored vegetables tend to be
                    Choose                                          Go Easy                 rich in many nutrients.

                                                                                            Leave the skin or the peel on
 Fruits
 •   Fresh fruit                                   • Frozen fruit packed in syrup           whenever possible to boost
 •   Frozen fruit without added sugar              • Canned fruit packed in light           the fiber content.
 •   Canned fruit packed in juice                    or heavy syrup
 •   Dried fruit                                   • Yogurt/chocolate-covered dried fruit   Try at least one meatless meal
                                                                                            each week using dried beans,
                                                                                            such as black beans and rice
 Vegetables
                                                   • Frozen vegetables in cheese            or vegetarian chili.
 •   Fresh vegetables
 •   Plain frozen vegetables                         or butter sauce
                                                                                            Look for unsalted nut butters if
 •   No-salt-added canned vegetables               • Frozen French fries/onion rings
 •   Dried beans, peas and lentils                 • Canned vegetables                      you need to watch your sodium
                                                                                            intake.
 Nuts & Seeds
                                                                                            Watch portion sizes
 • Unsalted nuts and seeds                         • Salted nuts and seeds
                                                                                            of nuts and seeds
 • Natural (oil on top) peanut or other            • Coconut
                                                                                            because they’re
   nut butters
                                                                                            high in calories.

Copyright © 2010 by Joslin Diabetes Center, Inc.                                                                        5
(www.joslin.org). All rights reserved.
Meats
Meat, Poultry and Seafood: Choose light and lean
Meats, poultry and seafood are the main protein foods in most people’s eating               Nutrition Notes:
plan. Beef, pork and lamb tend to be higher in saturated fat than poultry and
fish, so it’s important to not only choose leaner cuts of meat, but also limit              Trim away any visible fat
portion sizes to between 3-6 ounces. Seafood, especially fatty fish, contains a             before cooking.
type of heart-healthy fat called omega-3 fatty acids, so aim to eat fish at least
twice a week.                                                                               Use lowfat cooking methods,
                                                                                            such as grilling, broiling or roasting.
                     Choose                                          Go Easy                Select grades of
 Beef/Pork/Lamb/Veal                                                                        meat that are the
 • Loin cuts, such as tenderloin                   •   Rib eye, T-bone cuts, ribs           leanest; choice
   and sirloin                                     •   Less than 90% lean ground beef       grades of meat have
 • Round (eye of round, top round)                 •   Ground pork, ground lamb             a moderate amount
 • 90% (or higher) lean ground beef                •   Organ meats (kidney, liver, heart)   of fat; and prime cuts
 • Extra-lean ham                                                                           of meat are the fattiest cuts.
 • Soy crumbles
                                                                                            Aim to limit red meat intake to no
 Poultry                                           • Chicken or turkey with skin/duck
                                                                                            more than 2-3 times per week.
 • Chicken or turkey breast, no skin
                                                   • Fried chicken                          Look for cold-cuts and processed
 • Ground chicken or turkey breast
                                                   • Ground chicken or turkey
                                                                                            meats with no more than 3
                                                                                            grams of fat per ounce.
 Seafood
 • Fatty fish (salmon,                             • Fried or breaded seafood               Try to choose lower-sodium
   tuna, halibut,                                                                           cold-cuts, if they’re available.
   mackerel)
 • Shrimp and shellfish                                                                     Add tomato slices and green
                                                                                            leaf lettuce to help “bulk up” your
                                                                                            sandwiches.

Deli Meats/Processed Meats
Balancing convenience with nutrition
Believe it or not, you can find healthy selections at the deli counter.
Lean deli meats include turkey and chicken breast, lean roast beef and lean
ham. Save even more fat on cold-cut sandwiches by using mustard instead of
mayonnaise.

                          Choose                                         Go Easy

 •   Turkey/chicken breast                                   •   Regular cold-cuts
 •   Lowfat cold-cuts (95-99% fat-free)                      •   Hotdogs
 •   Lite/reduced-fat hotdogs                                •   Sausage
 •   Canadian bacon                                          •   Bacon
 •   Vegetarian hotdogs, sausage, bacon
 •   Tofu




Copyright © 2010 by Joslin Diabetes Center, Inc.                                                                            6
(www.joslin.org). All rights reserved.
Dairy Foods
Milk, Yogurt and Eggs: Aim for non-fat and lowfat
There are a lot of options in the dairy case to help you meet your heart-healthy          Nutrition Notes:
goals. For example, milk and yogurt are excellent sources of calcium and
                                                                                          Use fat-free evaporated skim
protein, but whole-milk versions are high in saturated fat. The solution? Choose
                                                                                          milk or fat-free half and half
non-fat or lowfat varieties. Eggs are a very nutritious food, and even though
                                                                                          instead of cream.
they contain cholesterol, you can still fit them into your eating plan – up to 3
yolks per week is fine.                                                                   Gradually switch from
                                                                                          whole milk to 2% milk
                     Choose                                         Go Easy               to 1% milk to skim
                                                                                          milk – the change
 Milk and Cream                                                                           in flavor and
 •   Skim (nonfat) or 1% (lowfat) milk             •   Whole milk/reduced fat (2%) milk   consistency will be
 •   Fat-free evaporated milk                      •   Whole evaporated milk
                                                                                          less noticeable.
 •   Non-fat or lowfat soy or rice milk            •   Light, heavy or whipping cream
 •   Fat-free half and half/                       •   Half & half/nondairy creamer       Fruited yogurts tend to be higher
     nondairy creamer                                                                     in calories than plain yogurt.
                                                                                          Sweeten plain yogurt with fresh
 Yogurt                                            • Whole milk yogurt                    or canned fruit.
 • Fat-free or lowfat yogurt                       • 2% Greek-style yogurt
                                                                                          Brown eggs contain
 Sour cream                                                                               the same calories and
 • Fat-free or light sour cream                    • Regular sour cream
                                                                                          nutrients as white eggs.
 Eggs
 • Egg whites or egg substitutes                   • Whole eggs (more than 3 per week)


