Weight Management/ Nutrition

1. Weight Management/ Nutrition

2. “A man’s health can be judged by which he takes two at a time – pills or stairs” - Joan Welsh

3. Counting Calories… • What is a calorie? • How is caloric content of food determined? • How do we determine recommended daily caloric intake? • Resting metabolic rate • Estimated caloric expenditure from activity

4. What is a calorie? • A calorie is a unit of measurement for energy. • Derives from the Latin calor (heat). In most fields, it has been replaced by the joule, the SI unit of energy. • The small calorie or gram calorie (c) approximates the energy needed to increase the temperature of 1 g of water by 1 °C. This is about 4.185 J. • The large calorie (C) or kilogram calorie approximates the energy needed to increase the temperature of 1 kg of water by 1 °C. This is about 4.185 kJ, and exactly 1000 small calories. • In scientific contexts, the name "calorie" refers strictly to the gram calorie, and this unit has the symbol cal. SI prefixes are used with this name and symbol, so that the kilogram calorie is known as the "kilocalorie" and has the symbol kcal. • Colloquially, and in nutrition and food labeling, the term "calorie" almost always refers to the kilogram calorie.

5. Combustion of food • Bomb calorimetry

6. Recommended Caloric Intake (for weight maintenance) • CI= Basal metabolic rate + Calories used for activity Recommended Caloric Intake (for weight increase) • CI > Basal metabolic rate + Calories used for activity

7. Recommended Caloric Intake (for weight loss) • CI < Basal metabolic rate + Calories used for activity

8. How do you calculate basal metabolic rate? • “Gold standard”: Indirect calorimetry during resting and fasting [12h post absorptive] conditions • The more muscle mass…the more oxygen the body consumes… the higher metabolism (BMR) • Males have higher amount of muscle mass therefore higher metabolism • Muscle requires more energy to be sustained than fat for example. • 3.5 ml/kg/min is a normal resting oxygen consumption value, which is converted into energy equivalents.

9. Resting metabolic rate • Height + weight (body surface area) and gender used in original equations for estimating BMR • The original Harris-Benedict equations • for men, 66.4730 + (13.7516 * w) + (5.0033 * s) − (6.7550 * a) • for women, 655.0955 + (9.5634 * w) + (1.8496 * s) − (4.6756 * a) > • where w = weight in kilograms, s = stature in centimeters, and a = age in years. • Resting Metabolic Rate Calculator: • Women: BMR = (4.35 x weight in pounds) + (4.7 x height in inches) - (4.7 x age in years) [MAY BE INACCURATE] • Men: BMR = 66 + (6.23 x weight in pounds) + (12.7 x height in inches) - (6.8 x age in years) (imperial units)

10. What about your activity level? • Sedentary: (little or no exercise): BMR x 1.2 • Light activity: (moderate exercise or sports 1 to 3 days per week): BMR x 1.375 • Moderate activity: (moderate exercise or sports 3 to 5 days per week): BMR x 1.55 • Very active: (hard exercise or sports 6 to 7 days per week): BMR x 1.725 • Extremely active: (very hard exercise or sports and a physical job, activity or training 2 times per day): BMR x 1.9

11. Specific expenditure for various activities

12. laid Mats Daily Activity Log • Cycling at a slow pace: 20 minutes (120 kcals) • Watching TV: 2 hours • Working in front of computer: 8 hours • Pondering how horrible life is and why I am not getting paid more: 2 hours • Playing the guitar: 1 hour • Talking on the phone: 1 hour • Sleeping: 9 hours 40 minutes • Estimated Energy Requirement (EER): 2678 Calories (including basal metabolic rate for a 31-year-old 190 lbs male) • In other words: very SEDENTARY

13. Mats Daily Eating Log • Meat and beans (26.2 cup equivalent) • Meat sauce • Ham • Fruits (2.8 cup equivalent) • Bananas • Vegetables (2.3 cup equivalent) • Tomato sauce • Grain (31.3 cup equivalent) • Spaghetti • Rye Bread • Milk (15.4 cup equivalent) • Yoghurt

14. Excess stored as fat? Macronutrients • Use MyPyramidTracker.gov (USDA) • and compare and contrast with formulas presented in today’s class.

15. Mats Energy Balance/Day • Energy intake-Energy expenditure: 6769-2678 = +4091 kcal • Milk 513% • Meat and Beans 403% • Vegetables 80% • Fruits 115% • Grains 348%  • “Your reported food energy intake is very much higher than your Estimated Energy Requirement for the day. An increase of 500 or more Calories per day over time could result in regular and perhaps quick weight gain.**If you consume 500 Calories more a day than you need, you could gain about 1 pound per week”      

16. Mats in 12 years…

17. Why isn’t Mats abnormally fat already? • TRUE: Acetyl CoA [used in the committed step of fatty acid synthesis] and NADPH [serves as electron donor; from the pentose phosphate pathway] • TRUE: Some researchers claim ~ 2% of excess glucose is turned into glycerol (backbone of triglycerides) • Then the question arises whether or not three free fatty acids are added to each glycerol). • Triglycerides are stored in adipocytes (fat cells) • All excess glucose/protein may not be converted into fat after all… • Where does excess glucose go? • Urine • Yes, I pee a lot. • Increased body temperature • I’m hot too ;-).

