Chapter 9 Energy Balance and Healthy Body Weight
Chapter 9 Energy Balance and Healthy Body Weight Nutrition: Concepts & Controversies, 12 e Sizer/Whitney
Increasing Prevalence of Obesity
What Are the Risks from Underweight? § Disadvantages § Siege or famine (1 st to die!) § Hospital stays § Wasting disease § Heart disease
Cancer: Stroke Daytime sleepiness/sleep apnea Breast, ovary, cervix, endometrium (women) esophagus Impaired breathing kidney Pancreatitis gallbladder Kidney disease non-Hodgkins disease Liver disease stomach and prostate (men) Gallbladder disease colorectal Carpal tunnel syndrome Type 2 Diabetes Low back pain High blood cholesterol Pain Urinary stress incontinence Surgical complications High blood pressure Infections following wounds Infertility Health Dangers of Excess Weight Heart disease Impaired immunity Osteoarthritis Gout
Visceral Fat and Subcutaneous Fat
How Fat Is Too Fat? § Evaluate health risks of obesity § Body mass index (BMI) § Waist circumference § Disease risk profile § Social costs of being overfat § Economic costs of being overfat
Chronic Disease Risks According to BMI Values and Waist Circumference
BMI Values Used to Assess Weight for Adults Fig. 6 -1, p. 171
Indicators of an Urgent Need for Weight Loss
The Body’s Energy Balance § Energy budget § Change in energy stores = energy in – energy out § Energy in § Foods and beverages § Energy out § Varies widely § Lifestyle (exercise) and metabolism
The Body’s Energy Balance § Calorie needs § activity and weight § Energy output § Basal metabolism (BMR) § Voluntary activities § Thermic effect of food
Components of Energy Expenditure
Factors That Affect the BMR
The Body’s Energy Balance § Estimated energy requirements (EER) § Reference man and woman § Taller people § Need more energy § Energy need diminishes with age § DRI method § Gender, age, physical activity, body size and weight, and growth
Average Body Composition of Men (12 -20%) and Women (20 -30%) –healthy ranges
Three Methods of Assessing Body Fatness
How Did We Get So Fat? More calories Bigger portions Fast Food Physical inactivity Passive entertainment Genetics Prenatal factors Childhood development Emotional influences
Hunger, Appetite, Satiation, and Satiety
Inside-the-Body Causes of Obesity § Genetics § One obese parent = 30 -70% chance of obesity § Influence tendency to gain weight or stay lean § Environmental factors
Outside-the-Body Causes of Obesity § External cues to overeating § Available foods § Larger portions § Physical inactivity § Inactivity epidemic
Outside-the-Body Causes of Obesity § Attain healthy body weight § Diet § Physical activity § Behavior change
How the Body Loses and Gains Weight § Tissue lost or gain § Depends on what you do § Water § Fat or muscle § Rapid weight loss is anything but fat § 1 lb. of Fat = 3500 calories
Moderate Weight Loss Versus Rapid Weight Loss § Gradual weight loss is preferred § 1 -2 lbs. /week or 10% in 6 -12 mths. § Fasting § Body adjustments § Sacrifice lean tissue § Death § Ketosis § Incomplete break down of fat molecules
Feasting and Fasting
Moderate Weight Loss Versus Rapid Weight Loss § Short-term fasting § Seems to be tolerated § Effects of deprivation § Overeat or binge eating § Weight loss technique § Slowing of metabolism § Low-carbohydrate diets (initial water loss) § DRI minimum carbohydrate intake level is 130 g/day
Weight Gain § Energy-yielding nutrients contribute to body stores § Four sources of energy § Alcohol § Two types of energy stores § An excess of any food will become fat
Popular Fad Diets (Read Consumer Corner p. 345) § Effectiveness § General reduction in calories § Doesn’t mater if CHO, Fat, or PRO § Adequacy § Safety § Personal responsibility § Lifestyle or behavior change
Achieving and Maintaining a Healthy Body Weight § What is your motivation? § Benefits of modest weight loss § Focus on health or fitness
What Diet Strategies Are Best for Weight Loss? § Aim for a realistic target § Reasonable, specific, measurable goals § Recommended weight loss § § Keep records Plan your diet Realistic calorie intakes Adequate diets
Recommended Daily Food Intakes for Low-Calorie Diets
What Diet Strategies Are Best for Weight Loss? § § § Manage portion sizes Calorie calculations Energy density (cal/weight in grams) Artificial sweeteners Meal spacing (3 -6 meals a day) § Always eat breakfast
Examples of Energy Density
Physical Activity in Weight Loss and Maintenance § Weight loss § Increase caloric expenditure § During activity § Up to 1 hour following activity § Increase in muscle mass § Weight maintenance § Choosing activities § enjoyable
What Strategies Are Best for Weight Gain? § Physical activity § Resistance training = added muscle = § High-calorie diet (nutritious food) § Increased daily caloric intake § High energy density foods
Medical Treatment of Obesity § Obesity medications § OTC § Prescription § Obesity surgery § Lipectomy
Surgical Obesity Treatments
Characteristic of successful weight maintainers? § Lifelong commitment § Cultivate habits for a healthy weight § Exercise regularly § Keep track of food/exercise habits
Behavior Modification for Weight Control § Behavior modification § Change behavior § Change thought processes § Food and activity diary § Don’t attempt to modify all behaviors at once
Behavior Modification for Weight Control § Modifying behaviors § Eliminate inappropriate cues § Suppress cues § Strengthen cues § Repeat the desired behaviors § Emphasize negative consequences § Emphasize positive consequences § Establish baseline § Cognitive skills
The Perils of Eating Disorders Controversy 9
Introduction § Eating disorders § Anorexia nervosa § Bulimia nervosa § Binge eating disorder § Young women § All people § Beginnings of disorders
Society’s Influence § Many causes to eating disorders § Societal pressure for thinness § Distorted body image § Media messages § Unrealistic ideals § Dieting as risk
Tips for Combating Eating Disorders
Criteria for Diagnosis of Anorexia Nervosa
Criteria for Diagnosis of Bulimia Nervosa
The Cycle of Bingeing, Purging, and Negative Self-Perception
Criteria for Diagnosis of Binge Eating Disorder
- Slides: 47