Nutrition Essentials: A Personal Approach Unit Outline UNIT 10 NUTRITION FOR A HEALTHY WEIGHT AND FIT BODY OVERVIEW In Unit 10, students will learn about body composition and what it means for overall health. The functions of adipose tissue are covered and several methods of assessing body composition are reviewed. The unit provides an overview of energy metabolism, energy balance, and the various components of energy expenditure. Several ways to estimate energy needs are presented. Causes and consequences of excess body weight are described. Students will learn about a variety of useful weight management options, including lifestyle changes, prescription medications, and bariatric surgery, as well potentially harmful methods, such as fad diets and weight loss supplements. The unit also provides information on weight gain for underweight individuals. Unit 10 examines several types of eating disorders, including binge-eating disorder, anorexia nervosa, and bulimia nervosa. LEARNING OUTCOMES Module 10.1 1. Define all of the key terms in this module. 2. List major health risks associated with excess body fat. 3. Explain why the distribution of body fat may be more important to health than the percentage of body fat. 4. Calculate your BMI and use the value to determine whether your weight is healthy. 5. Describe practical ways to measure body composition. Module 10.2 1. Define all of the key terms in this module. 2. Describe the uses of energy by the body and explain the concept of energy balance. 3. Identify factors that influence the development of excess body weight. Module 10.3 1. Define all of the key terms in this module. 2. Evaluate weight-reduction diets for safety and long-term effectiveness. 3. Identify medical options for overweight and obesity. 4. Identify key factors for successful weight loss and maintenance. 5. Plan a long-term weight-loss regimen that’s safe and effective. 6. Discuss ways to gain weight safely and sensibly. Module 10.4 1. Define all of the key terms in this module. 2. Explain why disordered eating practices and eating disorders are common among young Americans. Copyright © 2015 McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Nutrition Essentials: A Personal Approach Unit Outline 3. Identify major kinds of eating disorders, and discuss signs and symptoms, risk factors, and treatments for these conditions. Module 10.5 1. Define all of the key terms in this module. 2. List five health benefits of a physically active lifestyle. 3. Distinguish moderate-intensity activities from vigorous-intensity activities. 4. Plan nutritionally adequate, high-carbohydrate menus. 5. Estimate an athlete’s energy and protein needs. 6. List at least five ergogenic aids that athletes often use, and describe their effects on health and physical performance. UNIT OUTLINE I. Overweight or Obese (Module 10.1) A. Introduction 1. Overweight has extra body weight that’s contributed by bone, muscle, body fat, and/or body water 2. Obesity is a condition characterized by excessive and unhealthy amounts of body fat 3. Overweight and obese people have a greater risk of developing serious chronic diseases including type 2 diabetes, hypertension, and cardiovascular disease (CVD) than people who are not overweight or obese 4. Obesity is a prevalent nutritional disorder in the U.S. 5. According to experts at the Centers for Disease Control and Prevention, cultural, behavioral, and environmental factors may be largely responsible for racial/ethnic differences in obesity rates 6. Obese children have higher risk of maturing into obese adults than children who aren’t obese 7. In most countries, overweight and obesity are responsible for more deaths than the number caused by being underweight B. Body Composition and Adipose Tissue 1. Your body is composed of 2 major compartments: fat-free mass and total body fat a. Fat-free mass is comprised of body water, mineral-rich tissues such as bones and teeth, and protein-rich tissues, including muscles and organs b. Total body fat includes “essential fat” and fat tissue c. Essential fat is also in certain bones and nervous tissue d. Fat tissue contains adipose cells that are specialized for storing energy in the form of triglycerides 2. Adipose Cells a. Fat cells remove excess triglycerides from the bloodstream for storage when food is plentiful Copyright © 2015 McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Nutrition Essentials: A Personal Approach Unit Outline 3. 4. 5. 