Nu fsp chapter 11   weight loss
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Nu fsp chapter 11   weight loss Nu fsp chapter 11 weight loss Presentation Transcript

  • Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Chapter 11 Weight Loss
  • Basics of Weight Control How may Calories are in a pound of body fat? • 1 pound of fat = 454 grams • 1 gram of fat = ~ 9 Calories • 1 pound of pure fat = ~ 4,086 Calories • Body fat contains some protein, minerals and water • 1 pound of body fat = ~ 3,500 Calories
  • Is the caloric concept of weight control valid? • First Law of Thermodynamics – Energy is neither created nor destroyed
  • Caloric Concept of Weight Control • Caloric costs for changes in body mass – Fat = 9 Calories per gram – Protein = 4 Calories per gram – Carbohydrate = 4 Calories per gram – Water = 0 Calories per gram • Caloric cost of weight loss may vary • Loss of body fat, however, costs about 3,500 Calories /pound
  • Estimated Energy Requirement (EER) • A key factor is the Physical Activity Level (PAL), which is the TDEE divided by the BEE. The PAL is used to determine the Physical Activity (PA) coefficient
  • How much weight can I lose safely per week? • Without medical supervision – Recommended maximal amount • Adults: 2 pounds/week • Growing children: 1 pound/week – Realizable goals • Adults: 1 pound/week • Growing children: ½ pound/week – Weight loss should be body fat
  • 1. Behavior Modification • Learn new ways to deal with old problems • For weight control, reduce or eliminate physical or social stimuli that contribute to – Excessive caloric intake – Physical inactivity • Learn to eat a leaner, healthier diet • Learn to exercise more
  • How do I apply behavior-modification techniques in my weight-control program? • YOU are the most important component of your weight- control program • YOU must – Face the fact that being overweight impairs your health – Know that losing weight will improve your health – Establish weight loss as a high priority – Be able to tolerate some discomfort as you make changes
  • Behavior Modification • One of the first steps is to identify your dietary and exercise behaviors - Keep a 24-hour record
  • Diet and Exercise Behaviors • Establish long-range and short-range goals – Long-range • Lose 10-15% of body weight over 4-6 months – Short-range • Lose 1-2 pounds per week • Small behavior changes – “ Nothing builds success like success” – Small Steps
  • Behavior Modification: Suggestions • Self-discipline, self-control, and advanced planning • Foods to eat • Food purchasing • Food storage • Food preparation and serving • Location • Restaurant eating • Methods of eating • Activity • Mental attitude
  • Self-discipline, self-control, and advanced planning • Establish realistic weight-loss goals • Establish weight loss as a high priority • Think about this priority before eating • Take small helpings deliberately • Plan for a modest daily caloric deficit • Check your body weight on a regular basis
  • Foods to eat • Use low-Calorie healthful foods for snacks • Plan low-Calorie, high-nutrient meals • Plan your food intake for the entire day • Eat only foods that require no or minimal processing • Allow yourself small amounts of foods you like, but stay within daily caloric limits • Know the Food Exchange system, particularly portion size and high-fat foods and Calories per exchange
  • Food purchasing • Do not shop when hungry • Prepare a shopping list and do not deviate from it • Buy only nutrient-dense foods • Read and compare food labels • Buy natural foods as much as possible
  • Food storage • Keep high-Calorie foods out of sight • Have low-Calorie snacks like carrots and radishes readily available
  • Food preparation and serving • Buy mainly foods that require preparation of some type • Do not add fats or sugar in preparation, if possible • Prepare only small amounts. Be able to visualize one serving size for any given food • Do not use serving bowls on the table • Put the food on the plate, preferably a small one
  • Location • Eat in only one place, such as the kitchen or dining area • Avoid food areas such as the kitchen or snack table at a party • Avoid restaurants where you are most likely to buy high-Calorie items
  • Restaurant eating • When eating out, select the low-Calorie items • Request your meals be prepared without fat • Have condiments, like butter, mayonnaise, and salad dressing served on the side; use sparingly • Order water, not a high-Calorie beverage • Be wary of portion sizes as most restaurant servings contain 2-3 normal servings. Ask for a take-home container before you eat and put half of your meal in the box.
