Maintaining a Healthy Weight
Being overweight increases your risk of developing high blood pressure. In fact, blood pressure rises as body weight increases. Losing even 10 pounds can lower blood pressure — and it has the greatest effect for those who are overweight and already have hypertension.
Being overweight or obese are also risk factors for heart disease. They increase your chance for developing high blood cholesterol and diabetes — two more major risk factors for heart disease.
Am I overweight?
Two key measures are used to determine if someone is overweight. These are the body mass index, or BMI, and waist circumference.
BMI relates weight to height. It gives an approximation of total body fat — and that's what increases the risk of obesity-related diseases. Overweight is defined as a BMI of 25 to 29.9; obesity is defined as a BMI equal to or more than 30.
Calculate your body mass index (BMI)
But BMI may overestimate body fat or inaccurately estimate total body fat in muscular persons or those losing muscle. For example, older persons often have lost muscle mass and, so, have more fat for a given BMI than younger persons do. That's why waist measurement is often checked as well. Another reason is that too much body fat in the stomach area also increases disease risk. A waist measurement of more than 35 inches in women and more than 40 inches in men is considered high.
Should I Lose Weight?
For people who are considered obese (BMI greater than or equal to 30), or for those who are overweight (BMI of 25 to 29.9) and have two or more risk factors, the guidelines recommend weight loss. Even a small weight loss (just 10 percent of your current weight) will help to lower your risk of developing diseases associated with obesity. Patients who are overweight, do not have a high waist measurement, and have less than 2 risk factors may need to prevent further weight gain rather than lose weight. Talk to your doctor to see if you are at an increased risk and if you should lose weight.
How Can I Lose Weight?
There is no magic formula for weight loss. You must eat fewer calories than you burn. Just how many calories you burn daily depends on factors such as your body size and how physically active you are.
If you have to lose weight, it's important to do so slowly. Aim for losing no more than
pound to 2 pounds a week. One pound equals 3,500 calories. So, to lose 1 pound a week, you need to eat 500 calories a day less or burn 500 calories a day more than you usually do.
Try starting with a weight loss of 10 percent of your current body weight over 6 months. This is the healthiest way to lose weight — and importantly — it offers the best chance of long term success.
The DASH eating plan is a healthy plan and can be made lower in calories for those who need to lose weight.
Tips for Eating Out
So, if you're treating yourself to a meal out, here are some tips to help make it a dining experience that is both tasty and good for you.
Will the restaurant:
- Serve margarine rather than butter with the meal?
- Serve fat free (skim) milk rather than whole milk or cream?
- Trim visible fat from poultry or meat?
- Leave all butter, gravy or sauces off a dish?
- Serve salad dressing on the side?
- Accommodate special requests?
- Use less cooking oil when cooking?
Select foods which are:
- Steamed
- Garden fresh
- Broiled
- Baked
- Roasted
- Poached
- Lightly sauteed or stir-fried
Healthy Shopping
The new National Heart, Lung, and Blood Institute Obesity Guidelines say that you can reduce the time you spend cooking healthy by using a shopping list and keeping a well-stocked kitchen. Read the labels as you shop and pay attention to serving size and servings per container. Compare the total calories in similar products and choose the lowest calorie ones.
So, shop for quick low fat food items and fill your kitchen cupboards with a supply of lower calorie basics like the following:
Fat free or low fat milk, yogurt, cheese, and cottage cheese
Light or diet margarine
Eggs/Egg substitutes
Sandwich breads, bagels, pita bread, English muffins
Soft corn tortillas, low fat flour tortillas
Low fat, low sodium crackers
Plain cereal, dry or cooked
Rice, pasta
White meat chicken or turkey (remove skin)
Fish and shellfish (not battered)
Beef: round, sirloin, chuck arm, loin and extra lean ground beef
Pork: leg, shoulder, tenderloin
Dry beans and peas
Fresh, frozen, canned fruits in light syrup or juice
Fresh, frozen, or no salt added canned vegetables
Low fat or nonfat salad dressings
Mustard and catsup
Jam, jelly, or honey
Herbs and spices
Salsa
These low-calorie alternatives provide new ideas for old favorites. When making a food choice, remember to consider vitamins and minerals. Some foods provide most of their calories from sugar and fat but give you few, if any, vitamins and minerals.
This guide is not meant to be an exhaustive list. We stress reading labels to find out just how many calories are in the specific products you decide to buy.
