THE FAMILY HEALTH CHALLENGE

Guidebook

Developed by

The Mary Mitchell Family and Youth Center

and

Committee of Interns and Residents/SEIU Health

Copyright 2011 Mary Mitchell Family & Youth Center and the Committee of Interns and Residents. All rights reserved. Copying and distribution of this document is permitted.

www.Bronxcan.com

Mary Mitchell Family and Youth Center

Dear Fellow Bronxite: In its annual county health report, the Robert Wood Johnson Foundation found that the Bronx ranks 62nd out of 62 counties in New York State in health outcomes making it the unhealthiest county in the state. The findings are based on a number of factors, including individual health behaviors, clinical care, social and economic factors, and physical environment. The County Health Report has been a call to action for elected officials, community leaders, and individuals throughout the Bronx to address the health issues endemic to our communities. To that end, we are proud to have launched our Bronx CAN (Change Attitudes Now) Health Initiative. Since June of this year, the Bronx CAN Health Initiative has brought together individuals, health providers, places of worship, community gardens, community centers, schools, and civic-minded groups of all kinds to promote the types of behaviors that lead to healthy lifestyles. The goal of the Bronx CAN Health Initiative is to have all members of our community young and old alike build healthier lives, free of ailments like obesity, diabetes, high blood pressure and high cholesterol, and cardiovascular disease. Weve been working to make the Bronx healthier by using the natural and human resources right here in our communities: the best advice and care of our experts in the health care field, the healthy food providers in the area, and the outdoor spaces that surround the 33rd District. Now, we are pleased to launch the last leg of the Bronx CAN Health Initiative: the Family Health Challenge. Developed by the Mary Mitchell Center and the Committee of Interns and Residents, the Family Health Challenge is meant to provide information to youth and families about the health crisis in our neighborhoods that stems from what we eat and the lack of exercise we get. In fact, half the children born this year in the Bronx will have diabetes in their lifetime and 60% of adults are overweight or obese. Contained in this booklet is information on ways we can combat this epidemic. It is centered on six components and eight health behaviors. Our offices are providing free copies of this booklet to ANY school, child, or parent in the Bronx who vows to take the Family Health Challenge for EIGHT weeks, from October 24 th to December 19th. To learn more about the Bronx CAN Family Health Challenge, contact Senator Riveras Bronx CAN Health Coordinator, Jessica Flores at bronxcan@gmail.com or 718-933-2034. Sincerely yours,

Ruben Diaz, Jr. Bronx Borough President

Gustavo Rivera New York State Senate, 33rd District

Bronx Can Health Initiative www.bronxcan.com

MMC/CIR Family Health Challenge Page 1

The Family Health Challenge Overview

The Mary Mitchell Center (MMC) and the Committee of Interns and Residents (CIR) developed the Family Health Challenge in order to provide information to families about the health crisis in our neighborhood that stems from what we eat and the lack of exercise we get. In fact, half the children born this year in the Bronx will have diabetes in their lifetime and 60% of adults are overweight or obese. We believe that every person deserves to be healthy and that we should work together to make it easier for children and their parents to make healthy decisions. The Family Health Challenge has six components: 1. Choose your challenges. MMC and CIR have created eight challenge activities. Each challenge should be given to a group of children or youth for one week. We recommend doing all eight challenges but an instructor can decide for how many weeks and which challenges they want to use. 2. Learn about healthy choices and why they are important. Each week there is one challenge for participating children or youth. There is an information sheet about that challenge for the instructor to use and to send home to the parents. (sheets included) 3. Take action to make healthy choices. Youth are asked to take an action as a challenge to being healthy. They are either asked to do something (for example: eat more fruits and vegetables) or to stop doing something (for example: dont eat fast food). 4. Reflect on the challenges and how they impact the individual and the family. Children or youth are asked to reflect on the challenge and their progress each day. They can do this through individual recording sheets or with a large recording sheet used for the whole group. This includes reflection on how the child informed their family about the challenge. (templates included) 5. Celebrate success! At the end of the challenge the group should celebrate the success of the children or youth with a party that includes healthy food and certificates of accomplishment. Contact us to get certificates from Senator Rivera and the Bronx Borough President. 6. La Canasta a food buying club for the Bronx. To help families get access to healthy food, the Mary Mitchell Center has created a food buying club and any group of people can become a delivery site if they have at least five members and a way to manage the food drop off. We hope that schools will be willing to act as drop off sites for the families in their schools so that the families will have access to healthy, low-cost food. For more information, on this, contact Heidi Hynes or Idalmi Acosta at the Mary Mitchell Center at 718 583-1765 or Nagiane Lacka at the Committee of Interns and Residents at 212-356-8100.

Bronx Can Health Initiative www.bronxcan.com

MMC/CIR Family Health Challenge Page 2

Family Health Challenge

Instructions for Week 1
Because your family deserves to be safe and healthy!
Week 1: Only drink water or milk for a week (No Soda or Juice) This week, only drink water or milk. If you drink milk, drink 1% or 2%; food high in fat like whole milk and cheese are high in calories. The low-fat products taste almost the same and are much healthier. Each day write in yes or no to indicate if you only drank water or milk that day.

Our bodies are made up of 60% water and need liquids to flush out waste from organs and carry nutrients to cells.1 When you feel thirsty your body is telling you that you need water. If your body doesnt get enough water you may have a dry mouth, dry skin, headaches, constipation or feel tired or dizzy. If you have a sugary drink when you are thirsty you confuse your body; it needs water and you are feeding it calories and fat. Even though you are drinking something, your body still needs water. Drinking soda actually moves nutrients out of your body instead of where they need to go in your body and the sugar you drink (about 10 teaspoons in a cup!) turns to fat. 100% juice has too much sugar/sweetener and has the same effect. Diet soda is not better, the sugar replacement used is controversial, and it has many of the same negative effects as regular soda such as effecting your bones.2 We need water to live and NYC tap water is free and some of the best tasting water in the Country!3 Bottled water is not more pure than tap water, it is just expensive and the cost of transporting it is bad for the environment. Soda and other sweet drinks should be treated like dessert. If this sounds boring try sparkling water. Use only 1% or 2% milk. Milk in the U.S. is fortified with vitamins A and D, it has vitamin B which plays a role in cardiovascular health, and contains calcium which protects against colon cancer and osteoporosis. Calcium also helps blood clotting, nerves, and muscles function properly. Milk is a super drink with a lot of benefits! The fat in whole milk is mostly saturated animal fat, which is the kind that raises blood cholesterol. Young children drink whole milk because they need fat, but adults and children above age 5 need the nutrients in milk without the fat. If you drink whole milk, try 2% and if you already drink 2%, try 1%. Cheese and other dairy products made from reduced fat milk taste the same.4

