Our Health section editor this month is a friend who graciously agreed to fill an empty spot in our schedule, and who is well qualified to address the topic of healthy weight loss. I'd like to introduce all our readers to STEPHANIE RUSSELL. Stephanie received her B.S. in Nutrition from Oregon State University in 2005, and recently completed the Dietetic Internship Program at Central Washington University. She currently works as a Registered Dietitian at Memorial Hospital's North Star Cancer Care Center in Yakima, WA, and also as a consultant dietitian for long-term care facilities.

Stephanie grew up in Gresham, Oregon where she participated in gymnastics, cross-country, and track. She has been married to her high school sweetheart for seven years, and when not working enjoys running, hiking, writing, and spending time with friends and family. - Kim McCorquodale

For a lot of people, the decision to lose weight means purchasing the latest diet pill, following a fad diet, or resorting to more extreme measures such as surgery. These days it is all about the "quick and easy" way to lose weight, so it is no surprise that the diet industry is a multi-billion dollar industry.

It is true that some of these methods may indeed result in some degree of weight loss, but how often do they lead to long-term weight control? All you have to do is look around to see the answer. Some individuals spend years moving from one weight loss strategy to another, compromising their health and spending hundreds and thousands of dollars along the way, yet never achieving long-term weight control.

For some obese individuals, a doctor may determine the use of diet pills or surgical procedures to be necessary if the health risks associated with obesity outweigh the risks associated with these weight loss methods. However, for most individuals these"quick & easy" weight loss methods are not warranted and often result in a lifetime of frustration and failure. Luckily, there is a weight loss "diet" that is cost-effective, has numerous health benefits, and is guaranteed to produce long-term results. It does not come in a pill, and does not require an incision, it is simply this: Eat Right and Exercise.

Unfortunately, the answer to healthy weight control is simple in theory, yet not so simple in reality. It is a challenge for many people to eat healthy and exercise when time, energy, and motivation is low. It takes time and energy to exercise and prepare healthy meals. Even for someone who has extra time, lack of motivation can be a debilitating factor. For individuals that are motivated, often times the main motivator to lose weight is appearance.

In today's society, where a higher value is placed on what a person looks like vs. other qualities, the pressure to lose weight often leads to the decision to resort to one of the numerous "quick and easy' weight loss methods previously mentioned. Motivation to lose weight is a key factor in achieving healthy weight loss and long-term weight control. Motivation derived from the desire to "look good" usually leads to short-term weight loss, and health is usually of little concern.

However, with more and more Americans becoming increasingly aware of the associations between obesity and chronic diseases such as diabetes, heart disease, and certain types of cancer, motivation is shifting from appearance to health. When health is the main motivator, people tend to be more willing to find the time and energy to make the changes necessary to lose weight the healthy way.

WHY EXERCISE?

In order to achieve weight maintenance, energy intake must equal energy expenditure, and to lose weight energy intake must be less than energy expenditure. The most effective and healthiest way to achieve weight loss and long-term weight maintenance is through the combination of exercise and consuming a healthy balanced diet.

Popular American activities, such as watching television, using the computer, and talking on the phone don't exactly expend a lot of energy. In addition, many Americans are busy working long hours and raising families. Thus, it is becoming increasingly more difficult to find the time to participate in regular physical activity. If one does not make time to exercise, it won't happen! Just like other daily activities, exercise must be planned for and made a priority. The benefits of regular physical activity are numerous, and the role exercise plays in weight loss, weight maintenance, and overall health is crucial.

There are many ways a person can lose weight. A person may choose to lose weight by reducing calorie intake, increasing physical activity, or both. A person who chooses to lose weight by following a low, or very low, calorie diet can usually achieve quick results. Unfortunately, when this method is used much of the weight lost is lean body mass (LBM). When calories are restricted to the degree that a state of starvation, or semi-starvation, is induced and weight loss is rapid, muscle protein is broken-down to be used for energy. If starvation continues, eventually the body will further adjust and begin to utilize more fat stores in order to minimize protein wasting.

