For many people, the word “malnutrition” evokes images of starving children in third world countries, eyes sunken in and ribs sticking out, physically wasting away from lack of food availability. While undernutrition is a serious global public health problem, and does affect individuals even in our own country, the most prevalent form of malnutrition in the U.S. is obesity. Malnutrition refers to a diet that does not provide the right balance of nutrients for optimal health and is broadly divided into ‘undernutrition’ and ‘overweight and obesity’. More than 2/3rds of adults in the U.S. are either overweight or obese, and prevalence is increasing in the adolescent and childhood populations as well.
We have all heard by now about the obesity epidemic in our country and see it every day. You look around, and it seems like most people you see walking through the supermarket, picking their children up from school, or stopping for a drink at Dunkin are, if not obviously obese, at least overweight. And if it’s not so evident right here in the extremely fortunate town of Montville, it’s noticeable almost anywhere else you go. But what does it really matter, isn’t this just the new normal?
As a healthcare provider, I see patients every day who are affected both physically and financially by diseases and afflictions that could likely be avoided or minimized with adequate weight control. Obesity is associated with increased risk of almost every major chronic disease as well as overall earlier mortality, anywhere from 3 to 20 years shortened life expectancy depending on the extent. Being overweight or obese increases your risk of developing many health complications, but I will list just a few:
- Heart attack
- Blood clots
- Type 2 diabetes
- Chronic kidney disease
- Liver disease
- Kidney stones
- Sleep apnea
- Pregnancy complications
- Back pain
- Joint pain
Okay, it’s important to try to maintain a healthy weight…so how do we get there? At the most basic level, to achieve weight loss the number of calories we expend each day must be greater than the number of calories coming in. This means, maintenance of healthy weight = healthy diet + regular exercise. If the answer is so straightforward, then why is it so hard to lose weight? The reason is because humans are animals, and biologically our goal is to survive – we are simply not designed to lose weight. Limiting the number of calories consumed causes the body to try to conserve energy, and results in a reduction in our basal metabolic rate – our body is actively fighting us. We have taste buds and smell receptors to make eating a pleasant and satisfying experience, so that we want to do it again and again. Depriving ourselves of food leads to obsessive thinking, as well as depression, anxiety, and irritability, as again, we are not designed to lose weight.
Do I tell you this to discourage you? Absolutely not. Many people struggle to lose weight, especially as they get older, but my hope is that by understanding the enormity of the challenge, you may be a little easier on yourself if you slip up from time to time, but then be able to pick yourself up and persevere. Here are some tips on overcoming the challenge and creating an effective eating strategy:
- Set reasonable weight loss goals. Research supports that small amounts of weight loss, even just 10% of total body weight, can make enough of a difference to lower blood pressure, cholesterol, and blood sugar. Some degree of weight is genetically determined, so not everyone can be model-thin. Reflect on your goals. Place your focus on trying to achieve a healthy weight for the purpose of avoiding complications down the road, for the benefit of both yourself and your loved ones.
- Food is all around us. It is nearly impossible to ignore food in our society – vending machines and snack bars around every corner, social gatherings and holidays centered around a large meal, the ability to quickly purchase calorie-dense foods off the dollar menu at a drive thru. How can we combat this? Start within your own home. While walking down the snack aisle of the grocery store, realize that if you buy a bag of chips or box of cookies, you or someone in your family will eventually eat it. But if it isn’t there, you can’t eat it! Protect yourself from that moment of weakness by surrounding yourself with healthier options.
- Don’t deprive yourself. Completely denying yourself certain snack foods or desserts will only make you want them more! Allow yourself periodic treats, in moderation, with attention to portion control. For example, instead of eating directly out of the bag of Lays, pour a handful of chips into a small bowl and leave the full bag closed up in the cupboard. OR, rather than even keeping the temptation in your house, allow yourself a small bag of chips only on occasion when out to lunch. Complete deprivation and extreme dieting is not sustainable; aim to develop an eating pattern that you know you’ll be able to stick to in the long run.
- Limit “empty” calories from soft drinks and alcoholic beverages. A single large Coke at McDonald’s adds about 344 calories to your day, but the fact is that liquid calories don’t fill you up the same as solid foods. Therefore, it is easy to consume hundreds of extra calories in a short amount of time without getting the nourishment you need and deserve.
