Obesity Diet and Physical Activity

Obesity Diet and Physical Activity
Pennington Biomedical Research Center Division of Education

Obesity in the United States
Approximately 66% (or two thirds) of U.S. adults are overweight or obese. Healthy People 2010: reduce the prevalence of obesity among adults to less than 15%. The obesity rate increased from the late 1970’s to 2003 from 15 to nearly 33 percent. Results from the NHANES indicate that approximately 66% (or two thirds) of U.S. adults are overweight or obese. One of the national health objectives for the year 2010 is to reduce the prevalence of obesity among adults to less than 15%. However, the prevalence of obesity continues to rise in the U.S. When comparing age-adjusted estimates from NHANES II ( ) to the most recent NHANES ( ), an increase in obesity prevalence from 15 to nearly 33 percent was found among U.S. adults. 2009 CDC

Obesity in the U.S. Body mass index (BMI) weight (kg)/ height squared (m2). BMI is significantly correlated with total body fat content. With a BMI of: You are considered: Below 18.5 Underweight Healthy Weight Overweight 30 or higher Obese Body mass index (BMI) is a mathematical ratio which is calculated as weight (kg)/ height squared (m2). It is used to describe an individuals relative weight for height, and is significantly correlated with total body fat content. BMI is intended for those 20 years of age and older. You can find tables on the web that have done the math and metric conversions for you. BMI tables: 2009 NIDDK

Obesity in the U.S. Obesity class BMI (kg/m2) Class I 30.0- 34.9
Obesity is further divided into three separate classes, with Class III obesity being the most extreme of the three. Obesity class BMI (kg/m2) Class I Class II Class III (Extreme Obesity) ≥ 40.0 BMI greater than 30 is considered obese. However, there are three different classes of obesity: Class 1 is when BMI is in the range of 30 to Class 2 is with BMI ranges from 35 to 39.9 and Class 3 is when BMI is greater than 40. With a BMI of: You are considered: Below 18.5 Underweight Healthy Weight Overweight 30 or higher Obese 2009 CDC, NHLBI

Obesity in the United States
Percent of Obese (BMI > 30) in U.S. Adults In the United States, some minority groups are more affected than others. Income and education are also related to obesity prevalence. Some states have significantly higher rates of obesity than others. This is the latest obesity map that can be downloaded from the CDC website. It shows U.S. Obesity Trends from 1985 to 2006. During the past 20 years there has been a dramatic increase in obesity in the United States. This slide set illustrates this trend by mapping the increased prevalence of obesity across each of the states. In 2006, only four states had a prevalence of obesity less than 20%. Twenty-two states had a prevalence equal or greater than 25%; two of these states (Mississippi and West Virginia) had a prevalence of obesity equal to or greater than 30%. The data shown in these maps were collected through the CDC’s Behavioral Risk Factor Surveillance System (BRFSS). Each year, state health departments use standard procedures to collect data through a series of monthly telephone interviews with U.S. adults. Prevalence estimates generated for the maps may vary slightly from those generated for the states by the BRFSS as slightly different analytic methods are used. 2009 NIDDK, Women’s Health

Obesity in the U.S. Being overweight/obese substantially raises one’s risk of morbidity from: Hypertension Dyslipidemia Type 2 Diabetes Coronary Heart Disease Stroke Gallbladder Disease Osteoarthritis Sleep apnea Certain cancers (endometrial, breast, prostate, colon) Being overweight/obese substantially raises one’s risk of morbidity from: Hypertension Dyslipidemia Type 2 Diabetes Coronary Heart Disease Stroke Gallbladder Disease Osteoarthritis Sleep apnea Certain cancers (endometrial, breast, prostate, colon) Higher body weights are also associated with increases in all-cause mortality. Obesity increases the risk for chronic diseases as mentioned here. Loss of body weight leads to normal risk level for chronic disease. Higher body weights are also associated with increases in all-cause mortality. 2009 J La State Med Soc. 2005; 156: S42-S49.

Obesity is also associated with:
Obesity in the U.S. Obesity is also associated with: High blood cholesterol Complications of pregnancy Menstrual irregularities Hirsutism (presence of excess body and facial hair) Stress incontinence ( urine leakage caused by weak pelvic-floor muscles) Psychological disorders such as depression Increased surgical risk Obesity is also associated with: High blood cholesterol Complications of pregnancy Menstrual irregularities Hirsutism (presence of excess body and facial hair) Stress incontinence ( urine leakage caused by weak pelvic-floor muscles) Psychological disorders such as depression Increased surgical risk These are some other conditions that are associated with obesity. Complications of pregnancy can be devastating to a young woman and psychological disorders such as depression occur more frequently. For any kind of surgical intervention, the surgeon may have the person follow a strict liquid diet for weight loss prior to surgery. 2009 NIDDK

