Transcript Obesity Diet and Physical Inactivity

Obesity
Diet and Physical Activity
Pennington Biomedical Research Center
Division of Education
Obesity in the United States
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Approximately 66% (or two thirds) of U.S.
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Healthy People 2010: reduce the prevalence of
obesity among adults to less than 15%.
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The obesity rate increased from the late 1970’s to
2003 from 15 to nearly 33 percent.
2009
CDC
adults are overweight or obese.
Obesity in the U.S.
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Body mass index (BMI)
weight (kg)/ height squared
(m2).
BMI is significantly correlated
with total body fat content.
With a BMI of:
You are considered:
Below 18.5
Underweight
18.5 - 24.9
Healthy Weight
25.0 - 29.9
Overweight
30 or higher
Obese
BMI tables:
http://www.nhlbisupport.com/bmi
2009
NIDDK
Obesity in the U.S.
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Obesity is further divided
into three separate classes,
with Class III obesity being
the most extreme of the three.
With a BMI of:
You are considered:
Below 18.5
Underweight
18.5 - 24.9
Healthy Weight
25.0 - 29.9
Overweight
30 or higher
Obese
2009
CDC, NHLBI
Obesity class
BMI (kg/m2)
Class I
30.0- 34.9
Class II
35.0-39.9
Class III
≥ 40.0
(Extreme Obesity)
Obesity in the United States
Percent of Obese (BMI > 30) in U.S. Adults
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In the United States, some
minority groups are more
affected than others.
Income and education are
also related to obesity
prevalence.
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Some states have
significantly higher rates
of obesity than others.
http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps
2009
NIDDK, Women’s Health
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Obesity in the U.S.
Being overweight/obese substantially raises one’s risk of morbidity from:
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Hypertension
Dyslipidemia
Type 2 Diabetes
Coronary Heart Disease
Stroke
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Gallbladder Disease
Osteoarthritis
Sleep apnea
Certain cancers
(endometrial, breast, prostate, colon)
Higher body weights are also associated
with increases in all-cause mortality.
2009
J La State Med Soc. 2005; 156: S42-S49.
Obesity in the U.S.
Obesity is also associated with:
2009
NIDDK
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High blood cholesterol
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Complications of pregnancy
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Stress incontinence
( urine leakage caused by
weak pelvic-floor muscles)
Menstrual irregularities
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Psychological disorders such
as depression
Hirsutism
(presence of excess body
and facial hair)
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Increased surgical risk
What Causes Obesity?
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2009
CDC
Energy imbalance over a long
period of time.
Energy in > Energy out.
Excess calories and lack of
physical activity.
Energy balance is like
a scale. When
calories consumed
are greater than
calories used, weight
gain is the result.
Calories Used
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Eating, digestion, sleeping, breathing, and movement.
Excess calories.
Physical activity.
Energy Balance
Food/beverages
consumed
2009
CDC
Calories in
Calories used
(consumed)
(expended)
Necessary
physiological
functions
Physical activity
Overweight
The Right Approach
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2009
NIDDK
If your BMI is between 25 and 30 and you are otherwise healthy
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Try to avoid gaining any additional weight
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Look into healthy ways of losing weight and increasing physical activity
Overweight
The Right Approach
Talk to your doctor about losing weight if you fall into any one of the three scenarios:
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BMI is 30 or above, or
BMI is between 25 and 30 and:
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Waist measures > 35 inches (women) or
> 40 inches (men)
and:
1.
2009
NIDDK
You have other health conditions
You have other health conditions
Weight Loss & Maintenance
Strategies to Consider
Physical Activity
&
Diet Therapy
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Why Treat Overweight and Obesity?
