Module

Lifestyle Disease and Risk

Reduction Program

By Samuel Martínez
BEYOND OVERWEIGHT AND OBESITY:
GAINING A SLIM AND HEALTHY BODY
 Table of Contents

Introduction………………………………………………………………………………..1
Definitions & Facts……………………………………………………………………….2
How can overweight and obesity be reduced?……………………………………………4
Treatment………………………………………………………………………………….5
Program…………………………………………………………………….......................7
First Session……………………………………………………………………….9
Second Session………………………………………………………...................10
Third Session……………………………………………………………………..11
Fourth Session……………………………………………………………………12
Fifth Session…………………………………………………………...................13
Lecture Series……………………………………………………………………………14
Obesity and its Associated Risk Factors………………………………………...15
Obesity: Diet and Physical Activity…………………………………...................31
Pathophysiology, Risk Assessment and Prevalence……………………………..47
Physical Activity & Health………………………………………………………59
Eat Well & Keep Moving………………………………………………………..70
The 3rd Revolution in Health…………………………………………………….86
Behavior Change……………………………………………………...................95
The Vegetarian Advantage……………………………………………………..101
A Vegan Approach to Chronic Disease Prevention………………….………...113
Appendix A…………………………………………………………………..………..129
World Vegetarian Gourmet…………………………………………..………...130
Vegetarian Recipes…………………………………………………...………...131
Exercise Program………………………………………………………………132
Movies……………………………………………………………….................133
Body Mass Index Chart………………………………………………………..134
Healthy Eating Plate…………………………………………………………...135
Appendix B……………………………………………………………………………136
Budget………………………………………………………………………….137
Materials……………………………………………………………..................138
Lifestyle and Health Risk Questionnaire………………………………............139
Certificate……………………………………………………………………....141
References……………………………………………………………………………...142
 INTRODUCTION

In today's world, it is very well seen to have a slim, healthy and vibrant body. The

sad fact is that lately, only a small percentage of the world's inhabitants have good

physical health body expressed with the proper weight, because the vast majority is in the

overweight range and with a growing obesity levels; for this reason, overweight and

obesity have become real epidemics that make no difference of race or social status

(Mustafa, Salleh, Isa, & Ghazi, 2013).

This growing trend is due in large part to changes that globalization has brought to

humanity. Some of the most important changes (at the same time risk factors) takes place

on diet, becoming poorer in nutrients and high in fat and refined sugars; the

mechanization of work involving more robotic technology; the massive use of public

transport to work, school, church, and finally creating new forms of entertainment such as

video games and multiple technology products, with which the old form of entertainment

involving physical exercise outdoors, has been put aside. (Basch, Samuel, & Ethan, 2013;

Beaglehole & Yach, 2003; Boutayeb, 2006; Goryakin & Suhrcke, 2014)

One of the worst consequences of these epidemics is that not only affect adults,

but also children and adolescents, affecting not only their physical health, but also self-

esteem, body satisfaction and security in themselves, besides being teased by peers.

(Goto, Kiyohara, & Kawamura, 2010; Hamid, Islam, & Ray, 2013; Silva-sanigorski et

al., 2010).

Because overweight and obesity are linked to the development of cardiovascular

diseases, diabetes, hypertension and dyslipidemia, it is important to have more than ever
programs focused on prevention and changes in lifestyle, including consultation on

nutrition and physical activity (Aranceta et al., 2007; Silva-sanigorski et al., 2010)

DEFINITIONS & FACTS

 Overweight and Obesity: The World Health Organization defines overweight

(BMI 25–29.9 kg/m2) and obesity (BMI ≥30 kg/m2) as accumulation of fat at

abnormal or excessive levels to impair health (WHO, 2014).

 Body mass index (BMI): “It is a simple index of weight-for-height that is

commonly used to classify overweight and obesity in adults. It is defined as a

person's weight in kilograms divided by the square of his height in meters

(kg/m2)” (WHO, 2014).

 Etiology: “The fundamental cause of obesity and overweight is an energy

imbalance between calories consumed and calories expended, basically an

increased intake of energy-dense foods that are high in fat; and an increase in

physical inactivity due to the increasingly sedentary nature of many forms of

work, changing modes of transportation, and increasing urbanization” (WHO,

2014).

 Risk Factors (Mayo Clinic, 2014)

 Genetics

 Family lifestyle

 Inactivity

 Unhealthy diet and eating habits

 Quitting smoking

 Pregnancy
  Lack of sleep

 Certain medications

 Age

 Social and economic issues

 Medical problems

 Classification (Mayo Clinic, 2014):

BMI Weight status

Below 18.5 Underweight

18.5-24.9 Normal

25.0-29.9 Overweight

30.0-34.9 Obese (Class I)

35.0-39.9 Obese (Class II)

40.0 and higher Extreme obesity (Class III)

 Key facts (WHO, 2014):

 Worldwide obesity has nearly doubled since 1980.

