Diabetes Treatments

Diabetes Care 29, 2140-2157. Today we will to talk about diabetes. How much physical activity daily will help us prevent or help us manage diabetes? …

Getting Ready

1 Review the lesson plan and read the educator resources before each
session
2 Prepare to do chair exercises Choose Module E with bands found
elsewhere in this document or Tufts/CDC Growing Stronger, Part I a
separate booklet or online at:
http://wwwcdcgov/nccdphp/dnpa/physical/growing_stronger/growing_stronger
pdf
3 Make copies of chair exercise guide for participants to take home if
not done so already
4 Copy and staple the handouts that best meet the needs of your audience
one set for each participant
5 Gather supplies needed for lesson, recipe, and activities

General Supplies

1 Handouts for participants
2 Pens or pencils for participants to write on the handouts
3 Plastic plate with three sections, cereal bowl, and 8-ounce glass to
demonstrate the plate method of meal planning
4 Assorted food models or other representations for each food group on the
plate
5 Exercise bands Optional: step counters to replace those that are lost
or broken
6 Optional: If time permits, then play Bingo for Better Health
Supplies for bingo are bingo cards for all participants found elsewhere
in the manual, large dry beans for bingo pieces,
and prizes such as
magnifying glasses, measuring cups, healthy snacks, bottled water, spice
blends, packets of artificial sweetener, low-calorie and shelf-stable
milk products, canned or fresh fruits and vegetables, night lights, and
lotion or hand cream

Supplies When Preparing a Recipe for Participants Strongly Recommended

1 Ingredients to prepare the recipe provided or another healthy recipe
2 Supplies for tasting recipe, such as plates, forks or spoons, and
napkins

Beginning the Session

1 Introduce yourself by name and the organization that you represent
Take attendance
2 Summarize the lesson by going over the objectives Let the group know
that the session will be informal and that questions can be asked at any
time

Objectives for Participants

1 Understand what diabetes is and how it affects a persons health
2 Learn how to care for the feet, eyes, and teeth to control diabetes
complications
3 Understand what carbohydrates are and what healthy foods provide them
4 Learn how to use the plate method to control portion sizes and plan
balanced meals
5 Do chair exercises, complete physical activity charts, and set new
physical activity
goals
Author

Mindy Bell, Graduate Assistant, Department of Foods and Nutrition, The
University of Georgia, Athens, GA 30602, 706-542-4869

Menus and Physical Activity Programs

Mindy Bell, Graduate Assistant, Department of Foods and Nutrition, The
University of Georgia, Athens, GA 30602, 706-542-4869

Educator Resources

Before presenting the lesson, read these resources that were used to
prepare this lesson:

American Diabetes Association, Your Bodys Well Being,
http://diabetesorg/type-1-diabetes/well-beingjsp and Types of
Carbohydrate, http://diabetesorg/nutrition-and-recipes/nutrition/types-
of-carbjsp
Bantle, J P, Wylie-Rosett, J, Albright, A L, Apovian, C M, Clark,
N G, Franz, M J, et al 2006 Nutrition recommendations and
interventions for diabetes - 2006: A position statement of the American
Diabetes Association Diabetes Care 29, 2140-2157
National Institute of Diabetes and Digestive and Kidney Diseases NIDDK,
http://wwwdiabetesniddknihgov
USDHHS and USDAs Food Pyramid, http://wwwmypyramidgov

This lesson discusses carbohydrates, with an emphasis on healthy
carbohydrate-containing foods that are important to include in a healthy
diet Although
fiber is a carbohydrate, it is only mentioned briefly
because it is not digestible and does not impact blood glucose levels
However, it should be recognized that the 2005 Dietary Guidelines for
Americans encourages choosing fiber-rich fruits, vegetables, and whole
grains often to maintain good health Consumption of these foods is
promoted in the section of this lesson for diabetes menu planning

