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What is Your Healthy WeightChristine Zoumas, MS, RD
Dept. of Family and Preventive MedicineCancer Prevention and Control Program
In the American Association for Cancer Research's new cancer report lies the sad fact
that about half of the 585,720 cancer deaths expected to occur in the United States this year
are related to preventable behaviors
A combination of weight problems, poor diet, and exercise account for another third of all
preventable cancers
Top Preventable Causes of Cancer
American Association for Cancer Research
American Cancer Research Institute, aicr.org
Body Weight and Cancer Risk
AICR's expert report, Food, Nutrition, Physical Activity and the Prevention of Cancer and its continuous updates found a strong link between excess body fat and increased risk for the following cancers:
Esophagus Pancreas*Colon* and RectumEndometrium*Kidney
Postmenopausal breast*GallbladderOvarian* Prostate* (aggressive)Liver*
Evidence also indicates that being overweight and obesity may also be associated with an increased risk of non-Hodgkin lymphoma, multiple myeloma and cervical cancer
• produces proteins called cytokines, which cause inflammation, a factor for increased cancer risk
• produces more estrogen, a sex hormone linked to higher risk of some cancers
• leads to insulin resistance, which causes the body to produce more insulin and related growth factors, increasing risk for cancer
How Does Body Fat Affect Your Risk for Cancer?
Excess Fat
Be as lean as possible throughout life without being underweight
Whether or not your own weight is healthy for you depends on several factors:
· How much of your weight is fat
· Where your body fat is located
· If you have weight related health problems
Aim to Be a Healthy Weight
How Much of Your Weight is Fat?
· Height and weight, body mass index (BMI)
· Waist circumferences
· Body composition measures (dual energy x-ray absorptiometry, electrical conductance or impedance, skinfold measures)
Body Mass Index (BMI)
BMI = weight (lbs) X 703height squared (in2)
On-line BMI Calculator
Underweight = BMI < 18.5Healthy weight = BMI 18.5-24.9Overweight = BMI 25-29.9Obese = BMI 30-39.9Severely obese = BMI >40
BMI and Weight
Where is Your Body Fat Located?
Classification of Overweight and Obesity by BMI, Waist Circumference and Associated Disease Risk*
Disease Risk* Relative to Normal Weight and Waist Circumference
Men ≤40 in >40 in
Women ≤35 in >35 in
BMI (kg/m2)
Underweight <18.5 — —
Normal+ 18.5 – 24.9 — —
Overweight 25.0 – 29.9 Increased High
Obesity 30.0 – 34.9 High Very High
35.0 – 39.9 Very High Very High
Extreme Obesity
≥40 Extremely High Extremely High* Disease risk for type 2 diabetes, hypertension, and CVD.+ Increased waist circumference can also be a marker for increased risk even in persons
of normal weight.
Source (adapted from): Preventing and Managing the Global Epidemic of Obesity. Report of the World Health Organization Consultation of Obesity. WHO, Geneva, June 1997
Goals of Weight Loss to Achieve a Healthy Weight
• Reduce body weight and maintain a lower body weight for the long term
• An initial weight loss of 5 to 10 percent of body weight is recommended
Condition Health Benefits of Modest (10%) Weight Loss
Mortality • 20-25% fall in overall mortality
• 30-40% fall in diabetes-related deaths
• 40-50% fall in obesity-related cancer deaths
Diabetes • Up to a 50% fall in fasting glucose
• Over 50% reduction in risk of developing diabetes
Lipids • 10% fall in total cholesterol
• 15% fall in LDL cholesterol
• 30% fall in triglycerides
• 8% increase in HDL cholesterol
Blood pressure • 10 mmHg fall in diastolic and systolic pressures
Benefits of a 10% Weight Loss
Aim to move your weight in this direction
BMI and Weight
Energy Balance
Energy In = Energy Out
Energy In
CHO 4 kcals/gram
Fat 9 kcals/gram
Protein 4 kcals/gram
Alcohol 7 kcals/gram
Energy Out
Basal Metabolic Rate (BMR)• Minimum energy needed to keep you alive
(meet basic physiological needs)• ~50 to 60% of total energy needs
Physical Activity (Calorie burning activity)• Cardio• Lifestyle• ~25 to 50% of total energy needs
Calculating Your BMR
The Harris-Benedict Equation
Man: 66.5 + 13.8 x (weight in kg) + 5 x (height in cm) - 6.8 x (age) = 1745 kcal/day
Woman: 655.1 + 9.6 x (weight in kg) + 1.8 x (height in cm) - 4.7 x (age) = 1536 kcal/day
• Lean body mass • Hormones
• Age • Caffeine
• Gender • Drugs
• Body size • Starvation
• Stress
Factors that Affect Your BMR
Physical Activity
Your daily activity will determine will affect energy needs
• Sedentary people expend less than ½ energy of BMR in physical activity
• Very active athletes can expend twice BMR
Activity LevelActivity Factor
Resting: Sleeping, reclining
1.0
Sedentary: Bedridden Minimal movement, largely Activities include: watching television, reading, etc.
