Healthy Snacking at the Corner Store A Healthy Corner Store Program Curriculum for Middle School-Age Youth Facilitator’s Guide D.C. Hunger Solutions 2009 The Healthy Corner Store Program is funded by the District of Columbia, Department of Health, Community Health Administration. D.C. Hunger Solutions Points of view or opinions in this publication are those of D.C. Hunger Solutions and do not necessarily represent official positions or policies of the Department of Health. Acknowledgements The D.C. Healthy Corner Store Program is supported by the District of Columbia Department of Health, Community Health Administration. Points of view or opinions in this curriculum are those of the authors and do not necessarily represent official positions or policies of the Department of Health. This curriculum was prepared by D.C. Hunger Solutions staff Kristin Roberts, with assistance from Alexandra Ashbrook and D.C. Hunger Solutions intern Kendra Tolbert. D.C. Hunger Solutions thanks the following partners for their contributions to this curriculum: • Dr. Dawanna James-Holly, D.C. Office of the State Superintendent of Education, for reviewing the curriculum and providing comments; • Maurice Hill, Ward 7 Arts Collaborative, for designing the “I buy healthy foods” postcard; • Students and staff of Freedom Youth Academy and Boys and Girls Clubs of Greater Washington-FBR Branch for piloting the curriculum; • Dr. Joel Gittelsohn, Center for Human Nutrition, Bloomberg School of Public Health and director of the Baltimore Healthy Stores program; and • Staff at The Food Trust of Pennsylvania. Questions about this curriculum may be forwarded to D.C. Hunger Solutions (info@dchunger.org). Lesson 1: Using the 10% Rule Time: about 1 hour Lesson Outline Preparation: Fill two drinking glasses with sugar in preparation for “What’s Hiding in Your Soda?” Instructions are listed in Part 2. I. Introduction (10 minutes) II. What’s Hiding in Your Soda? (5-10 minutes) III. How to Tell If a Snack or Drink is Healthy (15 minutes) IV. Would You Buy That Snack? (15-30 minutes) V. Summary (5 minutes) Materials Needed □ Pre-Test Survey □ Two 20-ounce soda bottles (1 cola, 1 clear) □ 4 drinking glasses (two empty; one containing 15.5 teaspoons sugar for cola; one containing 18.5 teaspoons sugar for clear soda) □ 1 measuring teaspoon □ Bag of sugar □ Apple (or photo of an apple – Attachment A) □ One bag of butter popcorn (or photo of popcorn – Attachment A) □ Several healthy snack food and drink packages with Nutrition Facts labels visible – 1 snack/ drink per group of 3 participants (examples: 100% juice; pretzels; granola bars; low-fat milk; raisins) □ Paper □ Pencils □ Copies of handouts: • • Handout 1: “The 10% Rule” Handout 2: “Would You Buy that Snack?” Objectives By the end of this lesson, participants will be able to: • Recognize how much sugar and how many calories a soda contains. • Identify three key terms on a Nutrition Facts label and use the label to decide whether a food is healthy. • Compare and contrast different Nutrition Facts labels. • Investigate and analyze the role of advertising in influencing our food choices. Conversion key for measuring the amount of sugar in the sodas you use: 1 teaspoon of sugar = 4.2 grams of sugar Lesson 1: Using the 10% Rule I. Introduction (10 minutes) A. Overview of the Program (3 min.) Briefly introduce the Healthy Snacking at the Corner Store program to the participants. The introduction can include the following points, as applicable: • We are beginning a program where you [participants] will learn how to pick the snacks and drinks that are good for you and help keep you healthy and strong. • This program consists of four lessons that we will be teaching this week [or over the next few weeks]. • I / We [the instructors] think this program is important because … • This program is part of the Healthy Corner Store Program, which we will talk about over the next few lessons. • Most importantly, we will have fun! B. Introductory / ice-breaker game (3 min.) Ask participants to complete the following sentence: “If I were a fruit, I would be a _____________ because _________________.” Example: If I were a fruit, I would be a peach because I am sweet. C. Pre-test survey (3-5 min.) Distribute one survey to each participant. Ask participants to write their first names on their surveys. Tell the participants that this is not a test, but a survey (which will be repeated at the end of the four lessons) to find out what they learned during the Healthy Snacking Program and what they thought of the program. Collect the surveys when participants are finished and keep them until the end of the program. Pre-test survey results will be compared with post-test surveys to measure change in NOTE: participants’ knowledge about healthy snacking. II. What is Hiding in Your Soda? (5-10 minutes) Bring out one 20-ounce bottle of a cola and one 20-ounce bottle of clear or light-colored soda. Ask participants if they think the sodas are healthy or unhealthy. TIP: Participants are likely to think that soda is unhealthy but unable to identify exactly why. Tell participants: We are going to find out for sure. What’s really inside these soda bottles? Ask for a participant to come forward. Ask that participant to measure the amount of sugar he/she thinks is in the cola, but by scooping sugar into an empty glass with a teaspoon. Count out loud each scoop of sugar. Tell the rest of the group to advise the participant when to stop. Lesson 1: Using the 10% Rule NOTE: 1 teaspoon of sugar = 4.2 grams of sugar Ask the same participant to scoop into a different glass the amount of sugar he/she thinks is in the clear/light soda. Count out loud each scoop of sugar. Tell the rest of the group to advise the participant when to stop. Participants might believe the cola has more sugar. If that is the case, ask them why they believe one soda has more sugar than the other. Next, bring out the glasses with the pre-measured amounts of sugar that accurately represent the amount of sugar in the sodas, and compare the pre-filled glasses to what the participant spooned out. (Typically, 15.5 teaspoons are in cola and 18.5 teaspoons are in clear/light-colored soda.) If the participants assumed the dark soda had more sugar, explain to them dark and light sodas are similar in their ingredients and amounts of ingredients, including sugar. The main difference is the amount of food dye. Inform participants that this amount of sugar (16 teaspoons) is already more than 3 times the recommended amount that children should consume each day. Debrief reactions to this activity with the following questions: • Did it surprise you that the soda contained this much sugar? • What would happen if you had one 20-ounce soda every day? Answer: Each 20-ounce bottle of cola contains about 65g of sugar or 15 ½ teaspoons. If you had one bottle every day, that would be equal to eating 52 pounds of sugar a year! That is three times as much sugar as a kid should have in a year. • Why should you avoid consuming excessive sugar? Answer: Sugar contains calories, which we will learn more about in this program. Too much sugar can lead us to consume excess calories, which can make us gain weight. Being overweight or obese is unhealthy. It can lead to diabetes, heart disease, and asthma. Too much sugar can cause cavities, too. • Why else might drinking too much soda be unhealthy? Answer: For many children, when they drink a lot of soda, they tend to skip healthier drinks. • What are some healthier drinks that you could have instead of a soda? Answer: Water; 100% juice; low-fat (1%) or skim milk (it’s okay to have chocolate or strawberry milk sometimes, too); vegetable juice; sugar-free flavored water. • How much money would spend in a year if you had one 20-ounce. soda each day? Answer: A brand name soda typically costs $1.30 at the corner store. $1.30 a day x 365 days a year = $474.50. Imagine what else you could spend $475 on … Inform participants that many of these alternatives to soda are available in corner stores, often about the same price as a soda, and that they can pick a different – healthier – drink when they’re feeling thirsty. If participants include sports drinks among the healthier alternatives to soda, explain that TIP: many people think sports drinks are healthy. However, although these drinks usually contain less sugar than soda, they rarely contain much fruit juice, and rarely are sugar-free. Lesson 1: Using the 10% Rule Talking points and answers to other common questions: • It is important not to make any children in the group – especially those who are overweight – not feel singled out in any way. This first talking point is important to set the tone for the discussion: Weighing too much is something that all Americans can struggle with, no matter how old they are or how much money they have. We all need to be careful to have good nutrition and get enough physical activity. • Compared to other states, Washington, D.C., has the highest rate of overweight children ages 10-17 – 22.8% of children. • East of the Anacostia River – in D.C.’s Wards 7 and 8 – overweight and obesity rates are higher than in most other Wards of the city. • Even for children who are not overweight, good nutrition is important for overall good health, feeling good and having lots of energy every day, and doing well in school and other activities. III. How to Tell if a Drink or Snack is Healthy (15 minutes) A. Discussion (3-5 min.) Inform participants that although we want to be healthy and make healthy food and drink choices, sometimes it’s hard to figure out which foods and beverages are healthy or which ones are not so healthy – and why. Hold up an apple (or photo of an apple – Attachment A) and ask if participants think an apple is a healthy snack. Ask them: Why or why not? Answers might include: “An apple is healthy snack because we need to eat fruit each day. Fruit contains vitamins and no preservatives.” Hold up the bag of butter popcorn (or a photo of popcorn – Attachment A), and ask students if they think it is healthy, and why or why not. Answers might include: “Popcorn is unhealthy because it is too salty,” or “popcorn is healthy because it is low-fat.” Ask participants to share ideas on how you determine a food is healthy and good for you. Answers might include: • Talk to people you trust • Ask a doctor • Learn about it in a school health class • Research it online • Read a label • Ask a health professional • Look at USDA’s MyPyramid Tell students (if this answer has not already been volunteered) that one key way to figuring out whether a food or drink is good for you is to read the Nutrition Facts label on the package. Mention that laws require food companies to label Nutrition Facts and Ingredients on all products. More information about MyPyramid (formerly called the Food Guide Pyramid) and MyPyramid for Kids, for children ages 6-11, is at www.mypyramid.gov. Lesson 1: Using the 10% Rule Note: Different laws apply for fresh fruits and vegetables, so you won’t always be able to find a label