1. Module 7: Meeting Energy Needs

2.  Overweight/obesity  Energy Balance  Dieting  Fad Diets  Weight Loss Success

3.  32.2% of men and 35.5% of women are obese.  16% of children and adolescents (ages 2-19 years) are obese.  Chronic Diseases attributed to Obesity  CHD - Type 2 Diabetes  Certain Cancers -Hypertension  Dyslipidemia -Stroke  Liver and Gallbladder disease -Liver/Gallbladder  Sleep Apnea -Osteoarthritis  Gynecological problems (abnormal menses, infertility)

4.  Healthy People 2010 national health objectives:  To reduce the prevalence of overweight and obesity among adults to less than 15%.  To reduce the prevalence of obesity among children and adolescents to less than 5%.  2003—2006, 16.3% of children and adolescents aged 2– 19 years were obese, at or above the 95th percentile of the 2000 BMI-for-age growth charts

5.  For adults, overweight and obesity ranges are determined by using weight and height to calculate the "body mass index" (BMI).  BMI is used because, for most people, it correlates with their amount of body fat.  To what group of individuals will this not apply?  BMI between 25 and 29.9 = Overweight.  BMI of 30 or higher = Obese.

6. Energy Input = Energy Output (or calories in = calories out)  Energy Input = Calories from food  Energy Output = Metabolism (BMR) Physical Activity Thermic Effect of Food Being in Energy Balance results in Weight Maintenance

7.  Basal Metabolic Rate (BMR):  Calories expended for vital organ functioning in resting state; ~60-70% of total calorie needs.  Affected by gender, body composition/muscle tone, age, temperature (including fever), health status, thyroid hormone  Physical Activity:  Calories burned influenced by weight, muscles used, length of time of exercise  Thermic Effect of Food:  Energy used to digest, absorb and process nutrients.

8.  Positive Energy Balance =  Input > Output (eat more than expended)  Results in weight gain  Negative Energy Balance =  Input < Output (eat less than expend)  Results in weight loss  Must have a calorie deficit of about 3500 kcal per week to lose one pound/week…deficit of 500 kcals/day over 7 days.

9.  Obesity is a chronic disease  Treatment requires long-term lifestyle changes (no quick fix).  Dieters are misdirected  More concerned about weight loss than healthy, active lifestyle.  Unrealistic weight expectations.

10.  Emphasizes one or two foods.  Severely restricts food choices; rigid eating plans.  What nutrients are fad diets usually lacking?  Temporary solution to weight loss…not long- term; focus is not on permanent eating, exercise, or behavior changes.  What are your concerns about fad diets?

11.  Promote quick weight loss  Limited food selections; rituals  Use of testimonials  Cure-alls  Recommend expensive supplements  No permanent lifestyle changes advocated  Critical of the scientific community

12.  What factors are affecting obesity?  What can we do to help decrease obesity as well as prevent weight gain?

13.  National Weight Control Registry www.nwcr.ws www.nwcr.ws  Investigates characteristics of individuals who have succeeded at long-term weight loss.  45% lost weight on their own; 55% used a program.  98% modified their food intake.  94% increased their activity (walking most reported).

14.  Calorie control  Portions  Eat less overall, but still choose variety of foods  Stay within your daily calorie needs  Plan meals ahead  Write down what you eat; self-monitoring  Focus on fruits, vegetables, whole grains, fat-free or low-fat milk and milk products, lean meats, poultry, fish, beans, eggs, and nuts  Emphasize low in saturated fats, trans fats, cholesterol, salt, and added sugars

15.  Exercise on regular basis; ACSM Position  To prevent weight gain: 150-250 min/week  Weight loss: 150->250 min/week  Weight maintenance after weight loss: >250 min/week  Children and teens: 60 mins per day Donnelly JE, et al. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Medicine & Science in Sports & Exercise 2009; 41:459-471.