Script

Give participants their handouts
Remember to take attendance

Introduction

Today we will to talk about diabetes All of our key messages are very
important for people who are at risk of getting diabetes which is many if
not most older people and for those who already have diabetes Talking to
your doctor and getting checked for blood pressure, cholesterol, and A1c
for people with diabetes are all important How much physical activity
daily will help us prevent or help us manage diabetes? Wait for responses
Yes - 30 minutes daily What kinds of foods help prevent and manage
diabetes? Wait for responses Right - 7 to 10 servings of fruits and
vegetables; most fruits and vegetables are low in salt and fat, too Three
servings of whole grain foods, such as whole grain breads and
cereals, help
control our blood sugar and leave us feeling full And three servings of
low-fat milk products provide us with the important protein and calcium we
need each day Remember that people with diabetes and older people in
general are at risk of getting foodborne illnesses, the flu, and colds, so
hand-washing is very important Does anyone know how long we should wash
our hands before preparing food? Wait for responses Yes - washing your
hands for 20 seconds helps ensure that youve removed bacteria and that
your hands have gotten clean

Lets review the handout titled Seniors Taking Charge of Your Health and
talk about what you eat to stay healthy Wait for responses What helps
you be physically and mentally active? Wait for responses What are some
things that help you be positive and help cheer you up? Wait for
responses Good ideas What are some check-ups that we need? Collect
answers Right You can check your feet daily, which is especially
important for those with diabetes Ask your doctor how often you should
have your blood pressure, blood cholesterol, blood sugar, and body weight
checked You may need these checked more often if you have high blood
pressure,
high blood cholesterol, or diabetes Regular vision and hearing
check-ups are also important Ask your doctor or pharmacist to review your
medications to help avoid medication problems

What is Diabetes?

What does having diabetes mean to you? Gather and discuss responses Many
of us may think of blood sugar when we hear the word diabetes, and thats
because diabetes results when blood glucose sugar is too high People
with diabetes cannot make or use the hormone insulin correctly Insulin
helps move glucose from your blood into your cells to give you energy
There are two main types of diabetes, type 1 and type 2 People with type
1 diabetes do not make insulin and need lifelong insulin therapy to
survive Type 2 is the most common form of diabetes in older adults
People with type 2 diabetes can make insulin, but not enough to keep blood
glucose levels in the normal range People with type 2 diabetes must work
with their doctor to control diabetes, which may include taking oral
medicine and/or daily insulin injections A healthy diet and regular
physical activity are always an important part of diabetes prevention and
management

How do you know if you have diabetes? Symptoms are
not always obvious,
which is why some people have diabetes for many years without knowing it
Symptoms may include feeling tired and having excessive fatigue, hunger,
thirst, and urination Your doctor can do a fasting blood test to diagnose
diabetes, and this test measures the amount of sugar in your blood after
fasting for at least six hours

Risk Factors and Complications

There are many risk factors for type 2 diabetes, or things that increase
the chances of getting it Can you think of any of these? Gather and
discuss responses Thats right - things that are linked to diabetes
include:
Physical inactivity
Eating too many high-fat, high-calorie foods that can lead to
unhealthy weight gain
Ethnicity - some ethnic groups, such as African Americans and
Hispanics/latinos, are at increased risk
Having an immediate family member with diabetes, such as a sibling or
parent
Having had gestational diabetes or gave birth to a baby weighing more
than 9 pounds

While there is no cure for diabetes, it can be managed and even prevented
through healthy lifestyle habits and regular check-ups Some risk factors,
such as physical inactivity and
unhealthy eating that contribute to being
overweight, are things that we can control to lower our risk for and manage
diabetes

Getting checked regularly by health care professionals is also an important
way to prevent and manage diabetes Your doctor can check you for diabetes
and can help you to control risk factors If you have diabetes, they will
make a care plan for you, such as when to check your blood glucose and
which medicines to take Your doctor can also help you to prevent and
control complications of diabetes

As you may know, diabetes can have serious and life-threatening effects on
your health Even though people with diabetes may feel normal, they are at
risk for several complications that can develop overtime Does anyone know
what some common complications are? Wait for responses and discuss Right
- diabetes can affect many parts of the body, including our eyes, feet,
skin, teeth, kidneys, and heart

So lets talk about some of the ways that we can care for ourselves to
prevent and manage diabetes and its complications

Foot, Vision, and Dental Care for Diabetes

Regular self-checks are important for people with diabetes, along with
regular check-ups from health
care professionals Lets look at the
handout called Checklist for Diabetes Prevention and Management Review
handout with participants using the added details below

Vision: Diabetes ususally does not lead to total vision loss, but it can
increase the risk of eye problems including cataracts, glaucoma, and
damaged blood vessels in the eyes Protect eye health by visiting an eye
care professional regularly We can also care for our eyes by working with
our doctor to keep blood glucose in a healthy range and by wearing
sunglasses outside to help prevent cataracts

