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Wardlaw’s Contemporary Nutrition, 10th Edition Instructor’s Manual Chapter 7

Wardlaws Contemporary Nutrition 10th Edition Smith


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CHAPTER 7
ENERGY BALANCE AND WEIGHT CONTROL

OVERVIEW

This chapter first addresses energy balance, including energy intake and expenditure. Factors
that contribute to energy expenditure and ways to determine it are described. Energy imbalances and
determining a healthy body weight are discussed with considerable time devoted to diagnosing
obesity. An emphasis is placed on the fact that obesity has multiple causes, with both heredity and
environment playing roles. Arguments for and against the Set Point Theory are presented. The
discussion of obesity treatment emphasizes controlling energy intake, increasing energy expenditure,
and modifying behavior. Principles for a sound weight-loss plan are discussed. Suggestions for
obtaining professional help and managing morbid obesity, including medications and surgery, are
provided. Treatment of underweight is discussed. The Nutrition and Your Health section,
investigates current popular diets and their safety and efficacy.

KEY TERMS

Adaptive thermogenesis Direct calorimetry Positive energy balance


Adjustable gastric banding Dual Energy X-ray Relapse prevention
Air displacement Absorptiometry (DEXA) Resting metabolism
Amphetamine Energy balance Self-monitoring
Bariatrics Gastroplasty Set point
Basal metabolism Hypothalamus Sleeve gastrectomy
Bioelectrical impedance Identical twins Stimulus control
Body mass index (BMI) Kilocalorie Thermic effect of food
Bomb calorimeter Indirect calorimetry Thrifty metabolism
Brown adipose tissue Lean body mass Underwater weighing
Chain-breaking Leptin Underweight
Cognitive restructuring Lower-body obesity Upper-body obesity
Contingency management Negative energy balance Very-low-calorie diet (VLCD)

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Wardlaw’s Contemporary Nutrition, 10th Edition Instructor’s Manual Chapter 7

STUDENT LEARNING OUTCOMES

Chapter 7 is designed to allow you to:

7.1 Describe energy balance and the uses of energy by the body.
7.2 Compare methods to determine energy use by the body.
7.3 Discuss methods for assessing body composition and determining whether body weight and
composition are healthy.
7.4 Explain factors associated with the development of obesity, and outline the risks to health
posed by overweight and obesity.
7.5 List and discuss characteristics of a sound weight-loss program.
7.6 Describe why reduced calorie intake is the main key to weight loss and maintenance.
7.7 Discuss why physical activity is a key to weight loss and especially important for later weight
maintenance.
7.8 Describe why and how behavior modification fits into a weight-loss program.
7.9 Outline the benefits and hazards of various weight-loss methods for severe obesity.
7.10 Discuss the causes and treatment of being underweight.
7.11 Evaluate popular weight-reduction diets and determine which are safe and successful.

LECTURE OUTLINE

7.1 Energy Balance


A. Overview
1. Maintaining a healthy weight is associated with longevity and high quality of
life
2. 68.8% of North American adults are overweight
3. 34% of North American adults are obese
4. Figure 7-1 illustrates obesity trends among U.S. adults.
5. Prevention is key: 10 pound weight gain or increase of 2 inches WC should
signal reevaluation of diet and lifestyle
6. Successful weight loss comes from hard work and commitment
7. Calorie restriction, increased physical activity, and behavior modification are
three elements of a successful weight loss program
B. Positive and Negative Energy Balance
1. Figure 7-2 displays a model for energy balance
2. Equilibrium between intake and output results in weight maintenance
3. Positive energy balance is required during pregnancy, infancy, and childhood
4. Negative energy balance is required for successful weight loss; results in
reduction of some lean tissue in addition to adipose tissue.
5. Weight gain is a result of excess food intake coupled with limited physical
activity and slower metabolism
C. Energy Intake
1. “Defensive eating”
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Wardlaw’s Contemporary Nutrition, 10th Edition Instructor’s Manual Chapter 7

