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 Health risks if overweight and overfat Huge health issue in US (see page 280)

Increasing Prevalence of Obesity (BMI >30) among U.S. Adults _ 1991: Only four states had obesity rates greater than 15 percent. Key: <10% No Data 10%–14% 15%–19% 20%–24% >25% _ 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 Prevalence - 2004 9 states > 25% population obese

Evaluating Weight/Health Status Compare weight to standard height-weight tables Tables are of limited value and use

Evaluating Weight/Health Status Body Mass Index (BMI) Preferred measure for evaluating weight Based on significant amount of research

BMI

BMI Figures Men Women 19.8 18.8 21.1 19.3 22.2 20.9 23.6 23.1 25.8 26.2 28.1 29.9 31.5 34.3 35.2 38.6 41.5 45.4

* Increased health risks, see pg 262/263 BMI Weight/health Less than 18.5 Underweight* 18.5 - 24.9 Healthy 25 - 29.9 Overweight* 30 -39.9 Obese* Over 40 Extreme obesity* * Increased health risks, see pg 262/263

Health Risks and Weight 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 > 40 Extreme Underweight < 18.5 Increased, may be significant

BMI BMI is not a good measure for evaluating a body builder/serious athlete’s weight/health Low end is an appropriate measure of being underweight for all

BMI Calculating BMI BMI = weight in pounds x 703 (height, inches)2

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

Calculating BMI BMI = weight in pounds x 703 (height, inches)2 Weight, lbs = desired BMI x (height, inches)2 703

BMI Figures Men Women 19.8 18.8 21.1 19.3 22.2 20.9 23.6 23.1 25.8 26.2 28.1 29.9 31.5 34.3 35.2 38.6 41.5 45.4

BMI

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

Body Fat 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 Health risks increase when: Males: % body fat > 22 – 25 % Females: % body fat > 32 – 35 % Higher number is for those 40 and over.

Measuring % Body Fat % body fat is difficult to measure accurately Common methods for measuring: Fat fold measures with calipers Bioelectric impedance Underwater weighing MRI

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

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 > 40 Extreme Underweight < 18.5 Increased, may be significant

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

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 maintain their weight? Individuals with a healthy BMI should maintain their current weight. Individuals who are overweight, do not have a high waist circumference, and have less than 2 risk factors should prevent further weight gain

Who should gain 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

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

Strategies for Weight Loss 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 Avoid fad diets and weight loss supplements Avoid very low calorie diets Never less than 1200 kcal per day Why??

Strategies for Weight Loss Increase level of physical activity 30-45 minutes, 3-5 days a week Add weight bearing exercise to build muscle Why?

Adding Physical Activity

Strategies for Weight Loss Reduce portion size Increase intake of fiber (why?) More fruits and veggies More whole grain products Limit empty calories Soda, alcohol, candy…..

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 Others????

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 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 …..