Body Composition, Obesity, and Weight Control. Copyright 2006 Lippincott Williams & Wilkins

Body Composition, Obesity, and Weight Control Chapter 16 Copyright © 2006 Lippincott Williams & Wilkins. Gross Composition of the Human Body Copyr...
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Body Composition, Obesity, and Weight Control

Chapter 16 Copyright © 2006 Lippincott Williams & Wilkins.

Gross Composition of the Human Body

Copyright © 2006 Lippincott Williams & Wilkins.

Two-Component p Model • Two distinct compartments p – Fat-free body mass (FFM) – Fat mass (FM)

• Tissue densities – FFM: 1.100 g/cm3 – FM: 0.900 g/cm3 Copyright © 2006 Lippincott Williams & Wilkins.

Copyright © 2006 Lippincott Williams & Wilkins.

Copyright © 2006 Lippincott Williams & Wilkins.

Essential Fat Essential fat • ~3% of body mass • Consists of fat stored in: – – – – – – – – –

Marrow of bones Heart Lungs Liver Spleen Kidneys Intestines Muscles Lipid-rich tissues of the central nervous system

Sex-specific fat (Females) • ~9% 9% off body b d mass • Essential for childbearing and other hormonerelated functions In essence, what represents the minimal fat percentage necessary for healthy female function?

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Storage g Fat • Consists of fat accumulated in adipose p tissue depots • Storage fat includes

How much of this fat do we need for normal function?

– Visceral Vi l adipose di tissue ti – Subcutaneous adipose tissue

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M are different Men diff t from f women. Copyright © 2006 Lippincott Williams & Wilkins.

Lean Body Mass (LBM) vs. F F Fat-Free B Body d M Mass (FFM) LBM • theoretical entity

FFM • represents the body mass devoid of all fat

• contains the non–sexspecific essential fat ( 3% off fat) (~3% f t)

• FFM = Body Mass – Fat M Mass

• LBM = FFM + essential fat WHY? Copyright © 2006 Lippincott Williams & Wilkins.

Minimal Leanness Standards Men e

Women o e

• Fat-free mass

• Fat-free mass

• 3% essential fat

• 3% essential fat • 9% sex-specific fat

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Menstrual Cycle y Disturbances • Common among athletic females, especially i ll whom? h ? – Athletes who need low-weight to do well – Athletes hl who h need d to “look “l k good” d” to do d wellll

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Menstrual Cycle Disturbances (cont)

• Delayed-onset menstruation • Oligomenorrhea – Irregular menstrual cycles

• Amenorrhea – Complete cessation of menses – Occurs in 2 to 5% of women in the general population – May M occur in i up to t 40% off women in i sports t Copyright © 2006 Lippincott Williams & Wilkins.

Methods to Assess Body Size and Composition

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Methods to Assess Body Size and d Composition C iti • FM and FFM are assessed by: y – Direct measurement by • chemical analysis y • dissection

– Indirect estimation byy • hydrostatic weighing • anthropometric measurements • other simple procedures including body stature and mass Copyright © 2006 Lippincott Williams & Wilkins.

Copyright © 2006 Lippincott Williams & Wilkins.

Copyright © 2006 Lippincott Williams & Wilkins.

Copyright © 2006 Lippincott Williams & Wilkins.

Copyright © 2006 Lippincott Williams & Wilkins.

Copyright © 2006 Lippincott Williams & Wilkins.

Residual Lung g Volume • Air that remains in lungs after a complete exhalation h l ti • Greatest source of error in calculating body volume

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Siri Equation q • % Bodyy Fat = 495 ÷ Bodyy Densityy – 450 • Example:

Where does “Body Density come from? Why is it valuable?

% Body Fat = 495 ÷ 1.0417 – 450 = 25.2% g) = 50 kg g × 0.252 = 12.6 kg g FM ((kg) FFM (kg) = 50 kg – 12.6 kg = 37.4 kg Copyright © 2006 Lippincott Williams & Wilkins.

Th “BOD POD” The Copyright © 2006 Lippincott Williams & Wilkins.

Skinfold Measurements • The rationale for using g skinfolds to estimate total body fat comes from the p between close relationship – Subcutaneous fat – Internal fat – Whole-body density

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Skinfold Measurements ((cont’d)) • The sum of several skinfolds reflects – Amount of subcutaneous fat – An estimate of total body fat – An estimate of body density

• Are useful measurements for describing regional distribution of fat

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Copyright © 2006 Lippincott Williams & Wilkins.

Copyright © 2006 Lippincott Williams & Wilkins.

Copyright © 2006 Lippincott Williams & Wilkins.

Copyright © 2006 Lippincott Williams & Wilkins.

Copyright © 2006 Lippincott Williams & Wilkins.

Copyright © 2006 Lippincott Williams & Wilkins.

Limitations of Skinfold Testing g • High g SEE • Low interrater reliability • Especially difficult to get accurate readings in obese people!

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Girth Measurements • • • •

Easily administered Valid Attractive alternatives to skinfolds Useful measurements for describing regional distribution of fat (fat patterning) • Waist circumference is the best anthropometric th t i estimate ti t off abdominal bd i l visceral fat fat Copyright © 2006 Lippincott Williams & Wilkins.

