1. Energy Balance and Body Composition

2. Energy Balance Type of energy Amount at one time Timing of meals Energy stored in body Energy INTAKE Metabolism Daily Activity Exercise-type and intensity Thermal effect of meals Energy Expenditure

3. Energy intake Type of energy : ie.. Quality of energy intake Carbohydrate vs Fat Amount at one time: i.e. Quantity of energy intake All at once vs small amounts Timing of Meals: E arly vs late Energy Stores ; Glycogen reserve in Liver and Muscle

4. Energy In: The kCalories Foods Provide Food Intake; Regulated by Food Intake; Regulated by –Appetite initiates eating through the sight, smell, thought or taste of food. – –Hunger is the feeling that motivates us to eat and is controlled by the hypothalamus. –Satiation is the feeling of satisfaction and fullness that causes us to stop eating. –Satiety reminds us not to eat again until the body needs food.

6. Energy In: The kCalories Foods Provide Food Intake Food Intake –Overriding Hunger and Satiety  Stress eating is eating in response to arousal.  Cognitive influences such as perceptions, memories, intellect, and social interactions –Sustaining Hunger and Satiety  Protein is the most satiating.  Complex carbohydrates are satiating.  High-fat foods stimulate and entice people to eat more.

7. Energy In: The kCalories Foods Provide Food Intake Food Intake – –Message Central—The Hypothalamus   Integrates messages about energy intake, expenditure, and storage

8. Energy Expenditure Metabolism : Age, gender, body composition, diet, exercise, stress, disease, drugs Daily Activity : Sedentary daily life activities vs busy or active life Exercise : Aerobic vs Resistant training, Duration and intensity Thermal Effect of Meals: Type and Number of Meals Physical Activity

10. Energy Out: The kCalories the Body Expends Components of Energy Expenditure Components of Energy Expenditure –Basal Metabolism (basal metabolic rate, BMR)  2/3 of energy expenditure For most sedentary individuals  Supports the basic processes of life  Resting metabolic rate (RMR) is a measure of energy slightly higher than BMR.

12. Energy Out: The kCalories the Body Expends Components of Energy Expenditure Components of Energy Expenditure –Basal Metabolism - Factors affecting BMR  Aging slows BMR  Height – the taller, the higher the BMR  Growth increases BMR.  Body composition (lean body mass increases BMR)  Fever increases BMR.  Stress increases BMR.  Environmental temperature - both heat and cold raise BMR

13. Energy Out: The kCalories the Body Expends Components of Energy Expenditure Components of Energy Expenditure –Basal Metabolism - Factors affecting BMR  Fasting/starvation slows BMR. (Dieting)  Malnutrition slows BMR.  Hormones –Thyroid hormones can increase or decrease BMR. –Premenstrual hormones can increase BMR.  Smoking increases BMR.  Caffeine increases BMR.  Sleep slows BMR.

14. Energy Out: The kCalories the Body Expends Components of Energy Expenditure Components of Energy Expenditure –Physical activity  Most variable and changeable  Voluntary  It can be significant in weight loss and weight gain.  Duration, frequency and intensity influence energy expenditure.

15. Energy Out: The kCalories the Body Expends Components of Energy Expenditure Components of Energy Expenditure –Thermic effect of food (TEF) is estimated at 10% of total energy intake and involves digestion and absorption.  Carbohydrate 5-10%  Fat 0-5%  Protein 20-30%  Alcohol 15-20% –Adaptive thermogenesis is the adjustment in energy expenditure related to environmental changes.

16. Energy Out: The kCalories the Body Expends Estimating energy requirements is affected by many factors. Estimating energy requirements is affected by many factors. –Gender – men generally have a higher BMR –Growth – BMR is high in people who are growing –Age – BMR declines as lean body mass decreases –Physical activity – Activities are clustered by intensity and vary considerably –Body composition and body size – taller people have more surface area and heavier people have higher BMRs

17. Body Weight, Body Composition, and Health Current weight standards use height and weight data and do not take body composition into consideration. Current weight standards use height and weight data and do not take body composition into consideration. These may be misleading. These may be misleading.

18. Changes 1980-2000 No Data14.446.01976 to 1980 2.923.056.01988 to 1994 4.730.564.51999 to 2000 Severe Obesity (BMI > 40) ‏ Obesity (BMI > 30) ‏ Overweight (BMI > 25) ‏ Increase in Prevalence (%) of Overweight (BMI >or= 25), Obesity (BMI >or=30) and Severe Obesity (BMI >or=40) Among U.S. Adults.

20. Body Weight, Body Composition, and Health Defining Healthy Body Weight Defining Healthy Body Weight –The Criterion of Fashion  Society values change over time.  Perceived body images –The Criterion of Health  Good health supercedes appearance.  Longevity is a criterion.

22. Body Weight, Body Composition, and Health Defining Healthy Body Weight Defining Healthy Body Weight –Body mass index (BMI) measures relative weight for height.  Underweight is a BMI below 18.5.  Overweight is a BMI above 25.  Obese is a BMI above 30.

27. Body Weight, Body Composition, and Health Body Fat and Its Distribution Body Fat and Its Distribution –Fat Distribution  Intra-abdominal fat around abdominal organs may be critical.  Central obesity is excess fat around the trunk of the body. It is also called abdominal fat or upper- body fat.  Associated with increased risks

28. Visceral Abdominal Fat Fat mainly around the waist is more likely to develop health problems than fat mainly in hips and thighs. Fat mainly around the waist is more likely to develop health problems than fat mainly in hips and thighs. This is true even if BMI falls within the normal range. This is true even if BMI falls within the normal range.

