Dietary Changes for Women in Sobriety: A Cooking Demonstration Lesson

1. Dietary Changes for Women in Sobriety: A Cooking Demonstration Lesson Conducted by Melodie Anne Coffman

2. Alcoholics Anonymous • International non-profit organization • Focuses on 12 step program for sobriety • Designated sponsor helps keep you on track • Self-funded--does not receive government funds • Meetings occur at various locations several times per day • Attend meetings as often as you need

3. Sub-group • Sub-group of women in the surrounding Phoenix, Arizona area • Group consists of 15 women in sobriety • Meet Mondays at 6:00 for 1-hour meeting • Meetings typically have a specific topic or agenda focusing on the Alcoholics Anonymous book

4. Food & nutrition demo • Monday, December 5th 2011 @ 5:30 • 12 women in attendance • Each woman took a pretest upon arrival • 20 minute lecture on important nutrients for this population • Fiber • Calcium • Antioxidants • Macronutrients

5. …..continued • Food demonstration making baked stuffed chicken roulades • Plating tips and techniques • Food tasting • While women ate, I discussed specific amounts of nutrients in the dinner items from the demo • Post-demonstration survey

6. Baked Stuffed Chicken Roulade • Yield: 2 chicken roulades • Ingredients • 2 skinless chicken breasts • 2 tsp. dry ranch mix • 1/2 cup fresh baby spinach • 1/4 cup diced heirloom tomatoes • 2 tsp. feta cheese • 2 slices mozzarella cheese • 1 cup water • Non-stick pan spray

7. Butterfly chicken

8. Filling roulade

9. Rolling roulade

10. Finished result

11. Mango Brown Rice • Yield: 2 1/2-cup servings • Ingredients • 1/2 cup brown rice • 1 cup water • 1 oz. olive oil • 1/4 cup diced mango • 1/2 tsp. powdered garlic • 1/2 tsp. Italian seasoning • Salt and pepper to taste

12. Garlic Sautéed Spinach with Heirloom Tomatoes • Yield: 2 1-cup servings • Ingredients • 1 oz. olive oil • 2 peeled garlic cloves, chopped • 2 cups baby spinach • 1/2 cup diced heirloom tomatoes • Salt and pepper to taste

13. Finished plate***Please excuse the desserts in the background

14. Let’s Talk About Fiber

15. Fiber Questions Before

16. Fiber Questions After

17. Information retained • 8 women, both before and after, were able to identify soluble fiber as a type of dietary fiber • Prior to the demo, 5 women identified insoluble fiber, which doubled to 10 women after the demo • Only 2 women correctly identified the recommended 21-25 g of daily fiber for women before the demo • By the end, 9 women correctly identified the ideal fiber range • Most women were aware that meat was not a source of fiber

18. General calcium knowledge

19. How much calcium in milk?

20. Bioavailability All women answered this question correctly in the post-test

21. Absorption Source of error in pretest: One woman selected two answers

22. Fat-soluble definition

23. Calcium needs

24. Calcium summary • 10 women after the survey, as compared with 2 women beforehand, correctly identified amount of calcium in milk • All participants gained knowledge of calcium bioavailability • Most women (11 of 12) correctly identified vitamin D as an essential nutrient for calcium absorption during both the pretest and post-test • 50% more women correctly circled 1,000 mg as the proper intake during the post-test

25. Antioxidants

26. Vitamin C needs

27. Functions

28. Smoking

29. Antioxidant summary • Prior to lecture, only half of the group was aware of vitamin C’s role in collagen formation • Knowledge of ideal vitamin C intake improved by 54% by the end of the lecture • Post-test results show that all women correctly identified functions of vitamin C and increased needs for smokers

30. Macronutrients

31. Types

32. Is fiber a carb?

33. Calories

34. Calculations

35. …….continued

36. Macronutrient summary • Women did not retain knowledge about types of macronutrients • By the end of the lecture and demo, the majority of the group were able to identify the correct calories per macronutrient and conduct basic calculations

37. The ladies

38. Demographics

39. Goals & Objectives***Shark the Boston Terrier also attended the demo

40. Goal 1: Women attending Alcoholics Anonymous meetings will understand the connection between smoking, oxidation and dietary habits that can combat oxidative damage. • Objective 1: Following the cooking demonstration and discussion, 25% of participants will state that they plan to cut back or quit smoking. • Objective 2: Following the cooking demonstration and discussion, 50% of participants will be able to list at least three excellent dietary sources of vitamin C.