a. Making careful and conscious food choices, especially regarding portion


size
b. Required to limit calorie intake in an environment with an abundant
food supply and many modern conveniences that decrease physical
activity
2. Bomb calorimeter: instrument used to determine calorie content of food
3. Energy content of macronutrients and alcohol (adjusted for digestibility and
absorbability)
a. Carbohydrates yield 4 calories/gram
b. Protein yields 4 calories/gram
c. Fat yields 9 calories/gram
d. Alcohol yields 7 calories/gram
D. Energy Output
1. Basal metabolism
a. Minimum energy expended in a fasting state
b. 60% to 75% of total energy use by body
c. Resting metabolic rate (RMR) is higher than BMR and is the amount of
calories a body uses when not in strict fasting state as with BMR
d. Factors that influence basal metabolism
1) Lean body mass
2) Amount of body surface
3) Gender
4) Body temperature
5) Thyroid hormone
6) Stress
7) Pregnancy
8) Caffeine and tobacco use
e. Basal metabolism lowered 10% to 20% during low-kilocalorie intake
(150 to 300 kcals per day)
f. Basal metabolic rate declines about 1-2% each decade past age 30
2. Energy for physical activity
a. 15% to 35% of total energy output
b. Emphasis on increasing general activity
c. Obesity linked to inactivity
3. Thermic effect of food (TEF)
a. 5% to 10% of total calories eaten
b. "sales tax" for food eaten
c. TEF value for protein-rich meal is higher than TEF for carbohydrate-
rich meal which is still greater than fat-rich meal.
d. Larger meals result in higher TEF values than same amount of food
eaten slowly over many hours.
4. Adaptive Thermogenesis
a. Increase in non-voluntary physical activity (e.g., shivering, fidgeting)
b. Accounts for very small portion of energy use
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Wardlaw’s Contemporary Nutrition, 10th Edition Instructor’s Manual Chapter 7

c. Brown adipose tissue: specialized adipose tissue that wastes calories as


heat
1) Infants and hibernating animals have brown adipose tissue;
adults have very little
2) Probably used for temperature regulation
7.2 Determination of Energy Use by the Body
A. Direct and Indirect Calorimetry
1. Direct calorimetry measures release of body heat
a. Person resides in insulated chamber
b. Calculates energy expenditure by measuring change in temperature of
water surrounding the insulated chamber
c. Expensive and complex
2. Indirect calorimetry measures amount of oxygen consumed and carbon dioxide
expelled (see Fig. 7-6)
a. Predictable relationship between body’s use of energy and oxygen
b. More convenient and portable than direct calorimetry
B. Estimates of Energy Needs
1. Estimated Energy Requirements (EER): Food Nutrition Board
a. For men 19 years and older:
1) EER = 662 – (9.53 × AGE) + PA × (15.91 × WT + 539.6 × HT)
b. For women 19 years and older:
1) EER = 354 – (6.91 × AGE) + PA × (9.36 × WT + 726 × HT)
c. Variables
1) EER = estimated energy requirement
2) AGE = age (years)
3) PA = physical activity estimate
4) WT = weight (kg)
5) HT = height (m)
2. To estimate your caloric needs, you can go to www.ChooseMyPlate.gov
3. Figure 7-7 presents MyPlate caloric guidelines for different ages and genders
7.3 Assessing Healthy Body Weight
A. Overview
1. Factors to consider when determining a healthy weight
a. Weight history should be considered
b. Pattern of fat distribution in the body
c. Family history of weight-related disease
d. Current health status
1) Hypertension
2) Elevated LDL-cholesterol
3) Family history of obesity, cardiovascular disease, or certain
forms of cancer (e.g., uterus, colon)
4) Pattern of upper-body fat distribution
5) Elevated blood glucose
2. Healthy lifestyle contributes more to health status than number on the scale
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Wardlaw’s Contemporary Nutrition, 10th Edition Instructor’s Manual Chapter 7