Because there is strong evidence that weight
loss reduces risk factors for diabetes and
cardiovascular disease, such as:
blood pressure
serum triglycerides
total serum cholesterol
low-density lipoprotein cholesterol
blood glucose levels
2009
NHLBI
Weight Loss Programs
Any safe and effective weight-loss program should include these components:
Healthy eating plans that reduces caloric intake
Regular physical activity and/or exercise instruction
Tips on healthy behavior
Slow and steady weight loss of about ¾ to 2 pounds a week
Medical care if needed
A plan to keep the weight off after you have lost it
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2009
NIDDK
Weight Loss
The key to any successful weight loss is making
changes in your eating and physical activity
habits that you can keep for the rest of your life.
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NIDDK
Physical Activity
Physical Inactivity
In the U.S.
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Many studies show that Americans are too sedentary.
Due to
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Increased use of technology.
Increased use of automobiles.
According to the Behavioral Risk Factor Surveillance System, in 2000 more
than 26 percent of adults reported no leisure time physical activity.
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CDC
Physical Inactivity
In the U.S.
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Physical inactivity contributes to premature deaths.
Rates differ by race and ethnicity.
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Hispanic women - most inactive
Hon-Hispanic women – second
Asian and Pacific islander women – third and, lastly,
White non-Hispanic women - fourth.
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Women’s Health
Physical Activity
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2009
CDC
Contributes to weight loss.
Helpful for the prevention of overweight and obesity.
Helps maintain weight loss.
Physical Activity
2009
CDC
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Occupational work
 Carpentry, construction, waiting tables, farming
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Household chores
 Washing floors or windows, gardening, or yard work
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Leisure time activities
 Walking, skating, biking, swimming, playing Frisbee,
dancing, softball, tennis, football, aerobics
Physical Activity
Regular physical activity is good for overall health.
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Physical activity decreases the risk for:
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Physical activity also helps to:
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CDC
Colon cancer
Diabetes
High blood pressure
Control weight
Contribute to healthy bones, muscles, and joints
Reduce falls among the elderly
Relieve the pain of arthritis.
How Much Physical Activity a Day?
The 2005 Dietary Guidelines for Americans recommend the following for adults:
To reduce the risk of chronic diseases in adulthood:
Engage in at least 30 minutes of moderate-intensity physical activity,
above usual activity, at work or home on most days of the week.
To help manage weight and prevent gradual, unhealthy weight gain in adulthood:
Engage in approximately 60 minutes of moderate- to vigorous-intensity activity
on most days of the week while not exceeding caloric intake requirements.
To sustain weight loss in adulthood:
Participate in at least 60 to 90 minutes of daily moderate- to vigorous-intensity
physical activity while not exceeding caloric intake requirements. (Some may need
to contact their healthcare provider before participating in this level of activity.)
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Dietary Guidelines for Americans
How Much Physical Activity a Day?
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2009
Any activity helps.
Moderate physical activity brings
health benefits.
Make it personal.
Start slowly (10 minute walk/day).
Increasing Physical Activity
You can increase your physical activity by taking small steps to change what you do everyday.
If you normally…
Then try this instead!
Park as close as possible to the store
Park farther away
Let the dog out back
Take the dog for a walk
Take the elevator
Take the stairs
Have lunch delivered
Walk to pick up lunch
Relax while the kids play
Get involved in their activity
2009
Women’s Health
How Many Calorie Am I Burning?
Calories burned/hour of activity
Activity
100 lb
150 lb
200 lb
Bicycling, 6 mph
160
240
312
Bicycling, 12 mph
270
410
534
Jogging, 7 mph
610
920
1,230
Jumping rope
500
750
1,000
Running, 5.5 mph
440
660
962
Running, 10 mph
850
1,280
1,664
Swimming, 25 yds/min
185
275
358
Swimming, 50 yds/min
325
500
650
Tennis singles
265
400
535
Walking, 2 mph
160
240
312
Walking, 3 mph
210
320
416
Walking, 4.5 mph
295
440
572
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American Heart Association
How Many Calories Do I Need?
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2009
ACS
To maintain - use your current weight.
To lose - use the average healthy weight recommended for your height.
