Online Training - We Can!^® Energize Our Families: Parent Program

Chapter 5: Parent Program Session 2: Maintain a Healthy Weight—The Energy Balance Equation

Slide 1

Welcome to Chapter 5, where you will learn about Session 2 of the Parent Program—Maintain a Healthy Weight: The Energy Balance Equation.

Slide 2
Session 2 presents, in further detail, the concept of Energy Balance―the core of the We Can! program. During the session, participants will also learn how portion size and daily time spent doing physical activity impact the Energy Balance equation.

The use of the Body Mass Index, or BMI, is another idea that will be introduced to participants to further help them understand the concept of a healthy body weight in their children.

Slide 3

The beginning of Session 2 is a good time to have an open discussion of how parents made out with the Try Tips to Eat Well and Move More activity they practiced since the last meeting. Were they successful? More importantly, what were the challenges and what were the benefits associated with trying these new behaviors?

Slide 4

Since the concept of Energy Balance is at the core of the We Can! Parent Program, it is essential that participants grasp this concept. The Leader’s Guide will help you explain it clearly and guide you through some group activities to ensure participants can fully understand Energy Balance and apply it to their own lives. Here is the basic concept:

• Energy Balance is key to maintaining a healthy weight. To help participants understand this concept, you can ask them to imagine a scale. On one side of the scale are the calories you take into your body by eating or drinking. This is referred to as ENERGY IN.
• On the other side of the scale are the calories your body burns while it is carrying out basic functions like breathing, digestion, and physical activity. This is called ENERGY OUT.
• So, you can see that in order to maintain your weight at the same level over time, ENERGY IN must equal ENERGY OUT.

Slide 5

If you burn more energy (calories) than you take in, you will lose weight. Similarly, if you take in more energy (calories) than you burn, you will gain weight.

Participants need to recognize that even small changes are important and really do make a difference. Present them with an example of simply eating 150 fewer calories per day than they normally do. That could be as easy as switching from a 12 ounce regular soda to water, or from a medium-sized French fries to a small. That, alone, can lead to a 5 pound loss over 6 months or a 10 pound loss over a year.

Of course, you don’t need to exactly balance the calories you take in every day with those you burn up. It’s the balance over time that is important.

Slide 6

A person’s success in maintaining Energy Balance depends on factors such as behavior, environment—even genetics.

• By behavior, we mean, how many calories do they consume and how much physical activity do they do?
• Environment refers to the opportunities and challenges for eating well and physical activity that they find at home, work, school, and in their community.
• And genetics play a role in determining weight. Genes can affect how the body stores or burns calories for energy.

It’s important to point out to parents that, although they can’t change their genetics, they can change their behavior and be mindful of their environment. During this session and in the remainder of the program, you will be exploring with parents some easy ways to balance energy to help them maintain their family’s weight. The discussion should also touch on strategies for balancing energy in different scenarios, such as during the holiday season or when a child is less active, perhaps due to an illness.

Slide 7

During your discussions with parents about how to maintain Energy Balance, the goal is to get parents thinking in terms of working out a “lifestyle energy budget.” In other words, you want them to keep in mind that maintaining Energy Balance is similar to balancing a budget. For example, if they know they’ve eaten more calories than they budgeted for today, then they can reduce the calories they consume the next day or increase their activity level to help stay on budget. Again, it should be stressed that it’s the Energy Balance over time that is important.

Slide 8

Energy Balance differs somewhat with regard to children, and this should be noted during the session. Because children are still growing, Energy Balance for them is when there is a relationship between ENERGY IN and ENERGY OUT that supports natural growth without promoting excess weight gain.

Slide 9

To get a clearer grasp of the concept of energy budgeting, participants complete a worksheet called Energy Balance: ENERGY IN & ENERGY OUT.

The ENERGY IN & ENERGY OUT worksheet lists a variety of meals, one of which you will assign to each participant. The worksheet also includes examples of physical activity and the number of calories each burns. Their task is to use the handout to figure out how much physical activity a 150 pound person will need to do to burn off the calories from the meal.

After 10 minutes, participants will discuss their answers and share their insights about the activity. Remind parents that to burn off a meal or snack higher in fat and calories, a person has to do a greater amount of physical activity.

Slide 10

This next activity, which examines Body Mass Index, or BMI, is designed to help participants determine whether someone is at a healthy weight. BMI is a measure of weight in relation to height that can help people determine whether or not they are at a healthy weight.

Slide 11

You can walk the group through an exercise that looks at examples of people with different heights and weights, and uses the chart to determine if they fall into the healthy, overweight, or obese categories. Participants should find that it is actually easy to calculate BMI.

Here’s an example of an exercise:
Dan weighs 218 pounds and is 5 feet 9 inches tall. His wife, Susie, weighs 134 pounds and is 5 feet 4 inches tall. Are Dan and Susie at healthy weights? Use the BMI chart to check whether their weights fall into the healthy, overweight, or obese category. If weights fall between two BMIs, choose the lower BMI.