41. Results • Women did not commit to refraining from cigarette smoking • More than half of the group were able to list at least two functions of vitamin C

42. Goal 2: Women attending Alcoholics Anonymous meetings will gain understanding of the importance of calcium and vitamin D in the diet and the risk of osteoporosis in menopausal women. • Objective 1: After the demonstration and discussion, 75% of participants will state how much calcium they need in the diet. • Objective 2: Following the demonstration and discussion, 25% of women will be able to list at least two foods or drinks fortified with calcium and vitamin D.

43. Results • 92% of women were able to state how much calcium they need in the diet by the end of the demo • More than half of the group were able to state at least two specific foods with calcium

44. Goal 3: Women attending Alcoholics Anonymous meetings will learn dietary sources of fiber and the roles of fiber in the diet. • Objective 1: By the end of the demonstration and discussion, 50% of women will be able to state how much fiber is needed in the diet. • Objective 2: After the demonstration and discussion, 25% of women will be able to state at least two functions or benefits of fiber.

45. Results • 75% of women correctly identified optimal fiber intake of 21-25 g • The majority of the group were able to list several functions and benefits of fiber in an open question-and-answer session

46. Goal 4: Women attending Alcoholics Anonymous meetings will be able to identify macronutrients and calculate macronutrient calories off of a food label. • Objective 1: Following the demonstration and discussion, 50% of women will be able to list all three macronutrients (carbohydrates, protein and fat). • Objective 2: By the end of the demonstration and discussion, 25% of women will be able to state the calories per gram in each macronutrient.

47. Results • More than two-thirds of the group were able to correctly calculate calories from carbs, protein and fat • There was very little difference in identifying macronutrients from a list in the post-test as compared with the pretest • I hypothesize that group members mixed up micronutrients with macronutrients, based on the results

48. Enjoying the food

49. Sources of error • Some women did not answer all questions • Two women showed up late and did not get all of the instructions for the pre-test • Education varied from high school level to medical doctor

50. References • Alcoholics Anonymous. "Alcoholics Anonymous : Frequently Asked Questions About A.A.'s History." Web. 22 Oct. 2011. <http://www.aa.org/lang/en/subpage.cfm?page=287>. • Alcoholics Anonymous. "This Is A.A.: An Introduction to the A.A. Recovery Program." Web. 21 Oct. 2011. <http://www.aa.org/pdf/products/p-1_thisisaa1.pdf>. • Anonymous, personal communication. Phoenix/Scottsdale Alcoholics Anonymous Chapter. November 7, 2011 • BecomeAnEx.org. National Alliance for Tobacco Cessation. "The Benefits and Rewards Of Quitting Smoking." Web. 21 Oct. 2011. <http://www.becomeanex.org/benefits-and-rewards.php>. • Boyle, M. A. & Holben, D. H. (2010). Community Nutrition in Action: An Entrepreneurial Approach (5th ed.). Wadsworth Cengage Learning: Belmont, CA • Higdon, Jane. “Vitamin D.” Linus Pauling Institute.March 2004. Web. 30 Oct. 2011. <http://lpi.oregonstate.edu/infocenter/vitamins/vitaminD/> • Mayo Clinic. "Dietary Fiber: Essential for a Healthy Diet.” Mayo Foundation for Medical Education and Research, 19 Nov. 2009. Web. 21 Oct. 2011. <http://www.mayoclinic.com/health/fiber/NU00033>. • McKinley Health Center.“Macronutrients: The Importance of Carbohydrate, Protein and Fat.”March 2008. Web. 7 Nov. 2011. <http://www.mckinley.illinois.edu/handouts/macronutrients.htm> • NIAAA Publications. "Alcohol and Nutrition - Alcohol Alert No. 22- 1993." National Institute on Alcohol Abuse and Alcoholism, Oct. 1993. Web. 22 Oct. 2011. <http://pubs.niaaa.nih.gov/publications/aa22.htm>. • Office of Dietary Supplements (ODS). "Dietary Supplement Fact Sheet: Calcium." National Institutes of Health. Web. 22 Oct. 2011. <http://ods.od.nih.gov/factsheets/Calcium-HealthProfessional>. • Office of Dietary Supplements (ODS). "Vitamin C." National Institutes of Health. Web. 20 Oct. 2011. <http://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional>. • PubMed Health. "Osteoporosis - Thin Bones." U.S. National Library of Medicine, Nov. 2010. Web. 20 Oct. 2011. <http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001400/>.