Kin 110 Lecture 9

1
Kin 110 Lecture 9

• Ch. 9 Weight Control

2
Energy Balance and Imbalance

• Weight Control Overview
• Energy Balance
• What drives us to eat and participate in activity
• Indices for body composition assessment
• Fat distribution and health concerns
• healthful approaches to weight loss

3
Energy Balance

• Fig 9-1, p 311
• Positive Energy Balance
• Negative Energy Balance
• Maintaining balance is important health goal for
  the prevention of many diseases
• Energy Intake (macromolecules)
• convenience
• energy content of a meal
• Calorimeter
• 1 kcal - energy to raise 1 kg of water 1 degree
  Celsius

4
Energy Use

• Basal Metabolism (BMR)
• 60 - 70 of total energy used by body
• minimal energy needed to keep awake resting body
  alive
• varies 25-30 between people
• Liver, Muscle/Brain, heart, kidneys (in order of
  energy utilized at rest)
• 1 kcal/Kg/hour, influenced by
• lean body mass and surface area,
• Age, (declines 2 per decade)
• nervous and hormonal activity,
• nutritional state, pregnancy
• caffeine and tobacco use
• low energy intake - decrease BMR

5
Energy Use

• Physical Activity (variable)
• can increase energy expenditure 25-40
• many choices available
• take stairs, walk to corner store, increase
  movement
• Thermic effect of food
• (5-10 ) of total intake
• digestion, absorption, process

6
Energy Use

• Adaptive Thermogenesis (7)
• overfeeding and shivering
• brown adipose tissue
• Measurement of Energy Use
• Calorimeter
• direct / indirect
• Estimates by weight, degree of physical activity
  and age

7
Estimating Energy Needs

• Sedentary - 20 kcal/Kg
• Light Activity - 30 kcal/Kg
• Heavy Activity - 45 kcal/Kg
• Estimates per day
• 1600 kcal/day
• sedentary women, older adults
• 2200 kcal/day
• active women, men
• 2800 kcal/day
• v. active women, active men,

8
Food Intake

• Hunger - physiological drive to eat
• controlled by internal body mechanisms
• Appetite - psychological drive to eat, external
  stimulus
• Satiety - state in which there is no longer the
  desire to eat

9
Estimating Healthy Weight

• Most are based on large population data,
• general guides not intended for individual
  application
• Family History of obesity related conditions is
  very important
• High BP, LDL, Glucose,
• obesity, heart disease, cancer
• Important to make individual estimate of healthy
  weight
• what weight you maintained as an adult for one
  year without significant hunger
• Be realistic healthy lifestyle is most important

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Healthy Weight

• Body Mass Index (BMI)
• Table 9-1, p. 318
• body weight/heightheight
• health risk with BMI over 25
• over fat or overweight???
• Metropolitan Life Tables
• longevity not health, limited population
  inclusion

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Energy Imbalance

• Energy intake exceeds output
• can lead to obesity
• Obesity - excess body fat
• BMI over 30, weighing 20 more that healthy
  weight
• Health problems Table 9-2, p.319
• Over Fat
• males 25 , females 30-35
• BMI over 40 sever health risk
• Underwater weighing,Skin Folds, Bio-electrical
  impedance

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Fat Distribution

• Fig 9-7, p 322
• Upper body obesity
• heart disease, high blood pressure, diabetes
• testosterone and alcohol
• lower body obesity requires about 20 lbs more
  for same health risk
• 90 are mildly obese in USA
• juvenile onset, increased risk
• 10 loss for healthier weight

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Why ??

• Many factors both genetic and psychological are
  influential
• Identical twins
• genes determine metabolic rates and brain
  chemistry
• Body Types
• ectomorph, mesomorph, endomorph
• differences in met. , surface area
• Thrifty metabolism

14
Environmental Influence

• Family eating patterns or genetics ?
• Little change in gene pool, but increase in
  obesity
• Table 9-3, p. 326

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Treatment of Obesity

• Number 2 health risk in US after smoking
• chronic disease
• treatment is long term lifestyle change
• as with diabetes and high BP, need to have
  healthy active living with appropriate dietary
  modifications

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5 Principles of Treatment

• Goals of dieting misdirected
• be realistic, most under BMI of 25
• focus on healthy active lifestyle and maintenance
  of body weight
• Body defends itself against weight loss
• basal metabolism drops
• increased efficiency of fat storage
• Weight Cycling is Common
• 5 maintain loss, others gain more, increased
  health risk

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Principles

• Weight gain in adulthood is common
• Focus on changing Body Composition
• loss should be from adipose not lean tissue
• rapid loss is fluid and lean mass
• only highly motivated should attempt weight loss
• begin with maintenance, and awareness of eating
  habits and physical activity patterns

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Weight Loss Guidelines

• Table 9-4, p 331
• Control energy intake, increase expenditure,
  acknowledge that lifelong change is necessary
• Rate of Loss
• slow weight loss 1-2 Lb per week
• maintenance for a few months following 10
  reduction
• Flexibility
• participate in normal activities
• Individual taste and habits

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Weight loss Guidelines

• Intake
• meet nutritional needs
• minimum 1200-1500 kcal /day
• reduce hunger and fatigue
• choose common foods
• Behavior Modification
• lifetime focus to maintenance of healthy
  lifestyle
• changes are reasonable
• Overall Health
• Should consult physician if
• existing health problems, (over 35) or plan to
  lose weight very quickly
• regular activity, rest, stress reduction
• address underlying psychological issues

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Controlling Intake

• Estimate requirements and reduce by 400 kcal /
  week
• count fat (g) not entire diet
• focus on naturally low fat foods rather than fat
  reduced
• use exchange system (Appendix c)
• reduce fat but increase bulk
• complex carbohydrates, fiber
• stick to food guide, reduce high fat foods
• Table 9-5, p 333

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Physical Activity

• Regular activity has many benefits
• 200 kcal expenditure
• walking for 1 hour
• cycling for 30 min
• swimming for 20 min
• running for 15 min
• Lifestyle change - activity habits and daily
  routine
• quick walks, stairs, fidgeting
• Table 9-6,. P 334

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Behavior Modification

• Lifestyle changes
• food intake and activity
• Chain Breaking
• breaking link between behaviors that encourage
  overeating/inactivity
• Stimulus control
• altering environment
• Cognitive restructuring
• changing frame of mind regarding eating

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Behavior Modification

• Contingency Management
• forming plans of action to respond to potential
  overeating situations
• Self Monitoring
• tracking of foods and conditions affecting
  choices
• Table 9-7, p. 336
• lists many helpful behaviors
• Prevent lapse, relapse
• positive framing, social support