Chapter 7,8,9,10 : Protein, Fitness Energy Balance and Weight Control Spring 2011 Prof.

Ado

Overview of Protein
Body is made up of thousands of proteins Contains nitrogen, carbon, hydrogen, and oxygen Functions

Regulates and maintains body functions Provides essential form of nitrogen (in the form of amino acids)

Amino Acid
NH2 O

OH

R group
Nitrogen group

Acid group

Protein Organization
Order

of amino acids in a protein determines its ultimate shape final shape determines its function in the body

Proteins

Denaturation of Proteins

Heat/acid/alkaline/enzymes Results in alteration of the proteins three-dimensional structure

Health and Plant Proteins

Heart healthy Cancer-fighting Bone health Better glucose control Soy and menopausal symptoms

Plant Sources
Provide protein, minerals, and dietary fiber Contain no cholesterol Limited saturated fats High fiber

Time needed to adjust to the higher fiber load

Digestion of Protein in the Stomach and small Intestine

Denatured By cooking and acid in the stomach Gastrin Stimulates the release of acid and pepsin Pepsin -Breaks down proteins Release of CCK (Cholecystokinin, a peptide hormone responsible for stimulating the digestion of protein in the small intestine. Peptones peptides amino acids Small peptides and amino acids Ready for absorption

Denaturation

Protein Calorie Malnutrition

Lack of protein in your diet will yield the following two diseases: Marasmus
Seen in hospitalized patients

Kwashiorkor

Protein Calorie Malnutrition

Protein Balance

RDA for Protein

Increased by ~10-15 gm /day for pregnancy The RDA for protein for most healthy adults is 0.8 g/kg of body weight. Endurance athletes

May need 1.2 1.7 gm/kg healthy weight

Provide about 8-10% of total kcal Most of us eat more than the RDA for protein.

Current Protein Recommendations

RDA for Protein

Promotes equilibrium

0.8 gm of protein / kg of healthy body weight. What would be the recommended amount of protein for a 154-pound female? 154 lb. = 70 kg 2.2 kg/lb. 70 kg x 0.8 g protein = 56 g protein kg healthy body weight How about someone with 220 lb?

Animal Protein

Contribution to our diet

~70% of our protein intake

Top 5 contributors of protein in U.S. diet:

Beef Poultry Milk White bread Cheese

Worldwide, 35% comes from animal sources

Energy Balance
65% 30% Red

of adults are overweight of total population is obese

flags:

10 pounds of weight gain 2-inch increase in waist circumference

Energy Balance

Energy In vs. Energy Out

Basal Metabolism
Minimum energy expended to keep a resting, awake body alive ~60-70% of total energy needs Includes energy needed for maintaining heartbeat, respiration, body temperature Amount of energy needed for basal metabolism varies between individuals Approximately 1 kcal/minute

Factors that Influence Basal Metabolism

Body surface area (weight, height) Lean body mass Gender Body temperature Thyroid hormone Nervous system activity Age Calorie intake Pregnancy Use of caffeine and tobacco

Physical Activity
Increases More Lack

energy expenditure

activity, more energy burned

of activity is a major cause of obesity

Thermic Effect of Food (TEF)

Energy used to digest, absorb, and metabolize food nutrients Sales tax of total energy consumed ~5-10% above the total calories consumed TEF is highest for protein > carbohydrate > fat

Adaptive Thermogenesis

Nonvoluntary physical activity

Triggered by overeating Fidgeting and shivering Maintenance of muscle tone Maintenance of posture

Overeating
Increases sympathetic nervous system activity

Resists weight gain Brown Adipose Tissue

Participates in thermogenesis

2005 Dietary Guidelines for Americans

30 minutes/day physical activity

Reduce risk of chronic disease

60 minutes/day physical activity

Manage body weight and prevent weight gain

90 minutes/day physical activity

Sustain weight loss

Determination of Energy Needs

Direct calorimetry
Measures heat output Expensive and complex

Indirect calorimetry
Measures the amount of oxygen consumed Oxygen consumed is related to energy expended

Estimated Energy Requirement (EER)

Men 19 years and older:

Women 19 years and older:
PA = physical activity estimate WT = weight in kg HT = height in meters (inches / 39.4)

EER= 662-(9.53 x AGE) + PA x (15.91 x WT + 539.6 x HT)

EER= 354- (6.91 x AGE) + PA x (9.36 x WT + 726 x HT)

Physical Activity Estimate

ACTIVITY LEVEL
Sedentary (no exercise) Low Activity (walks the equivalent of ~2 miles/day) Active (walks the equivalent of ~7 miles/day) Very Active (walks the equivalent of ~17 miles/day)

PA (MEN) 1.00 1.11

PA (WOMEN) 1.00 1.12

1.25 1.48

1.27 1.45

What is a Healthy Body Weight?