Calculating Ideal Body Weight
For men:
Use 106 pounds of body weight
for the first 5 feet of their height.
Add 6 pounds for each
additional inch.
For women:
Use 100 pounds of body weight
for the first 5 feet of their height.
Add 5 pounds for each
additional inch.
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A 5’9 man’s ideal body weight would be:
First 5’0 = 106 lb standard weight for men
Plus 9 additional inches 9 (6 lbs)= 54 lbs
106 + 54= 160 pounds (± 10%)= 144 to 176
144 to 176 pounds is this man’s idea weight
A 5’4 woman’s ideal body weight would be:
First 5’0= 100 lb standard weight for women
Plus 4 additional inches  4(5 lbs)= 20
100 + 20= 120 pounds (± 10%)= 108 to 132
108 to 132 pounds is this woman’s ideal weight
How Many Calories Do I Need?
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USDA’s MyPyramid site: http://www.mypyramid.gov/
Determines calorie needs and calculates the servings
needed from food groups.
The American Cancer Society (ACS) site:
http://www.cancer.org/docroot/PED/content/PED_6_1x_
Calorie_Calculator.asp
The ACS site indicates the number of calories that are
needed per day to maintain your current weight.
On the Path to Increased Physical Activity
Before Beginning an Exercise Program
You should check with your doctor before beginning an exercise program if you:
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2009
Mayo Clinic
Are a man older than age 40 or
a woman older than age 50
Have had a heart attack
Have a family history of heart-related
problems before age 55
Have heart, lung, liver or kidney disease
Feel pain in your chest, joints, or muscles
during physical activity
Have high blood pressure, high
cholesterol, diabetes, arthritis,
osteoporosis, or asthma
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Have had joint replacement surgery
Smoke
Are overweight or obese
Tale medication to manage a
chronic condition
Have an untreated joint or muscle
injury, or persistent symptoms after
a joint or muscle injury
Are pregnant
Unsure of your health status.
Health Benefits of
Physical Activity
Health benefits of physical activity. CMAJ. 2006; 174(6): 801-809.
Physical Activity
Primary Effects on Diabetes Mellitus
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Aerobic and resistance types of
exercise decrease the incidence of type
2 diabetes.
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A modest weight loss through diet and
exercise reduces the incidence of
diabetes.
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CMAJ. 2006;174(6): 801-809.
Physical Activity
Secondary Effects on Diabetes Mellitus
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Exercise helps in the management
of diabetes.
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Aerobic and resistance training
help in the control of diabetes
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CMAJ. 2006;174(6): 801-809.
Physical Activity
Primary Effects on Cancer
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Routine activity reduces the incidence cancers.
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Activity results in a 30-40% reduction in the relative risk of
colon cancer and breast cancer.
Moderate physical activity is believed to exhibit a greater
protective effect than activities of less intensity.
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CMAJ. 2006;174(6): 801-809.
Physical Activity
Secondary Effects on Cancer
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Regular physical activity - important.
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Increased self-reported physical activity =
decreased reoccurrence of cancer and a
decreased risk of death from cancer.
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Reduced cancer-related death.
2009
CMAJ. 2006;174(6): 801-809.
Physical Activity
Primary Effects on Osteoporosis
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Many studies have been conducted.
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According to findings, routine physical
activity, especially weight-bearing and
impact exercise, prevents bone loss
associated with aging.
2009
CMAJ. 2006;174(6): 801-809.
Physical Activity
Secondary Effects on Osteoporosis
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Regular physical activity can lead to stronger
bones.
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Bone responds to physical stress at any age; even
in the elderly.
Osteoporosis
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CMAJ. 2006;174(6): 801-809.
Eating for Weight Loss
The Critical Role of Healthy Eating
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2009
CDC
Good nutrition leads to a healthier life.
Many do not eat based on MyPyramid recommendations.
