Energy Balance. Energy Balance. Food For Thought: A TINY INDULGENCE

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Karin Fleming
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1 Energy Balance Energy balance for adults means that the number of calories eaten equals the number of calories that are used by the body. In this state, weight maintenance will occur. Weight maintenance is defined as having a weight that does not increase or decrease by more than 5% over time. 1 The population-wide increase in weight is caused by a combination of environmental and lifestyle factors that make it easy for people to eat more calories than their bodies can use. However, genetic factors can determine whether a person will become obese meaning that some individuals are more susceptible than others to becoming obese when exposed to excess calories in the food environment. 2 It is often assumed that the damage caused by unhealthy eating can be undone by being physically active. However, the reality is that there is no substitute for healthy eating, especially in the case of weight control. Using common catch phrases such as all foods fit, and everything in moderation may cause individuals to become complacent when faced with unhealthy choices. However, it only takes a small number of extra calories each day to cause a significant weight problem. How much is too much? A Canadian study, found that obese men and women ate an average of only 200 calories more per day than non-obese individuals. 3 Consuming as few as 50 to 150 extra calories per day can cause an individual to become obese. 4-6 Therefore, even small increases in caloric intake can have significant negative implications for the overall health of employees. Consequently, the types and amounts of food available to people in their work environments should be carefully considered. Food For Thought: A TINY INDULGENCE Consuming an extra 100 calories per day, can result in a 4.5 kg (10 lb) weight gain in one year. 7 This is the amount of calories in: 1 cup of soda, 10 jelly beans, 5 chocolate covered almonds, half of a donut, or one quarter of a muffin. 8 The bottom line: Even a small daily treat can have negative long-term effects on weight. Project Health Rethinking Healthy Eating: Examining the Evidence 23

What Role Does Calorie Intake Play in Energy Balance? It is estimated that 60% to 100% of obesity among Canadians is related to excess calorie consumption.

2 What Role Does Calorie Intake Play in Energy Balance? It is estimated that 60% to 100% of obesity among Canadians is related to excess calorie consumption. 9 There were up to 530 more calories available for each Canadian to consume in 2002 than there were in Three food items account for more than half of this increase: salad oils, wheat flour, and soft drinks. 7 The extra calories in our diets are most often found in sweet baked goods, convenience foods (deep fried foods, frozen and preprepared meals, side dishes, and frozen pizza), salad dressing, potato chips, salty snacks, and french fries. 7 The portion sizes that we typically eat are also much larger than the recommended portion sizes in Canada s Food Guide, leading to higher calorie intake overall, even for foods considered to be healthy. 10 Food For Thought: HOW MUCH EXERCISE? In order to burn off an extra 530 calories per day, a person would have to walk at a moderate pace for two hours per day, seven days per week. 11 This is significantly more time than is required to meet the current physical activity guidelines. The bottom line: People need daily physical activity to help maintain their health and weight, however, calorie intakes overall need to be decreased to reduce weight. Project Health Rethinking Healthy Eating: Examining the Evidence 24

Physical Activity and Energy Balance The Role of Physical Activity in Weight Loss Moderate-intensity physical activity (defined as walking 150 minutes per week at a 6.

3 Physical Activity and Energy Balance The Role of Physical Activity in Weight Loss Moderate-intensity physical activity (defined as walking 150 minutes per week at a 6.4 kilometer (4 mile) per hour pace), can help to maintain weight. However, this amount of physical activity is not enough to cause weight loss (defined as losing more than 5% of body weight). 1 It requires a significant increase in physical activity in order for weight loss to occur (up to 80 minutes of moderate intensity physical activity per day), well above the amount needed to maintain good health. 1,7 The Importance of Physical Activity Physical activity can help to prevent falls as well as chronic diseases such as osteoporosis, cardiovascular disease, certain types of cancer, and diabetes. 1,12,13 Participating in regular physical activity can also have a significant positive effect on waist circumference, even when there is no substantial weight loss involved. 14 Canada s new Physical Activity Guidelines, launched in January 2011, recommend adults (18 to 64 years of age) accumulate at least 150 minutes of moderate-tovigorous intensity aerobic physical activity per week in bouts of 10 minutes or more. Adults should also perform strengthening activities (for muscles and bones) at least two days per week. In addition, more physical activity provides even greater health benefits. 15 Tools: PROMOTING PHYSICAL ACTIVITY IN YOUR WORKPLACE For more information on physical activity, see the toolkit: Active Employees, Active Workplaces: Promoting & Supporting Physical Activity at Work at under Project Health Resources. Project Health Rethinking Healthy Eating: Examining the Evidence 25