Weekly Facts

Nutrition and Healthy Eating. Mayo Clinic. Mayo Foundation for Medical Education and Research. 7 January 2011. http://www.mayoclinic.com/health/water/NU00283 2 Elena Conis. Milk, soft drinks and bone strength. Los Angeles Times. 3 May 2010. http://articles.latimes.com/2010/may/03/health/la-he-nutrition-lab-20100503 3 Michael Howard Saul. New Yorks Tap Water Defeated by Tiny Wisconsin Town. The Wall Street Journal. 22 June 2010. Dow Jones & Company. http://blogs.wsj.com/metropolis/2010/06/22/new-yorks-tap-water-defeated-by-tiny-wisconsin-town/. 4 Skim Milk: Natural Weight-Loss Foods. Discovery Fit and Health. 2011 Discovery Communications. http://health.howstuffworks.com/wellness/foodnutrition/natural-foods/natural-weight-loss-food-skim-milk-ga.htm.
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Bronx Can Health Initiative www.bronxcan.com

MMC/CIR Family Health Challenge Page 3

Family Health Challenge

Instructions for Week 2 and 3
Because your family deserves to be safe and healthy! Week 2: Eat 1 fresh fruit each day. The US Department of Agriculture suggests that children 8 years old and under eat 1 to 1 cups of fruit per day. A cup of fruit is about one orange, pear or apple. Try eating 1 piece of fruit (or a cup of any fresh fruit like grapes or sliced melon). Use the Family Health Challenge Chart to write the number of fruits you ate each day. Drinking fruit juice does not count for this challenge; whole fruit is much better than fruit juice because it has fiber and more nutrients. Week 3: Eat 1 1/2 cups of vegetables every day. Try eating one RAW veggie! The US Department of Agriculture recommends that children 8 years old and under eat 1 cups of vegetables per day because vegetables have important nutrients that our bodies need. A half cup of vegetables is about one carrot or one celery stick. Cooking some vegetables can lower their nutritional value so try a veggie raw! Every day record the number of cups of vegetables you ate in the Family Health Challenge chart. Remember that at every meal half of your plate should have fruits and vegetables.

Weekly Facts
Eating Fruits and vegetables is like taking delicious vitamins! They are full of things that our bodies need to grow, function properly and prevent disease. Eating fruits and vegetables can reduce risk type 2 diabetes and protect against certain cancers, such as mouth, stomach, and colon cancer. They have fiber which can reduce the risk of heart disease and reduce blood cholesterol levels. Fruits and vegetables have Vitamin C which helps heal cuts and wounds, and keeps teeth and gums healthy. They also have Vitamin A which helps protect against infections. Whole Fruits Fruit juices contain little or no fiber. Whole fruits have potassium which can maintain healthy blood pressure, reduce the risk of developing kidney stones and decrease bone loss. Most fruits are naturally low in fat, sodium, and calories. None have cholesterol. 5 Eating a portion of fruit has more benefits, less sugar, and makes you feel fuller than a portion of juice. Try eating one RAW veggie! Try raw carrots or celery. Cooking vegetables changes the way they are processed in your body; some vitamins are enhanced when the vegetable is cooked and others when the vegetable is raw, so try both!

Food Groups. Choose My Plate. 4 June 2011; USDA. http://www.choosemyplate.gov/foodgroups/index.html.

Bronx Can Health Initiative www.bronxcan.com

MMC/CIR Family Health Challenge Page 4

Family Health Challenge

Instructions for Week 4 & 5
Because your family deserves to be safe and healthy!
Week 4: Eat whole grains once every day Very processed grains like white rice, white bread and pasta do not have much nutritional value. Try eating brown rice, whole wheat or multi-grain bread, or whole wheat pasta with one meal each day. Write the number of times you ate whole grains each day in your Family Health Challenge Chart. Week 5: Exercise everyday for 30 minutes Every day do a physical activity for 30 minutes, you can walk up stairs or get off the bus one or two stops early to walk. You do not have to do it for 30 minutes straight; it can be 15 minutes twice a day or 10 minutes three times a day, etc. If your doctor says its ok, it is best to exercise in a vigorous way at least three times a week (run, walk fast, bike). Write down the number of minutes you exercised each day.

Weekly Facts
Eat whole grains once every day. There are whole-grain versions of rice, bread, flour, crackers and pasta at any grocery store. Enjoy high-fiber cereals like bran flakes, shredded wheat or oatmeal. Try whole-wheat toast, whole wheat bagels or whole-wheat tortillas. Other whole grains include barley, brown rice, buckwheat, bulgur (cracked wheat), millet, oatmeal, popcorn and wild rice. All types of grains are a good source of carbohydrates, but whole grains are even better. Before a grain is processed it is a whole grain, it has a casing that is full of fiber, selenium, potassium and magnesium. Refined grains have this layers removed, taking away some of the nutritional value. For example, a slice of white bread (made from refined grains) has 1.9 grams protein and 0.6 grams fiber. A slice of whole-wheat bread (made from whole grains) has 3.6 grams protein and 1.9 grams fiber. Always pick whole grains over refined grains when you can.6 Exercise everyday for 30 minutes Exercise doesnt need to be difficult, do something you enjoy like dancing, soccer, playing in the park or going for a walk. You don't need a lot of time--take the stairs instead of the elevator, walk during your lunch break. Doing a little all day adds up. Physical activity stimulates brain chemicals that can make you feel happier and more relaxed; regular exercise can even help prevent depression. Exercise also helps you fall asleep faster and stay asleep; at the same time, it gives you more energy. Physical activity helps the circulation of blood through your heart and blood vessels, this makes your heart and lungs work more efficiently so you will have more energy to do the things you enjoy. Physical activity can help prevent type 2 diabetes, osteoporosis, certain types of cancer, high blood pressure and cholesterol.7

Whole Grains. Mayo Clinic. 1998-2011 Mayo Foundation for Medical Education and Researh. http://www.mayoclinic.com/health/whole-grains/NU00204. Fitness. Mayo Clinic. 1998-2011 Mayo Foundation for Medical Education and Researh. http://www.mayoclinic.com/health/exercise/HQ01676/NSECTIONGROUP=2.
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Bronx Can Health Initiative www.bronxcan.com

MMC/CIR Family Health Challenge Page 5

Family Health Challenge

Instructions for Week 6
Because your family deserves to be safe and healthy!
Week 6: Eat small portions of meat and grains Eat only one portion of grain and meat per meal. Think of one portion as the same size as your fist. Our stomachs are not that big and we dont need a lot of food to be healthy.

