Download (10)weight Management Balance Calories Pdf
Successful weight loss does not require people to follow a specific diet plan, such as Slimming World or Atkins. Instead, they should focus on eating fewer calories and moving more to achieve a negative energy balance.
Download (10)weight management Balance calories pdf
The most important component of an effective weight-management program must be the prevention of unwanted weight gain from excess body fat. The military is in a unique position to address prevention from the first day of an individual's military career. Because the military population is selected from a pool of individuals who meet specific criteria for body mass index (BMI) and percent body fat, the primary goal should be to foster an environment that promotes maintenance of a healthy body weight and body composition throughout an individual's military career. There is significant evidence that losing excess body fat is difficult for most individuals and the risk of regaining lost weight is high. From the first day of initial entry training, an understanding of the fundamental causes of excess weight gain must be communicated to each individual, along with a strategy for maintaining a healthy body weight as a way of life.
Evidence shows that genetics plays a role in the etiology of overweight and obesity. However, genetics cannot account for the increase in overweight observed in the U.S. population over the past two decades. Rather, the behavioral and environmental factors that conspire to induce individuals to engage in too little physical activity and eat too much relative to their energy expenditure must take most of the blame. It is these factors that are the target of weight-management strategies. This chapter reviews the efficacy and safety of strategies for weight loss, as well as the combinations of strategies that appear to be associated with successful loss. In addition, the elements of successful weight maintenance also will be reviewed since the difficulty in maintaining weight loss may contribute to the overweight problem. A brief discussion of public policy measures that may help prevent overweight and assist those who are trying to lose weight or maintain weight loss is also included.
Increased physical activity is an essential component of a comprehensive weight-reduction strategy for overweight adults who are otherwise healthy. One of the best predictors of success in the long-term management of overweight and obesity is the ability to develop and sustain an exercise program (Jakicic et al., 1995, 1999; Klem et al., 1997; McGuire et al., 1998, 1999; Schoeller et al., 1997). The availability of exercise facilities at military bases can reinforce exercise and fitness programs that are necessary to meet the services' physical readiness needs generally, and for weight management specifically. For a given individual, the intensity, duration, frequency, and type of physical activity will depend on existing medical conditions, degree of previous activity, physical limitations, and individual preferences. Referral for additional professional evaluation may be appropriate, especially for individuals with more than one of the above extenuating factors. The benefits of physical activity (see Table 4-1) are significant and occur even in the absence of weight loss (Blair, 1993; Kesaniemi et al., 2001). It has been shown that one of the benefits, an increase in high-density lipoproteins, can be achieved with a threshold level of aerobic exercise of 10 to 11 hours per month.
As valuable as exercise is, the existing research literature on overweight individuals indicates that exercise programs alone do not produce significant weight loss in the populations studied. It should be emphasized, however, that a large number of such studies have been conducted with middle-aged Caucasian women leading sedentary lifestyles. The failure of exercise alone to produce significant weight loss may be because the neurochemical mechanisms that regulate eating behavior cause individuals to compensate for the calories expended in exercise by increasing food (calorie) intake. While exercise programs can result in an average weight loss of 2 to 3 kg in the short-term (Blair, 1993; Pavlou et al., 1989a; Skender et al., 1996; Wadden and Sarwer, 1999), outcome improves significantly when physical activity is combined with dietary intervention. For example, when physical activity was combined with a reduced-calorie diet and lifestyle change, a weight loss of 7.2 kg was achieved after 6 months to 3 years of follow-up (Blair, 1993). Physical activity plus diet produces better results than either diet or physical activity alone (Blair, 1993; Dyer, 1994; Pavlou et al., 1989a, 1989b; Perri et al., 1993). In addition, weight regain is significantly less likely when physical activity is combined with any other weight-reduction regimen (Blair, 1993; Klem et al., 1997). Continued follow-up after weight loss is associated with improved outcome if the activity plan is monitored and modified as part of this follow-up (Kayman et al., 1990).