Copyright © 2006 Lippincott Williams & Wilkins.

Bioelectrical Impedance Analysis (BIA) • A small, alternating current flowing between two electrodes – Passes more rapidly through hydrated fat-free body tissues and extracellular water – Passes more slowly through fat or bone

• Impedance to the electric current – Relates to the quantity of total body water, which in turn, relates to • FFM • Body density • % body fat Copyright © 2006 Lippincott Williams & Wilkins.

Copyright © 2006 Lippincott Williams & Wilkins.

Limitations of BIA • Requires q measurement byy experienced p personnel under strictly standardized conditions – Electrode placement – Hydration status – Skin temperature – Recent physical activity Copyright © 2006 Lippincott Williams & Wilkins.

Dual-Energy X-Ray Absorptiometry Ab ti t (DXA) • Two distinct x-rayy energies g – penetrate into bone and soft tissue – depth of 30 cm

• DXA has the ability to quantify tif – bone mineral content – total FM – total FFM Copyright © 2006 Lippincott Williams & Wilkins.

Body Mass Index (BMI) • BMI = Body Weight (lbs) ÷ Height (in)2 * 703 • OR • BMI = Body Mass (kg) ÷ Height (m)2 • Example: g ÷ ((1.753 m))2 BMI = 97.1 kg = 97.1 kg ÷ 3.073 m2 =3 31.5 5 kg•m g –2 Copyright © 2006 Lippincott Williams & Wilkins.

Copyright © 2006 Lippincott Williams & Wilkins.

Regional g Distribution of Bodyy Fat • Abdominal visceral fat (AVF) ( ) • Abdominal subcutaneous fat • Skeletal muscle

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Regional Distribution of Body Fat (cont’d) • Elevations in AVF volume – increased risk for developing CVD – increased risk of getting type 2 diabetes – increased chances of metabolic syndrome

• Waist W i t circumference i f i a good is d predictor of AVF Copyright © 2006 Lippincott Williams & Wilkins.

Fat cells get larger, typically, as we pack on the lbs lbs. • Can we ever get more fat cells?

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Average Values for Body C Composition iti • Male Averages for Body Fat: 12 - 15% • Female Averages for Body Fat: 25 - 28%

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Criteria for Excessive Bodyy Fat • Percentage g bodyy fat – Men: >20% – Women: >30%

• Fat patterning – Waist-to-Hip Waist to Hip Ratio – Waist Girth

• Fat F t cellll size i and d number b Copyright © 2006 Lippincott Williams & Wilkins.

Global Epidemic p • In 2000,, 310 million adults worldwide were classified as clinically obese • Over a 115 million adults in developing countries suffer obesity-related problems • Overweight regularity in youths: – ~15 to 20% of children – ~12% 12% off adolescents d l t Copyright © 2006 Lippincott Williams & Wilkins.

Copyright © 2006 Lippincott Williams & Wilkins.

Where do Genetics Fit In? • Leptin—hormone released by fat cells – Production? – Activity?

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How Leptin Should Work

Leptin Function, We Think • • • •

Affects hypothalamus activity Indicates d we have h enough h fat f stored d Thus, we are sated If not functioning properly, we eat more!

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Achieving Optimal Body Composition Through Diet and Exercise

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“Most Most obese persons will not stay in treatment. Of those who stay in treatment most will not lose weight, treatment, weight and of those who do lose weight, most will regain it. it ” Dr. Albert Stunkard Obesity Specialist at Penn

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Basics of Weight Control

Yes, it’s really this simple.

Yes, there are lots of variables for which to account.

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Dieting g •Ap prudent dietaryy approach pp to weight g loss unbalances the energy balance equation – Reduce daily energy intake to 500 to 1000 kCal below the daily energy expenditure

• Note: Results may not not always be predictable

Principle of?

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Setpoint p Theoryy • Argues g that p people p have a well-regulated g internal control mechanism • Control center – may be located in the lateral hypothalamus – possibly within the fat cells themselves

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Copyright © 2006 Lippincott Williams & Wilkins.

Popular p Dietaryy Approaches pp • • • • •

Low carbohydrate-ketogenic y g diets The South Beach Diet High protein diets High-protein What are the Semistarvation diets pros and cons p Well-balanced diets to all of these?

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Exercise and Weight g Loss • Popular misconceptions –E Exercise i increases i appetite tit so that th t a proportionate increase in food g the caloric deficit intake negates exercise produces – The relatively small calorie-burning effect of a normal exercise workout does not “dent” the body’s fat reserves compared with food restriction Copyright © 2006 Lippincott Williams & Wilkins.

What do you say to people who have these ideas?

Exercise and Weight g Loss (cont’d) ( ) • Total energy gy expended p in physical p y activityy follows a dose-response relationship – Adjust volume – Adjust intensity – Adjust frequency

• Diet plus exercise – Provides ideal combination for weight loss and maintenance Copyright © 2006 Lippincott Williams & Wilkins.

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