Maintaining Your Health on Mackinac
Calorie Counting Is a Practical Tool forWeight Control
By Yvan Silva, M.D.

The wars against weight loss continue. Diets are invented. Diets are started. Diets are discarded. Losing sufficient weight safely, in a reasonable period of time, and then maintaining weight control is the obvious goal. Most of us can't seem to reach it. Why? We cannot seem to maintain a balance between calories in and calories out. Too many calories in, and not enough burned off. The logistics are simple.

Several studies have shown that obesity, defined as 30 percent over ideal body weight, has continued to increase over the past decade, and 60 percent of Americans fit that definition today. Fat reduction in the diet alone, as it is currently thought, will not produce and sustain weight loss. Sure, the number of calories will be less, in that fats provide nine calories per gram, while carbohydrates and proteins provide four. Most obese individuals take in more calories than they believe they do. A common breakfast of three pancakes with butter and syrup and a glass of chocolate milk adds up to almost a thousand calories. Did you know that?

Calorie counting seems like a daunting task. Studies have shown that people who take the trouble to document their intake by writing down portions and calories, will have a good idea, usually after a week, of how many calories there are in about 75 percent of what they eat. Yet remembering all of this in practice is difficult, and it may be better to remember food intake in blocks of 100-calorie units, and ways to burn calories in 100-calorie units. Many factors influence caloric needs to maintain health, including your actual weight and your regular activity levels.

Generally, to lose a pound per week, you should eat 3,500 calories less, or 500 per day less than you need. Trying to lose two pounds per week is strenuous, and more than that, it is just counterproductive, because it will slow down your metabolism and curtail your energy.

Here is a formula for caloric needs: Moderate activity is defined as the equivalent of walking two miles a day. The sedentary state is less than that - very little activity. Greater physical activity, ideally a regular exercise program, is even more desirable. This may include regular physical exercise - 20 to 30 minutes per day of sustained activity, five or more days per week.

Multiply your present weight by the factor below: For a sedentary man, 14; woman, 12; moderately active man, 17; woman, 15. Thus, a moderately active 160-pound woman would need 2,400 calories per day to maintain her current weight; she would be able to take in 1,900 calories per day comfortably, and lose a pound per week. To lose two pounds per week, the intake would be restricted to 1,400 calories per day.

A recent study involved 38 dieters over the period of Thanksgiving until two weeks after New Year's Day. The group that kept strict records of what they ate, and the calories, lost an average of seven pounds during the holiday period. Those who did not gained three pounds, on average. Attention to detail is clearly more meaningful, and gets better results.

At each meal, in addition to counting, portions can be divided such that half of the meal is comprised of vegetables, a quarter lean protein, and a quarter complex carbohydrates such as corn, potatoes, or brown rice. This can trim hundreds of calories at each meal. There's little point in getting into foods you lose control with, like peanuts, potato chips, ice cream, pizza, desserts, and other "trigger" foods. Keep away from them. You'll just have to cut the calories out with the rest of the foods you're going to eat. Bulky foods that induce satiety are good. Fresh produce, stews, pasta, and other high fiber foods will give you less calories than, say, dried fruit, high-fat snacks, cookies, candy, and the like. Adding vegetables as ingredients in your meals, as well as side dishes, will give you higher volume and fewer calories. Remember to count the calories in what you drink. A glass of orange juice is 110 calories, colas are 160 calories, beer is 146, and wine is about 120 calories in a five-ounce glass.

Eating in a restaurant can be a real challenge. The portions keep getting bigger, and the urge to eat what you pay for can drive you to finishing (never mind the waiter asking you why you didn't like it, if you didn't finish it). Ordering low-fat items, appetizers instead of entrees, and splitting entrees with a partner can work to your advantage. As far as fast food places, you can go in armed with calorie counts for each franchise and each item - they're available in several published sources. A truly balanced meal of complex carbohydrates, protein, and fat should carry you to the next meal without the need to snack. Salad dressings and mayonnaise can add 200 to 600 extra calories. Choose wisely, and use them on the side. Sugars and fats are commonly used together in popular desserts - check combinations and portions.

The new federal guidelines for ideal weights, in effect resetting the scales, have resulted

in defining an amazing 60 percent of Americans as overweight. The term BMI is now used with everyday frequency. The Body Mass Index (BMI) of an individual is 704.5 x Weight in Pounds Divided by Height in Inches Squared. The new guidelines define healthy weight as a BMI of 19 to 25, and a BMI of 25 or greater as overweight. In addition to your weight, it's a good idea to calculate your individual BMI.

What is a calorie? It's a measure of energy. One calorie is the amount of heat required to raise the temperature of one gram of water by one degree Celsius. A dietary calorie is technically a kilocalorie, that is, the amount of heat required to raise the temperature of one kilogram of water by one degree Celsius. The terms are used interchangeably. Thus calories express the amount of energy available in the food you eat, and they also express the amount of energy you expend when you exercise. Calories in. Calories out.

Here is some practical information that might help. In 100- calories units, rounded off to describe portions in food groups:

Protein: 1.5 ounces cooked hamburger; 2.25 ounces skinless chicken breast; 3 ounces of tuna canned in water; 1.5 hardcooked large eggs.

Fat: 1 tablespoon each of butter, margarine, olive oil, mayonnaise, or 1 ounce of cheddar cheese.

Carbohydrates: 1.5 slices of whole wheat bread; 1.5 whole large oranges; 3.5 ounces of baked potato; .5 cup cooked spaghetti; 1 cup of Cheerios; 3.5 ounces canned black beans.

These are examples. Details are available readily on labels of food products, and on Web sites like health.gov; Nutritiondata. com, and others. It is usually held that three ounces of meat is about the size of a deck of cards.

When it comes to exercise, the number of calories burned relates to size and sex. Men, who are larger and have more muscle, burn more calories than women. If you're trying to lose weight, you must do plenty of aerobic exercise. In addition, weight training, even at modest levels, is important to build and tone muscle, which raises the basal metabolic rate. Here are some examples relating to exercise to burn 100 calories; the first number relates to a 130- pound woman, and the second number to a 155-pound man. You can adjust these according to your own weight.

Jogging: 15 minutes; 9 minutes. Walking at four miles per hour: 25 minutes; 22 minutes. Golf: 26 minutes; 22 minutes. Swimming, leisurely: 18 minutes; 15 minutes. Bicycling, stationary: 20 minutes; 15 minutes. Low aerobics, lowimpact: 17 minutes; 17 minutes. Further information is also available online from health. gov.

Most mineral and vitamin requirements are readily met with a diet rich in fruits and vegetables. A daily multivitamin is generally regarded as acceptable.

All this seems like a lot of mathematics. But it really is simple, surely, simpler than figuring your income tax. Get a calorie counter, start to count calories in a daily record, and get started. Or work with 100 calorie-unit blocks. It will soon become a part of your regular life. You will soon learn how to do what you need to do. A nationwide poll found that 78 percent of obese Americans weren't even trying to lose weight, mainly because they just didn't know how in a practical way. Don't quit if you fail. There are no quick fixes. It takes solid perseverance, attention to detail, good knowledge, and a continuing educated effort.

Dr. Silva is a professor of surgery at Wayne State University and a resident of Woodbluff on Mackinac Island.