1. Maintaining Energy Balance and a Healthy Weight

2. Obesity Gene u http://www.nlm.nih.gov/medlineplus/vide os/news/fighting_fat_112211.html http://www.nlm.nih.gov/medlineplus/vide os/news/fighting_fat_112211.html u Medline Plus

3. Fit vs Fat u There is a discussion about fitness and fatness. u The fit vs fat argument states that fitness is more important than fatness.

4. Fit vs Fat u The point is that fatness is a symptom of bad nutrition and physical activity. u It has been stated that by focusing on the obesity epidemic, we are causing people to get fatter.

5. Fit vs Fat u This occurs because people try to diet away the fat and end up getting fatter. u Most people who try to lose weight (fat) are unsuccessful (98% failure rate).

6. Fit vs Fat u The recommendation is that by focusing on the behaviors of eating nutritiously and increasing physical activity, the person will be healthier even if he/she doesn’t lose any weight.

7. Fit vs Fat u The contention is that a fat person who eats well and is physically activity is healthier from a disease risk standpoint than a leaner person who does not practice these behaviors.

8. Fit vs Fat u Additionally, it has been stated that most risk factors of disease associated with obesity can be reduced by eating better and becoming more active.

9. Fit vs Fat u Thoughts?

10. Maintaining Energy Balance and a Healthy Weight u Regular physical activity along with a nutritious diet is key to maintaining a healthy weight. u Balance calories consumed and calories expended. u U.S. Department of Health and Human Services

11. Maintaining Energy Balance and a Healthy Weight u In most individuals, weight gain results from a combination of excess calorie consumption and inadequate physical activity. u U.S. Department of Health and Human Services

12. Maintaining Energy Balance and a Healthy Weight  An individual ’ s physical activities may account for as much as 15 to 40 percent of the calories burned each day. u While vigorous exercise uses calories at a higher rate, any physical activity will burn calories. u U.S. Department of Health and Human Services

13. Maintaining Energy Balance and a Healthy Weight u A 140-pound person can burn 175 calories in 30 minutes of moderate bicycling, and 322 calories in 30 minutes of moderate jogging. u The same person can also burn 105 calories by vacuuming or raking leaves for the same amount of time. u U.S. Department of Health and Human Services

14. Body Composition u Overweight and obese individuals have incorporated patterns of overeating and physical inactivity into to their lifestyles, while others have developed food and/or exercise addictions.

15. Body Composition u Many are lured by fad diets and exercise gimmicks, and some resort to extreme behaviors such as avoiding food, bingeing and purging, and exercising compulsively.

16. Body Composition u Since reduction of body fatness is a need or goal of many exercise program participants, exercise programs should be designed to aid in accomplishing this objective, and doing so sanely and rationally.

17. Factors Influencing Body Composition u Energy intake u Energy output u Genetics

18. Caloric Balance u Body composition is determined by a complex set of genetic and behavioral factors.

19. Caloric Balance u Though the contributing variables are many, the fundamental determinant of body weight and body composition is caloric balance.

20. Caloric Balance u Caloric balance refers to the difference between caloric intake and caloric expenditure.

21. Caloric Balance u The First Law of Thermodynamics states that energy is neither created nor destroyed; u therefore, body weight is lost when caloric expenditure exceeds caloric intake (negative balance) u and weight is gained when the opposite situation exists.

22. Fat Management u Energy in = energy out = no change in fatness u Energy in > energy out = get fatter u Energy in < energy out = lose fat

23. Caloric Balance u One pound of fat is equivalent to approximately 3500 kcal of energy.

24. Caloric Balance u Shifts in caloric balance will be accompanied by changes in body weight. u The nature of the weight change varies markedly with the specific behaviors that lead to the caloric imbalance.

25. Caloric Balance u Fasting and extreme caloric restriction (starvation and semi-starvation diets) cause substantial losses of water and fat-free tissue.

26. Caloric Balance u An exercise-induced negative caloric balance results in weight loss consisting primarily of fat.

27. Caloric Balance u High resistance exercise programs may lead to a gain in fat-free weight. u Cardiorespiratory endurance training usually results in a maintenance of fat- free weight.

28. Caloric Balance u Both types of programs can contribute to a loss of body fat, although aerobic activity is more efficient because it involves a sustained, high rate of energy expenditure.

29. Body Composition u It is recommended that both an increase in caloric expenditure through exercise and a decrease in caloric intake be used to accomplish this goal.

30. Body Composition u Exercise also helps maintain resting metabolic rate and thus the rate of weight loss.

31. Body Composition Programs u Adoption of a physically active lifestyle. u Adoption of dietary guidelines.

32. Dietary Guidelines u Eat a variety of foods. u Balance the food you eat with physical activity. u Choose a diet with plenty of grain products, vegetables, and fruits.

