Podcast
Questions and Answers
What is the purpose of calculating desired body weight?
What is the purpose of calculating desired body weight?
What is a safe and effective rate of weight loss per week?
What is a safe and effective rate of weight loss per week?
Which measurement is NOT essential for developing weight loss goals?
Which measurement is NOT essential for developing weight loss goals?
How much weight does Shawn need to lose to achieve his ideal body weight based on the example provided?
How much weight does Shawn need to lose to achieve his ideal body weight based on the example provided?
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What does Total Energy Expenditure (TEE) reflect?
What does Total Energy Expenditure (TEE) reflect?
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What factors are critical for effective weight management?
What factors are critical for effective weight management?
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In the case of attaining weight loss goals, which scenario is more realistic for a new individual?
In the case of attaining weight loss goals, which scenario is more realistic for a new individual?
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What percentage of weight reduction is associated with improved overall health?
What percentage of weight reduction is associated with improved overall health?
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What percentage of Total Energy Expenditure (TEE) does Resting Energy Expenditure (REE) account for?
What percentage of Total Energy Expenditure (TEE) does Resting Energy Expenditure (REE) account for?
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Which factor is considered the most controllable in Total Energy Expenditure?
Which factor is considered the most controllable in Total Energy Expenditure?
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How many calories are needed for a daily deficit to lose 1 lb of fat per week?
How many calories are needed for a daily deficit to lose 1 lb of fat per week?
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What is the primary method to measure Resting Energy Expenditure (REE)?
What is the primary method to measure Resting Energy Expenditure (REE)?
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Which of the following is NOT a component of Total Energy Expenditure?
Which of the following is NOT a component of Total Energy Expenditure?
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What is the recommended duration of moderate to vigorous physical activity per week for effective weight loss?
What is the recommended duration of moderate to vigorous physical activity per week for effective weight loss?
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According to the information, what is a healthy rate of weight loss per week?
According to the information, what is a healthy rate of weight loss per week?
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What is the caloric equivalent of 1 pound (0.45 kg) of body weight?
What is the caloric equivalent of 1 pound (0.45 kg) of body weight?
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Study Notes
Weight Management
- Weight management depends on energy balance—calories consumed and calories expended
- 5% to 10% weight reduction improves overall health
- Safe weight loss is 1-2 lbs per week
- Multiple goals may be needed to achieve desired body fat percentage and weight
Objectives
- Review anthropometric measurements and body composition assessments
- Understand best practices for obesity treatment and weight gain prevention
- Learn key nutrition messages from USDA 2010-2015 Guidelines
- Understand and apply ACSM Metabolic calculations
- Understand total energy expenditure (TEE) and its components
Calculation of Desired Body Weight (BW)
- Purpose: calculate weight loss and determine the desired percentage of fat for individuals
- Ideal Body Weight (IBW) calculation considers the desired percentage of body fat relative to lean body mass (LBM).
- Example: A 190 lb (86.4 kg) man with 22.3% body fat has 42.37 lbs (19.25 kg) of fat weight and 147.63 lbs (67.1 kg) LBM. IBW is estimated at 173.68 lbs (78.9 kg) at 15% body fat for a man.
- Weight loss is calculated by subtracting IBW from current body weight
Example Problem
- Shawn, weighing 225 lbs with 30% body fat, aims for 25% body fat.
- LBM calculation: 102.27 kg total weight - 30.68 kg fat = 71.59 kg LBM
- IBW calculation: 95.45 kg
- Weight loss needed: 102.27 kg (current) - 95.45 kg (IBW) = 6.82 kg (15 lbs).
- Goal attainment, 1-2 lbs per week loss is recommended
Energy Balance
- Body weight management depends on energy balance—calories consumed vs. calories expended.
- Total Energy Expenditure (TEE): the total number of calories expended each day reflecting metabolic processes within the body
- Influenced by genetics, lean body mass (LBM), gender, and ethnicity
Total Energy Expenditure (TEE)
- Resting Energy Expenditure (REE/RMR/BMR): 55% to 75% of TEE, body's energy needs for vital functions
- Thermic Effect of Food (TEF): 7-10% of TEE, increase in metabolic rate after eating (used to digest food)
- Physical Activity Expenditure (PAE): 15% to 30% of TEE, energy used during physical activity (calories burned). Most controllable aspect of TEE
Estimated Calorie Needs
- Table details estimated calorie needs by age, gender, and physical activity level.
