1. Energy Balance Energy intake vs. energy output Positive, negative, neutral Sources of input? Forms of output?

2. Energy In Regulation of intake –Internal cues Hunger –Prompts eating Satiation –Signals to stop eating Satiety –Tells when you are ready to eat again

3. 3

4. 4

5. Estimated via nutrient databases or nutrient analysis software Calories in these can be based on bomb calorimeter measurements Calculated using known fuel values Fat 9 kcal/g Carbohydrates 4 kcal/g Protein 4 kcal/g Alcohol 7 kcal/g

6. 6

7. Energy In Regulation of intake –External cues Appetite –Psychological desire to eat –Influenced by the eating environment

8. Energy In Internal factors –Gastrointestinal sensations Sense of fullness –Neurological and hormonal factors Neuropeptide Y Ghrelin Leptin

9. Energy In External factors –Portion size Super-size culture –Environment and social factors Hypothalamus –Emotional factors Hypothalamus

10. Energy In: Regulatory Factors

11. Energy Out: Fuel Uses Total energy expenditure Major components of energy expenditure –Energy expenditure at rest (basal energy expenditure) Energy for basic body functions Affected by body size, composition, age, and gender

12. Energy Out: Fuel Uses Major components of energy expenditure –Physical activity Highly variable Affected by body size, fitness level, type of activity –Thermic effect of food (TEF) Energy to digest, absorb, metabolize food

13. Energy Out: Fuel Uses Estimating total energy expenditure –Resting energy expenditure (REE) 1.0 kcal/kg/hr for males 0.9 kcal/kg/hr for females –Physical activity Add a % of REE (see Table 8.2) –Thermic effect of food 6% to 10% of (REE + physical activity)

14. Estimating Energy Expenditure Estimated Energy Requirement (EER) –Equations for males and females Factors for age, weight, height, and physical activity –Predicts total energy expenditure (TEE)

15. Body Composition: Understanding Fatness and Weight

16. Body composition –Fat and lean muscle mass Assessing body weight –Body mass index (BMI) Weight (kg) × height 2 (m) BMI ≤ 18.5 kg/m 2 = underweight BMI 18.5 to ≥ 25 kg/m 2 = normal weight BMI 25 to ≤ 30kg/m 2 = overweight BMI ≥ 30 kg/m 2 = obese

19. 19 Measuring Body Fat Content Underwater weighing Air displacement –BodPod® Skinfold thickness Bioelectrical impedance Dual energy X-ray absorptiometry (DEXA)

20. 20

21. Central obesity is associated with a higher risk of heart disease, hypertension, insulin resistance and type 2 Diabetes. With an increase in waist circumference the risk of death increases as well. Intra-abdominal fat is the depot that conveys the biggest health risk.

22. Body Composition: Understanding Fatness and Weight Assessing body fatness –DXA –Underwater weighing –BodPod –Skinfold measurements –Bioelectrical impedance Photo © Jones and Bartlett Publishers

23. Body Composition: Understanding Fatness and Weight Body fat distribution –Gynoid obesity (“pear”) Excess fat in hips and thighs –Android obesity (“apple”) Excess fat around abdomen –Waist circumference

24. Overweight and Obesity Factors in development of obesity –Biological Heredity Gene-environment (Epigenetics) Fat cell development Sex and age Race and ethnicity

25. Overweight and Obesity Factors in development of obesity Socioeconomic status Built environment –“Human formed, developed, or structured areas” Social factors

26. Overweight and Obesity Factors in development of obesity –Lifestyle and behavioral factors Physical activity –Lack of exercise Psychological factors –Restrained eaters –Binge eaters

27. Overweight and Obesity Health risks of overweight and obesity –Heart disease, stroke, diabetes, hypertension, metabolic syndrome, cancer, gallbladder disease, joint disease, and sleep apnea Weight cycling –Low LDL cholesterol, hypertension

28. 28 Treatment of Overweight and Obesity Three Key Components of a Sound Weight Loss program –Control of energy intake Adipose tissue contains approximately 3500 kcals Low energy density diet –Regular physical activity –Control of problem behaviors Behavior modification techniques

29. 29

30. 30

37. Weight Management Adopting a healthy weight- management lifestyle Diet and eating habits –Total calories –Crash diets don’t work –Balancing energy sources: fat, carbohydrate, and protein –Eating habits –Physical activity

38. Weight Management Weight-management approaches –Self-help books and manuals Watch for signs of a fad diet –Meal replacements –Self-help groups –Commercial programs –Professional counselors

39. Weight Management Weight-management approaches –Prescription drugs –Over-the-counter drugs and dietary supplements Cautions of safety/ingredients

40. Weight Management Weight-management approaches –Surgery Extreme obesity Last-ditch effort Gastric banding Gastric bypass

41. Underweight Causes and assessment –Altered responses –Eating disorders factors –Metabolic and heredity factors –Prolonged physical and emotional stress –Addiction to alcohol and street drugs –Bizarre diet patterns

42. Underweight Weight-gain strategies –Small, frequent meals –Fluids between meals –High-calorie foods and beverages –Timers or other cues –Vitamin/mineral supplements