The use of behavior and lifestyle modification in weight management is based on a body of evidence that people become or remain overweight as the result of modifiable habits or behaviors (see Chapter 3), and that by changing those behaviors, weight can be lost and the loss can be maintained. The primary goals of behavioral strategies for weight control are to increase physical activity and to reduce caloric intake by altering eating habits (Brownell and Kramer, 1994; Wilson, 1995). A subcategory of behavior modification, environmental management, is discussed in the next section. Behavioral treatment, which was introduced in the 1960s, may be provided to a single individual or to groups of clients. Typically, individuals participate in 12 to 20 weekly sessions that last from 1 to 2 hours each (Brownell and Kramer, 1994), with a goal of weight loss in the range of 1 to 2 lb/wk (Brownell and Kramer, 1994). In the past, behavioral approaches were applied as stand-alone treatments to simply modify eating habits and reduce caloric intake. However, more recently, these treatments have been used in combination with low-calorie diets, medical nutrition therapy, nutrition education, exercise programs, monitoring, pharmacological agents, and social support to promote weight loss, and as a component of maintenance programs.
A significant part of weight loss and management may involve restructuring the environment that promotes overeating and underactivity. The environment includes the home, the workplace, and the community (e.g., places of worship, eating places, stores, movie theaters). Environmental factors include the availability of foods such as fruits, vegetables, nonfat dairy products, and other foods of low energy density and high nutritional value. Environmental restructuring empha-sizes frequenting dining facilities that produce appealing foods of lower energy density and providing ample time for eating a wholesome meal rather than grabbing a candy bar or bag of chips and a soda from a vending machine. Busy lifestyles and hectic work schedules create eating habits that may contribute to a less than desirable eating environment, but simple changes can help to counter-act these habits.
Nutrition education is distinct from nutrition counseling, although the contents overlap considerably. Nutrition counseling and dietary management tend to focus more directly on the motivational, emotional, and psychological issues associated with the current task of weight loss and weight management. It addresses the how of behavioral changes in the dietary arena. Nutrition education on the other hand, provides basic information about the scientific foundation of nutrition that enables people to make informed decisions about food, cooking methods, eating out, and estimating portion sizes. Nutrition education programs also may provide information on the role of nutrition in health promotion and disease prevention, sports nutrition, and nutrition for pregnant and lactating women. Effective nutrition education imparts nutrition knowledge and its use in healthy living. For example, it explains the concept of energy balance in weight management in an accessible, practical way that has meaning to the individual's lifestyle, including that in the military setting.
Educational formats that provide practical and relevant nutrition information for program participants are the most successful. For example, some military weight-management programs include field trips to post exchanges, restaurants (fast-food and others), movies, and other places where food is purchased or consumed (Vorachek, 1999).
The involvement of spouses and other family members in an education program increases the likelihood that other members of the household will make permanent changes, which in turn enhances the likelihood that the program participants will continue to lose weight or maintain weight loss (Hart et al., 1990; Hertzler and Schulman, 1983; Sperry, 1985). Particular attention must be directed to involvement of those in the household who are most likely to shop for and prepare food. Unless the program participant lives alone, nutrition management is rarely effective without the involvement of family members.
Weight-management programs may be divided into two phases: weight loss and weight maintenance. While exercise may be the most important element of a weight-maintenance program, it is clear that dietary restriction is the critical component of a weight-loss program that influences the rate of weight loss. Activity accounts for only about 15 to 30 percent of daily energy expenditure, but food intake accounts for 100 percent of energy intake. Thus, the energy balance equation may be affected most significantly by reducing energy intake. The number of diets that have been proposed is almost innumerable, but whatever the name, all diets consist of reductions of some proportions of protein, carbohydrate (CHO) and fat. The following sections examine a number of arrangements of the proportions of these three energy-containing macronutrients. 041b061a72