Energy Balance and Obesity1. What are the components of the energy balance equation? Does the macronutrient breakdown of the diet matter in terms of energy balance? Why or why not?- the components of the energy balance equation are energy in, energy out, and body fatness. 2. What constitutes “energy in” and how is it measured? What are some limitations to measuring “energy in”?• The "energy in" side of the body's energy budget is measured in calories taken in each day in the form of foods and beverages.• Calories in food and beverages can be estimated using the exchange system, obtained from published tables or computerized diet assessments.3. What are the three components of “energy out” and what percentage of overall energy expenditure is accounted for by each component?- The three components of “energy out: are basal metabolism, voluntary activities (the two majorones) and the “thermic effect of food”.4. How is Basal Metabolic Rate calculated (be able to calculate it)? What factors impact a person’s BMR?1. Convert your weight to kg (2.2 lbs / kg)2. Multiply kg by kcals/kg/hr – 1.0 kcals/kg/hr for men – 0.9 kcals/kg/hr for women3. Calculate 24hr caloric need (multiply by 24 hours)• Age • Growth • Fever • Malnutrition • Thyroxine • Height • Body Composition • Stress • Ambient Temperature • Fasting/ Starvation5. What is the BMI? Be able to calculate it and be able to interpret the BMI in terms of weight status. What doesn’t the BMI measure?• Weight for height (>120%) – Hamwi equation• Body Mass Index (BMI) (>30)– Weight (kg) / (ht)2 (meters)– Weight (lb) x 703/(ht) 2 (in) - less than 18.9 –underweight- 18.9 – 24.9 –normal- 25.0-29.9 –overweight- more than 30 -obese6. What are the health risks associated with obesity? • Most obese people suffer illnesses, and obesity is considered a chronic disease• An estimated 300,000 people in the U.S. die each year from obesity-related diseases• Obesity elevates the risk of these conditions/diseases:– Hypertension Flat feet– Heart disease Sleep apnea and problems – Stroke some cancers– Diabetes high accident rate– Hernias arthritis7. What is the difference between fat free mass and fat mass? We discussed several waysto determine % body fat such as skinfold measurements, BIA and underwater weighing. How are each of these methods used to assess percent body fat? 8. What is the gynoid body shape? What is the android body shape? Which of these is more dangerous in terms of cardiovascular risk? 9. What are the environmental causes of obesity? • Inactivity!!!!!! – 25% adults sedentary• Caloric beverage consumption– the average 12- to 19-year-old male who consumes soda pop drinks more than two cans per day, while the average female consumes 13⁄4 cans a day• Portion Sizes10. What are the three components of a successful weight loss program? Provide details on the dietary recommendations for weight loss. How much of a calorie deficit must one createto lose a pound of body fat? - diet modification, physical activity, behavior modificationPhysical Activity 1) Choose active exercise; 2) Move large muscle groups;3) Time, not speed;4) Exercise daily!Behavior Modification• Eliminate or suppress inappropriate eating cues • Strengthen appropriate eating cues • Repeat desired behaviors • Reward positive behaviors• Withhold rewards for inappropriate behaviors• Create an energy deficit – One pound of body fat = 3,500 kcals – Energy deficit of 500 kcals/day= 1 lb weight lost/wk• Emphasize high carbohydrate foods that are nutrient dense• Eat regular meals with no skipping • Keep food records11. What are some components of fad diets? • Promises of a quick fix• Dire warnings from a single product or regimen• Claims that sound too good to be true• Simplistic conclusions drawn from a complex study• Recommendations based on a single study• Dramatic statements that are refuted by reputable scientific organizations• Lists of "good" and "bad" foods• Advice given to help sell a product• Opinions based on studies published without peer review• Recommendations from studies that ignore differences among individuals or groups12. What are the risks/benefits of alternative treatments for obesity such as drugs, surgery and very low calorie diets?• Surgery– Gastric Bypass – Laparoscopic Gastric Banding – Gastric Sleeve• Drugs• Very low calorie diets – < 800 kcals/day – High in proteinEating Disorders1. What are the three most common types of eating disorders and what are the characteristics of each?- Characteristics of Anorexia Nervosa• Patient is unaware of condition • Distorted body image • Lack of menstruation • Mood and behavior changes• Physical exhaustion- Characteristics of Bulimia Nervosa • More prevalent than anorexia, more men • Tend to be close to ideal body weight but with large weight fluctuations• Low self esteem, often associated with depression• Awareness of disorder• Periods of calorie restriction alternate with periods of bingeing and purging• Laxative abuse • Feelings of being out of control, embarrassed, depressed, guilty- Characteristics of Binge Eating Disorder• Periods of restriction generally followed by periods of bingeing• No purging • Feelings of being out of control, embarrassed, depressed, guilty• Responds more readily to treatment than other eating disorders2. What are the causes of each?3. What are the dangers of each?- Dangers of Anorexia Nervosa • Similar to classic PEM • Slowing of growth and development • BMR declines due to loss of lean body mass • Bones weaken • Heart muscle is weakened • Anemia • Slowing of GI function • Electrolyte imbalance • Death, often due to heart failure- Dangers of Bulimia Nervosa • Impairs fluid and electrolyte balance ▫ can lead to abnormal heart rhythms• Irritation and infection of the pharynx, esophagus, and salivary glands• Erosion of teeth • Tear or rupture of esophagus or stomachDANGERS OF BINGE EATING???Pregnancy, Lactation and Infant Feeding1. Describe the concept of critical periods. What are the three stages in the development of a human baby and how long does each last?• Each organ and tissue type grows with its own characteristic pattern and timing.• The development of each takes place only at a certain time--the critical period.• If the development of an organ is
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