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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 sortterm 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 overfeeding 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.
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.
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