Eating for health vs. to lose weight Family support and involvement Setting SMART goals

1. Eating for health vs. to lose weight • Family support and involvement • Setting SMART goals

2. Energy Balance more less Body Weight Ein Eout PA RMR Food Drink Ein = Eout

3. Weight Gain more less PA RMR Food Drink Body Weight Ein Eout Ein > Eout

4. Weight Loss more less PA RMR Food Drink Body Weight Ein Eout Ein < Eout

5. Can someone eat a 100% fat diet and lose weight?

6. more less 700kcals ~1500kcals 5 Pepsi’s PA RMR RMR and very light activity for 130 lb woman Food Drink Body Weight Ein Eout Ein < Eout

7. Kim (39 years old) after her Oprah Show make-over

8. more less E for PA increases by 500 kcals/d E intake increases by 800 kcals/d PA RMR Food Drink Body Weight Ein Eout “I am training for a marathon, so why am I gaining weight?” Ein > Eout

9. more less RMR lower than average 1,100 vs. 1,300 Average energy intake PA RMR Food Drink Body Weight Ein Eout “My metabolism is slow.”

10. Successful weight losers National Weight Control Registry http://www.nwcr.ws/ • To be on the list • have lost 30+ lbs, kept it off >1 yr • Who are they? • actual wt lost: >60lbs; maintained new wt: >5yrs • middle aged; most overweight / obese as children • most had at least 1 overweight / obese parent

11. NWCR What did they do? • Weight loss: no one “magical” way to lose wt. • Weight maintenance • small changes in diet • many areas = add up to a lot • sustainable throughout life • low-fat diet (~24% of E as fat) • activity – more than 1 hour / day (2X recommended) • self-monitoring

12. Are wt loss programs, books, “diets” BAD?

13. Do we burn more calories digesting celery than it provides? 1 celery stalk = 6 calories How many calories do we save if we snack on celery instead of Wheat Thins? Wheat Thins: 1 serv. (16 crackers) = 140 cals

14. What kind of diet is best for weight management? • Kennedy, ET, et al. Popular diets: correlation to health, nutrition, and obesity. J Am Diet Assoc 2001;101:411-420 • Continuing Survey of Food Intake by Individuals (1994-1996) • 10,000+ adults (19ys old+) Authors’ review of the literature “ Is there an optimal diet for weight loss? … any diet that reduces energy intake leads to weight loss. … Weight loss is independent of macronutrient composition.”

15. What type of diet is best for weight maintenance? • Lowest BMI • vegetarian • high CHO/low fat • high CHO Pyramid • Nutrient profile • Best: high CHO Pyramid • Worst: low CHO diet

16. But, what about evil carbs?! “There remains no consensus about the optimal dietary composition for sustained weight loss.” Das, et al. Am J Clin Nutr. 2007 Apr;85(4):1023-30 “…weight loss [on] low-CHO diets was [due to] decreased calorie intake and increased diet duration, but not to reduced CHO content.” Efficacy and safety of low-carbohydrate diets: a systemic review. DM Bravata, et al. JAMA 289(14):1837;2003

17. http://www.drphil.com/ • McGraw's 7 Keys • understand, face your "personal truth"--what you think about yourself and your weight --and replace toxic messages with positive thoughts • learn to counter emotional eating • change your environment • master impulse eating • choose foods • adopt an exercise habit • assemble a support circle • … plan emphasizes foods with high nutritional yields for few calories, and that cannot be eaten quickly (generally because they're high in fiber), so you're less likely to overeat.

18. Good sources for healthy food choices

19. Guidance on weight loss

20. Eating for health vs. to lose weight • Family support and involvement • Setting SMART goals • Step 1 – think specifically about your diet • Step 2 – goals worksheet on CWR site