Cheese
It’s hard to resist a slice of cheese; fortunately, you don’t have to. Despite            Nutrition Notes:
being high in saturated fat, cheese contains nutrients such as protein and cal-
                                                                                          Look for cheeses with no more
cium. Today there are many types of lower-fat cheeses to choose from, and, in
                                                                                          than 3 grams of fat per ounce.
most cases, you’ll hardly notice a difference in flavor from the full-fat version!
                                                                                          Save money and
                    Choose                                         Go Easy                calories by using
                                                                                          small amounts of
 Cottage/Ricotta cheese
                                                   • 4% or 2% milk-fat cottage cheese
                                                                                          stronger cheese
 • Fat-free/lowfat cottage cheese
 • Fat-free/light/part-skim ricotta                • Whole-milk ricotta cheese            (blue, sharp cheddar, parmesan).

                                                                                          The lower the fat content of
 Cream cheese/Spreadable cheese                                                           the cheese, the harder it is to
 • Fat-free/light cream cheese                     • Cream cheese
                                                                                          cook with.
 • Goat or feta cheese                             • Whipped cream cheese
 • Light spreadable cheese                         • Cheese spread

 Hard cheese
 • Light or reduced-fat cheese                     • Regular hard cheese
 • Light string cheese                             • Whole-milk mozzarella




Copyright © 2010 by Joslin Diabetes Center, Inc.                                                                       7
(www.joslin.org). All rights reserved.
Breads, Cereals and Grains
Breads and Baked Goods: Go for the grain
There are plenty of healthy whole-grain, high-fiber breads and rolls to choose
from in the supermarket. Whole-grain breads and baked goods are packed
with fiber, vitamins, minerals and antioxidants. Most of them are low in
saturated fat, too.

                                                                                           Nutrition Notes:
                       Choose                                     Go Easy
                                                                                           Choose breads and
 Breads, Rolls, Bagels, Tortillas                                                          rolls with the words
                                                    • White bread/rolls/biscuits
 • Whole-grain (whole-wheat, rye,                                                          “whole-wheat” as the
                                                    • Cheese or garlic bread
   pumpernickel, oatmeal) bread,                                                           first ingredient.
                                                    • Quick breads (banana, date nut,
   rolls, English muffins, bagels
                                                      corn, etc.)
 • Whole-wheat/corn tortillas                                                              Look for breads that contain at
                                                    • Tortillas made with lard
                                                                                           least 2-3 grams of fiber per slice.
 Muffins and Pastries
 • Fat-free/lowfat muffins                          • Muffins/croissants/scones/pastries   Limit oversized bagels, muffins
 • Angel food cake                                  • Doughnuts/crullers                   and sandwich rolls.

 Pancakes, Waffles and French Toast
 • Lowfat/reduced-fat pancakes                      • Frozen French toast
   and waffles                                      • Frozen waffles
 • Whole-grain pancakes, waffles,
   French toast


Cereals, Grains and Pasta: Go for the grain                                                Nutrition Notes:
Just as you might choose whole-grain bread for your morning toast or lunch-
time sandwich, don’t forget to go for whole-grain cereals and pasta for the                Choose cereals with at least 3
same nutrition benefits. Add more variety to your meals by not only choosing               grams of fiber and no more than
brown rice, but also trying other healthy grains, such as quinoa, barley and               3 grams of fat per serving.
couscous.
                                                                                           Limit cereals that list sugar as the
                                                                                           first or second ingredient.
                      Choose                                      Go Easy
                                                                                           Instant hot cereals tend to be
 Cereals                                                                                   higher in sodium
 • Whole-grain, high-fiber                         • Sugar-coated cereals
                                                                                           than the regular
   cold cereal                                     • Cereals made with saturated
 • Oatmeal/oat bran
                                                                                           versions.
                                                     or trans fat
                                                                                           Packaged,
 Grains
 • Brown rice, wild rice                           • Packaged rice/grain mixes             seasoned rice
 • Barley, bulgur, quinoa, kasha                   • Rice or other grains made with        and pasta mixes are usually
 • Whole-wheat couscous                              butter, cheese or cream sauce         high in sodium. Use one fourth to
                                                                                           one half of the seasoning packet
 Pasta                                                                                     when preparing.
 •   Whole-grain/whole-wheat pasta                 • Packaged pasta mixes
 •   Spinach pasta                                 • Pasta made with butter, cheese        Brown rice has nearly three
 •   Yolk-free noodles                               or cream sauce                        times the fiber of white rice.
 •   Ramen noodles                                 • Canned pasta




