Leigh Anna Davenport Dietetic Intern Houston VA Medical Center

Leigh Anna DavenportLeigh Anna Davenport

Dietetic Intern Dietetic Intern

Houston VA Medical CenterHouston VA Medical Center

Obesity Trends* Among U.S. AdultsBRFSS, 1985

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1986

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1987

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1988

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1989

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1990

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1991

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1992

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1993

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1994

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1995

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1996

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1997

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% ≥20%

Obesity Trends* Among U.S. AdultsBRFSS, 1998

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% ≥20%

Obesity Trends* Among U.S. AdultsBRFSS, 1999

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% ≥20%

Obesity Trends* Among U.S. AdultsBRFSS, 2000

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% ≥20%

Obesity Trends* Among U.S. AdultsBRFSS, 2001

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 2002

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

Obesity Trends* Among U.S. AdultsBRFSS, 2003

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

Obesity Trends* Among U.S. AdultsBRFSS, 2004

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

Obesity Trends* Among U.S. AdultsBRFSS, 2005

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Obesity Trends* Among U.S. AdultsBRFSS, 2006

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Obesity Trends* Among U.S. AdultsBRFSS, 2007

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Obesity Trends* Among U.S. AdultsBRFSS, 2008

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Obesity Trends* Among U.S. AdultsBRFSS, 2009

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Obesity Trends* Among U.S. AdultsBRFSS, 2010

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

2000

Obesity Trends* Among U.S. AdultsBRFSS, 1990, 2000, 2010

(*BMI 30, or about 30 lbs. overweight for 5’4” person)

2010

1990

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Eat Well….Live Well!Eat Well….Live Well! Food & EnergyFood & Energy Carb CrazeCarb Craze Protein PowerProtein Power Fat FactsFat Facts Physical Activity & HydrationPhysical Activity & Hydration Why Worry About it Now?Why Worry About it Now? Healthy HabitsHealthy Habits Portion DistortionPortion Distortion QuestionsQuestions

How Do I Get Energy?How Do I Get Energy?

What provides energy for your What provides energy for your body?body?

FoodFoodHow do we measure energy in How do we measure energy in

our food?our food?

CaloriesCaloriesWhat nutrients in food provide What nutrients in food provide

calories?calories?• CarbohydratesCarbohydrates• ProteinProtein• FatFat

What is a calorie?What is a calorie?

CaloriesCalories

Caloric BreakdownCaloric Breakdown

1 g Carbohydrates: 1 g Carbohydrates: 4 calories 4 calories

1 g Protein: 4 1 g Protein: 4 calories calories

1 g Fat: 9 calories1 g Fat: 9 calories

How Do I Use EnergyHow Do I Use Energy

1. Basal Metabolism1. Basal MetabolismEnergy to stay alive Energy to stay alive (breathing, heart beat)(breathing, heart beat)

2. Physical Activity2. Physical ActivityEnergy needed toEnergy needed tomove musclesmove muscles

3. Thermic Effect of3. Thermic Effect ofFoodFoodEnergy needed for Energy needed for

digestiondigestion

Energy BalanceEnergy Balance

Excessive calories are stored as body fatExcessive calories are stored as body fat If you eat too few calories, your body may not If you eat too few calories, your body may not

be able to carry out all of its necessary be able to carry out all of its necessary functionsfunctions

EnergyEnergy Have you ever had an Have you ever had an

“energy drink”?“energy drink”?

These are often filled These are often filled with caffeine, which with caffeine, which simply speeds up the simply speeds up the heart rate for a short heart rate for a short length of time. That is length of time. That is not energy!not energy!

Food gives you energy!Food gives you energy!

Carbohydrates: Carbohydrates: Provide energyProvide energy

1. Simple Sugars

2. Complex carbs

(starches)

ProteinProtein Important for: Important for:

Muscle Growth Muscle Growth and repairand repair

Building material Building material for many body for many body tissuestissues

Choose Wisely:

• Fish, shellfish, lean meats • Trim fat and remove skin • Limit high fat processed meats • Choose beans, nuts, & seeds

FatFatEat More:Eat More:

Unsaturated FatUnsaturated Fat Vegetable oils, Vegetable oils,

nuts, and fishnuts, and fish

Needed for energy storage and vitamin absorption

Eat Less: Saturated Fat

• High fat dairy• fatty meats

Trans Fat • Fried food • baked goods

Can raise cholesterol and increase risk of heart disease

Estimated Calorie NeedsEstimated Calorie Needs

Activity LevelActivity Level

GenderGender AgeAge SedentarySedentary Moderately Moderately ActiveActive

ActiveActive

FemaleFemale 14-1814-18 18001800 20002000 24002400

MaleMale 14-1814-18 2000-24002000-2400 2400-28002400-2800 2800-32002800-3200

Food LabelsFood Labels•Serving Size•Servings per Container•Calories•Daily Values

•5%DV or less is low •20%DV or more is high 

•Total Fat 25-35 % of total calories•Saturated Fat < 16 gm•Cholesterol < 300 mg•Sodium < 2400 mg•Total Carbohydrate 130 gm•Dietary Fiber 25 gm

Physical ActivityPhysical Activity At least 60 minutes of vigorous activity on At least 60 minutes of vigorous activity on

most days of the week most days of the week Keeps your heart healthy and strongKeeps your heart healthy and strong Helps bones stay strongHelps bones stay strong Releases stress and anxietyReleases stress and anxiety Increase your chances of living longerIncrease your chances of living longer Burns calories and increases the metabolic rateBurns calories and increases the metabolic rate Sleep better at nightSleep better at night

Physical Activity and Your HealthPhysical Activity and Your Health

Physical activity along with a healthy diet Physical activity along with a healthy diet can help decrease your risk of:can help decrease your risk of: Heart diseaseHeart disease StrokeStroke Type 2 diabetesType 2 diabetes High blood pressureHigh blood pressure High cholesterolHigh cholesterol

Types of Physical ActivityTypes of Physical Activity

AerobicAerobic Moving continuously in a rhythmMoving continuously in a rhythm Makes you breathe harder and your heart beat fasterMakes you breathe harder and your heart beat faster Running, jumping rope, swimming, dancing, biking Running, jumping rope, swimming, dancing, biking

Muscle-strengtheningMuscle-strengthening Making muscles work more than usualMaking muscles work more than usual Climbing, tug-of-war, lifting weights, push-ups Climbing, tug-of-war, lifting weights, push-ups

Bone-strengtheningBone-strengthening Moving our bones against the force of gravityMoving our bones against the force of gravity Running, jumping rope, basketball, tennis, weight-lifting Running, jumping rope, basketball, tennis, weight-lifting

Balance and StretchingBalance and Stretching Enhance physical stability and flexibility, which reduces risk of injuriesEnhance physical stability and flexibility, which reduces risk of injuries Gentle stretching, dancing, yoga, martial arts, and t’ai chiGentle stretching, dancing, yoga, martial arts, and t’ai chi

HydrationHydration WaterWater

8-10 cups of water per day8-10 cups of water per day Before, during, and after athletic Before, during, and after athletic

performance to replace lossesperformance to replace losses Sports drinksSports drinks

OK to use during prolonged activity (over 1 OK to use during prolonged activity (over 1 hr) to replace electrolyteshr) to replace electrolytes

Not appropriate for short intervalsNot appropriate for short intervals May cause upset stomach during exercise May cause upset stomach during exercise

due to high sugar contentdue to high sugar content

Why Worry About Your Why Worry About Your Nutrition Now?Nutrition Now?

Habits (healthy or unhealthy) are formed Habits (healthy or unhealthy) are formed early in lifeearly in life Current teen diet trendsCurrent teen diet trends

• Under-consumption of vitamins, minerals, and fiberUnder-consumption of vitamins, minerals, and fiber• Over-consumption of saturated fat and total fatOver-consumption of saturated fat and total fat

17% of children and adolescents are obese 17% of children and adolescents are obese • Over 50% have at least one cardiovascular disease risk Over 50% have at least one cardiovascular disease risk

factor, such as high cholesterol or factor, such as high cholesterol or high blood pressurehigh blood pressure Childhood obesity increases the risks of:Childhood obesity increases the risks of:

• Heart diseaseHeart disease• DiabetesDiabetes• Certain types of CancerCertain types of Cancer• Bone and joint disordersBone and joint disorders

AtherosclerosisAtherosclerosis Fatty deposits (plaque) Fatty deposits (plaque)

build up in arteries, build up in arteries, making it harder for making it harder for blood to flowblood to flow

Arteries can then Arteries can then rupture, causing a blood rupture, causing a blood clot which slows or stops clot which slows or stops blood flowblood flow

If this is in a coronary If this is in a coronary artery it is called a artery it is called a myocardial infarctionmyocardial infarction, or , or heart attackheart attack

If this happens in the If this happens in the brain, it is called a brain, it is called a strokestroke

So What Can I Do?So What Can I Do? Healthy Habits: Healthy Habits:

Eat three meals each dayEat three meals each day Eat 5 servings of fruits and vegetablesEat 5 servings of fruits and vegetables Eat 3 servings of low-fat dairy Eat 3 servings of low-fat dairy Choose lean meat and protein sourcesChoose lean meat and protein sources Make “half of your grains whole”Make “half of your grains whole” Exercise dailyExercise daily Stay hydratedStay hydrated Watch portion sizesWatch portion sizes

Portion sizesPortion sizes

SummarySummary

It’s a balancing act!

