TCOYD Through Weight Management: Nutrition and Physical Activity Felicia Gomez, Ph.D. Owner, Pinnacle Training Systems. Associate Professor, Exercise Science CSU, Fresno
Financial Disclosure Felicia Gomez, PhD - Reports she has no relevant financial interests disclose that may be associated with this CME activity
Unhealthy Lifestyles are the status quo If people don t change their unhealthy lifestyles, the consequences will cause them to pay dearly for it in more ways than they ever imagined.
Alarming Statistics 67% of Americans are overweight or obese. The Centers for Disease Control report that: About 13% of US children ages 8 16 are overweight or obese. Less than 15% of US adults exercise 60 minutes or more a minimum of 3 times each week. Less than 10% of kids ages 8 18 exercise for 60 minutes or more 3 times a week. More than 300,000 people die each year from illnesses caused by or made worse by obesity.
Obesity Trends* Among U.S. Adults 1999 1990 2009 No Data <10% 10% 14% 15% 19% 20% 24% 25% 29% 30%
1985 No Data <10% 10% 14%
1986 No Data <10% 10% 14%
1987 No Data <10% 10% 14%
1988 No Data <10% 10% 14%
1989 No Data <10% 10% 14%
1990 No Data <10% 10% 14%
1991 No Data <10% 10% 14% 15% 19%
1992 No Data <10% 10% 14% 15% 19%
1993 No Data <10% 10% 14% 15% 19%
1994 No Data <10% 10% 14% 15% 19%
1995 No Data <10% 10% 14% 15% 19%
1996 No Data <10% 10% 14% 15% 19%
1997 No Data <10% 10% 14% 15% 19% 20%
1998 No Data <10% 10% 14% 15% 19% 20%
1999 No Data <10% 10% 14% 15% 19% 20%
2000 No Data <10% 10% 14% 15% 19% 20%
2001 No Data <10% 10% 14% 15% 19% 20% 24% 25%
2002 No Data <10% 10% 14% 15% 19% 20% 24% 25%
2003 No Data <10% 10% 14% 15% 19% 20% 24% 25%
2004 No Data <10% 10% 14% 15% 19% 20% 24% 25%
2005 No Data <10% 10% 14% 15% 19% 20% 24% 25% 29% 30%
2006 No Data <10% 10% 14% 15% 19% 20% 24% 25% 29% 30%
2007 No Data <10% 10% 14% 15% 19% 20% 24% 25% 29% 30%
2008 No Data <10% 10% 14% 15% 19% 20% 24% 25% 29% 30%
2009 No Data <10% 10% 14% 15% 19% 20% 24% 25% 29% 30%
2010 No Data <10% 10% 14% 15% 19% 20% 24% 25% 29% 30%
Summary During the past 20 years there has been a dramatic increase in obesity in the US. No state has a prevalence of obesity less than 20%. 24 states have a prevalence > 25% 13 of these states now have a prevalence of obesity > 30%.
1995 Prevalence of Diabetes 2005 Age-adjusted Percentage of U.S. Adults Who Had Diagnosed Diabetes 2000 <4.5% 4.5-5.9% 6.0-7.4% 7.5-8.9% 9.0% 2009
Number and Percentage of U.S. Population with Diagnosed Diabetes, 1958 2010 7 25 Percentage with Diabetes 20 Number with Diabetes 6 5 15 4 10 3 2 5 1 0 0 1958 61 64 67 70 73 76 79 82 Year 85 88 91 94 97 00 03 06 09 Number with Diabetes (Millions) Percentage with Diabetes 8
Prevalence of Diabetes 7.0 Percent 6.5 California 6.0 USA 5.5 5.0 4.5 4.0 1995 CDC 2002 1996 1997 1998 1999 2000
Relationship of Obesity to Diabetes
Obesity (BMI 30 kg/m2) 1994 No Data Diabetes 2000 <14.0% 14.0% 17.9% 1994 No Data 18.0% 21.9% 2010 22.0% 25.9% 2010 2000 <4.5% 4.5% 5.9% 6.0% 7.4% 26.0% 7.5% 8.9% >9.0%
Obesity-related Complications Type 2 diabetes mellitus Obstructive sleep apnea Cardiovascular heart disease Orthopedic disorders Psychosocial impact Low self-esteem Poor body image Depression High blood pressure High blood lipids
Diabetes Prevention Program
TCOYD Through Weight Management: Nutrition and Physical Activity
Energy Balance Equation
Energy Balance Energy In = Energy Out Energy In > Energy Out Energy In < Energy Out
Weight Loss Dilemma
What Are We Doing? Calories In Typical energy intake Dieting Incidence Outcome Calories Out Physical activity habits Role of technology
Energy In Fat-free foods Light foods Where is the problem Short-term success Long-term outcome
Bigger Meals, Bigger People Upgrade to a Big Xtra with cheese, supersize the drink and fries = 1,805 calories and 84 g of fat A traditional McDonald s burger with a 16-oz Coke and a small order of fries = 627 calories and 19 g of fat
Portion Sizes
Weight Watchers Asian Chicken Salad
Portion Distortion Quiz Do You Know How Food Portions Have Changed in 20 Years?
CHEESEBURGER 20 Years Ago 333 calories Today How many calories are in today s cheeseburger?