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Higher-Fat Foods |
Lower-Fat Foods |
| Dairy Products |
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Evaporated whole milk |
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Evaporated fat-free (skim) or reduced-fat (2%) milk |
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Whole milk |
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Low-fat (1%), reduced-fat (2%), or fat-free (skim) milk |
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Ice cream |
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Sorbet, sherbet, low fat or fat-free frozen yogurt, or ice |
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Whipping cream |
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Imitation whipped cream (made with fat-free [skim] milk) |
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Sour cream |
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Plain low-fat yogurt |
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Cream cheese |
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Neufchatel or "light" cream cheese or fat-free cream cheese |
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Cheese (cheddar, Swiss, jack) |
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Reduced-calorie cheese, low-calorie processed cheeses, etc. |
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Fat-free cheese |
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American cheese |
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Fat-free American cheese or other types of fat-free cheeses |
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Regular (4%) cottage cheese |
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Low-fat (1%) or reduced-fat (2%) cottage cheese |
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Whole milk mozzarella cheese |
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Part-skim milk, low-moisture mozzarella cheese |
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Whole milk ricotta cheese |
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Part-skim milk ricotta cheese |
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Coffee cream (1/2 and 1/2) or nondairy creamer (liquid, powder) |
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Low-fat (1%) or reduced-fat (2%) milk or non-fat dry milk powder |
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| Cereals, Grains, and Pastas |
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Ramen noodles |
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Rice or noodles (spaghetti, macaroni, etc.) |
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Pasta with white sauce (alfredo) |
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Pasta with red sauce (marinara) |
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Pasta with cheese sauce |
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Pasta with vegetables (primavera) |
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Granola |
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Bran flakes, crispy rice, etc. |
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Cooked grits or oatmeal |
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Reduced-fat granola |
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| Meat, Fish and Poultry |
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Coldcuts or lunch meats (bologna, salami, liverwurst, etc.) |
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Low-fat coldcuts (95 to 97% fat-free lunch meats, low-fat pressed meats) |
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Hot dogs (regular) |
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Lower-fat hot dogs |
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Bacon or sausage |
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Canadian bacon or lean ham |
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Regular ground beef |
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Extra lean ground beef such as ground round or ground turkey (read labels) |
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Chicken or turkey with skin, duck, or goose |
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Chicken or turkey without skin (white meat) |
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Oil-packed tuna |
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Water-packed tuna (rinse to reduce sodium content) |
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Beef (chuck, rib, brisket) |
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Beef (round, loin) (trimmed of external fat) (choose select |
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Pork (spareribs, untrimmed loin) |
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Pork tenderloin or trimmed, lean smoked ham |
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Frozen breaded fish or fried fish (homemade or commercial) |
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Fish or shellfish, unbreaded (fresh, frozen, canned in water) |
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Whole eggs |
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Egg whites or egg substitutes |
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Frozen TV dinners (containing more than 13 grams of fat per serving) |
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Frozen TV dinners (containing less than 13 grams of fat per serving and lower in sodium) |
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Chorizo sausage |
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Turkey sausage, drained well (read label) |
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Vegetarian sausage (made with tofu) |
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| Baked Goods |
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Croissants, brioches, etc. |
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Hard french rolls or soft brown ’n serve rolls |
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Donuts, sweet rolls, muffins, scones, or pastries |
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English muffins, bagels, reduced-fat or fat-free muffins or scones |
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Party crackers |
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Low-fat crackers (choose lower in sodium) |
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Saltine or soda crackers (choose lower in sodium) |
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Cake (pound, chocolate, yellow) |
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Cake (angel food, white, gingerbread) |
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Cookies |
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Reduced-fat or fat-free cookies (graham crackers, |
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ginger snaps, fig bars) (compare calorie level) |
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| Snacks and Sweets |
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Nuts |
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Popcorn (air-popped or light microwave), fruits, vegetables |
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Ice cream, e.g., cones or bars |
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Frozen yogurt, frozen fruit or chocolate pudding bars |
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Custards or puddings (made with whole milk) |
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Puddings (made with skim milk) |
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| Fats, Oils, and Salad Dressings |
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Regular margarine or butter |
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Light spread margarines, diet margarine, or whipped butter, tub or squeeze bottle |
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Regular mayonnaise |
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Light or diet mayonnaise or mustard |
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Regular salad dressings |
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Reduced-calorie or fat-free salad dressings, lemon juice, or plain, herb flavored, or wine vinegar |
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Butter or margarine on toast or bread |
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Jelly, jam, or honey on bread or toast |
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Oils, shortening, or lard |
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Nonstick cooking spray for stir-frying or sautéing |
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As a substitute for oil or butter, use applesauce or prune puree in baked goods |
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| Miscellaneous |
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Canned cream soups |
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Canned broth-based soups |
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Canned beans and franks |
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Canned baked beans in tomato sauce |
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Gravy (homemade with fat and/or milk) |
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Gravy mixes made with water or homemade with the fat skimmed off and fat-free milk |
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Fudge sauce |
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Chocolate syrup |
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Avocado on sandwiches |
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Cucumber slices or lettuce leaves |
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Guacamole dip or refried beans with lard |
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Salsa | |
Your Weight Is As Important To Us As It Is To You!