- Slow it down. It takes about 20 minutes for your brain to catch up with your stomach and realize that it’s full. So if you eat too quickly in the time before this signal is able to make its way to your brain, you will likely consume more than you need. You can feel full on less food if you just take your time eating.
- Reflect on when and why you eat. Yes, we need food for energy – 3 meals and 2 snacks per day is typically recommended for the general population. But be honest. Do you also eat when you’re bored, or depressed, or just because you are around other people who are eating? Paying attention to your eating behaviors can help you kick unhealthy habits. Look for another diversion to take the place of food when you notice these emotional triggers creeping in.
Let’s not forget about the younger population. Obesity in childhood and adolescence can result in early onset of many of the health issues mentioned previously, as well as increased risk of adulthood obesity. Importantly, especially at a young age, obesity can also have severe psychosocial implications including depression, anxiety, and low self-esteem. Set your children up for success by following these health and wellness tips:
- Allow easy access to healthy snacks. Instead of stocking your pantry with Chips Ahoy and Cheez-Its, try training your child to instead reach for apple slices, fruit cups, baby carrots and slice bell peppers with ranch dressing, or yogurt tubes – not only are they a fun hands-on snack, but they contain the protein, calcium, and vitamin D that kids need.
- Reduce negative associations. Try not to use food as a reward or punishment, as these situations can result in abnormal eating behaviors later on in life. Consider offering a trip to the zoo or aquarium, or a family bike ride, for a good report card or sports victory rather than an ice cream cone or candy bar.
- Allow kids to help make decisions about food. Bring your child to the grocery store to get excited about the variety of interesting fruits and vegetables available. Allow your kids to help cook – if they feel a part of the process they may be more interested in eating and trying new healthy foods.
- Encourage family time. Make an effort to eat together as a family at the table, rather than separately or in front of the TV. Promote interest in family matters. Ask your child about school or friends and encourage reflection on positive things that happened that day, which can result in family bonding as well as improve self-esteem and contentment that they are being listened to. Avoiding eating in front of the TV can also discourage binging behaviors and unhealthy associations.
- Stay active. Limit screen time to less than 2 hours per day, and encourage at least 60 minutes of physical activity. Get outdoors. Encourage sports involvement. Go on a family bike adventure or take your dog on a long walk. Cultivate interest in nature by going on hikes or picking up interesting looking stones and leaves by the brook.
- Lead by example. Children with one obese parent are two to three times more likely to be obese, and fifteen times more likely when both their parents are obese. Practice what you preach. Involving the whole family, rather than singling out your one child who needs to lose weight, has shown higher rates of success and may help to enforce a stronger bond among your family.
For more tips, check out www.myplate.gov, a website based on MyPlate – a visual representation of healthy eating created by the USDA. The carefully designed image features a typical dinner plate with sections divided fruits, vegetables, grains, protein, and dairy – notice that half the plate should be fruits and vegetables! MyPlate promotes moderation and balance across food groups, as each group is a good source for particular nutrients. Take a look through the website and find dietary information and recommendations for all ages; for example, you can navigate sections specific to ‘college students’, ‘preschoolers’, ‘dieters’, and ‘pregnant & breastfeeding women’. You’ll also find eBooks and online games to get kids interested in their food choices too!
At Changebridge Medical Associates, we want you and your family to prioritize your health and maximize your quality of life which is why we want to share helpful advice and tips with you to keep you and your family healthy and fit.
Carrie Schroeder, PA-C, is a New Jersey native who graduated with her Bachelors Degree in Science, Summa Cum Laude, from North Carolina State University and her Graduate degree from DeSales University in Pennsylvania. During college, Carrie spent her summers as a volunteer EMT, and quickly learned that she was destined to continue her career as a healthcare provider. These experiences motivated Carrie to focus on disease prevention and overall health and wellness in order to start tackling small and complex health concerns, taking the appropriate steps to keep her patients healthy and on the right path. Carrie resides in the local community and in her free time, loves to read, especially James Patterson and Harlan Cohen novels, enjoys hiking, is an avid NC State Wolfpack and New York Giants football fan, and volunteers at local food and toy drives during the holidays.