Living HealthyLiving Healthy: : Tools for Successful Weight LossTools for Successful Weight Loss

Wayne Larsen CSCSWayne Larsen CSCSB.S. Exercise and Sports ScienceB.S. Exercise and Sports Science

University of UtahUniversity of Utah

Overview:Overview:

•America’s obesity epidemicAmerica’s obesity epidemic•Metabolism and energy balanceMetabolism and energy balance•Successful weight loss – what really works?Successful weight loss – what really works?•The role of aerobic exerciseThe role of aerobic exercise•Applying the FITT principle to weight lossApplying the FITT principle to weight loss•Debunking a few myths!Debunking a few myths!

America’s “Obesity Epidemic”America’s “Obesity Epidemic”

CDC stats on obesity:CDC stats on obesity:•1960: 13.4% of

Americans •1999-2000: 30.9% of

Americans •Affects 1 in every 3 Affects 1 in every 3

adults, 1 of every 6 adults, 1 of every 6 childrenchildren

Health RisksHealth Risks– Type II diabetesType II diabetes– HypertensionHypertension– High cholesterolHigh cholesterol– Heart diseaseHeart disease– Gall bladder diseaseGall bladder disease– OsteoarthritisOsteoarthritis– Respiratory problemsRespiratory problems– Some cancersSome cancers– HerniasHernias– Varicose veinsVaricose veins– Complications in surgery/pregComplications in surgery/preg

So What Happened?So What Happened?

• No one No one decidesdecides to become overweight! to become overweight!• Most weight gain is result of complicated changes in our Most weight gain is result of complicated changes in our

environment:environment:– Calorie-dense food more readily availableCalorie-dense food more readily available– Opportunities for physical activity are lackingOpportunities for physical activity are lacking– Stress and other emotional triggers to eat are highStress and other emotional triggers to eat are high

• Our goals:Our goals:– Increase awareness of these problemsIncrease awareness of these problems– Find workable solutionsFind workable solutions– Individual responsibility- chose to act rather than be acted upon!Individual responsibility- chose to act rather than be acted upon!

Causes?Causes?

• Physical inactivityPhysical inactivity– Modern technology has dramatically decreased the Modern technology has dramatically decreased the

necessitynecessity to move to move– Busy lifestyles make time more and more scarceBusy lifestyles make time more and more scarce– Cycle of deconditioning/fatigue makes exercise less Cycle of deconditioning/fatigue makes exercise less

and less appealingand less appealing– Estimates are that <30% of Americans exercise 30 Estimates are that <30% of Americans exercise 30

min/day, and min/day, and 40% don’t’ exercise at all40% don’t’ exercise at all

It all comes down to energy balance!It all comes down to energy balance!

•While many factors contribute to obesity, ultimately While many factors contribute to obesity, ultimately a a positive caloric balancepositive caloric balance is the cause. is the cause.

– Positive energy balancePositive energy balance•Kcals in Kcals in >> ((RMR + Activity + TEE)RMR + Activity + TEE)

– Negative energy balanceNegative energy balance•Kcals in Kcals in << ( (RMR + Activity + TEE)RMR + Activity + TEE)

Balancing the energy equation:Balancing the energy equation:

So how many calories should I take in?So how many calories should I take in?

Energy Out: your daily expenditureEnergy Out: your daily expenditure

Energy Out: your daily expenditureEnergy Out: your daily expenditure

• Resting Metabolic Rate (RMR)Resting Metabolic Rate (RMR)•Kcals/day at quiet restKcals/day at quiet rest•Lean body mass (muscle) is Lean body mass (muscle) is most significant most significant

determinant of RMRdeterminant of RMR•Very low calorie diets reduce metabolic rateVery low calorie diets reduce metabolic rate•RMR tested by measuring resting O2 uptake RMR tested by measuring resting O2 uptake •Can be estimated using prediction equationsCan be estimated using prediction equations

Energy Out: your daily expenditureEnergy Out: your daily expenditure

•Physical ActivityPhysical Activity– Most variable AND changeable!Most variable AND changeable!– Includes structured exercise, lifestyle activities, and Includes structured exercise, lifestyle activities, and

involuntary movement (i.e. fidgeting)involuntary movement (i.e. fidgeting)– Increases RMR by Increases RMR by 25-40%25-40% – Significant in weight gain/loss!Significant in weight gain/loss!

Energy out: your daily expenditureEnergy out: your daily expenditure

• Thermic effect of foodThermic effect of food– Energy required to digest, absorb, process foodEnergy required to digest, absorb, process food– Approx. 10% above total energy consumedApprox. 10% above total energy consumed– Fat is far less Fat is far less thermogenicthermogenic than carbohydrate than carbohydrate– Protein is more Protein is more thermogenicthermogenic than carbohydrate than carbohydrate

Set-Point TheorySet-Point Theory•The set-point is a kind of “thermostat” for The set-point is a kind of “thermostat” for

fat -set at higher levels for some, and fat -set at higher levels for some, and lower for others. Each person’s set-lower for others. Each person’s set-point is defended by hormones that point is defended by hormones that dictate hunger and metabolism.dictate hunger and metabolism.