Over the past few years it has become clear that weight is an important health issue. Being overweight is a risk factor for health problems such as diabetes, high blood pressure, high cholesterol and triglycerides, arthritis, gall bladder disease, gynecologic problems, some cancers, and even lung problems. Some people who need to lose weight for their health don't recognize it, while others who don't need to lose weight, want to get thinner for cosmetic reasons. We understand that in some ways your weight is different from, for example, your cholesterol level or your blood pressure, because you can't see what these are by looking at someone. Many patients have had health-care providers who approached their weight in a less-than-sensitive or helpful manner. Some patients may have had health-care encounters in which they felt blamed, but not helped. Please be assured that when we bring up your weight, it's because we know that this is an important aspect of your overall health care. We understand, though, that successful weight management is a long-term challenge.
By the same token, we may discuss weight goals that are different from those you select. Weight can affect a person's self-esteem. Excess weight is highly visible and evokes some powerful reactions, however unfairly, from other people and from the people who possess the excess weight. The amount of weight needed to improve your health may be much less than you wish to lose when you consider how you evaluate your weight. If we suggest an initial weight goal that seems too heavy for you, please understand that our major emphasis is on your health and that your health can be greatly improved by a loss of 5-10 percent of your starting weight. That doesn't mean you have to stop there, but it does mean that an initial goal of losing 5-10 percent of your starting weight is both realistic and valuable.
Behaviors That Will Help You Lose Weight and Maintain It
Set The Right Goals
Setting the right goals is an important first step. Most people trying to lose weight focus on just that one goal: weight loss. However, the most productive areas to focus on are the dietary and exercise changes that will lead to that long-term weight change. Successful weight managers are those who select two or three goals at a time that they are willing to take on, that meet the following criteria of useful goals:
Effective goals are 1) specific; 2) attainable; and 3) forgiving (less than perfect). "Exercise more" is a commendable ideal, but it's not specific. "Walk five miles everyday" is specific and measurable, but is it attainable if you 're just starting out?" Walk 30 minutes every day" is more attainable, but what happens if you're held up at work one day and there's a thunderstorm during your walking time another day? "Walk 30 minutes, five days each week" is specific, attainable, and forgiving. In short, a great goal!
Nothing Succeeds Like Success
Shaping is a behavioral technique in which you select a series of short-term goals that get closer and closer to the ultimate goal (e. g., an initial reduction of fat intake from 40% of calories to 35% of calories, and later to 30%). It is based on the concept that "nothing succeeds like success." Shaping uses two important behavioral principles: 1) consecutive goals that move you ahead in small steps are the best way to reach a distant point; and 2) consecutive rewards keep the overall effort invigorated.
Success (But Not With Food)
Rewards that you control can be used to encourage attainment of behavioral goals, especially those that have been difficult to reach. An effective reward is something that is desirable, timely, and contingent on meeting your goal. The rewards you administer may be tangible (e. g., a movie or music CD or a payment toward buying a more costly item) or intangible (e. g., an afternoon off from work or just an hour of quiet time away from family). Numerous small rewards, delivered for meeting smaller goals, are more effective than bigger rewards, requiring a long, difficult effort.
Balance Your (Food) Checkbook
Self-monitoring refers to observing and recording some aspect of your behavior, such as calorie intake, servings of fruits and vegetables, exercise sessions, medication usage, etc., or an outcome of these behaviors, such as weight. Self-monitoring of a behavior can be used at times when you're not sure how you're doing, and at times when you want the behavior to improve. Self-monitoring of a behavior usually changes the behavior in the desired direction and can produce " real-time" records for review by you and your health care provider. For example, keeping a record of your exercise can let you and your provider know quickly how you're doing, and when the record shows that your exercise is increasing, you'll be encouraged to keep it up. Some patients find that specific self-monitoring forms make it easier, while others prefer to use their own recording system.
While you may or may not wish to weigh yourself frequently while losing weight, regular monitoring of your weight will be essential to help you maintain your lower weight. When keeping a record of your weight, a graph may be more informative than a list of your weights. When weighing yourself and keeping a weight graph or table, however, remember that one day's diet and exercise patterns won't have a measurable effect on your fat weight the next day. Today's weight is not a true measure of how well you followed your program yesterday, because your body's water weight will change much more from day to day than will your fat weight, and water changes are often the result of things that have nothing to do with your weight-management efforts.
Avoid A Chain Reaction
Stimulus (cue) control involves learning what social or environmental cues seem to encourage undesired eating, and then changing those cues. For example, you may learn from reflection or from self-monitoring records that you're more likely to overeat while watching television, or whenever treats are on display by the office coffee pot, or when around a certain friend. You might then try to sever the association of eating with the cue (don't eat while watching television), avoid or eliminate the cue (leave coffee room immediately after pouring coffee), or change the circumstances surrounding the cue (plan to meet with friend in non-food settings). In general, visible and accessible food items are often cues for unplanned eating.
Get The (Fullness) Message
Changing the way you go about eating can make it easier to eat less without feeling deprived. It takes 15 or more minutes for your brain to get the message you've been fed. Slowing the rate of eating can allow satiety (fullness) signals to begin to develop by the end of the meal. Eating lots of vegetables can also make you feel fuller. Another trick is to use smaller plates so that moderate portions do not appear meager. Changing your eating schedule, or setting one, can be helpful, especially if you tend to skip, or delay, meals and overeat later.