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Nutrition chapter 9

overweight
body weight above a healthy weight. BMI 25 to 29.9
underweight
body weight below a healthy weight. BMI below 18.5
it isnt your weight you need to control; its the ______ or ______
fat, adipose tissue, in your body in proportion to the lean- your body composition
you cant control bodu composition but you can control behaviors
adipose tissue
the body’s fat tissue. it performs several functions, including the syntesis and secretion of the hormones leptin involved in apetitie regulation
body composition
the proportions of muscle, bone, fat and other tissue that make up a person’s total weight
obesity
over-fatness with adverse health effects, as determined by reliable measures and interpreted with good medical judgments. BMI of 30 or higher
obesity statistics in the US
1960: 13%
today: 68%
children: 17%
obesity is a disease
risksof being underweight
affects fewer than 2% of americans
1) malnutrition
2) early death
3) surgical complications
4) pressure to gain weight. fat is needed for adequate nutrients
risks of too mich body fat?
1) 300,000 lives would be saved and $147 billion spent on abesity related health care
2) extra productivity would pump $73 billion into the national economy
3) can develop heart disease and cancer
In obesity, a shift in the balance of ______ which favor both tissue inflammation and insulin resistance.
adipokines,
this may lead to diabetes, heart disease, and other chronic diseases
extreme obesity
clinicallt severe overweight, presenting very high risks to health, the condition pf having BMI of 40 or higher (morbid)
adipokines
protein hormones made and released b adipose tissue cells
visceral fat
fat stored within the abdominal cavity in association with the internal abdominal organs. this poses greater risks for chronic disease
subcutaneous fat
fat stored directly under the skin of the abdominal, thighs, hips, and legs. Less of a threat for chronic disease.
disease risks of obesity
70% of obese people suffer from at least one
1) Diabetes
2) Heart disease
3) Hypertension (high blood pressure)
4) Gallbladder stones
5) Nonalcoholic fatty liver leading to fibrosis, cirrhosis, and cancer
Other cancers
Stroke
How is obesity defined?
How is obesity defined?
Using the BMI
Central obesity
excess fat in the abdomen and around the trunk. elevates the risk of death from all causes.
Visceral adipose tissue
Visceral adipose tissue
releases more fatty acids into the blood than other types of fat tissue, contributing to a blood lipid profile associated with the metabolic syndrome that predicts heart disease.
Apple body type signals this (older people)
pear is normal (younger people)
Two other factors also affect body fat distribution:
Moderate to high intakes of alcohol associate directly with central obesity.

Higher levels of physical activity correlate with leanness

metabolic syndrome
a combination of central obesity, high blood glucose (insulin resistance), high blood pressure, and altered blood lipids that greatly increase the risk of heart disease
body mass index (BMI):
an indicator of obesity or underweight, calculated by dividing the weight of a person by the square of the person’s height. 20yrs+

two draw backs:
1) fail to indicate how much of a person’s weight is fat
2) where that fat is located

Obesity is measured in three ways
1) BMI
2) waist circumference
3) disease risk profile
waist circumference
a measurement of abdominal girth that indicates visceral fatness
Body’s energy balance
when more food energy is consumes than is needed over days or weeks, excess fat accumulates in the fat cells in the body’s adipose tissue where it is stored.

Change in energy stores = energy in 2 energy out.
Too much or too little fat on the body today does not necessarily reflect today’s energy budget.35 Small imbalances in the energy budget compound over time.

What determines energy spent
What determines energy spent
energy expenditures vary so widely amoug people that estimating an individual person’s need requires knowing something about the person’s lifestyle and metabolism
how many calories do you need?
you need to take in enough calories to cover your energy expenditure each day.
energy output is measured in two ways
1)basal metabolism
2) voluntary activities
basal metabolism
the sum of total of all the involuntary activities, that are necessary to maintain life, including circulation, respiration, nerve activity, etc. but excludes digestion and voluntary activities. largest component of daily energy exenditure
voluntary activities
intentional activities (such as walking, sitting, or running, conducted by voluntary muscles
thermic effect of food
the body’s speded- up metabolism in response to having eaten a meal.
basal metabloic rate (BMR)
basal metabloic rate (BMR)
the rate at which the body uses energy to support its basal metabolism.
In General:
Women 1300 – 1500 calories
Men 1500 – 1900 calories (they have more muscle therefore a faster metabolism rate)
Factors that affect BMR
Factors that affect BMR
What increases your metabolic rate?
1) More muscle
2) Height
3) Growth
4) Fever
5) Stresses
6) Smoking
7) caffeine
What decreases your metabolic rate?
1) Less muscle and more fat
2) Fasting/Starvation
3) Malnutrition
4) Aging
5) Sleep
estimated energy requirement (EER)
DRI recommendation for energy intake, accounting for age, gender, weight, height, and physical activity

reflect the needs of only those people who exactly match the characteristics of the “reference man and woman

