FCSN 245 Basic Nutrition Summer 2005 Episode III Dr. David Gee - PowerPoint PPT Presentation

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FCSN 245 Basic Nutrition Summer 2005 Episode III Dr. David Gee

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20% fat diet, 40 hrs/wk physical work. Arizona Pima Indians ... People are far more likely to maintain weight loss eating a balanced healthy diet ... – PowerPoint PPT presentation

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Title: FCSN 245 Basic Nutrition Summer 2005 Episode III Dr. David Gee


1
FCSN 245 Basic Nutrition Summer 2005 Episode
III Dr. David Gee
  • Starting tomorrow, all lectures will be held in
    PE 201
  • Clicker points attendance sheets
  • Course web page
  • www.cwu.edu/geed
  • Grades so far posted on bulletin board outside
    136 Michaelsen

2
Healthy Weight and the Non-Diet Approach
  • David L. Gee, PhD
  • Professor of Food Science and Nutrition
  • Central Washington University

3
Prevalence of Overweight in the US
  • 1990 56 of Americans were overweight
  • 23 were obese
  • 2000 64 of Americans were overweight
  • 30 were obese
  • At this rate
  • In 2010 73 overweight
  • In 2020 84 overweight
  • In 2030 96 overweight
  • Increases in overweight/obesity were seen in
  • Both males and females
  • All age groups
  • All ethnic groups

4
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5
Ethnicity and Overweight (BMI27.5) Prevalence
6
Prevalence of overweight in children.
  • CDC (2004)
  • Overweight above the 95th percentile for BMI
    based on NHANES II data from 1970s
  • For adolescents 12-19 yrs
  • 1974 7.4
  • 2002 15.6

7
Prevalence of Overweight Children in the US
8
Epidemic Increase in Childhood Overweight,
1986-1998 JAMA 2862845-2848 (2001)
9
Epidemic Increase in Childhood Overweight,
1986-1998 JAMA 2862845-2848 (2001)
  • National Longitudinal Survey of Youth
  • 1986-1998
  • 8,270 children, aged 4-12 yrs
  • Prior studies show it took 30 years for
    overweight prevalence to double. Current study
    show doubling time to be less than 12 years.
  • Rate of increase particularly high in African
    American and Hispanic children

10
Why lose weight?
  • Obesity is associated with greater risk of
  • Diabetes
  • Hypertension stroke
  • Coronary heart disease
  • Most cancers (except lung cancer)
  • Sleep apnea, arthritis, gall stones, ….
  • Overfat vs Underfit ????
  • Good question
  • Vast majority of overfat are underfit

11
Obesity and Causes of Death in the US
12
Epilog Supersize Me The Food Industry Strikes
Back NY Times (July 7, 2005)
  • 20 states have passed Common sense consumption
    laws preventing personal injury lawsuits related
    obesity (11 states pending)
  • During elections of 2002 2004, the food and
    restaurant industry gave 5.5 million to
    politicians in the 20 states.
  • Institute on Money in State Politics.

13
Epilog Supersize Me The Food Industry Strikes
Back NY Times (July 7, 2005)
  • 83 of public opposed to obesity lawsuits against
    restaurants and fast food companies
  • Pelman Bradley vs McDonalds
  • Initial personal injury lawsuit dismissed
  • Jan 2005, panel of 3 Federal Judges reinstated
    deceptive practices claim (McDonalds falsely
    presented their food as nutritionally beneficial
    to consumers)

14
Is being overweight really that dangerous? Excess
Deaths Associated with Underweight, Overweight,
and Obesity JAMA 20052931861-1867
  • Underweight and obesity… were associated with
    increased mortality…
  • Overweight was not associated with excess
    mortality.
  • Study finds government overstated danger of
    obesity USA Today 4/19/05
  • http//www.usatoday.com/news/health/2005-04-19-obe
    sity-danger_x.htm

15
For adults ages 25-59, increased mortality in
underweight and obese categories, but not
overweight category.
16
Is Obesity a Public Health Problem?
  • Obesity and Overweight prevalence is rising
    rapidly
  • Obesity is associated with increased risk of
    mortality (overweight?)
  • Overweight is a temporary period of transition
    (many/most overweight people become obese)

