1. Leigh Anna Davenport Dietetic Intern Houston VA Medical Center

2. Obesity Trends* Among U.S. Adults BRFSS, 1985 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

3. Obesity Trends* Among U.S. Adults BRFSS, 1986 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

4. Obesity Trends* Among U.S. Adults BRFSS, 1987 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

5. Obesity Trends* Among U.S. Adults BRFSS, 1988 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

6. Obesity Trends* Among U.S. Adults BRFSS, 1989 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

7. Obesity Trends* Among U.S. Adults BRFSS, 1990 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

8. Obesity Trends* Among U.S. Adults BRFSS, 1991 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

9. Obesity Trends* Among U.S. Adults BRFSS, 1992 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

10. Obesity Trends* Among U.S. Adults BRFSS, 1993 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

11. Obesity Trends* Among U.S. Adults BRFSS, 1994 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

12. Obesity Trends* Among U.S. Adults BRFSS, 1995 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

13. Obesity Trends* Among U.S. Adults BRFSS, 1996 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

14. Obesity Trends* Among U.S. Adults BRFSS, 1997 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%

15. Obesity Trends* Among U.S. Adults BRFSS, 1998 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%

16. Obesity Trends* Among U.S. Adults BRFSS, 1999 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%

17. Obesity Trends* Among U.S. Adults BRFSS, 2000 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%

18. Obesity Trends* Among U.S. Adults BRFSS, 2001 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

19. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) Obesity Trends* Among U.S. Adults BRFSS, 2002 No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

20. Obesity Trends* Among U.S. Adults BRFSS, 2003 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

21. Obesity Trends* Among U.S. Adults BRFSS, 2004 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

22. Obesity Trends* Among U.S. Adults BRFSS, 2005 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

23. Obesity Trends* Among U.S. Adults BRFSS, 2006 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

24. Obesity Trends* Among U.S. Adults BRFSS, 2007 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

25. Obesity Trends* Among U.S. Adults BRFSS, 2008 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

26. Obesity Trends* Among U.S. Adults BRFSS, 2009 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

27. Obesity Trends* Among U.S. Adults BRFSS, 2010 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

28. 2000 Obesity Trends* Among U.S. Adults BRFSS, 1990, 2000, 2010 (*BMI 30, or about 30 lbs. overweight for 5’4” person) 2010 1990 No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

29. Eat Well….Live Well!  Food & Energy  Carb Craze  Protein Power  Fat Facts  Physical Activity & Hydration  Why Worry About it Now?  Healthy Habits  Portion Distortion  Questions

30. How Do I Get Energy? What provides energy for your body? Food How do we measure energy in our food? Calories What nutrients in food provide calories? CarbohydratesCarbohydrates ProteinProtein FatFat

31. What is a calorie?

32. Calories Caloric Breakdown  1 g Carbohydrates: 4 calories  1 g Protein: 4 calories  1 g Fat: 9 calories

33. How Do I Use Energy 1. Basal Metabolism Energy to stay alive (breathing, heart beat) 2. Physical Activity Energy needed to move muscles 3. Thermic Effect of Food Energy needed for digestion

34. Energy Balance Excessive calories are stored as body fat Excessive calories are stored as body fat If you eat too few calories, your body may not be able to carry out all of its necessary functions If you eat too few calories, your body may not be able to carry out all of its necessary functions

35. Energy  Have you ever had an “energy drink”? These are often filled with caffeine, which simply speeds up the heart rate for a short length of time. That is not energy! These are often filled with caffeine, which simply speeds up the heart rate for a short length of time. That is not energy! Food gives you energy! Food gives you energy!

