Nu fsp chapter 11 weight loss

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Chapter 11Weight Loss

Basics of Weight ControlHow may Calories are in a pound of body fat?

• 1 pound of fat = 454 grams• 1 gram of fat = ~ 9 Calories• 1 pound of pure fat = ~ 4,086 Calories• Body fat contains some protein, minerals and water• 1 pound of body fat = ~ 3,500 Calories

Is the caloric concept of weight control valid?

• First Law of Thermodynamics– Energy is neither created nor destroyed

Caloric Concept of Weight Control

• Caloric costs for changes in body mass– Fat = 9 Calories per gram– Protein = 4 Calories per gram– Carbohydrate = 4 Calories per gram– Water = 0 Calories per gram

• Caloric cost of weight loss may vary• Loss of body fat, however, costs about 3,500 Calories /pound

Estimated Energy Requirement (EER)• A key factor is the Physical Activity Level (PAL),

which is the TDEE divided by the BEE. The PAL is used to determine the Physical Activity (PA) coefficient

How much weight can I losesafely per week?

• Without medical supervision– Recommended maximal amount

• Adults: 2 pounds/week• Growing children: 1 pound/week

– Realizable goals• Adults: 1 pound/week• Growing children: ½ pound/week

– Weight loss should be body fat

1. Behavior Modification

• Learn new ways to deal with old problems• For weight control, reduce or eliminate physical or

social stimuli that contribute to– Excessive caloric intake– Physical inactivity

• Learn to eat a leaner, healthier diet• Learn to exercise more

How do I apply behavior-modification techniques in my weight-control program?• YOU are the most important component of your weight-

control program• YOU must

– Face the fact that being overweight impairs your health– Know that losing weight will improve your health– Establish weight loss as a high priority– Be able to tolerate some discomfort as you make changes

Behavior Modification• One of the first steps is to identify your dietary and

exercise behaviors - Keep a 24-hour record

Diet and Exercise Behaviors

• Establish long-range and short-range goals– Long-range

• Lose 10-15% of body weight over 4-6 months

– Short-range• Lose 1-2 pounds per week

• Small behavior changes– “ Nothing builds success

like success”– Small Steps

Behavior Modification: Suggestions• Self-discipline, self-control, and advanced planning• Foods to eat• Food purchasing• Food storage• Food preparation and serving• Location• Restaurant eating• Methods of eating• Activity• Mental attitude

Self-discipline, self-control, and advanced planning

• Establish realistic weight-loss goals• Establish weight loss as a high priority• Think about this priority before eating• Take small helpings deliberately• Plan for a modest daily caloric deficit• Check your body weight on a regular basis

Foods to eat

• Use low-Calorie healthful foods for snacks• Plan low-Calorie, high-nutrient meals• Plan your food intake for the entire day• Eat only foods that require no or minimal processing• Allow yourself small amounts of foods you like, but

stay within daily caloric limits• Know the Food Exchange system, particularly portion

size and high-fat foods and Calories per exchange

Food purchasing

• Do not shop when hungry• Prepare a shopping list and do not deviate from it• Buy only nutrient-dense foods• Read and compare food labels• Buy natural foods as much as possible

Food storage

• Keep high-Calorie foods out of sight• Have low-Calorie snacks like carrots and radishes

readily available

Food preparation and serving

• Buy mainly foods that require preparation of some type

• Do not add fats or sugar in preparation, if possible• Prepare only small amounts. Be able to visualize one

serving size for any given food• Do not use serving bowls on the table• Put the food on the plate, preferably a small one

Location

• Eat in only one place, such as the kitchen or dining area

• Avoid food areas such as the kitchen or snack table at a party

• Avoid restaurants where you are most likely to buy high-Calorie items

Restaurant eating

• When eating out, select the low-Calorie items• Request your meals be prepared without fat• Have condiments, like butter, mayonnaise, and salad

dressing served on the side; use sparingly• Order water, not a high-Calorie beverage• Be wary of portion sizes as most restaurant servings

contain 2-3 normal servings. Ask for a take-home container before you eat and put half of your meal in the box.

