Dietary Considerations in Obesity

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Dietary Considerations in Obesity

• Krista Chalifoux, BSc, RD
• Adult Weight Management Clinic and Bariatric
  Surgery Clinic
• Royal Alexandra Hospital
• Edmonton, Alberta
• CSCN Public Forum Winnipeg, MB
• May 31, 2007

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Outline

• Prevalence of Overweight and Obesity
• Healthy Weights and Measures
• BMI
• Waist Circumference
• 6 Steps to a Healthier You

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Prevalence of Overweight and Obesity

• 59 of the population is overweight (BMI gt25)
• 1 in 4 (23) is obese (BMI gt30)
• Estimates from Canadian Community Health Survey
  (2004)
• Obesity has become the most prevalent nutritional
  problem in the world
• beating undernutrition and infectious disease as
  the most significant contributor to ill health
  and mortality
• 2006 Canadian Clinical Practice Guidelines on
  the management and
• prevention of obesity in adults and Children
  CMAJ
• 2007176(8suppl)online 1 - 117

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Obesity Trends Among Canadian AdultsHPS, 1985
(BMI ? 30, or 30 lbs overweight for 54 adult)
Source Katzmarzyk PT. Can Med Assoc J
20021661039-1040.
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Obesity Trends Among Canadian AdultsCCHS, 2002
(BMI ? 30, or 30 lbs overweight for 54 adult)
Data from Statistics Canada.
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What is a Healthy Weight?

• Range of shapes and sizes
• Body Mass Index (BMI) is used along with waist
  circumference to assess risk of health problems
  due to excess weight

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Body Mass Index

• BMI weight (kg) / height (m)2
• Body mass index may not accurately predict health
  risk in
• Adults who are not finished growing
• Adults who naturally have a very lean or a very
  muscular build
• Certain racial and ethnic groups
• Adults over the age of 65

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Body Mass Index
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Figure pg 4 - pls scan
BMI 23
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Waist Circumference

• Waist circumference is a measure of the health
  risk associated with too much stomach fat.
• Increased risk of developing health problems such
  as type 2 diabetes, heart disease and high blood
  pressure.

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Waist Circumference

• Increased risk of health problems if waist
  circumference is larger than
• Men 40 inches or 102 cm
• Women 35 inches or 88 cm

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What can we do?

• Prevent further weight gain
• Achieve and maintain a healthy weight
• Prevent the development of chronic disease
  through healthy lifestyle changes
• How do we do this?

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6 STEPS to a Healthier YOU
1) Set goals 2) Achieve balance 3)
Watch portion sizes 4) Eat more vegetables
and fruit 5) Choose whole grains
6) Prepare healthy foods
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Step One Set Goals

• Making changes towards a healthy lifestyle is
  easier if you can make goals that are SMART
• Specific
• Measurable
• Achievable
• Rewarding
• Time Frame

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Why SMART Goals?

• Specific Determine what you are going to do
  and how
• Measurable So you can look at your
  progress
• Achievable Within your reach, not an
  impossible dream
• Rewarding Possible to complete and within
  your current ability
• Time Frame Allow enough time to reach
  your goal

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Goal Setting

• Pick ONE thing that you are ready to change this
  week and set a course of action
• Think about it
• Is this goal realistic for you?
• Can you add it to your lifestyle over the
  long-term?

Work towards your goals one step at a time
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Example Healthy Eating

• Goal? Eat 5 or more servings of vegetables
  and fruit each day for 1 week
• How to do it? Eat a piece of fruit at
  breakfast and
• afternoon snack
• Add 1- 2 servings of vegetables to
• lunch and supper
• How to measure it? Write down what you eat in a
  journal
• Reward? Plan next Friday night out at the
  comedy club with my best friend

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Track Your Progress

• Record your food intake and activity daily
• provide a realistic view of your routine and
  habits
• identify problem areas and triggers
• Keep tracking your progress
• Celebrate success

Many people underestimate food intake by 33 and
overestimate activity by 50
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Step Two Achieve Balance

• Achieve and maintain a healthy body weight
• Lower risk for health problems
• Feel your best

Healthy Eating
Active Living
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A Healthy Weight Loss Plan

