• Activities of Daily Living (ADL)
• Diet
• Non-exercise Activity Thermogenesis (NEAT)
• Exercise
  

Summary of energy expenditure and energy intake

• Energy Expenditure equal to Energy Intake = Weight Maintenance (due to equilibrium of calories burned vs. calories absorbed)
• Energy Expenditure greater than Energy Intake = Weight Loss (due to energy deficit)
• Energy Expenditure less than Energy Intake = Weight Gain (due to energy surplus)

Over the past thirty years, the prevalence of obesity in the U.S. has increased 23.   Concurrently, physical activity levels have decreased.  This along with wide-spread changes of diet may be key contributors to the obesity epidemic.

ACSM Guidelines

Activities of daily living (ADL) refer to the basic tasks of everyday life 78.  Some examples include walking around the house, performing regular household chores (washing the dishes, vacuuming, etc.), bathing, raking up leaves in the yard, etc.  The sum of such activities throughout the day comprises an individual’s ADL level.  Another factor that affects ADL is the mode an individual utilizes to complete a task.

ADL examples

• Bathing

• Dressing

• Walking

• Household chores

• Yard work

Examples for Increasing ADL

• Walking to the mail box instead of driving
• Taking the stairs instead of the elevator
• Hand washing dishes instead of machine washing
• Biking to work instead of driving
• Mowing the lawn with a push mower instead of a riding mower
• Parking the car in a space further away from the destination

Numerous activities that were once accomplished manually now are frequently completed via an automated alternative 47 .   Many examples for increasing ADL, including those listed above involve replacing an automated task with a manual task whenever possible.  Although some of the activities may burn more calories than others, the frequency and accumulation of ADL is important for gross energy expenditure.

Eating healthy can help reduce cholesterol levels, blood pressure, and excess body weight 39 .   A diet that provides adequate macro and micronutrient balance as well the appropriate caloric intake can help prevent obesity 39.

Currently there are many diets that claim to prevent obesity and promote weight loss.  However, many of these diets lack appropriate balance.  For example, the popular “low-carb” diets heavily restrict carbohydrate intake and attempt to replace carbohydrate calories with fat and protein.  Many people lose or maintain weight with such diets however; they may present an increase for prevalence of heart disease.  This is mainly due to the increase in LDL cholesterol (the “bad” cholesterol) and the decrease in HDL cholesterol (the “good” cholesterol) that is associated with these diets 14.

To promote a balanced diet and healthy living, the American Heart Association (AHA) established the Eating Plan for Healthy Americans 2.   This plan not only involves advice on diet, it also includes physical activity.

AHA Eating Plan for Healthy Americans

• Eat a variety of fruits and vegetables. Choose 5 or more servings per day.
• Eat a variety of grain products, including whole grains. Choose 6 or more servings per day.
• Include fat-free and low-fat milk products, fish, legumes (beans), skinless poultry and lean meats.
• Choose fats and oils with two grams or less saturated fat per tablespoon, such as liquid and tub margarines, canola oil and olive oil.
• Balance the number of calories eaten with the number used each day. (To find this number, multiply weight in pounds by 15 calories. This represents the average number of calories used in one day for moderately active individuals. 13 calories represents the number of calories used in one day for inactive individuals. Less active people burn fewer calories.)
• Maintain a level of physical activity to remain fit and match the number of calories eaten. Walk or partake in other physical activities for at least 30 minutes on most days. Weight loss can be achieved by doing enough activity to use up more calories than are taken in each day.
• Limit the intake of foods high in calories or low in nutrition, including foods like soft drinks and candy that have a lot of sugars.
• Limit foods high in saturated fat, trans fat and/or cholesterol, such as full-fat milk products, fatty meats, tropical oils, partially hydrogenated vegetable oils and egg yolks. Instead choose foods low in saturated fat, trans fat and cholesterol from the first four points above.
• Eat less than 6 grams of salt (sodium chloride) per day (2,400 milligrams of sodium).
• Have no more than one alcoholic drink per day for women and no more than two for men. "One drink" is no more than 1/2 ounce of pure alcohol. Examples of one drink are 12 oz. of beer, 4 oz. of wine, 1-1/2 oz. of 80-proof spirits or 1 oz. of 100-proof spirits.

Following this eating plan aids in the achievement and maintenance of a healthy eating pattern. Benefits of a healthy eating pattern include having a healthy body weight, desirable blood cholesterol level, and normal blood pressure. Every meal does not have to meet all of the guidelines. It is important to apply the guidelines to the overall eating pattern of several days. These guidelines may do more than improve heart health. They may reduce the risk for other chronic health problems including, type 2 diabetes, osteoporosis (bone loss), and some forms of cancer.