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Small Changes = Big Differences

Volpe, Stella Lucia Ph.D., R.D., L.D.N., FACSM

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ACSM's Health & Fitness Journal: May 2009 - Volume 13 - Issue 3 - p 35-36
doi: 10.1249/FIT.0b013e3181a1eaad
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In Brief

We often ask people to make significant changes to their lifestyles to see results quickly; however, it is often difficult for people to make big changes, especially as people get older and often are more established in their habits. In this article, I will focus on tips we can give to clients to help them make small changes that will lead to better health. Most recently, Hill (1) stated, "An alternative strategy to address the obesity epidemic involves not focusing on weight loss but promoting small changes in diet and physical activity to initially prevent further weight gain." The focus on weight loss may be the reason many people are not losing weight, and why, instead, we have seen increases in body weight globally, even during the last year. Targeting healthy eating habits could help prevent further weight gain (1,2).

DIETARY CHANGES

Let's begin with how people can make small changes to their diet that can lead to a healthier body weight and better metabolic profiles. People are surrounded by many choices every day. For clients who eat lunch at a fast-food restaurant each day, they could order healthier choices there, as opposed to a burger and french fries. Because fast-food restaurants have a lot more choices, healthier choices have become easier and can be gradually integrated into a person's lunch.

Using smaller plates and cups to consume meals is another small way to make big changes over time. For example, a person who really likes ice cream can use a coffee cup instead of a bowl. Although he/she may return for a second helping when first making this change, over time, the one cup will be satisfying.

When at gatherings or parties where food is often abundant, keeping more than an arm's reach away from food is a helpful way to eat less. Instead, put some items on a small plate then walk away from the table to consume them. Clients can be encouraged, "Don't deprive, downsize!"

Certainly, including more fruits and vegetables into one's diet is not only healthy, but also can help with weight loss. Typically, by adding more fruits and vegetables, a person often decreases his/her intake of other items. In addition, if someone drinks a lot of sodas, I will often tell them to cut back even on one soda per day, which could prevent weight gain or result in weight loss.

Including whole grains into one's diet is great for a person's metabolic profile and also may result in a greater feeling of fullness. Easy ways to include whole grains are to choose whole grain breads, as well as brown rice instead of white rice.

In addition, eating breakfast is important for weight management. Those who eat breakfast expend more energy in a day than those who do not. Including protein at breakfast also results in feeling more satisfied for a longer period of time.

In addition to eating breakfast, eating every three to four hours helps people to maintain glucose levels, which prevents a person from feeling light-headed, which could lead to eating a lot more food. An easy way to begin consuming smaller, more frequent meals is to split a normal-sized meal into two smaller meals.

Eating slowly can help to stave off hunger. The saying that it takes 20 minutes for our brain to know we have eaten is not a myth. In our rapidly moving society, taking even 10 minutes to eat lunch away from the desk is important - mentally and physically.

Photo courtesy of Power Systems.

INCREASING PHYSICAL ACTIVITY

A big misconception with physical activity is that it must be performed all at once and for at least 20 minutes at a time to be beneficial. In addition, our clients often feel that if they are not able to exercise for their "usual" time, that they should not exercise at all. Another motto I like to use is "Better Than Nothing" (the "BTN Principal"). Getting individuals to be physically active at all can be a challenge. But letting people realize that performing some activity is better than nothing, decreases their anxiety about having to be at the gym or run for 45 minutes. It also will lead to better adherence, especially on days when individuals have to rush to take a child to school and then go to work.

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In addition, research has shown that doing physical activity in shorter bouts throughout the day not only can result in weight loss, but improves cardiovascular fitness as well (3,4,6). Shorter bouts of physical activity also may increase adherence because of people's hectic schedules. Thus, a person may do 10 minutes of physical activity in the morning, 10 minutes at noon, and 10 minutes in the evening. This adds up over time and is beneficial from a cardiovascular fitness perspective.

Other tips for increasing activity include sitting on a balance ball while working on the computer or watching television and is another way to add activity to one's day. Although this does not lead to a great deal of energy expenditure, it helps to increase core muscles and also helps with posture. Taking the stairs instead of the elevator or escalator can increase energy expenditure, leading to weight loss and cardiovascular benefits (5).

Parking farther away at work and/or when going shopping also will increase energy expenditure. Dancing, performing sit-ups, or other activities during television commercials increase energy expenditure and may be especially helpful during the colder months and/or in communities where walking outside in the evening is not safe. Taking walks with the dog and/or family members on a daily basis (even if they are short walks) provides a wonderful way to have special time together, as well as getting exercise.

SUMMARY

Eating well and getting some physical activity in each day is important for our health and overall well-being. Doing so does not have to be complicated or stressful, nor does it require joining a gym. Small changes in eating and physical activity can lead to big changes in health. The ideas previously provided are a small start to many other changes that can occur in people's lives. Being creative and allowing people to consider what works best for them will lead to the best success - better health!

References

1. Hill JO. Can a small-changes approach help address the obesity epidemic? A report of the Joint Task Force of the American Society for Nutrition, Institute of Food Technologists, and International Food Information Council. Am J Clin Nutr. 2009;89(2):477-84. Epub 2008 Dec 16.
2. Hill JO, Peters JC, Catenacci VA, Wyatt HR. International strategies to address obesity. Obes Rev. 2008;9(Suppl 1):41-7.
3. Jakicic JM, Wing RR, Butler BA, Robertson RJ. Prescribing exercise in multiple short bouts versus one continuous bout: effects on adherence, cardiorespiratory fitness, and weight loss in overweight women. Int J Obes Relat Metab Disord. 1995;19(12):893-901.
4. Jakicic JM, Winters C, Lang W, Wing RR. Effects of intermittent exercise and use of home exercise equipment on adherence, weight loss, and fitness in overweight women: a randomized trial. JAMA. 1999;282(16):1554-60.
5. Reynolds LR, Anderson JW. Practical office strategies for weight management of the obese diabetic individual. Endocr Pract. 2004;10(2):153-9.
6. Snyder KA, Donnelly JE, Jabobsen DJ, Hertner G, Jakicic JM. The effects of long-term, moderate intensity, intermittent exercise on aerobic capacity, body composition, blood lipids, insulin and glucose in overweight females. Int J Obes Relat Metab Disord. 1997;21(12):1180-9.

Web sites

America on the Move. Available from: http://aom2.americaonthemove.org/.
    American Dietetic Association. Available from: http://eatright.org/cps/rde/xchg/ada/hs.xsl/index.html.
      © 2009 American College of Sports Medicine