A variety of foods and beverages contain simple sugars. Some are naturally occurring, but many are created through refining and added to processed foods and beverages to enhance their taste, smell, texture, and color. Whatever their source, all sugars are treated the same way by the body’ they’re all broken down into glucose to provide energy. All sugars provide 4 calories per gram.

The two main categories of simple sugars in foods are monosaccharides and disaccharides.

Monosaccharides are simple carbohydrates that contain one single unit of sugar. The three common monosaccharides found in the diet are glucose, fructose, and galactose.

Glucose, also called dextrose, adds a mildly sweet taste to foods. In foods, it is often found paired with another monosaccharide to form a disaccharide or a double sugar unit; for example, glucose and galactose are linked together to form lactose, the main sugar found in milk and milk products.

In the body, glucose provides the brain, nervous system, and many body cells with their main source of energy.

Fructose, also known as fruit sugar or levulose, is the sweetest sugar. Fructose is found in fruits, some vegetables, table sugar, and honey. Fructose and glucose are also found in high-fructose corn syrup, a caloric sweetener used in a variety of commonly consumed foods and beverages.

Some people are unable to digest fructose because of fructose intolerance, a rare genetic diso4rder; many others can have fructose malabsorption and experience bloating, abdominal pain, diarrhea, and other gastrointestinal symptoms.

Galactose, another monosaccharide, is rarely found in foods by itself but is attached to glucose to create lactose, the main sugar found in milk and milk products.

Disaccharides are made of two monosaccharides (single units of sugar) linked together. The disaccharides found in foods and beverages are sucrose, lactose, and maltose.

Sucrose, also known as table sugar, is made when glucose is paired with fructose. It is extracted from sugar beet or sugar cane plants and is purified and refined to create white table sugar. Molasses is also created from the sugar-refining process; brown sugar is white sugar turned brown through the addition of molasses. Sucrose is also added to a variety of foods and beverages, including soda; baked goods such as cookies, cakes, and pies; ready-to-eat cereals; dairy foods; canned fruit; and others.

Lactose, commonly known as milk sugar, is made up of glucose and galactose. It is naturally found in milk, cheese, and yogurt, and in foods and beverages made with them. Lactose is added as an ingredient to a variety of processed foods, beverages, and even medications.

People with lactose intolerance are unable to digest small amounts of lactose. This occurs because their bodies don’s make enough of the enzyme lactase, with lactose intolerance can experience cramps, nausea, bloating, gas, or other symptoms when they consume milk, cheese, yogurt, or any lactose-containing foods or beverages.

Maltose, also known as malt or malt sugar, is made of two glucose units joined together. It is created when starches, long chains of monosaccharides, are broken down in the body into two glucose units. Maltose is sound in some commercial cereals and baked goods and is fermented to make beer.

Nutritive Sweeteners

Unlike artificial sweeteners that have few or no calories, nutritive sweeteners contain calories. Simple sugars (monosaccharides and disaccharides) and sugar alcohols can come from natural or refined sources; high-fructose corn syrup, another nutritive sweetener, is commercially created and used in a variety of foods and beverages.

Naturally Occurring Sugars

Here are some examples of naturally occurring sugars in foods and beverages:

• Fructose (in fruit)
• Lactose (in milk and milk products)
• Fructose plus glucose (in honey)
• Sucrose (in real maple syrup)

As you can see, some foods and beverages that contain naturally occurring sugars also deliver many nutrients and other healthful substances. For example, fruit is a rich source of fiber, vitamins, minerals, and phytochemicals; milk and milk products, especially low-fat and nonfat varieties, provide calcium, vitamin D, and high-quality protein.

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Physical Activity and Exercise

Physical activity is the umbrella term used to describe any bodily movement produced by contracting skeletal muscle that increases energy expenditure above a basal level. Exercise is physical activity that is planned, structured, and done repetitively to improve health or fitness.

