Ch. 8/9 Energy Balance and Body Composition Weight Management

Question 1

energy balance

Answer 1

• Energy In = Energy Out… Energy Balance
• Kcal In = Kcal Out… Energy Balance
• Input = Output… Energy Balance
• Input Output… positive energy balance (gain weight)

Question 2

What determines how many calories a person needs?

Answer 2

• Gender
• Height
• Weight
• Age
• Physical Activity

Question 3

Kcal Requirements: Mifflin-St.Jeor

Answer 3

Males: REE = 10 (W) + 6.25 (H) – 5 (A) + 5
Females: REE = 10(W) + 6.25 (H) – 5 (A) – 161

• Weight in cm, height in cm, age in years
• Use actual weight
• Add physical activity level to determine Total Energy Expenditure (TEE)

Question 4

Kcal Requirements: kcal/kg

Answer 4

Obese: 21
Sedentary: 25-30
Moderately active: 30-35
Very active: 40

Question 5

Percentages of Energy Expenditure

Answer 5

50-65% Basal Metabolism
10% Thermic Effect of Food
30-50% Physical Activity

Question 6

Basal Metabolism

Answer 6

Energy needed to maintain life when a body is at complete rest after a 12-hour fast

Question 7

Basal Metabolic Rate

Answer 7

rate at which the body spends E for maintenance activities, slows w/age

Question 8

What factors effect BMR?

Answer 8

• Age
• Height
• Growth
• Body Composition (more lean tissue = higher BMR)
• Fever (goes up)
• Stress
• Temperature
• Fasting/Starvation (goes down, body adaptation)
• Smoking (nicotine increases energy expenditure)
• Caffeine (increases)
• BMR (lowest here)

Question 9

Components of Energy Expenditure

Answer 9

Physical activity:
-Most variable component of E expenditure

Thermic Effect of Food:

• Estimate of E required to process food
• Approx. 10% of intake
• Usually not added to E need calculations

Adaptive Thermogenesis:

• E expended when a person must adapt to dramatic changes in circumstances – rare, ICU conditions
• Usually not added to E need calculations

Question 10

Body Mass Index

Answer 10

= Index of one’s weight in relation to height
•Kg/m2
•[pounds/in2] x 703
•numerous online calculators (ex. CDC)
•Used in clinic as a screening tool
•Limitations: muscle weighs more than fat

Categories
-Under 30

Question 11

Body Fat Distribution: Upper Body Fat

Answer 11

more common in men, closely associated w/heart disease, stroke, diabetes, hypertension, and some types of cancer (ex. apple)

Question 12

Body Fat Distribution: Lower Body Fat

Answer 12

more common in women and not usually associated w/chronic disease (ex. pear)

Question 13

Medical Complications of Obesity

Answer 13

• Heart disease
• T11 Diabetes mellitus
• HTN
• Stroke
• Some cancers
• Osteoarthritis
• Gallbladder disease
• Sleep Apnea
• NAFLD

Question 14

Weight Loss Strategies: Prescription Meds

Answer 14

diff modes of action (ex. decrease appetite)

Question 15

Weight Loss Strategies: Surgery

Answer 15

• -> surgical interventions to promote weight loss
  1. Liposuction: removes evidence, doesn’t reduce health risks
  2. Gastric Bypass: bypassing the stomach completely
  3. Gastric Sleeve
  4. Gastric Band: reducing opening of esophagus to stomach, can be adjusted

-Surgeries are not a “quick fix,” must have lifestyle modifications

Question 16

Weight Loss Strategies: Lifestyle Modification

Answer 16

• -> diet and exercise
  1. Weight Cycling (Yo-Yo Effect): diet, regain more weight than before, diet, regain more → subsequent diets result in slower weight loss

Question 17

Psychological Cycle of Weight Loss

Answer 17

I am fat and unhappy →
I want to be happy →
If I lose weight, I will be happy →
I try to hard to reach an unrealistic goal →
I lose a little weight, but then regain it (and sometimes more) →
back to I am fat and unhappy

Question 18

What are the strategies for successful weight loss?

Answer 18

• Making commitment
• Find inner motivation
• Set realistic goals