After giving parents approximately 2 minutes to do the exercise, you can discuss the answer, which is that Dan’s BMI is 32, so he is obese. And, Susie’s BMI is 23, so she is at a healthy weight.

Slide 12

During the discussion of BMI, it is important to mention that the chart doesn’t work very well for people who are extremely muscular, very tall, or very short. In such cases, it may incorrectly classify someone as overweight or obese when they really are not. Overall, however, BMI is a good indicator of healthy weight for the majority of the adult population.

The chart used in the previous slide is also not appropriate for children; different BMI charts are used for children. Because children are still growing and boys and girls grow at different rates, children’s charts take gender and age into account in determining weight status. If parents have questions, encourage them to ask their family doctor, pediatrician, or other health care provider to assess their children’s weight with BMI-for-Age growth charts.

Slide 13

Another important concept to address in Session 2 is serving size versus portion size.

A serving is a measured amount of food or drink, such as one slice of bread or one cup of milk. Nutrition recommendations use serving sizes to help people understand how much of different types of foods they should eat to get the nutrients they need.

A portion, on the other hand, is the amount of a specific food or drink you choose to have at a meal or snack. Portions can be larger or smaller than recommended servings.

Slide 14

A good way to demonstrate the difference between portion and serving size is to engage participants in a hands-on activity. Here’s an example the Leader’s Guide suggests you do with the group:

Ask for three volunteers and give them each a large bowl. Hand the first volunteer a large bag of pretzels and ask him or her to take the amount of pretzels he or she would normally snack on and put it in the bowl. Then have the other volunteers repeat the same process. Ask all three to guess how many calories they think is in the portion of pretzels they each took. Now, ask each volunteer to count exactly how many pretzels are actually in the bowl. Then, ask them to read the Nutrition Facts label on the bag to determine how many servings are in the portion they put into their bowls and how many calories these portions represent. This simple exercise illustrates portion control and how the calories can add up when we eat more than one standard serving of food.

Slide 15

Anyone eating on the run or at restaurants has probably noticed that food portions have gotten larger over the years. Some portions are called “super size,” while others have simply grown in size, providing enough food for at least two people.

During this part of the session, you will explore that idea with the group and introduce an activity called the Portion Distortion Quiz to help illustrate it. There are also accompanying slides for this activity that have pictures of different portions of foods. We Can! community sites have told us that this quiz is one of the most engaging and eye-opening activities in the Parent Program.

View and download the full Portion Distortion presentation (9.7 MB)

Slide 16

Here is an example from the Portion Distortion Quiz:

Do you know how food portions have changed in 20 years? Twenty years ago, a typical portion of spaghetti and meatballs was one cup and three small meatballs, which totaled 500 calories. How many calories do you think are in today’s portion of spaghetti and meatballs?

Slide 17

A typical portion of spaghetti and meatballs today has about 1,025 calories—more than twice as many calories as compared to 20 years ago!

Slide 18

Parent Program facilitators at the Unity Health Care Upper Cardozo Health Center in Washington, DC say the Portion Distortion slide set included with the curriculum is especially helpful for teaching this concept to parents who have low health literacy or language barriers.

These slides also are available in Spanish on the We Can! website page of Spanish-language resources.

Slide 19

Session 2 touches only briefly on the other side of the Energy Balance equation—managing ENERGY OUT, since this topic is handled more in depth in Session 4 (Chapter 7).

A good way to open the discussion is by asking participants to guess how much physical activity both adults and children should be getting each day. Then, share the guidelines with them that are in the guide—for adults, at least 30 minutes and if possible 60, and for children, at least 60 minutes of physical activity on most, preferably all, days of the week.

Note that these recommendations are consistent with the new Physical Activity Guidelines for Americans released in 2008. They note that adults should get up to 2 hours and 30 minutes of moderate activity per week. And, children and adolescents should do 60 minutes or more per day.

Participants may find it challenging to fit in that amount of physical activity every day. It’s important to explain that research shows they can do several shorter sessions of 10 minutes each that total the recommended number of minutes of activity and still get the same benefits.

Slide 20

You can then ask participants for ideas for short bursts of activity that their families can fit in during the day. If necessary, you can guide them to suggested responses, such as:

• Challenge your child to a race to the end of the block and back. Or
• Schedule a regular session of “family hoops” at a local basketball court or on their basketball hoop at home.
  

Slide 21

A We Can! General Community Site at the Frederick County Health Department in Maryland developed a series of convenient physical activities that can be done while in a waiting room or during television commercials, designed to encourage people to fit in physical activity wherever they happen to be. Parents might also find it helpful to share with others in the group some of the physical activities they’ve listed on their We Can! Daily Physical Activity Planner and their Eat Well and Move More tracking sheets, which is discussed more in Chapter 7 of this training.