kuliah 10 energy & weight management 2015-2016

7/23/2019 Kuliah 10 Energy & Weight Management 2015-2016

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Energy Balance &

Weight ManagementDr. Hadi Riyadi

Dept. Gizi Masyarakat, FEMA, InstitutPertanian Bogor

2015



Weight ManagementWeight Management

Obesity has doubled since 1960

At current rates, all American adultswill be overweight by 2030



TE!"E #PE$IFI$ %EA!T% &I#'# (FE)$E##I"E B(D* FAT

1 Abnormal !lasma li!id and li!o!rotein levels

2 "ndometrial, breast, !rostate, and colon cancers

3 "normous !sychological burden and socialstigmati#ation and discrimination

$ %allbladder disease

& 'y!ertension, stro(e, and dee! vein thrombosis

6 )m!aired cardiac *unction *rom increased mechanicalwor( and autonomic and le*t ventricular dys*unction

+ )ncreased insulin resistance in children and adults andty!e 2 diabetes -0. o* these !atients are overweight/



TE!"E #PE$IFI$ %EA!T% &I#'# (FE)$E##I"E B(D* FAT

- Menstrual irregularities

9 Osteoarthritis, degenerative oint disease, andgout

10 roblems receiving anesthetics during surgery11 enal disease

12 lee! a!nea, mechanical ventilatory constraints!articularly in e4ercise/, and !ulmonary

disease *rom im!aired *unction because o*added e** ort to move the chest wall



+se *our Inor-ation+se *our Inor-ation

Too/sToo/s Te Mirror Boy Mass Ine34BMI6

Goa/7718.5729.:

Boy Fat ;

< 25; -en, =0;

>o-en aist $ir?u-eren?e

<90 -en, =5 >o-en

aist@ %ip &atio

<0.:0 -en, 0.80 >o-en

B/oo ana/ysis



Miller IL. 2010. Weight Management for Triathletes

the World Triathlon Corporation (WTC) consisting of a 2.4mile (!."# $m) s%im& a 112mile(1"0.2' $m) iccle ride and a marathon 2#.2mile (42.2 $m) r*n



the strength5to5weight ratio is acritical *actor in s!ort

o im!rove the strength5to5weight

ratio or the body !ro*ile, athletesty!ically resort to what amounts to aweight5loss strategy by increasing

activity, reducing energy inta(e, ordoing both



ea/ty oy >eigtea/ty oy >eigt

A healthy body weight is a weight that isassociated with health and longevity

)t is a weight at which the ris( o* illness and

death is lowestWhat a healthy weight is *or you de!ends not

only on how much you weigh, but also onyour body com!osition

7ody com!osition re*ers to the !ro!ortion o*your body that is *at versus lean tissue



7M) o* Miss America ageant Winners7M) o* Miss America ageant Winners

SOURCE: Rubinstein, S., and B. Caballero. 2000. Is Miss America an undernourished role model Journal of American Medical Association 2!"#2$%: $&'(.

Used )ith *ermission +rom the American Medical Association.



Te ar-Te ar- up4y Make Dietaryup4y Make Dietary

$ange$ange eres te ECien?e

Diet an Disease $onne?tion &eu?es in?ien?e o

(esity

%eart Disease@

%ypertension

Type II Diaetes

$an?er

Artritis #/eep apnea

oint pain

AMD77 Age7&e/ate

Ma?u/ar Degeneration



educes tresseduces tress

Diet an #tress ?onne?tion I-proCes

#eCerity o stress

i.e. Fight, flight &

freeze Maintains ea/t

>i/e ea/ing >itstress

&eu?es stressre/ate epressionan isorere eating

#pees stressre?oCery



I-proCes #ports Peror-an?eI-proCes #ports Peror-an?e

(Cera// >e//ness (Cera// >e//ness

Diet Enan?es #portPeror-an?e Diet ?ontriutes to (Cera//

e//ness !ongeCity



+*trient ,ensit



1"

Energy- o% %e generate /nerg from ood

- /nerg In and /nerg *t Inp*t 3 ood and Calories

*tp*t 3 Metaolism (M5) and 6hsical 7cti8it

- alance Weight Maintenance

Weight Increase Weight Loss



19

Components of /nerg

*tp*tWe +eed /nerg for:

- asal Metaolism

M5 3 asal Metaolic 5ate- 6hsical 7cti8it

- Metaoli;ing ood



20

Balance food calories

with physical activity level



21



2!