36. Carbohydrates: Provide energy 1.Simple Sugars 2.Complex carbs (starches)

37. Protein Important for: Important for: Muscle Growth and repair Muscle Growth and repair Building material for many body tissues Building material for many body tissues Choose Wisely: Fish, shellfish, lean meats Trim fat and remove skin Limit high fat processed meats Choose beans, nuts, & seeds

38. Fat Eat More: Unsaturated Fat Unsaturated Fat Vegetable oils, nuts, and fish Vegetable oils, nuts, and fish Needed for energy storage and vitamin absorption Eat Less: Saturated Fat High fat dairy fatty meats Trans Fat Fried food baked goods Can raise cholesterol and increase risk of heart disease

39. Estimated Calorie Needs Activity Level GenderAgeSedentary Moderately Active Active Female14-18180020002400 Male14-182000-24002400-28002800-3200

40. Food Labels Serving Size Servings per Container Calories Daily Values 5%DV or less is low 20%DV or more is high Total Fat 25-35 % of total calories Saturated Fat < 16 gm Cholesterol < 300 mg Sodium < 2400 mg Total Carbohydrate 130 gm Dietary Fiber 25 gm

41. Physical Activity  At least 60 minutes of vigorous activity on most days of the week Keeps your heart healthy and strong Keeps your heart healthy and strong Helps bones stay strong Helps bones stay strong Releases stress and anxiety Releases stress and anxiety Increase your chances of living longer Increase your chances of living longer Burns calories and increases the metabolic rate Burns calories and increases the metabolic rate Sleep better at night Sleep better at night

42. Physical Activity and Your Health  Physical activity along with a healthy diet can help decrease your risk of: Heart disease Heart disease Stroke Stroke Type 2 diabetes Type 2 diabetes High blood pressure High blood pressure High cholesterol High cholesterol

43. Types of Physical Activity Aerobic Moving continuously in a rhythm Moving continuously in a rhythm Makes you breathe harder and your heart beat faster Makes you breathe harder and your heart beat faster Running, jumping rope, swimming, dancing, biking Running, jumping rope, swimming, dancing, bikingMuscle-strengthening Making muscles work more than usual Making muscles work more than usual Climbing, tug-of-war, lifting weights, push-ups Climbing, tug-of-war, lifting weights, push-upsBone-strengthening Moving our bones against the force of gravity Moving our bones against the force of gravity Running, jumping rope, basketball, tennis, weight-lifting Running, jumping rope, basketball, tennis, weight-lifting Balance and Stretching Enhance physical stability and flexibility, which reduces risk of injuries Enhance physical stability and flexibility, which reduces risk of injuries Gentle stretching, dancing, yoga, martial arts, and t’ai chi Gentle stretching, dancing, yoga, martial arts, and t’ai chi

44. Hydration  Water 8-10 cups of water per day 8-10 cups of water per day Before, during, and after athletic performance to replace losses Before, during, and after athletic performance to replace losses  Sports drinks OK to use during prolonged activity (over 1 hr) to replace electrolytes OK to use during prolonged activity (over 1 hr) to replace electrolytes Not appropriate for short intervals Not appropriate for short intervals May cause upset stomach during exercise due to high sugar content May cause upset stomach during exercise due to high sugar content

45. Why Worry About Your Nutrition Now?  Habits (healthy or unhealthy) are formed early in life Current teen diet trends Current teen diet trends Under-consumption of vitamins, minerals, and fiberUnder-consumption of vitamins, minerals, and fiber Over-consumption of saturated fat and total fatOver-consumption of saturated fat and total fat 17% of children and adolescents are obese 17% of children and adolescents are obese Over 50% have at least one cardiovascular disease risk factor, such as high cholesterol or high blood pressureOver 50% have at least one cardiovascular disease risk factor, such as high cholesterol or high blood pressure Childhood obesity increases the risks of: Childhood obesity increases the risks of: Heart diseaseHeart disease DiabetesDiabetes Certain types of CancerCertain types of Cancer Bone and joint disordersBone and joint disorders

46. Atherosclerosis  Fatty deposits (plaque) build up in arteries, making it harder for blood to flow  Arteries can then rupture, causing a blood clot which slows or stops blood flow  If this is in a coronary artery it is called a myocardial infarction, or heart attack  If this happens in the brain, it is called a stroke

47. So What Can I Do? Healthy Habits:  Eat three meals each day  Eat 5 servings of fruits and vegetables  Eat 3 servings of low-fat dairy  Choose lean meat and protein sources  Make “half of your grains whole”  Exercise daily  Stay hydrated  Watch portion sizes