•The body cannot tell the difference The body cannot tell the difference between between dieting dieting and and starvationstarvation; long ; long term caloric deprivation signals the body term caloric deprivation signals the body to turn down it’s metabolic rate to to turn down it’s metabolic rate to maintain the set-point. Calories are maintain the set-point. Calories are burned more efficiently, so even a burned more efficiently, so even a stringent diet may not elicit weight loss.stringent diet may not elicit weight loss.

•ExerciseExercise is the is the only known way to “re-set” this internal thermostat, and LOWER one’s set-point.

Successful Weight Loss =Successful Weight Loss =

•Aerobic ExerciseAerobic Exercise PLUSPLUS

•Strength TrainingStrength Training PLUSPLUS

•Sound nutritionSound nutrition PLUSPLUS•Behavior modificationBehavior modification

RESULT:RESULT: A NEW LIFESTYLEA NEW LIFESTYLE

How to determine my “ideal” body weight?How to determine my “ideal” body weight? (and is there such a thing?!?)(and is there such a thing?!?)

• Advantages of body composition measurementAdvantages of body composition measurement– Measure fat mass and fat-free massMeasure fat mass and fat-free mass– Accounts for differences in denser tissues like Accounts for differences in denser tissues like

bone, musclebone, muscle– Proportion (and distribution) of fat is link to health Proportion (and distribution) of fat is link to health

risksrisks– Allows for healthy and realistic weight loss goals Allows for healthy and realistic weight loss goals

to be setto be set

Methods for measuring body compositionMethods for measuring body composition

• SkinfoldsSkinfolds• Bioelectrical impedanceBioelectrical impedance• Underwater weighingUnderwater weighing• DXA (dual x-ray DXA (dual x-ray

absorbtiometry)absorbtiometry)– The gold standard measureThe gold standard measure– Easy, comfortable to useEasy, comfortable to use– Quantifies fat Quantifies fat andand lean lean

componentscomponents– Tracks Tracks regional regional changes in fat changes in fat

and lean tissue, as well as whole and lean tissue, as well as whole bodybody

How to determine my “ideal” body weight?How to determine my “ideal” body weight? (and is there such a thing?!?)(and is there such a thing?!?)

•Health goals vs. appearance goals – do Health goals vs. appearance goals – do they coincide….?they coincide….?

•Being thin doesn’t guarantee Being thin doesn’t guarantee health health •Being heavier doesn’t have to be Being heavier doesn’t have to be

unhealthyunhealthy•Even a small weight loss (10% of body Even a small weight loss (10% of body

wt) can wt) can significantlysignificantly decrease health risks decrease health risks

•Physical activity and cardiovascular Physical activity and cardiovascular fitness are much more predictive of health fitness are much more predictive of health than body weightthan body weight

Applying the Applying the F.F.I.T.T. Principle to I.T.T. Principle to Weight LossWeight Loss

• FFrequency:requency:– >> 5 5 days per week days per week– Higher freq. = increased caloric deficitHigher freq. = increased caloric deficit– Cross-train to minimize boredom and risk Cross-train to minimize boredom and risk

of overuse injuryof overuse injury– Lower freq. needed to Lower freq. needed to maintainmaintain a given a given

level of fitness than to level of fitness than to attain attain itit

The F.The F.I.I.T.T. Principle and Weight LossT.T. Principle and Weight Loss

•IIntensity:ntensity:– Initial intensity Initial intensity moderatemoderate, or HR of 50-70% , or HR of 50-70% – Progress to Progress to vigorousvigorous, , or HR ofor HR of 70-80% 70-80%

But don’t I need to keep my heart rate in the 50-70% “fat burning But don’t I need to keep my heart rate in the 50-70% “fat burning zone” to lose weight?!?zone” to lose weight?!?

Myth #1: The “Fat Burning Zone”Myth #1: The “Fat Burning Zone”

Fact: A higher percentage of calories from fat are used at lower intensitiesFact: Even though the percentage of calories from fat decreases with increased exercise intensity, the absolute number of fat calories rises.Fact: You don’t’ have to BURN fat to LOSE fat…a calorie burned is one less stored as fat!