CHEESEBURGER 20 Years Ago 333 calories Today 590 calories Calorie Difference: 257 calories
Maintaining a Healthy Weight is a Balancing Act Calories In = Calories Out How long will you have to lift weights in order to burn the extra 257calories?
Calories In = Calories Out If you lift weights for 1 hour and 30 minutes, you will burn approximately 257 calories.
SPAGHETTI AND MEATBALLS 20 Years Ago 500 calories 1 cup spaghetti with sauce and 3 small meatballs Today How many calories do you think are in today's portion of spaghetti and meatballs?
SPAGHETTI AND MEATBALLS 20 Years Ago Today 500 calories; 1 cup spaghetti with sauce and 3 small meatballs 1,025 calories; 2 cups of pasta with sauce and 3 large meatballs Calorie Difference: 525 calories
Maintaining a Healthy Weight is a Balancing Act Calories In = Calories Out How long will you have to houseclean in order to burn the extra 525 calories?*
Calories In = Calories Out If you houseclean for 2 hours and 35 minutes, you will burn approximately 525 calories.
FRENCH FRIES 20 Years Ago 210 Calories 2.4 ounces Today How many calories are in today s portion of fries?
FRENCH FRIES 20 Years Ago 210 Calories 2.4 ounces Today 610 Calories 6.9 ounces Calorie Difference: 400 Calories
Maintaining a Healthy Weight is a Balancing Act Calories In = Calories Out How long will you have to walk leisurely in order to burn those extra 400 calories?
Calories In = Calories Out If you walk leisurely for 1 hour and 10 minutes you will burn approximately 400 calories.
PEPPERONI PIZZA 20 Years Ago 500 calories Today How many calories are in two large slices of today s pizza?
PEPPERONI PIZZA 20 Years Ago 500 calories Today 850 calories Calorie Difference: 350 calories
Maintaining a Healthy Weight is a Balancing Act Calories In = Calories Out How long will you have to play golf (while walking and carrying your clubs) in order to burn those extra 350 calories?*
Calories In = Calories Out If you play golf (while walking and carrying your clubs) for 1 hour you will burn approximately 350 calories.
Energy Out Physical Activity Habits Recommended amounts Sedentary Adults Sedentary Kids TV watching Computer/video games
What Do People Want? Lose weight rapidly Eat what they want Do as little physical activity as possible
So.What Do People Do? FAD DIETS Yo-Yo Dieting
Fad Diets Promise of rapid weight loss Elements of ritual and sacrifice Magical food or food combination Unlimited foods of some type Rigid menus or monotonous food choices Jargon and scientific ½ truths Omits need for physical activity
Effectiveness of Fad Dieting
Effects of 3 forms of Diet on Fat Loss 100 80 60 40 % Fat Loss 20 0 Fasting Mod. Diet Ex. + Diet
Reasons For Failure: Habits Design of diets Food selection
Bottom Line
Effective Weight Loss Calories In Eat in moderation/smaller portion sizes Increase complex CHO intake Calories Out Activities of daily living (Active Living Concept) Exercise program
Nutrition Suggestions Decrease portion sizes ½ a donut vs a whole Make healthy and wise choices Increase complex carbohydrates Decrease simple carbohydrates Lean cuts of meat (drain fat) Low fat choices Fat free vs light
Cont d Protein in every meal Doggie bags at restaurants Eat high fat foods in moderation Ask for sauces/dressings on the side Minimize fast food meals Grilled vs fried Small/regular vs supersize
Physical Activity What do you need to do? No pain no gain? Exercise plan what is this??? Do I have time? Is it ok to sweat?
Exercise Program for Type II Diabetics Caloric expenditure >1000 kcal/wk Frequency 3-5 days/wk (if 3 d/wk, workouts should be nonconsecutive) acute exercise affects blood glucose for 72 hrs
Intensity low-to-moderate intensity (40-70% VO2 max; 60-80% HR max; RPE) Duration directly related to energy expenditure inversely related to intensity minimum 10-15 minutes/session for wt. loss, build up to high duration (60 min)
Mode Easy control of intensity; requires little skill Weight bearing vs. non-weight bearing energy expenditure directly related to amount of muscle mass used dictated by complications or coexisting conditions Resistance training improvement of muscle strength, endurance, increase flexibility, enhance body composition, decreases CVD risk factors
Rate of progression depends on age, functional capacity, medical/clinical status, personal preferences/goals Limitations increased % type II, low % type I muscle fibers low capillary density
Exercise Regularly Participate regularly in some enjoyable physical activity. Although there are different types of exercise to achieve different goals. The best physical activity program is one you ENJOY!!!! TOLERATE
Small Steps to Regular Exercise Schedule your exercise time (prioritize) Do something you enjoy Exercise with a group
Small Steps to Regular Exercise Be accountable to someone (buddy) Keep a progress chart Exercise to music Associate with other exercisers
Busting Through Barriers Aim to do half the workout SHOW UP; half the battle is getting out the door Self-conscious??? Look around you!!! Easily bored? Vary your workouts and strive to learn two new exercises/month
Conclusions Epidemic of type II diabetes sweeping the globe is associated with decreasing levels of activity and increasing prevalence of obesity, therefore promoting exercise and healthy nutrition is a vital component of prevention and management.
You have the ability to impact others about lifestyle changes and adopt lifelong healthy habits!
Questions? Please do not hesitate to contact us at any time. Felicia Gomez fgomez@pinnacletrainingsystems.com 559-977-1739