General guidelines on how to lose weight(2)

Limitation of fats in the diet

Operationalization

TDCR vs. TDCI

In the previous article [Powertec (136)], it was mentioned that your basis of subtracting the 500 calories should be from thetotal daily caloric intake(TDCI); however, in most instances, the computation of TDCI is so demanding and difficult for people, like you, who are on the go to keep up with the demands of daily living. In fact, you might need the help of a nutritionist-dietitian to compute for it.Thus, instead of TDCI, it is thetotal daily caloric requirement(TDCR)which is used.

Assuming that you opted to lose 1 pound per week, then you need to reduce your TDCR by 500 calories per day or 3,500 calories per week. Since you are moderately active, your TDCR should be 157 pounds x 15 giving a product of 2,355 calories; and since you are 38 years old, you need to subtract 100 from 2,355 giving a difference of 2,255[1]. If you have normal weight, the total number of calories that you need to take per day in order to maintain your normal weight is 2,255 calories; this is your TDCR; but since you are overweight, you need to reduce your TDCR by 500 calories per day [consult Powertec (136)for all the necessary tables].

Limitation of fat intake

To fast track your weight reduction, you limit your fat intake to 10% of the TDCR; hence, 10% of 2,255 is 225.5 or 226 calories which is equivalent to 25 grams of fat per day, derived from dividing 226 by 9. You need to take only 25 grams of fat per day which means limiting your fat intake to 10% of the TDCR. This is the smallest amount of fatintake allowable to you; if you take less than 10%, you will suffer from some vitamin deficiencies, especially linked to the fat-soluble vitamins [1].

If you used to take 80 grams of fat per day, but now you are taking only 25 grams per day, then you are reducing your food intake by 495 calories per day derived from multiplying 55 (the difference of 80 – 25) grams of fatby 9 calories. If you multiply 495 by 7 days, then you are losing approximately 3,500 calories per week which could reduce your weight by 1 pound per week. This means that even if you will not reduce your protein and carbohydrate intake, the reduction in fat intake is enough to effect reduction in your weight.

In the preceding example, you limited your fat intake to 10%. If you want to use 20% or 30%, then it is also acceptable; however, you now need to reduce also your protein and carbohydrate intake, enough to give a total of 500 calories of daily reduction in your TDCR.

When you have reached your ideal weight, you now shiftto consumingyour total TDCR which is 2,255 calories. You need to take foods whose total caloric contribution will be 2,255. You do not need to reduce it; otherwise, you become underweight.

Ways of reducing fat intake

  1. Avoid deep-fried and fried foods;
  2. Take fatty meats, lard, butter, cheese, cream, whole milk, egg yolk, vegetable oils, nuts, chocolates, avocados, olives, and margarine [1] in moderate amounts;
  3. When buying packed foods, read the “Nutrition Facts” and find out the saturated fat It should contain less than 10% of saturated fat; and
  4. When buying packed foods, select those not containing trans-fatty acid and hydrogenated fats.

Reference:

  1. Roth, Ruth A. Nutrition and Diet Therapy. Singapore: Delmar Learning, 2007.

General guidelines on how to lose weight(1)

Limitation of fats in the diet

One of the ways of facilitating your weight reduction is to focus on the limitation of fat intake. This is very effective because one gram of fats could give you 9 calories of energy whereas protein and carbohydrates could only give you 4 calories per gram. Thus, if you limit your intake of fats, your losing calories—and subsequently your weight—would be faster than when you solely restrict your protein or carbohydrate intake.

Steps

Determine how many calories you need to maintain your ideal weight. You can look at your ideal body weight in the ensuing Table 1[1]USDA Acceptance Weights for Adults

*The higher weights in the ranges generally apply to men, who tend to have more muscle and bone than women; the lower weights more often apply to women [1].

To find your calorie needs, multiply your ideal weight by 15 if you are moderately active or by 20 if you are very active[1].

