

Losing Weight: Start By Counting Calories

Americans are getting fatter. We're putting on the pounds at an alarmingly rapid rate. And we're sacrificing our health for the sake of super-sized portions, biggie drinks, and two-for-one value meals, obesity researchers say.


Poor diet and physical inactivity account for more than 400,000 premature deaths each year in the United States, second only to deaths related to smoking, says the CDC. People who are overweight or obese are more likely to develop heart disease, stroke, high blood pressure, diabetes, gallbladder disease, and joint pain caused by excess uric acid (gout). Excess weight can also cause interrupted breathing during sleep (sleep apnea) and wearing away of the joints (osteoarthritis). Carrying extra weight means carrying an extra risk for certain types of cancer, including endometrial, breast, prostate, and colon cancer.

But there is hope for overweight Americans. They can take small, achievable steps to improve their health and reverse the obesity epidemic. This message is the cornerstone of a national education campaign announced in March 2004 by the Department of Health and Human Services (HHS).

As part of HHS' renewed efforts to combat obesity, the Food and Drug Administration's Obesity Working Group released its Calories Count report in March 2004, highlighting actions that the agency will work toward to help consumers make smart choices about their diet. These actions include strengthening food labeling, educating consumers about maintaining a healthy diet and weight, and encouraging restaurants to provide calorie and nutrition information. Also included are increased enforcement to ensure food labels accurately portray serving size and strengthened scientific research aimed at reducing obesity and developing foods that are healthier and lower in calories.

Are You Overweight?






link to long descriptionThe BMI ranges shown at left are for adults. They are not exact ranges of healthy and unhealthy weights. However, they show that health risk increases at higher levels of overweight and obesity. Even within the healthy BMI range, weight gains can carry health risks for adults.



Overweight: BMI from 25 up to 30 refers to overweight.


Successful 'Losers'

Although many people who lose weight may eventually gain it back, it's a myth that this happens to everyone, says Rena Wing, Ph.D., a professor of psychiatry at Brown Medical School in Providence, R.I. Wing, the co-developer of a research study known as the National Weight Control Registry, has worked to deflate this myth.


How do they do it?


Six years after their weight loss, most of the registry's successful losers still report eating a low-calorie, low-fat diet. They also exercise for about an hour or more a day, expending about 2,800 calories per week on a variety of activities.









Setting a Goal

The first step to weight loss is setting a realistic goal. By using a BMI chart and consulting with your health care provider, you can determine what is a healthy weight for you.


To reach your goal safely, plan to lose weight gradually. A weight loss of one-half to two pounds a week is usually safe, according to the Dietary Guidelines for Americans 2000. This can be achieved by decreasing the calories eaten or increasing the calories used by 250 to 1,000 calories per day, depending on current calorie intake. (Some people with serious health problems due to obesity may lose weight more rapidly under a doctor's supervision.) If you plan to lose more than 15 to 20 pounds, have any health problems, or take medication on a regular basis, see your health care professional before you begin a weight-loss program.

Changing Eating Habits

Dieting may conjure up visions of eating little but lettuce and sprouts--but you can enjoy all foods as part of a healthy diet as long as you don't overdo it. To be successful at losing weight, you need to change your lifestyle--not just go on a diet, experts say. This requires cutting back on the number of calories you eat by eating smaller amounts of foods and choosing foods lower in calories. It also means being more physically active.


Use the Food Guide Pyramid developed by the U.S. Department of Agriculture and HHS to help you choose a healthful assortment of foods. Include bright-colored (red, yellow, green, and orange) vegetables and fruits, grains (especially whole grains), low-fat or fat-free milk, and fish, lean meat, poultry, or beans. Choose foods naturally high in fiber, such as fruits, vegetables, legumes (such as beans and lentils), and whole grains. The high fiber content of many of these foods may help you to feel full with fewer calories. To be sure that a food is whole grain, check the ingredient list on the food label--the first ingredient should be whole wheat or whole grain.

All calorie sources are not created equal. Carbohydrate and protein have about four calories per gram, but all fats, including oils like olive and canola oil, have more than twice that amount (nine calories per gram).

Keep your intake of saturated fat, trans fat, and cholesterol as low as possible. All of these fats raise LDL (or "bad

cholesterol"), which increases your risk for coronary heart disease. Foods high in saturated fats include high-fat dairy products (like cheese, whole milk, cream, butter, and regular ice cream), fatty fresh and processed meats, the skin and fat of poultry, lard, palm oil, and coconut oil. Trans fat can often be found in processed foods made with partially hydrogenated vegetable oils such as vegetable shortenings, some margarines (for example, stick margarines that are hard), crackers, cookies, candies, snack foods, fried foods and baked goods.

If you drink alcoholic beverages, do so in moderation (no more than one drink a day for women, and no more than two drinks a day for men). Alcoholic beverages supply calories but few nutrients. A 12-ounce regular beer contains about 150 calories, a 5-ounce glass of wine about 100 calories, and 1.5 ounces of 80-proof distilled spirits about 100 calories.

