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Nutitional Science > Lecture 9: Weight Management > Flashcards

Lecture 9: Weight Management Flashcards

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1
Q

Energy Out: Basal Metabolic Rate

A
  • Energy required to maintain functions of the body while at rest (after 12 hr fast & rest)
  • Involuntary activities: respiration, circulation, synthesize new cells & hormones, sending nerve signals, fluid balance, body temperature
  • BMR accounts for about 60-70% of TEE
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2
Q

Energy Out: Basal Metabolic Rate (Determinants)

A
  • Lean Body Mass (age, gender)
    • Obese usually have higher LBM and burn more Calories/d
  • Height (LBM and body surface)
  • Age: decrease BMR 3-5%/10 yrs after age 30 (LBW and hormone changese
  • thyroid hormone: (incease BMR)
  • starving/fasting: (decrease BMR)
  • Growth: want your BMR to increase
  • Healing/fever (7% increase BMR)
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3
Q

Can you change your BMR?

A
  • Increase: building or maintain LBM – physical activity, >1.05g/kg protein intake* (research still conducted)
  • Decrease: energy restricted diets, lower lean body mass
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4
Q

Energy Out: Physical Activity/Exercise

A

-Most variable of outputs
-Accounts for ~15-35% of TEE
*Couch potato: ~ 10%
*Athlete in training ~ 50%
Dual effect on output
↑ Energy expenditure during and after exercise
↑ LBM= ↑ BMR

  • Energy costs of various activities (table 13.2)
    • Higher intensity= more Calories burned per minute
    • Stretching vs running at 8.6 mph
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5
Q

Energy Out: Thermic Effect of Food

A
  • Energy used in food digestion, absorption, transport metabolize, and storage of nutrients
  • TEF accounts for ~5-10% of the energy consumed & TEE
    • Consume 500 Kcals = 25-50 Kcals needed for TEF
  • Perhaps more energy needed metabolize protein and carbohydrate than fat
    • Meta-analysis found higher protein (25-35% Calories), low-fat diet had more weight loss (~2lbs) than lower protein (12-18%), low-fat diet with similar Caloric intake*
    • AMDR for protein: 10-35%
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6
Q

Alternative Means to “Speed Up Your Metabolism”

A
  • Protein
  • may preserve LBM: > 1.05 g/kg/d
  • Increase thermogenesis
  • Satiety
  • Caffeine
  • Increase BMR but has not shown to reduce body weight
  • Increase blood pressure, irregular heartbeat, sleep disturbance
  • Capsaicin in chili peppers (cayenne pepper)
  • Cold water: REE increases 25-30% for 30-40 min
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7
Q

Fed & Overfed State

A
  • Glucose for energy, maintain blood glucose levels, then glycogen formation
    • Remaining glucose converted to FA for energy storage
  • Amino acids used for body protein needs
    * Excess converted to FA for energy storage
  • FA used for fuel
    * Excess stored  excess body weight
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8
Q

Short-Term Fast (0-6 hrs)

A
  • 0-6 hr fast (between meals & overnight)
    1. Liver glycogen to maintain blood glucose levels and for energy
    2. Gluconeogenesis to maintain blood glucose levels and glucose for brain
    3. FA for energy
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9
Q

3-5 Day Fast

A
  • 3-5 d fast (no glycogen left)
    1. Gluconeogenesis- fast rate of protein breakdown (and glycerol) for maintaining blood glucose levels
    2. FA & Ketones
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10
Q

5-7 Day Fast

A

-5-7 d fast
*Metabolic rate slows and energy needs declines
*Gluconeogenesis slows down
1. Ketones & FA- nervous system adapts to use ketones, spares protein.
2 . Gluconeogensis from protein (to keep the TCA cycle working & maintain BG levels & for RBC)

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11
Q

Estimating Energy Requirements

A

Techniques
Macronutrients + O2 –> ATP + CO2+ H2O and heat

  • Direct calorimetry
  • Indirect calorimetry
  • Record intake over 3-7 days and use average
  • Rough estimate
  • Predictive equations
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12
Q

DRI: Estimated Energy Requirement (EER)

A
  • Average dietary energy intake (kcal) to maintain energy balance in a healthy adult
  • Individualized: age, gender, weight, height, level of physical activity
  • Modified if healing, disease or pregnancy
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13
Q

A Healthy Body Weight

A

-Body weight: bone, muscle, fat, tissue, fluid*, blood etc.

