Nutrition and Fitness for Working Women

Nutrition and Fitness for
Working Women
Wendy L. Ward-Begnoche, Ph.D
UAMS/ACH
501-364-1021
[email protected]
A Healthy Lifestyle
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Nutrition
Fitness
Sleep
Emotional health
Overview
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We know what to do, or do we?
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Nutrition
Fitness
Sleep
Emotional Health
Why we don’t make the changes
Understanding barriers to change
Developing a plan for yourself
We know what to do, or do we?
ENERGYin -- ENERGYout
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Smaller portion sizes
Fewer sugared drinks
Increase fruit/vegetable intake
Do not skip meals
Do not eat in front of the TV or computer
No foods are forbidden, just moderation
2 hours a day or less of “screen time”
Increase physical activity
What we ACTUALLY do:
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Skip breakfast or other meals
Vending machines—drink and eat
Overeat at night
Eat “comfort foods” not fruits/vegs
Reward successes with food
Work long hours including late into the night
Eat at our desks, at our computers, in front of TV
Diet/weight cycles
Take care of others
Stay up late
Pay gym fees and don’t go, buy equip and don’t use
HOURS and HOURS of screen time
Nutrition
Educate Yourself
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Nutritionist visit(s)
Magazine—watch for fad diets and hype
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Self
Fitness
Shape
Websites
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nat.crgq.com--Nutrition Assessment Tool
mypyramid.gov—Individualized nutritional
plan
Specific Negative Nutritional
Behaviors
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poor water intake
milk ingested is not skim
high intake of sugary drinks such as soda pop, sweet
tea, juices
large number of meals eaten outside home
high fat intake/high saturated fat intake
high caloric intake
high sodium intake
high intake of sugar
large portion sizes
hiding/sneaking food
dieting
skipping meals
eating seconds and thirds without waiting 20 minutes
Specific Negative Nutritional
Behaviors
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poor intake of vegetables
poor intake of fruits
poor fiber intake
poor protein intake
eating in the bedroom
eating in front of TV/Computer
eating alone
eating late at night
poor food choices made at work
"grazing" throughout the day
use of diet pills, diuretics, laxatives, herbal products
eating fast foods, poor choices in work cafeteria
unhealthy ways of home-cooking
Negative Eating Patterns
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Binging
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Emotional Eating
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Sweets, carbs
feeling out of control when eating,
overeating in a period of 2 hours or less,
feelings of guilt/shame after eating,
eating until physically uncomfortable,
Binging
boredom, sad, angry, worried/stressed, bored
binging
Night Eating Syndrome
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skip > 4 breakfasts a week
>50% of calories after 7 pm
difficulty falling asleep and staying asleep > 4 nights a week
Things to Ask Yourself
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A typical breakfast, lunch, dinner, snack
Perceived appetite level (peaks)
Top 3 favorite foods
Top 3 foods most often eaten
Other family members eating habits affect yours
Do you reward yourself with food?
Do you ignore internal hunger cues?
Do you try new fruits/vegetables? Other healthy foods?
Try a new food a week—have it several times
Splurge once a week or once a month
Create a list of reasons why eat nutritiously
Allow choices of food items during meal planning only
Additional Changes to Consider
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Small meals and snacks through the day,
metabolism will increase.
Meal planning snacks and meals before grocery
shopping
Eat when you are hungry, and stop when you
are barely full.
Drink water. Often when we feel hungry we are
really thirsty.
Eat only recommended serving sizes for all food
Choose “healthy” offerings from fast food
restaurants. Take half home or split.
Additional Changes to Consider
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Fewer trans fats and saturated fats in favor of
unsaturated fats (peanut butter, olive oil, canola oil,
nuts) which actually improve cholesterol.
Do not add butter, margarine, or other oils in cooking if
at all possible. Bake/broil instead of frying.
Read and understand food labels
For each meal, divide a small size plate in half. ½ =
fruits/veggies. ¼ = carbs. ¼ = protein. Having
proteins in every meal is tastier, more satisfying, more
nutritious, and keeps the metabolism going.
Snack foods should be fruits, vegetables, whole grains,
and low fat dairy products.
Decrease the amount of sugar in your diet.
Serve a variety of healthy foods. The more flavors,
smells, and textures the more you will stick with it.
Additional Changes to Consider
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Take small bites, chew slowly, swallow, and pause
between bites. Also, enjoy the smell of food. All of these
can trigger the brain to feel full.
Keep healthy and nutritious choices at home. Remove
less healthy foods.
Have all family members make nutrition changes
Develop new holiday rituals that are not food related
Decrease eating “empty” calories—foods with no
nutritious value
Focus on slow and steady calorie reduction not slicing
calories too strongly, too quickly.
