NCM 105 Energy Balance PDF

ENERGY INTAKE Calories in a diet are estimated by multiplying grams of carbohydrates, protein, fat, and alcohol by appropriate calories per gram. The total number of calories in a food or diet can be estimated by Energy...

ENERGY INTAKE Calories in a diet are estimated by multiplying grams of carbohydrates, protein, fat, and alcohol by appropriate calories per gram. The total number of calories in a food or diet can be estimated by Energy multiplying total grams of these nutrients by the appropriate calories per gram—namely, 4 cal/g for carbohydrates and protein, 9 cal/g for fat, and 7 cal/g for alcohol. Balance However, counting calories is imprecise and requires accurate portion sizes and nutritional composition. Another method is to estimate servings from each food group, which involves multiplying the number of servings by the average amount of Dr. Ann C. Nery calories in a serving. This method depends on the quality of foods consumed and accuracy of portion size estimation. NCM 105_energy balance - October 5, 2024  ENERGY EXPENDITURE The body uses energy for involuntary activities and purposeful PA. The total of these expenditures represents the number of calories a person uses in a day. Basal metabolism is the amount of calories needed to fuel involuntary body activities after a 12-hour fast. It accounts for 60% to 70% of total calories expended, with less active individuals using more calories. A rule-of-thumb method for estimating BMR is to multiply healthy weight by 10 for women and 11 for men. However, this method does not account for other factors a ecting metabolic rate, such as body composition. Lean tissue contributes to a higher metabolic rate than fat tissue, resulting in higher metabolic rates in men. Aging causes calorie requirements to decrease, but strength training can increase BMR, even in frail, institutionalized individuals. Basal Metabolic Rate (BMR) or Basal Energy Expenditure (BEE): the amount of calories expended in a 24-hour period to fuel the involuntary activities of the body at rest and after a 12-hour fast. Resting Metabolic Rate (RMR) or Resting Energy Expenditure (REE): the amount of calories expended in a 24-hour period to fuel the involuntary activities of the body at rest. RMR does not adhere to the criterion of a 12- hour fast, so it is slightly higher than BEE because it includes energy spent on digesting, absorbing, and metabolizing food. NCM 105_energy balance - October 5, 2024 ff  Physical activity (PA) contributes to 30% of total calories used, with intensity Estimating Total Energy Expenditure and duration a ecting energy consumption. Heavier individuals burn more calories. Total calorie needs can be imprecisely estimated by using predictive equations, of which more than 200 have been published. The following are Estimating daily PA calories is easier by calculating the percentage increase di erent approaches for estimating calorie needs; all yield estimates, not above BMR based on estimated intensity of daily activities. Recording all precise measurements. activity for a 24-hour period is a tedious process. Add the results of the rule-of-thumb methods described earlier for Thermic e ect of food is an energy expenditure that represents the cost of estimating BMR and calories spent on activity (Box 7.1). processing food, estimated to be 10% of total calorie intake in a normal mixed diet. Use a simple formula of calories per kilogram of body weight, such as 25 cal/kg to 30 cal/kg, which is often used for nonobese adults. This formula is It varies with food composition, frequency, and meal size. Despite its adjusted upward or downward based on the client’s age, weight, or activity legitimate use of calories, thermic e ect is often underestimated when level. estimating calorie requirements due to its small energy content and imprecise estimation. Use a standard reference that lists estimated daily calorie needs based on gender, age, and activity. Table 7.3 lists estimated daily calorie needs. Healthy weight is statistically related to good health, but the relationship is more complex than just the number on the scale. Body fat, distribution, and health risks also in uence weight. Table provides standards for evaluating ideal body weight, body mass index, and waist circumference, but these values are arbitrary as risk exists on a continuum without absolute cuto s. Activity: compute for your ETEE Pass it in the Gclassroom NCM 105_energy balance - October 5, 2024 ff ff ff fl ff  Ideal Body Weight Body mass index (BMI) has replaced traditional height-weight measurements The Hamwi method is a quick and easy way to compute “ideal” body weight in clinical settings, as the U.S. Preventive Services Task Force (USPSTF) (IBW) based on an adult’s height and gender. The formula is as follows: concluded in 2003 that BMI is an acceptable measure for identifying adults For women: Allow 100 pounds for the rst 5 ft of height Add 5 pounds for each with excess weight. additional inch of height The formula to calculate BMI is weight in