Health

1. Health Chapter 8 Maintaining a Healthy Weight

2. Eye on the Media • Are t.v. shows like ‘Biggest Loser’ and ‘Extreme Makeover’ good? • What about the idea that shows like this give children the idea that they have to look a certain way? • Is there too much emphasis from the media on weight?

3. Stats • 30% or 60 million, adult Americans are obese with more women, 33%, then men, 28%. • Since 1991 the number of overweight children & adolescents has went up 74% and tripled in the last 20 yrs. • Obesity may account for as many as 400,000 deaths annually. • Table 6.1, pg 176 • Why? Increased caloric intake and reduced activity levels.

4. Adipose Tissue • Tissue made up of fibrous strands around which specialized cells designed to store liquefied fat are arranged. • Adipose tissue stores the excess energy that you consume. • The continuous buildup of adipose tissue leads to excess weight and can eventually result in obesity.

5. Body Image and Self-Concept • Body image – our subjective perception of how our body appears • The average women is 5’4’’, 143 lbs and wears a size 10-12, but the average model is 5’10’’. 110 lbs. • Many men & women have some part of their body that they are not happy with. • Combine this unhappiness with the media and social ideals and problems can arise.

6. Body Image and Self-Concept • Society’s ideal body image for a man and a women changes over time. • What was ideal in the 40’s and 50’s changed in the 70’s & 80’s, and again in the late 90’s into today. • Not everyone agrees with societies ideal body image. What is it? • Bigorexia – the obsession with getting bigger and more muscular, and thinking that your body is never muscular enough

7. Body Image and Self-Concept • What do most women want to look like? • What do most men want look like? • What do women want men to look like? • What do men want women to look like? • Does your ideal image agree with society?

8. Defining Overweight and Obesity • Overweight – a condition in which a person’s excess fat accumulation results in a body weight that exceeds desirable weight by 1-19% • Obesity – a condition in which a person’s body weight is 20% or more above desirable weight as determined by standard height/weight charts • Desirable weight – range deemed appropriate for people, taking into consideration gender, age and frame size

9. Defining Overweight and Obesity • Body mass index – a mathematical calculation based on weight and height; used to determine desirable body weight • Sleep apnea – a condition in which abnormalities in the structure of the airways lead to periods of greatly restricted air flow during sleep. Resulting in reduced levels of blood oxygen and placing greater strain on the heart to maintain adequate tissue oxygenation • Positive caloric balance – caloric intake greater than caloric expenditure

10. Determining Weight and Body Composition • Body mass index – indicates the relationship of body weight to height, pg 180 • Nomogram – a graphic means of finding an unknown value, pg 181 • New BMI charts for children and adolescents. • Height/weight tables are no longer considered to be the best way to determine whether body weight is acceptable.

11. Determining Weight and Body Composition • Healthy body weight can be determined by using the weight guidelines in the 2005 Dietary Guidelines for Americans. • This uses the waist-to-hip ratio (WHR), pg 182 • Women with a WHR of .80 or less are within the healthy range. • Men with a WHR of .90

12. Determining Weight and Body Composition • Electrical impedance – a method used to measure the % of body fat using a harmless electrical current • Adipose tissue resists that passage of the electrical current more than muscle tissue does. • BOD POD – an egg-shaped chamber that uses computerized pressure sensors to determine the amount of air displaced by the person's body, similar to hydrostatic weighing

13. Determining Weight and Body Composition • Skinfold measurement – a measurement to determine that thickness of the fat layer that lies immediately beneath the skin; used to calculate body composition • Accurate to within 4% at best • Young adult men 10-15%, above 25% are obese • Young adult women 22-25%, above 30% are obese

14. Determining Weight and Body Composition • Hydrostatic weighing – weighing the body while it is submerged in water • 97% accurate technique. • But you need a large tank, harness/chair attached to a scale, trained individual. • Some people are reluctant to have hydrostatic weighing done because you want as little clothing on as possible for more accurate results • The subject must also be able to remain still underwater long enough to have their weight read

15. Determining Weight and Body Composition • One’s appearance may seem to be the easiest method of determining one’s body size, for most people it is not an accurate measure. Why? • Weight scales are convenient but are not always accurate. • Your body weight fluctuates throughout the day. • Scales also do not take into consideration body frame and composition.

16. Causes of Obesity • Genetics, physiology, metabolism, environmental, psychological? • Genetics, dietary practice and activity level seem to all play a role. • Also sex, age, socioeconomic status and race. • Among women, obesity is strongly associated with socioeconomic status, being twice as common among those with lower status. • 66% of black women compared with 49% of white women.

