Energy Balance and Weight Management

Healthy Body Weight Body Composition

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Energy
the capacity to do work energy derived from food potential energy which can be converted to chemical, mechanical or heat energy

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Energy Nutrients Transformation

Energy Nutrients
metabolism

CO2 + H2O

released as heat

Energy
fuel for activities transferred into other compounds

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Measurement of the Energy Content of Food

Direct calorimetry
measures the amount of heat released heat released upon food ignition and total combustion in a bomb calorimeter and defined in terms of kcal *1 kcal is the amount of heat released that raises the temperature of 1L of water by 1C

heat released in a bomb calorimeter is potentially equivalent to the amount of food energy available from its metabolism
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Measurement of the Energy Content of Food Physiological Fuel Value

the number of kcalories that the body derives from a food, as contrasted with the number of kcalories determined by calorimetry * metabolism not all energy is released as heat; a
certain proportion is trapped in the form of high energy phosphate bonds (also depends on the digestibility of food)

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Measurement of the Energy Content of Food

Indirect calorimetry
measures the amount of O2 consumed during metabolic oxidation, the proportion of O2 consumed/amount of specific carbonaceous material oxidized is constant as is the proportion of CO2 that results a common way of determining food energy utilization

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Summary of the Fate of Food Energy

FOOD ENERGY
Digestible (absorbed) Energy
Some loss in urine, sweat and sloughed cells

1%-9% Non-digestible Energy (lost in feces or used by bacteria)

50% Heat released in catabolism 6%-10% Energy required for digestion, absorption, distribution, modification, and storage of digestible nutrients

Net Metabolizable Energy (provide for basal metabolism and physical activities)

25% - 40% Energy Utilized or Trapped in ~P

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Energy Needs of the Human Body

The human bodys energy need or expenditure is determined by: 1. basal metabolism 2. physical activities 3. diet induced thermogenesis
* additional energy needed as requirement for growth in normal body growth from infancy to childhood; growth of placenta, fetus and other tissues in pregnancy; and muscle growth in body building
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Basal Metabolism
energy expenditure for involuntary activities (also resting energy expenditure REE) constitutes almost of the caloric requirements of an individual includes all activities continuously occurring in the body

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Basal Metabolic Rate

can be determined by measuring the O2 consumption (as well as CO2 and N excretion) of a person:
awake but at complete rest (free from physical fatigue, nervousness and tension) in a neutral warm environment after fasting overnight or at least 12 hours after the last meal

in kcal/min/kgBW

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Physical Activities
voluntary movement of the skeletal muscles and support systems most variable and most changeable depends on muscle mass, body weight and activity
the larger the muscle mass required and the heavier the weight of the body part being moved, the more energy is spent the longer, the more frequent, and the more intense the activity, the more kcalories spent

mobilize the organism to increase fuel utilization and O2 consumption are approximated by measuring O2 consumption using portable respirometers
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Diet induced Thermogenesis

or thermic effect of food

when a person eats, the GIT muscles speed up their rhythmic contractions, the cells that manufacture and secrete digestive juices begin their task, and some nutrients are absorbed by active transport
influenced by meal size and frequency
greater for high-protein and fat foods and for a meal eaten all at once

*for an average Filipino diet 6% of total energy intake (or add 6% to sub-total of BMR and PA)

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Calculating Total Energy Requirement per Day

I.

BMR
1 Kcal/Kg/hour for adult male 0.9 Kcal/Kg/hour for adult female

II.

PHYSICAL ACTIVITY
sedentary 50% of BMR light activity 65% of BMR moderate activity 70% of BMR heavy work 75-100% of BMR

III.

THERMIC EFFECT OF FOOD

6% of (BMR+PA)

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Energy Balance
The amount of energy taken in by an individual should be equal to the amount of energy expended during the day if this is so, the individual attains a DESIRABLE BODY WEIGHT.

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Energy Balance
energy imbalance results to the individual being OVERWEIGHT or UNDERWEIGHT determined by:
use of height to weight tables use of body mass index (BMI) determination of body composition the % of body fat
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Energy Balance
OVERWEIGHT +energy balance may result in:
psychological disturbances changes in normal body functions increased risks in developing certain diseases

UNDERWEIGHT -energy balance may result in:

retarded growth of children and wasting of tissues nervousness lowered resistance to germs sterility

best way to control:

maintain nutritionally adequate diet which will minimize hunger increase physical activity modify eating behavior patterns

best way to control:

physical activity to build muscles with increased energy intake eat energy dense foods
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Healthy Body Weight

defined by 3 criteria: 1. a weight within the suggested range for height 2. a fat distribution pattern that is associated with low risk of illness and death 3. freedom from all medical conditions that would suggest a need for weight loss
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Weight for Height Tables

overweight if a persons actual weight is 10-20% above normal weight range obese if 20% or more above the standard underweight if a persons actual weight is 10% below standard

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Body Mass Index

actually an index of a persons weight in relation to height
BMI = weight in Kg

height in m2

values correlate with disease risks both underweight and overweight impair health status
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Body Composition
the proportions of muscle, bone, fat, and other tissue that make up a persons total body weight Body weight = fat + lean tissue (including water) for an active individual may be overweight but carry little body fat for inactive people, they may have acceptable weights but may carry too much body fat
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Body Fat and Its Distribution

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Body Fat and Its Distribution

