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Pennington Nutrition Series
Healthier lives through education in nutrition and preventive medicine




       Body Mass Index (BMI) is a way to define over-                The distribution of body fat is important from a
 weight and obesity. The index is a mathematical formula in   chronic disease perspective. Those who have more
 which a person’s body weight in kilograms is divided by      body fat in the abdominal area have an increased risk
 the square of his or her height in meters [kg/m2]. The BMI   for elevated triglycerides, high blood pressure and
 is more highly correlated with body fat than any other       glucose intolerance. Waist circumference correlates
 mathematical ratio of height and weight; however, athletes   well with chronic disease risk. A waist circumference
 and individuals with a high percentage of muscle may         of 40 inches (102 cm) or more in men or a waist
 have a BMI in the overweight range because of the higher     circumference of 35 inches (88cm) or more in women
 density of muscle compared to fat.                           puts one at greater risk of insulin resistance and the
         A BMI of 18 to 25 is considered normal weight.       chronic diseases associated with it.
         Individuals with a BMI of 25 to 29.9 are
         considered overweight, and those with a BMI of             When someone is a few pounds overweight and
         30 or more are considered obese.                     is motivated to lose weight, there are safe and effec-
                                                              tive methods to lose a few pounds and to maintain a
         Overweight is defined as increased weight in         weight loss.
         relation to height.
         Obesity is defined as an excessively high
         amount of body fat or adipose tissue in
         relation to lean body mass.




                innovate           educate            improve lives
1 Dieting with the                                      How to use the exchange plan:
                                                             The number of exchanges per day is determined
Exchange Diet                                           by the number of calories needed in the diet. It is
                                                        different for each person and depends on height, weight
     An exchange diet breaks food down into six
                                                        and the amount of energy expended. The table shows a
categories: starch/bread, meat, vegetables, fruit,
                                                        basic diet composition using the exchange system. The
milk, and fat. The exchange diet was created by the
                                                        most accurate way to determine the number of ex-
American Dietetic Association and the American
                                                        changes needed is with the help of a registered dieti-
Diabetes Association as a treatment of diabetes and
                                                        tian, health professional or a trained fitness profes-
other chronic diseases. It also works well for use in
                                                        sional.
weight management. It is a balanced system, with
foods from each group, and can be followed indefi-
nitely. The diet is an easy way to monitor intake of
carbohydrates, fat and protein as well as portion
sizes.




 Exchanges For Various Calorie Levels
 Calories/day            1200 1400 1500 1600 1700 1800 2000 2100 2200

 Meat                    4       4       5        6      6        6       6       6        6
 Bread/starch            5       7       7        7      8        9       10      11       11
 Vegetables              2       3       4        2      2        2       2       2        3
 Fats                    3       3       3        3      3        4       4       5        5
 Fruit                   3       3       3        3      3        3       3       3        4
 Skim milk (cups)        2       2       2        -      -        -       -       -        -
 2% milk                 -       -       -        2      2        2       2       2        3
Example of a
daily exchange diet:
                                                         2 Dieting using calorie
                                                         control portions
 1800 Calories                                                Meal Replacement Plan. The rationale behind
                                                         this plan is the use of a liquid formula or a
 Breakfast                                               packaged item with a fixed number of calories to
 2 Fruit                  1 cup orange juice             replace a meal. This takes the guesswork out of
                                                         meal planning, and the person can be assured not
 2 Bread                  2 slices of toast              to take in too many calories. By controlling
 1 Meat                   1 hard-cooked egg              portion sizes, fat and carbohydrate, a person can
                                                         control calories.
 2 Fat                    2 tsp margarine
                                                              The replacement items are balanced and
 1 Milk                   1 cup ½% milk
                                                         contain a mix of protein, carbohydrate and fat as
 Free food                coffee or tea                  well as other nutrients. Four different types of
                                                         meal replacements are available: powder mixes,
                                                         shakes, bars and prepackaged meals like TV
 Lunch                                                   dinners. The usual plan is to use a meal replace-
 2 Meat                   ½ cup tuna                     ment for one or two meals a day while having
                                                         sensible meals that combine lean meat, starch,
 2 Bread                  2 slices whole wheat bread     vegetables and fruit for the other meals during the
 1 Vegetable              ½ cup tomato slices            day. An intake of five fruits and vegetables is
                                                         recommended. A meal replacement program is
 Raw vegetable            Lettuce/cucumber salad
                                                         more effective for losing weight than a conven-
 2 Fruit                  1 cup sliced peaches           tional, structured weight loss diet. Meal replace-
 2 Fat                    2 tsp margarine                ments offer a convenient, nutritionally balanced
                                                         weight loss alternative to conventionally struc-
 Free foods               Tea with lemon                 tured weight loss diets.


