Dieting Do #2

Working It Out—and Off!

It's difficult to lose weight while living with your father whose fondness for old-school, fat-is-fine cooking earned him the affectionate nickname "Mr. Butter." Dianne Fontes has always loved food like her dad, who at age 79 is the self-appointed household chef.

But Dianne hated feeling that in her early 50's, her unfettered enjoyment of his fat-loaded food was turning her into him. "I'm turning into that old man," Dianne recalls thinking as the pounds built up on her body and she gradually lost her energy as well as her sense of femininity. At her high of 250-plus pounds, she says, "I was sexless, fat, a nonentity."

Not wanting to hobble her father's culinary hobby, Dianne settled on exercise as her first dieting priority. A year later and about 70 pounds past her first visit to the gym, the 5'4" post office window clerk says, "I'm a convert. I am to exercise what born-again Christians are to religion."

You've Got to Move It, Move It
For most of her life, Dianne's notion of taking a walk was traveling from the kitchen to the sofa to watch TV. Her favorite activities were sewing, knitting and reading. "If I could sit and do it, I'd do it. But if I had to move, forget it."

Fact is, Americans don't have to move in their daily lives, with the television and video games to entertain them and labor-saving devices such as remote controls to do everything from changing their TV channels to opening their garage doors.

Left to their own devices to seek out physical activity, many Americans instead lead sedentary lives like Dianne did for years.

Some 24 percent don't engage in any physical activity to speak of during their leisure time, according to the Surgeon General's 1996 Report on Physical Activity and Health, and 54 percent do less than is recommended.

The end result? Unwanted pounds. The solution? Exercise.

Physical activity has been shown to be an important—and probably the most essential component— of a successful weight loss program. Health experts, including those at the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC), recommend that people do at least 30 minutes of moderate physical activity on most days of the week. However, if you have been sedentary, speak with your doctor before you take up strenuous physical activity, especially if you have known health problems.

Take a Walk, Go Dancing!
"There's no way around exercise," says cardiologist Stephen Sinatra, M.D., who points out that excess weight—even 10 pounds (for women)—is a risk factor for heart disease.

Sinatra, who frowns on weight-loss drugs, encourages his patients to make exercise part of their lifestyle. "I tell people to go out and walk the dog, park their car farther from the store, get a treadmill, just walk or go dancing. There are lots of ways to incorporate exercise into your life without it feeling like exercise. Without an adequate exercise program, it's going to be very difficult to lose weight. It's going to be impossible."

"In fact," Sinatra adds, "Exercise is more important than diet when it comes to losing weight. You can't lose weight without increasing your basic metabolic rate. If you eat loads of high-glycemic carbohydrates like breads, pasta, rice and corn every day, you won't metabolize it. You're going to store it and wear it."

How to Lose It
To lose a pound a week, you need to burn 3,500 calories, or 500 calories each day through exercise (or less if you're cutting back on what you eat, as well).

NIH provides the following rough estimates of how many calories are burned per hour of exercising. The numbers were figured for a 150-pound person. Heavier? You'll burn more calories. Lighter? You'll burn fewer.

Calories Burned Per Exercise*

Type of Exercise--------------------------->Calories (per/hr)
Bicycling ------------------------------------->410
Jogging -------------------------------------->740
Jumping Rope ------------------------------->750
Swimming ----------------------------------->275
Tennis --------------------------------------->400
Walking -------------------------------------->320

Exercising Your Options
To incorporate exercise into her daily life, Dianne chose to join a gym. She was happy, when she took a free introductory tour of her local health club, to see that those working out weren't the "Spandex queens" she had envisioned. "There were people of all ages, 16 to 90, and of all sizes, fat and thin."

Dianne spends 45 minutes every other day on a stationary bike at the club, and on most in-between days, spends 20 to 30 minutes on the bike and another 20 minutes toning her body by lifting weights. She enjoys the bike, which increases the likelihood that she will keep it up long-term to continue her weight loss and maintain it. Her combined aerobic/weight training activity has been shown to be even more effective for weight management than aerobic activity alone.

"You can lose the weight with just aerobic exercise because your body is burning calories, but you're burning off some muscle, too," explains fitness trainer and health club manager Steven Morningstar.

"Muscle burns more calories than fat does, so adding some weight-lifting to your workout can increase your lean muscle mass, raise your metabolism, and allow you to eat more calories and still lose weight."