to tell you about an apple or banana or other fresh fruits and veggies. Typically, there are no labeling requirements for food in restaurants. Some cities have requirements for restaurants to put nutrition information on menus. D.C. is considering a menu-labeling law like that. Ask participants if they think that having labels on food packages is a good idea. Answers might include: Yes,agoodidea x x x No,abadidea Helps consumers make good choices Encourages food companies to put in healthy ingredients Helps protect against false advertising, since companies can’t claim a food is low-fat if the label shows that the product is high in fat x x x x Labels are too complicated Most people don’t read them anyway Most eating/purchasing decisions are based on advertising It costs too much money and the money would be better spent elsewhere Ask participants to identify what information on the label would help them determine whether the popcorn is healthy or unhealthy. Tell participants: One easy way to judge whether a food or drink is a healthy choice is to use the 10% Rule. To use the 10% Rule, you need to read the Nutrition Facts label and pay special attention to the % Daily Value column on ithe right-hand side. B. Activity: Practicing the 10% Rule (10 min.) Distribute Handout: “The 10% Rule” and use the handout to guide the discussion. (Participants can name a hypothetical product to go with the label.) Referring to the handout, ask participants which things on the Nutrition Facts label they should eat a lot of, and which things they should avoid eating too much of. (Do this part quickly; participants can call out answers.) Thank participants for their answers, and tell them they are going to learn The 10% Rule – an easy way to use all that information on the label. Make sure not to get too technical. Participants do not need an in-depth understanding of TIP: each nutrient on the label – just enough to understand how to use the different nutrients to decide if a food is healthy or not. Go through the label fairly quickly so participants do not get bored. The 10% Rule was developed by Dr. Joel Gittelsohn, Center for Human Nutrition, Bloomberg School of Public Health, Johns Hopkins University. Dr. Gittelsohn directs the Baltimore Healthy Stores program. Lesson 1: Using the 10% Rule The 10% Rule Explain how the 10% Rule works. The 10% Rule is a quick and easy way of reading a Nutrition Facts label – especially useful in a corner store, where you’re going in and out and making quick decisions. You check the label to see if the food or drink contains 10% or more of your Daily Value of “good” nutrients (like fiber and vitamins) and 10% or less of your Daily Value of “bad” nutrients (like fat and sodium). Tell participants to follow these step-by-step instructions: 1. Locate the Serving Size and Servings Per Container lines (highlighted in the blue bubble on the handout.) Ask: How many servings are in this product? Answer: There are two. Ask: How many servings does the information on the label refer to? Answer: All of the information on the label refers to one serving. This can be tricky – all the amounts listed on the Nutrition Facts label must be multiplied by the number of Servings Per Container if you consume the entire package. 2. Locate the next line on the label: Calories. A good rule of thumb for using calorie content to judge whether a snack or drink is healthy is to look for snacks with 200 cal or fewer per serving. Ask participants how many calories are in one serving of the food whose label is on “Using the 10% Rule.” (Answer: 250.) Ask: Based just on the calorie count, is this a healthy snack? Answer: No. 3. Locate the % Daily Value column, and put your finger on it. [Go around the class and make sure all participants have located the column.] 4. Locate the green area on the label handout. This is the “Get More” category. In this section we want to look for 10% or more. 10% or more is high (good). Less than 10% is low (bad). The nutrients in this category are dietary fiber, vitamins, and minerals. These keep us healthy and strong. We usually do not eat enough of these. 5. Now locate the red area on the handout. Everything in the red box is the “Look for Less” category. In this box, we want 10% or less of Daily Value. 10% or less is low (good). More than 10% is high (bad). The nutrients in this category are total fat, saturated fat, cholesterol, and sodium (salt). Sometimes a label also includes trans fat. When we eat these too much and too often, they can put us at risk for obesity or disease. 6. Since there is not a % Daily Value for how much sugar you should eat each day, an easy guide is to look for 10 grams of sugar or less. Ask for a volunteer to come to the front and practice using the 10% Rule with the bag of butter popcorn or any other food package you have available. Quickly remind the participants which nutrients are part of the “Get Less” (bad) category TIP: (10% or less): total fat, saturated fat, cholesterol, sodium, and trans fat (if listed). Remind them which nutrients are part of the “Get More” (good) category (10% or more): dietary fiber, vitamins and minerals. Guide the volunteer participant through reading and evaluating each line on the label. Ask the participant to read aloud the % Daily Value for each nutrient. Ask the class if each nutrient meets The 10% Rule. After the entire label has been completed, ask the class if the snack is overall good or bad. Calorie criteria for healthy snacks based on calorie count criteria developed by The Food Trust for single-serving snacks. Lesson 1: Using the 10% Rule Tell participants: Most foods don’t perfectly fit the definition of “healthy” or “unhealthy.” You can use The 10% Rule to pick the best choice out of the snacks available when you’re in the store, or at the vending machine. You might pick the one that’s lowest in fat, salt, or sugar or the one that’s highest in calcium or fiber. Background information on the Nutrition Facts label: TIP: • Calories – the amount of energy in the food. An average adult diet is 2,000 calories per day. A 20-oz. cola has 250 calories. • Serving Size and Servings Per Container – This can be tricky because sometimes what looks or feels like a single serving of a drink or food is actually two or more servings. (Many 99-cent bags of chips, for example, contain two or three servings in one bag that feels like a single-serving size.) If you consume the whole package, you need to do some math to find out the amount of calories, fat, etc. you are consuming. • Total fat – there are “good” fats and “bad” fats. Total fat tells you how many grams of fat are in one serving. • Saturated fat and trans fat – These are the bad fats. Too much of these fats can raise the cholesterol levels in your blood, which can lead to heart disease or stroke. We should limit the amount of these fats that we eat. • Cholesterol – This is a substance that your body produces naturally and is also found in foods. Eating too much cholesterol can lead to health problems, including heart disease and stroke. We should limit the amount of cholesterol we eat. • Sodium – Sodium is salt. We should stay away from too much sodium in our diets. It can lead to high blood pressure. • Total Carbohydrate – This category includes the amount of sugar and dietary fiber in a food. • Dietary Fiber – Dietary fiber is good for us. It lowers cholesterol and keeps us regular. • Sugars – As discussed in the soda demonstration, eating too much sugar can be bad for our health for a variety of reasons. • Protein – Protein is important for energy and rebuilding our cells. Most people usually get enough protein. • Vitamins and Minerals – These are very important to our health. Most people do not get the amount of vitamins and minerals we need in a day. Make sure to eat foods high in vitamins and minerals. • Ingredients: The ingredients in the food or drink are listed in order of weight in the package, starting with the largest amount. More background about sugar: If participants are interested in knowing more about sugar, point out that not all foods and drinks with sugar are created equal. Tell participants: you may notice that 100% juice has sugar in it, too. This sugar is different from the sugar found in soda and juice cocktails. The sugar found in 100% juice is the sugar found naturally in all fruits and vegetables. The sugar found in soda and other drinks is added sugar. It is usually a syrup or processed white sugar. This is the sugar we want to avoid. You can tell if a food has added sugar by looking at the Ingredients section on the Nutrition Facts label. If there is added sugar, you will see it in the ingredients list. Added sugar can be called “sugar” or Lesson 1: Using the 10% Rule “syrup,” or it might even have a fancy name, the scientific name for a sugar. But you can figure out if it is sugar: if it ends in ose, “-o-s-e,” then it is an added sugar. One common example is high-fructose corn syrup. IV. Would You Buy That Snack? (15-30 minutes) Ask participants: Besides the Nutrition Facts label, how else do we decide what foods to eat or what drinks to drink? Guide participants toward this answer: Food and drink companies advertise their products to us all the time, in many places. The purpose of advertising is to persuade customers – that’s us! – to buy a product and to make people think it will taste good. Advertising also gives customers information about products. Ask participants: What are some places that you see or hear advertising for foods or drinks? Answers might include: on billboards, on TV or radio, on food packages, in stores, on the Internet Ask participants to think of a slogan or an advertisement for a food or beverage. Share about five responses. Possible examples: • McDonald’s: “I’m lovin’ it.” • Sprite: “Image is nothing, taste is everything. Obey your thirst.” • Lay’s potato chips: “Betcha can’t eat just one.” • Subway: “Eat fresh!” • Taco Bell: “Think outside the bun.” Ask participants to identify common devices used to advertise a product. Answers can include: • A jingle – a catchy phrase that is easy to remember and set to a tune • A celebrity or cartoon character endorsement • An exaggerated claim about the product. Example: “This is the best pizza in the city.” (A company cannot say something false like “this pizza will help you lose weight” if the pizza will not do that. However, you can “puff-up” your product.) • Use of attractive, happy people. (“If use this product, you will be like them.”) Ask participants: What kind of food do you think is advertised most? And to whom? Why or why not? Guide them toward this answer: most food advertising you encounter is promoting junk food, and much of it is directed toward children and teenagers. A few stats on food advertising: TIP: • Food companies spend about $10 billion per year advertising food to children (Center for Science in the Public Interest) Lesson 1: Using the 10% Rule • 80% of foods advertised on commercials during TV shows intended for children are for convenience/fast foods and sweets (CSPI) • In 2004, almost $7 billion was spent on advertising for snacks, beverages, and candy. A little less than $5 million was spent advertising the 5 A Day fruit and vegetable campaign (Consumers Union) Ask participants: Do you think food advertising works? Answers might include: • Yes, I buy foods that I see commercials for. • No, I don’t care what the commercials say. I eat what I like. Tell participants: We’re going to test some advertising ourselves. Explain that in a moment they will be working in pairs (or teams of up to five participants if you have a big class) to help a company launch a new type of healthy snack for children/teens. They will have an opportunity to create an advertisement for the company and should use some of the advertising devices that were just discussed. Divide participants into pairs or small groups. Give each team a healthy snack or drink product with Nutrition Facts label visible in preparation for the Would You Buy That Snack? activity. Choose healthy items according to The 10% Rule. TIP: Examples of healthy products for the advertising activity: Snacks x x x x x x x x x Drinks Fruit (e.g., banana, orange) Vegetables (e.g., baby carrots) Granola bars (low-fat) Pretzels (low-salt and regular) Low-salt chips Baked chips Unsalted nuts No-sugar trail mix Dried fruit x x x Water 100% juice Low-fat milk (plain and flavored) Distribute Handout 2: Would You Buy That Snack? Read the instructions aloud and tell participants they will have five minutes (or longer, depending on the time available) to complete the activity and prepare their advertisement. Tell students to be prepared to present the name of their snack and the advertisement they create. (The assignment says they need to present to their boss and a group of kids. This class is the group.) Circulate around the room as the teams are preparing. After ten minutes, ask each team to present their advertisements with the rest of the class. TO INSTRUCTOR: Usually, the snacks and drinks that are least healthy are available from NOTE most corner and convenience stores, while the healthier choices are not typically as available in corner stores. Lesson 1: Using the 10% Rule After each team presents, ask the team: • What are the healthy features of your product that you were advertising? • Do you think your advertising will impact whether people want to buy this product? Why? And ask the audience: • What did you like about the advertisement? • Would you buy their snack? Why or why not? After all the teams have shared their advertisements, ask: • Which of the snacks have you seen in a corner store? • Why do you think corner stores carry mostly unhealthy snacks? Explain that in the next three sessions, we will be talking more about why it’s hard to find healthy snacks in the corner store, and what we can do to change that. V. Summary (5 minutes) Check for understanding of the session, by asking: • Did you learn anything that surprised you today? • Please share three important things to look for when you read a Nutrition Facts label. • How can you decide if a snack is good for you or not so good? • What did you learn about advertising? (If necessary, guide students toward the answer that advertising influences what consumers buy, and there is much more advertising for unhealthy foods and drinks. Sometimes advertising can mislead you to think that a food is healthy when it’s really not so healthy.) Sources – Lesson One • Dietary Guidelines for Americans 2005. • U.S. Department of Agriculture. (Handout #1 – “The 10% Rule” – is adapted from the USDA Team Nutrition “Read It Before You Eat It” poster.) Lesson 1: Using the 10% Rule 10 Handout 1 Using The 10% Rule … Use the Nutrition r be m n u s! e g h k t rvin c e e C h of s Facts label to find a healthy choice … ��������������� ������������������������� ������������������������ ������������������ ������������ ��������������������� ������������� �������������� ��� ���������������� �������������� ���������������� Get MORE ��� 10% or LESS is good! ��� ������������ ��� ���������������������� ��� ���������������� ��������� 10% or MORE is good! Get LESS �� 10g or LESS is good! ���������� 10% or MORE is good! ���������� �� ��������� �� �������� ����� ��� �� � ������������������������������������������������������� ����������������������������������������������������� ������������������� ��������� ����� ����� ��������� ��������� ��� ��� ������� ����������� ������ ������������������ ������������� ��������� ��������� ��������� ��� ����� ������� ���� ��� Get MORE ��� ����� ������� ���� ��� Get LESS These are good for your health! Too much of these can be bad for your health. Look for 10% or MORE Daily Value of: Look for 10% or LESS Daily Value of: * Dietary Fiber * Calcium * Fats * Vitamin A * Iron Look for 10g or LESS of: * Vitamin C * Sodium * Cholesterol * Sugar The 10% Rule was developed by Dr. Joel Gittelsohn, Center for Human Nutrition, Bloomberg School of Public Health, Johns Hopkins University. This illustration is adapted from the USDA Team Nutrition poster “Read It Before You Eat It.” Handout 2 Would You Buy That Snack? Directions: You work for an advertising agency. Your team’s assignment is to think of a name and design an advertisement for a new snack made by a food company. The company has created a new healthy food/drink and wants to advertise it to children in 4th to 8th grade. You will receive a big raise if you are successful. The first thing you need to do for your boss is to figure out what makes your product healthy. The second thing you need to do is create an advertisement for your product that would encourage children to buy your product. The advertisement should last for one minute or less. You must report to your boss and a group of kids in five minutes with the following information: 1. Why is it the healthy snack? Instructions: Using the 10% Rule and your product’s Nutrition Facts label, fill in this grid to decide if each snack is healthy or not. If the answer to the question in the grid is yes, write a checkmark (or any positive symbol, picture, or word) in the box. Isthesnacklowin totalfat? Isthesnacklowin saturatedfat? Isthesnacklowin sugar? Isthesnackhighin dietaryfiber? Isthesnacklowin cholesterol? Isthesnacklowin sodium? Isthesnackhighin vitamins? Isthesnackhighin minerals? 2. Using the boxes with checkmarks, list the healthy features of your snack that you are going to advertise. Handout 2 cont. 3. What are you going to name your product? 4. Make up a jingle, slogan, song, rap, or skit to advertise your product. Make sure to appeal to your audience — 4th to 8th-graders. Write the words below, and be ready to perform it for your boss and a group of children. Remember: the advertisement should be one minute or less. Attachment A apple Attachment A buttered popcorn D.C. Healthy Corner Store Program Healthy Snacking at the Corner Store Pre-Program Survey First Name: _________________________________ Please circle or fill in your answers below. 1) How many sodas do you drink in a week? 0 1-2 3-4 5 or more 2) Can you find a healthy snack in the corner store? Yes No I don’t know If you said yes, write one example: _____________________________________________ 3) Can you tell if a drink is good for you? Yes No If you said yes, how can you tell? ______________________________________________ 4) Does advertising (like TV commercials) help you pick what foods to eat? Yes No I don’t know 5) Would the corner store owner sell healthy snacks if you asked for them? Yes No I don’t know 6) Is it unhealthy to be overweight? Yes No I don’t know Why or why not: ___________________________________________________________ _________________________________________________________________________ 7) Do you think your neighborhood has enough healthy food? Yes No I don’t know Why or why not: ___________________________________________________________ _________________________________________________________________________ Please return this survey to D.C. Hunger Solutions: Mail: 1875 Connecticut Ave. NW, Suite 540, Washington, DC 20010 Fax: 202-986-2525 Email: kroberts@dchunger.org Lesson 2: Snack Attack! Time: 50 minutes – 1 hour Lesson Outline Preparation: Before the lesson begins, set up the Healthy Snack Fair, following the instructions on the Go For 100% Juice” and “Have a Low-Fat Snack Attack” Handout. Use one table for the snack taste-test and one table for the drinks. If participants arrive early, they can help you set up. Preparation takes about ten minutes. (Note: this activity is optional.) I. Snack Inventory (10-15 minutes) II. Review from Lesson (1 - 5 minutes) III. One Step at a Time (5-10 minutes) IV. Healthy Snack Fair (20 minutes) V. Summary (10 - 30 minutes) Materials Needed □ Selection of healthy and unhealthy (based on 10% Rule) snack and drink packages [You can use the same packages used in Lesson 1] □ Flip chart paper or chalkboard □ “HEALTHY” sign □ 100% juice samples (see Handout “Go For 100% Juice”) □ Samples of low-fat snacks – baked chips and pretzels (see Handout “Have a Low-Fat Snack Attack) □ Two tables at least 3 feet long □ Copies of handouts: • Handout 1: “My Snacking Diary” • Handout 2: “Take a Step Toward Healthier Snacking” • Handout 3: “Go For 100% Juice” (plus supporting materials, listed on handout) • Handout 4: “Have a Low-Fat Snack Attack” (plus supporting materials, listed on handout) Objectives As a result of this lesson, participants will be able to: • Reflect on their snacking habits. • Identify health risks of unhealthy snacking and benefits of healthy snacking. • Sample healthy snacks and drinks. • Select healthier snacks and drinks at the corner store. Lesson 2: Snack Attack I. Snack Inventory (10-15 minutes) As participants walk into the session, welcome them and distribute Handout 1: My Snacking Diary and encourage them to complete only Part One. Tell participants to think of their favorite snack food and snack drink. Ask for a volunteer note-taker to come forward to write two headings, “SNACKS” and “DRINKS” on the flip chart or chalkboard. Ask each participant to share his or her favorite snack and drink. (If the group is too big to complete this in the allotted time, each person could choose either a snack or a drink to share.) Ask the note-taker to write each person’s answer in the appropriate column. Once the list is complete (or, for a very large group, you have a representative list of snacks), ask for a new volunteer to come place an asterisk (*) next to all of the snacks that he or she thinks are healthy. If few healthy snacks are listed, encourage the participants to add some healthy snacks NOTE: to the list. Ask participants to reflect on how many of the snacks listed are healthy versus unhealthy. Ask participants to share ideas on why people sometimes choose to eat unhealthy snacks instead of healthy ones. Some ideas might include: • The influence of advertising (You may need to guide participants toward this answer by reminding them of the advertising activity in Lesson One) • Unhealthy snacks are less expensive • Unhealthy snacks