Energy Balance and Healthy Body Weight

Zeina Nakat

Energy

Can be expressed as:

Kilocalories (units of heat energy; 1 kcal = 1 Cal = 1000 calorie)

1 Cal is the amount of heat necessary to raise the temperature of 1 kg water 1o C

Kilojoules (units of mechanical energy; 1 Kcal = 4.18 Kj = 1 Cal)

Food Energy

How to Measure Food Energy?

Apparatus= Bomb Calorimeter (closed container surrounded by a known volume of water)

Instrument that measures the heat energy released when foods are burned calculation of energy in food

Food Energy

Amount of energy actually used by the body:

4 Kcal/g of CHO (0 Kcal/g fibers)

4 Kcal/g proteins 9 Kcal/g of fats 7 Kcal/g alcohol

Caloric Density

DEFINITION: amount of energy provided per gram of food. (amount of Cal/g of food)

Fats or high-fat foods have the highest caloric density

Not to be confused with Nutrient Density!

Stored Energy in the Body

1. Glycogen in muscle & liver (small amount, short-term stores) 2. Triglycerides in adipose tissue (large amounts, long term stores) 3. Proteins in muscles (emergency stores)

Energy Balance

If Energy Intake (food consumption) = Energy Expenditure => stable body weight If Energy Intake > Energy Expenditure => weight gain If Energy Intake < Energy Expenditure => weight loss

Energy Expenditure

Components:
1. Resting Energy Expenditure (REE): used by the body at rest & awake, for vital body functions 2. Energy expenditure during Physical Activity (PA) 3. Thermic Effect of Food (TEF): energy used during consumption of food

--- The sum of the 3 gives Total Energy Expenditure (TEE) ---

1-Resting Energy Expenditure (REE)

Resting Energy Expenditure (REE)/Basal Metabolism (BM)/Basal Metabolic Rate (BMR):

MAJOR part of the Total Energy Expenditure (TEE) in most people (60-70%)

Energy spent by the body when resting & awake for various unconscious, involuntary activities such as: Muscular, Thermal, Electrical, and Biochemical work

1-Resting Energy Expenditure (REE)

Expression:
REE or Basal Metabolism (BM): kcal/24 hours

Energy expenditure of organs and tissues is variable:

Nervous system and liver are metabolically very active

Adipose tissue is much less metabolically active that lean (= non-fat) tissue

1-Resting Energy Expenditure (REE)

Factors affecting REE or BM:

o

Body Weight: in particular Lean Body Mass (body mass - fat mass). Increase LBM leads to increase in BM Body Surface: (depends on height & weight). Body surface increase leads to BM increase (bigger heat loss)

1-Resting Energy Expenditure (REE)

Sex: BM is 5-10% lower in women (higher fat/muscle ratio than men) Age: BM decreases with age

Highest during periods of rapid growth Decrease during aging: lower cell metabolism & shift in proportion of muscles to fat (5% every
decade)

1-Resting Energy Expenditure (REE)

o

Hormones: Growth Hormone, Thyroxine & Adrenaline (Epinephrine) lead to BM

o
o

Fever: increases BM
Sleep: BM decreases by ~ 10 % (lower muscular and nervous activities) Environment: BM increases in both cold & hot environments (cold: thermogenesis, hot: sweating)

1-Resting Energy Expenditure (REE)

o

Pregnancy: BM increases (placental/fetal growth and mothers increased cardiac work) Nutritional State: eating very low amounts of calories decreases BM (fasting/dieting/starvation) Caffeine and Nicotine: BM increases

P.S: Smoking may keep some peoples weight off, but at a high cost!!

2-Physical Activity (PA)

PA varies greatly among people according to their level of activity:

Sedentary activity/lifestyle: seated and standing activities Light activity: garage work, child care, house cleaning, etc Moderate activity: gardening, farming, etc Heavy activity: heavy manual work, athletes, etc

2- Physical Activity (PA)

MENTAL ACTIVITY DOES NOT SIGNIFICANTLY AFFECT ENERGY EXPENDITURE!!!

