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5StepstoManageObesity

©2007,Dr.AnjaliAroraISBN978-81-207-3249-0

Allrightsarereserved.Nopartofthispublicationmaybereproduced,storedinaretrievalsystemortransmitted,inanyformorbyanymeans,mechanical,photocopying,recordingorotherwise,withoutpriorwritten

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Theauthorwishestothankallacademicians,scientistsandwriterswhohavebeenasourceofinspiration.

Introduction

O besity is one of the primary lifestyle diseases of the present century. It refers to excess bodyweight in the form of fat. Obesity has become the direct result of unhealthy food habits and asedentary lifestyle. It is themain predisposing cause of diseases like blood pressure, diabetes andheart disease.Managing obesity has therefore become crucial in order to lessen the incidence ofassociateddiseases.

01.TestYourselfForObesity

Yes No Diet

Youlikefried,saltedandsugaryfoods. Youdonotlikeeatingfruits. Youarenotaregularsaladconsumer.

Yes No SedentaryHabits

Youhaveajobwhichrequiresyoutobesittingmostofthetime. Youdonotgetanytimeforexercise. Youdonotenjoyworkingoutorgoingforawalk.

Yes No Lifestyle

Youhavemorethantwosmalldrinks3-4timesaweek. Youarefondofsnackingonpackedfoodsbetweenmealsorwithyourdrinks. Youeatout4-5timesperweek.

Yes No CouchPotato

Youeatwhilewatchingtelevisionorreading. Youtendtoovereatwhenyouaretiredordepressed. Youliketohitthebedimmediatelyafterdinner.

Themore times you answered ‘yes’ to the above statements, the greater your risk of beingoverweightorobese,andhavingheartdisease,strokeorcoloncancer.

02.UnderstandObesityUnderstandObesity

Obesitycanbedefinedasthepresenceofexcessadiposetissueinthebody.

Morethan20%oftheidealweightindicatesexcessweight,andmorethan30%indicatesobesity.

01.BodyMassIndex(BMI)

BMI is the index of obesity. It is calculated as the ratio of bodyweight in kg to height square inmeters.

02.BasalMetabolicRate

Thefollowingequationcanbeusedtofindyourbasalmetabolicrate,orhowmanycaloriesyouburnperdayatrest(throughheartbeat,maintainingbodytemperatureandbreathing).Youshouldmultiplyyourweightinpoundsby11.

(Toconvertyourweightfromkgtolbsmultiplyby2.2)

Ifyouareover20years,youmustmakeanadjustmenttothecalculationtoarriveatyourBMR.Foreachdecadeover20,subtract2%fromyourtotal.Takingtheexampleofapersoninhis30swithaweightof140lbs.

140x11=1540

2%of1540=30

1540-30=1510

Therefore,apersoninhis30sshouldhaveabasalmetabolicrateof1510andsoon.

So,thispersonshouldhaveapproximately1510caloriesinadaytomaintainhis/hercurrentweight.In order to loseweight he/shewill have to consume food of less calorific value or burn caloriesthroughbriskexercise.

03.ThePimaParadox

ThePimaIndiansareknowntobetheheaviestpeopleintheworld.Someoftheiradultsweighmorethan500pounds.

ManygenerationsoftheseIndianslivedinthedesert,underfamineconditions.ThemostsuccessfulsurvivorsofthePimawerethosewithgeneswhichhelpedthemstoreasmuchfataspossiblewhenfoodwas available.Now in thepresent times this fat storagegoes against them.ManyobesePimateenagersonmodernAmericandietaresufferingfromdiabetes.

Nowcomestheparadox.It isseenthatagroupofPimaIndians livinginSierraMadreMexicoareobesebutdonothaveobesityrelateddisease.

Thoughboththesepopulations(American&MexicanPimaIndians)consumedthesameamountofcalories each day, the Mexican Pima Indians lived like their ancestors. They physically labouredthroughoutthedayandateatraditionaldietthatwaslowinfat.

So,thoughitisapparentthatthePimaIndiansmayhaveageneticpredispositiontowardsobesitybutthe importantaspect is theenvironment thatyou live in.Yourenvironmentand lifestyledeterminesyourhealthyliving!

04.BodyTypes

Wehavepartialcontroloverourbodyshapeandsize.Partially,ourgeneticpredispositioncontrolsourmetabolism,bodytypeandthetendencytostorefat.

ApplesandPears

Whetheryouhaveanapple(android)orpear(gynoid)bodytype,isdeterminedbyyourwaist-tohipratio.Divideyourwaistmeasurementbyyourhipmeasurementtogettheratio.

