Module 7: Energy in, Energy Out Participant Guide

Session Focus

Losing weight can help you prevent or delay type 2 diabetes.

In this session, we will talk about:

  • The link between weight loss and energy in, energy out

  • How the type and amount of food you eat affects energy in and energy out

  • How the amount of activity affects energy in and energy out

  • How to create the right balance of energy in and energy out

You will also make a new action plan!

Key points to remember:

To find out how many calories you burn, you need to know:

  • How much you weigh

  • Your activity

  • How long you do it

  • Your pace (or rate of movement -- low, moderate, or high)

Calories and Weight

Balancing Calories In and Calories Out

Before we get into this module, let’s talk a little bit about body shame, body dysmorphia, and disordered eating. Almost 1 in 10 women in the US suffers from an eating disorder during her lifetime, and I don’t want this module to be upsetting to anyone who already struggles with disordered eating, or to trigger someone to start feeling shame about the size of their body.

There’s a lot of talk about calories in this module, and you already know that one of the goals of the DPP is to achieve moderate weight loss.

But we’re not here to starve ourselves or to obsess about calories, we’re here to moderate our caloric intake so that we can prevent type 2 diabetes while postpartum, and every woman’s body is different. Two women could eat the exact same thing and end up at different body weights. So if that’s at all triggering for you, please reach out to your health coach to talk more about that.

Source: National Eating Disorders. https://www.nationaleatingdisorders.org/statistics

Paula’s Story—Part 1

Paula is 36 years old and weighs 240 pounds after giving birth to her healthy baby boy 4 months ago. She’s at a higher risk for type 2 diabetes as she experienced both gestational diabetes and hypertension during pregnancy. Her doctor has told her that she can lose 5% of her weight through CDC’s National Diabetes Prevention Program (DPP) lifestyle change program to lower her risk. That is about 12 pounds total. But Paula is wondering why her doctor is suggesting a year-long program over a diet that would help her lose weight faster. Her doctor explains that slow and steady weight loss is safer and more effective.

Gradual weight loss is the way to make lasting changes. Research suggests that each person will lose weight at different rates, but losing an average of about 1 to 2 pounds per week can be a safe goal and should not affect your milk supply or your health, according to most experts.

Paula needs to adjust the amount of calories she consumes and the amount she burns if she wants to lose 1 pound a week. She can do this by eating fewer calories and increasing activity.

Small Changes for Paula

What Paula Is Doing

Here are some of the small changes Paula has made:

  • She adjusted her regular breakfast from three eggs to two eggs and had an English muffin with light butter instead of two slices of toast with butter and jelly, saving her about 200 calories.

  • She decided that she would measure the amount of sugar and cream she added to her coffee. To her surprise, she was able to cut another 150 calories by using 1 teaspoon of sugar and 2 tablespoons of cream per cup, and her coffee still tasted good!

  • After breakfast, she took a 30-minute walk before work. She walked as briskly as she could while still passing the Talk Test.

  • At lunch, she ate some apple slices instead of chips with her sandwich and had sparkling water instead of her usual bottle of soda. This cut out 345 calories.

  • Paula and her wife went out for dinner. She asked for her salad to be served with the dressing on the side so she can control the amount added to her food. This cut out 100 calories.

These days, Paula is losing about 1 pound each week through a mixture of eating and activity changes. And she’s halfway to her goal weight!

Ways to Eat Fewer Calories

Here are some ways to cut calories at each meal. Try these healthy swaps.

Rethink Your Drink

One way to cut calories is to think about what you drink. Drinks don’t fill you up the way food does. And, as you can see below, calories from drinks can really add up! But here’s the good news: If you replace drinks that are high in calories with drinks that have low or no calories, you can save a lot of calories!

Sources:

Small Changes to Your Drinks Make a Big Difference

Use Nutrition Facts Wisely

When choosing your drink, the calories in some of your favorites may surprise you. Use the Nutrition Facts label. It lists the calories in one serving. You can also check the product’s website or ask to see the Nutrition Facts in a restaurant. Another way to cut calories is to think about how much you drink. For high-calorie drinks, size really matters!

Here is the Nutrition Facts label on a 20-ounce bottle of soda. It says that one serving is 8 ounces. It tells you that there are 2½ servings in the bottle. And it lists the calories in one serving (100).

To figure out the calories in the whole bottle, multiply the calories in one serving by the number of servings in the bottle (100 x 2½). If you were to drink the whole bottle, you would take in 250 calories.

