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DIGESTION and ABSORPTION

VIEWS: 0 PAGES: 37

									Figure 6-5 (continued fasting).
  Energy Balance and Weight
        Management
ENERGY IN
Ø Regulation of food intake:
Ø Hunger
Ø Satiation and satiety
Ø Appetite
          ENERGY OUT
Ø Energy expenditure at rest:
Ø BMR - basal metabolic rate: rate of
  energy expended at rest (kcal/hr or
  kcal/day), also called RMR (resting
  metabolic rate).
Ø Factors that affect BMR (page 257)
           ENERGY OUT
Ø Energy expenditure for physical activity:
Ø Depends on the activity duration, type,
  and intensity (page 255)
Ø Also affected by body size and fitness
  level
           ENERGY OUT


Ø NEAT is the energy associated with
 unintentional activities like fidgeting,
 maintenance of posture, or spontaneous
 muscle contraction
          ENERGY OUT
Ø Energy expenditure to process food:
Ø Thermic effect of food (TEF) – the
  energy used to digest, absorb, and
  metabolize energy-yielding food
Ø TEF is lower for fat than for
  carbohydrate and protein
Ø TEF peaks one hour after eating, and
  normally dissipates within 5 hours
Ø Accounts for ~10% of total energy
  expenditure
      Components of Energy
          Expenditure

Ø Physical Activity = 30-50%
Ø TEF = 10%
Ø BMR = 50-65%
 MEASUREMENT of ENERGY
     EXPENDITURE

Ø Estimating energy expenditure:
Ø EER – an equation used to estimate REE
  based on age, weight, height, and sex
Ø Page 257
      BODY COMPOSITION

Ø Assessing body weight:
Ø weight tables
Ø body mass index (BMI) =
        weight (kg)
        height (m2)
          BODY COMPOSITION


Ø   As the BMI table
    shows, healthy weight
    falls between a BMI of
    approximately 18.5
    and 24.9.
   BODY FAT DISTRIBUTION
Ø gynoid obesity (pear-shaped figure), more
  common in women
Ø android obesity (apple-shaped figure),
  more common in men
  l   increases risk of heart disease and diabetes
      mellitus (Type II)
“apple”   “pear”
     WHAT CAUSES OBESITY?
        Current Thinking
Ø   Hereditary and genetic factors
Ø   Sociocultural influences
Ø   Age and lifestyle
Ø   Sex
Ø   Race and ethnicity
Ø   Socioeconomic status
Ø   Employment
Ø   Psychological factors
     ENERGY IMBALANCE:
     Overweight and Obesity

Ø Health risks (page 265)
Ø 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
Ø National Center for Health Statistics
  suggests nearly 25% of children are
  overweight or obese
Ø 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:

Ø 9% of males and 6% of females were
 overweight
  HEALTH CONSEQUENCES
Ø Overweight children and adolescents are
  more likely to become overweight or
  obese adults
Ø Type 2 diabetes, high blood lipids,
  hypertension, early maturation and
  orthopedic problems also occur with
  increased frequency in overweight youth
ECONOMIC CONSEQUENCES
Ø In 2000, the total cost of obesity was
  estimated to be $117 billion
Ø Most of the cost associated with obesity is
  due to type 2 diabetes, coronary heart
  disease, and hypertension
     WEIGHT MANAGEMENT
       What Works?????
Ø 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
Ø A slow weight loss (1-2 pounds per
  week) is the best way
Ø To lose 1 pound of fat, you must burn
  an extra 3500 calories (in one week that
  = 500 calories per day)
      WEIGHT MANAGEMENT

Ø Important Components:
  l   Diet composition
  l   Physical activity
  l   Behavioral change
  l   Balancing acceptance and change
  l   Support!
              DIET COMPOSITION
Ø   A Healthful Eating Plan
    Involves:
    l   Realistic energy intake
    l   Nutritional adequacy
    l   Small portions, small
        frequent meals
    l   Reduced simple sugar
        and alcohol intake
    l   Adequate water
          PHYSICAL ACTIVITY
Ø   Contributions to weight loss and maintenance:
    l   Direct increases in energy output (muscles and
        cardiovascular system)
    l   Indirect energy output (elevated BMR)
    l   Appetite control
    l   Psychological benefits


Ø   Note: Spot reducing is not possible.
        BEHAVIORAL CHANGE
Ø   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).

                               Figure 7-7 Food and Activity Diary
             SUPPORT

• Family
• Friends
• Weight Loss Support Groups
      WEIGHT MANAGEMENT

Ø Adjuncts to treatment
  l   Drugs
  l   Self-help activities
  l   Commercial programs
  l   Professional private counselors
  l   Surgery: gastric bypass, gastric banding
   Why is abdominal fat bad?
Ø http://www.health.harvard.edu/newsweek/
 Abdominal-fat-and-what-to-do-about-it.htm

								
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