Even with this adjustment, the body will continue to use some muscle stores for energy, and LBM will continue to decrease. Muscles require daily maintenance, and LBM is highly metabolically active. When a person participates in regular physical activity (both cardiovascular and strength training), calorie expenditure and LBM increase. An increase in LBM results in an increase in the Resting Metabolic Rate (RMR), which is responsible for approximately 60-70% of energy expenditure. Likewise, a decrease in LBM and/or an increase in percentage body fat will result in a decrease in RMR.

In addition to the decrease in LBM, the body also responds to starvation or semi-starvation by instituting a mode of energy conservation that results in further reduction in the RMR.

Therefore, when rapid weight loss is achieved through calorie restriction alone, a person may reach their goal weight, but their body composition will not be the same. For example, let's say a 125 pound woman gains 20 pounds, then decides to lose the weight by following an 800 calorie/day diet and does not exercise. She may ultimately reach her previous weight of 125 pounds; however, she will now have a higher percentage of body fat to LBM. She now finds it more difficult to maintain her weight, and so eventually regains the 20 pounds. She again loses the weight in the same manner, and when she again reaches her goal weight of 125 pounds she will have an even higher percentage of body fat to LBM, making it even more difficult to maintain her weight.

This struggle, that has been described, is known as the "Yo-Yo syndrome," and is familiar to many Americans. A reduction in LBM and RMR will make it more difficult to lose weight, and more difficult to maintain weight loss. Because regular exercise has the ability to increase LBM, RMR, and energy expenditure, it allows for a more liberal calorie-restriction and makes weight loss and long-term weight maintenance more achievable. In other words, if your percentage of LBM is higher, your RMR is also higher, and you don't have to restrict your calories as much to lose weight.

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For a person who normally leads a sedentary lifestyle, the addition of regular physical activity alone can result in weight loss. However, a moderate reduction in calorie intake combined with regular physical activity will render best results. In theory, a deficit of 3500 calories will result in a 1 pound weight loss. Therefore, a person who burns 500 calories/day 7 days /week during physical activity, but does not make any dietary changes will lose ~ 1 pound/week. If that same person decided to decrease caloric intake by 300 calories/day, they could lose a little over 1.5 pounds/week.

For most people weight loss between .5-2 pounds/week is considered an ideal rate of weight loss, and weight loss at a higher rate is not recommended. The combination of moderate calorie restriction and exercise allows a person to lose weight at an effective and healthy rate, and unlike other weight loss strategies, this program can be followed for life.

FOLLOW A HEALTHY DIET, BUT DON'T DIET

Energy intake vs. energy expenditure is the major determinant of weight loss. However, healthy weight loss is about more than just energy balance. A person can lose weight by eating fast food as long as calorie intake is kept less than energy expenditure. It is important to consume a balanced diet consisting of appropriate servings from all food groups to assure nutritional needs are being met. This becomes especially important when calories are being restricted, because when less food is being eaten there is less opportunity to derive essential nutrients from foods.

Fad diets that encourage restriction of major macronutrients, such as low-carbohydrate diets, are unnecessary and can also be harmful. Glucose derived from dietary carbohydrate is, among other uses, an essential fuel source for the brain and exercising muscle. The idea that carbohydrates make you "fat" is a myth. Calories in excess lead to weight gain, regardless of whether the energy substrate is carbohydrate, fat, or protein.

People lose weight on low-carbohydrate diets, because by limiting carbohydrates they are also limiting calories. It is true that consumption of high protein and high fat foods may increase satiety, and consumption of simple sugars and refined grains may decrease satiety. However, instead of limiting the total amount of carbohydrates consumed, focus should be on the type of carbohydrate consumed. For example, limiting processed grains, snack foods, and simple sugars while replacing them with high-fiber, whole grain choices will increase nutritional value and satiety.

Perhaps the most important food concept to implement during weight loss and weight maintenance is portion control. It may be helpful to document food intake in a journal in order to become aware of what is actually being consumed on a daily basis. When selecting foods from any food group, nutrient dense foods that are high in nutritional value, and relatively low in calories, are the best options. Nutrient dense foods include a variety of fruits and vegetables, lean meats, whole grains, and low or nonfat dairy products.

