Tag Archives: Obesity

Eat Well

Eat Well, Exercise Well, Be Well: Dietary and Fitness Guidelines

Eat Well

When it comes to the secrets of living a healthy life, it seems that there are no secrets. From diet gurus to celebrities, everyone seems to have the answers on healthy living. Since the 1980s, the United States government has also weighed in, with dietary guidelines that it publishes every 5 years. The intent is to provide research-backed diet and physical activity recommendations to reduce the risk of diseases linked to poor diet and activity, such as high blood pressure, heart disease, and type 2 diabetes. Here is a round-up of the government’s latest key recommendations from the publication, 2015-2020 Dietary Guidelines for Americans.

EAT WELL

Calories, Calories, Calories
In recent years, obesity has been a national concern, since it has been associated with serious conditions like cancer, heart disease, and type 2 diabetes. Controlling total calorie intake is essential to maintaining ideal body weight. If you are trying to lose weight, you will need to expend more calories than you take in. This means getting plenty of exercise and cutting down on foods that are high in calories.

So how many calories should you be consuming? This depends on several factors, such as age, gender, height, weight, and physical activity level. To keep calories under control, you want to focus on eating foods full of many nutrients, especially potassium, fiber, vitamin D, and calcium. You may want to talk with your doctor or a registered dietitian about an eating plan that is right for you. In general, try to keep calories in check. Aim to meet calorie needs, but not exceed them. Reducing portion size and eating more meals at home are great ways to avoid exceeding calorie needs. In addition, eating foods high in nutrients but lower in calories can help.

Foods to Enjoy

  • Eat a lot of fruits and vegetables—Fresh fruits and vegetables are lower in calories compared to processed foods. Focus on color when eating fruits and vegetables. Dark green, red, and orange vegetables are especially packed with good-for-you nutrients. When preparing a meal, try and fill half your plate with fruits and vegetables.
  • Eat a lot of whole grains—Examples of whole grains are brown rice, oatmeal, bulgur, and whole-wheat pasta. Your goal should be to make half your grains whole grains.
  • Have more dairy—Focus on low- or non-fat milk, cheese, and yogurt.
  • It is okay to eat certain fats—Some fats are okay to consume in moderation. These are monosaturated or polyunsaturated fats, which are found in foods like nuts and fish.
    Power up on protein—Seafood, lean meats, poultry, beans, and soy products are good sources of protein. Be sure to choose protein foods that are low in saturated fat and calories.

Fruits and Vegetables

Food to Eat Less

  • Limit refined grains—Examples of refined grains are white bread, corn flakes, grits, regular pasta, and white rice. These foods tend to be high in calories and sugar but low in fiber.
  • Limit foods containing added sugars—This includes sugar-sweetened drinks and snacks.
  • Limit foods high in saturated fats—This includes certain kinds of meat and dairy products (whole milk, cream, and butter). Less than 10% of calories should come from saturated fats.
  • Keep trans fat consumption as low as possible—You can do this by limiting foods containing solid fats and partially hydrogenated oils, such as margarine and baked goods.
  • Limit salt intake—Too much of it can increase your risk for high blood pressure, which can lead to kidney damage, heart disease, and stroke. On a daily basis, adults should consume less than 2,300 mg of sodium.
  • If you drink alcohol, do so in moderation —Women should consume no more than 1 alcoholic drink a day, while men should consume no more than 2 drinks a day. Also, keep track of the calories in each drink. Mixed drinks tend to have higher calories.

Preparing Your Plate
Remembering which foods to limit, and which to eat more of, may be daunting. To help you remember, the United States Department of Agriculture created a simple image of a sectioned plate as a guideline for healthy eating. The Choose My Plate guidelines emphasize nutrient-dense foods and beverages, such as vegetables, fruits, whole grains, low- or non-fat milk, beans, and nuts. If remembering how much and what to eat is a chore, you can just keep these simple things in mind to ensure that you are eating well when you sit down for a meal:

  • Fill half your plate with fruits and vegetables.
  • When eating grains, make sure half your grains are whole grains.
  • Choose fat-free and low-fat (1%) milk products.
  • Avoid oversized portions.
  • Enjoy your food, but be mindful of how much you are eating. Try to eat less.
  • Drink water instead of sugary drinks.
  • When cooking, try to use less or no salt in the recipe. When you eat your meals, do not add any extra salt. Over time, you will adjust to less salt in your food.

