How learning to cook can help you resolve your issues with food. Reviewed by Charlotte Grayson Mathis, MD If you feel like you're losing the fight against food -- scarfing chips and cookies when you should be munching on carrots -- maybe it's time you learned the rules of healthy eating and healthy cooking. Learning to feel more comfortable in the kitchen can help you feel closer to your food -- and closer to a healthy lifestyle. Diet Secret: Eat at home and learn healthy cooking tricksAmericans eat a lot of food they didn't cook themselves. While three-quarters of us eat most dinners at home, less than 60% of us prepare them in our own kitchens. In 2005, the trend of combining the convenience of take-out food with the comforts of home found each American buying an average of 57 restaurant meals to eat elsewhere, up from 33 meals 20 years ago. And when we do cook, we seldom cook from scratch. Last year, less than half of main meals prepared at home included even one fresh product, according to research from the NPD Group. Why don't we cook more often? Many of us are just too busy--and too tired to face the kitchen after a long day of work. Others don't cook because they see food as the enemy, and are afraid they'll eat what they've made--maybe even all of what they've made, says therapist Karen R. Koenig, author of The Rules of "Normal" Eating and The Food and Feelings Workbook. Another cause for kitchen avoidance is the fear of making mistakes. According to Koenig, some people see the food they make as an extension of themselves, so they worry about being judged by the outcome. Ordering in takes a load of pressure off the perfectionist's back--you can blame a lousy dinner on the restaurant it came from, instead of on yourself. Some of us hope that, by steering clear of the kitchen, we can keep the numbers on the scale from creeping slowly upwards. But when it comes to what we eat, ignorance is not bliss. And avoiding the issue won't keep us from getting fat. In fact, studies show that we're more apt to eat too much, too fast when we don't keep an eye on what goes into our mouths. And how can we make sure our meals are healthy and low-calorie if we don't know how they were prepared? Learn healthy cooking tricks—and resolve your food issues, tooOne of the best ways to watch what you eat is to make it yourself. "I love shortbread cookies," says Vicki Smythe, 26, a personal trainer. "But I had no idea how much butter was in them until I baked a few batches last week--an entire cup of butter in just 1 dozen cookies! I used to eat up to 4 or 5 cookies at a time, but now I'll definitely be stopping at 2!" There are more reasons than just a reality check. "Cooking helps food matter," Koenig says. Many of us are disconnected from food because we're disconnected from our bodies. Cooking helps us tune in to how food smells and looks (real food - not its fake, processed equivalent), as well as to the whole process of feeding ourselves; a process in which food is energy and nourishment--not the enemy. If your biggest food issue is speed eating (which often leads to overeating), cooking can help you slow you down and connect with your senses, she says. Tasting and smelling food as it cooks encourages you to do the same as you eat. You're also more motivated to slow down and really enjoy a meal after working hard to make it. Learn healthy cooking tricks—and resolve your food issues, too continued...Food and cooking have emotional associations, says Koenig, and paying attention to how you feel as you cook you get in touch with feelings you have about the past that relate to food. Were you often urged to finish your dinner because a parent "worked so hard to make it for you"? Or was your childhood spent eating frozen dinners and fending for yourself? The process of cooking can help you understand why you feel the way you do about food. Ready to get started? Here are 4 healthy cooking tricks that can help you be just as comfortable in the kitchen as you are on the couch. Healthy Cooking Tip #1: Stock your kitchen.Healthy cooking starts with filling your cupboards. Keep these basics on hand, and you'll be able to whip up delicious meals in less than the time it takes for pizza to be delivered. Basic healthy cooking tools:
Basic healthy cooking ingredients:
Healthy Cooking Tip #2: Plan ahead.Simplify dinnertime prep by making as much as possible ahead of time, O'Rourke suggests. Make double or triple the amount the recipe calls for, and freeze the extra for future use. (Be sure to label and date each item). Minestrone soup is a great example of something that freezes well and thaws into an instant healthy meal, says Carol Hildebrand, co-author, with her brother Bob Hildebrand, executive chef at The Three Stallions Inn in Randolph, Vermont, of 500 3-Ingredient Recipes, 500 5-Ingredient Desserts and 3-Ingredient Slow Cooker Comfort Foods. For example:
Healthy Cooking Tip #3: Keep it simple, sweetheart!Using just these basic healthy cooking tools, ingredients, and pre-made foods, you can make any of the following healthy meals in minutes:
Healthy Cooking Tip #3: Keep it simple, sweetheart! continued...o Quick chicken soup: Saute pre-cut chicken breast, garlic and onion in bottom of a soup pot with a small amount of
o Quick apple crisp. Microwave chopped apples topped with sprinkled cinnamon. Serve with a sprinkle of rolled oats and sugar. o Grilled fruit. Grill pineapple, peach or banana, and top with a small scoop of ice cream. o Fruit 'n' yogurt sundaes. Spoon low-fat yogurt and chopped fruit into a sundae glass. Pile high, and top with a cherry and reduced-sugar chocolate syrup. Healthy Cooking Tip 4: Fold in flavor.Garlic and onion add flavor depth to any dish, Hildebrand says, and you can up the ante even more with spices like basil, oregano and cilantro--fresh, if possible. A sprinkle of chopped cilantro over black bean soup, for example, adds punch to the entire dish, she says. And salt, when used judiciously, brings out flavor like nothing else. To save on fat and calories, use low-fat plain yogurt in place of sour cream or mayonnaise, and buy low-fat cheese and milk instead of full-fat versions, says O'Rourke. Add flavor to vegetables with low-fat cheese, nuts, salad dressing or margarine with no Trans fat; then add herbs and spices. Blatner suggests an Italian blend on green beans, curry on cauliflower, cumin on sauteed bell peppers, and lemon pepper on broccoli. And there you have it: 4 healthy cooking tricks for a lifetime of good taste. Bon appetit! ENROLL NOW!
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December 9, 2007
HEALTHY COOKING TRICKS
FAD DIET EXPOSED BY DR. PAMELA PEEKE AND KATHLEEN ZELMAN, RD
| Lose 21 Pounds in 21 Days: The Martha's Vineyard Diet Detox By Kathleen M. Zelman, MPH, RD, LD What It Is Lose 21 Pounds in 21 Days: The Martha's Vineyard Diet Detox is not a traditional diet, but a detoxification program designed both to "cleanse" the body and cause weight loss. Author Roni DeLuz, a registered nurse and naturopathic doctor (not to be confused with a medical doctor) says she created the liquid diet when she was trying to heal herself. Dieters are supposed to cleanse their bodies by drinking liquids every two hours. They choose from a limited number of options including water, homemade soups, juices made from fruits and vegetables, and powdered antioxidant berry and green drinks available from the author's web site. In theory, once free of toxins, your body functions better and your metabolism soars so you can shed those extra pounds. According to the author, this "is not a so-called weight loss diet; it is a safe, 100% natural healthy detox that allows you to safely lose 21 pounds in 21 days." The Lose 21 Pounds in 21 Days plan is based on three principles: rest, reduce, and rebuild. "Rest comes from not chewing and ingesting nutrients in liquid form. Eliminating toxins, resting the body and engaging in elimination therapy, you cleanse and rebuild the body so it can shed weight," says DeLuz. Dieters choose between a two-day weekend plan, a seven-day plan, or the full 21-day plan, all with a similar schedule of drinking every two hours. DeLuz recommends a 21-day detox yearly, a seven-day cleanup each calendar season, and a weekend detox each week. Supplements including enzyme capsules, an herb cleansing formula, and aloe Vera, as well as services like lymph drainage massages, cellulite treatment, liver flushes, kidney cleanses, body wraps, detoxifying baths, and weekly coffee enemas and colonics are part of the plan. Exercise is included, as long as it can be tolerated and is approved by your doctor. But the recommended physical activity is limited to walking, yoga, a chi machine (a so-called "passive aerobic exerciser"), or jumping on a trampoline, which is encouraged for lymphatic draining to help your body "oxygenate," according to DeLuz. After 21 days, dieters go off the detox plan carefully, because their cleaned bodies will "no longer tolerate processed and junk foods, which will cause weight gain," explains DeLuz. The author recommends slowly awakening the digestive system with a daily protein powder supplement along with vegetables, soy milk, 3-4 ounces of salmon, and 1 cup nonfat yogurt. More nutritious foods are then added. Nutritional supplements (green drinks, berry drink, and protein shakes) continue to be recommended in smaller doses. What You Can Eat Every two hours, you drink a designated liquid. And at the end of the day, you've consumed 40-48 ounces of water, 32-40 ounces of herbal tea, 16 ounces of vegetable-based soup, and 32 ounces of either a green drink made from vegetables, vegetable juice, or a berry drink. "The plan provides approximately 1,000 calories and about 20 grams of protein per day, depending on your choices," says American Dietetic Association spokeswoman Amy Jamieson-Petonic, MEd, RD. What You Can Eat continued... There are plenty of fruits and vegetables on the Lose 21 Pounds in 21 Days plan that are either juiced, pureed, cooked, or come in a powdered form. But there's very little else. Allowed foods include garlic, beans, carrots, cucumbers, celery, collard greens, kale, beets, sweet potatoes, summer squashes, most green vegetables, tomatoes, and purple cabbage. Nutritionists