Current height/weight standards

Weight associated with health and longevity May not be the healthiest weight for individual

Review of family history Personal weight history Healthy lifestyle contribution

Weight-Related Conditions

A Healthy Body Weight

What is the lowest weight maintained for more than a year? What weight was maintained without constantly feeling hungry? Establish a personal healthy weight

BMI: Overweight and Obesity

Underweight

= BMI < 18.5 Healthy weight = BMI 18.5-24.9 Overweight = BMI 25-29.9 Obese = BMI 30-39.9 Severely obese = BMI >40

Height / Weight Table

Perspective on Weight
Aim for personal healthy weight Avoid unrealistic goals Listen to bodys cues (for hunger) Eat a healthy diet Be physically active Size acceptance

Obesity
Excessive

amount of body fat

Women > 35% body fat Men > 24% body fat
Increased

risk for health problems Are usually truly overweight

Estimation of Body Fat

Underwater weighing Very accurate Fat is less dense than lean tissue Fat floats

Underwater Weighing

Estimation of Body Fat

Air displacement Determines the body volume

Displace air in a sealed chamber

Body density = Body wt/body volume % Body fat= (495/body density)-450

Bod Pod

Skinfold Measurements

Estimation of Body Fat

Bioelectrical impedance
Low-energy current that measures the resistance of electrical flow Fat is resistant to electrical flow; the more the resistance, the more body fat

DEXA (dual x-ray photon absorptiometry)

X-ray body scan that allows for the determination of body fat Most accurate but expensive

Dual X-ray Photon Absorptiometry

Body Fat Distribution

Upper-body obesity, Apple shape Associated with

Cardiovascular disease, HTN, type 2 diabetes Testosterone and excessive alcohol Abdominal fat is released into the liver and promotes inflammation in the body

Defined as
Waist measurement of > 40 for men Waist measurement of >35 for women

Body Fat Distribution

Body Fat Distribution

Lower-body

obesity, Pear shape Encouraged by estrogen and progesterone After menopause, upper-body obesity more common Fewer health risks than upper-body obesity

Juvenile-Onset Obesity
Develops

in infancy or childhood Increase in the number of adipose cells Adipose cells have long lifespan and need to store fat Makes it difficult to lose fat (weight loss)

Adult-Onset Obesity
Develops

in adulthood Fewer (number of) adipose cells Adipose cells are larger (store excess amount of fat) If weight gain continues, the number of adipose cells can increase

Obesity and Nature Debate

Identical twins
When raised apart still have similar weights

Genes
Affect metabolic rate, fuel use, brain chemistry, body shape Account for up to 70% of weight differences

Thrifty metabolism gene

More fat storage to protect against famine

Set-Point Theory
Weight

is regulated by the body Genetically predetermined body weight Body resists weight change Leptin assists in weight regulation Reduction in calorie intake results in lower metabolic rate Ability to shift the set-point weight?

Opponents of Set-Point Theory

Weight

does not remain constant environments can alter

Different

weight

People

settle into a particular weight based on current circumstances

Obesity and Nurture Debate

Environmental

weight Learned eating habits Activity factor (or lack of) Poverty and obesity Female obesity is rooted in childhood obesity Male obesity appears after age 30

factors influence

Nature and Nurture

Obesity

is nurture allowing nature to express itself Location of fat is influenced by genetics Child of obese parents is especially at risk Increased physical activity and moderate calorie intake can promote healthy weight

What Encourages Excess Body Fat?

Why Diets Dont Work

Obesity

is a chronic disease

Treatment requires long-term lifestyle changes

Dieters

are misdirected

More concerned about weight loss than healthy lifestyle Unrealistic weight expectations

Looking for a Sound Weight-Loss Program?