Interval TrainingInterval Training

•Interval training refers to Interval training refers to mixed-intensitymixed-intensity exercise. exercise.– Intermittent, harder efforts (70-90%) ofIntermittent, harder efforts (70-90%) of– 10 sec.-3 min. 10 sec.-3 min. – mixed in with exercise performed at a more comfortable pacemixed in with exercise performed at a more comfortable pace

•Interval training aids weight lossInterval training aids weight loss– Burns more calories within the same time period than does steady-state exerciseBurns more calories within the same time period than does steady-state exercise– Interval training creates a greater post-exercise caloric burn, Keeping metabolism Interval training creates a greater post-exercise caloric burn, Keeping metabolism

elevated longer.elevated longer.•Anyone can do interval training.Anyone can do interval training.

– Not just for athletesNot just for athletes– Work/rest ratios can be self-determined based on RPEWork/rest ratios can be self-determined based on RPE– Intervals can be done in any exercise mode Intervals can be done in any exercise mode

Applying the F.I.Applying the F.I.T.T.T. Principle to T. Principle to Weight LossWeight Loss

• TTime: how long should I ime: how long should I exercise?exercise?

• ACSM: ACSM: 20-60 min/day20-60 min/day– 150 min150 min. per week for weight loss. per week for weight loss– Data support threshold of Data support threshold of 200 min./week200 min./week

as most effective (National Weight Loss as most effective (National Weight Loss Registry)Registry)

– 10 min, 2-3x/day confers same 10 min, 2-3x/day confers same healthhealth benefits as continuous exbenefits as continuous ex

• When it comes to weight When it comes to weight loss/maintenance, more is loss/maintenance, more is better!better!

Intensity vs. Duration: Intensity vs. Duration: which is more important?which is more important?

•Inverse relationship between intensity and Inverse relationship between intensity and durationduration

•In early stage (base-building phase), duration In early stage (base-building phase), duration is more important than intensityis more important than intensity

•Build duration gradually (Build duration gradually (<<10%/week) 10%/week) •Focus is consistency; 5-7 days/weekFocus is consistency; 5-7 days/week•Add intervals and increase intensity once Add intervals and increase intensity once

duration of 45 min. is comfortableduration of 45 min. is comfortable•Fitness easier to Fitness easier to maintainmaintain than than attainattain

Myth #2: “Working out in the morning means I can relax the Myth #2: “Working out in the morning means I can relax the rest of the day”rest of the day”

• Termed “compensation” in weight loss researchTermed “compensation” in weight loss research• Compensating means the caloric deficit created Compensating means the caloric deficit created

during exercise is rendered ineffective by during exercise is rendered ineffective by decreaseddecreased activity through the rest of the dayactivity through the rest of the day– Fact:Fact: the small activities of daily life add up to significant the small activities of daily life add up to significant

calories burnedcalories burned– Fact:Fact: the less you can sit during the day, the better the less you can sit during the day, the better– Fact: Fact: fidgety people are rarely overweight!fidgety people are rarely overweight!

Applying the F.I.T.Applying the F.I.T.T.T. Principle to Principle to Weight LossWeight Loss

• TType of exercise (mode)ype of exercise (mode)What is the “best” exercise for weight loss???What is the “best” exercise for weight loss???

The Answer:The Answer:

The one(s) you will DO! The one(s) you will DO! JJ– Vary your routine oftenVary your routine often– Make it social!Make it social!– Try NEW stuff…take risks!!Try NEW stuff…take risks!!– Find something you ENJOYFind something you ENJOY– Set a GOAL….dream big!Set a GOAL….dream big!

•Other Considerations:Other Considerations:– Orthopedic conditions Orthopedic conditions – WeatherWeather– SkillSkill– Accessibility/convenienceAccessibility/convenience

Two more myths.....Two more myths.....•Exercise will increase my appetite and make me eat more!Exercise will increase my appetite and make me eat more!

FACTFACT: Most report a decrease in appetite, and an increased awareness of : Most report a decrease in appetite, and an increased awareness of “fullness”“fullness”FACTFACT: eating “more” may not be bad, it food CHOICE is better: eating “more” may not be bad, it food CHOICE is better

•““It takes too much exercise to burn a significant number of It takes too much exercise to burn a significant number of calories – it’s easier to just eat less”calories – it’s easier to just eat less”

FACTFACT: A 30 min session of exercise may only burn 300 calories: A 30 min session of exercise may only burn 300 caloriesFACTFACT: Even at only 3-4x/wk, over a year creates a 13-23 lb loss: Even at only 3-4x/wk, over a year creates a 13-23 lb lossFACTFACT: Exercise becomes more effective as fitness level increases:: Exercise becomes more effective as fitness level increases:

• Increased exercise tolerance: ability to burn more calories before fatigueIncreased exercise tolerance: ability to burn more calories before fatigue• Improved fat metabolism: adaptations that increase ability to burn fat Improved fat metabolism: adaptations that increase ability to burn fat • Increase in post-exercise metabolic rateIncrease in post-exercise metabolic rate• Increase in resting metabolic rate: relative to increases in lean massIncrease in resting metabolic rate: relative to increases in lean mass