1. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 Energy Balance and Body Composition Chapter 6

2. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 Energy Imbalance Feasting –More energy consumed than expended Excess: stored as fat –Alcohol Slows the body’s use of fat for fuel –Excess carbohydrate First stored as glycogen: limited capacity Beyond storage capacity: used for energy displacing use of fat

3. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014

4. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 Energy Imbalance (cont’d.) Feasting –Dietary fat Immediately routed to adipose tissue: stored until needed for energy –Excess protein Nitrogen atoms removed and converted to triglycerides and stored in fat cells

5. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014

6. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 Energy Imbalance (cont’d.) Fasting –Glycogen stores and fatty acids from adipose tissue: used initially to fuel the body Glycogen exhausted within one day –Nervous system Glucose is required for energy –Protein breakdown Provides glucose to fuel the brain

7. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 Energy Imbalance (cont’d.) Fasting –Ketone body production as fast continues –Glycogen stores and fatty acids from adipose tissue: used initially to fuel the body Glycogen exhausted within one day –Nervous system Glucose is required for energy

8. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 Energy Imbalance (cont’d.) Fasting –Protein breakdown Provides glucose to fuel the brain –Ketone body production as fast continues

9. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014

10. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014

11. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 Energy Imbalance (cont’d.) Fasting –Metabolism slows Conserves fat and lean tissue –Hazards Wasting away of lean tissue Impairment of disease resistance Lower body temperature Disruption of body’s fluid and electrolyte balances –Why is fasting non-optimal for weight loss?

12. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 Energy Balance Change in energy stores = energy in (kcal) – energy out (kcal) Energy in food and beverages (Appendix A)

13. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 Energy Balance (cont’d.) Energy out –What is basal metabolism? Measurements: basal metabolic rate (BMR) and resting metabolic rate (RMR) Factors that raise and lower the BMR: age, height, growth, body composition, etc. (Table 6-1)

14. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014

15. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 Energy Balance (cont’d.) Energy out –Voluntary activities: factors influencing kcalories spent Muscle mass Body weight Activity: duration, frequency and intensity –Energy spent on various activities (Table 6-2) –What is the thermic effect of food?

16. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 Energy Balance (cont’d.) Factors influencing energy expenditure –Gender: higher BMR for men –Growth: increased BMR with growth –Age: BMR declines during adulthood –Physical activity: energy needs vary by activity –Body composition and body size: higher BMR for tall persons

17. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 Energy Balance (cont’d.) “How To” estimate energy requirements –Equations for estimated energy requirements Dependent upon age, weight, height, and physical activity

18. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 Body Weight and Body Composition What should be the primary focus of weight management efforts? Healthy body weight criterion –Fashion: unrealistic ideals Accept a healthy body weight (Table 6-3)

19. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 Body Weight and Body Composition (cont’d.)

20. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014

21. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014

22. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 Body Weight and Body Composition (cont’d.) Obesity or overweight diagnosis –Requires a BMI value plus some measure of body composition and fat distribution Fat distribution –Central obesity: visceral fat –What are the health concerns associated with central obesity?

23. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014

24. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 Body Weight and Body Composition (cont’d.) Fat distribution –“Apple profile”: central obesity Common in post menopausal women and even more common in men Influential factors: alcohol consumption and physical activity –Waist circumference (Appendix E) Associated health problems Men: > 40 inchesWomen: > 35 inches

25. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014

26. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 Body Weight and Body Composition (cont’d.) Skinfold measures –Accurate estimate of total body fat and a fair assessment of the fat’s location Ideal amount of body fat: depends partly on the person –Man within recommended BMI: 18 to 24 percent fat composition –Women athletes: 15 to 20 percent

27. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 Health Risks of Underweight and Obesity Health risks of being underweight –Inability to preserve lean tissue when fighting a wasting disease, e.g., cancer –Menstrual irregularities and infertility –Osteoporosis and bone fractures –Anorexia nervosa

28. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 Health Risks of Underweight and Obesity (cont’d.) Health risks of being overweight or obese –Hypertension –Type 2 diabetes –Other risks: High blood lipids, cardiovascular disease, sleep apnea, osteoarthritis, abdominal hernias, some cancers, varicose veins, gout, gallbladder disease, kidney stones, respiratory problems, etc.

29. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014

30. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 Health Risks of Underweight and Obesity (cont’d.) Identifying those at risk from obesity –BMI Overweight: 25.0 through 29.9 Obesity: greater than 30 –Waist circumference Women: greater than 35 inches Men: greater than 40 inches –Individual’s disease risk profile

31. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 Health Risks of Underweight and Obesity (cont’d.) Social and economic costs of obesity –Social stigma –Increased costs Insurance premiums Clothing