 In 2008, more than 1.4 billion adults, 20 and older, were overweight. Of
these over 200 million men and nearly 300 million women were obese.
 35% of adults aged 20 and over were overweight in 2008, and 11% were
obese.
 65% of the world's population live in countries where overweight and
obesity kills more people than underweight.
 More than 40 million children under the age of 5 were overweight or
obese in 2012.
 Obesity is preventable.
 HOW CAN OVERWEIGHT AND OBESITY BE REDUCED? (WHO, 2014)

Overweight and obesity, as well as their related noncommunicable diseases, are largely

preventable. Supportive environments and communities are fundamental in shaping

people’s choices, making the healthier choice of foods and regular physical activity the

easiest choice (accessible, available and affordable), and therefore preventing obesity.

At the individual level, people can:

 Limit energy intake from total fats and sugars.

 Increase consumption of fruit and vegetables, as well as legumes, whole grains
and nuts.
 Engage in regular physical activity (60 minutes a day for children and 150

minutes per week for adults).

Individual responsibility can only have its full effect where people have access to a

healthy lifestyle. Therefore, at the societal level it is important to:

 Support individuals in following the recommendations above, through sustained

political commitment and the collaboration of many public and private
stakeholders.
 Make regular physical activity and healthier dietary choices available, affordable

and easily accessible to all - especially the poorest individuals.

The food industry can play a significant role in promoting healthy diets by:

 Reducing the fat, sugar and salt content of processed foods;

 Ensuring that healthy and nutritious choices are available and affordable to all
consumers;
 Practicing responsible marketing especially those aimed at children and teenagers;
 Ensuring the availability of healthy food choices and supporting regular physical
activity practice in the workplace.
 TREATMENT (Mayo Clinic, 2014)

The goal of obesity treatment is to reach and stay at a healthy weight. You may need

to work with a team of health professionals—including a dietitian, behavior therapist

or an obesity specialist—to help you understand and make changes in your eating

and activity habits.

The treatment tools include:

 Dietary changes

 A reduced-calorie diet

 Feeling full on less

 Adopting a healthy-eating plan

 Restricting certain foods

 Meal replacements

 Being wary of quick fixes

 Exercise and activity

 Exercise at least 150 minutes a week of moderate-intensity physical

activity to prevent further weight gain or to maintain the loss of a modest

amount of weight.

 Increase your daily activity for example parking farther from store

entrances rev up your household chores, garden, and get up and move

around periodically.

 Behavior change

 Counseling

 Support groups
 Prescription weight-loss medications

 Orlistat (Xenical)

 Lorcaserin (Belviq)

 Phentermine-topiramate (Qsymia)

 Phentermine (Adipex-P, Suprenza)

 Weight-loss surgery

 Gastric bypass surgery

 Laparoscopic adjustable gastric banding (LAGB)

 Gastric sleeve

 Biliopancreatic diversion with duodenal switch

 PROGRAMS

Exercise Program

This program is designed to help participants to know the variety of exercises that

are available to start a more active lifestyle. Since the great majority of the participants

are at least in the overweight range and few practice physical activity, this course will

serve as a fundamental guide to understanding the mechanisms of exercise and

techniques to accomplish this safely.

Nutrition Program

This program—along with physical activity—is one of the cornerstones in the

treatment of obesity. It will include understanding of the nutritional foundation for

healthy eating, and a vegetarian cooking workshop as the healthiest way to enjoy an

abundant life in quantity and quality.

Behavioral Changes Program

As an integral part of the program, it cannot miss a space dedicated to our

behavior, what determines our thoughts, our actions and decisions in everyday life. It

includes fundamental aspects of behavioral psychology and will give the firm foundation

for participants to understand and apply basic concepts in their life. The importance of

this space is that the changes we make in our lives based on learning, motivation and

perseverance are which will continue over time, minimizing discouragement and

abandonment of new habits.

 OUTLINE OF THE PROGRAMS

The Lifestyle Modification program called “Beyond overweight and obesity: gaining a

slim and healthy body” is composed of five sessions once a week every Sunday among

the members of the Seventh-day Adventist Church at the University of Montemorelos

(Mexico). The complete health presentations made in power point will be seen in the

different lectures and the extra materials and instructions for all activities will be seen in

the appendix.
Lecture Series
Appendix A
 “WORLD VEGETARIAN GOURMET”

This activity will aim to present the food culture of the countries represented, as

well as increase the friendly ties between the participants.

Indications:

Each participant will prepare a meal from their native country, with the particularity that

the ingredients will be completely vegan. All participants who are from the same country

can be joined to cook together.

