Nutrition and Diet Therapy (Finals) October 19, 2023

TRANSFORMATION OF ENERGY
1. Chemical energy - may be release during chemical reaction
2. Electrical energy - use for transmitting nerve impulses and
carrying out brain activity
3. Mechanical energy - muscle contractions
4. Thermal energy - regulation of body temperature
SOURCES OF STORED ENERGY
Glycogen - only 12-36 hour reserve of glycogen exist in liver and
muscle and is quickly depleted.
Adipose (fat) tissue - fat stores are generally the largest resource of
stored energy.
Muscle mass - energy stores in the form of muscle protein.
ENERGY BALANCE: body weight is maintained when calories
eaten equal the number of calories the body expends or burns.
Overweight-a person weights more according to standard of height
and weight.
Obesity -when overweight is the result of excessive body fat rather
than enhanced muscle or skeletal tissue.
OBESITY
defined as excess fat accumulation under the skin and around
the organs in the body.
weight-related health problems can be divided into four categories:
1. Metabolic
• type 2 diabetes
• Dyslipidemia (elevated blood lipids, high cholesterol)
2. Degenerative
-osteoarthritis and joint problems and pulmonary diseases
3. Neoplastic
- any forms of cancer (endometrial breast, colon, prostate, and
ovarian)
4. Anatomic
•individuals exceeding a healthy weight have a greater risk of
gastrosophageal reflux disease (GERD) and obstructive sleep apnea
How to Achieve Weight Loss
1. Diet therapy
-consume highly nutritious food vegetable, high fiber
grains, heart-healthy protein such as sea food and low fat dairy.
2. Behavior change method or Behavior modification
-regardless of which type of eating pattern for weight loss,
true behavior change is a must.
WEIGHT CONTROL: BEHAVIOR MODIFICATION
TECHNIQUE

Subcutaneous fat - fat accumulated in the lower body (the pear Self-Monitoring
shape). -keep a food diary and record all food intake
Visceral fat - fat in the abdominal area (the apple shape) -keep a weekly graph of weight change
-keep an exercise diary
*abdominal fat correlates more with health risks such as
cardiovascular disease and type 2 diabetes.
*in women, it also correlates with breast cancer risk and gallbladder
disease.
Stimulus Control -at home limit all food intake
Obesity and Health
Nutrition and Diet Therapy (Finals) October 19, 2023

Slowed down eating -drink a glass of water before each meal. Take intake. The size of the opening can be controlled via a balloon inside
sips between bits of food the band.
-try to be the last one to finish eating
•Roux-en-Y gastric bypass (RYGB). Food intake is limited
Reward Yourself -chart your progress as surgeons create a small pouch for the stomach. This pouch is then
-make an agreement with yourself for a meaningful connected to a different part of the intestine (bypassing the stomach
reward -don’t reward yourself with food and duodenum), thereby changing the way food is absorbed. The
pouch is only about the size of a walnut.
Cognitive Strategies -view exercise as a means of controlling
hunger Underweight
-practice relaxation techniques extreme underweight is associated with serious health
problems in all age group.
3. Physical activity
-staying physically active to build and preserve muscle, in General causes of Malnutrition - Poor food intake - Increase in
tandem with a healthier diet, are the ingredients for weight loss and energy requirements - Poor utilization of available nutrients
healthy weight maintenance
Interventions
Benefits of Physical Activity
-Eat frequently (five or six small meals per day) to avoid feeling full.
THE BRAIN BENEFITS OF EXERCISE
-Eat food that are dense in nutrients and calories (e.g., nuts, seeds,
•INCREASES PRODUCTION OF NEUROCHEMICALS THAT dried fruit, egg, avocado, yogurt). Limit heavy amounts of sugar or
PROMOTE BRAIN CELL REPAIR unhealthy fats.
•IMPROVES MEMORY
•Lengthens memory SPAN -Add healthy fat to food in cooking such as olive or canola oil or
•Boosts Decision Maling Skills mayonnaise. Butter, whole milk, and cheese have higher amounts of
•Prompts Growth of New Nerve Cells and Blood saturated fats and may need to be used with a little more discretion in
Vessels •Improve Multitasking and Planning those with cholesterol concerns.

4. Weight Loss Drugs
-xenical (1990) reduces the body's ability to absorb fats from
foods
-fenfluramine, Meridia
5. Surgery
• Adjustable gastric band (AGB). A small bracelet-like band
is placed around the top of the stomach to restrict the size of the
opening from the throat to the stomach, thereby reducing food
-Pack foods to eat when away from home so there are no gaps in
eating if a restaurant is not convenient.
-Check out high-calorie snack recipes to make at home such as milk
shakes and puddings and dense foods such as a homemade peanut
butter granola bar.
-Consider supplement drinks to boost calories as needed.
-Encourage parents of underweight children to provide support, but
not threaten, bribe, or force-feed their child, as their child will
engage in the opposite behavior and back away from the food.
EATING DISORDER: A High Prize for Thinness
Nutrition and Diet Therapy (Finals) October 19, 2023

