A goal of 25 to 35 g of fiber per day is considered reasonable for an average-sized adult. Both types of fiber are found in grains, fruits, vegetables, nuts, and seeds with insoluble fiber, primar- ily the fiber in vegetables, wheat, and most grain products. Soluble fiber is highest in legumes, fruits, oats, and barley. Sodium: Sodium plays an essential role in fluid regulation and blood pressure however, consuming less sodium is not harmful and is recommended for the healthy adult. High-salt intake has been associated with increased calcium excretion in the urine. Also, many employees at risk for high blood pressure can reduce the likelihood of their developing the condition by decreasing sodium consumption. Sodium should be limited to 2,300 mg per day and less than 1,500 mg for those with hypertension as well as older adults. Alcohol: If employees consume alcoholic beverages, they should be advised to consume them only in moderation because alcohol has effects that are harmful when consumed in excess and sup- plies calories but few or no nutrients. Moderation is defined as no more than 1 drink per day for women and no more than 2 drinks per day for men. Alcohol intake should be strongly dis- couraged in female employees who are trying to conceive or who are pregnant, any employee who plans to drive or participate in activities that require skill, and anyone using prescription or OTC medications. The program goals and objectives should target the nutritional needs of the individual or work- force based on risk factors, health indicators, and organizational culture. Information provided needs to be based on scientific research and should follow the most current guidelines (see page 276). Programs should emphasize the National Health Promotion and Disease Prevention objectives and the Dietary Guidelines for Americans recommendations for eating a variety of foods, including an emphasis on fruits, vegetables, and whole grains. Depending on the employee demographics and health risks, offering information and programs to support weight maintenance and weight loss may be appropriate. Most adults should not gain weight, because weight gain is associated with increased risk for high blood pressure, heart disease, stroke, diabetes, cancers, arthritis, breathing problems, and other illnesses. Pro- gram goals should focus on facilitating balancing the amount of calories consumed with the amount expended as necessary to maintain body weight or to reduce or improve body weight. Thirty minutes or more of moderate physical activity on most (preferably all) days of the week is recommended to reduce chronic disease in adulthood however to lose weight or sustain weight loss 60–90 minutes of moderate to vigorous physical activity is recommended on most days of the week, while not exceeding caloric intake requirements. Obesity (BMI 30) is a serious issue. Obesity is considered a risk factor for hypertension, Type 2 diabetes, some types of cancers (endometrial, colon, gallbladder, prostate, kidney, and breast cancer), sleep apnea, asthma, arthritis, and gallbladder disease. Being overweight and obesity also are associated with depression, incontinence, and increased surgical risks, as well as qual- ity-of-life issues, such as limited mobility, decreased physical endurance, and job discrimina- tion. Weight loss, as modest as 5 to 15 percent of total body weight in a person who is overweight or obese, reduces the risk factors. BMI is a measure of weight in relation to height. Determining BMI is currently recommended because (1) there is a correlation between BMI and risk for disease, (2) calculating BMI is sim- ple, rapid, and inexpensive, and (3) it correlates well with total body fat for most individuals. Limitations of BMI are that it can overestimate body fat in persons who are very muscular, and it can underestimate body fat in persons who have lost muscle mass, such as the elderly. There- fore, actual diagnosis of overweight or obesity should be made in consultation with a health professional. Having a BMI in the overweight or obese range does not necessarily indicate that 273 Program Objectives and Elements
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