What Causes Obesity? Energy imbalance over a long period of time.
Energy in > Energy out. Excess calories and lack of physical activity. Energy balance is like a scale. When calories consumed are greater than calories used, weight gain is the result. Overweight and obesity are a result of energy imbalance over a long period of time. An energy imbalance arises when the number of calories consumed is greater than the number of calories used by the body. Weight gain usually involves the combination of consuming too many calories and not expending enough through physical activity, although weight gain could result from one or the other. 2009 CDC

Calories Used Eating, digestion, sleeping, breathing, and movement.
Excess calories. Physical activity. Energy Balance Necessary physiological functions Our bodies need calories to perform necessary daily functions: For breathing, for digesting the food we eat, and for movement. Weight gain occurs when the calories we consume exceed this need. Physical activity plays a key role in energy balance because it uses up calories consumed. Calories in Calories used (consumed) (expended) Physical activity Food/beverages consumed 2009 CDC

Overweight The Right Approach
If your BMI is between 25 and 30 and you are otherwise healthy Try to avoid gaining any additional weight Look into healthy ways of losing weight and increasing physical activity 2009 NIDDK

Overweight The Right Approach
Talk to your doctor about losing weight if you fall into any one of the three scenarios: BMI is 30 or above, or BMI is between 25 and 30 and: You have other health conditions Waist measures > 35 inches (women) or > 40 inches (men) and: Talk to your doctor about losing weight if you fall into any one of the three scenarios: Your BMI is 30 or above, or Your BMI is between 25 and 30 and you have: Two or more of the following health problems: diabetes, high blood pressure, heart disease, stroke, cancer, sleep apnea, osteoarthritis, gallbladder disease, liver disease, irregular menstrual periods, or A family history of heart disease or diabetes Your waist measures over 35 inches (women) or 40 inches (men)– even if your BMI is less than 25– and you have: Two or more of the health problems listed above, or 2009 NIDDK

Weight Loss & Maintenance Strategies to Consider
Physical Activity & Diet Therapy The safest strategies to consider for weight loss are increasing physical activity and considering a calorically reduced exchange diet. Reducing total caloric intake while eating a variety of foods is the safest way to lose weight in the long run. 2009

Why Treat Overweight and Obesity?
Because there is strong evidence that weight loss reduces risk factors for diabetes and cardiovascular disease, such as: blood pressure serum triglycerides total serum cholesterol low-density lipoprotein cholesterol blood glucose levels Because there is strong evidence that weight loss: In overweight and obese individuals reduces risk factors for diabetes and cardiovascular disease. Reduces blood pressure in both overweight hypertensive and non-hypertensive individuals. Reduces serum triglycerides and increases high-density lipoprotein (HDL) cholesterol; and produces some reduction in total serum cholesterol and low-density lipoprotein (LDL) cholesterol. Reduces blood glucose levels in overweight and obese persons with and without diabetes. 2009 NHLBI

Weight Loss Programs Healthy eating plans that reduces caloric intake
Any safe and effective weight-loss program should include these components: Healthy eating plans that reduces caloric intake Regular physical activity and/or exercise instruction Tips on healthy behavior Slow and steady weight loss of about ¾ to 2 pounds a week Medical care if needed A plan to keep the weight off after you have lost it Any safe and effective weight-loss program should include these components: Healthy eating plans that reduce calories without ruling out specific foods or food groups Regular physical activity and/or exercise instruction Tips on healthy behavior changes that also consider your cultural needs Slow and steady weight loss of about ¾ to 2 pounds a week and not more than 3 pounds a week (although weight loss may be faster at the start of a program) Medical care if planning to lose weight by following a special formula diet A plan to keep the weight off after you have lost it 2009 NIDDK

Weight Loss The key to any successful weight loss is making changes in your eating and physical activity habits that you can keep for the rest of your life. 2009 NIDDK

Physical Activity

Physical Inactivity In the U.S.
Many studies show that Americans are too sedentary. Due to Increased use of technology. Increased use of automobiles. Despite all of the health effects associated with regular physical activity, many Americans remain sedentary. Increases in technology have increased the ease at which we live our lives. For example, cars are used to run short distance errands; whereas in the past one may have walked to their destination, or biked. According to the Behavioral Risk Factor Surveillance System, in 2000 more than 26 percent of adults reported no leisure time physical activity. According to the Behavioral Risk Factor Surveillance System, in 2000 more than 26 percent of adults reported no leisure time physical activity. 2009 CDC

