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Healthy Weight Management, Through Nutrition, Exercise And Lifestyle


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Approaches to Healthy Weight Management by Adam Rinde,ND

Published in: Health & Medicine

Healthy Weight Management, Through Nutrition, Exercise And Lifestyle

  1. 1. Healthy Weight Management T hrough Nutrition, Exercise and Lifestyle By Adam Rinde, ND Bastyr Center for Natural Health April 26, 2007
  2. 2. Intro: About Me <ul><li>Current Resident and Physian at the Bastyr Center for Natural Health, Seattle, WA. </li></ul><ul><li>Trained in Naturopathic Medicine with emphasis in Family Medicine and Physical Medicine. </li></ul><ul><li>Interests in chronic inflammatory conditions, autoimmune diseases, metabolic syndrome, endocrine disorders, and mind-body medicine. </li></ul><ul><li>N.D. , Doctorate in Naturopathic Medicine, Bastyr University, Kenmore/Seattle, WA 2006 </li></ul><ul><li>B.S. Bachelors of Science, University of Arizona, 1992 </li></ul><ul><li>10 years background in exercise, conditioning, and coaching to general population and athletes . </li></ul><ul><li>5 years experience working in corporate America </li></ul>
  3. 3. About Me <ul><li>Practice philosophy: </li></ul><ul><ul><li>I believe in being caring, informative, and personable with my patients. </li></ul></ul><ul><ul><li>Health has many layers involving physical, behavioral, emotional, and spiritual elements. </li></ul></ul><ul><ul><li>I strive to offer the high benefit/ low risk care that adds to my patient’s quality of life and reduces disease morbidity. </li></ul></ul><ul><ul><li>Admitting what you don’t know is as or more important then stating what you know. </li></ul></ul><ul><li>Treatment Philosophy: </li></ul><ul><ul><li>I believe chronic poorly regulated Inflammation is the root of many diseases </li></ul></ul><ul><ul><li>I strive for sustainable treatment approaches </li></ul></ul><ul><ul><li>My goal is to treat the cause not just symptoms. </li></ul></ul><ul><ul><li>I believe that all health decisions should come from the place of “what works” rather then from the place of “what’s accepted”… </li></ul></ul><ul><li>Currently available to see patients in the teaching clinic or practitioner care clinic of Bastyr Center for Natural Health in Seattle. </li></ul>
  4. 4. Principles of Naturopathic Medicine <ul><li>First do no harm </li></ul><ul><li>Promote the healing power of nature </li></ul><ul><li>Treat the whole person </li></ul><ul><li>Find and treat the underlying cause </li></ul><ul><li>Doctor as teacher </li></ul><ul><li>Practice preventative medicine </li></ul><ul><li>Promote Wellness </li></ul>
  5. 5. How is Naturopathic Medicine Different then conventional medicine ? <ul><li>Education and training involves specialized emphasis in nutrition, herbal medicine, homeopathy, physical medicine, hydrotherapy, minor surgery and lifestyle interventions. </li></ul><ul><li>Emphasis on nutrition, lifestyle, botanical, and natural based therapeutics. </li></ul><ul><li>Naturopaths are trained in minor surgery/office procedures but not general surgery. </li></ul><ul><li>Approach to assessment, diagnosis, and treatment is holistic. </li></ul><ul><li>Time spent with patients is longer (on average 30-60 minutes per/visit vs. approx. 12 minutes) </li></ul><ul><li>Lower invasive therapies which may require more patient effort to achieve cure </li></ul><ul><li>Only licensed in 14 states </li></ul><ul><li>Don’t currently accept Medicare </li></ul><ul><li>Naturopathic Physicians currently don’t have hospital privileges </li></ul><ul><li>Residencies are available to some, but not required to practice </li></ul><ul><li>Covered by most but not all insurance providers. </li></ul>
