Transcription:

Melanie Cole: Welcome. This is Christiana Care's Weight Management Podcast Series. I'm Melanie Cole and today we're talking about long-term weight loss solutions. Our speakers in this podcast series represent Christiana Care Weight Management, a program that uses healthcare experts such as dieticians, exercise and behavioral specialists to help people lose weight and keep it off. Joining me is Martha Henley. She's a Registered Dietician at Christiana Care Weight Management in the Department of Metabolic Health. Martha, I'm so glad to have you join us again. Tell us a little bit about what it means to eat healthy. As we're talking about long-term weight loss and behavior and lifestyles are such a big part of that. What does it even mean to eat healthy?

Martha Henley: Well, eating healthy starts with eating a variety of different foods from the different food groups. Choosing lean proteins such as fish, whole tree lean cuts of beef, but also plant based sources of protein. Soy based proteins such as tofu, beans and legumes are some of the healthiest foods. If I had to pick one power food or super food, it would have to be beans. Other healthy foods. Dairy can be quite controversial. Some people are not comfortable with dairy or have problems with dairy, but dairy does give us a lot of good things. Calcium and Vitamin D full of protein. So if you tolerate dairy, I think dairy is a good addition or some sort of dairy alternative such as a soy or an Almond dairy alternative or milk. The hallmark of healthy eating would be plenty of fruits and vegetables. If we look at the New American Plate put out by the USDA, the emphasis there is on a leaner, greener plate, very plant based food dense, and there's smaller areas on the plate for the lean protein. And we don't want to totally forget about carbs and starch. These foods can do a lot of very good things. They're comfort foods which might be good at this time. They should be whole grains meaning they have at least three grams of fiber per serving and that's the best way to tell whether or not something is a whole grain. So it's really including a little bit of all of it.

Host: Well, thank you so much for that, Martha. So how many calories is there sort of a number, and I know everybody's different, but how many calories should we be eating to maintain a healthy weight? And how many for actual weight loss are we looking at a drastic reduction? How does that work?

Martha Henley: If we're looking at those numbers from a long-term weight loss basis, we really have to look to the findings of the National Weight Control Registry. This is a study that's been going on for 26 years began in 1994 and the goals of the researchers were to find out not necessarily how people lost weight, but how they were able to keep it off. As you know, a lot of weight loss is not that difficult. Almost any type of diet or change in how you're eating can allow you to lose weight. But the whole key of the Holy grail is to keep it off long-term. So what researchers found by looking at about 10,000 people, actually a little bit more over 26 years, is that people who could keep the weight off, women consumed about 1300 calories a day and men about 1600. But there's a lot of variation there. So that's from a maintenance standpoint, certainly to lose weight, it's very individualistic. Those numbers would have to be customized based on how the person's currently eating, what their activity is. Sometimes people might need to go as low as what we consider a very low calorie diet, 800 to a thousand calories a day. That's something that should be medically monitored. In other cases, if people are larger and more physically active, many people can start losing weight at 1500 calories or even 2000 calories if they're already used to taking in 3000 calories a day.

Host: Well, that was a great explanation. Tell us a little bit about the National Weight Control Registry. What is that?

Martha Henley: It is basically a long-term perspective study that was started in 1994. Dr. James Hill out of the University, Colorado collaborated with Arena Wing from Brown Medical School and they invited people who lost at least 30 pounds and kept the weight off for a year more to participate in the study. A yearly researchers send quite extensive and detailed surveys to the individuals about their diet, their exercise, and their lifestyle habits. And the people return the surveys and they've managed to find some similarities between individuals who can keep the weight off for the long-term. And then maybe the rest of us.

Host: So then tell us a little bit about the research on how the National Weight Control Registry examines the behavioral and psychological characteristics of weight maintainers, as well as some of the strategies that they use to maintain their weight losses. How does that all work? How do they come up with this information?