a. Eat according to hunger cues and remain physically active


b. Allow nature to take its course
c. Healthy weight is individualized; considered in terms of health, not
math
B. Body Mass Index (BMI)
1. BMI is a convenient clinical tool to estimate weight status
2. Diagnosis of obesity depends on BMI, assessment of body fat amount and
distribution, and weight-related medical problems
3. Weight (in kg) divided by height2 (in meters) (see Table 7-1)
a. BMI 40 or greater: severely obese
b. BMI 30–39.9: obese
c. BMI > 25: health risks begin
d. BMI of 18.5 to 24.9 is healthy
4. BMI should not be applied to
a. Children or adolescents still growing
b. Frail older people
c. Pregnant and lactating women
d. Highly muscular individuals
5. Figure 7-8 illustrates estimates of body shapes at different BMI values.
6. Figure 7-9 displays a convenient height/weight table based on BMI.
7. Easier to measure than total body fat
C. Estimating Body Fat Content and Diagnosing Obesity
1. Table 7-2 presents health problems associated with excess body fat.
2. Desirable amount of body fat
a. Women: 16% to 30% (>35% considered obese)
b. Men: 11% to 20% (>24% considered obese)
3. Body fat estimation methods
a. Underwater weighing: determines body volume by measuring
difference in convention body weight and underwater body weight (see
Fig. 7-10).
b. Air displacement (BodPod): body volume quantified by measuring the
space a person takes up inside a measurement chamber (see Fig. 7-11).
c. Skinfold thickness: use calipers to measure the fat layer directly under
the skin at multiple sites and then plug these values into a formula (see
Fig. 7-12)
d. Bioelectrical impedance: measures resistance to an electrical current to
determine fat and lean mass (see Fig. 7-13)
e. Dual Energy X-ray Absorptiometry (DEXA): uses X-rays to determine
weight of fat, fat-free soft tissue, and bone mineral; is considered most
accurate method of body fat assessment (see Fig. 7-14)
D. Using Body Fat Distribution to Further Evaluate Obesity
1. Upper body (android) obesity (see Fig. 7-15)
a. Related to insulin resistance and fatty liver leading to heart disease, high
blood lipids, and diabetes
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Wardlaw’s Contemporary Nutrition, 10th Edition Instructor’s Manual Chapter 7

b. Encouraged by alcohol intake, smoking, and testosterone


c. Apple shape
d. Waist circumference > 40" (102 cm) for men; > 35" (88 cm) for women
e. Along with BMI > 25, associated with significant health risk
2. Lower body (gynoid) obesity (see Fig. 7-15)
a. Fat resists being shed
b. Encouraged by estrogen and progesterone
c. Pear shape
7.4 Why Some People Are Obese—Nature versus Nurture
A. How Does Nature Contribute to Obesity?
1. Genetic background accounts for up to 70% of weight differences between
people
2. Inherited "thrifty metabolism" predisposes one to obesity; enables us to store fat
readily
3. Chances of becoming obese
a. 10% if no obese parents
b. 40% if one obese parent
c. 80% if two obese parent
4. Genes determine metabolic rate, fuel use, brain chemistry
5. Does the body have a set point for weight?
a. Set-point theory: genetically predetermined weight or fat content
b. Supporting evidence
1) Hypothalamus monitors the amount of body fat in humans and
tries to keep it constant
2) Leptin: hormone released from adipose, promotes sense of
fullness and reduction of appetite
3) Thyroid hormone levels decrease when calorie intake is low,
reducing metabolic rate
4) With weight loss, body becomes more efficient at storing fat by
increasing lipoprotein lipase activity.
c. Opposing views
1) Weight does not remain constant throughout life
2) Weight changes with changes in environment
3) Resistance to weight gain is much less than resistance to weight
loss
B. Does Nurture Have a Role?
1. Environmental factors can impact weight
2. High-fat diets and inactivity promote weight gain
3. Poverty can contribute to obesity
4. Inactivity, stress, boredom, and large pregnancy weight gain are associated with
obesity
5. Adult obesity is often rooted in childhood obesity for women
6. Culture influence perceptions of beauty and body weight
7.5 Treatment of Overweight and Obesity
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Wardlaw’s Contemporary Nutrition, 10th Edition Instructor’s Manual Chapter 7

