Obesity

There has been much written recently about the “epidemic” of childhood obesity as well as the extent of adult obesity in the United States.  Obviously there is much yet to be learned about this complex problem but I thought it might be worthwhile to review some concepts which are generally considered to be valid by most in the healthcare professions.

The First law of Thermodynamics
One of my professors—an endocrinologist—insisted that the major contribution to obesity has to do with more calories being ingested than calories being expended.  This is what is meant by the First Law of Thermodynamics or the balance of energy in/energy out.

In recent decades we have become more and more of a sedentary society.  This is probably one reason why the American Academy of Pediatrics encourages its members to advise families to restrict “screen time” to less than 2 hours per day.  In addition there is encouragement for children under the age of two years to have no exposure to television.

As a society, we need to exercise more.  Take the stairs instead of the elevators.  Walk more and if driving park some distance from your destination so as to walk more.  Try to have 60 minutes of aerobic exercise daily for 7 days of the week.

8 To Live By
My employer is Intermountain Healthcare.  Several years ago they gathered physicians, dietitians, exercise specialists, nurses, and others and developed the “8 To Live By Habit Builder” program.  The following are suggested as having the biggest impact on ones weight, health, and outlook.

  1. Always eat breakfast—and make it healthy.  Aim for inclusion of 3 of the 5 food groups(dairy, fruit and vegetables, protein, grains, fats and oils).
  2. Eat more fruits and vegetables.  Aim for 1-2 cups of fruit and 1 ½-3 cups of vegetables.
  3. Limit—or eliminate—sweetened drinks.  Aim for less than12 ounces per week of soda and sports drinks; limit juice to less than 6 ounces daily.  Drink eight glasses of water daily and aim for three glasses of milk.  Years ago, pediatricians would “introduce” white grape juice or apple juice to four month old infants.  What a mistake!  We now recommend waiting until after 12 months and limiting to 4-6 ounces per day—if at all.  Juice has carbohydrates, calories, and no protein.
  4.  Limit screen time(television, video games, Internet).  Limit to 1-2 hours per day.
  5. Increase your physical activity.  Aim for at least 60 minutes of physical activity every day.
  6. Eat meals together as a family—sitting down.  We encourage families to aim for at least eight meals per week  to gather as a family.  Turn off the TV and talk with each other.
  7. Be positive about food.  Be food-friendly, not food-phobic.  All foods can fit in a balanced diet.
  8. Do not criticize about weight.  Do not criticize your own body.  Do not compare your own weight, size, or shape to anyone else’s.

Intermountain Healthcare has developed a weekly tracker and a website to assist individuals, children, teens, and families with these habits and if interested the web address is www.intermountainlive.org.

George Durham, M.D. (Utah)