U.S. Eating Habits
82
81%
80
78
77%
Percentage of adults
reporting that they
consumed fewer than
5 servings of fruits and
vegetables/day, 2000
76
74
73%
72
70
68
In 2000, the larger
majority of U.S. adults
reported that they
did not consume 5 or more
servings of fruits and
vegetables/day.
Men
Women
Total
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CDC. Behavioral Risk Factor Surveillance System
Dietary Guidelines for Americans, 2005
Tips for Healthy Eating
MyPyramid, which is the newest Food Guide Pyramid,
recommends the following for a healthy lifestyle:
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Make half your grains whole
Vary your veggies
Focus on fruit
Get your calcium rich foods
Go lean with protein
Find your balance between food and physical activity
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MyPyramid: http://mypyramid.gov/
A Healthy Diet
The 2005 Dietary Guidelines for Americans defines a healthy diet as one that:
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Emphasizes fruits, vegetables, whole grains, fat-free or low-fat milk, & milk products;
Includes lean meats, poultry, fish, beans, eggs, and nuts
Is low in saturated fats, trans fats, cholesterol, salt (sodium), and added sugars.
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MyPyramid: http://mypyramid.gov/
Dietary Guidelines for Americans, 2005
Key Recommendations for the General Population
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1. Adequate Nutrients Within Calorie Needs
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Consume a variety of nutrient-dense foods (whole grains, fruits and vegetables,
lean meats, low-fat dairy) and beverages within and among the basic food groups
while choosing foods that limit the intake of saturated fats and trans fats,
cholesterol, added sugars, salt, and alcohol.
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Meet recommended intakes within energy needs by adopting a balanced eating
pattern, such as the USDA Food Guide or the Dietary Approaches to Stop
Hypertension (DASH) Eating Plan.
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MyPyramid: http://mypyramid.gov/
Dietary Guidelines for Americans, 2005
Key Recommendations for the General Population
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MyPyramid: http://mypyramid.gov/
2. Weight Management
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To maintain body weight in a healthy range, balance
calories from foods and beverages with calories expended.
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To prevent gradual weight gain over time, make small
decreases in food and beverage calories and increase
physical activity.
Dietary Guidelines for Americans, 2005
Key Recommendations for the General Population
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3. Physical activity
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Engage in regular physical activity and reduce sedentary
activities to promote health, psychological well-being,
and a healthy body weight.
Achieve physical fitness by including cardiovascular
conditioning, stretching exercises for flexibility, and
resistance exercises for muscle strength and endurance.
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MyPyramid: http://mypyramid.gov/
Dietary Guidelines for Americans, 2005
Key Recommendations for the General Population
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4. Food Groups to Encourage
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Consume a sufficient amount of fruits and vegetables while
staying within energy needs.
Choose a variety of fruits and vegetables each day. Select
from all five vegetable subgroups (dark green, orange,
legumes, starchy vegetables, and other vegetables) several
times a week.
Consume 3 or more ounce-equivalents of whole-grain
products per day, with the rest of the recommended grains
coming from enriched or whole-grain products. At least half
the grains should come from whole grains.
Consume 3 cups per day of fat-free or low-fat milk or
equivalent milk products.
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MyPyramid: http://mypyramid.gov/
Dietary Guidelines for Americans, 2005
Key Recommendations for the General Population
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5. Fats
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Keep total fat intake between 20 - 35 percent of calories
(With most fats coming from sources of polyunsaturated
and monounsaturated fatty acids, such as fish, nuts, and vegetable oils).
Limit intake of fats and oils high in saturated and/or trans fatty acids,
and choose products low in such fats and oils.
Consume less than 10 percent of calories from saturated fatty acids
Consume less than 300 mg/day of cholesterol
Keep trans fatty acid consumption as low as possible
When selecting and preparing meat, poultry, dry beans, and milk or milk
products, make choices that are lean, low-fat, or fat-free.
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MyPyramid: http://mypyramid.gov/
Dietary Guidelines for Americans, 2005
Key Recommendations for the General Population
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6. Carbohydrates
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Choose fiber-rich fruits, vegetables, and whole grains often.
