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Weight, Body Composition, and Health. Maintaining a Healthy Body Weight. Weight and Health. Goal is to determine if an individual is: Underweight Health risks Healthy weight Overweight (BMI > 25) Health risks if overweight and overfat Huge health issue in US (see page 280). Key:.

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Weight, Body Composition, and Health

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Weight, Body Composition, and Health

Maintaining a Healthy

Body Weight


Weight and Health

  • Goal is to determine if an individual is:

    • Underweight

      • Health risks

    • Healthy weight

    • Overweight (BMI > 25)

      • Health risks if overweight and overfat

      • Huge health issue in US (see page 280)


Key:

No Data

<10%

10%–14%

15%–19%

20%–24%

_

>25%

_

Increasing Prevalence of Obesity (BMI >30) among U.S. Adults

1991: Only four states had obesity

rates greater than 15 percent.

1996: Over half of the states

had obesity rates greater than

15 percent.

2001: Only one state had an obesity

rate below 15 percent, most had

obesity rates greater than 20 percent

and one had an obesity rate greater

than 25 percent.


Obesity Trends* Among U.S. AdultsBRFSS, 2003

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%


Obesity Trends* Among U.S. AdultsBRFSS, 2004

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%


Obesity Trends* Among U.S. AdultsBRFSS, 2007

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%


Obesity Trends* Among U.S. AdultsBRFSS, 2008

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%


Obesity Trends* Among U.S. AdultsBRFSS, 2009

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%


Obesity Trends* Among U.S. AdultsBRFSS, 2010

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%


U.S. Data

  • Obesity has risen 75% in 10 years.

  • Obesity has risen nearly 100% in 20 years.

  • Rates have doubled in children in 20 years.

  • Rates have tripled in teens in 20 years.

  • Self-reported data indicate that 61% of adults

  • are overweight or obese.

  • Data based on direct measurements indicate that two-thirds of adults are overweight or obese.


U.S. Obesity Data by Race


Overweight Children

  • Children most likely to have a high BMI when:

    • Either parent or both overweight or obese

    • They live in smaller families

    • They are poor

    • They consume a high proportion of calories from fat

    • They are avid TV watchers – more screen time is associated with higher weight


Maine Obesity Data

% ObeseYear

10-141995

15-191996

15-191997

15-191998

15-191999

15-192000

15-192001

20-242002

15-192003

20-24 2004

24.82007

25.8 2009

26.5 2011

* BMI > 30, CDC


Evaluating Weight/Health Status

  • Compare weight to standard height-weight tables

    • Tables are of limited value and use

  • Body Mass Index (BMI)

    • Preferred measure for evaluating weight

    • Based on significant amount of research


BMI

  • Upper end of BMI may not be a good indicator of health for:

    • body builder or serious athlete’s weight/health

    • the elderly

  • Low end of the BMI is an appropriate measure of being underweight for all


BMI

  • Calculating BMI – most use BMI calculators or charts (see page 341)

    BMI = weight in pounds x 703

    (height, inches)2

    Weight, lbs = desired BMI x (height, inches)2

    703


BMI

  • Calculating the weight associated with a desired BMI:

    Weight, lbs = desired BMI x (height, inches)2

    703


Health Risks and BMI


Health Risks and Weight

  • Health risks in each category increase if:

    • Waist is > 40” men, > 35” women

    • Smoke

    • Physically inactive

    • High blood glucose

    • High LDL levels or low HDL levels

    • Family history of heart disease, stroke, hypertension, type II diabetes


Body Fat

  • Need enough body fat to meet basic needs, but not so much as to increase health risks

    • Essential Body Fat:

      • Males: 3% body fat

      • Females: 12% body fat, 20% for reproductive health (menstruation and fertility)

        • The latter value has recently come into question


% Body Fat and Health

  • Desirable % body fat levels: text values

    • Males: 8 - 24 %

    • Females: 21 – 33 %


Measuring % Body Fat

% body fat is difficult to measure accurately

  • Common methods for measuring:

    • Fat fold measures with calipers

    • Bioelectric impedance

    • Underwater weighing

    • Air displacement

    • X-ray, MRI, CT and other expensive techniques


Distribution of Body Fat Matters

  • Central Obesity (apple shape)

    • Fat stored around the organs of the abdomen

    • Associated with increased risk of:

      • Heart disease

      • Stroke

      • Hypertension

      • Some cancers


Distribution of Body Fat

  • More on central obesity

    • More common in men and post-menopausal women

    • Associated with smoking

    • Abdominal fat is likely to go directly to the liver and be used to make VLDL  LDL


Distribution of Body Fat

  • Lower-Body Obesity (pear shape)

    • Fat stores are concentrated around the hips and thighs

    • Doesn’t raise health risks as much as central obesity.