Feet: For people with diabetes, it is important to self-check feet daily
to make sure calluses, ulcers, and other problems are not forming You may
need a small mirror to help you do this if you cannot see them easily
Nerves and blood vessels in the legs and feet often become damaged in
people with diabetes Thats why its important to check your feet and to
be careful in exposing them to heat and cold, since you may not be able to
feel an injury A foot care professional should check for problems, too,
about once per year

Dental: High blood glucose levels can make us more prone to infections and
may contribute to gum
disease If this problem is not treated, teeth may
become loose and fall out Thats why we need to care for our teeth and
gums Can anyone name some important ways we can care for our teeth? Wait
for responses and discuss Thats right - be sure to brush and floss your
teeth everyday, and see your dentist twice a year Remember that its
still important to prevent infection in your gums by keeping them clean,
even if you wear dentures or no longer have your original teeth

Menu Planning for Diabetes

Healthy eating is another important part of diabetes prevention and
management as you saw on your last handout Eating healthy foods in the
right portions throughout the day can help to keep blood glucose under
control It can also help to keep your heart healthy, which is important
for everyone Eating a variety of foods helps us to get many different
nutrients that our bodies need

One nutrient that many people with diabetes are concerned about is
carbohydrate What does that term mean to you? Gather responses It
sounds like many of you have an idea of what carbohydrates are
Carbohydrates include sugars, starches and fiber, and are found in many
common foods Sugars and starches are
the carbohydrates that raise blood
sugar after a meal and give us energy Can anyone give some examples of
foods that have carbohydrates in them? Wait for responses Right - sugars
are found in many foods, and can be either natural or added Fruit, some
vegetables, and milk contain natural sugars, while cakes and ice-cream
often contain added sugars Starches are found in foods such as beans and
foods made with flour, such as bread Carbohydrates are listed on the
Nutrition Facts panel of food labels Be sure to read the value for Total
Carbohydrate because this tells you the amount of sugar and starch in a
serving of the food youre eating

Many healthy foods, such as fruits and some vegetables, whole grain foods,
and milk products, all contain carbohydrates These foods also provide
many vitamins and minerals that our bodies need Many not-so-healthy
choices also contain carbohydrates, such as pie and doughnuts The less
healthy choices often have a lot of extra sugar added to them and usually
are not whole grain They also tend to have few nutrients

Everyone, including people with diabetes, should eat a variety of healthy,
carbohydrate-containing foods These foods provide us
with many of the
nutrients we need The important thing is to eat the recommended serving
sizes regularly throughout the day at meals and snacks

Lets look at the handout titled Carbohydrates in Foods to help us
identify which carbohydrate-containing foods we should eat everyday Read
the directions on the handout with participants and allow a few minutes to
complete the activity Then, go over the answers and discuss
Participants should have circled: First row sweet potato, beans, yogurt;
second row whole wheat bread, apple, oatmeal; third row low-fat milk,
corn

Plan My Plate

Now that we know about some of the healthy foods we should eat everyday,
lets learn about planning healthy meals by looking at the handout called
Plan My Plate Using the plate method makes it easy to plan balanced
meals, particularly at lunch and dinner Our plate is divided into four
sections: protein foods, non-starchy vegetables, starchy vegetables, and
starchy grains There are also two circles at the bottom, representing a
fruit and a milk product serving Lets talk about each section on our
plate:

Protein foods: Includes choices such as meat, fish, and poultry, low-fat
cheese, or cottage cheese
These foods do not contain carbohydrates, but
are rich in protein Two to three ounces or about the size of a deck of
cards is a serving for most meats A half-cup serving of cottage cheese
can also count as a protein serving in place of a meat

Vegetables: Half the space on our plate is for vegetables, starchy and non-
starchy Can anyone give me examples of non-starchy vegetables ones that
do not contain much carbohydrate? Gather and discuss responses Right -
examples include peppers, green beans, carrots, and broccoli The other
vegetable section is for starchy vegetables Can you think of some starchy
vegetables ones that are rich in carbohydrate? Gather responses Great
- sweet potatoes, white potatoes, corn, peas, and beans are all good
examples For most vegetables, cup is a serving, but for raw leafy
greens, one cup counts as a serving