are quick to point out that the Lose 21 Pounds in 21 Days plan is lacking in essential protein, fat, and fiber, which could be dangerous. "Diet plans deficient in protein can lead to muscle wasting, and when you don't ingest enough essential fatty acids from fat, you also risk compromising your immune function," says nutrition and fitness expert Pamela Peeke, MD. This plan makes it almost impossible to go out to eat, unless you take along your drink. Be prepared to give up coffee, which experts point out can result in headaches. Alcohol is also on the extensive list of foods and beverages to avoid until the maintenance stage, and even then it is very limited. How It Works "When you're trying to lose weight, your body is not metabolizing or eliminating correctly, so if you put back natural nutrition into your body, you will lose weight," says the author. She blames the "toxins" in the foods and beverages we consume for causing us to be unhealthy and gain weight. Liquid foods are recommended in the Lose 21 Pounds in 21 Days plan because they allow rest from chewing and are better absorbed in the body. Not so, says Peeke. There is no advantage to consuming foods in liquid form. In fact, it works against you. She says whole foods -- not pureed or juiced -- are the best form to eat. "Your body needs whole foods to chew, digest, absorb to keep the gastrointestinal tract functioning well," Peeke says. "Every part of the intestine is designed to extract nutrients, so there is no advantage in liquefying them." DeLuz thinks everyone needs to detox, and says that unless you have a medical condition, there are no consequences to the cleansing and detoxifying 21 day plan." The Lose 21 Pounds in 21 Days plan would be difficult for anyone who is working or traveling to follow, Jamieson points out. "It is unrealistic to follow the plan unless you are at home," says Jamieson. She also thinks it is expensive, with all the recommended treatments, supplements, and the need for a juicer not found in most home kitchens. A 21-day program plus nine-day maintenance pack is available online for $199 from the author. The web site estimates that the plan costs around $12 per day, but does not indicate what that amount includes. What the Experts Say Yes, you can lose weight rapidly with Lose 21 Pounds in 21 Days: The Martha's Vineyard Diet Detox. But experts say this is more likely a result of severe caloric restriction, rather than detoxification. Peeke warns that this kind of 21-day detox can actually make you fatter in the end. What the Experts Say continued... "You might lose weight because you are taking in so few calories, but most of the lost weight will be fluids and muscle," she says. "In the absence of adequate protein, your body has to get protein from some source, so it burns up its own muscle mass. And at the end of the fast, the dieter will weigh less -- but their body composition will be higher in fat and lower in muscle." The principle of detoxification raises a red flag, says Michelle May, MD, author of Am I Hungry. "The suggestion that we are filled with toxins creates fear that drives book and product sales," she says. "But in truth, our bodies naturally rid themselves of undesirable substances without any human intervention whatsoever." Says Holly Wyatt, MD, an obesity expert with the University of Colorado: "If anything is important to weight loss, it is getting plenty of liquids and staying well hydrated so the liver and kidneys can function optimally, do their jobs, and rid the body of any toxins." The detox diet is deficient in protein, fiber, essential fatty acids, fat-soluble vitamins, and certain minerals, experts say. "The only positive thing to say about this plan is that it encourages plenty of fruits and vegetables, which most people don't get enough of in their diets," says Jamieson-Petonic. Experts agree there is no credible science to substantiate the claims this plan is built upon, such as the need for detoxification, lymphatic draining, liquid nutrition, and frequent bowel cleansing. There are no studies available to document that dieters will lose 21 pounds in 21 days. Instead, this claim is based on testimonials from the author's clinic and her co-author's personal experience. Unless you have a problem associated with your lymph system, this system does not need any help. "If you are concerned about your lymph system, the best thing you can do is get plenty of exercise and drink lots of water -- but you don't need to jump on trampolines or get lymphatic massages," says Peeke. Another problem is that the Lose 21 Pounds in 21 Days plan is likely to leave you hungry. "When you drink most of your calories, you usually don't get the same satiety value as eating solid foods. So dieters may feel very hungry on this plan," says Jamieson. And what happens when the 21-day period is over? "When using enemas and fasting techniques, the fluids you lose come back almost immediately when you reintroduce food and stop the unusual behavior," says Wyatt. Wyatt cautions that this plan could leave dieters feeling dizzy, dehydrated, and light-headed. This, she says, is the result of an inadequate diet -- not as a result of feeling sick as your body dumps toxic residues as the author explains. Food for Thought While the plan may sound like a scientific approach to weight loss, it lacks the fundamentals that dietitians, doctors, and health authorities know are essential for good health. Further, drinking excessive amounts of liquids that are inadequate in many needed nutrients, along with taking such measures as enemas and lymphatic draining, could be unsafe. If you want to lose weight safely and naturally and keep it off, find a plan you can stick with long term -- one that includes regular physical activity and a well-balanced diet. | ||