48. Portion sizes

49. Summary It’s a balancing act!

50. Do You Know How Food Portions Have Changed in 20 Years? National Heart, Lung, and Blood Institute Obesity Education Initiative

51. BAGEL 20 Years Ago Today 140 calories 3-inch diameter How many calories are in this bagel?

52. 140 calories 3-inch diameter Calorie Difference: 210 calories 350 calories 6-inch diameter BAGEL 20 Years Ago Today

53. How long will you have to walk your dog in order to burn the extra 210 calories?* *Based on 145-pound person Maintaining a Healthy Weight is a Balancing Act Calories In = Calories Out

54. If you walk the dog for 1 hour and 10 minutes you will burn the extra 210 calories.* *Based on 145-pound person Calories In = Calories Out

55. CHEESEBURGER 20 Years Ago Today 333 caloriesHow many calories are in today’s cheeseburger?

56. Calorie Difference: 257 calories 590 calories CHEESEBURGER 20 Years Ago Today 333 calories

57. Maintaining a Healthy Weight is a Balancing Act Calories In = Calories Out How long will you have to lift weights in order to burn the extra 257 calories?* *Based on 145-pound person

58. If you lift weights for 1 hour and 13 minutes, you will burn approximately 257 calories.* * Based on 145-pound person Calories In = Calories Out

59. SPAGHETTI AND MEATBALLS 20 Years AgoToday 500 calories 1 cup spaghetti with sauce and 3 small meatballs How many calories do you think are in today's portion of spaghetti and meatballs?

60. Calorie Difference: 525 calories 1,025 calories 2 cups of pasta with sauce and 3 large meatballs 20 Years AgoToday 500 calories 1 cup spaghetti with sauce and 3 small meatballs SPAGHETTI AND MEATBALLS

61. How long will you have to run in order to burn the extra 525 calories?* *Based on 145-pound person Maintaining a Healthy Weight is a Balancing Act Calories In = Calories Out

62. * Based on 145-pound person If you run (6 mph or 10 min/mile) for 45 minutes, you will burn approximately 525 calories.* Calories In = Calories Out

63. FRENCH FRIES 20 Years AgoToday 210 Calories 2.4 ounces How many calories are in today’s portion of fries?

64. 610 Calories 6.9 ounces Calorie Difference: 400 Calories FRENCH FRIES 20 Years AgoToday 210 Calories 2.4 ounces

65. How long will you have to go shopping in order to burn those extra 400 calories?* *Based on 145-pound person Maintaining a Healthy Weight is a Balancing Act Calories In = Calories Out

66. *Based on 145-pound person If you go shopping for 2 hours and 40 minutes you will burn approximately 400 calories.* Calories In = Calories Out

67. 85 Calories 6.5 ounces How many calories are in today’s portion? SODA 20 Years AgoToday

68. Calorie Difference: 165 Calories 250 Calories 20 ounces 85 Calories 6.5 ounces SODA 20 Years Ago Today

69. How long will you have to play basketball to burn those extra 165 calories?* * Based on 145-pound person Maintaining a Healthy Weight is a Balancing Act Calories In = Calories Out

70. If you played basketball for 31 minutes, you will burn approximately 165 calories.* *Based on 145-pound person Calories In = Calories Out

71. 320 caloriesHow many calories are in today’s turkey sandwich? TURKEY SANDWICH 20 Years AgoToday

72. Calorie Difference: 500 calories 820 calories320 calories TURKEY SANDWICH 20 Years AgoToday

73. How long will you have to play softball in order to burn those extra calories?* *Based on 145-pound person Maintaining a Healthy Weight is a Balancing Act Calories In = Calories Out

74. *Based on 145-pound person If you play softball for 1 hour and 30 minutes, you will burn approximately 500 calories.* Calories In = Calories Out

75. Thank you for participating in Portion Distortion ! For more information about Maintaining a Healthy Weight visit www.nhlbi.nih.govwww.nhlbi.nih.gov Or www.ChooseMyPlate.gov

76. QUESTIONS