WAIST/HIP=RATIO

Iftheratioisgreaterthan0.85forwomen,or0.95formen,thenyouareanapple.Iftheratioisless,thanyouareapear.Menandwomencanbeofeitherbody type.According to theexperts, Indiansshouldhavealesswaist/hipratio.

Applesstoreexcessweightintheirabdomen,ratherthantheirhipsandthighs.Fatdistributedintheabdomenisoftenassociatedwithcertainmetabolicproblemslike,highcholesterol,heartdisease,anddiabetes.

Ifyouareanapple,andyouhaveabodymassindex(BMI)ofover30,youareatariskofdevelopingcoronaryheartdisease.

Pearsmostlycarryexcessweightintheirbottom,hipsandthighs.Apearcanhaveaverysmallwaist,narrow shoulders, andwider hips and thighs. Inwomen this body shape becomes suited to child-bearing.Asthisfathasaspecialpurpose,thebodyprotectsitandburnsotherstoresoffat–firstfromtheface,thenthearms,bustandsoon.

Endomorphs,MesomorphsandEctomorphs

Endomorphstendtobeshorterthanaverageandhaveatendencytobeoverweight.Theyoftenhavealowermetabolicratethanotherbodytypes.

Mesomorphsareofaverageheightwithwelldevelopedmuscles.Theyhaveahigherratioofmuscletofat,andtendtohaveahighmetabolicrate.

Ectomorphs are tall for their weight and possess long, thin limbs. They have a naturally highmetabolicrate.Also,theycandigestahigh-caloriedietwithoutputtingonweight.

03.MeasureYourRiskSinceobesitycanleadtomanydiseases,youmustdeterminewhetheryourweightiswithinacceptablelimits.

IdealBodyWeight

Itisdifficulttodefine‘ideal’weight.Twopeopleofthesameheightandapparentbodysizemayhavedifferentweightsbecauseofagreatdifference in theamountof leanbodymass (muscleweighingmorethanfat).‘Idealweight’istheweightatwhichyouwouldlookandfeelhealthyandattractive.

Anotherimportantfactortomaintainanidealweightisthebody’s‘setpoint’.Eachofushasanaturalweightrangebuiltintoourgeneticpattern(withinabouttenpounds).

Bodymassindexhasbeencreatedasastandardforcategories–underweight,overweight,obeseandsoon.Thisscaleisusedtogiveaclinicaldefinitionforobesity.

Withconsistentovereating,noexercise,oryoyodieting,oneoftenreachesaweightwellabovethesetpoint.Therefore,yourbasalmetabolic rate reflects thenumberofcaloriesyoucanconsume tomaintainyourcurrentweight.Toloseweight,youmusteithereatfewercaloriesthanareindicatedinyourBMR,orburnupmorecaloriesthroughincreasedexercise.

CountingYourCalories

A calorie is a unit of energy. Energy obtained from food can be stored or used up by the body.Excessivecaloriesobtainedfrom,e.g.fatsinfood,leadstoobesity,heartdiseaseandotherillnesses.

CalculateYourWeightinKilogramsfromlbs

Divideyourweightinlbs/2.2

i.e.‘x’lbs/2.2=‘y’kg

Remember,obesityisfarmorethananunattractiveappearance.Itisoftenavisiblemarkerofotherunderlyingriskfactors.

Totalmortality increaseswith increasingBMI. 25%of incidence of coronary heart disease canbeattributedtobeingoverweight.Theprevalenceofhighbloodpressureanddiabetesis2.9timeshigherforoverweightpeople.

Alongwithhyperlipidemia(highcholesterolorother lipids)andtheaboveriskfactors, there isanincreaseintheincidenceofstroke.Increaseinweightisoftenassociatedwithhightriglycerides,highLDL-C(badcholesterol)andlowHDL-C(goodcholesterol).

Weightgain,canbedue to lackof the thyroidhormone.Obesity is linked to insulin resistanceandmetabolicabnormalitieswhichleadtoatherosclerosis(blockageofarterieswithfat).Morbidobesitycansometimesbehelpedwithsurgery.

04.FatsAndDieting01.FattyFacts

Thefattylayerbeneathourskinhelpsconservebodyheatandregulatebodytemperature.Italsoprovidesinsulationagainstcold.

Fatplacedaroundourjointshelpsasalubricantinallowingsmoothmovement.

Ourvitalorganslikeliver,heartandbrainareallcushionedbyfattopreventinjury.

Cholesterol:Animportanttypeoffat

Cholesterolisafatwhichisapartofeachcellandisimportantforitsfunctioning.

Cholesterol isaprecursorofvitamins,hormonesandbileacids.Bileacidsaid indigestionoffoodinthebody.

Tocontrolexcessivefatinthebody,naturehasgivenusahormonecalledleptin.