6. b. When your body needs energy, your adipose cells release fat into the bloodstream for other cells to use as fuel Subcutaneous tissue holds skin in place over underlying tissues as muscle, and it also contains fat cells Subcutaneous fat helps insulate your body against cold temperature and protects muscles and bones from bumps and bruises Visceral fat is adipose tissue that’s under your abdominal muscles and hangs over your stomach and intestines like a protective apron Women generally have more subcutaneous fat than men C. Health Effects of Excess Fat 1. Overweight or obese people have increased risks of: a. Heart disease b. Type 2 diabetes c. Cancers d. Hypertension e. High total cholesterol or high triglyceride levels f. Stroke g. Liver and gallbladder disease h. Sleep apnea and other breathing problems i. Osteoarthritis j. Abnormal menstrual cycles, infertility 2. The distribution of a person’s excess body fat is closely associate with the risk of obesityrelated diseases a. A person with central-body obesity is sometimes described as having an “apple” body shape b. Some people, especially women, tend to store extra subcutaneous fat below the waist, primarily in the buttocks and thighs c. A quick and easy method to determine whether you have an unhealthy amount of visceral fat is to measure your waist circumference D. What’s Body Mass Index? 1. Body Mass Index (BMI) is a numerical value based on the relationship between body weight and risk of chronic health problems associated with excess body fat 2. To calculate your BMI, use the following formula: a. Weight (lb)/[height(in)]2 × 703 b. You can also use the BMI calculator at http://nhlbisupport.com/bmi/ 3. Healthy BMIs range from 18.5 to 24.9 4. As BMI increases, the risks of heart disease, hypertension, type 2 diabetes, gallstones, certain cancers, and breathing problems increase 5. Muscle is denser than fat; a muscular person whose BMI is in the overweight range may actually have a healthy percentage of body fat Copyright © 2015 McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Nutrition Essentials: A Personal Approach Unit Outline 6. Your BMI doesn’t provide the entire picture regarding your chances of developing diseases that are associated with having excess body fat E. Measuring Body Fat 1. Bioelectrical impedance technique estimates body composition. A device measure the conduction of a weak electrical current through the body 2. Taking skinfold thickness measurements at multiple body sites is another technique F. How Much Body Fat is Healthy? 1. Some fat is essential for good health, but too much fat my interfere with your body’s ability to function normally a. A man is overweight when his body is 22% to 25% fat b. A woman is overweight when her body is 32% to 37%fat c. A man is obese when fat comprises 26% or more of his body d. A woman is obese when fat makes up 38% or more of her body 2. Adults tend to gain fat tissue as they age, but for older adults, some additional fat doesn’t necessarily contribute to health problems II. Factors That Influence Your Body Weight (Module 10.2) A. Calories In: Calories Out 1. Biological fuels are foods and beverages that contain macronutrients (energy intake) 2. Energy output (energy expenditure) refers to energy (calories) cells use to carry out their activities 3. Metabolism refers to all chemical changes or reactions that constantly occur in living cells a. Anabolic reactions require energy to occur b. Catabolic reactions release energy c. Basal metabolism is the minimal number of calories the body uses for vital activities after fasting and resting for 12 hours 4. Metabolic rate, the rate at which cells use energy for their metabolic activity is regulated by thyroid hormone a. Body composition – a person who has more muscle mass will have a higher metabolic rate than someone with less muscle tissue b. Sex – males generally have higher metabolic rates than women because they tend to have more lean body mass c. Age – basal metabolism declines as one grow older, primarily due to the loss of fatfree tissues such as muscle d. Caloric intake – the body conserves energy when calorie intakes are very low or lacking altogether 5. You can estimate your daily metabolic rate by following a rule of thumb formula a. Formula for men = 1.0 kcal/kg/hr b. Formula for women = 0.9 kcal/kg/hr Copyright © 2015 McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Nutrition Essentials: A Personal Approach Unit Outline 6. 7. 8. 9. c. Hourly basal metabolic rate: _____ kcal/hr × 24.hr = _____ kcal/day Physical activity increases energy output above basal metabolic needs Thermic effect of food (TEF) – energy used to digest foods and beverages as well as absorb and further process the macronutrients Nonexercise activity thermogenesis (NEAT) – involuntary skeletal muscular activities such as fidgeting Table 10.4 list approximate caloric output/minute of selected physical activities (150pound person) B. Energy Balance 1. Energy balance is when your calorie intake from food and beverages equals your calorie input for basal metabolism, physical activity, TEF, and NEAT 2. If your calorie intake is lower than your calorie output, you’re in a negative energy state 3. If your calorie