10 Tips for Weight Maintenance

If you've worked hard to achieve your weight loss goal, you'll want to enjoy your healthy weight for life.

Here are our top ten tips for weight maintenance:

1.  Monitor Your Weight
Check your weight each week (don't weigh yourself too often it's natural for your weight to fluctuate daily). Use your bathroom scales, or find a pair of pants that are comfortable at your goal weight and identify if they get significantly tighter or looser.

It's normal for your weight to fluctuate by 1-2 kilograms, but if you notice your weight increasing on two or more consecutive weeks try one (or a combination) of the following three actions:

• Decrease your calorie intake
• Increase the duration and / or frequency of your exercise sessions
• Be honest with yourself: are there any areas of your lifestyle, behaviour or environment that have changed?

You should set an upper and a lower limit on your weight (a Dietitian can help you set appropriate limits). If you hit your upper or lower limit, seek professional help from a Dietitian or Doctor as soon as possible. And don't procrastinate for too long - it's much easier to reverse a 1-2kg weight gain than it is to reverse a 5-7kg weight gain!

2.  Monitor Your Eating Patterns
Keep a food diary to ensure that you are eating the right amounts of food from each of the five food groups. It may sound tedious, but a food diary helps you to check that you are eating regularly. Try to maintain a consistent eating pattern, including weekends and holidays.

3.  Exercise
To maintain your weight you need to exercise at a moderate intensity (a rate at which your heart rate is elevated but you can still carry out a conversation) for at least 250 minutes per week. Try walking for 30 minutes on five days of every week. For the fitter members of the audience, you can try vigorous cardiovascular exercise such as jogging for 20 minutes a day on three days of the week.

If you want to change the shape of your body or strengthen your muscles, try resistance training, or performing exercise against an opposing force such as water, free weights, weight machines, a theraband, a fit ball or even your own body weight. Resistance training increases the proportion of lean body tissue (muscle) in your body contributing to a higher metabolic rate, as well as improving your posture, flexibility and strength. If you are interested in starting a resistance training program, it's best to have a program designed by an Exercise Physiologist or a personal trainer.

4. Continue to Set Goals
The goal of weight loss is change, whereas the goal of weight maintenance is no change. It can be hard to maintain your resolve when you don't see results for the effort you are putting in. To account for this, try setting other life goals that are better enjoyed at a lower weight (e.g. joining a community walking group or travelling).

5. Reward Yourself
When you were losing weight you were probably enjoying the associated rewards: complements from friends, the excitement of fitting into smaller clothes and a dropping body weight. You'll have to devise a new set of rewards to keep you motivated during weight maintenance: treat yourself to a massage, buy a book or have a manicure of pedicure at the end of every month. You'll need to reward yourself for at least the first few years after weight loss.

6. Enlist Support
While you were losing weight it's likely that you received encouragement from family, friends and health professionals. Weight maintenance can be just as difficult as weight loss at times - and it can be a more isolated process. But it doesn't have to be that way. Tell the important people in your life that maintaining your healthy weight is important to you, and that you'd like their support and encouragement for the long term.

7. Stay Vigilant
It's easy to become complacent when you achieve your weight loss goal. People sometimes fall into the trap of thinking, "I can have an extra scoop of chocolate ice cream - I've lost a lot of weight and I'm feeling really good". Just because you've lost weight it doesn't mean that extra calories don't add up anymore!

It's important to treat yourself from time to time, but it's also important to recognise when extra treats are creeping into your diet too often. By keeping a food diary (or just listing your treats on a notepad) you can identify how frequently you are indulging. You should consume no more than 2-3 treats per week, and try to limit your treats to a 200 Calorie portion.

8. Be Organised
It's hard to manage your weight when the rest of your life is in chaos. Leave plenty of time to relax, sleep, shop for healthy foods, prepare healthy meals and exercise.

9. Maintain a Healthy Level of Self Esteem
Don't link how you feel about yourself to your weight. Be happy with you weight and proud of the weight loss that you have achieved.