 Dinner                                                       A meal replacement plan
 3 Meat                   3 oz baked chicken                  Breakfast        Meal replacement
 2 Bread                  ½ cup mashed potato                 Lunch            Sensible meal or meal
                          1 small whole-grain roll                             replacement

 1 Vegetable              ½ cup broccoli                      Dinner           Sensible meal

                          ½ cup carrots                       Snacks           Fruit, vegetables, fat-free
                                                                               yogurt or cheese, nuts,
 Raw vegetable            tossed salad                                         pretzels or air-popped
 2 Fat                    1 tbsp salad dressing                                popcorn
                          1 tsp margarine
 Free foods               Coffee


 Evening Snack
 1 Bread                  2 graham crackers
 1 Milk                   1 cup ½% milk



For more information about the Exchange diet, contact:
         http://www.diabetes.org/home.jsp
Heli Roy, PhD, RD,
Associate Professor

References:

www.cdc.gov


Noakes M, Foster PR, Keogh JB, Clifton PM.
   Meal replacements are as effective as
   structured weight-loss diets for treating
   obesity in adults with features of metabolic
   syndrome. J Nutr. 2004 Aug;134(8):1894-9.


Truby H, Millward D, Morgan L, Fox K,
    Livingstone MB, DeLooy A, Macdonald I. A
    randomised controlled trial of 4 different
    commercial weight loss programmes in the
    UK in obese adults: body composition
    changes over 6 months. Asia Pac J Clin
    Nutr. 2004 Aug;13(Suppl):S146.


www.slim-fast.com/plan/index.asp?bhcp=1
                                                                           The Pennington Biomedical Research Center is a
                                                                           world-renowned nutrition research center.
Halford JCG, Ball MF, Pontin EE, Maharjan LB,
     Dovey TM, Pinkney JH, Wilding JPH, Mela                               Mission: To promote healthier lives through research
     DJ. The impact of using meal-replacements                             and education in nutrition and preventive medicine.
     versus standard dietetic advice on body
     weight, appetite, mood, and satisfaction                              The Pennington Center has five priorities in research:
     during a 12-week weight control. North                                    1. Clinical Obesity Research
     American Association for the Study of                                     2. Experimental Obesity
     Obesity Conference, November 14-18,                                       3. Functional Foods
     2004, Las Vegas, Nevada.                                                  4. Health and Performance Enhancement
                                                                               5. Nutrition and Chronic Diseases
                                                                               6.   Nutrition and the Brain

                                                                           The research fostered by these divisions can have a
                                                                           profound impact on healthy living and on prevention
                                                                           of common chronic diseases, such as heart disease,
Louisiana State University Agricultural Center                             cancer, diabetes, hypertension and osteoporosis.
William B. Richardson, Chancellor
Louisiana Agricultural Experiment Station                                  The Division of Education provides education and
David J. Boethel, Vice Chancellor and Director                             information to the scientific community and the public
Louisiana Cooperative Extension Service                                    about research findings, training programs and
Paul D. Coreil, Vice Chancellor and Director                               research areas, as well as providing educational
                                                                           events for the public on various health issues.
Pub. 2912-D           (20M)      3/06
Issued in furtherance of Cooperative Extension work, Acts of Congress of   We invite people of all ages and backgrounds to
May 8 and June 30, 1914, in cooperation with the United States             participate in the exciting research studies being
Department of Agriculture. The Louisiana Cooperative Extension Service     conducted at the Pennington Center in Baton Rouge,
provides equal opportunities in programs and employment.                   Louisiana. If you would like to take part, visit the
                                                                           clinical trials web page at www.pbrc.edu or call (225)
                                                                           763-2597.

