Nutrition and Health Lecture 8 PDF

Faculty of Applied Health Sciences Department of Health Sciences Nutrition and Health HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Nutrition to support health Public...

Faculty of Applied Health Sciences Department of Health Sciences Nutrition and Health HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Nutrition to support health Public – Eating Well with Canada’s Food Guide Nutritionist/Dietitians – Health Canada’s Dietary Reference Intake tables HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences What is a healthy body weight? A healthy body weight – is appropriate for your age – is maintained without constant dieting – is acceptable to you – is based on family history of body shape and weight – promotes good eating habits and allows for regular physical activity HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Energy balance Underweight: having too little body fat to maintain health. Overweight: having a moderate amount of excess body fat. Obesity: having an excess of body fat that adversely affects health. HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Evaluating body weight A person’s actual weight is not the only factor to consider. Determining if a person’s body weight is healthy should include: – Body Mass Index (BMI) – body composition – pattern of fat distribution HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Evaluating body weight Body Mass Index – expresses the ratio of a person’s weight to the square of their height – BMI = weight (kg) / height (m)2 HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Evaluating body weight Overweight – BMI between 25 and 29.9 – increases the risks of high blood pressure, heart disease, type 2 diabetes sleep disorders, osteoarthritis, gallstones – can lead to obesity Obesity – BMI over 30 HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Evaluating body weight Underweight – BMI below 18.5 – increased risk of infections and illness and can even be fatal – can be just as unhealthy as overweight HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Underweight Overweight Obese HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Obesity in Canada https://www150.statcan.gc.ca/n1/pub/11-627-m/11-627- m2018033-eng.htm HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Diet and Health Cancer Other Heart disease COVID-19 Accidents Stoke Chronic lower respiratory diseases Obesity-linked Diabetes Not obesity-linked Influenza and pneumonia Alzheimer's 0 5 10 15 20 25 30 Percent of total deaths HLSC 2P91 Nutrition Statistics Canada, 2022  Faculty of Applied Health Sciences Department of Health Sciences Evaluating body weight Limitations of the Body Mass Index (BMI) The BMI is not appropriate for those who are – under the age of 18 years (talk about next week) – pregnant or nursing – over age 65 years – certain ethnic and racial groups – high in muscle mass BMI = 41.4 HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Evaluating body weight Body composition – provide an assessment of: lean body mass percent body fat – different methods with strengths and limitations HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Evaluating body weight Fat distribution pattern – measured by waist-to-hip ratio and waist circumference – look at fat patterning Apple-shaped - upper body – abdominal/central fat – increased risk for chronic diseases Pear-shaped – lower body – subcutaneous/peripheral fat – no increased risk for chronic diseases HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Evaluating body weight Strengths Limitations BMI Accurately predicts health Cannot indicate pattern or risks related to obesity in amount of fat or lean body large groups of individuals mass. Does not account for differences in gender, frame size, or activity level. Body composition Most accurate way to Does not identify where measure body fat the fat is located. Fat patterning Based on body shape, can Does not directly measure indicate if a person has a body fat content. higher risk of certain chronic diseases. HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Adult nutrition Dietary analysis will reveal important points – diet should reflect your needs – nutrient content is important for energy balance HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Gaining or losing weight Whether a person gains or loses weight depends on: 1. Energy balance = energy intake vs. energy expenditure HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Energy balance Occurs when energy intake = energy expenditure – Energy intake = kcal from food – Energy expenditure = energy expended at rest and during physical activity HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Energy balance HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Energy output Basal metabolism or basal metabolic rate (BMR) – energy expended to maintain basal, or resting, functions of the body (respiration, circulation, secretion, communication) – highest proportion of total energy expenditure HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Energy output (cont’) Different weight Similar weight HLSC 2P91 Nutrition Similar BMR Different BMR  Faculty of Applied Health Sciences Department of Health Sciences Energy output (cont’) Direct calorimetry – measures the amount of heat the body releases – 1 kcal = amount of energy (heat) required to raise 1 kg (1 L) of water by 1°C at sea level HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Energy output (cont’) Indirect calorimetry – estimates energy expenditure based on O2 consumption and CO2 release – less expensive and more accessible HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Energy output (cont’) Physical activity – voluntary movement of