30. WMWM Waist Management

32. Waist Circumference To measure waist circumference, place a tape measure around bare abdomen just above hip bone. To measure waist circumference, place a tape measure around bare abdomen just above hip bone. Be sure that the tape is snug, but does not compress your skin, and is parallel to the floor. Relax, exhale, and measure waist. Be sure that the tape is snug, but does not compress your skin, and is parallel to the floor. Relax, exhale, and measure waist.

33. Body Weight, Body Composition, and Health Body Fat and Its Distribution Body Fat and Its Distribution –Waist Circumference Women with a waist measurement of more than 35 inches Men with a waist measurement of more than 40 inches

34. Body Weight, Body Composition, and Health Body Fat and Its Distribution Body Fat and Its Distribution –Measures of Body Composition (%BF)  Monitoring changes over time is important.  Fatfold measures  Hydrodensitometry  Bioelectrical impedance

36. Body Weight, Body Composition, and Health Health Risks Associated with Body Weight and Body Fat Health Risks Associated with Body Weight and Body Fat –An appropriate weight for an individual depends on many factors which include body fat distribution, health history and current state of health. –Health Risks of Underweight  Cannot handle medical stresses  Menstrual irregularities and infertility  Pregnancy problems  Osteoporosis and bone fractures

38. Body Weight, Body Composition, and Health Health Risks Associated with Body Weight and Body Fat Health Risks Associated with Body Weight and Body Fat  Diabetes  Hypertension  Cardiovascular disease  Sleep apnea  Osteoarthritis  Some cancers  Gallbladder disease  Kidney disease  Respiratory problems – Pickwickian syndrome  Complications in pregnancy and surgery

39. Body Weight, Body Composition, and Health Health Risks Associated with Body Weight and Body Fat Health Risks Associated with Body Weight and Body Fat –Cardiovascular disease and obesity have a strong relationship. –Diabetes and obesity have a strong relationship.  Insulin resistance and obesity have a strong relationship.

40. Eating Disorders

42. Many individuals, including young females, suffer from eating disorders. Many individuals, including young females, suffer from eating disorders. These include anorexia nervosa, bulimia nervosa and binge-eating disorders. These include anorexia nervosa, bulimia nervosa and binge-eating disorders. The causes include a combination of sociocultural, psychological, and perhaps neurochemical factors. The causes include a combination of sociocultural, psychological, and perhaps neurochemical factors. Athletes are among the most likely group to develop eating disorders. Athletes are among the most likely group to develop eating disorders.

43. The Female Athlete Triad Disordered eating habits can develop. Disordered eating habits can develop. –Desire to improve performance –Enhance aesthetic appeal of their performance –Meet unsuitable weight standards

45. The Female Athlete Triad Osteoporosis Osteoporosis –Stress hormones compromise bone health. –Stress fractures are common bone injuries. –Adequate calcium is recommended.

46. Preventing Eating Disorders in Athletes Follow USDA Food Guide for food servings. Follow USDA Food Guide for food servings. Eat frequently, especially healthy snacks. Eat frequently, especially healthy snacks. Establish a reasonable weight goal. Establish a reasonable weight goal. Allow reasonable time to achieve the weight goal. Allow reasonable time to achieve the weight goal. Join a weight maintenance support group. Join a weight maintenance support group.

47. Anorexia Nervosa Characteristics of Anorexia Nervosa Characteristics of Anorexia Nervosa –Self-starvation – tremendous self-control to limit eating –Physical consequences are major and life threatening. Treatment is multidisciplinary Treatment is multidisciplinary –Food and weight –Relationships with self and others

48. Bulimia Nervosa Characteristics of Bulimia Nervosa Characteristics of Bulimia Nervosa –Binge eating – lack of control over eating, excessive kcalories from high-fat, low-fiber and high- carbohydrate foods eaten all at once –Purging – cathartic and/or emetic Treatment of Bulimia Nervosa Treatment of Bulimia Nervosa –Weight maintenance –Regular exercise –Counseling

49. Fig. H8-2, p. 275 Negative self-perceptions Purging Restrictive dieting Binge eating Stepped Art

50. Binge-Eating Disorder An unspecified eating disorder sharing some of the characteristics of anorexia nervosa and bulimia nervosa yet does not meet the criteria for diagnosis. An unspecified eating disorder sharing some of the characteristics of anorexia nervosa and bulimia nervosa yet does not meet the criteria for diagnosis. Lack of self-control over eating with binges Lack of self-control over eating with binges Consuming large quantities of food, eating quickly, feeling uncomfortably full, eating alone, and feeling disgusted or guilty Consuming large quantities of food, eating quickly, feeling uncomfortably full, eating alone, and feeling disgusted or guilty Marked distress Marked distress Occurrence of two times per week for six months Occurrence of two times per week for six months Not associated with compensatory behaviors Not associated with compensatory behaviors

51. Eating Disorders in Society Occur more commonly in developed nations where food and money are plentiful Occur more commonly in developed nations where food and money are plentiful Learning to appreciate the uniqueness of oneself may be a key to prevention. Learning to appreciate the uniqueness of oneself may be a key to prevention.