10. Don't Use Food to Stabilise Your Moods
If you are feeling stressed or upset, find a non-food related way of calming yourself - go for a walk or call a friend.

Lastly, don't forget that weight maintenance can be just as challenging as weight loss (if not more so in the first two years). But it gets easier with time, and by following our advice you will be well on your way to success.

SLEEP More, WEIGH Less

Did you know that under-sleeping can lead to poor performance and impaired judgement and has also been linked to depression, obesity, diabetes and hypertension. A new study of 1,200 people showed that the average Australian adult gets less than seven hours sleep a night, below the seven to eight hours recommended by sleep experts.

A study by Columbia University, found people who slept four hours or less per night were 73% more likely to be overweight or obese. Also, people who habitually slept for five hours had 15% more ghrelin, a hormone which increases feelings of hunger, than those who slept for eight hours. Those who slept for less time were also found to have 15% less leptin, a hormone which suppresses appetite. "These differences are likely to increase appetite, and therefore contribute to obesity" Dr Taheri states. The subjects in the study also tended to eat more sweet and starchy foods when sleep was cut short.

While research continues, sleep still remains one of the body's most mysterious processes. We do know that sleep is absolutely necessary for survival and even occasional sleeping problems can make daily life feel more stressful or cause you to be less productive. Sleep loss also affects growth hormone secretion that is linked to obesity and impairs the body's ability to use insulin, which can lead to the onset of diabetes. It is paramount that we discover more about this activity where we spend a third of our lives - sleeping.

There are prescriptions and non-prescription drugs, herbs, remedies, technologies, etc that may help you get a good night's sleep. Some work for some and not for others.

Here are some tips you can try at home tonight. These tips are intended for the average adult, but not necessarily for children or persons experiencing medical problems:

• Imagining - Think of a hammock - you're up off the ground, wrapped in a cocoon of comfort, swaying gently in the open air. The sun is warm on your face and there's a cool breeze blowing you back and forth. This visualisation helps you "see" what the reward for sleeping will be, getting you more in the mood to sleep. Visualisation has proved helpful in developing the appropriate brain wave patterns for sleep.
• Magnesium - Has a calming effect on the nervous system. It is part of bones and cells, especially the smooth cells of arteries, and assists in the absorption of calcium and potassium. Over 300 enzymes in our body need magnesium to function properly. It is so important, that the brain stores a "safety supply" to have in the event of a drop in the magnesium reserves.
• Nutmeg - Grind fresh nutmeg and serve it with warm low fat milk and a touch of honey. Milk is naturally high in calcium and rich in tryptophan; together they can be a powerful tranquilizer (and very delicious).
• Hot foot baths - In the Eastern World, a hot foot bath is a traditional remedy; it draws blood from the brain to calm a racing mind. Try soaking your feet in a hot bath with a cupful of Epsom salts and a few drops of lavender essential oil, which will soothe you. Your feet absorb the magnesium from the Epsom salts and relax you further.
• Stomach rub - Soothes down the digestive system and helps bring about deeper relaxation. Lie on your back and place your hand on your belly button. Begin to make small circles in a clockwise direction as you gently glide your hand over your stomach. Let your circles gradually become bigger and bigger. When your circles reach the outside of your stomach, gradually reduce their size until you are back at your belly button again. Reverse the direction; repeat the whole series with your other hand and do this several times. Doing this with lavender oil can create an even more relaxing experience.
• Listening to an audio book - The brain works like a tape player - with one main auditory loop that processes words. If you fill that loop with an interesting book, there's no room for your own worrisome internal narrative. Especially helpful for those who have continuous thoughts running through their heads.
• Deep breathing - Take a deep breath in then slowly release out - focussing on your breathing causes your mind to get distracted from your worries and focussed on your breathing. Doing this for a few minutes can relax your mind and help you get a more peaceful sleep.
• Turn it off - Sleep experts suggest refraining from doing work, watching television, or being on the computer at least an hour before bed time. This allows your brain to start to 'wind down'.

