NEWS for North Dakotans
Agriculture Communication, North Dakota State University
7 Morrill Hall, Fargo, ND 58105-5665

August 27, 1998

New Guidelines Underscore 5 Plus 5 Concept

The first federal guidelines designed to help physicians care for adults who are overweight or obese has set out successful strategies for weight loss. These recently released recommendations include reducing calorie intake, increasing physical activity and, in some cases, using behavior therapy to improve eating and physical activity habits.

Physicians are advised to have their patients try lifestyle therapy for at least six months before embarking on physician-prescribed drug therapy. An educator at North Dakota State University says an effort now underway in North Dakota also promotes the concepts behind lifestyle therapy.

"Through a number of our educational programs, we're asking North Dakotans to take the 5 plus 5 challenge. That means eating five servings of fruits and vegetables a day plus doing 30 minutes of physical activity on five days, or more, of each week," says Julie Garden-Robinson, extension food and nutrition specialist at NDSU.

The National Institutes of Health in Bethesda, Md., estimates that 97 million American adults are overweight or obese—a number representing about 55 percent of the total adult population. These individuals are at increased risk of illness from high blood pressure (hypertension), blood disorders, type 2 diabetes, heart disease, stroke, gallbladder disease, osteoarthritis, sleep apnea and respiratory problems, and certain cancers. The total costs attributable to obesity-related disease in this country now approach $100 billion annually.

When it comes to dietary habits that can affect overall healthfulness, most North Dakotans need to improve. Based on a recent survey, the state health department reports that only 18 percent of adults, only 30 percent of youth in grades 9 to 12 and only 33 percent of sixth graders were eating five servings of fruits and vegetables each day.

The federal guidelines direct physicians to have their overweight and obese patients engage in moderate physical activity, progressing to 30 minutes or more on most days of the week—preferably every day. Most North Dakotans could improve in this area of their lives too. The health department survey found that about 34 percent of all North Dakotans are inactive—meaning they engage in no physical activity outside of their work. Only 17 percent of North Dakota's adults engage in light or moderate activities. As for the state's youth, 37 percent of youth in grades 9 to 12 are physically active while about 50 percent of sixth graders are physically active for the recommended amount of time.

The ill effects of the diet and physical activity levels reported by many North Dakotans are reflected, at least in part, by a number of health statistics: as measured by body mass index (BMI), 32 percent of North Dakota adults were overweight in 1996; 22 percent of North Dakota adults have been told their blood pressure is high; a child in North Dakota is 32 times more likely to develop type 1 diabetes than a child in Japan; and estimates indicate that currently there are about 110,000 North Dakotans who either have or will develop diabetes within their lifetime.

Another recommendation from the federal guidelines points out that cutting back on dietary fat can help reduce calories and is a heart-healthy eating behavior, but reducing dietary fat alone—without reducing calories—will not produce weight loss.

"Most fruits and vegetables are naturally low in calories and fat and none contain cholesterol. So, setting a goal for yourself of eating at least five servings of fruits and vegetables every day would be the first and perhaps easiest step toward reducing dietary fat," says Garden-Robinson. "At the same time, you should become a scrupulous reader of food labels. Many fat-free foods are loaded with empty calories, those coming from simple carbohydrates like sugar. Also, some food processors increase a product's sodium content to offset the loss of flavor due to the reduced or eliminated fat content."

For people wanting to lose weight, their initial goal should be a 10-percent reduction from their baseline, or where they're at when they begin reducing their fat and calorie intake. The federal guidelines say a reasonable time line for a 10-percent reduction in body weight is six months. Weight loss should not exceed 1 or 2 pounds per week. With success and if warranted, additional weight loss can follow. For older adults, an evaluation of potential risks and benefits should guide physicians' decisions regarding weight-loss treatments.

"Healthier lifestyles can benefit virtually anyone," concludes Garden-Robinson. "People are never too old to benefit, at least to some extent, from healthy lifestyle changes."

For more information about North Dakota's 5 Plus 5 program, contact your local office of the NDSU Extension Service.

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Source: Julie Garden- Robinson (701) 231-7187

Editor: Dean Hulse (701) 231-6136