Name Fisher  Partial KEY

Metabolism – A Balancing Act – 75 Informal Points

Introduction
In any cell, two basic processes, catabolism and anabolism, work together to balance what is being
built with what is being broken down. In catabolism, energy rich fuel molecules are broken down to
release their energy to supply the cell’s needs. Anabolism, on the other hand, takes simple building
blocks and uses them to build up more complex molecules a cell may need for growth and repair.
Together, anabolism and catabolism make up metabolism, the sum of all of the chemical reactions
that occur within body cells. These important reactions help convert the fuel in the food we eat to
power for everything we do.

Last year in PBS, you learned that the calorie is a measure of energy. Calories are stored in the
molecules that make up the food that we eat. We burn these molecules through the process of
cellular respiration and release energy that can be used by the body. To remain fit, you must balance
the amount of calories you ingest with the amount you spend completing daily activities. If what is
being consumed is not balanced by what is being burned, you’ll notice the difference on the
bathroom scale.

So how much energy do you use in a day? Remember that even when you are sleeping or watching
TV, your body is using energy. Energy cannot be seen or touched, but it keeps your heart beating,
your neurons firing and your muscles pumping. Basic metabolic functions and chemical reactions
that break down and build new materials are always occurring. Your total energy expenditure
includes energy used at rest and during physical activity.

In this activity, you will play the role of a registered dietician or a nutrition counselor and meet with a
client hoping to adopt a more healthy lifestyle. You will analyze the diet of your client and balance
the energy he or she consumes with the energy expended in daily activities. Examining standard
measures of weight and fitness, as well as the theory behind gaining and losing weight, will help you
see how too many or too few calories will impact the health of many body systems. Report your
findings to your client and suggest ways he or she can better utilize energy for optimum performance
and health.

Procedure
Jeremy Brown is a 24-year-old man who has always been in good health. A busy law student, Jeremy
finds he has less and less time to exercise. He used to cook most of his meals at home, but now he
grabs whatever he can when he is on the way to the library or to class. His doctor just called him to let
him know that his routine physical results revealed a mildly elevated LDL and a low HDL level. Both his
mom and his dad have shown early signs of heart disease.

Trisha Knowles is a19-year-old sophomore majoring in Biology. Trisha gets up to go running every
morning before class and sometimes adds a second workout in after dinner. She is a strict vegetarian
and she has recently cut all carbohydrates (except for an occasional slice of wheat toast) out of her diet.
Trisha is convinced she needs to lose at least 10 more pounds. She drinks plenty of water and
consumes a sugar-free energy drink when she needs to stay up and study, but she still feels tired and
run down.

Hans Spielman is a 22-year-old senior who has not worried much about his weight in the past four
years. He does not want to lose his scholarship so most of his focus is on his GPA and his internship at
the local hospital. Hans knows he has gained weight over the past four years, but he did not realize how
bad it was until his doctor referred to him as obese at his last appointment. Hans wants to lose weight,
but his doctor fears that he will not lose the weight in a safe manner unless he consults with an expert.
 All three individuals begin to worry about their health and decide to see the campus nutritionist (that’s you!)

1. Note that you will be assigned one of the three clients.

2. Use the Internet to research a career as a dietician or a nutritionist. These careers are similar, but
there are some differences. Fill in the table below to compare the two professions.
Similarities Differences
 Dieticians are considered to be nutritionists but
 Both experts in food and diet not all nutritionists are dieticians
 Know how diet, nutrition and supplements affect  Dietician has a slightly higher ranking due to
the body and overall health more education and licensing
 Both considered to be healthcare professionals  Nutritionists do not necessarily have any
professional training and may be self-proclaimed
nutritionists; therefore it is important to check their
credentials before trusting them; Nutritionists
should not diagnose diseases

3. Create two career journals: 1) Dietician and 2) Nutritionist. Describe the education required for the
position and the standard salary range for individuals in this field. List at least five duties of this
biomedical professional. Under your list, write a short paragraph describing how a dietician and
nutritionist might help the patient you have been specifically assigned.
In the first session with either Jeremy, Trisha, or Hans, you collect basic information from the client and
record height and weight. The patient has been asked to keep a detailed food log, chronicling all of his
or her meals, drinks, and snacks, for the past week.
4. You have a partially completed Client Report relating to your specific patient. Your task will be to
analyze the patient’s diet and complete this report. Bulleted items describe the tasks you will need to
complete to finish your assessment. You will receive more instructions as you complete each step.
5. Know that body Mass Index (BMI) is a measure of body fat based on both height and weight of an
individual. BMI is a simple numeric measurement that can be used to determine whether an adult is
overweight. View the Howard Hughes Medical Institution video clip on BMI at
http://www.hhmi.org/biointeractive/body-mass-index-bmi Record important information from the
video clip in the space below.
 Standard BMI values:

 What is considered a healthy BMI?