Do You Know How Food Portions Have

Changed in 20 Years?

National Heart, Lung, and Blood InstituteObesity Education Initiative

BAGELBAGEL 20 Years

AgoToday

140 calories 3-inch diameter

How many calories are in this bagel?

140 calories 3-inch diameter

Calorie Difference: 210 calories

350 calories 6-inch diameter

BAGELBAGEL

20 Years Ago

Today

How long will you have to walk your dog in order to burn the extra 210 calories?*   *Based on 145-pound

person

Maintaining a Healthy Weight is a Balancing Act

Calories In = Calories Out

If you walk the dog for 1 hour and 10 minutes you will burn the extra 210 calories.*

*Based on 145-pound person

Calories In = Calories Out

CHEESEBURGER

20 Years Ago

Today

333 calories How many calories are in today’s cheeseburger?

Calorie Difference: 257 calories

590 calories

CHEESEBURGER

20 Years Ago

Today

333 calories

Maintaining a Healthy Weight is a Balancing Act

Calories In = Calories Out

How long will you have to lift weights in order to burn the extra 257 calories?*

*Based on 145-pound person

If you lift weights for 1 hour and 13 minutes, you will burn approximately 257 calories.*

*Based on 145-pound person

Calories In = Calories Out

SPAGHETTI AND MEATBALLS

20 Years Ago Today

500 calories1 cup spaghetti with sauce and 3 small meatballs

How many calories do you think are in today's portion of spaghetti and meatballs?

Calorie Difference: 525 calories

1,025 calories 2 cups of pasta with sauce and 3 large meatballs

20 Years Ago Today

500 calories1 cup spaghetti with sauce and 3 small meatballs

SPAGHETTI AND MEATBALLS

How long will you have to run in order to burn the extra 525 calories?*

*Based on 145-pound person

Maintaining a Healthy Weight is a Balancing Act

Calories In = Calories Out

*Based on 145-pound person

If you run (6 mph or 10 min/mile) for 45 minutes, you will burn approximately 525 calories.*

Calories In = Calories Out

FRENCHFRENCH FRIESFRIES

20 Years Ago

Today

210 Calories2.4 ounces

How many calories are intoday’s portion of fries?

610 Calories6.9 ounces

Calorie Difference: 400 Calories

FRENCH FRIES

20 Years Ago

Today

210 Calories2.4 ounces

How long will you have to go shopping in order to burn those extra 400 calories?* *Based on 145-pound

person

Maintaining a Healthy Weight is a Balancing Act

Calories In = Calories Out

*Based on 145-pound person

If you go shopping for 2 hours and 40 minutes you will burn approximately 400 calories.*

Calories In = Calories Out

85 Calories 6.5 ounces

How many calories are in today’s portion?

SODA

20 Years Ago

Today

Calorie Difference: 165 Calories

250 Calories 20 ounces

85 Calories 6.5 ounces

SODA20 Years Ago

Today

How long will you have to play basketball to burn those extra 165 calories?*

*Based on 145-pound person

Maintaining a Healthy Weight is a Balancing Act

Calories In = Calories Out

If you played basketball for 31 minutes, you will burn approximately 165 calories.*

*Based on 145-pound person

Calories In = Calories Out

320 calories How many calories are in today’s turkey sandwich?

TURKEY SANDWICH

20 Years Ago

Today

Calorie Difference: 500 calories

820 calories 320 calories

TURKEY SANDWICH

20 Years Ago

Today

How long will you have to play softball in order to burn those extra calories?*

*Based on 145-pound person

Maintaining a Healthy Weight is a Balancing Act

Calories In = Calories Out

*Based on 145-pound person

If you play softball for 1 hour and 30 minutes, you will burn approximately 500 calories.*

Calories In = Calories Out

Thank you for participating in Portion Distortion!

For more information about Maintaining a Healthy Weight

visit www.nhlbi.nih.gov

Or

www.ChooseMyPlate.gov

QUESTIONSQUESTIONS