Fit Together

1. Fit Together Weight Management and Health Implications March 3, 2014

2. Pop Quiz! • About what percentage of American adults are overweight? • True or false: The consumption of low-calorie sweeteners has helped Americans control their weight. • Approximately how many female high school and college students have either anorexia or bulimia? • 0% • 1% • 2%

4. Statistically speaking: • 24% of Americans between the ages of 18-29 are obese. • 1/3 of American children are at risk of becoming overweight. • The number of obese adults doubled between 1971 and 2006. • The rate of Type 2 diabetes has risen 33% just in the last decade. • It is estimated that by 2015 (next year!!) 75% of adults will be overweight and 41% will be obese.

5. Source: National Center for Health Statistics, 2008. *Includes obesity

6. Overweight and obesity among adults NOTE: Overweight but not obese is body mass index (BMI) greater than or equal to 25 but less than 30; grade 1 obesity is BMI greater than or equal to 30 but less than 35; grade 2 obesity is BMI greater than or equal to 35 but less than 40; grade 3 obesity is BMI greater than or equal to 40. SOURCE: CDC/NCHS, Health, United States, 2012, Figure 11. Data from the National Health and Nutrition Examination Survey.

7. Understanding “weight” • Controlling body weight typically is a matter of controlling body fat. • The most important consideration for health is not weight, but body composition. • Proportion of fat to fat-free mass. (Which is?) • Many people who are “overweight” are also “overfat”, which contribute to health risks. • We want to achieve appropriate body composition, not set and conform to rigid standards of total body weight. • Energy balance

8. Contributing factors to obesity: • Genetic: individual and parental genetic influences • Physiological: metabolism is the key factor, but hormones play a [lessor] role • Lifestyle: increased energy intake and decreased physical activity • Psychosocial: using food and eating as coping mechanisms

9. Metabolism and energy-balance: • Metabolism is the sum of all the vital processes by which food energy and nutrients are made available to and used by the body. • The largest component is resting metabolic rate (RMR), which is the energy required to maintain vital body functions such as temperature, heart rate, and respiration while the body is at rest. • RMR accounts for 65-70% of daily energy expenditures. Digestion accounts for approximately 10%, and 20-30% is expended during physical activity. • Men typically have a higher RMR than women because of a higher amount of muscle mass (muscle is more metabolically active than fat). • Effect of exercise • Energy-balance equation

10. Role of hormones • Hormones play a larger role in accumulation of body fat in women then men • Puberty, pregnancy, and menopause • Most of the fat accumulation is seen as healthy and normal, particularly at puberty and pregnancy • Cases of obesity based solely on hormones are very rare but do exist.

11. Lifestyle factors: • Genetic and physiological factors may increase the risk for excess body fat but don’t explain the increasing rate of obesity in the US. • Eating: • High-fat, high-sugar, calorie dense foods • Eating out more often • Packaged and processed foods • Psychosocial factors: • Using food as a coping mechanism • Obesity and socioeconomic status • Food in culture

12. Adopting a healthy lifestyle for successful weight management • Diet and eating habits: • Total calories (broadly based on gender, age, and activity level, but is very individual) • Portion sizes (concentrating on portion size may be easier than counting calories for some, but be aware of the risk of underestimation) • Energy density: number of calories per oz or gram • Eating habits: small, frequent meals on a regular schedule

13. Physical Activity and Exercise • All physical activity can help you manage your weight- even fidgeting! • If you walk around during the commercial breaks of 2 hours of prime time programming you’ll accumulate 30 minutes of activity! • First steps towards activity for a sedentary person are pretty basic: walking, gardening, housework for 150 minutes (or more)/week. • Once you’re more active, begin a formal exercise program (which will be discussed in a later class). • The body can continue to burn calories even after you’re done with moderate intensity endurance exercise. • Resistance training helps maintain muscle mass and prevent a decrease in RMR.