17. Causes of Obesity • Heredity accounts for 25-40% of the development of obesity. • There is no specific gene that they can find that causes people to be obese, but they are looking. • Typically you will inherit your family traits.

18. Causes of Obesity • Hypothyroidism – a condition in which the thyroid gland produces an insufficient amount of the hormone thyroxin • Hyperthydroidism – the thyroid gland produces an excessive amount of the hormone thyroxin • Thyroxin regulates metabolism. • Hormonal changes can also effect ones eating habits or metabolism rate.

19. Causes of Obesity • Set point – a genetically programmed range of body weight, beyond which a person finds it difficult to gain or lose additional weight • Adaptive thermogenesis – the physiological response of the body to adjust its metabolic rate to the presence of food, theory as to why 90% of people who go on a diet regain the weight lost

20. Causes of Obesity • African American, American Indian and Hispanic American women have the highest risk of becoming overweight. • The more an ethnic group has adapted to and absorbed western culture the higher the rate of obesity within that group. Why? • Upper socioeconomic women tend to be thinner than lower socioeconomic women, while among men there is not such a pattern.

21. Causes of Obesity • Environmental factors such as – smells, advertisements, clocks, portion size, price, availability of food, number of food choices can all make us eat more • People eat in response to their emotions. • Others eat out of habit and associate food with certain activities. • Some develop relationships with food that substitute for real human relationships.

22. Causes of Obesity • Hypercellular obesity – a form of obesity that results from having an abnormally high number of fat cells. • Baby’s who are overfed will develop a greater number of fat cells. • When these infants reach adulthood they will have more fat cells. • Hypertrophic obesity - a normal number of fat cells, but the individual fat cells are enlarged

23. Causes of Obesity • After puberty the number of fat cells remain the same but each fat cell can get bigger. • Many dietary practices are actually initiated during infancy and early childhood. • Children also model what their parents eat and how their parents respond to food. • Children also mimic their parents behavior towards exercising and eating a balanced diet.

24. Causes of Obesity • Inactivity is considered the single most important reason that obesity is so high. • Longer work hours at sedentary jobs, a decline in physical education programs in school and increased participation in sedentary recreational activities. • Also many of the laborsaving devices and increased automation in the home and workplace have contributed to increased inactivity. • Nearly 2/3 of Americans are not physically active on a regular basis & 25% are completely sedentary.

25. Caloric Balance • People gain weight when their energy (caloric) input exceeds their energy output. • Consuming about 3,500 calories a week more than is needed results in a weight gain of 1 lb of fat. • People lose weight when their energy output exceeds their energy input. Fig 6-2 • UDA dietary guidelines are based on consuming 2,000 calories a day.

26. Caloric Balance • Some people need more others less. • Depending on: • Basal metabolism • Activity requirements • Thermic effect of food • Basal metabolic rate – the amount of energy expressed in calories, that the body requires to maintain basic functions. • Lots of factors that effect BMR

27. Caloric Balance • Factors effecting BMR: • Age • Body composition • Activity level • Caloric intake • Hormones • Sleep • Body temperature • Environmental temperature • Physical conditioning • Sex • Pregnancy

28. Caloric Balance • Each person’s caloric activity requirement vary directly according to the amount of daily physical work completed. • You must calculate you energy expenditure in order to determine your energy consumption needs. • Table 2.5 • Which activity burns the most calories per hour per pound?

29. Caloric Balance • Thermic effect of food – refers to the amount of energy our bodies require for the digestion, absorption and transportation of food • Fat requires less energy to convert it to energy stores. • Protein and carbs require more.

30. Weight-Management Techniques • Weight loss occurs when the calories consumed are fewer than required by the body for physiological maintenance and activity. • A simple concept that seems to be made more difficult by the $50 billion-a-year weight loss industry. • When a diet fails it is more often the person’s fault and not the diets. • Then the cycle begins.

31. Weight-Management Techniques • A commitment to a lifestyle change of eating in healthy ways and engaging in regular exercise seems to be the most effective strategy for weight loss and weight maintenance. • A goal of no more than 2 pounds per week should be set. What?

32. Weight-Management Techniques • Dietary alterations such as reducing caloric intake are the most common. • Be wary of very strict diets. • Most people do not follow a strict diet for very long. (the cycle returns) • Portion control along with a well balanced diet works best. • Add in an increase in activity level and presto!

