Consumer education booklet

1Copyright © 2010 by Joslin Diabetes Center, Inc. (www.joslin.org). All rights reserved.

Joslin’sSupermarket Smarts™

Making Heart-Healthy Choices Aisle By Aisle

Distributed Courtesy of Unilever


About Joslin Diabetes Center

Joslin Diabetes Center is the world’s preeminent diabetes clinic, diabetes research center and provider of diabetes education. Joslin is dedicated to ensuring that people with diabetes live long, healthy lives and offers real hope and progress toward diabetes prevention and a cure for the disease. Founded in 1898 by Elliott P. Joslin, M.D., Joslin is an independent nonprofit institution affiliated with Harvard Medical School.

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


Getting StartedMaking a few simple changes in your food choices can help keep your heart healthy and can also help you if you have diabetes or are controlling your weight. Even better – what’s good for you is also good for your whole family. You don’t have to buy special foods or cook special meals for yourself if the entire family eats the same way. Healthy eating is good for everyone!

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

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

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

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

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

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


Label ReadingOne of the first steps to healthier eating is learning how to read the Nutrition Facts panel on the food label. There’s a lot of information on a food label – but the good news is that you don’t have to read all of it! For heart health, here are some of the most important sections of the food label to pay attention to:

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

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

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

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

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

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

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


Shopping Tips

ProduceFruits, Vegetables, Nuts & Seeds: Choose moreThe main message for fruits and vegetables? Eat more! In fact, aim to eat 5 to 9 servings of different fruits and vegetables every day. It sounds like a lot, but remember that fruits and vegetables are full of vitamins, minerals and fiber – and they’re low in calories. Choose fresh or frozen fruits and vegetables whenever possible. While you’re at it, don’t forget to add dried beans, peas and lentils to your menu. They’re also high in fiber and other nutrients, including protein. They can add variety to your diet – and save you money at the same time! Nuts and seeds are high in calories, so eating smaller amounts is the way to go. But, they’re full of heart-healthy fat, protein and fiber, too.

Choose Go Easy

Fruits• Fresh fruit• Frozen fruit without added sugar• Canned fruit packed in juice• Dried fruit

• Frozen fruit packed in syrup• Canned fruit packed in light

or heavy syrup• Yogurt/chocolate-covered dried fruit

Vegetables• Fresh vegetables• Plain frozen vegetables• No-salt-added canned vegetables• Dried beans, peas and lentils

• Frozen vegetables in cheese or butter sauce

• Frozen French fries/onion rings• Canned vegetables

Nuts & Seeds• Unsalted nuts and seeds• Natural (oil on top) peanut or other

nut butters

• Salted nuts and seeds• Coconut

• Shop the perimeter. For the most part, some of the healthiest foods in the grocery store are found along the perimeter, or outer sections. The produce section, meat, fish and poultry cases, and dairy sections are usually found along the perimeter of the store.

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

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

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

Nutrition Notes:

Whole fruits have more fiber than fruit juice and contain less sugar.

Choose different colored fruits for the best nutrition.

To save money, buy fruits and vegetables that are in season.

Dark green and deep orange-colored vegetables tend to be rich in many nutrients.

Leave the skin or the peel on whenever possible to boost the fiber content.

Try at least one meatless meal each week using dried beans, such as black beans and rice or vegetarian chili.

Look for unsalted nut butters if you need to watch your sodium intake.

Watch portion sizes of nuts and seeds because they’re high in calories.


MeatsMeat, Poultry and Seafood: Choose light and leanMeats, poultry and seafood are the main protein foods in most people’s eating plan. Beef, pork and lamb tend to be higher in saturated fat than poultry and fish, so it’s important to not only choose leaner cuts of meat, but also limit portion sizes to between 3-6 ounces. Seafood, especially fatty fish, contains a type of heart-healthy fat called omega-3 fatty acids, so aim to eat fish at least twice a week.

Choose Go Easy

Beef/Pork/Lamb/Veal• Loin cuts, such as tenderloin

and sirloin• Round (eye of round, top round)• 90% (or higher) lean ground beef• Extra-lean ham• Soy crumbles

• Rib eye, T-bone cuts, ribs• Less than 90% lean ground beef• Ground pork, ground lamb• Organ meats (kidney, liver, heart)

Poultry• Chicken or turkey breast, no skin• Ground chicken or turkey breast

• Chicken or turkey with skin/duck• Fried chicken• Ground chicken or turkey

Seafood• Fatty fish (salmon,

tuna, halibut, mackerel)

• Shrimp and shellfish

• Fried or breaded seafood

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

Choose Go Easy

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

• Regular cold-cuts• Hotdogs• Sausage• Bacon

Nutrition Notes:

Trim away any visible fat before cooking.

