The Secret of Great Health Care
Nutrition (Free Ebook Chapter) Obesity rates increased from 15.0% in the late 1970’s to the current rate of about 34% of Americans. This includes 33.3 percent of men and 35.3 percent of women. In 1991 only 4 states had obesity rates greater than 15%; fifteen years later no state had a rate of obesity below 15%. Obesity is one of the biggest risk factors for many diseases including cardiovascular disease, diabetes, hypertension and multiple types of cancer. In addition it is a costly; it costs America society about 100 billion dollars each year. Classifying weight is a typically done by determining the body mass index (BMI), but there are other methods to determine how obese someone is. Determining body fat is more technically challenging as many methods for this determination take more training than measuring a height and a weight (which is how body mass index is determined). Some methods to classify obesity include: The BMI is closely related to the amount of body fat. It will overestimate the amount of fat for an individual with a lot of muscle mass and underestimate the degree of fat in someone with substantial muscle wasting. Mathematical formulas, charts and websites are available to assist people in figuring out BMI. Anyone can determine body mass index if they know their height and weight. Depending on the number assigned to the given height and weight the patient will be placed in a classification of underweight, normal, overweight or obese. Underweight is a BMI less than 18.6; normal weight is a BMI between 18.6 and 24.9; overweight is a BMI between 25-29.9 and anything over 30 is considered obese. Online tools are available. An on-line calculator (http://www.nhlbisupport.com/bmi/bmicalc.htm ) and an on-line chart (http://www.nhlbi.nih.gov/guidelines/obesity/bmi_tbl.htm ) is available. Another way to determine risk from body fat is to determine where the patient holds most of his/her fat. Obesity that is localized to the abdomen is much more dangerous than fat on the legs, arms or hips. Abdominal obesity can be measured by diagnostic scans, but this is an expensive way to determine how much fat is in the abdomen. Measuring waist circumference is the most common method to determine abdominal fat. Men with a waist circumference more than 37 inches and females with a waist circumference greater than 32 inches are at increased risk for heart disease. To determine the waist-to-hip ratio, the waist circumference is divided by the hip circumference. When the waist-to-hip ratio is greater than 0.9 in men or 0.8 in women, the patient is at jeopardy for problem secondary to obesity.
Causes of Obesity When the amount of energy consumed (in the form of food) is greater than the energy expended (in form of activity) the excess energy will be stored as fat. The opposite is also true. To lose weight one must expend more energy than one consumes. Food and drink make up energy in. Energy out is affected by age, sex, amount of muscle mass, activity level, genetics, temperature and current disease states. One pound of energy equals 3500 calories. To lose one pound, an energy deficit of 3500 calories must be created. To gain one pound of weight you must have a net gain in energy expenditure of 3500 calories. The individual who eats the same thing every day and goes on a one mile (which burns about 100 calories) walk after dinner, every day, will lose approximately 1 pound in 35 days. This may not sound like a lot but it adds up to almost 11 pounds a year. It may even be more than that. When someone exercises they increase muscle mass. Muscle mass burns more calories than fat, so if someone gains 5 pounds of muscle mass they may increase there daily energy expenditure by 50 calories a day. This means that they are burning more calories with every activity that they do. Fifty extra calories per day will add up to about 6 pounds of fat burning per year. You may be thinking that will only be a one pound weight loss over one year. While that is technically true – you have lost 6 pounds of fat, while putting on 5 pounds of muscle. This will result in clothes fitting better, looking better, feeling better, looking better and possibly an improvement in blood pressure, blood glucose and cholesterol levels. Many factors contribute to increased body weight among Americans: There is a complex interaction between genetics and lifestyle that adds to the prevalence of obesity. Dopamine (a chemical in the brain) regulates eating habits and is genetically variable. Genetics has a role in if the fat is stored in the abdomen, legs or gluteal region. Families also share lifestyles. Parents who eat well and exercise regularly typically have children who share comparable practices. Many disease states are associated with the development of obesity: Also many medications increase the risk of obesity. Common medications include: Products to help with exercise and weight loss Turbulence Training - Lose fat and gain muscle without cardio. Discover the cardio free fat loss workouts using weight training exercise and interval training to burn fat, get rid of stubborn belly fat, and build muscle. Top Secret Fat Loss - The Reason You Can't Lose Weight has Nothing to Do With Your Will-Power, Over-Eating or the Right Diet! ... The Reason You