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Lecture 18 - Body Weight2
Course: NUTRI SCI 10, Spring 2010School: Berkeley
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18: Lecture Body Weight RecommendedReadings: FromThompsonetal,TheScienceof Nutrition,partsofChapter13. Important Words Anthropometry Bioelectricimpedanceanalysis Bodyweightpercentile Calipers DXA Failuretothrive Healthybodyweight Metabolicfitness Obese Overweight Skinfoldthickness Underweight 2 Lecture Outline Defininghealthfulbodyweight Importanceofahealthfulbodyweight Measuringhealthfulweight...
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18: Lecture Body Weight
RecommendedReadings: FromThompsonetal,TheScienceof Nutrition,partsofChapter13.
Important Words
Anthropometry Bioelectricimpedanceanalysis Bodyweightpercentile Calipers DXA Failuretothrive Healthybodyweight Metabolicfitness Obese Overweight Skinfoldthickness Underweight
2
Lecture Outline
Defininghealthfulbodyweight Importanceofahealthfulbodyweight Measuringhealthfulweight Geneticfactorsthatmayregulateenergy intake,bodyweightandbody composition Theimportanceoflifestyleandhabits Summary
3
Healthy Weight Implies Reduced Risk of Disease
Unhealthy Healthy Unhealthy
DiseaseRisk
AdultBMI
4
How is Healthy Weight Measured?
BMI (Body Mass Index) 18.5 25 30
BMI = Wt (kg) / Ht (cm)2
NIDDK Website
Und erw eigh t
5
There are Racial Differences in Prevalence of Overweight & Obesity
InAdults: BMI<18.5 =Underweight BMIof18.525=Normal BMI2530 =Overweight BMI>30 =Obese
% in California 2004, CBRFFS African American = 70.5% Latino, Hispanic = 69.6% White = 53% Other = 40.4% 6
Defining Healthy Weight in Children
Inchildren,standardsarenot inabsoluteBMIunitssince bodycompositionnaturally changesaschildrenmature; andbodycompositionnaturally differsforboysandgirls,with differencesaccentuatedat puberty.
Referencedatacollected from19631994. SeeCDCwebsite. 7
Weight Status Categories in Children
WeightStatus Category Underweight Healthyweight Overweight Obese PercentileRange(matchedfor ageandgender) Lessthanthe5thpercentile 5thpercentiletolessthanthe85th percentile 85thtolessthanthe95thpercentile Equaltoorgreaterthanthe95th percentile
8
Prevalence of High BMI in Boys and Girls Aged 2 Through 5 Years, 1999-2008
Ogden, C. L. et al. JAMA 2010;303:242-249.
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Lecture Outline
Defininghealthfulbodyweight Importanceofahealthfulbodyweight Measuringhealthfulweight Geneticfactorsthatmayregulateenergy intake,bodyweightandbody composition Theimportanceoflifestyleandhabits Summary
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Risks Associated with Being Underweight
Malnutritionandassociatedclinical disease Psychosocialconcerns
Undiagnosedprimarydisease
failuretothriveifachild Anorexiaorbulemiaifadolescentoradult Depression,anxiety,familydysfunction
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Obesity as a Risk Factor
Implicatedin: Hypertension Heartdisease Type2diabetes Stroke Dyslipidemia Cancers Liverdisease Problem:
Doestherecent increaseinobesity causeanincreasein deathsfromthese causes?
12
ExcessDeathsAssociatedwith Underweight,Overweight,andObesity
Flegal, K. M. et al. JAMA 2005;293:1861-1867.
RelativetoBMI18.5to<25 Underweight(BMI<18.5) Overweight(BMI2530) Obese(BMI>30)
ExcessDeaths 33,746 86,094(noexcess) 111,909
13
Shift in the Traditional Paradigm
OLD:Losingweightistheonlywaytobe healthy. NEW:Manyfactorsdefinehealth. Overweightpeoplecanimprovefitness andhealththroughlifestylechanges, whetherornottheyloseweight.
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Metabolic Fitness
Theabsenceofbiochemicalriskfactors associatedwithobesity,suchas elevatedfastingconcentrationsof cholesterol,triglycerides,glucose,or insulin;impairedglucosetoleranceor elevatedbloodpressure(p.1383)
Reductionsinriskfactorsarenotdependent onweightloss!
