Transcript Childhood and Adolescent Weight Management

Fit
in
Florida!
Jodi Brindisi, RD LDN, CPT
January 4, 2011
Life expectancy would grow
by leaps and bounds if
green vegetables smelled
as good as bacon.
-Doug Larson
Overview
• Trends and statistics in
Florida
• BMI (body mass index)
• What can I do?
•Nutrition
•Physical Activity
Florida Statistics
• Nearly 2 out of 3 (64.5%) US
adults are overweight or obese.
 Florida average: 60.7 %
• 26.2 percent of Florida adults ate
the recommended five servings of
fruits and vegetables/day
Not getting better….
• 45.3 percent of Florida adults met the
guidelines for physical activity.
• Obesity-related medical expenditures
for adults in Florida total over $3.9
billion, with over half of the costs
being financed by Medicare and
Medicaid.
Consumption Trends
• Every year, the typical American now
consumes:
• 149 pounds of caloric sweeteners
• 54 gallons of soda
• 200 pounds of mostly refined grains.
What ever
happened to…
• Home cooked meals
• Hide and seek, climbing
trees, playing tag
• Drinking water and
milk with dinner
• Dining out and
desserts for special
occasions
WHY ARE
WE
CONCERNED?
"Can Johnny come out and eat?"
Health Consequences
of being Overweight
•
•
•
•
•
Hypertension
Type 2 DM
Cardiovascular Disease
Sleep Apnea
Osteoarthritis
• For every 2-pound increase in weight, the risk of
developing arthritis is increased by 13%
• Reflux
• Depression
• ADL
Obesity and
Premature Death
• 2003 study found that a BMI >45
at 20 years of age results in a
reduction of life expectancy of
• 22 years for black males
• 12 years for white males
• 8 years for white females
• 4 years for black females
Fontaine, Redden, Wang, Westfall, Allison. JAMA 2003; 289, 187-193.
Body Mass Index (BMI)
National Institutes of Health (NIH)
BMI classification:
Normal:
18.5 - 24.9
Overweight: 25.0 - 29.9
Weight (kg)
BMI = Height (m2) Level 1 Obesity:
30.0 - 34.9
Level 2 obesity:
35.0 - 39.9
Level 3 obesity:
> 40
(>225% ideal body weight)
Key Components of
Living a Healthy Lifestyle
• Nutrition
• Physical Activity
• Behavior Modification
Nutrition
• Low to no-calorie beverages
• Portion Control
• Scheduled Meal/Snack times
• Limit…
• YES to…
Drinking your Calories
• Water water water!!!!!
• Limit soda, juice, sports drinks,
sweet tea.
• What do you put in your coffee?
• Mistaken hunger signals…thirst?
Portion
Distortion
BAGEL
20 Years Ago
140 calories
3-inch diameter
Today
350 calories
6-inch diameter
Calorie Difference: 210 calories
SPAGHETTI AND
MEATBALLS
20 Years Ago
500 calories
1 cup spaghetti with sauce
and 3 small meatballs
Today
1,025 calories
2 cups of pasta with sauce
and 3 large meatballs
Calorie Difference: 525 calories
CHOCOLATE CHIP COOKIE
20 Years Ago
55 calories
1.5 inch diameter
Today
275 calories
3.5 inch diameter
Calorie Difference: 220 calories
Common Household
Measurements
•
•
•
•
•
•
•
3 oz. meat: size of a deck of cards/bar of soap
1 oz. cheese: size of 4 dice
2 Tbsp peanut butter: size of a ping pong ball
1/2 cup pasta: size of a tennis ball
Average bagel: size of a hockey puck
1/2 teaspoon oil: size of one thimble
1 ounce nuts: two shot glasses
Portion Distortion
• Nutrition Facts label: follow
serving size
• Just eat less!
• Plate
• 2/3 vegetables
• 1/3 protein
• 1/3 starch (complex)
Scheduled Meal Times
• Keep metabolism moving!!!
• Don’t skip meals!!! (especially
breakfast!)
• Plan for healthy snacks to prevent
overeating
• Eat majority of calories earlier in day.
Nutrition
Facts Label
• Get more
• Fiber
• Vitamin A
• Vitamin C
• Calcium
• Iron
• Limit
• Total Fat: Sat/Trans
• Cholesterol
• Sodium
• Sugar
Limit….
• Fried foods, fast foods, eating out
• Cakes, cookies, pies, candy
• Butter, mayonnaise, cream sauces
• Substitute!
• Satisfy cravings: crunchy, sweet,
savory
• Spray butter, low-fat condiments
YES to…
• Whole grains
• 9 servings of fruits and
vegetables/day
• Low-fat dairy products
• Lean proteins
• At least 25 grams of fiber daily
The only way to keep your
health is to eat what you don't
want, drink what you don't
like, and do what you'd rather
not.