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December 8, 2007
OBESITY AND YOUR HEALTH
The large number of people with obesity and the serious health risks that come with it make understanding its causes and treatment crucial. This fact sheet provides basic information about obesity:
What is it?
How is it measured?
What causes it?
What are the health risks?
What can you do about it?
"Obesity" specifically refers to an excessive amount of body fat. "Overweight" refers to an excessive amount of body weight that includes muscle, bone, fat, and water. As a rule, women have more body fat than men. Most health care professionals agree that men with more than 25 percent body fat and women with more than 30 percent body fat are obese. These numbers should not be confused with the body mass index (BMI), however, which is more commonly used by health care professionals to determine the effect of body weight on the risk for some diseases.
How is obesity measured?
Measuring the exact amount of a person's body fat is not easy. The most accurate measures are to weigh a person underwater or in a chamber that uses air displacement to measure body volume, or to use an X-ray test called Dual Energy X-ray Absorptiometry, also known as DEXA. These methods are not practical for the average person, and are done only in research centers with special equipment.
There are simpler methods to estimate body fat. One is to measure the thickness of the layer of fat just under the skin in several parts of the body. Another involves sending a harmless amount of electricity through a person's body. Results from these methods, however, can be inaccurate if done by an inexperienced person or on someone with extreme obesity.
Because measuring a person's body fat is difficult, health care professionals often rely on other means to diagnose obesity. Weight-for-height tables, used for decades, have a range of acceptable weights for a person of a given height.
One problem with these tables is that there are many versions, all with different weight ranges. Another problem is that they do not distinguish between excess fat and muscle. According to the tables, a very muscular person may be classified obese when he or she is not. The BMI is less likely to misidentify a person's appropriate weight-for-height range.
Body Mass Index The BMI is a tool used to assess overweight and obesity and monitor changes in body weight. Like the weight-for-height tables, BMI has its limitations because it does not measure body fat or muscle directly. It is calculated by dividing a person's weight in pounds by height in inches squared and multiplied by 703.
Two people can have the same BMI but different body fat percentages. A bodybuilder with a large muscle mass and low percentage of body fat may have the same BMI as a person who has more body fat. However, a BMI of 30 or higher usually indicates excess body fat.
The BMI table below provides a useful guideline to check your BMI. First, find your weight on the bottom of the graph. Go straight up from that point until you come to the line that matches your height. A BMI of 25 to 29.9 indicates a person is overweight. A person with a BMI of 30 or higher is considered obese. Please review your findings with your health care provider if your BMI is outside of the normal range.
**Without Clothes
Sources
George Bray, M.D., Pennington Biomedical Research Center. National Heart, Lung, and Blood Institute's Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report.
Health care providers are concerned not only with how much fat a person has, but also where the fat is located on the body. Women typically collect fat in their hips and buttocks, giving them a "pear" shape. Men usually build up fat around their bellies, giving them more of an "apple" shape. Of course some men are pear-shaped and some women become apple-shaped, especially after menopause.
Excess abdominal fat is an important, independent risk factor for disease. Research has shown that waist circumference is directly associated with abdominal fat and can be used in the assessment of the risks associated with obesity or overweight. If you carry fat mainly around your waist, you are more likely to develop obesity-related health problems. Women with a waist measurement of more than 35 inches and men with a waist measurement of more than 40 inches may have more health risks than people with lower waist measurements because of their body fat distribution.
