Weight, Body Composition, and Health

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Weight, Body Composition, and Health

• Maintaining a Healthy
• Body Weight

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Weight and Health

• Goal is to determine if an individual is
• Underweight
• Health risks
• Healthy weight
• Overweight (BMI gt 25)
• Health risks if overweight and overfat
• Huge health issue in US (see page 280)

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Increasing Prevalence of Obesity (BMI gt30) 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.
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Obesity Trends Among U.S. AdultsBRFSS, 2003
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519 2024 25
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Obesity Trends Among U.S. AdultsBRFSS, 2004
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519 2024 25
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Obesity Trends Among U.S. AdultsBRFSS, 2007
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519 2024 2529
30
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Obesity Trends Among U.S. AdultsBRFSS, 2008
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519 2024 2529
30
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Obesity Trends Among U.S. AdultsBRFSS, 2009
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519 2024 2529
30
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Obesity Trends Among U.S. AdultsBRFSS, 2010
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519 2024 2529
30
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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.

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U.S. Obesity Data by Race
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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

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Maine Obesity Data

• Obese Year
• 10-14 1995
• 15-19 1996
• 15-19 1997
• 15-19 1998
• 15-19 1999
• 15-19 2000
• 15-19 2001
• 20-24 2002
• 15-19 2003
• 20-24 2004
• 24.8 2007
• 25.8 2009
• 26.5 2011
• BMI gt 30, CDC

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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

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BMI

• Upper end of BMI may not be a good indicator of
  health for
• body builder or serious athletes weight/health
• the elderly
• Low end of the BMI is an appropriate measure of
  being underweight for all

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BMI Weight/health
Less than 18.5 Underweight
18.5 - 24.9 Healthy
25 - 29.9 Overweight
30 -39.9 Obese
Over 40 Severely obesity
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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

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BMI

• Calculating the weight associated with a desired
  BMI
• Weight, lbs desired BMI x (height, inches)2
• 703

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Health Risks and BMI
Weight Class BMI Health Risks
Overweight 25 29.9 Increased
Class I Obesity 30 34.9 Moderate to significant
Class II Obesity 35 39.9 High/very high
Class III Obesity gt 40 Extreme
Underweight lt 18.5 Increased, may be significant
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Health Risks and Weight

• Health risks in each category increase if
• Waist is gt 40 men, gt 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

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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

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Body Fat and Health

• Desirable body fat levels text values
• Males 8 - 24
• Females 21 33

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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

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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

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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

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Distribution of Body Fat

• Lower-Body Obesity (pear shape)
• Fat stores are concentrated around the hips and
  thighs
• Doesnt raise health risks as much as central
  obesity.
• See most often in women during reproductive years

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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 gt 24.9

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What are the Health Issues?

• Health issues associated with being overweight or
  obese
• Type II diabetes
• Hypertension
• High cholesterol
• Heart disease

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Health Issues

• Health issues continued
• Gall bladder disease
• Osteoarthritis
• Respiratory problems
• Hernias
• Varicose veins
• Flat feet
• Complications during surgery and pregnancy

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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

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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

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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

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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.

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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

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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

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Making a Change!
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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??

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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?

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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

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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

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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

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Extreme Measures

• Extreme weight loss measures may be called in
  cases of severe obesity (BMI gt40)
• When health issues of weight are greater than the
  health issues associated with the treatment

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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

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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!

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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

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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

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Strategies for Weight Gain

• Snack between meals, but not too close to meals!
• Chose nutritionally /calorie dense snacks
• 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 ..