Physical Inactivity In the U.S.
Physical inactivity contributes to premature deaths. Rates differ by race and ethnicity. Hispanic women - most inactive Hon-Hispanic women – second Asian and Pacific islander women – third and, lastly, White non-Hispanic women - fourth. Physical inactivity contributes to 300,000 preventable deaths a year in the U.S. Rates of physical activity differ by race and ethnicity in a number of ways. Hispanic women (57.2%) appear to have the highest rates of inactivity among women, followed by black non-Hispanic women (55.2%), Asian and Pacific islander women (42.6%), and, lastly, white non-Hispanic women (36.1%). 2009 Women’s Health

Physical Activity Contributes to weight loss.
Helpful for the prevention of overweight and obesity. Helps maintain weight loss. Physical activity contributes to weight loss, especially when it is combined with a calorie reduction. Regular physical activity is extremely helpful for the prevention of overweight and obesity. Regular physical activity is also very important in maintaining weight loss. 2009 CDC

Physical Activity Occupational work
Carpentry, construction, waiting tables, farming Household chores Washing floors or windows, gardening, or yard work Leisure time activities Walking, skating, biking, swimming, playing Frisbee, dancing, softball, tennis, football, aerobics Physical activity is any bodily movement produced by skeletal muscles that results in an expenditure of energy with a range of activities such as: Occupational work Carpentry, construction, waiting tables, farming Household chores Washing floors or windows, gardening, or yard work Leisure time activities Walking, skating, biking, swimming, playing Frisbee, dancing, softball, tennis, football, aerobics 2009 CDC

Regular physical activity is good for overall health.
Physical activity decreases the risk for: Colon cancer Diabetes High blood pressure Physical activity also helps to: Control weight Contribute to healthy bones, muscles, and joints Reduce falls among the elderly Relieve the pain of arthritis. Regular physical activity is good for overall health. Physical activity decreases the risk for: Colon cancer Diabetes High blood pressure Physical activity also helps to: Control weight Contribute to healthy bones, muscles, and joints Reduce falls among the elderly Relieve the pain of arthritis. 2009 CDC

How Much Physical Activity a Day?
The 2005 Dietary Guidelines for Americans recommend the following for adults: To reduce the risk of chronic diseases in adulthood: Engage in at least 30 minutes of moderate-intensity physical activity, above usual activity, at work or home on most days of the week. To help manage weight and prevent gradual, unhealthy weight gain in adulthood: Engage in approximately 60 minutes of moderate- to vigorous-intensity activity on most days of the week while not exceeding caloric intake requirements. To sustain weight loss in adulthood: Participate in at least 60 to 90 minutes of daily moderate- to vigorous-intensity physical activity while not exceeding caloric intake requirements. (Some may need to contact their healthcare provider before participating in this level of activity.) How Much Physical Activity a Day? The 2005 Dietary Guidelines for Americans recommend the following for adults: To reduce the risk of chronic diseases in adulthood: Engage in at least 30 minutes of moderate-intensity physical activity, above usual activity, at work or home on most days of the week. To help manage weight and prevent gradual, unhealthy weight gain in adulthood: Engage in approximately 60 minutes of moderate- to vigorous-intensity activity on most days of the week while not exceeding caloric intake requirements. To sustain weight loss in adulthood: Participate in at least 60 to 90 minutes of daily moderate- to vigorous-intensity physical activity while not exceeding caloric intake requirements. (Some may need to contact their healthcare provider before participating in this level of activity.) 2009 Dietary Guidelines for Americans

How Much Physical Activity a Day?
Any activity helps. Moderate physical activity brings health benefits. Make it personal. Start slowly (10 minute walk/day). The key is that physical activity does not have to be vigorous in intensity in order to receive health benefits. Moderate physical activity, such as 30 minutes of brisk walking five or more times a week, also has health benefits. Not everyone will begin at the same level, either. Start slowly (10 minute walk/day) and gradually increase the amount and duration of your activities. 2009

Increasing Physical Activity
You can increase your physical activity by taking small steps to change what you do everyday. If you normally… Then try this instead! Park as close as possible to the store Park farther away Let the dog out back Take the dog for a walk Take the elevator Take the stairs Have lunch delivered Walk to pick up lunch Relax while the kids play Get involved in their activity 2009 Women’s Health

How Many Calorie Am I Burning?
Calories burned/hour of activity Activity 100 lb 150 lb 200 lb Bicycling, 6 mph 160 240 312 Bicycling, 12 mph 270 410 534 Jogging, 7 mph 610 920 1,230 Jumping rope 500 750 1,000 Running, 5.5 mph 440 660 962 Running, 10 mph 850 1,280 1,664 Swimming, 25 yds/min 185 275 358 Swimming, 50 yds/min 325 650 Tennis singles 265 400 535 Walking, 2 mph Walking, 3 mph 210 320 416 Walking, 4.5 mph 295 572 The chart shows the approximate calories spent per hour by a 100-, 150-, and 200- pound person doing a particular activity. 2009 American Heart Association