  6. 6. How is Naturopathic Medicine similar to conventional medicine? <ul><li>4-Year full-time, doctorate-level naturopathic medical school didactic coursework almost identical to conventional school (Basic Sciences, Clinical Science, Diagnostics) </li></ul><ul><li>1000 hours of clinical training comparable to conventional medical School </li></ul><ul><li>Practitioners are governed by state department of health </li></ul><ul><li>Practitioners must sit for a federally regulated licensee exam. </li></ul><ul><li>Ongoing continuing education required to maintain licensure. </li></ul><ul><li>Naturopaths can diagnose and treat most diseases that a conventional primary care physician can in 14 licensed states. </li></ul><ul><li>Naturopaths can function as a primary care physician in the state of Washington </li></ul>
  7. 7. Naturopathic Medicine examples of therapeutic modalities <ul><li>Lifestyle Counseling </li></ul><ul><li>Homeopathy </li></ul><ul><li>Botanical Medicine </li></ul><ul><li>Neutraceuticals </li></ul><ul><li>Aromatherapy </li></ul><ul><li>Nutrient Therapy </li></ul><ul><li>Therapeutic Diets </li></ul><ul><li>IV Nutrient Therapy </li></ul><ul><li>Therapeutic Injection therapy (in some states) </li></ul><ul><li>Soft Tissue Massage </li></ul><ul><li>Muscle Energy Stretching </li></ul><ul><li>Naturopathic Spinal Manipulation </li></ul><ul><li>Acupuncture (in some states) </li></ul><ul><li>Hydrotherapy </li></ul><ul><li>Baleotherapy </li></ul><ul><li>Colon Hydrotherapy </li></ul><ul><li>Physiotherapy </li></ul><ul><li>Craniosacral Therapy </li></ul><ul><li>Antimicrobial Therapy </li></ul><ul><li>Natural Based Pharmaceutical Interventions. </li></ul>
  8. 8. Today’s Topic <ul><li>Weighing in on the weight issue </li></ul><ul><li>Principles of Healthy Eating </li></ul><ul><li>Tools and Tips for Healthy Eating </li></ul><ul><li>Exercising for Weight Management </li></ul><ul><li>Exercise Tools and Tips </li></ul><ul><li>Other important factors in weight management. </li></ul><ul><li>Other things you want me to cover? </li></ul><ul><li>Questions : please hold until the end(non-diagnostic or treatment related please) </li></ul>
  9. 9. The Weight Issue <ul><li>Obesity Statistics </li></ul><ul><ul><li>60% of U.S. adults obese or overweight according to NHANES </li></ul></ul><ul><ul><ul><li>Statistics are based on BMI not waist to hip: ratio </li></ul></ul></ul><ul><li>Some Complications Pinned on Obesity </li></ul><ul><ul><li>Heart Disease </li></ul></ul><ul><ul><li>Stroke </li></ul></ul><ul><ul><li>Diabetes Type II </li></ul></ul><ul><ul><li>Some cancers </li></ul></ul><ul><ul><li>Asthma </li></ul></ul><ul><ul><li>Osteoarthritis </li></ul></ul><ul><ul><li>Gall Stones </li></ul></ul>
  10. 10. What’s important? Really? and Why do you want to lose weight? <ul><li>Appearence, quality of life, preventing disease, or reducing disease complications? </li></ul><ul><li>All of the above? </li></ul><ul><ul><li>.... I knew you would say that </li></ul></ul><ul><li>Appendicular Adiposity vs. Abdominal (Visceral) Adiposity </li></ul><ul><li>Waist circumference is probably the most important anthropometric factor when preventing disease </li></ul><ul><ul><li>Android/abdominal adiposity </li></ul></ul><ul><ul><li>>88 cm in women and >102 cm in Men may be positive predictors of cv disease </li></ul></ul>