Methods of eating

• Eat slowly. Chew your food thoroughly or drink water between bites

• Eat with someone; conversation slows eating• Cut food into small pieces• Do not do anything else while eating• Relax and enjoy the meal• Eat only at specified times• Eat only until pleasantly satisfied, not stuffed• Spread your total Calories over the day; snack often

Activity• Decrease the amount of time spent being sedentary• Increase the amount of daily NEAT• Walk more• Use the stairs, not the elevator or escalator• Do exercise snacks. Brisk 10-minute walk• Get involved in physical activities with others• Avoid sedentary night routines• Start a regular exercise program, both aerobic and resistance

exercises• Schedule exercise as an appointment in your daily planner

Mental attitude

• Recognize that you are not perfect and that lapses will occur

• Deal positively with your lapse; put it behind you and get back on your program

• Put reminders on the refrigerator door at home or on your telephone at work

• Reward yourself for sticking to your plans

Weight maintenance

• Maintaining your new healthy body weight is the key• Lifelong commitment to healthy diet and exercise

behaviors is needed• Prevent a lapse from becoming a relapse

– Injury can curtail exercise– Have alternative exercises you can do

• National Weight Control Registry– Maintained weight loss for at least 2 years

2. Dietary Modifications

• To lose weight, the key component is Calories– One needs to consume fewer Calories than one expends

How can I determine the number of Calories needed in a diet to lose weight?

• First, calculate how many Calories (C) you need daily to maintain your current body weight

• Second, estimate how much weight you want to lose each week.

• Example:– 35-year old sedentary woman needs 1,820 C to maintain

current body weight at 140 pounds– To lose 1 pound/week would require a 500 C daily deficit – 1 pound of fat = 3,500 Calories; 3,500 ÷ 7 = 500 C– 1,830 ― 500 = 1,330 C day diet

Why does a person usually lose the most weight during the first week on a reducing diet?

• The goal is to lose body fat, not muscle• Weight loss via dieting may come from decreased

body stores of carbohydrate and protein and resultant body water losses, which require no Calories– Carbohydrate stores may also bind water– Carbohydrate losses: 300 grams– Associated water losses: 900 grams– Total losses: 1,200 grams (1.2 kg), or 2.6 pounds– Water is also lost with muscle protein losses

• Loss of 1 pound occurs with < 3,500 Calorie deficit

Why does it become more difficult to lose weight after several weeks or months on a diet program?

1. Body water losses decrease – Body weight losses are now primarily from body fat, which

requires an energy deficit of 3,500 Calories

2. At your lower body weight, you need fewer daily Calories to maintain this weight– Example: Male who needs 18 Calories/lb to maintain weight

• 200 lbs x 18 = 3,600 Calories to maintain weight• 180 lbs x 18 = 3,240 Calories to maintain weight

3. To maintain a set rate of weight loss, you would need to cut more Calories from the daily diet

What are the major characteristics of a sound diet for weight control?

• Hundreds of diet plans have been proposed– Fast and easy diet plans

• No such diet

• Most diet plans focus on macronutrients– Acceptable Macronutrient Distribution Range

(AMDR)• Carbohydrate: 45-65% of energy intake• Fat: 20-35% of energy intake• Protein: 10-35% of energy intake

Popular Diets (Diet Books)Diet PlanDiet Plan Average Average

Daily Daily CaloriesCalories

%%

CarbohydratCarbohydrateses

%%

FatFat%%

ProteinProtein

Weight Weight watcherswatchers

1,4501,450 5656 2424 2020

AtkinsAtkins 1,5201,520 1111 6060 2929

South South BeachBeach

1,3401,340 3838 3939 2323

VolumetricVolumetricss

1,5001,500 5555 2323 2222

Jenny CraigJenny Craig 1,5201,520 6262 1818 2020

ZoneZone 1,6601,660 4040 3030 3030

OrnishOrnish 1,5201,520 7777 66 1717

Adapted from Consumers Union. Rating the Diets.Consumer Reports 70 (6):21, 2005.

