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Energy BalanceChapter 7

Energy Intake

•Calories come from carbohydrates, protein, fat,and alcohol

•The total number of calories in a food or diet canbe estimated by multiplying total grams ofcarbohydrates, protein, or fat by the appropriatenumber of calories/gram

•Even when all food consumed is measured, thenutrient values available in food compositionreferences represent average, not actual,nutrition content

Energy Intake (cont’d)

•Easier way to count calorie intake is to estimatethe number of servings from each food group aperson consumes; multiply the number ofservings by the average amount of calories in aserving; then add the calories from each groupto get an approximation of the total caloriesconsumed

•Accuracy of “counting servings” depends on thequality of foods consumed and the accuracy ofportion size estimation

Energy Expenditure

•Basal metabolism

–Caloric cost of staying alive or the amount ofcalories required to fuel the involuntaryactivities of the body at rest after a 12-hourfast

–Basal metabolic rate (BMR) accounts forapproximately 60% of total calories expended

oThe less active a person is, the greater theproportion of calories used for basal energyexpenditure (BEE)

Energy Expenditure (cont’d)

•Basal metabolism (cont’d)

–Rule-of-thumb guideline for estimating BMRis to multiply healthy weight (in pounds) by10 for women and 11 for men

–When actual weight exceeds healthy weight,an “adjusted” weight of halfway betweenhealthy and actual can be used

–Rule of thumb based on weight only

Energy Expenditure (cont’d)

•Basal metabolism (cont’d)

–Lean tissue (muscle mass) contributes to ahigher metabolic rate than fat tissue

–Loss of lean tissue that usually occurs withaging beginning sometime around age 30 isone reason why calorie requirementsdecrease as people get older

Energy Expenditure (cont’d)

•Physical activity

–Accounts for approximately 30% of totalcalories used

–Rule-of-thumb method for estimating dailycalories expended on physical activity is tocalculate the percent increase above BMRbased on the estimated intensity of usualdaily activities

Energy Expenditure (cont’d)

•Estimating total calorie requirements

–Estimated energy requirements (or EER)based on age, weight, height, and physicalactivity (PA), with defined PA factors for menand women based on intensity of activity

–Quicker and easier reference is theMyPyramid calorie level table based ongender, age, and activity

Calories in Versus Calories Out

•State of energy balance is the relationshipbetween the amount of calories consumed andthe amount of calories expended

•A “positive” energy balance occurs when calorieintake exceeds calorie output

•A “negative” calorie balance occurs when calorieoutput exceeds intake

Question

•Is the following statement true or false?

A man with an actual weight of 210 pounds anda “healthy” weight of 175 pounds has a basalmetabolic rate of 2,220.

Answer

False.

Rationale: When actual weight exceeds healthyweight, an “adjusted” weight of halfwaybetween healthy and actual can be used:

210 – 175 = 35

35/2 = 17.5

175 + 17.5 = 192.5

192.5 x 11 = 2117.5 BMR

What Is “Normal” Weight

•“Normal” or “desirable” weight is that which isstatistically correlated to good health

•3 criteria used for assessing overweight andobesity:

–Body mass index (BMI)

–Waist circumference

–Existing health problems

What Is “Normal” Weight (cont’d)

•Body mass index

–Body mass index (BMI) has replaced traditionalweight–height calculations that were used todetermine “ideal” or “desirable” body weight

–Formula to calculate BMI is weight in kg/height inmeters squared or weight in pounds/height in inchessquared x 703

–Drawback

oDoes not take body composition into account

–Skinfold measurements and bioelectrical impedancecan assess body composition, but neither techniqueis widely used

What Is “Normal” Weight (cont’d)

•Waist circumference

–Location of excess body fat may be a moreimportant and reliable indicator of disease risk

–Storing a disproportionate amount of total bodyfat in the abdomen increases risks for type 2diabetes, dyslipidemia, hypertension, andcardiovascular disease

–Abdominal fat is clinically defined as a waistcircumference ≥40 inches in men and ≥35inches in women

What Is “Normal” Weight (cont’d)

•Existing health problems

–Presence of existing health problems impactsa person’s absolute risk related to weight

–Generally, the number and severity ofcomorbid conditions increases with increasinglevels of obesity

Energy Balance in Health Promotion

•Approximately 66% of the adult Americanpopulation is overweight or obese

•Preventing or reducing overweight is achievedby adopting a lifestyle approach that includeshealthier food choices, increasing physicalactivity, and behavior modification

Energy Balance in Health Promotion(cont’d)

•Healthier choices

–Encompasses a 2-pronged approach

oEating less of certain items

oEating more of others

–Emphasis is on healthy and wholesome choices

oRemember fat-free foods still contain calories fromprotein and carbohydrates

–Reducing alcohol intake is another way to consumefewer calories

Energy Balance in Health Promotion(cont’d)

•Portion control

–Portion sizes have grown over the last 20years

–“Portion distortion” appears to be awidespread problem

–Change the environment

o Food should be less accessible, lessvisible, and proportioned in smallerquantities

Energy Balance in Health Promotion(cont’d)

•Physical activity

–Only 30% of American adults engage in regularleisure-time physical activity; 39% of adults do notengage in any leisure-time physical activity

–Benefits of increasing activity are dose-dependentand occur along a continuum

–Minimum of 30 minutes/day of moderate-intensityactivity above usual activity is recommended

–Other types of exercise are also recommended

Question

•There are 3 criteria used for assessingoverweight and obesity. What is one ofthese criteria?

a. Height

b. Healthy weight

c. Existing health problems

d. Basal metabolic rate

Answer

c.Existing health problems

Rationale: 3 criteria used for assessingoverweight and obesity include:

–Body mass index (BMI)

–Waist circumference

–Existing health problems

How to Burn 150 Calories(Based on a 150-Pound Person)

•Pedal a stationary bicycle for 20 minutes

•Practice fast dance steps for 24 minutes

•Work in the garden for 27 minutes

•Walk briskly (3.5 mph) for 33 minutes

•Clean the house for 38 minutes

Suggestions for Increasing Activity

•Find something enjoyable

•Use the buddy system

•Spread activity over the entire day if desired

•Start slowly and gradually increase activity

•Move more

•Keep an activity log