Dispelling the Myth: Labour-Related Physical Activity The rapid weight gain that has occurred in North America in the past 30 years is often attributed to the reduction in labour-related physical

4 Dispelling the Myth: Labour-Related Physical Activity The rapid weight gain that has occurred in North America in the past 30 years is often attributed to the reduction in labour-related physical activity. 9 Current research suggests reduced labour-related physical activity is not the main reason for population weight gain. 7,9 The decline in labour-related physical activity occurred mostly between 1950 and This reduction in physical activity would only account for a three pound weight gain across the population (or 26 calories per day). 9 Food For Thought: PHYSICAL ACTIVITY GUIDELINES AND WEIGHT LOSS If a sedentary individual started walking 30 minutes per day at a moderate intensity, five days a week for one month, (with energy intake held constant), this person could expect to lose 0.5 kg (1 lb). 16 The bottom line: Physical activity is an important part of a healthy lifestyle, however, physical activity alone is not an effective weight loss strategy. Project Health Rethinking Healthy Eating: Examining the Evidence 26

Leisure-Time Physical Activity Over 50% of Canadians report that they are physically active; however, only 15% of Canadians are active enough to meet current physical activity guidelines.

5 Leisure-Time Physical Activity Over 50% of Canadians report that they are physically active; however, only 15% of Canadians are active enough to meet current physical activity guidelines. 17 Leisure-time physical activity is related to healthy weight maintenance. Canadian men with a healthy weight (BMI kg/m 2 ) perform an average of 35 minutes of moderate-to -vigorous physical activity per day, while overweight and obese men performed 26 and 19 minutes respectively. Similarly, women with a healthy weight perform 25 minutes of moderate to vigorous physical activity per day, while overweight and obese women performed only 20 and 13 minutes respectively. 17 What About Resistance Training? The muscles in our body burn more calories than fat tissue. However, even a big increase in muscle mass of 4.5 kilograms (10 pounds) would only burn an extra 45 calories per day. 18 That s the equivalent of less than two coffee creamers. 8 Studies of the effects of resistance training on body weight typically show a weight loss of less than 1 kg (2.2 pounds) overall. 1 Success Stories: THE NATIONAL WEIGHT CONTROL REGISTRY The National Weight Control Registry is a roster of people who have successfully maintained a 10% weight loss. In addition to significantly reducing their energy intake, these individuals walk an average of 45 kilometres per week. 19 Project Health Rethinking Healthy Eating: Examining the Evidence 27

Limitations of Physical Activity in Energy Balance Compensation As physical activity levels go up, people do not necessarily lose as much weight as they expect.

14,20 In fact, large increases in physical activity may reduce leptin in the blood (a hormone that sends signals to your brain that you are full).

6 Limitations of Physical Activity in Energy Balance Compensation As physical activity levels go up, people do not necessarily lose as much weight as they expect. 14 This is thought to be due to an energy compensation effect where physical activity causes increased energy intake. 14,20 In fact, large increases in physical activity may reduce leptin in the blood (a hormone that sends signals to your brain that you are full). As a result of lower leptin, people experience more hunger and tend to seek out food based rewards. 20 This is one reason why people do not lose as much weight as they may expect, when they become physically active. 14,20 Compensatory Intentions Individuals who are trying to control their eating behaviours often think of a coping strategy to prevent themselves from feeling guilty while indulging in a tempting food. 21 For example, promising yourself to go for a run after eating a cookie. However, people who use this strategy usually fail to perform the compensatory behaviour, leading to weight gain. 21 There is also a tendency to underestimate the number of calories that have been consumed and overestimate the number of calories that can be burned during physical activity. 21 Food for Thought: PHYSICAL ACTIVITY AND WEIGHT LOSS Physical activity has a multitude of health benefits. However, the calories that are used during physical activity are a small fraction of the calorie deficit that is needed to cause weight loss. 7,14 The bottom line: Individuals who are trying to lose weight are unlikely to be successful if they do not simultaneously reduce energy intake. 1 Project Health Rethinking Healthy Eating: Examining the Evidence 28

Energy Balance References 1. Physical Activity Guidelines Advisory Committee. G.4 Energy balance. In: Physical Activity Guidelines Advisory Committee Report, 2008. Washington, DC: U.S.

