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Oct 10 - weight loss diets and risk reduction.doc

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Physical Education and Sport
Scott Forbes

Oct 10 – Weight loss and risk reduction Etiology of obesity Factors: 1.) Biological 2.) Behavioural 3.) Environmental Weight management 1.) Goals for weight management 2.) Prevention of weight gain 3.) Environment Bio factors • Experimental obesity (rodent models) • Metabolic susceptibility to obesity (obese prone vs. Obese resistant) • Established obesity alters metabolism to promote weight gain following weight loss • Regulation of energy balance is most sensitive at high energy flux • Our bodies biologically programmed to promote energy intake and protect against weight loss If there is a mismatch in energy balance it will shift the fuels you are using If you consume a high carb meal and it exceeds our energy expenditure, it will reduce fat oxidation. If you reduce fat oxidation, you will store the fat instead of burning it Behavioural factors • Energy intake changes (energy-dense, high fat) • Physical activity changes (ex. Amish vs. Colorado = 400-600 kcal/day) • Diet composition during negative, positive, or equal energy balance (effect of fat).. are low fat diets effective? • Other factors (portion size, energy density, added sugars) • Physical activity (energy expenditure, RMR, fat oxidation) • If you do some sort of strength training, even when losing weight, you can maintain RMR • In an equal energy balance, if you had a high fat diet, you wont be as full as if you ate a high carb diet. So you would eat more and soon you would be in a positive energy balance (over the 3500 calories) Environmental Factors • Physical activity environment (technology, transportation, screen, safety, etc.) • Food environment (energy-dense, high fat, added sugars, inexpensive, marketed) Over time, as a population we will all gain weight and all become obese. One option is to just prevent weight gain and be at status quo. Another option is to lose weight. Ex. Go on a caloric deficit, eat less, do more physical activity Another option is preventing weight regain. After you lose weight, you can easily regain weight. Weight Management Obesity treatment • Few succeed in long-term maintenance of weight loss • Failure largely due to using 1 strategy to attack 3 separate issues Goals for weight management Define success? 1.) Prevention 2.) Losing weight 3.) Making weight loss All 3 goals require understanding of energy balance Weight Management • Beyond effect on hunger and satiety, hypocaloric diets of varying diet composition are no different eliciting weight loss Dansinger et al (2005) • N = 160 overwight or obese participants.. assigned to diet (atkins, ornish, weight watchers, zone) • Each diet modestly reduced body weight and risk factors at 1 year • In each diet group, Approx 10% of participants lost 10% of body weight • Weight reductions highly associated with waist reduction Cardiac Factors • All diets Reduced LDL • All diets Increased HDL • No program altered TG, BP, or FPG • All diets increase C-reactive protein • The amount of weight loss predicted the amount of improvement of cardiac risk factor Comment • No single diet program provided satisfactory adherence levels • Equally poor adherence across diet groups • Most who lose weight (regardless of diet) will regain within 1-3 years Weight Loss Maintenance National weight control registry • Established in 93 and over 6000 people are registered • Developed to provide information about individuals who have been successful in long term weight loss maintenance (Maintain at least 30 pounds (13.6 kg) loss for at least 1 year) Info About NWCR • Self-reported success • 77.4% women, 95.3% white • Average loss = 70 pounds (31.8 kg) for 6 years • Annual questionnaire to follow up Results from NWCR • Many different approaches to loss but more similarity in maintenance • Low energy, low fat intake (24%), break
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