 What BMI values are associated with being overweight or obese?

 A BMI below 18.5 (shown in white) is considered
underweight.
 A BMI of 18.5 to 24.9 (green) is considered healthy.
 A BMI of 25 to 29.9 (yellow) is considered overweight.
 A BMI of 30 or higher (red) is considered obese.
6. Refer to information found on the Client Report and calculate your client’s BMI using the formula
shown below. Show all work neatly in the space below. Make sure to use the correct units. Remember,
there are 0.454 kilograms per pound, 2.54 centimeters in an inch, and 100 cm in a meter.

o BMI = weight (kg)

_________________

[height (m)]2

7. Record BMI and discuss the implications of this value directly on the Client Report.
8. Read the information presented under Activity Level on the Client Report.
9. Note that Basal Metabolic Rate (BMR) is the baseline rate at which your body uses energy. This
value takes gender, height, weight and age into consideration to calculate the number of calories
needed to fuel the basic functions of life. Calculate your client’s BMR using the appropriate formula
shown below. Neatly show all work.
o Men: BMR = 66.5 + (13.75 x W) + (5.003 x H) – (6.775 x A)
o Women: BMR = 655.1 + (9.5663 x W) + (1.85 x H) – (4.676 x A)
o W = actual weight in kilograms
o H = height in centimeters
o A = age in years
10. Record BMR directly on the Client Report.
11. Notice that BMR only accounts for the body’s resting energy needs. To get an accurate value for the
amount of energy a person spends per day, you need to factor in your level of physical activity. The
more you exercise, the more calories you burn and thus, the more calories you need to consume.
12. Once you know your client’s BMR, calculate his or her caloric needs based on level of activity using
an approximation called the Harris-Benedict equation. Use information about this equation found at BMI-
Calculator.net http://www.bmi-calculator.net/bmr-calculator/harris-benedict-equation/ to determine
activity factor and record your findings in the space below.
13. Multiply the BMR you calculated by this activity factor to determine the number of calories your client
should consume daily to maintain his or her current weight. This value is referred to as the Total Daily
Energy Expenditure (TDEE). Show your work in the space below and record the final TDEE on the
Client Report.
14.

15. Read the information presented in the Food Intake portion of the Client Report.
16. Compare how much energy your client uses during a typical day (the TDEE) to how much energy he
or she consumes (average calorie consumption per day). Calculate a difference, showing all work in the
space below.

 According to these values, is your client consuming too many or too few calories?
17. Record the calorie deficit or surplus directly on the Client Report.
18. Predict your client’s expected weight loss or gain if he continues these activities and eating patterns
for one month. Neatly show all work in the space below. Use the information below to help you
estimate this value and record your findings directly on the Client Report.
o To lose weight, you need to create a calorie deficit. To gain weight you need to
increase your calories about your TDEE.
o There are approximately 3500 calories in a pound of stored body fat.
o If you create a calorie deficit of 500 calories per day, you will be down 3500 calories in
a week, and thus lose 1 pound. If you consume an extra 500 calories a day, you will be up 3500 calories
in a week, and thus gain 1 pound. NOTE: This assumes a constant activity level (as controlled for by
your activity factor).

Things to know and be able to do regarding the calculations:

 Formulas will be given, but conversion factors will NOT be given.

 Focus on calorie numbers and how they correlate to weight gain and
loss
 Know that BMR multiplied by the activity factor gives the Total Daily
Expenditure (TDEE) and is the amount of calories a person needs to
sustain themselves and not change weight each day; know how to
use
o Activity factor values will be given and do not need to be
memorized
 There are 3500 calories in a pound
 Small amounts of extra or deficit calories add up over time
19. Analyze your client’s food choices. Explore the components of a healthy day’s eating at the USDA
ChooseMyPlate site http://www.choosemyplate.gov/.
20. Click on each section of the plate piece to view recommendations on the components of a healthy
diet. Review healthy food choices in each section.
21. Analyze your client’s food choices in the space below.
22. Write a detailed paragraph describing what you have found and what you will say to your patient in
the space below. (You may use separate paper if you wish, or even type this.)