Seek

advice from a Registered Dietitian Control calorie intake Increase physical activity Acknowledge need for lifelong changes to maintain healthy weight

Weight-Loss Triad

Control Calories

Sedentary society---requires less calories Low-fat, high-fiber approaches

Most successful in long-term studies

No diet has a metabolic advantage

Read food labels Keep a food log (portion size awareness)

Regular Physical Activity

Important for weight maintenance Promotes steady weight loss

Expends 100-300 kcal while controlling calories

Boosts self-esteem Add weight resistance

Increase Increase Increase Increase

lean body mass fat use bone health metabolic rate

Physical Activity Recommendations

60 minutes/day to maintain body weight 60-90 minutes/day for maintenance of weight loss Pedometer

Goal 10,000 steps a day

What it Takes to Lose a Pound

Body

fat contains 3500 kcal per pound storage (body fat plus supporting lean tissues) contains 3300 kcal per pound have an energy deficit of about 3300 kcal to lose a pound per week

Fat

Must

Do the Math
To lose one pound, you must create a deficit of 3300 kcal

So to lose a pound in 1 week (7 days), try cutting back on your kcal intake and increase physical activity so that you create a deficit of about 500 kcal per day

- 500 kcal x 7 days = - 3500 kcal = ~ 1 pound of weight day week loss in 1 week

Sound Weight Loss Program

Rate

of loss Flexibility Intake Behavior modification Overall health

Behavior Modification
Modify

problem (eating) behaviors Chain-breaking Stimulus control Cognitive restructuring Contingency management Self-monitoring

Chain-Breaking
Breaking

the link between two behaviors links can lead to excessive

These

intake

Stimulus Control
Altering

the environment

Minimize the stimuli for eating

Putting

you in charge of temptations

Cognitive Restructuring
Changing

your frame of mind regarding eating eating due to stress with

Replacing

walking

Contingency Management
Forming

a plan of action

Response to a situation
Rehearsing

appropriate responses

The pressure of eating at parties

Self-Monitoring
Tracking

foods eaten and conditions affecting eating your eating habits

Understanding

Weight Maintenance

Prevent relapse
Occasional lapse is fine, but take charge immediately Continue to practice newly learned behavior Requires motivation, movement, and monitoring

Have social support

Encouragement from friends/ family/ professionals

Diet Drugs

Amphetamine (Phenteramine)
Prolongs the activity of epinephrine and norepinephrine in the brain Decreases appetite Not recommended for long-term use (dependency)

Sibutramine (Meridia)
Enhances norepinephrine and serotonin activity Decreases appetite Not recommended for people with HTN

Orlistat (Xenical)

Inhibits (lipase) fat digestion Reduces absorption of fat by 30% in the small intestine Dietary fat is deposited in the feces, with resulting side effects Must still control fat intake Malabsorption of fat-soluble vitamins Supplement needed at bedtime Alli---Low dose of Orlistat, available OTC

Orlistat (Xenical)

Treatment of Severe Obesity

Very Low-Calorie Diets (VLCD)

Recommended for people >30% above their healthy weight 400-800 kcal per day Low carbohydrate and high protein Cause ketosis Lose ~3-4 pounds a week Require careful physician monitoring Health risks include cardiac problems and gallstones

Bariatric Surgery

Adjustable Gastric Banding

Reduces opening from esophagus to stomach by gastric band Decreases amount of food eaten Band can be inflated or deflated

Gastroplasty - Stomach Stapling

Most common surgical procedure for treating severe obesity Reduces the stomach size

From 4 cups to 1 oz (shot glass size)

Overeating will result in rapid vomiting Smaller stomach promotes satiety earlier 75% will lose ~50% of excess body weight

Gastroplasty

Criteria for Gastroplasty

BMI > 40 Obese for > 5 years No history of alcoholism No history of major psychiatric disorder Costly procedure Follow-up needed after procedure loss Requires major lifestyle changes

Underweight is Also a Problem

BMI

of <18.5

Associated

with increased deaths, menstrual dysfunction, pregnancy complications, slower recovery from illness/surgery

Treatment for Underweight

Intake

input) Encourage regular meals and snacks Reduce activity (energy output) Increase portion size Strength training

of energy-dense foods (energy

Fad Diets
Promote

quick weight loss Limited food selections Use of testimonials Cure-alls Recommend expensive supplements No permanent lifestyle changes advocated Critical of the scientific community

Types of Popular Diets

Low or restricted carbohydrates Carbohydrate focused diets Low-fat approaches Novelty diets Meal replacements

Popular Diets