The three main types of exercise are as follows:

• Aerobic (endurance) exercise
• Muscle-strengthening exercise (resistance or weight training)
• Bone-strengthening exercise (weight-bearing exercise)

In aerobic (or endurance) exercise, you move large muscles in your body rhythmically for a sustained period of time. This causes your heart to beat faster than usual. Examples include: brisk walking, running, bicycling, jumping rope and swimming.

Three components of aerobic exercise include intensity, frequency, and duration.

When you do muscle-strengthening exercise, your muscles work or are held against a force or weight. Examples include resistance training and lifting weights.

Elastic resistance bands can be used to perform resistance exercise, as can your own body weight (to do push-ups, lunges, or squats), free weights (dumbbells or barbells), and some exercise equipment (such as a leg press machine).

Three components of muscle-strengthening exercise include intensity, frequency, and repetitions.

Bone-strengthening exercise (also known as weight-bearing or weight-loading activity) applies force to bones to help them grow and strengthen; for example, when you walk, a force is created by impact with the ground. Examples of exercises that strengthen bones (and are also considered aerobic and muscle-strengthening) include jumping jacks, running, brisk walking, and weight –lifting.

Health Benefits and Risks

Incorporating regular exercise into your life can provide you with countless health and other benefits. Research shows that physical activity can benefit adults and children by

• Improving cardiorespiratory fitness
• Improving muscular fitness
• Improving bone health
• Improving cardiovascular and metabolic health biomarkers

In adults and older adults, there’s strong evidence that regular physical activity

• Reduces the risk of coronary heart disease, stroke, high blood pressure, type 2 diabetes, metabolic syndrome, and some cancers (including colon and breast) as well as early death from heart disease, some cancers, and other conditions.
• Reduces the risk of unhealthy blood lipid levels
• Improves cardiorespiratory and muscular fitness
• Helps prevent falls that can potentially lead to fracture
• Reduces risk of depression
• Improves cognition (including thinking, learning, and judgment skills) in older people

Physical activity might also reduce symptoms of depression, improve functional ability, increase bone density, reduce hip fracture risk, improve the quality of sleep, and reduce the risk of lung and endometrial cancers.

Role in Weight Management

How physically active you are in general plays a key role in determining how much you weigh and how well you are able to maintain your weight over the long-term. Although engaging in aerobic or endurance-type exercise is most effective in helping you maintain your body weight, doing weights and other muscle-strengthening exercise also helps. Regular exercise can help both children and adults keep their body fat levels down (the more muscle mass you have, the more calories you burn or use up and the less body fat you have).

Being physically active, especially when you also reduce your total daily calorie intake, can create an energy deficit that leads to weight loss. Physical activity might also help reduce fat in the abdominal area (too much abdominal or visceral fat can increase the risk for heart disease and other conditions). Studies also show that for those who have lost weight, being physically active is the best way to keep weight off long-term.

Most physical activities pose little risk for most people, but doing too much physical activity and exercise or suddenly becoming more active than usual can increase your risk for musculoskeletal injuries. Some sports, including contact sports like soccer or football, can also be associated with a higher injury risk.

Weekly Recommendations

To complement the Dietary Guidelines for Americans, in 2008 the U.S. Department of Health and Human Services (HHS) issued Physical Activity Guidelines for Americans ages 6 and above. These science-based guidelines are the first to be unveiled by the U.S. government in an effort to help Americans understand the importance of physical activity and exercise and incorporate more of it into their daily lives.

For adults and older adults without health or medical conditions that limit their mobility, both aerobic and muscle-strengthening exercise are recommended. The weekly recommendations are as follows:

• Aerobic exercise – 2 ½ hours (150 minutes) at moderate intensity + 1 ¼ hours (75 minutes) at vigorous intensity or 1 ¼ hours (75 minutes) each of moderate and vigorous-intensity exercise
• Muscle-strengthening exercise (that works all the major muscle groups including legs, hips, back, abdomen, chest, shoulders, and arms) – 2 or more days per week, but never the same muscles on back-to-back days

Pregnant women who already engage in vigorous activity such as running can continue with such activity but should work with their health-care provider to adjust their activity level over time. After the first trimester, pregnant women should avoid exercises in which they need to lie on their backs as well as activities that can increase the risk of falls or abdominal trauma including downhill skiing, horseback riding, soccer, and basketball. They should also avoid scuba diving because it can cause dangerous gas bubbles in the baby’s circulatory system.