17
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18
Is Obesity a Public Health Problem?
  • Obesity and Overweight are associated with
    increased risk of diabetes, hypertension,
    dyslipidemia
  • While treatment of these diseases has improved
  • Health care costs are rising
  • Quality of life impacted

19
The Obesity Epidemic in America Whos
responsible?
  • Personal responsibility
  • Environmental influences
  • Do we need a Food Police?
  • http//www.nytimes.com/2005/06/12/business/yourmon
    ey/12food.html?pagewanted1

20
Discussion What role should American society
play in addressing the Obesity Crisis?
  • Name
  • 1 Weight problems are a matter of personal
    responsibility.
  • No significant changes need to be made.
  • 2 Weight problems are significantly influenced
    by environmental factors.
  • Society needs to implement changes.
  • 3 Weight problems are highly influenced by
    environmental factors and will lead to
    catastrophic health problems.
  • Society needs to implement sweeping changes.

21
Why we gain weight Genes/Biology vs Environment
  • Overweight is a result of both
  • Adoption studies (biology)
  • Adopted adults have BMI that are more similar to
    biological parents than to adoptive parents.
  • Animal studies (biology)
  • genetically obese rats and mice

22
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23
Genes/Biology vs Environment (cont.)
  • Migration studies (environment)
  • Japanese
  • Hawaiian Japanese
  • Californian Japanese
  • Dietary Change Studies (biology and environment)
  • SW Native Americans

24
Pima Indians
  • Mexican Pima Indians
  • subsistence farming ranching
  • 20 fat diet, 40 hrs/wk physical work
  • Arizona Pima Indians
  • mechanized agriculture, sedentary lifestyle
  • 40 fat diet

25
Pima Indians
  • Arizona Pima Indians are
  • 1 inch taller
  • 57 pounds heavier
  • 70 obese
  • 50 with diabetes by age 35

26
Genes vs Environment Conclusions
  • Genes for weight gain predisposes some
    individuals towards weight gain.
  • Environment determines which of those individuals
    actually gain weight.
  • The rapid change in obesity prevalence is likely
    to be more due to changes in the environment than
    changes in our genetic pool.

27
What is a Healthy Weight?
  • A broad range of weight which allows for minimal
    risks for chronic diseases.
  • Goes beyond using only body weight as a criteria
    for good health.

28
Determination of your "healthy weight".
  • Step 1. Body Mass Index
  • BMI BW(kg)/Ht2(m2)
  • Dr. Phil
  • from Nutrition Action Health Letter, Jan. 2004
  • 64" 78" x 0.0254(m/in) 1.93m
  • 240lbs / 2.2(lb/kg) 109kg
  • BMI 109/(1.932)109/3.72
  • 29.3

29
BMI Classifications
  • BMI 19 - 25 Desirable
  • BMI 25 - 30 Overweight
  • BMI 30 - 35 Obese, category 1
  • BMI 35 - 40 Obese, category 2
  • BMI 40 Severe obesity

30
BMI and Mortality Risk
31
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32
Healthy Weight (cont.)
  • If your BMI 25, then consider presence of other
    health risk factors.

33
Healthy Weight (cont.)
  • Body Fat Distribution
  • upper body fatness associated with higher health
    risks
  • Waist Circumference (1998 NIH)
  • 35 for females,
  • 40 for males

34
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35
Healthy Weight (cont.) Know your blood lipids!
  • Hyperlipidemia/dyslipidemia
  • TC 240 mg/dl
  • LDL-C 160 mg/dl
  • HDL-C
  • TG 200 mg/dl

36
Healthy Weight (cont.) Know your blood pressure!
  • High Blood Pressure
  • Systolic BP 140 mm Hg or
  • Diastolic BP 90 mm Hg or
  • Borderline hypertensive
  • Pre-hypertensive
  • 130/85

37
Healthy Weight (cont.) Know your blood sugar and
history
  • Hyperglycemia (Diabetes)
  • Fasting Blood Glucose
  • 126 mg/dl
  • Impaired Glucose Tolerance
  • Pre-diabetic
  • 110 mg/dl
  • Gestational Diabetes
  • Family History of Diabetes