How Many Calories Do I Need?
To maintain - use your current weight. To lose - use the average healthy weight recommended for your height. If you are currently overweight, in order to determine your calorie needs per day, you must not use your current weight. Instead use the average healthy weight recommended for your height. The reason that you must do this is because fat requires less calories than muscle. In order to prevent over exceeding calorie requirements, additional body fat must be accounted for. 2009 ACS

Calculating Ideal Body Weight
For men: Use 106 pounds of body weight for the first 5 feet of their height. Add 6 pounds for each additional inch. For women: Use 100 pounds of body weight for the first 5 feet of their height. Add 5 pounds for each additional inch. A 5’9 man’s ideal body weight would be: First 5’0 = 106 lb standard weight for men Plus 9 additional inches 9 (6 lbs)= 54 lbs = 160 pounds (± 10%)= 144 to to 176 pounds is this man’s idea weight A 5’4 woman’s ideal body weight would be: First 5’0= 100 lb standard weight for women Plus 4 additional inches  4(5 lbs)= = 120 pounds (± 10%)= 108 to to 132 pounds is this woman’s ideal weight A simple formula can be used to determine one’s ideal body weight (IBW). Once the IBW is determined, add and subtract 10% to adjust for different body frames. Ideal body weight should fall somewhere in that range. IBW is based on height and gender. For men: Use 106 pounds of body weight for the first 5 feet of their height. Add 6 pounds for each additional inch. A 5’9 man’s ideal body weight would be: First 5’0 = 106 lb standard weight for men Plus 9 additional inches 9 (6 lbs)= 54 lbs = 160 pounds (± 10%)= 144 to 176 144 to 176 pounds is this man’s idea weight A 5’4 woman’s ideal body weight would be: First 5’0= 100 lb standard weight for women Plus 4 additional inches  4(5 lbs)= 20 = 120 pounds (± 10%)= 108 to 132 108 to 132 pounds is this woman’s ideal weight For women: Use 100 pounds of body weight for the first 5 feet of their height. Add 5 pounds for each additional inch. 2009

How Many Calories Do I Need?
USDA’s MyPyramid site: Determines calorie needs and calculates the servings needed from food groups. The American Cancer Society (ACS) site: The ACS site indicates the number of calories that are needed per day to maintain your current weight. Are you interested in knowing how many calories you require per day? There are many websites that can do the calculations for you. For example, the American Cancer Society (ACS) has a site: The ACS site indicates the number of calories that are needed per day to maintain your current weight. Another example is the USDA’s MyPyramid site: Simply enter age, gender, and level of physical activity to determine kcal needs 2009

On the Path to Increased Physical Activity

Before Beginning an Exercise Program
You should check with your doctor before beginning an exercise program if you: Are a man older than age 40 or a woman older than age 50 Have had a heart attack Have a family history of heart-related problems before age 55 Have heart, lung, liver or kidney disease Feel pain in your chest, joints, or muscles during physical activity Have high blood pressure, high cholesterol, diabetes, arthritis, osteoporosis, or asthma Have had joint replacement surgery Smoke Are overweight or obese Tale medication to manage a chronic condition Have an untreated joint or muscle injury, or persistent symptoms after a joint or muscle injury Are pregnant Unsure of your health status. You should check with your doctor before beginning an exercise program if you: Are a man older than age 40 or a woman older than age 50 Have had a heart attack Have a family history of heart-related problems before age 55 Have heart, lung, liver or kidney disease Feel pain in your chest, joints, or muscles during physical activity Have high blood pressure, high cholesterol, diabetes, arthritis, osteoporosis, or asthma Have had joint replacement surgery Smoke Are overweight or obese Tale medication to manage a chronic condition Have an untreated joint or muscle injury, or persistent symptoms after a joint or muscle injury Are pregnant Unsure of your health status. 2009 Mayo Clinic

Health Benefits of Physical Activity
Health benefits of physical activity. CMAJ. 2006; 174(6):

Physical Activity Primary Effects on Diabetes Mellitus
Aerobic and resistance types of exercise decrease the incidence of type 2 diabetes. A modest weight loss through diet and exercise reduces the incidence of diabetes. Both aerobic and resistance types of exercise have been shown to be associated with a decreased risk of type 2 diabetes. In a large prospective study, each increase of 500 kcal in energy expenditure per week was associated with a decreased incidence of type 2 diabetes of 6%. A modest weight loss through diet and exercise has been suggested to reduce the incidence of diabetes among high-risk people (e.g. those who are overweight) by about 40-60% over 3-4 years. 2009 CMAJ. 2006;174(6):