15
Campfield et al. Science. 1998.280:1383-1387.
BMI, Fitness, and Mortality
Mortalityrateslowerforfitmenthanunfit menatanyBMIcategory
Barlow et al. Int J Obes. 1995;19(Suppl 4):S41-S44.
Cardiorespiratoryfitnessbetterpredictor ofmortalityinwomenthanBMI L Farrell et al. Obes Res. 2002;10:417-423. Outline
Defininghealthfulbodyweight l
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Lecture Importanceofahealthfulbodyweight Measuringhealthfulweight Geneticfactorsthatmayregulateenergy intake,bodyweightandbody composition Theimportanceoflifestyleandhabits Summary
17
Estimating Body Fat
Problem:Nodirectmeasurementofbodyfat inalivingperson Estimatesarebasedon:
Allmethodsbasedonestimations
takingameasurement applyingaformulathatmakesassumptionsabout bodycomposition
Howgoodarethemeasurements? Howaccuratearetheassumptionsforthe formulas?
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Estimating (Measuring?) % Body Fat
BMI Anthropometry BioelectricalImpedance BodyDensity:wateror displacement DXA:dualenergyXray
The gold standard!
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21
BMI
BMI=Weight(kg)/[Height(m)]2 Problems: Noaccountingfordifferencesinmuscularity orbonemass/density Samecriteria/cutoffsformenandwomen,all races,andallages Notallfathasequalhealthrisk
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Principle:Accumulationofsubcutaneousfatinspecificplaces (upperarm,waist/flank,upperthigh)willbeproportionaltototal 23 bodyfat.
Principle:Fatisabetterinsulatorthaneithermuscleorblood.
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Principle:FatismorebuoyantthanLBM,weighinglessinwater.
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Lecture Outline
Defininghealthfulbodyweight Importanceofahealthfulbodyweight Measuringhealthfulweight Geneticfactorsthatmayregulateenergy intake,bodyweightandbody composition Theimportanceoflifestyleandhabits Summary
27
How do we assess genetic contributors to human traits?
Blueeyes,short,diabetic,fat? Twins:monozygoticvsdizygotic Adoptionstudies
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29
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Heritability Estimates
Obesity Height Schizophrenia Diabetes,Type2 Hypertension Alcoholism HeartDisease .80.90 .90 .68 .60 .57 .57 .49
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Role of Genetics (cont.)
Over 600 genes, markers, & chromosome regions have been linked to obesity. Nutrition genomics (study of food-gene interaction) has already found applications in cancer, diabetes & heart disease. Genetic factors influencing obesity are complex and multifaceted. (p. 779)
Skelton, et al. Ped Clinics No Am. 2006;53:777-794.
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Conclusions
Stronggeneticcomponenttoobesity Ourindividualgenesaffectshowwe respondtoenvironment
33
Lecture Outline
Defininghealthfulbodyweight Importanceofahealthfulbodyweight Measuringhealthfulweight Geneticfactorsthatmayregulateenergy intake,bodyweightandbody composition Theimportanceoflifestyleandhabits Summary
34
Health Advice
Exercise Eatfruits&vegetables Limitfoodswithlownutrientdensity Limitfoodswithhighenergydensity
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36
Effect of exercise
ChangeinBodyweight:
responders:lost5.2kg:n=32 nonresponders(noweightloss):n=26
SameimprovementsinBlood pressure,restingheartrate, increasedaerobiccapacity,waist circumference
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EatingBehaviorsAssociatedWith Obesity
PositiveAssociations: Eatingrestaurantpreparedfood Skippingbreakfast NegativeAssociation: Breastfeeding
38
Lecture Outline
Defininghealthfulbodyweight Importanceofahealthfulbodyweight Measuringhealthfulweight Geneticfactorsthatmayregulateenergy intake,bodyweightandbody composition Theimportanceoflifestyleandhabits Summary
39
Summary
Healthybodyweightguidelineshavebeen developedforusebythegeneralpublic Theseareonlyguidelinesandshouldnotbe equatedwithhealthordiseaseattheindividual level Attheindividuallevel,healthismoreclosely relatedtometabolicfitnessthantomeasures ofbodyfatnessalone Metabolicfitnesscanbeimproved,eveninthe absenceofweightloss,bystayinginenergy balance,consumingahealthydiet,andgetting lotsofexercise.
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