Here’s what recommended for children aged 6 and above:

• At least 1 hour (60 minutes) of physical activity, mostly from aerobic exercise; muscle- and bone-strengthening activities should also be included as part of the 60 minute recommendation.

Intensity is the amount of effort needed to perform an activity or exercise.
Frequency s how often or the number of times an activity or exercise is performed.
Duration is how long a period of time (in minutes or hours) during which an activity or exercise is performed.
Repetition refers to an exercise (for example, lifting weights or performing some other muscle-strengthening activity or exercise) that is repeated and often counted.
Cardiorespiratory fitness (also known as endurance) is a health-related component of physical fitness; it is the ability of the circulatory and respiratory systems to supply oxygen during sustained physical activity.
Functional ability is an individual’s ability to perform tasks or behaviors that enable her to carry out everyday activities (for example, climbing stairs, going grocery shopping, or preparing meals at home).
Moderate-intensity physical activity is activity performed at 3 – 5.9 times the intensity of rest.
Vigorous – intensity physical activity is activity performed at 6 or more times the intensity of rest.

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Underweight is defined as having a BMI below 18.5. The World Health Organization (WHO) created the following definitions for thinness based on BMI:

• Mild thinness – BMI between 17 and 18.99
• Moderate thinness – BMI between 16 and 16.99
• Severe thinness – BMI below 16

Although some people can be naturally thin and still healthy, in large part because of genetic factors, some might lose weight suddenly or over time for other reasons. These include

• Decreased appetite due to illnesses or diseases such as hypothyroidism, cancer, Crohn’s disease, inflammatory bowel disease, or celiac disease
• Decreased appetite because of medications taken for depression, high blood pressure, or osteoporosis (aspirin and some other nonsteroidal anti-inflammatory medications can also cause gastrointestinal side effects that can contribute to weight loss)
• Refusal to eat because of an eating disorder such as anorexia
• Problems chewing, tasting, or swallowing
• Depression, anxiety, or other psychological problems that reduce appetite
• Mobility problems that make it difficult to shop for and prepare meals
• Limited finances or lack of transportation that make food shopping and preparation difficult

Being underweight can contribute to symptoms such as lethargy (lack of energy), depression, and loose, elastic skin. It can also contribute to several negative health consequences, including the following:

• Increased risk for anemia and other nutritional deficiencies
• Increased risk of bone loss and osteoporosis
• Lowered immune function (which makes you more susceptible to and less able to fight off infections)
• Delayed wound healing
• Heart problems and blood vessel diseases
• Reduced muscle strength
• Reduced ability of your body to regulate temperature
• Increased risk of amenorrhea in women

How to Gain Weight

If you want or need to gain weight to make up for weight loss caused by illness, stress, or other causes, here are some tips to help you do so safely:

• Increase fluid intake. Drinking more low-fat milk and 100% fruit juice can provide you with valuable nutrients without filling you up.
• Add vegetable oils (like canola and olive oils), vegetable oil spreads, or salad dressing (made with unsaturated fats) to foods or use them to cook or prepare foods such as pasta, potatoes, lean meats and poultry, and salads.
• Eat nuts, seeds, and nut butters (for example, add almonds, walnuts, or sunflower seeds to salads; use pine nuts or shaved almonds to top sautéed broccoli or green beans; spread almond or peanut butter on apple slices, celery sticks, or toasted whole wheat bread).
• Add shredded cheese or grated Parmesan cheese to salads, potatoes, pasta, vegetable side dishes, and soups.
• Eat small, frequent meals. This will give you more opportunities to get key nutrients into your diet without filling you up too much.
• Do muscle-strengthening exercises twice a week, working all your major muscle groups.

