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Over the past 20 years, obesity in the United States has doubled. Nearly one-third of adults are obese, meaning
they have a body mass index (BMI ) of 30 or greater. Individuals who have a BMI> 30 and have comorbidities (e.g., diabetes,
hypertension, dyslipidemia, cardiovascular disease, etc.) are one of the fastest growing segments of the population.
In March 2005, a New England Journal of Medicine article titled “Deadweight? — The Influence of Obesity on
Longevity” (http://content.nejm.org/cgi/content/short/352/11/1135?query=TOC) presented the following sobering
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- Two-thirds of U.S. adults are overweight or obese; one-third of adults qualify as obese.
- Up to 30 percent of U.S. children are overweight, and childhood obesity has more than doubled in the past 25 years.
- Childhood diabetes has increased 10-fold in the past 20 years.
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Ideally, the goal for adults should be to achieve and maintain a body weight that optimizes their health. However, for obese adults, even modest weight loss (e.g., 10 pounds) has positive health benefits.
And, prevention of further weight gain is also important. |
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For overweight children and adolescents, the goal is to slow the rate of weight gain while achieving normal
growth and development. Maintaining a healthy weight throughout childhood may reduce the risk of becoming
an overweight or obese adult. |
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Manage Your Weight: Manage Your Food Selections |
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Those who follow a typical American diet and activity patterns are likely to be eating more calories than
they burn. For these people, eating fewer calories and increasing physical activity are keys to controlling
their weight. Eating 50 to 100 calories less per day may prevent gradual weight gain. But eat an additional
50-100 calories per day, and you could gain 10 pounds in a year! That’s why cutting out 500 calories or more
per day is a common initial goal in many weight-loss programs. |
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Portion Contortion: Controlling the Distortion |
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An easy and effective way to limit calories is to control portion sizes, particularly when eating
calorie-dense (or rich) foods. Portion sizes have increased significantly over the past two decades.
Today, we are bombarded with free or low cost “upgrades” on portion sizes. Kids are growing up in a
“Super Size” world. So, it is essential to understand how offered portion sizes compare to recommended
portion sizes. |
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Twenty years ago, the average size of a bagel was 3-inches in diameter and had 140 calories. Today, it has
doubled to 6-inches in diameter, and 350 calories. To burn that extra 210 calories, one would have to rake
leaves for 50 minutes! An average cheeseburger 20 years ago had 330 calories and, today, it has 590 calories!
One would have to lift weights for 1½ hours to burn that additional 270 calories! French fries back then
averaged 2.4 ounces/serving and had 210 calories. Today – you guessed it … a lot, lot more! Today, that
order of fries is 6.9 ounces and provides a whopping 610 calories. Are you prepared to walk for an hour
and 10 minutes to burn those additional 400 calories? |
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Interested in learning more about portion distortions? Quiz yourself and your family on Portion Distortion
I (2003) and Portion Distortion II (2004) made available by the National Heart, Lung, and Blood Institute
(NHLBI) at http://hin.nhlbi.nih.gov/portion/. You can also learn how much physical activity is required to
burn off the extra calories provided by today's larger portions. It may just help you say “No thank you”
to that next offer! |
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Reportioning Your Plate |
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Controlling portion sizes is not new, and has been an important strategy in many weight management plans.
There are many simple analogies to use. For example, a serving of meat is considered to be 3 ounces; this
is about the size of a deck of cards. Imagine six dice. This would equal a1½ ounce serving of cheese. A cup
of pasta or rice is about the size of a baseball. And a teaspoon of butter would equal the top of one’s
thumb (to the first joint). |
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Just these few examples probably have you thinking about the foods on your plate! Check out these sample
menu plans: |
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Another tip: Our dinner plates have gotten larger in size. Using a smaller plate can help you limit your intake at meals. |
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Counter Balancing Those Extra Calories: Get Moving! |
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Caloric intake is only one side of the energy balance equation. Caloric expenditure (how much energy we
burn) needs to be in balance with caloric intake to maintain body weight, but must exceed caloric intake
to achieve weight loss. Up to 60 minutes of moderate-to-vigorous-intensity physical activity per day may
be needed to prevent weight gain. As much as 60 to 90 minutes of moderate-intensity physical activity per
day is recommended to sustain weight loss for previously overweight people. Initially, most individuals
should aim for slow, steady physical activity. Men over age 40, women over age 50, and anyone with a
history of chronic diseases such as heart disease or diabetes should consult with a healthcare provider
before starting a vigorous exercise program. The 2005 Dietary Guidelines
(http://www.health.gov/dietaryguidelines/dga2005/document/pdf/Chapter2.pdf ) also has a “calorie estimate”
chart based on gender, age, and three different levels of activity. |
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Conclusion |
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On some days, the foods you eat may add up to more than the recommended servings from one food group and
less from another. Don’t worry. Just be sure that the average of several days or a week comes close to
what’s recommended in your chosen meal plan. For more interactive tools to help you attain your fitness
goals, check out http://www.nhlbi.nih.gov/health/public/heart/obesity/lose_wt/control.htm Remember to aim
for a gradual increase in physical activity once you have discussed any individual health concerns with your
primary healthcare provider. |
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Please note: If you have related topics of interest that you would like to learn more about in future articles, contact
CDR Jean Makie, Chair, D/N-PAC, at makiej@cder.fda.gov.
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