What causes obesity?
Obesity occurs when a person consumes more calories from food than he or she burns. Our bodies need calories to sustain life and be physically active, but to maintain weight we need to balance the energy we eat with the energy we use. When a person eats more calories than he or she burns, the energy balance is tipped toward weight gain and obesity. This imbalance between calories-in and calories-out may differ from one person to another. Genetic, environmental, and other factors may all play a part.
Genetic Factors
Obesity tends to run in families, suggesting a genetic cause. However, families also share diet and lifestyle habits that may contribute to obesity. Separating genetic from other influences on obesity is often difficult. Even so, science does show a link between obesity and heredity.
Environmental and Social Factors
Environment strongly influences obesity. Consider that most people in the United States alive today were also alive in 1980, when obesity rates were lower. Since this time, our genetic make-up has not changed, but our environment has.
Environment includes lifestyle behaviors such as what a person eats and his or her level of physical activity. Too often Americans eat out, consume large meals and high-fat foods, and put taste and convenience ahead of nutrition. Also, most people in the United States do not get enough physical activity.
Environment also includes the world around us—our access to places to walk and healthy foods, for example. Today, more people drive long distances to work instead of walking, live in neighborhoods without sidewalks, tend to eat out or get "take out" instead of cooking, or have vending machines with high-calorie, high-fat snacks at their workplace. Our environment often does not support healthy habits.
In addition, social factors including poverty and a lower level of education have been linked to obesity. One reason for this may be that high-calorie processed foods cost less and are easier to find and prepare than healthier foods, such as fresh vegetables and fruits. Other reasons may include inadequate access to safe recreation places or the cost of gym memberships, limiting opportunities for physical activity. However, the link between low socio-economic status and obesity has not been conclusively established, and recent research shows that obesity is also increasing among high-income groups.
Although you cannot change your genetic makeup, you can work on changing your eating habits, levels of physical activity, and other environmental factors.
Try these ideas:
• Learn to choose sensible portions of nutritious meals that are lower in fat.
• Learn to recognize and control environmental cues (like inviting smells or a package of cookies on the counter) that make you want to eat when you are not hungry.
• Engage in at least 30 minutes of moderate-intensity physical activity (like brisk walking) on most, preferably all, days of the week.
• Take a walk instead of watching television.
• Eat meals and snacks at a table, not in front of the TV.
• Keep records of your food intake and physical activity.
Other Causes of Obesity
Some illnesses may lead to or are associated with weight gain or obesity. These include:
• Hypothyroidism, a condition in which the thyroid gland fails to produce enough thyroid hormone. It often results in lowered metabolic rate and loss of vigor.
• Cushing's syndrome, a hormonal disorder caused by prolonged exposure of the body's tissues to high levels of the hormone cortisol. Symptoms vary, but most people have upper body obesity, rounded face, increased fat around the neck, and thinning arms and legs.
• Polycystic ovary syndrome, a condition characterized by high levels of androgens (male hormone), irregular or missed menstrual cycles, and in some cases, multiple small cysts in the ovaries. Cysts are fluid-filled sacs.
A doctor can tell whether there are underlying medical conditions that are causing weight gain or making weight loss difficult.
Lack of sleep may also contribute to obesity. Recent studies suggest that people with sleep problems may gain weight over time. On the other hand, obesity may contribute to sleep problems due to medical conditions such as sleep apnea, where a person briefly stops breathing at multiple times during the night.
(Visit www.win.niddk.nih.gov/publications/health_risks.htm#sleep for more information on the relationship between sleep apnea and obesity.) You may wish to talk with your health care provider if you have difficulty sleeping.
Certain drugs such as steroids, some antidepressants, and some medications for psychiatric conditions or seizure disorders may cause weight gain. These drugs may slow the rate at which the body burns calories, stimulate appetite, or cause the body to hold on to extra water. Be sure your doctor knows all the medications you are taking (including over-the-counter medications and dietary supplements). He or she may recommend a different medication that has less effect on weight gain.