18. FAT: 9 C/g. 70C/9C per gram = ~7.777g/serving Reading Food Labels • Based on your RMR + physical activity calculations: How much whole milk can you consume per day to fulfill your daily caloric need? • Based on daily recommended intake: Are you over-consuming any of the micro/macronutrients mentioned on the food label (if you fulfill your entire caloric intake with this particular food item)? • Do the same tasks as above, but this time with skim milk. • What about 0-calorie sodas? How many can you consume per day? Any side effects? Mats: 2678 Calories daily expenditure (RMR + Activity) 2678 C/ 150 C (per serving) = 17.8 servings to fulfill daily caloric need just with whole milk Fat: 17.8 servings x 8 g/serving = 142.82 g total (over-consuming since RDI for me is ~85 g)

19. Reading Labels • Law requires the following on a label: • # of servings per container • serving size • # of calories per serving • % of total fat (including saturated and trans fat), cholesterol, sodium, total carbohydrates (including fiber & sugars), protein, vitamin, and minerals

20. Reading Labels cont… • % Daily Value • Based on 2,000 to 2,500 calorie/day • If you require more or less, your personal daily value will change (make adjustments based on RDI on food labels) • 65 grams of fat is based on 2000 C diet. • Mats 2678 C: [65/2000] x 2678 = 87.035 grams of fat/day • For total carbohydrates, dietary fiber, vitamins, and minerals, your daily value goal is to reach 100% • Choose foods with a low % daily value for fat, saturated fat, cholesterol, and sodium

21. Reading Labels cont… • Footnote will include: • An upper limit for total fat, saturated fat, trans fat, sodium,cholesterol, and carbs (dietary fiber; minimum amount). • Based on sound research for optimal body function. • Calories per gram for Fats, Protein, and Carbohydrates.

22. Reading Labels cont…

23. Healthy Food Shopping • Read labels while shopping • Observe serving sizes • # of servings per container • Compare the total # of calories in similar products • Keep fat and sodium to a minimum • Shop for low fat food items and lower calorie staples • It is possible to eat healthy even if you are busy.

24. Fast Food / Eating Out • Quick service & low prices • High in fat and calories • Low in many essential nutrients and dietary fiber • Is it possible to make healthy choices at fast food restaurants??? • Look at the nutritional info at restaurants (ASK IF THEY HAVE A CHART) • Broiled, baked, roasted vs. fried • Look at the portion size • America has the largest portion sizes in the world • Sometimes even the kind menu is appropriate

25. Dietary Supplements • Is it necessary to take a dietary supplement? • The best and most preferred method is to eat a healthy diet • Dietary supplements are often less effective in delivering these nutrients to your body • Certain conditions and lifestyles may require supplementation (anemia, pregnancy, & vegetarianism)

26. Dietary Supplements cont… • Taken in concentrations higher than the RDA, may result in the following: • undesirable side effects • toxicity • interfere with the absorption of other vital nutrients

27. Weight loss • CI < Basal metabolic rate + Calories used for activity

28. Commercial Weight Loss Products • Appetite suppressants • Metabolism boosters • Weight loss programs

29. Appetite Suppressants • Description:help diminish a person’s appetite, cut cravings, increase their overall level of energy and metabolism, resulting in an increase in the number of calories they burn • Side effects: • Nutrient deficiencies • High levels of caffeine or herbal ephedra that cause hypertension, cardiac arrhythmia, myocardial infarcation, and/or stroke • Examples: Hydroxycut, Xenadrine-EFX, and Trim Spa

30. Metabolism Boosters • Description: • Increases your basal metabolic rate • Appetite suppressants can also act as metabolism boosters • Increases the building of lean muscle mass & decreases the production of fat • Caution:long term effects are not known

31. Weight loss programs • Design: • Utilizes a reduced-calorie diet • Some are pre-packed foods • Many have maintenance plans once you have reached your weight loss goal • Cautions: • “yo-yo” dieting • BMR drops • Examples:Slim Fast, Jenny Craig, & Weight Watchers, Low Carbohydrate – High Protein plans

32. Red Flags when Considering a Weight Loss Plan • May claim that exercise or calorie reduction is not necessary • Costly • Emphasizes a particular food • Atkins diet • The world's largest organization of food and nutrition professionals,[7] calls the Atkins Diet "a nightmare of a diet."[8] The official spokesperson of the American Dietetic Association elaborated: "The Atkins Diet and its ilk--any eating regimen that encourages gorging on bacon, cream and butter while shunning apples, all in the name of weight loss--are a dietitian's nightmare."[9] The ADA has been warning Americans about the potential hazards of the Atkins Diet for almost 30 years now.[10] Atkins dismissed such criticism as "dietician talk".[11] "My English sheepdog," Atkins once said, "will figure out nutrition before the dieticians do."[12] The problem for Atkins (and his sheepdog), though, is that the National Academy of Sciences, the most prestigious scientific body in the United States, agrees with the AMA and the ADA in opposing the Atkins Diet.[13] So does the American Cancer Society;[14] and the American Heart Association;[15] and the Cleveland Clinic;[16] and Johns Hopkins;[17] and the American Kidney Fund;[18] and the American College of Sports Medicine;[19] and the National Institutes of Health.[20] Atkins suffered cardiac arrest in 2002! • Extreme results over little time • "The low-carbohydrate diet produced a greater weight loss for the first six months, but the differences were not significant at one year. The low-carbohydrate diet was associated with a greater improvement in some risk factors for coronary heart disease. • "Adherence was poor and attrition was high in both groups. Longer and larger studies are required to determine the long-term safety and efficacy of low-carbohydrate, high-protein, high-fat diets. [New England Journal of Medicine 2003]" • Does not include typical healthy behavior modifications • Exercise • Well-rounded healthy diet