38
Healthy Weight Summary
  • If your BMI is 19-25, you are at a Healthy
    Weight.
  • Health problems are not weight related
  • If your BMI is 25 and you have no other risk
    factors, you are at a Healthy Weight.
  • If your BMI is 25 and you have one or more risk
    factors, you are NOT at a Healthy Weight.
  • Weight loss is likely to improve your health

39
Should everybody who is overweight try to lose
weight? Will weight loss improve your quality of
life? A Prospective Study of Weight Change and
Health-Related Quality of Life in Women
  • JAMA Dec. 1999
  • Nurses Health Study
  • 40,098 women, 4 yr longitudinal study
  • Weight changes
  • Quality of life questionnaire
  • Physical function
  • Vitality
  • Freedom from bodily pain
  • Mental health

40
The effect of weight gain/loss on Vitality Score
  • Weight gain
  • associated with declines in vitality scores in
    all BMI categories
  • Weight loss
  • associated with improved vitality scores only in
    women with BMI25

41
The effect of weight gain/loss on Mental Health
Score
  • Weight gain
  • associated with a decline in mental health scores
    in all weight categories
  • Weight loss
  • associated with improved mental health scores
    only in obese class I women and declined in
    normal weight women.

42
A Prospective Study of Weight Change and
Health-Related Quality of Life in
Women. Conclusions
  • For women at all BMI categories
  • Dont gain weight
  • Reduced quality of life
  • For overweight and obese women
  • Weight loss is generally associated with improved
    quality of life
  • For normal weight women
  • Weight loss does not improve quality of life
  • May actually reduce quality of life

43
Do media images affect your idea of what you
should look like?
2000 Grammy Awards
Do media images actually Contribute to weight pr
oblems?
44
Bottom Line on Weight Loss
  • Lose weight for the right reasons
  • Improve health and your quality of life
  • Losing weight to attain the perfect body
  • May lead to frustration
  • And, ironically, weight gain
  • May lead to eating disorders

45
Dietary Means to a Healthy Weight
  • Weight loss occurs when in negative energy
    balance
  • Weight loss is only half the battle
  • Maintenance of weight loss is the critical problem

46
Dietary Means to a Healthy Weight Balanced
Reduced Calorie Diet
  • Characteristics
  • Calories reduced by 500-1000 Cal/day
  • CHOPROFAT 50-60 10-15 20-30
  • Examples
  • Weight Watchers, Jenny Craig, Slim Fast
  • What the research shows
  • Short-term outcomes
  • Modest weight loss, improved health
  • Long-term outcomes
  • Success rate not great

47
Dietary Means to a Healthy Weight Low
Carbohydrate Diets
  • Characteristics
  • Very low in CHO
  • Restricted intakes of fruit, cereals, pasta,
    bread, potatoes, rice
  • Caloric intake not specified
  • Examples
  • Atkins diet
  • What the research shows
  • Short-term outcomes
  • 6 month studies, good weight loss, no substantial
    change in heart disease risk factor, drop-out
    rate significant
  • Long-term outcomes
  • No long term studies, health risks?

48
Dietary Means to a Healthy Weight The
Carbohydrate Restrained Diets
  • Characteristics
  • Lower in CHO than Dietary Guidelines but higher
    than Low Carb diets (40 CHO, 30FAT, 30PRO)
  • Low glycemic index foods encouraged
  • Monounsaturated fats encouraged
  • Examples
  • Zone Diet, South Beach Diet
  • What the research shows
  • Little research available on these diets

49
Dietary Means to a Healthy Weight Healthy
Diet/Non-Diet Approach
  • Characteristics
  • Focus on quality of the diet, not quantity
  • Attaining good health is primary goal, not weight
    loss
  • Examples
  • DASH diet, Dietary Guidelines, Food Guide
    Pyramid
  • What the research shows
  • Short-term outcomes
  • Slow, limited weight loss, health benefits
  • Long-term outcomes
  • U. Colorados Weight Loss Registry
  • Diet most adopt in order to maintain weight loss

50
Summer 2005 Final Exam
  • Thursday, July 28, 1250PM, 201 PE
  • Gee
  • Lecture materials
  • Chapter 11-Achieving and Maintaining a Healthful
    Body Weight
  • Chapter 9 Nutrients Involved in Bone Health
  • 20 MC/TF questions
  • See www.cwu.edu/geed tomorrow for study guide
  • Take Home essay question (turn in with final)
  • What is the role of American Society in
    Addressing the US Obesity Crisis?
  • 1 page, double space, 12 pt font, 1 margins
  • 10 pts grammatically perfect, well thought out,
    clearly states and defends position.

