Energy Balance and Healthy Body Weight Chapter 9
Energy Balance and Healthy Body Weight Chapter 9 Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Learning Objectives n n Delineate the health risks of too little and too much body fatness, with emphasis on central obesity and its associated health risks. Describe the roles of several factors, including BMR, in determining an individual’s daily energy needs. Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Learning Objectives n n n Calculate the BMI for various people when given their height and weight information, and describe the health implications of any given BMI value. Identify several factors, including hormones, that contribute to increased appetite and decreased appetite. Describe some inside-the-body factors and theories of obesity development. Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Learning Objectives n n n Describe some outside-the-body factors that may affect weight-control efforts. Briefly describe metabolic events occurring in the body during both feasting and fasting. Develop a weight-loss plan that includes controlled portions of nutrient-dense foods and sufficient physical activity to produce gradual weight loss while meeting nutrient needs. Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Learning Objectives n n Defend the importance of behavior modification in weight loss and weight maintenance over the long term. Compare and contrast the characteristics of anorexia nervosa and bulimia nervosa, and outline strategies for combating eating disorders. Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Introduction n Health risks Overweight n Underweight n n Misconceptions about weight Focus on weight n Focus on controlling weight n Focus on short-term endeavors n n Body composition Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
The Problems of Too Little or Too Much Body Fat n U. S. prevalence Underweight n Overweight n Epidemic n n More than two-thirds of adults in U. S. are overweight or obese n Obesity rates are expected to increase Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Increasing Prevalence of Obesity Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Obesity, Overweight, and Underweight in the U. S. Population Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
What Are the Risks from Underweight? n Disadvantages Siege or famine n Hospital stays n Wasting disease n Cancer n Heart disease n Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
What Are the Risks from Too Much Body Fat? n n Obesity-related illnesses Chronic diseases Extreme obesity vs. smoking Inflammation n n Adipokine Other risks Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Underweight, Overweight, and Mortality Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
What Are the Risks from Central Obesity? n Risks of visceral fat n n Subcutaneous fat Increases risk of death from all causes Metabolic syndrome Fat distribution Apple vs. pear n Factors affecting distribution n Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Visceral Fat and Subcutaneous Fat Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
How Fat Is Too Fat? n Evaluate health risks of obesity Body mass index (BMI) n Waist circumference n Disease risk profile n n n Social costs of body fatness Economic costs of body fatness Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Chronic Disease Risks According to BMI Values and Waist Circumference Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Indicators of an Urgent Need for Weight Loss Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
The Body’s Energy Balance n Energy budget n n Energy in n n Change in energy stores = energy in – energy out Foods and beverages Energy out Varies widely n Lifestyle and metabolism n Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
The Body’s Energy Balance n Calorie needs Monitor activity and weight n Energy output n Basal metabolism (BMR) n Voluntary activities n Thermic effect of food n Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Components of Energy Expenditure Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Factors That Affect the BMR Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
The Body’s Energy Balance n Estimated Energy Requirements (EER) Reference man and woman n Taller people n Need more energy n Energy need diminishes with age n n DRI method n Gender, age, physical activity, body size and weight, and growth Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Body Weight vs. Body Fatness n Body Mass Index (BMI) General guidelines n Underweight n Overweight n Obesity n Drawbacks n Amount or location of fat n Diagnosis requirements n Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Measures of Body Composition and Fat Distribution n Waist circumference n n Visceral fatness Skin fold test Dual-energy X-ray absorptiometry Each method has advantages and disadvantages Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Average Body Composition of Men and Women Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Three Methods Used to Assess Body Fat Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
The Appetite and Its Control n Hunger Response to physiological need n Chemical messengers n Hypothalamus n Ghrelin n Opposes weight loss n Impact of sleep n Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Hunger, Appetite, Satiation, and Satiety Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
The Appetite and Its Control n Appetite Can occur without hunger n Factors affecting appetite n Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
The Appetite and Its Control n “Stop” signals Hormones and sensory nerve messages n Satiation n Various organs n Satiety n Regulates frequency of meals n Leptin – adipokine hormone n Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
The Appetite and Its Control n Meal composition Energy nutrients n Protein n Fat n Fibers n Added sugars n Water n Puffed air n Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Inside-the-Body Theories of Obesity n Set-point theory n n Thermogenesis n n Body organs regulate body fatness Brown adipose tissue (BAT) Genetics and obesity Influence tendency to gain weight or stay lean n Environmental factors n Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Outside-the-Body Theories of Obesity n External cues to overeating Available foods n Human sensations n Larger portions n n Food supply n Addictive? n Dopamine Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Outside-the-Body Theories of Obesity n Physical inactivity Screen time n Sedentary jobs n n Neighborhoods Built environment n Food deserts n n National goals to slow or reverse obesity epidemic Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Community Strategies to Combat Obesity Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
