HASfit makes no warrants, promises, or claims regarding accuracy of the calories burned estimate. It is provided only as a general reference and each person should use an indirect calorimetry system for a more accurate estimate.
Putting on excess weight is very common for a number of reasons that we’ll explain. But it’s not an inevitable part of the aging process, and it could put your health at risk. If you understand why you tend to gain weight more easily as you get older, you can do something about it. And doing something about it is what this book is all about.
There is a long waiting list for elderly obese residents as typically only a few overweight residents are allowed per home and it makes little financial sense for most senior living communities to offer obese care. In fact, Medicaid, which covers more than 60% of all nursing home residents, does not cover the specialized equipment necessary for obese patients.
An early hint that gut microbes might play a role in obesity came from studies comparing intestinal bacteria in obese and lean individuals. In studies of twins who were both lean or both obese, researchers found that the gut community in lean people was like a rain forest brimming with many species but that the community in obese people was less diverse—more like a nutrient-overloaded pond where relatively few species dominate. Lean individuals, for example, tended to have a wider variety of Bacteroidetes, a large tribe of microbes that specialize in breaking down bulky plant starches and fibers into shorter molecules that the body can use as a source of energy.
Obese people often have chronic low-level inflammation, which can, over time, cause DNA damage that leads to cancer. Overweight and obese individuals are more likely than normal-weight individuals to have conditions or disorders that are linked to or that cause chronic local inflammation and that are risk factors for certain cancers (26). For example, chronic local inflammation induced by gastroesophageal reflux disease or Barrett esophagus is a likely cause of esophageal adenocarcinoma. Obesity is a risk factor for gallstones, a condition characterized by chronic gallbladder inflammation, and a history of gallstones is a strong risk factor for gallbladder cancer (27). Chronic ulcerative colitis (a chronic inflammatory condition) and hepatitis (a disease of the liver causing inflammation) are risk factors for different types of liver cancer (28).
In general, women collect fat in their hips and buttocks, giving their figures a “pear” shape. Men, on the other hand, usually collect fat around the belly, giving them more of an “apple” shape. (This is not a hard and fast rule; some men are pear-shaped and some women become apple-shaped, particularly after menopause.)
Lean body mass declines at a rate of 0.3 kg/year (0.66 lb) beginning around the third decade of life. Because lean body mass tends to be replaced by fat, total body weight generally remains stable. Beginning around age 65 to 70, weight loss occurs at a rate of 0.1 to 0.2 kg/year as a result of changes in hormones regulating appetite and satiety, along with decreases in basal metabolic rates.6,8
I also visited Tic Gums in White Marsh, Maryland, a company that engineers textures into food products. Texture hasn’t received the attention that flavor has, noted Greg Andon, Tic’s boyish and ebullient president, whose family has run the company for three generations. The result, he said, is that even people in the food industry don’t have an adequate vocabulary for it. “They know what flavor you’re referring to when you say ‘forest floor,’ but all they can say about texture is ‘Can you make it more creamy?’ ” So Tic is inventing a vocabulary, breaking textures down according to properties such as “mouth coating” and “mouth clearing.” Wielding an arsenal of some 20 different “gums”—edible ingredients mostly found in tree sap, seeds, and other plant matter—Tic’s researchers can make low-fat foods taste, well, creamier; give the same full body that sugared drinks offer to sugar-free beverages; counter chalkiness and gloopiness; and help orchestrate the timing of flavor bursts. (Such approaches have nothing in common with the ill-fated Olestra, a fat-like compound engineered to pass undigested through the body, and billed in the late 1990s as a fat substitute in snack foods. It was made notorious by widespread anecdotal complaints of cramps and loose bowels, though studies seemed to contradict those claims.)
Obesity is most commonly caused by a combination of excessive food intake, lack of physical activity, and genetic susceptibility. A few cases are caused primarily by genes, endocrine disorders, medications, or mental disorder. The view that obese people eat little yet gain weight due to a slow metabolism is not generally supported. On average, obese people have a greater energy expenditure than their normal counterparts due to the energy required to maintain an increased body mass.
The one fast-food restaurant near that busy East L.A. intersection otherwise filled with bodegas was a Carl’s Jr. I went in and saw that the biggest and most prominent posters in the store were pushing a new grilled-cod sandwich. It actually looked pretty good, but it wasn’t quite lunchtime, and I just wanted a cup of coffee. I went to the counter to order it, but before I could say anything, the cashier greeted me and asked, “Would you like to try our new Charbroiled Atlantic Cod Fish Sandwich today?” Oh, well, sure, why not? (I asked her to hold the tartar sauce, which is mostly fat, but found out later that the sandwich is normally served with about half as much tartar sauce as the notoriously fatty Filet-O-Fish sandwich at McDonald’s, where the fish is battered and fried.) The sandwich was delicious. It was less than half the cost of the Sea Cake appetizer at Real Food Daily. It took less than a minute to prepare. In some ways, it was the best meal I had in L.A., and it was probably the healthiest.
“Obesity wreaks so much havoc on one’s long-term survival capacity that obese adults either don’t live long enough to be included in the survey or they are institutionalized and therefore also excluded. In that sense, the survey data doesn’t capture the population we’re most interested in,” says Masters, a Robert Wood Johnson Foundation Health & Society Scholar at Columbia’s Mailman School and the study’s first author.