Copyright © 2010 by Joslin Diabetes Center, Inc.                                                                            8
(www.joslin.org). All rights reserved.
Butter/Margarine/Soft Spreads                                                         Nutrition Notes:

Go for the “good” fats                                                                Try a soft spread that contains
Skip the butter, since it’s high in saturated fat, or else use a very small amount.   plant sterols to help lower your
And stick margarine may contain both saturated fat and trans fat. A better            cholesterol.
option is a soft spread (also referred to as a soft, vegetable oil tub spread),       The more solid a margarine
which provides a source of monounsaturated and polyunsaturated “good”                 is, the more saturated fat it
fats and a delicious buttery taste - with 70% less saturated fat than butter, and     contains.
no trans fat. Some even contain ingredients such as plant sterols (natural plant
ingredients that can lower LDL cholesterol) for an additional heart-healthy           Light tub spreads are best
benefit. Try different kinds until you find the one that tastes good to you.          used on toast, bagels and
                                                                                      vegetables; they’re not meant
                             Choose                                     Go Easy       for cooking or baking.

 Butter/Margarine/Soft Spreads
 • Trans-fat-free tub soft spread or squeeze margarine         • Butter
 • Tub soft spread with plant sterols                          • Stick margarine




Prepared Foods
Try not to sacrifice health for convenience. Prepared foods in the grocery store
are quick and easy, but many of them are high in calories and unhealthy fats.         Nutrition Notes:
Stock up on salads and cooked vegetables and make them the basis for a
healthy, take-home meal.                                                              Stock up on fresh
                                                                                      vegetables and fruits
                                                                                      at the salad bar.
                     Choose                                      Go Easy
                                                                                      Use skinless rotisserie chicken
 •   Rotisserie chicken (no skin)                  • Fried chicken, chicken wings     breast to make sandwiches or
 •   Sushi                                         • Mayonnaise-based salads          to add to soups and stews.
 •   Green salad/fruit salad                         (potato, macaroni)
 •   Oil-based pasta salad
 •   Hummus




Copyright © 2010 by Joslin Diabetes Center, Inc.                                                                      9
(www.joslin.org). All rights reserved.
Oils, Mayonnaise, Salad Dressings
Oils, mayonnaise and salad dressings can definitely be part of a heart-healthy              Nutrition Notes:
eating plan. The key is to choose liquid vegetable oils rather than fats that are
solid at room temperature (such as shortening and butter), and to use either                All fats, even
lower-fat versions of mayonnaise and salad dressings, or just small amounts of              healthy ones, are
the regular versions.                                                                       high in calories, so
                                                                                            use them sparingly
                                                                                            if your goal is to
                        Choose                                        Go Easy               lose weight.
 Oils                                                                                       Even fat-free dressings and
 • Vegetable oils (canola, peanut, olive,                • Shortening and lard              mayonnaise still contain calories.
   corn, sunflower, safflower, soybean,                  • Coconut/palm/palm kernel oil
   flaxseed)                                             • Salt pork                        Drizzle flaxseed oil on your salad
 • Non-stick cooking sprays                                                                 or vegetables or dip your bread
                                                                                            into a small amount of it. But
 Mayonnaise                                                                                 don’t use flaxseed oil in cooking
 • Fat-free/light mayonnaise                             • Regular mayonnaise               or baking.

 Salad Dressing
 • Fat-free/lowfat/light salad dressing                  • Creamy-style dressings
 • Balsamic/wine vinegar                                 • Regular salad dressings



Beverages
Empty calories or nutrient-rich?
Water is one of the healthiest beverages to drink. But when you’re looking for              Nutrition Notes:
more flavor and variety, try to choose beverages that are not high in calories
and added sugars such as high-fructose corn syrup. One hundred percent fruit                Choose decaffeinated coffee, tea
juice contains many of the same nutrients as the fruit itself, but tends to be              and herbal teas if you need to
higher in calories, so limit your intake to no more than one serving (4 fl. oz.) or         limit caffeine.
try a light-style juice.                                                                    Use skim or lowfat milk to
                                                                                            make cocoa or to add to tea
 Choose                                            Go Easy                                  and coffee.
 •   Water (bottled, seltzer, sparkling)           • Tonic water
 •   Coffee, tea (plain, unsweetened)              • Regular soda
 •   Diet tonic water                              • Sugar-containing flavored water/
 •   Diet soda                                       enhanced water
 •   Diet ice tea                                  • Energy/sports drinks
 •   Sugar-free soft drinks                        • Fruit smoothies made with regular
 •   Fruit smoothies made with                       yogurt
     lowfat yogurt                                 • Sweetened iced tea, coffee drinks
 •   Lowfat coffee drinks                            (latte, cappuccino)
 •   Low-sodium vegetable juices                   • Vegetable juices
 •   100% fruit juice (limit to one serving        • Fruit juice drinks, punches, blends,
     or 4 ounces per day)                            or cocktails
 •   Sugar-free cocoa mixes                        • Cocoa mixes




Copyright © 2010 by Joslin Diabetes Center, Inc.                                                                        10
(www.joslin.org). All rights reserved.
Snacks and Sweets
Everything in moderation
Enjoying a snack or a sweet treat is one of life’s pleasures. There are many            Nutrition Notes:
lower calorie, fat-free and lowfat treats to choose from. Keep in mind that
even fat-free or sugar-free foods still have calories, so it’s a good idea to           Choose sugar-free gelatin and
watch portion sizes.                                                                    pudding to save on fat and calories.