Weekly Facts
Babies are born knowing to eat when they are hungry and to stop when they arent. As we grow up, we learn to eat more than we need because we have to clean our plates or because commercials and restaurants tell us we can and should eat more.8 Our stomachs are not that big and we dont need a lot of food to be healthy. Your stomach is about the size of your fist and that is the amount of food you need at each meal to feel satisfied. It takes about 20 minutes for your stomach to tell your brain that you have eaten enough, so eat slowly and take breaks so you can listen to your body. So how did you eat so much last night? Your stomach is like a balloon that can stretch to three times its size. You may fell this stretch when you start belching, feel uncomfortably full or get heartburn. Heartburn is when your stomach is so full that the acid in your stomach used to break down food starts to go into your esophagus because the natural cap on your stomach is busted open!9 Studies have shown that however much or however little food we are served, that is how much we eat and we feel satisfied. If you were served cup of rice or 3 cups, you would eat it all and say you were comfortable either way. Even if you are served food you think tastes bad, you will still eat it just because it is in front of you. It sounds crazy, but it is true!10 Eat only one portion of grain and meat per meal. If you had a whole plate of ground beef for dinner you would have a lot of protein, but you wouldnt have anything else your body needs; it is the same for all foods. Different foods give us the nutrients and vitamins we need so we need a little bit of everything. If we increase the amount of fruits and vegetables we eat, it is easy to eat less grain and meat because we have other things to make us satisfied. Pay attention to package labels that indicate how big a portion is, sometimes one package contains several portions but we eat the whole thing by ourselves. The chart below outlines portions for each food group. Vegetables Fruit

Carbohydrates

Meat

Fats & Sugars

Snacks

Elaine Magee, MPH, RD. How to Stop Overeating. WedMD. 2006. http://www.webmd.com/diet/features/overcoming-overeating. 9 Cassy Richmond. The Consequences of Overeating. MSN. 3 December 2010. http://health.ninemsn.com/au/naturaltherapies/naturalhealth/8175269/whathappens-to-your-body-when-you-overeat. 10 Do Increased Portion Sizes Affect How Much We Eat? Research to Practice Series No. 2: Portion Size. Centers for Disease Control and Prevention, 2006.
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Bronx Can Health Initiative www.bronxcan.com

MMC/CIR Family Health Challenge Page 6

Family Health Challenge

Instructions for Week 7
Because your family deserves to be safe and healthy!
Week 7: Do not eat take out, instead have one healthy, homemade meal for dinner this week and sit down with the whole family to eat. The food you prepare at home is healthier than eating in a restaurant and when you eat with your family, your family is healthy too. Eat at home with the family and no distractions (turn the TV off, dont read anything at the table, and just talk to each other!). Write yes or no each day to indicate if you avoided eating out.

Weekly Facts
Sharing homemade meals is one of the greatest habits that a family can practice together; it can have a positive effect on your familys physical, mental and emotional health & strength. When their families eat dinner together, children are more likely to perform well in school and less likely to use drugs. Family members are more likely to share what is on their mind and talk through difficulties. Research shows that when families eat together at home they usually eat more fruits and vegetables and fewer fried foods and soda. Kids who frequently eat dinner with their families are also less likely to be overweight.11

Oftentimes, the amount of food served at restaurants is more than we actually need, and costs far more than it would if prepared at home. For example, a restaurant charges $8-14 for a pasta dish that may only cost $1-3 per pound to make at home. Also, since someone else is doing the food preparation, there is no way of knowing the ingredients or quality of the food that you eat. Restaurants sometimes add extra ingredients like fat, sugar and preservatives to make the food look or feel a certain way. Fast food chains are the most common restaurants we eat out at, but they are also the least healthy for us. They serve food which is mostly processed, not fresh, and often produced in another location before it gets reheated and served to local customers. Its also very fattening: we know that some hamburgers contain 2,500 calories12more than some people should eat during an entire day! If you made the same burger at home it would have less fat and calories, it would have no extra chemicals and it would probably taste better!

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Jeanie Lerche Davis. Family Dinners are Important. WebMD. July 17, 2007. http://children.webmd.com/guide/family-dinners-are-important. McDonald's USA Nutrition Facts for Popular Menu Items. McDonalds USA. http://nutrition.mcdonalds.com/nutritionexchange/nutritionfacts.pdf.

Bronx Can Health Initiative www.bronxcan.com

MMC/CIR Family Health Challenge Page 7

Family Health Challenge

Instructions for Week 8
Because your family deserves to be safe and healthy!
Week 8: Watch only 1 hour of screen time each day. Screen time includes watching TV and videos, playing video games and hand-held games, and using the computer for recreational purposes. Limit the total time you do any of these activities to one hour. Instead of screen time find a way to help your neighborhood by volunteering or joining a community garden. On your Family Health Challenge Chart write the number of hours of screen time you watched each day.

Weekly Facts
Most children watch an average of four hours of television each day. The more time we spend in front of a screen, the less time we spend with family and friends or doing other fun activities.13 Children who watch more than two hours of TV a day are more likely to be overweight. The more time you spend in front of a screen, the more you are likely to resist going to sleep and having trouble falling asleep. Adolescents who spend more than two hours a day in front of a screen are more likely to have emotional, social and attention difficulties and are more likely to bully than children who don't. Also, elementary students who have TVs in their bedrooms tend to perform worse on tests than those who don't.14 It is also important to understand what is on the screen: Violence? Food and toy advertisements?15 There is so much to do outside of television: play outdoors or indoors, board games, hide and go seek, reading, sports, art and volunteering. Get involved in your community Having a safe and healthy neighborhood is part of being healthy. Find a way to help your neighborhood by volunteering or visiting a community garden. There are enough volunteer opportunities for everyone to get involved however they choose: from animal shelters to youth groups, extra help is always needed and appreciated. Volunteering in your community has more benefits than you can measure: you can meet new people, learn new skills, use talents you never knew you had and use your experience for future references and job opportunities.16 Visiting a community garden or park can reduce your stress level, improve your well being and mental health, allow you to eat healthier foods for less money, breath fresher air, increase your physical activity, and beautify your neighborhood.17 A community garden can grow flowers or food; it can be at a school, hospital, or in a neighborhood. You dont have to own land, you can eat what you grow and your food wont have pesticides or chemical fertilizers. Visiting a community garden is a good way to learn about what is happening in your neighborhood.18