From that total, subtract the following according to your age:

                              Age 25-34, subtract 0

                             Age 35-44, subtract 100

                             Age 45-54, subtract 200

                             Age 55-64, subtract 300

                              Age 65+, subtract 400[1]

To find your fat-gram allowance, multiply your daily calories by the percentage of fat desired (10%, 20%, or 30%); then divide by 9 calories/g[1].

Operationalization

Suppose you are male, 38 years old, with height of 5’ 4”,  with present weight of 170 pounds, and moderately active. Firstly, you want to find out if you are overweight, underweight, or with normal weight. So you look at Table 1, and you find out that the maximum weight that you should have is 157 pounds. Offhand, you are overweight by 13 pounds. Therefore, the program that you will need is weight reduction.

Ideally, you need to lose 1-2 pounds per week; thus, if you prefer to lose 1 pound per week, then you will need 13 weeks or approximately three months to normalize your weight. If you want to accelerate your weight reduction, you can target to lose 2 pounds per week, and you need around 6-7 weeks or 1 ½ months.

Before proceeding with the discussion, you need to understand two technical terms: (1) total daily caloric intake (TDCI), and total daily caloric requirement (TDCR). TDCI refers to the actual number of calories that you take each day, while TDCR refers to the number of calories that you should take each day to maintain your ideal weight [Please consult Powertec (20)].

Since you are overweight, it is safe to assume that your TDCI has been very much higher than your TDCR. You have been taking more calories than what you need, or more than what you can burn. Thus, the excess calories are stored and deposited in your body making you heavier than your ideal weight. Therefore, in your weight reduction, the basis of subtracting the number of calories that you need to slice off each day should be from the TDCI.

 

Reference:

  1. Roth, Ruth A. Nutrition and Diet Therapy. Singapore: Delmar Learning, 2007.

What are trans fats? Part 1

Definitions                                                                                     

There are two broad types of trans fats—otherwise known as trans fatty acids—in  foods: (1) the naturally-occurring, and (2) the artificial trans fats. Naturally-occurring trans fats are produced in the gut of some animals, and foods prepared from these animals, such as milk and meat products, may contain small quantities of these fats.  Artificial trans fats, on the other hand, are manufactured in an industrial processes wherein hydrogen is added to the liquid vegetable oils to make them more solid. When you use the hydrogenated oil in preparing your foods, such as cookies, doughnuts, frozen pizza, stick margarines, pie crusts, crackers, pastries and fried foods, it will inevitably follow that you take in trans fatty acids when you take these foods! Thus, unknowingly, your  main source of trans fatty acids  is from your diet [1].

Some companies prefer to use trans fats because they are easy to use, less expensive to produce and have longer shelf life.   They, at the same time, provide foods with a desirable taste and texture. In some countries, however, the use of trans fats is restricted because of its ill effects on health [1].

Adverse effects on health

There are two types of cholesterol in your body: (1) high-density lipoprotein  cholesterol, otherwise known as HDL-cholesterol, and (2)  the low-density lipoprotein cholesterol, also known as LDL-cholesterol. The HDL-cholesterol has been proven to be  “good” while the LDL-cholesterol has been found to be “bad”. The reason for this is that HDL-cholesterol has been established by scientific study that it promotes the so-called “reverse cholesterol transport” wherein cholesterol is eliminated from your body, whereas the LDL-cholesterol promotes the deposition of cholesterol in the different tissues of your body, causing the blockage of both the small and large  arteries. Worse and very fatal, the development of obstruction in the small arteries  could  take place in your heart, which could lead to heart attack—medically known as myocardial infarction. When this takes place, you may die!

When you take a lot of foods rich in trans fats, your “good” cholesterol (HDL)  decreases while your “bad” cholesterol  (LDL)  increases. This will  mean that the rate of deposition of cholesterol in your tissues will be faster than its elimination. When this happens, you are prone to develop diseases of the heart and the blood vessels—otherwise known as cardiovascular diseases. Examples of cardiovascular diseases are hypertension, atherosclerosis (hardening and narrowing of the large arteries), and  arteriolosclerosis (hardening and narrowing  of the small  arteries).  Stroke (bleeding in the brain) and diabetes mellitus could also develop because of high intake of trans fats [1].