                                                                                        Enjoy sweets and desserts –
                          Choose                                 Go Easy                as an occasional treat – and in
                                                                                        small amounts!
 Snacks
 •   Baked potato or corn chips/unsalted pretzels   •   Potato or corn chips
 •   Light/reduced-fat popcorn                      •   Popcorn
 •   Reduced-fat crackers/rice cakes                •   Peanut butter/cheese crackers
 •   Lower-fat granola/snack bars                   •   Granola/snack bars/trail mix


 Sweets
 •   Fruit juice bars/popsicles/fudgesicles         • Ice cream/ice cream bars
 •   Sherbet/sorbet/light ice cream                 • Regular cookies/cakes/pies
 •   Fat-free pudding/gelatin
 •   Light or fat-free non-dairy whipped topping



Soups, Frozen Entrees and More
Read the label
Sometimes good nutrition is sacrificed for the sake of convenience. But you             Nutrition Notes:
can still find a quick, easy meal that isn’t laden with sodium and fat. How? Read
the food label! Also, remember that even frozen entrees don’t offer enough              Healthier frozen entrees have
vegetables, so add additional vegetables or a salad to fill you up. And the next        no more than about 400
time you eat pasta, look for a lower-sodium, low-saturated-fat variety – or try         calories, 15 grams of fat, and
your hand at making your own sauce. It really is quick and easy!                        600 milligrams of sodium.

                                                                                        Round-out frozen
                         Choose                                  Go Easy
                                                                                        entrees by adding a
 Soups                                                                                  green salad, a piece of
 • Lower-sodium broth-based soups                   • Regular broth-based soups         fruit and a glass of skim
 • Reduced-fat, lower-sodium                        • Cream-style soups and chowders    or lowfat milk or yogurt.
   cream-style soups                                • Regular bouillon cubes
 • Low-sodium bouillon cubes/packets                  or packets                        Try reduced-sugar or sugar-free
 • Lower-sodium bean-based chili and stews                                              fruit spreads in place of regular
                                                                                        jam or jelly to save calories.
 Frozen Entrees
 • Reduced-fat frozen entrees (no more              • Breaded or fried entrees
   than 400 calories per entrée)                    • Frozen pizza
 • Frozen veggie burgers

 Jarred/Canned Foods
 • Tomato-based spaghetti/marinara/pasta sauce      • Cream-style pasta sauce
 • Fat-free/reduced-fat gravy                       • Regular gravy
 • Jams and jellies



Copyright © 2010 by Joslin Diabetes Center, Inc.                                                                     11
(www.joslin.org). All rights reserved.
Joslin Publications
          Joslin publishes a variety of diabetes-related books, cookbooks and DVDs. Below are a
          few that may be of interest.

            Staying Healthy with Diabetes – Nutrition & Meal Planning
            Staying Healthy with Diabetes – Weight & Wellness
            Staying Healthy with Diabetes – Physical Activity & Fitness
            What You Need to Know About Diabetes – A Short Guide
            Joslin’s Guide to Managing Childhood Diabetes – A Family Teamwork Approach
            The Joslin Diabetes Quick and Easy Cookbook
            The Joslin Diabetes Healthy Carbohydrate Cookbook
            Joslin Cooks! Favorite Recipes & Food for Thoughtfrom the Staff of Joslin Diabetes Center
            Keep Moving...Keep Healthy with Diabetes – DVD

          To learn more about Joslin’s books, cookbooks and DVDs, visit online at www.joslin.org/store
          or call (800) 344-4501.




Copyright © 2010 by Joslin Diabetes Center, Inc.                                                         12
(www.joslin.org). All rights reserved.

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Heart-Healthy Shopping Guide