Starchy grains: Rice, bread, and pasta are all examples of grain foods
Try to choose whole grain varieties as often as you can, such as brown rice
and 100 whole wheat bread A serving of grains is usually about one slice
of bread or cup rice or pasta

Fruit and Milk Products: At the bottom, there is also a place to have a
fruit and a
milk product at meals Half a cup is a serving for most
fruits, or a small piece of whole fruit One cup is a serving for most
milk products, such as milk and yogurt If you are full, you can save the
fruit or milk serving for a snack later in the day

Most meals at senior centers follow this plate plan, because they usually
provide at least two vegetables, one fruit, one serving of meat, poultry,
or fish, one starchy food that is usually whole grain, and one milk product
such as low-fat milk

Activity: Plan a Plate

Walk participants through an example of how to plan a plate using food
models Then, have volunteers practice planning a healthy plate with
various food models from the different food groups Discuss each plate
with the group and talk about the healthy aspects of the meals Remind
participants of how much a serving is for each type of food

Menu and Recipe

As weve learned today, healthy eating is an important part of diabetes
prevention and management, so lets turn to a sample menu and recipe that
shows healthy eating patterns, called Sample Menu 3 This menu has
about 1,800 calories Todays menu helps us to see how we can control
portion sizes and eat balanced meals
and snacks with a variety of foods
Each meal contains some carbohydrate from foods such as whole grains,
fruit, starchy vegetables, and milk products In general, three to four
servings of carbohydrate-containing foods at meals and one to two servings
of carbohydrate-containing foods at snacks is appropriate for older people
with diabetes Each meal also has protein from foods such as lean meats,
skinless poultry, fish, and low-fat cheese

All of the foods on our menu are given in the right serving sizes to help
with meal planning and portion control You may want to measure out foods
that you eat regularly until you can eyeball how much a serving actually
is Once you know what a serving looks like, you wont need to measure
anymore, but will still be able to control your portions Notice that our
menu contains at least seven servings of fruits and vegetables, at least
three servings of whole grains, and three servings of low-fat milk
products Also, notice that some of these healthy carbohydrate-containing
foods are at each meal and snack to help us space carbohydrates throughout
the day, which helps to better control blood sugar

The menu has a recipe for you to try at home, too
Todays recipe is a
super easy and inexpensive chicken and rice You may already have most of
the ingredients on hand at home The tomato sauce and spices give it a
zippy flavor without adding a lot of fat or salt Controlling the amount
of salt and fat in the foods we eat is a very good way to keep your heart
healthy, especially if you have diabetes Encourage participants to
describe other healthy aspects of the menu and if the recipe is used for
tasting, then ask the participants to share their opinions Be sure to
remind participants to follow any special dietary restrictions prescribed
by their health care providers and tell participants what is in the recipe
in case anyone is allergic to any of the ingredients

Be Physically Active Everyday

Another way to help keep our hearts healthy and to help control blood
glucose for people with diabetes is physical activity

Today were going to learn some chair exercises that can be done almost
anytime or anywhere As you may guess, they are done in chairs, so theyre
wonderful for practicing at home on your own, too We will do a group of
six exercises today, most of which use a resistance band as a fun way to
help challenge and
strengthen our muscles Next week, we will do a
different group of six more exercises We will continue to do our chair
exercises at each session until weve learned all of them As we start
today, lets first do a warm-up to help get our minds and muscles ready to
be active Start the exercise session with a five to ten minute warm-up
Then, begin Exercise Module E bands or Tufts/CDC Growing Stronger, Part
I Note: You can also play music to move and groove to, as this can make
the session more fun and helps to synchronize everyones movements

NOTE: For groups using step counters: Have you been using your step counter
to increase your walking? Wait for responses If so, then have you been
writing down your step counts on the Physical Activity Chart? Wait for a
show of hands Has anyone increased their number of steps since the last
time we met? Wait for responses and invite participants to share ways
theyve found to increase their number of steps You should feel very
proud of yourself The step counter helps us to see our improvements, and
it is a big accomplishment to reach a personal goal Does anyone need help
with their step counter or need a new Physical Activity Chart?
Respond as
needed and help participants at the end of the lesson