are available everywhere you go – in corner stores, vending stands, vending machines, etc. • Healthy food is hard to find and can require preparation • Lack of knowledge about what is healthy Ask several participants to share where they typically get their favorite snacks and drinks (e.g, from home, the corner store, an afterschool program, etc.) and whether the place they get their snack determines whether the snack is healthy or not. For instance, a snack may be healthier at school, since D.C. school vending machines are not allowed to sell soda or candy, or at an afterschool program, where snacks must meet certain U.S. Department of Agriculture nutrition guidelines. II. Review from Lesson One (5 minutes) Ask participants to stand up for an activity. Give each person an empty snack or drink package and ask the group to stand in a line (shoulder to shoulder, all facing toward you). Stand a few feet in front of the students holding the “HEALTHY” sign in front of you. Instruct participants to take a look at their packages and then examine the Nutrition Facts label on the back, keeping the 10% Rule in mind. Ask participants if they need a quick review of the 10% Rule from the last session. If yes, quickly summarize the 10% Rule from Lesson 1. Lesson 2: Snack Attack! To use the 10% Rule, you check the label to see if the food or drink contains 10% or more of your Daily Value of “good” nutrients (like fiber and vitamins) and 10% or less of your Daily Value of “bad” nutrients (like fat and sodium). Explain the activity: Participants should assemble in a horizontal line facing the instructor (like they would to play “Simon Says”). Tell participants that you will read one fact from the Nutrition Facts label at a time. They should take a step forward if their label matches the fact that you read. Each step they take represents one step toward healthy snacking. At the end of the activity, the line will look very different, and the group will talk about why. [NOTE: Emphasize that the activity is not meant to be a race toward the “healthy” sign.] Ask, one question at a time: • Is your product low in total fat? • Is your product low in sugar? • Is your product low in sodium? • Is your product high in dietary fiber? • Is your product low in saturated fat? • Is your product high in any vitamins or minerals? • Is your product low in cholesterol? By the end, some students will have taken more steps forward than others, so the line is no longer straight. Ask several students nearest the “healthy” sign what products they have and for which questions they stepped forward. Do the same with several students in the middle and near the back. Discuss with participants that often, a food or drink is not 100% healthy or 100% unhealthy – it might fit the 10% Rule for some nutrients and not others. The best approach to deciding whether a snack is a healthy choice is to consider all the information that the label gives you and choose the healthiest option. III. One Step at a Time (5-10 minutes) Inform students that everyone eats things that are unhealthy once in a while but that eating unhealthy food day after day can negatively impact your health. Ask students: What are some of the bad things that result from too much unhealthy snacking? Let them brainstorm, and encourage them to use what they’ve already learned. Guide participants toward the following answers: • An unhealthy diet gives you a low energy level. • Unhealthy snacking can put you at risk for obesity, which puts you at risk for many other problems, including: • High blood pressure (hypertension) • Coronary heart disease • High cholesterol Lesson 2: Snack Attack • • Type 2 diabetes • Stroke • Osteoarthritis (a degeneration of cartilage and bone within a joint) • Gallbladder disease • Sleep apnea and respiratory problems like asthma • Some cancers (endometrial, breast, and colon) Eating too many unhealthy snacks can prevent you from getting enough vitamins and minerals. There are all kinds of problems that can happen from not getting enough vitamins and minerals, like: • Calcium and vitamin D deficiency can lead to weakened bones. • Not getting enough vitamin C can lead to a disease called scurvy – your teeth fall out and your gums bleed • Low vitamin A intake can lead to poor eyesight or Night Blindness (can’t see as well in the dark) • Zinc and vitamin K deficiency can lead to slower-than-normal healing of cuts, scrapes, and bruises • Low vitamin B or iron intake can lead to anemia (low red blood cell count), which prevents oxygen from getting to your body parts Many of the more extreme problems (like scurvy) that result from vitamin deficiency are NOTE: not very common in the U.S. today, because many foods are fortified with vitamins. Still, there are many children and adults who do not consume adequate amounts of all the vitamins we need to be healthy, develop properly, and thrive. TIP: Depending on participants’ age, attention span, and level of knowledge about health and health problems, you might want to give them only a few examples of the consequences of obesity and vitamin deficiency. You also may need to explain some of the illnesses and conditions. To help the group understand some of the illnesses (especially those related to obesity), you can ask whether they know anyone with diabetes, high blood pressure, or heart disease. Ask participants: Now that we know what can go wrong from too much unhealthy snacking, what do you think are some benefits of eating lots of healthy snacks? Guide participants toward the following answers: • Healthy snacks taste good! • Eating lots of healthy snacks helps you feel good, strong, and healthy, and maintain a healthy weight. • For most kids, when you’re a healthy weight, it helps you feel good about yourself, too. • Good nutrition – lots of healthy snacks – even helps you do well on tests and in your classes at school. Tell participants: Fruits and veggies are great snack choices. They’ve got many benefits, including: • They’re high in vitamins and minerals, which keep us strong and healthy. • They’re high in fiber, which keeps us regular and full longer, and also can lower cholesterol. • They’re naturally low in fat and cholesterol. Lesson 2: Snack Attack! Tell participants: And when we eat healthy foods, we get lots of benefits, like: • Calcium – strengthens bones • Vitamin C and E – antioxidants, they protect cells from free radicals, supports a strong immune system • Vitamin D – strengthens bones Ask participants who in the group thinks they need to have fewer unhealthy snacks and drinks and more healthy ones. Tell participants: Almost everyone can benefit by choosing more healthy snacks and cutting out some of the unhealthy ones. It’s ok to make changes one step at a time. Distribute Handout 2: “Take a Step Toward Healthier Snacking.” Using the handout, discuss steps participants can take toward healthier snacking. NOTE TO INSTRUCTOR: the “Steps” handout depicts four sets of snacks and drinks. Each “step” represents a set of choices that are healthier than the ones below them. Moving toward a healthy diet takes place “one step at a time.” Ask several participants to comment on the handout and think about what steps would be reasonable for them to take. IV. Healthy Snack Fair (20 minutes) Tell participants that they’re going to a Healthy Snack Fair, where they get to taste some healthy snacks and drinks that they might not have seen in the corner store before. They might find some new healthy snacks that they really like and can ask their corner store to sell. (A) Ask for four volunteers to serve as “Station Managers” at the taste-testing stations. Tell the Station Managers that they will be working in pairs to serve snack and drink taste tests and teach their friends about healthy snacks and drinks that they could ask their corner store to sell. Have these four students go to the tables and read the instructions sheet for the snacking fair. [Note to facilitator: It is helpful to have an adult at each taste-test station to help the “Station Managers” understand their instructions and oversee the activity.] Assign one pair to the juice station (Handout 3: 100% Juice plus accompanying materials) and the other pair to the snack station (Handout 4: Baked Chips & Pretzels plus accompanying materials). (B) When the snack fair stations are ready, thank the four volunteers, and tell the rest of the group that they will have 10 minutes to visit the two snacking stations, where they will taste healthy drinks and snacks. Tell participants to take just one drink sample, and one of each of the snack samples. Monitor the activity and once everyone has enjoyed a taste-test, ask participants to return to their seats. Debrief by asking: • What did you learn from this activity? • Did anything surprise you? • Share a fact you learned about healthy snacking. • Did you like the baked chips? The pretzels? The 100% juice? Would you buy it? Why or why not? Lesson 2: Snack Attack Make sure that the four Station Managers get a chance to visit each other’s stations before TIP: the snack fair ends. V. Summary (10 - 30 minutes) Conclude this section of the lesson by asking participants to return to My Snacking Diary – Part Two (Handout 1). Ask participants to think about the healthier snack options they have learned about today, and what steps they can pledge to take toward healthier snacking. Inform participants that in the next lesson, they will be using My Snacking Diary to make pledges to snack healthier. Choosing for Yourself There are three options for this activity, depending on how much time you have and the proximity of your program site to a corner store. If you are teaching this lesson as a guest instructor at a program site, be sure to ask the NOTE: site staff permission before taking participants to a store, or instructing them to visit a store on their own. (A) You will need several adults for this option. To prepare, give each participant a pencil and a sheet of paper. Explain to participants that you will be going to visit a corner store to practice looking for healthy choices. (Whether participants actually buy the items is up to the individual program.) They should examine Nutrition Facts labels to help identify healthier items, be as quiet as possible in the store, and be careful to put any items that they take off the shelf back in the same place. Take the group to a corner store. Introduce yourself to the store owner or cashier and explain that you are just visiting to help the students learn about healthy snacks. In small groups (2-4 people), take participants into the store, and instruct them to point out three healthy snack food choices and three healthy drink choices. For each item they pick out, they should write down the name and the reason they chose it. Supervise the activity closely, and assist participants with examining Nutrition Facts labels to make their choices. If there are not three healthy choices available in each category, ask participants to keep this in mind for the next lesson’s discussion. When you return to the