Not motivated to join a gym, or don't want to spend the money? Just making small changes in your everyday activities can add up to better health. Consider:

• Taking the stairs instead of the elevator or escalator at work and at the mall.
• Taking a walk first thing every morning, alone or with a neighbor, or walking each evening after dinner.
• Getting off the bus one stop early and walking the rest of the way.
• Mowing your lawn or doing some gardening.
• Planning an active getaway, where you can hike, bike or just throw a frisbee, instead of lying on the beach all day.
• Park your car at the far end of the parking lot when you go to the mall.
  

On the Road to Health

Dianne didn't lose her 70 pounds by exercise alone. She watches the amount of fat and sugar in her food choices. And to keep feeling full, she eats five or six "mini-meals" a day, including plenty of fruits and vegetables. By day, she remains very attentive about her food intake. In the evening, she partakes in her father's fabulous cooking with a new eye to portion and calorie control.

But Dianne credits her 45-minute exercise routine, more than anything else, for her shrinking size. "I even look at food in a different way. When I feel like eating a Big Mac that's 500 or 600 calories, I ask myself, 'Would I want to go to the gym and work out for an hour to offset that?'" No thank you, she says, 45 minutes on the bike is enough. She will ride on until she loses another 20 or 30 pounds, and to maintain her weight after that. "I don't want to be a skinny size 2, just healthy," she says.

How has her conversion from couch potato paid off? "I feel incredible," Dianne proclaims. "I'm much more agile. My breathing is better. I sleep better. And I enjoy getting dressed up now."

Dieting Do #1

How Did I Get Like This?!!!

With no full-length mirrors at home to shatter her delusions of slendeur, and thanks to her habit of catalog shopping, which spared her for months at a time from facing a clothing store's mirror, 38-year-old Kelly (not her real name) managed to pass years without reflecting on her mounting weight. It wasn't until Kelly's 5' 3" frame tipped the scale at upwards of 215 pounds that she committed herself to shedding the problem pounds.


"I had no idea I looked like that and I couldn't figure out how I'd gotten to look like that. I was astonished," says the drug reviewer with the U.S. Food and Drug Administration who found herself finally in a mirrored dressing room. "But the day I started my diet, I felt a hundred pounds lighter. Just knowing that I was moving in the right direction—that I didn't make my problem worse today—lifted a weight that I didn't even know was there."


Her figurative hundred aside, Kelly lost 80 pounds in about 18 months and shrank from a size 22 to an eight, focusing along the way on choosing healthful, low-calorie foods. She faithfully monitored the food that crossed her lips for calories, fat and fiber, the three keys to healthfully filling up while slimming down

Calorie Counts as Bottom Line

Tracking your calories can be a simple and useful to manage the amount of food you eat. Adding up calories in a portion of food is easy these days: just look at the nutrition facts on the labels of packaged foods.

People can eat, on average, some 2,000 calories per day to maintain their weight. But the calories you should consume can increase or decrease based on factors such as your sex (men tend to naturally have more muscle mass and burn more calories than women), age (people tend to burn less calories as they get older), and level of physical activity (those who exercise burn extra calories compared to their sedentary peers).

"The problem with weight loss is it is a discipline," acknowledges Stephen Sinatra, M.D., a cardiologist. "Treating weight loss is almost like treating cancer. You've really got to take it seriously."

For a rough idea of how many maintenance calories you need in a day, the American Dietetic Association suggests a three-part calculation:

• Figure out your basic metabolic rate (BMR) by taking your ideal weight and multiplying it by 10 if you're a woman, 11 if you're a man.
• Then add 20 percent of that number if you're sedentary, 30 percent if you do light activity, 40 percent if you do moderate activity, and 50 percent if you're very active.
• Finally, add another 10 percent of that total (for digesting and absorbing nutrients) to get your total calorie allowance for the day.

So how many calories can you eat to lose weight? Do some more simple math: 3,500 calories equals one pound of body fat, so eating 500 less calories a day than your maintenance amount should help you lose weight at a safe rate of about a pound per week (500 calories per day x 7 days in a week = 3,500 calories).

Beware of crash diets with drastic calorie cutting: as a rule of thumb, women need at least 1,200 calories per day and men 1,500 to feed their bodies needed nutrients. In addition to fatigue, dizziness and hair loss that can result in the short term from very low-calorie diets and fasting, such overly restrictive weight loss tacks can increase a person's risk for gallstones and serious and sometimes deadly gallbladder and heart conditions.

