1. Energy Balance Chapter 7

2. Energy Intake
Calories come from carbohydrates, protein, fat, and alcohol
The total number of calories in a food or diet can be estimated by multiplying total grams of carbohydrates, protein, or fat by the appropriate number of calories/gram
Even when all food consumed is measured, the nutrient values available in food composition references represent average, not actual, nutrition content

3. Energy Intake (cont’d)
Easier way to count calorie intake is to estimate the number of servings from each food group a person consumes; multiply the number of servings by the average amount of calories in a serving; then add the calories from each group to get an approximation of the total calories consumed
Accuracy of “counting servings” depends on the quality of foods consumed and the accuracy of portion size estimation

4. Energy Expenditure Basal metabolism
Caloric cost of staying alive or the amount of calories required to fuel the involuntary activities of the body at rest after a 12-hour fast
Basal metabolic rate (BMR) accounts for approximately 60% of total calories expended
The less active a person is, the greater the proportion of calories used for basal energy expenditure (BEE)

5. Energy Expenditure (cont’d)
Basal metabolism (cont’d)
Rule-of-thumb guideline for estimating BMR is to multiply healthy weight (in pounds) by 10 for women and 11 for men
When actual weight exceeds healthy weight, an “adjusted” weight of halfway between healthy and actual can be used
Rule of thumb based on weight only

6. Energy Expenditure (cont’d)
Basal metabolism (cont’d)
Lean tissue (muscle mass) contributes to a higher metabolic rate than fat tissue
Loss of lean tissue that usually occurs with aging beginning sometime around age 30 is one reason why calorie requirements decrease as people get older

7. Energy Expenditure (cont’d)
Physical activity
Accounts for approximately 30% of total calories used
Rule-of-thumb method for estimating daily calories expended on physical activity is to calculate the percent increase above BMR based on the estimated intensity of usual daily activities

8. Energy Expenditure (cont’d)
Estimating total calorie requirements
Estimated energy requirements (or EER) based on age, weight, height, and physical activity (PA), with defined PA factors for men and women based on intensity of activity
Quicker and easier reference is the MyPyramid calorie level table based on gender, age, and activity

9. Calories in Versus Calories Out
State of energy balance is the relationship between the amount of calories consumed and the amount of calories expended
A “positive” energy balance occurs when calorie intake exceeds calorie output
A “negative” calorie balance occurs when calorie output exceeds intake

10. Question Is the following statement true or false?
A man with an actual weight of 210 pounds and a “healthy” weight of 175 pounds has a basal metabolic rate of 2,220.

11. Answer
False. Rationale: When actual weight exceeds healthy weight, an “adjusted” weight of halfway between healthy and actual can be used: 210 – 175 = 35 35/2 = = x 11 = BMR

12. What Is “Normal” Weight
“Normal” or “desirable” weight is that which is statistically correlated to good health
3 criteria used for assessing overweight and obesity:
Body mass index (BMI)
Waist circumference
Existing health problems

13. What Is “Normal” Weight (cont’d)
Body mass index
Body mass index (BMI) has replaced traditional weight–height calculations that were used to determine “ideal” or “desirable” body weight
Formula to calculate BMI is weight in kg/height in meters squared or weight in pounds/height in inches squared x 703
Drawback
Does not take body composition into account
Skinfold measurements and bioelectrical impedance can assess body composition, but neither technique is widely used

14. What Is “Normal” Weight (cont’d)
Waist circumference
Location of excess body fat may be a more important and reliable indicator of disease risk
Storing a disproportionate amount of total body fat in the abdomen increases risks for type 2 diabetes, dyslipidemia, hypertension, and cardiovascular disease
Abdominal fat is clinically defined as a waist circumference ≥40 inches in men and ≥35 inches in women

15. What Is “Normal” Weight (cont’d)
Existing health problems
Presence of existing health problems impacts a person’s absolute risk related to weight
Generally, the number and severity of comorbid conditions increases with increasing levels of obesity

16. Energy Balance in Health Promotion
Approximately 66% of the adult American population is overweight or obese
Preventing or reducing overweight is achieved by adopting a lifestyle approach that includes healthier food choices, increasing physical activity, and behavior modification

17. Energy Balance in Health Promotion (cont’d)
Healthier choices
Encompasses a 2-pronged approach
Eating less of certain items
Eating more of others
Emphasis is on healthy and wholesome choices
Remember fat-free foods still contain calories from protein and carbohydrates
Reducing alcohol intake is another way to consume fewer calories

18. Energy Balance in Health Promotion (cont’d)
Portion control
Portion sizes have grown over the last 20 years
“Portion distortion” appears to be a widespread problem
Change the environment
Food should be less accessible, less visible, and proportioned in smaller quantities

19. Energy Balance in Health Promotion (cont’d)
Physical activity
Only 30% of American adults engage in regular leisure-time physical activity; 39% of adults do not engage in any leisure-time physical activity
Benefits of increasing activity are dose-dependent and occur along a continuum
Minimum of 30 minutes/day of moderate-intensity activity above usual activity is recommended
Other types of exercise are also recommended

20. Question
There are 3 criteria used for assessing overweight and obesity. What is one of these criteria?
a. Height
b. Healthy weight
c. Existing health problems
d. Basal metabolic rate

21. Answer Existing health problems
Rationale: 3 criteria used for assessing overweight and obesity include:
Body mass index (BMI)
Waist circumference

22. How to Burn 150 Calories (Based on a 150-Pound Person)
Pedal a stationary bicycle for 20 minutes
Practice fast dance steps for 24 minutes
Work in the garden for 27 minutes
Walk briskly (3.5 mph) for 33 minutes
Clean the house for 38 minutes

23. Suggestions for Increasing Activity
Find something enjoyable
Use the buddy system
Spread activity over the entire day if desired
Start slowly and gradually increase activity
Move more
Keep an activity log