Chapt 7, 8, 9, 10_lectureEnergy Balance and Weight Control

7/31/2019 Chapt 7, 8, 9, 10_lectureEnergy Balance and Weight Control

1/87

Chapter 7,8,9,10 :Protein,Fitness

Energy Balanceand Weight Control

Spring 2011

Prof. Ado


2/87

Overview of Protein

Body is made up of thousands of proteinsContains nitrogen , carbon , hydrogen , andoxygenFunctions Regulates and maintains body functions

Provides essential form of nitrogen (in theform of amino acids)


3/87

Amino Acid

R group Acid groupNitrogen group

NH2 O

R C C OH

H


4/87

Protein Organization

Order of amino acids in a proteindetermines its ultimate shape

Proteins final shape determines itsfunction in the body


5/87

Denaturation of Proteins

Heat/acid/alkaline/enzymesResults in alteration of the proteins

three-dimensional structure


6/87

Health and Plant Proteins

Heart healthyCancer-fighting

Bone healthBetter glucose controlSoy and menopausal symptoms


7/87

Plant Sources

Provide protein, minerals, and dietary fiberContain no cholesterol

Limited saturated fatsHigh fiber Time needed to adjust to the higher fiber load


8/87

Digestion of Protein in theStomach and small Intestine

Denatured By cooking and acid in the stomach Gastrin

Stimulates the release of acid and pepsin Pepsin-Breaks down proteins

Release of CCK ( Cholecystokinin, a peptide hormone

responsible for stimulating the digestion of protein inthe small intestine.Peptones peptides amino acidsSmall peptides and amino acids

Ready for absorption


9/87

Denaturation


10/87


11/87

Protein Calorie

MalnutritionLack of protein in your diet will yield the

following two diseases:Marasmus Seen in hospitalized patients

Kwashiorkor


12/87

Protein Calorie Malnutrition


13/87

Protein Balance


14/87

RDA for Protein

Increased by ~10-15 gm /day forpregnancyThe RDA for protein for most healthyadults is 0.8 g/kg of body weight. Endurance athletes May need 1.2 1.7 gm/kg healthy weight

Provide about 8-10% of total kcalMost of us eat more than the RDA forprotein.


15/87

Current Protein Recommendations


16/87

RDA for Protein

Promotes equilibrium

0.8 gm of protein / kg of healthy body weight. What would be the recommended amountof protein for a 154-pound female?

154 lb. = 70 kg

2.2 kg/lb.70 kg x 0.8 g protein = 56 g protein

kg healthy body weight

How about someone with 220 lb?


17/87

Animal Protein

Contribution to our diet ~70% of our protein intakeTop 5 contributors of protein in U.S. diet: Beef Poultry Milk

White bread CheeseWorldwide, 35% comes from animalsources


18/87

Energy Balance

65% of adults are overweight

30% of total population is obese

Red flags: 10 pounds of weight gain 2-inch increase in waist circumference


19/87


20/87

Energy Balance


21/87

Energy In vs. Energy Out


22/87

Basal Metabolism

Minimum energy expended to keep aresting, awake body alive~60-70% of total energy needs

Includes energy needed for maintainingheartbeat, respiration, body temperature

Amount of energy needed for basal

metabolism varies between individuals Approximately 1 kcal/minute


23/87

Factors that Influence Basal Metabolism

Body surface area (weight, height)Lean body massGenderBody temperatureThyroid hormoneNervous system activity

AgeCalorie intakePregnancyUse of caffeine and tobacco


24/87


25/87

Thermic Effect of Food (TEF)

Energy used to digest, absorb, andmetabolize food nutrients

Sales tax of total energy consumed ~5-10% above the total caloriesconsumed

TEF is highest for protein >carbohydrate > fat


26/87

Adaptive Thermogenesis

Nonvoluntary physical activity Triggered by overeating Fidgeting and shivering

Maintenance of muscle tone Maintenance of posture

Overeating

Increases sympathetic nervous system activityResists weight gainBrown Adipose Tissue

Participates in thermogenesis


27/87

2005 Dietary Guidelines for Americans

30 minutes/day physical activity Reduce risk of chronic disease

60 minutes/day physical activity Manage body weight and prevent weight gain

90 minutes/day physical activity Sustain weight loss


28/87

Determination of Energy Needs

Direct calorimetry Measures heat output Expensive and complex

Indirect calorimetry Measures the amount of oxygen consumed Oxygen consumed is related to energy

expended


29/87

Estimated Energy Requirement(EER)

