Chapter. Energy Balance and Weight Management: Finding Your Equilibrium

Transcription

1 Chapter 9 Energy Balance and Weight Management: Finding Your Equilibrium

2 Regulation of intake Hunger Prompts eating; physiological desire Satiation Signals to stop eating Satiety Lack of hunger Appetite Psychological desire Energy In

3 Energy In Control by Committee Diet Composition Sensory Properties Portion Size Environmental and Social Factors Emotional Factors Gastrointestinal Sensations Neurological and Hormonal Factors

4 Energy In: Regulatory Factors Photo: istockphoto/thinkstock

5 Energy Out: Fuel Uses Major components of energy expenditure Energy Expenditure at Rest Energy for basic body functions Affected by body size, composition, age, gender Energy Expenditure for physical activity Highly variable Affected by body size, fitness level, type of activity Energy expenditure to process food Thermic effect of food (TEF) Energy to digest, absorb, metabolize food

6 Brief history Direct vs. indirect calorimetry The Measurement of Energy Doubly labeled water Expenditure

7 DRIs for Energy: Estimated Energy Requirements Estimated Total Energy Requirement DRIs for Energy: Estimated Energy Requirements Energy intake predicted to maintain energy balance Equations for males and females Factors for age, weight, height, physical activity

8 Body Composition: Understanding Fatness and Weight Assessing body weight Body mass index (BMI) Weight (kg) height 2 (m)

9 What are the health risks associated with being overweight? Body Mass Index

10 Body Composition: Understanding Fatness and Weight Assessing body fatness Densitometry and Underwater Weighing Densitometry and Air Displacement Dual-Energy X-Ray Absorptiometry Isotope Dilution Skinfold Thickness Bioelectrical Impedance Analysis Computed Tomography and Magnetic Resonance Imaging Near-infrared interactance

11 Body Composition: Understanding Fatness and Weight Body Fat Distribution

12 Weight Management The Perception of Weight What Goals Should I Set? Adopting A Healthy Weight-Management Lifestyle

13 Weight Management Diet and Eating Habits Total Calories Crash Diets Don t Work! Balancing Energy Sources: Fat Balancing Energy Sources: Carbohydrates Balancing Energy Sources: Protein Eating Habits

14 Weight Management Physical Activity Comstock Images/Alamy Images

15 Weight Management Thinking and Emotions Stress Management Balancing Acceptance and Change

16 Weight Management Weight-management approaches Self-help books and manuals Meal replacements Self-help groups Commercial programs Professional private counselors Food and Drug Administration-Approved Weight-Loss Medications OTC drugs and dietary supplements Surgery

17 Weight Management

18 Underweight Definition BMI < 18.5 kg/m 2 Causes and assessment Weight-gain strategies Small, frequent meals Fluids between meals High-calorie foods and beverages Use timers or other cues to prompt eating Take a balanced vitamin/mineral supplement

19 Healthy Weight Management Healthy weight management means focusing on metabolic fitness healthy levels of blood lipids and blood pressure rather than on achieving a specific weight. Permanent healthy behaviors are necessary for a long-term weightmanagement lifestyle.

20 Why Do We Have Hunger Pangs? When the stomach has been without food for at least three hours, intense stomach contractions begin, sometimes lasting two to three minutes. Healthy young people have the strongest contractions, due to good muscle tone in the GI tract. After 12 to 24 hours, contractions of an empty stomach can cause painful hunger pangs.

21 Position on Weight Management It is the position of the Academy of Nutrition and Dietetics that successful weight management to improve overall health for adults requires a lifelong commitment to healthful lifestyle behaviors emphasizing sustainable and enjoyable eating practices and daily physical activity.

22 Spotlight on Obesity: The Growing Epidemic

23 Obesity as a Behavioral Problem People respond differently to different strategies and different situations Obesity rates in the U.S. has increased dramatically in the past three decades Adults Children Courtesy of the World Health Organization.

24 Factors in the Development of Obesity Biological Factors Fat Cell Development Hypercellular obesity Hypertrophic obesity Hyperplastic obesity Photo: Donna Beer Stolz, Ph.D., Center for Biologic Imaging, University of Pittsburgh Medical School.

25 Factors in the Development of Obesity Sex and Age Race and Ethnicity Data from Bully P, Elosua P. Changes in body dissatisfaction relative to gender and age: the modulating character of BMI. Span J Psychol. 2011;14(1):

26 Factors in the Development of Obesity Social and Environmental Factors Socioeconomic Status Food insecurity Level of education Environment Where you live Build environment

27 Factors in the Development of Obesity Lifestyle and Behavior Factors How Often Do You Eat Out? Our Social Networks Reproduced from Bureau of Labor Statistics, U.S. Department of Labor. Spotlight on Statistics: Food for Thought, November

28 Factors in the Development of Obesity Social and environmental Factors Lack of Physical Activity Psychological Factors Emotional Eating Restrained eaters Binge eaters Reproduced from U.S. Bureau of Labor Statistics. American Time Use Survey

29 Let s Move! Childhood Overweight Childhood and Teenage Obesity: The First Generation That Does Not Outlive Its Parents Courtesy of Let s Move!

30 Health Risks of Overweight and Obesity Hypertension Heart disease and stroke Diabetes Cancer Sleep apnea Osteoarthritis Gout Gallbladder disease Weight cycling

31 Obesity Is a Preventable National Crisis Acceptable methods for weight loss and management Dietary interventions, physical activity, behavior and environmental modifications, surgical and pharmacological treatments

32 Obesity Trends Reproduced from Centers for Disease Control and Prevention. Overweight and obesity. Adult obesity statistics. Obesity prevalence in 2011 varies across states and regions. Accessed 11/26/12. Reproduced from Centers for Disease Control and Prevention. Overweight and obesity. Adult obesity statistics. Obesity prevalence in 2011 varies across states and regions. Accessed 8/23/12. See U.S. map showing changes in obesity over time at