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Calories-Food,

energy, and energy

balance

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Calories-Food, energy,

and energy balanceEnergy nutrients

Carbohydrates = 4 kcal/g Proteins = 4 kcal/g

Fats = 9 kcal/g

Calorie

Is the unit used to measure the amount ofenergy that foods provide to the body

It is defined as the amount ofenergy needed to

raise a kilogram of water (about 4 cups) from150C to 160C (590F to 610F).

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How the energy content

of food is measured

Calorimetry

Bomb calorimeter

The food is

completely burnedThe energy (heat)

released raises the

temperature ofwater

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The bodys need for energy

1. Energy spent on basal metabolism

Energy required while at rest

2. Energy spent on physical activity

3. Energy spent on dietary thermogenesis

Energy expended during digestion of food,

absorption and utilization of nutrients

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Basal metabolism Energy used to support body processes such as

growth, tissue repair and maintenance. Measurement is called:

Basal Metabolic Rate or BMR

Assessed while at complete physical and emotionalrest

It includes energy the body spends for breathing, the

pumping of the heart, the maintenance of bodytemperature, transport of nutrients and waste fromthe cells and other life sustaining, ongoing functions

These processes require no conscious efforts, theyare continuous activities that the body must performto sustain life

60-80% of the calories needed each day are spent onbasal metabolism

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Basal metabolism

How to calculate your basal metabolic rate.

This is a very, very rough estimate.

For men: multiply body weight in pounds

by 11 170 lb man x 11 = 1870 calories

For women: multiply by 10

135 lb woman x 10 = 1350 calories

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Energy spent on physical activities

Second highest expenditure of energy

Varies depending upon how active the person is

Inactive lifestyle = 30% of basal metabolic kcalAverage active = 50% of basal metabolic kcal

Active life style = 75% of basal metabolic kcal

Examples: An average active male whose basal metabolism

is 1870 kcal1870 * 0.5 = 955 kcal for physical activities

An average active female whose basalmetabolism is 1350 kcal

1350 * 0.5 = 675 kcal for physical activities

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Energy spent on

dietary thermogenesisThis energy is estimated to be 10% of the energy

needed for basal metabolism + physical activities

Also known as specific dynamic action of foods ordiet-induced thermogenesis or thermal effect of foods

Male - 1870 basal + 955 physical activity = 2825 kcal

10% of 2825 kcal = 0.1 * 2825 kcal = 283 kcal fordietary thermogenesis.

Female - 1350 basal + 675 physical activity = 2025 kcal

10% of 2025 kcal = 0.1 * 2025 kcal = 203 kcal fordietary thermogenesis

Total calories needed for a day from examples:

Male: 1870 + 955 + 283 = 3108 kcalFemale: 1350 + 675 + 203 = 2228 kcal

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Where is the energy in foods?

Most foods are a mixture of energy macronutrients For example a cup of soup contains proteins,

carbohydrates and fat

How to calculate the caloric value of foods?

Assume the soup has 10 g of protein, 15 g of

carbohydrates and 5 g of fat To calculate energy value of soup

10g protein X 4 kcal/g =40 kcal 15g carbohydrate X 4 kcal/g = 60 kcal

5g fat x 9 kcal/g = 45 kcal

Total calories = (40+60+45) = 145 kcal

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From the example: Protein = 40 kcal

Carbohydrate = 60 kcal

Fat = 45 kcal

Total calories = 145 kcal

To calculate the percent of calories (energy)

from each macronutrient

From protein: (40/145) X 100 = 28%

From carbohydrate: (60/145) X 100 = 41%

From fat: (45/145) X 100 = 31%

Where is the energy in foods?

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Energy regulation of

the body

Energy is balanced

The number of

calories you consume

is the same as thenumber you need

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Negative Energy Balance

Negative energy balance

Energy intake is less

than energy expenditure

If you want to lose

weight, it helps to be in

negative energy balance

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Positive Energy Balance

Positive energy balance

Energy intake is more

than energy expenditure

If you want to gain

weight, it helps to be inpositive energy balance

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Weight control:

Obesity and underweight

Obesity is defined as an excess of body fat Ways to measure obesity

Percent body fat

Weight for height range

Body Mass Index (BMI)

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Percent Body Fat

Obese is

Men > 20% body fat

Women > 25% body fat

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Weight for height

How to know your weight for height range Calculating it :

Women: 5 feet = 100 lbs; each additional

inch = 5 lbs; 10% of totalExample: 5 feet, 7 inch woman =135 lbs 13.5 lbs

Healthy weight range is 121.5 - 148.5 lbs

Men: 5 feet = 106 lb; each additionalinch = 6 lbs; 10% of total

Example: 5 foot 7 inch man =148 lbs 14.8 lbs

Healthy weight range is 133.2 - 162.8 lbs

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Body Mass Index (BMI)

It is calculated by dividing body weight (in

kilograms) by height ( in meters) squared

There are many different websites that will do

the calculation for you.