Balanced Weight-loss Diets

• Examples of diet plans– Various health profession organizations

• Key points of such diet plans– Reduced in Calories yet supply all essential nutrients– Contain a wide variety of foods that appeal to your taste

and help prevent hunger between meals; moderate in fat – Suited to your current lifestyle and personal preferences– Provide a slow rate of weight loss; 1-2 pounds/week– A lifelong diet

Weight-loss Diet Plans

• Current research– The Calorie content of the diet is the key factor– Diets varying in carbohydrate, fat, or protein are

equally effective if caloric content is similar

Is it a good idea to count Calories when attempting to lose body weight?

• Counting Calories may be helpful during early stages of a diet

• Learning the Food Exchange System and using Food Labels helps you learn the caloric contents and serving sizes of various foods, which can help in the selection of low-Calorie, nutrient dense foods

• Keep track of foods rich in fat and sugar

What is the Food Exchange System?

How can I determine the number of Calories I eat daily?

• Carry a notebook with you and a reminder, such as a rubber band on your finger

• Record your daily food intake, and physical activity, in detail, as soon as possible

• Record food intake over a 3-7 day period of time which represents your normal dietary habits

• Use the Food Exchange System or Nutrition Facts on food labels to record serving size and Calories

• Use measuring devices, such as a measured cup• Learn to estimate portion sizes

Determining Caloric Intake

• Eating out– Fast-food restaurants

• Nutrition fact sheets• See Appendix F

– Other restaurants• Use PDA or cell phone• Email [email protected]• Receive response with Calorie, fat, and carbohydrate

content

Determining Caloric Intake

• Enter food record into MyPyramid dietary analysis program

• You may keep a record of your caloric (energy) intake over the course of a year

What are some general guidelines I can use in the selection and preparation of foods to promote weight

loss or maintain a healthy body weight?

• Consumer Reports study of 32,000 dieters who lost weight and kept it off– The National Weight Control Registry

• No specific plan but used sensible strategies– Cut portion sizes– Eat fewer Calories from fat and sugar– Eat healthier carbohydrates, fats, and proteins

Guidelines for Weight Control and Healthy Eating

1. Decrease caloric intake -- eat more nutrient-dense foods and fewer energy-dense foods

2. Eat foods that make you feel full 3. Restrict portion sizes 4. Eat less fat 5. Eat fewer and smaller amounts of refined sugar 6. Reduce the intake of both fat and sugar 7. Eat more low-fat dairy products


8. Eat more low-fat meat and meat substitutes 9. Eat more whole, unprocessed carbohydrates10. Eat more fruits11. Eat more veggies12. Consume fewer high-Calorie fat exchanges13. Reduce liquid Calories14. Limit intake of alcohol15. Limit salt intake


16. Eat slowly 17. Nibble, don’t gorge 18. Eat breakfast 19. Learn to cook 20. Learn low-Calorie foods


1. Eat more nutrient-dense foods and fewer energy-dense foods


2. Eat foods that make you feel full Volumetrics: High-volume, low-Calorie foods

SoupsSaladsVegetablesWhole grains


3. Restrict portion sizesEvolution of Coca-Cola

8-ounce bottle12-ounce bottle20-ounce bottle64-ounce fountain serving

Evolution of fast-food hamburgersSingle 4-ounce pattyDouble burgerTriple burger


4. Eat less fat Proposed rationale:• Rich in Calories • Appetizing and does not rapidly suppress the appetite• Has a lower TEF or higher metabolic efficiency• May be stored preferentially in the abdominal area


5. Eat fewer and smaller amounts of refined sugar• Reduce intake of sugar-sweetened beverages• Use sugar substitutes


6. Reduce the intake of both fat and sugar• May constitute 50% of daily energy intake


7. Eat more low-fat dairy products• Rich in protein, vitamins and minerals, especially calcium


8. Eat more low-fat meat and meat substitutes• Very lean meat exchange

• Fish, chicken breast, beef eye of round, flank steak• 35 Calories, 1 gram of fat

• High in protein• Low in fat• Low in Calories• Rich in minerals (iron and zinc)