(Men) EER ± 200 cal. (Women) EER ± 160 cal.
Virtually everyone’s energy requirement falls within these larger ranges:
(Men) EER ± 400 cal. (Women) EER ± 320 cal

DRI Method for Est. Energy
Gender. Women generally have less lean body mass than men; in addition, women’s menstrual hormones influence the BMR, raising it just prior to menstruation.

Age. The BMR declines by an average of 5 percent per decade, as mentioned, so age is a determining factor when calculating EER values.

Physical activity. To help in estimating the energy spent on physical activity each day, activities are grouped according to their typical intensity.

Body size and weight. The higher BMR of taller and heavier people calls for height and weight to be factored in when estimating a person’s EER.

Growth. The BMR is high in people who are growing, so pregnant women and children have their own sets of energy equations.

What increases calories burned during exercise?
More Muscle mass

Higher Body weight

Activity
-duration
-frequency
-intensity

2 Most important tools for keeping weight off?
1) healthy food choices
2) excercise
Food choices affected by:
Hunger

Appetite

Satiation

BMI calculations
In pounds and inches
weight (lb) × 703BMI = height (in.2)
4 Disadvantages of the BMI
4 Disadvantages of the BMI
Athletes (because their highly developed musculature falsely increases their BMI values).

Pregnant and lactating women (because their increased weight is normal during child-bearing).

Adults older than age 65 (because BMI values are based on data collected from younger people and because people “grow shorter” with age).

Women older than age 50 with too little muscle tissue (they may be overly fat for health yet still fall into the normal BMI range)

3 types of body fat testing
1) skinfold
2) hydrostatic weighting
3) bioelectric impedance
skin folding
measurement of the thickness of a fold of skin and subcutaneous fat on the back of the arm, below the shoulder blade, or places using a caliper
Dual-energy X-ray absorptiometry (DEXA).
Two low-dose X-rays differentiate among fat-free soft tissue (lean body mass), fat tissue, and bone tissue, providing a precise measurement of total fat and its distribution in all but extremely obese subjects.
How much is ideal??
If the answer is “health,” then the ideal depends partly on your lifestyle and stage of life.

For example, competitive endurance athletes need just enough body fat to provide fuel, insulate the body, and permit normal hormone activity but not so much as to weigh them down.

Hungar
the physiological need to eat, experienced as a drive for obtaining food, an unpleasant sensation that demands relief. must eat every 4-6hrs
satiation definition
the perception of fullness that builds throughout a meal, eventually reaching the degree of fullness and satisfaction that halts eating, generally determines how much food is consumed at one sitting
satiety definition
the perception of fullness that lingers in the hours after a meal and inhibits eating until the next mealtime. generally determines the length of time b/w meals
gherlin
a hormone released by the stomach that signals the brain’s hypothalamus and other regions to stimulate eating (growling)
appetite
the psychological desire to eat; a learned motivation and a positive sensation that accompanies the sight, smell, or thought of appealing foods
factors affecting appetite
Appetite stimulants or depressants, other medical drugs.

Cultural habits (cultural or religious acceptability of foods).

Environmental conditions (people often prefer hot foods in cold weather and vice versa).

Hormones (for example, sex hormones).

Inborn appetites (inborn preferences for fatty, salty, and sweet tastes).

Learned preferences (cravings for favorite foods, aversion to trying new foods, and eating according to the clock).

Social interactions (companionship, peer influences).

Some disease states (obesity may be associated with increased taste sensitivity, whereas colds, flu, and zinc deficiency reduce taste sensitivity).

satiation process
Eat every 4hrs
Brain receives signals
Decrease interest in food and meal size – Usually…

Comes from many organs:
Sensations in the mouth associated with greater food intake trigger increased satiation.