Fat distribution Intraabdominal fat Central obesity

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Body Fat and Its Distribution

Intra-abdominal fat
fat stored within the abdominal cavity in association with the internal abdominal organs, as opposed to the fat stored directly under the skin (subcutaneous fat)

Central obesity
excess fat around the trunk of the body fat that collects in the central abdominal area of the body may lead to diabetes, stroke, hypertension, and coronary artery disease
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Body Fat and Its Distribution

Fatfold measurements
provide an accurate estimate of total body fat and a fair assessment of the fats location about of body fat lies beneath the skin, so the thickness of this subcutaneous fat is assumed to reflect total body fat measures taken from central body sites better reflect changes in fatness than those taken from upper sites (arm and back)
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The Bodys Energy Budget

The Economics of Feasting

excess energy from carbohydrate, fat, protein and alcohol will be

stored in the body as fat fat from food, as compared with carbohydrate and protein is especially easy for the body to store in fat tissue
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The Bodys Energy Budget

The Economics of Fasting

the body spends energy all the time even when the person is asleep

and totally relaxed, the cells of many organs are hard at work cellular work, which maintains all life processes, represents about 2/3 of the total energy a person spends in a day (the other 1/3 is the work that a persons muscles do voluntarily during waking hours

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The Bodys Energy Budget

The Economics of Fasting
Energy Deficit
when food is not available, the body uses fuel reserves from its own tissues because it is the bodys priority to meet the energy needs for the ongoing cellular activity if the individual choose not to eat, it is called fasting if they have no choice, it is called starving

Glycogen used first

at the beginning of fast, liver glycogen and the bodys stored fat breakdown to glucose and fatty acids respectively and they flow into the cells to fuel work after several hours, most glucose are used up and liver glycogen is exhausted the decrease in blood glucose concentration signals more fat breakdown
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The Bodys Energy Budget

The Economics of Fasting
Glucose needed for the brain
the nervous system (including the brain and nerve cells) and RBCs cannot use fatty acids as source of energy, only glucose the nervous system consumes about 2/3 of the total glucose/day or around 400 to 600 kcal worth

Protein breakdown and ketosis

body protein tissues (liver and muscle) breakdown
for the first few days of fast body proteins provide 90% of needed glucose glycerol from TAG breakdown provide 10% of needed glucose after several weeks (>3 weeks) ketosis or ketone body production rises

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The Bodys Energy Budget

The Economics of Fasting

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The Bodys Energy Budget

The Economics of Fasting
Slowed metabolism
as fasting continues and the body is shifting to partial dependence on ketone bodies for energy, the body simultaneously reduces its energy output (metabolic rate) and conserves both fat and lean tissue because of the slowed metabolism, the loss of fat falls to a base minimum, thus, although weight loss during fasting maybe quite dramatic, fat loss may actually be less than when at least some food is supplied

Hazards of fasting
wasting of lean tissues impairment of disease resistance lowering of body temperature disturbances of the bodys fluid and electrolyte imbalance
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Diseases Related to Energy Balance and Eating Disorders

obesity
bulimia nervosa anorexia nervosa

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Obesity
Factors Causing Obesity
Genetics and weight
when both parents are obese, chances are the children are obese (~80%)

Lipoprotein Lipase (LPL)

LPL is an enzyme which promotes fat storage in fat cells and muscle cells; therefore, increased LPL activity stores more fat

Leptin
a protein coded for by a human gene called ob gene (obesity gene) expressed in fat cells acts on the hypothalamus suppressing hunger and increasing energy expenditure if the gene is defective, no leptin is produced and therefore can cause obesity
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Obesity

The mouse on the right is genetically obeseit lacks the gene for producing leptin. The mouse on the left is also genetically obese but remains lean because it receives leptin. agvargas

Obesity
Factors Causing Obesity
Fat Cell Development

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Obesity
Factors Causing Obesity
Set-Point Theory
proposes that body weight like body temperature is physiologically regulated people who lose weight on reducing diets quickly regain all their lost weight suggesting that somehow the body chooses a weight that it wants to be and defends that weight by regulating eating behaviors and hormonal actions the body adjusts metabolism whenever it gains or loses weight in the direction that returns to the initial body weight; energy expenditure increases with weight gain and decreases with weight loss

Environmental Stimuli
people may overeat in response to stimuli in their surroundings especially due to availability of delectable foods
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Obesity
Factors Causing Obesity
Physical Inactivity
people maybe obese not because they eat too much but because, they spend too little energy physical activity
is a necessary component of nutritional health needed if people are to eat enough food to deliver all the nutrients needed without unhealthy weight gain lowered to 1% by modern technology

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Obesity
Treatments obesity drugs
sibutramine
suppresses apetite most effective when used in combination with reduced kcalorie diets and increased physical activity side effects: dry mouth, headache, constipation, rapid high rate and high blood pressure

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Obesity
Treatments obesity drugs
orlistat
inhibits pancreatic lipase activity in the GI tract, thus blocking dietary fat digestion and absorption by 30% taken with meals of reduced kcalorie, low fat diet side effects: gas, frequent bowel movements and reduced absorption of fat soluble vitamins

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Obesity
Treatments surgery

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Bulimia Nervosa

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Bulimia Nervosa

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Bulimia Nervosa

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Bulimia Nervosa

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Bulimia Nervosa

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Anorexia Nervosa

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Anorexia Nervosa

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