Use lowfat cooking methods, such as grilling, broiling or roasting.

Select grades of meat that are the leanest; choice grades of meat have a moderate amount of fat; and prime cuts of meat are the fattiest cuts.

Aim to limit red meat intake to no more than 2-3 times per week.

Look for cold-cuts and processed meats with no more than 3 grams of fat per ounce.

Try to choose lower-sodium cold-cuts, if they’re available.

Add tomato slices and green leaf lettuce to help “bulk up” your sandwiches.


Dairy FoodsMilk, Yogurt and Eggs: Aim for non-fat and lowfatThere are a lot of options in the dairy case to help you meet your heart-healthy goals. For example, milk and yogurt are excellent sources of calcium and protein, but whole-milk versions are high in saturated fat. The solution? Choose non-fat or lowfat varieties. Eggs are a very nutritious food, and even though they contain cholesterol, you can still fit them into your eating plan – up to 3 yolks per week is fine.

Choose Go Easy

Milk and Cream• Skim (nonfat) or 1% (lowfat) milk• Fat-free evaporated milk• Non-fat or lowfat soy or rice milk• Fat-free half and half/

nondairy creamer

• Whole milk/reduced fat (2%) milk• Whole evaporated milk• Light, heavy or whipping cream• Half & half/nondairy creamer

Yogurt• Fat-free or lowfat yogurt

• Whole milk yogurt• 2% Greek-style yogurt

Sour cream• Fat-free or light sour cream • Regular sour cream

Eggs• Egg whites or egg substitutes • Whole eggs (more than 3 per week)

CheeseIt’s hard to resist a slice of cheese; fortunately, you don’t have to. Despite being high in saturated fat, cheese contains nutrients such as protein and cal-cium. Today there are many types of lower-fat cheeses to choose from, and, in most cases, you’ll hardly notice a difference in flavor from the full-fat version!

Choose Go Easy

Cottage/Ricotta cheese• Fat-free/lowfat cottage cheese• Fat-free/light/part-skim ricotta

• 4% or 2% milk-fat cottage cheese• Whole-milk ricotta cheese

Cream cheese/Spreadable cheese• Fat-free/light cream cheese• Goat or feta cheese• Light spreadable cheese

• Cream cheese• Whipped cream cheese• Cheese spread

Hard cheese• Light or reduced-fat cheese• Light string cheese

• Regular hard cheese• Whole-milk mozzarella

Nutrition Notes:

Use fat-free evaporated skim milk or fat-free half and half instead of cream.

Gradually switch from whole milk to 2% milk to 1% milk to skim milk – the change in flavor and consistency will be less noticeable.

Fruited yogurts tend to be higher in calories than plain yogurt. Sweeten plain yogurt with fresh or canned fruit.

Brown eggs contain the same calories and nutrients as white eggs.

Nutrition Notes:

Look for cheeses with no more than 3 grams of fat per ounce.

Save money and calories by using small amounts of stronger cheese (blue, sharp cheddar, parmesan).

The lower the fat content of the cheese, the harder it is to cook with.


Breads, Cereals and GrainsBreads and Baked Goods: Go for the grainThere are plenty of healthy whole-grain, high-fiber breads and rolls to choose from in the supermarket. Whole-grain breads and baked goods are packed with fiber, vitamins, minerals and antioxidants. Most of them are low in saturated fat, too.

Choose Go Easy

Breads, Rolls, Bagels, Tortillas• Whole-grain (whole-wheat, rye,

pumpernickel, oatmeal) bread, rolls, English muffins, bagels

• Whole-wheat/corn tortillas

• White bread/rolls/biscuits• Cheese or garlic bread • Quick breads (banana, date nut,

corn, etc.)• Tortillas made with lard

Muffins and Pastries• Fat-free/lowfat muffins• Angel food cake

• Muffins/croissants/scones/pastries• Doughnuts/crullers

Pancakes, Waffles and French Toast• Lowfat/reduced-fat pancakes

and waffles• Whole-grain pancakes, waffles,

French toast

• Frozen French toast• Frozen waffles

Cereals, Grains and Pasta: Go for the grainJust as you might choose whole-grain bread for your morning toast or lunch-time sandwich, don’t forget to go for whole-grain cereals and pasta for the same nutrition benefits. Add more variety to your meals by not only choosing brown rice, but also trying other healthy grains, such as quinoa, barley and couscous.