References

1. Gangwisch. D, Malaspina. D, Boden-Albala. B, (2005) Inadequate Sleep as a Risk Factor for Obesity: Analyses of the NHANES I; COlumbia University, College of Physicians and Surgeons, New York, NY.
2. Taheri. S, Lin. L, Austin. D, Young. T, Mignot. E, (2004) Short Sleep Duration is Associated with Reduced Leptin, Elevated Ghrelin, and Increased Body Mass Index. PLos Med 1(3): e62. doi:10.1371/journal.pmed.0010062.

Modifiable Risk Factors For Stroke

A modifiable risk factor is a health risk which is in your control. Age, gender and genetics are non-modifiable factors as we cannot change them. A modifiable risk factor however, can be eliminated with the correct lifestyle.

A recent study of 6,000 people from 22 countries called 'Interstroke' evaluated risk factors of stroke. The study showed that 10 risk factors are associated with 90% of the incidence of stroke and that most of these can be changed by lifestyle.

A stroke can be devastating resulting in death or a lifetime of physical impairment. The good news from this study is that many strokes can be predicted and the resultant burden of the disease reduced by following certain measures. Of the modifiable risk factors, blood pressure (hypertension) control was identified as the most important.

Five modifiable risk factors of hypertension, current smoking, abdominal obesity, diet and physical activity accounted for 80% of stroke.

When additional risk factors such as having Type 2 Diabetes, a high alcohol intake, psychosocial issues, abnormal apoliproprotein ratios and cardiac causes (such atrial fibrillation or flutter, previous myocardial infarction or valve disease) are taken into account these 10 risk factors account for 90% of the risk of stroke (1).

The following are key strategies for significantly reducing the risk of stroke:

• Maintain a healthy weight
• Limit your salt, processed and takeaway food intake
• Eat a balanced diet of vegetables, fruit, fish, poultry, meat, nuts and seeds, low fat dairy and whole grain carbohydrates
• Limit alcohol intake. Aim for no more than 2 standard drinks per day
• Go to your GP for a check up regularly
• Monitor your cholesterol levels
• Quit smoking
• Measure your waist regularly
• Exercise daily - aim for at least 30 minutes
• Get treatment for depression or stress

Unlike cardiac disease where there can be a lifetime of medication in order to reduce risk factors, the above strategies are all about leading a healthy lifestyle and that is free.

References

1. O'Donnell. M. J, Xavier. D, Liu L, et al. Risk factors for ischemic and intracerebal haemorrhagic stroke in 22 countries (The Interstroke Study): Lancet 2010; DOI: 10.1016/S01140-6736(10)60834-3. Available at: http://www.thelancet.com/

Stay Cool This Summer – How to Avoid Heat Illness

Despite what has been an unseasonably mild summer to date, the hotter days are becoming more frequent and it is important to be aware of the dangers of exercising during this time of year. Summer climates increase the risk of developing heat illnesses such as heat stroke when exercising, resulting in many debilitating health complications such as:

• Feelings of tiredness, weakness, dizziness and faintness
• Dehydration and headaches
• Excessive fatigue
• Heat cramps

So what can you do to help yourself avoid these possible side effects?

Pre-exercise

• Hydrate effectively – Daily water requirements during summer increase to a minimum of 4L per day
• Drink 2-3 cups of water 2 hours before and 1 cup 10-15min before undertaking exercise
• Avoid hot foods, alcohol and heavy foods that increase your core temperature
• Choose lightweight, light-colored and loose-fitting clothing as well as wearing a hat
• Use sun block with an SPF rating of 15+ or higher

During exercise

• Avoid exercise during the hottest time of day; train closer to sunrise or sunset
• Drink 1 cup of water every 15minutes throughout exercise
• If you feel any headaches, fatigue or irritability or notice your exercise performance decreasing, stop exercising and cool off

Post-exercise

• Weigh yourself before and after exercise and replace any lost fluids accordingly
• Drink 1.5L of water for every kilogram of fluid you lost during exercise
• Try to avoid too much sports drink, however for intense exercise above 60min, these may help to further accelerate water intake after exercise in the heat

Remember: Planning ahead for exercise in the heat will assist you in avoiding the health complications associated with heat illness this summer.

