Biochemistry and Nutrition NURS 1117

Objectives At the end of this presentation students will be able to: Define weight management Describes concepts related to weight management Describe relationships between energy and obesity Synthesize appropriate weight management protocols

Prevalence In developed countries, 20% of men are obese and the level is a few points higher in women Overweight is more common in the population than obesity. 62% of males and 50% of females are overweight in developed countries. Patterson & Pietinen, 2004

Energy and Weight Mgt. Energy needs= BMR+ DIT + PA BMR- Basal Metabolic Requirement DIT- Diet Induced Thermogenesis PA- physical Activity Energy is also needed for new tissue growth e.g. in pregnancy and to recovery from illness

Energy and Weight Mgt. BMR- energy needed at rest to sustain basic life functions (= 70% of energy needs) DIT- energy needed to absorb, digest, transport & interconvert nutrients (=10% of intake) PA- energy expenditure caused by movement; conscious and unconscious

Energy and Weight Mgt. Modulators of BMR- (BMR is affected by) Age, gender, body habitus Modulators of DIT (DIT is affected by) Size and quantity of food- high protein meals causes higher DIT than fat or carbohydrate dieys

Hormones Influencing energy use and storage Leptin- regulates appetite (Leptin levels are increased in obese individuals) Adiponectin- regulates appetite (inversely related to adipose tissue mass) Other hormones that affect energy storage TNF α- Tissue Necrosis Factor Alpha IL 6 - Interleukin 6 PAI- Plasminogen Activator Inhibitor

Terms related to energy GE (Gross Energy)- all the energy from food if it were burnt in oxygen DE (digestible energy)- portion of GE that is actually absorbed across the GI tract. NB- portion of GE is always lost in faeces e.g.. Component of fibre, grains and nuts ME (metabolisable energy)- actual energy available for metabolism or portion of DE excluding energy lost in urine

Weight Management Steps A balance of the three macronutrients: carbs, fat, and protein Consume a rich spectrum of micronutrients, including vitamins, minerals, and antioxidants Intake good sources of bulking fiber

Weight Management Steps Choose slow-releasing- low glycaemic index food, so as not to spike blood sugar non-processed, whole foods Reduce snacking Exercise Reduce- discontinue smoking

To lose weight Eat less, reduce portions of all foods especially foods containing oils & fats Avoid sweetened beverages, less alcohol, more water Be physically active Exercise daily & make exercise a part of your lifestyle

To lose weight Change some old habits which prompted you to eat e.g. eating & watching TV Set yourself a goal for losing weight Do not try to lose too much weight too soon. Go slowly, lose a little at a time & keep it off

To lose weight Adopt healthy diet & exercise habits Keep a record of what you eat & the exercises you do Do not skip meals, especially breakfast

Factors that protect against weight gain High intake of non-starch polysaccharides- (supported by strongest research evidence) Breast feeding Intake of low glycaemic index foods Increased eating frequency Regular physical activity

Consequences of obesity MetabolicCVSCancerMechanicalSocial DM (type 2)HypertensionBreastOsteoarthritisLow self esteem Insulin Resistance Varicose VeinsProstateObstructive sleep opnea Criticism by society Dyslipedimia e.g. incresaed VLDL & LDL Peripheral Odema Kidney & Colon

References Patterson, R. E. & Pietinen, P. (2004). Assessment of Nutritional status in individuals and populations. In M. Gibney, B. Margetts, J. Kearney & L. Arab. Public Health Nutrition. (pp ). Oxford: Blackwell Publishing Company. Prentice, A. (2007). Energy. In J. Mann & S. Truswell. Essentials of Human Nutrition. (3 rd Ed.). (pp ). Oxford: University Press.

References Omari, A. & Caterson, D. (2007). Overweight & Obesity. In J. Mann & S. Truswell. Essentials of Human Nutrition. (3 rd Ed.). (pp ). Oxford: University Press. Tucker, S. & Dauffenbach, V. (2011). Nutrition and Diet Therapy for Nurses’. (1 st Ed.). Boston: Pearson Press