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Completing Your PAL Forms

Completing Your PAL Forms. 1. PAL Forms. PAL: Personal Awareness Log Paperwork you will be COMPLETING and TURNING IN on a weekly basis during Stage I of the Dr. Dean Ornish Program for Reversing Heart Disease. 2. The Benefits of PAL and Other Forms.

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Completing Your PAL Forms

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  1. Completing Your PAL Forms 1

  2. PAL Forms • PAL: Personal Awareness Log • Paperwork you will be COMPLETING and TURNING IN on a weekly basis during Stage I of the Dr. Dean Ornish Program for Reversing Heart Disease. 2

  3. The Benefits of PAL and Other Forms • Research shows that self-monitoring is one of the most important tools used for succeeding at lifestyle change. • Self-monitoring using PAL and other forms helps you: • Outline clear goals for nutrition, exercise, group and stress management. • Self-assess how you are doing on a daily basis. • Recognize and celebrate the areas in which you’re doing well. • Identify the areas in which you need to focus. 3

  4. Is all this paperwork necessary? • The PAL forms assist the Ornish team in: • identifying any barriers • helping you reach goals • customizing the Program to meet your needs • Careful monitoring will ensure good nutrition and safe and effective participation in all four elements as well as ensure maintenance to lifestyle change. • The PAL forms are a tool to help the Ornish team help you. • They are not meant to be judgmental. 4

  5. How to Complete YourNutrition PAL Formand Weekly Food Diary 5

  6. Step 1:Identify the foods you have eaten and the amount consumed. • Sample Dinner Meal • 1 Boca Burger on 1 Whole-Wheat Bun • 1 Tbsp ketchup, 1 lettuce leaf, 1 tomato slice • ½ cup Vegetarian Baked Beans • 1 cup Field Green Salad • 2 Tbsp fat-free French dressing • 1 cup Fresh Cubed Melon 6

  7. Step 2: Determine corresponding food groups based on the Reversal Food Pyramid. 7

  8. Step 3: Determine the amount of servings eaten. SERVING SIZE reference found on back of Nutrition PAL Form. 8

  9. Step 4: Record information on food diary. WEEKLY FOOD DIARY Grains (6+ whole grains) 1 whole wheat bun (2) Vegetables (3+) 1 lettuce, 1 tomato slice (<1) 1 cup field greens (1) Fruits (2-4) I cup melon (1) Full Fat Soy (1) Other Protein (1-3) I Boca Burger (1) I/2 cup veg baked beans (1) Nonfat Dairy (0-2) Sweets (0-2)/Alcohol (0-1) Free Food: 2 T FF French dressing (1) Record all meals and snack. 9

  10. Step 5: Transfer servings to Nutrition PAL Form. 10

  11. Step 5: Continued 11

  12. Know Your PAL Form Leave shaded areas blank. For staff use. 12

  13. Low-Fat Foods ≤ 3 grams Fat Per Serving LOW-FAT FOOD = An Ornish-friendly food with 3 grams of fat or less per serving, which also contains trace amounts of unsaturated fat(s) as a minor ingredient. 0-3 SERVINGS ALLOWED/DAY. INGREDIENTS:WATER, TOMATOES, ENRICHED PENNE PASTA (DURUM SEMOLINA, NIACIN, FERROUS SULFATE (IRON), THIAMINE MONONITRATE, RIBOFLAVIN, FOLIC ACID), ROASTED RED PEPPERS, ONIONS, TEXTURED SOY PROTEIN (NON-GMO), TOMATO PASTE, BURGUNDY WINE, TEXTURED WHEAT PROTEIN, ROASTED GARLIC, SALT, ORGANIC EVAPORATED CANE JUICE, CORNSTARCH, SPICES, EXPELLER PRESSED OLIVE OIL, NATURAL FLAVOR, MALT EXTRACT, CITRIC ACID, GARLIC POWDER, ONION POWDER, CARRAGEENAN (FROM SEAWEED), SESAME OIL. 13

  14. INGREDIENTS:WATER, SOY PROTEIN CONCENTRATE, WHEAT GLUTEN, CONTAINS LESS THAN 2% OF NATURAL FLAVOR, SALT, MALTODEXTRIN, DRIED ONION, YEAST EXTRACT, SESAME OIL, DEFATTED WHEAT GERM, CARAMEL COLOR, HYDROLYZED CORN, SOY AND WHEAT GLUTEN, SOY SAUCE (WATER, SOYBEANS, WHEAT, SALT), AUTOLYZED YEAST EXTRACT, NATURAL AND ARTIFICIAL FLAVOR (CONTAINS COTTONSEED), METHYLCELLULOSE, DISODIUM GUANYLATE, DISODIUM INOSINATE, SUCCINIC ACID  14

  15. Weekly Food Diary Name: ________________ Monday Food & Amount: Other Grains 1 cup Yves Veggie Penne ** Vegetables (3+) ½ cup tomato sauce Fruits (2-4) Full Fat Soy (1) Other Protein (1-3) 1 Boca Burger (1) * Nonfat Dairy (0-2) Low fat Foods (0-3) 1 Boca Burger (1) 2 servings Yves Veggie Penne Sweets (0-2) / Alcohol (0-1) 1 1 3 15

  16. Tips for Nutrition PALs: • Always include accurate amounts for all foods and beverages recorded. Don’t forget snacks or drinks. • Save food labels and bring them to the next session if unsure of a packaged food. • Always refer to the serving sizes listed of the back of the Nutrition PAL form when estimating servings. • Write legibly. • Be as accurate and descriptive as possible, using “FF” for fat-free foods, “WG” or “WW” for whole-grains and whole- wheat foods. • Indicate whether vegetables are cooked or raw, and fruits are fresh or canned.

  17. Stress Management, Exercise andGroup Support PAL Forms

  18. Sample Week PAL Form MONDAY • 30 minutes meditation • 30 minutes yoga poses • 45 minutes swimming TUESDAY – CLASS • 60 minutes – Ornish yoga class • 50 minutes treadmill WEDNESDAY – BAD DAY! • 15 minutes deep breathing THURSDAY – CLASS • 60 minutes Ornish yoga class • 45 minutes treadmill FRIDAY • 15 minutes imagery • 15 minutes deep relaxation • 15 minutes yoga poses • 40 minutes biking SATURDAY • 60 minutes relaxation/yoga CD • 30 minutes resistance band SUNDAY • 60 minutes relaxation/yoga CD

  19. 01/02/09 30 60 30 60 Ornish yoga class      15 15 sitting in traffic Ornish yoga class 60      15 15 15 45 8 2 30 12 8 60 Relax CD 8 2 60 8 Relax CD 30 12 51 minutes 360 Leave shaded area blank. For staff use. 14 3 45 swim yard 30 2 treadmill 12 50 4 3 2 treadmill 4 45 14 5 4 yard 14 40 30 bike 6 12 4 bands 30 4 4 4 180 minutes 25 24

  20. More PAL Tips • Total your weekly minutes for stress management and exercise. • Don’t forget to record exercise and stress management done during weekly class time. • Add comments about encounters or stressful situations you may have had during the day/week. • Write down any questions or concerns you may have during the week on the back of any one of your forms for the staff to address. 20

  21. Questions 21

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