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Weight Management

Weight Management. Achieving and Maintaining a Healthful Body Weight 5/9/07. What is a Healthful Body Weight?. A healthful weight Is appropriate for your age Is maintained without constant dieting Is acceptable to you Is based on family history of body shape and weight

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Weight Management

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  1. Weight Management • Achieving and Maintaining a Healthful Body Weight • 5/9/07

  2. What is a Healthful Body Weight? • A healthful weight • Is appropriate for your age • Is maintained without constant dieting • Is acceptable to you • Is based on family history of body shape and weight • Promotes good eating habits and allows for regular physical activity

  3. What is a Healthful Body Weight? • Underweight: having too little body fat to maintain health. • Overweight: having a moderate amount of excess body fat.

  4. What is a Healthful Body Weight? • Obese: having an excess of body fat that adversely affects health. • Morbid obesity: body weight exceeding 100% of normal, creating a very high risk for serious health complications.

  5. Evaluating Body Weight • A person’s actual weight is not the only factor to consider. • Determining if a person’s body weight is healthful should include: • Determining the Body Mass Index (BMI) • Measuring body composition • Assessing the pattern of fat distribution

  6. Evaluating Body Weight • Body Mass Index • Expresses the ratio of a person’s weight to the square of their height • BMI = weight (kg) / height (m)2 • BMI values below 18.5 or above 30 have increased risks of health problems

  7. Mortality risk vs. BMI

  8. Evaluating Body Weight

  9. Evaluating Body Weight • Body Composition • Measurement of body fat and lean muscle mass • Can be measured by • Underwater weighing • Skinfold measurements • Bioelectric impedance analysis • Near infrared reactance • Bod Pod™

  10. Evaluating Body Weight

  11. Evaluating Body Weight

  12. Evaluating Body Weight • Fat Distribution Pattern • Measured by waist-to-hip ratio and waist circumference • Apple-shaped fat patterning - upper body • Increased risk for chronic diseases • Pear-shaped fat patterning – lower body • No significant increased risk for chronic diseases

  13. Evaluating Body Weight

  14. Gaining or Losing Weight • Whether a person gains or loses weight depends on • Energy intake vs. energy expenditure • Genetic factors • Childhood weight • Behavioral factors • Social factors

  15. Energy Balance • Energy balance • Occurs when energy intake = energy expenditure • Energy intake = kcal from food • Energy expenditure = energy expended at rest and during physical activity

  16. Energy Balance

  17. Energy Balance

  18. Energy Balance

  19. Energy Intake • Calculating the energy that is in a particular food • Carbohydrate is 4 kcal/g • Protein is 4 kcal/g • Fat is 9 kcal/g • Alcohol is 7 kcal/g • 1 cup of quick oatmeal has 142 kcal • 6 grams protein x 4 kcal/gram = 24 kcal • 25 grams carbohydrate x 4 kcal/gm = 100 kcal • 2 grams fat x 9 kcal/gram = 18 kcal • Total kcal = 24 kcal + 100 kcal + 18 kcal = 142 kcal

  20. Total Energy Expenditure • Total energy expenditure = • basal metabolic rate (BMR) • + thermic effect of food (TEF) • + energy expended in physical activity

  21. Energy Balance • Basal Metabolic Rate (BMR) • Energy expended to maintain basal, or resting, functions of the body • Basal metabolism is the highest proportion of total energy expenditure • More lean tissue increases your BMR • BMR decreases with age

  22. Energy Balance • Thermic Effect of Food (TEF) • Energy expended to process food

  23. Physical activity

  24. Genetic Factors • Genetic factors account for about 25% of a person’s body fat. • Different ideas have been suggested to explain the impact of genetics on body fat. • Thrifty Gene Theory • Set-point Theory • Leptin Theory

  25. Genetic Factors • Thrifty Gene Theory • Proposes that a gene (or genes) causes people to be energetically thrifty • Proposes that people with this gene expend less energy than other people and therefore gain weight • A “thrifty gene” has not been identified

  26. Genetic Factors • Set-Point Theory • Proposes that each person’s weight stays within a small range (set point) • The body compensates for changes in energy balance and keeps a person’s weight at their set point