program site, congratulate the participants for their good investigative work at the corner store. Tell them that the next lesson will open with a discussion of what they found at the store. (B) Set up a mock corner store aisle at the program site. You will need a variety of snack foods and drinks that are similar to what is found in a typical corner store in your area. Follow the same instructions as those for option “a.” Congratulate the participants for their good investigative work at the mock corner store. Tell them that the next lesson will open with a discussion of what they found at the store. (C) Ask participants to visit a corner store near their home or the program site on their own. Give the same instructions as those in option “a.” Lesson 2: Snack Attack! Tell participants to do their best investigative work at the corner store. Tell them that the next lesson will open with a discussion of what they found at the store. Sources – Lesson Two • “Chips vs. Pretzels” Handout - developed by Dr. Joel Gittelsohn, Center for Human Nutrition, Bloomberg School of Public Health, Johns Hopkins University. Dr. Gittelsohn directs the Baltimore Healthy Stores program. Lesson 2: Snack Attack Handout 1 My Snacking Diary Name: _______________________________________ Part One – My snacks are … 1. My favorite snack food is: ___________________________________________________ 2. My favorite snack drink is: ___________________________________________________ 3. During the school year, I usually get snacks at (circle): School Home Corner Store Afterschool Program Other: ___________________________ 4. During the summer, I usually get snacks at (circle): School Home Corner Store Afterschool Program Other: ___________________________ Part Two – I Pledge to … I pledge to take these steps toward healthier snacking (check as many boxes as you think you can do): □ Drink more water □ Drink less soda □ Eat one fruit each day □ Eat baked chips instead of regular chips □ Eat pretzels instead of regular chips □ Drink 100% juice Part Three – How much do I need … If you have access to the Internet, you can find out exactly what foods you need in day. Go to the web site for the Food Pyramid – www.mypyramid.gov. After you enter your age, gender, height, weight, and amount of activity you do each day, you will get a MyPyramid Plan. Handout 2 Handout 3 “Think Your Drink” – Go For 100% Juice! Background Many people love to drink juice. Many people think drinking juice is healthy—and it can be. But you must be an educated consumer to figure out which type of juice is good for you. Many drinks say on the label that they contain juice, but if you investigate, you will discover that some drinks only contain a little juice and a lot of sugar! That means a lot of calories and not a lot of nutrition benefits. Always look for 100% juice—it has many vitamins, and the sugar is natural, not added. Set-up Set up a juice-tasting station with these supplies: • “Why 100% Fruit Juice” cards • “Think Your Drink” cards • A bottles of 100% juice and a juice drink • Nutrition Facts about 100% juice and a juice drink—place the nutrition info beside each sample bottle • Small cups filled with 100% fruit juice (be careful not to fill cups all the way to the top!) Station Manager’s Job Help your friends figure out what drink is the best by conducting a taste test of typical drinks available in corner stores and sharing information about the drinks. You can do this by: • Showing them the difference between 100% juice and juice drinks. • Explaining the nutritional benefits (especially vitamins) of 100% juice. • Giving them samples of 100% juice. Ready to go! As customers visit your juice testing station, be ready to: • Show the different types of juice and juice drinks and their nutrition info. • Ask customers to guess which one has the most nutrients and which is the healthiest. • Offer a taste test of 100% juice. • Give each person one “Why 100% Fruit Juice” card and one “Think Your Drink” card. Handout 4 Have a LOW-FAT Snack Attack! Background Many of us love to eat chips. They are an inexpensive, tasty, crunchy snack—and they’re easy to find. The problem is eating a lot of chips means eating a lot of fat and cholesterol, and that can be bad for us. The good news is that there are other crunchy snacks that have less fat. Pretzels and baked chips both taste great and are about the same price as regular chips. Set-up Set up a snack-testing station with these supplies: • Sample packages of regular chips, baked chips, and pretzels • “Baked Chips vs. Regular Chips vs. Pretzels” handout • Small sandwich bags or plates with about six pretzels or six baked chips • Oven-fried french fries recipe cards • Nutrition Facts about regular chips, baked chips, and pretzels – place the nutrition info beside each sample package Station Manager’s Job Help your friends figure out which crunchy snacks are low-fat, and convince them to consider choosing a healthier (lower-fat) option next time they want chips. You can do this by: • Showing them the nutritional difference between regular chips, baked chips, and pretzels. • Explaining the nutritional benefits (low-fat) of baked chips and pretzels. • Giving them samples of baked chips and pretzels. Ready to go! As customers visit your snack-testing station, be ready to: • Show the different types of snacks and ask customers which snack they usually buy. • Show customers the different nutrition information and ask them to guess which ones are the low-fat options and which is the healthiest. • Offer a taste test of both baked chips and pretzels. • Give each person one “Baked Chips vs. Regular Chips vs. Pretzels” handout and one oven-fried french fries recipe cards. Lesson 3: Curbing Obesity – You Decide! Time: 50-60 minutes Lesson Outline I. Review Lesson Two (3-5 minutes) II. Healthy Snack Pledge (5 minutes) III. Obesity – What’s the Problem? (10 minutes) IV. Solving the Problem – What Do You Think? (20-25 minutes) V. Summary (5 minutes) Materials Needed □ Paper and pens/pencils □ Butcher block or flip chart paper □ Tape □ Crayons or markers □ Handout 2 (lesson 2): “My Snacking Diary” (each participant uses same copy from Lesson 2) □ Two signs: “Great Idea” and “Bad Idea” □ Handout 1: “All About Obesity” □ Handout 2: “Calories Count” Objectives As a result of this session, participants will be able to: • Discuss the scope of the obesity epidemic in the U.S. and in the District • Identify three possible reasons for and three negative consequences of childhood obesity • Analyze possible policy solutions to childhood obesity • Generate ideas for how to promote healthy eating and active living in D.C. Lesson 3: Curbing Obesity – You Decide! I. Review Lesson Two (3-5 minutes) Ask participants to take out their “Steps Toward Healthier Snacking” handouts from the last lesson. (Or, if the instructor keeps handouts at your program, pass them out to the participants.) Review the “steps” and make sure participants understand what each of the steps represents. II. Healthy Snack Pledge (5 minutes) Next, ask participants to take out their “My Snacking Diary” handouts (or pass out the handouts to participants) and look at “Part Two” (the bottom half of the page). Ask participants to think about the healthier snack and drink options they learned about and tasted in the last session and the steps they can pledge to take toward healthier snacking. Ask participants to check as many boxes as they think they can do. Optional Ask participants to report back on their visit to corner stores to examine the healthy choices available. III. Obesity – What’s the Problem? (10 minutes) Discuss with participants: • For the rest of this lesson we are going to be talking about overweight and obesity. • Especially if there are overweight children in the group: Overweight and obesity – that is, weighing too much – are problems that all Americans can struggle with, no matter how old they are or how much money they have. We all need to be careful to have good nutrition and get enough physical activity. • Maintaining a healthy weight is important for overall good health, feeling good, having lots of energy every day, doing well in school, and growing up to be a healthy adult. • Everyone has things about themselves and their bodies that they do not like. It is important when we are talking about this sensitive topic of one’s weight that no one acts disrespectfully or is mean to anyone else. overweight and obese are often used interchangeably in this curriculum, because we are TIP: more interested in participants understanding the overall issues and concepts than in focusing on scientific details. If participants are interested (and if this level of detail is age-appropriate), explain the distinction: “Overweight” is defined as BMI at the 85th to below the 95th percentile for children of the same age and gender. The 85th to below the 95th percentile also is considered “at risk for obesity.” “Obesity” is defined as at or above the 95th percentile. These definitions are based on the 2000 CDC Growth Charts for the United States. Ask participants: What does it mean to be overweight or obese? Answers might include: • People who are fat. • People who eat too much. • People who don’t exercise. Lesson 3: Curbing Obesity – You Decide! Explain to participants: The most common way doctors determine whether someone is overweight is by measuring body mass index, or BMI. BMI is a number calculated from weight and height. If you want to know your BMI, you should ask a doctor or nurse to help you figure it out. TO INSTRUCTOR: if you are not a medical professional, do not determine participants’ NOTE BMIs. For adults it is ok to give out a chart so they can figure it out themselves, but do not offer any interpretation of the result. Give each participant a sheet of paper. Ask participants: Why do you think children become overweight? Ask them to focus on children, and write down on their papers five reasons why. (Give the group two minutes to write down their answers.) Tell participants that everyone is going to share an answer. When time is up, ask for a volunteer to record everyone’s reasons on blackboard or a piece of flip chart paper. (If you do not have a large piece of flip chart paper, participants could read their answers aloud and the group can raise their hands to indicate agreement with the answer.) Answers might include: • Kids watch too much TV / screen time – video games, etc. • Kids eat too much junk food. • Kids don’t play enough sports or exercise enough. As each participant shares a reason, write the reasons on the board and ask other participants to raise their hands if they had the same reason, count number of hands raised and record next to the reason EXAMPLE: watch too much TV (5) Thank participants for their answers and point out that the group has named many of the causes of obesity that “experts” have identified. • Emphasize: There are many factors that affect whether a person becomes overweight, and it is important to understand that different causes affect different people