Bariatric Times - June 2008 - (Page 11)

Bariatric Times • June 2008 Practice Management Perspective any weight loss attempt; it can account for a difference of up to a 2,000kcal expenditure per day in active versus sedentary individuals.19 Patients can be encouraged to stand while using the phone, iron while watching television, run errands on foot, take stairs instead of elevators, walk down the hall rather than e-mail a coworker, and so on—the possibilities are endless. Furthermore, studies have shown that lifestyle activity can be as effective as a more structured program in lowering blood pressure and body-fat percentage.20 Where NEAT is concerned, every step counts. Unlike NEAT, which occurs as a result of basic lifestyle, exercise is designed to improve one or several fitness parameters: cardiorespiratory fitness, muscular strength, or balance and flexibility. Walking is one of the most common and convenient exer- 11 marketplace may have considerable influence on the portion sizes that individuals view as typical and appropriate to consume on a single eating occasion.13 RDs can help patients eat less by teaching them to leave a little food behind at each meal—a realistic and achievable goal. Eating better. Effective weight loss education must include strategies to not only eat less, but to also eat better. Lower fat, whole foods (i.e., fruits, vegetables, legumes, and whole grains) can help patients reduce overall intake and increase total nutrient consumption. Fresh produce is particularly high in water, adding weight and volume to increase satiety without adding energy.14 Evidence shows that subjects in a reduced-fat and increased fruit and vegetable group lost 33 percent more weight at six months than those who only decreased their fat intake.21 This is consistent with Ledikwe, et al., who demonstrate that a low-energy-dense diet is associated not only with reduced calorie intake and increased food consumption, but also with higher diet quality than a high-energy-dense diet.15 cises. Steps can be accumulated throughout the day as individuals walk in the course of completing tasks (NEAT) and in purposeful, planned exercise. Additionally, though many individuals often assume that physical activity, especially planned exercise, needs to be performed in single bouts, several studies indicate that two or more intermittent bouts of exercise throughout the day produce health benefits equivalent to single, THE EXERCISE SPECIALIST: INTEGRATING PHYSICAL ACTIVITY INTO A HEALTHY LIFESTYLE Physical activity is an important aspect of any weight loss treatment; the combination of diet and exercise is the most effective behavioral approach to obesity treatment, better than either alone.16 Despite the significant physical and mental benefits associated with regular physical activity, many of those most in need (i.e., the overweight and obese) may perceive it as daunting.17, 18 It is crucial, therefore, for the specialist to clarify the definitions for physical activity and exercise. Physical activity includes any movement involving contractions of the muscles and energy expenditure, and exercise is a type of physical activity.19 Non-exercise activity thermogenesis (NEAT), or general lifestyle activity, is an integral part of

Table of Contents Feed for the Digital Edition of Bariatric Times - June 2008

Bariatric Times - June 2008 Endoluminal Treatment Options for Morbid Obesity: Devices and Techniques for Natural Orifice Approaches The Multidisciplinary Approach to Weight Loss: Defining the Roles of the Necessary Providers Acute Bleeding after Gastric Bypass Editorial Message Contents ASMBS: 25 Years Editorial Board Surgical Site Infection In The Morbidly Obese Patient: A Review Consultant's Corner The Link Between Sleep Loss and Obesity: Understanding the Mechanisms Responsible for Weight Gain with Sleep Deprivation Volume Matters Journal Watch Advertiser Index

Bariatric Times - June 2008

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