13

The Children in Balance initiative at the Friedman School of Nutrition Science and Policy at Tufts University. Screen Time: Limit It. Tufts University. http://www.tufts.edu/nutrition/childreninbalance/documents/ScreenTime.pdf. 14 Children and TV: Limiting your child's screen time. Mayo Clinic. Mayo Foundation for Medical Education and Research 2 April 2011. http://www.mayoclinic.com/health/children-and-tv/MY00522. 15 Tips to Reduce Screen Time. National Heart Lung and Blood Institute. US Department of Health and Human Services. http://www.nhlbi.nih.gov/health/public/heart/obesity/wecan/reduce-screen-time/tips-to-reduce-screen-time.htm 16 Its My Life. PBS Kids. 2005 CastleWorks. http://pbskids.org/itsmylife/emotions/volunteering/article2.html What is a Community Garden. American Community Gardening Association. http://www.communitygarden.org/learn/ 17 What is a Community Garden. American Community Gardening Association. http://www.communitygarden.org/learn/ 18 The Multiple Benefits of Community Gardening. The Green Institute. 18 January 2006. http://www.communitygarden.org/docs/learn/articles/multiple_benefits.pdf.

Bronx Can Health Initiative www.bronxcan.com

MMC/CIR Family Health Challenge Page 8

Week 1: Drink ONLY water or low-fat milk.

Did you drink ONLY water or low-fat milk today? Monday Tuesday Wednesday Thursday Friday Saturday Bonus: What other Sunday challenge did you try?

Was it hard not to drink sugary drinks?

Week 2: Eat 3 fresh fruits each day.

How many pieces of fruit did you eat today? Monday Tuesday Wednesday Thursday Friday Saturday Bonus: What other Sunday challenge did you try?

Did you eat more of these fruit than usual?

Week 3: Eat 3 cups of vegetables each day.

How many cups of vegetables did you eat today? Monday Tuesday Wednesday Thursday Friday Saturday Bonus: What other Sunday challenge did you try?

What vegetables did you like?

Week 4: Eat whole grains once a day.

How many portions of whole grain did you eat today? Monday Tuesday Wednesday Thursday Friday Saturday Bonus: What other Sunday challenge did you try?

Was it hard finding whole grains? Did they taste different?

Bronx Can Health Initiative www.bronxcan.com

MMC/CIR Family Health Challenge Page 9

Week 5: Exercise for 20 minutes per day.

How many minutes of exercise did you do today? Monday Tuesday Wednesday Thursday Friday Saturday Sunday Bonus: What other challenge did you try?

What activities did you do for exercise?

Week 6: Eat small portions of meat and grains (the size of your fist) everyday.
How many small portions did you eat today? Monday Tuesday Wednesday Thursday Friday Saturday Sunday Bonus: What other challenge did you try?

Was it difficult to eat smaller portions?

Week 7: Don't eat out or get take out.(Instead eat a home-cooked meal, with others and no distractions)
Did you avoid eating out or eating take out today? Monday Tuesday Wednesday Thursday Friday Saturday Sunday Bonus: What other challenge did you try?

At home, who cooked for you? What kind of food did you eat? Was it hard not to eat out or eat take out?

Week 8: Watch only ONE hour of Screen Time (t.v., computer, video games) every day.
How much Screen Time (t.v., computer, video games) did you view today? Monday Tuesday Wednesday Thursday Friday Saturday Sunday Bonus: What other challenge did you try?

Bronx Can Health Initiative www.bronxcan.com

MMC/CIR Family Health Challenge Page 10

Querido residente del Bronx: En el informe anual de salud de condados, la fundacin Robert Wood Johnson encontr que el Bronx esta en el ltimo lugar de los 62 condados en el estado hacindolo el condado menos saludable del estado de Nueva York. Los resultados estn basados en una serie de factores, incluyendo las conductas de salud, atencin clnica, factores econmicos y sociales, y el medio ambiente fsico. El Informe de Salud del Condado ha sido un llamado a la accin para los oficiales electos, lderes comunitarios e individuos a travs del Bronx para enfrentar los problemas de salud que son endmicos de nuestras comunidades. Con ese fin, estamos orgullosos de haber lanzado La Iniciativa de Salud Bronx CAN (Cambiar Actitudes Ahora). Desde junio de este ao, la Iniciativa Bronx CAN ha unido a individuos, proveedores de salud, organizaciones religiosas, jardines comunitarios, centros comunitarios, escuelas y grupos cvicos para promover mejores hbitos de salud. Nuestra meta como parte de la Iniciativa Bronx CAN es que todos los miembros de la comunidad jvenes y adultos adapten mejores hbitos de salud y que tengan vidas ms saludables, libre de enfermedades como la obesidad, la diabetes, la hipertensin, el colesterol alto y las enfermedades cardiovasculares. Hemos estado trabajando para hacer el Bronx ms saludable usando recursos naturales y humanos que se encuentran aqu mismo en nuestras comunidades: el mejor asesoramiento y asistencia de nuestros expertos en el campo de la salud, los proveedores de alimentos saludables en nuestra rea, y los espacios al aire libre que rodean el distrito senatorial 33. Estamos orgullosos de lanzar la ltima etapa de la Iniciativa de Salud Bronx CAN: El Reto de Salud Para Familias y Jvenes. Desarrollado por el Centro Comunitario Mary Mitchell y el Comit de Internos y Residentes, El Reto de Salud Para Familias y Jvenes ofrece informacin a jvenes y a sus familias sobre la crisis de salud en nuestras vecindades que se deriva de la forma que comemos y la falta de ejercicio. De hecho, la mitad de todos los nios nacidos este ao tendrn diabetes en su vida y el 60% de los adultos estn actualmente sobre peso u obesos. Este folleto contiene informacin sobre las maneras en las cuales podemos combatir esta epidemia. El folleto se centra en seis componentes y ocho conductas de salud. Nuestra oficina esta ofreciendo copias gratuitas de este folleto a CUALQUIER escuela, nio, padre o madre en el Bronx que se comprometa a asumir El Reto de Salud Para Familias y Jvenes por OCHO semanas, del 24 de Octubre hasta el 23 de Diciembre. Para aprender ms sobre El Reto de Salud Bronx CAN Para Familias y Jvenes, contacte a la coordinadora de la Iniciativa Bronx CAN, Jessica Flores: escrbale al correo electrnico BronxCAN@gmail.com o llame al 718-933-2034. Sinceramente,

Ruben Diaz, Jr.