  • 1. Joslin’s Supermarket Smarts ™ Making Heart-Healthy Choices Aisle By Aisle Copyright © 2010 by Joslin Diabetes Center, Inc. 1 (www.joslin.org). All rights reserved. Distributed Courtesy of Unilever
  • 2. About Joslin Diabetes Center Joslin Diabetes Center is the world’s preeminent diabetes clinic, diabetes research center and provider of diabetes education. Joslin is dedicated to ensuring that people with diabetes live long, healthy lives and offers real hope and progress toward diabetes prevention and a cure for the disease. Founded in 1898 by Elliott P. Joslin, M.D., Joslin is an independent nonprofit institution affiliated with Harvard Medical School. For more information about Joslin, call 1-800-JOSLIN-1 or visit www.joslin.org. Copyright © 2010 by Joslin Diabetes Center, Inc. 2 (www.joslin.org). All rights reserved.
  • 3. Getting Started Making a few simple changes in your food choices can help keep your heart healthy and can also help you if you have diabetes or are controlling your weight. Even better – what’s good for you is also good for your whole family. You don’t have to buy special foods or cook special meals for yourself if the entire family eats the same way. Healthy eating is good for everyone! Tips for Easier and Healthier Shopping One way to get started with healthier shopping and eating is to have a few goals in mind. The goals are simple: • Eat the right types of fats. We need fat for overall health. But the type of fat makes a difference to heart health, and the total amount of fat we eat is also important. Eating too much of some types of fat (saturated fat, trans fat and cholesterol) can increase one’s risk of heart disease. • Eat more fiber. Fiber keeps the digestive tract healthy and can help lower the risk for heart disease. • Eat less sodium and salt. Too much sodium and salt in the diet can raise blood pressure. • Eat a variety of nutrient-rich foods. Choose a variety of nutrient-rich foods and beverages within and among the basic food groups. Examples include: fresh fruits and vegetables, whole grain cereals, brown rice and whole grain breads, along with fat-free and lowfat dairy products, legumes, poultry, lean meats and fish. Limit your intake of more refined and processed foods which tend to be higher in fat, sugar, calories and/or sodium. How do you do all this? One way is to learn how to read food labels. The second way is to use this booklet as a guide when making food choices in the grocery store. Let’s get started. Copyright © 2010 by Joslin Diabetes Center, Inc. 3 (www.joslin.org). All rights reserved.
  • 4. Label Reading One of the first steps to healthier eating is learning how to read the Nutrition Facts panel on the food label. There’s a lot of information on a food label – but the good news is that you don’t have to read all of it! For heart health, here are some of the most important sections of the food label to pay attention to: • Serving size. Always look at the serving size, which is found right at the top of the label, just underneath the Nutrition Facts title. A food item’s serving size might be larger or smaller than what you might be planning to eat. • Total fat. Fat is an essential nutrient. But eating too much can lead to weight gain and increase your risk of heart disease. Reading the Nutrition Facts label for total fat can help you limit your fat intake. Also, be sure to limit the intake of foods high in saturated and trans fat. • Saturated fat. Saturated fat is an unhealthy fat because it can raise blood cholesterol, especially LDL, or “bad” cholesterol. Try to limit foods high in saturated fat, such as butter, whole milk dairy foods and red meat, as much as possible. • Trans fat. Like saturated fat, trans fat (made by a process called hydrogenation) is an unhealthy fat. Trans fat can raise LDL cholesterol and lower HDL, or “good” cholesterol. Some margarines and snack foods contain trans fat. Look for 0 grams of trans fat on the food label. • Cholesterol. Saturated fat is more likely to raise your LDL cholesterol than the cholesterol found in food. But it’s still a good idea to limit your intake of cholesterol to no more than 300 milligrams (mg) per day. Only foods made from animal products contain cholesterol. • Sodium. Aim for no more than 2400 mg of sodium per day (about the amount in one teaspoon of salt). Low sodium foods are those with no more than 140 mg per serving. • Dietary fiber. Fiber is found in whole grain breads, cereals and pasta; fruits and vegetables; and beans and legumes. Aim for 20 to 35 grams each day. Choose foods with at least 3 grams of fiber per serving. Copyright © 2010 by Joslin Diabetes Center, Inc. 4 (www.joslin.org). All rights reserved.
  • 5. Shopping Tips • Shop the perimeter. For the most part, some of the healthiest foods in the grocery store are found along the perimeter, or outer sections. The produce section, meat, fish and poultry cases, and dairy sections are usually found along the perimeter of the store. • Shop from a list. Using a shopping list can make it easier to remember to buy healthier foods and can also limit “impulse” buying. A list can also help you stick to your food budget. • Shop after eating. If you go grocery shopping when you’re hungry, you might find it harder to resist tempting goodies, especially sweets and snack foods. Next, use the following food lists as a guide to making better food choices. Produce Nutrition Notes: Fruits, Vegetables, Nuts & Seeds: Choose more Whole fruits have more fiber The main message for fruits and vegetables? Eat