Weight Management

1. Weight Management

3. Risk Factors for CVD Established By American Heart Association • . Tobacco Use • 2. High Blood Pressure • 3. Unhealthy Cholesterol Levels • 4. Physical Inactivity • 5. Obesity • 6. Diabetes

4. What Percentage o f Americans are Overweight?

5. WHAT’S HAPPENING??? • About 65%, including 30% who are obese. • The rate of obesity among adults has increased more than 75% since 1990.

6. One-third of children and teens — about 25 million kids — are overweight or on the brink of becoming so. All are at an increased risk of developing diabetes, high cholesterol and other health problems. Our Latest Obesity Epidemic

7. Do You Drink A Lot of Calories? Most are drinking a lot of soda and other sugary drinks. "I calculate the calories they get from drinks, and it's often 500 calories or more a day. Just by cutting those out, they can lose a pound a week."

8. What Happened To the Kids That Play Outside? • Some have mothers and fathers who don't want to say "no" to them when it comes to food or TV and computer time, she says. "I worked with an overweight boy whose parents estimated he watched 10 hours of TV a day."

9. A Recent Nutritionist Said: Some families don't seem to know how to plan and make healthful meals, Ayoob says. "This is a generation of young parents who may have grown up on a lot of high-calorie take-out food, processed snacks and few fruits and vegetables If they grew up that way, those are the eating habits they're going to teach their kids."

10. Parents Need to Be Role Models in Nutrition . Moms and dads may want their kids to eat more fruits and vegetables, but they aren't eating enough themselves

11. Body Composition Essential Fat Storage Fat

12. Essential Fat Lipids in nerve (myelin coats nerve axons), brain, heart, lung, liver, mammary glands, cell membranes. 3% body weight in men 12% body weight in women

13. Storage Fat Adipose tissue Subcutaneous (below skin) Also around some major organs How much you have? Based on….. gender, age, heredity, metabolism, diet, activity level

14. Percent body fat… more important than actual weight.. from a health perspective

16. Energy balance: Working toward a healthy fat ratio

17. Energy input (food, calories) Energy use Resting metabolism (55-75%) Food digestion ( 5-15%) Physical activity (10-40%) Storage of excess as fat

18. Energy balance equations: Energy in = energy out….. maintains current weight Energy in > energy out….. weight gain (store fat) Energy in < energy out….. weight loss (burn fat) Variables for these equations are energy input and physical activity

19. What is RMR? • Resting Metabolic Rate- the energy required to vital body functions, including respiration, heart rate, body temperature and blood pressure while the body is at rest.

20. Concepts: Somewhat subjective……. Overweight: total body weight above recommended range Obesity: serious degree of overweight

21. Height weight Charts Based on insurance company statistics “ideal” body weights based on statistical mortality rates, sex, age, and height

22. Body Mass Index (BMI) weight (kg) divided by square of height (m) BMI = 18.5-24.9 considered healthy BMI > 25 classified as overweight BMI > 30 classified as obese

23. Another Method of Calculating BMI: (non-metric) • BODY MASS INDEX (BMI)- Based on concept that weight should be in proportion to height. Usually fairly accurate w/ health risk studies. • Calculate BMI: 1. Mult. Weight In Pounds by 704 • 2. Height in inches squared • 3. Divide Answer in Step 1 by • the answer you calculated in # 2.

