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Energy balance

a) Understand the body’s need for energy
Living tissue is maintained by constant expenditure of energy (ATP),
which is obtained from food.
Energy requirements include growth, tissue repair, homeostasis and
muscular activity.
b) Know the components of energy intake and
expenditure
Typical UK diet contains 37% fat, 48%
carbohydrate and 11% protein (energy-wise).
However, fat yields per gram the greatest
amount of calories; 9.46C/g compared to
carbohydrates and proteins at ~4.7C/g.
Excess energy is stored as glycogen, in the
liver and muscle, and fat. Glycogen is a sort-
term source of carbohydrate for emergency
use and becomes limiting, so excess energy is
primarily stored as fat.
The major energy source in humans is triglycerides found in
adipocyte fat.
Energy taken in is expended in metabolism.
Anaerobic respiration produces 2 ATP from glucose.
Aerobic respiration produces ~38 ATP from glucose and ~129 ATP
from fat.
c) Define BMR and understand influencing factors
The Basal Metabolic Rate (BMR) is the rate of energy use by an
awake person at physical and mental rest in comfortably warm
environment at least 12h after last meal and 24h after hard
exercise.
The BMR provides energy for maintenance of temperature,
cardiovascular and respiratory function, muscle tone and other
essential activities of tissue and cells.
A number of factors influence the Basal Metabolic Rate:
• Body weight is the main determinant of BMR, so the higher
the body weight, the higher the BMR.
• Height and Weight jointly influence the BMR, so a tall thin
person will have a higher BMR than a short thin person, as
well as a short fat person will have a higher BMR than a short
thin person.
• Age is also a contributing factor in BMR. Growing children
have higher BMR’s as their brain, with the highest metabolic
rate in the body, represents larger proportion of body weight.
Elderly people have lower BMR’s as muscle and fat, with lower
metabolic rates; represent larger proportion of body weight.
• Gender influences BMR as men, whose bodies have a higher
% of muscle and lower % fat than women have a higher BMR,
as muscle has a higher metabolic rate than fat.
Overweight people have a higher BMR and thus need to consume
more calories daily to overweight status. If they stop over-eating,
high BMR will exceed energy intake and they will lose weight. As
weight falls, so does BMR until their weight stabilizes when energy
intake equals output.
d) Understand the effects of physical exercise on energy
expenditure
During physical activity, mechanical work associated with muscle
contraction requires energy, which is released either as heat during
ATP synthesis, or during muscular contraction through ATP
hydrolysis.
The Activity Energy Expenditure (AEE) is responsible for 15-30% of
total energy expenditure, and varies considerably between
individuals.
Weight training is anaerobic and burns carbohydrates, while
Cardiovascular exercises are aerobic and burn fat.
Energy intake is also closely linked to level of physical exercise,
because exercise stimulates hunger, a mechanism designed to
maintain body mass at a constant level in the face of rising energy
expenditure.
e) Define adaptive thermogenesis
Adaptive thermogenesis is heat production induced by diet (DIT),
environmental temperature (CIT), stress and drugs.
f) Describe the role of DIT and NEAT in response to over-
feeding
In Diet-Induced thermogenesis (DIT) energy is expended in the
chewing, digesting, absorbing, transporting, utilizing, storing and
excreting of food and nutrients.
10-25% of total calories in body are expended by DIT.
Large meals result in larger energy expenditure than small meals,
and DIT can differ apon composition of meals, as ATP expenditure
differs among macronutrients:
Fat 0 - 3 % of DIT energy
Carbohydrate 5 - 10% of DIT energy
Protein 20 - 30% of DIT energy
Alcohol 10 - 30% of DIT
energy
DIT is an adaptive response,
so that weight gain is opposed
by DIT when energy intake is
increased, giving rise to the
“Set Point” theory.

