ABCT1D06 Nutrition and Healthy Living

Weight Management
Dr. Christine Li

Learning outcomes
1. Estimate total calorie need using the formulas presented
2. Identify the components of energy needs and the factors that affect the
energy needs

3. Identify weight status based weight, height, age and sex using appropriate
formulas

4. Describe the potential causes and health consequences of overweight and

obesity.

5. Describe the factors contributing to obesity and the prevention of obesity in

children and adults.

6. Describe weight-loss methods that have been demonstrated to be successful

and those that have not.

Energy
Calorie

A unit of measure used to express the amount of energy produced by foods in the form
of heat

The calorie used in nutrition is the large calorie, or the kilocalorie (kcal)

The large calorie or kilogram calorie (symbol: Cal), also known as the food calorie, is
defined in terms of the kilogram rather than the gram.

1 Cal = 1 kcal = 4.2 kJ

Calorie

Bomb Calorimeter

The caloric value of food is determined by

burning it in a bomb calorimeter

Q = M C T
Q: Heat adsorbed by water
M: Mass of water
C: specific heat capacity of water (1 cal / (g oC))

T: Temperature increased

The Bodys Need for Energy

Basal metabolism is energy used to support body processes such as growth,
health, tissue repair and maintenance, and other functions

Energy for breathing, pumping of the heart, maintenance of body temperature, and
other life-sustaining, ongoing functions

Dietary thermogenesis is the energy expended during the digestion of food

and the absorption, utilization, storage, and transport of nutrients

The Bodys Need for Energy

Energy from food fuels body processes

Muscular activity and growth

Tissue repair and maintenance
Chemical processes and body temperature

Three Types of Energy-Requiring Processes

Basal Metabolic Rate (BMR)

The rate at which energy is used by the body when it is at complete rest.

Expressed as calories used per unit of time per unit of body weight
Also called resting metabolic rate (RMR) or resting energy expenditure (REE)

Basal Metabolic Rate (BMR)

Indirect calorimetry

Clinical method of measuring BMR

Measure energy expenditure form
determination of the amount oxygen
utilized by the body during a specific unit of
time.

Energy expended for Basal Metabolism

Men

BMR calories = body weight (lbs) x 11

Women:

BMR calories = body weight (lbs) x 10

Actual calories for BMR

Varies 1020%
Depends on physical activity, muscle mass, height, health status, genetic traits

Energy expend in physical Activity

The energy spend for physical activity can vary a lot

It usually accounts for the second highest amount of calories we expend

Energy expended for dietary thermogenesis

(Thermic effect of foods)
Calories expended for dietary thermogenesis are estimated as 10% of the
sum of basal metabolic and usual physical activity calories

Example:

1,500 calories for basal metabolic need

450 calories are required for usual activity
1,500 calories + 450 calories = 1,950 calories
Dietary thermogenesis 10% x 1,950 calories, or 195 calories

Adding it All Up
Estimated total daily calorie needs equal the sum of calories used for basal
metabolism, physical activity, and dietary thermogenesis

Energy in Foods
Energy nutrients supply energy

Carbohydrates = 4 calories/gram
Proteins = 4 calories/gram
Fats = 9 calories/gram

Alcohol also supplies energy

7 calories/gram

Calories in Foods
High-fat foods provide more calories per ounce than foods that contain
mostly carbohydrates or protein

Which contains the most calories a tablespoon of margarine, sugar, or

pork?

Calculating Total Calories Based on Carbohydrate,

Protein, and Fat Content

Nutrient grams x calories/gram = calories

Example:

15 g carbohydrate x 4 cal/g = 60 calories

10 g protein x 4 cal/g = 40 calories
5 g fat x 9 cal/g = 45 calories
Total = 145 calories

Most Foods Are a Mixture

Some foods (e.g. oil and table sugar) consist almost exclusively of one energy
nutrient

Most foods are a mixture of proteins, fats, and carbohydrates

Whats the caloric value of these foods?

One contains 420 calories, another 205, and the third 118 calories
A

cup of peanuts

1 medium boiled potato

1 cup of white rice

Food Intake
Hunger

Physiological response to nerve signals and chemical messengers

Hypothalamus

Influences

Satiation signal to stop eating

Satiety signal to not to start eating again

Hunger, Satiation, and Satiety

Factors That Influence Eating

Overriding hunger and satiety

External cues

Large portion sizes, favorite foods, abundance or variety of foods

Cognitive influences

Time of day, availability, sight, taste of food

Environmental influences

Stress eating

Perceptions, memories, intellect and social interactions

Disordered eating

Anorexia nervosa

Nutrient Composition for Sustained

Satiation and Satiety
Protein is most satiating
Low-energy density and high-fiber foods effectively provide
satiation

Fat has a weak effect on satiation

High-fat foods strong satiety signals

The Question of Energy Balance

Energy balance

Negative energy balance

The number of calories used equals the number of calories consumed; weight is maintained

Energy intake is less than the amount of energy expended; weight is lost

Positive energy balance

More energy is available from foods than is needed by the body; weight is gained
Normal during childhood growth, pregnancy, or regaining weight following an illness

Energy Balance

Keep Calories in Perspective

Calorie is not a word that means fattening or bad for you

Calories represent our source of energy and are a life- and health-sustaining
property of food

Caloric content of individual foods does not make a food good or bad
The sum of calories and nutrients in foods make up our dietary pattern

Class activity

Calculate your energy needs

1.
List three factors that can influence an individuals BMR and indicate whether each factor
would increase or decrease their BMR.