Leptinisahormonewhichisknowntoplayaroleinobesity.Leptininthebrain,triggersanactiveformofpeptidewhichhelpsincontrollinghunger,burningofcaloriesandaidsinbettermetabolism.

02.FatStorage

Adietwithlotofrefinedsugarlikesweets,chocolates,aerateddrinks,anddessertscancauseobesitywithoutovereating.

Ahigh fat dietmakes the body shift itsmetabolism towards storing fat, instead of burning fat forenergy.Lipoproteinlipase(LPL),anenzymewhichbreaksdownfatmolecules,helpsstorageinyourbody’sfatcells.Themorethefateaten,themoreisitsstorage,particularlyaroundtheabdomenandhips.Whenyoureducefatfromyourdiet,youfirstlosefatfromtheabdomen.

FatCells

If you keep overeating, your fat cells grow larger. You also start forming new fat cells and gainweight.Ifyoudecreaseyourfoodintake,thesizeofthefatcellsdecreases,butthenumberdoesnot.So in addition to feelinghungry, your body thinks you are starving, and it tries to compensate byslowingdownyourmetabolicrate.Whenyourmetabolismbecomesslow,thenyourcalorieburningalsoslowsdown.

ImpactofObesity

Very obese men between (25-35 years of age) are seen to have a 12-fold greater risk of dyingprematurelyascomparedtotheircounterpartswithnormalweight.

Itisseenthatobesepeoplehaveahigherrateofmedicalproblems.Inmoderatelyobesepeople,therecanbemultiplemedicalproblemslike:-

Cardiac:Highbloodpressure,heartfailure,heartdisease

Gastrointestinal:Gallstones,recurrentheartburn

Endocrine:Diabetes,highlipids(cholesterol),menstrualirregularity,infertility

Pulmonary:Obstructivesleepapnoea

Musculoskeletal: Degeneration of knees, backache, disc herniation, osteoporosis, pathologicalfractureofbone

Skin:Multipledisorders

Cancer:Variousorgans

WaterRetentionandWeight

Waterretentionisaconditionwherethebodyholdswater.Medically,excesswateraccumulatesandbecomesvisiblewhenthebodyholdsabouttwolitresofwater.Afeelingofheavinessandbloatingistheresult.

Waterretentioncanbeduetothepresenceofcertaindiseases.Inwomen,waterretentionispartofthepremenstrual syndromeormenopause.Heavily salted foods likepickles,and tamarind, tomatoandvinegarpastescanhelpaccumulatewater.

Toavoidwaterretention,consumelesssaltandhavenaturaldiureticslikecoconutwaterandapples.

03.FatTalk

It has been computed that every pound of your fat contains about five thousand feet of bloodvessels.Ifyouhavetwelveextrapoundsoffat,yourheart(inadditiontoitsregularpumping)will have to propel blood through some twenty extramiles of blood vessels every 5/6th of asecond.Astimegoesby,theamountofextrastrainputonourheartandthecirculatorysystemsurfacesintheformofdiseases(e.g.highBP,heartdisease).

Cravingforsweetsandcarbohydratesrepresentsaformofstarvation.Mostfoodsleavethebodystarvedforessentialvitamins,mineralsandantioxidants.Itisbettertoeathealthy,thantostarveyourself!

Excessivesweets,ano-fibredietandeatingunhealthyfoodsleadtomorehungerandbingeing,whicheventuallyresultsinobesity.

Haveabalancedmealwithplentyofvitamins,minerals,proteins,acertainamountofstarchesandasmallamountofsweetsorfats.

Keepyourweightundercontrol.Ithelpsyourheartandprolongsahealthylife.

Exercisewillinglyandintelligently.

Tryandmaintainagoodposture.

Stress,littleexercise,lackofsleep,drinking,smokingandwrongeatinghabitsleadtoabadbloodcirculation.Awrongemotionalstatusresultsinlessbloodsupplytothebrain.

Afatiguedbrainandasluggishbodyaretheconsequencesoffatdepositionandillhealth.

04.DietaryFat

Yourbodyconvertsdietaryfatcaloriesintobodyfat.Thisisdonetouseandstoreenergy.Proteinsandcarbohydratesprovideonly4caloriespergram.Fatprovides9caloriespergram.One300mlaerateddrinkcontainsapproximately120-130calories.Toloseweightnotonlydocalorieshavetobereducedbutconsumptionofunhealthytypeoffoodshavetoberestricted.

CalculationofYourCalorificFat

If your calorie intake is 1600, 10-25% (maximum) calories can be allowed in the form of fat (ofwhich7%issaturatedfat).

e.g.Taking25%ofcaloriesforfat.

i.e.400caloriesmaximumcanbeconsumedintheformoffatinatotalintakeof1600cals/day.