Moderate physical activitiesinclude:

Bicclin- #less than

$0 miles *er hour%

al/in-bris/l

#about

"

miles

*er

hour%

1ancin-

ei-ht trainin-

#-eneral li-ht )or/out%

ardenin-3

ard )or/

4i/in-

ol+ #)al/in-and carrin- clubs%

i h i l i i i



24

igorous physical activitiesinclude:

ei-ht li+tin-

#5i-orous e++ort%

S)immin-

#+reestle

la*s%

Bas/etball

#com*etiti5e% Aerobics

4ea5 ard )or/,such as cho**in- )ood

Bicclin- #more

than $0 miles

*er hour%

Runnin-,

6o--in-

#& miles *er hour%

al/in-

5er +ast

#7 miles*er hour%



2'

/nerg alance



2#

!nput &"utput

E#ample

Inta/e:",700 /cal

Out*ut:

",00& /cal

IMBALANCE:

395 kcal

Eatin- Brea/+ast

20 min.

At the m

70 min.

Co++ee Brea/

$0 min.

Sittin- in Class

$!0 min.al/in- to

Cam*us20 min.

1ressin-3

ashin-

20 min.

al/in- on

Cam*us

"0 min.

Snac/

$0 min.

8irar3Stud

$!0 min. Eatin- 8unch

"0 min.

al/in- 4ome

20 min. Eatin- 1inner

"0 min.

Chec/ email

"0 min. 1ri5in- to9+rom

1ate

"0 min.

Slee* $32hours

1ancin-

70 min.Eatin- Snac/

20 min

4an-in- out

)ith 1ate

$20 minEmailin-3;e<tin-

Studin-$20 min

Undress3Sho)er

"0 min

'&0

&0

&0

$0020

2$0

2&

$&02&0

2& "(&00

&200

2!0$00

&

$200 '&&&

700"(0

&0

$!0

2'0

$0&

7(0

al/in- to9+rom

Cam*us

"0 min.

7 da in thelife<

C l i d /



2=

Calories and /nergalance +T igher

order mathCalories I+ 3 Calories >T Maintain

WeightCalories I+ ? Calories >T @7I+Weight

Calories I+ A Calories >T LB/Weight

;o maintain a desirable )ei-ht, ener-

inta/es should not e<ceed ener- needs.



2"



29

/nerg alance- +egati8e energ alanceachie8ed 8ia:

,ecreased caloric inta$e Increased caloric o*tp*t

Comination of the ao8e



!0

ItDs all ao*t Calorie

alance- If o* eat more calories than o*r od*ses& the %ill e stored as fat

- ne po*nd of od fat is eE*al to !&'00 $cal In theor& losing one po*nd reE*ires a deficit of

!&'00 calories

Eatin- &00 +e)er calories *er da 9 ore<*endin- &00 more calories 9 )ouldresult in losin- one pound per week



!1

Weight Management

- To maintain od %eight in a healthrange& alance calories from foodsand e8erages %ith calories eFpended

- To pre8ent grad*al %eight gain o8ertime& ma$e small decreases in foodand e8erage calories and increase

phsical acti8it



!2

/nerg /Fpendit*re- Calorie eFpendit*re depends on:

Weight of person

Tpe of acti8it

- Length of acti8it

- Bpeed of acti8it

- Metaolic rate

From: Ainsworth, BE, et. al. 1993. Compendium of physicalactivities: classication of ener!y costs of human physical

activities. "edicine and #cience in #ports and E$ercise. %&'1(: )1*+.



!!