You can find specific information on the ChooseMyPlate website.

Exercise Well
A nutritious diet and exercise go together for maintaining a healthy lifestyle. To achieve and maintain a healthy body weight, adults should aim for 150 minutes of moderate to intense physical activity each week. Some examples of activities are brisk walking, biking, and swimming. Before starting any kind of exercise program, be sure to check with your doctor if you have any health issues that may limit your exercise program.

Be Well
Guidelines provide the foundation for a healthy lifestyle. But living a healthy lifestyle takes discipline and a positive attitude. Working with your doctor and perhaps other professionals, like a dietitian or fitness trainer, can be helpful in keeping you motivated and on track for reaching your health goals. Also, a healthy lifestyle should not be a chore, but something enjoyable.

Make exercise fun—a weekend hike, a lunch-hour walk with co-workers, or a pick-up game of basketball with your neighbor are just some ideas. And when mealtimes roll around, put on your creative chef hat! Come up with new approaches to breakfast, lunch, and dinner menus that incorporate fresh, nutrient-dense foods, and get friends and family involved in preparing meals. Experiment with herbs and spices to flavor your meals instead of the old salt standby. Armed with guidance, support, and motivation, a healthy lifestyle is within your reach!

Written by Marjorie Montemayor-Quellenberg, MA

RESOURCES:
Choose My Plate—US Department of Agriculture
http://www.choosemyplate.gov

Eat Right—Academy of Nutrition and Dietetics
http://www.eatright.org

CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca

Dietitians of Canada
http://www.dietitians.ca

REFERENCES:

2015-2020 Dietary guidelines for Americans. US Department of Agriculture and US Department of Health and Human Services. Available at: https://health.gov/dietaryguidelines/2015/guidelines/. Accessed February 14, 2017.

BMI calculator. ChooseMyPlate—US Department of Agriculture website. Available at: http://www.choosemyplate.gov/weight-management-calories/weight-management.html. Accessed February 14, 2017.

Dietary interventions for cardiovascular disease prevention. EBSCO DynaMed Plus website. Available at: http://www.ebscohost.com/dynamed. Updated February 5, 2015. Accessed March 9, 2015.

What is MyPlate? US Department of Agriculture ChooseMyPlate website. Available at: https://www.choosemyplate.gov/MyPlate. Accessed February 14, 2017.

Last reviewed February 2017 by Michael Woods, MD, FAAP

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

causes of carpal tunnel

Common Causes of Carpal Tunnel Syndrome

Common Carpal Tunnel Causes

Carpal Tunnel happens when the tendons become swollen (tenosynovitis) or if the tunnel size itself decreases because of injury-causing compression to the median nerve.  When compression occurs, a person can experience numbness, tingling, or a dull sensation of the thumb, index, middle and ring fingers. Symptoms may include pain during pinching and gripping, or a feeling of clumsiness and the inability to hold things. The best way to avoid carpal wrist pain is to understand the main causes of carpal tunnel and use that information at work and at home.

WHAT IS THE CARPAL TUNNEL?
The carpal tunnel is a small space at the wrist in which the median nerve and nine tendons pass through. The median nerve travels on top of the tendons through the tunnel. The tunnel itself is made up of your wrist bones and along the top of the tunnel is a thick fibrous ligament called the transverse carpal ligament.

COMMON CAUSES OF CARPAL TUNNEL
Carpal Tunnel is typically not related to a specific injury. Some common causes of carpal tunnel syndrome include:

Genetic Predisposition – Many cases can be a result of physical characteristics of carpal tunnel or medical conditions associated with CTS, which also run in the family.

Repetitive Movements – Certain types of work, leisure, and sports activities require use of the hand and wrist repetitively. Occupations such as manufacturing/assembly line workers, grocery checkers, musicians, carpenters, and many others require the same movements. Common hobbies such as golfing, knitting, and gardening also require repeated movements that cause carpal tunnel syndrome.

Injury or Trauma – Sprain or fracture of the wrist can cause swelling and pressure to the median nerve.

Pregnancy & Menopause – Hormonal fluctuation in women plays a role in CTS. Such fluctuation may cause fluid retention and other changes that cause swelling in the body. Fluid retention frequently occurs during the last trimester of pregnancy and is the reason for CTS.

