Publication # 21
Obesity
Diet and Physical Activity
Pennington Biomedical Research Center
Division of Education

Obesity in the United States
 Approximately 66% (or two thirds) of U.S.
adults are overweight or obese.
 Healthy People 2010: reduce the prevalence of
obesity among adults to less than 15%.
 The obesity rate increased from the late 1970’s to
2003 from 15 to nearly 33 percent.
2012
CDC

Obesity in the U.S.
 Body mass index (BMI)
weight (kg)/ height squared With a BMI of: You are considered:
(m2). Below 18.5 Underweight
18.5 - 24.9 Healthy Weight
25.0 - 29.9 Overweight
 BMI is significantly correlated
30 or higher Obese
with total body fat content.
BMI tables:
http://www.nhlbisupport.com/bmi
2012
NIDDK

Obesity in the U.S.
• Obesity is further divided
into three separate classes, Obesity class BMI (kg/m2)
with Class III obesity being
the most extreme of the three. Class I 30.0- 34.9
Class II 35.0-39.9
Class III ≥ 40.0
With a BMI of: You are considered:
(Extreme Obesity)
Below 18.5 Underweight
18.5 - 24.9 Healthy Weight
25.0 - 29.9 Overweight
30 or higher Obese
2012
CDC, NHLBI

Obesity in the United States
Percent of Obese (BMI > 30) in U.S. Adults  In the United States, some
minority groups are more
affected than others.
Income and education are
also related to obesity
prevalence.
 Some states have
significantly higher rates
of obesity than others.
http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps /
2012
NIDDK, Women’s Health

Obesity in the U.S.
Being overweight/obese substantially raises one’s risk of morbidity from:
 Hypertension  Gallbladder Disease
 Dyslipidemia  Osteoarthritis
 Type 2 Diabetes  Sleep apnea
 Coronary Heart Disease  Certain cancers
 Stroke (endometrial, breast, prostate, colon)
Higher body weights are also associated
with increases in all-cause mortality.
2012
J La State Med Soc. 2005; 156: S42-S49.

Obesity in the U.S.
Obesity is also associated with:
 High blood cholesterol  Stress incontinence
( urine leakage caused by
 Complications of pregnancy weak pelvic-floor muscles)
 Menstrual irregularities  Psychological disorders such
as depression
 Hirsutism
(presence of excess body  Increased surgical risk
and facial hair)
2012
NIDDK

What Causes Obesity?
 Energy imbalance over a long
period of time.
 Energy in > Energy out.
 Excess calories and lack of
physical activity. Energy balance is like
a scale. When
calories consumed
are greater than
calories used, weight
gain is the result.
2012
CDC

Calories Used
 Eating, digestion, sleeping, breathing, and movement.
 Excess calories.
 Physical activity.
Energy Balance
Necessary
physiologica
Calories in Calories used l functions
(consumed) (expended)
Food/beverage Physical activity
s consumed
2012
CDC

Overweight
The Right Approach
 If your BMI is between 25 and 30 and you are otherwise healthy
 Try to avoid gaining any additional weight
 Look into healthy ways of losing weight and increasing physical activity
2012
NIDDK

Overweight
The Right Approach
Talk to your doctor about losing weight if you fall into any one of the three scenarios:
1. BMI is 30 or above, or
2. BMI is between 25 and 30 and:
1. You have other health conditions
3. Waist measures > 35 inches (women) or
> 40 inches (men)
and:
1. You have other health conditions
2012
NIDDK

Weight Loss & Maintenance
Strategies to Consider
Physical Activity
&
Diet Therapy
2012

Why Treat Overweight and Obesity?
Because there is strong evidence that weight
loss reduces risk factors for diabetes and
cardiovascular disease, such as:
blood pressure
serum triglycerides
total serum cholesterol
low-density lipoprotein cholesterol
blood glucose levels
2012
NHLBI

Weight Loss Programs
Any safe and effective weight-loss program should include these components:
 Healthy eating plans that reduces caloric intake
 Regular physical activity and/or exercise instruction
 Tips on healthy behavior
 Slow and steady weight loss of about ¾ to 2 pounds a week
 Medical care if needed
 A plan to keep the weight off after you have lost it
2012
NIDDK

Weight Loss
The key to any successful weight loss is making
changes in your eating and physical activity
habits that you can keep for the rest of your life.
2012
NIDDK

Physical Activity

Physical Inactivity
In the U.S.
 Many studies show that Americans are too sedentary.
 Due to
 Increased use of technology.
 Increased use of automobiles.
According to the Behavioral Risk Factor Surveillance System, in 2000 more
than 26 percent of adults reported no leisure time physical activity.
2012
CDC