Men 19 years and older:EER= 662-(9.53 x AGE) + PA x (15.91 x WT + 539.6 x HT)

Women 19 years and older:EER= 354- (6.91 x AGE) + PA x (9.36 x WT + 726 x HT)

PA = physical activity estimate WT = weight in kg HT = height in meters (inches / 39.4)


30/87

Physical Activity Estimate ACTIVITY

LEVEL

PA (MEN) PA (WOMEN)

Sedentary(no exercise)

1.00 1.00

Low Activity(walks theequivalent of ~2 miles/day)

1.11 1.12

Active (walks theequivalent of ~7 miles/day)

1.25 1.27

Very Active (walksthe equivalent of

~17 miles/day)

1.48 1.45


31/87

What is a Healthy Body Weight?

Current height/weight standards Weight associated with health and longevity May not be the healthiest weight for individual

Review of family historyPersonal weight history

Healthy lifestyle contribution


32/87

Weight-Related Conditions


33/87

A Healthy Body Weight

What is the lowest weight maintained formore than a year?

What weight was maintained withoutconstantly feeling hungry?

Establish a personal healthy weight


34/87

BMI: Overweight and Obesity

Underweight = BMI < 18.5Healthy weight = BMI 18.5-24.9Overweight = BMI 25-29.9Obese = BMI 30-39.9

Severely obese = BMI >40


35/87

Height / Weight Table


36/87

Perspective on Weight

Aim for personal healthy weight Avoid unrealistic goals

Listen to bodys cues (for hunger) Eat a healthy dietBe physically active

Size acceptance


37/87

Obesity

Excessive amount of body fat Women > 35% body fat Men > 24% body fat

Increased risk for health problems

Are usually truly overweight


38/87

Estimation of Body Fat

Underwater weighing Very accurateFat is less dense than lean tissueFat floats


39/87

Underwater Weighing


40/87

Estimation of Body Fat

Air displacementDetermines the body volume Displace air in a sealed chamber

Body density =Body wt/body volume

% Body fat=

(495/body density)-450

d d


41/87

Bod Pod


42/87

Skinfold Measurements


43/87


44/87

D l X Ph t Ab ti t


45/87

Dual X-ray Photon Absorptiometry


46/87

Body Fat Distribution

Upper- body obesity, Apple shape Associated with Cardiovascular disease, HTN, type 2

diabetes Testosterone and excessive alcohol Abdominal fat is released into the liver and

promotes inflammation in the body

Defined as Waist measurement of > 40 for men Waist measurement of >35 for women


47/87



48/87


Lower- body obesity, Pear shape Encouraged by estrogen and

progesterone After menopause, upper-body obesitymore common

Fewer health risks than upper-bodyobesity


49/87

Juvenile-Onset Obesity

Develops in infancy or childhoodIncrease in the number of adipose

cells Adipose cells have long lifespan andneed to store fat

Makes it difficult to lose fat (weightloss)


50/87


51/87

Obesity and Nature Debate

Identical twins When raised apart still have similar weights

Genes Affect metabolic rate, fuel use, brain

chemistry, body shape Account for up to 70% of weight

differencesThrifty metabolism gene More fat storage to protect against famine


52/87

Set-Point Theory

Weight is regulated by the bodyGenetically predetermined body weight

Body resists weight changeLeptin assists in weight regulationReduction in calorie intake results inlower metabolic rate

Ability to shift the set-point weight?


53/87

Opponents of Set-Point Theory

Weight does not remain constant

Different environments can alterweight

People settle into a particular weightbased on current circumstances


54/87

Obesity and Nurture Debate

Environmental factors influenceweightLearned eating habits

Activity factor (or lack of)Poverty and obesity

Female obesity is rooted inchildhood obesityMale obesity appears after age 30


55/87

Nature and Nurture

Obesity is nurture allowing natureto express itself Location of fat is influenced bygeneticsChild of obese parents is especiallyat risk Increased physical activity andmoderate calorie intake canpromote healthy weight

What Encourages Excess Body Fat?


56/87

What Encourages Excess Body Fat?


57/87

Why Diets Dont Work

Obesity is a chronic disease Treatment requires long-term lifestyle

changes

Dieters are misdirected More concerned about weight loss than

healthy lifestyle Unrealistic weight expectations

L ki f S d


58/87

Looking for a SoundWeight-Loss Program?