Limit your use of beverages and foods that are high in added sugars--those added to foods in processing or preparation, not the naturally occurring sugars in foods such as fruit or milk. Foods high in added sugars provide calories, but may have few of the other beneficial nutrients, such as fiber, vitamins, and minerals, that your body needs. A food high in added sugars will list a sugar as the first or second ingredient on the ingredient list. Some examples of added sugars are corn syrup, high fructose corn syrup, maltose, dextrose, honey, fruit juice concentrates, and maple syrup. In the United States, foods high in added sugars include non-diet soft drinks, sweetened beverages, including teas, fruit drinks, and fruitades, sweets and candies, and cakes and cookies.

Using the Food Label

Under regulations from the FDA and the U. S. Department of Agriculture, the food label, found on almost all processed foods, offers more complete, useful and accurate nutrition information than ever before. Even when restricting calories and portions, you should use the Nutrition Facts panel on the food label to make sure you get all the essential nutrients for good health.

When concerned about reducing calories or controlling your weight, one of the first places you should look on the Nutrition Facts panel is the serving size and the number of servings per package, which are listed at the top. The serving size affects the calories, the amounts of each nutrient, and the percent Daily Values (%DV) for the nutrients listed on the panel.

"To be sure you know how many calories you're consuming, you need to compare what you are actually eating to the serving size on the label," says Naomi Kulakow, coordinator for education and outreach in the FDA's Center for Food Safety and Applied Nutrition. For example, if there is one cup in a serving and the package contains two servings, you need to double the calories and other nutrient numbers if you eat the whole package. Many items sold as single portions--like a 20-ounce soft drink, a 3-ounce bag of chips, and a large bagel--actually provide two or more servings.

In addition to calories and serving sizes, there are other parts of the Nutrition Facts panel, such as the list of nutrients, that can help you make healthy food choices while you lose weight. The nutrients listed first are the ones that some people eat more of than they need. Eating too much fat, saturated fat, trans fat, cholesterol, or sodium may increase your risk for chronic diseases like heart disease, diabetes, some cancers, or high blood pressure. "These are nutrients you should try to limit in your diet," says Kulakow. "The goal is to stay below 100 percent of the Daily Value for each of them for the day."

The Nutrition Facts panel also shows how much dietary fiber, vitamin A, vitamin C, calcium, and iron are contained in a serving. These are the nutrients you want to get at least 100 percent of the Daily Value every day for good health.

The %DV is the quickest way to determine how a serving of food fits in with recommendations for a healthful diet, says Kulakow. To tell if a food is high or low in a nutrient, "just glance at the %DV--5 percent of the Daily Value or less is low, and 20 percent or more is high," she says.

You can also use the %DV to compare similar products or to help you balance food choices throughout the day. "For example, if you eat a favorite food that's high in fat at one meal, balance it with low-fat foods at other times of the day," says Kulakow. Or use the %DV when comparing foods and claims, for example, to find out which frozen dinner is lower in saturated fat--particularly when it involves a comparative nutrient claim, such as reduced-fat. "You don't need to know the precise definition of 'low' or 'reduced,'" says Kulakow. "Just look at the Percent Daily Value and see which product is higher or lower in the nutrient you are interested in."

The %DVs are based on a 2,000-calorie daily diet. But even if you eat more or less than 2,000 calories, the %DV still gives you a frame of reference to gauge your calorie and nutrient intake.

"Too often, people use the food label only when they want to restrict calories and fat--but not as a tool to help them increase the nutrients they need to get in adequate or greater amounts," says Kulakow. While restricting calories is important for weight loss, getting adequate amounts of fiber, calcium, and other key nutrients is also critical to good health.

Kulakow advises caution when choosing foods that are labeled "fat-free" and "low-fat." Fat-free doesn't mean calorie-free. To make a food tastier, sometimes extra sugars are added, which adds calories. So dieters should always check the Nutrition Facts panel to get complete information, says Kulakow.

Increasing Physical Activity


In addition to helping to control weight, physical activity decreases the risk of dying from coronary heart disease and reduces the risk of developing diabetes, hypertension, and certain cancers. Researchers also have found that daily physical activity may help a person lose weight by partially lessening the slow-down in metabolism that occurs during weight loss.



Prescription Weight-Loss Drugs








Over-the-Counter Drugs

Until recently, weight-control drugs containing the active ingredient phenylpropanolamine (also used as a nasal decongestant) were available over-the-counter (OTC). However, based on evidence linking this ingredient to an increased risk of bleeding in the brain (hemorrhagic stroke), the FDA asked drug manufacturers to discontinue marketing products containing phenylpropanolamine. In addition, the FDA issued a public health advisory in November 2000, warning consumers to stop using products containing this ingredient.

The FDA is proposing to classify phenylpropanolamine as "not generally recognized as safe" and is proceeding with regulatory actions that will likely remove this ingredient from the market. Although cough-cold products were reformulated using other nasal decongestant ingredients, there is no currently available active ingredient that is generally recognized as safe and effective for use in an OTC weight-control drug product.

Beware of Unproven Claims

Some dietary supplement makers claim their products work for weight loss. These products are not approved by the FDA before they are marketed. Under existing laws, manufacturers have the responsibility for ensuring that their dietary supplement products are safe and effective.


Worth the Effort


Linda Bren is a staff writer for FDA Consumer.

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