Physical Activity Secondary Effects on Diabetes Mellitus
Exercise helps in the management of diabetes. Aerobic and resistance training help in the control of diabetes Exercise interventions have also been shown to be effective in the management of diabetes. Both aerobic and resistance training have been shown to be of benefit for the control of diabetes; however, resistance training may have a greater benefits than aerobic training on glycemic control. In a cohort study, it was found that physically inactive men with established diabetes had a 1.7-fold increased risk of premature death when compared to physically active men with diabetes. 2009 CMAJ. 2006;174(6):

Physical Activity Primary Effects on Cancer
Routine activity reduces the incidence cancers. Activity results in a 30-40% reduction in the relative risk of colon cancer and breast cancer. Moderate physical activity is believed to exhibit a greater protective effect than activities of less intensity. Several studies have indicated that routine activity, whether as part of a job or as a leisure activity, is associated with reductions in the incidence of specific cancers, in particular colon and breast cancer. One recent study of colon and breast cancer revealed a 30-40% reduction in the relative risk of colon cancer in physically active men and women, and a 20-30% reduction in the relative risk of breast cancer in physically active women when compared to their inactive counterparts 2009 CMAJ. 2006;174(6):

Physical Activity Secondary Effects on Cancer
Regular physical activity - important. Increased self-reported physical activity = decreased reoccurrence of cancer and a decreased risk of death from cancer. Reduced cancer-related death. Regular physical activity may be associated with health benefits to patients with established cancer. Two recent studies involving cancer patients (breast and colon) indicated that increased self-reported physical activity was associated with a decreased reoccurrence of cancer and a decreased risk of death from cancer. Another investigation revealed a reduction of 26-40% in the relative risk of cancer-related death and recurrence of breast cancer among the most active women when compared to the least active 2009 CMAJ. 2006;174(6):

Physical Activity Primary Effects on Osteoporosis
Many studies have been conducted. According to findings, routine physical activity, especially weight-bearing and impact exercise, prevents bone loss associated with aging. Several longitudinal studies have examined the effects of exercise training on bone health in children, adolescents and young, middle-aged, and older adults. Although the numbers of studies and total participants are small when compared to studies found in the cardiovascular literature, the results are rather compelling and they indicate that routine physical activity, especially weight-bearing and impact exercise, prevents bone loss associated with aging. 2009 CMAJ. 2006;174(6):

Physical Activity Secondary Effects on Osteoporosis
Regular physical activity can lead to stronger bones. Bone responds to physical stress at any age; even in the elderly. Preliminary evidence suggests that regular physical activity is an effective secondary prevention strategy for the maintenance of bone health and the fight against osteoporosis. Two studies, one on older women ages and another on early postmenopausal women, have supported this finding. Osteoporosis 2009 CMAJ. 2006;174(6):

Eating for Weight Loss

The Critical Role of Healthy Eating
Good nutrition leads to a healthier life. Many do not eat based on MyPyramid recommendations. Research shows that good nutrition lowers one’s risk for many chronic diseases, including heart disease, stroke, some types of cancer, diabetes, and osteoporosis. Although Americans are slowly adopting healthier diets, there still remains a large gap between recommended dietary patterns and what Americans actually eat. 2009 CDC

U.S. Eating Habits In 2000, the larger majority of U.S. adults
reported that they did not consume 5 or more servings of fruits and vegetables/day. 81% 77% 73% According to a study by CDC, In 2000, the larger majority of U.S. adults reported that they did not consume 5 or more servings of fruits and vegetables/day. 2009 CDC. Behavioral Risk Factor Surveillance System

Dietary Guidelines for Americans, 2005 Tips for Healthy Eating
MyPyramid, which is the newest Food Guide Pyramid, recommends the following for a healthy lifestyle: Make half your grains whole Vary your veggies Focus on fruit Get your calcium rich foods Go lean with protein Find your balance between food and physical activity MyPyramid, which is the newest Food Guide Pyramid, recommends the following for a healthy lifestyle: Make half your grains whole Vary your veggies Focus on fruit Get your calcium rich foods Go lean with protein Find your balance between food and physical activity 2009 MyPyramid:

A Healthy Diet The 2005 Dietary Guidelines for Americans defines a healthy diet as one that: Emphasizes fruits, vegetables, whole grains, fat-free or low-fat milk, & milk products; Includes lean meats, poultry, fish, beans, eggs, and nuts Is low in saturated fats, trans fats, cholesterol, salt (sodium), and added sugars. The Dietary Guidelines for Americans (2005) recommends that we eat more whole grains, more fruits and vegetables and less sugar and fat. 2009 MyPyramid:

Dietary Guidelines for Americans, 2005 Key Recommendations for the General Population
1. Adequate Nutrients Within Calorie Needs Consume a variety of nutrient-dense foods (whole grains, fruits and vegetables, lean meats, low-fat dairy) and beverages within and among the basic food groups while choosing foods that limit the intake of saturated fats and trans fats, cholesterol, added sugars, salt, and alcohol. Meet recommended intakes within energy needs by adopting a balanced eating pattern, such as the USDA Food Guide or the Dietary Approaches to Stop Hypertension (DASH) Eating Plan. Dietary Guidelines for Americans, 2005 Key Recommendations for the General Population Adequate Nutrients Within Calorie Needs Consume a variety of nutrient-dense foods (whole grains, fruits and vegetables, lean meats, low-fat dairy) and beverages within and among the basic food groups while choosing foods that limit the intake of saturated fats and trans fats, cholesterol, added sugars, salt, and alcohol. Meet recommended intakes within energy needs by adopting a balanced eating pattern, such as the USDA Food Guide or the Dietary Approaches to Stop Hypertension (DASH) Eating Plan. 2009 MyPyramid:

2. Weight Management To maintain body weight in a healthy range, balance calories from foods and beverages with calories expended. To prevent gradual weight gain over time, make small decreases in food and beverage calories and increase physical activity. Dietary Guidelines for Americans, 2005 Key Recommendations for the General Population Weight Management To maintain body weight in a healthy range, balance calories from foods and beverages with calories expended. To prevent gradual weight gain over time, make small decreases in food and beverage calories and increase physical activity. 2009 MyPyramid:

3. Physical activity Engage in regular physical activity and reduce sedentary activities to promote health, psychological well-being, and a healthy body weight. Achieve physical fitness by including cardiovascular conditioning, stretching exercises for flexibility, and resistance exercises for muscle strength and endurance. Dietary Guidelines for Americans, 2005 Key Recommendations for the General Population Physical activity Engage in regular physical activity and reduce sedentary activities to promote health, psychological well-being, and a healthy body weight. Achieve physical fitness by including cardiovascular conditioning, stretching exercises for flexibility, and resistance exercises for muscle strength and endurance. 2009 MyPyramid:

4. Food Groups to Encourage Consume a sufficient amount of fruits and vegetables while staying within energy needs. Choose a variety of fruits and vegetables each day. Select from all five vegetable subgroups (dark green, orange, legumes, starchy vegetables, and other vegetables) several times a week. Consume 3 or more ounce-equivalents of whole-grain products per day, with the rest of the recommended grains coming from enriched or whole-grain products. At least half the grains should come from whole grains. Consume 3 cups per day of fat-free or low-fat milk or equivalent milk products. Dietary Guidelines for Americans, 2005 Key Recommendations for the General Population Food Groups to Encourage Consume a sufficient amount of fruits and vegetables while staying within energy needs. Choose a variety of fruits and vegetables each day. Select from all five vegetable subgroups (dark green, orange, legumes, starchy vegetables, and other vegetables) several times a week. Consume 3 or more ounce-equivalents of whole-grain products per day, with the rest of the recommended grains coming from enriched or whole-grain products. At least half the grains should come from whole grains. Consume 3 cups per day of fat-free or low-fat milk or equivalent milk products. 2009 MyPyramid:

5. Fats Keep total fat intake between percent of calories (With most fats coming from sources of polyunsaturated and monounsaturated fatty acids, such as fish, nuts, and vegetable oils). Limit intake of fats and oils high in saturated and/or trans fatty acids, and choose products low in such fats and oils. Consume less than 10 percent of calories from saturated fatty acids Consume less than 300 mg/day of cholesterol Keep trans fatty acid consumption as low as possible When selecting and preparing meat, poultry, dry beans, and milk or milk products, make choices that are lean, low-fat, or fat-free. Dietary Guidelines for Americans, 2005 Key Recommendations for the General Population Fats Keep total fat intake between percent of calories (With most fats coming from sources of polyunsaturated and monounsaturated fatty acids, such as fish, nuts, and vegetable oils). Limit intake of fats and oils high in saturated and/or trans fatty acids, and choose products low in such fats and oils. Consume less than 10 percent of calories from saturated fatty acids Consume less than 300 mg/day of cholesterol Keep trans fatty acid consumption as low as possible When selecting and preparing meat, poultry, dry beans, and milk or milk products, make choices that are lean, low-fat, or fat-free 2009 MyPyramid:

6. Carbohydrates Choose fiber-rich fruits, vegetables, and whole grains often. Choose and prepare foods and beverages with little added sugars or caloric sweeteners. Reduce the incidence of dental caries by practicing good oral hygiene and consuming sugar- and starch-containing foods and beverages less frequently. 7. Sodium and Potassium Consume less than 2,300 mg (approximately 1 teaspoon of salt) of sodium per day. Choose and prepare foods with little salt. At the same time, consume potassium-rich foods, such as fruits and vegetables. Dietary Guidelines for Americans, 2005 Key Recommendations for the General Population Carbohydrates Choose fiber-rich fruits, vegetables, and whole grains often. Choose and prepare foods and beverages with little added sugars or caloric sweeteners. Reduce the incidence of dental caries by practicing good oral hygiene and consuming sugar- and starch-containing foods and beverages less frequently. 7. Sodium and Potassium Consume less than 2,300 mg (approximately 1 teaspoon of salt) of sodium per day. Choose and prepare foods with little salt. At the same time, consume potassium-rich foods, such as fruits and vegetables. 2009 MyPyramid:

8. Alcoholic Beverages Those who choose to drink alcoholic beverages should do so sensibly and in moderation (≤ 1 drink for women/day and ≤ 2 drinks for men/day). Alcoholic beverages should be avoided by individuals engaging in activities that require attention, skill, or coordination, such as driving or operating machinery. Alcoholic beverages should not be consumed by some individuals, including: those who cannot restrict their alcohol intake, women of childbearing age who may become pregnant, pregnant and lactating women, children and adolescents, individuals taking medications that can interact with alcohol, and those with specific medical conditions. Dietary Guidelines for Americans, 2005 Key Recommendations for the General Population Alcoholic Beverages Those who choose to drink alcoholic beverages should do so sensibly and in moderation (≤ 1 drink for women/day and ≤ 2 drinks for men/day). Alcoholic beverages should be avoided by individuals engaging in activities that require attention, skill, or coordination, such as driving or operating machinery. Alcoholic beverages should not be consumed by some individuals, including: those who cannot restrict their alcohol intake, women of childbearing age who may become pregnant, pregnant and lactating women, children and adolescents, individuals taking medications that can interact with alcohol, and those with specific medical conditions. 2009 MyPyramid:

9. Food Safety To avoid microbial food borne illness: Clean hands, food contact surfaces, fruits, and vegetables Meat and poultry should not be washed or rinsed. Separate raw, cooked, and ready-to-eat foods while shopping, preparing, or storing foods. Cook foods to a safe temperature to kill microorganisms. Chill (refrigerate) perishable food promptly and defrost foods properly. Avoid raw (unpasteurized) milk or any products made from unpasteurized milk, raw or partially cooked eggs or foods containing raw eggs, raw or undercooked meat and poultry, unpasteurized juices, and raw sprouts. Dietary Guidelines for Americans, 2005 Key Recommendations for the General Population Food Safety To avoid microbial food borne illness: Clean hands, food contact surfaces, and fruits and vegetables. Meat and poultry should not be washed or rinsed. Separate raw, cooked, and ready-to-eat foods while shopping, preparing, or storing foods. Cook foods to a safe temperature to kill microorganisms. Chill (refrigerate) perishable food promptly and defrost foods properly. Avoid raw (unpasteurized) milk or any products made from unpasteurized milk, raw or partially cooked eggs or foods containing raw eggs, raw or undercooked meat and poultry, unpasteurized juices, and raw sprouts. 2009 MyPyramid:

Goals for Weight Management of Weight Lost
Weight loss: Goals for Weight Management of Weight Lost To follow a sensible weight loss plan includes both a slow weight loss due to dietary changes and an adoption of a physical activity program that can be maintained in the long term.

Calorie Deficit Needed For Weight Loss
A calorie deficit of no more than 500 kcal/day. This can be achievable through the combination of diet + exercise. An example of how to create a calorie deficit of 500 kcal/day through diet + exercise would be: eating 250 kcal less per day, along with burning 250 calories through exercise A calorie deficit of 500 kcal/day generally results in approximately 1 lb lost/ week. This can be achievable through dieting alone (eating 500 less kcal/day). However, the deficit is easier to achieve through the combination of diet + exercise. An example of how to create a calorie deficit of 500 kcal/day through diet + exercise would be: eating 250 kcal less per day, along with burning 250 calories through exercise 2009 ACS

Calorie Deficit Needed For Weight Loss
A caloric deficit of 500 can be done by: Eating 250 kcal less per day: Leave out mayonnaise in a sandwich Leave out dessert Switch from soft drinks to water Reduce portion sizes burning 250 calories through exercise: Walk for 30 minutes Swimming 25 yards Bicycling for 30 minutes 2009

Exercise + Dieting Calorie Deficit
Initially physical activity, in combination with dieting, is an important component of weight loss. However, after around 6 months, physical activity will not lead to substantially greater weight losses when combined with dieting. The benefit of sustained physical activity thereafter is mainly through its role in the prevention of weight gain. In addition, it has a benefit in reducing cardiovascular and diabetes risks beyond that produced by weight gain alone. Initially (during the first 6 months) physical activity, in combination with dieting, is an important component of weight loss. However, after around 6 months, physical activity will not lead to substantially greater weight losses when combined with dieting. The benefit of sustained physical activity thereafter is mainly through its role in the prevention of weight gain. In addition, it has a benefit in reducing cardiovascular and diabetes risks beyond that produced by weight gain alone. 2009 NHLBI