more! In fact, aim to eat 5 to than fruit juice and contain 9 servings of different fruits and vegetables every day. It sounds like a lot, but less sugar. remember that fruits and vegetables are full of vitamins, minerals and fiber – Choose different colored fruits and they’re low in calories. Choose fresh or frozen fruits and vegetables whenever for the best nutrition. possible. While you’re at it, don’t forget to add dried beans, peas and lentils to your menu. They’re also high in fiber and other nutrients, including protein. To save money, buy fruits and They can add variety to your diet – and save you money at the same time! Nuts vegetables that are in season. and seeds are high in calories, so eating smaller amounts is the way to go. But, they’re full of heart-healthy fat, protein and fiber, too. Dark green and deep orange- colored vegetables tend to be Choose Go Easy rich in many nutrients. Leave the skin or the peel on Fruits • Fresh fruit • Frozen fruit packed in syrup whenever possible to boost • Frozen fruit without added sugar • Canned fruit packed in light the fiber content. • Canned fruit packed in juice or heavy syrup • Dried fruit • Yogurt/chocolate-covered dried fruit Try at least one meatless meal each week using dried beans, such as black beans and rice Vegetables • Frozen vegetables in cheese or vegetarian chili. • Fresh vegetables • Plain frozen vegetables or butter sauce Look for unsalted nut butters if • No-salt-added canned vegetables • Frozen French fries/onion rings • Dried beans, peas and lentils • Canned vegetables you need to watch your sodium intake. Nuts & Seeds Watch portion sizes • Unsalted nuts and seeds • Salted nuts and seeds of nuts and seeds • Natural (oil on top) peanut or other • Coconut because they’re nut butters high in calories. Copyright © 2010 by Joslin Diabetes Center, Inc. 5 (www.joslin.org). All rights reserved.
  • 6. Meats Meat, Poultry and Seafood: Choose light and lean Meats, poultry and seafood are the main protein foods in most people’s eating Nutrition Notes: plan. Beef, pork and lamb tend to be higher in saturated fat than poultry and fish, so it’s important to not only choose leaner cuts of meat, but also limit Trim away any visible fat portion sizes to between 3-6 ounces. Seafood, especially fatty fish, contains a before cooking. type of heart-healthy fat called omega-3 fatty acids, so aim to eat fish at least twice a week. Use lowfat cooking methods, such as grilling, broiling or roasting. Choose Go Easy Select grades of Beef/Pork/Lamb/Veal meat that are the • Loin cuts, such as tenderloin • Rib eye, T-bone cuts, ribs leanest; choice and sirloin • Less than 90% lean ground beef grades of meat have • Round (eye of round, top round) • Ground pork, ground lamb a moderate amount • 90% (or higher) lean ground beef • Organ meats (kidney, liver, heart) of fat; and prime cuts • Extra-lean ham of meat are the fattiest cuts. • Soy crumbles Aim to limit red meat intake to no Poultry • Chicken or turkey with skin/duck more than 2-3 times per week. • Chicken or turkey breast, no skin • Fried chicken Look for cold-cuts and processed • Ground chicken or turkey breast • Ground chicken or turkey meats with no more than 3 grams of fat per ounce. Seafood • Fatty fish (salmon, • Fried or breaded seafood Try to choose lower-sodium tuna, halibut, cold-cuts, if they’re available. mackerel) • Shrimp and shellfish Add tomato slices and green leaf lettuce to help “bulk up” your sandwiches. Deli Meats/Processed Meats Balancing convenience with nutrition Believe it or not, you can find healthy selections at the deli counter. Lean deli meats include turkey and chicken breast, lean roast beef and lean ham. Save even more fat on cold-cut sandwiches by using mustard instead of mayonnaise. Choose Go Easy • Turkey/chicken breast • Regular cold-cuts • Lowfat cold-cuts (95-99% fat-free) • Hotdogs • Lite/reduced-fat hotdogs • Sausage • Canadian bacon • Bacon • Vegetarian hotdogs, sausage, bacon • Tofu Copyright © 2010 by Joslin Diabetes Center, Inc. 6 (www.joslin.org). All rights reserved.
  • 7. Dairy Foods Milk, Yogurt and Eggs: Aim for non-fat and lowfat There are a lot of options in the dairy case to help you meet your heart-healthy Nutrition Notes: goals. For example, milk and yogurt are excellent sources of calcium and Use fat-free evaporated skim protein, but whole-milk versions are high in saturated fat. The solution? Choose milk or fat-free half and half non-fat or lowfat varieties. Eggs are a very nutritious food, and even though instead of cream. they contain cholesterol, you can still fit them into your eating plan – up to 3 yolks per week is fine. Gradually switch from whole milk to 2% milk Choose Go Easy to 1% milk to skim milk – the change Milk and Cream in flavor and • Skim (nonfat) or 1% (lowfat) milk • Whole milk/reduced fat (2%) milk consistency will be • Fat-free evaporated milk • Whole evaporated milk less noticeable. • Non-fat or lowfat soy or rice milk • Light, heavy or whipping cream • Fat-free half and half/ • Half & half/nondairy creamer Fruited yogurts tend to be higher nondairy creamer in calories than plain yogurt. Sweeten plain yogurt with fresh Yogurt • Whole milk yogurt or canned fruit. • Fat-free or lowfat yogurt • 2% Greek-style yogurt Brown eggs contain Sour cream the same calories and • Fat-free or light sour cream • Regular sour cream nutrients as white eggs. Eggs • Egg whites or egg substitutes • Whole eggs (more than 3 per week) Cheese It’s hard to resist a slice of cheese; fortunately, you don’t have