in different ways. • Tell participants: The most important thing to remember about preventing obesity is energy balance – when you eat more calories than you use, those are extra calories. Extra calories, whether they come from fat or another nutrient, are stored in your body as fat and lead to weight gain. TIP: Researchers identify the following as common causes and risk factors for obesity: • Genetics or family history. People with obesity in their families are more likely to become obese. • Behavior – What you do or don’t do. • • Energy intake – When you eat more calories than you use, those are extra calories. Can you please put it back in? I want it in both places, to make sure the instructor understands the info. • Sedentary lifestyle – A lack of exercise can cause us to gain weight. Remember the energy balance? If you are taking more in than you are using, it will be stored as fat. Environmental factors • At home: What your parents eat or give you to eat affects your risk for obesity. Lesson 3: Curbing Obesity – You Decide! • In your community: Whether you have places to run, walk, play, or ride a bike affects your risk for obesity. Some people live in neighborhoods that are unsafe for playing outside or don’t have parks or other places to be active. Next, ask participants where they think D.C. ranks compared to other places in the number of people who are overweight or obese. Answer: Compared to other states, D.C. has the highest rate of overweight children ages 10-17 – 22.8% of children. Tell participants the following information: Childhood obesity is a big problem all over the country. • Childhood obesity is such a huge problem in the United States that in 2004, the Surgeon General said, "Because of the increasing rates of obesity, unhealthy eating habits, and physical inactivity, we may see the first generation that will be less healthy and have a shorter life expectancy than their parents." • Children who are overweight are more likely to become obese adults. • About 23 million children are overweight or obese. It is a big problem in D.C., too, and it is affecting a lot of children and adults: • 55% of adults in D.C. are overweight or obese. • East of the River – in D.C.’s Wards 7 and 8 – overweight and obesity rates are higher than in other Wards. Some children do not know which wards they live in. If that is the case at your program, you TIP: can name some neighborhoods to illustrate what we mean by “east of the river” or “Wards 7 and 8.” Remind participants that in the previous two lessons, they learned some of the negative health consequences of unhealthy snacking and obesity, and we will quickly review those. Overweight and obesity put you at risk for many other problems, including: • High blood pressure (hypertension) • Coronary heart disease • High cholesterol • Type 2 diabetes IV. Solving the Problem – What Do You Think? (20-25 minutes) Remind participants that energy balance is the key to maintaining a healthy weight and preventing obesity. Tell participants that just like there are many causes for obesity, there are also many ways to solve the problem. People like doctors, teachers, parents, ministers, the mayor, the D.C. Health Department, and others all have ideas for how to reduce obesity and make sure everyone in D.C. is healthy. If participants are not familiar with the term “policy,” explain that a policy is like a law or TIP: rule that people have to follow, and a it has a specific purpose, such as trying to help people be healthier. For example, schools have policies that children must be immunized against disease so that infections don’t spread. NHANES 2003-2006. Source: American Heart Association. Lesson 3: Curbing Obesity – You Decide! Tell participants that one idea that the District government is exploring to help reduce obesity is creating policies that will ensure that everyone has healthy food in their neighborhood and nice, safe places to play and exercise, no matter what part of the city they live in. Ask participants: Should all people be able to find healthy food in their own neighborhood? Have participants vote “yes” or “no” with a thumbs-up or thumbs-down. TIP: Guide participants toward the answer “yes.” You can rephrase the question to ask whether access to healthy food is a right for only certain people (such as wealthy people). Ask several participants to explain their opinions on this question. Next, tell participants: In a moment we will start an activity where you can share your opinions about how to reduce obesity and help kids be healthy. Post two signs—“Great Idea” and “Bad Idea” – at opposite ends of the room. Explain: I will be reading some different policy ideas for how to reduce obesity. (Note: Remind participants that a policy is like a law or rule and has a specific purpose, such as trying to help people be healthier.) You should consider your opinion about each one – whether it is a good idea or a bad idea and why. Then you will express your opinion by standing up and moving to a point between the two signs that represents your opinion. Tell participants: For instance, I will state the following policy idea: “The government will only allow people to eat blue foods.” If you strongly agree with that policy, stand under the “Great Idea” sign. If you strongly disagree, stand under the “Bad Idea” sign. If you are not sure, stand in the middle. If you think it’s kind of a bad idea, stand somewhere near “Bad Idea” sign, or if you think it’s kind of a good idea, stand somewhere near the “Great Idea” sign. Ask participants if everyone understands the instructions. Tell participants that in order for the activity to work, they must agree a few ground rules: • You can stand at any point along the continuum and you can move at any time if you change your opinion. • There are no right or wrong answers. • Be respectful of each person. • Listen to what each person has to say. • If you want to talk, raise your hand. Ask if participants can agree to these rules and if they want to add any rules. Now have the participants stand up in preparation for the first policy. Begin by reading the first statement to the participants and ask them to stand under or near the sign that represents their opinion of the policy. Ask participants at various points along the continuum to share their opinions and why. Ask questions to help them flesh out the pros and cons for each idea. TIP: You do not need to ask all of the questions below. Choose the ones that most interest the participants in your program. Lesson 3: Curbing Obesity – You Decide! 1) All trucks that sell ice cream and candy must also sell fruits and healthy drinks (water, juice, etc.). TO INSTRUCTOR: After participants give their opinions about this idea, share this NOTE information with participants: This is not currently the policy in D.C., but some cities are assisting businesses to bring fresh produce to neighborhoods that do not have sufficient fresh produce through “green carts,” which are like ice cream trucks, but with fruits and vegetables. Examples of pros and cons: • Pro: Gives exposure to healthy options; kids can access the healthy food where they live; people buy lots of food from these trucks; a way for small businesses to increase sales • Con: food safety concerns; businesses may have to invest in new refrigeration; maybe people will not buy the food; hard to enforce it 2) Any foods sold in schools must be healthy. TO INSTRUCTOR: This rule is part of the DCPS Local Wellness Policy (the policy has NOTE specific nutrition standards). DCPS high schools’ vending machines cannot have soda or candy. Vending machines are not allowed in elementary schools. A la carte options must meet certain nutrition guidelines. Examples of pros and cons: • Pro: Children will have more healthy choices at school; children would be forced to pick healthy foods. • Con: Some schools rely on funding from snack and beverage companies that supply vending, advertising, etc. 3) Any time a new road is built, it must include a bike lane, so that children can ride bicycles to school instead of riding in a car or on the bus. Examples of pros and cons: • Pro: Bike lanes make bicycling safer; bicycling is good exercise and helps the environment; biking is less expensive than driving. • Con: Some people don’t have bikes; bicycling can still be unsafe, even with bike lanes; you can’t ride a bike to school in bad weather. 4) The District will put a tax on all unhealthy foods and drinks. TO INSTRUCTOR: D.C. currently has taxes on food. NOTE taxes.” Some states/cities have “snack Examples of pros and cons: • Pro: It might discourage people from buying unhealthy items. • Con: It would be hard to determine hard and fast criteria for what is an “unhealthy” food or drink; since food companies frequently introduce and discontinue products, the list of taxable unhealthy items would always be changing; and training grocery store employees to know the list would be a major task; often “junk food” is the least expensive food option, so a tax would make it even harder for some people to afford enough food. Lesson 3: Curbing Obesity – You Decide! 5) Schools will measure each student’s BMI (Body Mass Index) every year. TO INSTRUCTOR: DCPS school nurses will begin measuring and tracking student BMIs in NOTE the 2009-2010 school year. Examples of pros and cons: • Pro: regular BMI measurements would help children and their parents know how healthy they are and what they need to improve on. Schools could help the students who are at risk for obesity. • Con: Students who are overweight could be singled out for special treatment and embarrassed. Some people might think BMI information should be kept private. 6) Every school, afterschool, and/or summer program will include daily physical activity. TO INSTRUCTOR: The District has physical education and health standards for all schools NOTE – public and charter. The city is considering creating wellness policies for child care centers, but there are not yet physical activity policies for summer and afterschool programs. Examples of pros and cons: • Pro: More children would have opportunities to exercise. There would be more games and recreation at programs. • Con: Some programs don’t have sports/recreation equipment and some don’t have space for physical activity. Some children don’t like sports. Physical activity might take time away from academic or other lessons. 