However, even favorite foods can be included as part of a healthy diet when consumed in moderation. The USDA Food Guide Pyramid is an excellent tool that anyone can use to teach portion control, and to help devise an individualized healthy, balanced eating plan.

GENETIC COMPONENT

A pattern of overweight or obesity can often be found in families, leading many people to blame inheritance for their inability to maintain a healthy body weight. However, it is not quite that simple. Patterns of obesity found in families may be in part genetics, but environmental factors also play a key role. As well as shared similarities in genetic make-up, families share similarities in diet, activity level, and other lifestyle practices. Even if a person has a genetic make-up that makes them more prone to obesity, healthy body weight can be achieved through lifelong adherence to healthy eating patterns and an active lifestyle.

Further proof that the obesity crisis is not simply an issue of inheritance can be found when overweight and obesity statistics of today are compared with statistics from several years ago. Fifty years ago the number of obese and overweight individuals was significantly less than today, yet genetics remain relatively unchanged. One thing that has changed is environmental factors such as increased availability of processed foods, fast foods, increased portion sizes, and decreased activity levels. Something else that has changed is the idea of what the ideal body size is, especially for women.

Many women feel pressured to achieve unrealistic body sizes, and often resort to dangerous behaviors to fit today's "ideal" of beauty. It is important for everyone to understand that beauty comes in all different body types and sizes, and what really matters is that you are healthy. Body weight is only one indicator of fitness and health, and in some circumstances is unreliable.

For example, a person who participates in regular exercise, and follows a healthy diet, may weigh several pounds more than another person of equal age, gender, and height, and still be healthier. This is possible when one person has more LBM, since muscle weighs more than fat. Frame size may also account for variability in body weight. Thus, a better indicator of fitness and health would be to obtain a measurement of body fat percentage, which takes into consideration the distribution of body weight and not just total weight.

PROMOTING LIFELONG HEALTH

An age group that continues to show a disturbing upward trend in obesity and overweight is children and adolescents. A lot of attention is given to finding ways to correct obesity once it is reached. This is certainly an important area of focus, but equally as important is the need to focus on preventing the development of obesity in the first place. Children are strongly influenced by their parents, peers, media, and teachers. Therefore, the responsibility to decrease childhood obesity rates will require a unified effort.

At home, parents are responsible for not only teaching their children healthy eating and activity patterns, but for setting an example as well. Schools have a responsibility to encourage healthy eating choices in the cafeteria, offer nutrition classes to students, and make regular physical activity classes a priority. If nutrition education is taught in an out of the classroom at an early age, children are more likely to continue making healthy choices away from home and throughout life.

CONCLUSION

There is no doubt that the American society of today is full of many obstacles that make it difficult to achieve and maintain a healthy body weight. However, most of these challenges are within our control. When motivated for the right reasons, a lifelong commitment to balanced eating and physical activity is achievable, and the benefits to overall health are endless.

Here is a list of the reputable internet sources I used for the article appearing in the previous two columns of this page. They provide a lot of quality information on this topic.

	MyPyramid.gov - MyPyramid, released by the United States Department of Agriculture (USDA) on April 19, 2005, is an update on the ubiquitous U.S. food guide pyramid. The new icon stresses activity and moderation along with a proper mix of food groups in one's diet. As part of the MyPyramid food guidance system, consumers are asked to visit the MyPyramid website for personalized nutrition information. Significant changes from the previous food pyramid include: It measures quantities in cups and ounces instead of "servings." It includes a new symbol - a person on the stairs, representing physical activity. source: wikipedia
	MyPyramid for Kids - Lots of material here for using as interesting tools to get kids eager to learn about nutrition and how "you 'are what you eat' from your head down to your feet."
	Dietary Guidelines for Americans - The Guidelines provide authoritative advice about how good dietary habits can promote health and reduce risk for major chronic diseases. They serve as the basis for Federal food and nutrition education programs.
	American Cancer Society - Eating right, being active, and maintaining a healthy weight are important ways to reduce your risk of cancer - as well as heart disease and diabetes. Learn the American Cancer Society's guidelines for diet and activity, and find tips for a healthy lifestyle and community.
	America on the Move - America On the Move offers free, personalized online resources, interactive tools, community support, and fun events for learning about weight and health.