Medical Conditions – Diabetes, hypothyroidism, lupus, obesity, and rheumatoid arthritis.

ACTIVITIES TO AVOID TO MINIMIZE SYMPTOMS

  • Avoid keeping your wrists bent in either direction. The best position for the wrist is neutral (straight)
  • Avoid rapid repetitive forceful or prolonged hand or arm use such as seen with factory work or data entry.
  • Avoid tight gripping and pinching
  • Avoid pressure to the palm or wrist
  • Avoid extreme cold or vibration.
weight loss

Weight Loss: What Are Your Options?

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The prevalence of obesity has increased steadily in Western cultures over the past century, particularly during the last several decades. In fact, most health professionals agree that we are in the midst of an obesity epidemic in the United States.

Being overweight is closely linked to many very serious health conditions. It is a significant risk factor for coronary artery disease (CAD), stroke, high blood pressure, high cholesterol, high triglycerides, low levels of HDL (high-density lipoprotein—the “good” cholesterol), and type 2 diabetes. Fortunately, even modest reductions in weight can help reduce the risk or improve these conditions. Plus, practicing the behavioral changes of a healthier diet and regular exercise may actually reduce these risk factors whether weight loss occurs or not.

Energy Balance: The Simple Principle of Weight Loss
Scientists often explain weight loss quite simply in terms of the energy balance equation: energy in versus energy out. To lose weight, you must consume fewer calories than you burn or, in reverse, you must burn more calories than you consume.

This is, of course, easier said than done. But no matter what weight loss methods you may employ—diet, exercise, medications, supplements, surgery, therapy, group support—the principle of energy balance is unavoidable. In fact, experts from both traditional and nontraditional disciplines agree that to achieve and maintain weight loss you must make changes in your diet and activity level to favorably affect the balance of the energy equation.

Using Strategies to Get Started
Getting started is often the most difficult part of losing weight. Any changes you make in your eating and exercising behaviors must become habitual, which takes time. In addition, carrying extra weight, no matter how much, can affect how you feel about yourself psychologically, sometimes making it more difficult to take the necessary steps to begin to change.

The following 5 strategies are crucial to successful weight loss and can help to overcome some of these barriers:

• Set and commit to realistic goals and monitor your progress toward achieving these goals
• Slowly modify your eating and exercise behaviors, as well as habits influencing both
• Examine and restructure unrealistic, negative thoughts, or expectations
Reduce stress
• Develop a network of social support and information

weight_loss

Looking at Weight Loss Aids
There is a great deal of interest in whether prescription medications or supplements can facilitate weight loss. Some medications suppress appetite by interfering with brain chemicals that affect mood and appetite. Others reduce fat absorption from the gut. Here are examples of medications that may be recommended for weight loss:

• Diethylpropion
• Lorcaserin
• Orlistat
• Phendimetrazine
• Phentermine—can be taken alone or in combination with another medication

Some studies have supported the use of these medications when combined with lifestyle changes. For example, as part of a review of weight loss drugs, researchers analyzed 15 trials involving almost 10,000 people who were either taking orlistat or placebo. Compared to the placebo group, those taking orlistat had a higher chance of achieving a 5% or 10% weight loss. These types of medications, though, are usually prescribed only for people who are severely obese when other methods of weight loss have not worked. Accordingly, these medications are not without side effects or potential adverse events and should only be used with careful monitoring by your doctor.

The same goes for dietary supplements. Supplements do not undergo the same rigorous approval process as drugs. That being said, certain supplements may provide weight loss benefits since they may contain similar mechanisms of action as drugs. Along the same line, some of the same risks and side effects may be present, as well, which is why you should talk to your doctor before taking any over-the-counter weight loss products.

Also, be sure you know what is in diet medications and supplements. Some medications and supplements that were used in the past have been pulled from the market as it was found that the dangers of taking them were higher than the benefits. Whenever you are considering taking a diet supplement, know exactly what is in the product and share this information with your doctor.

