3/10/2015
“Working in the Trenches”
…..ideas when addressing ordinary people about weight loss
and lifestyle habits
Karen Massey RD/LD
INTEGRIS-Health
Community Wellness
Oklahoma Statistics
Presentation Objectives:
1. Appreciate and recognize how pervasive
nutrition misinformation affects lifestyle
choices and behaviors.
2. Effectively translate the science of nutrition
(i.e. energy balance) into practical and appropriate
recommendations that resonate with
clients/patients.
When consumer perception clashes with science….
“Weight control is a
life long venture.”
Obese Oklahoma: Without action, more
Oklahomans will die from preventable
diseases
Reliable information often co-mingled with
Fraudulent &/or Unrealistic Claims
The Energy Equation
Calories = Energy
Food is our fuel. The human “engine” burns food for fuel to give us the energy we need to
move about and maintain body functions. We measure food (or fuel) in an energy unit called,
calories. How many calories a person requires depends on several factors. People who
engage in lots of physical activity need more food (calories) than people who sit.
Weight Control and Energy Balance
If we eat the same number of calories as we burn—body weight stays the same. If we eat
more calories that we burn—our body stores the “surplus” in the form of body fat. The reverse
is also true—if we eat fewer calories than we actually need, the body will withdraw energy
(calories) from body fat stores.
# body fat = 3,500 calories
How fast can I lose weight?
'Natural Cures' Author Kevin
Trudeau Sentenced to 10
Years Prison
Realistically, most people should strive for about 1/2 # - 2 # ↓ /week.
(= 3,500 ÷ 7 days/week = 500)
To lose 1# per week, a calorie “deficit” of 500 calories/day must be created. There
are only 2 ways to create a calories deficit:
Eat Less –
Move More –
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3/10/2015
National Weight Control Registry
Weight Loss is Complicated
• Different strokes for different folks. Having a “one-size-fitsall” approach is doomed to fail.
• “Energy Balance” is always in a state of flux.
• The “energy equation” only works in the face of activity…even
if expenditure is only adding a small deficit.
• Many factors affect food choices…proximity, emotions,
experiences, perceptions, attitudes.
People (like puppies) come in different Shapes &
Sizes
http://www.nwcr.ws/
Attention Doomsayers: It is possible to lose weight!
Losing weight is one thing. Keeping it off is another.
•
There are over 10,000 people who have done it!
National Weight Control Registry (NWCR)
To be listed on the registry, participants have to:
• lose at least 30 pounds
• keep it off for at least 3 years
For the record, many have lost a lot more than 30 pounds, and have been hanging in
there a lot longer than 3 years. The amount lost ranges from 30 to 300 pounds, and
there are those who have remained successful losers for over 66 years!
What’s their secret?
90%
78%
75%
62%
Exercise (on average—about 1 hour a day)
Eat breakfast every day.
Monitor weight (on average, they weigh themselves a least once a week)
Limit TV time to less than 10 hours a week! (that’s less than 1 ½ hrs/day)
Should losing weight be a competition?
Competitions can be inspiring and motivating. However, there are those who question the
notion of pitting one individual against another in the name of weight loss. Fair or unfair;
there are a number of factors that influence the odds of winning (or losing). The very fact
that certain inherited traits can “make” or “break” any individual is why it’s almost
impossible to come up with a set of rules that would levy an equitable contest for all.
5 Traits Favoring Weight Loss:
• Stocky Muscular Body (Mesomorph)
• Long Lanky Limbs (Ectomorph)
• Soft & Squishy (Endomorph)
1.
2.
3.
4.
5.
Being Tall. A 7-foot tall person needs more food than someone 5-feet tall.
Youth. Younger people need more calories than older people.
Gender. Sorry ladies, weight loss contests favor men.
Body Composition. A (partly) inherited trait.
Weight. Heavier people (like tall people) require and expend proportionally more
energy.
•
•
Why compete?
Is it fair that a (high-risk) contestant might glean more health benefits (by losing only a
few pounds) than the contest winner?
Wouldn’t it make more sense to encourage positive lifestyle habits for everyone
regardless of shape, size, age, weight?
Don’t “skinny” people need to eat well and exercise too?
Questions to Ponder:
•
•
What should I count? ……. fat grams? carbs? calories?
Ordinary People “hit the wall”
Counting Calories is Easy and Effective
•
The most direct way to address body weight is to focus on calories.
•
It’s easier because there’s only one number to tally.
•
It’s effective because when you count calories you are, in fact, counting all the sources of calories
simultaneously—fat, carbohydrate, protein and alcohol.
•
Counting total calories is efficient because you’re rolling them all into one list instead of trying to
add each one separately.
Carb-depletion doesn’t just happen to elites.
Mere mortals can also “bonk” or “hit the
wall” if they over-restrict carbohydrate.
Counting Calories is Deeply Personal—it meets you where you’re at.
Food preferences are acquired over the years, and are highly influenced by our
surroundings, family, friends, mood and taste perceptions. No one gains excess body
weight by eating foods they don’t like. For those who gain their excess body weight
by overeating rib-eyes, bacon and cheese—going on a “low-carb” diet won’t help
much. People who gain weight by eating too much bread, pasta and sweets aren’t
likely to do well on a “low-fat” diet since many high-carb foods are already low in fat.
A beer drinker isn’t going to lose his beer belly unless he addresses his beer calories.
And, (obviously) going on a beer-free diet isn’t going to help someone who doesn’t
drink beer. Counting calories cuts to the chase—it’s the straightest path to achieving
personal goals. Every person is unique. It meets you where you’re at.
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Carbohydrate is the preferred fuel for ordinary exercisers too
• A well-nourished adult can store
approximately 500 grams of carbohydrate
as glycogen
“I’m back on track”
….working out, cut out
the bread, sugar, carbs”
• Of this, approximately 400 grams are stored
as muscle glycogen
• 90-110 grams as liver glycogen
• ˂25 grams circulate in the blood as glucose
• RDI for Carbohydrate (min) = 130g
Crunching the numbers………………...
500 g CHO X 4g H20/g = 2000 g
2000 g ÷ 28 g/oz = 71.4 oz
71.4 oz ÷ 16 oz/# = 4.46 #
In other words, body weight can
“appear” to be reduced by ~ 4-5
pounds by restricting carbohydrate.
Spot Reducing Myth
There is no such thing as spot reducing.
When it comes to myths and misinformation—rumors about the “abs”
(abdominal muscles) seem to flourish! There are all sorts of “miracle” gadgets
and devices purported to transform soft bellies into a six-pack physique.
Recommendations for strength-training the abs are the same as for training
any other muscle group. Strength train abs 2-3 times per week, on
nonconsecutive days doing 1-3 sets.
Visceral Fat
The abdominal muscles are a flat “wall” of muscular tissue that covers the
internal organs. Body fat can accumulate on top or underneath this muscle
wall. The fat that accumulates underneath the abs is known as “visceral fat.”
Visceral fat cannot be “pinched” because it is underneath the abdominal wall,
but can (indirectly) be measured with a measuring tape. Having a waist >35inches for women or >40-inches in men is associated with increased health
risks.
Subcutaneous Fat
In contrast, the fat that accumulates on top of the abdominal wall and can be
“pinched,” is often referred to as having “love-handles” or a “muffin top.”
Exercising the ab muscles (underneath) will not shrink the fat on top of them.
You might have strong abs, but the fat on top will still be there. To lose belly
fat—a caloric deficit must be created. There are only 2 ways to create a caloric
deficit—eat less and/or move more. Contrary to popular belief--doing 1000
sit-ups will NOT “spot reduce” belly fat.
#1 Reason given for not exercising:
TIME
QUESTION:
ANSWER:
1. How much physical activity
is recommended for
health?
2. How many hours, on
average, are spent
watching TV?
3. How many minutes of
commercial advertising in
1 hour of prime time TV?
1. 150 Minutes moderate
physical activity/week
(= 20 minutes per day)
2. 3.4 hours
3. 21 minutes
TMI or GTK?
What to do with Information Technology
• Keeping track is one of the most powerful tools for making
lifestyle changes.
• It’s easier to keep track than it has ever been! Information is
literally at our fingertips. If you google, “calories in a
banana”—you’ll get 18, 200, 000 results in .35 seconds.
• Knowing that that cheeseburger (you just ate) has 850 calories
is shocking, but it has 850 calories whether you know it or
not…knowing is better.
• Everyone who’s ever kept a food record will experience an
“oh-oh” moment. Ultimately, it’s empowering.
Working in the Trenches”
…..ideas when addressing ordinary people about
weight loss and lifestyle habits
• Ask questions. Seek to understand. What’s
“driving” food and activity decisions?
• Gather information. Use food records or tracking
devices as tools for understanding.
• Work together. Meet client where they are at.
• Listen for clues. Ask client for their “take”.
• Use expertise wisely—provide appropriate
information in timely manor.
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