  11. 12. Benefits of Weight Management <ul><li>General Benefits come from maintaining a stable weight </li></ul><ul><li>No one knows for certain but it: </li></ul><ul><ul><li>May Lower Risk of CV disease </li></ul></ul><ul><ul><li>May Lower Risk of Type II Diabetes </li></ul></ul><ul><ul><li>May Lower Risk of Hypertension </li></ul></ul><ul><ul><li>May Lower Cholesterol Levels </li></ul></ul>
  12. 13. Risks of Weight Loss Programs <ul><li>A low-BMI has been associated with increased mortality </li></ul><ul><ul><li>The relative risk of death in men and women with a BMI of 18.5-20.9 was 1.3 and 1.2 , compared to those 23.5-24.9 Adams et al: Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old. N Engl J Med 355:763-778, 2006  [PMID: 16926275 </li></ul></ul><ul><li>Rapid weight loss may cause gallstones </li></ul><ul><ul><li>Slow 1-2 lb/weight loss/week advised </li></ul></ul><ul><li>Psychological Distress </li></ul>
  13. 14. Weighing on the Weight Issue <ul><li>The anti-fat movement </li></ul><ul><ul><li>The weight loss industry $$$$$ </li></ul></ul><ul><ul><li>Media bias </li></ul></ul>
  14. 15. Anti-Fat Movement
  15. 16. Fat Acceptance Movement <ul><li>Fat acceptance movement </li></ul><ul><ul><li>The Obesity Myth by Paul Campous </li></ul></ul><ul><ul><li>Big Fat Lies by Gaesser </li></ul></ul><ul><ul><li>Fat Politics by J. Eric Oliver </li></ul></ul><ul><ul><li>When Women Stop Hating Their Bodies by Hirshmann and Hunter </li></ul></ul><ul><ul><li>Overcoming Overeating by Hirschmann and Hunter </li></ul></ul><ul><ul><li>Love Your Body Day </li></ul></ul>
  16. 17. Healthy Body Image
  17. 18. Principles of Healthy Weight Management address and treat the cause <ul><li>Screen for medical risk Factors </li></ul><ul><li>Dietary Choices </li></ul><ul><ul><li>Quantity of food and Quality of Food? Macronutrient, Micronutient profiles. </li></ul></ul><ul><li>Exercise/Level of Activity </li></ul><ul><ul><li>Quantity, Intensity, cardio., resistance exercise </li></ul></ul><ul><li>Lifestyle </li></ul><ul><ul><li>Sleep, stress, balance, etc. </li></ul></ul><ul><li>Psycho-emotional Health </li></ul><ul><ul><li>Relationship with food, binge eating, cravings, depresson. </li></ul></ul><ul><li>Emerging Factors </li></ul><ul><ul><li>GI microflora balance, sleep quality/quantitiy </li></ul></ul>
  18. 19. Healthy Weight Management A comprehensive approach
  19. 20. What can cause weight management problems beyond caloric intake and sedentary lifestyle? <ul><li>Endocrine Disorders </li></ul><ul><ul><ul><li>Insulin/glucose dysregulation </li></ul></ul></ul><ul><ul><ul><ul><li>Type II diabetes </li></ul></ul></ul></ul><ul><ul><ul><li>Growth hormone deficiency(rared) </li></ul></ul></ul><ul><ul><ul><li>Thyroid disorders </li></ul></ul></ul><ul><ul><ul><li>Adrenal disorders </li></ul></ul></ul><ul><ul><ul><li>Polycystic ovarian syndrome </li></ul></ul></ul><ul><li>Sleep disorders </li></ul><ul><li>Gastrointestinal Disorders </li></ul><ul><li>Psychologic Disorders </li></ul><ul><li>Genetics </li></ul><ul><ul><li>Ghrelin-appetite hormone </li></ul></ul><ul><ul><li>Twins,adoptee’s </li></ul></ul>
  20. 21. Healthy Eating: what you eat matters
  21. 22. Macronutrient Based Diet Systems <ul><li>USDA </li></ul><ul><li>Mediterranean Diet (or High PUFA diet) </li></ul><ul><li>Atkins Type Diet (High Protein/Low Carb) </li></ul><ul><li>Zone Diet (40-30-30) </li></ul><ul><li>High Complex Carb/High Fiber, low fat diet (65:19:19) </li></ul><ul><li>Body Ecology Diet </li></ul>