  27. Physiologic factors • Hunger • Proteins released by body (hormones, peptides)

  28. Physiologic Factors • Leptin • Leptin is a hormone produced by fat cells that causes reduced food intake, reduced weight, decreased body fat • Leptin is controlled by the ob gene • Mutation of the ob gene causes reduced levels of leptin leading to increased food intake and reduced energy output

  29. Physiologic Factors • Ghrelin • Ghrelin is synthesized in stomach, functions as a hormone • Role in appetite regulation through its actions on the hypothalamus • Stimulates appetite, increases amount of food one eats

  30. Physiologic factors • Peptide YY (PYY) • PYY is produced in the gastrointestinal tract • Released after meal in proportional amounts to the energy content of the meal. • Functions to decrease appetite, decrease food intake • May play important role in obesity

  31. Childhood Factors • Environmental factors in childhood can influence • Food choices • Activity levels • Later adult behaviors • Childhood overweight increases the risk of heart disease and premature death as an adult.

  32. Behavioral Factors • Food Choices • The composition of a person’s diet should remain balanced. • Hunger vs. Appetite • Appetite, a psychological desire to eat, can cause people to overeat.

  33. Social Factors • Social factors influencing our diet include: • Family or cultural traditions • Holidays and celebrations • Easy access to high-fat foods • Less physically active lifestyles • Societal expectations of the “perfect” body

  34. Determining Kilocalorie Needs • The most accurate way to determine your energy needs: • Calculate your BMR • BMR = weight (kg) x 1.0 (for men) • BMR = weight (kg) x 0.9 (for women) • Add the energy required to maintain your activity level to your BMR

  35. Achieve & Maintain Healthful Weight • Healthful weight change requires • Gradual change in energy intake • Regular and appropriate physical exercise • Application of behavior modification techniques

  36. Achieve & Maintain Healthful Weight • Effective weight loss should include • Following recommended serving sizes • Reduced intake of high-fat and high-energy foods • Regular physical exercise • To increase energy expenditure • To increase BMR

  37. Achieve & Maintain Healthful Weight • Weight loss medications and herbal supplements: • May have dangerous side effects • Many have been removed from market • Should only be used if a person has • A BMI of 30 kg / m2 • A BMI of 27 kg / m2 and other health risk factors

  38. Achieve & Maintain Healthful Weight • Effective weight gain should include • Eating 500 to 1,000 extra kcal/day • Eating frequently throughout the day • Maintaining a balanced diet, limiting fat intake to 15-30% of total energy intake • Avoiding tobacco products which depress appetite and increase BMR • Regular exercise with resistance training

  39. Protein supplements • Do not increase muscle growth or strength • Claim to be anabolic (increase muscle mass) • Protein supplements • Androstenedione (affects HDL and LDL negatively)

  40. Anabolic steroids • Cause major health problems, including: • Unhealthy changes in blood cholesterol • Mood disturbances • Testicular shrinkage in men • Breast enlargment in men • Irreversible clitoral enlargement in women

  41. Disorders Related to Energy Intake • Underweight • BMI below 18.5 kg / m2 • Increases the risk of infections and illness and can even be fatal • Can be just as unhealthy as overweight

  42. Disorders Related to Energy Intake • Overweight • BMI between 25 and 29.9 kg / m2 • Increases the risks of high blood pressure, heart disease, type 2 diabetes sleep disorders, osteoarthritis, gallstones • Can lead to obesity

  43. Disorders Related to Energy Intake • Obesity and Morbid Obesity • Obesity: BMI from 30 to 39.9 kg / m2 • Morbid obesity: weight that exceeds 100% of normal • 5 of the 9 leading causes of death in the US are associated with obesity • A multifactorial disease – many things cause obesity

  44. Disorders Related to Energy Intake

  45. Disorders Related to Energy Intake • Treatments for obesity may include • Low-calorie diet and regular exercise • Prescription medications • Surgery • Gastroplasty • Gastric bypass • Gastric banding

  46. Disorders Related to Energy Intake

  47. Disorders Related to Energy Intake

  48. Great websites for BMI calculation • National Heart, Lung, and Blood Institute: BMI Calculatorhttp://www.nhlbisupport.com/bmi/bmicalc.htm • Centers for Disease Control: BMI Calculator and Factors that Affect BMIhttp://www.cdc.gov/nccdphp/dnpa/bmi/bmi-for-age.htm

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