5/6/7T: Calorie alance

+o Loss or gain of %eight occ*rs %hen:

$um%er of alories onsumed E'()*+

$um%er of alories E#pended

$ =OU>1 ? "&00 Calories

I+ ou eat &00 calories MORE than ou e<*end, e5erda +or an entire )ee/, ou I88 -ain $ *ound

Simple Math



!4

o% m*ch eFercise to

offset rea$fastGagel %ith Cream Cheese

Coffee %ith Cream

,*n$in ,on*ts M*ffin

"0( Calories

7(0 Calories

"2 Minutes Runnin- a

$0 Minute3Mile

?

2& Minutes S)immin- 8a*s

2& Minutes Cclin- @ $& mi3hr

1

2

125 pound (45kg woman

?



!'

o% m*ch eFercise to

cancel o*t l*nchGT*r$e Band%ich

12 o;. Boda

1 o;. 6otato Chips

&!& Calories

"'' Calories

( Miles al/in- Bris/l@$" min3mile

?

$ 4our o+ 1o)nhill S/iin-

1

2 2 Slices o+ Cheese =ia

125 pound (45kg woman



!#

Composition of Weight Loss %H

ood 5estriction /J/5CIB/

!"#2 kg !"23 kg !"1# kg

$a%l&

'e%g)

Lo** $000 /cals3da 2.& hrs. o+ e<ercise3da



8actors ontributing to8actors ontributing to

"4cess 7ody 8at"4cess 7ody 8at

%enetic *actors

hysiological *actorsMetabolic rate

'ormones

:i*estyle *actors

"atinghysical activity

sychological *actors



!"

+Apple, and +-ear, Bod& .ape* Compared



Regulation of energy %alance

- Bhortterm reg*lation

The shortterm reg*lation of energ alancein8ol8es the control of food inta$e from meal tomeal.

We eat in response to h*nger& %hich is thephsiological dri8e to cons*me food. We stopeating %hen %e eFperience satiet& the feeling off*llness and satisfaction that follo%s foodinta$e.

!9



Regulation of energy %alance- Longterm reg*lation

In addition to shortterm reg*lation of food inta$e& the od alsoreg*lates energ inta$e on a longterm asis.

Bhortterm reg*lators of energ alance affect the si;e and timingof indi8id*al meals. If a change in food inta$e is s*stained o8er along period& ho%e8er& it can affect longterm energ alance and&hence& od %eight and fatness.

Longterm reg*lator signals comm*nicate the odDs energreser8es to the rain& %hich in t*rn releases ne*ropeptides thatinfl*ence energ inta$e andHor energ eFpendit*re. If this longterm sstem f*nctions effecti8el& od %eight remains some%hatstale o8er time.

40



41



42



4!

These obese mice have a defect in the gene that codes for leptin.Without leptin, they become extremely obese. In a Rockefeller

niversity study by !r. "e#rey $riedman, the mouse on the right

received leptin treatments for four and a half %eeks and then%eighed in at about &' grams( the mouse on the left did not haveany treatment and %as %eighed at about )* grams. +ormal mice

starting the study %eighed about - grams/



44

Caallero & 7llen L& and 6rentice 7. 201! /ncclopedia of *man +*trition



7 small red*ction in the percentage of M lost is oser8ed if eFercise is

incl*ded %ith the dietetic inter8ention. Th*s& for eFample& in a%oman losing 1' $g& eFercise %o*ld red*ce her M loss from!.# $g (24K) to !.0 $g (20K). Bimilar *t E*antitati8el greaterenefits are seen in men: or a 1'$g %eight loss& eFercisered*ced M loss from !.# $g (24K) to 2.' $g (1=K).





-enition of successful wei!ht loss



-enition of successful wei!ht lossmaintenance

D There is no universally accepted de0nition ofsuccessful %eight loss maintenance.

D 1ne de0nition, proposed in the 223linical 4uidelineson the Identi0cation, 5valuation, and Treatment of1ver%eight and 1besity in 6dults,77 developed by anexpert panel convened by the ational 1besity5ducation Initiative of the ational 8eart, 9ung, and

:lood Institute +89:I/, in cooperation %ith theational Institute of !iabetes and !igestive and;idney !iseases in <==', is that successful %eightloss maintenance is a %eight regain of >& kg +).)lb/ in - years, follo%ing a <?@ reduction in body%eight.

