Eating for health vs. to lose weight Family support and involvement Setting SMART goals
Body Weigh
t
Food Drink
Ein Eout
PARMR
Energy Balance
Ein = Eout
Body Weigh
t
Food Drink
Ein
Eout
PARMR
Weight Gain
Ein > Eout
Body Weigh
t
Food Drink
Ein
Eout
PARMR
Weight Loss
Ein < Eout
Can someone eat a 100% fat diet and lose weight?
Body Weigh
t
Food Drink
Ein
Eout
PARMR
Ein < Eout
700kcals
RMR and very light activity
for 130 lb woman
5 Pepsi’s
~1500kcals
Kim (39 years old)
after her Oprah Show make-over
Body Weigh
t
Food Drink
Ein
Eout
PARMR
Ein > Eout
“I am training for a marathon, so why am I gaining weight?”
E for PA increases by 500 kcals/dE intake
increases by 800 kcals/d
Body Weigh
t
Food Drink
Ein
Eout
PARMR
“My metabolism is slow.”
RMR lower than average
1,100 vs. 1,300Average
energy intake
Successful weight losers
• 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
National Weight Control Registryhttp://www.nwcr.ws/
NWCR
• 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
What did they do?
Are wt loss programs, books, “diets” BAD?
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
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.”
Lowest BMI
• vegetarian
• high CHO/low fat
• high CHO Pyramid
Nutrient profile
• Best: high CHO Pyramid
• Worst: low CHO diet
What type of diet is best for weight maintenance?
“…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
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
McGraw's 7 Keys 1. understand, face your "personal truth"--what you think about
yourself and your weight --and replace toxic messages with positive thoughts
2. learn to counter emotional eating3. change your environment4. master impulse eating5. choose foods6. adopt an exercise habit7. 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.
http://www.drphil.com/
Good sources for healthy food
choices
Guidance on weight loss
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