Weight Management and Healthy Body Weight

Weight Management: overweight children

1 in 7 is overweight. in the year 2020 it will be 1 in 5

Body fat

1 pound of body fat = 3500 kcal. excess fat will become adipose tissue

Sound Weight Loss

1. Aware of the problem: assess and evaluate current status. 2. Setting Goals: first target is 5-10% loss in BW, time frame: 1-2 lbs per week. 3. Moderation: 500-1000 kcal/ day difference. incorporation modest caloric constriction with elevated physical activity.

Preventing weight gain

50-100 kcal reduction per day. 60 minutes of moderate- vigorous PA per day.

PA and body mass: weight loss

500 kcal or more reduction per day. 30 min/day of PA and more is better

Start: Goals and Assessment

Assessments: height, weight waist circumference, body composition. calculate athlete's estimated energy needs. determine appropriate deficit: 250-1000 calories per day. Goals: realistic, timely, appropriate.

Negative effects of YoYo

Associated with upper body fat deposition. Discouragement, decreased self-esteem

BMI and Health Risks

BMI and mortality rates have a strong correlation. :Underweight and obese have increased mortality risk., BMI is more accurate in approximating body fat than measuring body weight alone., BMI is better predictor of a population's disease risk than an individual's risk of chronic disease.

Energy Output

Basal metabolic rate, thermic effect of food, physical activity

Achieving a Positive Energy Balance

Caloric in take is more than caloric expenditure. 2300 to 3600 calories above is about 1 pound of muscle. optimal weight gain is about 1/2 to 1 lb per week. CHOs should predominate, protein support.

Android or Apple Shaped

Classic "pot-belly shape". More highly correlated with metabolic risk: Metabolic Syndrome: several CHD risk factors clustered, Insulin resistance - Type II Diabetes, High blood pressure, Elevated lipids

Tips for Weight Gain

Consume fluids after meals to avoid being full on fluids. Avoid carbonated beverages - bloating. have small frequent meals/snacks throughout the day. Consume a variety of nutrient/energy dense foods. Use high calorie beverages at meals. Include bedtime snacks one hour before.

Unhealthy Weight Loss

Decrease in performance, Glycogen depletion, Dehydration, Increased loss of fat-free mass, Impaired functional capacity, Lower quality training sessions

Maintain Training Energy Levels

Determine energy needs and deficit ranges, Dietary modifications, Healthy eating patterns and foods, Eat for fuel (training takes adequate energy), Small amounts of favorite foods, Assess training and performance level

Resistance Training: Weight Loss

Does not enhance weight loss. It may increase fat-free mass and increase fat loss.

Gynoid or Pear Shaped

Encouraged by estrogen and progesterone, After menopause, upper-body obesity appears. Less health risk than upper-body obesity. More difficult to lose and keep fat "off"

Best weight loss program

Moderate Calorie Intake Behavior Management Elevated Physical activity

Resistance Training

Must address "overload principle." Train major muscles. Train for hypertrophy: 8 to 12 reps/set, 3 to 5 sets/muscle group, 2 to 3 times/week

Indirect Measures of Body Composition

Underwater weighing (densitometry): Gold Standard (+2.5-3% error) , Air displacement plethysmography, Dual X-ray absorptiometry, Field Methods: Bioelectrical impedance analysis, Skinfold measurement, Circumferences

BMI in children

Underweight < 5th percentile Healthy weight 5-90th percentile At Risk of Obesity 90-94.9th percentile Obesity >95th percentile

Why can't quick weight loss be mostly fat?

body fat contains 3500 kcal per pound. must have an energy deficit 3500 kcal to lose a pound per week. lean tissue and water account for dramatic weight loss in fad diets

Factors Affecting BMR

body size: 75-80% of BMR depends on amount of LBM. height and weight are indicators of size. age: BMR decreases 2% per decade after 30 yrs. gender: males are greater than females (more LBM)

PA for Weight loss

brisk walk. effective to prevent weight gain greater than 3%. will provide only modest weight loss. will improve weight loss with modest dieting. great PA associated with greater weight loss.

Things that we need to change

chain breaking, stimulus control, cognitive restructuring, contingency management, self-monitoring

Thermic Effect of Food

diet-induced energy expenditure. digestion, absorption, and processing of ingested nutrients. 5-10% above the total energy consumed. protein is greater than CHO and that is greater than fat.

Short Term Goals

dieting and exercise

Dietary Modification

eat nutrient rich foods. eat lower-fat foods. favorite foods in smaller amounts. colorful plate mean fruits and vegetables present. eat more often. reduce portion size. menu planning, meal planning keep records.

Female Athlete Triad

eating disorder, amenorrhea, osteoporosis.

Stress eating

eating in response to complex humans emotions: boredom, depression, anxiety

Situational Factors Affecting BMR

elevating: magnitude of LBM, fever, stress. lowering: fasting/starvation- hinders net caloric cost of dieting

Basal Metabolic Rate

energy for maintenance of normal body functions and homeostasis. sedentary: 60-70%. athletes: 40-60%

Negative Energy Balance

energy intake is less than the energy expended. results in weight loss.