  22. 23. Healthy Eating what you eat matters-general principles <ul><li>Choose lower saturated fats/lower Inflammatory meat sources (i.e.. Fish, Buffalo, Elk) </li></ul><ul><li>Avoid Trans Fats (New York, New York) </li></ul><ul><li>Eat whole grains in your diet (Artichokes, Barley, Oats, Brown Rice, Quinoa, Buckwheat) </li></ul><ul><li>Emphasize low inflammatory foods (whole foods vs. processed foods/and inflammatory meats) </li></ul><ul><li>Consume diet high in PUFA’s (cold-water fish, walnuts, olive oils, flax) </li></ul><ul><li>Use anti-inflammatory spices (turmeric, rosemary, boswelia, ginger) </li></ul><ul><li>Have some form of soluble fiber with every meal (beans, artichoke hearts, fruits (aim for 30 g of fiber daily) </li></ul><ul><li>Eat a serving of protein consistently with each meal. </li></ul><ul><li>When possible, eat organic </li></ul><ul><li>Take a quality multivitamin Daily </li></ul>
  23. 24. Healthy Eating what you eat matters
  24. 26. Doctor Adam’s Power Foods <ul><li>Soluble Fiber (Black beans, Sweet potatoes, Seeds, Peas, Beets, Oats, Barley, Apples, Bananas, Berries) Aim for 30 g daily not exceeding 50 g. </li></ul><ul><li>Green Tea </li></ul><ul><li>Sardines and Salmon </li></ul><ul><li>Antioxidants (Pomegranate Juice (may interact with some medications), Bell Peppers, Tomatoes </li></ul><ul><li>Cruciferous Vegetables (Broccoli, Cauliflower, Kale) </li></ul><ul><li>Oils/Fats (Olive Oil, Flax Oil, Fish Oil) </li></ul>
  25. 27. Antioxidants in Food <ul><li>Carotenoids (carrots, fruits, kale, eggs) </li></ul><ul><li>Flavanoids (berries, cherries, grapes, tea, cocoa, wine, cranberries) </li></ul><ul><li>Isothiocyanates (found in kale, cauliflower,etc) </li></ul><ul><li>Phenols (apples, pears, citrus) </li></ul><ul><li>Sulfides (garlic, leeks, onions) </li></ul>
  26. 28. Doctor Adam’s Power Snacks <ul><li>Aim for snacks in the 100-200 calorie range </li></ul><ul><ul><li>Lara Bars or Kashi Bar </li></ul></ul><ul><ul><li>Doctor Adam’s Power Smoothie </li></ul></ul><ul><ul><li>A cup of frozen blueberries </li></ul></ul><ul><ul><li>Organic Popcorn with powdered flax </li></ul></ul><ul><ul><li>2 tablespoons Almond Butter with 10 Baby Carrots </li></ul></ul><ul><ul><li>1 cup of Snap Peas </li></ul></ul><ul><ul><li>4 Tablespoons Hummus and 10 Baby Carrots Carrots </li></ul></ul><ul><ul><li>10-15 Edamame Shells </li></ul></ul><ul><ul><li>10 almonds or pistachios </li></ul></ul><ul><ul><li>Want something sweet? </li></ul></ul><ul><ul><ul><li>Try Macaroons, Dried Cherries, Figs, 2 squares of dark chocolate. </li></ul></ul></ul>
  27. 29. Getting those Veggies in… <ul><li>Experiment with all types of Greens </li></ul><ul><ul><li>Steaming Green Leafy Vegetables, Broccoli, Cauliflower and tossing with Olive Oil and rosemary. </li></ul></ul><ul><ul><li>Add your favorite protein side to a colorful salad </li></ul></ul><ul><ul><li>Eat Vegetable/Bean Soups </li></ul></ul><ul><ul><li>Eating Veggies with Dip (colorful peppers dipped in Hummus, carrots dipped in almond butter) </li></ul></ul><ul><ul><li>At supermarket, purchase pre-chopped veggies from Salad Bar if the issue is convenience. </li></ul></ul><ul><ul><li>If necessary, pick a green medical food like “Greens First” and drink a greens beverage every day. </li></ul></ul>
  28. 30. Principles of Healthy Eating How much you eat matters!
