Today is Senior Health and Fitness Day and in support we've posted one of our Here's to your Health presentations on Healthy Weight Management.
Obesity has doubled among the population aged 65 and older since 1987. A Task Force of the National Institutes of Health (NIH) estimates that more than 25% of American adults are obese and therefore at risk of heart disease, Type 2 diabetes, high blood pressure, stroke and some forms of cancer.
What is Obesity vs. Being Overweight?
Most people believe that obese is being very overweight, but it is not that simple. In fact, “overweight” is defined as an excess amount of body weight that includes muscle, bone, fat and water. “Obesity” is specifically an excess amount of fat. Bodybuilders, for example, with a lot of muscle can be overweight, but not obese.
A certain amount of body fat is necessary for heat insulation, shock absorption and other body functions. Women as a rule have more body fat than men, and so the proportion of fat considered “healthy” varies by gender. The current standard is that men with body fat more than 25% and women with more than 30% body fat are obese.
Measuring the exact amount of body fat is not easy. The US Preventive Services Task Force recommends using the body mass index (BMI), which is simply weight adjusted for height. As an example, go to the BMI table, and then find your height in the far left-hand column. Then find your weight to the right of your height, and look at your weight group and classification. Are you normal, overweight or obese?
If you are obese, you are more likely to suffer from: gallbladder disease and gallstones; liver disease; osteoarthritis-the result of excess weight on the joints; gout; pulmonary or lung problems-including sleep apnea; and, if a woman, you are at more at risk for cancer of the gallbladder, breast, cervix, uterus and ovaries.
Are You an Apple or a Pear?
Research tells us that not only how much fat a person has is a predictor of risk, but also where that fat is stored on the body. Women typically collect fat in their hip and buttocks, giving them a “pear” shape. Men usually build up fat around their bellies, giving them more of an “apple” shape. Of course men can become more pear-shaped as they age, and some women become more appleshaped after menopause. However, an apple shape is a predictor of heart disease. If you carry fat around your waist you are more likely to develop health problems. Among Asian Americans or persons of Asian descent a waist measurement is a better predictor of disease than using the BMI index.
Measure your waist:
• Women with a waist measurement of > 35 inches,
• Men with a waist measurement of >40 inches are at greater health risk, particularly for heart disease and stroke.
What Causes Obesity and Being Overweight?
Both obesity and being overweight occur when you consume more calories than you burn. However, genetic, environmental, psychological and other factors play a role.
Genetics: Obesity and being overweight does tend to run in families, suggesting a genetic cause. Remember that families do share diet and lifestyle habits that contribute to the problem. Research is beginning to show that heredity can be linked to obesity.
Environment: Lifestyle, such what a person eats and your level of physical activity strongly influences your weight - so genes need not to destine people to lifetimes of obesity. People can change eating habits and levels of activity.
Psychological: Many people respond to negative emotions such as anger, boredom or sadness by eating. Most overweight people have more psychological problems than people of average weight.
Other Causes: Some illnesses also lead to obesity as well as a tendency to gain weight. These include hypothyroidism, Cushing’s syndrome, depression and certain neurological problems. Drugs such as steroids and some antidepressants can also cause weight gain.
Who Should Lose Weight?
The standard in US healthcare is to lose weight if your BMI is 30 or more. If your BMI is between 25 and 29.9, prevention of weight gain is recommended unless your doctor recommends weight loss due to other health factors.
Fortunately, a weight loss of only 5-10% can improve health! The NIHrecommends if you are obese that you lose 10% of your baseline weight (the weight you are now that classifies you as “obese”) at a rate of 1-2 lbs/week. If you are overweight, reduce calories by 300-500/day and you should have a loss of .5 lbs per week.
What Happens 6 Months After You Start Losing Weight?
We now know that in general after 6 months of weight loss, the rate at which weight usually declines does plateau. If you need to lose more weight, it will take intense management and discipline on your part to watch your diet, sustain physical activity and behavior control. This is now the weight
management stage, and you are considered successful if you regain less than 6.6 pounds in the next 2 years and sustain a waist reduction of 1.6 inches from your waist measurement when you started.
Eating for Successful Aging-5 Simple Suggestions:
Loss of weight and sustaining weight is never easy, but the following are 5 suggestions that represent lifestyle changes that help you.
1. Eat plant-based foods: Healthy eating plans includes include foods with whole grains, fresh vegetables, fresh fruit and beans, nuts and seeds.
2. Drink water: Age increases your sense of thirst. By the time you feel thirsty, you are already slightly dehydrated. So drink until you have had enough, and then drink a little more. Although a common guideline says drink 8 glasses a day, a better individualized amount of how much water
you need is to divide your weight in half – this is the approximate amount of fluid ounces you need daily. Remember that drinks with alcohol or caffeine do not count – they only make you urinate more!
3. Watch fat, cholesterol and sodium: This guideline is particularly important for women. Women on average lose more muscle and gain fat more than men do. Therefore, women need to watch the intake of the following fats even more closely:
a. Saturated fat: butter, cheese, whole milk, meat, cream, poultry, chocolate, lard and solid shortening all have saturated fat and raise your cholesterol.
b. Polyunsaturated fat: while vegetable oil lowers polyunsaturated fats, it also promotes oxidation. Oxidation enables cells in your arteries to absorb fat and cholesterol. Over time oxidation builds up plaque, narrowing your arteries.
c. Monounsaturated fat: Olive oil, canola oil and nuts contain this fat that may help lower blood cholesterol. It is a good idea to control all types of fat, but when do you add fat to your diet,
choose monounsaturated fat.
d. Sodium: You need only a small amount of salt in your diet – less than one quarter teaspoon daily to help regulate fluid balance. Controlling sodium can be as easy as limiting processed foods, and carefully watching how much salt you add to foods when cooking and eating.
4. Watch calories: As you age your metabolism slows and fat accounts for a greater proportion of weight. This reduces your need for calories. Don’t forget this fact. On average women gain a pound per year after age 35.
5. Consider supplements: Talk to your doctor about certain vitamin or mineral supplements. Especially important are calcium, Vitamin D, C and E, selenium and co-enzyme Q10-all antioxidants. Do NOT decide on your own about these supplements, as taking too much is dangerous.
These five simple suggestions and making a few adjustments for aging can make the issue of being an apple or a pear a discussion solely for produce section of the grocery store and not your doctor’s office!
References
“Obesity and Other Chronic Conditions Drive Medicare Spending Increases” Diabetes, Obesity and CVD American Diabetes Association November 2006
"Successful Aging" Mayo Clinic Health Information, 2000
"The Practical Guide-The Identification, Evaluation and Treatment of Overweight and Obesity in Adults" National Institutes of Health – National Heart, Lung and Blood Institute North American Association for the Study of Obesity October 2000
“USPSTF Recommends Obesity Screening for all Adults” Medscape Medical News 12/01/03
“Understanding Adult Obesity: Do You Know the Health Risks of Being Overweight?” Briefings on Patient Safety National Institutes of Health 2000
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