skeletal muscles and support systems above basal heart lungs – most variable HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Energy output (cont’) Thermic effect of food – energy required during digestion – proportional to energy content of mixed meal (5-10%) HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Energy balance To be weight stable, every calorie in must equal every calorie out Difficult to measure energy expenditure on a day-to-day basis due to fluctuations in: – activity – environment – diet composition What can we do? HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Estimate energy needs DRI tables HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Gaining or losing weight Whether a person gains or loses weight depends on: 1. Energy balance = energy intake vs. energy expenditure 2. Genetic factors HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Genetic factors Genetic factors account for about 25% of a person’s body 25% fat Genetic factors 75% Non-genetic factors HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Genetic factors Different ideas have been suggested to explain the impact of genetics on body fat Thrifty Gene Theory Set-Point Theory HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Thrifty Gene Theory Evolved from hunter-gatherers who went without food for extended periods of time Modernization has allowed us to expend less energy (energy conservation) while taking in more HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Set-Point Theory Increase intake, increase BMR; decrease intake, decrease BMR Study looked at weight gain with 1000 kcal extra energy per day and demonstrated inter-twin variation intra-twin similarities Bouchard et al., 1990, New HLSC 2P91 Nutrition Eng J Med 322:1477  Faculty of Applied Health Sciences Department of Health Sciences Gaining or losing weight Whether a person gains or loses weight depends on: 1. Energy balance = energy intake vs. energy expenditure 2. Genetic factors 3. Physiological factors HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Physiological factors Hunger and satiety (talked about this in Lecture 3) Proteins – ghrelin – peptide YY – leptin HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Leptin  Energy expenditure  Food intake   HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Gaining or losing weight Whether a person gains or loses weight depends on: 1. Energy balance = energy intake vs. energy expenditure 2. Genetic factors 3. Physiological factors 4. Behavioural and social factors HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Behavioural factors Food choices – the composition of a person’s diet should remain balanced Hunger vs. Appetite – appetite, a psychological desire to eat, can cause people to overeat HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Social factors Social factors influencing our diet include: – family or cultural traditions – holidays and celebrations – easy access to high-fat foods – less physically active lifestyles – societal expectations of the “perfect” body HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Causal web of factors ASPQ, 2004 HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Healthy body weight Healthy body weight change requires: – gradual change in energy intake HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Healthy body weight Effective weight loss should include: – following recommended serving sizes – eat more fresh and less processed foods – increase nutrient density HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Healthy body weight Effective weight gain should include: – eating 500 to 1,000 extra kcal/day – eating frequently throughout the day – maintaining a balanced diet, limiting fat intake to 15-30% of total energy intake – avoiding tobacco products which depress appetite and increase BMR HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Healthy body weight Healthy body weight change requires: – gradual change in energy intake – application of behavioural modification techniques HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Healthy body weight Serving size HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Healthy body weight Healthy body weight change requires: – gradual change in energy intake – application of behavioural modification techniques – regular and appropriate physical activity HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Physical health Physical health includes – nutrition – physical activity HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Physical activity, exercise, & physical fitness Physical activity: any muscle movement that increases energy expenditure. Leisure time physical activity: any activity unrelated to a person’s occupation. – e.g., hiking, walking, biking – includes exercise – purposeful, planned physical activity HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Physical activity, exercise, & physical fitness Physical fitness: state of being created by the interaction between nutrition and physical activity Physical fitness includes: – cardiorespiratory fitness Endurance – musculoskeletal fitness Flexibility – flexibility Strength – body composition HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Benefits of physical activity Regular physical activity – makes weight management easier – expend more energy at rest (greater BMR) due to greater lean mass HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Benefits of physical activity (cont’) Reduces the risk of – cardiovascular disease – obesity – type 2 diabetes – osteoporosis – colon cancer HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Physical fitness program A sound physical fitness program – meets your personal goals – is fun – warm