-What is a healthy body weight?
*A weight appropriate for your age, physical development
*A weight that someone can realistically achieve without disordered eating & exercise patterns & is acceptable to the individual
*A weight where your nutrient needs can be met
*A weight associated with reduced disease risk
~Overweight & obesity are associated with DM, HTN, heart disease, stroke, gallbladder dz., osteoarthritis, sleep apnea, cancers (endometrium, breast, prostate, colon)
*Adequate lean and fat tissues

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14
Q

Estimation of Healthy Weight

A

For men:
106 pounds for the first 5 feet
add 6 pounds per each inch over five feet
A man who is 5’10” should weigh 166 lbs. (149-183 lbs)*

For women:
100 pounds for the first 5 feet
add 5 pounds per each inch over five feet
A women who is 5’10” should weigh 150 lbs. (135-165 lbs)*
*+/- 10% for frame size

110-120%: overweight
>130%: obese

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15
Q

Assessing Body Weight: Body Mass Index

A

Body mass index (BMI)= weight (kg)/height (m)2
BMI = [weight (lbs) / height (inches)2] x 703

Underweight: <18.5
Normal: 18.5-24.9
Overweight: 25-29.9
Obese: 30 or greater
Morbid Obesity: 40 or greater
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16
Q

Assessing Body Weight: Body Mass Index (disease and limitation)

A

Disease risk increases when BMI 25, especially >30

Limitations:

  • Fat distribution
  • Doesn’t take muscle mass and bone size into account
  • Not as useful in people >65
  • Ethnic variation (higher risk of disease at lower -BMI and waist circumferene cut-offs)
17
Q

Body Composition: Assessing LBM vs Fat Mass

A

Methods are estimates:

  • Fat folds (skin folds)
  • Underwater weighing
  • Bioelectrical impedance
  • Dual-energy x-ray absorptiometry (DEXA)
  • Bod Pod
18
Q

Body Fat Distribution

A

Abdominal fat increase chronic disease risk

  • Waist-to-hip ratio
    • Men > 0.90
    • Women > 0.80
  • Waist circumference
    • Men above 40 in. (or 102 cm.)
    • Woman above 35 in. (or 88 cm.)
19
Q

Concerns of Being Overweight/Obese

A

Overweight & obesity are associated with:

  • Hypertension
  • Metabolic Syndrome
  • Type 2 Diabetes Mellitus*
  • Heart disease & stroke*
  • Cancers* (endometrium, breast, prostate, colon)
  • Gallbladder dz.
  • Osteoarthritis
  • Sleep apnea
  • In the top 10 leading causes of death
20
Q

Metabolic Syndrome

A

Must have 3 of these 5 criteria:

  • Waist circumference
    • Male > 40 in.
    • Female > 35 in.
  • TG > 150 mg/dL
  • HDL-C: male < 40 and female < 50 mg/dL
  • Blood Pressure > 130/85 mmHg
  • Fasting Blood Glucose > 100 mg/dL
21
Q

Fitness vs Fatness

A
  • Overweight with the absence of risk factors
  • Health at Every Size
    • Self-acceptance: human beauty regardless of weight
    • Physical activity: enjoyment & quality of life
    • Normalized eating: peaceful relationship with food, relearn to eat in response to hunger and fullness cues.
  • Remaining concerns: osteoarthritis, cancers, gallstones, erectile dysfunction, sleep apnea
22
Q

Why Are So Many People Overweight?