Obesity is more than a cosmetic problem. Many serious medical conditions have been linked to obesity, including type 2 diabetes, heart disease, high blood pressure, and stroke. Obesity is also linked to higher rates of certain types of cancer. Men who are obese are more likely than nonobese men to develop cancer of the colon, rectum, or prostate. Women who are obese are more likely than nonobese women to develop cancer of the gallbladder, uterus, cervix, or ovaries. Esophageal cancer has also been associated with obesity.
Other diseases and health problems linked to obesity include:
• Gallbladder disease and gallstones.
• Fatty liver disease (also called nonalcoholic steatohepatitis or NASH).
• Gastroesophageal reflux, or what is sometimes called GERD. This problem occurs when the lower esophageal sphincter does not close properly and stomach contents leak back—or reflux—into the esophagus.
• Osteoarthritis, a disease in which the joints deteriorate. This is possibly the result of excess weight on the joints.
• Gout, another disease affecting the joints.
• Pulmonary (breathing) problems, including sleep apnea, which causes a person to stop breathing for a short time during sleep.
• Reproductive problems in women, including menstrual irregularities and infertility.
Health care providers generally agree that the more obese a person is, the more likely he or she is to develop health problems.
Psychological and Social Effects
Emotional suffering may be one of the most painful parts of obesity. American society emphasizes physical appearance and often equates attractiveness with slimness, especially for women. Such messages make overweight people feel unattractive. Many people think that individuals with obesity are gluttonous, lazy, or both. This is not true. As a result, people who are obese often face prejudice or discrimination in the job market, at school, and in social situations. Feelings of rejection, shame, or depression may occur.
Who should lose weight?
Health care providers generally agree that people who have a BMI of 30 or greater can improve their health through weight loss. This is especially true for people with a BMI of 40 or greater, who are considered extremely obese.
Preventing additional weight gain is recommended if you have a BMI between 25 and 29.9, unless you have other risk factors for obesity-related diseases.
Obesity experts recommend you try to lose weight if you have two or more of the following:
• Family history of certain chronic diseases. If you have close relatives who have had heart disease or diabetes, you are more likely to develop these problems if you are obese.
• Preexisting medical conditions. High blood pressure, high LDL cholesterol levels, low HDL cholesterol levels, high triglycerides, and high blood glucose are all warning signs of some obesity-associated diseases.
• Large waist circumference. Men who have waist circumferences greater than 40 inches, and women who have waist circumferences greater than 35 inches, are at higher risk of diabetes, dyslipidemia (abnormal amounts of fat in the blood), high blood pressure, and heart disease.
Fortunately, a weight loss of 5 to 10 percent of your initial body weight can do much to improve health by lowering blood pressure and other risk factors for obesity-related diseases. In addition, research shows that a 5- to 7-percent weight loss brought about by moderate diet and exercise can delay or possibly prevent type 2 diabetes in people at high risk for the disease. In a recent study, participants who were overweight and had pre-diabetes—a condition in which a person's blood glucose level is higher than normal, but not high enough to be classified as diabetes—were able to delay or prevent the onset of type 2 diabetes by adopting a low-fat, low-calorie diet and exercising for 30 minutes a day, 5 days a week. For more information about pre-diabetes and diabetes, visit www.diabetes.niddk.nih.gov.
How is obesity treated?
The method of treatment depends on your level of obesity, overall health condition, and readiness to lose weight. Treatment may include a combination of diet, exercise, behavior modification, and sometimes weight-loss drugs. In some cases of extreme obesity, bariatric surgery may be recommended. (Visit www.win.niddk.nih.gov/publications/gastric.htm for more information on bariatric surgery.)
Remember, weight control is a life-long effort, and having realistic expectations about weight loss is an important consideration. Eating a healthful diet and getting at least 30 minutes of moderate-intensity physical activity on most, preferably all, days of the week have important health benefits. Sixty minutes of physical activity a day may be required to prevent gradual weight gain in adulthood. Previously overweight and obese individuals are encouraged to get 60 to 90 minutes of exercise a day to sustain weight loss.
Although most adults do not need to see their healthcare professional before starting a moderate-intensity physical activity program, men older than 40 years and women older than 50 years who plan a vigorous program or who have either chronic disease or risk factors for chronic illnesses should speak with their health care provider before starting a physical activity program.
For more information on health risks, treatment options, and binge eating, refer to these Weight-control Information Network (WIN) publications:
Active at Any Size. Available from WIN and online at
www.win.niddk.nih.gov/publications/active.htm.
National Institutes of Health (NIH) Publication No. 04-4352. April 2004.
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