33. Dietary Guidelines u Choose a diet low in fat, saturated fat, and cholesterol. u Choose a diet moderate in sugars. u Choose a diet moderate in salt and sodium.

34. Dietary Guidelines u If you drink alcoholic beverages, do so in moderation.

35. Body Composition Programs u Behavior modification techniques can help people make these lifestyle changes.

36. Behavior Modification u Exercise specialists, nutritionists, and psychologists need to work together to help their clients, especially obesity prone individuals, modify their physical activity and eating attitudes and behaviors.

37. Physical Activity u The initial exercise program should be based on low intensity and progressively longer duration physical activity.

38. Physical Activity u Work toward increasing the intensity to bring the person into a target heart rate range suitable for cardiorespiratory conditioning.

39. Physical Activity u The higher intensity will allow for a shorter duration per session, or fewer sessions per week for the same weekly energy expenditure.

40. Physical Activity u The transition to higher intensity exercise will increase the number of opportunities to incorporate activities that naturally require a high rate of energy expenditure.

41. Physical Activity u For many (especially older) obese subjects, a walking or other low intensity exercise program may be all they desire, and movement toward a more intense program may not be warranted.

42. Recommendations u The first step is to gain an understanding of why the person is overfat/obese. u Consider genetics, social factors, psychological factors, nutrition patterns, hormones, and activity levels.

43. Recommendations u Attempt to determine if you are dealing with hypertrophic obesity or hyperplasic obesity.

44. Recommendations u Once you understand the potential causes of the problem, then focus on behaviors which can be changed: u Better nutritional patterns u Increased physical activity u Incidental PA u Aerobic exercise u Resistance training

45. Recommendations u The optimal approach to fat loss combines a mild caloric restriction with regular endurance exercise and avoids nutritional deficiencies. u To maintain LBM, resistive training should also be included.

46. Recommendations u A desirable fat loss program is one that meets the following criteria:

47. Recommendations u 1. Provides intake not lower than 1220 kcal/day for normal adults and ensures a proper blend of foods to meet nutritional requirements. u (Note: this requirement may not be appropriate for children, older individuals, and athletes).

48. Recommendations u 2. Includes foods acceptable to the dieter in terms of socio-cultural background, usual habits, taste, costs, and ease in acquisition and preparation.

49. Recommendations u 3. Provides a negative caloric balance (not to exceed 500 to 1000 kcal/day), resulting in gradual weight loss without metabolic derangement, such as ketosis.

50. Recommendations u 4. Results in a maximal weight loss of 1 kg/week.

51. Recommendations u 5. Includes the use of behavior modification techniques to identify and eliminate diet habits that contribute to malnutrition or overconsumption.

52. Recommendations u 6. Includes an exercise program that promotes a daily caloric expenditure of 300 or more kcal. u For many participants, this may be best accomplished with low intensity, long duration exercise, such as walking.

53. Recommendations u 7. Provides that new eating and physical activity habits can be continued for life in order to maintain the achieved lower body weight. u Portion control, low fat diet, minimize simple CHO and increase PA

54. Caution u The balance between intensity and duration of exercise should be manipulated to promote a high total caloric expenditure (300 to 500 kcal per session and 1000 to 2000 kcal per week for adults).

55. Caution u Obese individuals are at an increased relative risk for orthopedic injury, and this may require that the intensity recommended for improvement of cardiorespiratory endurance.

56. Caution u Non-weight bearing activities (and/or rotation of exercise modalities) may be necessary and frequent modifications in frequency and duration may also be required.

57. Setting Goals u A healthy body weight is based on the client’s present FFM and % BF goal.

58. Current Body Wt Goal % Fat* Goal % LBM* Current % Fat* Current Fat Wt Current LBM Target Body Wt 1 * % is expressed as a decimal. Divide by 100 before entering the data. X  by minus Computing Target Wt assuming all wt. Loss is fat Fill in boxes with double lines and compute others

59. Reminder u Data by Blair (1999) demonstrates that fitness level counteracts many of the negative impacts of obesity.

60. Reminder u Those obese individuals who are active may have greater protection against disease than those of normal fatness who are inactive. u 1/3 of the obese will not have other risk factors for early death.

61. Reminder u Fat can be fit (at least from a cardiovascular standpoint) u However, that does not mean that it is OK (medically) to be fat.

62. ACSM recommends u eat 250 less per day u expend 250 more per day u (walk 2.5 miles) u = 500 kcal per day reduction

63. ACSM recommends u do this 7 days a week u = 3500 kcal in a week u = 52 lbs in a year