(The prepared food will be served in the fellowship potluck for all participants)
 Vegetarian Recipes

Quick Homemade Gluten

(Makes 1-1/4 to 1-1/2 pounds or 2 to 2-1/2 cups)

2 cups gluten flour

1 teaspoon garlic powder
1 teaspoon ground ginger
1-1/4 cups water or vegetable stock
3 Tablespoons soy sauce
1-3 teaspoons toasted sesame oil (optional)

 Add garlic powder and ginger to flour and stir. Mix liquids together and add to flour
mixture all at once. Mix vigorously with a fork. When it forms stiff dough knead it 10
to 15 times.
 Let the dough rest 2 to 5 minutes, then knead it a few more times. Let it rest another
15 minutes before proceeding.
 Cut gluten into 6 to 8 pieces and stretch into thin cutlets.

Tofu

2 quarts soy milk

Coagulant: 2 tsp. Terra Alba aka Gypsum (Calcium Sulphate)

 Boil the soy milk for 5 minutes and then cool to 160-175°F (70-80°C) degrees.
 If making soy milk fresh using a soy milk maker, there is no need to boil the milk
again.
 Dissolve the coagulant of your choice in a cup of warm water--do not let it set too
long!
 Mix the water and coagulant mixture into the hot soy milk. Gently stir the milk
but do not over mix. Allow the mixture to sit undisturbed for 15-25 minutes.
 While the mixture sits, small white curds will separate from amber colored
liquid.
 Once the process is complete, transfer the curds into a molding container lined
with cheese cloth or a similar fabric. Fold the fabric over the curds and place a
small weight on top to begin pressing out the liquid. Allow the mixture to be
pressed by the weight for 20-30 minutes or until it holds together. Remove the
block of tofu from the mold.
 If the tofu will not be consumed the same day it’s made, store the tofu in a
container with cold water in the refrigerator. The soaking water should be
changed daily.
 Makes a little less than a pound of tofu.
 “EXERCISE PROGRAM”

For a good implementation of this program, there must be appropriate sportswear

and sports shoes before to start. The exercise program begins with a period of 5 minute

warm-up, followed by touching their heels, raise up and stretching head, hand, torso,

hips, and knees and legs (8 counts each one). After warming-up, the participants will

walk briskly in a period of 40 minutes. Completing this period, the cooling down will be

done by chest up, stretching their backs (8 counts each one) and touching both of their

ankles, one side only, the other side, and touch the middle floor (8 counts). It is important

to remember that proper hydration is necessary, therefore each participant will drink 50-

100 ml of water every 15-20 minutes.

 MOVIES

Super Size Me

Documentary filmmaker Morgan Spurlock makes himself

a test subject of this documentary about the commercial food
industry. Rigorously eating a diet of McDonald's fast food, three
times a day for a month straight. Spurlock is out to prove the
physical and mental effects of consuming fast food. While doing
this, Spurlock also provides a look at the food culture in America
through it is schools, corporations, and politics as seen through
the eyes of regular people and health advocates. "Super Size Me"
is a movie that sheds a new light on what has become one of our
nation's biggest health problems: obesity.
http://www.imdb.com/title/tt0390521/plotsummary

Facing the Giants

Grant Taylor is the head coach at Shiloh

Christian Academy, and has yet to post a winning
record in his six-year tenure. After his seventh
season begins with a three-game losing streak,
the players' fathers start making noises about
replacing him with defensive coordinator Brady
Owens. This is not the only problem Grant is
facing; his car is breaking down, and he discovers
that he is the reason that his wife Brooke cannot
become pregnant. He creates a new coaching
philosophy and decides to praise God, no matter
what the result. At the same time he guides and
urges each one of his players to give the
maximum effort, and motivates them to believe
they can win under God's guidance. From that
point on, the Eagles lose only one more game for the rest of the season and advance all
the way to the state championship game against the three-time defending champion
Richland Giants. Even though the Eagles have only a third as many players as the Giants,
the Eagles hold their own and ultimately win the game on a 51-yard field goal from a
backup kicker who had never kicked more than a 35-yarder before. Grant's prayers for
children are also answered as he and Brooke have children after two years.
http://en.wikipedia.org/wiki/Facing_the_Giants
Appendix B
Materials Budget

Advertisement/pamphlets $ 25

Papers $ 15

Ball pens $5

Print outs $ 25

Shirts with print $ 500

Cooking Utensils $ 35

Cooking Ingredients $ 50

Certificates $ 20

Movies $ 80

Total $ 755
Karada Scan measures the body fat percentage by
the Bioelectrical Impedance (BI) method. Muscles,
blood vessels and bones are body tissues with a
high water content that conducts electricity easily.
In order for the scale to determine your body
composition, it uses the electrical impedance, along
with your height, weight, age and gender
information to generate results based on body
composition.

A Tape was necessary to measure waist

circumference.

Mechanical Physician Scale to get the weight and height of participants.

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