D The criterion of <?@ %eight loss is recommendedbecause %eight losses of this magnitude have beensho%n to have positive health conseAuences.

D The de0nition assumes that the %eight loss isintentional.

ei!ht Cyclin!



ei!ht Cyclin!

/ea*ona0le 'e%g) oal* and Epec)a)%on* Compared



49

/ea*ona0le goal we%g)

(5 )o 1! 0elow %n%)%al we%g)

Accep)a0le we%g)

.ugge*)ed eal)&

we%g) range

$%*appo%n)%ng we%g)

%me (&ear

Ac)ual we%g)

22!

app& we%g)

$ream we%g) ' e % g ) ( p

o u n d *

1!

12!

14!

16!

1#!

2!!

1!!



'0

Bo What ,oes Wor$G

- 5easonale treatments: small changes&moderate losses& reasonale goals.

- 1 2 lsH%$ recommended moderate

loss can impro8e health '10K of od%t- Bet specific& realistic& forgi8ing goals

*nreasonale goals saotage efforts



'1

/nerg alance

- !'00 $cals 3 1 N od fat

- to lose 1N H %$ ? !'00 $cals H %$

('00 $cals H da)- Bafe rate for %t loss: O 2

lsH%ee$ 10K od %tH# months



Weight,*oss +trategies- /nerg Inta$e

- 6hsical 7cti8it

- eha8ioral Changes

'2



'!

WeightLoss Btrategies

/nerg Inta$e- e realistic ao*t /nerg Inta$e !00'00 $calsHda red*ction for MI

et%een 2= !'

'001000 $calsHda red*ction for MI ?!' Bmaller portions

Incl*de foods of lo%er energ densit& higher

in fier& lo%er in fat Watch empt $cals from alcohol and s*gar



'4

WeightLoss Btrategies

/nerg Inta$e- Cons*ming a lo%calorie& lo%fat diet- 5ed*cing the energ densit

($ilocaloriesHgram %eight of food) of the

diet 8er 1 ear& the condition that red*cedfat and cons*med %aterrich foods had a lo%er energdensit& reported less h*nger& and lost more %eight (=.9$g 8s. #.4 $g) than the condition that red*ced fat onl.

- a8ing a highl str*ct*red diet




h



'#

Weight Loss Btrategies6hsical 7cti8it

- @reater amo*nts of phsical acti8it&greater %eight loss occ*rs

- Increases metaolic rate %ith dail8igoro*s acti8it

- Ma decrease od fat and increase leanod mass

- Ma help c*r appetite- Can red*ce stress& impro8e selfesteem



'=

6hsical 7cti8it- Choose acti8ities that o* enPo andare %illing to do reg*larl

- Lo% to moderate intensit for longerd*ration is recommended

- ,ail ro*tines



6hsical 7cti8it

- Be physically active e8er da

- /nd*rance eFercise

- Btrength training

Reduce the riskReduce the risk

of chronicof chronic

diseasedisease

&? minutes B day&? minutes B day

Crevent gradualCrevent gradual%eight gain%eight gain

)? minutes B day)? minutes B day

Sustain %eightSustain %eight

lossloss)?D=? minutes B)?D=? minutes B

dayday

/Fercise g*idelines and sample prescription plan for



g p p p pmaFimi;ing energ eFpendit*re and longterm %eight control

'9

W i h L B i



#0

Weight Loss Btrategieseha8ioral Changes

- Identif eha8iors food records helpf*l

- Learn alternati8e %as to deal %ith stress

- Belfmonitoring of %eight

- Change eha8iors %ith realistic goals Changing eha8iors

,o not grocer shop %hile h*ngr

/at slo%l

- B*pport gro*ps- 5e%ard s*ccess (*t not %ith food)



Btart %ith Lifestle ChangesBehavior change %ecome

cognitive adaptation in 9,74 wees.

Be patient:

7.Be Realistic.4.+et goals %ased on a

pattern that will eep youhealthy.

