Week 9 Lecture 1

Answer 1

Emotional behaviour
School absence
High cholesterol
High blood pressure
Pre diabetes
Bone and joint problems
Breathing difficulties

Increased risk or becoming over weight adults

Risk of I’ll health and premature mortality in adult life

Question 2

Energy Balance

Answer 2

Energy In = Energy Out
• Maintain weight
• Energy In > Energy Out • Gain weight
• Stored as fat

• Energy In < Energy Out
• Lose weight
• Body pulls of fat stores and lean tissue

Question 3

Energy Intake

Answer 3

Food and drink provide the energy for the body

• Energy values of food can be calculated from the amounts of each macronutrient (and alcohol)
• But how much does each provide?

Question 4

Energy Intake

Answer 4

1 g CHO = 4 (3.75) kcals
• 1 g Fat = 9 kcals
• 1 g Protein =
• 1 g alcohol =

Question 5

Basal Metabolic Rate or Resting Metabolic Rate

Answer 5

Required to maintain and regulate to body.
• Can be a 10% difference between BMR vrs. RMR

• Normally around 60-80% of total energy expenditure
• But can vary significantly

Question 6

Facors effecting BMR

Answer 6

Age – decrease of ~1-2% per decade from 2nd to 7th – attributed to decline metabolic activity in FFM

• Body composition – FFM – very metabolically active

• Genetics

•Gender–some is linked to FFM
• Menstrual cycle – RMR lowest during the follicular phase, highest during the luteal phase – can be between 100-300 kcal/day
• Exercise – increases again in body comp, but also type of exercise - EPOC

Question 7

Thermic Effect of food (TEF)

Answer 7

Energy cost of food consumption.
• Digestion
• Absorption
• Transport
• Metabolism
• Storage

• Accounts for 5-10%

Question 8

Physical Activity

Answer 8

Provides the greatest variation, includes:
• Daily living
• Planned exercise
• SPA (spontaneous)

• Can be as little as 15-20% in sedentary individuals

• Or as high as 50 % in active individuals

Question 9

Daily Energy Intake/Expenditure

Answer 9

Average Nutritional Requirements:
• Men: 2500 – 3000 kcal
• Women: 2000 – 2500 kcal

Question 10

Total energy requirement - calculation

Answer 10

Harris & Benedick Equation to calculate BMR (1918 & 1919) • BMR for men:
• BMR = 66.5 + (13.75 x weight in kg) + (5.003 x height in cm) – (6.755 x age in years)

• BMR for women:
• BMR = 655.5 + (9.563 x weight in kg) + (1.850 x height in cm) – (4.676 x age in years)

• Cunningham Equation:
• Lean body mass x 22 + 500

Question 11

Assessing Body Weight

Answer 11

The first step in weight management is to assess current weight

Can be tricky:
• Body weight is not a good indicator of health risk

Body weight includes: • Water
• Bones
• Lean tissue
• Fat

Health NOT appearance should be a criteria for body weight

Question 12

Body Mass Index (BMI)

Answer 12

Describes the relative weight for height in regards to health
•BMI = weight (kg) / heights (m)2

Question 13

BDA – The association of UK Dietitians

Answer 13

Lots of information and fact files for healthy eating.
• Different population, medical conditions and specific nutrient information

Question 14

Carbohydrates (CHO)

Answer 14

4 kcal/g
• Advised to provide 50-55% of
energy for our diet
• <10% from added sugars

Question 15

Fibres (non-digestible carbs)

Answer 15

• 2 kcal/g
• > 30g/day

Soluble fibre
• Dissolves in water, is readily fermented in the colon into gases and physiologically active by-products, and can be prebiotic and viscous.
• It delays gastric emptying which in turn can cause an extended feeling of fullness.

Insoluble fibre
• Does not dissolve in water, is metabolically inert and provides bulking, or it can be prebiotic and metabolically ferment in the large intestine.
• Bulking fibres absorb water as they move through the digestive system, easing defecation.

Question 16

Protein

Answer 16

• 4 kcal/g
• Advised to provide 10-15% of
energy for our diet
• Athletes?
• Elderly??

Question 17

fat

Answer 17

9 kcal/g
• Advised to provide 30-35% of
energy for our diet
• Saturated FA: <10%
• MUFA: >10%
• PUFA: 5-10%
• Ω6, Ω3 (5:1)
• Cholesterol: <300 mg/g

Question 18

Alcohol

Answer 18

• 7 kcal/g
• Advised to provide <3% of energy for our diet

Answer 19

Bread, rice, potatoes, pasta & other starchy foods
• 1/3 of foods eaten - but amount depends on Energy requirements (≥ 6 portions/day)
• Provides Energy, carbohydrate, fibre, protein
• Vitamins: B1 (Thiamin), B6, B9 (folate)
• Minerals: Calcium, magnesium, zinc & iron
• Include at meals.
• 2- 3 portions wholegrain/day
• Limit the amount of fat you add to these in cooking or preparation.

Answer 20

≥ 5 portions a day.
• Provide carbohydrate, fibre.
• Vitamins – vitamin C, carotenes (vitamin A), B vitamins, vitamin K • Minerals – Calcium, potassium, Magnesium, iron
• Plant substances – eg. lycopenes, flavonoids
• Low energy density (water, fibre)
• Eat at least 5 a day. Include at meals and use as snacks.