(Similarlyminimumcaloriescanbecalculatedas:10×1600)

Tocalculatethequantityoffatallowedtobeusedinaday.

Weknowthatonegmoffat=9calories

400/9=44gmoffatandfatproducts(approximately)canbeused/day.

Thisisforapersonmaintainingidealbodyweight.

In order to loseweight, calculate the number of calories youburn eachday.To lose one pound aweek,youshouldeatapproximately500calorieslessthanyouburnperday.

05.ObesityInChildren

Guidingsmallerchildrentowardsahealthybehaviourbecomesimportantastheirhabitsgetsetoncethey grow up. With more and more parents getting involved in their work and respective lives,childrenatlargeareentertainingasedentarylifestyle.Onemustrealisethatitisextremelydifficulttomaintainahealthybodyweightwithalowlevelofphysicalactivity.

Modern environment has eliminated many reasons for increased physical activity. Convenienttransportation, computers, long hours of homework, movies and television along with fast foodeatinghasencouragedbingeingandasedentarylifestyle.

Obesity is not solely the result of low levelsofphysical activity. It actually arises fromanenergyimbalance in which energy intake exceeds energy expenditure. Adults must convince children toreplacefattyfoodswithwholesomeeating.Inturn,theymustpracticewhattheypreach!

Weightreductioncouldresultwithalittlemorewalkingandeatinglessoffattyfoods.Whattoday’sgeneration of school kids have to realise is that fat around you, also means fat deposits in yourarteriesandotherorgans.Itmaybuildupslowly,butitwillbethere!

Itisespeciallyimportantforeveryoverweightchild(orachildwithafamilyhistoryofobesity,heartattackorstroke)andalsoanadolescentaround18yearsofagetogetabaselineoflipidprofileandbloodsugarassayed.Iftheparametersforthetestsarehigh,theirparentsmustactonitimmediately!

Inyoungerchildren(5-10years)combiningincreasedactivityandtryingtoreducetheintakeofabout100-200caloriesperdaybydrinkingmorewater(thanaerateddrinks)willhelpinthereductionofexcessiveweight.Inwinter,hotandfreshvegetables,dal,chickensoupsshouldbewelcomed.Intheholidaysespeciallysummer,moreofsaltednimbupani(lemonjuice)andlassi(buttermilk)shouldbearound.Besidesahealthydiet,childrenshouldbemade to indulge inphysicalactivities.This isimportant for their development, both physically and mentally. This is much better than treatingestablished obesity. Healthy behaviours involving physical activity and proper nutrition play animportantroleinkeepingtheweightofthechildrenundercontrol.

06.Dieting

Dieting is an exhaustiveprocess and causesweight fluctuations.Manydieters experienceweaknessandirritability.Incompleteexerciseisalsooftenperformedbydietersbygoingtoaerobicclassesoragym,afewtimesaweek.Thisisnotthesolution.Focusonreducingthenumberofcalorieseateninaday.Thiswillhelpinasteadyweightloss.Forgoodhealth,boostyourmetabolism24hoursaday.

Eatandexercisesensibly,andyouwillbeatmuchlessriskofdevelopingobesityrelateddiseases.

EffectsofDieting

Dietingresultsintheprocessofsemistarvation,duetodeprivationoffoodsthatyoulike.

Dietingleadstoloweredmetabolismespeciallyinwomen(astheirmetabolismforgeneticreasonsisslower).

Alongwithdietingitisimportanttomakethebodyphysicallyactivethroughoutyourworkinghours.Your24hrsadaycalorieburningpowerdependsupontheleanmusclemassthroughstrengtheningexercises.

Ithasbeenscientificallyestablishedthattheweightfluctuationsfromyo-yodietingareassociatedwithanincreasedriskforheartdisease.

Itisnotthefitnessclassesfor40mins,fivedaysaweekwhicharegoingtohelpyou.Itisthelittle5minsofwalkingmanytimesadaywhichhelpsdoubleyourcalorieburning.

07.HowYourBody‘Loses’Weight

The firstweek of dieting usually produces themost dramaticweight loss.When you start dieting,yourbodyusesupitsglycogenstoresbeforeitbeginstoburnexcessfatforfuel.

Asyouusetheglycogenstores,yourbodyshedsthewaterthatwasboundtotheglycogen.

Onceglycogenstoresaredepleted,thebodyshiftstoburningfatstoresforenergy.Losingfatisamuchslowerprocess.

Sensible,healthyfatlossisintherangeof1-2lbsperweek.Ifyoutrytoloseweightmorequickly,anumberofundesirableeffectscanoccur:

Youwillburnupleanbodytissueratherthanfatstores,leavingyouwithlessmuscleandmorefat.