Physical Inactivity
In the U.S.
 Physical inactivity contributes to premature deaths.
 Rates differ by race and ethnicity.
 Hispanic women - most inactive
 Hon-Hispanic women – second
 Asian and Pacific islander women – third and, lastly,
 White non-Hispanic women - fourth.
2012
Women’s Health

Physical Activity
 Contributes to weight loss.
 Helpful for the prevention of overweight and obesity.
 Helps maintain weight loss.
2012
CDC

Physical Activity
 Occupational work
 Carpentry, construction, waiting tables, farming
 Household chores
 Washing floors or windows, gardening, or yard work
 Leisure time activities
 Walking, skating, biking, swimming, playing Frisbee,
dancing, softball, tennis, football, aerobics
2012
CDC

Physical Activity
Regular physical activity is good for overall health.
 Physical activity decreases the risk for:
 Colon cancer
 Diabetes
 High blood pressure
 Physical activity also helps to:
 Control weight
 Contribute to healthy bones, muscles, and
joints
 Reduce falls among the elderly
 Relieve the pain of arthritis.
2012
CDC

How Much Physical Activity a
Day?
The 2005 Dietary Guidelines for Americans recommend the following for adults:
To reduce the risk of chronic diseases in adulthood:
Engage in at least 30 minutes of moderate-intensity physical activity,
above usual activity, at work or home on most days of the week.
To help manage weight and prevent gradual, unhealthy weight gain in
adulthood: Engage in approximately 60 minutes of moderate- to vigorous-
intensity activity on most days of the week while not exceeding
caloric intake requirements.
To sustain weight loss in adulthood:
Participate in at least 60 to 90 minutes of daily moderate- to vigorous-
intensity physical activity while not exceeding caloric intake
requirements. (Some may need to contact their healthcare
provider before participating in this level of activity.)
2012
Dietary Guidelines for Americans

How Much Physical Activity a Day?
 Any activity helps.
 Moderate physical activity brings
health benefits.
 Make it personal.
 Start slowly (10 minute walk/day).
2012

Increasing Physical Activity
You can increase your physical activity by taking small steps to change what you do everyday.
If you normally… Then try this instead!
Park as close as possible to the store Park farther away
Let the dog out back Take the dog for a walk
Take the elevator Take the stairs
Have lunch delivered Walk to pick up lunch
Relax while the kids play Get involved in their activity
2012
Women’s Health

How Many Calorie Am I Burning?
Calories burned/hour of activity
Activity 100 lb 150 lb 200 lb
Bicycling, 6 mph 160 240 312
Bicycling, 12 mph 270 410 534
Jogging, 7 mph 610 920 1,230
Jumping rope 500 750 1,000
Running, 5.5 mph 440 660 962
Running, 10 mph 850 1,280 1,664
Swimming, 25 yds/min 185 275 358
Swimming, 50 yds/min 325 500 650
Tennis singles 265 400 535
Walking, 2 mph 160 240 312
Walking, 3 mph 210 320 416
Walking, 4.5 mph 295 440 572
2012
American Heart Association

How Many Calories Do I Need?
 To maintain - use your current weight.
 To lose - use the average healthy weight recommended for your height.
2012
ACS

Calculating Ideal Body Weight
For men: A 5’9 man’s ideal body weight would be:
Use 106 pounds of body weight First 5’0 = 106 lb standard weight for men
for the first 5 feet of their height. Plus 9 additional inches 9 (6 lbs)= 54 lbs
Add 6 pounds for each 106 + 54= 160 pounds (± 10%)= 144 to 176
additional inch. 144 to 176 pounds is this man’s idea weight
For women: A 5’4 woman’s ideal body weight would be:
Use 100 pounds of body weight First 5’0= 100 lb standard weight for women
for the first 5 feet of their height. Plus 4 additional inches  4(5 lbs)= 20
Add 5 pounds for each 100 + 20= 120 pounds (± 10%)= 108 to 132
additional inch. 108 to 132 pounds is this woman’s ideal weight
2012

How Many Calories Do I Need?
 USDA’s MyPyramid site: http://www.mypyramid.gov/
 Determines calorie needs and calculates the servings
needed from food groups.
 The American Cancer Society (ACS) site:
http://www.cancer.org/docroot/PED/content/PED_6_1x_
Calorie_Calculator.asp
 The ACS site indicates the number of calories that are
needed per day to maintain your current weight.
2012

