M.

Prasad Naidu
MSc Medical Biochemistry, Ph.D,.

ENERGY IN
Regulation of food intake:
Hunger
Satiation and satiety
Appetite

Energy expenditure at rest:
BMR - basal metabolic rate: rate of energy
expended at rest (kcal/hr or kcal/day), also
called RMR (resting metabolic rate).
Factors that affect BMR (page 257)
Energy expenditure for physical activity:
Depends on the activity duration, type,
and intensity
Also affected by body size and fitness level

NEAT is the energy associated with
unintentional activities like fidgeting,
maintenance of posture, or spontaneous
muscle contraction


Energy expenditure to process food:
Thermic effect of food (TEF) the energy
used to digest, absorb, and metabolize
energy-yielding food
TEF is lower for fat than for carbohydrate
and protein
TEF peaks one hour after eating, and
normally dissipates within 5 hours
Accounts for ~10% of total energy
expenditure
Estimating energy expenditure:
EER an equation used to estimate REE
based on age, weight, height, and sex
Page 260
Assessing body weight:
weight tables
body mass index (BMI) =
weight (kg)
height (m2)

As the BMI table
shows, healthy weight
falls between a BMI of
approximately 18.5 and
24.9.
gynoid obesity (pear-shaped figure), more
common in women
android obesity (apple-shaped figure), more
common in men
increases risk of heart disease and diabetes
mellitus






apple pear
Hereditary and genetic factors
Sociocultural influences
Age and lifestyle
Sex
Race and ethnicity
Socioeconomic status
Employment
Psychological factors
Health risks (page 265)
Prevalence of overweight and obesity it is a
worldwide public health problem. We are
now seeing an obesity epidemic in children as
well as adults.




National Center for Health Statistics suggests
nearly 25% of children are overweight or
obese
There are now about 5 million obese children
in the United States up by 50% since 1991

A 1999 Survey of Seattle High Schools showed
that:

9% of males and 6% of females were
overweight

Overweight children and adolescents are
more likely to become overweight or obese
adults
Type 2 diabetes, high blood lipids,
hypertension, early maturation and
orthopedic problems also occur with
increased frequency in overweight youth

In 2000, the total cost of obesity was
estimated to be $117 billion
Most of the cost associated with obesity is
due to type 2 diabetes, coronary heart
disease, and hypertension

Unfortunately, there is no magic pill, no
perfect diet. The simple fact is, if you
consume more calories than you burn, you
will gain weight
A slow weight loss (1-2 pounds per week) is
the best way
To lose 1 pound of fat, you must burn an
extra 3500 calories (in one week that = 500
calories per day)

Important Components:
Diet composition
Physical activity
Behavioral change
Balancing acceptance and change
Support!
A Healthful Eating Plan
Involves:
Realistic energy intake
Nutritional adequacy
Small portions, small
frequent meals
Reduced simple sugar and
alcohol intake
Adequate water

Contributions to weight loss and maintenance:
Direct increases in energy output (muscles and
cardiovascular system)
Indirect energy output (elevated BMR)
Appetite control
Psychological benefits

Note: Spot reducing is not possible.
Behavior modification:
the changing of behavior
by the manipulation of
antecedents (cues or
environmental factors
that trigger behavior),
the behavior itself, and
consequences (the
penalties or rewards
attached to behavior).
Figure 7-7 Food and Activity Diary
Family
Friends
Weight Loss Support Groups
Adjuncts to treatment
Drugs
Self-help activities
Commercial programs
Professional private counselors
Surgery: gastric bypass, gastric banding