  29. 31. Resources: Caloric Intake Goal <ul><li>Based on BMR and Activity index </li></ul><ul><li>Healthy weight loss goals usually 1-2 lbs./week </li></ul><ul><li>3500 kcal deficit/week = 1 lb of fat/week </li></ul><ul><li>Most Low Calorie diets aim for 500 Kcal below current Daily Caloric Requirements </li></ul>
  30. 32. Principles of Healthy Eating How much you eat matters <ul><li>Know your Daily Caloric Intake Requirement </li></ul><ul><ul><li>Using BMR calculations and activity index </li></ul></ul><ul><li>Know Serving Sizes </li></ul><ul><ul><li>Vegetables, Legumes 2/3 of plate, Grains 1/3, Proteins 1/3 and Fats/Oils One capful </li></ul></ul><ul><ul><li>Or: </li></ul></ul><ul><ul><ul><li>Vegetables/Legumes (3 DVD cases) </li></ul></ul></ul><ul><ul><ul><li>Grains (1 Rubix Cube) </li></ul></ul></ul><ul><ul><ul><li>Protein (Playing Deck of Cards) </li></ul></ul></ul><ul><ul><ul><li>Fats/Oils (I-capful) </li></ul></ul></ul><ul><li>Snacks: kept to 100-200 Kcal </li></ul>
  31. 33. Portion Distortion 610 Calories 6.9 ounces Calorie Difference: 400 Calories FRENCH FRIES 20 Years Ago Today 210 Calories 2.4 ounces
  32. 34. Portion Distortion COFFEE 20 Years Ago Coffee (with whole milk and sugar) Today Mocha Coffee (with steamed whole milk and mocha syrup) 45 calories 8 ounces 350 calories 16 ounces Calorie Difference: 305 calories
  33. 35. Portion Distortion Calorie Difference: 525 calories Courtesy of National Heart, Lung, and Blood Institute 1,025 calories 2 cups of pasta with sauce and 3 large meatballs 20 Years Ago Today 500 calories 1 cup spaghetti with sauce and 3 small meatballs SPAGHETTI AND MEATBALLS
  34. 36. Healthy Eating Your lifestyle Matters <ul><li>Make your own food </li></ul><ul><li>Slow down, breathe fully, and chew when you eat </li></ul><ul><li>Avoid skipped meals </li></ul><ul><li>Catch yourself when stress eating and develop alternate coping strategies </li></ul><ul><li>Stock your car with water and healthy snacks </li></ul>
  35. 37. The Healthful Kitchen <ul><li>A high quality blender for smoothies and soups </li></ul><ul><li>Vegetable Steamer </li></ul><ul><li>Crock Pot </li></ul><ul><li>Vitamix® for whole vegetable juicing </li></ul><ul><li>Rice Cooker (great for whole grains and many are good for steaming) </li></ul><ul><li>If you like to Grill….The George Forman Grill </li></ul><ul><li>Water Filter </li></ul>
  36. 38. Taste Enhancers <ul><li>Garlic </li></ul><ul><li>Onions </li></ul><ul><li>Spices </li></ul><ul><li>Olives </li></ul><ul><li>Avocados </li></ul><ul><li>Essential Fatty Acids </li></ul><ul><li>1997 by the center for Human Nutrition at the University of California at Los Angeles, </li></ul>
  37. 39. Exercise John Turner, age 67 Weight lifter by Etta Clark, Pomegranate Art Books, San Francisco, (1995)
  38. 40. Weight Training and BMR <ul><li>Primary effect of resistance training is the addition of fat free mass preserving and maybe elevating Basal Metabolic Rate </li></ul><ul><li>Caloric expenditure effect extends beyond the exercise session which ranges (200-500 kcal/hour depending on intensity) </li></ul>
  39. 41. Exercise <ul><li>200 minutes per/week of moderate intensity Exercise (jogging, running, cycling, cross-country skiing) </li></ul><ul><li>Moderate Intensity defined as 70-85 % of HR max </li></ul><ul><li>Combine with Resistance Training 2 sessions, per week, 8-10 exercises emphasizing large muscle groups (ie. Lower Body), 70-80% of 1Rep Maximum, 8-12 reps per set, with last two repetitions close to full fatigue </li></ul><ul><li>Incorporate Daily Living Activities that expend higher amounts calories </li></ul>