    • See most often in women during reproductive years


Waist Circumference

  • Health risks increase when waist circumference is:

    • Greater than 40” in men

    • Greater than 35” in women

  • Risk is even greater if BMI is also > 24.9


What are the Health Issues?

  • Health issues associated with being overweight or obese:

    • Type II diabetes

    • Hypertension

    • High cholesterol

    • Heart disease


Health Issues

  • Health issues continued

    • Gall bladder disease

    • Osteoarthritis

    • Respiratory problems

    • Hernias

    • Varicose veins

    • Flat feet

    • Complications during surgery and pregnancy


Health Issues - Underweight

  • Increased risk of infection and illness

  • Tired and weak (may be anemic)

  • Amenorrhea (periods stop)

  • Reduced fertility

  • Complications during surgery

  • Poor growth and development in kids


Summary

Methods for Evaluating Weight/Health Status

  • Compare weight to standard tables (not useful)

  • Calculate BMI

  • Determine % body fat

  • Evaluate fat distribution

  • Measure waist circumference

  • Consider other risk factors


Who should lose weight?

  • For people who are overweight or obese and have 2 or more risk factors weight loss is recommended

    • even a small weight loss (10% of body weight) will significantly decrease health risks


Who should lose/gain weight?

  • Healthy BMI - maintain current weight.

  • Overweight, desirable waist measurement, less than 2 other risk factors  prevent further weight gain

  • Obese – lose weight

  • Individuals who are have a BMI of less than ______ should gain weight.


Strategies for Weight Loss

  • In general need to decrease caloric intake and increase physical activity

    • Generally need both for long-term weight loss and health

  • To lose 1 pound per week you need to reduce caloric intake (or increase caloric output) by:

    • 500 kcal per day = 3500 kcal/week


Strategies for Weight Loss

  • Set reasonable goals

    • 1-2 pounds per week

    • Loss of 10% of body weight

    • May set interim goals if a large amount of weight loss is desired


Making a Change!


Strategies for Weight Loss

  • Avoid fad diets and weight loss supplements

  • Avoid very low calorie diets and skipping meals

    • Never less than 1200 kcal per day

    • Why??


Strategies for Weight Loss

  • Increase level of physical activity

    • 30-45 minutes moderate intensity, 5 days a week

    • Add weight bearing exercise to build muscle

      • Why?


Strategies for Weight Loss

  • Reduce portion size

  • Increase intake of fiber (why?)

    • More fruits and veggies

    • More whole grain products

  • Eliminate empty calories

    • Soda, alcohol, candy…..

  • Decrease calories from liquid sources


Strategies for Weight Loss

  • Drink plenty of water

  • Eat a salad before dinner

    • Low calorie dressing

  • Buy/make fixed size portions

  • Avoid buffets and family style serving

  • Reduce fat content of foods w.o increasing portion size


Strategies for Weight Loss

  • Avoid starving all day…..leads to binging

  • Join a weight loss group

    • Provides support and accountability

    • Some offer nutritional guidance as well


Extreme Measures

  • Extreme weight loss measures may be called in cases of severe obesity (BMI >40)

    • When health issues of weight are greater than the health issues associated with the treatment


Extreme Measures

  • Treatment is usually:

    • Surgery to drastically reduce stomach size and to bypass some of the SI

      • Long-term success depends upon compliance with dietary restrictions

      • Lifetime medical supervision is needed

      • At high risk of many vitamin and mineral deficiencies

    • Medications


Weight Gain

  • Goal is to add lean body mass (as well as body fat if extremely underweight)

    • Exercise is an important component of weight gain

  • Weight gain can be just as challenging as weight loss!


Strategies for Weight Gain

  • Chose energy dense foods

    • May be higher fat choices

    • Someone who is seriously underweight can afford a little more fat

    • Examples:

      • 2% milk vs. skim milk

      • Peanut butter on anything

      • Salmon vs. haddock


Strategies for Weight Gain

  • Eat regular meals

    • Do not call a “non-meal” a meal

    • Lettuce or carrots or an apple are not lunch

  • Leave salad for last

  • Increase portion size

    • Extra meat or cheese on sandwich

    • Larger bowl of cereal, add a banana


Strategies for Weight Gain

  • Snack between meals, but not too close to meals!

    • Chose nutritionally /calorie densesnacks

      • Peanut butter on apple or crackers

      • Bowl of cereal with milk

      • Trail mix (seeds, nuts, raisins….)

      • Slimfast or instant breakfast

  • Drink caloric beverages

    • Milk, juice …..


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