References

• Quinn, E. 2009, Hot Weather Exercise Safety: Tips for preventing heat stroke, heat exhaustion, heat rash and dehydration’,http://sportsmedicine.about.com/od/enviromentalissues/a/Exercise_Heat.htm
• Sawka, M.N., Burke, L.M., Eichner, R., Maughan, R.J., Montain, S.J., Stachenfeld, N.S. 2007, Exercise and Fluid Replacement, Medicine and Science in Sports and Exercise, vol. 39, no. 2, pp. 377-90.
• Sawka, M.N., Montain, S.J. 2000, Fluid and electrolyte supplementation for exercise heat stress, American Journal of Clinical Nutrition, vol. 72, no. 2, pp. 5645. 

Managing Obesity in the Workplace

In 1997 the World Health Organisation (WHO) formally recognised obesity as a global epidemic.  The WHO estimates that at least 400 million adults (9.8%) are obese (1).   Similarly in Australia, overweight and obesity is recognised as a major public health issue, and ranks alongside smoking as the most important preventable cause of ill health (2).  The prevalence of obesity has more than doubled over the past decade with current obesity rates of 19% for men and 22% of women (3).

Overweight and obesity is responsible for a large proportion of the total burden of disease. The Australian Institute of Health and Wellness (AIHW) report that overweight and obesity contributed to 7.5% of the total health burden or the total of ill-health, disability and premature death that occurred in Australia in 2003 (4).  Obesity is linked to five of the top eight chronic diseases of Australians including cardiovascular heart disease, type II diabetes, arthritis, depression and stroke (4).

Research also demonstrates that obese people have much higher rates of ill-health as well increased overall mortality risk; someone with a BMI of 35 has 2½ times the risk of premature death compared to a person with a BMI of 20 (5).

Obesity in the workplace
In the workplace, the incidence of obesity is also growing.  A 2010 AIHW report identified increasing numbers of obese employees across a range of occupations.  The most recent estimates are 18.7% of the working population; 20.9% males and 16.5% females (6).  The effects of obesity have particular relevance in the workplace as obesity is also associated with decreased physical function, increased risk of injury, and reduced productivity (7).  Another recent study found that extremely obese workers had difficulty performing necessary work functions and struggled to complete work in the expected time due to feeling tired, weak, and short of breath (8).

Wesley Corporate Health has been conducting Health Risk Assessments on Queensland employees for 20 years and our data shows that 22% of employees are obese and an additional 37% are overweight.

The economic costs of obesity
The economic costs for obesity are large. These economic consequences include direct costs from increased health care services and indirect costs associated with lost economic production (9).  Calculations in the United States indicate that in comparison with people of normal weight obese people have a 36% higher annual health care costs which amounted to $147 billion dollars in 2008 (10). Another study in England measured the indirect costs of obesity (i.e. lost productivity and absence from work due to ill health or premature death) to be twice the direct health care costs (9).

Determinates of obesity in the workplace
Obesity is strongly correlated to poor diet and physical inactivity both which are highly prevalent in Queensland.  Decreased leisure time and increased time spent at work also contribute to increasing obesity trends.  In addition to this, the study found that employees were increasingly reliant on convenience food due to these increased work demands (7).

Fortunately obesity and the resultant chronic disease it causes is preventable. The best time to take action is before the onset of chronic disease.

Obesity prevention programs - what works?
The workplace offers great potential for health improvement.   Benefits of workplace interventions include access to a large population, increased opportunity for follow up and the ability to support interventions with changes to worksite infrastructure and policies.  It is an ideal setting to adopt interventions that aim to reduce the incidence of obesity.  Workplaces also offer great communication channels through intranet and messages boards.