  40. 42. Calories per Exercise/Activity <ul><ul><li>Some High Yield exercises </li></ul></ul><ul><ul><ul><li>Basketball-full court </li></ul></ul></ul><ul><ul><ul><li>Stationary Bike 15-20 MPH </li></ul></ul></ul><ul><ul><ul><li>Skating (Inline/Ice) </li></ul></ul></ul><ul><ul><ul><li>Skiing Cross-country/Downhill </li></ul></ul></ul><ul><ul><ul><li>Tennis </li></ul></ul></ul><ul><ul><ul><li>Swimming 20-60 yards/minute </li></ul></ul></ul><ul><ul><ul><li>Jogging 5 MPH </li></ul></ul></ul><ul><ul><ul><li>Running 8 MPH </li></ul></ul></ul><ul><ul><ul><li>Stair climbing </li></ul></ul></ul><ul><ul><ul><li>Aerobic Dancing </li></ul></ul></ul><ul><li>High Yield Activities of Daily living </li></ul><ul><ul><li>Shoveling </li></ul></ul><ul><ul><li>Yard work/mowing, Gardening </li></ul></ul><ul><ul><li>Cleaning the house especially scrubbing, vacuuming </li></ul></ul><ul><ul><li>Taking the Stairs </li></ul></ul><ul><ul><li>Walking to the store for grocery shopping </li></ul></ul>
  41. 43. Exercises: Some of my favorites <ul><li>Squat-curl-shoulder press </li></ul><ul><li>Dumbbell Squats to curl-to press </li></ul><ul><li>Walking Dumbbell Lunges </li></ul><ul><li>Walking Lunge-Row </li></ul><ul><li>Cable Row </li></ul><ul><li>Gravitron Dips, Gravitron Pull-ups </li></ul><ul><li>Dumbbell incline bench </li></ul><ul><li>Core Stability Exercises </li></ul>
  42. 44. In the Gym <ul><li>High Yield exercises </li></ul><ul><ul><li>Treadmill, stationary bike, step master, step mill, step master </li></ul></ul><ul><li>High Yield classes </li></ul><ul><ul><li>Spinning, aerobic dance class, step class </li></ul></ul><ul><li>Lower Yield then advertised </li></ul><ul><ul><li>Elliptical Trainer (PMID: 17243225) </li></ul></ul>
  43. 45. Tips For Sticking to Exercise <ul><li>Choose a gym that is either inspiring or comfortable OR both. </li></ul><ul><li>Choose a gym within 10 minutes of Home or Work </li></ul><ul><li>Find your peak energy hour for exercise </li></ul><ul><li>If busy break your exercise sessions up into 2-3 exercise snacks. </li></ul><ul><li>Have a partner that is at the same exercise level as you </li></ul><ul><li>Don’t focus so much on the scale but rather how you feel and how your overall body is changing. </li></ul><ul><li>Change into exercise clothes at work before you leave for the day. </li></ul><ul><li>Always have an exercise bag packed and available in your car. (out of plain view!) </li></ul><ul><li>On the weekends dress in workout clothes </li></ul><ul><li>Switch things up, take classes, challenge yourself. </li></ul><ul><li>Develop Mantra “Mind over (fill in the blank)” </li></ul><ul><li>When losing motivation use the choice point method (you get one point for just going to gym!!!) </li></ul>
  44. 46. Cool Gadgets for Exercise <ul><li>Polar Heart Rate Monitor </li></ul><ul><li>Powerblocks (home dumbbell system) </li></ul><ul><li>Stretch Rope </li></ul><ul><li>Styrofoam Roller </li></ul><ul><li>Nike+ iPod Sport Kit </li></ul><ul><li>Burst Proof Physioball </li></ul>
  45. 47. Emerging Treatments for Obesity <ul><li>Pharmaceutical Fat Blockers, Appetite Suppressants </li></ul><ul><li>Gastric Bypass Surgery </li></ul><ul><li>Growth Hormone Injections </li></ul><ul><li>Mesotherapy </li></ul><ul><li>Intramuscular HCG </li></ul>
  46. 48. Other factors for future discussion <ul><li>Sleep </li></ul><ul><li>Stress Reduction/Meditation </li></ul><ul><li>Emotional Eating </li></ul>
  47. 49. Sleep <ul><li>Poor sleep associated with overweight and obesity in 1001 subjects. Linear relationship between decrease sleep time and BMI except in morbid obesity </li></ul><ul><ul><li>Verona, et. Al . Arch Intern Med. 2005 Jan 10;165(1):25-30 </li></ul></ul><ul><li>sleep apneic men had higher plasma concentrations of the adipose tissue-derived hormone, leptin, and of the inflammatory, fatigue-causing, and insulin resistance-producing cytokines tumor necrosis factor-alpha and interleukin-6 than nonapneic obese men, who had intermediate values, or lean men, who had the lowest values Vgontzas AN ,et. Al. J Clin Endocrinol Metab. 2000 Mar;85(3):1151-8. </li></ul>
