M.Prasad Naidu MSc Medical Biochemistry, Ph.D,. WEIGHT MANAGEMENT
Energy Balance and Weight Management ENERGY IN • Regulation of food intake: • Hunger • Satiation and satiety • Appetite
ENERGY OUT • Energy expenditure at rest: • BMR - basal metabolic rate: rate of energy expended at rest (kcal/hr or kcal/day), also called RMR (resting metabolic rate). • Factors that affect BMR (page 257)
ENERGY OUT • Energy expenditure for physical activity: • Depends on the activity duration, type, and intensity • Also affected by body size and fitness level
ENERGY OUT • NEAT is the energy associated with unintentional activities like fidgeting, maintenance of posture, or spontaneous muscle contraction
ENERGY OUT • Energy expenditure to process food: • Thermic effect of food (TEF) – the energy used to digest, absorb, and metabolize energy-yielding food • TEF is lower for fat than for carbohydrate and protein • TEF peaks one hour after eating, and normally dissipates within 5 hours • Accounts for ~10% of total energy expenditure
MEASUREMENT of ENERGY EXPENDITURE • Estimating energy expenditure: • EER – an equation used to estimate REE based on age, weight, height, and sex • Page 260
BODY COMPOSITION • Assessing body weight: • weight tables • body mass index (BMI) = weight (kg) height (m2)
BODY COMPOSITION • As the BMI table shows, healthy weight falls between a BMI of approximately 18.5 and 24.9.
BODY FAT DISTRIBUTION • gynoid obesity (pear-shaped figure), more common in women • android obesity (apple-shaped figure), more common in men • increases risk of heart disease and diabetes mellitus
“apple” “pear”
WHAT CAUSES OBESITY?Current Thinking • Hereditary and genetic factors • Sociocultural influences • Age and lifestyle • Sex • Race and ethnicity • Socioeconomic status • Employment • Psychological factors
ENERGY IMBALANCE: Overweight and Obesity • Health risks (page 265) • Prevalence of overweight and obesity – it is a worldwide public health problem. We are now seeing an obesity epidemic in children as well as adults.
OBESITY in our CHILDREN • National Center for Health Statistics suggests nearly 25% of children are overweight or obese • There are now about 5 million obese children in the United States – up by 50% since 1991
OBESITY in our CHILDREN A 1999 Survey of Seattle High Schools showed that: • 9% of males and 6% of females were overweight
HEALTH CONSEQUENCES • Overweight children and adolescents are more likely to become overweight or obese adults • Type 2 diabetes, high blood lipids, hypertension, early maturation and orthopedic problems also occur with increased frequency in overweight youth
ECONOMIC CONSEQUENCES • In 2000, the total cost of obesity was estimated to be $117 billion • Most of the cost associated with obesity is due to type 2 diabetes, coronary heart disease, and hypertension
WEIGHT MANAGEMENTWhat Works????? • Unfortunately, there is no magic pill, no perfect diet. The simple fact is, if you consume more calories than you burn, you will gain weight • A slow weight loss (1-2 pounds per week) is the best way • To lose 1 pound of fat, you must burn an extra 3500 calories (in one week that = 500 calories per day)
WEIGHT MANAGEMENT • Important Components: • Diet composition • Physical activity • Behavioral change • Balancing acceptance and change • Support!
DIET COMPOSITION • A Healthful Eating Plan Involves: • Realistic energy intake • Nutritional adequacy • Small portions, small frequent meals • Reduced simple sugar and alcohol intake • Adequate water
PHYSICAL ACTIVITY • Contributions to weight loss and maintenance: • Direct increases in energy output (muscles and cardiovascular system) • Indirect energy output (elevated BMR) • Appetite control • Psychological benefits • Note: Spot reducing is not possible.
Figure 7-7 Food and Activity Diary BEHAVIORAL CHANGE • Behavior modification: the changing of behavior by the manipulation of antecedents (cues or environmental factors that trigger behavior), the behavior itself, and consequences (the penalties or rewards attached to behavior).
SUPPORT • Family • Friends • Weight Loss Support Groups
WEIGHT MANAGEMENT • Adjuncts to treatment • Drugs • Self-help activities • Commercial programs • Professional private counselors • Surgery: gastric bypass, gastric banding
THANK YOU