Example from Centers for Disease Control:http://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calcu

lator/bmi_calculator.htm

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Body Mass Index (BMI)

The most healthy BMI range is 19-25 for men

and women

BMI < 19 is underweight

BMI between 25-30 is overweight

BMI > 30 is obese

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Obesity: A common problem

Incidence in US: 30% of adults are obese

25% of children are overweight

The incidence is on the riseInfluence of obesity on health

Diabetes

Hypertension

Stroke

High blood

cholesterol

Low HDL

Heart disease Certain cancers

Poor fitness level

Shortened lifeexpectancy

Depression

Gallbladder disease

Infertility

Accidents Skin disorders

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Obesity: A common problem

Social & cultural effects Unfair treatment from society

Isolation, rejection & inferiority feelings

What should be measured?

Obesity should be assessed by body fat content

Weight alone doesnt distinguish between leanbody mass (muscles, bone and water) and bodyfat

The weight of a 165 lb, 30 year old, 5 foot 6inch woman who trains heavily would indicate

obesity but she may have too little fat to betruly obese

http://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htm

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Methods for assessing body

fat content Skinfold thickness measurement

Measurement of the thickness

of fat under the skin

Skinfold calipers are used over

several sites of the body The body fat is determined by

plugging the thickness into a

formula

http://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htm

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Methods for assessing

body fat content Bioelectrical impedance analysis (BIA) Fat is a weaker conductor of electricity than

muscles or water

So body fat is estimated by determining howquickly the electric current passes from ankleto wrist

M th d f i

http://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htm

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Methods for assessing

body fat content Underwater weighing

The gold standard of body

fat assessmentFat, but not muscles and

bones, floats on water

The subject is firstweighed on dry land, next

is submerged in water and

exhales completely

The less the weight under water compared to the

weight on dry land, the higher the percentage of fat

http://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htmhttp://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htm

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Methods for assessing

body fat content BOD POD is based on

the same whole- bodymeasurement principle

as underwater weighing,

but using airdisplacement instead of

water

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Methods for assessing

body fat content Magnetic resonance imaging (MRI)

MRI, CT or CAT scans provide similar results A persons body fat and muscle mass can be

photographed when exposed to a magnetic field

(or in case of CAT scan, to radiation)

Volume of total fat and

muscle content can bedetermined

B d f t l ti i i t t

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Body fat location is important

More fat around waist for apple shape.

More fat around hips and thighs for pear shape.

Apple shape is at higher risk for diabetes,

hypertension, high blood cholesterol and heartdisease.

Apple shape Pear shape

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Causes of obesity Genetic influence

Heredity may account for 25-40% Errors in metabolism (rare)

Genetic predisposition for obesity when right

environmental triggers are present e.g. Physical inactivity or high fat intake

or high sodium intake

Set point theory suggests that individuals areprogrammed to weigh a certain amount andthe weight will return to that level when

weight is lost or gained Role of diet

Low physical activity promotes obesity

LIGHTNING QUIZ

i i

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Undernutrition

Worldwide, underweight due to inadequatediets is much more common than obesity and a

good deal more life threatening

In developed countries, however, underweight

largely results from illnesses, i.e., HIV/AIDS,

pneumonia, cancer, an eating disorder(anorexia nervosa), and the voluntary

restriction of food

Poverty is an important preventable cause of

undernutrition in developed countries

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Underweight defined

Underweight people have too little body fat

Women < 20% body fat, men < 12% body fat

or

BMI < 19 or 18. 5

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Underweight

A portion of people classified as underweightby the tables will not actually be underweight,they may just be genetically thin

People who are naturally thin often have asmuch difficulty gaining weight as obese people

have losing it

Unless health is compromised, there is noreason to be concerned about underweight

Health concerns might include fatigue,frequent illness, impaired concentration, orapathy

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Underweight

Underweight poses hazards when it is

accompanied by undernutrition

Inadequate supply of vitamins, minerals and

energy leaves the body unprepared to handle

its many metabolic and physical tasks

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Causes of underweight

Hunger, appetite and satiety irregularities

Metabolic factors

Psychological factors Hereditary tendencies

Habits learned in childhood - certain food

aversions

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Weight gain demands more calories

The demand for energy to support physical activityand growth might contribute to underweight

An extremely active boy during his adolescent

growth spurt may need > 4000 kcal/day to maintainhis body weight

He may be too busy to take time to eat

To gain weight, as many as 500 extra calories a dayare needed to gain a pound a week

1 lb of fat has about 3500 calories Like a weight loser, a person who wants to gain

weight must learn new habits and learn to like new

foods

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Weight gain strategies

Increase food intake, especially increase highenergy foods

Eat more frequently

Eat snacks between meals People who are underweight because of illness can

add calories by adding concentrated liquid

formulas No known pills, surgery or hormone therapy will

increase weight

While physical exercise burns calories, it is alsorequired to build up muscle tissue