 As a dietician or nutritionist you must have advice for your patient

regarding:
o Their current diet and health situation
o Prediction of weight and health in one month if no changes are
made
o Plan to improve diet and health
o Prediction of weight and health if improvements are made

23. Complete the remaining sections of the Client Report sheet. Report your findings in a clear succinct
conclusion and make recommendations to your client about improving lifestyle. Take all aspects of
health history into account.
24. Note the following websites (along with the MyPlate site) may be helpful in the completion of your
report:
o Food and Drug Administration: How to Understand and Use the Nutrition Facts Label
(Note: contains an example label showing recommended daily values)
http://www.fda.gov/Food/IngredientsPackagingLabeling/LabelingNutrition/ucm274593.htm
o NutriStrategy: Nutrients, Vitamins, Minerals and Dietary Information
http://www.nutristrategy.com/nutritioninfo2.htm

Conclusion Questions
1. What are the limitations of using BMI as a measure of weight and overall health? How might
muscle tone affect BMI?

BMI is a measurement that describes a person's weight

relative to height. When used with a large number of
people (e.g. a population), BMI values correlate with body
fatness. However, for a specific individual BMI is of limited
value because it does not provide information about his or
 her percent body fat or where the fat is distributed. The
BMI of athletes with well-developed muscle and dense
bones may be high even though their percent body fat is
not high.

2. What are factors that can increase or decrease BMR? Explain each.
Gender  males have a higher BMR than females cute to higher rate
of lean active body tissue compared to adipose tissue

Body Size  the larger the body the greater the metabolism rate , as
more energy is required to move a larger heavier mass

Lean Body Tissue compared to fat  greater lean body tissue

increases your metabolism rate as it is active tissue that burns
kilojoules at a faster rate

Hormones  certain hormonal conditions affect basal metabolic rate

people with an overactive thyroid have a greater metabolic rate

Infection & Illness  increase basal metabolic rate as the body works
harder to fight the infection

Fasting  decreases BMR as the body conserves energy to keep vital

organs functioning

Drugs  caffeine and nicotine increase BMR whilst others decrease it

such as Anti-depressents , social and prescription drugs

Climate  cold climates increase BMR as the body uses kilojoules to

maintain a stable body temperature

Age  later years often see a decline in BMR due to less activity and
reduced lean muscle tissue

Exercise  BMR is increased during any exercise and it remains high

for several hours after intense and prolonged exercise. the more
 exercise a person does the greater lean active body tissue and
increased BMR

3. What are the health risks associated with high levels of saturated fat and cholesterol in the diet?
Think back to what you learned in PBS.
Clog the arteries by building up along the walls and making the vessel “hard” or
cause a blot clot. This increases risk of stroke and heart attack and causes
heart disease.

4. Each gram of fat you consume provides over twice as many calories as a gram of protein or
carbohydrates. What does this tell you about your body’s ability to burn off these three fuels?
Which would require the most energy to burn?

Since each gram of fat you consume provides over twice as

many calories as a gram of fat, this tells us that it requires
more energy to burn off fats than it does to burn off
protein or carbohydrates. It takes the longest amount of
time to burn off fats, then proteins and carbohydrates are
the easiest to burn off.
 Carbohydrates and protein both have 4 calories per gram of the food
 Fats have 9 calories per gram of the food

25. Discuss at least two health risks faced by people with a BMI above 25.

• cardiovascular (heart and blood circulation) disease.

• gallbladder disease.
• high blood pressure (hypertension)
• type 2 diabetes.
• osteoarthritis.
• certain types of cancer, such as colon and breast cancer.

26. Discuss at least two health risks faced by people with a BMI below 20.
People with a BMI above 25 are classified as “underweight.”
Health risks can
include hormone dysregulation, anemia, low bone density, a low
functioning
immune system and cardiac problems

5. Describe how being overweight affects at least three other body systems.

-Cancers (IMMUNE)
-Depression (NERVOUS)
-Type II Diabetes (ENDOCRINE)
-Sleep Apnea (RESPIRATORY)
-Asthma (RESPIRATORY)
-Osteoarthritis ("swelling of bones/joints") (SKELETAL)
-Heart attack or stroke due to CARDIO
-High cholesterol
-High blood pressure
-Arteriosclerosis ("artery hardening") (Circulatory)

6. Describe how being underweight affects at least three other body systems.

-Anemia & nutrient deficiencies (CARDIO)

-Bone loss & osteoporosis (SKELETAL)
-Heart irregularities & blood vessels
- disease (CARDIO)
-Vulnerability to infection/disease (IMMUNE)
-Delayed wound healing (IMMUNE)
7. Explain how a nutritionist or dietician might help an athlete train for a major competition, race, or
game.

They can give guidance and meal plans to ensure the athlete is eating the right amount of nutrients
and calories for enough energy, weight maintenance, and muscle growth.