More Changes to Consider
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Make splurges healthy ones—fruit for dessert with cool
whip or no fat pudding
Make a plan for the toughest time of day for splurging—
afternoons and evenings
Use positive imagery--Imagine yourself making healthy
choices, doing physical activity, enjoying the new
lifestyle changes
Put healthy foods in the front of the fridge/cabinet
Make a list of healthy snacks not unhealthy ones
Nutrition Assessment
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Record baseline (weekdays and
weekends)
nat.crgq.com--Nutrition Assessment Tool
mypyramid.gov—Individualized nutritional
plan
Fitness
Fitness
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Cardio
Strength
Flexibility
Educate Yourself
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Personal Trainer or PT visit (s)
Magazine (watch for fads and hype)
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Self
Fitness
Shape
Specific Negative Fitness-Related
Behaviors
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Afterwork activities are sedentary
Too much screen time
Too little exercise
Low confidence in ability to exercise
Blaming genes when it is really lack of exercise
<2 types of physical activities
Uninterested in trying new physical activities
Activities limited to season
Engaged in activities with mild intensity
Activities are done alone
Buy the equipment, pay the gym fees, but don’t
do it
Specific Negative Fitness-Related
Behaviors
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Put others ahead of ourselves
Put our work ahead of ourselves
Perceived energy level
Ignore internal cues of stiffness or muscle
weakness
Decrease non-work "screen" time to
recommended 1-2 hours
Develop new holiday activity rituals such as a
family bike ride after Thanksgiving dinner.
Specific Negative Fitness-Related
Behaviors
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Focus on exercise sessions, but also on nonworkout activity (e.g., taking the stairs at work,
parking farther from the door to the store,
walking to the park, etc.).
Daily relaxation helps lower stress, which in turn
lowers cortisol levels. Cortisol increases appetite
and cravings for sweets, and also causes fat to
be deposited in the abdominal area. Learn
about deep breathing techniques, yoga, and
mental imagery as relaxation strategies.
Vary your exercise—inc motivation and uses
variety of muscle groups
Activity Assessment
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Take a list of all activities available in your area
(work, home, community centers, parks and rec,
church, etc.)
Include stretching, weightbearing and aerobic
Review list and rule out any activities hazardous
due to illnesses/diseases
Remove any activities you have really tried and
do NOT enjoy
Choose several to try regularly, rotate among
seasonal activities
Try new things occasionally
Create a list of reasons why exercise
Activity Assessment
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Record your activity (weekdays and
weekends)
Record flexibility, weightbearing and
cardio separately
Goals should be individualized, but think
about 30-60 minutes daily of cardio, 2
times a week weight training, flexibility
during cool down and 1/week 30-60
minutes
Sleep
Educate Yourself
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See a sleep specialist
Books on sleep
Sleep is as Necessary as Food,
Exercise
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How many hours are good for ME?
Worsens obesity
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Enhances craving for energy-boosting foods
Tiredness leads to exercise avoidance
Effects on metabolism, endocrine functioning
Worsens irritability, depression, anxiety, stress
People who exercise moderately but regularly
fall asleep 12 minutes earlier and slept 42
minutes longer than those who didn’t exercise
(reported in a study in the Journal of the
American Medical Association)
Sleep Debt
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Moody
Irritable
Less productive
Difficulty multitasking
Difficulty concentrating
Inc hormones that increase appetite
Possible inc risk for heart disease,
diabetes, and breast cancer
Negative Sleep-Related Behaviors
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Stay up late to work
Get up early to work
Not have a consistent sleep/wake cycle
Stay up late watching TV, surfing net
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Must see the end
Must watch XX show
Work avoidance
Can’t sleep due to stress
Ignore internal cues of tiredness
Work in bed
Caffeine intake after 2 pm
Sleep Assessment
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Consistent sleep wake/cycle—1 hr variance max
Keep bedroom cool at night
Do NOT use the snooze bar
Do not drink caffeine 8 hours or less before bed
Use relaxation strategies
Love your pet but don’t sleep with it
Love your children but don’t sleep with them
Do not exercise less than 3 or 4 hours before bed
Use the VCR for shows—work out and watch!
Remember less sleep means LESS efficiency/productivity
Use relaxation strategies for 15 minutes before going to
bed. This will help you unwind.
Sleep Assessment
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Bedtime routine—getting fully ready for bed followed by
a restful activity with low, soft light.
TV is not recommended as it can awaken the brain
Dark, quiet environment
Play soothing music and/or “white noise”
Use sleep medications only as directed
Alcohol helps you fall asleep but actually disrupts quality
of sleep
If you snore loudly, evaluate possible sleep apnea
Write down your worries or last minute to-do lists on a
pad next to the bed. You’ll sleep better and be less
stressed.
Difficulty falling asleep when they are overtired
Sleep Assessment
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Still awake after 20 minutes? Get up and do a relaxing
activity (read a book). Do NOT turn on the TV. Do NOT
surf the internet or check your email.
If teeth grinding is an issue, use massage or other
relaxation strategies and/or a warm compress on the
joint to treat. Do not chew gum or other chewy items,
and take small bites when you eat to avoid aggravating
the joint. Talk to your doctor about using NSAIDS
and/or a mouth guard.
Sleep disturbance correlates with multiple other
disorders—ADHD, depression, anxiety, etc. Sleep can
worsen these disorders, and these disorders can impair
sleep.
