Weight management principles and practices

Proper nutrition (eating a well-balanced diet) and daily physical activity are key components of a weight management program. In weight management programs, most clients are interested in losing body weight and body fat, but some need to gain body weight. The basic principle underlying safe and effective weight loss programs is that weight can be lost only through a negative energy balance, which is produced when the caloric expenditure exceeds the caloric intake. The most effective way of creating a caloric deficit is through a combination of diet (restricting caloric intake) and exercise (increasing caloric expenditure). On the other hand, for weight gain programs, the caloric intake must exceed the caloric expenditure in order to create a positive energy balance. “Weight Management Principles” (p. 239) summarizes principles and practices underlying the design of weight management programs.

People can win the battle of controlling body weight and obesity by not only understanding why they eat and monitoring their food intake closely, but also by incorporating more physical activity into their lifestyles.

The physically active lifestyle is characterized by

• daily aerobic exercise;
• strength and flexibility exercises;
• increased participation in recreational activities such as bowling, golf, tennis, and dancing; and
• increased physical activity in the daily routine at home and work through restricting use of labor-saving devices such as escalators, power tools, automobiles, and home and garden appliances.

In addition to these suggestions, you should encourage your clients to follow the Dietary Guidelines for Americans 2005 (U.S. Department of Health and Human Services 2005a). New, updated dietary guidelines are scheduled for release in the fall of 2010.

Adequate Nutrients Within Calorie Needs

• Consume a variety of nutrient-dense foods within and among the basic food groups; choose foods that limit intake of saturated and trans fats, cholesterol, added sugars, and salt; and limit intake of alcohol.
• Meet recommended intakes within energy needs by adopting a balanced eating pattern.

Weight Management

• To maintain body weight in a healthy range, balance calories from foods and beverages with calories expended.
• To prevent gradual weight gain over time, make small decreases in food and beverage calories and increase physical activity.

Physical Activity

• To reduce risk of chronic disease in adulthood, engage in at least 30 min of moderate-intensity physical activity, above usual activity, at work or home on most days of the week.
• For most people, greater health benefits can be obtained by engaging in physical activity of more vigorous intensity or longer duration.
• To help manage body weight and prevent gradual, unhealthy body weight gain in adulthood, engage in approximately 60 min of moderate- to vigorous-intensity exercise on most days of the week while not exceeding caloric intake requirements.
• To sustain weight loss in adulthood, participate in at least 60 to 90 min of daily moderate-intensity physical activity while not exceeding caloric intake requirements. Some people may need to consult with a health care provider before participating in this level of activity.
• Achieve physical fitness by including cardiovascular conditioning, stretching exercises for flexibility, and resistance exercises or calisthenics for muscle strength and endurance.

Food Groups to Encourage

• Consume a sufficient amount of fruits and vegetables while staying within energy needs. Two cups of fruit and 2 1/2 cups of vegetables per day are recommended for a reference 2000-calorie intake, with higher or lower amounts depending on the calorie level.
• Choose a variety of fruits and vegetables each day. In particular, select from all five vegetable subgroups (dark green, orange, legumes, starchy vegetables, and other vegetables) several times a week.
• Consume 3 or more ounce equivalents of whole-grain products per day, with the rest of the recommended grains coming from enriched or whole-grain products. In general, at least half the grains should come from whole grains.
• Consume 3 cups per day of fat-free or low-fat milk or equivalent milk products.

Carbohydrates

• Choose fiber-rich fruits, vegetables, and whole grains often.
• Choose and prepare foods and beverages with little added sugars or caloric sweeteners.
• Reduce the incidence of dental caries by practicing good oral hygiene and consuming sugar- and starch-containing foods and beverages less frequently.

Sodium and Potassium

• Consume less than 2300 mg (approximately 1 tsp of salt) of sodium per day.
• Choose and prepare foods with little salt. At the same time, consume potassium-rich foods such as fruits and vegetables.

Alcoholic Beverages

• Those who drink alcoholic beverages should do so sensibly and in moderation—defined as the consumption of up to one drink per day for women and up to two drinks per day for men.
• Alcoholic beverages should not be consumed by individuals who cannot restrict their alcohol intake, women of childbearing age who may become pregnant, pregnant and lactating women, children and adolescents, individuals taking medications that can interact with alcohol, and those with specific medical conditions.
• Alcoholic beverages should be avoided by individuals engaging in activities that require attention, skill, or coordination such as driving or operating machinery.