7) All afterschool programs will serve healthy suppers. TO INSTRUCTOR: The District is trying to become part of a federal afterschool supper NOTE program that enables afterschool program providers serve healthy suppers (dinners) to children up to age 18. If participants are interested in this issue, please contact D.C. Hunger Solutions to get involved in advocacy on this issue. Examples of pros and cons: • Pro: Programs would have enough funds to provide a whole meal – not just a snack – to children. Some children’s families do not have enough food at home to make dinner every night. Some parents work long hours, so their children are at an afterschool program until late in the evening. The meals would be nutritious and help children eat healthily. • Con: Some children would rather eat dinner at home. 8) Companies will not be allowed to advertise unhealthy food and drinks to children. TO INSTRUCTOR: You can remind participants of the advertising discussion in Lesson 1 NOTE – much more money is spent on advertising “junk food” than healthy food. Examples of pros and cons: • Pro: Children would not be encouraged to eat unhealthy foods / drinks. There might be more advertising for healthier foods. • Con: It would not be fair to censor or limit certain companies’ advertising. Thank participants for their input and good analysis. Lesson 3: Curbing Obesity – You Decide! VI. Summary (5 minutes) Pass out the “All About Obesity” handout and tell participants that the handout summarizes the points that have been covered in this lesson. Conclude this lesson by: • Asking the group to give several reasons why obesity is a problem for the city of D.C. • Repeating that energy balance is the most simple and important thing to remember about preventing obesity. • Asking each participant what she or he thinks is the best way to reduce obesity in D.C., and why. If necessary, prompt participants to think back to the “Good Idea/Bad Idea” activity and the TIP: pros and cons of various policy solutions. Encourage participants to be creative – if they have ideas that weren’t listed among the possible policies, that’s great! V. Optional Activity: Calories Count! Using MyPyramid (5-10 minutes) Preparation: Visit MyPyramid for Kids and enter hypothetical information (representative of the children in your program) to get a sample MyPyramid Plan for eating and physical activity. http://www.mypyramid. gov/mypyramid/index.aspx. TIP: If you do not have internet access, you can use the sample print-out included in the curriculum. sample was created using the following data: age - 10; female; weight - 80 lbs; height - 4’ 8”; The activity – less than 30 minutes per day. Ask participants to take out their “Using the 10% Rule” handouts from Lesson 2. (Or pass out the handouts.) Tell participants that in addition to following the 10% Rule for fat, sugar, etc., reading a food or drink’s calorie content is also important for figuring out if a snack is healthy. Calorie values are found on the top of the Nutrition Facts label. Remind participants that Nutrition Facts label includes “Servings Per Container” – the blue bubble points out that line. Remind participants that you usually cannot determine whether a food or drink is healthy by looking at only one line on the Nutrition Facts label. It is important to evaluate the whole item and choose the healthiest option possible. Tell participants: To find out exactly how many calories you need in day, you can go to the web site for the Food Pyramid – www.mypyramid.gov. After you enter your age, gender, height, weight, and amount of activity you do each day, you will get a printout similar to this one. Give participants a sample printout. TIP: These instructions also are printed on the handout “My Snacking Diary.” Tell participants: Because everyone is a different, each person has different calorie needs. The important thing to know is that calories consumed above the daily recommended amount will be stored by the body as fat. If we store too much fat on our bodies, we become overweight or obese. Tell participants: MyPyramid Plan also tells you how much of different types of foods to eat each day Lesson 3: Curbing Obesity – You Decide! – MyPyramid is a plan for your whole diet. Following these guidelines is another good way – besides the 10% Rule – to plan healthy snacks. However, since this program focuses just on snacks, we will not discuss the full diet plan. Sources – Lesson 3 • Centers for Disease Control and Prevention. www.cdc.gov; http://www.cdc.gov/nccdphp/dnpa/healthyweight/calories/index.htm Lesson 3: Curbing Obesity – You Decide! Handout 1 All About Obesity Obesity means very overweight. Being overweight is something that can happen to anyone – adults and children. We all need to be careful to have good nutrition and get enough physical activity. Maintaining a healthy weight is important for overall good health, feeling good and having lots of energy every day, growing up to be a healthy adult, and doing well in school. Who is obese? • • • • Childhood obesity is a huge problem in the U.S. In 2004, the Surgeon General warned that the increasing obesity rate, unhealthy eating habits, and physical inactivity may cause this generation to be less healthy and live shorter lives than their parents. Children who are overweight are more likely to become obese adults. About 23 million children are overweight or obese. 145 million American adults are overweight or obese – that’s about two thirds of adults. Obesity affects many people in Washington, D.C. • • • Compared to other states, D.C. has the highest rate of overweight children ages 10-17 – 22.8% of children. 55% of adults in D.C. are overweight or obese. East of the River – in D.C.’s Wards 7 and 8 – overweight and obesity rates are higher than in other Wards. What happens if you are overweight? Overweight and obesity put you at risk for other problems, including: • • • • • • • High blood pressure (hypertension) Heart disease High cholesterol Type 2 diabetes Stroke Sleep apnea and respiratory problems like asthma Some cancers (endometrial, breast, and colon) How do you know if you are overweight? The most common way to determine whether someone is overweight by measuring body mass index (BMI). BMI is a number calculated from weight and height. If you want to know your BMI, ask a doctor or nurse to help you figure it out. How do people become obese? These are some common causes for overweight and obesity: • Your family history – people with obesity in their families are more likely to become obese. • Nutrition and physical activity – The Energy Balance – when you eat more calories than you use, those are extra calories. Extra calories, whether they come from fat or another nutrient, are stored in your body as fat and can lead to gaining weight. • Your environment • At home: What your parents eat or give you to eat affects your risk for obesity. • In your community: Whether you have places to run, walk, play, or ride a bike affects your risk for obesity. Some people live in neighborhoods that are unsafe for playing outside or don’t have parks or other places to be active. Handout 2 Calories Count! What is a calorie? • Calories are the energy we get from any food. • A calorie is a calorie no matter what food it comes from. • The calories per serving in a food are found at the top of the nutrition label. • Your body uses calories all the time – even when you are sleeping. Your body uses the most calories when you walk, run, jump, play, dance, and do other kinds of exercise. Calories in vs. calories out • To maintain your current weight, you need to eat the same amount of calories your body uses. This called caloric balance. • When you eat fewer calories than you use, you lose weight. • When you eat more calories than you use, you gain weight. Any extra calories you eat are stored by your body as fat. Calories In Calories Out food beverages body functions physical activity Calorie Q & A Q: Are fat-free and low-fat foods low in calories? A: Not always. Some fat-free and low-fat foods have extra sugars, which push the calorie amount back up. Q: I’ve heard it is more important to worry about carbohydrates than calories. Is this true? A: By focusing only on carbohydrates, you can still eat too many calories. Also, without a variety of foods, you might not get enough of other important nutrients, and you will not be able to sustain the diet over time. Q: Does it matter how many calories I eat as long as I’m active? A: Physical activity is a vital part of weight control, but so is the number of calories you eat. If you consume more calories than you use through normal daily activities and physical activity, you will still gain weight. How many calories do you need? MyPyramid Plan can tell you how many calories you need in a day. 1. Go to www.mypyramid.gov 2. Click “MyPyramid Plan” on the left side of the screen 3. Answer questions 4. Click “submit” great idea! bad idea! Lesson 4: The Power to Make a Change Time: 50 minutes Lesson Outline I. Simultaneous Activities: What do you see now? What do you want to see? - 20 minutes II. The power to make a change - 5-10 minutes III. “I like to eat…” - 5 minutes IV. Don’t see it? Ask for it! - 5 minutes V. Closing – 10 minutes Materials Needed □ Flip chart paper/butcher block paper □ Pencils □ Scissors □ Markers/colored pencils/crayons □ Copies of Handouts: • Handout 1: Postcards (cut the sheet into four postcards) • Handout 2: Examples of Healthy Corner Store Program advertising materials • Handout 3: List of Healthy Corner Store Program member stores □ Ball □ Post-Test Survey Objectives By the end of this lesson, participants will be able to: • Identify food sources in their neighborhood. • Use knowledge gained in previous lessons to analyze the health of food sources. • Envision improvements in the food landscape and know how to advocate for them. • Take action toward increasing the availability of healthier food choices in neighborhood corner stores. Lesson 4: The Power to Make a Change I. Simultaneous Activities: What Do You See Now? What Do You Want to See? (20 minutes) Tell participants: We are going to start by taking a few minutes so everyone can think about the foods available in our own neighborhoods – and what foods we would like to have in our neighborhoods. Explain: We are going to divide into two groups. The “What Do You See Now?” group will close their eyes and think about a corner store in their neighborhood. Using words, pictures, or symbols, they will draw pictures of the store. The “What Do You Want To See?” group will imagine the perfect corner store – a healthy corner store – full of food that tastes good and is good for you. Divide the participants into two groups. Then, separate the two halves of the group into small groups of 3-5 people. Pass out paper and art supplies to the small groups. Give the groups 5 to 10 minutes to draw their pictures. TIP: Depending on the size of the group, you can have students do their own drawings. TIP: As groups finish their pictures, post them around the room. When the time is up, ask each group of students to stand beside their pictures. Ask each “What Do You See Now” group: Please point out three things you included in your drawing. Ask the whole group to reflect on the pictures of the existing corner stores and on what types of snack foods and drinks are usually available at the corner store. Sample points of discussion: • What do you see? • Would the food you see available be considered healthy based on what you know about nutrition? Why or why not? • Why do you think most corner stores you drew have unhealthy snacks, like chips, cakes and soda rather, than healthier choices, like fruits and vegetables? • Do you