up and cool down period – includes variety and consistency HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences https://csepguidelines.ca/wp- content/uploads/2018/03/CS EP_PAGuidelines_adults_en.p df HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences This week’s module Physical activity is an important component to healthy body weights and overall health. But everywhere you turn, a number of "quick fix" exercise programs promising weight loss and physical well-being are populating the airwaves and print. Identify 1 commercial exercise program (0.5 marks), who the target audience is (0.5 marks) and compare it against CSEP physical activity guidelines to see if it meets the guideline for the target audience in questions (1.5 mark) HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Other physical activity guides Early years (0-4) Children (5-11) HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Other physical activity guides Youth (12-17) Older adults (>65) HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Physical fitness program A sound physical fitness program – meets your personal goals – is fun – warm up and cool down period – includes variety and consistency – appropriately overloads the body HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Physical fitness program Overload principle: additional physical demands on the body to improve fitness – too much physical exertion is NOT recommended – FIT principle can be used to determine appropriate overload HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences FIT principle Frequency – the frequency of physical activity varies with fitness goals Intensity – determining proper intensity may be based on maximal heart rate Time of activity – whether the total activity time is an accumulation of activities or completed all at once HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Frequency Intensity Time HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Frequency Intensity Time HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Physical fitness program A sound physical fitness program – meets your personal goals – is fun – includes a warm-up and cool-down period – includes variety and consistency – appropriately overloads the body – integrates proper nutrition HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Fuel for physical activity Adenosine triphosphate (ATP) – the energy carrying molecule in the body ATP must be generated continuously since muscles store only enough ATP for 1 – 3 seconds of activity. HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Fuel for physical activity Creatine phosphate stores some energy that can be used to make ATP Creatine phosphate stores enough energy for 3 to 10 seconds of maximal physical effort HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Fuel for physical activity After creatine phosphate, carbohydrates and lipids are the next source of energy for the production of ATP Proteins are not used extensively as fuel source for physical activity HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Diet to support physical activity and health HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Diet to support physical activity and health Energy HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Diet to support physical activity and health Energy HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Diet to support physical activity and health Carbohydrates Costill & Miller 1980, Int J Sports Med 1:2-14 HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Diet to support physical activity and health Lipids Romijn et al., 1993, Am J Physiol 265:E380 HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Diet to support physical activity and health Protein HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Diet to support physical activity and health Water HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Diet to support physical activity and health B vitamins CHO metabolism thiamin riboflavin B12 panthothenic B6 niacin acid Protein metabolism Fat metabolism panthothenic niacin B6 riboflavin acid folate B12 niacin B12 HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Diet to support physical activity and health Canadian iron sufficiency Female Iron 100 Male Non-heme Heme 95 Percent sufficiency of the 90 85 population 80 75 70 65 60 55 50 5-13 14-18 19-50 51-79 Cooper et al, 2023 HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Sample “long answer” question – 10 marks You have a client that wishes to bring their body weight into a healthier range. Their height is 1.75 m and their weight is 110 kg. – What is their BMI and how would they be classified based on their BMI (show your work; 2 marks)? – Identify 4 aspects of weight management you will target and how you will discuss this with your client (8 marks). HLSC 2P91 Nutrition  Faculty of Applied Health Sciences Department of Health Sciences Sample “long answer” question – 10 marks You have been approached by a client, a healthy young woman in her twenties that is complaining of a lack of energy, and that she easily catches colds and finds it difficult to fight them. Simply, she doesn’t feel as healthy as she has in the past. Despite a relatively healthy diet, you suspects these problems may be due to her recent switch to an exclusive vegan diet. – List 5 nutrients that you would discuss with her, highlighting adaptations she must make to her diet to make her feel healthy again (Please note: DO NOT discuss supplements or fortification, please restrict your discussion to naturally occurring nutrients, focusing on what may have happened in her transition from a mixed to a vegan diet, and you must assume she wishes to remain on the vegan diet). HLSC 2P91 Nutrition