Calculating Total Energy Needs
- Measured using indirect calorimetry—measuring oxygen consumption.
- Calculated using predictive equations (Table 7.9). Factors include age, gender, height, weight, or fat-free mass.
- Physical activity factor is used to calculate TEE from REE
Common REE (RMR) Equations
- Formulas for calculating Resting Energy Expenditure (REE). Two different formulas are shown in the slide. Harris-Benedict and Mifflin-St Jeor
Activity Factors
- Table shows common activity factors used to estimate total daily calorie needs for weight maintenance. Levels range from sedentary to exceedingly active. (Common Activity Factors Table)
TEE Prediction Harris Benedict
- Example calculation for a 35-year-old male
- REE calculation using the Harris-Benedict equation factors in weight (kg), height (cm) and age.
- TEE is determined by multiplying REE and the PAL
- Calories needed for weight loss and maintenance are derived using this
Energy Expenditure
- 3,500 calories are needed to store/make 1 lb of body weight
- Healthy & reasonable weight loss is 1-2 lbs per week for most individuals
- Metabolic equations can estimate expended calories during workouts and exercise time.
ACSM Weight Loss Position Stand
- Diet and moderate-to-vigorous physical activity (MVPA) results in most significant weight loss
- Regular MVPA is needed to prevent weight regain after weight loss
- Increased levels of MVPA do result in better weight maintenance
Weight Loss & Obesity
- Various activities (walking, swimming, etc.) are suitable for weight loss.
- The FITT principle—Frequency, Intensity, Time, and Type—can be tailored to an individual's needs.
- High intensity activity can be worked into small periods.
Weight Loss FITT Principle
- Frequency (≥5 days/week) to maximize calorie expenditure.
- Intensity (progression from moderate to vigorous) that will result in greater health benefits.
- Time (minimum of 30 minutes/day, and can progress to 60 minutes/day, or even more.)
- Type (aerobic activities that involve large muscle groups). Resistance and flexibility training is an integral component of FITT
FITT Recommendations for Overweight/Obese Individuals
- Frequency recommendations (to maximize calorie expenditure)
- Intensity (moderate to vigorous) to improve health.
- Time (minimum of 30 min/day; can increase amount with gradual progression.)
- Type: Aerobic activities that involve larger muscle groups such as walking, cycling and swimming.
How to Calculate Metabolic Equations
- Example calculation of caloric expenditure using metabolic equations for a specific exercise. (See Example given)
Treating Obesity
- Many ineffective and some dangerous methods exist
- Appropriate methods for weight loss include exercise, a change in diet, behavioral strategies, and bariatric surgery.
- Bariatric surgery can be medically indicated in severe cases.
Inappropriate Weight Loss Methods
- Table 7.13 in the slides list various inappropriate methods
- Side effects listed for different diets
Nutritional Behavioral Strategies
- Tracking food and/or activity levels
- Setting realistic and specific goals
- Adjusting the environment to support behavior change
- Problem-solving to identify challenging situations and test possible solutions.
Weight Loss Supplements
- The EP has a responsibility to encourage healthy weight loss
- Many weight loss products lack evidence of efficacy
- It's essential to consult with a health care professional for appropriate use
- Be cautious when using unproven methods and/or supplements
Dieting
- Caution is required when approaching popular diets in general; some eliminate certain food groups.
- Variety is important for growth and development
- Seek professional advice to determine the safety and effectiveness of specific diets
Medications & Weight Management
- Table 7.14 lists medications and their potential effect on weight. (See Table in notes)
Nutrition during Pregnancy
- Increased energy and nutritional needs (up to 300 extra calories/day)
- Importance of prenatal vitamins (folic acid and iron) for preventing birth defects.
- Increased blood supply requires extra iron to support oxygen delivery
Nutrition for Children and Older Adults
- Recommended daily allowances for vitamin D (600 IU, up to 800 IU) for different populations.
- Calcium is important for childhood growth and development, with age-specific needs.
- Vitamin B12 supplementation can be beneficial for older adults.
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