Eat Well, Live Well Recharge your Plate, Prevent Disease Rita Zapién MS RD LD CDE September 2, 2010 CenterPoint Energy.

Eat Well, Live WellRecharge your Plate, Prevent Disease

Rita Zapién MS RD LD CDESeptember 2, 2010CenterPoint Energy

Definition of Obesity: Having a very high amount of body fat

in relation to lean body mass, or a BMI of ≥ 30

CDC Obesity Trend Maps http://www.cdc.gov/obesity/data/

trends.html#State

Adult BMI Chart

“Globesity”-

33% of world’s adult population is overweight or obese (200 million people)

By 2030, if trends continue 57.8% of world’s population will be overweight or obese.

BRFSS: Prevalence of BMI ≥ 25

% US adults 2002—58.8 2009—63 .8

% Texans 2002—62.8 2009—66.8

% Houston/Baytown/Sugarland 2002—61.2 2009—65.6

http://www.dshs.state.tx.us/chs/brfss/query/brfss_form.shtm

Accessed Aug 16, 2010

Why? Overweight and obesity result from an energy

imbalance. too many calories and not enough physical activity. 

Body weight is the result of genes, metabolism, behavior, environment, culture, and socioeconomic status. 

Behavior and environment play a large role causing people to be overweight and obese. greatest areas for prevention and treatment actions.

Excess weight is related to…

Coronary heart disease Type 2 diabetes Cancers (endometrial, breast, and colon) High blood pressure Abnormal cholesterol, triglycerides Stroke Liver and Gallbladder disease Sleep apnea and respiratory problems Osteoarthritis Gynecological problems (abnormal menses,

infertility)

Leading causes of Death--US

Heart disease Cancer Stroke (cerebrovascular diseases) Chronic lower respiratory diseases Accidents (unintentional injuries) Alzheimer's disease Diabetes Influenza and Pneumonia Kidney disease

At Risk for Diabetes? impaired glucose tolerance (IGT) and/or impaired fasting

glucose (IFG) 45 and older family history of diabetes overweight No regular exercise low HDL cholesterol or high triglycerides, high blood

pressure Non-Hispanic Blacks, Hispanic/Latino Americans, Asian

Americans and Pacific Islanders, and American Indians and Alaska Natives

History of diabetes during pregnancy or having a baby 9 pounds or more at birth

www.diabetes.org

Diabetes Nutrition

There is no “diabetic diet” or “ADA Diet” Carbohydrate Counting Diabetic Exchange Lists Experienced based estimation Reduced sodium, total and saturated fats 25-35 gm fiber/day

At risk for Heart Attack?

Smoking High blood pressure High blood cholesterol Diabetes Being overweight or obese Physical inactivity

www.heart.org

TLC Diet: Therapeutic Lifestyle Changes

Less than 7% of the day's total calories from saturated fat.

25-35 % of the day’s total calories from fat.

Less than 200 milligrams of dietary cholesterol a day.

Limit sodium intake to 2400 milligrams a day.

Just enough calories to achieve or maintain a healthy weight and reduce your blood cholesterol level.

At risk for High Blood Pressure?

Male over 40, female over 55 African American Overweight or obese Eat too much sodium (salt) Drink too much alcohol Not enough dietary potassium Not enough physical activity

Hypertension: DASH Diet

emphasizes fruits, vegetables, and lowfat dairy foods

low in saturated fat, total fat, and cholesterol.

The DASH eating plan includes whole grains, poultry, fish, and nuts and has reduced amounts of fats, red meats, sweets, and sugared beverages.

How many milligrams of sodium are in: teaspoon of salt? _______

Whataburger ?___ _Whataburger with medium fries? _______

medium orange? __________

At risk for Breast Cancer?

Aged 55 and older Family or personal history of breast cancer Caucasian Dense breast tissue Early menses, late menopause Not having children, or having later in life Alcohol use Overweight or obese Lack of exercise

www.cancer.org

At risk for Prostate Cancer?

65 and older Family history African American men have highest rate of

prostate cancer Inflammation?? Exposure to radiation or cancer causing

chemicals?? Diet high in animal fat?? Obesity

Cancer Nutrition

Maintain healthy weight Physical activity Diet focused on plant sources Limit alcohol

Fat

SaturatedPolyunsaturatedMonounsaturated

Obesity: The Next Generation

“Texas has the nation's highest rate of obese girls”

“The childhood obesity study found 20 percent of female Texans aged 10 to 17 were obese in 2007, up from 15 percent in 2003.”

“The 33.5 percent increase wasn't the nation's biggest spike, but it moved Texas' girls from the eighth highest rate to the No. 1 spot.”

www.chron.com, accessed May 11, 2010

Let’s Move

http://www.letsmove.gov/

White House Kitchen Garden

Nutrition Facts Labels

http://www.fda.gov/Food/LabelingNutrition

Secrets to keeping it off…Daily!

Sleep 8 hours Eat Breakfast Walk briskly 60 minutes Keep a food diary Weigh Find support Don’t give up

Lifestyle Issues and Behavior Modification in the Prevention and Treatment of Type 2

Diabetes. 4th Annual SLEH Diabetes Symposium. John P Foreyt, PhD, 2008.

More Secrets—National Weight Control Registry

78% eat breakfast every day 75% weigh them self at least once a week 62% watch less than 10 hours of TV per

week 90% exercise, on average, about 1 hour

per day 98% of Registry participants report that

they modified their food intake in some way to lose weight.

94% increased their physical activity, with the most frequently reported form of activity being walking

http://www.nwcr.ws/default.htm

Top Ten (Cheryl Forberg, RD)

1. had absolutely no idea how many calories their body really needs (and how many more they are actually taking in)

2. skipped breakfast and often, many other meals

3. didn’t eat enough fruit or vegetables

4. didn’t eat enough protein (lean protein)

5. didn’t eat enough whole grains

6. ate too much white stuff; white flour, white pasta, white sugar, white rice, simple carbs

7. didn’t feel they had time to plan ahead - they found themselves grabbing something quick for a meal - often consumed in the car or at their desk.

8. often had enough calories in beverages alone to meet their daily caloric needs -- but didn’t drink enough water

9. didn’t exercise enough (if at all)

10. prioritized their spouse, partner, children and/or their jobs over their own health and well-being

Top Ten (Cheryl Forberg, RD)

Plate Method

What should my numbers be?

Total cholesterol—less than 200 mg/dl HDL—40 or above male, 50 or above female LDL—less than 100 --100-129 is near or above optimal

Triglycerides less than 150 mg/dl

Fasting glucose less than 100

HgbA1c Less than 7%

What should my numbers be?

Blood pressure Normal < 120/80 Prehypertension 120–139/80–89 If you have diabetes or chronic kidney disease,

high blood pressure is defined as 130/80 mmHg

Waist circumference Men—less than or equal to 40 in. Women—less than or equal to 35 in.

What is the difference between a dietitian and a nutritionist?

Registered Dietitian Bachelor of Science in a nutrition-related field

biochemistry, anatomy, physiology, biology Complete a supervised dietetic internship with

a minimum of 900 hours. Pass a national board examination before

receive the credentials “RD” Complete continuing education courses

regularly in order to keep registration and licensure current

American Dietetic Association www.eatright.org

The “Power Plate”

Thank you!

"If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health." Hippocrates

“Eat food. Not too much. Mostly plants”Michael Pollan

© Rita Zapien MS RD CDE 2010