kilograms divided by height in For men: Allow 106 pounds for the rst 5 ft of height Add 6 pounds for each meters squared or weight in pounds divided by height in inches squared additional inch of height. multiplied by 703. Nomograms and tables that plot height and weight to determine BMI eliminate complicated mathematical calculations. Using this formula, a 5 ft 6 in tall women would have an “ideal” weight of 130 pounds and a man of the same height would have an “ideal” weight of 142 However, BMI levels de ning overweight and obesity are somewhat arbitrary pounds. IBW can be adjusted upward or downward by 10% based on estimation due to the continuous relationship between increasing weight and disease of a person’s frame size. Likewise, for people who are less than 5 ft tall, 21⁄2 risk. BMI does not take body composition into account, and ethnic pounds are subtracted for each inch under 5 ft. Although this formula is simple to di erences exist in the relationship between BMI and health risks. use, it does not take into account body composition or distribution of body fat, both of which impact health risk. Waist Circumference ENERGY BALANCE IN HEALTH PROMOTION Recent evidence suggests that waist circumference may be an acceptable Energy balance refers to the relationship between calorie intake and output, alternative to BMI measurement in some subpopulations. with a positive balance occurring when calorie intake exceeds output, leading to The location of excess body fat may be a more reliable indicator of disease weight gain. risk than the degree of total body fatness. Conversely, a negative balance occurs when output exceeds intake. In the US, Storing a disproportionate amount of total body fat in the abdomen 68.8% of adults and 35.7% of adults are overweight or obese, increasing the increases risks for type 2 diabetes and cardiovascular disease. risk of cardiovascular disease, hypertension, type 2 diabetes, and certain cancers. Men and postmenopausal women tend to store excess fat in the upper body, while premenopausal women store it in the lower body. Ethnic Poor food choices and physical inactivity contribute to this imbalance, with groups di er in where risk begins in relation to waist circumference. Americans consuming 35% of their total calories in empty form and fewer than 5% participating in 30 minutes of physical activity daily. NCM 105_energy balance - October 5, 2024 ff ff fi fi fi  State of energy balance: Eat Only to Relieve Hunger Choose Nutrient-Dense, Not Calorie-Dense Items Eating should not be a distraction from boredom or stress, and should be done Nutrient-dense items like fruits, vegetables, whole grains, legumes, nuts, mindfully, focusing on internal cues for satiety and not consuming excessive nonfat milk, and lean proteins are healthier alternatives to calorie-dense items calories, and not engaging in other activities. like fast foods. Maintain a Consistent Eating Pattern Eating out less, bringing healthy snacks home, and stocking the pantry with only healthy items can help maintain a healthy diet. Avoiding periods of hunger may help avoid bingeing; people become less discriminating in their food choices when they are “starving.” Avoid commercially pre-packaged "junk" foods that are modi ed to be "fat- free" or "sugar-free," as these foods still contain calories from protein and Breakfast is important for children and adults; observational studies show an carbohydrates. inverse relationship between the frequency of eating break- fast and the risk for obesity and other chronic diseases such as type 2 diabetes (Song, Chun, Obayashi, Cho, and Chung, 2005; Wyatt et al., 2002) NCM 105_energy balance - October 5, 2024  Activity Choices: Move More, Sit Less Right Portion Sizes Increased activity levels are dose-dependent and can range from 2 to 5 Over the past 20 years, portion sizes have increased signi cantly, with hours per week. grocery stores selling large food packages 10 times larger than regular ones. Muscle-strengthening activities, including strength training, resistance Restaurants consistently o er jumbo portions that are 250% larger than training, and endurance exercises, help build muscle, raise metabolic rate, regular ones. and increase weight loss and body fat loss. Even small changes in dishware size can increase calorie intake. This These activities also improve bone density and decrease the risk of "portion distortion" a ects people's perception of food intake, leading to osteoporosis. overconsumption and weight gain. Sedentary behavior increases the risk of weight gain, obesity, and chronic To combat this, strategies to make food less accessible include switching to diseases like type 2 diabetes and cardiovascular disease. smaller plates, buying smaller packages, buying prepackaged, portion- controlled items, storing food out of sight, ordering smaller portions at To reduce sedentary behavior, limit television viewing and replace it with restaurants, and using doggie bags. more physically active pursuits. NCM 105_energy balance - October 5, 2024 ff ff