WEIGHT LOSS ENCOURAGEMENT FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES

The Centers for Disease Control and Prevention report that obesity rates for individuals with developmental disabilities are 58% higher than for adults without disabilities. The rates for children with disabilities are 38% higher than for children without disabilities.'

Individuals with disabilities may find it difficult to control weigh due to challenges. These challenges might include:

• Physical limitations that make it difficult to exercise • Intellectual limitations that make it difficult to understand the importance of

maintaining a healthy weight • Feeding difficulties • Medications which contribute to weight gain and changes in appetite • Pain • Lack of energy

Caregivers for individuals with intellectual and developmental disabilities need to make efforts to help the individual manage their weight to prevent the health risks which result from obesity. These risks include:

• Heart disease • Type 2 diabetes • High blood pressure • Stroke • High blood cholesterol • Cancers such as endometrial, breast and colon • Respiratory problems • Sleep apnea • Increased risk for joint swelling and pain associated with arthritis • Increased risk for anxiety, depression, negative behaviors

Increased physical activity and healthy eating are the top recommendations for controlling weight. For those who are not accustomed to physical activities, begin slowly. If walking is not a barrier, build this activity into daily routines. For example, encourage walking to the mailbox to see if they have any mail, park farther away from stores, take neighborhood walks or go to parks. Neighborhood playgrounds are becoming more accessible for children with disabilities. Swimming is an activity which many can enjoy. Wii and Kinect have games which encourage dancing. For those unable to walk, encourage use of a manual wheelchair to build strength. Muscle strengthening exercises are recommended for all. Local fitness centers can be helpful in assisting in finding the right program for an individual. Physical therapists are a great resource

WVDHHR/CED/SFC/WEIGHT LOSS ENCOURAGEMENT FOR INDIVIDUALS W ITH DD/JULY 2 0 1 4

for recommendations for physical activity for an individual with limitations. Increased activity reduces boredom, which is often a cause of focus on food and overeating.

Start slowly with any new fitness activities. The Centers for Disease Control recommends that individuals exercise at least TA hours weekly, which is 30 minutes 5 days a week." Don't give up on the exercise plan. Research suggests that a person needs to follow a regular exercise plan for at least 12 weeks before the body fully adjusts.'" Make the physical activity part of the individual's daily routine, utilizing a schedule and sticking to it. Incentives/rewards for participation, such as stickers or other items which are a motivator for your individual, may be helpful.

Healthy eating habits result in improved health and weight loss. Caregivers can be a good role model by providing and consuming healthy foods themselves. (Two articles, "How to Use Fruits & Vegetables" and "Rethink Your Drink", which are part of this training module, offer suggestions.) Have healthy snacks (vegetables/fruits) and low calorie drinks (such as cold water. Crystal light, etc.) available between meals. Serve the drinks in a favorite water bottle to encourage intake. When shopping, select healthier foods which are lower in sugar, fat and carbohydrates. For individuals who have difficulty with portion control, purchase items with multiple smaller packets of snack foods. Using smaller plates to serve food assists with portion control. Encourage individuals who have the ability to assist in meal preparation. A favorite junk food does not have to be eliminated completely, but reduce the amount. Any questions about appropriate food/nutrition for an individual in your care can be directed to his/her health care provider or a nutritionist.

Benefits of weight loss through physical activity and healthy eating include:

• Being healthier • Increase in chances of living longer • Stronger muscles and bones • Reduces chance of becoming depressed • Increased energy • Better sleep at night

References: Department of Health & Human Resources, Centers for Disease Control and Prevention Department of Social & Health Services, Aging & Disability Services Administration The ARC

' w w w . c d c . g o v / n c d d d / d i s a b i l i t v a n d h e a l t h / o b e s i t v . h t m l 0 7 / 0 7 / 1 4

" Thea rc .o rg

"' D e p a r t m e n t o f Social & Hea l th Services, Ag ing & Disab i l i ty Services A d m i n i s t r a t i o n , " F o o d & Hea l th M a n a g e m e n t S t ra teg ies , N o v e m b e r 12 , 2 0 1 2 .