Seek advice from a RegisteredDietitian

Control calorie intakeIncrease physical activity

Acknowledge need for lifelongchanges to maintain healthy weight

W ight L T i d


59/87

Weight-Loss Triad


60/87

Control Calories

Sedentary society---requires less calories

Low-fat, high-fiber approaches Most successful in long-term studies

No diet has a metabolic advantage

Read food labels

Keep a food log (portion size awareness)


61/87

Regular Physical Activity

Important for weight maintenancePromotes steady weight loss Expends 100-300 kcal while controlling

caloriesBoosts self-esteem

Add weight resistance Increase lean body mass Increase fat use Increase bone health Increase metabolic rate

Physical Activity


62/87

Physical ActivityRecommendations

60 minutes/day to maintain body weight60-90 minutes/day for maintenance of weight lossPedometer Goal 10,000 steps a day


63/87

What it Takes to Lose a Pound

Body fat contains 3500 kcal perpound

Fat storage (body fat plus supportinglean tissues) contains 3300 kcal perpound

Must have an energy deficit of about3300 kcal to lose a pound per week


64/87

Do the Math

To lose one pound, you must create a deficit of 3300 kcal

So to lose a pound in 1 week (7 days), try cutting back onyour kcal intake and increase physical activity so that you

create a deficit of about 500 kcal per day

- 500 kcal x 7 days = - 3500 kcal = ~ 1 pound of weight

day week loss in 1 week


65/87

Sound Weight Loss Program

Rate of lossFlexibility

IntakeBehavior modificationOverall health


66/87


67/87

Chain-Breaking

Breaking the link between twobehaviors

These links can lead to excessiveintake


68/87

Stimulus Control

Altering the environment Minimize the stimuli for eating

Putting you in charge of temptations


69/87

Cognitive Restructuring

Changing your frame of mindregarding eating

Replacing eating due to stress with walking


70/87

Contingency Management

Forming a plan of action Response to a situation

Rehearsing appropriate responses The pressure of eating at parties


71/87

Self-Monitoring

Tracking foods eaten and conditionsaffecting eating

Understanding your eating habits


72/87

Weight Maintenance

Prevent relapse Occasional lapse is fine, but take chargeimmediately

Continue to practice newly learned behavior Requires motivation, movement, and

monitoring

Have social support Encouragement from friends/ family/

professionals


73/87

Diet Drugs

Amphetamine (Phenteramine) Prolongs the activity of epinephrine andnorepinephrine in the brain

Decreases appetite Not recommended for long-term use

(dependency)Sibutramine (Meridia)

Enhances norepinephrine and serotoninactivity Decreases appetite Not recommended for people with HTN


74/87

Orlistat (Xenical)

Inhibits (lipase) fat digestionReduces absorption of fat by 30% in the smallintestineDietary fat is deposited in the feces, withresulting side effectsMust still control fat intakeMalabsorption of fat-soluble vitamins

Supplement needed at bedtime Alli---Low dose of Orlistat, available OTC

Orlistat (Xenical)


75/87

Orlistat (Xenical)


76/87

Treatment of Severe

Obesity


77/87

Very Low-Calorie Diets (VLCD)

Recommended for people >30% abovetheir healthy weight400-800 kcal per dayLow carbohydrate and high proteinCause ketosisLose ~3-4 pounds a week Require careful physician monitoringHealth risks include cardiac problems andgallstones


78/87

Bariatric Surgery


79/87

Adjustable Gastric Banding

Reduces opening from esophagus tostomach by gastric bandDecreases amount of food eatenBand can be inflated or deflated


80/87

Gastroplasty - Stomach Stapling

Most common surgical procedure fortreating severe obesity

Reduces the stomach size From 4 cups to 1 oz (shot glass size)Overeating will result in rapid vomiting

Smaller stomach promotes satiety earlier75% will lose ~50% of excess bodyweight

Gastroplasty


81/87

p y


82/87

Criteria for Gastroplasty

BMI > 40Obese for > 5 yearsNo history of alcoholismNo history of major psychiatric disorderCostly procedure

Follow-up needed after procedure lossRequires major lifestyle changes


83/87

Underweight is Also a Problem

BMI of


84/87

Treatment for Underweight

Intake of energy-dense foods (energyinput)Encourage regular meals and snacksReduce activity (energy output)

Increase portion sizeStrength training


85/87

Fad Diets

Promote quick weight lossLimited food selectionsUse of testimonialsCure-allsRecommend expensive supplements

No permanent lifestyle changesadvocatedCritical of the scientific community

f l


86/87

Types of Popular Diets

Low or restricted carbohydratesCarbohydrate focused dietsLow-fat approachesNovelty dietsMeal replacements

Popular Diets


87/87

Documents

Chapt 7, 8, 9, 10_lectureEnergy Balance and Weight Control