On the Path to Increased Physical
Activity

Before Beginning an Exercise
Program
You should check with your doctor before beginning an exercise program if you:
 Are a man older than age 40 or
 Have had joint replacement surgery
a woman older than age 50
 Smoke
 Have had a heart attack
 Are overweight or obese
 Have a family history of heart-related
problems before age 55  Tale medication to manage a
chronic condition
 Have heart, lung, liver or kidney disease
 Have an untreated joint or muscle
 Feel pain in your chest, joints, or muscles
injury, or persistent symptoms after
during physical activity
a joint or muscle injury
 Have high blood pressure, high
 Are pregnant
cholesterol, diabetes, arthritis,
osteoporosis, or asthma  Unsure of your health status.
2012
Mayo Clinic

Health Benefits of
Physical Activity
Health benefits of physical activity. CMAJ. 2006; 174(6): 801-809.

Physical Activity
Primary Effects on Diabetes Mellitus
 Aerobic and resistance types of
exercise decrease the incidence of type
2 diabetes.
 A modest weight loss through diet and
exercise reduces the incidence of
diabetes.
2012
CMAJ. 2006;174(6): 801-809.

Physical Activity
Secondary Effects on Diabetes Mellitus
 Exercise helps in the management
of diabetes.
 Aerobic and resistance training
help in the control of diabetes
2012
CMAJ. 2006;174(6): 801-809.

Physical Activity
Primary Effects on Cancer
 Routine activity reduces the incidence cancers.
 Activity results in a 30-40% reduction in the relative risk of
colon cancer and breast cancer.
Moderate physical activity is believed to exhibit a greater
protective effect than activities of less intensity.
2012
CMAJ. 2006;174(6): 801-809.

Physical Activity
Secondary Effects on Cancer
 Regular physical activity - important.
 Increased self-reported physical activity =
decreased reoccurrence of cancer and a
decreased risk of death from cancer.
 Reduced cancer-related death.
2012
CMAJ. 2006;174(6): 801-809.

Physical Activity
Primary Effects on Osteoporosis
 Many studies have been conducted.
 According to findings, routine physical
activity, especially weight-bearing and
impact exercise, prevents bone loss
associated with aging.
2012
CMAJ. 2006;174(6): 801-809.

Physical Activity
Secondary Effects on Osteoporosis
 Regular physical activity can lead to stronger
bones.
 Bone responds to physical stress at any age; even
in the elderly.
Osteoporosis
2012
CMAJ. 2006;174(6): 801-809.

Eating for Weight Loss

The Critical Role of Healthy Eating
 Good nutrition leads to a healthier life.
 Many do not eat based on MyPyramid recommendations.
2012
CDC

In 2000, the larger
U.S. Eating Habits majority of U.S. adults
reported that they
did not consume 5 or more
82 81% servings of fruits and
80 vegetables/day.
78 77%
Percentage of adults
76 reporting that they
consumed fewer than
74 73% 5 servings of fruits and
72 vegetables/day, 2000
70
68
Men Women Total
2012
CDC. Behavioral Risk Factor Surveillance System

Dietary Guidelines for Americans,
2010
Selected messages
 Balancing Calories
 Enjoy your food, but eat less.
 Avoid oversized portions.
 Foods to Increase
 Make half your plate fruits and vegetables.
 Make at least half your grains whole grains.
 Switch to fat-free or low-fat (1%) milk.
 Foods to Reduce
 Compare sodium in foods like soup, bread, and frozen meals and
choose the foods with lower numbers.
 Drink water instead of sugary drinks.
2012
MyPyramid: http://mypyramid.gov/

A Healthy Diet
The 2010 Dietary Guidelines for Americans defines a healthy diet as one that:
 Emphasizes fruits, vegetables, whole grains, fat-free or low-fat milk, & milk products;
 Includes lean meats, poultry, fish, beans, eggs, and nuts
 Is low in saturated fats, trans fats, cholesterol, salt (sodium), and added sugars.
2012
MyPyramid: http://mypyramid.gov/

Dietary Guidelines for Americans,
2010
Key Recommendations for the General
Population
 Balancing calories to Manage weight
 Prevent and/or reduce overweight and obesity through improved eating and physical
activity behaviors.
 Control total calorie intake to manage body weight. For people who are overweight or
obese, this will mean consuming fewer calories from foods and beverages.
 Increase physical activity and reduce time spent in sedentary behaviors.
 Maintain appropriate calorie balance during each stage of life—childhood,
adolescence, adulthood, pregnancy and breastfeeding, and older age.
2012
MyPyramid: http://mypyramid.gov/