• Lose 5 - 10 of current weight in 6 months
• Reduces the risk and aids in managing many
  chronic diseases
• Lose no more than 1-2 lbs per week
• Includes all four food groups
• Eating well with Canadas Food Guide

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Fad Diets How to Spot One

• Suggests it can change body chemistry or genetics
• Promotes quick weight loss
• Praises or bans specific food groups
• Defines foods as good or bad
• Requires purchase of product/supplement
• Research is case report or testimonial, often
  written in the first person

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Fad Diets The Promises

• Its not a diet, but a way of life
• The food is delicious, you wont be hungry
• Youre overweight because you ate the wrong food
  (not too much of it)
• Youll lose weight eating the right food
• The diet will prevent or treat most major
  diseases

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Fad Diets The Bottom Line

• Caloric Restriction will cause weight loss
• Short term weight loss is possible
• Restrictive fad diets are not sustainable over
  the long term
• so weight regain often occurs
• If a diet sounds to good to be true
• It probably is.

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Healthy Eating Pattern

• Start your day with a good breakfast!
• Breakfast skippers tend to overeat during the
  rest of the day.
• Eating healthy food throughout the day will
  provide your body with the energy it needs.
• People with 4 5 eating events per day are more
  likely to achieve and maintain a healthy body
  weight
• If your meals are more than 4 5 hours apart you
  may need a snack.
• Make it a fruit or a vegetable more often.

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Step Three Watch Portion Sizes

• How much you eat is as important as what you eat.
• Eating portion sizes of foods and beverages right
  for your body will help you
• Maintain or achieve a healthy weight
• Get the nutrients and energy that your body needs.

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Portion Distortion

• Over the years, portion sizes have changed quite
  significantly.
• Do you remember when

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Bagel
20 Years Ago Today
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Cheeseburger
20 Years Ago Today
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French Fries
20 Years Ago Today
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Turkey Sandwich
20 Years Ago Today
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• Provides specific targets for males and females
  for different age categories
• Each food group has a target number of servings
• Proper portion sizes for one serving are also
  specified

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Do You Drink Your Calories?
The calories we drinkwe dont often count!
1 tsp sugar 16 calories
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Step Four Eat More Vegetables and Fruit

• Naturally high in vitamins, minerals and fibre
• Low in calories
• Frozen or canned fruits and vegetables are just
  as healthy as fresh

Aim for at least 5 servings of vegetables and
fruit each day.
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Ideas to Add Fruits and Veggies

• Keep washed and sliced vegetables in the fridge
• Add fruit to breakfast cereal or yogurt
• Bake with fruit
• Make fruit smoothies
• Add frozen vegetables to spaghetti sauce, soups,
  casseroles and stews

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Step Five Choose Whole Grains

• Helps you to meet your fibre needs
• Makes you feel full with fewer calories
• Helps to stabilize blood sugar levels
• Helps to lower blood cholesterol
• Promotes regular bowel movements
• Aim for at least 25 grams of fibre per day
• Drink 9 - 12 cups of fluid

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Step Six Prepare Healthy Foods

• The 4 Ps
• Plan
• Purchase
• Prepare
• Pack

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Planning Healthy Meals

• Plan ahead for your meals
• Keep ingredients on hand for quick and healthy
  recipes
• Stock your cupboards with lower fat, higher fibre
  choices
• Fill your fridge with vegetables and fruit
  (cleaned and ready to eat)

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Purchase Healthy Foods

• Plan a menu for the week
• Make a grocery list
• Eat a healthy snack before you shop!
• Shop along the outside edge of thestore
• This is where you will find the four food groups
• Skip the snack food aisle if it is too tempting

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Prepare Healthy Foods

• Use low-fat cooking methods
• Choose lean cuts of meat and trim any visible fat
• Use lower-fat dairy products
• Bake, steam, barbeque, grill, sauté or stir-fry
  with broth or juice

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Pack a Healthy Lunch
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6 STEPS to a Healthier YOU
1) Set goals 2) Achieve balance 3)
Watch portion sizes 4) Eat more vegetables
and fruit 5) Choose whole
grains 6) Prepare healthy foods
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For More Information or Services

• Websites
• Dietitians of Canada www.dietitians.ca
• Health Canada www.healthcanada.ca
• Capital Health www.capitalhealth.ca

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Questions?