Activity: Bingo for Better Health

Gather the group together to play Bingo for Better Health The bingo
cards are printed at the end of all of these lessons Give participants
large dry beans for bingo pieces and bingo cards that have a series of
nutrition and health-related illustrations in each bingo square Play this
game as normal bingo is played Shuffle the stack of large bingo pieces,
select one to call out to participants, and show the bingo piece to
participants The first participant to accurately declare bingo wins
Ideas for prizes include magnifying glasses to read food and medicine
labels, measuring cups, healthy snacks, bottled water, spice blends, small
packets of artificial sweetener, low-calorie pudding mix, shelf-stable milk
or soy products eg, low-calorie milk powder, low-calorie cocoa packet, 8-
ounce boxes of milk, canned or fresh fruits and vegetables, lights eg,
night light, flashlight, key-chain light, other battery-powered lights,
and small bottles of lotion or hand cream

Seniors Taking Charge of Your Health Lesson 3
|
|
|Eat Healthy |
| |
|What are some foods you eat to help you stay healthy? |
| |
| |
| |
|Today we will talk about eating healthy foods in the right |
|amounts for diabetes prevention and management |
|Be Active |
| |
|What are some activities you do to stay physically and mentally |
|active? |
| |
| |
| |
|Today we will do fun chair exercises using resistance bands |
|Be Positive |
|
|
|What are some things that cheer you up and help you enjoy life? |
| |
| |
| |
|Today we will discuss how to manage diabetes to prevent |
|complications that can affect our quality of life |
|Get Checked |
| |
|What are some check-ups we need? |
| |
| |
|Today we will talk about the importance of getting feet, eyes, |
|teeth, and gums checked to avoid diabetes complications |

Checklist for Diabetes Prevention and Management

|What To Care For |What I Can Do |
|Healthy Eating and |___ Eat a variety of healthy foods |
|Physical Activity |___ Eat sensible portions of |
| |carbohydrate-containing foods
throughout |
| |the day |
| |___7 to 10 servings of fruits and veggies|
| | |
| |___3 servings of whole grain foods |
| |___3 servings of low-fat milk products |
| |___ Be active - aim for 30 minutes of |
| |moderate physical activity everyday |
|Eyes and Vision |___ Call my doctor if I have a sudden |
| |change in vision |
| |___ See a professional once per year |
|Feet |___ Wear shoes that fit properly |
| |___ Self-check everyday for injury |
| |___ Get a professional foot check at |
| |least once per year |
|Teeth and Gums |___ Brush and floss daily |
| |___ See a professional twice per year |
|Regular Check-Ups |___ See my doctor regularly to get |
|
|screened for diabetes every 3 years |
| |___ Talk to my doctor about controlling |
| |risk factors for and complications of |
| |diabetes |

Carbohydrates in Foods

Carbohydrates are found in many different foods Circle the healthy
carbohydrate-containing foods below Plan your meals and snacks with foods
like the circled ones often

Plan My Plate

Sample Menu 3

Breakfast
Yogurt parfait make layers, made with cup low-fat, low-calorie vanilla
or peach yogurt, cup diced canned peaches packed in water or extra
light syrup, drained, cup whole grain unsweetened cereal such as
Cheerios or bran flakes
Pecan halves, unsalted, 2 tablespoons to sprinkle on parfait
Coffee or hot tea, 1 cup, with artificial sweetener as desired

Snack
Mandarin oranges, canned in juice or water, drained, cup
Milk, 1, 1 cup

Lunch
Barbequed pork sandwich, made with 2 ounces roasted pork tenderloin, 1

tablespoon barbeque sauce, 1 2 ounce whole wheat hamburger bun
Pinto beans, canned, rinsed and drained, heated, cup
Coleslaw, made with cup shredded cabbage, cup shredded carrots, 1
tablespoon reduced-fat mayonnaise

Snack
Whole wheat crackers such as Triscuit, low-sodium variety, 5 crackers
Cottage cheese, low-fat, calcium-fortified, cup

Evening meal
Spanish Chicken and Rice recipe provided
Broccoli, fresh or frozen, chopped, steamed, cup
Corn, frozen, boiled, cup, with 1 teaspoon soft tub margarine
Whole wheat bread, toasted, 1 slice, with 1 teaspoon soft tub margarine

Snack
Pudding, sugar-free, fat-free instant, prepared with milk, cup
Banana, sliced, 1 small or large