                                                                           Division of Education
                                                                           Phillip Brantley, PhD, Director
                                                                           Pennington Biomedical Research Center
                                                                           Claude Bouchard, PhD, Executive Director




                                         Visit our Web site:                     Visit our Web site:
                                        www.lsuagcenter.com                        www.pbrc.edu

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Dietary approach to weight loss

  • 1. Pennington Nutrition Series Healthier lives through education in nutrition and preventive medicine Body Mass Index (BMI) is a way to define over- The distribution of body fat is important from a weight and obesity. The index is a mathematical formula in chronic disease perspective. Those who have more which a person’s body weight in kilograms is divided by body fat in the abdominal area have an increased risk the square of his or her height in meters [kg/m2]. The BMI for elevated triglycerides, high blood pressure and is more highly correlated with body fat than any other glucose intolerance. Waist circumference correlates mathematical ratio of height and weight; however, athletes well with chronic disease risk. A waist circumference and individuals with a high percentage of muscle may of 40 inches (102 cm) or more in men or a waist have a BMI in the overweight range because of the higher circumference of 35 inches (88cm) or more in women density of muscle compared to fat. puts one at greater risk of insulin resistance and the A BMI of 18 to 25 is considered normal weight. chronic diseases associated with it. Individuals with a BMI of 25 to 29.9 are considered overweight, and those with a BMI of When someone is a few pounds overweight and 30 or more are considered obese. is motivated to lose weight, there are safe and effec- tive methods to lose a few pounds and to maintain a Overweight is defined as increased weight in weight loss. relation to height. Obesity is defined as an excessively high amount of body fat or adipose tissue in relation to lean body mass. innovate educate improve lives
  • 2. 1 Dieting with the How to use the exchange plan: The number of exchanges per day is determined Exchange Diet by the number of calories needed in the diet. It is different for each person and depends on height, weight An exchange diet breaks food down into six and the amount of energy expended. The table shows a categories: starch/bread, meat, vegetables, fruit, basic diet composition using the exchange system. The milk, and fat. The exchange diet was created by the most accurate way to determine the number of ex- American Dietetic Association and the American changes needed is with the help of a registered dieti- Diabetes Association as a treatment of diabetes and tian, health professional or a trained fitness profes- other chronic diseases. It also works well for use in sional. weight management. It is a balanced system, with foods from each group, and can be followed indefi- nitely. The diet is an easy way to monitor intake of carbohydrates, fat and protein as well as portion sizes. Exchanges For Various Calorie Levels Calories/day 1200 1400 1500 1600 1700 1800 2000 2100 2200 Meat 4 4 5 6 6 6 6 6 6 Bread/starch 5 7 7 7 8 9 10 11 11 Vegetables 2 3 4 2 2 2 2 2 3 Fats 3 3 3 3 3 4 4 5 5 Fruit 3 3 3 3 3 3 3 3 4 Skim milk (cups) 2 2 2 - - - - - - 2% milk - - - 2 2 2 2 2 3
  • 3. Example of a daily exchange diet: 2 Dieting using calorie control portions 1800 Calories Meal Replacement Plan. The rationale behind this plan is the use of a liquid formula or a Breakfast packaged item with a fixed number of calories to 2 Fruit 1 cup orange juice replace a meal. This takes the guesswork out of meal planning, and the person can be assured not 2 Bread 2 slices of toast to take in too many calories. By controlling 1 Meat 1 hard-cooked egg portion sizes, fat and carbohydrate, a person can control calories. 