The Weight Debate Continues

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The Weight DebateContinues
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The Obesity Epidemic

• Sixty percent of American adults are overweight
• Over thirty percent are obese
• CDC reports the nation is spending 93 billion on
  weight related diseases
• Health consequences include hypertension,
  hyperlipidemia, hyperinsulinemia, osteoarthritis,
  increased risk of some forms of cancer,
  nonalcoholic fatty liver disease, heart disease,
  reflux, sleep apnea, respiratory problems,
  gallbladder disease and stroke
• 80 of obese adults have at least one of these
  conditions
• Results in decreased quality of life, shorter
  lifespan

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Economic Cost of Obesity

• time off for sick days and doctors appointments
• Higher food and medication bills
• More gas used

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Why is it so hard to lose weight?

• Preventing weight loss is a biological need for
  survival

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Body systems will fight to maintain weight

• Ingestion of food sends neural messages and
  hormones to the brain which signals satiety
  regulating meal size and energy balance

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Leptin

• Leptin is a hormone made by fat cells that
  suppresses appetite and signals us to stop eating
  when fat stores are full
• Leptin resistance is common in obese people
  meaning their brain does not register satiety
• Low leptin and insulin levels in the brain during
  weight loss stimulate eating and suppress energy
  expenditure

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Ghrelin

• Ghrelin is a hormone produced in the stomach, the
  levels of which rise when hungry and decline
  after meals
• In a 2002 study in which subjects lost 17 of
  body weight, ghrelin output rose 25
• May 23,2002, New England Journal of Medicine
• Dieters who lose weight make more ghrelin than
  they did before dieting as if the body is trying
  to regain lost fat

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Pre-breakfast levels of leptin were 20 lower in
men who slept only 4 hours as compared to a night
they slept nine hours.

• Their ghrelin levels were elevated by more than
  25 during their day and they ate more crackers
  and sweets than when they were well rested.
• VanCauter, University of Chicago, November 2004,
• Journal of Clinical Endocrinology and Metabolism

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Research at BNL

• Identified brain circuits that lead to overeating
  in the obese
• These are the same pathways that cause cravings
  in addicted individuals

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On the Horizon

• Obestatin is a hormone discovered in late 2005
  found to decrease appetite
• Research scientists at Scripps have developed an
  anti-obesity vaccine which is directed at
  ghrelin. The vaccine binds to target sites
  preventing ghrelin from reaching the central
  nervous system leading to a reduction in weight
  gain.

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Battling Mother Nature

• Our bodies fight us to regain the lost weight
• Biological and physiological mechanisms defend
  extra fat and try to return the body to the
  weight it was
• Research shows that people who have lost weight
  are hungrier and not just for any food
• Weight loss signals the brain that you are
  starving and will slow metabolism
• Keep in mind that metabolic rate is linked to the
  amount of lean and muscle tissue you have
• The only way to counter this is to exercise more

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More Bumps in the Road

• Lipoprotein lipase, an enzyme that promotes fat
  storage, goes up in fat tissue when you lose
  weight so you tend to store fat rather than burn
  it
• The good news is that you wont gain weight
  unless you eat more

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The Weight Equation

• Energy InEnergy Out
• A caloric deficit can be achieved by decreasing
  calorie intake, increasing energy expenditure or
  both

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Strategies for Weight Loss and Weight Maintenance
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National Weight Control Registry Members

• Consume approximately 1400 calories about 24 of
  those calories from fat
• Expend about 400 calories each day in physical
  activity

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Why This Works

• Low calorie diets can reduce body weight by an
  average of 8 while reducing abdominal fat
• When weight loss occurs, the loss is about 75
  from fat and 25 from lean tissue
• Consuming fewer than 800 calories/day may lead to
  nutrient deficiencies, produce same weight loss
  after a year as LCDs but with more regained, does
  not lead to behavior changes, increase risk of
  developing gallstones

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The Volumetrics Eating Plan

• Latest research by Barbara Rolls at Penn State
  University
• Based on studies of portion size, fat content and
  calorie density
• Key to hunger control while losing or maintaining
  weight is satiety
• High water content lowers calorie density giving
  you a larger portion for the same number of
  calories

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• Several supporting studies have shown that eating
  a broth type soup or low fat salad prior to the
  meal reduces calorie intake for the whole meal.
• Drinking water will not reduce hunger. The water
  has to be in the food.
• Along with the water, the fiber in fruits and
  vegetables helps you feel fuller and has been
  shown to reduce calorie intake

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Do beverages help with weight loss?

• They are low density
• Hunger and thirst are regulated by separate
  mechanisms
• 150 calories from 12 ounces of soda, milk, orange
  juice consumed before a meal were found to raise
  total calorie consumption in that meal by 104
  calories
• No adjustment is usually made in food intake to
  adjust for the calories from beverages

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Very Low Calorie Density

• Cucumber
• Celery
• Chicken broth
• Lettuce
• Tomato
• Asparagus
• Broccoli
• Grapefruit
• Strawberries
• Fat free Italian dressing

• Vegetable soup
• Watermelon
• Cantaloupe
• Winter squash
• Carrots
• Peaches
• Fat free, sugar free yogurt
• Apple
• Blueberries
• Orange