...TO THE AMERICAN DIETETIC ASSOCIATION'S OFFICIAL WEBSITE   -  ( this section by Kim McCorquodale)

I recently took the time to look more closely at the Food & Nutrition Information section of this website. Under the "Nutrition Fact Sheets" tab is a section on "Weight Management" (all the way to the bottom of page) that provides supplemental material to Stephanie's article in the previous two columns.

One of the most interesting sections was the part that reviewed popular diets of 2005-2007. Some of the diets included The Cheaters Diet, The Sonoma Diet, and The Flavor Point Diet. Even though many of these diet books were written by professionals, they didn’t always include accurate and/or healthy information. A review of each of the diets was provided by a registered dietitian.

Let me take the time to include a little self-promotion on what a registered dietitian (RD) is. An RD is a nutrition specialist who has obtained a degree in nutrition or dietetics from an accredited university, and then completed a 6-12 month internship that included experience in a variety of settings. After all that, the individual must pass the RD exam, and complete continuing education to remain registered. So, remember anyone can call themselves a "nutritionist" and attempt to pass themselves off as an expert on the subject. An RD is the real deal.

Back to the webpage… Another interesting section is under Nutrition for Everyone and is called The Balancing Act: Eat Well and Move It! This section contains many tips on making small changes, and the benefits of daily physical activity. It also includes the basics of a healthy plan that we all know (and Stephanie reviewed prior), but have trouble implementing into our life. Maybe reviewing this will help you make a few changes in your life, and help you inspire others to do likewise.

Another valuable section is the Good Nutrition Reading List. This section gives you a short synopsis of reputable books and provides a way to purchase them.

Even though many of us know what healthier food choices are, we may not realize what a proper portion is. A lot of great information on this topic can be found at: HealthierUs.gov. Many of us are confused on the difference between portion sizes and serving sizes. The definitions are:

	Portion Size: The amount of a single food item served in a single eating occasion (such as a meal or snack). Another way to look at it is the amount offered in prepackaged foods or the amount you choose to put on your plate.
	Serving Size: This is the standard unit of measuring foods, such as a cup or an ounce. Or, basically the amount you should choose to put on your plate and consume during a single eating occasion.

It's a fact that our portion sizes have increased over time, so make sure to check the serving size on the label or in a basic nutrition book. An example is the bagel. Most bagels are sold in sizes that are at least (and are usually more than) 2 bread servings. Some bagels are 4 bread servings! Another good example is soda pop. Some of you may remember when soda pop was sold in 8 ounce bottles. Now 32 ounces of soda pop is considered a portion size by many.

This site also offers a SmallStep program with great tips on small changes that can produce big results. They provide an Activity Tracker with a place to record goals, save daily activity, view your progress and earn an achievement certificate. They suggest asking yourself:

	Was I successful in reaching my goal?
	If not, what got in my way?
	If yes, how can I build on my success and set new goals?

This is just a review of what this site offers, so take the time to check it out.

About /fit
Welcome to /fit! We hope that we can give you some good advice and information everyday on diet and fitness.

This site was started to help people who are struggling with what is basically a lifestyle problem. Since a huge percentage of Americans are either overweight or obese, we want to help by encouraging people to change their lifestyle for the better by exercising and watching their diet. Unfortunately, this is not just a matter of appearances.

The problem has turned into a national health care nightmare that is only going to get worse. But the good news is that there are some simple (although not necessarily easy) steps people can take to lose weight and improve their health and appearance. We are going to give you daily help in fighting the battle for health and fitness. Feel free to send us your thoughts, tips and suggestions. - / fit