Yourmetabolismwillswitchtosuper-efficientmode,makingitmoredifficulttoloseweight.

Themoreextremethediet,thegreaterthelikelihoodthatyourapidlygainbackanylostweight.

08.TheImportanceOfAbdominalObesity

Obesity traditionally has been defined using Body Mass Index (BMI). However, BMI does notdiscriminatebetweenmuscleandfatmass.Italsodoesnotprovideameasurementoffatdistributionwhichisthemaindeterminingfactorofcardiometabolicriskrelatedtoexcessbodyweight.

Lateststudieshaveshownthatwaisttohipratio(WHR)isthestrongestpositivemeasureassociatedwithmyocardial infarction (HeartAttack).Even at the lowest level ofBMI, an increasedwaist hipratioincreasestheriskforheartdisease.

FactorsLeadingtoExcessAbdominalFat

Societal(urbanisation,automation)

Cultural(foodchoices)

Individual(fastfood,leisureactivity)

Sedentarylivingwithdietaryfactorsbecomesakeyfactortowardsincreasedfatdeposition.

StepstoLowerAbdominalFat

Isocaloric(ofsamecalories)Substitution

Modestamountsofproteinshouldbesubstitutedforcarbohydrate(approximately30gmsubstitutionofchickenorcottagecheeseinsteadofrice).

Eucaloric(goodcalories)Substitution

Polyunsaturated fat to be substituted for a saturated fat diet. This is known to lessen central

obesity.

Increasingphysicalactivityalsohelpsindecreasingwaistcircumference.

Smoking

ThoughsmokingisassociatedwithareducedBMI,aitcanalsobeassociatedwithcentralobesity.

09.FiveTipsToLoseWeight

Drinkatleast8glassesofwaterperday.Itdecreasesyourappetiteandflushestoxinsfromyourbody.

Exercise regularly. It raisesyourmetabolism,helpsburncaloriesand tonesupyourbody.Donotexhaustyourself.

Thereisnoneedtostarveyourself.Eatasnackifyouarehungry.Salad,apieceoffruit,yogurtorclearsoupcanbetakenbetweenmealsorabouthalfanhourbeforeyourmeals.Remember,youneverfeelfullonfattyfood.

Avoidalcohol.Itgivesemptycalorieswhicharetakeninbythebodyassugar.Italsosuppressesthebody’sabilitytoburnfat.

Reducethesizeofyourplate(useanineinchplate)sothatitappearstobefull.

Eatthreemealsadayregularly.Enjoyyourfood,eatslowlyandchewwell.Avoidhavingabigmeal.Goinformorehighfibrefoods.

05.ObesityAndLifestyleObesityAndLifestyle

Afewsimplechanges inyourdietandlifestylecanhelpreduceobesity.This includesselectingtherighttypeoffatsin(smallerquantities)yourdiet.

01.FatsForYourDiet

MonounsaturatedFats

Monounsaturatedfatscanbeobtainedfromvegetablesources.Theyareolive,mustardandrapeseed(canola)oils.MonounsaturatedfatsareknowntodecreaselevelsofLDL-C(badcholesterol)withoutaffectingtheHDL-C(goodcholesterol).

PolyunsaturatedFats

Polyunsaturatedfatsareobtainedfromsafflower,sunflowerandcornoil.TheycanlowerbothyourLDL-CandHDL-C.

SaturatedFats

Saturatedfatsaretobeavoided.Theyincludebutter,coconutoil,palmoilandpartiallyhydrogenatedoils.TheyincreaseLDL-CanddecreaseyourHDL-C.

Omega6andOmega3FattyAcids

Omega6 fattyacidsaremainly found inmeatsandOmega3 fattyacidsare found in fishand flaxseedoils.Theyhelplowercholesterol.

Ricebranoilorsunfloweroilcanbeblendedwithmustardoil/oliveoil.Theidealoilhasabalancedfatty acid composition. Blend two oils, as no single oil canmeet the requirement of an ideal oil.Neverreusefriedoil,asitharmstheabody.Onlyusetheamountyouneedeachtime.

02.TheRoadToObesity

Emptycalories from refinedwhite sugar “sucrose” tops the list.Other calorific sweets likebrownsugar,cornsyrup,Indiansyrup(chashni)madefromsugar,fructose,dextrose,andmaltoseshouldbeavoided.

Sweetsmadeoutof thesealongwith fried, fatty foodsmakeadeadlycombination.Yougainmuchmoreweight.Alsotryandnotsubstitutesugarwithartificialsweeteners.Satiateyourselfwithsnackscontainingfreshfruits,salads(vegetables),andwholegrainproducts.

