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FCSN 245 – Basic Nutrition Summer 2005 Episode III – Dr. David Gee

FCSN 245 – Basic Nutrition Summer 2005 Episode III – Dr. David Gee. Starting tomorrow, all lectures will be held in PE 201 Clicker points: attendance sheets Course web page www.cwu.edu/~geed Grades so far posted on bulletin board outside 136 Michaelsen.

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FCSN 245 – Basic Nutrition Summer 2005 Episode III – Dr. David Gee

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  1. FCSN 245 – Basic NutritionSummer 2005Episode III – Dr. David Gee • Starting tomorrow, all lectures will be held in PE 201 • Clicker points: attendance sheets • Course web page • www.cwu.edu/~geed • Grades so far posted on bulletin board outside 136 Michaelsen

  2. Healthy Weight and the Non-Diet Approach David L. Gee, PhD Professor of Food Science and Nutrition Central Washington University

  3. Prevalence of Overweight in the US • 1990: 56% of Americans were overweight • 23% were obese • 2000: 64% of Americans were overweight • 30% were obese • At this rate • In 2010: 73% overweight • In 2020: 84% overweight • In 2030: 96% overweight • Increases in overweight/obesity were seen in: • Both males and females • All age groups • All ethnic groups

  4. Ethnicity and Overweight (BMI>27.5) Prevalence

  5. Prevalence of overweight in children. • CDC (2004) • Overweight = above the 95th percentile for BMI based on NHANES II data from 1970’s • For adolescents 12-19 yrs: • 1974 = 7.4% • 2002 = 15.6%

  6. Prevalence of Overweight Children in the US

  7. Epidemic Increase in Childhood Overweight, 1986-1998JAMA 286:2845-2848 (2001)

  8. Epidemic Increase in Childhood Overweight, 1986-1998JAMA 286:2845-2848 (2001) • National Longitudinal Survey of Youth • 1986-1998 • 8,270 children, aged 4-12 yrs • Prior studies show it took 30 years for overweight prevalence to double. Current study show doubling time to be less than 12 years. • Rate of increase particularly high in African American and Hispanic children

  9. Why lose weight? • Obesity is associated with greater risk of: • Diabetes • Hypertension & stroke • Coronary heart disease • Most cancers (except lung cancer) • Sleep apnea, arthritis, gall stones, …. • Overfat vs Underfit ???? • Good question • Vast majority of overfat are underfit

  10. Obesity and Causes of Death in the US

  11. Epilog: Supersize MeThe Food Industry Strikes BackNY Times (July 7, 2005) • 20 states have passed ‘Common sense consumption laws’ preventing personal injury lawsuits related obesity (11 states pending) • During elections of 2002 & 2004, the food and restaurant industry gave $5.5 million to politicians in the 20 states. • Institute on Money in State Politics.

  12. Epilog: Supersize MeThe Food Industry Strikes BackNY Times (July 7, 2005) • 83% of public opposed to obesity lawsuits against restaurants and fast food companies • Pelman & Bradley vs McDonald’s • Initial personal injury lawsuit dismissed • Jan 2005, panel of 3 Federal Judges reinstated ‘deceptive practices claim’ (McDonald’s falsely presented their food as nutritionally beneficial to consumers)

  13. Is being overweight really that dangerous?Excess Deaths Associated with Underweight, Overweight, and ObesityJAMA 2005:293:1861-1867 • “Underweight and obesity… were associated with increased mortality…” • “Overweight was not associated with excess mortality.” • “Study finds government overstated danger of obesity” – USA Today – 4/19/05 • http://www.usatoday.com/news/health/2005-04-19-obesity-danger_x.htm

  14. For adults ages 25-59, increased mortality in underweight and obese categories, but not overweight category.

  15. Is Obesity a Public Health Problem? • Obesity and Overweight prevalence is rising rapidly • Obesity is associated with increased risk of mortality (overweight?) • Overweight is a temporary period of transition (many/most overweight people become obese)