33. Weight-Management Techniques • Fad Diets • Over 150 popular diets. • Most promoted by celebs or people who claim to be nutrition experts. • With few exceptions these diets are ineffective and potentially dangerous. • Usually because the approach is in an attempt to achieve rapid weight loss. • Pros and cons in Table 6.6

34. Weight-Management Techniques • Most weight loss on a low-carb diet is water weight. • Complication associated with low-carb, high- protein diets: • Dehydration, hypertension, heart disease, cancer, electrolyte loss, calcium depletion, weakness due to inadequate carbs, nausea due to ketosis, vitamin 7 mineral deficiencies and possible kidney problems

35. Weight-Management Techniques • “Lite” foods are usually achieved by: • Lowering the carb content with the use of nonnutritive sweeteners • Reducing the portion size • Reducing the fat content of the original formula • Removing the fat completely.

36. Weight-Management Techniques • Controlled Fasting is recommended in extreme obesity cases. • Patients are only given water, electrolytes and vitamins. • Catabolizing – the metabolic process of breaking down tissue for the purpose of converting it to energy • Meal replacement drinks are considered a modified form of fasting, be careful of limiting the daily caloric intake.

37. Weight-Management Techniques • Weight Reduction Programs – Weight Watchers, Jenny Craig • These programs generally feature: • Well-balanced diets • Specific weight loss goals over a set period of time • Encourgament • Focus on regular physical activity • Maintenance program • Do they work?

38. Weight-Management Techniques • Americans spend in excess of $50 billion each year in an attempt to achieve & maintain weight loss. • The weight loss industry has capitalized & profited on the meaning that thinness has in the American culture, including a bias against large people. • These programs are promising not just weight loss but happiness & success in life as well.

39. Weight-Management Techniques • The commercials had to start changing in 1994. • Advertisements cannot misrepresent program performance. • They must disclose that weight lose is temporary and will most likely not approximate that of the successful subjects featured in the commercials. • Check out the ‘medical’ component of a program.

40. Weight-Management Techniques • Phenylporpanolamine (PPA) – the active chemical compound still found in some OTC diet products • Ephedra – ma huang & Chinese ephedra banned in 2003 by the FDA, but can still be found; linked to: • Heart attacks, strokes, hepatitis, headache, tremors, anxiety, extreme irritability and insomnia

41. Weight-Management Techniques • Aristolochia fangchi • Phentermine & fenfluramine – phenfen • Dexfenfluramine – Redux • Phentermine used with Prozac, Zoloft & Paxil • Sibutramine – Meridia • Orlistat – Xenical & Olestra

42. Weight-Management Techniques • Surgical Interventions – liposuction, tummy tucks, gastric bypass & gastric bands • Some insurance companies are paying for these surgical interventions. • Figure 6-5 • Body wraps • Cellulite – tissue comprised of fat cells intertwined around strands of fibrous connective tissue.

43. Weight-Management Techniques • Underweight – a condition in which the body is below the desirable weight • Very serious for some young adults. • Males tend to be particularly concerned with too thin a body type, preferring a lean muscular V-shaped appearance. • Weight Management Tips – pg 204

44. Lifetime Weight Control • Obesity and frequent fluctuation in weight are clearly associated with higher levels of morbidity and mortality. • Keys to your success: • Exercise • Dietary modification • Lifestyle support – support group • Problem solving • Redefinition of health

45. Lifetime Weight Control • Physical activity is now considered to be the most important component to a weight-loss program. • More fat is lost than is lost through dieting alone. • Weight loss achieved through physical activity is 95% fat and 5% lean tissue compared to 75% fat and 255 lean tissue when dieting alone.

46. Eating Disorders • A recent survey showed that dieting has become the norm for females starting at an early age. • 50% of 9 yr olds and 80% of 10 yr olds have reported dieting. • Conservative estimate indicate that after puberty 5 – 10 million females and 1 million males struggle with eating disorders. • Estimated that 8% of college women will develop an eating disorder, with college freshman women being at most risk for developing bulimia.

47. Eating Disorders • 90-05% of people with eating disorders are female. • Athletes such as dancers, gymnasts, swimmers, runners and wrestlers are at risk for developing easting disorders.

48. Anorexia Nervosa • An eating disorder in which the individual weighs less than 85% of the expected weight for their age, gender, height; and in females ceases to menstruate for at least 3 consecutive months • People with anorexia perceive themselves as overweight, even though they are underweight.

49. Anorexia Nervosa • Anorexia has become more common as changing cultural ideals for beauty have changed. • Marilyn Monroe a voluptuous 5’4, 128 lbs to Kate Moss at 5’7, 105 lbs. • Add in the celebs that have come out as suffering from anorexia. • Is that a good thing or a bad thing? • What about pro-anorexia websites?

50. Anorexia Nervosa • Over looked areas related to anorexia: • Anorexia in women of color – more pressure to fit into the ideal image of the dominate culture • Female athlete triad – absence of menses, low body fat and weight, osteoporosis • Men • Treatment can take up to 3-5 years.