5.hange slowly; %utsteadily.



#!



#4



#'



##



#=



#9

Weight Maintenance- Qigoro*s eFercise and caref*l eatingplans are $e

- reE*ent selfmonitoring isrecommended

- More attention needed on %eight

maintenance



=0

6re8ention

- /at reg*lar meals and limit snac$ing- ,rin$ %ater in place of high$cal e8erages

- Belect sensile portion si;es

- Limit dail energ inta$e to energeFpended

- Limit sedentar acti8ities e phsicallacti8e

Why is Weight *oss Maintenance



Why is Weight *oss MaintenanceDifficult<

- Longterm %eight loss maintenance ma ediffic*lt d*e to a comination of phsiological&en8ironmental& and pschological factors.

- 6roposed phsiological factors contri*ting to%eight regain incl*de red*ced resting metaolicrate and ins*lin and leptin resistance.

- /n8ironmental factors ma affect energ alance promoting increased inta$e andHor red*cedenerg eFpendit*re& ca*sing %eight regain to occ*r.

=1

T l " !



=2

Tale "!

6age 2#2

eat*res of a Bo*nd



=!

eat*res of a Bo*nd6rogram

- ood program that o* can follo% forlife

- oods that pro8ide adeE*ate n*trition- oods that o* chooseHli$e

- Weight loss 12 NH %ee$

- 5eg*lar meals

f B d 6



=4

eat*res of a Bo*nd 6rogram

- oods high in C& lo% fat- /Fercise

- Who is the promoterG

Creating an Indi8id*al



gWeightManagement 6lan

$. Assess our moti5ation and commitment

2. Set reasonable -oals

". Assess our current ener- balance

D ;o lose one *ound, ou must create a ne-ati5e ener- balance o+ "&00 calories

D ;o lose $32 *ound *er )ee/ reuires a ne-ati5e dail ener- balance o+ 2&0

calories

D ;o lose 2 *ounds *er )ee/ reuires a ne-ati5e dail ener- balance o+ $000

caloriesD Ener- balance is a++ected b +ood inta/e and ener- out*ut

7. Increase our le5el o+ *hsical acti5itFe<ercise habits are critical +or lon-9term

success

&. Ma/e chan-es in our diet and eatin- habits #e<*lain that eatin- habits is not 6ust

)hat ou eat, but ho), )here, )hen, and )h ou eat%

'. =ut our *lan into action

D rite dail

D et others to hel*

D ;hin/ *ositi5el



=#



==Caallero & 7llen L& and 6rentice 7. 201! /ncclopedia of *man +*trition



="


B*r8e of Weight Loss 5elated B*pplements



=9





"0

In teFt ig*re



"1

InteFt ig*re6age 29#

e ke& )o good eal) %* )o com0%ne *en*%0le

ea)%ng w%) regular eerc%*e"



"2

ther 5ecommendations

utrition Recommendations from the World

Health Organization (WHO)…

•

Energy: Sufficient to suort normal gro!th"hysical acti#ity" and $ody !eight (%&' *)+

• ,otal fat: -. to /0 of total energy*

Saturated fatty acids: to -0 of total energy

*

1olyunsaturated fatty acids: / to 20 of total energy

•

3ietary cholesterol: to / milligrams er day

• ,otal car$ohydrate: .. to 20 of total energy*

4omle5 car$ohydrates: .. to 2.0 of total energy

*

3ietary fi$er: 2 to 6 grams er day

* Refined sugars: to -0 of total energy

•

1rotein: - to -.0 of total energy

• Salt: 7er limit of 8 grams er day

,i t @ id li f



"!

,ietar) @*idelines for7mericans 2010

- Maintain calorie alance o8er time to achie8e and s*staina health %eight

- oc*s on cons*ming n*trientdense foods and e8erages- 6hsical acti8it

- oc*s on fr*its.- Qar o*r 8eggies- @et o*r calci*mrich foods- Ma$e half o*r grains %hole.- @o lean %ith protein.- Rno% the limits on fats& salt& and s*gars

Th Ch ll f ,i t



"4

The Challenge of ,ietar@*idelines

- 6eople 8ar in the amo*nt of a gi8enn*trient the need.