2.

Identify three reasons why an individuals total energy needs might change tomorrow.

3.

Identify three factors that might influence an individuals energy needs in 10 years.

Factors that Affect the BMR

Factor

Effect on BMR

Age

Lean body mass diminishes with age, slowing the BMR.a

Height
Growth

In tall, thin people, the BMR is higher.b

In children, adolescents, and pregnant women, the BMR is higher.
The more lean tissue, the higher the BMR (which is why males usually have a
higher BMR than females). The more fat tissue, the lower the BMR.
Fever raises the BMR.C
Stresses (including many diseases and certain drugs) raise the BMR.
Both heat and cold raise the BMR.

Body composition (gender)

Fever
Stresses
Environmental temperature
Fasting/starvation
Malnutrition
Hormones (gender)
Smoking
Caffeine
Sleep
a The BMR begins

Fasting/starvation lowers the BMR.d

Malnutrition lowers the BMR.
The thyroid hormone thyroxin, for example, can speed up or slow down the
BMR.e Premenstrual hormones slightly raise the BMR.
Nicotine increases energy expenditure.
Caffeine increases energy expenditure.
BMR is lowest when sleeping.

to decrease in early adulthood (after growth and development cease) at a rate of about 2 percent/decade.

A reduction in voluntary activity as well brings the total decline in energy expenditure to about 5 percent/decade.
b If

two people weigh the same, the taller, thinner person will have the faster metabolic rate, reflecting the greater skin

surface, through which heat is lost by radiation, in proportion to the body's volume (see Figure 8-5, p. 239).
c Fever raises the BMR by

7 percent for each degree Fahrenheit.

d Prolonged

starvation reduces the total amount of metabolically active lean tissue in the body, although the decline occurs sooner and to a greater
extent than body losses alone can explain. More likely, the neural and hormonal changes that accompany fasting are responsible for changes in the
BMR.

e The

thyroid gland releases hormones that travel to the cells and influence cellular metabolism. Thyroid hormone activity can speed up or slow down
the rate of metabolism by as much as 50 percent.

How is Weight Status Defined?

Culture and science define the

appropriateness of body size

Science defines standards for

body weight based on the risk of

death

Risk increases for the overweight

and underweight

Body Mass Index

Asian standard

Body mass index (BMI) is an indicator of the

status of a persons weight for his or her height

Calculated by dividing weight in kilograms by

height in meters squared kg/m2)

BMI
Under 18.5 kg/m2
18.5-22.9 kg/m2
23-24.9 kg/m2
25 kg/m2 or higher

Assessing Weight Status in Children and Adolescents

Standards used to assess weight status

in children and adolescents employ
BMI percentile ranges for girls and boys

Copies of all growth charts are

available at:

www.cdc.gov/growthcharts

Overweight and Obesity

69% of U.S. adults are overweight or obese
31.8% of U.S. children and adolescents are overweight or obese
20% of Hong Kong school aged children are overweight or obese
The high prevalence of overweight and obesity in the United States and
other countries is being matched by increased rates of obesity-related
health issues

The Influence of Obesity on Health

People who are obese are more likely to

experience diabetes, heart disease, certain types

of cancer, hypertension, and other health
problems

73% of obese adults have one or more metabolic

abnormality that increases disease risk

The Influence of Obesity on Health

Metabolism involves chemical changes that occur in the body

There is a higher incidence of metabolic abnormalities

Hypertension
Elevated triglycerides, glucose, and/or insulin
Excess liver fat
High C-reactive protein (a key marker of inflammation)

Weight loss paired with exercise reduces metabolic abnormalities and disease risks

Over weight = Over fat?

Subcutaneous and Visceral Fat

Body Shapes
Pear shape

Fat primarily in hips, upper arms and thighs

Less visceral fat, lower risk

Apple shape

Fat primarily in abdomen

More visceral fat, higher risk

Visceral Fat and Its Impact on Health

Visceral fat is more metabolically active and more strongly related to disease risk
than substantially
Impact of metabolic processes initiated by visceral fat

Chronic inflammation low-grade inflammation that lasts weeks, months, or years

Metabolic syndrome a constellation of metabolic abnormalities generally

Insulin resistance cells resist the action of insulin in facilitating the passage of glucose
into cells

Insulin resistance
Impaired glucose intolerance
Elevated blood glucose and triglycerides
Low HDL cholesterol
High blood pressure
Abdominal obesity

Visceral Fat and Its Impact on Health

Metabolic changes, in turn, can lead to:

Heart disease

Hypertension

Some cancers
Type 2 diabetes high blood glucose levels due to the bodys inability to use insulin
normally or to produce enough insulin
Fatty liver disease A reversible condition characterized by fat infiltration of the liver
(10% or more by weight)

