Chapter 9 Energy Balance

Nutrition HO-15

Obesity Prevalence

Obesity Prevalence

Dyslipidemia

Hypertension

Type 2 diabetes

Stroke

Coronary heart disease

Gallbladder disease

Osteoarthritis

Sleep apnea

Respiratory problems

Age-Adjusted Prevalence of Obesity and Diagnosed Diabetes Among U.S. Adults Aged 18 Years or older

Obesity (BMI ≥30 kg/m2)

Diabetes

1994

1994

2000

2000

No Data <14.0% 14.0-17.9% 18.0-21.9% 22.0-25.9% >26.0%

No Data <4.5% 4.5-5.9% 6.0-7.4% 7.5-8.9% >9.0%

CDC’s Division of Diabetes Translation. National Diabetes Surveillance System available at http://www.cdc.gov/diabetes/statistics

2010

2010

35% obese

65%

overweight obese

30% overweight

Body Mass

Index BMI

6’6” and 216 pounds = overweight

Determining Health Based on Weight

BMI

Waist Circumference

Disease Profile

Physical Activity (fitness level)

Determining Health Based on Weight

BMI

Waist Circumference

Disease Profile

Physical Activity (fitness level)

Determining Health Based on Weight

BMI

Waist Circumference

Disease Profile

Physical Activity

Determining Health Based on Weight

BMI

Waist Circumference

Disease Profile

Physical Activity

Determining Health Based on Weight

BMI

Waist Circumference

Disease Profile

Physical Activity (fitness level)

Low risk of morbidity / mortality

BMI = 30 = obese range

Waist Circumference = 32”

Healthy/ No diseases/ Normal blood work

Very active

Energy In• food• beverages

Energy Out• TEF• BMR• activity

Calories In• food• beverages

Calories Out• TEF• BMR• activity

What is a calorie?

What is a calorie?

Unit of food energy

Ener

gy O

ut ActivityBMRTEF

Energy In Energy Out

TEF

BMR

Activity

Food

Beverages

Weight Loss

Energy OutEnergy In

Food

Food

Food

Beverages

Activity

BMR

TEF

Weight Gain

Regulation of Appetite and Food Intake

Alcohol consumption

Sleep deprivation

Television

Am J Clin Nutr September 1, 2012 vol. 96 no. 3 492-497

Hormonal Influences

Thrifty Gene

• store energy

favor fat accumulation

• conserve energy

increased tendency to be sedentary

• save stored energy

diminished ability to use dietary fats as fuel

• store energy

Increased capacity to store body fat

NEA

TNon-exercise

Activity

Thermogenesis

(energy expenditure)

Dr. James Levine

Obesity: Global Epidemic

World Health Organization 2008

World Health Organization 2008

InfectionsRespiratory Illness

Parasites

Heart DiseaseDiabetes

Toda

y

1970

Mortality in Mexico

“We have not had a global collapse of willpower in the last

30 years”

Obesitygenetics

hormones

environment types of food

metabolism

social economic

THE Chapter

Nine END