intake is greater than your calorie output, you’re in a positive energy state 4. Maintenance of energy balance is critical for controlling body weight C. Factors That Influence Weight Gain 1. Biological factors a. Hunger is an uncomfortable feeling that drives a person consume food b. Satiety is the sense that enough food or beverages have been consumed to satisfy hunger c. Ghrelin, a hormone secreted mainly by the stomach, stimulates eating behavior d. Leptin, a hormone that reduces hunger and inhibits fat storage in the body 2. Genetic Factors a. Several genes contribute to human fatness b. If you gain weight easily, you may have inherited a “thrifty metabolism” c. According to the set-point theory, the body’s fat content is genetically predetermined 3. Environmental Influences a. Appetite is the desire to eat appealing food b. Food advertising is an aspect of the environment that has a powerful influence on your food choices c. Your environment affects whether you chose to be physically inactive or physically active III. Managing Your Weight Safely (Module 10.3) A. Features of Medically Sound Weight Loss Plans 1. A dieter’s goal should be reducing total calorie intake while obtaining all essential nutrients 2. A sound weight loss plan: a. Is safe and effective Copyright © 2015 McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Nutrition Essentials: A Personal Approach Unit Outline b. c. d. e. f. g. h. i. Meets nutritional, psychological, and social needs Incorporates a variety of common foods from all food groups Fosters a reasonable rate of weight loss Doesn’t require costly devices or diet books Accommodates family and restaurant meals, parties and special occasions Doesn’t make you feel deprived Emphasizes readily available nutritious foods Can be followed for a lifetime B. Weight Loss: Key Factors for Success 1. The motivation to lose weight and keep if off requires an overfat person to recognize there’s a need to change his or her behaviors 2. Setting goals is the first step to losing excess body fat 3. Making lifestyle changes includes diet and physical activity a. Follow a calorie restricted-diet b. Regular physical activity is critical for weight loss and maintenance 4. Changing your food- and exercise-related practices should include: a. Planning menus b. Shopping carefully c. Preparing and serving your food d. Eating smart e. Preparing for holidays and parties f. Using caution at restaurants g. Changing negative thought patterns 5. Successful dieters manage their weight by: a. Eating a low-calorie, low-fat diet b. Exercise, on average, for about an hour daily c. Eat breakfast d. Watch less than 10 hours of television per week e. Weigh themselves at least once a week C. Medical Treatments for Obesity 1. Weight loss medication approved by the FDA for long-term use for weight loss: a. Orlistat b. Belviq c. Qsymia d. These medicines can aid weight loss effort, but don’t replace the need to reduce calorie intake and physical activity 2. Surgical procedures such as bariatric surgeries drastically reduce the size of an obese a person’s stomach a. Bariatric medicine is the medical specialty that focuses on the treatment of obesity Copyright © 2015 McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Nutrition Essentials: A Personal Approach Unit Outline b. People who undergo such surgical procedures must make major lifestyle changes, such as learning to plan and consume frequent, small meals c. Patients often achieve normal blood pressure, glucose levels, and triglyceride levels after surgery d. The Roux-ex-Y operation involves using surgical staples to reduce the obese patient’s stomach to about 1.5 oz., which is approximately the volume of one egg e. Sleeve gastrectomy the surgeon staples the stomach to form a banana-shaped pouch that holds about 2 to 5 ounces of food f. Complications with gastric bypass include intestinal blockage and bleeding, leaks along the staple site, blood clot formation, and wound infection g. The adjustable gastric banding procedure creates a small stomach pouch with an adjustable band instead of fixed surgical staples D. Unreliable Weight Loss Methods 1. A fad is a trendy practice that has widespread appeal a. Fad diets rely on gimmicks b. The grapefruit diet is an example 2. Low-Carbohydrate Approaches a. Dr. Aitkin’s New Diet Revolution b. The Scarsdale Diet c. Early phase of the South Beach Diet d. Usually produce rapid weight loss initially, because the body loses water e. Carbohydrate-restricted diets often improve high-density lipoprotein and serum triglyceride levels 3. Very-Low Fat Approaches a. The Pritikin Diet b. Eat More, Weigh Less diet plan c. Result in rapid weight loss d. Very-low fat diets are not tasty, they eliminate many foods that are usually high on a favorite’s listing, such as ice cream and meat 4. Promoters’ claim that