A
  • Last 2 decades
    • Overweight children doubled
    • Overweight adolescents tripled
  • Calories in vs out but is this harder than it seems?
    • Genetics (Nature)
    • Environment (Nurture)
  • 69.2% of Adult Americans are overweight or obese
  • 36% are obese
  • 18% children 6-19 are obese
23
Q

Hormone: Leptin

A

release site: Fat (obese produce more but are not sensitive to signaling)

-decreases feeding

24
Q

Hormone: Insulin

A

Release site: Pancreas

  • decreases feeding
25
Q

Hormone: CCK

A

Release site: Gut

  • decreases feeding
26
Q

Hormone: PYY

A

Release site: Gut (obese has less)

  • decreases feeding
27
Q

Hormone: NPY

A

Release site: Hypothalamus

  • encourage intake of food
28
Q

Hormone: Ghrelin

A

Release site: Gut (Obese are sensitive)

  • encourage intake of food
29
Q

Genetics (Nature)

A

Thrifty metabolism theory
-Gene to conserve energy- expend less energy
-Useful when starvation was a problem
Set-point theory
-Body will try to maintain a set body weight
-In times of ↑ energy intake = ↑ BMR (↑ TEF, fidgeting)
-In time of ↓ energy intake = ↓ BMR

30
Q

Environment (Nurture)

A
  • Overeating – excess Calories
  • Physical inactivity
  • Overeating Reasons:
    • Learned eating habits from family, friends, time of day
    • Availability of high Calorie, low nutrient foods
    • Perception that healthy food is expensive
    • High Caloric foods taste good
    • Fewer family meals
    • Eating more meals outside the home
    • Increase servings, increase fat, Calories, salt, decrease fruits and vegetables
  • Physical inactivity
    • Work long hours
    • Driving
    • TV
    • Video games
    • Everything is automated
    • Lack of sidewalks
    • Lack of playgrounds
31
Q

Nature vs. Nurture

A
  • Genetic predisposition does not control one’s destiny
  • Those at risk for obesity must be ever-vigilant
  • Increased physical activity and moderate food intake can promote a healthy weight
32
Q

Approaches to Weight Loss: Eating Less

A
  • Eat within your Caloric needs: choosemyplate.gov
  • Choose lower energy density foods- next slide
  • Read food labels & Calorie menu boards
    • Should the government require labeling & banning toys?
  • More fiber- whole-grains, fruits & vegetables (foods that weigh more w/high water content)
  • Consume adequate water
  • Balanced macronutrient intake
    • Perhaps small protein at each meal as long as within Caloric needs (satiety, FFM, TEF)
  • Minimize empty calories: SOFAS
  • Eat smaller portions- salad plate
  • Split restaurant meals
  • Regular mealtime prevents overeating at next meal
    • Student question: what will happen if one doesn’t eat breakfast?
      * Breakfast eaters had a greater reduction in impulsive snacking and ate less at later meals. (recent 2013 study did not confirm)
      • Skipping breakfast is associated with a higher BMI and increased obesity risk, despite lower reported daily energy intakes. (some epidemiological studies)
  • Portion out your servings- don’t eat out of a bag
  • Eat slowly to allow hormones to signal feelings of fullness
    • Wait 20-30 minutes before you have seconds
    • Make your second serving just vegetables
  • Think before you eat- mindful eating
    * Am I hungry or bored?
    * Be aware while you eat : smell, taste, texture, feeling
    * Assess fullness during your meals: eat until you have had enough, not until you are full
33
Q

Approaches to Weight Loss: Being Physically Active

A
  • Prioritize your health
  • Find activities you love
  • Keep it simple: 3, 10 min segments; 20 min walk
  • Find a friend
  • Add it to daily activities
    • Park further
    • Take stairs
    • Walk or ride bike to school/work
34
Q

Approaches to Weight Loss:Setting Reasonable Goals

A

-Reduce wt by 5-10%
-1-2 lbs/week
-Decrease energy intake ~250-300 kcal/day
Small changes make big differences!
Goal is for life-long changes

Nutitional Science (11 decks)

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