25. Body Composition Analysis

26. Actual % body fat. Most accurate • Hydrostatic weighing • Skinfold measurements • Scanning Procedures • CT: Computed Tomography • MRI: Magnetic Resonance Imaging

27. Health Risks of Excess Body Fat 2X overall mortality rate - textbook statement

28. Excess weight is associated with…. • unhealthy cholesterol and triglyceride levels • impaired heart functions • death from cardiovascular disease • hypertension • some types of cancer • impaired immune function • gall bladder and kidney disorders • skin problems • sleep disorders • arthritis and other bone and joint disorders • diabetes

29. diabetes mellitus 18 million Americans disruption of normal metabolism pancreatic hormone, insulin stimulates cells to take up glucose to produce energy

32. Insulin (Beta Cells in Pancreatic Islet) • Function: • Facilitates glucose transport across plasma membranes (lowers blood glucose) • Increases glycogen storage (therefore lowers blood glucose, also) • Affects muscle, liver, adipose tissue • Control: • Blood glucose concentration

33. Glucagon (Alpha cells in pancreatic Islets) • Function: • Increases blood glucose concentration • Control: • Blood glucose concentration

34. diabetes mellitus • system fails…….. • glucose buildup in blood stream • kidney failure • nerve damage • circulation problems • retinal damage • blindness • hypertension • stroke • heart attack

35. diabetes mellitus • Type 1 (5-10% of diabetics) • pancreas produces no insulin • daily doses are required • usually strikes before age 30 • Type 2 (90% of diabetics) • pancreas doesn’t produce enough insulin • cells are resistant to insulin • or both • usually over age 40 • 1/3 must take insulin

36. diabetes mellitus • major risk factors for Type 2 • age • physical activity • family history • obesity

37. Diabetes mellitus Type 2: Excess body fat is major risk factor Obese = 3X more likely to get diabetes Type 2 increases with rate of obesity risk factors are acute if a person is more than twice their expected normal body weight

38. diabetes mellitus Type 2: Excess body fat is major risk factor • must factor in also…. • exercise • tobacco and alcohol use • high blood pressure • cholesterol levels • general health • body fat distribution (apple vs. pear)

39. Pancreas is stimulated to release insulin which stimulates the cells to uptake glucose from blood. Insulin also converts Excess glucose to glycogen(a polymer of glucose and thus a storage form) in the liver. During High Blood Sugar (after a meal)

41. Havard: Nurses Health Study …..120,000 women since 1976 80% increase risk of coronary heart disease over leaner women study concluded: to reduce the risk of dying early from any cause, maintaining a desirable body weight is important.

42. What causes us to be Overweight ? What is Causing the Obesity Trend in US right Now? How Can We “Get A Grip” or Manage our Weight so as Not For it To be A Health Risk for Ourselves or Our Children?

44. Genetics/Heredity Factors • More than 300 genes have been linked to obesity; but their actions still under study. Only a few have been truly isolated with cause and effect. • If both parents are overweight, child is twice as likely to be overweight than children with only one overweight parent. • There are overweight children who who parents who are not overweight. • CONCLUSION: YES, genes play a role in obesity. The genes are not destiny,however, but, rather a tendency.Environmental factors can outweigh their expression.

45. Latest Study : Obesity Gene • KLF14- A Master Switch….Turns On Several Metabolic Genes and is Now thought to be THE OBESITY GENE http://abcnews.go.com/Health/master-switch-gene-obesity-diabetes-discovered/story?id=13621353

46. Number of Fat Cell?? You accumulate a certain number of fat cells when you gain weight and that they shrink when a person loses weight. It is unclear whether or not fat cell number can be decreased. Hypothesized that one feels hungry because of extra starved fat cells…however this has not been proven

47. Role of Hormones • Hormones play a role in : • Accumulation of body fat, especially in females. Hormone responsible for this is estrogen. During puberty- larger breast, wider hips (secondary sex characteristics-fat accumulation is one) • Hunger. The latest studies on obesity and genetics look for defective gene that code for these hormones. Leptin, CCK, Peptide YY and Grhelin (see next slide)

48. LEPTIN • Leptin, a hormone secreted by the body’s fat cells. • Around 5-10% of overweight humans are probably deficient in leptin (Proc. Nat. Acad. Sci. 95: 11846, 1998).

49. Adipocytes and Leptin Leptin , makes you feel full, satisfied. You stop eating.

50. Hey brother! Did You Eat ALL the Cheese ?