2 Fat 2 tsp margarine The replacement items are balanced and 1 Milk 1 cup ½% milk contain a mix of protein, carbohydrate and fat as Free food coffee or tea well as other nutrients. Four different types of meal replacements are available: powder mixes, shakes, bars and prepackaged meals like TV Lunch dinners. The usual plan is to use a meal replace- 2 Meat ½ cup tuna ment for one or two meals a day while having sensible meals that combine lean meat, starch, 2 Bread 2 slices whole wheat bread vegetables and fruit for the other meals during the 1 Vegetable ½ cup tomato slices day. An intake of five fruits and vegetables is recommended. A meal replacement program is Raw vegetable Lettuce/cucumber salad more effective for losing weight than a conven- 2 Fruit 1 cup sliced peaches tional, structured weight loss diet. Meal replace- 2 Fat 2 tsp margarine ments offer a convenient, nutritionally balanced weight loss alternative to conventionally struc- Free foods Tea with lemon tured weight loss diets. Dinner A meal replacement plan 3 Meat 3 oz baked chicken Breakfast Meal replacement 2 Bread ½ cup mashed potato Lunch Sensible meal or meal 1 small whole-grain roll replacement 1 Vegetable ½ cup broccoli Dinner Sensible meal ½ cup carrots Snacks Fruit, vegetables, fat-free yogurt or cheese, nuts, Raw vegetable tossed salad pretzels or air-popped 2 Fat 1 tbsp salad dressing popcorn 1 tsp margarine Free foods Coffee Evening Snack 1 Bread 2 graham crackers 1 Milk 1 cup ½% milk For more information about the Exchange diet, contact: http://www.diabetes.org/home.jsp
  • 4. Heli Roy, PhD, RD, Associate Professor References: www.cdc.gov Noakes M, Foster PR, Keogh JB, Clifton PM. Meal replacements are as effective as structured weight-loss diets for treating obesity in adults with features of metabolic syndrome. J Nutr. 2004 Aug;134(8):1894-9. Truby H, Millward D, Morgan L, Fox K, Livingstone MB, DeLooy A, Macdonald I. A randomised controlled trial of 4 different commercial weight loss programmes in the UK in obese adults: body composition changes over 6 months. Asia Pac J Clin Nutr. 2004 Aug;13(Suppl):S146. www.slim-fast.com/plan/index.asp?bhcp=1 The Pennington Biomedical Research Center is a world-renowned nutrition research center. Halford JCG, Ball MF, Pontin EE, Maharjan LB, Dovey TM, Pinkney JH, Wilding JPH, Mela Mission: To promote healthier lives through research DJ. The impact of using meal-replacements and education in nutrition and preventive medicine. versus standard dietetic advice on body weight, appetite, mood, and satisfaction The Pennington Center has five priorities in research: during a 12-week weight control. North 1. Clinical Obesity Research American Association for the Study of 2. Experimental Obesity Obesity Conference, November 14-18, 3. Functional Foods 2004, Las Vegas, Nevada. 4. Health and Performance Enhancement 5. Nutrition and Chronic Diseases 6. Nutrition and the Brain The research fostered by these divisions can have a profound impact on healthy living and on prevention of common chronic diseases, such as heart disease, Louisiana State University Agricultural Center cancer, diabetes, hypertension and osteoporosis. William B. Richardson, Chancellor Louisiana Agricultural Experiment Station The Division of Education provides education and David J. Boethel, Vice Chancellor and Director information to the scientific community and the public Louisiana Cooperative Extension Service about research findings, training programs and Paul D. Coreil, Vice Chancellor and Director research areas, as well as providing educational events for the public on various health issues. Pub. 2912-D (20M) 3/06 Issued in furtherance of Cooperative Extension work, Acts of Congress of We invite people of all ages and backgrounds to May 8 and June 30, 1914, in cooperation with the United States participate in the exciting research studies being Department of Agriculture. The Louisiana Cooperative Extension Service conducted at the Pennington Center in Baton Rouge, provides equal opportunities in programs and employment. Louisiana. If you would like to take part, visit the clinical trials web page at www.pbrc.edu or call (225) 763-2597. Division of Education Phillip Brantley, PhD, Director Pennington Biomedical Research Center Claude Bouchard, PhD, Executive Director Visit our Web site: Visit our Web site: www.lsuagcenter.com www.pbrc.edu