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Cholesterol is a waxy fat-like substance. It is used to make Bile, the production of Vit D, hormones and is found in every cell. Your body produces all.

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Presentation on theme: "Cholesterol is a waxy fat-like substance. It is used to make Bile, the production of Vit D, hormones and is found in every cell. Your body produces all."— Presentation transcript:

1 Cholesterol is a waxy fat-like substance. It is used to make Bile, the production of Vit D, hormones and is found in every cell. Your body produces all you need. Cholesterol in your body comes from what your body makes PLUS what you eat. All foods from animals contain some cholesterol. This includes meats, such as beef, pork, lamb, chicken, and fish. It also includes dairy products, such as milk, cheese, and ice cream. Organ meats, such as liver, are especially high in cholesterol. 1

2 HDL/LDL/VLDL are carriers of cholesterol. “Good or bad cholesterol” is not true. It’s all the same cholesterol, it’s just “good or bad” determining on where it is carried (or stored) to within the body. The degree of lipid in a lipoprotein affects its density—the lower the density of a lipoprotein, the more lipid it contains relative to protein. The higher the density of a lipoprotein, the less lipid it contains relative to the protein. Lipoproteins 2

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8 Energy Balance CH 6 8

9 Measuring Energy calorie ◦The amount of heat necessary to raise 1 g of water 1º C ◦1,000 cal = 1 kcal Too small of a unit to measure so: 1 Calorie = 1 kcal 9

10 Forms of Energy Thermic effect of food is the greatest energy output: ◦Circulation ◦Respiration ◦Digestion ◦Absorption ◦Chemical energy : ◦Electrical energy: ◦Mechanical energy: ◦Thermal energy: 10

11 11 Energy Balance Total overall energy balance depends on intake in relation to output Energy Intake The main source of energy for all body work is food. This is supplemented with stored energy in the body tissue. Sources of Stored Energy 1. CHO: Glycogen (12-48hr reserve in liver and muscles) 2. Fat: Adipose tissue 3. Pro: Muscle mass

12 The Body’s Total Energy Requirements Depend on: 1.REE/RMR 2. Physical Activity 3. Thermic Effect of food 12

13 13 REE: Resting energy expenditure RMR: Resting Metabolic rate The sum of all internal working activities of the body at rest. 60% - 75% of body’s total expenditure BEE: Basal energy expenditure Difficult to maintain, used in clinical practice. Will be slightly lower than REE/RMR

14 14 Factors That Influence RMR: Lean Body Mass Growth Periods Body Temperature Fever increases BMR by 7% by each 1 ºF Hormonal Status

15 15 Ways to Measure RMR 1. Indirect Calorimetry Metabolic cart MedGem/BodyGem 2. *Mifflin-St.Jeor equation or Harris Benedict equation 3. Thyroid Function test Measure TSH Not expressed in kilocalorie amount but is a gauge for normal metabolic function

16 16 Thyroid is regulated by TSH made in the pituitary. TSH stimulates thyroxine. Blood test to determine TSH levels Hypothyroidism: Does not produce enough Thyroxine Metabolic rate is significantly lower than normal Levothyroxine (synthroid) Hyperthyroidism: Produces too much Thyroxine Metabolic rate is significantly higher than normal Antithyroid medication - Tapazole Thyroid

17 17 Physical Activity Part of TEE Accounts for work or recreation Highly variable PA factor

18 18 Thermal Effect of Food TEF: Activities of digestion, absorption transport and storage of food. The energy expenditure is approximately 10% of the foods energy content. Ex: 600 calorie meal would take ~60kcal to digest

19 Energy Requirements BEE TEF RMR = BEE + TEF TEE = RMR + TEF + Physical Activity * There are 3500kcal in one pound* 19

20 Assignment Find your BMR using the general formula (p.84) 2. Find your TEE using the Mifflin-St.Jeor equation (p.85) 3. Without changing your PA, how many calories per day would you need to consume to lose one pound in two weeks? 4. What is your BMR if you have a fever of F? 5. What are the two ways to lose or gain weight?

