© 2007 Thomson - Wadsworth Energy Balance & Healthy Eating.

© 2007 Thomson - Wadsworth

Energy Balance & Healthy Eating


Energy Balance


Components of Energy Expenditure


Basal Metabolism• Energy expended to sustain basic life

functionsRespiration, heart beat, nerve

function, muscle tone

• Basal metabolic rate (BMR)Amount of energy expended per hourAccounts for 50-65% TEEBMR measured in morning, fasting

state, & temperature-controlled room


Factors Influencing BMR

• Age• Sex• Growth• Body shape• Body composition

• Temperature• Stress• Fever• Thyroid function• Nutritional status


Physical Activity

• Accounts for 25-50% of TEE• Factors affecting amount of energy

needed:Time & intensity of activityBody sizeFitness


Thermic Effect of Food

• Accounts for 5-10% of TEE• Energy expended to digest, absorb,

transport, metabolize, & store nutrients following a meal

• Influenced by:Amount & composition of food


Assessing Total Energy Expenditure (TEE)

• Direct calorimetry• Indirect calorimetry• Use of stable

isotopes: Doubly labeled water

• Mathematical formulasDRIs

• Estimated Energy Requirements


Estimating Energy Requirements

Males (19 years and older)

EER = 662 - (9.53 x age) + PA x [(15.91 x wt) + (539.6 x ht)]

Females (19 years and older)

EER = 662 – (6.91 x age) + PA x [(9.36 x wt) + (726 x ht)]

*Age in years, weight in kilograms, height in meters


Estimating Physical Activity Factor

DescriptionPhysical Activity

EquivalentsMen:

PA FactorWomen:

PA Factor

SedentaryOnly activities required for normal independent living

1.0 1.0

Activities equivalent to walking at a pace of 2-4 mph for the following distances:

Low Active 1.5 to 3.0 miles/day 1.11 1.12

Active 3 to 10 miles/day 1.25 1.27

Very Active 10 or more miles/day 1.48 1.45


EER Example

Ex: 20 y.o. female, 5’4”, 123#, walks to class

• 5’4” 64 ÷ 39.37 = 1.63 m• 123# 123/2.2 = 55.9 kg

EER = 662 – 6.91(20) + 1.12[(9.36)(55.9) + (726)(1.63)]

= 662 – 138.2 + 1.12[523.22 + 1183.38]= 2435

2435 +/- 10% = 2192 – 2679 kcal/day


Regulation of Energy Balance

Brain uses information to coordinate adjustments in energy intake and expenditure to maintain energy balance on short- & long-term basis.


Short-Term Regulation of Food Intake


Hunger & Satiety

• HungerBasic physiological need for food

• SatietyPhysiological response to having eaten

enough• Influences

NeuropeptidesGI neural & hormonal signalsPancreasAdipose tissue


Appetite

• Desire for foodStimuli may override hunger & satiety Psychological vs physiologicalInfluences

• Appearance, taste, aroma, emotional states

• General vs specific


Long-Term Regulation of Weight: Set Point Theory

• Thermostat analogy• Energy-wasting proteins convert

energy to heat• When weight varies from “set point”

Food intake changes Energy expenditure changes


Assessing Body Weight

• Body Mass Index (BMI) = [wt (kg)] / [ht (m)2]

Healthy = 18.5 – 24.9 kg/m2 Overweight = 25-29.9 kg/m2

Obese ≥ 30 kg/m2


BMI & Weight-Related Morbidity & Mortality


Other Body Measurements• Body Composition

Adipose vs Muscle, water, & boneDeterminants:

• Genetics, sex, hormones, physical activity, diet

“Normal” body fat levels• Males = 12-20%• Females = 20-30%

• Waist CircumferenceMen ≤ 40 inchesWomen ≤ 35 inches


Waist-to-Hip Ratio

• Indicator of body fat distribution


Problems with using anthropometric measurements to assess health

• BMI/Weight does not account for body composition,

frame size, age, or ethnicityreported correlations between

categories and health risk skewed• Research

most looks just at weight, not lifestyle factors

Fitness is more important than fatness!


What is a healthy weight for you?• Consider genetics• Consider your own history

How has your weight changed?How has your life changed?

• Consider your eating and exercise habits


Weight Management

at UVa


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Students’ Perceptions of their Weight

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Students’ Intentions About Weight

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“Everyone is dieting…”

91% of women recently surveyed on a college campus had attempted to control their weight through dieting, 22% dieted “often” or “always”

(Kurth et al., 1995)


“…even though dieting doesn’t work…”

• Evidence is inadequate to recommend commercial or self-help programs [for weight loss] (Tsai & Wadden, 2005)

• Programs restricting dietary fat and/or focusing on behavior modification are generally no more effective than traditional dieting techniques (Miller, 2006)

• 95% of all dieters will regain their lost weight in 1-5 years (Grodstein, et al., 1996)


“…and is, in fact, harmful.”

• Dieting problems include: Increased risk of heart disease Slowed metabolism Nutrient deficiencies Loss of muscular strength and endurance Interference with concentration and reaction time Increased stress, low self-esteem, and feelings of

depression (NEDA 2006)

• 35% of “normal dieters” progress to pathological dieting. Of those, 20-25% progress to partial or full-syndrome eating disorders. (Shisslak & Crago, 1995)


Health At Every Size

1. Health enhancement

2. Size- and self-acceptance

3. Pleasure of eating well

4. Joy of movement

5. End to weight bias


Health At Every Size

Pleasure of eating well

Eating based on internal cues of hunger and satiety, appetite, and individual needs, rather than on external food plans or diets.


Intuitive Eating

• Unconditional permission to eat when hungry and what food is desired

• Eating for physical rather than emotional reasons

• Reliance on internal hunger and satiety cues to determine when and how much to eat


Does it work?

• Weight management

• Physical health

• Psychological health

• Nutritional adequacy


Weight Management

YES!

• “Listening to body signals in determining what, when, and how much to eat is associated with lower body mass.” (Tylka, 2006)

• Those scoring higher in “Intuitive Eating” had lower BMI values. (Hawks & Smith 2006)


Physical HealthYES!

“Size Acceptance and Intuitive Eating Improve Health for Obese, Female Chronic Dieters” (Bacon et al 2005)

HAES group maintained weight, improved cholesterol and blood pressure, and sustained improvements.

Diet group showed initial weight loss and metabolic improvement, but by 2 years weight was regained and little improvement was sustained.


Psychological Health

YES!• HAES vs dieters study (Bacon et al, 2005)

Depression: both improved, HAES sustained, diet group did not

Self-esteem: HAES group improved, diet group worsened

• Higher “intuitive eating” scores associated with higher levels of psychological health (Tylka 2006)

Self-esteem Satisfaction with life, optimism, proactive coping Eating disorder symptomatology


Nutritional Adequacy

YES!

• Intuitive eating correlated with variety in intake.

• No correlation between intuitive eating and % junk food consumed.

• Intuitive eating associated with greater pleasure in eating.

(Hawks & Smith 2006)


Strive for overall wellness• Get adequate sleep• Practice stress and time management• Be physically active• Engage social support


EAT WHAT YOU WANT …… when you are truly hungry. Stop when you are full. And eat exactly what appeals to you. Do this instead of any diet, and you are likely to maintain a healthy weight and avoid eating disorders. (National Eating Disorders

Association, 2002)

© 2007 Thomson - Wadsworth Energy Balance & Healthy Eating.

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Transcript of © 2007 Thomson - Wadsworth Energy Balance & Healthy Eating.