Unless you are dangerously underweight you canadopt an exercise program to increase lean bodytissues

W i ht t l th th

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Weight control: the myths

and realitiesWeight loss versus weight control

On any given day, about 40% of all adults are

trying to lose weight whether they need to or not

50% or more of people who are overweight or

obese are trying to lose weight

Americans spend $33 billion annually on weight

control products and services $120 per person/year

Yet Americans are gaining weight faster than theyare losing it

W i ht l

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Weight loss versus

weight control

It seems that some people cannot lose weight

and keep it off no matter how hard they try

The effectiveness of weight-control methods

should be gauged by their ability to preventweight regain

Successful weight control is characterized by

gradual weight loss from small and

individualized changes in eating and activity

Weight loss versus

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Weight loss versus

weight control

Any approach to weight loss that calls for areduction in caloric intake usually producesweight loss in the short run

But these methods fail in the long run

Because they become too unpleasant

There is a breakdown of willpower

Because of the feelings of hunger,deprivation and depression

People return to old habits or binge eating

and regain weight

Th b i f i ht l

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The business of weight loss There are easily more than 29,000 weight loss products

and services available currently Why are so many of them available?

Because there are gullible people willing to spend

money on them And, basically, none of them work, so new ones keep

being "invented"

Unfortunately, most weight loss products and servicesavailable on the market have not been shown to be safe

Laws and regulations do

not fully protect theconsumer from the

introduction of bogus

products and services

Di t ill

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Diet pills Fenfluramine was a widely used weight loss drug

Serious side effects

Withdrawn in 1997

Ephedra or ma huang (contains caffeine) Was a diet pill and energy booster

Serious side effects

It can no longer be sold for weight loss Xenical (orlistat) - Approved by FDA in 1999

Works by blocking fat absorption

Possible side effects: increased bowel movements;oily discharge

Leptin: Does not seem to hold much promise

It is a hormone produced in fat cells that maymodify caloric intake or energy expenditure

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Diet pills / drugs

Even though people using prescribed drugs are

carefully monitored by medical professionals,

serious side effects can develop

No diet drugs are absolutely safe and none

helps maintain weight loss after the drug is

discontinued

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Organized weight-loss

programs

Many of these programs do indeed bring

weight loss but there is little evidence that

people maintain weight loss and do not regain

Drastic measures

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Drastic measures

Fasting

People fast to lose weight, there is a rapid

rebound of weight Surgical techniques

Stomach surgery, reduces the size of stomach

to lower the amount of food intake

Gastric bypass surgery cost >$10,000, and

leads to an average weight loss of 100 lbs invery obese people

Stomach surgery

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Stomach surgery

Many people (70%) maintain a 50% weight loss five

years after surgery

The procedure is generally reserved for the very

obese (BMI > 40) or those with a BMI > 35 wheretheir weight jeopardizes their immediate health

Side effects: lower Vitamin B12 absorption and

increased risk of osteoporosis later in life

Brown, Nutrition Now, 6th ed, p. 10-9

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Drastic measures

Liposuction

Fat deposit in thighs, hips, arms, back, or

chin can be partially removed by liposuction

Fat can redeposit in the same places fromwhere it was removed

Surgery can carry infection hazards

Characteristics of a

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Characteristics of asuccessful weight loss and

maintenance program The program fosters weight loss maintenance for

at least 2 years

The program offers a long-term approach tobeneficial changes in diet and exercise

The program recommends or employs foods fromall of the food groups

The program employs relatively small andacceptable changes in usual lifestyle, dietary, and

other behaviors The program does not rely solely on drugs or

herbal remedies

The program does not employ very low-caloriediets (less than 1200 calories per day)

Importance of small

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Importance of small,

acceptable changes

Fat is put on over time and the best way to get ridof it is take it off slowly

Gradual losses in body fat do not requiredramatic changes in diet and activity level

Cutting back on 100 calories a day may reduce

weight by as much as 10 lbs a year Jogging 20 minutes a day could result in a 10 lb a

year weight loss

Routinely engage in more vigorous forms ofphysical activity

The secret to success is to include in a lifestylechange package foods and activities that areenjoyed

Small changes that have

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Small changes that have

staying power Use less margarine, butter & mayonnaise on foods Choose low-fat varieties of foods (cheese, milk,

yogurt, fish, poultry) that you like

Trim the fat off meats or buy lean meats Eat fewer fried foods

Eat breakfast

Eat fruits and vegetables for snacks

Cook at home

Walk to school Bike to work

Take the stairs

Go outside and play

Weight loss

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Weight loss

Gradual but lasting People who lose weight gradually are more likely

to keep it off than those who lose weigh rapidly

Weight loss at pound per week

LIGHTNING QUIZ

Brown, Nutrition Now, 6th ed, p. 10-14

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