NutritionalTherapeuticLifestyleChange(TLC)

Advantagesofconsumingcomplexcarbohydrates(grains,cereals,pasta,brownrice,missiroti,vegetables,fruits,nutsandseeds)

Theytakelongertodigestthanrefinedcarbohydrates.

Theycontainahigherpercentageofwaterandfibre.

Theyalsohelpyoufeelfullforalongertimeandkeepyourbloodsugarstable.

03.YourDailyDateWithFood

Breakfast

‘Breakfast’intermsmeansbreakingthefast.Thereisawell-knownsaying,whichseemstohavegotlostwiththepresentgeneration–“breakfast likeaking,havelunchlikeacommonerandconsumedinnerlikeapauper”.

Your liver has to work to flush out impurities. Dieting hampers the basic liver function ofmetabolisingstoredfatintoproductiveenergy.

Alsobydrinkinglotofwater,youslowdownfatloss.Mostofushaveafrugalbreakfastorweskipit.Wearealwaysinahurry.

Eatingawholesomelowfatbreakfastgivesyouenergyallthemorning.Thereleaseofserotonin(ahormone)with intake of complex carbohydrates (cereal,wholewheat bread) is important tomakeyoumentallycalmandrelaxed.

Foragoodbreakfastyoucanconsumeafruit,wholegraincereal,almonds,a littleskimmedmilk,coffeeortea.

Snackingbetweenmeals isgood topepupyourmetabolism. It isbetter toconsume6-8glassesofwaterduringtheday.Startwith2glassesofwater,whenyougetupinthemorning.Trycoldwater.Itisacalorieburningfluid.Ifyoudonotdrinkenough

water,yourbodyretainsthewaterithas.Also,wasteproductsaccumulateinthekidneys.

Duringtheday,onemustconsumesomethingbetween2-3hrsofthepreviousmealorsnack.Ifyoudonoteatfor4-6hrs,yourenergywavesasyourbloodsugarlevelsstarttodrop.Thismakesyoutiredandtense.

ForYourLunchandDinner

LowFatDiet

Itbasicallyfocusesoncuttingdownondietaryfat.Thisallowsthebodytouseupitsstoredfat.Alllowfatdietsencouragelotofsalads(withoutfatdressings),vegetablesandalimitedamountoffruits.

LowFatMediumCarbohydrateDiet

Thisisbasedonthepresumptionthateatingfatmakesyoufat.Ifadietprovidessufficientamountofcarbohydrateandprotein,thebodywillusetheseupasfuelforenergy.Fatcalorieswillnotbestoredandwhenthereisnothingtoburnforenergy,fatwillbeutilised.So,thiswillencouragethebodytogotoitsownfatstoresforenergytherebyutilisingextrafatwhichotherwisewouldhavebeenstored.

HighFibreintheDiet

Fibrebelongstothecarbohydratesgroup,whichremainsintactwhilepassingthroughthedigestivesystem.Itcomesfromtheindigestiblepartofplants.Theskinsofapplesandpears,theskinfoundonbeans and sweet corn, thewebs in the green leaves and the stringy fibres in celery, broccoli, etc.,belongtotheindigestiblepartofplants,thecellulosefibres.

HealthySnacking

Snacking is important duringmidmorning and tea time (late afternoon).Your snacking shouldbelowinfatandsweet.Eatbeforeyouarehungry.Youcangoinforsalads,peas,boiledchana,channamurmuras or air popped popcorn etc. Low fat biscuits, cookies, fresh juice (vegetable or fruit),nimbupaani,orlowfatyogurtcanalsobetaken.Caffeinatedproductsandalcoholshouldbekepttominimum.AccordingtoaSwissstudy,caffeinatedproductsliketea,coffeeactasdiureticandcausefluidloss.Alcoholicbeveragesmakethebodyburnfewercalories.Thisinturnfavoursfatstorage(potbelly)andweightgain,ariskfactorfordevelopingobesity.

04.AimToEatMore

ToShedWeight–caloriecutdown

Carbohydratesandcaloriesarenegligible invegetables likebrinjal,cucumber, tomato,cauliflowerandturnip,aswellasinleafyvegetableslikecelery,lettuce,spinach,soyabeanandcorianderleaves.Freshfruits,sproutedgrainsandlegumescanbetaken.

Water and tea are acceptable foods. Whole grain cereals, brown bread, pastas, etc., should beconsumedinmoderation.

Alcohol,fruitjuices,whitebread,sugarandsugarproducts,fatsandfriedfoodsshouldbeavoided.Potatoes,corn,meatandmeatproductsarealsoonthe‘avoid’list.