A recent report released by the Physical Activity Nutrition and Obesity Research Group (PANORG) at the University of Sydney summaries the best evidence currently available relating to the effectiveness of nutrition and physical activity interventions that have been implemented in the workplace.  The report concluded that there is strong evidence that multi-strategy workplace interventions that address physical activity and nutrition are effective for increasing physical activity, promoting healthy eating and preventing obesity.

Effective types of physical activity strategies include:

• Providing prompts to encourage stair use
• Providing access to places or opportunities for physical activity
• Providing education or peer support

Effective strategies to address nutrition are those that modify the food environment are:

• Food labelling
• Point-of-purchase promotions
• Providing access and improving availability of healthy food choices in canteens and vending machines

There is also evidence that providing counselling, individual behavioural skills training and involving workers in program development and implementation are important elements of effective interventions.
The type of intervention employed depends on the facilities and environmental features of your workplace.  The Centre for Disease Control and Prevention (CDC) has released a free web-based workplace obesity prevention program called LEAN Works!  The resource offers interactive tools and evidence-based resources to design effective worksite obesity prevention and control programs including an obesity cost calculator to estimate how much obesity is costing your company and how much savings your company could reap with different workplace interventions.  Click the LEAN Works! link to find out more information about how you can plan, build, promote and implement a workplace obesity prevention program in your workplace.

References

1. World Health Organisation. (2002). World Health Report. Retrieved Aug 11, 2010, from http://www.who.int/whr/2002/overview/en/index.html
2. Perkins, A. (2003). Obesity: National and local policy directions. Healthlink The Health Promotion Journal of the ACT Region, Autumn ed, 14-15.
3. Eckersley, R. (2003). Losing the battle of the bulge: Causes and consequences of increasing obesity. Healthlink The Health Promotion Journal of the ACT Region.
   Australian Institute of Health and Welfare. (2010). Australia's health 2010. Retrieved Aug 28, 2010, from http://www.aihw.gov.au/publications/aus/ah10/ah10.pdf
4. Douglas, K. (2003). Facts and figures on obesity in Australia and the health consequences. Healthlink The Health Promotion Journal of the ACT Region, Autumn ed, 7-8.
5. Australian Institute of Health and Welfare. (2010). Risk factors and participation in work. Retrieved Aug 28, 2010, from http://www.aihw.gov.au/publications/index.cfm/title/10741
6. Gemson, D., Commisso, R., Fuente. B., Newman, J., & Benson, S. (2008). Promoting weight loss and blood pressure control at work: impact of an education and intervention program. Journal of Occupational Medicine, 50, 272-281.
7. Gates. D., Succop, P., Brehm, B., Gillespie, G., & Sommers, B. (2008). Obesity and presenteeism: the impact of body mass index on workplace productivity. Journal of Occupational and Environmental Medicine, 50 (1).
8. World Health Organisation. (2007). The challenge of obesity in the WHO European Region and the strategies for response. Retrieved Sep 1, 2010, from http://www.euro.who.int/__data/assets/pdf_file/0010/74746/E90711.pdf
9. Centre for Disease Control and Prevention. (2010). Lean Works: Leading employees to activity and nutrition. Retrieved Aug 11, 2010, from http://www.cdc.gov/leanworks/index.html
10. Queensland Public Health Forum. (2002). Eat Well Queensland 2002-2012: Smart Eating for a Healthier State. Retrieved Sep 1,2010, from http://www.health.qld.gov.au/qphf/documents/30434.pdf
11. Physical Activity Nutrition Obesity Research Group. (2009). Evidence module: workplace physical activity and nutrition interventions. Retrieved Sep 1, 2010, from: http://sydney.edu.au/medicine/public-health/panorg/pdfs/Evidence_module_Workplace.pdf