21 Energy Needs and Life Cycle ◦Most rapid growth occurs during childhood? and adolescence? ◦With adulthood, energy needs level off. ◦Gradual decline as the aging process continues. ◦There is an average decline of BMR of 1-2% per decade. ◦A more rapid decline occurs at 40 for men and 50 for women. 21

22 Weight Management Ch15 22

23 Obesity Epedemic  34.2% of adults in the US are overweight  33.8% are obese  5.7% are extreme obese  16.9% of children and adolescents between 2 and 19 yo are obese 23

24 Body Composition Four body compartments that make up the total body: 1.Muscle 2. Fat 3. Water 4. Bone 24

25 Body Fat Methods 25 Body fat calipers Hydrostatic weighing Bioelectrical Impedance Anaylsis Dual Energy x-ray Air Displacement plethysmography – BOD POD

26 Obesity: 20% above a desired weight for height Overweight: body weight is above a population’s weight for height standard BMI: Tool to see if your bodyweight falls in normal/overweight category 26

27 BMI = Wt (kg)/Ht (m)² OR BMI= Wt (lb) x 703/Ht (in) ² 27 *ACSM “above average” 7-15% for yo M and % for yo F

28 Adult BMI Chart 28

29 Hamwi Method for Ideal Body Weight  Men: 106 lb for the first 5 feet then add or subtract 6 lb for each inch above or below 5 feet. Ex: 6’2” = ± 10% IBW =  Women: 100 lb for the first 5 feet then add or subtract 5lb for each inch above or below 5 feet. Ex: 5’7½” = ± 10% IBW: 29

30 Considerations for Ideal Body Weight 1. Frame Size: 2. Individual Variation 3. There is a biological need for fat: survival, reproduction ◦Minimum required for health: 5% men 12%women 30

31 31  Body Frame Estimate: Height (cm)/wrist circumference (cm) EX: IBW: 190# M Wrist circumference: 22.1cm What is his frame size? What is his IBW with frame size considered? Male Ratio Small ˃10.4 Medium 10.4 – 9.6 Large ˂ 9.6 Body weight calculations

32 32 Obesity: A National Epidemic

33 Obesity and Health A National Epidemic What is to blame? ◦Marketing? ◦Media and social images? ◦Lack of exercise? ◦Obesogenic environment? ◦Poverty? 33

34 Health Implications 34 HTN Hypercholesterolemia DM CHD Cancer

35 Causes of Obesity Input vs. Output 3500kcal = one pound Physical Activity Genetics Hormonal Physiological Psychological Environmental Factors Family Reinforcement 35

36 Set Point Theory Researchers confirmed after wt gains or losses, the body adjusts the metabolism to restore the original wt Energy expenditure ↑ after wt gain and ↓ after weight loss Explains why it is so difficult for an overweight person to maintain weight losses It is possible for a person to change their “set-point” weight but it takes time and effort 36

37 ◦Leptin: Released from the fat tissue to regulate satiety, food intake and bdwt ◦Early-Onset Obesity – Lack the leptin receptor. 3% ◦Ghrelin – Appetite stimulate secreted from the stomach ◦Investigations of the use of ghrelin antagonist 37 Hormonal

38 Genetic and Family Factors Strongest factor Potential body fat to carry Family reinforcement 38

39 Physiological Factors Fat cells Critical period in childhood BMR, PA, LBM Women store more fat during pregnancy and menopause 39

40 Psychological Factors Stress and comfort food Societal pressure 40

41 Environmental Factors Energy-dense food availability Convenience foods Portion Sizes ↓ in Food Preparation and Skill Physical Activity Screen Time ↓ physical requirement in household chores 41

42 Extreme Practices for Weight Loss Fad diets Fasting Specific Macronutrient Restrictions Drugs ◦Fen-phen, meridian, orlistat Surgery ◦Gastric restriction, lipectomy 42

43 Sound Weight Management Program Detect Problem Behaviors Record and analyze food intake Plan a behavior management strategy Set realistic goals Find a negative energy balance Make it nutritionally adequate Know the food groups! Don’t reinvent the wheel. Use choosemyplate.gov 43

44 The Non-Diet Approach Personalized Must be motivated Many factors considered ◦Food ◦Exercise ◦Stressors ◦Family support Goal: 1 – 2 lbs. or 1% of BW/week ◦It’s a marathon, not a sprint 44

45 Disordered Eating Patterns of eating that may lead to a full blown eating disorder ◦Anorexia Nervosa ◦Bulimia Nervosa ◦Binge Eating Disorder ◦Orthorexia 45

46 Children and Weight Loss Goal: Weight Maintenance Physical Activity is key Get kids involved with cooking and learning Roles for building a healthy eater ◦Parent: What is served and When ◦Child: Whether to eat and how much 46


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