dietary supplements are “magic bullets” for shedding unwanted weight quickly and effortlessly 5. Analyzing Advertising Hype, be wary of claims that the product or service: a. Causes rapid and extreme weight b. Requires no need to change dietary patters or physical activity c. Results in permanent weight loss d. Is scientifically proven or doctor endorse e. Displays before-and-after photos f. Includes a money-back-guarantee g. Is safe or natural h. Is supported by satisfied customers Copyright © 2015 McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Nutrition Essentials: A Personal Approach Unit Outline E. Gaining Weight 1. An underweight individual has a BMI that’s less than 18.5 2. To gain weight, underweight adults can gradually increase their consumption of caloriedense foods: a. Fatty fish b. Olives c. Avocados d. Seeds e. Low-fat cheese f. Nuts g. Nut butter h. Bananas i. Granola made with dried fruit, seeds, and nuts j. Regular meals and snack schedule IV. Disordered Eating and Eating Disorders (Module 10.4) A. Eating disorders are psychological disturbances that lead to serious problems a. Causes of eating disorders are unknown but genetic, social, and psychological b. Risk factors for eating disorders include: a. Sex (females are more likely to develop eating disorders b. History of eating and digestive problems in early childhood c. Low self-esteem d. History of being a victim of sexual abuse e. General psychological problems B. Binge-Eating Disorder 1. People with binge-eating disorder (BED) often eat an usually large amount of food at one time a. More quickly than usual during binge episodes b. Until they feel uncomfortably full c. Excessive amounts of food even when they’re not hungry d. Alone, because they’re embarrassed about their overeating behavior 2. A person with BED doesn’t purge following an episode of binge eating 3. This disorder is more common in people who are extremely obese C. Bulimia Nervosa 1. Bulimia nervosa (BN) is characterized by reoccurring episodes of overeating (bingeing) and purging 2. Repeated vomiting can cause: a. Blood chemistry abnormalities; blood potassium can drop dramatically b. Swelling of the throat c. Tears and bleeding of the esophagus Copyright © 2015 McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Nutrition Essentials: A Personal Approach Unit Outline d. Sores or scars on the knuckles e. Tooth decay 3. The person with BN feels a lack of control over the purging behaviors 4. They may view themselves as being overweight and rely excessively on body shape and weight to judge themselves D. Anorexia Nervosa 1. Anorexia Nervosa is a severe psychological disturbance characterized by self-imposed starvation that results in malnutrition and extreme underweight 2. People with AN: a. Limit calorie intake b. Are emotionally disturbed about their body weight and shape c. Have an intense fear of gaining weight or becoming fat d. Have not had a menstrual period for three or more cycles 3. Signs and symptoms of AN include: a. Confusion or slowed thinking b. Widespread delicate, dense, white hair on the skin c. Shrunken breast and buttocks d. Emotional depression e. Low blood potassium levels f. Tooth decay 4. People with AN engage in : a. Self-induced vomiting b. Abuse of laxatives or diuretics c. Excessive exercise regimens d. Use of appetite suppressants 5. With treatment, patients may recover and achieve a healthy weight 6. Female participating in appearance-based competitive sports that require low body mass, such as gymnastics, swimming, and figure skating, are at risk of developing female athlete triad a. Low energy intake b. Abnormal menstrual cycles c. Bone mineral irregularities d. Increased risks of bone fractures such as “stress” fractures E. Treating Eating Disorders 1. A key goal of therapy is for patients to achieve and maintain healthy BMIs without using unhealthy practices 2. Cognitive behavioral therapy teaches people ways to monitor their eating behavior and change their unhealthy eating habits 3. The affected person’s life may be at risk Copyright © 2015 McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Nutrition Essentials: A Personal Approach Unit Outline 4. Professional help is often available at student health centers and student guidance/counseling facilities on college campus VI. Get Moving, Get Healthy (Module 10.5) A. Health Benefits of Regular Exercise 1. Chronic illnesses can be prevented or improved by exercising more often 2. Exercising regularly can help: a. Control your weight b. Reduce your risk of CVD c. Reduce your risk of colon and breast cancer d. Strengthen your bones and muscles e. Improve your psychological well-being f. Increase your chances of enjoying a longer, healthy life B. What’s Physical Fitness 1. Physical fitness is the ability to perform moderate to vigorous-intensity activities