Hypothyroidism, also known as underactive thyroid, is a condition in which there is too little thyroid hormone (a hormone that keeps the metabolism revved up); symptoms might include weight gain or difficulty losing weight, constipation, hair loss, dry skin, and increased sensitivity to cold temperatures.

Amenorrhea is a condition in which a woman does not or no longer menstruates; it is caused by malfunctioning of the pituitary gland, ovaries, and uterus.

How to Lose Weight

To lose weight, you need to create an energy deficit, or use up more calories than you consume. But before you cut calories or increase energy intake, it’s important to see where you’re starting from. Here are four steps you can take before you embark on weight loss:

1. Determine how many calories you need to maintain a healthy body weight.

2. Find the MyPyramid daily meal pattern that’s associated with your recommended calorie level.

3. Keep a log of everything you eat and drink (including portion sizes) for several days (including weekdays and weekend days); then compare your intake with the meal pattern that’s recommended by MyPyramid. A registered dietitian (RD) can help you assess your current intake and make recommendations for trimming your total calorie intake. She will also take into account your medical history, physical activity level, and personal preferences to help you create a lifestyle plan to help you lose weight slowly and steadily in a safe way. To find an RD in your area, contact the American Dietetic Association.

4. Keep a log of your current physical activity habits and compare it with what’s recommended in current federal physical activity guidelines.

Before embarking on weight loss, it’s important to set realistic goals. If you aim too high, you might set yourself up for disappointment. Even if you do achieve your “dream” weight, you might not be able to comfortably maintain that weight over the long term without drastically cutting back on calories and increasing physical activity and exercise. It’s also important to keep in mind that it’s better to lose less weight and maintain that weight loss over time than to lose a lot of weight and gain most if not all of it back. Several studies have shown that losing even 5 percent of your initial body weight (10 pounds if you weigh 200, or 7.5 pounds if your weight 150) can significantly reduce your risk of several diet-related diseases and have health, physical, and emotional benefits.

Most experts recommend a weight loss of 1-2 pounds per week. People with a higher initial body weight might shed pounds more rapidly than that, while those who start at a lower initial body weight might lose weight more slowly.

Because it takes cutting back (or burning) 3,500 calories a week to lose 1 pound of body fat, a 500-calorie deficit is needed each day. That deficit can be achieved by pairing fewer calories with more physical activity. For example, you can reduce your calorie intake by 200-300 calories each day (about what’s in an average candy bar or 2 slices of bread with 1 tablespoon of butter) + increase energy expenditure by 100-150 calories.

Simultaneously combining dietary efforts with physical activity to lose weight is smart because it supports slow, gradual weight loss and preserves lean muscle tissue to keep your metabolism revved up.

Slow and steady weight loss can also help your body adjust to a new body weight and help you stick to your new, more healthful food and fitness behaviors. On the other hand, rapid weight loss can put your at risk for developing gallstones and can promote rapid loss of lean muscle tissue; that slows your metabolism and makes your body less efficient at burning body fat.

Curbing Calorie Intake

Here are some tips to help you reduce your total calorie intake:

• Reduce portions of foods you typically consume, especially those that are high in calories, fat, or added sugar.
• Replace foods high in saturated and trans fats with reduced or low-fat options.
• Decrease liquid calories; limit caloric beverages to low-fat or nonfat milk or soymilk, 100% fruit juice such as orange juice (up to one glass a day), and an occasional alcoholic beverage (if you are not on medications or have health conditions that preclude you from doing so).

Increasing Physical Activity and Exercise

Here are some tips to help you increase your daily energy expenditure:

• Find opportunities to walk more.
• Invest in a pedometer. Try USANA Pedometer to be best used with USANA Reset Program. Tracking the number of steps you take can be a great motivator; set a long-term goal of 10,000 steps a day and a short-term goal of increasing your daily mileage by 1,000 steps each day until you reach that goal.
• Instead of emailing or texting colleagues, get up and go see them or call them on the phone and walk and talk.
• If you don’t exercise regularly at a gym or at home, identify physical activities you enjoy (whether it’s dancing, ice skating, biking, or playing a sport). Set a goal to engage in that activity once a week; after you’ve done that for a month, add a day until you find yourself being more active several days a week.
• If you already go to the gym or do formal exercise, increase your frequency, intensity, or duration one or more times a week to burn more calories.
• Set small, reasonable goals. Sign up for a run or a charity walk alone or with a friend and use that as a great excuse to train more often and more intensely.
• Always check with a physician before engaging in exercise if you are pregnant or postpartum, have any medical conditions, or are on medications.