Fruits and vegetables are part of a

There are many different ways t o lose or main­tain a healthy weight. Using more fruits and veg­etables along w i th whole grains and lean meats, nuts, and beans is a safe and healthy one. Helping contro l your weight is not the only benefit of eating more fruits and vegetables. Diets rich in fruits and vegetables may reduce the risk of some types of cancer and other chronic diseases. Fruits and vegetables also provide essential vitamins and minerals, fiber, and other substances that are important for good health.

weaglit> y©ii most eat fewer calories

tlian your body ijsesc.

This doesn't necessarily mean that you have t o

eat less food. You can create lower-calorie versions of some of your favorite dishes by substituting low-calorie fruits and vegetables in

place of higher-calorie ingredients. The water

and fiber in fruits and veg­etables will add volume t o

your dishes, so you can eat the same amount of food with fewer calo­

ries. Most fruits and vegetables are naturally low in fat and calories and are filling.

As people become less active, their bodies need fewer calories. Even if you do not need to lose weight, you may still need to reduce calories sim­ply to maintain your current weight. Here are s o m e s imple ways to cut ca lor ies and eat fruits and vegetables throughout your day:

Breakfast: Start tiie Day Right. • Substitute some spinach, onions, o r mushrooms

for one of the eggs or half of the cheese in your morning omelet. The vegetables will add volume and flavor to the dish with fewer calories than the egg or cheese.

• Cut back on the amount of cereal in your bowl t o make room for some cut-up bananas, peaches,

o r strawberries.You can still eat a full bowl, but wi th fewer calories.

ugntenupvourLunciL • Substitute vegetables

such as lettuce, toma­toes, cucumbers, o r

onions for 2 ounces of the cheese and 2 ounces of the meat in your sandwich, wrap, or burrito.

The new version will fill you up wi th fewer calo­ries than the original.

• Add a cup of chopped vegetables, such as broccoli, carrots, beans, or red peppers, in place of 2 ounces of the meat or 1 cup of noodles in your favorite broth-based soup. The veg­etables will help fill you -up, so you won't ^- ^ miss those extra > calories.

• Add in I cup of chopped vegetables such as broccoli, tomatoes, squash, onions, o r peppers, while removing I cup of the rice o r pasta in your favorite dish.The dish with the vegetables will be just as satisfying but have fewer calories than the

same amount of the original version.

• Take a good look at your dinner plate. Vegetables, fruit , and whole grains should take up the largest port ion of your plate. If they do not, replace some of the meat, cheese, white pasta, or rice with legumes, steamed broccoli, asparagus, greens, or another favorite vegetable. This will reduce the total calories in your meal w i thout reducing the amount of food you eat. BUT remember to use a normal- or small-size p la te— not a platter.The total number of calories that you eat counts, even if a good proport ion of them come f rom fruits and vegetables.

Smart Snacks Most healthy eating plans allow for one o r t w o small snacks a day. Choosing most fruits and veg­etables will allow you t o eat a snack w i th only 100 calories.

About 100 Calories or Less • a medium-size apple (72 calories)

• a medium-size banana (105 calories)

• I cup steamed green beans (44 calories)

• I cup blueberries (83 calories)

• I cup grapes (100 calories) • I cup carrots (45 calories), broccoli (30

calories), o r bell peppers (30 calories) wi th 2 tbsp. hummus (46 calories)

The fruits and vegetables in the box above all have about 100 or fewer calories.

Instead of a high-calorie snack f rom a vending machine, bring some cut-up vegetables o r fruit f rom home. One snack-sized bag of corn chips (I ounce) has the same number of calories as a small apple, I cup of whole strawberries, A N D I cup of carrots with 1/4 cup of low-calorie dip.

Substitute one or two of these options for the chips, and you will have a satisfying snack with fewer calories.

It's t rue that fruits and vegetables are lower in calories than many other foods, but they do con­tain some calories. If you start eating fruits and vegetables in addition t o what you usually eat, you are adding calories and may gain weight. T h e key is subst i tut ion. Eat fruits and vegetables instead of some other higher-calorie food.

Fruilts and Vegetables f©r Weight Control t i l l iiuiib iiiiu vtiyutaums uie May nature

provided—or with fat-free or low-fat cooliing

techniques. Try steaming your vegetables, using low-calorie or

' low-fat dressings, and using herbs and

spices t o add flavor. Some cooking tech­

niques, such as breading and frying, or using high-fat

dressings or sauces will greatly increase the calories and fat in the dish. And eat your fruit raw to enjoy its natural sweetness.