1.3
Light: Office work, sitting, day consists of sleeping 8 hrs with 16 hrs of walking or
standing Activities include: walking, laundry, golf, ping pong, walking on level ground at
2.5-3 mph Usually includes 1 hr of moderate activity
1.5 - 1.6
Moderate:• Light manual labor• Activities include: walking 3.5-4 mph, cycling, tennis, dancing
1.6- 1.7
Very Active: Full-time athletes, agricultural laborers, active military duty, hard laborers (mine
and steel workers) Activities include: team sports, climbing
1.9 - 2.0
Activity Factors
Estimating Your Energy Needs
Total Energy Expenditure* (TEE) 1. Calculate Basal Metabolism
2. Find appropriate activity factors
3. Multiply 1 and 2
* Energy needs change (increase) during the following life cycle periods: Pregnancy Lactating Women Infants Children and Adolescents
http://www.health-calc.com/diet/energy-expenditure-advanced
http://www.scymed.com/en/smnxdg/health101/srcalx/sr35350.htm
Weight Loss Basics
Increase Energy Out:Increase Muscle Mass (exercise & activity) &
increase BMRIncrease physical activity (exercise & activity)
Decrease Energy In:Decrease Calories (energy) consumed
One pound of body fat = 3500 calories
Eat SmarterAnd
Move More
• A diet that is individually planned to help create a deficit of 500 to 1,000 kcal/day should be an integral part of any program aimed at achieving a weight loss of 1 to 2 lb/week.
• The diet should fit the patient’s lifestyle and food preferences.
• Dietary education is a necessary to achieve adjustment to a reduction in Calories.
Balance Calories in with Calories Out
• Food composition
• Reading nutrition labels
• Food purchasing
• Food preparation
• Reducing portion sizes
• Limiting alcohol consumption
Food Education
http://www.calorieking.com
http://www.myfitnesspal.com
http://www.fda.gov/Food/ResourcesForYou/Consumers/NFLPM/default.htm
All Food are Not Created Equal
• Nutrient density: A measure of nutrients (vitamins & minerals) provided per kcals of food
• Vegetables, Fruits, whole grains, lean proteins and low-fat dairy
• Empty calories: Provides kcals with few to none other nutrients
• Foods with lots of added sugar and fat such as sodas
Energy Density
Energy Density = Calories/volume
Choose low energy-dense foods that increase volume without increasing Calories (volumizing):
• Water• Air • Fiber
Limit high-energy dense foods that contain high amounts of added fats and sugars
Volumize
Volumize
Move More
Physical Activity
Aerobic Exercise = Exercise that increases your heart rate and breathing rate for a sustained amount of time to improve how your heart and lungs work together. Aerobic exercise burns calories
Strength Training Exercise = Exercise that improves the strength of muscles and bones, and increases the body’s ability to use energy (metabolism).
Lifestyle Activity = Physical activity that is unstructured and incorporated into daily tasks.
Physical ActivityGoal: 150 minutes a week of moderate-intensity or 75 minutes of vigorous activity is recommended for healthy weight control.
Dietary Change Should… Meets nutritional needs
Slow & steady weight loss
Adapted to individuals’ habits and tastes
Contains enough kcal to minimize hunger and fatigue
Contains common foods
Fit into any social situation
Change eating problems/habits
Improves overall health
Includes exercise
Includes behavior change
Questions?