A. Losing Body Fat


1. No longer use "3500-kcal rule" as predictor of weight loss (reduction of 500
kcal per day will lead to loss of 1 pound per week)
2. For overweight: Deficit of 10 kcal/day results in 1 pound weight loss over 3
years
3. Deficit of 500 kcal/day results in 25 pound weight loss in one year, with
continued loss of 22 pounds by the end of 3 years.
4. Weight loss occurs over time (not linear)
5. See web-based body weight simulator (http://bwsimulator.niddk.nih.gov)
B. What to Look for in a Sound Weight-Loss Plan
1. Control calorie intake; slow steady loss
2. Increase physical activity
3. Behavior Modification
4. Figure 7-16 lists characteristics of a sound weight-loss plan in 5 categories
a. Rate of loss
b. Flexibility
c. Adequate intake of nutrients
d. Behavior modification
e. Overall health
5. Recommendations included in the 2010 Dietary Guidelines for Americans
include decreasing caloric intake, while maintaining adequate nutrition, to result
in a slow and steady weight loss
C. Weight Loss in Perspective
1. Importance of obesity prevention
2. Need for public health strategies
3. Focus on children and adolescents
4. Shift adult focus to weight maintenance and increased physical activity
7.6 Control of Calorie Intake—The Main Key to Weight Loss and Weight Maintenance
A. Overview
1. Kilocalorie control: lose 1 pound per week
a. 1200 kilocalories per day for women
b. 1500 kilocalories per day for men
2. Lower fat, high fiber intake most successful in long term studies
3. Portion control and lower energy dense foods
4. Monitoring kilocalorie intake
a. Read labels (see Fig. 7-18)
b. Keep food records
c. Measure portions
d. Low/no calorie beverages
e. Use ChooseMyPlate.gov online to track your caloric intake and
compare those calories to those expended during physical activity.
5. Table 7-4 shows how to start reducing calorie intake.
B. Controlling Hunger
1. Understand how to distinguish true hunger from emotional eating
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Wardlaw’s Contemporary Nutrition, 10th Edition Instructor’s Manual Chapter 7

2. Grehlin is a hormone that, along with empty stomach signals brain when you
are hungry; signal can be delayed and take 20 minutes to reach brain
3. Goal: avoid being so hungry that you binge
4. Drinking water and high-volume foods can decrease hunger
5. Mindful eating can be a good approach
C. Conquering the Weight-Loss Plateau
1. Healthy weight loss is slow, erratic, and can lead to plateaus
2. Weight loss begins quickly as water and fat are both reduced.
3. "Calorie creep" contributes to plateau; calorie reduction is hard to maintain
4. Decreased metabolism from reduction in calorie contributes to plateau
7.7 Regular Physical Activity—A Second Key to Weight Loss and Especially Important for Later
Weight Maintenance
A. Benefits of physical activity are manifold
1. Enhanced calorie burning during and after exercise
2. Boosts self-esteem
3. Expending only 100-300 extra kcal/day above normal activity while controlling
calories can lead to steady weight loss
B. 2008 Physical Activity Guidelines for Americans
1. 150 minutes/week of moderate-intensity aerobic activity to maintain body
weight
2. Some individuals may require more than 300 minutes/week to observe benefits
C. Duration and regular performance are the keys to success
1. Choose an activity that can be continued over time
2. Lighter intensity activities are less likely to result in injury
D. Resistance exercise to increase lean body mass
E. Increase routine activity by parking farther away, using stairs, etc.
F. Use pedometer to track activity; aim for 10,000 steps.
7.8 Behavior Modification—A Third Strategy for Weight Loss and Management
A. Goals for weight loss should be realistic, focusing on behavior change.
B. Table 7-6 lists behavior modification principles for weight loss
C. The 2010 Dietary Guidelines for Americans has identified behaviors that are related to
body weight.
1. Focus on the total number of calories consumed.
2. Monitor food intake.
3. When eating out, choose smaller or lower-calorie portions.
4. Prepare, serve, and consume smaller portions of foods and beverages, especially
those high in calories.
5. Eat a nutrient-dense breakfast.
6. Limit your screen time.
D. Mindful Eating
1. Make changes to avoid triggers that may tempt you to eat less healthy food or to
eat too much, or both.
2. Being aware of the entire eating experience from food preparation to
consumption, recognizing and respecting hunger and satiety cues
8
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Wardlaw’s Contemporary Nutrition, 10th Edition Instructor’s Manual Chapter 7