  16. Is Obesity a Public Health Problem? • Obesity and Overweight are associated with increased risk of diabetes, hypertension, dyslipidemia • While treatment of these diseases has improved • Health care costs are rising • Quality of life impacted

  17. The Obesity Epidemic in America:Who’s responsible? • Personal responsibility • Environmental influences • Do we need a “Food Police”? • http://www.nytimes.com/2005/06/12/business/yourmoney/12food.html?pagewanted=1

  18. Discussion: What role should American society play in addressing the Obesity Crisis? • Name • 1: Weight problems are a matter of personal responsibility. • No significant changes need to be made. • 2: Weight problems are significantly influenced by environmental factors. • Society needs to implement changes. • 3: Weight problems are highly influenced by environmental factors and will lead to catastrophic health problems. • Society needs to implement sweeping changes.

  19. Why we gain weightGenes/Biology vs Environment • Overweight is a result of both • Adoption studies (biology) • Adopted adults have BMI that are more similar to biological parents than to adoptive parents. • Animal studies (biology) • genetically obese rats and mice

  20. Genes/Biology vs Environment (cont.) • Migration studies (environment) • Japanese • Hawaiian Japanese • Californian Japanese • Dietary Change Studies (biology and environment) • SW Native Americans

  21. Pima Indians • Mexican Pima Indians • subsistence farming & ranching • 20% fat diet, 40 hrs/wk physical work • Arizona Pima Indians • mechanized agriculture, sedentary lifestyle • 40% fat diet

  22. Pima Indians • Arizona Pima Indians are: • 1 inch taller • 57 pounds heavier • 70% obese • 50% with diabetes by age 35

  23. Genes vs Environment: Conclusions • Genes for weight gain predisposes some individuals towards weight gain. • Environment determines which of those individuals actually gain weight. • The rapid change in obesity prevalence is likely to be moredue to changes in the environment than changes in our genetic pool.

  24. What is a “Healthy Weight”? • A broad range of weight which allows for minimal risks for chronic diseases. • Goes beyond using only body weight as a criteria for good health.

  25. Determination of your "healthy weight". • Step 1. Body Mass Index • BMI = BW(kg)/Ht2(m2) • Dr. Phil • from Nutrition Action Health Letter, Jan. 2004 • 6‘4" = 78" x 0.0254(m/in)= 1.93m • 240lbs / 2.2(lb/kg) = 109kg • BMI = 109/(1.932)=109/3.72 • = 29.3

  26. BMI Classifications • BMI = 19 - 25 => Desirable • BMI = 25 - 30 => Overweight • BMI = 30 - 35 => Obese, category 1 • BMI = 35 - 40 => Obese, category 2 • BMI > 40 => Severe obesity

  27. BMI and Mortality Risk

  28. Healthy Weight (cont.) • If your BMI > 25, then consider presence of other health risk factors.

  29. Healthy Weight (cont.) • Body Fat Distribution • upper body fatness associated with higher health risks • Waist Circumference (1998 NIH) • > 35” for females, • > 40” for males

  30. Healthy Weight (cont.):Know your blood lipids! • Hyperlipidemia/dyslipidemia • TC > 240 mg/dl • LDL-C > 160 mg/dl • HDL-C < 40 mg/dl • TG > 200 mg/dl

  31. Healthy Weight (cont.):Know your blood pressure! • High Blood Pressure • Systolic BP > 140 mm Hg or • Diastolic BP > 90 mm Hg or • Borderline hypertensive • Pre-hypertensive • >130/85

  32. Healthy Weight (cont.):Know your blood sugar and history • Hyperglycemia (Diabetes) • Fasting Blood Glucose • > 126 mg/dl • Impaired Glucose Tolerance • Pre-diabetic • >110 mg/dl • Gestational Diabetes • Family History of Diabetes

  33. Healthy Weight Summary • If your BMI is 19-25, you are at a Healthy Weight. • Health problems are not weight related • If your BMI is > 25 and you have no other risk factors, you are at a Healthy Weight. • If your BMI is > 25 and you have one or more risk factors, you are NOT at a Healthy Weight. • Weight loss is likely to improve your health