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Low Calorie Density

• Oatmeal made with water
• Low fat yogurt
• Grapes
• Chicken noodle soup
• Low fat cottage cheese
• Split pea soup
• Green peas
• Corn on the cob
• Banana
• Grapes

• Sweet potato
• Baked potato with skin
• Shrimp or scallops
• Flounder or sole
• Light ice cream
• Rice
• Pasta
• Tuna, packed in water
• Lean Ham

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It may not be what you are eating, but how much
that will make a difference.Portion size relates
to the energy in side of the equation.
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Overeat on carrots or cookies, you are going to
store the extra calories
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For an eye opening look at the change in portion
sizes in thepast twenty years go
tohttp//hp2010.nhlbihin.net/portion/index.htm
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In Barbara Rolls lab the researchers combined
the principles of calorie density and portion
control

• The calorie savings was an astounding 800
  calories a day

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Another perk, people ate healthier because they
were eating more fruits, vegetables and whole
grains and less saturated and trans fats
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Successful weight loss happens slowly over time

• A realistic goal is 1-2 of your body weight per
  month
• Gradual weight loss will also preserve your lean
  body tissue and decrease risk of damage to your
  gallbladder

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Without permanent change in food choices or
portion sizes, the weight is regained

• This is the phenomenon called yo-yo dieting

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Fad diets drastically reduce your usual calorie
intake causing quick weight loss.

• Your brain and hormones that control your body
  weight will fight to keep your body weight from
  changing drastically.
• This control will bring your body back to its
  set point

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Atkins

• Lack of carbs in diet cause loss of glycogen
  stores from muscles leading to water loss
• Looks like rapid weight loss but the water is
  replaced when returned to a balanced diet
  causing regain
• After one year approximately the same weight loss
  results from Atkins and other diets
• Questionable health consequences from long term
  low carbohydrate, high protein intake

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Weight Watchers Point System

• Focuses on low calorie foods, whole grains,
  fruits and vegetables, healthy fats, exercise
  encouraged
• Group meetings designed to motivate and encourage
• Participants tend to focus on weight loss instead
  of healthy eating
• Without individual counseling health problems may
  be overlooked
• Gradual weight regain if dieters stop counting
  points when goal is reached

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Jenny Craig

• Participants are encouraged to adopt an active
  lifestyle, eat three meals and two snacks per
  day, eat smaller portions, increase fruit and
  vegetable intake
• High membership fees, cost of Jenny Cuisine food
  plus self purchased fruits and vegetables

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The French Womans Diet

• Mireille Guiliano wrote about a healthy
  lifestyle, promoting exercise, eating slowly,
  smaller portions and eating fruits and vegetables
  in season
• Eat three meals per day eliminating problem foods
  identified by journaling
• Add problem foods back into diet in smaller
  portions, increase exercise and water intake
• Weigh and measure everything for a few weeks to
  retrain your eye to what a normal portion is
• Not designed for weight loss

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Sonoma Diet

• Use whole foods and eliminate processed foods,
  simple carbs and saturated fats
• Focus is on what to eat, food combining and
  portion size
• No measuring and weighing, participants
  encouraged to eat consciously, concentrating on
  flavor and satisfaction from the meal
• Plan gets high marks for health benefits
• Eliminating favored foods may set some up for
  failure

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Fat Flush Plan

• Low carb diet eliminates wheat and dairy as
  metabolism blockers and includes several
  diuretic beverages each day along with a
  gamma-linolenic acid supplement touted to help
  burn fat
• No evidence that metabolism-blocking foods exist
• Eliminating wheat and dairy eliminate essential
  nutrients as well

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Calorie Restriction

• Not a weight loss plan but a lifestyle shown in
  studies to slow aging and increase lifespan
• Participants have lower rates of heart disease
  and diabetes, lower BMI, lower bp
• Advocates consume 10-25 fewer calories than
  normal
• Extreme diet taking tremendous motivation, 50
  reported low moods or depression, not recommended
  for most people

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Studies suggest the most significant factor in
successful weight loss is sticking to it,
regardless of the method chosen

• Most diets with moderate restrictions hold up
  against lifestyle needs, food preferences,
  determination while the extremes do not

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Forget the hype and the fads

• Fad diets do not lead to permanent weight loss
• High protein low carbohydrate dieting will lead
  to quick but unsustainable weight loss
• No foods burn fat
• Natural or herbal weight loss products are not
  necessarily safe

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How totip the scales in your favor

• Engage in physical activity
• Eat a low calorie/low fat diet
• Choose carbohydrates that are high in fiber
• Eat breakfast daily

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• Stop eating in front of the television
• Maintain a consistent eating pattern and calorie
  intake
• Dont skip your evening snack
• Get enough protein
• Do not drink your calories
• Monitor your weight
• Sleep

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The Debate Continues

• Fast Food Industry
• Creation of the fitness industry
• 48 with health problems directly related to
  weight
• The next generation at risk

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Tried and True?

• No definitive method for weight reduction
• Most of the time, overweight is a result of too
  many calories and not enough physical activity
• Physiological changes we are born with or develop
  as a result of overweight make it difficult to
  lose weight
• Choose a calorie reduction plan and exercise
  program that fits your lifestyle and stick to it

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There is an opportunity for success in every bite
you take

• The next step is up to you

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Nutrisense Inc.Amy Shapiro RD, CDN

• 373 Route 111
• Smithtown New York 11787
• [phone]