Choose Go Easy

Cereals• Whole-grain, high-fiber

cold cereal• Oatmeal/oat bran

• Sugar-coated cereals• Cereals made with saturated

or trans fat

Grains• Brown rice, wild rice• Barley, bulgur, quinoa, kasha• Whole-wheat couscous

• Packaged rice/grain mixes• Rice or other grains made with

butter, cheese or cream sauce

Pasta• Whole-grain/whole-wheat pasta• Spinach pasta• Yolk-free noodles• Ramen noodles

• Packaged pasta mixes• Pasta made with butter, cheese

or cream sauce• Canned pasta

Nutrition Notes:

Choose breads and rolls with the words “whole-wheat” as the first ingredient.

Look for breads that contain at least 2-3 grams of fiber per slice.

Limit oversized bagels, muffins and sandwich rolls.

Nutrition Notes:

Choose cereals with at least 3 grams of fiber and no more than 3 grams of fat per serving.

Limit cereals that list sugar as the first or second ingredient.

Instant hot cereals tend to be higher in sodium than the regular versions.

Packaged, seasoned rice and pasta mixes are usually high in sodium. Use one fourth to one half of the seasoning packet when preparing.

Brown rice has nearly three times the fiber of white rice.


Butter/Margarine/Soft SpreadsGo for the “good” fats Skip the butter, since it’s high in saturated fat, or else use a very small amount. And stick margarine may contain both saturated fat and trans fat. A better option is a soft spread (also referred to as a soft, vegetable oil tub spread), which provides a source of monounsaturated and polyunsaturated “good” fats and a delicious buttery taste - with 70% less saturated fat than butter, and no trans fat. Some even contain ingredients such as plant sterols (natural plant ingredients that can lower LDL cholesterol) for an additional heart-healthy benefit. Try different kinds until you find the one that tastes good to you.

Choose Go Easy

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

• Butter• Stick margarine

Prepared FoodsTry not to sacrifice health for convenience. Prepared foods in the grocery store are quick and easy, but many of them are high in calories and unhealthy fats. Stock up on salads and cooked vegetables and make them the basis for a healthy, take-home meal.

Choose Go Easy

• Rotisserie chicken (no skin)• Sushi• Green salad/fruit salad• Oil-based pasta salad • Hummus

• Fried chicken, chicken wings• Mayonnaise-based salads

(potato, macaroni)

Nutrition Notes:

Try a soft spread that contains plant sterols to help lower your cholesterol.

The more solid a margarine is, the more saturated fat it contains.

Light tub spreads are best used on toast, bagels and vegetables; they’re not meant for cooking or baking.

Nutrition Notes:

Stock up on fresh vegetables and fruits at the salad bar.

Use skinless rotisserie chicken breast to make sandwiches or to add to soups and stews.


Nutrition Notes:

All fats, even healthy ones, are high in calories, so use them sparingly if your goal is to lose weight.

Even fat-free dressings and mayonnaise still contain calories.

Drizzle flaxseed oil on your salad or vegetables or dip your bread into a small amount of it. But don’t use flaxseed oil in cooking or baking.

Oils, Mayonnaise, Salad DressingsOils, mayonnaise and salad dressings can definitely be part of a heart-healthy eating plan. The key is to choose liquid vegetable oils rather than fats that are solid at room temperature (such as shortening and butter), and to use either lower-fat versions of mayonnaise and salad dressings, or just small amounts of the regular versions.