are Fat and Unhealthy is Because You Have Disgusting Plaque and Horrible Little 'CRITTERS' Living in Your Guts!" Body Weight Exercise Revolution is a bodyweight workout that delivers vitality, health & your best body ever In Just 28 days. Bodyweight exercises only. No gym required. All NATURAL. No equipment required. Exercise Ebooks are a series of ebooks that offer the most powerful training information on the planet. Treatment Individuals with a BMI above 25 with two or more obesity related risk factors (hypertension, abdominal obesity, family history or heart disease or diabetes or dyslipidemia) should be treated. Anyone with a BMI greater than 30 should be treated regardless of risk factors. Rapid weight loss is often more pleasing to the patient, but long-term success with fast weight loss is poor. Losing weight rapidly is dangerous. Ideally, weight loss should occur at a rate of about one to two pounds a week. Weight loss needs to be individualized but lifestyle changes – dietary and physical activity – should be recommended for everyone. Diets should include a variety of fresh fruits and vegetables, whole grains, low-fat proteins and healthy fats. Weight loss should not include extreme measures but include a decrease in total energy intake while maintaining nutrient intake and increasing physical activity. Physical activity is vital in anyone who wants to lose weight. A minimum of 150 minutes of aerobic exercise per week of moderately intense exercise should be incorporated into each weight loss plan. More information on exercise is listed below. Individuals who want to lose weight should consider the use of a pedometer. They inspire people to be more active. Medication for weight loss works by two different mechanisms - they can increase energy expenditure or impair energy intake or absorption. When lifestyle intervention is not successful, medications are often used to help with weight loss. They are often used when individuals have a BMI above 30 or above 27 with obesity-related conditions, such abnormal cholesterol, high blood pressure or type II diabetes. When the BMI is greater than 40, than surgery can be used if medications and lifestyle interventions do not work. Surgery can also be used in those who have a BMI more than 35 and without any conditions such as sleep apnea, heart disease or diabetes. Surgery is not without risk and should be considered very carefully. Weight loss also has the potential to improve arthritis, heartburn, high blood pressure, diabetes, abnormal cholesterol, and depression. At the same time it reduces the risk of future diseases such as: heart disease, diabetes and some types of cancer. Diet is correlated to cancer prevention. Eating a diet high if fruits and vegetables reduces the risk of cancer. Vegetables such as lettuce, broccoli, cabbage, garlic, onions and other leafy green vegetables likely reduce the risk of oral, esophagus, stomach and throat cancer. A diet high in fiber - whole grains, fruits, vegetables and beans - may be helpful in the reducing some forms of cancers. Diets high in fat may also increase the risk of cancer.
Summary
Exercise and nutrition are key component to good health care. Utilize strategies outlined in this chapter to start an exercise and healthy eating program. The incorporation of exercise and good nutrition are key measures to the prevention of many diseases states.
Living a healthy lifestyle is one of the most cost effective, and underutilized ways to prevent the development or progression of chronic disease. Living a healthy lifestyle, in the American culture where a fast food restaurant is on almost every corner and it is glamorous to smoke and drink, is a challenging prospect. None-the-less, individuals who lead unhealthy lifestyles are at increased risk for death and disability.
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Maintaining a healthy lifestyle is not without challenges; it can be extremely difficult. It involves changing habits that have been ingrained in your lifestyle for many years. For example, unhealthy eating habits have been embedded into many people’s habits through out the years. Changing the diet to incorporate fruits, vegetables and lean meats can be very difficult. Finding sixty extra minutes in the day to incorporate an exercise program may involve major lifestyle shifts that cannot be overcome. Health care professionals struggle with the benefit of prescribing lifestyle changes. People are set in their ways and it can be difficult to dissuade their pattern of life that they have developed. Many feel that major lifestyle changes limit the amount of enjoyment they will get from life. This could not be further from the truth; lifestyle changes not only prolong life, but also improves the quality of life. Healthy lifestyle is the number one step to looking and feeling better.Lack of knowledge is a common barrier to practicing preventative health care. The 5-10 minute office visit you have with your doctor is not enough time to learn what you need to know about preventative health care. The majority of information about good preventative health care needs to come from outside the medical office. This is the role of the patient.
Nutrition and Weight
Why is obesity bad?
Obesity increases the risk of many diseases including:
