NIH

HEALTH AND WELLNESS EXPO.

TODAY WE'D LIKE TO KICK OFF OUR

EVENT BY BEGINNING OUR EXPERT

PANEL.

THE TOP SICK OVERWEIGHT AND

OBESITY, PUBLIC, SCIENTIFIC

CHALLENGES AND PERSPECTIVES.

WITH THAT BEING SAID, AT THIS

TIME I'D LIKE TO INTRODUCE THE

SENIOR WELLNESS OFFICIAL FOR THE

NATIONAL INSTITUTES OF HEALTH

AND ALSO THE ACTING OR THE

DIRECTOR OF THE OFFICE OF

RESEARCH SERVICES, DR. ALFRED

JOHNSON.

[APPLAUSE]

>> THANK YOU, CHRIS FOR THE

INTRODUCTION AND GOOD MORNING TO

ONE AND ALL.

IT IS MY PLEASURE TO ALSO

WELCOME YOU TO THE SECOND ANNUAL

NIH HEALTH AND WELLNESS EXPO.

THIS IS A VERY IMPORTANT EVENT.

ALL THE RESOURCES THAT THE NIH

HAS, THE MOST IMPORTANT RESOURCE

ARE OUR PEOPLE.

THE PEOPLE MAKE THIS RESEARCH

ENTERPRISE HAPPEN AND SO THE

HEALTH OF OUR PEOPLE IS A VERY

IMPORTANT ASSET THAT WE MUST

KEEP IN MIND.

SO I ALSO WANT TO THANK THE NIH

HEALTH AND WELLNESS COUNCIL WHO

ARE THE ORGANIZERS OF THIS EVENT

FOR ALL YOUR EFFORTS ON BEHALF

OF THE HEALTH AND WELLNESS OR

NIH EMPLOYEES.

AND WOULD ALSO LIKE TO RECOGNIZE

THE DIVISION OF NUTRITION,

RESEARCH COORDINATION FOR THEIR

AASSISTANCE IN ORGANIZING THE

EXPERT PANEL WE HAVE HERE TODAY.

THE SUBJECT OF OUR PANEL MIRRORS

THE GROWING CONCERN OF OUR

COUNTRY WITH OBESITY AND ITS

AFFECT ON THE HEALTH OF OUR

NATION.

THE PANEL WILL DISCUSS CAPACITY

CURRENT ISSUES WE FACE WITH

DIET, NUTRITION AND EXERCISE IN

HEALTHY WEIGHT MANAGEMENT.

THESE PANEL MEMBERS ARE HERE

BECAUSE OF THEIR SPECIAL

EXPERTISE RELATED TO EFFECTIVELY

PROMOTING HEALTHY LIFESTYLE

CHANGES THROUGH THEIR RESEARCH

AT NIH AND AROUND THE WORLD.

SO LET ME INTRODUCE OUR PANEL

MEMBERS AND THEN I WILL TURN IT

OVER TO THEM.

FIRST WE HAVE DR. VAN HUBBARD

WHO IS THE DIRECTOR OF THE

DIVISION OF NUTRITION RESEARCH

COORDINATION AND ASSOCIATE

DIRECTOR OF NUTRITIONAL SCIENCES

FOR NATIONAL INSTITUTE OF

DIABETES AND DIGESTIVE AND

KIDNEY DISEASES.

DR. HUBBARD.

MS. JANET DE JESUS, NUTRITION

EDUCATION SPECIALIST FROM THE

NATIONAL HEART, LUNG AND BLOOD

INSTITUTE, DR. AMBER  COURVILLE,

METABOLIC RESEARCH DIETITIAN

FROM THE NIH CLINICAL CENTER,

AND MS. KAREN MILLER KOVACS,

CHIEF SCIENTIST AND GENERAL

MANAGER OF REACH AND DEVELOPMENT

FROM WEIGHT WATCHERS

INTERNATIONAL.

THE PANEL WILL BE MODERATED BY

CHRIS GAINS, WHO YOU JUST MET.

FOLLOWING THE PANEL, THERE WILL

BE TIME FOR QUESTION AND ANSWERS

AND THAT IS A VERY IMPORTANT

PART OF THIS PANEL.

AT THE END OF THE PRESENTATION,

YOU'RE INVITED TO ATTEND FREE

FITNESS CLASSES THROUGHOUT THE

DAY.

THIS CONTINUES TOMORROW,

THURSDAY, FROM 11:30-4:00 P.M.

IN NATCHER AGAIN WITH

DEMONSTRATIONS, FITNESS

CLASSINGS AND HEALTH SCREENINGS

AND HEALTH INFORMATION BOOTHS

FROM OUR INSTITUTES AND CENTRES

AND AFFILIATES.

SO PLEASE JOIN US AND LEARN HOW

EACH OF US IN THE NIH COMMUNITY

CAN LIVE HEALTHIER LIVES.

ONCE AGAIN, I WANT TO THANK YOU

FOR COMING AND HAVING US AT NIH

LEARN HOW TO TAKE OUR BEST

ADVICE.

SO WITH THAT, I WILL TURN IT

OVER TO THE FIRST PRESENNER WHO

IS DR. HUBBARD.

LET'S THANK EACH PANEL IN

ADVANCE.

[APPLAUSE]

>> I JUST HAVE TO FIGURE OUT HOW

TO GET OFF THIS SCREEN.

>> DR. JOHNSON AND OTHERS IN THE

AUDIENCE AND HOPEFULLY AT THE

VIDEO CAST SITES, I AM DELIGHTED

TO HAVE THE OPPORTUNITY TO

EXCEPT AND HELP BE A PART OF

THIS EFFORT.

I DO THINK THAT NIH SHOULD BE A

LEADER IN TRYING TO PROMOTE

HEALTH OF ITS EMPLOYEES AND

THEIR FAMILIES.

WHAT I HOPE TO DO IN MY BRIEF

REMARKS IS TO TELL YOU A LITTLE

BIT ABOUT WHY THE TOPIC WAS

CHOSEN IN TERMS OF BEING A

PRESENTATION AND A REAL CONCERN

FOR BOTH THE EMPLOYEES OF NIH,

AS WELL AS THE COUNTRY AS A

WHOLE AND THE WORLD AS A WHOLE.

AND THEN PROVIDE SOME CONCEPTS

THAT YOU SHOULD THINK ABOUT AS

TO WHAT NEEDS TO BE DONE IN

TERMS OF MANAGING THE PROBLEM.

I THINK MOST OF THE PEOPLE HERE

DO RECOGNIZE THAT OBESITY IS A

MAJOR PUBLIC HEALTH PROBLEM.

ABOUT TWO-THIRDS OF THE U.S.

ADULTS ARE OVERWEIGHT AND THAT

GOES BY BMI OF 25 AND BMI I'LL

GET TO LATER.

OBESITY ABOUT 30% OR ALMOST 1/3

OF THE POPULATION HAS A BMI OF

OVER 30.

NEARLY 17% OF YOUTH ARE

CONSIDERED OBESE USING THE

95th PERCENTILE ON THE

CHILDREN'S GROWTH CURVES THAT

HAVE BEEN ESTABLISHED BY THE

CENTRES FOR DISEASE CONTROL AND

PREVENTION.

AND THERE ARE INCREASED NUMBER

OF DEATHS DUE TO THE

CONSEQUENCES OF OBESITY IN

ASSOCIATION WITH A POOR DIET AND

LACK OF ACTIVITY.

BUT THE OTHER THING THAT IS A

CONCERN, I WANT TO GET ACROSS TO

EVERYBODY IS, WE TALK ABOUT THE

PROBLEM IN THE U.S., BUTOY

BEESITY IS A PROBLEM IN EVERY

COUNTRY IN WHICH DATA IS

COLLECTED THROUGHOUT THE„i
WORLD.

BOTH DEVELOPED COUNTRIES AS WELL

AS DEVELOPING COUNTRIES.

AND THE ISSUE IN DEVELOPING

COUNTRIES IS GOING TO BE OF MORE

CONCERN AS WE GO FORWARD BECAUSE

THOSE COUNTRIES DO NOT HAVE THE

RESOURCES TO MANAGE THE

CO-MORBIDITIES THAT ARE

ASSOCIATED WITH OBESITY.

ANOTHER THING TO REMEMBER IS

THAT OBESITY IS A CHRONIC

DISEASE.

YOU DON'T GET TO ALL OF A SUDDEN

DEVELOP THE DIAGNOSIS OF

OBESITY, ADVERSE HEALTH AFFECTS

ARE PART OF CONTINUUM.

AND AT THE LEVEL OF WEIGHT OR

LEVEL OF BMI AT WHICH AN

INDIVIDUAL ACHIEVES HEALTH

DETRIMENT IS A LITTLE BIT

DIFFERENT FROM PERSON TO PERSON.

THE OTHER THING IS, TIME LIMITED

TREATMENTS ARE RARELY EFFECTIVE.

IT IS A CHRONIC DISEASE,

THEREFORE IT WILL REQUIRE

CHRONIC LIFE-LONG INTERVENTIONS

OR MANAGEMENT.

AND MULTIPLE SECTORS OF THE

COMMUNITY IMPACT THEŤ—

EFFECTIVENESS OF BOTH PREVENTION

AND INTERVENTION PROGRAMS AND

SUBSEQUENTLY WE HAVE TO BE

CONCERNED WITH THE ENVIRONMENT

AROUND US AS WE TRY TO SUPPORT

PEOPLE'S EFFORTS TO MAINTAIN OR

MANAGE THEIR WEIGHT.

THIS IS ABOUT AS FAR AS I GO

INTO THE SCIENCE.

OVERWEIGHT AND OBESITY IS DUE TO

A MULTIPLE COMPLEX FACTORS THAT

ALL CONTRIBUTE TO THE

DEVELOPMENT OF THE CONDITION OF

OVERWEIGHT AND OBESITY.

PART OF IT IS GENETIC.

THERE IS METABOLIC BEHAVIORS,

EACH INDIVIDUAL METABOLIZES

NUTRIENTS A LITTLE BIT

DIFFERENTLY.

IT HAS A LITTLE BIT DIFFERENT

LEVEL OF ENERGY EXPENDITURE.

BEHAVIORAL ISSUES ARE DIFFERENT

FROM INDIVIDUALS, THE

ENVIRONMENTAL AND CULTURAL

EXPOSURE IS DIFFERENT AND

SOCIALIO ECONOMIC COMPONENTS.

THESE ALL IMPACT THE DEVELOPMENT

OF WEIGHT PROBLEMS AND THEY ALL

INTERACT WITH ONE ANOTHER.

SUBSEQUENTLY, IN DOING STUDIES,

YOU HAVE TO TAKE INTO ACCOUNT

SOME OF THESE CONSIDERATIONS AS

YOU TRY TO INTERPRET THE DATA.

THE OTHER THEY THINK WE HAVE TO

BE CONCERNED WITH, AND I'M

BRINGING THIS UP BECAUSE YOU'LL

SEE A LOT OF COMMENTS IN THE

MEDIA, AND DIFFERENT STUDIES ARE

AIMED AT DIFFERENT THINGS.

SOME AIMED AT THE POPULATION,

SOME ARE AIMED AT THE

INDIVIDUAL.

SOME ARE AIMED AT INTERVENTION

AND SOME ARE AIMED AT

PREVENTION.

THERE ARE SIMILARITIES ACROSS

THESE DIFFERENT AREAS OF FOCUS

BUT THERE ARE ALSO DIFFERENCES

IN HOW YOU INTERPRET THE DATA

AND HOW YOU CAN GENERALIZE OR

HOW SPECIFIC THE COMMENTS MAY

APPLY TO YOU„i AS AN INDIVIDUAL.

AND SUBSEQUENTLY, WHEN YOU ARE

LOOKING AT REPORTS OR HEARING

INFORMATION AS PEOPLE DISCUSS

DIFFERENT ASPECTS OF DEALING

WITH WEIGHT MANAGEMENT, YOU NEED

TO RECOGNIZE THAT SOME OF THE

DIFFERENCES THAT MAY BE PLAYED

UP IN THE MEDIA ARE A

CONSEQUENCE OF„i THE DIFFERENT

Fo

ARE BEING TRANSLATED TO YOU.

I MENTIONED THAT BMI IS THE WAY

THAT MOST PEOPLE REFER TO OR

DESCRIBE OVERWEIGHT AND OBESITY.

BMI IS A MEASURE, BODY MASS

INDEX, AND IT'S DEFINED AS

WEIGHT AND KILO GRAMS OR HEIGHT

AND METERS SQUARED.

AND WE HAVE A LOT OF DATA

LOOKING AT HEALTH ASSOCIATIONS

IN RELATIONSHIP TO BMI.

HOWEVER, BMI IS A SCREENING OR

EPIDEMIOLOGICAL TOOL.

IT IS NOT A DIAGNOSTIC CRITERION

IN AND OF ITSELF.

FOR CHILDREN, BMI IS AGE AND

GENDER SPECIFIC SO BMI FOR AGE

IS A MEASURE–LUSED.

IF YOU HAVE BEEN TAKING YOUR

CHILDREN TO A HEALTH CARE

PROVIDER, YOU OFTEN SEE THE OR

YOU SHOULD BE SEEING THEM PLOT

OUT THE STATUS OF THE YOUTH ON

GROWTH CURVES THAT ARE IN THE

OFFICES.

I AM A PEDIATRICIAN BY TRAINING

AS WELL AND I THINK WE DO NEED

TO PROVIDE A HEALTHY START FOR

OUR YOUTH, BUT WE ALSO HAVE TO

REMEMBER THAT MANY PEOPLE BECOME

OBESE AS ADULTS.

SO YOU CAN'T JUST FORGET ABOUT

THE OLDER INDIVIDUAL AS WELL.

IN RECENT TRENDS FOR CHILDREN

AND ADOLESCENTS, YOU CAN SEE

HERE THAT FROM THE --

MOST OF THE INCREASE IN

OVERWEIGHT AND OBESITY IN YOUTH

OCCURRED BETWEEN THE 70s AND

THE LATE 90s.

AND WHEN YOU SEE IN THE MEDIA A

TRIPLING OF OBESITY IN YOUTH,

THIS IS WHAT IS BEING REFERRED

TO, FROM THE 70s TO THE LATE

90s, 2000.

OVER THE PAST DECADE, THE LEVEL

OF OBESITY HAS REMAINED PRETTY

CONSTANT AND PHYSICALLY USING

THE 95th PERCENTILE ON THE

GROWTH CURVES FOR YOUTH, THERE

HAS NOT BEEN A STATISTICAL

DIFFERENCE IN EITHER BOYS OR

GIRLS.

WHEN YOU LOOK AT MORE SEVERE

OBESITY AND THIS IS A PLOT OF AT

OR ABOVE THE 97th

PERCENTILE, YOU DO SEE A SLIGHT

INCREASE, ESPECIALLY IN BOYS, IN

THE HEAVIEST BOYS ARE GETTING

HEAVIER AND THAT IS STILL A„i

CONCERN.

IN TERMS OF ADULTS, YOU HAVE

MUCH OF THE SAME THING.

MOST OF THE INCREASE OCCURRED

FROM THE 70s UP UNTIL AROUND

2000.

PLEASE NOTE THAT THE OVERWEIGHT

LINE REMAINS ALMOST CONSTANT

THROUGHOUT THIS PERIOD OF TIME.

THAT MEANS THAT THE PEOPLE THAT

WERE CONSIDERED OF NORMAL

WEIGHT, GAINED WEIGHT ABOUT THE

SAME LEVEL AS THOSE THAT WERE IN

THE OVERWEIGHT CATEGORY MOVING

UP TO OBESE.

SO THAT AS PEOPLE MOVED OUT OF

THE HEALTHY WEIGHT ZONE, THEY

MOVED INTO THE OVERWEIGHT AND

PEOPLE IN THE OVERWEIGHT MOVED

UP INTO THE OBESE.

OF MORE CONCERN AND RECENTLY, IS

THE INCREASING PREVALENCE OF

PEOPLE THAT ARE CONSIDERED

EXTREME LEO BEES, AND THIS IS A

BMI OF 40 OR„i GREATER --

EXTREME LEE–r OBESE.

 --

EXTREME LEO BEES.

OVERALL, THE AVERAGE ADULT HAS

GAINED 24 POUNDS MORE THAN THE

ADULT AVERAGE ADULT IN 1960.

THE AVERAGE WEIGHTxD GAIN OVER

TIME IN ADULTS IS ABOUT A POUND

A YEAR.

THIS IS FAIRLY CONSISTENT,

HOWEVER, MALES ARE NOW GAINING

AND HAVE COME UP CLOSER TO THE

FEMALE LEVEL IN TERMS OF

PREVALENCE BUT IT'S ROUGHLY

ABOUT 30% FOR BOTH MALES AND

FEMALES.

THIS IS ANOTHER WAY OF SHOWING

THE INCREASE.

IT'S A CHANGE IN THE

DISTRIBUTION OF THE WEIGHT AND

EVERYBODY IS SHIFTING TO GETTING

HEAVIER.

AND I JUST WANTED TO ALSO

HIGHLIGHT THE FACT THAT

HISPANICS AND BLACKS ALSO HAVE

AN INCREASED PROBLEM OF OBESITY

IN ADULTS AS WELL„i AS YOUTH.

FROM THIS AREA, WELL, MOST OF

THIS DATA HAS COME FROM THE

NATIONAL HEALTH AND NUTRITION

EXAMINATION SURVEY, WHICH IS RUN

OUT OF THE NATIONAL CENTER FOR

HEALTH STATISTICS, WHICH IS A

LOCAL PART OF THE CDC AND THEY

TAKE TRAILERS AROUND THE COUNTRY

AND DO REPRESENTATIVE OF

PHYSICAL EXAMS IN THESE TRAILERS

OF PEOPLE FROM THE POPULATIONS

ACROSS THE COUNTRY, SO THAT WE

HAVE A REPRESENTATIVE SAMPLING.

ON OCCASION, THESE TRAILERS ARE

IN THE LOCAL AREA AND SHOULD YOU

EVER GET A POSTCARD OR

INVITATION PARTICIPATE, I WOULD

ENCOURAGE YOU TO DO SO.

THE PHYSICAL EXAM TAKES

APPROXIMATELY HALF A DAY.

HAVE YOU BLOOD WORK AND YOU HAVE

OR DO GET THE RESULTS ON THE

EXAM AS WELL AS INDIVIDUAL.

SO I WOULD ENCOURAGE EVERYBODY

TO PARTICIPATE IF YOU GET A

CHANCE.

IT'S A VERY INTERESTING THING TO

UNDERGO.

I WANTED TO SAY THE DEGREE OF

HEALTH RISK INCREASES WITH THE

DEGREE OF OVERWEIGHT AND HAS

SHOWN HERE, YOU START SEE ING

INCREASE IN RISK --

I'M USING DIABETES RISK IN THIS

CASE --

AS YOU GO UP IN BMI.

YOU HAVE INCREASED RJc
 EVEN AT

LOWER BMI BUT IT GOES UP AT A

FASTER RATE AS YOU GET ABOVE THE

BMI OF 30.

THIS IS ANOTHER SLIDE THAT SHOWS

RISK OF GAINED WEIGHT NO MATTER

WHAT YOUR STARTING BMI IS AND

THIS IS AN ADULT WEIGHT GAIN

AFTER AGE 21.

EVEN AT LOW BMI, IF THAT

INDIVIDUAL GAINS WAIT, THEY ARE

IN MUCH„i INCREASED RISK OF
HEALTH

DETRIMENT, IN THIS CASE,

MEASURED BY DIABETES, BUT OTHER

CONDITIONS AS WELL.

PEOPLE THAT ARE AT HIGHER LEVEL

OF BMI ARE AT A HIGHER RISK AND

THOSE WITH THE GREATEST BMI AND

GAINED WEIGHT ARE AT FURTHER

RISK BUT YOU HAVE A RISK OF, IN

ASSOCIATION WITH WEIGHT GAIN NO

MATTER WHAT YOU'RE STARTING BMI

IS.

THIS IS ALSO TRUE.

YOU HAVE INCREASED RISK AS YOU

GO UP FOR OTHER DISEASES AS

WELL, GALLBLADDER DISEASE, HEART

DISEASE, HYPERLIPIDEMIA, BLOOD

PRESSURE, OSTEOARTHRITIS.

THEY ALL GO UP WITH INCREASING

BMI.

YOUR HEALTH RISK IS ALSO

INFLUENCED BY WHERE THE FAT

DEPOSSITIED ON YOUR BODY AND

WHAT WE ALSO REFER TO AS THE

DEGREE OFŤ— THIS ROLE OR

INTRAABDOMINAL FAT AROUND THE

INTERNAL ABDOMINAL ORGANS.

VISIONING A LITTLE BIT TO SOME

OF OUR GUIDANCE, WE HAD THE

DIETARY GUIDELINES FOR OUR

AMERICANS.

THEY HAVE BEEN ISSUED EVERY FIVE

YEARS SINCE 1980 AND THE MOST

RECENT ONE WAS ISSUED IN THE END

OF 2010.

INCREASED EMPHASIS ON DIETARY

GUIDANCE TO HOPEFULLY REDUCE THE

RISK OF DIET-RELATED CHRONIC

DISEASES AND CONDITIONS, SUCH AS

OBESITY, CARDIOVASCULAR DISEASE,

HYPERTENSION, CANCER,

OSTEOPOROSIS AND MANY OTHERS.

JUST TO GIVE YOU AN INDICATION

OF WHY WE NEED TO LISTEN TO THIS

DIETARY ADVICE, THERE ARE A

NUMBER OF PARTS OF THIS DIE NET

WHICH WE ARE TRYING TO ENCOURAGE

PEOPLE TO EAT MORE AND EAT MORE

AS A WHOLE GRAIN, VEGETABLES,

FRUIT, DAIRY, SEAFOOD, AND THEN

FIBER, POTASSIUM, VITAMIN D,

CALCIUM.

AS A POPULATION, WE ARE NOT

DOING VERY WELL IN TERMS OF

CONSUMPTION OF SOME OF THESE

FOODS OR FOOD„i COMPONENTS OF

WHICH HAVE HEALTH BENEFITS.

HOWEVER, WE ARE CONSUMING MORE

OF OTHER THINGS WE DON'T NEED AS

MUCH AND THAT IS CALORIES,

ESPECIALLY CALORIEES FROM

SATURATED FAT AND ADDED SUGARS,

REFIND GRAINS, SODIUM AND

SATURATED FAT.

THE OTHER THING WE ARE DOING IS

THAT THERE HAS BEEN A

SIGNIFICANT CHANGE IN EATING

OCCASIONS.

AND ESPECIALLY IN TERMS OF

ENERGY CONSUMED DURING SNACKING.

BACK IN THE 70s, WE HAD ONLY

ONE SNACK PER DAY AND NOW WE ARE

UP TO ALMOST 3 SNACKING WITH

MUCH INCREASE, ABOUT 24% OF
THE„i

CALORIES CONSUMED ARE AT SNACKS.

THE AMOUNT OF CALORIES CONSUMED

IN MEALS HAS NOT CHANGED

SIGNIFICANTLY OVER THAT PERIOD

OF TIME.

ANOTHER WAY OF LOOKING AT THIS

IS, THE PERCENT OF PEOPLE

REPORTING SNACKS BACK IN THE

70s, 40% OF THE POPULATION DID

NOT SNACK AT ALL AND NOW THAT IS

DOWN TO 4%.

WHERE AS, PEOPLE THAT ARE

INCREASING BETWEEN THREE-FIVE

FAX IS NOW OVER 50% OF THE

POPULATION.

SAME WI WITH PHYSICAL ACTIVITY

GUIDELINES.

WE HAVE GUIDANCE IN WHICH

CHILDREN EXERCISE 60 MINUTES A

DAY AND ADULTS AN AVERAGE OF 30

MINUTES OF MODERN INTENSITY OR

75 MINUTES OF VIGOROUS ACTIVITY

PER WEEK.

THEN, WE GET MORE BENEFIT WITH

INCREASING LEVELS OF ACTIVITY.

HOWEVER, WHAT IS REALLY

HAPPENING, 6-11-YEAR-OLDS DO

FAIRLY WELL.

ONCE YOU GET PASSED AND INTO

ADOLESCENCE, AND„i ADULTS, THE

AMOUNT OF PEOPLE THAT ARE

ACTUALLY ACHIEVING THE

RECOMMENDED LEVELS OF ACTIVITIES

IS IN THE NEIGHBORHOOD OF LESS

THAN 10 EXERCISE OFTEN LESS THAN

5%.

THUS WE HAVE CHALLENGES IN

ACHIEVING IMPROVED HEALTH FOR

OUR NATION.

OVERALL, WE NEED IMPROVE OUR

RESEARCH TRANSLATION EFFORTS AND

HOPEFULLY SOME OF THE OTHER

TALKS TODAY WILL HELP IN

PROVIDING SOME INFORMATION

THERE.

WE NEED TO SET PRIORITIES AS A

SOCIETY, AS WELL AS AN

INDIVIDUAL, RECOGNIZE THE

COMPLEXITY OF THE INTERACTIONS

AND THE CAUSATION AND

INTERVENTION, RECOGNIZE THAT

MULTIPLE SECTORS OF THE

COMMUNITY IMPACT THE FACTIVENESS

PROGRAMS.

IT'S NOT JUST THE HEALTH CARE

SECTOR.

WE NEED TO DEVELOP PROGRAMS FOR

A DIVERSE SOCIOECONOMIC ANDY

ETHNIC POPULATION.

IN TERMS OF COMMUNICATION

PRIORITIES, WE NEED TO DO A

BETTER JOB IN CONVEYING COMPLEX

CONCEPTS.

I STILL DON'T THINK, AND MOST

PEOPLE RECOGNIZE OBESITY AS A

CHRONIC DISEASE.

MOST PEOPLE GO ON A DIET, THEY

THINK THAT DIE SET SHORT-TERM,

ONCE YOU LOST THE WEIGHT, YOU

CAN GO OFF YOUR DIET.

OBESITY IS A CHRONIC DISEASE.

DIET IS NOT A SHORT-TERM THING.

DIET SHOULD BE A LIFE-LONG

APPROACH.

EVERY ONE WILL NOT BE SUCCESSFUL

WITH THE SAME INTERVENTION.

WHAT WORKS FOR YOU MAY NOT WORK

FOR YOUR NEIGHBOR.

SUSTAINED SMALL CHANGES WILL

BENEFIT OVER A LONG PERIOD OF

TIME.

YOU DON'T HAVE TO MAKE MAJOR

CHANGES.

SMALL CHANGES OVER A LONG TIME.

THESE CHANGES SHOULD BE CHANGES

THAT YOU CAN ADOPT AND MAINTAIN.

WHO IS CONSIDERED OVERWEIGHT OR

OBESE?

IT'S ALSO A FUNCTION OF

PERCEPTIONS FROM THE MEDIA AND

FROM DIFFERENT CULTURES.

IMMEDIATELY AFTER THE SURGEON

GENERAL'S CALL TO ACTION ON

OVERWEIGHT AND OBESITY, A LOT OF

THE MEDIA DID NOT --

TOOK AWAY THEIR FILM ARCHIVE

FILM FEATURES OF THE TERRIBLY

OVERWEIGHT OR OBESE INDIVIDUALS

AND PUT A LITTLE BIT MORE

CONCENTRATION ON HEALTH.

BACK TO TODAY, WHEN THE MEDIA

COVERS THE TOPIC OF OVER WEIGHT

AND OBESITY, THEY ARE BACK TO

SHOWING THE SERIOUSLY OBESE

INDIVIDUAL --

SEVERELY OBESE INDIVIDUAL AND

THAT MAY LEND ITSELF TO THE

PUBLIC THINKING I'M NOT SO BAD

AS THAT INDIVIDUAL.

AND HEALTH IMPACTS START AT MUCH

LOWER LEVELŤ— OF OVERWEIGHT AND

THEN WE HAVE TO TALK ABOUT

ENERGY BALANCE.

THE OTHER THING IN TERMS OF

TALKING AND WE'LL HAVE SOME

OTHER MESSAGES ALONG THESE

LINES, PORTION SIZE VERSUS

SERVING SIZE.

MANY PEOPLE DON'T KNOW THE

DISTINCTION.

SERVING SIZE IS OR HAS BEEN

DEFINED AS WHAT YOU SHOULD

CONSIDER A SERVING.

A PORTION SIZE IS WHAT YOU

ACTUALLY CONSUME.

THE OTHER THING ON SERVING SIZES

IS IT'S NOT ALWAYS APPROPRIATE

TO ONLY HAVE ONE SERVING.

LIKE FOR FRUITS OR VEGETABLES,

IT'S PERFECTLY APPROPRIATE TO

HAVE MORE THAN ONE SERVING.

SO HOW YOU INTERPRET SOME OF

THESE MESSAGES IS ALSO AN ISSUE.

FITNESS VERSUS WEIGHT LOSS.

YOU CAN MAINTAIN YOUR WEIGHT,

IMPROVE YOUR FITNESS AND IMPROVE

YOUR HEALTH.

SO, WEIGHT IS NOT ALWAYS THE

BEST INDICATOR OF HOW TO IMPROVE

YOUR HEALTH AND WE SHOULD ALL

TRY TO IMPROVE OUR FITNESS AS

WELL.xD

ACTIVITY VERSUS EXERCISE.

YOU DON'T HAVE TO HAVE A FORMAL

EXERCISE PROGRAM.

YOU CAN JUST WALK A LITTLE BIT

MORE AROUND HERE.

YOU CAN GET OFF THE METRO AT A

STATION, ONE STOP AWAY FROM

WHERE YOUR DESTINATION IS.

YOU CAN WALK AROUND CAMPUS

RATHER THAN TAKE THE SHUTTLE.

YOU CAN DO --

TAKE THE STAIRS RATHER THAN THE

ELEVATOR.

THERE ARE A LOT OF SIMPLE THINGS

TO DO TO GET INCREASED ACTIVITY.

INTERPRETATION OF SCIENTIFIC

STUDIES.

THE MEDIA LOVES TO TRY TO LOOK

AT CONTROVERSY.

AND THEY PICK ON DIFFERENCES

BETWEEN STUDIES.

IT'S LIKE THE BLIND MAN RIDING

THE ELEPHANT.

IT'S RARE THAT TWO STUDIES ARE

IDENTICAL.

SUBSEQUENTLY, IF THERE ARE

SLIGHT DIFFERENCES IN THE

RESULTS, IT'S BECAUSE THEY ARE

DESCRIBING THE ELEPHANT FROM A
‡c

AND DIFFERENT PART OF THE BODY.

THE OTHER IMPORTANT THING IS

THAT WE NEED TO SUSTAIN

PROMOTION OF MORE HEALTHFUL

CHOICES RELATED TO DIET AND

ACTIVITY.

AS A FAMILY, AT THE INDIVIDUAL

LEVEL, WE NEED TO EMPHASIZE THE

PRIORITY AND RECOGNIZE THAT

PRIORITIES ARE INFLUENCED AND

SUPPORTED BY OTHERS AROUND YOU

AND OTHER EFFORTS AROUND YOU,

INVOLVING„i CULTURES,

SOCIOECONOMICS, PEERS AND TIME.

TIME IS A CRITICAL THING THAT

EVERYBODY SHOULD CONSIDER.

WHAT GOES INTO MAKING YOUR

DECISION AS TO WHETHER YOU'RE

ACTIVE, WHETHER YOU TAKE A WALK,

HOW YOU SELECT WHAT YOU COMPETE

WHEN YOU EAT.

AND OFTEN TIME IS CONSIDERED A

BARRIER TO LIFESTYLE

MODIFICATIONS.

YOU FEEL YOU DON'T HAVE THE

TIME.

YOU MAY HAVE TIME CONSTRAINTS.

THERE IS ALSO HOW MUCH TIME YOU

SPEND ON DIFFERENT PARTS OF YOUR

DAILY ACTIVITIES.

TIME ALLOCATION.

BUT WE HAVE TO ALSO CONSIDER

WHAT IS THE IMPACT OF TIME

CONSTRAINTS ON TIME ALLOCATION?

AND LOOK AT WHETHER IT'S THE

TIME PRESSURE AND CONSTRAINTS

THAT ARE REAL OR PERCEIVED,

WHETHER IT IS A CAUSE INCREASE

OF STRESS OR STRESS REDUCTION.

I OFTEN USE GOING INTO THE

PARKING LOT AT THE SHOPPING

MALL, PEOPLE LIKE TO PARK AS

CLOSE AS THEY CAN AND GET

STRESSED BECAUSE THERE A CAN'T

FIND A SPACE OR SOMEBODYŤ— ELSE

GRAB THAT IS SPACE RIGHT IN

FRONT OF YOU.

WHEREAS, IF YOU WENT INTO THE

SHOPPING MALL IMMEDIATELY WENT

TO THE DISTANT PARKING SPACE,

YOU WOULD PARK, YOU WOULDN'T

HAVE THAT STRESS, AND IF YOU

THINK ABOUT IT, HAVE YOU THAT

STRESS REDUCTION BY USING THAT

TIME YOU WERE WAITING FOR THAT

CLOSER SPACE BY WALKING INTO THE

MALL AND GETTING SOME EXERCISE

WHILE YOU'RE DOING IT.

SO RATHER THAN JUGGLE FEELING

THAT YOU'RE ALWAYS JUGGLING

DIFFERENT THINGS, THINK ABOUT

HOW YOU CAN PLAN YOUR DAY, PLAN

YOUR TIME, PLAN YOUR MONTH AND

SCHEDULE THINGS THAT WILL GIVE

YOU SOME HEALTH BENEFITS.

IN TERMS OF TIME ALLOCATION, OUR

CONCERNS ARE RELATED TO OUR

PRIORITY SETTING AND WE DO HAVE

A CHALLENGE AT THE INDIVIDUAL

LEVEL AND AT THE POPULATION

LEVEL, AT THE JOB LEVEL, AT THE

SCHOOL LEVEL, HOW DO WE ELEVATE

HEALTHFUL EATING AND INCREASED

PHYSICAL ACTIVITY IN PEOPLE'S

LIVES?

ESPECIALLY IN THE COMPLEX LIVES

OF POOR AND MINORITIES.

I ALSO THINK IN THE SCHOOLS, WE

ARE GIVING SOME INCREASED

EDUCATION.

BUT THE BEST FORM OF EDUCATION

IS REINFORCEMENT.

AND IN THE SCHOOLS BECAUSE OF

THE BUDGETARY CONSTRAINTS, WE

ARE OFTEN NOT GIVING THE

STUDENTS THE SUFFICIENT

OPPORTUNITIES TO PARTICIPATE IN

PHYSICAL ACTIVITY.

WE ARE NOST ALLOWING THEM TO

FOLLOW THEIR OWN SIGNALS IN

TERMS OF WHEN TO EAT.

WE ARE FORCING THEM TO EAT

EARLIER OR LATER THAN THEIR

LYING CALL CLOCK WOULD INDICATE

AND SOMETIMES --

BIOLOGICAL CLOCK --

AND SOMETIMES THE WORKPLACE DOES

THE SAME.

OUR ULTIMATE GOAL IS TO PREVENT

DISEASE AND DISABILITY.

WE NEED TO IMENTREPRENEUR OUR

EFFECTIVE TRANSLATION OF OUR

RESEARCH AND THAT IS THE KEY TO

OUR OVERALL SUCKESS AND SHOULD

IMPROVE THE HEALTH OF

AMERICANS --

SUCCESS AND SHOULD IMPROVE THE

HEALTH OF AMERICANS.

I ASK THAT EVERYBODY GO OUT AND

STRIVE TO MAKE A DIFFERENCE,

MAKE A DIFFERENCE FOR YOURSELF

AND MAKE A DIFFERENCE FOR THOSE

AROUND YOU AND MAKE A DIFFERENCE

FOR YOUR NEIGHBORS, FOR YOUR

FAMILY MEMBERS, YOUR YOUTH, YOUR

CHILDREN.

DO SOMETHING TO HELP SOMEBODY

ELSE ADOPT HEALTHIER LIFESTYLES.

THANK YOU.

[APPLAUSE]

>> THANK YOU DR. HUBBARD.

THAT THE TIME I'D LIKE TO

INTRODUCE MS. JANET DE JESUS

FROM THE NATIONAL, HEART, LUNG

AND BLOOD INSTITUTE.

>> GOOD MORNING, EVERYONE.

THANK YOU FOR HAVING ME.

IT'S A PLEASURE TO BE HERE.

TODAY THE OBJECTIVES OF MY TALK,

WE ARE GOING TO TALK A LITTLE

BIT ABOUT A PROGRAM AT NIH

OBESITY PROGRAM, CALLED, WE CAN.

I WANT TO TALK ABOUT THE

CHANGING FOOD PORTIONS IN

AMERICA AND HEALTHY BEVERAGE

RECOMMENDATIONS AND DISCUSS

PARENT ROLE MODELING THAT COMES

OUT OF, "WE CAN," SWELLS HEALTHY

WEIGHT RESOURCES FOR PARENTS,

COMMUNITIES AND CAREGIVERS.

SO I WANT TO THANK VAN.

HE SET A GOOD STAGE ON THE TOPIC

OF OBESITY AND OVERWEIGHT IN

AMERICA.

IT'S A REALLY SERIOUS PROBLEM.

SO I CAN SKIP MY FIRST TWO

SLIDES.

YOU SEEN THESE.

SO THE FIRST SON JUST THE

PREVALENCE OF U.S. CHILDREN IN

ADOLESCENCE WHO ARE OBESE.

WE JUST SAW THAT.

SO PAYING A HEAVY PRICE.

VAN TOUCHED ON THESE AS WELL.

THERE ARE SOME ISSUES THAT COME

OUT OF BEING OVERWEIGHT AND

OBESE AS FAR AS CHILDREN AND

ADULTS.

SO A LITTLE BIT ABOUT "WE CAN."

WHAT IS IT?

IT STAPEDES FOR WAYS TO ENHANCE

CHILDREN'S ACTIVITIES AND

NUTRITION.

IT'S A NIH PROGRAM, A

PARTNERSHIP BETWEEN FOUR

DIFFERENT INSTITUTES, NHLBI,

NIDDK, NICHD AND NCI.

THIS WAS LAUNCHED IN 2005.

2004 THERE WAS A WORKSHOP TO

REALLY TALK ABOUT THE ISSUE OF

OVERWEIGHT AND OBESITY, THE

GROWING TREND AND WHAT CAN WE DO

ABOUT IT?

WHAT IS AVAILABLE TO

COMMUNITIES, HEALTH CARE

PROVIDERS, ON THE TOPIC?

WAS FOUND IS IS THERE A LOT OF

YOUTH CURRICULA.

A LOT OF THINGS GOING ON IN

SCHOOLS THAT ARE BASED ON NIH

SCIENCE.

THE CATCH SPARK, I'LL TALK ABOUT

A FEW, BUT THERE WAS NOT A LOT

OF INFORMATION ABOUT PARENTS,

HEALTH CARE PROVIDERS, ON THE

TOPIC.

THAT'S WHERE "WE CAN" CAME F

IT'S A NATIONAL SCIENCE-BASED

EDUCATIONAL PROGRAM.

IT'S DESIGNED TO PREVENT

CHILDHOOD OBESITY, NOT A WEIGHT

LOSS PROGRAM.

IT TARGETS YOUTH, AGES 8-13.

WE ARE GOING TO GO LOWER SOON.

THEIR PARENTS AND CAREGIVERS.

SO WHAT BEHAVIORS DOES SCIENCE

TELL US ARE IMPORTANT IN

PREVENTING OBESITY?

THESE THREE CAME OUT WHEN THE

LITERATURE WAS RAN AND IT'S

STILL --

MORE SCIENCE COMING FORWARD,

IT'S STILL SEEMS TO POINT TO THE

THREE MAIN ISSUES, IMPROVING

FOOD CHOICES, INCREASING

PHYSICAL ACTIVITY AND REDUCING

SCREEN TIME.

PERMANENT BEHAVIOR CHANGE IS

HARD.

BUT "WE CAN" ENCOURAGES PARENTS

TO TAKE THE FIRST STEP AND TO

PIGGYBACK ON WHAT VAN SAID, TAKE

SMALL STEPS.

THERE ARE A LOT OF THINGS YOU

CAN DO TO MAKE A DIFFERENCE.

HOW DOES "WE CAN" MAKE THIS

SCIENCE„i ACTIONABLE?

WE HAVE YOUTH CURRICULA THAT WE

ARE --

THAT WERE ALREADY DEVELOPED

BEFORE WE CAN.

CATCH KIDS CLUB SPARK, MEDIA

SMART YOUTH, WHICH I'LL TALK

MORE ABOUT FROM NICH.

AND A SMART PROGRAM A SCREEN

TIME REDUCTION PROGRAM FROM STAN

FORMED.

FROM THAT, WE HAVE CURRICULA FOR

PARENTS AND YOUTH.

WE ALSO HAVE ADDITIONAL

RESOURCES FOR COMMUNITIES AND

PARTNERS.

IT'S REALLY FLEXIBLE TO FIT

DIFFERENT NEEDS.

SO I„i MENTIONED OUR AUDIENCE

BEFORE.

WE HAVE ABOUT OVER 1,500 "WE

CAN" COMMUNITY SITES ACROSS THE

COUNTRY THAT ARE USING OUR

CURRICULA.

AND THOSE INCLUDE INTENSIVE

SITES, BASIC SITES, AND WE

VALUES "WE CAN" CITIES AND

COUNTIES.

SO THE GOALS FOR THE PARENTS IN

THE PROGRAM ARE TO INCREASE THE

AVAILABILITYxD OF HEALTHY FOODS,

AND THIS CAN BE PARENTS AND

CAREGIVERS.

LIMIT THE AVAILABILITY OF SWEET

BEVERAGESES, HIGH FAT, LOW

NUTRIENT FOODS, EAT SMALL

PORTIONS IN HOMES AND

RESTAURANTS AND SUPPORT AND

ENABLE FAMILY PHYSICAL ACTIVITY

AND REDUCE SCREEN TIME.

SO RESOURCES FOR PARENTS.

WE HAVE A LOT OF GREAT THINGS ON

OUR WEBSITE„i IF YOU'RE A PARENT

OR CAREGIVER, YOU KNOW ANY

PARENTS INTERESTED IN OR COULD

USE OBESITY PREVENTION

INFORMATION, IT'S ALL IN THE

NHLBI WEBSITE OR THE "WE CAN"

WEBSITE.

LOG YOUR SCREEN TIME, YOU CAN

LOG YOUR PHYSICAL ACTIVITY AND

GET KIDS INVOLVED WITH THIS.

IT CAN BE A LOT OF FUN.

AND I'LL TALK MORE ABOUT

ADDITIONAL TIP SHEETS WE HAVE.

WE ALSO HAVE A FAMILY FINDING

THE BALANCE PARENT HANDBOOK.

THIS IS AVAILABLE IN ENGLISH AND

SPANISH.

NEXT SLIDE TAKES A MINUTE FOR

SOME REASON.

THERE WE GO, SO THE CURRICULA

THAT ACTUALLY CAME OUT OF "WE

CAN" IS A PAINT PROGRAM.

THIS FOCUSES ON ENERGY BALANCE,

PHYSICAL ACTIVITY, SCREEN TIME

REDUCTION AND THIS IS ACTUALLY

TAUGHT TWO PARENTS OR

CAREGIVERS.

IT CAN BE DONE ANY WHERE.

IF YOU'RE AN ADVOCATE AND YOU

WANT TO GET THIS IN ANY OF THE

SCHOOLS OR PARENT GROUPS, THIS

IS ALL AVAILABLE FOR FREE

ONLINE.

SO I MENTIONED MEDIA SMART USE

EARLIER.

THIS IS A PROGRAM FOR THE

NATIONAL INSTITUTES OF CHILD

HEALTH.

AND THIS IS TARGETING KIDS AGES

11-13.

SO IT'S A REALLY NEAT PROGRAM.

IT EMPOWERS KIDS TO LEARN AND BE

MEDIA SMART.

SO IT TEACHES THEM ABOUT BLEED

MESSAGES ABOUT NUTRICIAN

PHYSICAL ACTIVITY.

THEY LEARN HOW TO ANALYZE MEDIA

MESSAGES, CREATE THEIR OWN.

UNDERSTANDING THE IMPORTANCE OF

PHYSICAL ACTIVITY.

THEY EXPLORE NUTRITION.

SHOW CAN BE CARRIED OUT IN

SCHOOLS.

IT CAN BE CARRIED A PART OF

AFTER-SCHOOL PROGRAMS.

ANY PROGRAMS THAT HAS YOUTH,

THIS CAN BE IMPLEMENTED IN IT'S

REALLY FLEXIBLE AND FUN.

THEY ACTUALLY CREATE SOMETHING

CALLED A BIG PRODUCTION AT THE

END, WHERE THEY VIDEOTAPE

THEMSELVES AND SO IT'S A REALLY

FUN PROGRAM.

THIS IS AVAILABLE FREE ONLINE AS

WELL.

SO FOOD FOR THOUGHT.

NOW I WANT TO GET INTO KEY

MESSAGES FOR PARENTS AND

CAREGIVERS OUT THERE.

SO PORTION DISTORTION, YOU

PROBABLY HEARD„i THROUGH ALL THE

MEDIA AND SEEING YOURSELF HOW

MUCH PORTIONS HAVE GROWN.

WE HAVE A PORTION DISTORTION

ONLINE QUIZ ON OUR WEBSITE AND

I'M GOING GIVE ONE EXAMPLE.

SO FOR EXAMPLE, AND THIS IS JUST

ONE SAMPLE, FOODS ARE REALLY

DIFFERENT DEPENDING ON WHICH

RESTAURANT YOU GO TO.

SO, APPROXIMATELY 20 YEARS AGO,

ONE CUP OF SPAGHETTI SAUCE,

THREE MEET BALLS WAS ABOUT 500

CALORIES.

TODAY WHEN YOU GO OUT, YOUR

TYPICAL ITALIAN RESTAURANT, YOU

GET A MUCH LARGER PLATE.

SO CAN ANYONE IN THE AUDIENCE

GUESS APPROXIMATELY WHAT OUR

DISH WOULD BE TODAY?

HOW MANY CALORIES?

I HEAR 1200.

1,500.

SO, IT CAN BE --

SO FOR TWO CUPS OF PASTA WITH

THREE LARGE MEATBALLS, IT'S

ABOUT 1,025.

SOME PLACES WE GO IT CAN BE FOUR

CUPS OF PAST A SO REALLY YOU CAN

SEE, IF YOU EAT THE WHOLE THING

YOURSELF, YOU'RE GETTING AN

ENORMOUS AMOUNT OF CALORIES.

IT'S A REAL CHALLENGE.

SO THE CALORIE DIFFERENCE IS

ABOUT 525.

SO ARE YOU BEING MORE ACTIVE AS

A RESULT OF EASTING MORE?

PROBABLY NOT.„i

IT'S EASY TO GAIN WEIGHT THESE

DAYS.

BUT, YOU CAN PREVENT.

Y DON'T HAVE TO EAT THE LARGE

PORTIONS.

SOME TIPS WHEN YOU'RE AT HOME OR

EVEN OUT, EAT IN SMALLER PLATES

AND BOWLS.

I ALWAYS DO THIS.

IT REALLY HELPS.

IT LOOKS LIKE YOU'RE EATING MORE

BECAUSE YOU'RE EATING IN A

SMALLER BOWL.

YOU DON'T FEEL LIKE YOU HAVE TO

FILL THE PLATE.

I WRITTEN FIRST GOT MARRIED

SEVEN YEARS AGO AND WE

REGISTERED FOR OUR DISHES, WE

GOT OUR MAIN DISH AND IT'S THIS

BIG AND IT'S, WHO WILL REALLY

EAT OFF OF THAT?

HOW COULD YOU EVER FILL?

I EAT OUT OF THE SMALLER

VERSION.

I BOUGHT LITTLE RICE BOWLS TO

EAT MY PAST OUT OF.

SO IT'S REALLY AMAZING.

MEASURE YOUR GRAIN AND MEAT

SERVINGS.

THAT'S WHERE WE CAN GET A LOT OF

OUR CALORIES.

IF YOU LOOK AT THE NEW "MY

PLATE" THAT CAME OUT OF USDA,

HALF SHOULD BE FRUITS AND

VEGETABLES.

THAT'S A GREAT VISUAL TO SEE A

LARGER PORTION VEGETABLES AND

ABOUT A QUARTER FROM FRUITS AND

THEN THE REST GRAINS AND

PROTEINS.

EAT SLOW AND ENJOY YOUR FOOD.

IT SEEMS LIKE WE ARE NOELS A

RUSH THESE DAYS AND WE EAT SO

FAST AND OUR KIDS DO THE SAME.

SO TRY AND ENJOY IT AND YOU'LL

GET FULL FASTER.

WHEN EATING OUT, YOU CAN SHARE A

MEAL OR ORDER HALF PORTIONS.

THIS IS ONE OF MY BIG PET

PEEVES.

IF YOU THINK ABOUT A 12 OUNCE

CAN OF SODA, IF YOU HAVE JUST

ONE CAN EVERY DAY FOR A YEAR,

HOW MUCH SUGAR DO YOU THINK THAT

IS IN A YEAR?

SOME OF YOU PLAY SEEN THIS.

THINK BIG BAGS OF SUGAR.

THE ANSWER IS 30 POUNDS OF

SUGAR.

SO THAT'S JUST FOR ONE CAN.

HOW MANY PEOPLE DO YOU KNOW

PROBABLY DRINK SEVERAL CANS OR

DRINK–r LARGER–r BOTTLES?

SO HOW MUCH WEIGHT?

THIS IS IF SERVING CONSTANT AND

YOU ONLY CHANGED YOUR BEVERAGE

FROM WATER TO SODA OR SWITCHED.

HOW MUCH WEIGHT COULD YOU LOSE

IF YOU SWITCHED FROM REGULAR

SODA TO WATER?

ABOUT 15.

THAT'S BASED ON ABOUT 150

CALORIES OF SODA.

YOU CAN SEE IT REALLY ADDS UP.

AND THIS IS JUST AN EXAMPLE OF

HOW SERVING SIZES OF SODA HAVE

REALLY CHANGED.

I SEE LITTLE KIDS WALKING AROUND

WITH A 20 OUNCE SODA AND IT

BREAKS MY HEART.

SO, IF YOU HAVE KIDS, PLEASE DO

NOT EVER SERVE THEM SODA.

THAT'S MY BLUNT RECOMMENDATION.

THEY DO NOT NEED IT.

THEY REALLY DON'T.

THERE IS NOTHING NEEDED EVER IN

SODA.

HOPEFULLY THAT DIDN'T GO TOO

FAR.

SO HOW MANY CALORIES AND SUGAR

FOR BEVERAGES?

THIS IS AN EXAMPLE FROM ONE OF

OUR TIP SHEETS SHOWING THAT THE

TEASPOONS OF SUGAR AND THE

CALORIES.

WHEN WE GO OUT IN THE COMMUNITY,

WE HOLD UP A CARD AND ASK PEOPLE

TO GUESS HOW MANY TEASPOONS OF

SUGAR ARE IN A 12 OUNCE„i SODA
AND

THEN WE TURN IT AROUND AND SAY

IT'S ABOUT 10 1/4 OR 41 GRAMS OF

SUGAR.

YOU CAN DO ACTIVITIES WITH KIDS

WITH SUGAR CUBES, THEY CAN MAKE

THEIR OWN CARDS AND THEN SHOW

THEM WATER OR UNSWEET END

BEVERAGE AND TURN IT AROUND AND

IT'S ZERO.

ZERO CALORIES.

ZERO GRAMS OF SUGAR.

SO YOU DON'T HAVE TO BE A

NUTRITION EXPERT TO BE A

NUTRITION ADVOCATE OUT THERE IN

YOUR SCHOOLS NOR YOUR KID'S

CLUBS.

THEIR SPORTING EVENTS.

WHAT ARE YOU SERVING THERE?

WHAT KIND OF BEVERAGES?

SO YOU CAN ALWAYS MAKE A

DIFFERENCE.

SO PARENTS AS ROLE MODELS.

IT'S HARD BEING A PARENT.

I HAVE A TWO AND A 4-YEAR-OLD.

I NEVER IMAGINED IT WOULD BE

THAT COMPLEX EVEN THE HEALTHY

EATING PART.

MY HUSBAND AND I ARE BOTH

DIETICIANS AND WE THOUGHT, THIS

WILL BE A BREEZE.

BUT IT'S REALLY NOT THAT EXACT

AND IT'S DIFFICULT.

SO, FROM THEŤ— "WE CAN" PROGRAM
WE

TRY TO GIVE TIPS.

WE HAVE A LOT OF GREAT TIP

SHEETS FOR PARENTS.

I IF YOU WOULD OUR TIP SHEETS

SOME OF THE GREAT TIPS.

MAKE YOUR HOME A HEALTHY EATING

ZONE.

ONE OF OUR SITES CAME UP WITH

THE SLOWING SCAN IT'S BEING USED

A LOT NOW MAKING HEALTHY CHOICE

THE EASY CHOICE.

SO IF YOU HAVE A COOKIE VERSUS

AN APPLE, LIKE WHAT IS YOUR

CHILD GOING TOES.

>> WHAT ARE YOU GOING TO CHOOSE?

IF YOU ONLY HAVE AN APPLE, A

PAIR OR ABA NAN AIT WILL ALWAYS

BE A HEALTHY CHOICE.

SO EAT HEALTHY.

WATCH„i YOUR KIDS.

THEY WATCH YOU.

EVEN THE TINY LITTLE ONES.

AS YOUNG AS ONE YEARS OLD, MY

GIRLS WOULD JUMP UP ON MY LAP,

WHAT YOU EATING MAMMA?

GRAB MY FORK.

SO YOU'RE Pi ROLE MODEL.

IF YOU DON'T„i EAT THAT GREAT,
YOU

CAN MAKE CHANGES.

DO IT FOR YOUR KIDS.

DO IT FOR YOURSELF.

STOP YOUR KITCH --

STOCK YOUR KITCH WIN HEALTHY

FOODS.

IF YOU REALLY --

YOU DON'T NEED COOKIES OR CHIPS

OR ANYTHING LIKE THAT IN THE

HOUSE, IN MY OPINION.

HAVE HEALTHY THINGS, WHOLE

GRAIN.

IF YOU'RE GOING TO HAVE CRACKERS

HAVE WHOLE GRAIN OR WHOLE GRAIN

BREADS.

MAKE HEALTHY FOODS AVAILABLE

THEN IT WON'T BE ABOUT ALL OF

YOUR KIDS.

IF THAT'S ALL YOU HAVE, IT

DOESN'T HAVE TO BE.

KEEP HEALTHY FOODS WHERE KIDS

CAN SEE THEM ON THE BOTTOM ROW

OF THE REFRIGERATORS.

WHEN MY TWO-YEAR-OLD FLINGS OPEN

THE REFRIGERATOR DOOR, THAT'S

WHAT IS THERE.

ALL THE FRUIT CUT UP.

PLAN HEALTHY MEALS AHEAD OF

TIME.

THIS IS BEING A MOM, THIS IS

WHAT I STRUGGLED WITH THE MOST.

YOU WORK ALL DAY, YOU'RE TIRED,

PICK UP THE KIDS AND GO HOME.

WHAT AM I GOING TO COOK?

SO YOU CAN DO A LOT OF WEEKEND

COOKING.

GET THINGS READY THAT MORNING.

MY NEXT TIP WILL ADD ON TO THIS.

IF YOU CAN GET YOUR KIDS

INVOLVED, COOK AND EAT TOGETHER

AND WHEN I COME HOME, I GET MY

GIRLS WITH THEIR PLASTIC FORKS

CUTTING UP FRUITS.

THEY GET TO CHOOSE WHICH

VEGETABLE WE'RE HAVING.

ON THE WEEKENDS WE HAVE A LOT

MORE TIME SO WE CAN REALLY MAKE

LIKE A MORE IN-DEPTH MEAL

TOGETHER.

BUT I ENCOURAGE YOU AND I KNOW

IT CAN BE A HASSLE LIKE I'M SURE

MY DINNER WOULD BE READY MUCH

QUICK FER I DIDN'T INVOLVE MY

KIDS BUT YOU'RE TEACHING THEM.

AND THEY MAY TREAT IF THEY HELP.

SO TRY AND PROVIDE A HEALTHY

BREAKFAST EVERY DAY.

THERE IS A LOT OF NEW DATA ON

KIDS THAT EAT BREAKFAST AND

THINGS THEY ARE ABLE TO LEARN

MORE IN SCHOOL AND JUST HAVING

THAT ENERGY.

THERE IS A LOT OF GREAT HEALTHY

OPTIONS THAT ARE QUICK.

A BOWL OF CEREAL, FRUIT,

OATMEAL.

SO GET YOUR FAMILY MOVING.

TRY AND FIND ACTIVITIES THAT YOU

REALLY ENJOY TOGETHER AS A

FAMILY.

AND START EARLY IN LIFE.

EVEN WITH THOSE TINY LITTLE

ONES.

MAKE IT A ROUTINE TO BE ACTIVE.

IF YOU'RE SNUCK A RUT RIGHT NOW

LIKE AFTER DINNER WE GO WATCH

TV.

TRY AND CHANGE IT.

SLOWLY BUT SURELY YOU YOU YOU
CAN

DECIDE ON ACTIVITIES.

EVEN IF IT'S NOT SOMETHING THAT

IS COMPLETELY PHYSICALLY ACTIVE,

JUST GETTING THEM AWAY FROM THE

SCREEN TIME AND THE TV, TOO MUCH

OF THAT.

I MEAN, EVERYTHING IN MODERATION

IS FINE.

BUT THERE IS DEFINITELY TOO MUCH

SCREEN TIME.

I'LL TALK ABOUT THAT„i NEXT.

SO, BE CREATIVE, EVEN THIS WEEK

IT'S RAINY.

I'M LIKE, OHNO, WE CANNOT GO

OUTSIDE.

IF IT'S GOING TO BE POURING, YOU

CAN DO THINGS INSIDE.

YOU CAN PLAY CATCH, TAG,

HIDE-AND-SEEK.

GO FOR A WALK, DANCE.

WE ARE REALLY BIG INTO DANCE AT

MY HOUSE.

YOU DON'T HAVE TO LOOK GOOD

DOING IT T DOESN'T MATTER.

IT'S JUST YOU AND YOUR FAMILY.

PUT ON MUSIC IS HAVE LOTS OF

FUN.

SO LIMIT SCREEN TIME AND THIS IS

BECOMING EVEN MORE OF A PROBLEM

AS OVERWEIGHT INCREASES.

THERE IS A LOT OF DATA ON SCREEN

TIME CONNECTED TO OVERWEIGHT AND

OBESITY IN KIDS.

SO, IF YOU CAN SET AN EXAMPLE TO

LIMIT YOUR OWN SCREEN TIME, I

NONE MY FIRST DAUGHTER WAS BORN,

WE MADE A NEWEL MY HOUSE, MY

HUSBAND AND I, WE USED TO WATCH

THE NEWS WHILE WE EIGHT DINNER,

WE SAID NO TV UNTIL SHE GOES TO

BED.

SO IT WAS LIKE UNTIL 8 OR 9:00

P.M. THAT THE TV WAS OFF.

I HAD HEARD LIKE A NEW MOM THAT

IF THERE IS SOUND IN THE HOUSE,

KIDS DON'T LEARN AS MUCH OR THEY

ARE READING LESS.

SO THAT WAS OUR RULE.

WE STILL TRY THAT THESE DAYS.

SO PLAN HEALTHY ACTIVITIES

BEFORE THE TV IS TURNED ON.

SO THIS IS WHAT I MENTIONED

EARLIER TRYING TO PLAN DIFFERENT

ACTIVITIES.

AND IF WATCHING ACTIVITY TRY TO

AVOID SNACKING.

A LOT OF DATE ON THE EATING THAT

IS DONE DURING TV WATCH AND IT'S

USUALLY NOT HEALTHY EATING.

AND IF YOU CAN, DO FLOTPUT A TV

IN THE CHILD'S ROOM.

THIS IS REALLY A LOT OF DATA,

THEY STAY UP LATER AND OF COURSE

THEY WATCH MORE TV.

ONCE IT'S THERE THEY ARE IN

CONTROL AND THEY CAN TURN IT ON

WHENEVER THEY WANT.

THAT'S MY BEST ADVICE FOR THAT.

SO SECRETS TO MAKING HEALTHY AND

FUN SCHOOL LUNCHES.

YOU CAN SEND YOUR LUNCH TO

SCHOOL IF YOU DON'T LIKE THE

SCHOOL FOOD.

THAT'S AN OPTION.

I'LL PROBABLY BE DOING THAT FOR

MY KIDS WHEN THEY ARE IN PUBLIC

SCHOOL BECAUSE I HAVE SEEN THE

MENUS.

SO, IF YOU CAN, MAKE IT FUN FOR

YOUR KIDS.

THEY HAVE THESE LITTLE BOXES

THESE DAYS THAT HAVE DIFFERENT

CONTAINERS.

YOU CAN PICK A THEME.

HAVE A DIP DAY OR BACKWARDS DAY

WHERE YOU WRAP YOUR SANDWICH IN

LETTUCE INSTEAD OF BREAD.

TROPICAL TUESDAY.

OF COURSE ALL THIS NEEDS TO BE

DONE THE NIGHT BEFORE.

NOT IN THE MORNING BEFORE YOU'RE

LEAVING WORK BUT KEEP IT

INTERESTING.

READ THE NUTRITION FACTS LABEL

WHEN YOU'RE PACKING THE LUNCHES.

DITCH THE LIGHT BREAD.

DO SOME INTERESTING THINGS.

THERE IS LOTS OF FUN THINGS THAT

YOU CAN WRAP UP SANDWICHES NOW,

WHOLE GRAIN TORTILLAS OR PITA

BREAD.

MIX UP THE SIDES.

TRY AND GIVE DIFFERENT FUN AND

CREATIVE SIDES T DOESN'T HAVE TO

BE CHIPS OR COOKIES.

YOU CAN DO SOME DIFFERENT FRUITS

OR CEREALS.

AND TRY AND KEEP THE DRINKS

HEALTHY.

REALLY WATER OR MILL

SEMINOLE COUNTY ALL THAT IS

NEEDED.

KIDS DRINK A LOT OF JUICE THESE

DAYS TOO.

AND I WOULD RECOMMEND LOCAL

FRUIT OVER JUICE.

IS KIDS ARE DRINKING MORE THAN

THEY NEED.

TIPS FOR PICKETERS.

WE GET THAT QUESTION A LOT.

WHAT DO I DO IF MY KIDS WON'T

EAT THESE HEALTHY FOODS?

YOU CAN DO YOUR BEST.

LEAD BY EXAMPLE.

HAVE PLENTY OF HEALTH CHOICES.

IF THEY ARE ABLE TO CHOOSE,

MAYBE THEY'LL BE MORE WANT TO

EAT THOSE FRUITS AND VEGETABLES.

AND I MENTION TODAY BEFORE,

INVOLVE YOUR KIDS IN MEAL PREP.

AVOID HAVING THE UNHEALTHY FOODS

AROUND.

MAKE IT FUN.

CUT UP SANDWICHES INTO SHAPES.

HAVE DIFFERENT DIPS.

DON'T FORCE IT.

IF YOU'RE MAKING YOUR KID EAT

SOMETHING THAT IS PROBABLY NOT A

GREAT STRATEGY BECAUSE THEN THEY

WILL NEVER HEAT BROCCOLI AFTER

THAT EXPERIENCE.

SO - THEY WILL NEVER EAT THAT

BROCCOLI AFTER THAT EXPERIENCE.

WE HAVE TIPS FOR PARENTS

AVAILABLE ON THE "WE CAN"

WEBSITE.

PRINT THEM OUT OR HAVE THEM

AVAILABLE AT SCHOOLS OR ANY OF

THE PROGRAMS YOU KNOW OF WHERE

PARENTS ARE THERE.

WE HAVE A GREAT NEW FAMILY

COOKBOOK IT'S CALLED

"DELICIOUSLY HEALTHY MEALS" AND

ALSO AVAILABLE ON THE NHLBI

WEBSITE.

IF YOU GOOGLE NHLBI HEALTHY

EATING, THIS WILL COME UP.

WE HAVE OUR FAMILY MEALS AND

IT'S REALLY GREAT BECAUSE IT HAS

ALL OF THESE RERECIPES TESTED

WITH KIDS AND THE THAT WAS

CREATED THE RECIPES HAVE TWO

KIDS.

SO THEY ARE LOOK FAMILY

FRIENDLY.

THIS ARE LOTS OF TIPS ON GETTING

YOUR KIDS INVOLVED.

FOR EACH RECIPE IT SAYS HOW YOU

CAN INVOLVE YOUR KIDS.

SO SINGLE COPIES ARE AVAILABLE

FREE BUT YOU CAN ALSO DOWNLOAD

THE ENTIRE RECIPE BOOK OR SINGLE

RECIPES ON THE NHLBI WEBSITE.

WE VALUES A DELICIOUSLY HEALTHY

DINNERS.

AND THIS BOOK IS A LITTLE

MORE --

I WOULD SAY MORE GOURMET.

SO IF YOU'RE REALLY INTO THE

INTRICATE COOKING.

ME, I NEED LIKE FIVE

INGREDIENTS.

BUT IT'S REALLY --

PEOPLE LIKE THIS BOOK AS WELL.

SO PLEASE CHECK OUT OUR WEBSITE.

SO "WE CAN," WE ARE ON FACEBOOK,

SIGN UP BE OUR FRIENDS.

WE HAVE A GO SLOW AND LOW

WIDGET --

THE POWER IS GOING OUT.

A BMI CALCULATOR.

YOU CAN GO TO THE "WE CAN"

WEBSITE.

WE LOST IT.

SHOULD I JUST STOP?

KEEP GOING?

ALL RIGHT.

YOU CAN GO TO OUR WEBSITE FOR

INFORMATION ON HEALTHY EATING,

GETTING ACTIVE AND SCREEN TIME.

AND THAT IS THE END OF MY

PRESENTATION.

[LAUGHTER]

SO YOU CAN CONTACT ANY OF US "WE

CAN" MEMBERS.

I WANT TO ACKNOWLEDGE MELINDA

KELLY AND MELACES McGOWAN,

THOSE WERE THE CO-WEEKEND TEAM

LEADERS.

PLEASE LET US CONDITION AND WE

WILL BE THEME SHARE RESOURCES

WITH YOU.

THANK YOU.

[APPLAUSE]

 --

HAPPY TO SHARE RESOURCES WITH

YOU.

>> NEXT WILL BE DR. AMBER

COURVILLE BUT WE'LL HAVE TO WAIT

A MOMENT AS WE HAD A SLIGHT

DISCONNECTION IN OUR POWER.

WE LOST OUR CONNECTION.

SO WE WILL BE RESUMING

MOMENTARILY.

THERE IT IT IS.

NEXT IS THE NIH CLINICAL

DIETITIAN'S PROGRAM.

>> I WANT TO THANK THE

ORGANIZERS HERE.

TODAY I'M GOING TO TALK ABOUT

THE METABOLIC UNIT AT THE

CLINICAL CENTER.

SO IT'S A„i UNIT THAT IS PRETTY

NEW AND I'LL GO INTO THAT

INFORMED THERE AND THEN I WANT

TO TALK ABOUT THE STUDIES WE ARE

DOING LOOK AT OBESITY AND BODY

WEIGHT REGULATIONS.

AND THEN I'LL DISCUSS A FEW OF

THE LESSONS I LEARNED FROM

WORKING WITH A LOT OF THESE

PATIENTS WHO ARE TRYING TO LOSE

WEIGHT OR MAINTAIN IT WHERE

THEIR WEIGHT IS AND THEN–r

STRATEGIES, DIFFERENT STRATEGIES

THAT I FIND WORK WELL FOR
WEIGHT„i

MANAGEMENT.

SOCIETY METABOLIC UNIT IS VERY

NEW.

IT WAS OPEN IN THE SPRING OF

2007.

IT'S A 10-BED, INPATIENT UNIT ON

THE FIFTH FLOOR OF THE

CLINICALLENT AND THEN WE ALSO

HAVE A ARE SMALLER UNIT WHICH

HOUSES OUR THREE METABOLIC

SUITES WHICH I'LL DISCUSS LATER.

IT WAS BASICALLY IMPLEMENTED

INTO THE COLLEGE CALL CENTER

UNITS BECAUSE OF THE FACT

THAT --

INTO THE CLINICAL CENTER UNITS

BECAUSE OF THE EPIDEMIC AND PART

OF THE OBESITY STRATEGIC PLAN.

SO THE MISSION OF THE UNIT IS TO

PROVIDE SPECIALIZED

STATE-OF-THE-ART FACILITIES FOR

COMPREHENSIVE AND COLLABORATIVE

RESEARCH ON FACTORS THAT DRIVE

THE–r OBESITY EPIDEMIC.

WE HAVE A LOT OF DIFFERENT

STUDIES AND INVESTIGATORS THAT

WORK WITH US ON THIS UNIT.

SO WE HAVE QUITE A FEW

SPECIALIZED SERVICES THAT WE

HAVE ON OUR OCCUPANT THAT AREN'T

AVAILABLE IN OTHER AREAS AT THE

HOSPITAL.

ONE OF THE FIRST THINGS THAT YOU

CAN SEE IS A PICTURE OF THE

FITNESS TESTING UP IN THE

RIGHT-HAND CORNER.

WE HAVE A FITNESS ASSESSMENT LAB

AND IN THIS LAB, WE HAVE A BUNCH

OF BIKES AND TREAD MILLS AND WE

CAN ACTUALLY DO ASSESSMENT OF

YOUR PHYSICAL FITNESS AND WE CAN

TELL HOW MANY CALORIES YOU BURN

WHILE EXERCISING.

IT GIVES US A GOOD IDEA OF HOW

YOU ARE COMPARED TO OTHER PEOPLE

YOUR AGE, POSSIBLY.

OR HOW YOU HAVE CHANGED OVER

TIME IF YOU HAVE DONE SOME TYPE

OF AN INTERVENTION.

WE ALSO DO ENERGY ASSESSMENTS.

WE HAVE METABOLIC CHAMBERS ON

THE 7th FLOOR AND THEN

METABOLIC CARTS WHICH WE CAN

TAKE INTO THE COURTROOMS MEASURE

RESTING ENERGY EXPENDITURE AND

I'LL DISCUSS THOSE MORE IN A

LITTLE WHILE.

AND THEN A THIRD MATH WE HAVE„i

AVAILABLE TO US IS DOUBLY

LABELED WATER WHERE WE GIVE

SOMEONE JUST LIKE A GLASS OF

WATER TO DRINK AND THEY

BASICALLY TAKE THIS DOUBLY

LABELED WATER AND THEN THEY CAN

GO HOME AND WE CAN GET ENERGY

ASSESSMENTS FOR WHEN THEY ARE AT

HOME AND THEY ARE NOT PUT IN A

ROOM OR IN A BED.

SO IT GIVES US ANOTHER OPTION

FOR ASSESSING HOW MANY CALORIES

YOU BURN THROUGHOUT THE DAY.

WE HAVE A BODY COMPOSITION LAB

SO WE HAVE MULTIPLE MEASUREMENTS

MORE WE CAN LOOK AT HOW MUCH

BODY FAT SOMEONE HAS OR HOW MUCH

MUSCLE THEY HAVE OR EVEN THE

AMOUNT OF BONE MASS A PERSON

HAS.

SO WE CAN LOOK AT BODY

COMPOSITION OVER TIME F YOU'RE

IN NUTRITION INTERVENTION AND

YOU WANT TO SEE HOW MUCH WEIGHT

PEOPLE ARE LOSING AND IF THEY

ARE LOSING IT IN BODY FAT OR IN

LEAN MASS, OR MUSCLE MASS, WE

HAVE MULTIPLE MACHINES TO DO

THIS.

WE HAVE A DEXAWHICH A LOT OF YOU

KNOW OF BECAUSE IT IS USED FOR

BONE MINERAL METABOLISM TO LOOK

AT OSTEOPOROSIS AND RISKS.

WE HAVE A BAUD POD LIKE IT LOOKS

LIKE AN EGG WITH A WINDOW
WHEREŤ—

WE PUT PEOPLE IN THERE AND WE

JUST LOOK AT HOW MUCH AIR THEY

DISPLACE WITHIN THE POD.

AND THAT GIVES US AN IDEA OF HOW

MUCH BODY FAT THEY HAVE AND WE

DO THINGS LIKE MEASUREMENTS

WHERE WE USE TAPE MEASURES AND

LOOK AT CIRCUMFERENCES AROUND

YOUR ARMS OR LEGS OR TORSO.

OR SKIN FOLD MEASUREMENTS WHERE

WE PINCH THE SKIN AND TAKE A

LOOK AT HOW MUCH FAT BETWEEN

YOUR LAYERS OF SKIN AND I

PROMISE IT DOESN'T HURT IT'S

JUST A SIMPLE PINCH AND IT IS

REALLY EASY AND QUICK

MEASUREMENT.

IF WE ARE DOING THINGS OUTSIDE

OF THE CLINIC WHERE WE DON'T

HAVE ACCESS TO THE SOPHISTICATED

MACHINES OR WE WANT A QUICK

MEASUREMENT, WE CAN DO THINGS

LIKE„i SKIN FOLDS OR THE OTHER

METRICS.

ON THE UNIT I'M MOSTLY INVOLVED

IN, DIETARY ASSESSMENT AREA, SO

WE DO ALL DIFFERENT KINDS OF

DIETARY ASSESSMENTS FROM JUST

LOOKING AT PEOPLE FOR HEALTH

RISKS LIKE DIABETES OR HEART

DISEASE, TO ACTUALLY HAVING THEM

WRITE DOWN EVERY THING THEY PUT

IN THEIR MOUTH.

I DON'T ALWAYS SAY EAT, BECAUSE

GUM GOES IN YOUR MOUTH AND YOU

DON'T NECESSARILY EAT IT.

WE WILL HAVE THEM WRITE DOWN FOR

3-7 DAYS, ABSOLUTELY EVERYTHING

THAT THEY EAT FOR THOSE DAYS AND

WE'LL ACTUALLY HAVE THEM COME

INTO THE CLINIC AND GO OVER IT

WITH THEM MAKE SURE WE HAVE

ENOUGH INFORMATION.

WE HAVE LITTLE PLASTIC 3-D

MODELS THAT LOOK LIKE FOOD AND

WE'LL USE THE MEASURING CUPS WE

HAVE AND WE HAVE THEM COME INTO

THE CLINIC AND GO OVER IT WITH

THEM TO GET THE INFORMATION AND

PUT IT INTO A COMPUTER PROGRAM

SO WE CAN ASSESS THE NUTRIENTS

THAT ARE IN WHAT THEY ARE EATING

AND SEE WHERE THEY MAY BE

LACKING NUTRIENTS OR WHERE THEY

MIGHT WANT TO MAKE CHANGES.

FOR DIETARY ASSESSMENT, WE ALSO

DO CONTROLS, LAB EXERCISES.

SO FOR EXAMPLE, YOU CAN SEE ON

THE BOTTOM OF THE SCREEN, WE

HAVE WHAT WE CALL A FOOD ARRAY.

SO PATIENTS ACTUALLY GO INTO THE

LABORATORY AND WE HAVE THIS FOOD

WHICH HAS BEEN WEIGHED OUT BY

OUR SPECIAL METABOLIC–r KITCHEN.

ALL THIS FOOD AND PRE-WEIGHED

AND IT'S A PRETTY GOOD AMOUNT OF

FOOD.

PROBABLY ENOUGH FOR 6-8

SANDWICHES THERE.

WE WANT PEOPLE TO NOT FEEL LIKE

THEY HAVE TO EAT EVERYTHING.

IT WOULD BE PRETTY DIFFICULT TO

EAT THIS AMOUNT OF FOOD.

IT'S ABOUT 10,000 CALORIES.

AND I DON'T THINK WE EVER HAD

ANYONE FINISH THIS, WHICH IS A

GOOD THING.

I THINK I'D PROBABLY POP.

BUT WITH THIS, WE CAN MEASURExzś

THE FOOD BEFOREHAND AND MEASURE

IT AFTER AND FIND OUT EXACTLY

WHAT NUTRIENTS THEY HAVE CHOSEN

TO EAT.

SO BASICALLY WE PUT THEM IN THE

ROOM WITH THE FOOD BUFFET AND WE

SAY, EAT UNTIL YOU'RE FULL.

AND SO WE DOCK THIS ON MULTIPLE

OCCASIONS OR ONE OCCASION,„i BUT

GIVES US AN IDEA WHAT HAVE THEY

WILL CHOOSE EAT UNTIL THEY ARE

FULL.

WE ALSO HAVE OTHER FACILITIES

AVAILABLE TO US ON THE CLINICAL

OR ON THE UNIT.

WE HAVE THREE VENDING MACHINES

WHERE WE CAN LOOK AT 24 HOURS OF

FOOD INTAKE.

SO WE WEIGH EVERYTHING BEFORE WE

PUT IT IN THE VENDING MACHINES

AND THEN WE WEIGH EVERYTHING

THAT THE PATIENTS GIVE BACK TO

US AND SO FOR 24 HOURS SLAYINGS]

FREE FEES FOOD WITHIN THE

VENDING MACHINES.

SO WE ARE ABLE TO GET AN IDEA OF

HOW THEY HEAT WAY AS WELL.

WE DO A LOT OF CONTROLLED

FEEDING STUDIES ON THE UNIT.

CONTROLLED FEEDING STUDIES ARE

BASICALLY STUD NIECE WHICH WE

WEIGH ALL THE FOOD THAT WE SEE

THE PATIENTS IN OUR SPECIAL„i

METABOLIC KITCHEN AND THEN THAT

WAY WE KNOW EXACTLY WHAT NEWT

ENDS THEY ARE GETTING.

SO IT MAY BE JUST CONTROLLED FOR

FAT AND CALORIES OR IT MAY BE

CONTROLLED FOR VITAMIN A OR

VITAMIN D.

AND THAT WAY WE KNOW THAT

EVERYONE IS GETTING EITHER THE

EXACT NUMBER OF OR EXACT SAME

AMOUNT OF SPECIFIC NUTRIENTS OR

THAT THEY ARE GETTING THE EXACT

AMOUNT THAT THEY NEED TO

MAINTAIN THEIR WEIGHT DEPENDING

ON WHAT THE STUDY IS REQUIRING.

SO WE DO A LOT OF THE CONTROLLED

FEEDING STUDIES AND I'LL TELL„i

BUT ONE OF THEM A LITTLE BIT.

THEN WE ALSO DO A LOT OF CEREAL

TESTING A LOT OF BLOOD WORK

TESTING WHERE WE ARE TAKING LOTS

OF BLOOD DRAWS OVER A PERIOD OF

TIME, USUALLY 3-4 HOURS WHERE WE

ARE TAKING BLOOD DRAWS TO LOOK

AT DIFFERENT METABOLITES IN THE

BLOOD.

SO TO GIVE YOU AN IDEA OF WHAT

THE TWO MEAN METHODS WE USE FOR

MEASURING ENERGY METABOLISM.

THIS IS WHAT KEY CALL THE

METABOLIC CART.

SO THE PERSON LAYS IN THE BED.

IT'S USUALLY AFTER WE HAVE WOKEN

THEM UP.

WE LET THEM GET-UP-AND-GO TO THE

BATHROOM AND THEN LAY IN BED

AGAIN FOR A HALF HOUR WHILE THE

MACHINE WARMS UP.

AND THEN, THE TEST TAKES ABOUT

45 MINUTES AND WHAT THEY DO IS

PUT THAT PLASTIC HOOD OVER YOUR

HEAD AND THEN TUCK IF YOU REAL

TIGHT.

SO THAT ALL OF THE OXYGEN YOU'RE

BREATHING IN AND ALL OF THE

CARBON DIOXIDE YOU'RE EXHALING

CAN BE MEASURED.

AND LIKE I SAID, IT TAKES ABOUT

45 MINUTES.

I THINK THE BIGGEST CHALLENGE

WITH IT IS MAKING SURE PEOPLE

DON'T FALL ASLEEP BECAUSE THEY

HAVE JUST GOTTEN UP OUT OF BED

AND YOU'RE TELLING THEM TO BE

QUIET AND STILL FOR 45 MINUTES

AND IT COULD BE A CHALLENGE.

IT GIVES US AN IDEA OF HOW MANY

CALORIES YOU BURN AT REST.

SO JUST IF YOU WERE JOUST LAY IN

BED ALL DAY AND NOT GET UP OR DO

ANYTHING, HOW MANY CALORIES YOUR

BODY TIKES KEEP YOUR HEART

PUMPING AND BRAIN THINKING.

THINGS LIKE THAT.

SO THAT IS ONE OF OUR METHODS.

ANOTHER MATH WE HAVE AVAILABLE

TO US IS OUR WHOLE ROOM

METABOLIC CHAMBERS.

THESE ARE NICE BECAUSE YOU GET

AN IDEA OF WHAT SOMEBODY BURNS

IN AN AVERAGE DAY NOT JUST WHEN

THEY ARE LAYING IN BED.

FOR 23„i HOURS WE PUT PEOPLE IN

THESE SUITES.

THEY HAVE A BED, THEY HAVE A

TOILET.

THEY HAVE SINK SO YOU CAN WASH

UP.

NICE MIRROR, THEY ALSO HAVE THE

COMPUTER WORKSTATION YOU'LL SEE

IN THE REST OF THE HOSPITAL WITH

THE DVD PLAYER, TELEVISION,

COMPUTER, A LOT OF THEM WILL

WORK WHILE IN THE CHAMBER.

SO THEY ARE ABLE TO GET A LOT OF

WORK DONE AS WELL THEN WE DOCK

BLOOD DRAWS ON THE PATIENTS

WHILE IN THERE.

WE HAVE PORTS THEY CAN STICK

THEIR ARMS THROUGH SO WE CAN DO

THE SERIAL TEST WEEG DO ON THE

USUAL UNIT.

THEY STAY IN THERE FOR ABOUT 23

HOUSE AND WE GET A GOOD IDEA OF

WHAT THEY WILL BURN ON A NORMAL

DAY FOR THEM -- 23 HOURS.

SOME STUDIES HAVE THEM EXERCISE

AND SOME DON'T.

IT JUST DEPENDS.

WE CAN GET AN IDEA OF HOW MUCH

ENERGY THEY BURN WHILE SLEEPING

AND WHILE EXERCISING.

VERY SHORT PERIODS OF TIME, WE

CAN TAKE A LOOK AT–r THAT.

FOR BODY COMPOSITION, I ALWAYS

LIKE SHOWING THESE PICTURES

BECAUSE I THINK THEY ARE KIND OF

NEAT AND PEOPLE GET A LITTLE BIT

OF A SHOCK WHEN THEY GET THEIR

OWN.

SO THIS IS A PICTURE OF A WOMAN

WHO HAD HER BODY COMPOSITION

TESTED FROM THE DEXA.

ON THE LEFT-HAND SIDE YOU CAN

SEE THE BONE SCAN AREA AND ON

THE RIGHT-HAND SIDE YOU CAN SEE

MORE OF THE SOFT TISSUE.

SO THE MUSCLE AND BODY FAT.

SO THIS IS THE TEST THAT IS

PRETTY QUICK AND IT ONLY TAKES

ABOUT 15 MINUTES DEPENDOTH SIZE

OF THE PATIENT.

OUR UNIT IS DIFFERENT OR OUR

DEXA IS DIFFERENT BECAUSE IT'S

WIDER AND BIGGER THAN THE WON

FIND IN THE NORMAL AREA OF THE

HOSPITAL IN THE RADIOLOGY

SECTION.

SO WE CAN MEASURE PEOPLE THAT

ARE OVER 300 POUNDS WHEREAS THE

OTHER ONE CANNOT.

SO IF YOU ARE OVER 300 POUNDS,

IT TAKES A LITTLE BIT LONGER TO

DO THE TEST BUT IT GIVES US A

VERY ACCURATE IDEA OF HOW MUCH

BODY FAT A PERSON HAS.

SO YOU CAN SEE ON THIS ONE, THIS

WOMAN ISES AT THE HIGH END OF

THE OVERWEIGHT RANGE FOR BMI.

HER BM SYMPT 29.

SO 30 IS OBESE --

HER BMI IS 29.

HER BODY FAT PERCENTAGE IS 45T

GIVES US AN IDEA.

YOU CAN HAVE A WIDE RANGE WITHIN

A SINGLE POINT OF A BMI AS TO

PERCENT BODY FAT AND ACTUALLY AN

ATHLETE WHO IS FIT COULD BE

OVERWEIGHT AND HAVE HIGH PORTION

OF MUSCLE BUT VERY, VERY LEAN

AND NOT HAVE VERY MUCH BODY FAT

AT ALL.

SO IT GIVES US ANOTHER IDEA OF

SOME OF THE BODY COMPOSITION TO

FIGURE INTO THE EQUATION.

SO WE DO QUITE A FEW DIFFERENT

TYPES OF RESEARCH ON THE

METABOLIC UNIT.

WE HAVE QUITE AWE FEW DIFFERENT

INSTITUTES WORK WITH US ON THE

UNIT.

SOME OF THE STUD THESE WE DO ARE

WHAT WE CALL NATURAL HISTORY

PROTOCOLS.

WE FOLLOW HEALTHY VOLUNTEERS

OVER TIME.

ONE OF THE MAIN STUDIES WE HAVE

ON THE UNIT WE ARE FOLLOWING

PEOPLE WHO ARE RECOMMENDED

WEIGHT SO ANYWHERE FROM A BMI OF

LIKE 19 AS FAR UP AS 60.

SO ANYWHERE FROM WHAT WE

CONSIDER NORMAL OR RECOMMENDED

WEIGHT DO SEVERELY OBESE.

AND WE FOLLOW THOSE PEOPLE OVER

TIME.

THEY COME BACK AT ONE YEAR

VISITS AND WE DO ALL KINDS OF„i

TESTS.

SO EVERY TEST I TOLD YOU ABOUT,

WE DO - THEM.

WE ALSO PROVIDE THEM WITH

FEEDBACK ON WHERE THEY ARE AT

THAT POINT IN TIME.

THAT WAY WE CAN TRACK IF THEY

CHANGED AS WELL OVER THE YEARS.

SO IT GIVES US A LITTLE BIT OF

AN IDEA OF, DO THESE PEOPLE GO

FROM OVERWEIGHT TO OBESE TO

EXTREME LEO BEES?

ARE THEY ABLE TO MAINTAIN THEIR

WEIGHT OVER THAT TIME AND WHAT

ARE THEIR PATTERNS THAT ARE

DIFFERENT OVER THAT PERIOD OF

TIME?

WE ALSO HAVE QUITE A FEW

INTERVENTION STUDIES ON THE

UNIT.

IN MOST OF THEM, WE PUT HEALTHY

VOLUNTEERS ON WEIGHT LOSS

INTERVENTIONS AND WE JUST

EXAMINE CERTAIN OUTCOMES STOW

REALLY DEPENDS ON THE STUDY.

SO I HAVE THREE STUDIES ON HERE.

THE FIRST IS A WORK SITE

WELLNESS PROGRAM AND IS THIS A

STUD THEY I WORK ON WITH JANET

DE JESUS.

IT'S THE "KEEP THE BEAT" STUDY.

WITH THIS STUDY, ALL THE

PARTICIPANTS ARE ENCOURAGED,

THEY ARE ALL FEMALE THAT WORK AT

NIH.

MOSTLY ON THIS CAMPUS, AND ALL

OF THEM ARE ENCOURAGED TO

INCREASE THEIR EXERCISE.

SO EXERCISE EVERY SINGLE DAY.

WE GIVE

TRACK THEIR EXERCISE.

THEY ARE SUPPOSED WRITE DOWN HOW

MANY„i STEPS THEY DID EVERY DAY.

SO WE TRACK THEIR EXERCISE OVER

THE PERIOD OF TIME.

THEY ARE ALSO RANDOMIZED INTO

ONE OF TWO GROUPS.

AND THOSE ARE THE --

THAT'S THE NUTRITION PART OF THE

INTERVENTION.

THEY EITHER GO TO A WEBSITE AND

TAKE A LOOK AT THE NUTRITION

INFORMATION ON MY --

IT'S NOT MY PYRAMID ANYMORE IT'S

"CHOOSE MY PLATE" OR ON THE

NHLBI WEBSITE.

THIS SAY LOT OF VERY GOOD

INFORMATION THERE REGARDING

NUTRITION.

OR THEY GET RANDOMIZED INTO A

NUTRITION INTERVENTION GROUP

WHERE THEY HAVE A DIETICIAN WHO

MEETS WITH THEM INDIVIDUALLY AND

AS A GROUP AND WE MEET WITH THEM

EVERY TWO WEEKS FOR THE FIRST

THREE MONTHS OF THIS STUDY AND

THEN EVERY MONTH FOR THE LAST

THREE MONTHS OF THE STUDY.

SO THEY ARE IN THE STUDY FOR SIX

MONTHS.

AND THE GOAL IS TO SEE WHICH OR

ONE OF THE GOALS IS TO SEE WHICH

GROUP ENDS UP HAVING BETTER

HEALTH OUTCOMES.

SO NOT NECESSARILY WHICH GROUP

LOSES THE MOST WEIGHT BUT WHICH

GROUP IMPROVES THEIR HEALTH THE

MOST.

SO THAT STUDY IS GOING TO FOR A

LITTLE WHILE LONGER.

WE ARE GEARING UP TO GET TOWARDS

THE END, HOPEFULLY SO WE CAN GET

RESULTS.

BUT THAT IS ONE OF THE MAIN

STUDIES WE ARE WORKING ON RIGHT

NOW THAT INVOLVES NUTRITION

INTERVENTION.

WE VALUES A ONE-YEAR OUTPATIENT

WELLNESS PROGRAM AND THAT IS FOR

ANYONE IN THE LOCAL AREA.

AND WITH THAT ONE, IT'S AN NIDDK

PROTOCOL WITH DR. SIM COITS AND

WE ARE DOING WEIGHT LOSS CLASSES

FOR THAT ONE AS WELL.

PEOPLE COME IN WITH THE GOAL OF

LOSING ABOUT ONE POINT ARE POUND

PER WEEK FOR THE YEAR.

THEY COULD LOSE ABOUT 50-100

POUNDS THEORETICALLY OVER THE

COURSE OF THE STUDY BECAUSE WE

ENCOURAGE THEM TO LOSE 1-2

POUNDS A WEEK W THAT STUDY, WHAT

WE DO IS WE DO INDIVIDUAL

NUTRITION COUNSELING WITH THEM

AT THE BEGINNING AND THEN WE

ALSO DO WEIGHT LOSS CLASSES.

SO EVERY TWO WEEKS, THEY COME IN

AND THEY GET WEIGHED IN AND THEY

DO NUTRITION EDUCATION COURSES

AND WEIGHT LOSS COURSES.

WE TALK ABOUT MINDFUL EATING,

FOCUSING ON WHAT YOU'RE EATING

WHEN YOU'RE EATING, REALLY

MAKING THEM AWARE OF DIFFERENT

NUTRITION TOPICS.

AND THEN, AT THE END OF THE

YEAR, WE–r LOOK AT DIFFERENT,
HOW

THEY CHANGED.Ť—

HAVE ALL LOST WEIGHTS

WHAT HAPPENED?

WHAT WAS DIFFERENT BETWEEN

NUTRITION?

BETWEEN BLOOD WORK?

MANY OF THE DIFFERENT INDEXES WE

LOOK AT FOR THE ONES THAT DID

LOSE WEIGHT COMPARED TO THE ONES

WHO DIDN'T.

THAT'S A REALLY INTERESTING

PROGRAM AS WELL.

ANOTHER ONE OF THE CONTROL

TRIALS THAT WE DO IS ANOTHER

NIDDK TRIAL WITH DR. KEVIN HALL

WHO YOU HAVE SEEN ALL OVER THE

NEWS IN THE LAST WEEK OR SO WITH

HIS NEW PROGRAM, IT'S

INTERVENTION WHERE WE PUT PEOPLE

ON EITHER A LOW CARB DIET OR LOW

LOW-FAT DIET.

THEY ARE BOTH WEIGHT LOSS DIETS

AND LOOK AT HOW THEY RESPOND

METABOLICALLY.

HOW DOES THEIR ENERGY

EXPENDITURE CHANGE?

HOW DOES THEIR BLOOD GLUCOSE

REGULATION CHANGE?

AND MANY OTHER FACTORS AS WELL.

WITH THAT STUDY, THEY COME IN

FOR A TWO WEEK INPATIENT.

SO THEY ARE IN THE HOSPITAL FOR

TWO FULL WEEKS.

WE PUT THEM ON AN EXERCISE

REGIMEN AND A CONTROLLED DIET SO

WE KNOW EXACTLY WHAT THEY ARE

GETTING THE WHOLE THING.

EVERYBODYING IS WEIGHED AND

MEASURED.

AT THE END OF THE STUDY, THEY

GET TO GO IN THE VENDING

MACHINES FOR THREE DAYS SO WE

GET TO SEE WHAT TYPES OF FOODS

THEY CHOOSE ONCE THEY ARE

FINISHED WITH THE STUDY.

SO IT'S REALLY INTERESTING

STUDY.

I THINK WE ARE ABOUT HALFWAY

THROUGH IT.

SO I WORKED WAY LOT OF DIFFERENT

PATIENTS IN THE WEIGHT LOSS

SETTINGS OVER THE YEARS AND I

HAVE DEFINITELY LEARNED A LOT

FROM WORKING WITH A LOT OF THESE

PATIENTS AND SUBJECTS ON THESE

STUDIES THAT WE HAVE AT THE

CLINICAL CENTER OVER THE LAST 3

YEARS.

SO WHAT HAVE I ACTUALLY LEARNED?

ONE THING THAT I HEAR A LOT IS,

I'M GOING TO START MY DIET ON

MONDAY.

OR I'LL START IT NEXT WEEK AFTER

I GO GROCERY SHOPPING.

AND I REALLY TRY TO GET PEOPLE

TO UNDERSTAND THAT THE WORD,

DIET, DOESN'T NECESSARILY MEAN

THAT YOU'RE RESTRICTING

EVERYTHING THAT YOU COULD

POSSIBLY RESTRICT.

I TRY TO GET PEOPLE TO REALIZE,

AND I THINK BOTH DR. HUBBARD AND

JANET BOTH MENTIONED THIS.

YOU NEED MAKE THOSE LIFESTYLE

MODIFICATION SO YOU NEED TO

CHANGE THE WAY YOU'RE DOING

THINGS ON A DAILY BASIS.

OTHERWISE, IT'S PROBABLY NOT

GOING TO WORK.

I HAD PEOPLE WHO LOST 100

POUNDS, VERY QUICKLY, AND THEY

START GAINING IT BACK BECAUSE

THEY REALLY HAVEN'T CHANGED

ANYTHING.

IT'S VERY EASY TO RESTRICT

YOURSELF COMPLETELY FOR A LONG

PERIOD OF TIME.

SO THAT'S ONE OF MY FAVORITE

THINGS I HEAR.

ANOTHER ONE IS, I WANT TO LOSE

10–r POUNDS THIS WEEK.

I GET THAT ONE PRETTY OFTEN.

OR I WANT TO LOSE 100 POUNDS IN

THE NEXT MONTH OR TWO.

AND I JUST REALLY TRY TO MAKE

PEOPLE UNDERSTAND THAT THE

SLOWER YOU LOSE THE WEIGHT, THE

MORE LIKELY YOU ARE MAKING

LIFESTYLE CHANGES.

IF YOU'RE NOT CHANGING YOUR

HABITS, YOU'RE MOST LIKELY NOT

GOING TO BE ABLE TO LOSE THAT

WEIGHT AND MAINTAIN IT.

AND I THINK SOMETIMES IT'S VERY

FRUSTRATING FOR PEOPLE BECAUSE

THEY WANT THAT IMMEDIATE

SOLUTION.

BUT AT OTHER TIMES, IT TAKES

THEM A LITTLE WHILE BUT THEY

UNDERSTAND IT'S THE WAY WE ARE

ALL„i TELLING THEM TO DO IT.

ANOTHER BIG THING IS THEY THINK

DIET AND EXERCISE GO

HAND-IN-HAND.

I HAVE SEEN A LOT OF PEOPLE WHO
4'

DO ONE OR THE OTHER AND ALL OR

NOTHING AND IT SEEMS LIKE THE

PEOPLE THAT ARE MOST SUCCESSFUL

TEND TO DO A LITTLE BIT OF BOTH.

THEY RESTRICT WHAT THEY ARE

EATING A LITTLE BIT.

THEY MAKE HEALTHIER CHOICES AND

MAYBE LOWER FAT, LESS FRIED

FOODS, LESS SNACKING.

BUT THE ONES THAT ACTUALLY ALSO

EXERCISE WHILE THEY'RE DOING, IT

TEND TO FAIR MUCH BETTER FROM

THE STUD THESE WE HAVE BEEN

DOING.

SO I REALLY ENCOURAGE PEOPLE TO

TRY AND MAKE SURE THAT THEY ARE

GETTING THE RECOMMENDED AMOUNT„i

OF EXERCISE.

AND ALSO TRYING TO EATxNMORE

HEALTHFULLY USING THE "MY PLATE"

THAT JUST CAME OUT WHICH IS

EASIER FOR PEOPLE TO UNDERSTAND

WHEN YOU'RE TRYING TO EXPLAIN TO

THEM WHEN THEY NEED TO DO TO GET

A BALANCED DIET.

SO SOME OF MY STRATEGIES, AND I

JUST THREW DOWN A BUNCH OF THE

TOP ONES I HAVE NOTICED WORKED

FOR A LOT OF PEOPLE WHOING ARE

EITHER LOSING WEIGHT OR TRYING

TO KEEP THEIR WEIGHT THE SAME

BECAUSE ESPECIALLY WITH THE ONE

YEAR STUDY WHERE WE ARE TRYING

TO GET THEM THO LOSE WEIGHT,

SOME HIT THEIR WEIGHT GOAL

HALFWAY THROUGH.

SO BY SIX MONTHS IF THEY WEREN'T

TOO BICYCLE BEGIN WITH, IF THEY

DIDN'T HAVE TOO MUCH TWEET LOSE,

AT 6 MONTHS THEY WERE ALREADY

TRYING TO MAINTAIN THEIR WEIGHT.

SO SOME OF THE THINGS THAT I TRY

TO GET PEOPLE TO DO IS MEASURE

PORTIONS.

REALLY MAKING SURE THAT YOU'RE

EATING AN APPROPRIATE SERVING.

SO IF IT'S A SERVING OF FIVE

PRETZELS, YOU KNOW YOU'RE

GETTING ABOUT 100 CALORIES OR

SO.

PEOPLE TEND TO START WITH

MEASURING THEIR PORTIONS

ESPECIALLY WHEN THEY ARE TRYING

TO LOSE WEIGHT AND THEN THEY GO

BACK AND MEASURE THEM ABOUT A

MONTH OR TWO LATER AND THEY

REALIZE THEIR PORTIONS HAVE

DOUBLED AND THEY THOUGHT THEY

WERE EATING THE SAME AMOUNT.

I REALLY ENCOURAGE PEOPLE TO

KEEP TRACK AND LOOK AT THE

LABELS AND MAKE SURE THAT YOU'RE

GETTING WHAT A SERVING IS.

ANOTHER THING IS KEEPING TRACK.

THERE ARE TONS OF APPLICATIONS

ON THE INTERNET NOW AND PEOPLE

ARE USING THEM AND THEY ARE

FINDING THAT YOU GET IMMEDIATE

FEEDBACK FROM THEM.

YOU CAN PUT IN EVERYTHING YOU

HAVE EATEN ALL DAY AND GET

IMMEDIATE FEEDBACK EXPLAINING

THERE IS HOW MANY CALORIES AND

IF YOU HAVE BEEN WORKING LIKE MY

PATIENTS HAVE BEEN WORKING WITH

ME AND THEY KNOW HOW MANY

CALORIES THEY ARE SUPPOSED TO

GET, THEY CAN SAY I'M OVER AND

THEN THE NEXT DAY THEY REALLY

TRY TO STAY UNDER.

OR YOU CAN TRACK HALFWAY THROUGH

THE DAY AND YOU'LL SEE IT

HALFWAY THROUGH THE DAY YOU'RE

ALREADY 3/4 OF THE WAY DONE WITH

YOUR CALORIES SO YOU HAVE TO CUT

BACK AT NIGHT.

SO I THINK KEEPING TRACK WILL

REALLY HELP PEOPLE.

EXERCISING DAILYIA.

PUSH THAT ENOUGH.

THERE IS SO MANY OTHER BENEFITS

TO EXERCISE THAN„i JUST WEIGHT

MANAGEMENT.

EXERCISE HELPS WITH MOOD AND

YOUR CARDIOVASCULAR HEALTH.

SO REALLY TRYING TO GET THE

RECOMMENDED AMOUNT OF EXERCISE

EVERY DAY.

MOST PEOPLE WHO ARE TRYING TO

LOSE WEIGHT NEED AT LEAST 60

MINUTES A DAY AND PEOPLE WHO ARE

TRYING TO MAINTAIN THAT WEIGHT

LOSS TEND TO EXERCISE ABOUT THAT

MUCH AS WELL.

SO REALLY TRYING TO GET AT LEAST

30 MINUTES A DAY IF POSSIBLE

YOU'RE TRYING TO LOSE WEIGHT,

GET 60 MINUTES OF MODERATE

INTENSITY EXERCISE GETTING

YOURSELF OUT THERE, NOT JUST

WALKING THE DOG AND STOPPING

EVERY FIVE FEET.

ANOTHER THING DO I RECOMMEND AND

SOME PEOPLE ARE ON THE FENCEŤ—

WITH THIS ONE BUT I RECOMMEND

THAT PEOPLE WEIGH THEMSELVES

REGULARLY AND BY REGULARLY, I

DON'T MEAN OF FIVE TIMES A DAY.

I USUALLY TELL PEOPLE TO TRY AND

KEEP TRACK ABOUT ONCE A WEEK.

SAME DAY AND SAME TIME OF THE

DAY.

IT GIVES AN IDEA OF WHERE YOU

ARE.

IF YOU'RE A PERSON WHO LOST 50

POUNDS AND YOU WANT TO TRY TO

KEEP IT OFF, IF YOU DON'T KEEP

TRACK, MOST LIKELY IT WILL START

TO CREEP UP VERY SLOWLY BUT IT

WILL START TO CREEP UP.

SO YOU REALLY HAVE TO CATCH IT

AT THE BEGINNING SO YOU DON'T

HAVE PROBLEMS.

ANOTHER THING, DO NOT GIVE UP.

I SEE A LOT OF PEOPLE WHO ARE,

IF IT'S NOT COMING UP OR OFF

FAST ENOUGH, THEY SAY IT'S NEVER

GOING TO HOSPITAL AND THEY

TOLLINGY GIVE UP AND THEN SIX

MONTHS LATER --

NEVER GOING TO HAPPEN AND THEN

THEY GIVE UP.

YOU MAY HAVE A BAD DAY OR WEEK.

KEEPxD TRYING.

THAT'S A BIG THING.

ALSO MONITORING YOUR PROGRESS.

I HAVE PEOPLE KEEPING WEIGHT

LOGS WHERE EVERY WEEK THEY HAVE

A LOG BY THEIR SCALE.

THEY ARE KEEPING TRACK OR USING

ONE OF THE MOBILE PHONE APPS OR

COMPUTER APPLICATIONS.

AND THEN LASTLY, HAVE A REALLY

GOOD SUPPORT NETWORK.

IT'S REALLY HARD WHEN YOU HAVE

COWORKERS OR FAMILY MEMBERS THAT

DON'T SUPPORT WHAT YOU'RE TRYING

TO DO, ESPECIALLY WITH WEIGHT

LOSS.

THE OFFICES WITH ALL THE COOKIES

AND CANDIES LAYING ALL OVER THE

PLACE.

IT DEFINITELY SEA TWISABOTAGE

YOUR EFFORTS.

SO REALLY TRYING TO HAVE THAT

GREAT SUPPORT NETWORK THERE.

IF YOU HAVE THOSE TEMPTATIONS

AND YOU'RE WORRIED, %),%9

SOMEBODY RIGHT THERE THAT WILL

SUPPORT YOU AND YOU CAN TALK TO

THROUGH YOUR EFFORTS, DEFINITELY

HELPS.

WITH THAT, I THANK YOU FOR YOUR

ATTENTION.

[APPLAUSE]

>> I'D LIKE TO BRING TO THE

STAGE MS. KAREN MILLER KOVACS

FROM WEIGHT WATCHERS

INTERNATIONAL.

>> WE ARE GOING TO CHANGE GEARS

TODAY.

ED WHAT WE ARE GOING TO TALK

ABOUT IS THE DIFFERENCES BETWEEN

MEN AND WOMEN WHEN IT COMES TO

WEIGHT LOSS.

THIS HAS BEEN A REALLY

INTERESTING TOPIC FOR ME.

AND WHAT I'M GOING TO BE SHARING

WITH YOU IN A VERY

NON-SCIENTIFIC WAY, IS

ACCUMULATION OF ABOUT 10 YEARS

OF RESEARCH, MOST TESTIFY

CONDUCTED IN A PROPRIETARY WAY

BY WAIT WATCHERS INTERNATIONAL

TO LOOK AT PSYCHOMETRIC

DIFFERENCES BETWEEN MEN AND

WOMEN WHEN IT COMES WEIGHT LOSS.

THIS IS A REALLY IMPORTANT AREA

AND I BELIEVE ONE THAT HAS BEEN

SERIOUSLY UNDER STUDIED.

YOU CAN SEE FROM THIS SLIDES,

WEIGHT, ACCESS WEIGHT, IS AN

ISSUE FOR BOTH MEN AND WOMEN.

AND YET, WHEN WOi LOOK AT
STUDIES

THAT ARE BEING DONE, WHEN WE

LOOK AT CLINICAL TRIALS THAT ARE

DONE THAT RELY ON VOLUNTEERS

COMING IN, WE ARE VERY HUMAN.

THE STUDIES TEND TO BE ALL WOMEN

OR IF BOTH GENDERS ARE ACCEPTED,

YOU CONSISTENTLY SEE ABOUT NO

MORE THAN 15%.

THIS POSES A REAL PROBLEM.

THEN YOU WANT TO DO A

SUBANALYSIS, YOU DON'T HAVE A

SUFFICIENT NUMBER TO REALLY BE

ABLE TO TAKE A LOOK AT THINGS.

SO, I'M GOING TO TRY TO BE A

LITTLE OUT THERE TODAY SINCE

THIS IS AN NIH AND SCIENCE

COMMUNITY TO CHALLENGE US IN

TERMS OF THINKING THAT JUST AS

YOUR RIGHTFUL CRITICISM WAS

LAUNCHED DECADES AGO WHERE THE

CONVENTION WISDOM ASSOCIATED

WITH HEART DISEASE AND THE

TREATMENT OF HEART DISEASE WAS

BASED ALMOST EXCLUSIVELY ON

STUDIES THAT HAVE BEEN DONE
FOR–r

MEN, THE SAME CAN BE SAID IN

TERMS OF WEIGHT MANAGEMENT AND

WOMEN.

AND I WOULD CHALLENGE US TO SAY

THAT WEIGHT LOSS PROGRAMS,

WEIGHT LOSS WISDOM, WEIGHT LOSS

INFORMATION AND KNOWLEDGE THAT

IS OUT THERE AND DIRECTED TO THE

PUBLIC, IS BASED ON EXCLUSIVELY

ON WHAT WORKS FOR WOMEN.

AND IN FACT, PERHAPS NOT SO MUCH

ON A PHYSIOLOGICAL OR METABOLIC

BASIS, WOULD THAT HAVE A

DIFFERENCE IN TERM OF TREATMENT

RECOMMENDATIONS IN TERMS OF

OTHER ASPECTS OF LIFE?

MEN DESERVE BETTER THAN WHAT WE

HAVE HISTORICALLY GIVEN THEM.

SO AS I SAID, HOPEFULLY A LITTLE

BIT OF A FUN WAY, WE WILL TAKE A

LOOK WHAT THE WE HAVE COME UP

WITH SO FAR IN TERMS OF

DIFFERENCES BETWEEN MEN AND

WOMEN.

I ALWAYS FEEL BAD WHETHER I

SPEAK ON THE SUBJECT BECAUSE

TALK ABOUT STEREOTYPING.

I MEAN, I'M GOING SAY MEN DO

THIS AND WOMEN DO THAT.

BUT PLEASE UNDERSTAND, I DO GET

THERE IS A WIDE RANGE AND SO,
IN„i

TERMS OF WHAT PERTINES AN

INDIVIDUAL BASIS, AS OPPOSED TO

JUST GENDER DIFFERENCES IN

GENERAL, IT IS A LITTLE BIT

DIFFERENT.

BUT LET'S START WITH MOTIVATORS.

WHAT ARE THE MOTIVATORS IN TERMS

OF WEIGHT LOSS AND DO THEY

DIFFER BETWEEN MEN AND WOMEN?

EQUIPPEDLY OUR RESEARCH IN THIS

AREA HAS DEMONSTRATED THAT THERE

IS AN AGE BREAK BETWEEN THE

GENDERS.

GENERALLY MAN, WOMAN, UNDER THE

AGE OF 40, APPEARANCE TENDS TO

BE THE DRIVER IN TERMS OF A

MOTIVATOR OR A TRIG TORE LOSE

WEIGHT.

FOR WOMEN, THAT HOLDS TRUE OVER

45.

FOR MEN, IT DOESN'T.

THEY SWITCH TO HEALTH.

WHEN ARE NOT SURE EXACTLY ALL

THE REASONS BEHIND THIS,

CERTAINLY HEALTH ISSUES BECOME

MORE PREVALENT OVER THE AGE OF

45 IN BOTH MEN AND WOMEN.

WE HAVE SOME HYPOTHESIS

ASSOCIATED WITH THE PREVALENCE

OF MEN AND HEALTH AND ONE IS

THAT IT'S AT THAT TIME THAT MEN

CAN BE GAINING WEIGHT AND THEY

CAN BE GOING TO THEIR DOCTOR AND

HEAR THEY ARE GOING TO HAVE A

HEART ATTACK IF YOU DON'T TAKE

POUNDS OFF, WHICH CAN BE A MOAT

VARY FOR SOME MEN.

BUT ANOTHER ASPECT OF THIS HAS

TO DO WITH SOCIETAL NORMS

ASSOCIATED WITH APPEARANCE.

SO WE WON'T KNOW UNTIL THE

FUTURE WHETHER THAT AGE BREAK

STILL HAPPENS BUT, THE MEN THAT

ARE OVER 45 NOW HAVE NOT LIVED

IN THE WORLD OF THE YOUNGER MEN

WHERE MEN HAVE BEEN OBJECTIFIED

AS SEX OBJECTS AND HAVE A

GREATER PRESSURE, IF YOU WILL

N-TERMS OF APPEARANCE.

R., WHICH IS PART OF WHAT

SOCIETY THAT WE LIVE WHEN NOW.

ONE OF THE BIGGEST DIFFERENCES

BETWEEN MEN AND WOMEN HAS TO DO

WITH THE AWARENESS OF ACCESS

WEIGHT.

IN THE WORK THAT WE HAVE DONE AT

WAIT WATCHERS, THE TYPICAL GUY

HAS TO BE OBESE BEFORE HE

PERCEIVE THAT IS THERE IS ANY

ACCESS WEIGHT TO LOSE AT ALL.

CONVERSELY, WOMEN IN GENERAL,

TEND TO BE MUCH MORE WEIGHT

CONCERNED AND CONCERNED ABOUT

WEIGHT AT A LOWER WEIGHT.

SO WE HAVE MANY WOMEN WHO DON'T

EVEN NEED TO LOSE WEIGHT FOR

HEALTH REASONS AND YET HAVE A

DESIRE TO LOSE WEIGHT.

IN GENERAL WE HAVE MANY MEN WHO

WOULD BENEFIT FROM WEIGHT LOSS

AND DO NOT SEE THEMSELVES AS

HAVING A PROBLEM AT ALL.

AND THIS IS REALLY IMPORTANT

BECAUSE WE KNOW THAT AS THE

HEALTH AFFECTS GO WITH INCREASED

WEIGHT AND THE BMI BREAKS FROM

TERMS OF INCREASED DISEASE RISK

WITH WEIGHT TEND TO BE THE SAME

FOR MEN AND WOMEN, THAT THIS IS

REALLY OF CONCERN.

ONE OTHER THING THAT WE SEE

WITH, AND I THINK I'M GOING TO

GO INTO THIS LATER BUT I WANTED

TO BRING IT UP NOW TOO, MEN AND

WOMEN WHEN IT COMES WEIGHT, THEY

SPEAK DIFFERENT LANGUAGES.

IT'S IMPORTANT FOR US TO

RECOGNIZE THAT.

MEN AREN'T FAT.

THEY ARE BIG.

I'M LARGE.

THEY DON'T WANT TO LOSE WEIGHT.

THEY WANT TO GET FIT.

TO SAY TO A WOMAN, YOU'RE

LOOKING PRETTY SKINNY S A

COMPLIMENT.

TO SAY THAT TO A GUY IS AN

INSULT.

AND I THINK THAT IS SOMETHING WE

HAVE TO BE VERY AWARE OF IN

TERMS OF THE LANGUAGE THAT WE

USE IN TERMS OF WEIGHT LOSS

INTERVENTIONS AS WELL AS JUST

CULTURALLY AND AS GENDERS

SPEAKING TO EACH BOTHER THIS

VERY IMPORTANT TOPIC.

ANOTHER KEY ATTRIBUTE WE FOUND

THAT DIFFERENTIATES BETWEEN THE

JEEPED SERS WHEN IT COMES TO

LOSING WEIGHT --

BETWEEN THE JEEPEDDERS --

THE OBJECTIVE IS THE SAME --

GENDERS.

THE METHING ONIES ARE THE

SAME --

METHODOLOGIES --

BUT THE THOUGHT PROCESS

ASSOCIATED WITH IT IS VERY

DIFFERENT.

MEN TEND TO BE TOP-DOWN

THINKERS.

WHAT I CALL TOP-DOWN THINKERS.

THEY WANT TO GET THE PICTURE,

THE BIG PICTURE AND NOT GET HUNG

UP IN A LOT OF DETAILS.

SO BASICALLY TELL ME WHAT I NEED

TO DO.N%

I GET THE GIST OF IT.

NOW LET ME GO OUT AND DO IT.

WOMEN ON THE OTHER HAND,

DISSECT.

THEY WANT TO KNOW THE DETAILS.

THEY BUILD FROM THE BOTTOM UP.

WITHIN OUR POINT SYSTEM, FOR

THOSE WHO ARE FAMILIAR WITH IT,

WE HAVE IN WEIGHT ONERS, A POINT

SYSTEM.

THE MACRO NUTRIENTS PLAC UP THE

POINT.

YOU GET SO MANY POINTS FOR THE

DAY.

TYPICAL GUY:

HOW MANY POINTS DO I GET FOR A

DAY?

HOW DO I FIND THEM?

WHERE ARE THEY?

I'M GOD TO GO.

WOMEN:

HOW ARE THE POINTS CALCULATED?

WHY IS IT CALCULATED THAT WAY?

HOW DOES FOOD IN A POINT BECOME

A MEAL?

HOW DO MEALS BECOME A DAY AND

HOW MANY POINTS DO I HAVE FOR

THE DAY BUT TO BUILDUP?

COMPLETELY DIFFERENT THINKING.

AND SO, IN A APPROACHING THE

GENDERS, THE STRATEGIES NEED TO

BE USED IN TERMS OF GETTING THEM

STARTED AND GETTING THEM

THINKING, ARE DIFFERENT.

GENERALLY, AGAIN, WOMEN BEING

THAT BOTTOM-UP THINKERS, DETAIL

ORIENTED, THEY WANT LOTS OF

IDEAS.

THEY WANT A LOT OF TACTICS.

YOU COULD DO THIS OR THIS OR

THIS.

YOU MIGHT TRY THIS OR DO THAT.

YOU MIGHT WANT TO TRY --

XYZ BRAND, LOW FAT MAYONNAISE

BECAUSE IT HAS A SLIGHTLY TARTER

TASTE THAN BRAND ABC.

WOMEN REALLY RILEY LIKE THAT AND

THEY WANT DETAILS.

WHAT TO EAT, WHEN TO EAT, HOW

MUCH TO EAT, AND THEY WANT ALL

OF THAT INFORMATION BEFOREŤ—
THEY

GET STARTED.

BECAUSE THEY WANT TO GO IN

FEELING VERY FULLY IN CONTROL.

AGAIN MEN WITH THAT TOP-DOWN

THINKING, THEY WANT STRATEGIC

PLAN.

SIMPLE INSTRUCTION.

EAT THIS, DON'T EAT THIS.

AND BASIC INFORMATION SO THAT

THEY CAN GET STARTED TO LEARN.

THEY WILL GET STARTED AND AT THE

END, ONE OF THE INTERESTING

THINGS THEY TEND TO END UP IN

THE SAME PLACE.

THE DIFFERENCE THAT WOMEN NEED

THE DETAILS TO GET STARTED AND

MEN DON'T WANT THE DETAILS TO

GET STARTED BUT ONCE THEY GET

STARTED AND HAVE SOME SUCCESS,

THEN THEY IS THAT RIGHT ASK

QUESTIONS THEN I WANT TO KNOW

WHY AND,WORKS AND TO MANIPULATE

IT THAT WAY.

END UP INDEPENDENT SAME PLACE

BUT HOW THEY GET THERE ARE TWO

VERY DIFFERENT PATHS.

ONE OF THE THINGS THAT WE OFTEN

HEAR IN THE MEDIA AND CULTURALLY

IS THAT, HAS TO DO WITH

EMOTIONAL EATING.

THIS HAS BEEN ANIER WHERE I

THINK THAT LANGUAGE AGAIN COMES

VERY MUCH INTO PLAY.

WOMEN WILL SAY TO THEMSELVES AS

BEING EMOTIONAL EATERS.

AND THEY ARE.

BUT WHAT WE HAVE FOUND SAID THAT

MEN ARE EQUALLY EMOTIONAL IN

THEIR EATING IT'S JUST THE

DIFFERENT EMOTIONS TRIGGER THE

OVEREATING.

WOMEN TEND TO ASSOCIATE

OVEREATING WITH NEGATIVE

EMOTIONS.

I'M BORED.

I'M LONELY.

I'M SAD.

AND I OVEREAT IN THOSE

SITUATIONS OUT OF SEEKING

COMFORT FOR THOSE NEGATIVE

EMOTIONS.

MEN ON THE OTHER HAND, ALSO

RESPOND TO EMOTION BUT THEY TEND

TO RESPOND TO POSITIVE EMOTION

AND OVEREAT IN THOSE TIMES OF

VERY POSITIVE EMOTIONS.

THEY ARE HAVING A LOT OF FUN.

THEY ARE HAPPY.

THEY ARE JOYFUL.

THOSE ARE THE TIMES THAT MEN

TEND TO BE MORE PRONE TO

OVEREAT.

ZIMM A HIGH PERCEIVED LEVEL OF

NUTRICIAN DIET KNOWLEDGE.

THEY ALSO HAVE A LOT OF

EXPERIENCE.

IN THIS COUNTRY, THERE ARE NO

FEMALE DIETING VIRGINS I'M

AFRAID.

THEY START YOUNG.

AND WE JUST GET MORE AND MORE

EXPERIENCE AS THE YEARS GO ON.

I WAS TALKING WITH ANNA EARLIER,

KNIVES CHINA LAST WEEK AND IN A

VERY WARPED WAY, SO REFRESHING

TO SEE A COUNTRY OF DIETING

VIRGINS.

THEY DON'T KNOW WHAT THEY DON'T

KNOW AND IT'S SO INSPIRING TO BE

ABLE TO GIVE THEM THAT INITIAL

KNOWLEDGE TO GET THEM STARTED

AND NOT HAVE TO GO THROUGH ALL

THE BAGGAGE THAT IS SO PREVALENT

WITH WOMEN AND WEIGHT.

AND WOMEN LIKE TO MAKE WITH THAT

DETAIL, THEY LIKE TO MAKE–r A

LITTLE OF LITTLE CHANGES, GET

STUCK IN THE DETAILS.

MEN TONED HAVE LESS KNOWLEDGE

WHETHER IT COMES WEIGHT

MANAGEMENT, LESS EXPERIENCE, AND

THEY TEND TO PREFER TO MAKE

BIGGER CHANGES.

SO WONG OF THE THINGS I OFTEN

SAY IN TERMS OF THE BATTLE OF

THE BULGE IS THAT BOTH MEN AND

WOMEN FIGHT THE BATTLE BUT THEY

DO IT VERY DIFFERENTLY.

WE WOMEN, WE EVER THE 100 YEARS

WARS.

WE ATTACK.

WE RETREAT.

WE NEGOTIATE.

WE ARE CONSTANTLY AT WAR WITH

DIFFERENT LEVELS OF INTENSITY.

BECAUSE WEIGHT TENDS TO BE VERY

MUCH ON OUR MINDS.

SO WE ARE CONSTANTLY AWARE OF

IT.

MEN, AS I SAID, TYPICAL GUY, HAS

TO BE OBESE BEFORE HE CAN EVEN

THINK HE NEEDS„i TO SHED WEIGHT

BUT ONCE THAT MOMENT OF

AWARENESS COMES, ONCE THAT

DECISION IS MADE, IT'S THE

INVASION OF NORMANDY.

I'M GOING LOSE WEIGHT.

THIS IS HOW I'M GOING DO IT.

THEY JUST WANT TO GET IT DONE.

VERY DIFFERENT IN APPROACHES.

FOOD IS DIFFERENT, EXERCISE IS

DIFFERENT TOO.

WOMEN GENERALLY DON'T LIKE TO

EXERCISE.

DOESN'T MEAN WE DON'T DO IT,

PARTICULARLY WHEN THEY ARE IN A

WEIGHT LOSS EFFORT, THEY DO.

BUT IT'S A MEANS TO AN END.

THEY EXERCISE BECAUSE THEY HAVE

TO EXERCISE BECAUSE THEY WANT TO

CONTROL THEIR WEIGHT.

IT IS NOT OUT OF THE JOY OF

SWEATING EXEXERTING TIME AND

EFFORT IN EXERCISE THAT WOMEN

SEEK OR RECEIVE PLEASURE FROM

EXERCISE.

INTENSITY TENDS TO BE A TURNOFF.

WOMEN LIKE TO KEEP IT SIMPLE.

WALKING.

ACTIVITIES OF DAILY LIVING AND

THE LIKE.

YOU GOT ALL THESE HIGH-TECH

DEVICES OUT THERE.

THERE IS A FEW BUT IT'S A RARE

WOMAN YOU SEE WITH THE POLAR

HEART–r MONITOR WITH THE STRINGS

COMING OFF AND ALL OF THE

ELECTRONIC EQUIPMENT.

BOYS AND THEIR TOYS MUCH MORE

LIKELY TO BE DONE BY MEN.

THY TONED LIKE GENERAL

INFORMATION AND LESS WELL

DEFINED GOALS.

AND AGAIN, SIMPLICITY IS KEY.

IF YOU'RE DOING SOMETHING YOU

DON'T WANT TO DO BUT YOU GOT TO

DO IT, THEN YOU JUST DON'T WANT

TO SPEND YOUR LIFE THINKING

ABOUT IT,Ť— DOING IT AND PLAYING

WITH THE PIECES AND PARTS OF IT.

MEN, ON THE OTHER HAND, DO TEND

TO ACTUALLY GET PLEASURE FROM

THE ACT OF EXERCISE ITSELF WHERE

MEN ERR IS THAT THEY TEND TO

OVER ESTIMATE THE OUTCOME FROM

EXERCISE.

YOUTUBE A TYPICAL GUY, 30 YEARS

OLD, GAINED WEIGHT, HE WON'T

THINK HE HAS TO CHANGE HIS

INTAKE.

I JUST GOT TO GET TO THE GYM.

IF ONLY I GOT TO THE GYM.

UPON THEN I'D LOSE THE WEIGHT

AND THEY DON'T.

BECAUSE IT TAKES BOTH.

THEY LIKE TO SWEAT.

THEY LOVE THEIR TOYS.

AND THEY LIKE SEEING THE

PROGRESS IN QUANTITATIVE CHANGES

SUCH AS MILES RUN, NUMBER OF

REPS, AND THE NUMBER OF CALORIES

BURNED WHICH WOMEN TEND TO FOCUS

ON.

ANOTHER INTERESTING THEY THINK

WE HAVE FOUND AND AGAIN, THIS

COMES DOWN TO SEMANTICS IN TERMS

OF THE DIFFERENCES OF THE–r

JANUARYERS.

SUPPORT.

WE OFTEN LAWYER THAT WOMEN WANT

AND NEED A LOT EVER SUPPORT WHEN

IT COMES WEIGHT MANAGEMENT.

INTERESTINGLY ENOUGH, WE FOUND

THAT MEN NEED SUPPORT.

HOWEVER, THIS IS A REAL KEY

POINT FOR COMMUNE KATEING

BETWEEN THE GENDERS, IS THE–r

DEFINITION OF SUPPORT IS VERY

MUCH DIFFERENT.

WOMEN TEND TO WANT LOTS AND LOTS

OF EVENTUAL SUPPORT.

YOU'RE LOOKING GOOD, FEELING

GOOD.

THAT'S GREAT.

THAT'S WONDERFUL.

AND THEY REALLYŤ— APPRECIATE

UNSOLICITED COMMENTS AND

FEEDBACK.

AND WOMEN GENERALLY LIKE A WIDE

CIRCLE OF SUPPORT.

COWORKERS, FRIENDS, FAMILY

MEMBERS, THE MORE, THE BETTER.

THIS CONTRAST SHARPLY FROM MEN.

MEN TEND TO WANT PRACTICAL

SUPPORT.

THEY WANT INFORMATION AND THEY

TESTAMENT WHEN THEY ASKED FOR

IT.

SO SPECIFIC INFORMATION --

THEY WANT IT WHEN IT'S BEEN

ASKED FOR.

AND OUR RESEARCH CONSISTENTLY

SHOWN THAT FOR MEN, THE SINGLE

BIGGEST SOURCE OF NUTRITION AND

WEIGHT MANAGEMENT INFORMATION IS

THEIR SPOUSE.

OVER A DOCTOR, OVER WRITTEN

INFORMATION THAT THEY HAVE SEEN.

THE SPOUSE IS THE SOURCE.

AND THIS ONE AREA CAN MAKE THE

BIGGEST DIFFERENCE FROM TERMS OF

MEN AND WOMEN AND ABILITY TO

SUPPORT EACH OTHER.

ONE OF THEINAL GENES I USE THAT

KIND OF USUALLY BRINGS IT HOPE

IS --

HOME, SAY YOUR TOILET IS BROKEN.

WHAT DOES A WOMAN DO?

SHE CALLS HER NEIGHBOR, CALLS

HER COWORKER, CALLS THREE

DIFFERENT PLUMMERS PLUMMERS AND
THEN ASKS

HER HUSBAND.

WHAT DO YOU THINK?

DO THIS DO THIS?

MEN, NO TOL R IT'S LIKE, I FIX

IT MYSELF OR CALL THE PLUMBER.

THIS IS IT.

I'M FLOTGOING AROUND DOING A

SURVEY OF HOW DO I FIX THE

TOILET AND HOW MUCH SHOULD IT IS

NOT WHEN IT COMES WEIGHT

MANAGEMENT, THIS IS THE KEY

DIFFERENCE WHERE GENDERS GET IN

EACH OTHER'S WAY PARTICULARLY

WOMEN GETTING IN THE WAY OF MEN

IN TERMS OF WEIGHT LOSS.

IF A GUY ASKS FOR A PIECE OF

INFORMATION, HE WANTS THE PIECE

OF INFORMATION AND THAT'S IT.

HE IS NOT, WHEN YOU GO TOUT EAT,

THE GUY GENERALLY DOESN'T WANT

TO HEAR, WELL, GEE, MAYBE YOU

SHOULD HAVE THE SALMON, I THINK

THAT'S A GOOD CHOICE.

YOU VEHICLE A BAKED POTATO BUT

LEAVE THE SOUR CREAM OFF AND

BUTTER ON.

THAT'S HOW FEMALES THINK.

IF THE GUY SAID, WHAT DO YOU

THINK I SHOULD HAVE FOR DINNER,

THEN YOU GIVE HIM THE SALMON

WOULD BE A GOOD CHOICE.

AND THAT'S IT.

SO, THIS IS AN AREA WHERE A LOT

CAN BE DONE BUT IT'S WORTH IT.

BECAUSE WHEN THE GENDERS UNITE

GOOD THINGS CAN HAPPEN.

SEVERAL STUDIES THAT HAVE BEEN

DONE THAT DEMONSTRATE THAT

SPOUSES, MALE, FEMALE PARTNERS,

WORKING TOGETHER HAVE GREATER

WEIGHT LOSS SUCCESS THAN WHEN

PEOPLE ARE DOING ALONE.

AND WHY IS THAT?

IT MAKES SENSE IN SO MANY WAYS

BECAUSE THE GENDERS COMPLIMENT

EACH OTHER.

WOMEN HAVE A LOT TO LEARN FROM

MEN IN THE AREA OF MAKING

CHOICES, NOT PLAYING SO MUCH IN

THE AREA OF EXERCISE.

MEN HAVE A LOT TO LEARN FROM

WOMEN IN TERMS OF KNOWLEDGE

ABOUT FOOD AND NUTRITION, MAKING

CHOICES THAT WAY.