to. Despite Nutrition Notes: being high in saturated fat, cheese contains nutrients such as protein and cal- Look for cheeses with no more cium. Today there are many types of lower-fat cheeses to choose from, and, in than 3 grams of fat per ounce. most cases, you’ll hardly notice a difference in flavor from the full-fat version! Save money and Choose Go Easy calories by using small amounts of Cottage/Ricotta cheese • 4% or 2% milk-fat cottage cheese stronger cheese • Fat-free/lowfat cottage cheese • Fat-free/light/part-skim ricotta • Whole-milk ricotta cheese (blue, sharp cheddar, parmesan). The lower the fat content of Cream cheese/Spreadable cheese the cheese, the harder it is to • Fat-free/light cream cheese • Cream cheese cook with. • Goat or feta cheese • Whipped cream cheese • Light spreadable cheese • Cheese spread Hard cheese • Light or reduced-fat cheese • Regular hard cheese • Light string cheese • Whole-milk mozzarella Copyright © 2010 by Joslin Diabetes Center, Inc. 7 (www.joslin.org). All rights reserved.
  • 8. Breads, Cereals and Grains Breads and Baked Goods: Go for the grain There are plenty of healthy whole-grain, high-fiber breads and rolls to choose from in the supermarket. Whole-grain breads and baked goods are packed with fiber, vitamins, minerals and antioxidants. Most of them are low in saturated fat, too. Nutrition Notes: Choose Go Easy Choose breads and Breads, Rolls, Bagels, Tortillas rolls with the words • White bread/rolls/biscuits • Whole-grain (whole-wheat, rye, “whole-wheat” as the • Cheese or garlic bread pumpernickel, oatmeal) bread, first ingredient. • Quick breads (banana, date nut, rolls, English muffins, bagels corn, etc.) • Whole-wheat/corn tortillas Look for breads that contain at • Tortillas made with lard least 2-3 grams of fiber per slice. Muffins and Pastries • Fat-free/lowfat muffins • Muffins/croissants/scones/pastries Limit oversized bagels, muffins • Angel food cake • Doughnuts/crullers and sandwich rolls. Pancakes, Waffles and French Toast • Lowfat/reduced-fat pancakes • Frozen French toast and waffles • Frozen waffles • Whole-grain pancakes, waffles, French toast Cereals, Grains and Pasta: Go for the grain Nutrition Notes: Just as you might choose whole-grain bread for your morning toast or lunch- time sandwich, don’t forget to go for whole-grain cereals and pasta for the Choose cereals with at least 3 same nutrition benefits. Add more variety to your meals by not only choosing grams of fiber and no more than brown rice, but also trying other healthy grains, such as quinoa, barley and 3 grams of fat per serving. couscous. Limit cereals that list sugar as the first or second ingredient. Choose Go Easy Instant hot cereals tend to be Cereals higher in sodium • Whole-grain, high-fiber • Sugar-coated cereals than the regular cold cereal • Cereals made with saturated • Oatmeal/oat bran versions. or trans fat Packaged, Grains • Brown rice, wild rice • Packaged rice/grain mixes seasoned rice • Barley, bulgur, quinoa, kasha • Rice or other grains made with and pasta mixes are usually • Whole-wheat couscous butter, cheese or cream sauce high in sodium. Use one fourth to one half of the seasoning packet Pasta when preparing. • Whole-grain/whole-wheat pasta • Packaged pasta mixes • Spinach pasta • Pasta made with butter, cheese Brown rice has nearly three • Yolk-free noodles or cream sauce times the fiber of white rice. • Ramen noodles • Canned pasta Copyright © 2010 by Joslin Diabetes Center, Inc. 8 (www.joslin.org). All rights reserved.
  • 9. Butter/Margarine/Soft Spreads Nutrition Notes: Go for the “good” fats Try a soft spread that contains Skip the butter, since it’s high in saturated fat, or else use a very small amount. plant sterols to help lower your And stick margarine may contain both saturated fat and trans fat. A better cholesterol. option is a soft spread (also referred to as a soft, vegetable oil tub spread), The more solid a margarine which provides a source of monounsaturated and polyunsaturated “good” is, the more saturated fat it fats and a delicious buttery taste - with 70% less saturated fat than butter, and contains. no trans fat. Some even contain ingredients such as plant sterols (natural plant ingredients that can lower LDL cholesterol) for an additional heart-healthy Light tub spreads are best benefit. Try different kinds until you find the one that tastes good to you. used on toast, bagels and vegetables; they’re not meant Choose Go Easy for cooking or baking. Butter/Margarine/Soft Spreads • Trans-fat-free tub soft spread or squeeze margarine • Butter • Tub soft spread with plant sterols • Stick margarine Prepared Foods Try not to sacrifice health for convenience. Prepared foods in the grocery store are quick and easy, but many of them are high in calories and unhealthy fats. Nutrition Notes: Stock up on salads and cooked vegetables and make them the basis for a healthy, take-home meal. Stock up on fresh vegetables and fruits at the salad bar. Choose Go Easy Use skinless rotisserie chicken • Rotisserie chicken (no skin) • Fried chicken, chicken wings breast to make sandwiches or • Sushi • Mayonnaise-based salads to add to soups and stews. • Green salad/fruit salad (potato, macaroni) • Oil-based pasta salad • Hummus Copyright © 2010 by Joslin Diabetes Center, Inc. 9 (www.joslin.org). All rights reserved.
