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Never Underestimate the Power of a Few Small Choices

on Feb 27, 2012 in Wellness Blog

by Vicki Pepper, M.S., R.D.  Kaiser Permanente, San Diego California

Never underestimate the power of a few small changes. Think of the ripple effect of throwing something so tiny it would seem unnoticeable into a pond. Seems like it wouldn’t matter much, but we know that it doesn’t take a lot to disturb the delicate ecological balance of a pond. Our bodies are very similar to environmental systems. Small changes in behaviors can and do lead to dramatic changes in our health and wellbeing.

In this country changes in our food supply and lifestyle have had striking effects on our health. Twenty years ago only 10% of adults were obese, now 30% suffer from obesity. One in 50 children were obese in 1970, now one in three struggle with extra weight. Type 2 diabetes, once considered an old person’s disease, is now a growing epidemic in both children and adults.

The small shifts in calorie intake and calories burned and the effects it has had on our health are highlighted in a recent article in the American Journal of Medicine. The study analyzed diet, weight, and health statistics for nursing students in the United States. The study followed the students from their 20s until they were in their 50s. During the 28-year study the students gained on average approximately 35 pounds. To gain 35 pounds over 28 years the students’ caloric balance (calories in minus calories out) was over by 370 calories a day. Behaviorally that could be accomplished by adding an additional 13 extra calories a day to your diet every year for 28 years.

Unfortunately many Americans have faired worse than the students in the study. Statistics for the 20th century show that body weight was stable for most Americans through the late 80s. In the early 90s, adults and children started to gain weight rapidly. By 2008 obesity in America had increased from 10 to 14% to 25 to 30%, with several states reaching obesity rates of greater than 30% of the population. Child obesity rates grew 10 times as fast.

In just 20 years the weight and, consequently, the health of America changed dramatically. Let’s look at a few things that have led to these changes.


Then and Now

We burn far fewer calories. We move less and less. We spend about 80 minutes a day or 3 years of our lives in a car. We watch television for about 7 hours a day or 9 years in a lifetime. If we are an adult, we Facebook, Twitter, surf the Web, text, and use cell phones about 4 hours a day or 10 years in a lifetime and, if we are between 8 and 18, we spend twice that amount of time on those activities. Now imagine adding all the time we spend sitting at school, at work, at restaurants, and sleeping. Over the span of a lifetime the average American will spend half their life moving very little, if at all.

We live in times of food abundance. High calorie food is affordable, easy to find, tastes really good, and is heavily marketed to us on an hourly, if not minute-to-minute basis. In 1960, the average serving size for a soda was 7 ounces, not the 12 to 64-ounce servings common today. Movie theater popcorn used to be 5 cups and 233 calories. Now it is served in 20-cup portions that total 1,640 calories. When a New York study evaluated 39 popular food products, with the exception of white bread, the portion sizes for all those foods had more than doubled in the last 30 years. Increased portions alone have added about 200 extra calories a day to the typical American diet.

We snack more and on higher calorie, sugar-laden foods. In fact sugar consumption and obesity have grown at about the same rate. Since 1988, obesity has increased by 15 to 20% and sugar consumption by 17 to 23%.

In the early 1900s Americans ate 5 pounds of sugar a year or 2/10ths of an ounce per day. By 1980, sugar consumption had increased to 109 pounds per person a year or 5 ounces a day. Currently, Americans consume a whopping 170 pounds or almost a half pound of sugar a day!

Our greatest source of sugar is from soda pop. Soda, which is a nutritionally bankrupt food item, has now become the major source of American calories contributing 10% of our daily intake. Since 1960, the US soft drink industry has grown over 350% and now produces 18 billion gallons of soft drinks a year. The average adult drinks 50 gallons of soda a year. Since the 70s, 12 to 19-year olds drink 52% more soda and children under 11 consume 305% more soda. Soda and sweetened fruit juices have added yet another 300 calories daily to the average American palate.

No doubt there are other factors that have contributed to the uphill climb on the scale; but the ones discussed here are enough to stop and give one pause. Thinking about reversing these trends may seem overwhelming, but remember that it has been a series of very small changes, like the tiny object thrown in the pond, that led us down this road. Likewise, a few small changes can get us started back in the right direction.

If you need more convincing evidence about the effect of small choices, consider this: If you swapped out one 16 oz. bottle of soda for water everyday you would save yourself 73,000 calories in a year. That equals the amount of calories stored in 21 pounds of body fat!

In our weight management groups at the Positive Choice Wellness Center, we ask people do the following exercise to illustrate how small steps make for big changes. Stand and walk forward for 8 to 10 steps, make a mental note of where you are and the view in front of you. Now repeat the exercise, only this time take a ½-inch turn to the right of your original starting place and then step forward 8 to 10 steps. You will see after walking for awhile that a turn of just a ½-inch leads you in a whole new direction and offers a whole new view! The same is true when taking control of your health. Don’t worry about how you are going to achieve the final destination. Instead, focus on taking the daily small steps needed to get you going in the right direction. The rest takes care of itself.

If you find you need help making those small changes, try some of these support options.

Kaiser Permanente members can connect with a personal lifestyle coach by calling 1-866-402-4320 (8:30 a.m. to 4:30 p.m.). You will receive coaching on a weekly basis for weight loss, healthy eating, and fitness. There is no charge for this service.

Non-members and members are welcome at Kaiser Permanente’s Positive Choice Wellness Center located in Clairemont at 7035 Convoy Court, (858) 573-0090. The center offers free nutrition and fitness counseling and fee-for-service options like supplemented weight management programs, metabolic rate testing, body fat testing, personal training, muscle toning classes, yoga, food addiction recovery classes, and more.

Small Steps Towards Better Health…

  • Drink water with your meals. Try putting a pitcher of water flavored with lemon, lime, or cucumber slices on the table and keep one in the refrigerator.
  • Eat fruit instead of fruit juices.
  • Limit sodas to special occasions and holidays.
  • Pack lunches with water and offer to bring water to kids’ school parties, etc.
  • Avoid snacking because it is the thing to do at parties, the movies, etc.
  • Try to have just one planned snack a day.
  • Watch your portions, don’t fall for the super-size trap.
  • Move, move, move. Your whole lifestyle needs to be active to stay in calorie balance.
  • Eat at restaurants less often and, when you do, split the meals or take leftovers home. Avoid eating everything that is put in front of you. If you must text or talk on a cell phone, etc., try to do it while walking or standing.
  • If you have to take away your kids’ cell phones to get them to move, do it!
  • Keep sugary snacks and treats out of the house and eat these foods as an occasional treat, not a daily option.
  • Eat at home more often and eat wholesome home-cooked foods.
  • Eat at least 2 cups of vegetables a day and have at least 4 servings of fruit.
  • Come to one of the free visits with a dietitian or an exercise physiologist at the Positive Choice Wellness Center and get help with your diet or exercise routine.
  • Choose a life that has you outside, walking in the sun (with sunscreen), laughing with your friends, and spending time with people you love.

Written by Vicki Pepper, M.S., R.D. for Kaiser Permanente, San Diego California