Martha Henley: They have used mostly surveys that they send out yearly. The surveys look extensively at portions, types of foods, probably also activity use time. So how long is somebody sitting at a computer? How many minutes of the day are they out exercising? And also behaviors related to food preparation. How many meals out do you have a week? They ask the people who are enrolled in the study every year, how they do in each of these areas and that's how they come up with the general results. To summarize some of the results, basically most of the people who have kept the weight off our breakfast eaters, I know these days different types of eating patterns are popular for weight loss, things like intermittent fasting. So I don't know that breakfast has to be the be all end all. But the idea is that eating on a schedule is important and there is evidence that having some breakfast, especially some protein at breakfast can help increase calorie burn throughout the day and result in less food eaten throughout the day.

Many of the people who are successful long term weigh themselves at least once a week. So they're monitoring and doing a lot of self-monitoring, journaling and record keeping. Most of them limit their TV time or their screen time to no more than 10 hours a week. Most of them exercise at least one hour a day. And that translates into a lot of minutes of exercise about 360 per week. And this can be a very daunting guideline for some people. The important thing to keep in mind is that doesn't mean they're at the gym for 60 minutes at a stretch. Finally, successful weight managers tend to prepare 90% of what they eat at home instead of 67% that's what I think what most Americans do. So that translates into eating out about twice a week.

Host: Great information. And what about things like food journaling? Does this help or create feelings of guilt? You mentioned how often some people like to weigh a week, some people like to weigh every day. But what about food journaling and keeping track of what you're eating? Does this help?

Martha Henley: Absolutely. So food journaling is one of the corner stones of what the successful weight managers tend to do in the national weight control registry. And I shouldn't just leave it to food journaling. You could do exercise journaling, you could do general journaling maybe about feelings about how what you're doing when you're eating or how you're feeling when you go for food. So it doesn't have to just be what you're eating. But journaling in general is effective and it's one of the cornerstones of our programs here at Christiana as well. It really makes people accountable. It's very mind opening to what they're eating and educational. And it can be a very strong motivational tool to stick with a healthy meal plan.

Host: Well it certainly can be. I mean it's a great way to keep track cause we sometimes tend to forget about every little thing as we're putting them in our mouth or mindlessly eating. And before we wrap up, Martha, what about the tech gadgets that are out there to help us track our exercise and food intake? Do you like any of those? What do you think about that?

Martha Henley: I think they're wonderful and I think they're a great way for people who sometimes are reluctant or not interested at all in changing their fitness routine or exercising. It's a great way to get them interested in it. The Apple Watch, and I, again, I hate to just use brand names here, but the Apple Watch has been helpful for a lot of people. It's motivating. They can track and see where they are on their fitness circles. It also gives them the ability to interface with programs like My Fitness Pal so they can be tracking their calories and their nutrient intake as well. And looking at those two areas. A lot of these tech gadgets are great as well because they give people the opportunity to compete against each other or maybe work together as a family or a group of friends. So it's really spawned a lot in terms of weight loss challenges and I think it's very motivating and helps people keep pushing. I think some of those gadgets keep pushing the goals higher. So once the goal is accomplished consistently for a period of time, the goal keeps jacking up. So that's very, very helpful for people.

Host: Give us your best advice for long-term weight loss and what you tell people every day about successful strategies. To getting that weight off and keeping it off.

Martha Henley: Well first, a lot of people who do lose weight are worried about regain. And what we know is the longer you keep it off, the more consistent that you can be, the more likely you're going to keep it off long-term. National Weight Control Registry shows that if you keep it off two years or more, you're much, much less likely to gain it back. So it's about being consistent finding an exercise routine that you can embrace and enjoy. And it doesn't have to be a traditional exercise routine. And very importantly, getting satisfaction out of the foods you eat. So finding healthy foods that you can prepare and also taste good and give you satisfaction is important for the long-term

Host: Great information and so important for people to hear. Martha, thank you so much for coming on and sharing your expertise with us today. And that concludes this episode of Christiana Care Weight Management Podcast Series. For more Information regarding weight loss programs or to schedule an appointment with the weight management team, please call (302) 623-3475 or you can visit Christianacare.org/weight for more information and to get connected with one of our providers. Please share these shows with your friends on social media. That way we learn from the experts at Cristiana Cares Weight Management Team together. I'm Melanie Cole.