Canned or frozen fruits and vegetables are good options when fresh produce is not available. However, be careful t o choose those w i thout added sugar, syrup, cream sauces, or other ingredi­ents that will add calories.

Choose whole fruit over fruit drinks and inm99 Fruit juices have lost fiber f rom the fruit. It is bet­ter t o eat the whole fruit because it contains the

added fiber that helps you feel full. One 6-ounce serving of orange juice has 85 calories, compared t o just 65 calories in a medium orange.

Whole fruit gives you a bigger size snack than the same fruit dried—for the same number of calories. A small box of raisins (1/4 cup) is about 100 calo­ries. For the same number of calories, you can eat I cup of grapes.

Want More informationP

es for m o r e fruits and veg­

etables can help you manage your v/eight:

Centers for Disease Contro l and Prevention: v\ww.cdc.gov/5aday

US Department o f Agriculture, Center for Nut r i t ion Policy and Practice: www.usda.gov/cnpp

National Cancer institute: www.5aday.gov

Produce for Better Health Foundation: vmw.5aday.org

wvm.healthierus.gov/dieuryguidelines

W h e n i t comes t o we igh t loss, there 's no lack o f d iets p r o m i s i n g fast results . There are low-carb diets, high-carb diets, low-fat diets, grapefruit diets, cabbage soup diets, and blood type diets, to name a few. But no matter what diet you may try, to lose weight, you must take in fewer calories than your body uses. Most people try to reduce their calorie intake by focusing on food, but another way to cut calories may be to think about what you drink.

WhatDoYouDriiikP It Makes More Difference Than You Think! Calories in drinks are not hidden (they're listed right on the Nutrition Facts label), but many people don't realize just how many calories bev­erages can contribute to their daily intake. As you can see in the example on the next page, calories from drinks can really add up. But there is good news: you have plenty of options for reducing the num­ber of calories in what you drink.

Occas ion Instead of... Ca lor ies

M e d i u m cafe lat te (16 ounces ) made w i t h w h o l e m i l k

265 Small cafe latte ( I 2 ounces ) made w i t h fat-free m i l k

Lunchtime combo meal

20-oz. b o t t l e o f n o n d i e t co la w i t h y o u r lunch

2 2 7 Bo t t l e o f w a t e r o r d i e t soda mi

Afternoon 'brei^

Sweetened l e m o n iced tea f r o m t h e vend ing mach ine (16 ounces )

180 Sparkl ing w a t e r w i t h natura l l e m o n f lavor ( n o t swee tened )

Dinnertime A glass o f n o n d i e t g inger ale w i t h y o u r meal (12 ounces )

124 W a t e r w i t h a 0 ca lor ies f o r slice o f l e m o n t h e w a t e r m o r l ime, o r w i t h f r u i t • se l tzer w a t e r slice, o r • w i t h a splash o f a b o u t 30 " 1 0 0 % f r u i t ju ice ca lor ies f o r

se l tzer w a t e r w i t h 2 ounces o f fJB 1 0 0 % orange ju ice .

125-155 • Total b e v e r s ^ calories

7 9 6

(USDA National Nutrient Database for Standard Reference)

3

Substituting no—or low—calorie drinks for sugar-sweetened bever­ages cuts about 650 calories in the example on the previous page.

Of course, not everyone drinks the amount of sugar-sweetened beverages shown. Check the list below to estimate how many calo­ries you typically take in from beverages.