How to Maintain Weight Loss

For many people, losing weight is much easier than maintaining that weight loss long-term. But there are people who have been successful losers. The National Weight Control Registry (NWCR), a database of people who have lost significant amounts of weight and kept it off, was created by Rena Wing, Ph.D., and James O. Hill, Ph.D., from the University of Colorado. NWCR has tracked more than 5,000 of these individuals and has found the following:

• Registry participants have lost between 30 and 300 pounds (66 pounds on average); weight losses have been maintained for 1-66 years (5 ½ years on average).
• About half of all participants lost weight on their own, and the other half with help from some type of program.
• Almost all participants modified both their food intake and incorporated more physical activity to lose weight.

NWCR participants also report the following behaviors helped them keep their weight off long-term:

• Eating breakfast
• Weighting themselves at least once a week
• Watching less television
• Engaging in exercise for about an hour each day
• Eating consistently on weekdays and weekends
• Try USANA Diet Nutrtion Bars and Nutrimeal Drinks

National health and nutrition examination surveys are population-based surveys conducted by the National Center for Health Statistics. They are designed to assess the health and nutrition status of noninstitutionalized Americans. These surveys are currently conducted annually.

Sleep apnea is a condition in which an individual stops breathing briefly during sleep, often accompanied by snoring.

Osteoarthritis is a common form of arthritis characterized by the wearing down of cartilage (connective tissue found in many body parts) and the bone underneath it within joints.

A registered dietitian (RD) is a food and nutrition professional who has met American Dietetic Association (ADA) requirements; she received a Bachelor’s or Master’s degree in dietetics or nutrition, completed an approved internship program, passed the registration exam, and receives continuing education credits to maintain the RD credential.

Gallstones form when substances in bile (a fluid made by the liver and stored in the gallbladder) harden; they can cause pain or infection and may require surgical removal of the gallbladder.

Overweight and Obesity

According to the National Heart, Lung, and Blood Institute (NHLB), BMI is the common measurement used to determine weight status. Overweight, obesity, and extreme obesity are defined suing BMI as follows:

• Overweight – BMI 25.0-29.9
• Obesity – BMI 30 or above
• Extreme obesity – BMI 40 or above

Determining a Healthy Body Weight

According to the most recent National Health and Nutrition Examination Surveys (conducted between 2005 and 2006), more than 72 million American adults – about 1 in 3 men (or 33.3 percent) and 35.3 percent of women – are currently obese. Among children between the ages of 2 and 19, 16.3 percent are obese. Although obesity rates are still quite high, there was no measurable increase in incidence between 2003 and 2004.

There are many causes of obesity and overweight. A unique interaction between genes and environment contributes to the development of overweight and obesity. For many of us, being genetically susceptible to overweight or obesity coupled with living in an environment that promotes excess consumption of high-calorie, nutrient-poor foods and beverages is destined to cause weight gain that eventually leads to overweight or obesity.

Here are some of the many factors that play key roles in the development of overweight and obesity:

• Increased availability of high-calories, high-fat, and high-sugar foods and beverages that are easy to overconsume.
• Increased portion sizes of foods and beverages, especially those offered at restaurants, fast-food establishments, from vending machines, or wherever food is sold. People tend to consume more when offered larger portions than when offered smaller portions.
• More eating on the run and when distracted. People often consume more calories when they eat away from home, while driving, when listening to music, when socializing, or when otherwise on-the-go.
• Decreased physical activity because of unsafe neighborhoods, a lack of sidewalks or parks, and technological advances that make physical activity less of a necessity (for example, escalators, remote controls, and computers).