think corner stores should have healthier choices? Why or Why not? Allow participants to discuss responses and debate (respectfully) if there is disagreement among participants about answers. TO INSTRUCTOR: You can use these questions and reflections to review the nutrition NOTE information taught in previous lessons. Next, ask each “What Do You Want To See” group: Please point out three things you included in your drawing. Ask the whole group to reflect on: • What do you see? • In what ways is this store different from the stores that the “What Do You See Now” group drew? Thank participants for sharing their ideas. Lesson 4: The Power to Make a Change II. The Power to Make a Change (5-10 minutes) Ask participants to think about: How do we get from the picture of the current corner store to the pictures of the perfect corner store? Ask for a volunteer to record notes on a flip chart or chalkboard. Give participants three minutes to brainstorm what it would take to transform existing corner stores into sources of healthy food. Ask the volunteer recorder to keep notes of everyone’s ideas. (For younger children, you might need to help take notes.) Sample answers might include: • Take away all the junk food. • Make stores only sell healthy snacks. • Take away the advertising for cigarettes and alcohol. • Have taste tests. • Fix up the front of the stores. TIP: Be careful not to make store owners look like the “bad guy.” Participants may say negative things about merchants supplying only junk food. Discuss with participants that store owners need to make a profit in order to stay in business, and that they will sell what they think people want. Discuss that there can be misconceptions about healthy foods among customers and store owners, and that both store owners and customers can play a part in making healthier foods available. Explain that most corner store owners are interested in being good neighbors and serving their customers well. They want to know what customers like and don’t like and are willing to sell foods that customers ask for. Many corner store owners understand that healthy food is important for your overall health, and if they hear from enough customers that people want to buy healthy foods, they will make healthy foods available. Inform participants that the Healthy Corner Store Program is working to put some of their great ideas into action. Tell participants: I’m going to share one way that the Healthy Corner Store Program is making a change in corner stores. Ask participants to think back to the advertising activity they did in Lesson 1. Ask: Is there more advertising out there for unhealthy food, like soda and chips, or healthy food, like fruits and vegetables? Guide participants toward this answer: there is much more advertising, especially directed at children, for “junk food.” Tell the group: To counteract all that junk food advertising, the Healthy Corner Store Program is giving corner stores advertising for healthy food. Pass out several shelf labels and refrigerator decals. Ask participants to pass the labels around and pay attention to the words and messages. Ask for several volunteers to share their reactions to the labels. • Would these labels help you find healthier foods? Why or why not? Lesson 4: The Power to Make a Change • Would they make you want to buy healthier foods or drinks? Why or why not? Conclude this section by asking the group: Do you all have the power to make a change to our corner stores? Tell participants: When I count to three, everyone will have the chance to vote on whether you think we have the power to make a change and create healthy corner stores. Instruct participants: • To vote Yes, hold up your hand with a thumbs-up sign. • To vote No, hold up your hand with a thumbs-down sign. • If you’re not sure, hold up your hand with your thumb sideways. Count 1-2-3: Raise your hand and vote! Call on a few “yes,” a few “no,” and a few “not sure” voters and ask them to explain their answers. Tell students: You DO have the power to bring about change in your corner store. III. “I Like to Eat…” (5 minutes) Tell participants that one of the easiest and most effective ways to get a corner store owner to stock a healthy item they like, is simply to tell the corner store owner they like it and would buy it if it were offered. However, just asking for the food is not enough. Tell participants that they need to follow up and buy the things they ask for, so the store owner will continue to stock the products they like. Explain: It is important to be very specific when requesting products at the store. For example, if your mother told you, “Buy some vegetables at the store,” she would have to give more specific details so that you would know whether to buy carrots or greens. The same is true for a store owner. If you ask for juice or fruit, the owner of the store might not stock the kind you want. Instead, for example, ask for bananas and 100% orange juice. Check for understanding of this point by asking a few participants for examples of requests they would make at the corner store. Activity: Depending on what is appropriate for your program, choose between the following games. • Game 1: Have participants sit in a circle. Inform them they are going to play a memory game that will also help them practice telling corner store owners what healthy foods they like to eat. The first person will state one healthy food she likes to eat. The person to her right will state what the first person likes to eat and one thing that she likes to eat. The next person will state what the first person likes to eat, what the second person likes, and what he likes. This sequence continues until: 1) someone forgets one of the things a previous person likes; or 2) we complete the circle. If it ends because of the first option, restart at the next person in line. Do this up to three times. Choose one participant to start. • Game 2: Have participants stand in a circle. Inform them they are going to play a memory game that will also help them practice telling corner store owners what healthy foods they like to eat. The first person will state one healthy food she likes to eat, then will toss the ball to another person in the circle. That person will repeat what the first person said and then state what he likes to eat. This will continue until everyone has had the ball. Lesson 4: The Power to Make a Change Next, have the students pair up for a role-play exercise. Explain: one person in the pair is going to play the corner store owner and the other will play a customer. The “customers” will practice telling the “store owners” what they like to eat. After everyone has finished, have each pair switch roles and repeat the exercise and practice telling the corner store owner what they like to eat. IV. Don’t See It? Ask for It! (5 minutes) Remind participants that they can play an important role in bringing healthier snacks and drinks to their local corner stores. Store owners will only start to sell healthy foods if they believe that customers want to buy them. If participants don’t see healthy snacks and drinks they like at their corner store, they should ask the store owner to sell them. It is important to follow up by buying those healthier foods and drinks if the store starts selling them. Explain that if for some reason customers do not feel comfortable speaking with the owners of the stores (for example, if a glass barrier hinders communication), they can write their product requests. Pass out the “I Buy Healthy Foods” postcards (1-2 copies per person.) Instruct the participants how to use the postcards: Fill in the blank line in the sentence “Please sell ________ in your store“ the specific name, flavor, etc. of a healthy snack food or drink product. Sign the postcard with your first name. Ask participants to write on the blank line their favorite healthy drinks or snacks that they have talked about today. • If your program site is within two blocks of a corner store, instruct the students to drop off the postcard the next time they visit or pass by that store. • If your site is not within two blocks of a corner store, collect the postcards from the students. You, or another adult at your program, can deliver the postcards to the nearest Healthy Corner Store Program store. Pass out Handout 3: Healthy Corner Store Program members. TO INSTRUCTOR: If your site is near a Healthy Corner Store Program member store, please NOTE tell participants that that store is participating in the program. You can call D.C. Hunger Solutions (202-986-2200 or e-mail kroberts@dchunger.org) to find out the specific steps that the store has taken to become healthier. The postcard was designed by Maurice Hill, Ward 7 Arts Collaborative. Lesson 4: The Power to Make a Change V. Closing (10 minutes) 1) Have students complete post-test survey 2) Give a brief overview of all that has been covered over four sessions • Health consequences of good nutrition and bad nutrition • 10% rule and reading Nutrition Facts labels • Role of advertising in influencing food choices • Healthy snack and drink options • Steps to take toward healthier snacking • Obesity in Washington, D.C. and strategies for reducing the problem • The current food environment in participants’ neighborhoods; changes they would like to see; and how to bring about those changes 3) Questions 4) Goodbye and thanks Lesson 4: The Power to Make a Change Handout 1 Handout 2 Handout 3 D.C. Healthy Corner Store Program Healthy Snacking at the Corner Store Post-Program Survey First Name: _________________________________ Please circle or fill in your answers below. 1) How many sodas do you drink in a week? 0 1-2 3-4 5 or more 2) Can you find a healthy snack in the corner store? Yes No I don’t know If you said yes, write one example: _____________________________________________ 3) Can you tell if a drink is good for you? Yes No If you said yes, how can you tell? ______________________________________________ 4) Does advertising (like TV commercials) help you pick what foods to eat? Yes No I don’t know 5) Would the corner store owner sell healthy snacks if you asked for them? Yes No I don’t know 6) Is it unhealthy to be overweight? Yes No I don’t know Why or why not: ___________________________________________________________ _________________________________________________________________________ over Post-Program Survey (continued) 7) Do you think your neighborhood has enough healthy food? Yes No I don’t know Why or why not: ___________________________________________________________ _________________________________________________________________________ 8) What did you like about the Healthy Snacking at the Corner Store program? _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ 9) What would you change about the Healthy Snacking at the Corner Store program? _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ Please return this survey to D.C. Hunger Solutions: Mail: 1875 Connecticut Ave. NW, Suite 540, Washington, DC 20010 Fax: 202-986-2525 Email: kroberts@dchunger.org