3-Thermic Effects of Food (TEF)

Also called Diet-Induced Thermogenesis.

Energy spent to digest and absorb nutrients (digestive tract contraction, enzymes production, and nutrient absorption).
Depends on the nature of the food consumed (highest for proteins, then CHO, then fats).

Minor contributor to TEE

Total Energy Expenditure (TEE)

Measuring Total Energy Expenditure

Direct Calorimetry:
Determines Energy Expenditure by measuring heat production by the body (similar to bomb
calorimeter)

How?
Put individual inside insulated chamber containing water pipes and monitoring water temperature rise Calculate energy produced

Estimating Total Energy Expenditure

Daily caloric needs can be estimated using standard tables and equations which consider weight, height, sex, age and level of activity

Example:
1. REE: simple formula

Women: body weight (kg) x 0.9 x 24 hr Men: body weight (kg) x 1 x 24 hr

Estimating Total Energy Expenditure

2. Physical Activity: = REE energy multiplied by a factor that depends on the amount of activity

Sedentary activity: 20-40 % as big as REE

Light activity: 55%-65% as big as REE

Moderate activity: 70% -75 % as big as REE Heavy activity: 80-100 % as big as REE

Estimating Total Energy Expenditure

3. TEF: 10 % of (REE + PA) for a usual mixed diet

TEE: REE + PA + TEF

Normal Body Weight

Factors that determine body weight

Heredity and genetic factors influence:

Number, size & distribution of fat cells Energy expenditure (BMR)

Diet (eating behaviors, food selection) Level of physical activity

Body Weight vs. Body Fatness

Body Mass Index (BMI) = weight (kg)/height2 (m) BMI usually correlates with body fatness and degree of disease risks

O.K. between 18.5 and 25. Above and below, health risks increase progressively
In general, the higher the BMI, the more obese the person and the more the diseases

Body Weight VS. Body Fatness

BMI and Mortality Risks

Body Weight vs. Body Fatness

BMI Limitations:

Values fail to indicate how much of the weight is FAT Where that fat is located

BMI is NOT applicable for:

Athletes/highly muscular individuals Pregnant and lactating women Adults over 65 Children and growing adolescents < 20 years

Estimating Body Fatness

Assessment Techniques:

Skin calipers (fat fold test) Underwater weighing (density) Bioelectrical impedance (conductivity)

Healthy Fat %:

Men: 15-22 Women: 20-25

Estimating Body fatness

Body Fat Distribution

Women: around thighs and buttocks (lower body => Pear shape)

Encouraged by female sex hormones (till

menopause)

Stores of extra energy for pregnancy and lactation More difficult to lose than abdominal fat

Boy Fat Distribution

Men: around waist and abdomen (upper body => Apple Shape)

Encouraged by male sex hormones Closer association with diseases (cardiovascular, hypertension, diabetes, etc) Alcohol + Smoking are associated with central fat deposition

Underweight

Causes

Low energy input

Insufficient food intake (unavailability, anorexia) Poor absorption of consumed food Excessive physical activity Hyperthyroidism Stress (increase adrenaline --- increase BMR) Disease: HIV, cancer

High energy output

Underweight

Health consequences

Weakness
Sensitivity to cold Cessation of menstrual periods in women and decrease in testosterone levels in men Heart irregularities Shortened survival time

Eating Disorders

Anorexia Nervosa
Refusal to maintain a normal body weight An intense fear of gaining weight Distorted body image

Bulimia Nervosa
Repeated binge eating Vomiting/purging A feeling of lack of control over eating behavior

Overweight

Causes

High energy input

Overeating

NOTE: For each 3500 excess Calorie intake, you gain ~ 0.5 kg!