Health Implications

Although many people might think of overweight or obesity in terms of appearance, weighing more than what’s recommended can put you at increased risk for a variety of health, psychological, and social problems. Here are some of the many adverse health consequences that are associated with a higher body weight:

• Coronary heart disease
• Type 2 diabetes
• Cancers (including endometrial, breast, and colon)
• Hypertension (high blood pressure)
• Dyslipidemia (high total cholesterol or high levels of triglycerides)
• Liver and gallbladder disease
• Sleep apnea and respiratory problems
• Osteoarthritis
• Gynecological problems (including menstrual problems and infertility)

Having excess body fat – especially in your abdominal area – increases the risk of type 2 diabetes, high blood cholesterol, high triglycerides, high blood pressure, and coronary artery disease.

Determining A Healthy Body Weight

Body Mass Index

Body mass index (BMI) is a common measurement used to asses body weight; it is also an indirect but reliable way of gauging a person’s body fat level. BMI is determined from your weight and height. Here’s the formula for calculating it:

• BMI = weight (in pounds) divided by height (in inches, squared) and multiplied by 704.5

For example, here’s how a woman who weighs 130 pounds and is 5 feet 4 inches tall would determine her BMI using the formula:

1. Convert height to inches: 5 feet x 12 inches per foot = 60 inches; because the woman is 5 feet 4 inches, add 4 inches; height in inches = 64
2. Multiply answer from #1 by itself: 64x 64 =4096
3. Divide answer from #2 by 130: 4096 / 130 = 0.0317
4. Multiply answer from #3 by 704.5 to get BMI: 0.0317 x 704.5 = 22.36 = BMI

After you know your BMI, you can see which of the following weight categories it falls in:

• Underweight – BMI below 18.5
• Normal weight – BMI 18.5 – 24.9
• Overweight – BMI 25.0 – 29.9
• Extremely obese – BMI >= 40


Although BMI can be a useful estimate of a person’s body fat level, it has some weaknesses; it might overestimate body fat levels in those who have a lot of lean body mass and are muscular, and it might underestimate body fatness in those who are older and have lost muscle mass.

BMI-for-age is used to determine weight status in children. Because body fatness changes as children grow, and because girls tend to have more body fat than boys, gender and age are used to determine BMI values. Pediatricians and registered dietitians can asses children’s BMIs to determine whether their body weight falls within a normal range or whether they are at risk for obesity or overweight.

Waist Circumference

Measuring your waist size is useful in both adults and children. Having more abdominal or visceral fat can increase your risk for diet-related diseases including cardiovascular disease, high blood pressure, and type 2 diabetes.

Waist circumference measurements are especially useful for those whose BMI is less than 35; for some populations, waist circumference helps predict the risk of chronic illness better than BMI.

Here’s how to measure your waist circumference using a simple tape measure:

1. Place the tape measure snugly (but not tightly) around the bare abdomen just above the hip bone; make sure the tape measure is parallel to the floor.
2. Relax, exhale, and then measure the waist in inches.

As your waist circumference increase, so does your risk for cardiovascular and other diet-related diseases; those especially at risk include:

• Nonpregnant women with a waist measurement greater than 35 inches
• Men with a waist measurement greater than 40 inches

Eat to Beat Disease

Using a tape measure periodically to keep track of your waist size is a great way to determine how you’re doing in terms of body fat level and body fat distribution.

Although there are no established norms for waist circumference in children, those who measure above the 90th percentile are more likely to have heart disease risk factors such as higher levels of triglycerides and lower levels of HDL or good cholesterol, as well as obesity-related diseases and conditions.

Overweight and Obesity

A pediatrician can monitor your child’s waist circumference (measured at the end of the lowest rib after your child has taken a normal breath) at her annual checkup as part of an overall health assessment.

Visceral fat, also known as abdominal fat, is fat that accumulates around internal organs. This fat is more dangerous than other types of body fat because it’s believed to secrete potent hormones and other chemicals that increase the risk of cardiovascular and other diseases.