Any good diet plan will include exercise. It helps to increase metabolism and is one less opportunity to eat during the day. You should exercise for at least 30 minutes, five times a week. Regular exercise also helps your heart and lungs and lowers triglyceride levels that can cause heart disease. It also increases the HDL (“good cholesterol”) levels. Even simple measures such as taking the stairs instead of the elevator and short walks eventually add up to a lot of calories burned. Commercial fitness programs such as Boot Camp can help you start or improve upon a fitness program.
The World Health Organization (WHO) predicts that overweight and obesity may soon replace more traditional public health concerns such as undernutrition and infectious diseases as the most significant cause of poor health. Obesity is a public health and policy problem because of its prevalence, costs, and health effects. The United States Preventive Services Task Force recommends screening for all adults followed by behavioral interventions in those who are obese. Public health efforts seek to understand and correct the environmental factors responsible for the increasing prevalence of obesity in the population. Solutions look at changing the factors that cause excess food energy consumption and inhibit physical activity. Efforts include federally reimbursed meal programs in schools, limiting direct junk food marketing to children, and decreasing access to sugar-sweetened beverages in schools. The World Health Organization recommends the taxing of sugary drinks. When constructing urban environments, efforts have been made to increase access to parks and to develop pedestrian routes.
Many poor Chileans do their food shopping at small mom-and-pop stores that sell mostly processed and packaged food and little fresh produce. Above, a store in the El Bosque neighborhood of Santiago. Credit Victor Ruiz Caballero for The New York Times
Glass, T., Rasmussen, M., & Schwartz, B. (2006). Neighborhoods and obesity in older adults: The Baltimore memory study. American Journal of Preventive Medicine, 31(6), 455-463. Retrieved November 12, 2008 from: www.pubmedcentral.nih.gov/articlerender.
Step 1. A comprehensive medical examination is required, along with a medication regimen review and depression screening. Core laboratory tests are conducted, including an ultrasensitive thyroid-stimulating hormone test, urinalysis, and a fecal occult blood test.
Some states will be harder hit than others. Colorado, for example, can expect the numbers of older people with diabetes to increase by 138 percent by 2030, while Arizona will see its population of obese people over 65 grow by 90 percent.
Many people suffer from health issues due to their weight. 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.
For over 35 years, Structure House has provided effective, quality weight loss management and healthy eating programs for adults who need more guided eating routines and exercise plans. We are open to the public, please call today to learn more.
“At the same age, Gen X males have nearly double the prevalence of obesity: 18.3% compared with 9.4% for boomers. There is a smaller but still significant difference in females, with 12.7% of Gen X women being obese in 2008 and 10.4% of boomer females obese in 1989.
The first step in addressing skin problems is to conduct a skin assessment of obese patients. The specificity and degree of skin problems will determine the intervention. Nurses are advised to initiate measures to decrease friction as soon as possible after hospital admission. Additionally, in older women, urinary incontinence from a large, heavy abdomen causing the valve on the bladder to weaken may result in the leaking of urine when coughing or sneezing. Nurses should educate patients about keeping the area dry so as to prevent skin problems. Strategies to keep the area dry include wearing absorption pads in their underwear and changing underwear as soon as possible when leakage occurs.
An association between viruses and obesity has been found in humans and several different animal species. The amount that these associations may have contributed to the rising rate of obesity is yet to be determined.
23. The clinical and cost-effectiveness of medical nutrition therapies: evidence and estimates of potential medical savings from the use of selected nutritional intervention. June 1996. Summary report prepared for the Nutrition Screening Initiative.
So why don’t people just stop eating foods high fat and sugar if they know they can cause physical problems? Scientists are still searching for the answers, but it appears that our brains have been wired to encourage the consumption of calorie-rich foods, even at the expense of good health. Quite simply, these foods bring us pleasure.
Jump up ^ Wells JC (2009). “Thrift: A guide to thrifty genes, thrifty phenotypes and thrifty norms”. International Journal of Obesity (Review). 33 (12): 1331–38. doi:10.1038/ijo.2009.175. PMID 19752875.
A team from the University of Barcelona (UB) led by Dr Juan Carlos Laguna published a study in the journal Hepatology that provides clues to the molecular mechanism through which fructose (a type of sugar) in beverages may alter lipid energy metabolism and cause fatty liver and metabolic syndrome.
Jump up ^ Chiolero A, Faeh D, Paccaud F, Cornuz J (1 April 2008). “Consequences of smoking for body weight, body fat distribution, and insulin resistance”. Am. J. Clin. Nutr. (Review). 87 (4): 801–09. doi:10.1093/ajcn/87.4.801. PMID 18400700.
Jump up ^ Albuquerque, David; Nóbrega, Clévio; Manco, Licínio; Padez, Cristina (7 July 2017). “The contribution of genetics and environment to obesity”. British Medical Bulletin. Advance articles: 1–15. doi:10.1093/bmb/ldx022.
HEIDI L. GADDEY, MD, is associate program director at the Ehrling Bergquist Family Medicine Residency Program, Offutt Air Force Base, Neb. At the time this article was written she was associate program director at the David Grant Medical Center Family Medicine Residency Program, Travis Air Force Base, Calif….