Non-Exercise Activity
Thermogenesis (NEAT) is
spontaneous physical activity
unrelated to exercise, such as
activities of daily living,
fidgeting and maintaining posture. NEAT also contributes to total
energy expenditure.
Obesity
Incidence of obesity has increased to over 150 million people
worldwide, and is a major risk factor for type II diabetes, heart
attack, stroke, breast and colon cancers.

a) Understand BMI as a measure of obesity
Body Mass Index (BMI) is the weight relative to height measurement
that is used to define obesity. A BMI over 30 diagnoses obesity.
b) Understand the origin of obesity in terms of energy
imbalance
Obesity is caused by a long-term positive energy balance where
energy intake is greater than energy expenditure, resulting in
production of fat stores.
c) Describe the action of leptin and gut hormones in
regulating feeding behaviour and energy expenditure
Energy intake is regulated by Hunger and Satiety (Physiological
Stimuli) and Appetite (Psychological Stimuli).
The hypothalamus, the area of the brain that controls eating
behavior, is acted on by Metabolic, Hormonal, Neural, and
Thermostatic signals, as well as Psychological factors.
The mechanism is based on the set-point model, that body weight is
maintained at a constant level by controlling eating behavior and
burning excess fuel.

Leptin, a peptide hormone
secreted by adipose cells, is
the hormone while controls
body weight. Leptin is secreted
in proportion to tissue mass, a
greater fat mass results in
greater Leptin levels in the
blood. This increased
concentration of Leptin signals
to the hypothalamus to inhibit
feeding and increase energy
expenditure.

Gut Hormones are short term
control of food intake and come in many forms:
• Ghrelin, which is secreted in an empty stomach between
meals, causes the hypothalamus to stimulate hunger.
• Incretins, secreted by the duodenum during and after a fatty
meal, causes inhibition of gastric acid secretion gastric
emptying, pancreatic enzyme secretion and guy motility, ALL
contributing to satiety.
• Thyroxin, produced by the thyroid gland, increases heat
production, basal metabolic rate and general alertness.
• Norepinephrine, produced by adrenal gland, stimulates
glycogenesis and lipolysis, expending energy as heat in
thermogenesis.
d) Understand the relevance of central deposition of fat in
the health risks associated with obesity
Men tend to deposit fat at regions around the chest and abdomen
(apple), while women tend to deposit fat at regions around the
abdomen and the hips (pear).
Fat accumulation around the abdomen has higher disease risk,
especially for cardiovascular disease, type II diabetes and high blood
pressure, as visceral (organ covering) body fat has greater access to
circulation.
e) Appreciate the role of genes and
environment in development of
obesity
Mouse ob gene encodes leptin protein, and
so a homozygous mutant ob/ob results in
the production of an inactive protein, which
further results in obesity.
Loss of function mutations in two individuals
caused increases appetite and constant
hyperphagia (eating too much). When
treated with leptin, the children regained
normal weight as treatment restores
function.

More than 300 genes linked with human obesity have been found,
with roles likely to control feeding, energy efficiency or
adipogenesis. Most common form of human obesity are polygenic,
with many of these genes each contributing to the relative risk for
the development of obesity.
f) Explain the basis of some weight-reducing diets
Low Carbohydrate diets, such as the Atkins diet, are modeled so
that the body burns fat instead of carbohydrates for energy. Dieters
are at risk of heart attacks and strokes due to the diets being high in
saturated fats.
Low Glycemic Index (GI) diets raise blood sugar level slowly so
insulin levels can control body sugar levels effectively.
High Protein Diets are low in energy, but don’t provide the nutrients
and vitamins that are essential for bodily functions.
Low Fat diets are critical to reducing body weight as fat contains
more than twice as many calories per g as protein and
carbohydrates.
Diets do not work as food intake is reduced, the “adipostat” in the
hypothalamus acts to maintain fat stores at the “set point” and
defend the body against weight loss.
g) Discuss the roles of exercise and drugs in the
treatment of obesity
Physical Activity promotes weight loss by increasing energy
expenditure in conjunction to reduced energy intake. It is shown tat
short bouts of four 10-minute sessions of activity results in greater
weight loss than a 40-minute long bout session.
Physical Activity also improves cardiovascular and metabolic health,
as well as minimizing loss of muscle.

Drugs that treatment obesity include:
Orlistat, which inhibits pancreatic lipase, leaving TriAcylGlycerols only partially
digested and thus not absorbed.
Phentermine - an appetite suppressant.
Sibutramine - a satiety enhancer that increases the level of satiety –inducing
neurotransmitters by preventing their reuptake from the synaptic cleft.