Choose Go Easy

Oils• Vegetable oils (canola, peanut, olive,

corn, sunflower, safflower, soybean, flaxseed)

• Non-stick cooking sprays

• Shortening and lard• Coconut/palm/palm kernel oil• Salt pork

Mayonnaise• Fat-free/light mayonnaise • Regular mayonnaise

Salad Dressing• Fat-free/lowfat/light salad dressing• Balsamic/wine vinegar

• Creamy-style dressings• Regular salad dressings

BeveragesEmpty calories or nutrient-rich?Water is one of the healthiest beverages to drink. But when you’re looking for more flavor and variety, try to choose beverages that are not high in calories and added sugars such as high-fructose corn syrup. One hundred percent fruit juice contains many of the same nutrients as the fruit itself, but tends to be higher in calories, so limit your intake to no more than one serving (4 fl. oz.) or try a light-style juice.

Nutrition Notes:

Choose decaffeinated coffee, tea and herbal teas if you need to limit caffeine.

Use skim or lowfat milk to make cocoa or to add to tea and coffee.Choose Go Easy

• Water (bottled, seltzer, sparkling)• Coffee, tea (plain, unsweetened)• Diet tonic water• Diet soda• Diet ice tea• Sugar-free soft drinks• Fruit smoothies made with lowfat yogurt• Lowfat coffee drinks • Low-sodium vegetable juices• 100% fruit juice (limit to one serving or 4 ounces per day)• Sugar-free cocoa mixes

• Tonic water• Regular soda• Sugar-containing flavored water/

enhanced water• Energy/sports drinks• Fruit smoothies made with regular yogurt • Sweetened iced tea, coffee drinks

(latte, cappuccino)• Vegetable juices• Fruit juice drinks, punches, blends, or cocktails• Cocoa mixes


Snacks and SweetsEverything in moderationEnjoying a snack or a sweet treat is one of life’s pleasures. There are many lower calorie, fat-free and lowfat treats to choose from. Keep in mind that even fat-free or sugar-free foods still have calories, so it’s a good idea to watch portion sizes.

Choose Go Easy

Snacks• Baked potato or corn chips/unsalted pretzels• Light/reduced-fat popcorn• Reduced-fat crackers/rice cakes• Lower-fat granola/snack bars

• Potato or corn chips• Popcorn• Peanut butter/cheese crackers• Granola/snack bars/trail mix

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

• Ice cream/ice cream bars• Regular cookies/cakes/pies

Soups, Frozen Entrees and MoreRead the labelSometimes good nutrition is sacrificed for the sake of convenience. But you can still find a quick, easy meal that isn’t laden with sodium and fat. How? Read the food label! Also, remember that even frozen entrees don’t offer enough vegetables, so add additional vegetables or a salad to fill you up. And the next time you eat pasta, look for a lower-sodium, low-saturated-fat variety – or try your hand at making your own sauce. It really is quick and easy!

Choose Go Easy

Soups• Lower-sodium broth-based soups• Reduced-fat, lower-sodium

cream-style soups• Low-sodium bouillon cubes/packets• Lower-sodium bean-based chili and stews

• Regular broth-based soups• Cream-style soups and chowders• Regular bouillon cubes

or packets

Frozen Entrees• Reduced-fat frozen entrees (no more

than 400 calories per entrée)• Frozen veggie burgers

• Breaded or fried entrees• Frozen pizza

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

• Cream-style pasta sauce• Regular gravy

Nutrition Notes:

Choose sugar-free gelatin and pudding to save on fat and calories.

Enjoy sweets and desserts – as an occasional treat – and in small amounts!

Nutrition Notes:

Healthier frozen entrees have no more than about 400 calories, 15 grams of fat, and 600 milligrams of sodium.

Round-out frozen entrees by adding a green salad, a piece of fruit and a glass of skim or lowfat milk or yogurt.

Try reduced-sugar or sugar-free fruit spreads in place of regular jam or jelly to save calories.


Joslin Publications

Joslin publishes a variety of diabetes-related books, cookbooks and DVDs. Below are a few that may be of interest.

Staying Healthy with Diabetes – Nutrition & Meal Planning

Staying Healthy with Diabetes – Weight & Wellness

Staying Healthy with Diabetes – Physical Activity & Fitness

What You Need to Know About Diabetes – A Short Guide

Joslin’s Guide to Managing Childhood Diabetes – A Family Teamwork Approach

The Joslin Diabetes Quick and Easy Cookbook

The Joslin Diabetes Healthy Carbohydrate Cookbook

Joslin Cooks! Favorite Recipes & Food for Thoughtfrom the Staff of Joslin Diabetes Center

Keep Moving...Keep Healthy with Diabetes – DVD

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

Consumer education booklet

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