Friday, November 18, 2011

(7) Preventing Disease and Regaining Cardiovascular Health

The Importance of a Healthy Weight
Being overweight or obese increases your risk for many diseases and conditions. The more you weigh, the more likely you are to suffer from heart disease, high blood pressure, diabetes, gallbladder disease, sleep apnea, and certain cancers. On the other hand, a healthy weight has many benefits: It helps you to lower your risk for developing these problems, helps you to feel good about yourself, and gives you more energy to enjoy life.

Risk for Weight-Related Diseases
Body Mass Index (BMI)
Your BMI accurately estimates your total body fat. And, the amount of fat that you carry is a good indicator of your risk for a variety of diseases.
There are two ways to check your BMI:
• Use a BMI chart. First, find your height in the left-hand column. Then, follow it over until you find your weight. The number on the top of that column is your BMI.
Excerpted from “Facts About Healthy Weight,” from the Aim for a Healthy Weight Provider Kit, by the National Heart, Lung, and Blood Institute (NHLBI, www.nhlbi.nih.gov), part of the National Institutes of Health, 2006.
• Use the BMI calculator on the National Heart, Lung, and Blood Institute’s (NHLBI’s) Web site: http://www.nhlbisupport.com/bmi. Although BMI can be used for most men and women, it does have some limitations:
• It may overestimate body fat in athletes and others who have a muscular build.
• It may underestimate body fat in older persons and others who have lost muscle.
Waist Circumference Measurement
Your waist circumference is also an important measurement to help you figure out your overall health risks. If most of your fat is around your waist, then you are more at risk for heart disease and diabetes. This risk increases with a waist measurement that is greater than 35 inches for women and greater than 40 inches for men.
Other Risk Factors for Heart Disease
If you have other risk factors for heart disease and are overweight or obese, then you will be at greater risk for health problems. Your doctor will check your BMI, waist circumference, and other risk factors for heart disease:
• If you are overweight (BMI 25–29.9), do not have a high waist circumference, and have less than two risk factors, then it’s important that you not gain any more weight.
• If you are overweight (BMI 25–29.9) or have a high waist circumference and have two or more risk factors, then it is important for you to lose weight.
• If you are obese (BMI 30), then it is important for you to lose weight.
Even a small weight loss (just 5–10 percent of your current weight) will help to lower your risk of developing weight-related diseases.
How to Lose Weight and Maintain It
Changing the way you approach weight loss can help you be more successful at losing it. Most people who try to lose weight focus on one thing: weight loss. However, if you set goals, begin to eat healthy foods, become more physically active, and learn how to change behaviors, then you may be more successful at losing weight. Over time, these changes will become routine and part of your everyday life.
Weight Loss Goals
Setting the right goals is an important first step to losing and maintaining weight.
• Losing just 5–10 percent of your current weight over 6 months will lower your risk for heart disease and other conditions.
• Losing 1–2 pounds per week is a reasonable and safe weight loss. Losing weight at this rate will help you to keep off the weight. And it will give you the time to make new healthy lifestyle changes.
• Maintaining a modest weight loss over a longer period of time is better than losing a lot of weight and regaining it. You can think about additional weight loss after you’ve lost 10 percent of your current body weight and have kept it off for 6 months.
Keeping a Balance
Maintaining a healthy weight calls for keeping a balance . . . a balance of energy. You must balance the calories or energy that you get from food and beverages with the calories that you use to keep your body going and to be physically active.
• The same amount of energy IN and OUT over time = weight stays the same
• More energy IN than OUT over time = weight gain
• More energy OUT than IN over time = weight loss
Your energy IN and OUT doesn’t have to balance exactly every day: Balancing energy over time will help you to maintain a healthy weight in the long run.
Calories
Cutting back on calories is part of a healthy eating plan to lose weight. Choose foods that are lower in fats, especially saturated and trans fats, cholesterol, and added sugars. Also, pay attention to portion sizes. To lose 1–2 pounds a week, daily intake should be reduced by 500 to 1,000 calories. In general:
• Eating plans that contain 1,000–1,200 calories each day will help most women to lose weight safely.
• Eating plans that contain 1,200–1,600 calories each day are suitable for men and may also be appropriate for women who weigh 165 pounds or more or who exercise regularly.
If you eat 1,600 calories a day but do not lose weight, then you may want to cut back to 1,200 calories. If you are hungry on either diet, then you may want to boost your calories by 100 to 200 per day. Very low calorie diets of less than 800 calories per day should not be used unless you are being monitored by your doctor.
Physical Activity
Staying physically active and eating fewer calories will help you lose weight and keep the weight off over time.
How much physical activity should you aim for?
• For overall health and to reduce the risk of disease, aim for at least 30 minutes of moderate physical activity most days of the week.
• To help manage body weight and prevent gradual weight gain, aim for 60 minutes of moderate-to-vigorous physical activity most days of the week.
• To maintain weight loss, aim for at least 60–90 minutes of daily moderate physical activity.
You can break up the amount of time that you do physical activity, such as 15 minutes at a time. If you haven’t been physically active for some time, then don’t let that stop you. Start slowly and gradually increase your activity. For example, start walking for 10–15 minutes three times a week, then gradually build up to the recommended amount with brisk walking.
Other Weight Loss Options
Weight loss drugs and weight loss surgery may be options for some people who are at high risk from overweight or obesity or who have been unsuccessful at making lifestyle changes. If you think that you may benefit from weight loss drugs or surgery, then talk to your doctor.
Tips to Weight Loss Success
Maintaining long-term weight loss can be difficult. Three keys to success are setting realistic goals, following a healthy diet, and aiming for 60–90 minutes of physical activity most days of the week.
Other tips for weight loss success include the following:
• Set specific, realistic goals that are forgiving (less than perfect). To start, try walking 30 minutes, 3 days a week.
• Ask for encouragement from your health care provider(s) via telephone or e-mail; friends and family can help. You can also join a support group.
• Keep a record of your food intake and the amount of physical activity that you do. This is an easy way to track how you are doing. A record can also inspire you. For example, when it shows that you’ve been more active, you’ll be encouraged to keep it up.
• Change your surroundings to avoid overeating. For example, don’t eat while watching television. Plan to meet a friend in a nonfood setting.
• Reward your success but not with food. Instead, choose rewards that you’ll enjoy, such as a movie, music CD, an after-noon off from work, a massage, or personal time.

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