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Original document

Eating fewer calories while increasing physical activity are the keys to controlling body weight.

to the units for serving sizes and how they compare to the serving sizes in the USDA Food Guide and the DASH Eating Plan.

Lifestyle change in diet and physical activity is the best first choice for weight loss. A reduction in 500 calories or more per day is commonly needed. When it comes to body weight control, it is calories that count—not the proportions of fat, carbohydrates, and protein in the diet. However, when individuals are losing weight, they should follow a diet that is within the Acceptable Macronutrient Distribution Ranges (AMDR) for fat, carbohydrates, and protein, which are 20 to 35 percent of total calories, 45 to 65 percent of total calories, and 10 to 35 percent of total calories, respectively. Diets that provide very low or very high amounts of protein, carbohydrates, or fat are likely to provide low amounts of some nutrients and are not advisable for longterm use. Although these kinds of weightloss diets have been shown to result in weight reduction, the maintenance of a reduced weight ultimately will depend on a change in lifestyle. Successful and sustainable weight loss and weight maintenance strategies require attention to both sides of the energy balance equation (i.e., caloric intake and energy expenditure).

Physical Activity

OVERVIEW Americans tend to be relatively inactive. In 2002,25 percentof adult Americans did not participate in any leisure timephysical activities in the past month, 9 and in 2003,38percent of students in grades 9 to 12 viewed television3or more hours per day. 10 Regular physical activity andphysical fitness make important contributions to one’shealth,sense of well-being,and maintenance of a healthybody weight. Physical activity is defined as any bodilymovement produced by skeletal muscles resulting inenergy expenditure (http://www.cdc.gov/nccdphp/dnpa/physical/terms/index.htm). In contrast,physical fitness is

a multi-component trait related to the ability to performphysical activity. Maintenance of good physical fitnessenables one to meet the physical demands of work andleisure comfortably. People with higher levels of physicalfitness are also at lower risk of developing chronic disease.Conversely,a sedentary lifestyle increases risk for overweight and obesity and many chronic diseases,includingcoronary artery disease,hypertension,type 2 diabetes,osteoporosis,and certain types of cancer. Overall,mortality rates from all causes of death are lower in physically active people than in sedentary people. Also,physical activity can aid in managing mild tomoderate depression and anxiety.

9 Behavioral Risk Factor Surveillance System, Surveillance for Certain Health Behaviors Among Selected Local Areas—United States, Behavioral Risk Factor Surveillance System, 2002, Morbidity andMortality Weekly Report (MMWR) , 53, No SS-05. http://www.cdc.gov/brfss/. 10 Youth Risk Behavior Surveillance System, Youth Risk Behavior Surveillance— United States , 2003 MMWR 53(SS-2):1–29, 2004. http://www.cdc.gov/healthyyouth/yrbs/. DI E TARY GUIDE L INE S FOR AME R IC ANS , 2005 20

DISCUSSION Regular physical activity has been shown to reduce the risk of certain chronic diseases, including high blood pressure, stroke, coronary artery disease, type 2 diabetes,colon cancer and osteoporosis. Therefore, to reduce the risk of chronic disease, it is recommended that adults engage in at least 30 minutes of moderateintensity physical activity on most, preferably all, days of the week. For most people, greater health benefits can be obtained by engaging in physical activity of more vigorous intensity or of longer duration. In addition, physical activity appears to promote psychological wellbeing and reduce feelings of mild to moderate depression and anxiety. Regular physical activity is also a key factor in achieving and maintaining a healthy body weight for adults and children. To prevent the gradual accumulation of excess weight in adulthood, up to 30 additional minutes per day may be required over the 30 minutes for reduction of chronic disease risk and other health benefits. That is, approximately 60 minutes of moderateto vigorousintensity physical activity on most days of the week may be needed to prevent unhealthy weight gain (see table 4 for some examples of moderateand vigorousintensityphysical activities). While moderateintensity physical activity can achieve the desired goal, vigorousintensity physical activity generally provides more benefits than moderateintensity physical activity. Control of caloric intake is also advisable. However, to sustain weight loss for previously overweight/obese people, about 60 to 90 minutes of moderateintensity physical activity per day is recommended. Most adults do not need to see their healthcare provider before starting a moderateintensity physical activity program. However, 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 disease should consult their physician to design a safe, effective program. It is also important during leisure time to limit sedentary behaviors, such as television watching and video viewing, and replace them with activities requiring more movement. Reducing these sedentary activities appears to be helpful in treating and preventing overweight among children and adolescents.

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