Dietary Guidelines for Americans,
2010
Key Recommendations for the General
Population
 Foods and food components to reduce
 Reduce daily sodium intake to less than 2,300 milligrams (mg) and
further reduce intake to 1,500 mg among persons who are 51 and
older and those of any age who are African American or have
hypertension, diabetes, or chronic kidney disease. The 1,500 mg
recommendation applies to about half of the U.S. population,
including children, and the majority of adults.
 Consume less than 10 percent of calories from saturated fatty acids
by replacing them with monounsaturated and polyunsaturated fatty
acids.
 Consume less than 300 mg per day of dietary cholesterol
2012
MyPlate: http://mypyramid.gov/

Dietary Guidelines for Americans,
2010
Key Recommendations for the General
Population
 Foods and food components to reduce cont.
 Keep trans fatty acid consumption as low as possible by limiting
foods that contain synthetic sources of trans fats, such as partially
hydrogenated oils, and by limiting other solid fats.
 Reduce the intake of calories from solid fats and added sugars.
 Limit the consumption of foods that contain refined grains,
especially refined grain foods that contain solid fats, added sugars,
and sodium.
 If alcohol is consumed, it should be consumed in moderation—up
to one drink per day for women and two drinks per day for men—
and only by adults of legal drinking age.
2012
MyPlate: http://mypyramid.gov/

Dietary Guidelines for Americans,
2010
Key Recommendations for the General
Population
 Foods and nutrients to increase
 Individuals should meet the following recommendations as part of a healthy eating
pattern while staying within their calorie needs.
 Increase vegetable and fruit intake.
 Eat a variety of vegetables, especially dark-green and red and orange vegetables and
beans and peas.
 Consume at least half of all grains as whole grains. Increase whole-grain intake by
replacing refined grains with whole grains.
 Increase intake of fat-free or low-fat milk and milk products, such as milk, yogurt,
cheese, or fortified soy beverages.
2012
MyPyramid: http://mypyramid.gov/

Dietary Guidelines for Americans,
2010
Key Recommendations for the General
Population
 Foods and nutrients to increase cont.
 Choose a variety of protein foods, which include seafood, lean meat
and poultry, eggs, beans and peas, soy products, and unsalted nuts
and seeds.
 Increase the amount and variety of seafood consumed by choosing
seafood in place of some meat and poultry.
 Replace protein foods that are higher in solid fats with choices that
are lower in solid fats and calories and/or are sources of oils.
 Use oils to replace solid fats where possible.
2012
MyPyramid: http://mypyramid.gov/

Dietary Guidelines for Americans,
2010
Key Recommendations for the General
Population
 Foods and nutrients to increase cont.
 Choose foods that provide more potassium, dietary fiber,
calcium, and vitamin D, which are nutrients of concern
in American diets. These foods include vegetables,
fruits, whole grains, and milk and milk products.
2012
MyPyramid: http://mypyramid.gov/

Dietary Guidelines for Americans,
2010
Key Recommendations for the General
Population
 Building healthy eating Patterns
 Select an eating pattern that meets nutrient needs over
time at an appropriate calorie level.
 Account for all foods and beverages consumed and assess
how they fit within a total healthy eating pattern.
 Follow food safety recommendations when preparing and
eating foods to reduce the risk of foodborne illnesses.
2012
MyPyramid: http://mypyramid.gov/

Weight loss:
Goals for Weight
Management of Weight Lost

Calorie Deficit
Needed For Weight Loss
 A calorie deficit of no more than 500 kcal/day.
 This can be achievable through the combination of diet + exercise.
 An example of how to create a calorie deficit of 500 kcal/day through diet + exercise
would be: eating 250 kcal less per day, along with burning 250 calories through exercise
2012
ACS

Calorie Deficit
Needed For Weight Loss
A caloric deficit of 500 can be done by:
Eating 250 kcal less per day: and burning 250 calories through exercise:
 Leave out mayonnaise in a  Walk for 30 minutes
sandwich  Swimming 25 yards
 Leave out dessert  Bicycling for 30 minutes
 Switch from soft drinks to water  Gardening for 1 hr
 Reduce portion sizes
2012

Exercise + Dieting
Calorie Deficit
 Initially physical activity, in combination with dieting, is an important
component of weight loss.
 However, after around 6 months, physical activity will not lead to
substantially greater weight losses when combined with dieting.
 The benefit of sustained physical activity thereafter is mainly
through its role in the prevention of weight gain.
 In addition, it has a benefit in reducing cardiovascular and
diabetes risks beyond that produced by weight gain alone.
2012
NHLBI