Positive Energy Balance

energy intake is more than energy expended. results in weight gain

Energy Balanced

energy intake matches the energy expended. appropriate calories that is within AMDR.

Hypertrophy

enlarging existing cell size

Fat Mass

essential fat (M= 3-5%; F= 12-15%). nonessential (storage) fat

Exercise by itself leads to little weight loss

exercise prevents then decrease in RMR seen with dieting. exercise added to dieting increases the amount of weight lost. exercise added to dieting helps preserve FFM.

Satiety

feeling of fullness or satisfaction after eating

Empty calories

few or no essential nutrients. 35% of calories is fro extra solid fats and added sugars. beverages account for 400 calories per day.

Strongest Evidence to Healthy Weight

focus on total calories. record food intake. when eating out choose smaller portions or lower calorie options. Prepare, serve, and consume small portions. eat nutrients rich breakfast. limit screen time.

Energy Intake Assessment

food records, 24-h dietary recall, food frequency questionaires

Obesity

general population: one-third, additional one-third is overweight. in athletes, this is relatively rare. athletes at risk: football, wrestling, boxing, field events

Causes of Obesity

genetic predisposition, behavioral practices, social/ cultural influences, psychological factors, environmental factors.

Childhood Obesity: long-term

obese children 3x more likely to be obese adults, child usually does not grown out of obesity, prior to puberty there is very little sex difference in % fat

PA and Obese Wight Loss

obese lose little weight when incorporating only PA. most obese need to include caloric restriction to meet weight loss goals.

Fat Loss

obese: decrease in size but not in number, same is observed in children and adult. non-obese: decrease in size and not number

Percent Body Fat

percent mass divided by body mass

Hunger

physiological drive to eat. controlled by internal body

Dietary Intake Influences

physiological, environmental, social/culture, emotional

Contingency Management

plan for high risk situations

Waist Circumference

positioning of mass. apple vs. pear. men greater than 40 inches (102 cm) for women greater than 35 inches (88 cm). Narrowest part of the waist

Appetite

psychological drive to eat. often in the absence of hunger

Self-monitoring

record eating habits and foods consumed

PA levels and BMI

studies have revealed an inverse relationship between BMI and physical activity.

YoYo Effect

typically weight loss is not maintained. Only 5% of weight losers keep it off. 1/3 lost weight regained within 1 year.

Long term goal

weight loss (lbs.)

Fat Mass and Performance

There generally appears to be an inverse relationship between fat mass and performance of physical activities requiring movement of the body vertically or horizontally. Excessive fat mass is detrimental as it adds non-force producing mass to the body (dead weight). % Fat is inversely related to aerobic capacity

Fat-Free Mass

muscle, connective tissue, organ tissue, water

Fat Gain

non-obese: fill existing fat cells (hypertrophy). obese: filling of existing cells (hypertrophy) and then adding new cells (hyperplasia).

BMI

most widely used height for weight index. weight (kg) / height (m) squared. correlates fairly strongly with body fatness. Healthy 18.5-24.9.

Physical Activity

Adds to caloric deficit (energy expenditure). Maintains BMR and LBM. Allows moderation in diet in creating energy deficit. Workouts: aerobic activity burns fat- 300 kcal per workout. Essential part of keeping weight off.

Underwater Weighing

Also known as hydrostatic weighing: Considered "the standard". 2% error. Measures density. Based on Archimedes' principle. The heavier the underwater weight, the greater the fat-free mass

Air Displacement Plethysmography

Measures body volume like UWW. Air, rather than water, is displaced. BOD POD. Accuracy similar to UWW Smaller, lighter, more portable than UWW. Expensive

Bioelectrical Impedance Analysis

Measures resistance to flow of electrical current through body. Fat is an insulator thus creates a greater resistance (less H2O). Quick, easy, portable. Less accurate that UWW

Skinfold Assessment

Measures thickness of skin and underlying subcutaneous fat. Subcutaneous fat is proportional to total fat . Not as accurate as UWW (5%). Considered a field measure. Requires some skill. Inexpensive, very portable

Weight Management for Athletes

Impact on performance - need adequate CHO. Aesthetics/body image. Weight classifications for competition Changing body composition to aid performance. Increase muscle mass. Decrease fat mass

Control Calorie Intake

Increase: Whole grains, vegetables, fruits. Limit: Solid fats, added sugars, and alcohol. Minimal caloric intake: maintain nutrients for health. Calorically severe restrictive diets result in loss of FFM, and subsequent decrease in BMR (diet less effective). Women - 1200 kcal/day; Men - 1500 kcal/day. Less than 1000 kcal/day leads to intense hunger and diet fails.