At the Coffee Shop

Coffee drinks taste good and may be a regular part of your day, a morning routine, an afternoon pick-me-up, or a special treat. But the calories in some of your favorites may surprise you. When a coffee craving kicks in, try these tips.

  • Ask for your drink to be made with fat-free or 2% milk instead of whole milk.

  • Order the smallest size available.

  • Hold the flavors. Ask for half the syrup or ask for sugar free syrup. Flavored syrups contain sugar and add calories.

  • Skip the whip. The whipped cream on top of coffee drinks adds calories and fat.

  • Try lower-calorie drinks that you still enjoy. Swap out a latte for a cold brew. Try an espresso drink with just a little milk or cream. Check the online menu or ask for a recommendation at your coffee shop.

  • Order a plain cup of coffee and estimate your own milk, cream, and sugar. You may find that you can cut back on dairy or sweeteners when you’re in charge of them. Or try drinking your coffee black. Remember that plain coffee is very low in calories. It’s the flavoring that adds the calories!

  • Make coffee at home and save the special coffee drinks for an occasional treat.

Better Drink Choices

Here are some ideas for healthy drinks:

  • Choose water or sparkling water.

  • Carry a water bottle. Refill it all day long.

  • Flavor your water with no-calorie drink mix or add slices of lemon, lime, cucumber, or watermelon. Or add a splash of 100-percent fruit juice to plain sparkling water.

  • Drink tea or coffee without sugar. Enjoy them hot or cold.

  • Keep a pitcher of water in the fridge.

  • Put your pitcher of water on the table during meals.

  • If you order a smoothie, order the one with the fewest calories and ask for it to be made without added sugar. Fruit is naturally sweet.

  • If you do choose drinks that contain sugar, get the smallest size you can. Order a child’s size if possible.

  • Milk contains vitamins, minerals, and protein. But it also contains calories. Choosing low-fat or fat-free milk is a good way to cut calories and still get the nutrients your body needs.

How To Track the Calories You Take In

Paula’s Story—Part 2

Paula needs about 2,200 calories a day just to stay at the same weight. If she cuts out about 500 calories per day, that leaves her with around 1,700 calories.

It’s hard to do, but worth it. Taking small steps and focusing on one thing at a time helped keep Paula on track. But don’t forget that Paula can also get closer to her goal by increasing activities.

What are daily calorie needs?

Your daily calorie needs are the calories you need to maintain your weight. This number is based on your age, sex, height, build, and weight. It doesn’t take your activity level into account. It’s a general estimate.

Let’s see how Paula does on Sunday.

  • She ate three meals and two snacks for a total of about 2,000 calories.

  • She made an effort to increase her activity and walked after breakfast and after dinner. She also mowed the lawn. She burned about 310 calories with these activities.

To figure out Paula’s actual calories, we’ll start with the calories she takes in. Then we’ll subtract the calories she burns:

2,000 – 310 = 1,690

Paula is right on target!

These days, Paula is losing about 1 pound each week through a combination of eating and activity. And she’s halfway to her goal weight.

How To Track the Calories You Burn

How Many Calories Does Activity Burn?

Depending on your age, your biological sex, your level of physical activity, and your weight, you burn different amounts of calories.

If a 14-year-old girl, her mom (who’s an Olympic athlete), and her 80-year-old grandmother all did yard work together, they would burn different amounts of calories, even if they all weighed the same amount.

This chart shows about how many calories a person who weighs 154 pounds would burn at a moderate pace, but, as they say at the car dealership, your mileage may vary.

Source: Physical Activity for a Healthy Weight.

https://www.cdc.gov/healthy-weight-growth/physical-activity/index.html

Individual Assignment (Optional)

Without changing your routine, use this log for 2 days this week to track the calories you take in and the calories you burn doing physical activities. Then consider where you can make changes to your eating and exercise habits so that you consistently take in about 500 calories less than you burn. This is not meant to be an exact measurement of how many calories you burn. It is to give you an easy way to think about how you balance what you eat and drink with your physical activity. Remember that exercise will not have the same impact as what you eat, but it will increase the impact of cutting calories.

  1. Track your food and exercise calories for 2 days.

  2. Review your results.

    • You know yourself best.

    • Make easy changes first.

  3. Track again for 2 to 3 days once you have a good routine down.

  4. Repeat when your progress slows.

  5. Learn from your logs.