SO THERE IS A LOT THAT CAN BE

DONE AND ALL OF THE DETAILS AS

TO WHY WHEN YOU PUT GENDERS

TOGETHER, IS WEIGHT LOSS SUCCESS

GREATER?

YOU DON'T REALLY KNOW ALL THE

ANSWERS.

BUT JUST A FEW THAT MAKE THE

MOST SENSE IS BECAUSE THERE IS A

SHARED EATING ENVIRONMENT.

COMMON GOALS WHEN COMMUNICATED

IN A COMPLEMENTARY FASHION WORK.

SHARED ACTIVITY AND AGAIN MUTUAL

SUPPORT.

EVEN THE SIMPLE THINGS IN TERMS

OF IF A GUY RECOGNIZES THAT HIS

FEMALE PARTNER TENDS TO EAT OUT

OF MEGGATIVE EMOTION AND BEING

THERE TO SUPPORT, THE WOMAN

UNDERSTANDING THE GUY TENDS TO

OVEREAT ON HAPPY OCCASIONS,

SUPPORT.

IN THOSE SITUATIONS.

WHAT ARE THE IMPLICATIONS?

ONE IS THAT MEN WOULD REALLY

BENEFIT FROM HAVING GREATER

AWARENESS ASSOCIATED WITH WEIGHT

ISSUES AND THE NEED TO TAKE

ACTION SOONER ON A WEIGHT

CONCERN THAN THEY TEND TO DO.

ALSO, I THINK THAT WE AS HEALTH

CARE PROKERS AND THOSE DOING

RESEARCH IN THE AREA AS WELL AS

IN OUR PROVIDE LIVES --

HEALTH KAY PROFESSIONALS NEED TO

ASSOCIATE THE DIFFERENCES

BETWEEN JEEPEDDERS SO WE CAN

PROPERLY RESEARCH AND DESIGN

INTERVENTIONS --

GENDERS.

THAT ARE APPROPRIATE.

WE SPEND SO MUCH TIME LOOKING AT

SOCIOECONOMIC DIFFERENCES IN THE

AREAS OF OUR LIVES AND THIS IS

ONE AREA.

WHAT IS MORE BASIC THAN GENDER

DIFFERENCES WE NEED PAY MORE

ATTENTION TO AS WE GO ON TO

FIGHT THIS EPIDEMIC OF OBESITY.

AND ALSO TO LEVERAGE THE

DIFFERENCES.

THERE ARE NOT THAT MANY AREAS OF

LIFE NOW WHERE THERE IS SUCH

STRIKING GENDER AREAS OF

DIFFERENCE AS WE HAVE IN TERMS

OF GENDER AND WEIGHT LOSS AND

THERE IS MUCH KNOWLEDGE TO BE

GAINED AND THEN IMPLEMENTED IN

TERMS OF INCREASING

EFFECTIVENESS OF INTERVENTIONS.

SO, KEEP THAT IN MIND OVER

DINNER TONIGHT.

THANK YOU.

[APPLAUSE]

>> I WANT TO THANK THE ENTIRE

PANEL.

[APPLAUSE]

I WOULD LIKE TO, IF THERE IS

ANYONE WITH ANY QUESTIONS AT

THIS TIME, FOR ANYONE ON THE

PANEL, THEY CAN STAND UP AND ASK

QUESTIONS.

YES?„i

>> THERE IS QUITE A FEW AND THE

GOVERNMENT ACTUALLY HAS MY

PYRAMID TRACKER THAT I USUALLY

RECOMMEND THAT PEOPLE GO TO AS

WELL.

MY PYRAMID TRACKER.

>> NEXT QUESTION.

>> [OFF MIC]

>> THE QUESTION IS BASICALLY,

THERE ARE A LOT OF DIFFERENT

DIETS OUT THERE THAT HAVE BEEN

RECOMMENDED WHO ARE TRIED BY

VARIOUS GROUPS AND IS THERE A

COMMENT THAT CAN BE MADE IN

TERMS OF GENERAL RESPONSE TO

DIEYETS?

ONE COMMENT I'LL MAKE IS, IN

GENERAL, IF THE PERFECT DIET WAS

KNOWN, EVERYBODY WOULD BE

FOLLOWING DID OR TRYING TO

FOLLOW IT.

AND THERE WOULDN'T BE ALL THE

NEW DIETS COMING OUT ON THE

STREETS.

SECOND IS THAT AS I MENTIONED, I

THINK WE HAVE THE WRONG

PERCEPTION OF DIET.

PEOPLE USE THE TERM GOING TO A

DIET, AS IF IT IS A SHORT-TERM

APPROACH.

WHAT YOU HAVE --

WHEN YOU GO ON A DIET, YOU HAVE

TO ACCEPT THE IN FACT IF YOU

WANT TO MANAGE YOUR WEIGHT, YOU

HAVE TO MAKE A LIFE-LONG CHANGE

IN YOUR HABITS.

SO THE DIET BECOMES A NEW

PATTERN FOR YOU.

IN THE STUDIES THAT HAVE BEEN

DONE OVER THE YEARS AND IN

MULTIPLE REVIEWS, PEOPLE LOSE

WEIGHT ON A WIDE VARIETY OF

DIFFERENT DIETS AND SOMETIMES

JUST CHANGING YOUR APPROACH

HELPS YOU MAINTAIN THE NEW

PATTERN FOR A SHORT PERIOD OF

TIME.

HOWEVER, FROM THE DATA, THERE

SAY GROUP THAT HAS BEEN LOOKING

AT PEOPLE WHO HAVE SUSTAINED

WEIGHT LOSS OVER YEARS AND THIS

ISN'T MAGIC BUT THE AVERAGE

DIETARY PATTERN AND ACTIVITY

PATTERN OF THOSE THAT HAVE

SUSTAINED WEIGHT LOSS OVER YEARS

IS ROUGHLY A 25% FAT AND 15-20%

PROTEIN RISK CARBOHYDRATE DIET.

IT'S WHAT WORKS FOR YOU.

AND THEN PEOPLE THAT HAVE ALSO

SUSTAINED WEIGHT LOSS AVERAGE

BETWEEN 60-90 MINUTES OF

MODERATE LEVEL OF ACTIVITY

DAILY.

SO THERE IS A FAIR BIT OF

CONSISTENCY IN THE DIETARY AND

ACTIVITY HABITS OF THOSE WHO

SUSTAINED WEIGHT LOSS VERSUS

THOSE THAT OR DURING WEIGHT

LOSS.

THE OTHER MEN I WILL MAKE IN

REGARDS TO THAT IS PEOPLE, ONCE

IS THERE A BEEN OBESE, YOU HAVE

A METABOLIC CHANGE.

AND WHEN YOU LOSE WEIGHT, YOU --

IT'S RARE YOU EVER GO BACK TO

YOUR PRIOR METABOLIC STATUS.

SUBSEQUENTLY, AND THIS IS

PRIMARILY FROM STUDIES FROM

NEW YORK THAT HAS BEEN CONFIRMED

BY MANY OTHERS, AN INDIVIDUAL

WHO HAS BEEN OBESE AND LOSES

WEIGHT, REQUIRES LESS ENERGY TO

MAINTAIN THAT WEIGHT THAN A

PERSON WHO HAS NEVER BEEN OBESE.

>> AND I WOULD SAY THE PERFECT

DIET IS THE BETWEEN IS LIVEABLE

AND SUSTAINABLE BASED ON THE

INDIVIDUAL.

I THINK THAT WHILE THERE IS

GREAT INTEREST AND MUCH TO BE

LEARNED ASSOCIATED WITH THE

METABOLIC AFFECTS AND

PHYSIOLOGIC AFFECTS OF WEIGHT

GAIN, I WOULD SAY THAT IN THE

AREA OF HUMAN BEHAVIOR, BEHAVIOR

TRUMP BIOLOGY ANY DAY OF THE

WEEK.

AND SO, WHEN IT COMES WEIGHT

MANAGEMENTS IT'S MORE IN THE

MIND-SET THAN MOLECULES.

SO YOU HAVE TO FIND THE THING

THAT WORKS FOR YOU AND YOU CAN

DO FOR THE LONG TERM.

S.

>> [OFF MIC]

>> I THINK THE MAJOR THING IS TO

AGAIN HAVE A SUPPORTIVE

ENVIRONMENT IN YOUR WORKPLACE

AND AS YOU GO FOR SELECTING YOUR

MEALS, THERE WILL BE NEW

GUIDANCE COMING FORWARD, NOT

SURE WHETHER CHRIS TALKED ABOUT

IT IN OTHER FORMS IN TERMS OF

THE REGS OR GUIDANCE GIVEN TO

THE NIH CAFETERIA AND OTHER FOOD

ESTABLISHMENTS IN TERMS OF THE

OFFERINGS THAT THEY MAKE

AVAILABLE IN THE INFORMATION

THAT THEY PROVIDE.

AND SO THERE ARE GUIDANCE THAT

IS HAVE BEEN DEVELOPED PRIMARILY

THROUGH CDC BUT WITH–r INPUT
FROM

OTHER AGENCIES THAT WILL BE

ADOPTED ESPECIALLY AS NEW FOOD

ESTABLISHMENT CONTRACTS ARE

WRITTEN.

THE OTHER THING IS JUST AGAIN,

TAKE ADVANTAGE OF THE

OPPORTUNITY TO BE MORE ACTIVE IN

THE WORKPLACE RATHER THAN USE

THE ELEVATOR, USE THE STAIRS.

WALK FROM BUILDING TO BUILDING

IF YOU HAVE THE OPPORTUNITY.

EVEN WALK FROM WORKSTATION TO

WORKSTATION AND SAY SOMETHING

RATHER THAN SEND AN E-MAIL.

[OFF MIC]

>> SO BASICALLY ASKING WITH THE

CLINICAL CENTER THE TRIAL THAT

IS WE DO, ARE WE DOING ANY

STUDIES WHERE WE ARE USING

MOTIVATIONAL INTERVIEWING?

>> [OFF MIC]

>> SO BOTH THE WEIGHT LOSS

CENTER INTERVENTION CENTER

TALKING ABOUT WORK SITE WELLNESS

AND THE OTHER ONE, NIDDS A

ONE-YEAR INTERVENTION AND AS

DIETITIANS WE ARE TRYING TO USE

MOTIVATIONAL INTERVIEWING WHEN

WE WORK WITH THOSE PATIENTS SO

TRYING TO GET THEM TO CHANGE

THEIR BEHAVIORS AND HAVE THEM

FIGURE OUT ON THEIR OWN WHAT

THEY NEED TO DO TO BE ABLE TO DO

THAT.

>> [OFF MIC]

ED.

>> A COMPLEX QUESTION.

SO FOR THE FIRST PART, AS I

MENTIONED, IT'S REALLY AN

OVERWEIGHT PREVENTION PROGRAM.

SO ANY EDUCATION THAT IS OUT

THERE THAT GOES DIRECTLY TO THE

CHILDREN REALLY DOESN'T HIT

DIRECTLY AT, THIS IS FOR A

HEALTHY WEIGHT.

IT'S REALLY TO BE HEALTHIER SO

WE TALK ABOUT THE GOOD THINGS

ABOUT EATING HEALTHY FOODS AND

BEING MORE ACT AND I HAVE

FEELING BETTER.

SO ALL THESE PROGRAMS THERE IS

REALLY NOT A DISCUSSION ABOUT

WEIGHT OR OVERWEIGHT OR OBESITY.

WE DON'T EVEN USE THOSE WORDS.

FOR THE PARENTS, WE DO DISCUSS

THE HEALTH ISSUES F YOUR CHILD

OR FAMILY MEMBER DOES BECOME

OVERWEIGHT, BUT WE REALLY

ENCOURAGED THE PARENTS TO, VERY,

VERY SENSITIVE TOPIC.

YOU DON'T WANT IT TO GO THE

OTHER WAY AND ESPECIALLY GO THE

EATING DISORDER WAY.

SO WE DO HAVE A LOT OF TALKING

POINTS FOR PARENTS AND

CAREGIVERS TO BE SENSITIVE ABOUT

THE TOPIC.

AND AS FAR AS THE SELF-ESTEEM

ISSUE, WE REALLY DEPEND ON OUR

COMMUNITY SITES BECAUSE THEY ARE

THE ONES THAT ARE AT THE

FOREFRONT WITH THE KIDS EACH DAY

TO DEAL WITH THIS ISSUE AND FOR

EXAMPLE, OUR CATCH PROGRAM HAS A

PHYSICAL ACTIVITY COMPONENT AND

INSTEAD OF–r IT BEING
COMPETITIVE

PHYSICAL ACTIVITY, IT'S MORE

LIKE A PLAY OR EVERYONE CAN GET

INVOLVED AND EVERYONE IS PLAY

TEG SAME TIME.

SO IT'S A NONCOMPETITIVE, WHERE

A CHILD WON'T BE CHOSEN.

THAT'S REALLY THE WAY WE GET

AROUND THAT ISSUE.

EVERYONE IS INVOLVED AND BEING

ACTIVE DID THE FEELING GOOD.

>> GO AHEAD.

>> [OFF MIC]

>> THEY ARE BOTH SIX CARBON

SUGARS.

YES.

AND THERE IS A LOT OF

CONTROVERSY OVER THERE.

THERE IS A MIXTURE OF

INFORMATION THAT IS INTERPRETED

BETWEEN ANIMAL STUDIES AND HUMAN

STUDIES.

IN TERMS OF THE NEGATIVE IMPACT

OF FRUCTOSE, A LOT OF THE

NEGATIVE DATA IS DERIVED FROM

ANIMAL STUDIES INa
EA„ WHICH PURE

FRUCTOSE HAS BEEN GIVEN.

THERE HAVEN'T BEEN AS MANY

STUDIES THAT HAVE GIVEN DIRECT

EVIDENCE IN HUMANS.

WHERE THE NORMAL CONSUMPTION IS

AS A DISACCHARIDE OR

POLYSACCHARIDE AND THERE IS A

LOT OF CONFUSION AS YOU READ THE

LITERATURE AMONG VARIOUS GROUPS

ESPECIALLY THOSE THAT AREN'T AS

FAMILIAR WITH THE BIOCHEMISTRY.

YOU ALSO HAVE TO REMEMBER THAT

THE COMMON TABLE SUG SAR50%

FRUCTOSE.

AND A LOT OF PEOPLE DON'T

RECOGNIZE THAT WHETHER THEY TALK

ABOUT THE HIGH FRUCTOSE CORN

SYRUP WHICH IS 55% FRUCTOSE.

AND SO, IT IS NOT THAT DIFFERENT

FROM THE YOU ISCROSE OUT THERE.

IN TERMS OF METABOLIC

DIFFERENCES, THERE ARE SOME

LILTED STUDIES SHOWING THAT SOME

INDIVIDUALS HAVE DIFFERENCES IN

METABOLISM BUT IT'S FAR FROM A

CONSISTENT PICTURE FOR THE

GENERAL PUBLIC.

>> AT THIS TIME, ARE THERE ANY

ADDITIONAL QUESTIONS?

>> [OFF MIC]

>> WEIGHT WATCHERS DOESN'T

MANUFACTURE ANY FOODS.

WE HAVE SOME LICENSING

AGREEMENTS.

AND WE ARE CONSTANTLY

ENCOURAGING OUR LICENSEES TO GO

MORE WHOLESOME AND MORE

PROCESSED.

NO WEIGHT WATCHERS FOODS ARE

REQUIRED ON THE PROGRAM AND IN

FACT, OUR POINTS PLUS SYSTEM

FOCUSES SPECIFICALLY ON EATING

MORE WHOLESOME, LESS PROCESSED

FOODS AND IN FACT WE HAVE A SET

OF POWER FOODS WHERE WE FOCUS ON

THAT.

WE ARE ACTUALLY VERY COMMITTED

IN TERMS OF THE MILLIONS OF

PEOPLE THAT COME TO US FOR

WEIGHT LOSS SERVICES AND

ENCOURAGING LESS PROCESSED FOOD.

THERE ARE TIMES WHEN MORE

PROCESSED FOODS ARE CONVENIENT.

THERE IS NOTHING WRONG --

WE AREN'T TOTAL TOFU AND BEAN

SPROUTS OR ANYTHING LIKE THAT.

BUT TO THANK WE IN TERMS OF

ENCOURAGE THE USE OF PROCESSED

FOODS, I WOULD SAY CERTAINLY

THAT'S NOT THE CASE.

I WOULD ENCOURAGE ANYONE WHO

ISN'T AS–2H#AMILIAR TO WEIGHT

WATCH TOURS CONSIDER LEARNING

MORE ABOUT IT AT OUR WEBSITE OR

HERE I THEREIN IS A LOT OF

CLASSES HERE ON THE NIH CAMP US

AND YOU'LL LEARN WE ARE VERY

MUCH ABOUT HEALTHY EATING SUCH

TO THE EXTENT WITHIN OUR POINTS

PLUS SYSTEM THAT THERE IS NO

POINTS ASCRIBED TO FRUITS OR

VEGETABLES.

NOT THAT THEY DON'T HAVE

CALORIES BUT WE FIGURE OUT OTHER

WAYS TO DO IT BUT ACTUALLY IN

TERMS OF ENCOURAGING MORE

FREQUENT CONSUMPTION OF FRUITS

AND VEGETABLES.„i

>> ARE THERE ANY OTHER

QUESTIONS?

ONCE AGAIN I WANT TO GIVE THE

PANEL A GREAT HAND OF APPLAUSE.

HAVE YOU DONE AN EXCELLENT JOB

TODAY.

THANK YOU VERY MUCH FOR YOUR

PARTICIPATION IN THIS ENDURE

WITH THE„i KICKOFF TO THE HEALTH

AND WELLNESS COUNCIL.

NOBODY BEFORE YOU DEPART, PLEASE

FILL OUT AN EVALUATION FORM FOR

US.

WE WILL MAKE SURE THEY ARE

DISTRIBUTED TO YOU.

IF HAVE YOU THE OPPORTUNITY,

PLEASE GO DOWN STAIRS TO THE

VARIOUS BOOTHS AND INFORMATION

WE HAVE FOR TODAY AND FOR THOSE

WHO MAY HAVE BROUGHT YOUR

EXERCISE GEAR, PLEASE GO DOWN

STAIRS.

WE HAVE MANY AND VARIOUS

NUMEROUS FITNESS CLASSES GOING

ON ALL DAY TODAY AS WELL AS

TOMORROW.

IN ADDITION WITH THE INSTITUTES

WHO WILL BE HERE DISSEMINATING

WELLNESS-RELATED INFORMATION AS

WELL.

ONCE AGAIN, I DO WANT TO THANK

THE PANEL AND THANK EVERYONE FOR

THEIR PARTICIPATION.