  • 10. Oils, Mayonnaise, Salad Dressings Oils, mayonnaise and salad dressings can definitely be part of a heart-healthy Nutrition Notes: eating plan. The key is to choose liquid vegetable oils rather than fats that are solid at room temperature (such as shortening and butter), and to use either All fats, even lower-fat versions of mayonnaise and salad dressings, or just small amounts of healthy ones, are the regular versions. high in calories, so use them sparingly if your goal is to Choose Go Easy lose weight. Oils Even fat-free dressings and • Vegetable oils (canola, peanut, olive, • Shortening and lard mayonnaise still contain calories. corn, sunflower, safflower, soybean, • Coconut/palm/palm kernel oil flaxseed) • Salt pork Drizzle flaxseed oil on your salad • Non-stick cooking sprays or vegetables or dip your bread into a small amount of it. But Mayonnaise don’t use flaxseed oil in cooking • Fat-free/light mayonnaise • Regular mayonnaise or baking. Salad Dressing • Fat-free/lowfat/light salad dressing • Creamy-style dressings • Balsamic/wine vinegar • Regular salad dressings Beverages Empty calories or nutrient-rich? Water is one of the healthiest beverages to drink. But when you’re looking for Nutrition Notes: more flavor and variety, try to choose beverages that are not high in calories and added sugars such as high-fructose corn syrup. One hundred percent fruit Choose decaffeinated coffee, tea juice contains many of the same nutrients as the fruit itself, but tends to be and herbal teas if you need to higher in calories, so limit your intake to no more than one serving (4 fl. oz.) or limit caffeine. try a light-style juice. Use skim or lowfat milk to make cocoa or to add to tea Choose Go Easy and coffee. • Water (bottled, seltzer, sparkling) • Tonic water • Coffee, tea (plain, unsweetened) • Regular soda • Diet tonic water • Sugar-containing flavored water/ • Diet soda enhanced water • Diet ice tea • Energy/sports drinks • Sugar-free soft drinks • Fruit smoothies made with regular • Fruit smoothies made with yogurt lowfat yogurt • Sweetened iced tea, coffee drinks • Lowfat coffee drinks (latte, cappuccino) • Low-sodium vegetable juices • Vegetable juices • 100% fruit juice (limit to one serving • Fruit juice drinks, punches, blends, or 4 ounces per day) or cocktails • Sugar-free cocoa mixes • Cocoa mixes Copyright © 2010 by Joslin Diabetes Center, Inc. 10 (www.joslin.org). All rights reserved.
  • 11. Snacks and Sweets Everything in moderation Enjoying a snack or a sweet treat is one of life’s pleasures. There are many Nutrition Notes: lower calorie, fat-free and lowfat treats to choose from. Keep in mind that even fat-free or sugar-free foods still have calories, so it’s a good idea to Choose sugar-free gelatin and watch portion sizes. pudding to save on fat and calories. Enjoy sweets and desserts – Choose Go Easy as an occasional treat – and in small amounts! Snacks • Baked potato or corn chips/unsalted pretzels • Potato or corn chips • Light/reduced-fat popcorn • Popcorn • Reduced-fat crackers/rice cakes • Peanut butter/cheese crackers • Lower-fat granola/snack bars • Granola/snack bars/trail mix Sweets • Fruit juice bars/popsicles/fudgesicles • Ice cream/ice cream bars • Sherbet/sorbet/light ice cream • Regular cookies/cakes/pies • Fat-free pudding/gelatin • Light or fat-free non-dairy whipped topping Soups, Frozen Entrees and More Read the label Sometimes good nutrition is sacrificed for the sake of convenience. But you Nutrition Notes: can still find a quick, easy meal that isn’t laden with sodium and fat. How? Read the food label! Also, remember that even frozen entrees don’t offer enough Healthier frozen entrees have vegetables, so add additional vegetables or a salad to fill you up. And the next no more than about 400 time you eat pasta, look for a lower-sodium, low-saturated-fat variety – or try calories, 15 grams of fat, and your hand at making your own sauce. It really is quick and easy! 600 milligrams of sodium. Round-out frozen Choose Go Easy entrees by adding a Soups green salad, a piece of • Lower-sodium broth-based soups • Regular broth-based soups fruit and a glass of skim • Reduced-fat, lower-sodium • Cream-style soups and chowders or lowfat milk or yogurt. cream-style soups • Regular bouillon cubes • Low-sodium bouillon cubes/packets or packets Try reduced-sugar or sugar-free • Lower-sodium bean-based chili and stews fruit spreads in place of regular jam or jelly to save calories. Frozen Entrees • Reduced-fat frozen entrees (no more • Breaded or fried entrees than 400 calories per entrée) • Frozen pizza • Frozen veggie burgers Jarred/Canned Foods • Tomato-based spaghetti/marinara/pasta sauce • Cream-style pasta sauce • Fat-free/reduced-fat gravy • Regular gravy • Jams and jellies Copyright © 2010 by Joslin Diabetes Center, Inc. 11 (www.joslin.org). All rights reserved.
  • 12. Joslin Publications Joslin publishes a variety of diabetes-related books, cookbooks and DVDs. Below are a few that may be of interest. Staying Healthy with Diabetes – Nutrition & Meal Planning Staying Healthy with Diabetes – Weight & Wellness Staying Healthy with Diabetes – Physical Activity & Fitness What You Need to Know About Diabetes – A Short Guide Joslin’s Guide to Managing Childhood Diabetes – A Family Teamwork Approach The Joslin Diabetes Quick and Easy Cookbook The Joslin Diabetes Healthy Carbohydrate Cookbook Joslin Cooks! Favorite Recipes & Food for Thoughtfrom the Staff of Joslin Diabetes Center Keep Moving...Keep Healthy with Diabetes – DVD To learn more about Joslin’s books, cookbooks and DVDs, visit online at www.joslin.org/store or call (800) 344-4501. Copyright © 2010 by Joslin Diabetes Center, Inc. 12 (www.joslin.org). All rights reserved.