Preventing the intake of trans fats 

To find out if the food that you are about to take in contains trans fats, look at the “Nutrition Facts” of the product. You can also look at the “list of ingredients”. If “partially hydrogenated oil” is listed as one of the ingredients, then the food product contains trans fats [1].

Ways of lowering the intake of  trans fats and saturated fatty acids

As mentioned in the preceding paragraph, high level of  LDL in your systems is bad for your health, and  all means must be resorted to lower it. In line with this, the American Heart Association recommends that adults need to lower their intake of trans fat and limit their consumption of saturated fat to 5 to 6% of their total daily caloric intake [1].  This recommendation can be achieved through the following ways:

  • Eat a lot of  fruits, vegetables, whole grains, low-fat dairy products, poultry, fish and nuts. In addition,  limit your intake of  red meat and sugary foods and beverages [1].

(To be continued)

 

Reference:

http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyEating/Trans-Fats_UCM_301120_Article.jsp

General guidelines on how to lose weight (Part 1)

Compute for your ideal body weight

There is an ideal body weight (IBW) for every person, and it is computed in the following manner:

Height in centimeters – 100 = Ideal weight in kilograms (kg)

Thus, if your height  is 5 feet and 4 inches, its equivalence in centimeters is  64 inches x 2.54 = 162.56 centimeters. Ideal body weight will be:  162.56 centimeters – 100 = 62.56 kg. If you are an Asian or a woman, you can afford to deduct 5-10 percent from 62.56 kilograms, and your IBW will be:  62.56 – 6.25 = 56.31 kg or 124 lbs.  Your IBW is the most appropriate weight for your sex, age and degree of activity.

Compute for your total daily caloric need  

Your total daily caloric requirement (TDCR) is the number of calories that you need to take daily to maintain your IBW. If you take more than your TDCR, you will gain weight; if less, you will lose weight. If you will use your IBW in pounds, you need to multiply 15 if you are moderately active and multiply 20 if you are very active to compute for your TDCR (Roth, 2007).  This does not discriminate whether you are a male or a female; hence,  ball park  figures are used here.

Thus, if your IBW is 124 lbs, and you are moderately active, your TDCR will be  124 x 15 = 1,860 calories. If you are very active, your TDCR will be 124 x 20 = 2,480 calories. Initially, if it is too hard for you to use the lower value, you can take the average of 1,860 and 2,480, which is 2,170, as your starting TDCR. At the very start of your weight reduction program, you can afford to exercise some degree of flexibility because then you are still adjusting.

Compute for the total daily calories that you have been taking

Before the start of your weight reduction program, you have been taking a certain number of calories per day which is called    your  total daily caloric intake (TDCI).  Surely, if you are overweight now, your TDCI has been more than your TDCR!  TDCI can be roughly computed by adding the number of calories derived from a certain size of food. In the  food exchange lists, you will see, for instance, that one slice of bread provides the body with certain number of calories; a cup of rice weighing 150 grams, for another example, could provide certain number of calories. Adding all the number of calories coming from the different foods that you take each day will give you the TDCI.

If you have a  friend who is a nutritionist–dietitian, s/he could provide you with the  food exchange lists that would help and guide you  add up the total calories that you derived from the foods that you take each day. Searching the internet could be another  option of consulting  different food exchange lists. Of course, this process does not require very exacting computation! All you have to do is to approximate the TDCI.

Compute for the discrepancy between the TDCN and TDCI

If you are overweight now, your TDCI has been more than your TDCR! The difference between your TDCI and your TDCR is the excess energy that you have been taking and has been causing your being overweight! To normalize your body weight, and for you to achieve your IBW, you need to stop taking the excess energy.

Reduce the number of calories that you take each day

The physiological rate of reducing weight is to lose 1-2 pounds per week. To achieve this, you need to reduce your total  caloric intake by 3,500 -7,000 calories per week, or by 500 – 1,000 calories per day (Roth, 2007). One way of facilitating your weight reduction is to examine closely your intake of fats. Remember that for every gram of fats that you take in, you consume 9 calories! The caloric content of a gram of fats is the highest among the three food groups! Thus, it would be logical—and of prime importance—to  target its reduction because then it could significantly  facilitate your weight reduction.