Type of Beverage Calor ies in 12 oz

Calor ies in 20 oz

F ru i t punch 192 320

1 0 0 % apple ju ice 180 300

1 0 0 % o range ju ice 168 2 8 0

L e m o n a d e 168 280

Regular l emon/ l ime soda 148 2 4 7

Regular cola 136 2 2 7

Swee tened l e m o n iced tea ( b o t t l e d , n o t h o m e m a d e ) 135 225

Tonic w a t e r 124 207

Regular g inger ale 124 207

Spor t s d r i n k 99 165

Fitness w a t e r 18 36

U n s w e e t e n e d iced tea 2 3

D i e t soda ( w i t h aspar tame) 0* 0*

C a r b o n a t e d w a t e r (unswee tened ) 0 0

W a t e r 0 0

*Some diet soft drinks can contain a small number of calories that are not listed on the Nutrition Facts label. ( USDA National Nutrient Database for Standard Reference)

M i l k c o n t a i n s v i t a m i n s a n d o t h e r n u t r i e n t s t h a t c o n t r i b u t e t o g o o d h e a l t h , b u t i t a l so c o n t a i n s c a l o r i e s . C h o o s i n g l o w - f a t o r f a t - f r e e m i l k is a g o o d w a y t o r e d u c e y o u r c a l o r i e i n t a k e a n d s t i l l g e t t h e n u t r i e n t s t h a t m i l k c o n t a i n s .

Type of milk Calor ies per cup (8 ounces)

C h o c o l a t e m i l k ( w h o l e )

C h o c o l a t e m i l k ( 2 % reduced-fat )

C h o c o l a t e m i l k ( 1 % low-fat )

W h o l e m i l k (unf lavored )

2 0 8

190

158

150

2% reduced-fat m i l k (unf lavored) 120

1 % low-fa t m i l k (unf lavored) 105

Fat-free m i l k (unf lavored) 90

(USDA National Nutrient Database for Standard Reference)

p ^ ^ p . , , iggd Nutrition Facts Cai*̂ *""" Be aware that the Nutr i t ion Facts label on beverage containers may give the calories for only part of the contents.The example below shows the label on a 20-

NUTRITION FACTS LABEL Serving Size 8 fl. oz.

Servings Per Container (.^5

Amount perjecving Calories ( 100

oz. bottle. As you can see, it lists the number of calories in an 8-oz. serving (100) even though the bottle con­tains 20 oz. or 2.5 servings.To figure out how many calories are in the whole bottle, you need to mukiply the number of calories in one serving by the number of servings in the botde (100 x 2.5).You can see that the contents of the entire botde actually contain 250 calories even though what the label calls a "serving" only contains 100.This shows that you need to look closely at the serving size when comparing the calorie content of different beverages.

High-Calorie Culnrits in Unexnected Places Coffee drinks and blended fruit smoothies sound innocent enough, but the calories in some of your favorite coffee-shop or smoothie-stand items may surprise you. Check the website or in-store nutr i ­tion information of your favorite coffee or smoothie shop to find out how many calories are in different menu items. And when a smoothie or coffee craving kicks in, here are some tips to help min­imize the caloric damage:

Atttie coffee shy...

• Request that your drink be made with fat-free (skim) milk instead of whole milk.

• Order the smallest size available.

• Forgo the extra flavoring—the flavor syrups used in coffee shops, like vanilla or hazelnut, are sugar-sweetened and will add calories to your drink.

• Skip the Whip.The whipped cream I on top of coffee drinks adds calories and fat.

• Get back to basics. Order a plain cup of coffee with fat-free milk and artificial sweetener, or drink it black.

At the smoothie stand: • Order a child's size if available.

• Ask to see the nutrition information for each type of smoothie and pick the smoothie with the fewest calories.

• Hold the sugar Many smoothies contain added sugar in addition to the sugar naturally in fruit, juice, or yogurt. Ask that your smoothie be prepared without added sugar: the fruit is natu­rally sweet.

Better Beverage Choices Made Easy

lart be

• Choose water, diet, or low-calorie beverages instead of sugar-sweetened beverages.

• For a quick, easy, and inexpensive thirst-quencher, carry a water botde and refill it throughout the day.

• Don't "stock the fridge" with sugar-sweetened bever­ages. Instead, keep a jug or botdes of cold water in the fridge.

• Serve water with meals.

• Make water more exciting by adding slices of lemon, lime, cucumber, or watermelon, or drink sparkling water.

• Add a splash of 100% juice to plain sparkling water for a refreshing, low-calorie drink.

• When you do opt for a sugar-sweetened beverage, go for the small size. Some companies are now selling 8-oz. cans and botdes of soda, which contain about 100 calories.

• Be a role model for your friends and family by choos­ing healthy, low-calorie beverages.