Choose and prepare foods and beverages with little added sugars or caloric sweeteners.
Reduce the incidence of dental caries by practicing good oral hygiene and consuming
sugar- and starch-containing foods and beverages less frequently.
7. Sodium and Potassium
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Consume less than 2,300 mg (approximately 1 teaspoon of salt) of sodium per day.
Choose and prepare foods with little salt. At the same time, consume potassium-rich
foods, such as fruits and vegetables.
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MyPyramid: http://mypyramid.gov/
Dietary Guidelines for Americans, 2005
Key Recommendations for the General Population
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8. Alcoholic Beverages
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Those who choose to drink alcoholic beverages should do so sensibly and in
moderation (≤ 1 drink for women/day and ≤ 2 drinks for men/day).
Alcoholic beverages should be avoided by individuals engaging in activities that
require attention, skill, or coordination, such as driving or operating machinery.
Alcoholic beverages should not be consumed by some individuals, including:
those who cannot restrict their alcohol intake, women of childbearing age who
may become pregnant, pregnant and lactating women, children and adolescents,
individuals taking medications that can interact with alcohol, and those
with specific medical conditions.
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MyPyramid: http://mypyramid.gov/
Dietary Guidelines for Americans, 2005
Key Recommendations for the General Population
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9. Food Safety
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To avoid microbial food borne illness:
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Clean hands, food contact surfaces, fruits, and vegetables.
Meat and poultry should not be washed or rinsed.
Separate raw, cooked, and ready-to-eat foods while shopping,
preparing, or storing foods.
Cook foods to a safe temperature to kill microorganisms.
Chill (refrigerate) perishable food promptly and defrost foods properly.
Avoid raw (unpasteurized) milk or any products made from unpasteurized milk,
raw or partially cooked eggs or foods containing raw eggs, raw or undercooked
meat and poultry, unpasteurized juices, and raw sprouts.
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MyPyramid: http://mypyramid.gov/
Weight loss:
Goals for Weight
Management of Weight Lost
Calorie Deficit
Needed For Weight Loss
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ACS
A calorie deficit of no more than 500 kcal/day.
This can be achievable through the combination of diet + exercise.
An example of how to create a calorie deficit of 500 kcal/day through diet + exercise
would be: eating 250 kcal less per day, along with burning 250 calories through exercise
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Calorie Deficit
Needed For Weight Loss
A caloric deficit of 500 can be done by:
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Eating 250 kcal less per day:
Leave out mayonnaise in a
sandwich
Leave out dessert
Switch from soft drinks to water
Reduce portion sizes
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burning 250 calories through exercise:
Walk for 30 minutes
Swimming 25 yards
Bicycling for 30 minutes
Exercise + Dieting
Calorie Deficit
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2009
NHLBI
Initially physical activity, in combination with dieting, is an important
component of weight loss.
However, after around 6 months, physical activity will not lead to
substantially greater weight losses when combined with dieting.
The benefit of sustained physical activity thereafter is mainly
through its role in the prevention of weight gain.
In addition, it has a benefit in reducing cardiovascular and
diabetes risks beyond that produced by weight gain alone.
Goals for Weight Loss
And Management
The initial goal of weight loss therapy is to reduce body
weight by approximately 10 percent from baseline.
Once this goal is achieved, then further weight loss can be
attempted, if necessary.
A reasonable time line for a 10 percent reduction in body
weight is 6 months.
Experience reveals that lost weight is usually regained
unless a weight maintenance program, consisting of diet
therapy, physical activity and behavior therapy, is
continued indefinitely.
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2009
NHLBI
Goals for Weight Loss
And Management
For overweight individuals with BMIs in the typical range of 27 to 35 kg/m2, a decrease
of 300 to 500 kcal/day will result in weight losses of about ½ to 1 lb per week.
A 10 percent weight loss could be achieved within 6 months.