The question is: when should you consider taking these weight loss aids? While it depends on your overall health and medical history, the best approach may be a conservative one. For example, adopt lifestyle changes for 6-12 months before trying a drug or supplement. Your doctor can give you guidance as to which weight loss options you should try first.

by Jackie Hart, MD

RESOURCES:
National Heart, Lung, and Blood Institute
https://www.nhlbi.nih.gov

National Institute of Diabetes and Digestive and Kidney Diseases
http://www.niddk.nih.gov

CANADIAN RESOURCES:
Dietitians of Canada
http://www.dietitians.ca

Health Canada
http://www.hc-sc.gc.ca

REFERENCES:
Choosing a safe and successful weight-loss program. National Institute of Diabetes and Digestive and Kidney Disorders. Available at: http://www.niddk.nih.gov/health-information/health-topics/weight-control/choosing-safe-successful-weight-loss-program/Pages/choosing-safe-successful-weight-loss-program.aspx. Updated December 2012. Accessed January 14, 2016.

Diets for weight loss. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 21, 2015. Accessed January 14, 2016.

Obesity in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 21, 2015. Accessed January 14, 2016.

Rucker D, Padwal R, Li SK, Curioni C, Lau DC. Long term pharmacotherapy for obesity and overweight: updated meta-analysis. BMJ. 2007;335(7631):1194-1199.

Weight loss medications for obesity in adults. Available at: http://www.ebscohost.com/dynamed. Updated October 7, 2015. Accessed January 14, 2016.

7/6/2009 DynaMed’s Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Seo DC, Sa J. A meta-analysis of psycho-behavioral obesity interventions among US multiethnic and minority adults. Prev Med. 2008;47(6):573-582.

10/15/2010 DynaMed’s Systematic Literature Surveillance http://www.ebscohost.com/dynamed: US Food and Drug Administration. Meridia (sibutramine): market withdrawal due to risk of serious cardiovascular events. US Food and Drug Administration website. Available at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm228830.htm. Updated Sepember 9, 2013. Accessed January 14, 2016.

Last reviewed July 2016 by Michael Woods, MD Last Updated: 1/14/2016

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

Managing BMI to Improve Pre & Post Surgical Outcomes

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MANAGING A PATIENT’S BMI can reduce pain and improve outcomes pre & post surgically.
Physical therapists can treat patients for their pain (potentially related to their obesity) and can provide can provide general population information to patients regarding healthy eating, healthy recipes, general daily activity.

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Calculating Your Body Mass Index (BMI)

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What is the Body Mass Index (BMI)?

Body Mass Index (BMI) is a number calculated from a person’s weight and height. BMI is a fairly reliable indicator of body fatness for most people. BMI does not measure body fat directly, but research has shown that BMI correlates to direct measures of body fat, such as underwater weighing and dual-energy x-ray absorptiometry (DXA).1, 2 BMI can be considered an alternative for direct measures of body fat. Additionally, BMI is an inexpensive and easy-to-perform method of screening for weight categories that may lead to health problems.

How is BMI used?

BMI is used as a screening tool to identify possible weight problems in adults. However, BMI is not a diagnostic tool. For example, a person may have a high BMI. However, to determine if excess weight is a health risk, a healthcare provider would need to perform further assessments. These assessments might include skinfold thickness measurements, evaluations of diet, physical activity, family history, and other appropriate health screenings.

Why is BMI used to measure overweight and obesity?

Calculating BMI is one of the best methods for population assessment of overweight and obesity. Because calculation requires only height and weight, it is inexpensive and easy to use for clinicians and for the general public. The use of BMI allows people to compare their own weight status to that of the general population.

What are some of the other ways to measure obesity?

Other methods to measure body fatness include skinfold thickness measurements (with calipers), underwater weighing, bioelectrical impedance, dual-energy x-ray absorptiometry (DXA), and isotope dilution. However, these methods are not always readily available, and they are either expensive or need highly trained personnel. Furthermore, many of these methods can be difficult to standardize across observers or machines, complicating comparisons across studies and time periods.

What are the health consequences of being overweight and obese for adults?

The BMI ranges are based on the relationship between body weight and disease and death.5 Overweight and obese individuals are at increased risk for many diseases and health conditions, including the following:

  • Hypertension
  • Dyslipidemia (for example, high LDL cholesterol, low HDL cholesterol, or high levels of triglycerides)
  • Type 2 diabetes
  • Coronary heart disease
  • Stroke
  • Gallbladder disease
  • Osteoarthritis
  • Sleep apnea and respiratory problems
  • Some cancers (endometrial, breast, and colon)

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