Question 21

Milk, dairy foods & alternatives

Answer 21

2-3 portions/day
• Provides carbohydrate, protein, fat.
• Vitamins: Vitamin A, Riboflavin (B2), folate, B12 • Minerals: Calcium, zinc, iodine
• Dairy-free alternatives fortified with calcium
• Use lower fat choices

Question 22

Meat, fish, eggs, beans and alternatives

Answer 22

• 2-3 portions/day
• Provide protein
• Vitamins: Niacin (B3), B6, B12, Vitamin D.
• Minerals: Iron, zinc, selenium
• Include fish at least 1 portion/week, including a portion of oily fish • Limit higher fat choices & processed meats.
• Choose cooking methods without added fat.

Question 23

Foods and drinks high in fat and/or sugar

Answer 23

Limit foods high in sugar & fat.
• Provide Energy - carbohydrate (sugar) and fat (saturated & trans).
• Often high in salt.
• Choose oils & spreads lower in saturated fat.
• Eat less processed foods, bought cakes, biscuits, pastries.
• Add less sugar to food and choose unsweetened drinks.

Question 24

NHS 8 tips for eating well

Answer 24

Base your meals on starchy foods
• Eat lots of fruit and veg
• Eat more fish, including 1 portion of oily fish per week
• Cut down on saturated fat and sugar
• Eat less salt – no more than 6g per day for adults
• Get active and be a healthy weight
• Don’t get thirsty (1.2 litres fluid/day)
• Don’t skip breakfast
• http://www.nhs.uk/Livewell/Goodfood/Pages/eight-tips- healthyeating.aspx

Question 25

Salt

Answer 25

Daily intake: aim ≤6g/day (2.4g sodium – 1 teaspoon)
• http://www.nhs.uk/livewell/goodfood/pages/salt.aspx

• High salt foods: processed, packet & tinned foods , soups & sauces, bacon & ham, smoked foods, cheese, some cereals.
• Manufacturers need to reduce added salt
• Limit added salt at home

Question 26

Fluid Intake

Answer 26

Fluid Intake
• Approx. 1.2 litres per day as drinks (some from food) for most people.
• So 6-8 cups/day.
• All drinks count - but limit sugar.

Question 27

Alcohol

Answer 27

• In UK: alcohol is responsible for 33,000 deaths/year. 1 in 3 adults at risk of alcohol related liver disease.
• Sensible limits: 2-3units/day, plus some alcohol-free days.
• Calorie content:

No. of units = % ABV x volume in mls
100

Question 28

Key Concepts

Answer 28

Refocus attention to achieving and maintaining good health by focusing on:
– Health, not appearance, weight management priority – Setting realistic goals
– Healthy eating, not “dieting”
– Regular physically active

Weight management aims at changes that will last
• Any lasting change will be slow and gradual
• As a result, weight management is a commitment to a healthy lifestyle and should be viewed as an on-going process

Question 29

No “Quick Fix”

Answer 29

Too often weight loss programs focus on • Severely restrictive diets
• Unrealistic weight loss goals
• Inability to reach unrealistic weight loss goals and tendency to regain weight lost sets up an endless cycle of failure and discouragement
• Many people feel their weight loss efforts are unsuccessful, when in actuality it may be their weight loss goals are unrealistic

Question 30

Weight Loss and Body Composition

Answer 30

Quick changes in body weight are not simple changes in fat stores
• Weight gained or lost rapidly includes:
• Some fat
• Large amount of fluid
• Some lean tissue
• Because 60% of body weight is water, retention or loss of water dramatically affects body weight

Question 31

Weight-loss strategies

Answer 31

Modest weight loss (5-10%), even if still overweight, provides health benefits:
• Improves blood glucose control
• Lowers blood pressure
• Lowers LDL cholesterol

• Increased physical activity can:
• Increase HDL cholesterol
• Increase cardiovascular fitness

Question 32

Weight-loss strategies

Answer 32

• Reasonable goals
• Reasonable weight loss rate
• 0.5 to 1 kg per week
• Reasonable time frame
• 10% of body weight over 6 months
• Example: 120 kg person
• 10% loss over 6 months would be 12 kg

Question 33

Weight-loss strategies

Answer 33

Rapid weight loss typically results in:
• Excessive loss of lean tissue
• Including water loss
• Lower BMR
• Weight lost often regained
• May set into motion eating disorders

Eating plan: Healthy eating NOT dieting
– Be realistic about energy intake - Moderate calorie reduction
• BMI 27-35: 300 to 500 kcal/day reduction
• BMI ≥ 35: 500 to 1000 kcal/day reduction

Question 34

Weight-loss strategies

Answer 34

Eating plans: Healthy eating NOT dieting
– Eat smaller portions
– Emphasize lower energy density foods
– Remember water
– Focus on complex carbohydrates (containing fibre) – Reduce foods high in fat and/or simple sugars
– Watch for other empty calories such as beverages – Eat slowly - satiety signal sent after a 20-minute lag