For more severely obese individuals (BMI > 35), deficits of up to 500 to 1,000 kcal/day
will lead to weight losses of about 1 to 2 lb per week.
A 10 percent weight loss could be achieved within 6 months.
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NHLBI
Goals for Weight Loss
And Management
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After 6 months of weight loss treatment, the individual should be assessed.
If no further weight loss is needed, then the current weight should be maintained.
Sustained physical activity is particularly important in the prevention of weight regain.
If further weight loss is desired, another attempt at weight reduction can be made.
Pennington Biomedical Research Center
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2009
Division of Education
Phillip Brantley, PhD, Director
Pennington Biomedical
Research Center
Claude Bouchard, PhD,
Executive Director
Heli J Roy, PhD, RD, Associate
Professor
Beth Kalicki
About Our Company
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The Pennington Biomedical Research Center is a world-renowned nutrition research center.
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Mission:
To promote healthier lives through research and education in nutrition and preventive medicine.
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The Pennington Center has several research areas, including:
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Clinical Obesity Research
Experimental Obesity
Functional Foods
Health and Performance Enhancement
Nutrition and Chronic Diseases
Nutrition and the Brain
Dementia, Alzheimer’s and healthy aging
Diet, exercise, weight loss and weight loss maintenance
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The research fostered in these areas can have a profound impact on healthy living and on the prevention of common chronic diseases, such as heart
disease, cancer, diabetes, hypertension and osteoporosis.
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The Division of Education provides education and information to the scientific community and the public about research findings, training programs
and research areas, and coordinates educational events for the public on various health issues.
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We invite people of all ages and backgrounds to participate in the exciting research studies being conducted at the Pennington Center in Baton
Rouge, Louisiana. If you would like to take part, visit the clinical trials web page at www.pbrc.edu or call (225) 763-3000.
References
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Centers for Disease Control and Prevention (CDC):
Prevalence of Overweight and Obesity Among Adults: U.S., 2003-2004. Available at:
http://www.cdc.gov/nchs/products/pubs/pubd/hestats/obese03_04/overwght_adult_03.htm
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Womenshealth.gov. Physical Activity. Available at:
http://www.womenshealth.gov/pub/steps/Physical%20Activity.htm
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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Do You Know the Health Risks of Being Overweight? Available at:
http://win.niddk.nih.gov/publications/health_risks.htm
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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Statistics Related to Overweight and Obesity. Available at:
http://win.niddk.nih.gov/statistics/index.htm
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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Weight and Waist Measurement: Tools for Adults. Available at:
http://win.niddk.nih.gov/publications/tools.htm
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References
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Bellanger T, Bray G. Obesity related morbidity and mortality. J La State Med Soc.
2005; 156: S43-49.
National Heart, Lung, and Blood Institute (NHLBI). Clinical Guidelines on the
Identification, Evaluation, and Treatment of Overweight and Obesity in Adults.
Available at: http://www.nhlbi.nih.gov/guidelines/obesity/ob_exsum.pdf
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Choosing a Safe and Successful Weight-loss Program. Available at:
http://win.niddk.nih.gov/publications/choosing.htm
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Weight Loss for Life. Available at: http://win.niddk.nih.gov/publications/for_life.htm
Warburton D, Nicol C, Bredin S. Health benefits of physical activity: the evidence.
2006; CMAJ; 174(6): 801-809.
References
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Dietary Guidelines for Americans 2005. Available at:
http://www.health.gov/dietaryguidelines/dga2005/recommendations.htm
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American Heart Association (AHA). Physical Activity Calorie Use Chart.
Available at: http://www.americanheart.org/presenter.jhtml?identifier=756
American Cancer Society (ACS). Exercise Counts. How Many Calories Will Your
Activity Burn? Available at:
http://www.cancer.org/docroot/PED/content/PED_6_1x_Calorie_Calculator.asp
Mayo Clinic. Exercise: When To Check With Your Doctor First. Available at:
http://www.mayoclinic.com/health/exercise/SM00059