  • Methods of eating • Eat slowly. Chew your food thoroughly or drink water between bites • Eat with someone; conversation slows eating • Cut food into small pieces • Do not do anything else while eating • Relax and enjoy the meal • Eat only at specified times • Eat only until pleasantly satisfied, not stuffed • Spread your total Calories over the day; snack often
  • Activity • Decrease the amount of time spent being sedentary • Increase the amount of daily NEAT • Walk more • Use the stairs, not the elevator or escalator • Do exercise snacks. Brisk 10-minute walk • Get involved in physical activities with others • Avoid sedentary night routines • Start a regular exercise program, both aerobic and resistance exercises • Schedule exercise as an appointment in your daily planner
  • Mental attitude • Recognize that you are not perfect and that lapses will occur • Deal positively with your lapse; put it behind you and get back on your program • Put reminders on the refrigerator door at home or on your telephone at work • Reward yourself for sticking to your plans
  • Weight maintenance • Maintaining your new healthy body weight is the key • Lifelong commitment to healthy diet and exercise behaviors is needed • Prevent a lapse from becoming a relapse – Injury can curtail exercise – Have alternative exercises you can do • National Weight Control Registry – Maintained weight loss for at least 2 years
  • 2. Dietary Modifications • To lose weight, the key component is Calories – One needs to consume fewer Calories than one expends
  • How can I determine the number of Calories needed in a diet to lose weight? • First, calculate how many Calories (C) you need daily to maintain your current body weight • Second, estimate how much weight you want to lose each week. • Example: – 35-year old sedentary woman needs 1,820 C to maintain current body weight at 140 pounds – To lose 1 pound/week would require a 500 C daily deficit – 1 pound of fat = 3,500 Calories; 3,500 ÷ 7 = 500 C – 1,830 ― 500 = 1,330 C day diet
  • Why does a person usually lose the most weight during the first week on a reducing diet? • The goal is to lose body fat, not muscle • Weight loss via dieting may come from decreased body stores of carbohydrate and protein and resultant body water losses, which require no Calories – Carbohydrate stores may also bind water – Carbohydrate losses: 300 grams – Associated water losses: 900 grams – Total losses: 1,200 grams (1.2 kg), or 2.6 pounds – Water is also lost with muscle protein losses • Loss of 1 pound occurs with < 3,500 Calorie deficit
  • Why does it become more difficult to lose weight after several weeks or months on a diet program? 1. Body water losses decrease – Body weight losses are now primarily from body fat, which requires an energy deficit of 3,500 Calories 2. At your lower body weight, you need fewer daily Calories to maintain this weight – Example: Male who needs 18 Calories/lb to maintain weight • 200 lbs x 18 = 3,600 Calories to maintain weight • 180 lbs x 18 = 3,240 Calories to maintain weight 3. To maintain a set rate of weight loss, you would need to cut more Calories from the daily diet
  • What are the major characteristics of a sound diet for weight control? • Hundreds of diet plans have been proposed – Fast and easy diet plans • No such diet • Most diet plans focus on macronutrients – Acceptable Macronutrient Distribution Range (AMDR) • Carbohydrate: 45-65% of energy intake • Fat: 20-35% of energy intake • Protein: 10-35% of energy intake
  • Popular Diets (Diet Books) Diet PlanDiet Plan Average DailyAverage Daily CaloriesCalories %% CarbohydratesCarbohydrates %% FatFat %% ProteinProtein WeightWeight watcherswatchers 1,4501,450 5656 2424 2020 AtkinsAtkins 1,5201,520 1111 6060 2929 South BeachSouth Beach 1,3401,340 3838 3939 2323 VolumetricsVolumetrics 1,5001,500 5555 2323 2222 Jenny CraigJenny Craig 1,5201,520 6262 1818 2020 ZoneZone 1,6601,660 4040 3030 3030 OrnishOrnish 1,5201,520 7777 66 1717 Adapted from Consumers Union. Rating the Diets. Consumer Reports 70 (6):21, 2005.
  • Balanced Weight-loss Diets • Examples of diet plans – Various health profession organizations • Key points of such diet plans – Reduced in Calories yet supply all essential nutrients – Contain a wide variety of foods that appeal to your taste and help prevent hunger between meals; moderate in fat – Suited to your current lifestyle and personal preferences – Provide a slow rate of weight loss; 1-2 pounds/week – A lifelong diet
  • Weight-loss Diet Plans • Current research – The Calorie content of the diet is the key factor – Diets varying in carbohydrate, fat, or protein are equally effective if caloric content is similar
  • Is it a good idea to count Calories when attempting to lose body weight? • Counting Calories may be helpful during early stages of a diet • Learning the Food Exchange System and using Food Labels helps you learn the caloric contents and serving sizes of various foods, which can help in the selection of low-Calorie, nutrient dense foods • Keep track of foods rich in fat and sugar
  • What is the Food Exchange System?