Diet composition and obesity among Canadian adults. Statistics Canada. Cat. No. 82-003-XPE. 4. Cohen D, Farley TA. Eating as an automatic behavior. Prev Chronic Dis. 2008;5:A23. 5.

7 Energy Balance References 1. Physical Activity Guidelines Advisory Committee. G.4 Energy balance. In: Physical Activity Guidelines Advisory Committee Report, Washington, DC: U.S. Department of Health and Human Services; 2008:G40-i-G Loos RJ. Recent progress in the genetics of common obesity. Br J Clin Pharmacol. 2009;68: Langlois K, Garriguet D, Findlay L. Diet composition and obesity among Canadian adults. Statistics Canada. Cat. No XPE. 4. Cohen D, Farley TA. Eating as an automatic behavior. Prev Chronic Dis. 2008;5:A Hill JO, Peters JC, Wyatt HR. Using the energy gap to address obesity: A commentary. J Am Diet Assoc. 2009;109: Hill JO, Peters JC, Catenacci VA, Wyatt HR. International strategies to address obesity. Obes Rev. 2008;9: Slater J, Green CG, Sevenhuysen G, Edginton B, O'Neil J, Heasman M. The growing Canadian energy gap: More the can than the couch? Public Health Nutr. 2009;12: Health Canada. Nutrient value of some common foods. Ottawa, Ontario: Published by authority of the Minister of Health.; Bleich S, Cutler D, Murray C, Adams A. Why is the developed world obese? Annu Rev Public Health. 2008;29: Health Canada. Eating Well with Canada's Food Guide: A Resource for Educators and Communicators. Ottawa: Health Canada; Swinburn B, Sacks G, Ravussin E. Increased food energy supply is more than sufficient to explain the US epidemic of obesity. Am J Clin Nutr. 2009;90: Kesaniemi A, Riddoch CJ, Reeder B, Blair SN, Sorensen TI. Advancing the future of physical activity guidelines in Canada: An independent expert panel interpretation of the evidence. Int J Behav Nutr Phys Act. 2010;7: Warburton DE, Charlesworth S, Ivey A, Nettlefold L, Bredin SS. A systematic review of the evidence for Canada's physical activity guidelines for adults. Int J Behav Nutr Phys Act. 2010;7: Church TS, Martin CK, Thompson AM, Earnest CP, Mikus CR, Blair SN. Changes in weight, waist circumference and compensatory responses with different doses of exercise among sedentary, overweight postmenopausal women. PLoS One. 2009;4:e Canadian Society for Exercise Physiology. Canadian Physical Activity Guidelines. Accessed 24/01/ Hainer V, Toplak H, Mitrakou A. Treatment modalities of obesity: What fits whom? Diabetes Care. 2008;31 Suppl 2:S Colley RC, Garriguet D, Janssen I, Craig CL, Clarke J, Trembley MS. Physical activity of Canadian adults: Accelerometer results from the 2007 to 2009 Canadian Health Measures Survey. Statistic Canada. Cat. No X 18. Wolfe RR. The underappreciated role of muscle in health and disease. Am J Clin Nutr. 2006;84: Anderson JW, Konz EC, Frederich RC, Wood CL. Longterm weight-loss maintenance: A meta-analysis of US studies. Am J Clin Nutr. 2001;74: Turner JE, Markovitch D, Betts JA, Thompson D. Nonprescribed physical activity energy expenditure is maintained with structured exercise and implicates a compensatory increase in energy intake. Am J Clin Nutr. 2010;92: Kronick I, Knauper B. Temptations elicit compensatory intentions. Appetite. 2010;54: Project Health Rethinking Healthy Eating: Examining the Evidence 29

Identifying whether your clients are ready and willing to make lifestyle changes to lose weight

Identifying whether your clients are ready and willing to make lifestyle changes to lose weight Weight Loss Note to the Health Care Professional: Topics in this handout are discussed in Chapter 21 of the American Dietetic Association Guide to Diabetes Medical Nutrition Therapy and Education (1).