Goals for Weight Loss
And Management
 The initial goal of weight loss therapy is to reduce body
weight by approximately 10 percent from baseline.
Once this goal is achieved, then further weight loss can be
attempted, if necessary.
 A reasonable time line for a 10 percent reduction in body
weight is 6 months.
 Experience reveals that lost weight is usually regained
unless a weight maintenance program, consisting of diet
therapy, physical activity and behavior therapy, is
continued indefinitely.
2012
NHLBI

Goals for Weight Loss
And Management
 For overweight individuals with BMIs in the typical range of 27 to 35 kg/m2, a decrease
of 300 to 500 kcal/day will result in weight losses of about ½ to 1 lb per week.
 A 10 percent weight loss could be achieved within 6 months.
 For more severely obese individuals (BMI > 35), deficits of up to 500 to 1,000 kcal/day
will lead to weight losses of about 1 to 2 lb per week.
 A 10 percent weight loss could be achieved within 6 months.
2012
NHLBI

Goals for Weight Loss
And Management
 After 6 months of weight loss treatment, the individual should be assessed.
 If no further weight loss is needed, then the current weight should be maintained.
 Sustained physical activity is particularly important in the prevention of weight regain.
 If further weight loss is desired, another attempt at weight reduction can be made.
2012

Pennington Biomedical Research
Center
Heli J Roy, PhD, RD, Associate Professor
Beth Kalicki, BS
Phillip Brantley, PhD, Director, Division of Education
Steven Heymsfield, MD, Executive Director,
Pennington Biomedical Research Center
2012

About Our Company
The Pennington Biomedical Research Center is a world-renowned nutrition research center.
Mission:
To promote healthier lives through research and education in nutrition and preventive medicine.
The Pennington Center has several research areas, including:
Clinical Obesity Research
Experimental Obesity
Functional Foods
Health and Performance Enhancement
Nutrition and Chronic Diseases
Nutrition and the Brain
Dementia, Alzheimer’s and healthy aging
Diet, exercise, weight loss and weight loss maintenance
The research fostered in these areas can have a profound impact on healthy living and on the prevention of common chronic diseases, such as heart disease,
cancer, diabetes, hypertension and osteoporosis.
The Division of Education provides education and information to the scientific community and the public about research findings, training programs and
research areas, and coordinates educational events for the public on various health issues.
We invite people of all ages and backgrounds to participate in the exciting research studies being conducted at the Pennington Center in Baton Rouge,
Louisiana. If you would like to take part, visit the clinical trials web page at www.pbrc.edu or call (225) 763-3000.
2012

References
 Centers for Disease Control and Prevention (CDC):
Prevalence of Overweight and Obesity Among Adults: U.S., 2003-2004. Available at:
http://www.cdc.gov/nchs/products/pubs/pubd/hestats/obese03_04/overwght_adult_03.htm
 Womenshealth.gov. Physical Activity. Available at:
http://www.womenshealth.gov/pub/steps/Physical%20Activity.htm
 National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Do You Know the Health Risks of Being Overweight? Available at:
http://win.niddk.nih.gov/publications/health_risks.htm
 National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Statistics Related to Overweight and Obesity. Available at:
http://win.niddk.nih.gov/statistics/index.htm
 National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Weight and Waist Measurement: Tools for Adults. Available at:
http://win.niddk.nih.gov/publications/tools.htm
2012

References
 Bellanger T, Bray G. Obesity related morbidity and mortality. J La State Med Soc.
2005; 156: S43-49.
 National Heart, Lung, and Blood Institute (NHLBI). Clinical Guidelines on the
Identification, Evaluation, and Treatment of Overweight and Obesity in Adults.
Available at: http://www.nhlbi.nih.gov/guidelines/obesity/ob_exsum.pdf
 National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Choosing a Safe and Successful Weight-loss Program. Available at:
http://win.niddk.nih.gov/publications/choosing.htm
 National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Weight Loss for Life. Available at: http://win.niddk.nih.gov/publications/for_life.htm
 Warburton D, Nicol C, Bredin S. Health benefits of physical activity: the evidence.
2006; CMAJ; 174(6): 801-809.
2012

References
 Dietary Guidelines for Americans 2005. Available at:
http://www.health.gov/dietaryguidelines/dga2005/recommendations.htm
 American Heart Association (AHA). Physical Activity Calorie Use Chart.
Available at: http://www.americanheart.org/presenter.jhtml?identifier=756
 American Cancer Society (ACS). Exercise Counts. How Many Calories Will Your
Activity Burn? Available at:
http://www.cancer.org/docroot/PED/content/PED_6_1x_Calorie_Calculator.asp
 Mayo Clinic. Exercise: When To Check With Your Doctor First. Available at:
http://www.mayoclinic.com/health/exercise/SM00059
2012