Bronx Borough President

Gustavo Rivera
New York State Senate, 33rd District

Bronx Can Health Initiative www.bronxcan.com

MMC/CIR Family Health Challenge Page 11

Resumen del Reto Familiar de Salud

El Centro de Juventud Mary Mitchell (MMC) en conjunto con el Comit de Internos y Residentes mdicos (CIR) ha creado el Reto Familiar de Salud para proveer informacin a jvenes y a sus familias sobre la crisis de salud en la que se encuentra nuestras comunidades que se deriva de la forma que comemos y la falta de ejercicio que hacemos. De hecho, la mitad de todos los nios nacidos este ao tendrn diabetes en su vida y el 60% de adultos estn actualmente sobre peso u obesos. Nosotros creemos que cada persona merece ser saludable y para eso estamos dispuestos a trabajar junto con los nios y sus padres para proveer informacin que los ayudar a tomar mejores decisiones de salud. Este Reto Familiar de Salud tiene seis componentes: 1. Elija sus retos. El MMC y CIR han creado ocho actividades que tienen que ver con diferentes retos. Cada reto ser enfrentado por un grupo de nios o jvenes por una semana. Nosotros recomendamos completar los ocho retos, pero el instructor podr mejor decidir cuales retos se deben hacer y por cuantas semanas se deben hacer. 2. Aprenda sobre las opciones saludables y porque son importantes. Cada semana hay un reto en el cual pueden participar nios y jvenes. Hay una hoja con informacin acerca del reto que el instructor puede usar al igual que puede enviar esta informacin con los nios o jvenes a su casa para que las familias de los jvenes puedan leer los materiales y unirse a nuestra actividad. 3. Tomar accin para tener opciones ms saludables. Se les pedir a los jvenes que tomen accin para ser ms saludables. Se les pedir que hagan algo (por ejemplo: comer ms frutas y vegetales) o que dejen de hacer algo (por ejemplo: no comer comida frita). 4. Reflexione sobre los retos y como han impactado al individuo y su familia. Se les pedir a los jvenes que reflexionen sobre el reto de cada semana y como han progresado de da a da. Ellos pueden hacer esto a travs del uso de una hoja de papel individual o con una hoja de registro como grupo donde todos los nios puedan compartir sus logros. Esto incluira reflexionar como el joven ha impactado las vidas de sus familiares. 5. Celebrar el xito! Al final del reto, el grupo deber celebrar el xito de los nios o jvenes con una fiesta o celebracin que incluir comidas saludables y certificados de logros. Pnganse en contacto con nosotros para obtener certificados del Senador Rivera y el Presidente del condado del Bronx, Rubn Daz, Jr. 6. La Canasta un club para comprar comida en el Bronx. Este club ha sido creado por el MMC con el propsito de asegurar que las familias del Bronx tengan acceso a comidas ms saludables. Cualquier grupo de cinco personas, con la capacidad de distribuir el alimento, puede pedir que estas comidas sean distribuidas en su vecindad. Nosotros esperamos que las escuelas se puedan utilizar como centros de distribucin local y as las familias del Bronx puedan tener acceso a comidas ms saludables a un costo menor. Para ms informacin, por favor contacte a Heidi Hynes o Idalmi Acosta en el CMM a este nmero 718-583-1765 o a Nagiane Lacka del Comit de Internos y Residentes mdicos al telfono 212-356-8100.

Bronx Can Health Initiative www.bronxcan.com

MMC/CIR Family Health Challenge Page 12

El Reto Familiar de Salud

Instrucciones para la primera Semana
Su familia merece estar sana y estar segura!
Primera semana: Beba solamente agua potable o leche (no beba refrescos o jugos) durante toda la semana. Esta semana beba solamente agua potable o leche. Si decide tomar leche, beba leche de 1% o 2%; las comidas altas en grasa como la leche entera y el queso contienen un porcentaje alto de caloras. Los productos bajos en grasa saben casi igual y son mucho ms saludables. Cada da escriba Si o No para indicar si ha tomado solamente agua o leche (de 1% o 2%) ese da.

Informacin Semanal
El 60% del cuerpo humano es agua y necesita eliminar los residuos que producen los rganos para llevar los nutrientes importantes a las clulas.19 Cuando tiene sed, su cuerpo le est diciendo que necesita agua. Si su cuerpo est deshidratado, los sntomas incluyen el tener la boca seca o la piel seca, sentir dolor de cabeza, cansancio, vrtigo o estreimiento. Si usted toma una bebida azucarada cuando tiene sed, su cuerpo se confundesu cuerpo necesita agua, pero le est dando azcar y grasa. A pesar de que est tomando algo, su cuerpo todava necesita agua. Los refrescos sacan los nutrientes de su cuerpo en vez de mantenerlos dentro de su cuerpo. Tambin, el azcar (hay hasta 10 cucharaditas en un solo vaso!) y las caloras de los refrescos se convierten en grasa. Los jugos que son 100% puros tambin tienen demasiada azcar y tienen el mismo efecto. Los refrescos dietticos no son mejores--los endulzantes artificiales que tienen son controversiales y traen mucho de los mismo efectos negativos que los refrescos regulares, como un impacto negativo a sus huesos.20 Necesitamos el agua para vivir, y el agua del grifo de la ciudad de Nueva York es gratis y una de las ms sabrosas del pas.21 El agua embotellada no es ms pura que el agua del grifo: el agua embotellada es ms cara y el cargo adicional de la botella plstica para transportar el agua daa al medio ambiente. Usted debera pensar en los refrescos y otras bebidas con azcar como postres. Si la idea de tomar agua suena aburrido, pruebe el agua gaseosa. Tome Leche con 1% o 2% de Grasa. En los Estados Unidos, la leche es fortificada con vitaminas A y D; tambin tiene vitamina B, que mejora la salud del sistema cardiovascular. Tambin, la leche tiene calcio que protege en contra del cncer del colon y la osteoporosis. El calcio tambin ayuda al buen funcionamiento de la coagulacin de la sangre, los nervios y los msculos. La leche es una muy buena bebida, con muchos beneficios! La mayora de la grasa en la leche entera es grasa de animal saturada, que tambin sube el colesterol. Los bebs tienen que tomar leche entera porque necesitan la grasa, pero los adultos y los nios de ms de 5 aos de edad necesitan los nutrientes, pero no la grasa. Si toma leche entera, intente cambiar a leche de 2%. Si toma leche de 2%, intente tomar la de 1%. Si quiere comer queso, intente comer quesos y otros productos lcteos hechos de leche desnatada, que tienen casi el mismo sabor.22
Nutrition and Healthy Eating. Mayo Clinic. Mayo Foundation for Medical Education and Research. 7 January 2011. http://www.mayoclinic.com/health/water/NU00283 20 Elena Conis. Milk, soft drinks and bone strength. Los Angeles Times. 3 May 2010. http://articles.latimes.com/2010/may/03/health/la-he-nutrition-lab-20100503 21 Michael Howard Saul. New Yorks Tap Water Defeated by Tiny Wisconsin Town. The Wall Street Journal. 22 June 2010. Dow Jones & Company. http://blogs.wsj.com/metropolis/2010/06/22/new-yorks-tap-water-defeated-by-tiny-wisconsin-town/ 22 Skim Milk: Natural Weight-Loss Foods. Discovery Fit and Health. 2011 Discovery Communications. http://health.howstuffworks.com/wellness/foodnutrition/natural-foods/natural-weight-loss-food-skim-milk-ga.htm. Elena Conis. Milk, soft drinks and bone strength. Los Angeles Times. 3 May 2010. http://articles.latimes.com/2010/may/03/health/la-he-nutrition-lab-20100503
19

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El Reto Familiar de Salud

Instrucciones para la 2 y 3 Semana
Su familia merece estar sana y segura! Segunda Semana: Coma tres frutas todo los das El Departamento de Agricultura de los Estados Unidos sugiere que los nios menores de 8 aos deben comer de 1 1 tazas de fruta al da. Una taza es equivalente a una naranja, una pera o una manzana. Trate de comer 1 fruta (o un taza de frutas frescas como uvas o meln picado). Use la tabla al final de este folleto y escribir la cantidad de frutas que ha comido cada da. Tomando jugos de fruta no cuenta en este reto; la fruta natural es mucho mejor que los jugos hechos de fruta porque las frutas tienen ms fibra y ms nutrientes. Tercera Semana: Coma 1 taza de vegetales cada da. Intente comer un vegetal CRUDO diariamente! Los vegetales contienen nutrientes importantes que nos ayudan a mantenernos saludables. El Departamento de Agricultura de los Estados Unidos sugiere que los nios de 8 aos y menores coman 1 tazas de vegetales al da. Una taza mediana de vegetales es por ejemplo una zanahoria o un tallo de apio. Cocinar los vegetales reduce su valor nutritivo; por lo tanto, haga el esfuerzo de comerlos crudos.

Informacin Semanal
Comer frutas y vegetales es como tomar vitaminas con buen sabor! Tienen muchas cosas que el cuerpo necesita para crecer, funcionar bien e impedir enfermedades. Comer frutas y vegetales puede reducir el riesgo de diabetes tipo 2 y prevenir algunos tipos de cncer, como el cncer de boca, estmago, y de colon. Tambin, tienen fibra que pueden disminuir el riesgo de padecer de enfermedades del corazn y pueden reducir su colesterol. Las frutas y vegetales tambin tienen vitamina C, que ayuda a cicatrizar las heridas y mantener los dientes y encas saludables. Tambin, tienen vitamina A, que protege en contra de infecciones. Frutas Enteras Los jugos naturales no tienen mucha fibra. Las frutas enteras tienen potasio que ayuda a mantener su presin sangunea, reducen el riesgo de tener piedras en los riones y reducen la prdida de masa sea. La mayora de las frutas naturalmente tienen poca grasa, sodio y caloras. Ninguna fruta tiene colesterol. 23 Una racin de fruta entera tiene ms beneficios, menos azcar, y despus de comer fruta, uno se siente ms lleno que despus de tomarse una taza de jugo. Intente comer un vegetal CRUDO diariamente! Intente comer una zanahoria o un apio crudo. Cuando cocina los vegetales, su cuerpo los procesa diferente. Algunas vitaminas aparecen cuando se cocina el vegetal, otras vitaminas solo aparecen cuando uno se los come crudos. Intntelo de ambas formas!

23

Why it is important to eat Vegetables. Food Groups. United State Department of Agriculture. http://www.mypyramid.gov/pyramid/vegetables_why.html.

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El Reto Familiar de Salud

Instrucciones para 4 y 5 Semana
Su familia merece estar sana y segura!
Cuarta Semana: Coma granos integrales una vez al da. Los alimentos que contienen granos muy procesados, como el arroz blanco, la pasta y el pan blanco, no son muy nutritivos. En vez de esos alimentos, coma arroz, pan o pasta integral una vez al da. Usa la tabla al final de este folleto para escribir la cantidad de granos integrales que ha comido cada da. Quinta Semana: Haga ejercicios por 30 minutos diariamente. Cada da haga 30 minutos de actividad fsica. Puede subir escaleras o bajarse del autobs una o dos paradas antes de la suya para caminar. No tiene que hacerlo de una vez, puede ser 15 minutos dos veces al da, o 10 minutos tres veces al da, etc. Si su mdico le permite, lo mejor sera hacer ejercicios en forma vigorosa, por lo menos tres veces por semana. Corra, camine rpidamente o monte bicicleta y use la tabla al final de este folleto para escribir cuantos minutos de ejercicio ha hecho cada da.

Informacin Semanal
Coma granos integrales una vez al da. En todos los supermercados hay arroz, pan, harina, galletas, y pastas integrales. Consuma cereales con alta fibra como el trigo trisado o la avena. Intente comer tostadas, bagels o tortillas integrales. Los granos Integrales incluyen: cebada, arroz marrn, trigo sarraceno, trigo burgol (trigo partido), quinua, palomitas de maz y el arroz salvaje. Todos los granos son carbohidratos, pero los granos integrales son una mejor opcin. Los granos integrales mantienen su cscara. La cscara tiene fibra, potasio, selenio y magnesio. Los granos refinados no tienen esa cscara, y por lo tanto no tienen tantos nutrientes. Por ejemplo, una rebanada de pan blanco (hecho de granos refinados) tiene 1,9 gramos de protena y 0,6 gramos de fibra. Una rebanada de pan integral (hecho de granos integrales) tiene 3,6 gramos de protena y 1,9 gramos de fibra. Esta comiendo lo mismo pero recibiendo mucho ms con pan integral! Si tiene la opcin, elija los granos integrales.24 Haga ejercicios diariamente por 30 minutos. El ejercicio no tiene que ser difcil. Haga cosas que le gusta como bailar, jugar futbol, jugar en el parque o caminar. No necesita mucho tiempouse las escaleras en vez de usar el ascensor, camine durante su hora de almuerzo. Todo se va acumulando. Las actividades fsicas estimulan los qumicos del cerebro que le hacen sentirse ms feliz y ms relajado. Hacer ejercicios regularmente previene la depresin. Tambin, los ejercicios le ayudan dormir con ms facilidad, y tambin, le dan ms energa. Las actividades fsicas mejoran la circulacin de la sangre a su corazn. Eso hace que su corazn y sus pulmones trabajen con ms facilidad, por lo tanto, tendr ms energa para hacer las cosas que le gustan. Las actividades fsicas ayudan a prevenir la diabetes tipo 2, la osteoporosis, algunos tipos de cncer, la presin alta y el colesterol.25
Whole Grains. Mayo Clinic. 1998-2011 Mayo Foundation for Medical Education and Researh. http://www.mayoclinic.com/health/whole-grains/NU00204. Fitness. Mayo Clinic. 1998-2011 Mayo Foundation for Medical Education and Researh. http://www.mayoclinic.com/health/exercise/HQ01676/NSECTIONGROUP=2.
24 25

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El Reto Familiar de Salud

Instrucciones para la 6 Semana
Su familia merece estar sana y segura!
Sexta semana: Coma porciones ms pequeas de carne y granos. Coma solo una porcin de granos y carnes por comida. Una porcin no debe exceder el tamao de su puo. Nuestros estmagos no son tan grandes y no necesitamos tanta comida para llenarnos.

Informacin Semanal
Al nacer, los bebes instintivamente saben que deben comer cuando tienen hambre y que deben dejar de comer cuando estn satisfechos. Pero al crecer, se nos ensea la costumbre de comer ms de lo que necesitamos: aprendemos que cuando comemos, siempre hay que limpiar el plato, y los restaurantes y la propaganda nos incitan a creer que debemos comer ms.26 Nuestros estmagos no son tan grandes y no necesitamos mucha comida para ser saludables. Su estomago es casi del mismo tamao que su puo. Eso es ms o menos la cantidad de alimento que necesitamos comer en una comida para sentirnos satisfechos. Tarda casi 20 minutos para que su estmago comunique al cerebro que est a capacidad. Entonces, trate de comer ms despacio, tomando pausas para escuchar lo que le est diciendo su cuerpo. Si esto es cierto, cmo se puede comer tanto? Su estmago es como un globo que puede triplicarse en tamao. Uno puede sentir este estiramiento cuando tiene que eructar, cuando siente incomodo el abdomen, o cuando tiene acidez. La acidez es cuando su estomago est tan lleno que su cido no puede procesar la comida consumida, y empieza a subir por su esfago porque la tapa natural de su estomago se abri!27 Las investigaciones indican que por grande o por pequea que sea la porcin, siempre comemos la cantidad de comida que se nos sirve, y siempre nos resulta suficiente. Si a usted le sirvieran media taza de arroz o tres tazas, lo comera todo y se sentira satisfecho. Hasta si se le da comida que no le gusta se
Elaine Magee, MPH, RD. How to Stop Overeating. WedMD. 2006. http://www.webmd.com/diet/features/overcoming-overeating. 27 Cassy Richmond. The Consequences of Overeating. MSN. 3 December 2010. http://health.ninemsn.com/au/naturaltherapies/naturalhealth/8175269/whathappens-to-your-body-when-you-overeat.
26

lo comer solo porque est frente de usted. Parece ridculo, pero es la verdad!28 Coma solo una porcin de granos y carnes por comida. Si se comiera un plato entero de carne molida tendra mucha protena, pero no tendra otros nutrientes y vitaminas que su cuerpo necesita. Lo mismo se puede decir de todos los alimentos: cada uno tiene distintos beneficios, y los necesitamos todos, as tenemos que comer de todo un poco. Si comemos ms frutas y verduras, obtenemos los nutrientes suficientes para satisfacernos, y as podemos comer menos carne y grano. Fjese bien en las etiquetas de los paquetes que indican cual es el tamao de una porcin. A veces el contenido de un paquete suma varias porciones de comida, pero una sola persona se lo come todo. Esta grfica le dar une idea general del tamao de cada porcin en cada grupo alimenticio. Verduras Frutas

Carbohidratos

Carne

Grasas y Azucar

Tentempis

Do Increased Portion Sizes Affect How Much We Eat? Research to Practice Series No. 2: Portion Size. Centers for Disease Control and Prevention, 2006.
28

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El Reto Familiar de Salud

Instrucciones para Semana 7
Su familia merece estar sana y segura!
Sptima Semana: En lugar de comer en algn restaurante, coma una cena hecha saludablemente en su casa y sintese con la familia entera para cenar. Preparar la comida en casa es casi siempre ms nutritivo; y cuando nos sentamos en la mesa en familia, suele ser saludable. Coma en casa sin distracciones (apague el televisor, no lea en la mesa, y simplemente comparta y hable con su familia) Escriba Si o No cada da para indicar si evitaste comer en un restaurante.

Informacin Semanal
Compartir las comidas caseras es una de las costumbres ms importantes para una familia; puede tener un impacto positivo en la salud fsica, mental y emocional de todos los miembros de la familia. Cuando sus familiares comen juntos, los nios son ms propensos a sacar buenas notas y menos propensos a usar drogas. Los miembros de la familia tienen un lugar para compartir sus emociones y para hablar sobre desafos personales. Las investigaciones demuestran que cuando las familias comen juntos en la casa, usualmente comen ms frutas y verduras y menos comida fritas y sodas. Los nios que comen con su familia tambin son menos propensos a ser obesos.29

Muchas veces las porciones que sirven los restaurantes tienen ms de lo que necesitamos comer, y los platos siempre cuestan ms de lo que costaran si se prepararan en casa. Por ejemplo, los restaurantes cobran de $8-$12 por un plato de pasta que, cuando hecho en casa, no cuesta ms que $1-$3 por libra. Cuando alguien desconocido prepara su comida, no hay manera de saber los ingredientes usados o el valor nutricional de lo que est comiendo. A veces, los restaurantes le agregan ingredientes extras para manipular varios aspectos de la comida que preparan. Los restaurantes de comida rpida como McDonalds o Burger King son los ms populares, y tambin son los menos saludables. Usualmente sirven comida procesada y artificial, que no es fresca y que se produce en otro lugar, slo para recalentarse y servirle al cliente. Tambin, son grasosas: sabemos que algunas hamburguesas contienen ms de 2,500 calorasms de lo que muchas personas necesitan consumir en un da entero.30 Si usted prepara la misa hamburguesa en su casa, lo que cocina tendr menos grasa y caloras, no tendr qumicos o conservantes extra, y sabr mejor!

29 30

Jeanie Lerche Davis. Family Dinners are Important. WebMD. July 17, 2007. http://children.webmd.com/guide/family-dinners-are-important. McDonald's USA Nutrition Facts for Popular Menu Items. McDonalds USA. http://nutrition.mcdonalds.com/nutritionexchange/nutritionfacts.pdf.