14. “Dieting” for weight loss • There are numerous fad- and non-fad- diets on the market, including low-carb and low-fat diets, gluten-free diets, Paleo (and now “Werewolf”) diets, on and on. • Research on many of these diets has been mixed (fad diets are hard to track!), but two points have been clear: • Total calorie intake matters. • The best diet is probably one you can stick to! • Back to energy-balance!

15. Lifestyle strategies for successful weight management: • Food choices: • Follow the recommendations from ChooseMyPlateand focus on making good choices from each food group (http://www.choosemyplate.gov/food-groups/) • Check food labels for serving size, calories, and nutrient levels • Watch for hidden calories! Reduced-fat does not mean reduced-calorie. • Limit calories from sodas, fruit drinks, alcohol, energy drinks, and specialty coffees.

16. Pop Quiz! How much sugar? How many calories? Carbs? How much sugar? How many calories? Fat grams? Sugar grams? How many calories? Fat grams? Sugar grams?

17. Pop Quiz! How much sugar? How many calories? Carbs? 62g = 6 Krispy Kreme Original Glazed Doughnuts! 890 calories, 183g carbs = 7 Almond Joy bars! How much sugar? 81g = 7 bowls of Froot Loops or 42 sugar cubes! How many calories? Fat grams? Sugar grams? 2,010 calories, 131g fat, 153g sugar = 68 strips of bacon in terms of saturated fat and the sugar equivalent of 30 Chewy Chips Ahoy cookies! How many calories? Fat grams? Sugar grams? 660 cals, 22g fat, 95g sugar = 8.5 scoops of Edy’s Slow Churned Rich and Creamy Coffee Ice Cream!

18. Lifestyle strategies for successful weight management: • Planning and serving: • Keep a log of what you eat (we recommend MyFitnessPal or SuperTracker). • Eat 4-5 meals/day, including breakfast. Limit going out to eat and keep low-calorie snacks on hand (carrots, popcorn) to combat “munchies”. • Shop with a list and try not to shop when you’re hungry • Consume the majority of your calories during the day, not in the evening; avoid late-night eating. • Pay attention to portion sizes. Use measuring cups and spoons, a food scale, or the “rule of palm” if you’re out. Use smaller bowls and plates to help control portions sizes. • When you eat, eat in a designated spot and only eat. Don’t watch TV or read; eat slowly and concentrate on your food and feelings.

19. Lifestyle strategies for successful weight management: • Special occasions: • Try to choose a restaurant where you can make healthy food choices. Split large portions to take home with you for future lunch or dinners. • Request sauces and dressings on the side. • If you’re cooking for friends at home, send leftovers home with them. • If you’re eating at friends, don’t eat to be polite. If someone offers something you don’t want, decline firmly.

20. Lifestyle strategies for successful weight management: • Physical activity and stress management: • Start physical activity based on your current level of fitness and sedentary status • Build a fitness program that includes cardiorespiratory training, resistance training, and stretching • Watch for your current coping techniques for stress, boredom, or anxiety and adjust as necessary: • Try walking or meditation • Practice positive self-talk • Read a fitness magazine • Ask family and friends for support

21. Body Image • Women are much more likely than men to be dissatisfied with their bodies- and it starts at an early age • Females are more likely than men to diet and develop eating disorders • Media influences have a significant impact on male and female body image, but to girls/women to a greater extent

23. Avoiding body image problems • Focus on healthy habits and good physical health • Focus on good psychological health • Practice body acceptance • Find other things to appreciate about yourself besides an idealized body image • View eating as a morally neutral activity: eating, as it stands alone, isn’t “bad” and doesn’t make you “bad” • Realize the beauty and fitness industry is just that: an industry. Their goals are to make you dissatisfied with yourself so you’ll use their products/services.

24. Creating your weight management plan • Generally speaking: Remember “SMART” from Class 1? (Hint: you can find it on the IPA website!) • Strategies to creating your program: • Assess your motivation and commitment • Set reasonable goals • Assess your current energy balance • Increase your level of physical activity • Make changes in diet and eating habits • Put your plan into action!