  • How can I determine the number of Calories I eat daily? • Carry a notebook with you and a reminder, such as a rubber band on your finger • Record your daily food intake, and physical activity, in detail, as soon as possible • Record food intake over a 3-7 day period of time which represents your normal dietary habits • Use the Food Exchange System or Nutrition Facts on food labels to record serving size and Calories • Use measuring devices, such as a measured cup • Learn to estimate portion sizes
  • Determining Caloric Intake • Eating out – Fast-food restaurants • Nutrition fact sheets • See Appendix F – Other restaurants • Use PDA or cell phone • Email calories@dietdetective.com • Receive response with Calorie, fat, and carbohydrate content
  • Determining Caloric Intake • Enter food record into MyPyramid dietary analysis program • You may keep a record of your caloric (energy) intake over the course of a year
  • What are some general guidelines I can use in the selection and preparation of foods to promote weight loss or maintain a healthy body weight? • Consumer Reports study of 32,000 dieters who lost weight and kept it off – The National Weight Control Registry • No specific plan but used sensible strategies – Cut portion sizes – Eat fewer Calories from fat and sugar – Eat healthier carbohydrates, fats, and proteins
  • Guidelines for Weight Control and Healthy Eating 1. Decrease caloric intake -- eat more nutrient-dense foods and fewer energy-dense foods 2. Eat foods that make you feel full 3. Restrict portion sizes 4. Eat less fat 5. Eat fewer and smaller amounts of refined sugar 6. Reduce the intake of both fat and sugar 7. Eat more low-fat dairy products
  • Guidelines for Weight Control and Healthy Eating 8. Eat more low-fat meat and meat substitutes 9. Eat more whole, unprocessed carbohydrates 10. Eat more fruits 11. Eat more veggies 12. Consume fewer high-Calorie fat exchanges 13. Reduce liquid Calories 14. Limit intake of alcohol 15. Limit salt intake
  • Guidelines for Weight Control and Healthy Eating 16. Eat slowly 17. Nibble, don’t gorge 18. Eat breakfast 19. Learn to cook 20. Learn low-Calorie foods
  • Guidelines for Weight Control and Healthy Eating 1. Eat more nutrient-dense foods and fewer energy- dense foods
  • Guidelines for Weight Control and Healthy Eating 2. Eat foods that make you feel full Volumetrics: High-volume, low-Calorie foods Soups Salads Vegetables Whole grains
  • Guidelines for Weight Control and Healthy Eating 3. Restrict portion sizes Evolution of Coca-Cola 8-ounce bottle 12-ounce bottle 20-ounce bottle 64-ounce fountain serving Evolution of fast-food hamburgers Single 4-ounce patty Double burger Triple burger
  • Guidelines for Weight Control and Healthy Eating 4. Eat less fat Proposed rationale: • Rich in Calories • Appetizing and does not rapidly suppress the appetite • Has a lower TEF or higher metabolic efficiency • May be stored preferentially in the abdominal area
  • Guidelines for Weight Control and Healthy Eating 5. Eat fewer and smaller amounts of refined sugar • Reduce intake of sugar-sweetened beverages • Use sugar substitutes
  • Guidelines for Weight Control and Healthy Eating 6. Reduce the intake of both fat and sugar • May constitute 50% of daily energy intake
  • Guidelines for Weight Control and Healthy Eating 7. Eat more low-fat dairy products • Rich in protein, vitamins and minerals, especially calcium
  • Guidelines for Weight Control and Healthy Eating 8. Eat more low-fat meat and meat substitutes • Very lean meat exchange • Fish, chicken breast, beef eye of round, flank steak • 35 Calories, 1 gram of fat • High in protein • Low in fat • Low in Calories • Rich in minerals (iron and zinc)
  • Guidelines for Weight Control and Healthy Eating 9. Eat more whole, unprocessed carbohydrates • High volume food • Rich in fiber • Select 100% whole wheat or whole grain
  • Guidelines for Weight Control and Healthy Eating 10. Eat more fruits • Select fresh fruits • Select canned or frozen fruits in own juices • Avoid fruits in heavy sugar syrups • Limit intake of dried fruits (high in Calories) • Limit intake of fruit juices (high in Calories)
  • Guidelines for Weight Control and Healthy Eating 11. Eat more vegetables • High volume foods • Low in Calories • Rich in vitamins, minerals, fiber, phytonutrients • Many vegetables are listed as Free Food Exchanges • Fewer than 20 Calories per serving
