Transcript Session 3 PowerPoint Presentation

Eat To Lose Weight
Session 3
Sacred Heart Wellness Series
Beth McKinney, MSEd, RD, CHES
Checking in: Monitoring
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What are you noticing about your eating?
Nutrition
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Where are the calories?
Portion distortion
Calories
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Calories come from pro, carbs, fat
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Protein: 4 calories per gram
Carbs: 4 calories per gram
Fats: 9 calories per gram
What about alcohol???
Alcohol
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Beer: 12 ounces = 100
Wine: 6 ounces = 120
Mixed Drinks: 65 calories per ounce of
alcohol
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G&T: 175
Vodka Martini: 210
Rum and Coke: 150
Margarita (6 ounces): 300
Calories
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Calories come from pro, carbs, fat
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Protein: 4 calories per gram
Carbs: 4 calories per gram
Fats: 9 calories per gram
What about alcohol???
One pound fat = 3500 calories
Calories Count
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35OO calories = 1 pound body fat
Reduction 500 cals/day = lose 1 pound per week
Reduction 250 cals/day = lose ½ pound per week
Alternative: increase physical activity for
equivalent of 250 - 500 cals/day
Work toward small weight loss, not more than 1-2
pounds per week
Individual needs vary
Proportion of Calories
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Protein (4 calories per gram)
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Carbohydrates (4 calories per gram)
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10-15% of calories
40-60 grams pro/day (assume a 1600 calorie diet)
55-60% of calories
220-240 grams carbs/day
Fat (9 calories per gram)
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25-30% of calories
44-53 grams fat/day
What about other proportions?
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High Protein/No Carb
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Low Fat
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Migraines, bad breath due to formation of ketone bodies
Dehydration
Chronic stress on kidneys from excreting unused protein
Don’t feel full
Excess carbohydrate and protein can also cause weight gain
Miss out on essential fats needed for brain development, blood
clotting, nerve sensation, mood regulation.
High Fat
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Very high calorie diet increases risk of weight gain
High intake of saturated fat increases risk of heart disease
High fat foods replace nutrient dense foods
Wiggle Room
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Recommended proportions are
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55-65% carb
10-15% protein
25-30% fat
Wiggle Room
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45-55% carb
20-25%protein
25-30%fat
Insulin Resistance – What is it?
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Pancreas is producing insulin, but it’s not
working at the cellular level
Sometimes there is an over-production of
insulin
Also known as Syndrome X, Metabolic
Syndrome
Related to belly weight, HTN, dyslipidemia,
gout, polycystic ovary syndrome, Type 2
diabetes
The Low-Carb Approaches
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Rationale: Insulin causes weight gain
Many low-carbohydrate diets are extremely low,
<50 gm per day
The high protein includes high fat foods, with
usually no distinction saturated vs. unsat fat
There is no solid evidence that insulin causes
weight gain—but no solid evidence that it doesn’t
Rule of thumb >100 gm CHO/day for health (2530% of calories)
Calorie Deficit
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One pound fat = 3500 calories
Rule of thumb:
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If you create a deficit of 500 calories per day,
you lose 1 # per week.
If you create a deficit of 250 calories per day,
you lose 1/2 # per week.
Comparison chart
Breakfast
3/4 cup Grape Nuts: 300
1 cup 2% Milk:
121
1 banana:
105
Lunch
1 bagel:
290
2T cream cheese:
105
16 oz. Snapple Ice Tea:120
Total:
1041
Breakfast
1 cup Special K:
1/2 cup 2% Milk:
1 banana:
Lunch
Egg salad sandwich
(2 eggs, 2t. Mayo):
2 carrots:
Water:
Total:
110
61
105
350
62
0
688
Portion Size and you
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Can increased portion sizes
affect how much we eat?
Portion Size vs. Serving Size
Portion size: the amount of a single food item served in a
single eating event such as a meal or a snack.
Serving size: a standard unit of measure of foods. For
example, a cup or an ounce is used in dietary guidance
to help you compare while eating or shopping.
Portion Size: Then and Now
Portion sizes of many foods have increased
significantly over the past 2 decades
Larger portions are now offered all around us,
including in —
 restaurants
 vending machines
 packaged foods in grocery stores
Grains
Grains
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Everyday equivalents can help you judge
serving sizes to better practice portion
control. A serving of cooked macaroni is 1/2
cup or about the size of an ice-cream scoop.