Great Taste, More Filling

Reasonable calorie control is a must for weight loss, but doesn't have to leave you feeling hungry and deprived. In reaching her current weight of 137 and keeping off the lost pounds, Kelly has relied on high-fiber, low-fat diet foods, which she refers to as "big food— a lot with a few calories." For example, she eats "enormous quantities" of broccoli, tomatoes and other vegetables, including a big salad for lunch. And for a snack, Kelly chooses low-fat microwave popcorn over pretzels. Compare the labels: the popcorn has about 240 calories in a whole bag, the same as a handful of fat-free pretzels.

Why choose foods that are low in fat? Besides the known health risks of a diet high in fat (and particularly the saturated variety), fat is a diet "don't" because it contains more than twice as many calories per gram as a carbohydrate or protein.

To limit fat intake, try switching to low-fat milk and cheese and reduced- or non-fat mayonnaise, margarine and salad dressing. Eat low-fat meats such as skinless chicken and lean cuts of beef, as well as lower-fat fish such as tuna packed in water instead of oil. And cut back on high-fat desserts.

Don't be fooled by an oh-so-tasty cake that's touted as low-fat or fat-free: keep a skeptical eye on the calorie counts, too, because boosted sugar levels can make a calorie catastrophe of even a fat-free feast.

By checking the food label and eating no more than 30 percent of your daily calories from fat, you can eat more food with less calories. It's up to you: a sliver of cake or a breast of chicken. Kelly has learned to forsake the cake on all but the most special of occasions in favor of fruits, vegetables, beans and whole-grains that are not only low in fat, but rich in fiber to help quell her hunger.

Change for Life

Successful dieters like Kelly take in empty calories only sparingly, giving up many fatty and sweet foods and instead choosing a variety of foods from the traditional "food guide pyramid" that fuel their bodies with vitamins, minerals, carbohydrates and proteins.

Long-term successes are based on long-lasting attitude changes, not short-sighted deprivation tactics, experts emphasize. By being thoughtful about her food choices, Kelly has maintained her 80-pound weight loss for almost two years. "I miss the carefree, eat-whatever-you-want attitude a little bit," she admits. "Now, though, I see something in the store I'd like to try, but then I see the calories and say it can't possibly be worth it."

OK, sometimes it's worth it, Kelly confesses: "Once in a great while, I'll splurge." When she does indulge in high-fat treats, Kelly tries to slim-size her portions, eating only as much as it takes to satisfy her craving without stuffing her stomach.

Sinatra and other weight-loss experts agree that an occasional diversion won't foil your weight-loss attempts. With your focus fixed on the amount of calories, fat and fiber you take in at most meals, there's still room for enjoying what you eat. Have an eclair if that's what you crave. If you're eating right as a rule, you'll still be able to look at yourself in the mirror tomorrow.

"It's okay to cheat sometimes," says Sinatra. "It's okay to eat forbidden foods. But don't make it a habit. If you go off your eating plan three times in a row, it's over."

Move on to Dieting Do #2

Losing Weight ... and Keeping It Lost

As many as 300,000 American adults die each year from causes related to being overweight. Excessive weight is the main factor contributing to coronary heart disease, the number-one killer of men and women in the United States.

And those who are overweight also have an increased risk of high cholesterol, high blood pressure, diabetes and some types of cancer, as well as osteoarthritis and interrupted breathing pattern during sleep called sleep apnea.

For the 61 percent of American adults who are overweight, smart eating, along with habitual workouts, are the foremost formula for successful weight losers. But there's one more key to success. "The best and safest weight loss is one to two pounds per week, regardless of whether you want to lose 10 pounds or 20 pounds," says Stephen Sinatra, M.D., a cardiologist.


Some people will need additional support from:

• Groups such as Weight Watchers or an informal team of dieting buddies;
• Medications or dietary supplements to curb hunger or obstruct fat absorption; or
• Yoga, massage or other stress-relief regimen.

While looking good in the short term might be a powerful motivator for many people preparing for a wedding or high-school reunion, getting healthy, not just looking hot, is the best priority for controlling your weight for life, authorities agree. Says Arthur Frank, M.D., director of the George Washington University's Weight Management Program in Washington, D.C., "Being overweight is not merely a cosmetic problem. It has a dreadful effect upon your health and upon your comfort."

With smarts and support, you can shed pounds safely, and yes, keep them off. You may have heard the commonly cited statistic that 95 percent of those who lose weight regain it soon after.

"With all the gloom and doom, the reality is that people can lose weight," says Frank. "It's difficult, but people can maintain their weight, too."

To help you lose—and maintain weight— Discovery Health Online has laid out the four main components to weight-loss: sound nutrition, exercise, stress reduction and vitamin and/or dietary supplements.

To get started on the path to weight loss—and better health and longevity— move on to Dieting DO 1