Welcome to the Ticket 2 Health^TM Newsletter! This quarterly publication, delivered directly to subscribers via e-mail, is packed with news and tools pertaining to healthy living and weight management.

Today, in the general US population, 64% of adults are overweight. In the Department of Defense (DoD), 36.5% of service members under the age of 20 are overweight (by military standards), and 58.4% of those 20 and older are above the standard for their ages. Although not as high as the national figure, these percentages are of concern. Being overweight decreases stamina and increases the risk for heart disease, high blood pressure, diabetes, and other chronic conditions, all of which affect readiness. Furthermore, chronic overweight is associated with higher health care costs and lower productivity. In one study, unhealthy weight was found to increase an employer’s health care expenditures by an average of $70 per overweight person per year.

The negative impact on fitness and readiness associated with being overweight have led the Department of Defense to list weight reduction as one of its top health goals. The HITS Shape-Up Shop (SUS) provides a wealth of tools to help with achieving those goals. This newsletter will deliver up-to-the-minute information on SUS happenings and other news relevant to DoD’s healthy weight campaign. Our mission is to help Soldiers set and achieve meaningful, realistic goals for maintaining a healthy living plan. Start yours today by visiting the Shape-Up Shop and subscribing to SUS News!

Revisiting the Gremlins

Last year in the Hooah 4 Health Newsletter we did a series of articles on healthy eating. We talked about the forces in our culture, the "diet gremlins," that interfere with healthy eating plans:

• Fast and convenience foods that are high in fat and sugar
• Portion distortion - the every-increasing size of bagels, burgers, soft drinks, etc.
• The word "diet" itself, and the act of "dieting."
• Unhealthy relationships with food and body image
• Sedentary lifestyles

1. Forget the word "diet." No "diet" will work over the long haul. Metabolically, it is impossible to severely restrict calories or a specific nutrient without triggering a starvation response in which metabolism slows and the body tries valiantly (and successfully!) to store even more calories. Furthermore, deprivation causes craving - the mental equivalent of starvation mode that lures us toward forbidden items.
2. Recognize that sustainable weight loss is a slow process. It involves committing to behavior change, persistence, and giving up the wish for instant results. For most people, the maximum safe, sustainable weight loss is two pounds a month, or 24 pounds a year.
3. Make "calories out must exceed calories in" your mantra. If you're willing to significantly increase the calories you burn, you won't have to decrease those you take in as much but the "negative balance" must be maintained for weight loss to occur.
4. Whole grains, vegetables, plant oils, and fruits, are the staples of a healthy diet.
5. The vast majority of your intake must be high-quality nutrients. Refined (white) wheat products, sugary carbohydrates, and fatty meats are not good sources of calories.
6. Nutrient balance is essential. Your body needs all three energy nutrients (protein, fat, carbohydrate).
7. It is not necessary or wise to eliminate any food from your diet. Total deprivation leads to craving and loss of control over consumption. It is necessary to limit such items as refined sugar, animal fats, and "empty" calories (sodas containing sugar and sweets).
8. Get active! It is virtually impossible to lose a significant amount of weight and/or maintain a healthy weight without a physical activity program.

Small Steps - Step 1

The Department of Health and Human Services (DHHS) Steps to a Healthier US program emphasizes that small steps can lead to big gains in healthy living. Smallsteps contains four broad categories: 1) Get the facts, 2) Eat better, 3) Get active, and 4) Learn more. As we partner with Healthier US, we will feature one of the guiding steps in each of our first four newsletters. Please visit www.smallstep.gov for information and ideas about small steps you can take.

Step 1: Get the Facts
We are bombarded every day with conflicting information about our health. Is it better to eat a low-carb diet or a balanced diet? Should we be physically active three times a week or five times a week? And how can we be expected to follow any of these recommendations when we're always so busy?

It's no wonder that many of us throw up our hands and give up. But if we want to live long and fulfilling lives, it's essential that we learn the real facts about health, nutrition, and physical activity.

Luckily, the real facts are pretty straightforward. All you really need to know about a healthy lifestyle is:

• Eat a healthy diet that includes fruits, vegetables, and whole grain products -- and be sure to control portion sizes.
• Get physically active at least five times a week, for thirty minutes or more.
• Avoid tobacco and illegal drugs altogether.

Today's lifestyle doesn't allow much room for health. And that's where Small Steps comes in. We know that it's impossible for many people to make dramatic lifestyle changes. Instead, we want to help you learn ways that you can change small things about your life and see big results.

Risk Around the Waist
from the American Institute for Cancer Research

Body Mass Index (BMI) is one common method used by researchers and health care professionals to measure overweight and obesity. The BMI chart shows the range of healthy and unhealthy weight for different heights. You can contact the American Institute for Cancer Research to order a free BMI Calculator by calling 1-800-843-8114, ext. 110.

But some of the nation's premier researchers now say that waist fat poses far more health dangers than fat stored elsewhere. Medical experts are urging greater use of a waistline measurement when assessing health risks in adults.

A Wider Waist May Increase Insulin Production

The reason for measuring the waist appears to be twofold. First, studies link waistline or abdominal obesity with greater risk of some cancers. Scientists believe that higher levels of insulin and insulin-like growth factors commonly seen with excess abdominal fat stimulate cancer cell growth. Excess waistline fat seems to approximately double the risk of breast cancer in women after menopause, regardless of overall weight status. Abnormal insulin levels may also disrupt sex hormones, thus raising the risk of prostate cancer, which is hormonally related.

Second, large waists are one of the clinical indicators of metabolic syndrome. People with metabolic syndrome are at greater risk for diabetes, as well as high blood pressure. They are also more likely to develop elevated markers for inflammation, high uric acid (which can lead to gout) and an increased tendency for blood clotting. Metabolic syndrome doubles the risk of heart attack or stroke, according to one new study.

People can inherit a susceptibility for metabolic syndrome and possibly for storing fat on the waist. But lifestyle choices, like too high of a calorie intake and sedentary behavior coupled with aging and some medications or health problems, actually trigger the syndrome to develop. Regular exercise and a balanced diet that maintains a healthy weight are the best strategies to control waistline fat, prevent metabolic syndrome and reduce cancer risk.

How Do You Measure Up?

To assess a possible cancer risk due to excess body fat, measure your waist circumference. Place a tape measure around your waist immediately above the tip of the hipbone. Measure right after you exhale. For women, a waist measurement of 35 inches or more indicates high risk. For men, the significant figure is 40 inches or more.

In most cases, if a waistline measurement shows high risk, the BMI reading will be 30 or more, indicating obesity. However, if the BMI number is less than 30, you should still consider your situation serious if the waist measurement shows high risk.