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How Small, Sustainable Changes Can Stop Age-Related Weight Gain

By Medcan

Medcan’s Leslie Beck talks to Dr. Robert Ross, a global expert on sustainable lifestyle change, about his latest study.

Many adults gain weight as they age — about one to two pounds a year, research shows. A recent study indicates that small changes to one’s lifestyle can prevent the accumulation of those pounds. Eat Move Think host Leslie Beck, Medcan’s director of food and nutrition, recently spoke with the study’s lead researcher, Dr. Robert Ross of the Lifestyle and Cardiometabolic Research Unit at Queen’s University. Dr. Ross is a global expert on sustainable positive lifestyle change for weight loss and better health, and led the effort to develop Canada’s 24-Hour Movement Guidelines. In the following edited transcript of their conversation, Dr. Ross shares the study’s findings and discusses tips on how to prevent age-related weight gain.

Leslie Beck: Let’s start by talking about age-related weight gain. What does the science say?

Dr. Bob Ross: The science is fairly simple. We’re gaining weight as a population. That’s not unique to Canada. We used to say developing countries worldwide. But now it’s true of all countries. There are now more people with overweight or obesity than there are underweight. So clearly, it’s a problem. But a couple of points. One, the weight gain is subtle. It sort of catches us by surprise. Sometimes we don’t seem to be overeating that much, or less physically active than we once were. But boy, at the end of each year, that scale seems to give us just a little bit more bad news every year. And that certainly occurs with age, likely due in part to a decrease in physical activity that comes with aging. And it’s doubtless true that it also comes with some subtle changes in eating behaviours, as you know, far better than I.

LB: I’ve read that that adults gain, on average, one to two pounds every year.

BR: We have this term—obesogenic environment, that being physically active is not as easily accomplished today as it was 30 or 40 years ago. And consuming additional calories is a lot easier than it was. In my day when we got home from school, we threw down the school bag and we went out and we played—not because we were smarter or any more energetic than the kids today. We had nothing else to do! There were only two stations on TV, and they didn’t come in very clearly. So, by default the healthy choice was the easy choice. Today, by default, the unhealthy choice is the easy choice.

LB: And to lose excess weight, many people follow restrictive diets. And perhaps, at the same time, they follow an exercise program that requires them to make significant changes to their usual behaviour. What is the long-term success of making major lifestyle changes?

BR: Well, it’s a challenge, Leslie, to be sure. And the evidence is quite clear. Adults, if they adopt an increase in physical activity combined with a restrictive, good quality but reduced calorie diet—there’s absolutely no question that they can lose weight. That’s been demonstrated decade after decade. Achieving weight loss is not the issue. Sustaining that weight loss over two, three or four years has presented a challenge… Sustaining major changes in behaviours is very difficult.

Making small changes to your diet and physical activity level can prevent incremental weight gain over the years.

LB: Let’s talk about your most recent study. The idea is that making small changes to your diet and physical activity level can prevent that incremental weight gain over the years. So, first of all, what does a “small change approach” mean? Can you define that for us?

BR: Well, that means, as the name would suggest, Leslie, that we’re going to make small changes. And by small 100, 200 calories maximum, changes in either caloric intake–diet—or energy expenditure—exercise. So that’s the definition. Preventing weight gain through these small changes, we believe, is a first step to managing the obesity problem.

LB: What did you investigate, specifically?

BR: We proposed that adults randomized to a small change approach, who would be instructed on how to make these very small changes over three years, would prevent weight gain, compared to those in a control group, who only monitored their weight and were not given the same instruction. The monitoring-alone control group was just told, you live life the way you normally do. We hypothesized that the control group, the monitoring-alone group, would gain about two kilos of weight. And this small change group would not gain weight.

LB: And what did you find out?

BR: Well, in fact, what we saw, as expected, as hoped, the small change group, made up of men and women about 50 years of age, who followed the program for three years—they did not gain weight as a group. That was fantastic. What we did not expect was that those in the monitoring-alone group also did not gain weight. In the end, both arms of the trial did not gain weight.

LB: You talked about the monitoring-alone group, the control group, who were told not to make any changes to their usual diet or their usual physical activity level. Both groups had their weight monitored on a very regular basis, correct?

BR: Yes, they did. And we hypothesized in our paper that maybe that influenced behaviour. There’s a well-known phenomenon in randomized controlled trials, that people change behaviour just because they’re in the trial. Even though they’re in the monitoring-alone group, they say, “well, I’m in a study that’s trying to prevent weight gain, I guess I should prevent weight gain somehow.” So, it is possible that we inadvertently changed the behaviour of the monitoring-alone group.

LB: Let’s talk about the advantages of the small change approach.

BR: We’re not targeting weight, we’re targeting behaviours. The benefits that are associated with the small change approach are associated with three things. One, the increase in physical activity. Even small increases in physical activity are associated with health benefits. Two, consuming a healthier diet. I’m always chagrined at the fact that diet, for so many Canadians, means caloric restriction, as opposed to a healthier composition of the diet. And then the third is, you’re not gaining weight. Those three aspects of the small change approach are all associated with benefit.

LB: And I certainly think too, with this small change approach, making those small tweaks to your diet and to your physical activity are a heck of a lot easier to integrate into your everyday life and to maintain long term. If you eat an orange instead of drinking 12 ounces of orange juice, you’re going to drop 117 calories from your diet. If you simply skip that slice of cheese on your sandwich, you’ll save 115 calories. If you reduce your portion size of brown rice by half a cup, there goes 120 calories. These are really small changes. When it comes to exercise, obviously how many calories you burn depends on how much you weigh, but 20 minutes of brisk walking, 10 minutes of moderate cycling, or eight minutes of swimming breaststroke—all of those will burn roughly 100 calories. It’s doable. It’s really doable.

If you eat an orange instead of drinking 12 ounces of orange juice, you’re going to drop 117 calories from your diet.

BR: And sustainable. And you provide options, as opposed to a single strategy. I could reduce caloric intake by 100 calories, right, or I can walk the dog. I can incorporate that into my day in ways that make sense for me. And I don’t have to do the cheese thing every day, or the orange juice every day, or the walking. But I can do something, every day, make that conscious effort, and I think that’s very empowering for people.

LB: I have a quote from you here, that you told me when we spoke before, “if we can make those subtle and sustainable changes, eating that healthy diet, sitting less, moving a little bit more and appreciate that preventing weight gain is associated with health benefit… If we can appreciate that, then we’ve made progress.” That’s what you told me.

BR: Exactly. We’re going to make subtle changes in those causal behaviours. And we’re going to benefit. And that is so well-established in the literature. Give yourself a hug. Give yourself a pat on the back. You’re doing well. You’re healthier. Good for you.

Seeking help to make long-term sustainable lifestyle changes that help prevent weight gain? Arrange a consultation with one of our registered dietitians at bookingteam@medcan.com.

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