  • Guidelines for Weight Control and Healthy Eating 12. Consume fewer high-Calorie fat exchanges • Reduce intake • Butter • Margarine • Cooking oils • Salad dressing • Mayonnaise • Most are pure fat • Use fat-free or low-fat versions
  • Guidelines for Weight Control and Healthy Eating 13. Reduce liquid Calories • Beverages other than milk and fruit juice should have no Calories • Sweetened sodas and drinks may be associated with weight gain and obesity • Some specialty coffees contain as many Calories as McDonald’s Big Mac • Starbucks Choclaty Chip Frappuccino Blended Crème > 500 Calories
  • Guidelines for Weight Control and Healthy Eating 14. Limit your intake of alcohol – A gram contains 7 Calories, comparable to fat – Calories in alcohol do not replace Calories in a meal, so total caloric intake is increased – Selecting low-alcohol beer and wine may help save Calories • 64 Calories versus 150 Calories • Decreased carbohydrate and alcohol
  • Guidelines for Weight Control and Healthy Eating 15. Limit salt intake • Salt may increase appetite • Salt may increase thirst for sugar-sweetened beverages • Use herbs, spices and other nonsalt seasonings
  • Guidelines for Weight Control and Healthy Eating 16. Eat slowly • Eating slowly may help curb your appetite • Eat a low-Calorie soup or salad as an appetizer • May help curb the appetite for the main course
  • Guidelines for Weight Control and Healthy Eating 17. Nibble, don’t gorge • Eat 5-6 smaller snacks and meals during the day • May help curb the appetite • Use low-Calorie, nutrient-dense foods • 100-Calorie snacks • An apple • A hard-boiled egg • A dozen almonds • 3 Hershey’s kisses • 3 cups of air-popped, fat free popcorn
  • Guidelines for Weight Control and Healthy Eating 18. Eat breakfast • A hearty breakfast may help curb appetite through the morning hours • A high-protein breakfast may be helpful • Egg substitutes • Whole wheat bagels with salmon • Whole grain cereals with skim milk and fruit
  • Guidelines for Weight Control and Healthy Eating 19. Learn to cook • Select healthy foods • Cook and serve small portions • Ease of cooking • Microwaves • Electric grills
  • Guidelines for Weight Control and Healthy Eating 20. Learn low-Calorie foods • Learn to substitute low-Calorie foods for those high in Calories • Know the Food Exchange System • Practice what you learn • Gradual transition in small steps • Whole milk → low-fat milk → skim milk
  • Are very-low-Calorie diets (VLCD) effective and desirable as a means to lose body weight? • VLCD are modified fasts (< 800 Calories/day) • May be used under medical supervision • Not recommended for typical individual who wants to lose 10-20 pounds
  • Is it harmful to overeat occasionally? • Occasional overeating is not harmful to dieting, as long as it does not become a habit • Try to avoid high-fat meals if prone to cardiovascular disease • Rapid weight gain from overeating may occur, but is not body fat – Water retention with carbohydrate stores – Water retention with excess sodium • Getting back on your weight loss plan will return body weight to normal
  • 3. Exercise Modifications Increase any of the FITT Principles • Frequency • Intensity • Time • Type
  • Comprehensive Weight-Control Programs • Comprehensive program – Behavior modification – Diet – Exercise • Most important feature – Maintenance of stable healthy body weight • Lifelong commitment
  • What is more effective for weight control —dieting or exercise? • Dieting alone may be an effective means to lose excess body fat – Increasing protein content may help maintain muscle – Some indicate dieting alone to maintain weight is designed to fail in the long run • Exercise alone may also be an effective means to lose body fat – Dietary energy intake needs to remain constant
  • Dieting and Exercise for Weight Control • Combination of dieting and exercise is the most effective approach to weight control – A proper diet can control energy intake – A proper aerobic and resistance exercise program provides multiple benefits • Expends caloric energy • Prevent decrease in lean body mass • Maintain resting energy expenditure (REE) • Exercise may improve dietary compliance
  • Weight Control • The Bottom Line Eat less, move more