“Practical tips on taking care of the spirit’s temple”

Jason L. McKeown, M.D.

Our goals for today

• Define obesity and BMI• Examine the obesity epidemic in the US• Reveal consequences of obesity• Look at nutrition and its importance to health• Discuss basic concepts for weight loss• Recommendations for exercise• Discuss sleep hygiene• Summarize healthy living

Body Mass Index (BMI)•

or

• An objective measure of obesity• Misleading in muscular individuals and pregnancy

Agency for Healthcare Research and Quality. Screening for obesity in adults. Accessed June 22, 2010 from http://www.ahrq.gov/clinic/3rduspstf/obesity/obeswh.htm

BMI and Obesity

Normal weight 18.5 – 24.9

Overweight 25.0-29.9

Obese ≥ 30

• Class I 30-34.9

• Class II 35-39.9

• Class III ≥40

Morbid Obesity > 100 lbs. overweight or BMI ≥ 40

Agency for Healthcare Research and Quality. Screening for obesity in adults. Accessed June 22, 2010 from http://www.ahrq.gov/clinic/3rduspstf/obesity/obeswh.htmDugdale DC. Obesity. MedlinePlus. Accessed June 22, 2010 from http://www.nlm.nih.gov/medlineplus/ency/article/007297.htm

BMI calculator

• www.nhlbisupport.com/bmi/bmicalc.htm

The Obesity Epidemic

• Major modifiable cause of death in U.S. • Being obese is expensive!

– In 2000, the societal cost of obesity was about $117 billion. Now it’s estimated at $147 billion! (25% increase in 10 years!)

– Obese people spend $1,500 more each year on health care.

– Obese patients had 80% higher per capita spending for prescription drugs.

• The prevalence of obesity has increased in the U.S. with no sign of slowing. . .

What Causes Obesity?

• Genes• Hormones/gland

problems• Clowns• The royal family• Lifestyle• Our friends and

family

The Bad Fat-- Intra-Abdominal Fat

• Fat around the waist creates increased risk for heart disease, diabetes, cancer. . .

• Abnormal levels:Women > 35” Men > 40”

NIH Expert Panel Report, Am J Clin Nutr 1998;68:899-917

Diseases associated with obesity• Type 2 Diabetes• Osteoarthritis• Hypertension• Heart Failure• Cancer• High cholesterol• Obstructive Sleep Apnea• GERD• Gallstones • Depression • Infertility• Miscarriages

“Doesn’t it cost a lot of money to eat healthy?”

How many calories do you need?

Your weight x 10(Eg. 170 lbs x 10 = 1700 Cal)

Lifestyle adjustment:

+ 20% if sedentary (Eg. 1700 + 340 = 2040 Cal)

+ 30-40% if moderately active(Eg. 1700 + 680 = 2380 Cal)

Start Small, Think Big!

• Excess calories- many of us are getting calories and don’t realize it– Cut out sugar containing beverages (fruit punches,

Kool-Aid, sodas, Frappuccinos)– Eat fewer concentrated sweets (desserts, candy,

snacks)– Watch your portion sizes– Write down what you eat– Calorie listings– coming to your local restaurant

menu!

Start Small, Think Big!

• Fat- most changes if instituted over a longer time period are imperceptible– Go from whole milk to 2% then to 1% or skim– Use lower fat cheese (2%)– Avoid trans fat, frying; use more olive oil, canola oil

Start Small, Think Big!

• Red meat- - Limit to 1-2 times per week• Substitute alternatives in familiar recipes

– Turkey for beef

• Diets high in fat, excess calories, and red meats have been linked to increased cancer risk.

Start Small, Think Big!

• Fruit and vegetables- increase your intake – Most of us get less than 5/day– Add 1 to breakfast, lunch, and dinner– Add extra vegetables when dining out or choose the

vegetables instead of the fries– Try fruit and vegetables in convenient packages

• Diets low in fruit and vegetables and fiber have also been linked to increased cancer risk.

Start Small, Think Big!

• Fiber- More whole grain products on the market these days– Find breads that say 100% whole grain or have

whole grain as the first ingredient

You can do it!

• Don’t be afraid to try something new!• Don’t be a pill popper– extra vitamin

supplements, eg. B12 shots, don’t work!• Eat the real foods– the whole food is better for

you and it’s the way God intended.

Weight loss

• Negative energy balance requires increased energy consumption

Energy Output >> Caloric Input

How to start an exercise program

• Get checked out by your family physician first.–Cardio– brisk walking, jogging, treadmill, elliptical, etc. Goal is to maintain elevated heart rate to ensure max calorie burning.

–At least 3 time a week (preferably 5), 30 min per session

–30 minutes does not have to be consecutive–Cardio burns fat, reduces bone loss, risk of heart disease, cancer and depression

Getting started– How much is enough?

• Cardio intensity– Karnoven formula to calculate target HR– www.briancalkins.com/HeartRate.htm

• Resistance training– Use weight that is light enough to do 12-15 reps x 3

with exertion, but not exhaustion, ie. It shouldn’t be too easy. . .

– 2-3 times a week alternating muscle groups

But do something!

• Walk the stairs at the hospitals• Park as far from the church building as possible

Healthy Sleep Habits

• Get 7-9 hours of sleep• Go to bed and get up at about the same

time every day.• Develop a pre-sleep routine• Use relaxation to help you fall asleep• Protect your sleep time; enlist your family

and friends!

Healthy Sleep Habits• Sleeping environment:

– No animals!– Cooler temperature– Dark (eye shades, room darkening shades)– Quiet (unplug phone, turn off pager, use ear

plugs, white noise machine)• Avoid going to bed hungry, but no heavy meals

within 3 hours of sleep. • Get regular exercise but avoid heavy exercise

within 3 hours of sleep.

• Couch to 5k programs• www.eatright.uab.edu• www.realage.com (Mike Roizen, Dr. Oz)

DON’T GIVE UP!!!

• Make a commitment! Stick to it!• Phil 3:12-14, Paul was never satisfied. . . We

shouldn’t be either!!! whether spiritually OR physically.

• Eyes ahead! Press on toward your goal.

So whether you eat or drink, or whatever you do, do all to the glory of God.

I Corinthians 10:31