Healthy Weight: Tipping the Scales toward Better Health

Obesity. There seems to be evidence of this growing trend everywhere. It’s in the media, in advertisement, in our families, in us. And what makes the topic so tricky is that it involves one of the few things none of us can do without: food.

It’s true that when we come of age, many of us learn how to talk and how to walk, how to drive and (perhaps even) how to balance a checkbook. But how many of us learn how to eat with our health in mind? With over 1/3 of adults in the U.S. considered obese and the incidence of children who are overweight on the rise, it’s time for us to take note and take action.

Heart disease is the #1 cause of death among African-Americans in St. Louis. About 25 percent of all African-American deaths in our city are caused by heart disease. One of its leading culprits? You guessed it. Obesity. And while at times it may seem that obesity is merely a cosmetic concern, most of us may be surprised to learn how deep the problems it can cause can really be.

Obesity increases a person’s risk of numerous diseases and health conditions. According to the Centers for Disease Control and Prevention (CDC) here are a few:
• Hypertension (high blood pressure)
• Osteoarthritis (a breakdown of the soft tissue between the joints)
• Dyslipidemia (high total cholesterol)
• Type 2 Diabetes (the type that develops after birth)
• Coronary heart disease
• Stroke (blockage of oxygen rich blood to the brain which causes brain cells to die)
• Gallbladder disease
• Sleep apnea (symptoms include excessive sleepiness, swelling in the legs and loud snoring) and respiratory problems
• Some cancers (endometrial, breast and colon)

So what is obesity? It’s determined by a measure called the Body Mass Index (BMI). This is a number that can be calculated by taking a person’s height in inches and multiplying that number by itself (for example, a person who is 5’4” would start with their height in inches: 64 x 64 = 4096), dividing their weight in pounds by that number (for example, the same person weighs 165lbs / 4096 = 0.402) and multiplying it by 703 (for example 0.402 x 703 = 28). The result is the BMI. The BMI will fall into a category which determines whether a person is underweight, normal, overweight, obese or morbidly obese.

Keep in mind that this measure is not the final determining factor in assessing weight and health. It uses standard weight and height measures and so it does not distinguish between pounds that are fat and pounds that are muscle. It also doesn’t take into account gender differences, for example the fact that women are expected to have more body fat than men. The measure is a starting point. And since obesity trends use this measurement, it’s important to understand how it works.

Speaking of trends, they are astounding. According to the Centers for Disease Control, the percentage of adults with a Body Mass Index over 30 has changed drastically every five years for the last fifteen years.

In 1990 in most states fewer than 14% of their population was considered obese. More recently in 2006 in most states more than 25% of the population is considered obese.

As the United States becomes more and more technologically advanced, we’ve also become more and more sedentary, working in jobs that require a lot of brain power but little physical activity. We are entertained by television, movies and videogames which also require virtually no movement. We are a culture of convenience where even the smallest tasks can be done in less time and consequently with less effort. Our busy lifestyles and the growth of the “fast food” industry tempt us to pick up a quick bite which often means meals full of calories but with little nutritional value. Take all these factors combined with the new cultural norm of increased portion sizes (the more the merrier) and you’ve got the perfect formula for weight gain.

The medical community agrees that there are numerous causes of obesity. Genetics is one of them. Studies have indicated that there are some instances when children inherit weight problems from their parents. Medical conditions like Cushing’s disease and diabetes along with the use of certain medications like anti-seizure drugs, steroids and anti-depressants can encourage weight gain. Psychological factors like depression, boredom, grief and anxiety can lead a person to overeat in an effort to cope. Sometimes a person’s environment can play a role in them becoming obese. Children who are allowed to develop unhealthy eating habits and are not encouraged to exercise may become overweight or at risk for obesity as a result of their upbringing. But in a majority of instances, lifestyle is the number one factor for obesity—a lifestyle that involves more calories consumed than are used.

The cause of weight gain is simple. A person gains weight when they consume more calories than they use for their daily activity. The average number of calories that an adult male should consume each day is 2,550 calories. An adult woman should consume on average 1,940 calories. These numbers vary for children and teenagers and can even vary according to height and activity level. But we’ll start with the average.

To get a better idea of how quickly our portion proportions and calorie miscalculations can get us into trouble, let’s put ourselves in the shoes of an average busy working adult. The morning begins with a sugar filled breakfast of 2 Krispy Kreme doughnuts and a cup of coffee (one cream, two sugars) followed by lots of calls, emails to follow up on and a couple of meetings right before lunch. With a busy afternoon ahead and not much time for lunch, they pick up one bacon cheeseburger, a large fry and a super-sized soda from a fast food restaurant close to their job. The afternoon was busy as ever and soon turns into early evening so they purchase a Snickers bar from the vending machine in their building for a quick surge of energy. The day leaves them feeling tired so meal preparation is not on their list of things to do when they get home. They decide instead to stop and pick up a 3-piece fried chicken meal with and red beans and rice, two apple turnovers and a medium soda to drink. Now it’s time to do the math.

And so just like that, a person can consume more than twice their recommended calorie intake in one day. Imagine if this person made similar food choices three times a week. On average a male would consume almost 6,000 extra calories and a woman about 7,700 extra calories. This is equivalent to the energy it would take to walk for 21 hours, dance for 18 hours, ride a bike for 20 hours or play basketball for 14 hours!

Tipping the scale towards better health may be easier than you think. Trading some current food selections with some that are more nutritious and have fewer calories and adding a little physical activity to your daily routine can have you on the road to a healthy weight. For individuals who have a lot of weight to lose, shedding just 10 pounds can add years to your life and decrease your chances for heart disease and some of the other health conditions obesity can promote. Instead of a doughnut for breakfast, substitute a breakfast bar with whole grains, nuts and fruit. It’s a sweet treat with a fraction of the calories but lots of vitamins and nutrients your body needs. Swap a bacon cheese burger for a hamburger with all the toppings, light on the sauce, or a grilled chicken salad with one packet of dressing. A mid-day snack could be a piece of fruit, a cup of yogurt or a small bag of low calorie chips. And for dinner, grilled or baked meat with a hearty salad or vegetable medley of carrots, broccoli, or whatever you choose provides key nutrients but less fat.

In our daily lives we may find ourselves making choices that affect our finances, our employment or our family. At times we may even be impacted by the choices of others that affect us in ways we cannot control. But one thing we can control is what we do to take care of one of the most valuable things we possess in this life that we can never replace: our bodies. We must use whatever motivates us to change— longer life, more money (being unhealthy costs), family who depends on us, time to fulfill our dreams, ability to realize our purpose, energy to enjoy everyday life—combined with the strength of our will to make the decision to take care of a precious resource, our health. It’s one of those things we can easily take for granted…until it’s gone.

References
Coffee Calories: How Many in your Cup? www.mayoclinic.com/print/caloires Obesity & Overweight: Health Consequences
www.cdc.gov/nccdphp/dnpa/obesity/consequences.htm
Dietary Guidelines for Americans http://www.health.gov/dietaryguidelines
Krispy Kreme Nutritonal Facts www.krispykreme.com/doughnuts.pdf
Jack in the Box Nutritional Facts
www.jackinthebox.com/ourfood/dynamic/nutrition.php?
Recommended Calorie Intake
www.vitalhealthzone.com/nutrition/diets/recommended_calorie_intake.html
Setting Standards in the Definition of Obesity
www.obesityfocused.com/articles/about-obesity/definition-of-obesity.php
Obesity & Overweight: Trends
www.cdc.gov/nccdphp/dnpa/obesity/trend/index.htm

Health Department
City of St. Louis
Health Department web site