05.Exercise

The most efficient way of not adding fat to your body is by changing its metabolism through

exercise.Anoptimumrateofexerciseshouldbeoneatwhichyoucanbenefitfromfatburning.Thisshouldbewhileworkingatahealthyandsafepace!

Walkbrisklyanddetermineyourtargetheartrate!Todetermineyourtargetheartrate:

Subtractyourage(x)from220togetyourpersonalheartrate(200-x)=y

Yourtargetheartrateshouldbe60-80%ofyourpersonalheartrate,i.e.80%ofY=Z(beats/minute)

Thisshouldbeyourtargetheartrateforaerobicexercise.Ifyouareanolderpersonorabeginner,start with 60% of your heart rate and over a period of 6-8 weeks bring it up to yourmaximum.Rememberthereshouldbenopalpitationorpainduringexercise.Ifso,consultyourdoctor.

BackExercise

Kneetochestlift

Lieonyourbackandbendbothknees.

Usingbothhands,grasponelegandslowlypullittowardsyourchest.

Relax.Thenslowlyreturnit to thestartingposition.Repeat thiswiththeother leg.Doitseventimes.

LowBackStretch

Seatyourselfcomfortablyonachair.

Putyourfeetandkneesapart.

Slowlybendtowardsthefloorputtingyourhandsonthefloorinfrontofyou.

Holdthishanddownpositionforabout15-20seconds.

Slowlybringyourselfuptothesittingposition.

Repeattheexerciseseventimes.

ChestandShoulderRaise

Keepsittinguprightonyourchair.

Stretchyourlefthandstraightasifyouarewantingtotouchtheceiling.

Keepitinthatpositionfor10seconds.

Bringitdownslowly.

Similarlyrepeattheexercisewiththerighthand.

Theseexercisescanalsobeperformedwithweights(likedumbbells).

NeckStrengthening

Peopleworkingoncomputers,oranyonewithadeskjoboftencomplainsofneckorcervicalpain.Thesearebasicexercisestoavoidthepain.Ifthecervicalpainpersistsoraggravates,consultyourphysiotherapist.

Inastraightstandingpositionputbothyourhandsbehindyourhead.

Nowputpressurebackwardsonyourhandsthroughyourhead.

Nexttakeonehandtotheleftsideofyourhead.

Putpressureonthehandasifyouarewantingtomoveit.

Repeatthisontherightsideoftheheadwiththerighthand.

Repeattheexercise7timeseach.

ToningtheAbdomen

Reversetrunkrotation

Lieonyourbackonthefloor.

Extendyourarmsontheside.

Keepingyourupperbodyinpositionslowlybendyourlegstotheleft,touchingthefloorwiththeoutsideofyourkneeandfootofthelowerleg.

Getbacktothecentreposition.

Repeatontheotherside.

Doit7times.

Remember

Noexerciseshouldbedonewithjerks.

Allexercisesshouldbeconductedslowly.

If you are uncomfortable or experience pain on performing any type of exercise, stop theexercise.

Consultyourdoctorbeforestartingitagain.

AFewWords………..

Enjoyeatingyourfood.

Doregularexerciseandcontrolyourdietaryfatintake.

Haveasaladwitheachmainmeal(orasasnack).

Tryusinglowfatorfatfreedressing.

Bakeorsteamyourvegetables,fish,etc.

Lightlysautéorcook,with littlewaterandasmallamountofoil.Alwayscook inanon-stickvessel.

Make your food tasty by using herbs, instead of too much salt or oil. Seasoning food withpepper, basil, oregano, parsley, jalapinos, garlic, onions, shallots, ginger, not only gives adeliciousflavour,buttinglesyourpalateandkeepsyouinterestedinlowfatfood.

Replaceyourregularmilkwithlowfatorskimmedmilk.

Youcanalsohavesmallquantitiesoftofu,nuts,etc.

Eatlessofmeats,andevenpoultry.Substituteitwithvegetables.

Eatmoregrains(wholegrain,missiroti,etc).

Increase your intake of fruits (three fruits / day one with eachmainmeal and of a differentcolour).

Avoidtakingtoomuchoffruitswhicharesweetlikegrapes,bananasandmangoes.

PulseRate

Whileexercisingcheckyourpulsetoseeifyouareachievingyourtargetheartrate.

Youcancheckyourpulseeitheratyourwristoryourthroat.Gentlyusethepads,notyourfingertipstofindyourpulse.

StepI : StartwithOasbaselineandfeelyourpulseandcountitoveratensecondperiod.StepII : Thenmultiplytheresult‘b’by10.

b×10isyourexerciseheartrate.

Ifyourpulsecountislessthanyourheartratethenyouarenotexercisinghardenough.Ifyourpulserateishighbringitdown.Youshouldnotbeexercisingtoohard!