Goals for Weight Loss And Management
The initial goal of weight loss therapy is to reduce body weight by approximately 10 percent from baseline Once this goal is achieved, then further weight loss can be attempted, if necessary. A reasonable time line for a 10 percent reduction in body weight is 6 months. Experience reveals that lost weight is usually regained unless a weight maintenance program, consisting of diet therapy, physical activity and behavior therapy, is continued indefinitely. The initial goal of weight loss therapy is to reduce body weight by approximately 10 percent from baseline. Once this goal is achieved, then further weight loss can be attempted, if necessary. A reasonable time line for a 10 percent reduction in body weight is 6 months. Experience reveals that lost weight is usually regained unless a weight maintenance program, consisting of diet therapy, physical activity and behavior therapy, is continued indefinitely. 2009 NHLBI

For overweight individuals with BMIs in the typical range of 27 to 35 kg/m2, a decrease of 300 to 500 kcal/day will result in weight losses of about ½ to 1 lb per week. A 10 percent weight loss could be achieved within 6 months. For more severely obese individuals (BMI > 35), deficits of up to 500 to 1,000 kcal/day will lead to weight losses of about 1 to 2 lb per week. For overweight individuals with BMIs in the typical range of 27 to 35 kg/m2, a decrease of 300 to 500 kcal/day will result in weight losses of about ½ to 1 lb per week. A 10 percent weight loss could be achieved within 6 months. For more severely obese individuals (BMI > 35), deficits of up to 500 to 1,000 kcal/day will lead to weight losses of about 1 to 2 lb per week. 2009 NHLBI

After 6 months of weight loss treatment, the individual should be assessed. If no further weight loss is needed, then the current weight should be maintained. Sustained physical activity is particularly important in the prevention of weight regain. If further weight loss is desired, another attempt at weight reduction can be made. After 6 months of weight loss treatment, the individual should be assessed. If no further weight loss is needed, then the current weight should be maintained. Sustained physical activity is particularly important in the prevention of weight regain. If further weight loss is desired, another attempt at weight reduction can be made. 2009

Pennington Biomedical Research Center
Division of Education Phillip Brantley, PhD, Director Pennington Biomedical Research Center Claude Bouchard, PhD, Executive Director Heli J Roy, PhD, RD, Associate Professor Beth Kalicki Edited :October 2009 2009

About Our Company The Pennington Biomedical Research Center is a world-renowned nutrition research center. Mission: To promote healthier lives through research and education in nutrition and preventive medicine. The Pennington Center has several research areas, including: Clinical Obesity Research Experimental Obesity Functional Foods Health and Performance Enhancement Nutrition and Chronic Diseases Nutrition and the Brain Dementia, Alzheimer’s and healthy aging Diet, exercise, weight loss and weight loss maintenance The research fostered in these areas can have a profound impact on healthy living and on the prevention of common chronic diseases, such as heart disease, cancer, diabetes, hypertension and osteoporosis. The Division of Education provides education and information to the scientific community and the public about research findings, training programs and research areas, and coordinates educational events for the public on various health issues. We invite people of all ages and backgrounds to participate in the exciting research studies being conducted at the Pennington Center in Baton Rouge, Louisiana. If you would like to take part, visit the clinical trials web page at or call (225) 2009

References Centers for Disease Control and Prevention (CDC): Prevalence of Overweight and Obesity Among Adults: U.S., Available at: Womenshealth.gov. Physical Activity. Available at: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Do You Know the Health Risks of Being Overweight? Available at: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Statistics Related to Overweight and Obesity. Available at: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Weight and Waist Measurement: Tools for Adults. Available at: 2009

References Bellanger T, Bray G. Obesity related morbidity and mortality. J La State Med Soc. 2005; 156: S43-49. National Heart, Lung, and Blood Institute (NHLBI). Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. Available at: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Choosing a Safe and Successful Weight-loss Program. Available at: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Weight Loss for Life. Available at: Warburton D, Nicol C, Bredin S. Health benefits of physical activity: the evidence. 2006; CMAJ; 174(6): 2009

References Dietary Guidelines for Americans Available at: American Heart Association (AHA). Physical Activity Calorie Use Chart. Available at: American Cancer Society (ACS). Exercise Counts. How Many Calories Will Your Activity Burn? Available at: Mayo Clinic. Exercise: When To Check With Your Doctor First. Available at: 2009

Obesity Diet and Physical Activity

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