Weight managementBiochemistry and Nutrition

NURS 1117

ObjectivesAt the end of this presentation students will

be able to:Define weight managementDescribes concepts related to weight

managementDescribe relationships between energy and

obesitySynthesize appropriate weight management

protocols

PrevalenceIn developed countries, 20% of men are

obese and the level is a few points higher in women

Overweight is more common in the population than obesity. 62% of males and 50% of females are overweight in developed countries.

Patterson & Pietinen, 2004

Energy and Weight Mgt.Energy needs= BMR+ DIT + PA

BMR- Basal Metabolic Requirement

DIT- Diet Induced Thermogenesis

PA- physical Activity

Energy is also needed for new tissue growth e.g. in pregnancy and to recovery from illness

Energy and Weight Mgt.BMR- energy needed at rest to sustain basic

life functions (= 70% of energy needs)

DIT- energy needed to absorb, digest, transport & interconvert nutrients (=10% of intake)

PA- energy expenditure caused by movement; conscious and unconscious

Energy and Weight Mgt.Modulators of BMR- (BMR is affected by)

Age, gender, body habitus

Modulators of DIT (DIT is affected by)Size and quantity of food- high protein meals

causes higher DIT than fat or carbohydrate dieys

Hormones Influencing energy use and storageLeptin- regulates appetite

(Leptin levels are increased in obese individuals)

Adiponectin- regulates appetite(inversely related to adipose tissue mass)

Other hormones that affect energy storageTNF α- Tissue Necrosis Factor AlphaIL6- Interleukin 6PAI- Plasminogen Activator Inhibitor

Terms related to energyGE (Gross Energy)- all the energy from food if

it were burnt in oxygen

DE (digestible energy)- portion of GE that is actually absorbed across the GI tract. NB- portion of GE is always lost in faeces e.g.. Component of fibre, grains and nuts

ME (metabolisable energy)- actual energy available for metabolism or portion of DE excluding energy lost in urine

Weight Management StepsA balance of the three macronutrients: carbs,

fat, and protein

Consume a rich spectrum of micronutrients, including vitamins, minerals, and antioxidants

Intake good sources of bulking fiber

Weight Management StepsChoose slow-releasing- low glycaemic index

food, so as not to spike blood sugar

non-processed, whole foods

Reduce snacking

Exercise

Reduce- discontinue smoking

To lose weightEat less, reduce portions of all foods

especially foods containing oils & fats

Avoid sweetened beverages, less alcohol, more water

Be physically active

Exercise daily & make exercise a part of your lifestyle

To lose weightChange some old habits which prompted

you to eat e.g. eating & watching TV

Set yourself a goal for losing weight

Do not try to lose too much weight too soon. Go slowly, lose a little at a time & keep it off

To lose weightAdopt healthy diet & exercise habits

Keep a record of what you eat & the exercises you do

Do not skip meals, especially breakfast

Factors that protect against weight gainHigh intake of non-starch polysaccharides-

(supported by strongest research evidence)

Breast feeding

Intake of low glycaemic index foods

Increased eating frequency

Regular physical activity

Consequences of obesityMetabolic CVS Cancer Mechanica

lSocial

DM (type 2) Hypertension

Breast Osteoarthritis

Low self esteem

Insulin Resistance

Varicose Veins

Prostate Obstructive sleep opnea

Criticism by society

Dyslipedimia e.g. incresaed VLDL & LDL

Peripheral Odema

Kidney & Colon

ReferencesPatterson, R. E. & Pietinen, P. (2004).

Assessment of Nutritional status in individuals and populations. In M. Gibney, B. Margetts, J. Kearney & L. Arab. Public Health Nutrition. (pp. 66-82). Oxford: Blackwell Publishing Company.

Prentice, A. (2007). Energy. In J. Mann & S. Truswell. Essentials of Human Nutrition. (3rd Ed.). (pp. 73-88). Oxford: University Press.

ReferencesOmari, A. & Caterson, D. (2007). Overweight

& Obesity. In J. Mann & S. Truswell. Essentials of Human Nutrition. (3rd Ed.). (pp. 233-248). Oxford: University Press.

Tucker, S. & Dauffenbach, V. (2011). Nutrition and Diet Therapy for Nurses’. (1st Ed.). Boston: Pearson Press