Visceral Fat and Waist Circumference

Waist measurements of excess visceral fat

Men: > 40 inches (102 cm)

Women: > 35 inches (88 cm)

Inaccurate measure of visceral fat in large, muscular individuals

Strong indicator of disease risk

Measurement in clinical practice is encouraged

Determining Waist Circumference

Determining Waist Circumference

Japan requires adults age 5074 to have yearly waist

measurements

Those with large circumferences and weight-related

problems are given dieting guidance

Other ways to determine body fat

https://www.youtube.com/watch?v=VBJuVfiKrbY

Everybody Needs Some Body Fat

Body fat has essential functions

Essential role in manufacture of hormones

Required component in cell structures
Cushion for internal organs

Ideal Range
20-32
10-25

What Causes Obesity?

Factors contributing to excess body fat

An individuals genetic traits

Geneenvironment interactions
High added sugar intake
Poverty and low educational levels
Lack of sleep
Exposure to PCBs
Smoking cessation
Medications
Physical inactivity

Do Obese Children Become Obese Adults?

8% of obese 12 year olds who do not have obese parents

become obese adults

80% of obese 1014 year olds who have at least one obese
parent become obese adults

Obesity: The Future Lies in Its Prevention

Whether obesity is related to genetic predisposition, environmental factors, or a combination of the

two, certain steps can be taken to help prevent it

Preventing Obesity in Children

Lifestyle changes for the whole family develop healthy eating and activity habits

Offer nutritious food selections

Provide fun physical activities in schools and summer programs
Avoid negative focus on weight

Preventing Obesity in Adults

Weight gains likely between ages 2534

Many adults gain weight slowly (about 1 pound/year)

Some gain large amounts over short periods

Actions need to be taken

Engage in regular vigorous exercise

Reduce portion sizes
Get eight hours of sleep

Changing the Environment

Change food portion sizes
Limit access to junk food in schools
Build exercise parks
Develop community gardens
Provide more sidewalks, bicycle, and walking paths
Offer more nutrient-dense foods in restaurants

Weight Loss versus Weight Control

Diets and weight loss do not cure overweight

People return to old habits and regain weight

We are creatures of pleasure, not pain (feelings of hunger and deprivation)

Improved and enjoyable eating and exercise habits are needed to keep
excess weight off

The Business of Weight Loss

Thousands of weight-loss products and services are available
Most of them either dont work at all or dont prevent weight regain
No laws require a weight-loss product must be effective in order to be sold
Weight-loss products are usually not tested for safety before they reach the
market

Some cause serious problems, even death

Discontinued Weight-Loss Methods

Successful Weight Loss Programs

Lifestyle programs

Individually tailored, sustainable lifestyle changes

Positive and supportive counseling
Average loss of 13.8 pounds (6.8 kg) over 18 months

Physical Activity and Weight Control

Regular physical activity:

Reduces abdominal fat stores

Improves blood cholesterol, insulin sensitivity, and blood pressure

Regular resistance exercise:

Increases lean body mass

Reduces fat mass

Moderate physical activity with calorie reduction increases weight loss

Weight Loss: Making It Last

People who lose weight and maintain the weight loss:

Watch portion sizes carefully

Exercise regularly

Changes in diet and physical activity that are small, easy to implement, and
acceptable are key

Successful Weight Loss

Calorie Intake Reduction

In the recent past it was estimated that weight loss of a pound would
require a reduction in calorie intake of 3,500 calories

Not that straightforward calorie needs decrease over time as weight is lost

A weight-control plan must account for decreases in calorie needs related to

weight loss if weight loss is to continue

Identifying Small, Acceptable Changes

List the weak points in your diet and activity level

Consuming high-fat foods when eating out

Skipping breakfast; overeating later in the day
Driving instead of walking

For each weak point, identify acceptable and enjoyable options

Incorporate changes into an overall lifestyle improvement plan

Experiment to find small changes that will last

Take ActionSmall Steps Can Make a Big

Difference
Small steps for healthy eating

Eat cereal for breakfast; eat fruit before dinner

Eat more vegetables than meat
Drink skim milk; switch to flavored water
Stop eating when full; eat only when hungry
Reduce dessert size
Start new activity when tempted
Chew thoroughly

Take ActionSmall Steps Can Make a Big

Difference

Small steps for physical activity

Add 2000 steps; park farther away

Take a 10-minute walk in park
Lift weights while watching TV (10 min)
Do 10 sit-ups in the morning
Use the stairs
Walk the neighbors dog
Jump rope for two minutes
Dance for five minutes while no one is watching

What to Expect for Weight Loss

Expect gradual weight loss with peaks,
valleys, and plateaus not a straight
downward curve

Sometimes weight will be gained

Small changes should become an
enjoyable part of daily life

Summary

The overall energy requirement for the body includes: the energy for basal metabolism,
physical activity and dietary thermogenesis.

Factors affecting Basal metabolic rate (BMR)

BMI calculation and weight status determination
Cause and health Consequences of overweight and obesity
Visceral fat and waist circumference
Weight loss programs