Remember to drink plenty of fluids throughout the day Water, tea,
coffee, small amounts of juice, and other liquids all can help to keep you
hydrated

Spanish Chicken and Rice
Adapted from the NHLBI, the National Institutes of Health, 2003,
Publication No 03-2921

Serves 4

Ingredients:

2 cups cooked brown rice cook in unsalted water
1 to 1 cups cooked skinless chicken breast, in chunks fresh or canned,
7 ounce pouch or 10 ounce
can
cup diced sweet onion and cup diced green peppers
1 clove garlic, minced optional
2 teaspoons canola oil
1 cup no-salt-added tomato sauce 8-ounce can
teaspoon all-purpose salt-free seasoning blend

Directions:

1 In a small pan, sauté the onions and garlic in the canola oil over
medium heat for about 2 minutes until translucent
2 Reduce the heat to medium-low and add the tomato sauce and seasoning
blend; heat through, stirring occasionally
3 In a medium bowl, mix together the rice and chicken; pour in the sauce
and gently stir until all ingredients are fully combined

Nutrient Analyses of Sample Menus

|Day/ |Calories |Total Fat |Sat Fat |Total |Protein |Fiber g |
|Nutrient | |g |g |Carb g |g | |
|Sample 1 |1805 |52 |15 |257 |89 |28 |
|Sample 2 |1751 |56 |17 |228 |95 |34 |
|Sample 3 |1774 |50 |12 |240 |96 |27 |
|Sample 4 |1831 |60 |15 |240 |93 |34 |
|Sample 5 |1725 |52 |13 |228 |101 |26
|
|Sample 6 |1773 |58 |15 |234 |88 |27 |
|Sample 7 |1744 |61 |18 |221 |94 |32 |
|Sample 8 |1763 |53 |13 |235 |99 |30 |
|Sample 9 |1757 |51 |17 |232 |101 |30 |
|Sample 10 |1768 |56 |15 |227 |101 |26 |
|Sample 11 |1810 |68 |19 |223 |92 |27 |
|Sample 12 |1750 |50 |14 |242 |100 |31 |
|Average |1771 |56 |15 |235 |96 |29 |

Most of the sample menus provide nutrients in the ranges of:
1750 to 1850 calories
25 to 35 of total calories from fat
7 to 10 of total calories from saturated fat
50 to 60 of total calories from carbohydrate
20 to 25 of total calories from protein
25 to 35 grams of fiber

Nutrient analysis estimates were completed using Diet Analysis Plus,
Version 61, from ESHA Research, 2004 Nutrient values for individual
foods can vary depending on brand, type of processing, method of
preparation, and other factors Be sure to read the
Nutrition Facts panel
of food labels if youd like to know exactly how much of specific nutrients
are in the foods you buy

———————–
Seniors Taking Charge of Your Health

Lesson 3: Diabetes Prevention and Management

MILK PRODUCT
Skim Milk or 1 Milk or Yogurt 1 Cup

FRUIT
Cup or
Small Piece Fresh Fruit

STARCHY GRAIN

1 Slice Bread or
Cup Pasta or
S Cup Rice

STARCHY VEGETABLE

Cup

PROTEIN FOODS
Meat, F? Cup Rice

STARCHY VEGETABLE
Cup

PROTEIN FOODS
Meat, Fish, Poultry, Eggs,
Low-fat Cheese 2 to 3 oz
or
Cottage Cheese Cup

Include the fruit or milk in your meal or as part of your snack

NON-STARCHY VEGETABLES
1 or 2 Servings
Cup Most
1 Cup Raw Leafy Salad

Yogurt, low-fat and low-calorie, 1 cup

Ice-cream, cup or 1 small cone

Cake, 1 slice

Oatmeal, cup cooked

Apple, 1 small or cup sliced, raw or cooked

Whole wheat bread, 1 slice

Doughnut, 1 small

Corn, cup

Cookie, 1 small

Milk, low-fat, 1 cup

Beans, cup cooked

Sweet potato, medium or cup mashed

Estimated Nutrition Facts per serving:
250 calories
6 g total fat
1 g saturated fat
27 g carbohydrate
20 g protein
2 g fiber

Try this
Experiment with different herbs to garnish this dish, such as parsley, for
extra color and flavor if you wish You could also use salsa as your sauce
for a quick added zing

Source:nei.nih.gov