-Mark Twain
Physical Activity
• Aim for 30 minutes daily.
• Can be divided
• Cardiovascular
•Calorie burning
• Strength training
•Lean muscle mass
• Accountability: buddy?
Cardio
• ACSM recommends…
• 30 minutes, moderate intensity, 5 days a
week
• Weight maintenance, reduce risk of disease
• 60-90 minutes 5 days a week
• Weight loss
• Run, walk, elliptical, swim, dance
Strength Training
• ACSM guidelines: 8-12 exercises,
2-3 days per week
• Build lean muscle mass---increase
metabolic rate
• Free weights, resistance, machines
• Avoid excessive protein
• 0.8 g/kg of body weight
• Excess PRO=excess calories=weight gain
Let’s Get Moving!!
• Small changes…big difference.
• Park far from stores.
• Utilize lunch breaks.
• 2-minute tv commercial breaks
• “Play” with children; family walks
after dinner
…and moving!!
• Find something that you enjoy!
• Gym/YMCA
• Organized Club/Team
• Wii Fit
• Outdoors: cycling, walking,
tennis
How many calories
am I really burning?
•
•
•
•
Equipment readings not accurate
Based on age, sex, weight, heart rate
Invest in a heart rate monitor
Maximum heart rate: 220-age
• Goal: 60-85%
• i.e. 40 year old
• MHR: 180
• Target: 108-153
Calorie-Exercise Tradeoffs
100-calorie food choices
6 Ritz crackers
10 potato chips
½ plain doughnut
5 chocolate kisses
100-calorie exercises
11 minutes of jump rope
13 minutes of roller skate
15 minutes of play tennis
10 minutes of basketball
200-calorie food choices
10 french fries
1 cup vanilla yogurt
20 jelly beans
200-calorie exercises
20 minutes of swimming
20 minutes of walk briskly
30 minutes of baseball
300-calorie food choices
1 McD’s cheeseburger
Brownie with nuts
2/3 cup mac and cheese
300-calorie exercises
45 minutes of dancing
60 minutes of bike riding
90 minutes of volleyball
Behavior Modification
• Lifestyle Change…..NOT DIET!!!!!!!
• Get rid of “all or nothing” principle.
• If it’s too good to be true…
• Calories in versus calories out.
• 3500 calories=1 pound
• “Rome wasn’t built in a day.”
Health nuts are going to feel
stupid someday, lying in
hospitals dying of nothing.
-Redd Foxx
Recent Diet Trends
Low Fat
• Fat has 9 calories per gram; Carbs and
Protein have 4 calories per gram
• Decreasing total fat decreases total overall
calories: leading to weight loss
• Common Pitfall: low fat does not equal low
calorie
• ie Twizzlers, frozen yogurt
Low Carb
• Different philosophies
• Diet contains high satiety foods: protein and fat
• Carbohydrates---insulin secretion—may cause fat
to be deposited, stimulating brain to produce
hunger signals—repeat cycle
• Common Pitfalls: With reintroducing carbs,
quick weight gain, and “carb cravings!”
Vegetarianism
• Vegans: only plant-based foods
• No animal products: milk, eggs, meat, poultry, fish,
cheese
• Lacto-vegetarian: consume milk and milk
products along with plant-based foods
• No eggs, meat, fish and poultry
• Lacto-ovo vegetarians: eat eggs, milk and milk
products, along with plant-based foods
• No red meat, fish and poultry
May be Lacking…
• Protein
• Soy products, meat substitutes, legumes, lentils, nuts, seeds and whole
grains.
• Calcium
• Dark green vegetables: spinach, collard greens, kale, and broccoli
• Tofu enriched with calcium and fortified soy milk and fruit juices
• Vitamin B-12
• Almost exclusively in animal products, including milk, eggs and cheese.
• Enriched cereals, fortified soy products
• Iron
• Dried beans and peas, lentils, enriched cereals, whole-grain products,
dark leafy green vegetables, and dried fruit
• Combine with foods rich in vitamin C — such as strawberries, citrus
fruits, tomatoes, and broccoli
• Zinc
• Whole grains, soy products, nuts and wheat germ
Volumetrics
• Eat foods that make you full
• achieved through volume, not calories
• Low energy density
• Low number of calories for the volume
• We are visual!!!
• Larger portions are pleasing!
• Use small plates!!!
• Water, fruits/vegetables, fiber
• i.e. plum: 87% water/69 calories
Final Thoughts
When it comes to eating right
and exercising, there is no
"I'll start tomorrow."
Tomorrow is disease.
-V.L. Allineare
Thank you!