9. Eat more whole, unprocessed carbohydrates• High volume food• Rich in fiber• Select 100% whole wheat or whole grain


10. Eat more fruits• Select fresh fruits• Select canned or frozen fruits in own juices• Avoid fruits in heavy sugar syrups• Limit intake of dried fruits (high in Calories)• Limit intake of fruit juices (high in Calories)


11. Eat more vegetables• High volume foods• Low in Calories• Rich in vitamins, minerals, fiber, phytonutrients• Many vegetables are listed as Free Food

Exchanges• Fewer than 20 Calories per serving


12. Consume fewer high-Calorie fat exchanges• Reduce intake

• Butter• Margarine• Cooking oils• Salad dressing• Mayonnaise

• Most are pure fat• Use fat-free or low-fat versions


13. Reduce liquid Calories• Beverages other than milk and fruit juice should have no

Calories• Sweetened sodas and drinks may be associated with weight

gain and obesity• Some specialty coffees contain as many Calories as

McDonald’s Big Mac• Starbucks Choclaty Chip Frappuccino Blended Crème > 500 Calories


14. Limit your intake of alcohol– A gram contains 7 Calories, comparable to fat– Calories in alcohol do not replace Calories in a

meal, so total caloric intake is increased– Selecting low-alcohol beer and wine may help

save Calories• 64 Calories versus 150 Calories• Decreased carbohydrate and alcohol


15. Limit salt intake• Salt may increase appetite • Salt may increase thirst for sugar-sweetened beverages• Use herbs, spices and other nonsalt seasonings


16. Eat slowly• Eating slowly may help curb your appetite• Eat a low-Calorie soup or salad as an appetizer• May help curb the appetite for the main course


17. Nibble, don’t gorge• Eat 5-6 smaller snacks and meals during the day• May help curb the appetite• Use low-Calorie, nutrient-dense foods• 100-Calorie snacks

• An apple• A hard-boiled egg• A dozen almonds• 3 Hershey’s kisses• 3 cups of air-popped, fat free popcorn


18. Eat breakfast• A hearty breakfast may help curb appetite

through the morning hours• A high-protein breakfast may be helpful

• Egg substitutes• Whole wheat bagels with salmon• Whole grain cereals with skim milk and fruit


19. Learn to cook• Select healthy foods• Cook and serve small portions• Ease of cooking

• Microwaves• Electric grills


20. Learn low-Calorie foods• Learn to substitute low-Calorie foods for those

high in Calories• Know the Food Exchange System• Practice what you learn• Gradual transition in small steps

• Whole milk → low-fat milk → skim milk

Are very-low-Calorie diets (VLCD) effective and desirable as a means to lose body weight?

• VLCD are modified fasts (< 800 Calories/day)• May be used under medical supervision• Not recommended for typical individual who wants

to lose 10-20 pounds

Is it harmful to overeat occasionally?

• Occasional overeating is not harmful to dieting, as long as it does not become a habit

• Try to avoid high-fat meals if prone to cardiovascular disease

• Rapid weight gain from overeating may occur, but is not body fat– Water retention with carbohydrate stores– Water retention with excess sodium

• Getting back on your weight loss plan will return body weight to normal

3. Exercise Modifications

Increase any of the FITT Principles

• Frequency • Intensity• Time• Type

Comprehensive Weight-Control Programs

• Comprehensive program– Behavior modification– Diet– Exercise

• Most important feature– Maintenance of stable healthy body weight

• Lifelong commitment

What is more effective for weight control—dieting or exercise?

• Dieting alone may be an effective means to lose excess body fat– Increasing protein content may help maintain muscle– Some indicate dieting alone to maintain weight is designed

to fail in the long run

• Exercise alone may also be an effective means to lose body fat– Dietary energy intake needs to remain constant

Dieting and Exercise for Weight Control

• Combination of dieting and exercise is the most effective approach to weight control– A proper diet can control energy intake– A proper aerobic and resistance exercise program provides

multiple benefits• Expends caloric energy• Prevent decrease in lean body mass• Maintain resting energy expenditure (REE)• Exercise may improve dietary compliance

Weight Control

• The Bottom Line

Eat less, move more

Nu fsp chapter 11 weight loss

Health & Medicine