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Energy Balance, Weight Control and Eating Disorders Part 1 of 2

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Presentation on theme: "Energy Balance, Weight Control and Eating Disorders Part 1 of 2"— Presentation transcript:

1 Energy Balance, Weight Control and Eating Disorders Part 1 of 2
Chapter 10

2 Learning Outcomes Describe the many factors that have resulted in an increase in obesity in the US What is energy balance and what are the components of energy balance? Know the methods used to measure energy expenditure by the body. Explain internal and external regulation of hunger, appetite and satiety. Describe the methods available to measure body composition. What tools are available to determine whether body weight and body composition are healthy? Discuss the impact of genetics and environment on body weight and composition.

3 Obesity Trends* Among U.S. Adults BRFSS, 1990, 2000, 2010
(*BMI 30, or about 30 lbs. overweight for 5’4” person) 1990 2000 2010


5 The prevalence of childhood obesity is also increasing
Growth in Childhood Obesity Over Three Decades Age 6 to 11: 4%→ 13% Age 12 to 19: 5%→14% If obese at age 6 → 50% chance of lifelong obesity If obese at age 13 → 75% chance of lifelong obesity Blacks Mexican Americans 50% more likely to be obese than whites From NHANES

6 How did we get from a prevalence of 45% to 65%?

7 Energy Balance Energy intake Energy expenditure

8 Energy Balance Energy equilibrium Positive energy balance
Energy intake equals energy expenditure Positive energy balance Energy intake greater than energy expenditure Negative energy balance Energy intake less than energy expenditure

9 Factors Affecting Energy Balance and Weight
Role of environment Role of developmental behaviors Role of genetics Identical twins Set point theory Genetic and environment synergy Diseases and disorders

10 Obesity: A Multifactorial Disorder
Genetics Development Behaviors/likes, etc ‘hard wired in’ Environment

11 Energy Intake Energy intake Energy intake
Estimated via nutrient databases Calories based on bomb calorimeter Fat 9 kcal/gm Carbohydrates 4 kcal/gm Protein 4 kcal/gm Alcohol 7 kcal/gm Energy intake 11

12 Decrease your energy intake to lose weight
Daily calories to maintain a weight of 300 pounds kcal/day To lose 1-2 pounds/week, you need to deficit 3500 kcal/pound For 1 lb: 3500 kcal/7 days = kcal/day For 2 lbs: kcal/7 days kcal/day Daily calories to lose 1 pound/week kcal/day Daily calories to lose 2 pounds/week kcal/day

13 Why is reducing kcal so hard?
Out of Control Environment Stress and busy schedules Skipped meals Calorie-dense foods Large portions Increased variety

14 Contributions to Obesity: Learned Behaviors
“Clean your Plate” Club Food as a coping mechanism Food for celebration Food is love Food as a reward Food as comfort Learned Behaviors

15 CHICKEN CAESAR SALAD 20 Years Ago Today 3 ½ cups 390 calories
Calorie Difference: 400 calories

16 *Based on 160-pound person
If you walk the dog for 1 hour and 20 minutes, you will burn approximately 400 calories.* *Based on 160-pound person

17 It is easy to avoid “expending energy”
expenditure 17

18 Energy Expenditure Basal metabolic rate (BMR)
Minimum amount of energy in a fasting state Factors that increase basal metabolism Factors that decrease basal metabolism Other factors that go into TOTAL energy expenditure: Physical activity Thermic effect of food Adaptive thermogenesis

19 Measuring Energy Expenditure
Direct calorimetry Measures body heat Indirect calorimetry Collecting expired air Stable isotopes Estimated energy requirements (EERs) Harris-Benedict equation

20 Equations used to estimate energy needs
Harris Benedict Women: = ( 4.35 x weight in pounds ) + ( 4.7 x height in inches ) - ( 4.7 x age in years ) Men: = 66 + ( 6.23 x weight in pounds ) + ( 12.7 x height in inches ) - ( 6.8 x age in year ) EER: Similar but has physical activity built in to the equation Also, has separate equations for adult men and women, toddlers, boys and girls aged 3-18, and obese girls and boys aged 3-18


22 Increase your energy expenditure to lose weight
To lose 1-2 pounds/week via exercise, you need to burn kcal in a week You burn about 100 kcal/mile Number of miles extra to lose 1 lb/wk miles or 5 miles/day Number of miles extra to lose 2 lb/wk 70 miles or 10 miles/day 22

23 What controls energy balance?
intake Energy expenditure 23

24 Eating Behavior Regulation
Hunger Physiological drive for food Appetite Psychological drive for food Satiety Fulfilling either drive Hypothalamus regulates food intake: Gherlin, Leptin, Endorphins



27 Genes influence a person’s appetite, metabolism, and fat storage

28 Genes influence a person’s appetite, metabolism, and fat storage
100% 90% 50% 0% Rare (Prader Willi, No Leptin production) Leptin: Hormone made in fat tissue that decreases appetite and increases energy expenditure Lipoprotein lipase: enzyme that promotes fat storage More enzyme = more storage Ghrelin: Protein secreted by stomach that stimulates appetite and promotes energy storage Eat anything and not gain weight

29 Genetics dictate your “set point”
Forced dietary manipulation Ad libitum fed

30 Gene-Environment Interactions in Obesity
Then: Now: 30 Body Mass Index

31 Estimating Body Weight and Composition
Weight-for-height tables Body Mass Index (BMI)


33 Weight and Health: Calculating BMI
BMI = weight in pounds x (height, inches)2 Or weight in kg (height, meters)2

34 Assessing Body Fat Distribution
Upper body (Android) Increased health risks Men waist greater than 40 inches Women waist greater than 35 inches Lower body (Gynecoid) Lower health risks


36 Risk of Associated Disease* According to BMI and Waist Size
Classification Waist ≤ 40in (M) or 35in (W) Waist > 40in (M) or 35in (W) <18.5 Underweight -- Normal May increase risk Overweight Increased High Obese (Class I) Very High Obese (Class II) ≥40 Obese (Class III) Extremely High *Type 2DM, HTN, and CVD

37 Measuring Body Fat Content
Underwater weighing Air displacement BodPod® Skinfold thickness Bioelectrical impedance Dual energy X-ray absorptionmetry (DEXA)






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