without becoming excessively tired 2. Proper nutrition is essential for optimal physical fitness and sports performances 3. Determining the intensity of Physical Activity a. Intensity refers to the level of exertion (physical effort) used to perform an activity b. Low-intensity activity c. Moderate-intensity activity d. Vigorous-intensity activity 4. The Physical Activity Pyramid a. This pyramid represents various activities that need to be performed regularly and discourages physical inactivity b. Performing aerobic exercise at least three times a week raises your heart rate c. Aerobic exercise involves sustained, rhythmic contractions of large muscle groups in the legs and arms 5. Recommendations for Physical Activity a. Moderate-intensity physical activity for 150 mins a week b. Vigorous-intensity physical activity for 75 mins a week c. Eight to 10 strengthening exercises twice a week d. Spread the activities our over a week C. Fueling Exercise 1. In aerobic conditions cells can metabolize glucose completely to C02 and H2O 2. Fat supplies more ATP-energy than carbohydrate 3. Fatty acids aren’t very useful fuel for intense, brief exercise because it has fewer oxygen atoms in relation to carbon atoms 4. When cells don’t have much oxygen (anaerobic conditions), glucose is a major source of energy Copyright © 2015 McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Nutrition Essentials: A Personal Approach Unit Outline 5. EC 10.1 illustrates what happen under anaerobic conditions a. Cell convert glucose to pyruvate and then to lactic acid b. The breakdown of glucose to lactic acid produces a small amount of ATP c. Lactic acid accumulates in muscles and converts to a lactate d. Some of the lactate enter the bloodstream e. The liver can convert lactate into glucose 6. Fat is the primary fuel that muscles use while resting or engaged in low- to moderateintensity physical activities D. General Dietary Advice for Athletes 1. Athletes generally need more energy to support their physically active lifestyles 2. Male athletes who train or compete aerobically for more than 90 minutes daily need at least 50 kcal/kg/day 3. Recommended diets for athletes should supply adequate amounts of energy from carbohydrates 4. Carbohydrate, or glycogen, loading involves altering dietary and physical activity patterns a few days before an event to increase muscle glycogen stores well above the range 5. Athletes can delay fatigue by consuming 30 to 60 g of carbohydrate per hour of activity 6. Athletes should drink enough water to maintain proper hydration during endurance events 7. Athletes who train intensely each day need to consume 8 to 10 g of carbohydrate/kg of body weight to replenish their muscle glycogen stores 8. Energy or sports, bars are essentially cookies made from soy and milk proteins that are fortified with vitamins, minerals, and fiber 9. Protein provides no more than 15% of the body’s energy needs 10. Athletes should avoid losing more than 2% of their body weight during exercise 11. Sports drinks provide some nutritional benefits beyond those of plain water 12. Water Intoxication can occur when people drink much water, which dilutes the level of sodium of their blood 13. A small degree of dehydration can lead to declines in an athlete’s endurance, strength, and overall performance a. Heatstroke is a medical emergency that needs to be treated by trained medical staff b. To reduce the risk of heat illnesses, you should avoid exercising under extremely hot, humid conditions c. Replace fluid losses that occur during prolonged exertion E. Ergogenic Aids: Separating Fact and Fiction 1. Erogenic aids – foods, devices, dietary supplements, and even drugs a. Aids used to improve athletes physical performance b. No reliable scientific evidence supports the effectiveness of most dietary supplements purported to have ergogenic effects Copyright © 2015 McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. Nutrition Essentials: A Personal Approach Unit Outline c. Dietary practices such as consuming sufficient water, electrolytes, and carbohydrates, and eating a balanced, varied diet can enhance physical performance 2. Caffeine in energy drinks can increase alertness and decrease fatigue 3. Excess caffeine is toxic 4. Combining energy drinks with alcohol is dangerous F. Physically Active for a Lifetime 1. Consider your fitness goals 2. Join a fitness facility, gym, or purchase special exercise equipment 3. Include aerobic, resistance, and stretching activities in your weekly exercise regimen 4. Tips: a. Choose physical activities you enjoy b. Increase the amount of time you spend walking each day c. Reduce the amount of time you spend sitting d. Take stairs e. Park your car farther f. Lift handheld weights g. Adapt moderate-intensity Copyright © 2015 McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.