Sleep Assessment
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Record your sleep (weekdays and
weekends) including bedtime, wake time,
awakenings, naps
Goals should be individualized, but think
about 7-9 hours
Emotional Health
Emotional Health
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Time
Time
Time
Time
Time
for yourself
with friends
with spouse without kids
with kids
with extended family members
Meditation/Relaxation
Stress Management
Why We Don’t Make The Changes
Motivation To Change
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Motivational to Change stage:
Precontemplation Stage: Denial or unwillingness to
accept a problem, see no benefits in change
Contemplation Stage: Know problem; fear of change,
unprepared for change, barriers to change
Preparation Stage: Not knowing how/what to do to
change
Action Stage: Implementing change; readiness and
learning
Maintenance Stage: Action with increased ease
toward change
Motivation to Change: Stage
Shifting
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PC and C stage: Education, drop out prevention
P and A stage: Work on relapse prevention
Best predictors of drop out and relapse is stage
and stage-related
Obesity >50% want home-based treatment vs
5% want clinic-based treatment
Use motivational issues to galvanize change
Barriers to Change
Barriers to Change
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Access to nutritious choices
Access to physical activity
Financial
Spousal reactions/support
Overextended in caregiving role
Social pressure
Cultural influence
Emotional problems
Other medical conditions—chronic pain, GI….
Motivational stage
How to Identify Barriers and Motivate
Yourself
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What concerns you about your weight/health?
What three things do you want to change?
Do you think you CAN change?
What would you choose to change first?
Who in the family makes the worst food choices? Who is the least
active?
What have you eaten in the last 24 hours? Weekend?
What is dinnertime like?
How often do you eat out?
What do you eat at work?
What kind of milk does your family drink?
Show me what size is one serving of—meat, cheese, carbs
What physical activity have you had in the last 24 hours? Weekend?
How much “screen time” do you have?
What are your favorite family activities? Peer activities?
Unconscious Beliefs
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Do what I say not what I do
I’m not a good XX if I…
God made me this way…
Nothing I do will change it anyway
My family is “big boned”
HEALTHY AT EVERY SIZE
 Not all people are currently at their most “healthy weight”
 Movement towards a more balanced life will produce a “healthy
weight”
 Focusing on weight loss leads to weight cycling and increased
weight
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Do not weigh often, focus on other indicators of health
 Focusing on self-acceptance and a healthy lifestyle leads to
“healthy weight”
 Healthy eating is relaxed, comfortable, natural not restrictive,
negative
Jon Robison, Ph.D.
Developing a Plan
Developing a Plan
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Motivation—stage shift changes
Self monitoring and record
Set specific, measurable goals
Problem solving strategies
Record goals/Graph
Reward Yourself
Do It Now: Step 1
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Graph where you are now
Graph where you would like to be
Do It Now: Step 2
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Review earlier slides
List needed behavioral changes
Choose 1-3 of multiple nutrition and/or
physical activity goals
Goal is behavioral change NOT weight
Success could be speed, strength, energy
level, specific goal achievement, etc
Incorporate family involvement in
behavioral plan creation
How to Choose Goals
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Family and peer participation!!
Assess motivation and post reminders
Really think through goals—de-emphasize weight
Plan for meals given your life circumstances
Plan for exercise given your life circumstances
Permanent part of the schedule
Give yourself choices
Start with easier things first to build positive
momentum
Make small changes, 1-3 goals each month or each
quarter
Looks fun—try it!
Remember to Apply Behavioral
Principles
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Shaping—start small and build (walk -> run; 10 min > 30 min)
Stimulus control (always workout/eat at same time;
always workout on commercials)
Premack Principle—pair a high frequency, fun activity
with a desired activity
To improve commitment—make public the goal
Positive coach vs negative thinking
Find what will motivate and maintain progress
Covariation—change several related behaviors at once
will increase success not limit success (myth)
Do It Now: Step 3
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Create graph for each of your 1-3 goals
Record baseline
Do It Now: Step 4
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Short term reward list
Long term reward list
Link rewards to healthy eating or activity
Don’t use food as rewards
Withhold unless there is goal achievement
Do It Now: Step 5
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Review, revise every 3 months
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Motivational stage changes
Goal achievement—Reward
Reward success in changes even if BMI is the
same!!
Goal not achieved--Find out WHY—
nonjudgmental and problem-solving focus
Add new goals after old goals become habits
Reward only current goals
Change rewards—keep yourself motivated
Overview

We know what to do, or do we?







Nutrition
Fitness
Sleep
Emotional Health
Why we don’t make the changes
Understanding barriers to change
Developing a plan for yourself
Nutrition and Fitness for
Working Women
Wendy L. Ward-Begnoche, Ph.D
UAMS/ACH
501-364-1021
[email protected]
Extra Information
ADULT BODY MASS INDEX (BMI)
Overweight =
Obese =
25-29
30 or greater
WAIST CIRCUMFERENCE
35” or less
CALORIES
Women: 1800 (<30 min ex) 2000 (30-60 min ex)
It takes 3500 calories LESS to lose a pound of fat
CDC