How the Body Loses and Gains Weight n Tissue lost or gain n n Depends on what you do n Water n Fat or muscle Smoking n Hazards Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Moderate Weight Loss vs. Rapid Weight Loss n n Gradual weight loss is preferred Fasting Body adjustments n Sacrifice lean tissue n Death n n Ketosis n Break down of fat molecules Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Feasting and Fasting Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Feasting and Fasting Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Moderate Weight Loss Versus Rapid Weight Loss n Short-term fasting Seems to be tolerated n Effects of deprivation n Overeat or binge eating n Weight loss technique n Slowing of metabolism n n Ketosis upsets the acid-base balance n DRI minimum carbohydrate intake level Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Weight Gain n Energy-yielding nutrients contribute to body stores Four sources of energy n Alcohol n Two types of energy stores n n An excess of any food will become fat Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Achieving and Maintaining a Healthy Body Weight n n n What is your motivation? Three realms to produce results Reality check Set achievable goals Keep records Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Tips for Accepting a Healthy Body Weight Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Dodging Fad-Diet Detours n Effectiveness n n Are fad diets nutritious? n n n Both sides of the coin Recommended supplements Are the diets safe? Success for the fad-diet industry is built on failure for the dieter Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
What Food Strategies Are Best for Weight Loss? n Appropriate calorie intakes Minimum calorie recommendations n Composition of weight loss n n Adequate intakes n n Portion sizes n n Supplements Read labels Meal spacing n Snacking Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Eating Patterns for Low-Calorie Diets Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
What Food Strategies Are Best for Weight Loss? n Calorie excesses n n Low energy density foods n n Little daily decisions add up May not reflect nutrient density Nonnutritive sweeteners Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Energy Density and Meal Size Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Meal Makeover – Reducing the Calories in Meals Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Physical Activity in Weight Loss and Maintenance n Weight loss n n Physical activity alone Advantages of physical activity Feelings of satiation n Lean tissue n Bone loss n Stress n Warning n n Choosing activities Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
What Strategies Are Best for Weight Gain? n High energy density Increased daily caloric intake n Choose nutritious foods n n n Portion sizes and meal spacing Physical activity n Resistance training Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Tips for Gaining Weight Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Medical Treatment of Obesity n Obesity medications Over-the-counter (OTC) medications n Prescription medications n n Obesity surgery Extreme obesity n Not a sure cure n Complications n Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Surgical Obesity Treatments Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Herbal Products and Gimmicks n Herbals and botanicals n n Sold as ‘dietary supplements’ n Lack of FDA approval Other gimmicks Saunas or steam baths n Cellulite n Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Once I’ve Changed My Weight, How Can I Stay Changed? n Lifelong commitment n n n Self-efficacy and keys to success Physical activity n n Cultivate healthy habits Weight cycling Support groups Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Behavior Modification for Weight Control n Behavior modification Change behavior n Change thought processes n n Food and activity diary n Don’t attempt to modify all behaviors at once Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
A Sample Food and Activity Diary Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Behavior Modification for Weight Control n Modifying behaviors Eliminate inappropriate cues n Suppress cues n Strengthen cues n Repeat the desires behaviors n Emphasize negative consequences n Emphasize positive consequences n n Cognitive skills Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
The Perils of Eating Disorders Controversy 9 Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Introduction n Eating disorders Anorexia nervosa n Bulimia nervosa n Binge eating disorder n n Young women n n All people Early in life the patterns for eating disorders begin Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Society’s Influence n Many causes to eating disorders n n Media messages n n Societal pressure for thinness n Distorted body image Unrealistic ideals Dieting as risk Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Eating Disorders in Athletes n n Motivations Risk factors n n Female athlete triad n n Male and female athletes Three medical problems Male athletes and eating disorders n Weight-gain problems Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
The Female Athlete Triad Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Tips for Combating Eating Disorders Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Anorexia Nervosa n Characteristics n n Cannot recognize condition Role of the family Self-starvation Physical perils Damage to whole body n Death n n Treatment Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Bulimia Nervosa n Characteristics n n n More prevalent than anorexia nervosa Role of the family Binge eating and purging Stages of a binge n Methods for purging n n n Physical and psychological perils Treatment Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
The Cycle of Bingeing, Purging, and Negative Self-Perception Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Binge Eating Disorder n n Differences from bulimia nervosa Responds more readily to treatment Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
Toward Prevention n Suggestions Encourage positive eating & physical behaviors n Promote a positive body image n Encourage frequent & enjoyable family meals n Help young people nurture their bodies n Talk with young people about mistreatment n Nutrition: Concepts & Controversies, 13 th edition, Sizer & Whitney
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