Low energy output

Low physical activity Hypothyroidism Genetics

Overweight

Health consequences:

Cardiovascular diseases (heart disease, stroke) Diabetes (Type II) Joint diseases, varicose veins, and hernias Sleep apnea & respiratory problems Cancer Hypertention Gall bladder disease Psychological problems

Social and Economic Cost of Obesity

Our society places enormous value on thinness, especially for women. Fat people:

Are less sought after for romance Are less often hired Pay higher insurance premiums Pay more for clothing ~ $40 billion are spent yearly on weight loss in the U.S.

-- Prejudice defines obese people by their appearance rather than by their character! --

Go Signals: Hunger and Appetite

Understanding what drives us to eat will help us solve food intake problems

Hunger: physiological need to eat (4-6 hours after

each meal)

Appetite: psychological desire to eat

--Appetite and hunger usually go hand in hand, but one can prevail without the presence of the other--

Stop Signal: Satiety

Satiety: the perception of fullness that lingers

in the hours after a meal and inhibits eating until the next meal

The stomach has the ability to grow and accommodate larger and larger meals The feeling of stomach shrinking and early satiety occurs with chronic exposure to small meal portions

Causes of Obesity

Multiple factors are involved Internal and external factors operate together and in different combinations in different people Obesity has been declared a chronic disease!

Causes of Obesity
Behavioral Influences

Environmental

Climate

Changes in living conditions Urbanization Labor-saving devices Changes in transportation Changes in working
conditions

Obesity
Age Gender Ethnicity Hormonal Genetic

Habits Emotions Attitudes Beliefs Cognition

Biological

Internal Cues: Obesity and Genetics

Genetic makeup influences the bodys predisposition to consume/store too much energy or burn too little Children tend to resemble their biological parents One obese parent raises the risk of obesity to 60% in a child, two obese parents make it 90%

External Cues: Obesity and Behavior

Food availability:

High calorie, high fat foods are readily available, inexpensive and wonderfully delicious Food portion sizes are growing and this may contribute to more obesity

The more the diet is palatable and filled with sugars and fats, the more the likelihood of overeating and becoming obese
In general, most people will eat when presented with delicious foods, even if they are not hungry

External Cues: Obesity and Behavior

Complex human sensations:

Loneliness, low self-esteem, feeling down, or stressed

Nature of fat:

Fat delivers more than twice the calories of CHO or proteins Extremely palatable The body stores fat preferentially and with great efficiency Fat requires the least amount of diet-induced thermogenesis

External Cues: Obesity and Behavior

Physical inactivity

Modernization and sedentary lifestyle

Obese people often engage less in physical activity

One study showed that in children, obesity increases by 2% per hour of TV watching

Obesity Treatment

Best way to fight obesity

1. Diet therapy 2. Physical activity 3. Behavior modification

Benefits of Physical Activity

Increases TEE Increases resting BMR Accelerates loss of body fat Helps regulate appetite Helps control stress and stress-induced overeating Enhances self esteem

Weight Gain and Loss

Day to day shifts in weight are usually due to water shifts and other factors, NOT fat content Rapid weight loss is usually due to fluids and lean body mass loss

Food deprivation leads to binge eating and overeating when food is available
Fasting is not an effective weight loss regimen

Achieving and Maintaining a Healthy Body Weight

Accept a healthy body weight (opposite to Ideal)

Stop dieting to lose weight. Adopt a healthy eating & exercise lifestyle Value yourself for human attributes other than body weight (importance of self acceptance) Develop social support systems Have realistic expectations regarding body size and shape Exercise, exercise, and exercise!

Achieving and Maintaining a Healthy Body Weight

Adopt a healthy eating plan for life

Should consist of foods you like, readily available and affordable Thinking of it as a lifelong endeavor (producing lasting change) Eat high-fiber foods, and consume sufficient water Eat controlled portions at planned times, and eat them at a leisurely pace (avoid deprivation) Eat in response to hunger, not appetite Dont skip meals, especially breakfast!

Achieving and Maintaining a Healthy Body Weight

Achieving and Maintaining a Healthy Body Weight

Quick fix diets and weight loss gimmicks are ineffective!

Rating Sound and Unsound Diets

Rating Sound and Unsound Diets

Rating Sound and Unsound Diets