Figure 6-5 (continued fasting).
Energy Balance and Weight
Management
ENERGY IN
 Regulation
of food intake:
 Hunger
 Satiation
 Appetite
and satiety
ENERGY OUT
 Energy
expenditure at rest:
 BMR - basal metabolic rate: rate of
energy expended at rest (kcal/hr or
kcal/day), also called RMR (resting
metabolic rate).
 Factors that affect BMR (page 257)
ENERGY OUT
 Energy
expenditure for physical activity:
 Depends on the activity duration, type,
and intensity (page 255)
 Also affected by body size and fitness
level
ENERGY OUT
 NEAT
is the energy associated with
unintentional activities like fidgeting,
maintenance of posture, or spontaneous
muscle contraction
ENERGY OUT
 Energy
expenditure to process food:
 Thermic effect of food (TEF) – the
energy used to digest, absorb, and
metabolize energy-yielding food
 TEF is lower for fat than for
carbohydrate and protein
 TEF peaks one hour after eating, and
normally dissipates within 5 hours
 Accounts for ~10% of total energy
expenditure
Components of Energy
Expenditure
 Physical
Activity = 30-50%
 TEF = 10%
 BMR = 50-65%
MEASUREMENT of ENERGY
EXPENDITURE
 Estimating
energy expenditure:
 EER – an equation used to estimate REE
based on age, weight, height, and sex
 Page 257
BODY COMPOSITION
 Assessing
body weight:
 weight tables
 body mass index (BMI) =
weight (kg)
height (m2)
BODY COMPOSITION

As the BMI table
shows, healthy weight
falls between a BMI of
approximately 18.5
and 24.9.
BODY FAT DISTRIBUTION
 gynoid
obesity (pear-shaped figure), more
common in women
 android obesity (apple-shaped figure),
more common in men

increases risk of heart disease and diabetes
mellitus (Type II)
“apple”
“pear”
WHAT CAUSES OBESITY?
Current Thinking








Hereditary and genetic factors
Sociocultural influences
Age and lifestyle
Sex
Race and ethnicity
Socioeconomic status
Employment
Psychological factors
ENERGY IMBALANCE:
Overweight and Obesity
 Health
risks (page 265)
 Prevalence of overweight and obesity – it
is a worldwide public health problem. We
are now seeing an obesity epidemic in
children as well as adults.
OBESITY in our CHILDREN
 National
Center for Health Statistics
suggests nearly 25% of children are
overweight or obese
 There are now about 5 million obese
children in the United States – up by 50%
since 1991
OBESITY in our CHILDREN
A 1999 Survey of Seattle High Schools
showed that:
 9%
of males and 6% of females were
overweight
HEALTH CONSEQUENCES
 Overweight
children and adolescents are
more likely to become overweight or
obese adults
 Type 2 diabetes, high blood lipids,
hypertension, early maturation and
orthopedic problems also occur with
increased frequency in overweight youth
ECONOMIC CONSEQUENCES
 In
2000, the total cost of obesity was
estimated to be $117 billion
 Most of the cost associated with obesity is
due to type 2 diabetes, coronary heart
disease, and hypertension
WEIGHT MANAGEMENT
What Works?????
 Unfortunately,
there is no magic pill, no
perfect diet. The simple fact is, if you
consume more calories than you burn,
you will gain weight
 A slow weight loss (1-2 pounds per
week) is the best way
 To lose 1 pound of fat, you must burn
an extra 3500 calories (in one week that
= 500 calories per day)
WEIGHT MANAGEMENT
 Important





Components:
Diet composition
Physical activity
Behavioral change
Balancing acceptance and change
Support!
DIET COMPOSITION

A Healthful Eating Plan
Involves:





Realistic energy intake
Nutritional adequacy
Small portions, small
frequent meals
Reduced simple sugar
and alcohol intake
Adequate water
PHYSICAL ACTIVITY

Contributions to weight loss and maintenance:





Direct increases in energy output (muscles and
cardiovascular system)
Indirect energy output (elevated BMR)
Appetite control
Psychological benefits
Note: Spot reducing is not possible.
BEHAVIORAL CHANGE

Behavior
modification: the
changing of behavior
by the manipulation of
antecedents (cues or
environmental factors
that trigger behavior),
the behavior itself, and
consequences (the
penalties or rewards
attached to behavior).
Figure 7-7 Food and Activity Diary
SUPPORT
•
•
•
Family
Friends
Weight Loss Support Groups
WEIGHT MANAGEMENT
 Adjuncts





to treatment
Drugs
Self-help activities
Commercial programs
Professional private counselors
Surgery: gastric bypass, gastric banding
Why is abdominal fat bad?
 http://www.health.harvard.edu/newsweek/
Abdominal-fat-and-what-to-do-about-it.htm