Nerve stretch receptors in the stomach sense the stomach’s distention with a meal and fire, sending a signal to the brain that the stomach is full.

As nutrients from the meal enter the small intestine, they stimulate other receptor nerves and trigger the release of hormones signaling the hypothalamus about the size and nature of the meal.

The brain also detects absorbed nutrients delivered by the bloodstream, and it responds by releasing neurotransmitters that suppress food intake.

Stomach ajusts to______
meals eaten. If a person usually eats small meals but eats a larger meal, they may feel uncomfortably full because the stomach has adapted to smaller foods
satiety process
Suppression of hunger
Hormones and Signals used to sustain feelings of fullness
Leptin is released to alert that food is needed
leptin
travels from the adipose tissue via the bloodstream to the brain’s hypothalamus, where it promotes the release of neurotransmitters that both suppress appetite and increase energy expenditures and, ultimately, body fat loss.
Ultimately controlled by fat tissues
affected by meal composition.
proteins sate hunger longer than added sugars
Inside-the-Body Theories of Obesity
Set-point theory
-Body organs regulate body fatness

Thermogenesis
-Brown adipose tissue (BAT)

Genetics and obesity
-Influence tendency to gain weight or stay lean
-Environmental factors

Set-point theory
theory stating that the body’s regulatory controls tend to maintain a particular body weight overtime, opposing efforts to lose weight by dieting
Thermogenesis
the generation and release of body fuels. describes adjustments in energy expenditure related to changes in environment such as to and to psychological events such as underfeeding or truama
Brown adipose tissue (BAT)
a type of adipose tissue abundant in hibernating animals and human infants and human adults. abundant pigmented enzymes of energy metabolism give BAT a dark appearance under microscope. the enzymes release heat from fuels without doing other work
Genetics and Obesity
1) genetic variation might reasonably be expected to explain why some people get fat while others stay lean
2) environmental factors- tempted with savory foods
Outside-the-Body Theories of Obesity (food supply and external cues)
External cues to overeating
-Available foods (being exposed)
-Human sensations (loneliness, yearning, craving)
-Larger portions (eat the large portions given)

Food supply
Addictive? yes
Dopamine is released for a pleasurable feeling after eating. These releases decrease after a while therefore more food is needed to supply this pleasurable high

Outside-the-Body Theories of Obesity (physical, neighbohoods)
Physical inactivity
-Screen time (electronics replaced outdoor play , )
-Sedentary jobs

Neighborhoods (unsafe, encouraging)
-Built environment
-Food deserts (no access to fresh, healthy food)

National goals to slow or reverse obesity epidemic

built envrionment
the building, roads, utilities, homes, etc, form a physical the physical characteristics of a community
food deserts
urban and rural low-income are with limited access to affordable and nutritious foods
Community Strategies to Combat Obesity
Community Strategies to Combat Obesity
How the Body Loses and Gains Weight
Tissue lost or gain
-Depends on what you do
-Water (lose or gain water weight)

Fat or muscle (burning fat/ gaining muscle)

Smoking (stunts appetite)
-Hazards
tobacco related illnesses

Moderate Weight Loss vs. Rapid Weight Loss
Gradual weight loss is preferred (lean body mass is spared while fat is lost)

Fasting
-Body adjustments (converts protein to glucose)
-Sacrifice lean tissue for raw materials to make glucose
-Death after 10 days

Ketosis
-Break down of fat molecules to make ketone bodies, the feed the brain when too little carbs are available

Moderate Weight Loss Versus Rapid Weight Loss (fasting, technique)
Short-term fasting
-Seems to be tolerated
-Effects of deprivation (increase appetite, damage tissues)
-Overeat or binge eating
Weight loss technique
-Slowing of metabolism
Ketosis upsets the acid-base balance (excess mineral loss)
-DRI minimum carbohydrate intake level (130/day)
Weight Gain
Energy-yielding nutrients contribute to body stores
-Four sources of energy (proteins, carbs, fat, alcohol)
-Alcohol (converted to fat)
-Two types of energy stores
1) glycogen
2) fat

An excess of any food will become fat

Achieving and Maintaining a Healthy Body Weight
What is your motivation?

