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Heart Association Offers Weight Loss Guidelines
Heart Association Offers Weight Loss Guidelines -- Posted by Gumbo on 11-05-04 17:50
Heart Association Offers Weight Loss Guidelines
October 25, 2004
DALLAS (American Heart Association) -- Recognizing that obesity is a major
risk factor for heart disease, the American Heart Association has given
cardiologists a recipe for helping obese patients lose weight, in a new
scientific statement, published in Circulation: Journal of the American
Heart Association.
Insulin resistance, type 2 diabetes, cholesterol disorders, hypertension and
inflammation are among the heart disease risk factors linked with obesity.
In addition, severe obesity is associated with abnormal heart function and
structure.
The scientific statement: "Clinical Implications of Obesity with Specific
Focus on Cardiovascular Disease," reviews the effects of obesity and weight
loss on cardiovascular structure and function. It provides healthcare
professionals with treatment guidelines for weight management in adult
patients with obesity who have or are at risk for cardiovascular disease. It
is endorsed by the American College of Cardiology Foundation.
The statement recommends diet, physical activity and behavior therapy for
some people with a body mass index (BMI) of 25 to 29.9. Behavioral
strategies include: self-monitoring, goal setting, stress management and
social support.
Drug treatment can be considered for those with a BMI of 30 or higher who
are unable to achieve adequate weight loss by diet, physical activity and/or
behavior modification.
Surgery -- such as gastric bypass -- should be considered for those with a
BMI of 35 or higher who are unable to lose weight with conventional therapy
and have no contraindications for surgery.
Even moderate weight loss -- 5 percent to 10 percent of initial body
weight -- can improve the metabolic profile of overweight and obese
patients, said lead author Samuel Klein, M.D., director of the Center for
Human Nutrition, at Washington University School of Medicine, St. Louis, Mo.
Limiting calories is still the key to weight loss. And losing weight at a
pace of one to two-pounds a week may be better for long-term weight loss.
The National Institutes of Health also recommends a 500- to 1000-kcal/d
deficient diet for obese people, which should result in one to two lost
pounds per week.
An "energy deficit" diet is one in which more calories are burned than
consumed.
Data from clinical trials demonstrate that different dietary interventions
can cause short-term weight loss.
The writers suggest that overweight or obese patients consume a diet that
induces an initial energy deficit of 500 to 1000 Kcal/d and includes a
variety of fruits, vegetables, grains, low-fat or nonfat diary products,
fish, legumes, poultry and lean meats.
They should also limit foods high in saturated fat, trans-fatty acids and
cholesterol and follow the current dietary guidelines of the American Heart
Association.
"Making life-long dietary and physical activity changes is key for
successful weight management, so it's important that people select a healthy
diet that they can follow for the rest of their lives," said Robert H.
Eckel, M.D., one of the statement authors and President-elect of the
association.
The panel notes that for obese patients it is usually much easier to induce
a daily energy deficit by restricting energy intake than by increasing
energy expenditure. A person weighing 90 kg (198 pounds) would need to walk
briskly for four to five hours a day to increase their energy expenditure to
reach the equivalent of reducing calorie intake by 750 to 1,000 kcal/day.
However, a high level of regular physical activity is important for
preventing weight regain, and reducing the risk of coronary heart disease.
"Often physicians give advice without considering the patient's priorities,
motivation or confidence in undertaking change. Instead, obesity therapy
should involve 'patient-centered counseling,' which encourages patients to
set goals and express their own ideas or therapy with input form the
healthcare professional," the authors wrote.
The treatment plan must also consider patients' readiness and ability to
comply with any proposed treatment plan.
"Effective therapy requires a long-term structured approach with continued
support from the physician and other caregivers, particularly if weight gain
recurs," they added
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