DEXA

Like UWW, also considered a standard. Relies on X-ray technology. Also measures bone mineral density. Provides regional composition measures. Technical and expensive

Performance Related

Lose weight: aesthetics, make weight classifications. Gain weight: healthy weight gain-lean body mass. Modify body composition: enhance strength-to- mass ratio.

Set Monitor Initial Weight Loss Goals

Loss of 5-10% of current body weight, 1-2 pounds per week (monitor weekly), Off season activity

BMI Limitations

Overestimates adiposity in heavily muscled athletes. Underestimates body fat in people who have lost muscle mass

Successful Strategies

PA, social support, recording eating, plan menus and meals, positive self-talk, reasonable expectations, no fad diets, relapse strategies.

Fat- free Mass and Performance

Physical performance activities require application of force, either moving the athlete, and/or applying force against an external object (throwing, pushing, lifting) is positively related to the absolute amount of Fat-Free Mass (FFM) and body size. Too muscled may hamper absolute speed. Position players in football differ in FFM

Muscle Dysmorphia

Preoccupation with body shape/size, preoccupation with muscularity impairs other aspects of life, Excessive exercise, Obsesses about food, May abuse steroids, if I am not large than I am inadequate. diet is regimen: more protein with low body fat.

Set and Monitor Goals

Realistic goals: weight targets- fat loss. Time frame goals: short term: 1-2 lbs pounds per week and 5-10% of BW over 3-6 month period. loner term goals: Performance, age, and gender healthy target

Requirements for Gaining Weight

Regular participation in a resistance training program. Achieving a positive energy balance. Achieving a positive nitrogen balance.

Behavior Modifications

Rewards: do you use food as a reward? Self-monitoring: keeps records of what, when, and how you feel. Cognitive restructuring: reasonable goals and time frames, think about progress, not short comings. Portion control: swap sizes, take some home, share with a friend, one plate one cookie, one is okay not more than one. Shopping: lists and stick to them, avoid ready to eat foods. Activities: insight foods (fruits); out of sight foods (freezer). Holidays and parties: less alcohol, politely decline. Eating: leaving some on the plate, don't eat and watch TV.

Weight loss

Success rate: 5% after 3 years. Spot reduction: no such thing. quick weight loss: not fat weight but water. Ketosis: insufficient CHO is diet but a high protein diet. Dieting and the athlete: weight loss out of season, low CHO leads to muscle wasting. Fad diets not made for athletes.

Chain Breaking

TV and Eating

Athletes Rapid Weight Loss Practices

Water loss by: Excessive exercise, Exercising in rubber/plastic suits, Exercising in hot areas or saunas, Fluid restriction, food restriction (fasting), Vomiting, laxative use, diuretic abuse

Relapse Strategies

Window: 3-5 lbs of weight gain. lack of physical activity- 4 days in a row. Second repetition of destructive behavior. Withdraw from support group. Failure to participate in nonfood-oriented leisure activities for more than once per week.

Physical Activity

activity-induced energy expenditure. increases energy expenditure beyond BMR by 0-40%. more activity, more energy burned: athletes naturally have greater energy expenditure, aerobic activity burns fat, anaerobic activity may build muscle.

Weight Management: adults

adding healthful weight- add muscle, maintaining healthy weight gain, preventing graduate weight gain over time, those needing to lose weight losing fat mass, preventing weight regain after weight loss.

Best weight for the athlete

assess BMR, BC (LBM, and fat mass) circumferences, eating behaviors, exercise habits, seasonality, attitude toward changes in nutrition

External Cue Theory

availability, time of day, social obligations, characteristics of food, peers, authority figures

Estimation

based on how you feel, weight history, fat distribution, family history of obesity-related disease, current health status, and lifestyle.

Stimulus Control

be in charge of temptations

Adult Obesity: long-term

most adult weight gain is 25-55yrs, women gain- child bearing years, males- gain about 1-2 lbs per year of fat, loss of muscle.

Behavior Mangement

identify behaviors that led to the weight gain, behaviors that are appropriate and effective during weight loss, changing of lifestyle to keep weight off. attend both sides of energy balance equation.

Health Consequences of Obesity

increased mortality, Increased morbidity: heart disease, hypertension, stroke, type 2 diabetes- increasing in younger people, osteoarthritis

Hyperplasia

increasing the number of fat cells

Positive Nitrogen Balance

input is larger than output. intake equals 1.4-2.0 g/kg BW. excessive amount not recommended. supplements not required but can offer advantages.

Dieting

is for weight loss not weight management. dietary intake: eating pattern of reduced calories and the maintenance of reduced calories. should include exercise. must consider eating behaviors during the diet and after then target weight is met.

Overweight and obesity

it is nearly 2/3 of adults. BMI greater than or equal to 30.

Cognitive Restructuring

labeling foods "off limits," think about progress, not limitations, seat realistic goals

Percent body fat

laboratory/technology assessment. Fat mass, Fat-free mass

Preventing weight regain

more PA is better in preventing weight regain after weight loss. 60 minutes a day of walking at modest intensity. 300 minutes per week.