  48. 50. Summary <ul><li>Accept your body, no matter what. Don’t fall victim to stereotypes. </li></ul><ul><li>Weight stability is most important, however when losing weight lose it slowly. </li></ul><ul><li>Diet: </li></ul><ul><ul><li>A lower calorie diet, rich with fiber, protein, omega-3, and satiating additives (spices, olives, garlic) </li></ul></ul><ul><ul><li>Know serving sizes </li></ul></ul><ul><ul><li>Snack with power foods @ 100-200 Kcal/snack </li></ul></ul><ul><li>Switch from Coffee to Green Tea for Ergogenic </li></ul><ul><li>Exercise: Moderate-intensity aerobic exercise 4 days/week + 2 days of hypertrophic resistance training. Incorporate daily living exercise. </li></ul><ul><li>Sleep: 2-3 full cycles of sleep per/night (reduces leptin) </li></ul><ul><li>Stress Management: Meditation 10 minutes per/day reduces cortisol </li></ul>
  49. 51. Resources Obesity measurements <ul><li>BMI Body Fat % </li></ul><ul><ul><li>Hydrostatic Tanks, BOD POD, Bio-impedance, Caliper </li></ul></ul><ul><li>Waist circumference </li></ul><ul><li>Waist to Hip Ratio </li></ul><ul><li>BMR (Basal Metabolic Rate) </li></ul>
  50. 52. Questions
  51. 53. Resources
  52. 54. Resources: Doctor Adam’s Power Smoothie <ul><li>1 -2 Tablespoons of Rice Protein (prefer Nutribiotic Rice Protein </li></ul><ul><li>1 Cup of Blueberries (Frozen or Fresh)@ Trader Joes </li></ul><ul><li>1 Tablespoon of Flax Oil or 1 Tablespoon of Ground Flax seeds (choose Spectrum or Udo’s Oil) </li></ul><ul><li>10 Oz of Almond Milk (Pacific Breeze) </li></ul><ul><li>5 ice cubes </li></ul><ul><li>Blend and Drink 1x/day </li></ul>
  53. 55. Resources: Basal Metabolic Rate Harris Benedict Equation <ul><li>Women: 655 + (4.3 x weight in pounds) + (4.7 x height in inches) - (4.7 x age in years) </li></ul><ul><li>Men: 66 + (6.3 x weight in pounds) + (12.9 x height in inches) - (6.8 x age in years) </li></ul>
  54. 56. Resources, Activity Index to find Daily Caloric Intake Requirement for Weight Maintenance <ul><li>If you are sedentary : BMR x 20 percent </li></ul><ul><li>If you are lightly active: BMR x 30 percent </li></ul><ul><li>If you are moderately active (You exercise most days a week.): BMR x 40 percent </li></ul><ul><li>If you are very active (You exercise intensely on a daily basis or for prolonged periods.): BMR x 50 percent </li></ul><ul><li>If you are extra active (You do hard labor or are in athletic training.): BMR x 60 percent </li></ul>
  55. 57. Resources: web sites <ul><li> </li></ul><ul><li> </li></ul><ul><li> </li></ul><ul><li> </li></ul><ul><li> </li></ul><ul><li> </li></ul>
  56. 58. Resources: Places To Shop <ul><li>Groceries </li></ul><ul><ul><li>Whole Foods, PCC, Central Market </li></ul></ul><ul><ul><ul><li>Also: QFC, Trader Joes, and Fred Meyer </li></ul></ul></ul><ul><li>Meals to Go: </li></ul><ul><ul><li>Organic To Go, Delicious Plant </li></ul></ul><ul><li>Vegetable/Fruit Delivery </li></ul><ul><ul><li>Pioneer Organic </li></ul></ul><ul><li>Nutritional Supplements </li></ul><ul><ul><li>Bastyr Dispensary, Pharmaca, Seattle Super-supplements, PCC, Whole Foods </li></ul></ul><ul><ul><ul><li>Mail/Online </li></ul></ul></ul><ul><ul><ul><ul><li>Emerson Ecologics ( ) </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Natural Partners </li></ul></ul></ul></ul>
  57. 59. References: Books I recommend <ul><li>The Encyclopedia of Natural Medicine , by Pizzorno and Murray </li></ul><ul><li>Total Wellness by Pizzorno </li></ul><ul><li>Core Performance by Verstegen </li></ul><ul><li>Full Catastrophe Living by Kabat-Zinn </li></ul>