  34. Should everybody who is overweight try to lose weight?Will weight loss improve your quality of life?A Prospective Study of Weight Change and Health-Related Quality of Life in Women • JAMA Dec. 1999 • Nurse’s Health Study • 40,098 women, 4 yr longitudinal study • Weight changes • Quality of life questionnaire • Physical function • Vitality • Freedom from bodily pain • Mental health

  35. The effect of weight gain/loss on:Vitality Score • Weight gain: • associated with declines in vitality scores in all BMI categories • Weight loss • associated with improved vitality scores only in women with BMI>25

  36. The effect of weight gain/loss on:Mental Health Score • Weight gain • associated with a decline in mental health scores in all weight categories • Weight loss • associated with improved mental health scores only in obese class I women and declined in normal weight women.

  37. A Prospective Study of Weight Change and Health-Related Quality of Life in Women.Conclusions: • For women at all BMI categories: • Don’t gain weight • Reduced quality of life • For overweight and obese women: • Weight loss is generally associated with improved quality of life • For normal weight women • Weight loss does not improve quality of life • May actually reduce quality of life

  38. Do media images affect your idea of what you should look like? 2000 Grammy Awards Do media images actually Contribute to weight problems?

  39. Bottom Line on Weight Loss • Lose weight for the right reasons • Improve health and your quality of life • Losing weight to attain the ‘perfect body’ • May lead to frustration • And, ironically, weight gain • May lead to eating disorders

  40. Dietary Means to a Healthy Weight • Weight loss occurs when in negative energy balance • Weight loss is only half the battle • Maintenance of weight loss is the critical problem

  41. Dietary Means to a Healthy WeightBalanced Reduced Calorie Diet • Characteristics • Calories reduced by 500-1000 Cal/day • CHO:PRO:FAT = 50-60%: 10-15%: 20-30% • Examples • Weight Watchers, Jenny Craig, Slim Fast • What the research shows: • Short-term outcomes • Modest weight loss, improved health • Long-term outcomes • Success rate not great

  42. Dietary Means to a Healthy WeightLow Carbohydrate Diets • Characteristics • Very low in CHO • Restricted intakes of fruit, cereals, pasta, bread, potatoes, rice • Caloric intake not specified • Examples • Atkins diet • What the research shows: • Short-term outcomes • 6 month studies, good weight loss, no substantial change in heart disease risk factor, drop-out rate significant • Long-term outcomes • No long term studies, health risks?

  43. Dietary Means to a Healthy WeightThe Carbohydrate ‘Restrained’ Diets • Characteristics • Lower in CHO than Dietary Guidelines but higher than Low Carb diets (~40% CHO, 30%FAT, 30%PRO) • Low glycemic index foods encouraged • Monounsaturated fats encouraged • Examples • Zone Diet, South Beach Diet • What the research shows: • Little research available on these diets

  44. Dietary Means to a Healthy WeightHealthy Diet/Non-Diet Approach • Characteristics • Focus on quality of the diet, not quantity • Attaining good health is primary goal, not weight loss • Examples • DASH diet, Dietary Guidelines, Food Guide Pyramid • What the research shows: • Short-term outcomes • Slow, limited weight loss, health benefits • Long-term outcomes • U. Colorado’s Weight Loss Registry • Diet most adopt in order to maintain weight loss

  45. Summer 2005 – Final Exam • Thursday, July 28, 12:50PM, 201 PE • Gee • Lecture materials • Chapter 11-Achieving and Maintaining a Healthful Body Weight • Chapter 9 – Nutrients Involved in Bone Health • 20 MC/TF questions • See www.cwu.edu/~geed tomorrow for study guide • Take Home essay question (turn in with final) • What is the role of American Society in Addressing the US Obesity Crisis? • 1 page, double space, 12 pt font, 1” margins • 10 pts: grammatically perfect, well thought out, clearly states and defends position.

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