Eating Healthy on a Budget

Introduction

The diet industry brings in over a billion dollars a year with quick fix fad diets and pills guaranteeing weight loss. The problem with the industry is that there is no quick fix for obesity. These fad diets are only contributing to the problem. We live in an age of instant gratification and convenience and as a result we are more sedentary. A few of the contributing factors leading to obesity are: increased portion sizes; fast food and eating out more often; increased soft drink and sugary beverages; increased television, internet use, and video gaming (Purnell & Paulanka, 2008). Obesity puts people at risk for other diseases. The best way to prevent obesity related disease is to lose weight. But there is no quick weight loss plan that has lasting results. Losing weight for your health is a life style change. It takes learning to eat a balanced diet and becoming more active. However, eating healthy nutritious foods cost more than eating low cost foods most people can afford (Palmer, 2009). Learning how to stretch your food budget is one of the factors that will help you be successful at changing your life style for health. Teaching this group of older adults who are currently obese and on a tight budget make the topic life style changes for weight loss while maintaining their food budget. Each of them have some knowledge and are motivated by internal locust. They are all female, over age 65, while, and all have a high school education.

Obesity and Health Consequences

Obesity is becoming one of the most prevalent diseases of our time. According to the National Health and Nutrition Examination Survey data from 2007-2008 reported that 68% of adults age > 20 are overweight or obese with a Body Mass Index (BMI) >25 kg/m2 (Centers for Disease Control and Prevention, 2008). Of that the percentage of adults considered obese with a BMI >30 kg/m2 was 33.8%. The report also showed that men were slightly more obese than women. Obesity is a worldwide health epidemic. Obesity puts people at risk for Type 2 Diabetes, hypertension, certain cancers, stroke, and other diseases (Purnell & Paulanka, 2008). People with abdominal fat are more likely to develop Type 2 Diabetes, metabolic syndrome, insulin resistance, dyslipidaemia, inflammation, thrombosis, and Cardiovascular Disease (Appel & Bannon, 2007). Fenn (2007) showed in his study that having an abdominal girth > 35 inches for women and > 42 inches for men showed an increased risk factor. 90% of the hospitalized patients I have seen are obese with a BMI >30 kg/m2 and 20% of them have a BMI > 40 kg/m2 which is considered morbidly obese. The risk of premature death in patients with a BMI > 30 kg/m2 is 50-100% greater than that of a patient with a BMI of 20-25 kg/m2 (Riley, 2005) The average hospital stay for these patients is 7 days due to all of their co-morbidities. Palmer (2009) reports that obesity alone accounts for over $75 billion dollars in health care costs per year.

Older Adults and Obesity

In older adults obesity has been linked to worse health related quality of life (Flood & Newman, 2007). Obese older adults are more likely to report feelings of hopelessness and may be less likely to be motivated to change. Many of these people have tried to lose weight multiple times and either had lost it only to gain it and more back or lost very little. In older adults the health related problems from obesity become even more prevalent. The increased weight leads to Degenerative Joint Disease and subsequently joint replacement surgery. Many of these patients also develop respiratory problems like Sleep Apnea and Congestive Heart Failure from the weight on their system (Flood & Newman, 2007).

Keys to Losing Weight

The only way to effectively and permanently lose weight is to eat a balanced diet and get some form of exercise in on most days (Bowles, Picano, Epperly, & Myer, 2006). In other words adopt a healthy life style. Some other key components are drinking enough water for your body, eating every 2-4 hours, and making sure you are not eating more calories than you are burning. According to Flood and Newman (2007) many older adults do not understand how to eat a balanced diet for weight loss. Many of the people in this age group grew up with the concept that a proper meal had to have meat and potatoes. Assessing what the client currently eats is important to get a baseline of their nutritional deficits and knowledge. It is imperative with this age group to educate them about Vitamin D, Calcium, and Vitamin B12 intake. Older adults need a protein intake of 0.8 g/kg body weight and need to increase that to 1.0-1.3 g/kg who engages in resistance training. Fiber is another important dietary consideration as it has been associated with lowering blood sugar and blood fat levels while promoting peristalsis. Older adults are encouraged to drink at least 30 mL/kg of body weight of water per day. The body requires a minimum of 1000mL of water per day just to compensate for insensible losses (Flood & Newman, 2007). Exercise is the last category for life style change (Pender, Murdaugh, & Parsons, 2010). Even beginning with 5-10 minutes of walking will benefit weight loss efforts. A Baseline assessment for endurance and flexibility needs to be done to suggest the best and safest way to begin an exercise routing for the older adult.

The Clients

Older adults tend to focus on past life experiences they may be reluctant to try anything they feel they have already failed at so it will be important to be able to show them how to be successful this time. One client is in the pre-contemplative stage of change while the other two are in the contemplative stage (Bastable, 2008). One has a blind eye so is physically limited and will need to sit where she can see well. Each client is motivated by internal locust and wants to change. Two are Diabetic and want to know how to better control there Diabetes with diet. All three are on a fixed budget and have little confidence in being able to change due to the increased costs of healthy food. The plan is to have each of them take notes from a power point presentation. I will have them figure out their weight in KG so that we can work out how much water and protein they each need. I will have a tool available to determine how many calories they need for their Base Metabolic Rate (BMR). Older adults also may not remember all of the information presented so handouts and interactive activity will help stimulate memory. I will give them handouts with tips on reading labels and what foods to buy in season so that they cost less. Some of the strategies for eating healthy on a budget will include meal planning, honing the seasons, eating less animal protein, eating smaller portions, adding legumes, cutting out waste, and cutting out low nutrient foods.

Conclusions

With the prevalence of obesity and Diabetes increasing yearly there is no time like the present to begin educating people on how to change their life style to combat it. Losing even 10% of your body weight can significantly reduce your risks of developing Diabetes and Cardiovascular Disease. Fad diets do not work and you can not expect to lose weight overnight. Successful weight loss requires life style and behavioral change. The keys to losing weight are eating every 2-4 hours, not skipping meals, drinking adequate water, and getting some form of exercise most days of the week. Older adults may not be as easy to motivate due to their feelings of hopelessness over their obesity. Another factor is their budget may prevent them from being able to but healthy foods. They need good strategies for planning and implementing a healthy diet. Older adults are often low in Vitamin D and B 12. Because older adults tend to focus on past life experiences they may be reluctant to try anything they feel they have already failed at so it will be important to be able to show them how to be successful this time. Older adults also may not remember all of the information presented so handouts and interactive activity will help stimulate memory.



References
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