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El Reto Familiar de Salud

Instrucciones para Semana 8
Su familia merece estar sana y segura!
Octava Semana: Limitarse a una hora Frente a la Pantalla cada da. Piense en el tiempo que pasa sentado frente a la pantalla-- viendo programas y videos por la televisin, jugando videojuegos, y usando la computadora. Es importante que haga tales actividades en moderacin: limtese a una hora o menos frente a la pantalla cada da. En vez de eso, busque una manera de ayudar a su vecindario o visite un jardn comunitario o un parque. En la tabla al final de este folleto, escriba cuantas horas pas frente de la pantalla cada da.

Informacin Semanal
La mayora de nios ven, en promedio, cuatro horas de televisin cada da. Mientras ms tiempo gastemos frente a la pantalla, ms tiempo perdemos con nuestra familia y nuestros amigos, o participando en otras actividades divertidas.31 Los nios que ven ms de dos horas de televisin cada da estn ms dispuestos al sobrepeso y a la obesidad. Mientras ms tiempo gastes frente a una pantalla, ms probable encontrars los problemas de sueo y el insomnio. Los adolescentes que pasan ms de dos horas frente a la pantalla al da tienen ms probabilidades de tener problemas emocionales, sociales y acadmicos, y de intimidar a otros nios. Tambin, los chicos que estn en la escuela primaria y tienen televisiones en sus cuartos generalmente reciben calificaciones ms bajas que otros alumnos.32 Tambin, es importante saber lo que se ve en la pantalla: Violencia? Propaganda para comida y de juguetes?33 Hay mucho que hacer ms all de la televisin: jugar afuera o adentro de la casa, leer, jugar deportes, arte e involucrarse en su comunidad. Levntese y haga algo divertido! Involcrese en su comunidad Tener un vecindario seguro y saludable es parte de tener una buena salud. Busque la manera de ayudar en su vecindario, ya sea haciendo trabajo voluntario o unindose a un grupo que mejore la comunidad. Ser voluntario es uno de las actividades ms productivas y con ms beneficios posibles, y las oportunidades para hacerlo abundan. De los refugios de animales a los jardines comunitarios, hasta los grupos de juventud, la ayuda y la participacin de voluntarios siempre se necesitan y es siempre agradecida. Mientras esta mejorando a su comunidad, se mejora usted mismo: puede conocer gente nueva, aprende nuevas habilidades, utilizar talentos que nunca supo que tena y eventualmente puede usar su experiencia para oportunidades de trabajo en el futuro.34 Visitar a un jardn comunal/comunitario o un parque puede reducir su estrs, y mejorar su bienestar y salud mental; puede encontrar comida ms saludable por menos dinero, puede tomar aire fresco, hacer actividades fsicas, y embellecer a su barrio.35 Un jardn comunitario se puede utilizar para crecer flores, o comida. Con jardines comunitarios, nadie tiene que ser dueo del terreno, se puede comer lo que crece, y su comida no tendr insecticidas o abono qumico. Visitar un jardn comunitario es una buena manera de aprender sobre su barrio y conocer a sus vecinos. 36

31

The Children in Balance initiative at the Friedman School of Nutrition Science and Policy at Tufts University. Screen Time: Limit It. Tufts University. http://www.tufts.edu/nutrition/childreninbalance/documents/ScreenTime.pdf. 32 Children and TV: Limiting your child's screen time. Mayo Clinic. Mayo Foundation for Medical Education and Research 2 April 2011. http://www.mayoclinic.com/health/children-and-tv/MY00522. 33 Tips to Reduce Screen Time. National Heart Lung and Blood Institute. US Department of Health and Human Services. http://www.nhlbi.nih.gov/health/public/heart/obesity/wecan/reduce-screen-time/tips-to-reduce-screen-time.htm. 34 Its My Life. PBS Kids. 2005 CastleWorks. http://pbskids.org/itsmylife/emotions/volunteering/article2.html What is a Community Garden. American Community Gardening Association. http://www.communitygarden.org/learn/. 35 What is a Community Garden. American Community Gardening Association. http://www.communitygarden.org/learn/. 36 The Multiple Benefits of Community Gardening. The Green Institute. 18 January 2006. http://www.communitygarden.org/docs/learn/articles/multiple_benefits.pdf.

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Primera Semana: Beba SOLO agua y/o leche sin grasa.

Bebi solo agua y/o leche desgrasada hoy? Lunes Martes Mircoles Jueves Viernes Sbado Domingo Qu otro reto ha tratado de completar?

Le fue difcil no beber bebidas azucaradas?

Segunda Semana: Coma 3 frutas frescas cada da.

Cuntos pedazos de fruta ha comido hoy? Lunes Martes Mircoles Jueves Viernes Sbado Domingo Qu otro reto ha tratado de completar?

Comi ms de estos alimentos que lo normal?

Tercera Semana: Coma 3 tazas de vegetales cada da.

Cuntas tazas de vegetales ha comido hoy? Lunes Martes Mircoles Jueves Viernes Sbado Domingo Qu otro reto ha tratado de completar?

Cules vegetales le gustan?

Cuarta Semana 4: Coma granos integrales una vez al da.

Cuntas porciones de granos integrales ha comido hoy? Lunes Martes Mircoles Jueves Viernes Sbado Domingo Qu otro reto ha tratado de completar?

Result difcil encontrar comida con granos integrales?

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Quinta Semana: Haga ejercicios por 20 minutos cada da.

Cuntos minutos de ejercicio ha hecho hoy? Lunes Martes Mircoles Jueves Viernes Sbado Domingo Qu otro reto ha tratado de completar?

Cules actividades fsicas ha hecho?

Semana 6: Coma porciones pequeas todos los da.

Cuntas porciones pequeas ha comido hoy? Lunes Martes Mircoles Jueves Viernes Sbado Domingo Qu otro reto ha tratado de completar?

Le result difcil comer menos?

Sptima Semana: No coma en restaurantes y no ordene comida de afuera. (Coma en casa con su familia).
Evit el comer u ordenar para llevar de restaurantes hoy? Lunes Martes Mircoles Jueves Viernes Sbado Domingo Qu otro reto ha tratado de completar?

Quin cocin? Qu comi? Le fue difcil el no comer u ordenar para llevar de restaurantes?

Octava Semana: Disfruta solo UNA hora en frente de una pantalla ( televisin, computadora, video juegos) todos los das.
Cuntas horas de tiempo ha pasado en frente de la pantalla hoy? Lunes Martes Mircoles Jueves Viernes Sbado Domingo Qu otro reto ha tratado de completar?

Qu actividades hizo en vez de estar en frente de la pantalla?

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