-are considered to be medical illnesses and lead to nutritional • Growth of fine hair over body (e.g. lanugo)
deficiencies, medical complications. and in the extreme, disability • Brittle hair and nails
and death. -Muscle weakness and lethargy
• Drop in internal body
- are mental illnesses that cause or marked by in a person's everyday temperature, causing the person to feel cold all the time
diet it can manifest as eating extremely small amounts of food or • Severe constipation
severely overeating and obsession with food or body shape. They can • Low blood
affect anyone, but most prevalent in young women. pressure, slowed breathing and pulse
Causes of Eating Disorders Health Risk with Anorexia
This may be caused by several factors, including geneties, brain - Heart failure
biology. personality traits, and cultural ideals. - Kidney failure
Biologic - factors can Influence the development of eating - low protein stores
disorders. Genetic predisposition and alteration in central nervous - digestive problems
system (CNS) activity can directly affect food behavior 2. Bulimia Nervosa (binge and purge syndrome)
Psychologic - levels of serotonin and other neurotransmitters can - an eating disorder in which cycles of gorging on large quantities of
result in psychologic conditions such as depression that indirectly food are followed by self-induced vomiting and use of diuretics or
influence the development of eating disorders. laxatives to avoid weight gain.
Types of Eating Disorders - People with bulimia nervosa uncontrollably consume large amounts
of food in short periods of time, then purging using laxatives, or over
1. Anorexia Nervosa extreme psycho-physiologic aversion to food exercising to rid themselves of the food they ate. They fear gaining
resulting in life-threatening weight loss. weight despite being at a normal weight.
- an eating disorder causes by a morbid fear of fat in which a Clinical signs
distorted body image is reflected as fat when the body is actually
malnourished and thin from self-starvation. • Growth status is generally normal
• Poor concentration
-Chronically inflamed and sore throat
Clinical signs: • Swollen glands in the neck and below the jaw from chronic
vomiting
• Arrested growth and maturation
• Worn tooth enamel and increasingly sensitive and decaying teeth as
• Underweight (body mass index (BMI<17.5 or body weight <85%
a result of exposure to stomach acids
of expected weight for height and gender)
• Intestinal distress and irritation from laxative abuse
• Amenorrhea (cessation of menstruation)
• Gastroesophageal reflux disorder
•Poor concentration
• Dry and yellowish skin
Nutrition and Diet Therapy (Finals)
Health Risk with Bulimia
- Dental problems
- Stomach rupture
- Menstruation irregularities
Binge Eating Disorder
People with binge eating disorder regularly and uncontrollably
consume large amounts of food in short periods of time. Unlike
people with other eating disorders, they do not purge.
COMMON SYMPTOMS OF BINGE EATING DISORDER
• Eating large amounts of food rapidly, in secret an until
uncomfortably full, despite not feeling hungry.
• Feeling of lack of control during episodes of binge eating.
• Feeling of distress, such as shame, disgust, or guilt, when thinking
about the binge-eating behavior.
• No use of purging behaviors such as calorie restriction, vomiting,
excessive exercise, laxative or diuretic use, to compensate for the
binging.
Health Risk with Binge Eating Disorder
- High blood Pressure
- High cholesterol
- Gall bladder disease
- diabetes
- heart disease
- certain type of cancer
Pica
Pica is another eating disorder that involves eating things
that are not considered food. They crave non-food substances such as
ice, dirt, soil, chalk, soap, paper, hair, cloth, wool, pebbles, laundry
detergent, or cornstarch.
This disorder is most frequently observed in children,
pregnant women, and individuals with mental disorders. Individuals
with pica may be at an increased risk of poisoning, infections, gut
Injuries, and nutrition deficiencies.
October 19, 2023
Depending on the substances ingested, pica may be fatal.
Types of Pica
• Amylophagia (consumption of starch and paste)
• Coprophagia (consumption of excrement)
• Geophagy (consumption of soil, clay, or chalk)
Consumption of dust or sand has been reported among iron
deficient patients.
• Hematophagy (ingestion of blood)
• Hyalophagia (consumption of glass)
• Pagophagia (pathological consumption of ice)
•Self-cannibalism (rare condition where body parts may be
consumed
• Trichophagia (consumption of hair or wool)
• Urophagia (consumption of urine)
• Xylophagia (consumption of wood)
• Cautopyreiophagia (ingestion of burt match heads).
Rumination Disorder
A condition in which a person regurgitates food they have
previously chewed and swallowed, re-chews it and then either re-
swallows it or spits it out.
This rumination typically occurs within the first 30 minutes
after a meal. Unlike other medical conditions, such as reflux, it is
voluntary.
This disorder can develop during infancy, childhood, or
adulthood. In infants, it sends to develop between 3 to 12 months and
often disappears on its own. If not resolved, rumination disorder can
result in weight loss and severe malnutrition which can be fatal.
AVOIDANT/RESTRICTIVE FOOD INTAKE DISORDER
This disorder is characterized by failing to meet your
minimum daily nutrition requirements because you don't have an
interest in eating; you avoid a certain sensory characteristic, such as
color, texture, smell, or taste.
Nutrition and Diet Therapy (Finals) October 19, 2023

ARFID can result in significant weight loss or failure to gain

weight in childhood, as well as nutritional deficiencies that can cause
health problems.

COMMON SYMPTOMS OF ARFID

• Avoidance or restriction of food intake that prevents the person
from eating sufficient calories or nutrients.
•Eating habits that interfere with normal social functions, such as
eating with others.
• Weight loss or poor development for age and height.
• Nutrition deficiencies or dependence on supplements or tube
feeding.

Other Nutrition Disorders

Purging Disorder, individuals with this disorder often use purging
behaviors such as vomiting, laxatives, diuretics, or excessive
exercising, to control their weight or weight. However, they do not
binge,
Night Eating Disorder, individuals with this disorder frequently eat
excessively, often after awakening from sleep.

OTHER NUTRITION DISORDERS

Orthorexia, individuals tend to have an obsessive focus on healthy
eating, to an extent that disrupts their daily lives. For instance, a
person may eliminate entire food groups, fearing unhealthy. This can
lead to malnutrition, severe weight loss, difficulty eating outside the
home and emotional distress. Individuals with orthorexia rarely focus
on losing weight. Instead, their self-worth, identify or satisfaction is
dependent on how well they comply with their self-imposed diet
rules.

Prevention and treatment

requires medical nutrition therapy and psychotherapy.