- The challenge of the ,5I is todetermine the est amo*nt torecommend for e8erod.

- *ifestyle diseases: conditions that mae aggra8ated modern lifestlesthat incl*de too little eFercise& poor

diets& and eFcessi8e drin$ing andsmo$ing. Lifestle diseases are alsoreferred to as diseases of affl*ence.

Tools for ,iet 6lanning



"'

Tools for ,iet 6lanning



"#

M6ramid



"=

M6ramid,esign

- Ma$e smart choicesfrom e8er foodgro*p

- ind alance et%een

food and phsicalacti8it

- oc*ses on n*trientrich foods in sensile

portion si;es

M 6 id R C t



""

M6ramid Re Components- 7cti8it

5eg*lar phsicalacti8it and red*cedsedentar acti8ities

- Qariet /at foods from all

gro*ps ands*gro*ps

- 6roportionalit Identifies

proportions offoods that sho*ldma$e a healthf*ldiet

- Moderation

Cons*me less of solidfats and added s*gars

Cons*me more ofn*trientrich foods

- 6ersonali;ation ne si;e does not fit all C*stomi;e o*r plan at

%%%.M6ramid.go8

- @rad*al impro8ement

Ta$e small steps toimpro8e diet and lifestlee8erda

Qisit %%%.smallstep.go8

(sing -he =owerf th = id



"9

of the =yramid

- Btep 1: /stimate o*r dail energneeds

- Btep 2: *ild o*rdail eating plan

- Btep !: Let thepramid g*ide o*rfood choices

ood Lael*: 5m.c san. a.-o5 G ms oo a . m



90

Ma$ing etter ood Choices



91

Ma$ing etter ood Choices

,onDt s*persi;eThin$ grilled& not fried

78oid allo*caneatresta*rants

S*st sa no.U

'(0 calories

27 - +at

! - saturated +at

$,"&0 calories

7" - +at

$" - saturated +at

-he $ewest >ood ?uide =yramid



- Balancing &alories V /nPo o*r food& *t eat less. V 78oid o8ersi;ed portions.

- >oods to !ncrease V Ma$e half o*r plate fr*its and 8egetales. V Ma$e at leasthalf o*r grains %hole grains. V B%itch to fatfree or lo%fat (1K) mil$.

- >oods to Reduce V Compare sodi*m in foods li$e so*p& read& and fro;en meals and choose the foods %ith lo%er n*mers. V ,rin$ %ater instead of s*gardrin$s.

- Wesite: http:HH%%%.choosemplate.go8H

Incl*des interacti8e tools incl*ding a personali;ed dail food plan and foodtrac$er

http://www.choosemyplate.gov/

http://www.choosemyplate.gov/



When tra8eling in ia&Bantorini (a @ree$Island)& E)- &DR!$@& and BE

H)==A& fortomorro% o* madie.

If o* ma$e it home&

eFercise often&hard& and a longtime.

5eferences



f- Ma*ghan 5. 2014. Bports n*trition : /ncclopaedia of sports

medicine 8ol*me JIJ. ohn Wile Bons& West B*sseF.

- Miller IL. 2010. Weight Management for Triathletes. 7achen :Meer Meer Bport.

- Mc7rdle W,& Ratch I& Qictor L. Ratch QL. 201!. Bports andeFercise n*trition. 4th ed. altimore : Lippincott Williams Wil$ins.

- Bmolin L7& @ros8enor M. 2010. +*trition and %eight management.Becond /dition. +e% Xor$ : Chelsea o*se 6*lisher.

- Caallero & 7llen L& and 6rentice 7. 201! /ncclopedia of *man+*trition. /lse8ier

- >.B. ,epartment of 7gric*lt*re and >.B. ,epartment of ealth and*man Ber8ices. ,ietar @*idelines for 7mericans& 2010. =th/dition& Washington& ,C: >.B. @o8ernment 6rinting ffice&,ecemer 2010

kuliah 10 energy & weight management 2015-2016

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