51
  • Bergman Bennett
  • Study old exams and example question on their web
    pages
  • 40 MC/TF questions

52
Key Points Diet and Weight Loss
  • Prevention is far easier than the cure
  • People lose weight using many types of dietary
    programs
  • Always energy balance
  • People are far more likely to maintain weight
    loss eating a balanced healthy diet

53
Exercise and Weight Loss
  • U. Colorados Weight Loss Registry
  • Exercised used by nearly 100
  • Walking the most common form of exercise
  • Benefits of Exercise
  • Rate of weight loss greater
  • Caloric restriction not as great
  • Quality of weight loss better
  • Proactive choice vs dieting
  • Health benefits independent of weight loss

54
Rates of physical inactivity in the US
55
Exercise and Weight Loss Structured Exercise
  • Aerobic Exercise
  • Burns more calories, more fat
  • Stress duration initially
  • Strength Training
  • Builds more lean tissue
  • Increases basal metabolic rate

56
Exercise for Weight Loss Walking vs
Running Going 4 miles
57
Exercise for Weight Loss Walking vs
Running Going 1 hour
58
Exercise and Weight Loss Structured Exercise
  • Successful Programs
  • Convenient
  • Enjoyable
  • Safe
  • affordable
  • Subject realizes net benefit over costs

59
Exercise and Weight Loss Lifestyle Activity
  • 24 hr day
  • Sleep/rest 10 hrs
  • Structured exercise 1 hr
  • What you do the remaining 13 hrs of the day?
  • Burn extra 25 Cal/hr 325 Cal/day
  • 33 pounds of fat loss per year
  • Develop a new attitude about being active
  • Pedometers and 10,000 step programs
  • Health benefits significant

60
Weight Loss/Weight Maintenance Behavior/Attitude
Changes
  • Pay attention to what you eat
  • Success of weight loss programs
  • Examine
  • Triggers for eating
  • Emotional eating
  • Its not just what your eating, its whats
    eating you!
  • Risky situations
  • Behavior Modification Programs
  • Track/record eating behaviors
  • Identifies problems
  • Sets goals and establishes rewards
  • Continual reassessment/problem solving

61
For more severe weight loss
  • Prescription Drugs
  • For those with BMI 30 or
  • For those with BMI 27 and risk factors
  • Meridia (Sibutramine, Abbott Lab)
  • Suppresses appetite
  • Xenical (Orlistat, Roche)
  • Inhibits fat absorption
  • Long term success and risks

62
For those with Severe Obesity
  • Surgical Methods
  • For those with BMI 40

63
For those with Severe Obesity
  • Gastroplasty
  • Reduces size of stomach by banding or stapling
  • Gastric Bypass Surgery
  • Reduces size of stomach
  • Bypasses much of the small intestine
  • Outcomes
  • Rapid and substantial weight loss
  • Side effects
  • Dangers

64
Tips from the National Weight Control Registry
(est. 1994)
  • Focus on successful weight loss
  • 3000 people
  • kept 30 lbs off 1year
  • Average 60 lbs for 5 yrs
  • 80 female

65
  • many had bad genes
  • 2/3rds were overweight as children
  • 46 w/one or both parents overweight
  • 60 had family history of obesity
  • any age
  • average age 45 yrs

66
Tips from the National Weight Control Registry
  • Failed to lose weight in the past
  • Dont view past failures as signs you cant
    succeed
  • Found process difficult
  • No pain, no loss
  • Made smaller lifestyle goals
  • Planned indulgences

67
How they lost weight
  • 10 lost weight with diet only
  • 1 w/ exercise only
  • 89 w/ diet exercise
  • used many types of diets to lose weight
  • 50 did it on their own

68
How they maintained their weight loss
  • Low fat diets
  • Watched calories
  • Daily exercise
  • averaged 2600 Cal/week, 1 hr/day
  • 70 walked or walked other exercise
  • 20 weight training
  • 20 bicycling
  • 18 aerobic dance
  • avg 3 hrs/week of TV

69
Tips from the National Weight Control Registry
  • Do what you want, not what you should

70
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