Recommended serving sizes for other grains
include:
Food Serving Size:
Cooked pasta or oatmeal = 1/2 cup
Whole-wheat bread = 1 slice
Whole-wheat crackers = 6 whole
http://www.mayoclinic.com/health/portion-control/
Fruits
Fruits
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One cup of mixed berries, cherries or cubed
cantaloupe equals one serving. One cup is about
the size of a tennis ball. Other serving sizes of
fruit include:
Food Serving Size:
Apple, pear or banana = 1 small
100 percent fruit juice = 1/2 cup
http://www.mayoclinic.com/health/portion-control/
Vegetables
Vegetables
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Until you're comfortable judging serving sizes,
you may need to use measuring cups and spoons.
A half a cup of cooked carrots, for example,
equals one serving. Here are the recommended
serving sizes for other vegetables:
Food Serving Size:
Raw leafy vegetables =2 cups
Raw vegetables, chopped=1 cup
Chopped, cooked or canned vegetables =1/2 cup
http://www.mayoclinic.com/health/portion-control/
Dairy
Dairy
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Serving sizes of dairy products may be smaller
than you think. For example, one serving of lowfat cheddar cheese is 2 ounces or about the size of
two dominoes. Here are serving sizes for other
dairy products:
Food Serving Size:
Low-fat or fat-free milk or yogurt =1 cup
Part-skim mozzarella cheese =1 1/2 ounces or
about 1/3 cup shredded
http://www.mayoclinic.com/health/portion-control/
Meat and Beans
Meat and Beans
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Familiar objects can help you picture proper
portions for meat, poultry, fish and beans. For
example, a 3-ounce serving of fish is about the
size of a deck of cards. Here are the serving sizes
for meat and meat substitutes:
Food Serving Size:
Cooked skinless poultry or fish =3 ounces
Cooked lean meat =1 1/2 ounces
Cooked legumes or dried beans =1/2 cup or about
the size of an ice cream scoop
http://www.mayoclinic.com/health/portion-control/
Does Portion Size Matter?
Large portion sizes do not matter if a person:
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chooses to eat only an appropriate serving
size rather than the whole portion served
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eats fewer calories in subsequent meals and
snacks to control overall calorie intake
Do you?...
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Do people intuitively assess how much is an appropriate
serving size?
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Do people actually eat only the appropriate serving size
when more is offered?
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Do people adjust what they eat at subsequent meals after
consuming large portion sizes?
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Research shows
 people often eat the amount in front of them
 people have difficulty assessing whether or not it is an
appropriate amount
Portion Size Matters
Short-term studies show that people eat
more when they are confronted with
larger portion sizes.
Portion Size Affects Consumption
Submarine sandwich study
Subjects received different size (6-, 8-, 10-, and 12-inch) submarine
sandwiches for lunch on 4 different days
Men and women ate significantly more as the size of the sandwich
offered increased
Pasta study
In a restaurant setting, a pasta entrée was served in different portion sizes
on different days
People ate more when offered larger portions
Rolls et al. JADA 2004.
Diliberti et al. Obesity Res 2004.
Does awareness of portion size
matter?
Portion Size and Snacks
Participants received snacks of potato chips in identical bags increasing in size
(from 28g to 170g)
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Men and women, intake increased significantly as package size increased
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Women ate 18% more and men 37% more from the 170g bag than when
served an 85g bag
Participants did not adjust their intakes at dinner to compensate for the differences
in snack intake
Combined calorie intake was much greater when they consumed the larger snack
Rolls et al. Appetite 2004.
Portion Size and Snacks
People in a movie theater were given medium (120 g) or large
(240 g) buckets of popcorn.
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Subjects were divided into 2 groups based on whether they
thought the taste was favorable or unfavorable
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Larger portion sizes increased the amount eaten regardless
of how participants rated the popcorn’s taste
Wansink and Park. J Database Marketing 1996.
How accurately do we assess portion
size?
Generally people incorrectly assess how much they
eat
Gender, age, weight, and level of education cause
differences in estimating portion size
Food cues may override physiologic satiety cues,
including
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Large portions
Easy access
Sensory attractiveness of food
What factors are associated with
increased food consumption?
Other cues also cause people to eat more than
they need, such as
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restaurant setting
convivial atmosphere
choosing foods with high energy density
alcohol consumption
Opinions? Thoughts?
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Where is your thinking now?