Further discussion of this topic, particularly the method of reducing fat intake,  will be continued in the second part.

Reference:

Roth, Ruth A. Nutrition and Diet Therapy. Singapore: Delmar Learning, 2007.

Obesity as a risk factor for chronic diseases

Obesity is one of the most common disorders in medical practice. In the United States about 60 million people are now obese (more than 30%) and 68% of population is overweight.  It is alarming that overweight rates among children have doubled and among adolescents even tripled, increasing the number of years they are exposed to the health risks of obesity. Obesity is defined as an excess of body fat. The best way to classify obesity is to use body mass index (BMI). It closely correlates with excess fat tissue, and it’s calculated by dividing measured body weight in kilograms by the height in meters squared.  A normal BMI is defined as 18.5 – 24.9. Overweight is defined as BMI 25-29, 9 and obesity is BMI over 30. Class I obesity is 30-34.9, class II obesity 35-39, 9 and extreme obesity, or class III is over 40. Obesity is a risk factor for developing type 2 diabetes, cardiovascular diseases, especially coronary disease, hypertension, obstructive sleep apnea , knee osteoarthritis, hyperlipidemia (high blood cholesterol levels) and even cancer.  It is also an important risk factor for stroke, abdominal angina, obesity hypoventilation syndrome (Pickwickian syndrome) and deep vein thrombosis (which is a risk factor for developing pulmonary embolism).  For example, except the fact that diabetes is the risk factor for developing coronary disease it is also the leading cause of amputation of the lower limbs throughout the world.

The main cause of obesity in the most of cases is sedentary life and chronic ingestion of excess calories. But, nowadays, it has been discovered that genetic influences are very important, to even 40-70 %. Most probably is that obesity develops from the interactions of multiple genes, environmental factors and behavior. Since there is a rapid increase in obesity in the last 30 years it is obvious that environmental factors have the most important role in the development of this disease. Upper body obesity (excess fat around waist and flank) is much more dangerous than lower body obesity (fat in the thighs and buttocks) and it is a greater risk for developing diabetes mellitus, stroke, coronary artery disease and early death. Of course, it is important to know  that obesity itself leads to hyperlipidemia, which leads to atherosclerosis, and that’s the most important risk factor for developing cardiovascular and cerebrovascular disease, and they are the leading cause of death in the Western World. Of course atherosclerosis will develop even if people have low cholesterol levels and if they are slim, but the process will be slower and the stenosis of the arteries probably won’t be significant.  Also, some studies have shown that being only 10 pounds overweight increases the force on the knee by 30-60 pounds with each step. Overweight women have nearly 4 times the risk of knee osteoarthritis; for overweight men the risk is 5 times greater. For a woman of normal height, for every 11 lb weight loss (approximately 2 BMI units), the risk of knee osteoarthritis dropped > 50%. Conversely, a comparable weight gain was associated with an increased risk of later developing knee OA. It is obvious that obesity plays an important role in the development of the most important chronic diseases today and by controlling our weight we can significantly decrease the risk of sudden and early death as well as the disability caused by stroke, heart attack, osteoarthritis or diabetes.

References:

1. Role of Body Weight in osteoarthritis, http://www.hopkinsarthritis.org/patient-corner/disease-management/role-of-body-weight-in-osteoarthritis/

2. Maxine A.Papadakis, Current Medical Diagnosis and Treatment 2014, Visceral Artery Insufficiency (Intestinal Angina), p 453-454

3. Diabetes and Amputation, http://www.diabetes.co.uk/diabetes-and-amputation.html

4. Kumar and Clark, Clinical Medicine, 2005, 6th edition, Obesity p.252-257

5.Robert B.Baron, MD, MS, Nutritional Disorders, Obesity, , Current Medical Diagnosis and Treatment 2014, 53rd edition p.1213-1215

6. Robert F.Kushner, Evaluation and Management of Obesity, Harrison’s Principles of Internal Medicine (18th edition), p 629-634