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Weight-loss solutions.

Ever worry about skin breakdown, shoulder injury, or outgrowing your chair? Carrying too much weight around may be part of the problem. If so, one solution is a combination of diet, exercise, and lifestyle choices to help you lose that weight and reduce the risk of nasty health stuff like heart disease, stroke, high blood pressure, skin issues, and joint and breathing problems. Better health and more energy come as a bonus.

The combination of paralysis and decreased activity level means wheelchair users normally burn fewer calories, burn them more slowly (metabolism rate), and have lower muscle mass, especially in the lower body. What this means is we burn fewer calories throughout the day, and continuing to eat the same amount as pre-injury translates into extra pounds.

Wheelers need to eat less and weigh less: about 5-10% less than pre-injury for manual-chair users, and 10-15% less for power-chair users.

How to Get There

Body weight is the result of eating and lifestyle habits. Taking in more calories than you use up means you gain weight; burning off more than you consume results in weight loss. The challenge is in finding the will, resolve, and best methods to burn off calories. The solution? Get in the habit of eating less and doing more. It's really pretty simple; it's just not easy.

Want to lose a pound? Take in 3,500 fewer calories or burn off that many more. Want to lose a pound a week? Reduce your calories by 500 per day or burn off that many more through increased activity each day.

Fewer calories in(Eating less) + more calories out(increased activity/exercise) = weight loss

Losing weight--and keeping it lost--involves making some basic lifestyle changes in eating habits and activity level. Start with the food pyramid of grains, vegetables, fruit, milk, and meat and beans. Daily recommended amounts are usually around 6 oz of grain (approximately 6 slices of bread), 2 1/2 cups of vegetables, 2 cups of fruit, 3 cups of low-fat or skim milk, and approximately 5 1/2. oz of meat and beans combined. People often eat far more protein because portions are much smaller than what they normally consume.

In general, 1/4 cup cooked dry beans, 1 egg, 2 tablespoons of peanut butter, or 1/2 ounce of nuts or seeds qualify as one ounce from the meat and beans group. As a rule of thumb, three ounces of meat is about the size of a deck of playing cards.

Depending on your height and frame size, you should be taking in a total of no more than 1,500-2,200 calories over the course of a day. To get an idea of how many calories you're consuming, start reading those Nutrition Facts labels, which list serving sizes, calorie amounts, and overall contents. Remember, recommended serving sizes are often smaller than you might think, so use a measuring cup to see how much (or how little!) that amount--often 1/2 cup or one cup--actually is. Eating more than recommended means taking in more calories.

No more than 30% of your total daily calories should come from fat, so choose low-fat, non-fat, trans-fat free, and fat-free versions of foods. Stay clear of trans fats--which are found in shortening, some margarine, crackers, candies, cookies, snack foods, fried foods, baked goods, and other processed foods made with "partially hydrogenated vegetable oils"--as they are generally unhealthy and can raise cholesterol levels. And low-fat or non-fat don't necessarily mean low calorie.

Beware the Snack Attack!

If you must snack, keep track of what you're eating; they should be under 100 calories. Replace high-fat snack foods with healthy ones such as fruits, vegetables, or low-fat dairy products. For fruit, try a small banana, pear, apple, orange, or 1/2 apple with 1/2 tablespoon smooth peanut butter. Or drink two cups of V-8 or eat a stalk of celery and 1 tablespoon of creamy peanut butter. You can also have a small container of low-fat yogurt or try 1/4 cup low-fat cottage cheese with 1/4 cup chopped fruit or a mini box of raisins.

Traditional snacks such as cookies, chips, and candy offer two to three times as many calories. Other quick fixes such as sodas or fruit drinks are loaded with sugar or high-fructose corn syrup and, depending on size, have 200-300 calories (two to three times as many as an apple or banana), with no nutritional value. A simple Web search for calories in fast food and beer will tell you most of what you need to know.

Shop the outer edge of the grocery store, which usually has fresh produce, dairy products, whole grains, dairy, and meat items, as opposed to center aisles that are packed with processed high-calorie, high-fat foods.

Start Moving!

By increasing your activity level you increase muscle mass, raise your metabolism rate, and burn more calories. Increase metabolism and muscle mass through a combination of weight training and aerobic exercise: wheeling, three-wheel bikes, or table-top cycles. Avoid boredom--and the urge to eat--by developing hobbies and healthy habits. Instead of dessert, go wheeling after meals. Avoid eating while cooking or sitting in the kitchen, or while in front of the TV or computer. Steer clear of temptations such as bakeries, buffet restaurants, and parties, where drinking alcohol and overeating are likely.

Eating only one or two meals a day encourages fat storage and decreases metabolism, so go for small frequent meals instead. Drink a glass of water before meals and snacks. Staying active, getting enough sleep, and drinking 8-12 cups of water a day will also help raise metabolism rates.

Know Yourself

Maybe you are motivated by how you look or how you feel (increased energy, easier transfers, more confident). Maybe it's health issues such as not growing out of your chair, decreasing your skin risk, or making easier transfers, weight shifts, and skin checks. Perhaps it's as simple as fitting into your clothes or having a reason to buy new ones. Find out what motivates you--and use it.

Weight loss does not happen overnight, so it's important to set clear, realistic, and attainable goals. These can be anything from better food choices, fewer calories, and increased fluid intake to increased activity level or weight loss. The more sensible your goals, the easier they will be to achieve.

Make one change at a time and once it's a habit, make another. Keep in mind you are adopting healthy eating habits for a lifetime.

Helpful Tips for Losing Weight

* Weight loss takes time, so aim for slow, steady progress; be patient.

* Set realistic goals.

* Stick to your plan--if you "fall off the wagon," get back on.

* Choose activities that are fun and plan ahead, especially if your schedule is busy.

* Get some support or team up with a friend.

* Avoid extreme dieting.

* Stay motivated!

Preparation of this article was funded by the U.S. Department of Education's National Institute on Disability and Rehabilitation Research (NIDRR). The opinions here are those of the grantee and do not necessarily reflect those of the U.S. Department of Education. For more information about this and other research projects at Craig Hospital, contact Susan Charlifue, PhD, 303-789-8306 /
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Title Annotation:living WELL
Author:Holicky, Richard
Publication:PN - Paraplegia News
Date:Nov 1, 2009
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