33. Healthy weight management • Always includes behavior modification • Proper nutrition • Choose a variety of food (vegetables, fruits, whole grains, skim milk, fish, lean cuts of meat, and beans) • Choose sensible portion sizes • Check product labels for calories, number of servings, & fat grams • Regular physical activity

34. Guidelines for a Successful Weight Loss Program • Mild caloric restriction • Dynamic aerobic exercise • Realistic weight loss: 2 lbs/week • Learn healthy behavior modification • Lifetime commitment to healthy eating and regular exercise, one you can follow for a lifetime, anywhere at anytime • Portion sizes, maintain nutritionally sound meals

35. Ideal Weight vs. Natural Weight • “Ideal weight” is sometimes unrealistic • Natural weight is achieved when a person eats healthy portions of a variety of foods and exercises regularly • Look yourself in the mirror • Can’t see your toes? • Can’t tie your shoe laces appropriately?

36. Eating Disorders • Eating disorders are potentially life threatening, mental health conditions related to obsessive eating patterns • Types of Eating Disorders • Anorexia Nervosa • Bulimia Nervosa • Fear of Obesity • Activity Nervosa

37. Eating Disorders – Underlying Issues • A distorted body image • Always striving for perfection • A need to be in control • Low self-esteem • Depression • There is a conflict between a desire for perfection and feelings of personal inadequacy

38. Causes of Eating Disorders • Causes are numerous and complex • Psychological factors • Chemical imbalances • Emotional disorders • Family pressure • Culture • Society • Media

39. Who’s at Risk? • More women than men, but it is believed to be underreported in men • Individuals living in economically developed nations • College campuses • Upper middle class women • Certain female sports • Certain male sports

40. Nutrition • Define the essential nutrients and describe their roles

41. Essential Nutrients • 40 different nutrients are required to maintain good health • NO SINGLE FOOD SOURCE contains all these nutrients!!!! • Everybody knows that Captain Crunch has them all!

42. Macronutrients • Provides the bulk of required energy • Carbohydrates • Proteins • Fats

43. Carbohydrates • 55 – 60% of daily caloric intake • 4 Calories/gram • Major source of energy for central nervous system + entire body at >60% VO2max • Synthesized into glycogen into muscle and liver • 3 Types: • Complex carbohydrates • Dietary Fiber • Soluble • Insoluble • Simple carbohydrates

44. Complex Carbohydrates • 45 – 50% of daily caloric intake • Low in calories (4 Calories/g) • Provides a steady source of energy in the form of glucose • Rich source of micronutrients (vitamins & minerals) • Food sources: breads, cereals, pastas, grains

45. Dietary Fiber • Roughage or bulk • RDA: 25 – 30 grams/day • Not digested by the small intestine • Lowers an individual’s risk of developing CVD and cancer • 2 types: Soluble and Insoluble

46. Soluble Fiber • Aids the body in removing fats • Reduces blood cholesterol & blood glucose • Food sources: oats, fruits, barley, and legumes

47. Insoluble Fiber • Cannot be digested by body • Increases peristalsis • Reduces the risk of colon cancer: • Allows food residue to pass more quickly through the intestinal tract • Food sources: wheat, cereal, vegetables, and the skins of fruits

48. Simple Carbohydrates • Found naturally in milk, fruit, honey, and some vegetables • Foods high in simple carbohydrates: • Candy, cake, soda, and jelly • “Empty Calories” • Limit to 10% of daily caloric intake

49. Simple sugars • In general, rapidly elevate blood glucose levels – high glycemic index – which causes large secretion of insulin w When intake exceeds usage, stored within the cells as fat, particularly in adipocytes Complex CHOs • Generally require more time to break down (lower glycemic index), therefore causing more moderate elevation in insulin secretion w Have less impact on blood lipid levels CHO Types

50. High GI foods (GI >85) Soft drinks, honey/syrups, ice cream, whole wheat bread, raisins, potatoes, carrots, beer Moderate GI foods (GI 60-85) Pastry, pita bread, white rice, orange, popcorn, banana, low-fat ice cream Low GI foods (GI <60) Spaghetti, milk, grapefruit, beans, apples, pears, peanuts, and yogurt Glycemic Index (GI) The glycemic response to carbohydrate varies depending on the food