Three realms to produce results:
1) eating patterns
2) physical activity
3) behavior modification

Reality check

Set achievable goals

Keep records

Dodging Fad-Diet Detours
Effectiveness
Both sides of the coin
Are fad diets nutritious?
Recommended supplements
Are the diets safe?
Success for the fad-diet industry is built on failure for the dieter
What Food Strategies Are Best for Weight Loss?
Appropriate calorie intakes
-Minimum calorie recommendations
-Composition of weight loss (weight lost early in dieting may be composed of a greater % of water and lean tissue)

Adequate intakes (of fresh fruit and veggies)
-Supplements (provides vitamins/ minerals

Portion sizes (larger portions increase energy intake)
-Read labels (compare calories per serving)

Meal spacing (three meals a day)
-Snacking (save calorie- free foods for snacks)

night eating syndrome
daily calories consumed after 7 p.m. frequent nighttime awakening to eat, and a high calorie intake
energy density
energy density
a measure of the energy provided by a food relative to its weight
What Food Strategies Are Best for Weight Loss? 2 (calories)
Calorie excesses (limit)
-Little daily decisions add up

Low energy density foods (provides more food and greater satiety for the same number of calories)
-May not reflect nutrient density
(nutrient per calorie) low fat milk and soft drinks weigh the same but have different nutritional values

Nonnutritive sweeteners
-tricks the brain into craving more calories.

The “Best Way to Lose Weight for Good” Diet
Exercise=success

Well-balanced meal plan
-Excess calories from protein, carbohydrates, or fat can make you gain weight

Behavior change (strive to eat healthy foods. stop eating bad foods)

How many pounds/week is safe? a pound or two

Physical Activity in Weight Loss and Maintenance
Weight loss
-Physical activity alone ( not easily achieved by itself)

Advantages of physical activity
-Feelings of satiation (reduces daily food intakes and heightens the feeling during meals)
-Lean tissue (added healthful tissue, burns more calories
-Bone loss (avoided b proper diet that meets calcium and protein needs
-Stress (promotes restful sleep, reduce food consump.)
-Warning ( non-athletes can negate any calorie burned by eating a “treat”

Choosing activities
moderate-to- vigorous aerobic exercise along with strength training

More Advantages of Physical Activity
Increase muscle and metabolic rate

decrease body fat

Burns calories—you get to eat more

curbs appetite

increase self-esteem

increase physical well-being

What Strategies Are Best for Weight Gain?
High energy density (high in fat)
-Increased daily caloric intake
-Choose nutritious foods (unsaturated fats)

Portion sizes and meal spacing (increase portion sizes; eat frequently)

Physical activity(gain muscle and fat)
-Resistance training (building muscle and increase healthy body mass)

Medical Treatment of Obesity
Medical Treatment of Obesity
Obesity medications
-Over-the-counter (OTC) -medications (No associated with successful weight loose or maintenance)
-Prescription medications (help only temporary while they are being taken)

Obesity surgery (limit a person’s food intake by reducing the size of the stomach and delaying the passage of food to the intestine)
-Extreme obesity (40 or above)
-Not a sure cure (do not lose or gain back the weight)
-Complications (nausea, internal hernia, repeated surgeries)

Herbal Products and Gimmicks
Herbals and botanicals
-Sold as ‘dietary supplements but are harmful to the body’
-Lack of FDA approval because they can have serious consequences like cardiac arrest

other gimmicks
-Saunas or steam baths do not melt the fat away. they just get rid of water weight which can lead to dehydration
-Cellulite it is simply fat, awaiting the body’s call for energy. These gimmicks are useless against it

botanical
pertaining to or made from plants; any drug, medicinal preparation, dietary supplement, or similar substances obtained from a plant
Once I’ve Changed My Weight, How Can I Stay Changed?
Lifelong commitment
-keeping healthy habits

Self-efficacy and keys to success ( personal belief of success; address small lapses)
-Physical activity (regulatory)
-Weight cycling (yo yo dieting)

Support groups (group support, team work)

weight cycling (yo yo dieting)
repeated rounds of weight loss and subsequent regain, with reduced ability to lose weight with each attempt.
Behavior Modification for Weight Control
Behavior modification
-Change behavior
-Change thought processes

Food and activity diary
-Don’t attempt to modify all behaviors at once. Set priorities and change them few at a time.

behavior modification
alteration of behavior using methods based on the theory that actions can be controlled based on the theory that actions can be controlled by manipulating the environment factors that cue the actions
cognitive skills
changes to conscious thoughts with the goal of improving adherence to lifestyle modification

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