AerobicExercises

Aerobicexerciseslikewalking,running,cyclingandswimming,speedupyourmetabolismandburnyourcalories.

AnaerobicExercises

Anaerobic exercises help in toning the body. They do not burn many calories but build musclethrough resistance.Theyare likeweight liftingandcallisthenics (a systembasedupon tinymusclecontractionsandlongbodystretches).Itisasystemdesignedtoputnopressureonthelowerbackorspineandmakeyoulookgraceful.

06.Yoga

Yoga means ‘yoke’, i.e. joining of the mind and the body. It is one of the oldest systems ofselfdevelopmentandpractisestheartofphysical,mentalandspiritualbalanceandcontrol.Combineyogawithaerobicexerciseinyourexerciseschedule.Itwillnotonlyhelpyoutrimoutbutwillalsoaidinrelaxingyourbodyandcalmingyournerves.

Youcanalsodance,weighttrain,playoutdoorsportsordospotexercise.Whatevertypeofaregularexerciseprogrammemakesyouhappy,doit!Weightlosswillmakeyoulookandfeelgreat!

PostWorkoutMuscleSoreness

Togetridofthemusclesorenessafterexercise,takeacoldshower.Afterahardworkoutlacticacidmaydevelopinthebody.Acoldshowerhelpsconstrictthebloodvesselsinthemuscleandreducesinflammationandsoreness.

07.SurgeriesForObesity

BariatricSurgery(forMorbidObesity)

In general, in order to qualify for bariatric surgery youmust be ‘morbidly obese’,which usuallymeansbeingoverweightby100pounds(man)or80pounds(woman)withaBodyMassIndex(BMI)of40+.

Bariatricsurgicalproceduresareofdifferenttypesbutarecollectivelyknownas“bariatricsurgery”.This is the last solution toweight loss inmorbidlyobesepatientsonwhomthemoreconventionalweightlossprogrammeshavefailed.

Bariatric surgical procedures are major gastrointestinal operations that (a) seal off most of thestomachtoreducetheamountoffoodonecaneat,and(b)rearrangethesmallintestinetoreducethecalories the bodies can absorb. Bariatric surgery compels patients to change their eating habitsradically.

Thehigherthemotivationofpatientstoloseweightandmanagethepost-operativerequirementsofdietarymodificationandbehaviouraltherapy,themoresuccessfulbariatricsurgeryislikelytobeinsolvingtheirobesityandweightproblems.

Liposuction(Suction-AssistedLipectomy)

Thissurgeryis tohelp improvebodyshapebyremovingexercise-resistantfatdepositswitha tubeandvacuum technique.Here targeted fat cellsare infusedwith salinecontaininga localanaestheticsolution before liposuction to reduce post-operative bruising and swelling.Common locations forliposuction includeabdomen,buttocks,hips, thighs,knees, cheeksandchin.For largervolumesoffat, ultrasound-assisted lipoplasty (UAL) can be performed. UAL is a new technique in which aultrasound probe is inserted beneath the skin to “liquify” the fat before it is suctioned. Risks areswelling,numbness,soreness,burningsensation.UALrequireslargerincisionsforcannula.

MythsAndFactFileMyth

Alcoholisgoodfortheheart.

Fact

Alcoholhasemptycalories,whichgetconvertedintofat.Ethylalcoholinalcoholicdrinksisknowntoincreasebloodpressureandweakenheartmuscles.RedwineinstudieshasbeenshowntoincreaseHDL2,thesubfractionofgoodcholesterol.

Myth

Crashdietingisgoodforlosingweight.

Fact

Crashdietingmakesyouloseweightfaster,butwithdireconsequencesofpermanentorgandamageandlossofleanmuscleandtissue.

Myth

Ifyoutryandloseweightfaster,youlosefat.

Fact

Healthyfatlossshouldbe1-2lbsperweek,otherwiseyouwillburnupleanbodytissuefasterthanfatstores.

Myth

Goingvegetarianishelpfulforhealth.

Fact

Notreally.Vegetarianfoodhelpsreducetheriskofheartdiseases.Eatingvegetarianfriedfoodandsweetswillnothelpinanywayandisasbadastakingnon-vegetarianfood.

Myth

Nutshaveoilsandarefattening.

Fact

Nutsareabithighincaloriesbutareanexcellentsourceofvitaminsandfibre.Smallquantitiesofmixednutslikewalnutsandalmonds(1/3ofacup)havegoodmonounsaturatedfats.

Myth

Carbohydratesandallproteinshave4caloriespergram.

Fact

Itisonlyvegetariancarbohydrateslikericewhichhave4caloriespergram.Animalproteinscomewithnaturalfatsandtheyhave9acaloriespergram.