E. Other Behavior Modification Strategies


1. Chain-breaking: separates behaviors that occur together (e.g., eating chips and
watching television)
2. Stimulus control: removes temptations (e.g., remove fat-laden snacks from
view)
3. Cognitive restructuring: changes frame of mind (e.g., exercise rather than binge
for stress reduction)
4. Contingency management: prepares for situations that may trigger overeating or
hinder physical activity
5. Self-monitoring: reveals patterns that explain problem eating habits; key
behavioral tool for weight-loss program
F. Relapse Prevention Is Important
1. Can be considered hardest part of weight control
2. Changing self defeating thoughts
3. Acknowledge relapse but move forward
G. Social Support Aids Behavioral Change
1. Friends and family can both help and harm efforts
2. Continued relationship with health professional for accountability can be
important
H. Societal Efforts to Reduce Obesity
1. The 2010 Dietary Guidelines for Americans contains three guiding principles
a. Ensure all Americans have access to nutritious foods and opportunities
for physical activity
b. Help individuals change behaviors through environmental strategies
c. Help individuals with lifelong healthy eating, physical activity, and
weight-management behaviors
2. Changes in foods eaten outside the home
3. Social marketing programs to promote healthy eating and active living
7.9 Professional Help for Weight Loss
A. Overview
1. Healthcare professionals
a. Physician
b. Registered dietitian
c. Exercise physiologist
2. Weight loss organizations may help, but are also expensive and may not utilize
the expertise of licensed healthcare professionals
a. Take Off Pounds Sensibly (TOPS)
b. Weight Watchers
c. Jenny Craig
d. Physicians’ Weight Loss Center
B. Medications for Weight Loss
1. Who are candidates? BMI > 30 or > 27 with weight-related conditions
2. Medications alone have not been found to be successful
3. Classes of Medications
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Wardlaw’s Contemporary Nutrition, 10th Edition Instructor’s Manual Chapter 7

a. Phenteramine (Fastin or Ionamin) prolongs the activity of epinephrine


and norepinephrine in the brain (appetite reduction)
b. Orlistat (Xenical) reduces fat digestion by inhibiting lipase activity in
the small intestine (see Fig. 7-19)
1) Fat intake must be controlled to avoid unpleasant side effects of
fat malabsorption
2) Absorption of fat-soluble vitamins is limited
c. Lorcaserin hydrochloride (Belviq) alters serotonin receptors found
within the feeding center of the hypothalamus of the brain
d. Off-label applications: some medications are not approved for weight
loss per se, but weight loss is a side effect (e.g., some antidepressants)
e. Medications may aid weight loss, but are not a substitute for calorie
control, increased physical activity, and behavior modification
C. Treatment of Severe Obesity
1. Very-low-calorie diets
a. Used in patients with body weight >30% above healthy weight
b. Require careful monitoring of a physician
c. Health risks
1) Heart problems
2) Gallstones
d. 400–800 kilocalories/day; low in carbohydrate and fat, high in high-
quality protein
e. Weight regain is likely without maintenance plan and long-term support
2. Bariatric surgery (see Figure 7-20)
a. Types of surgery
1) Adjustable gastric banding reduces the opening from the
esophagus to the stomach with a hollow gastric band that can be
adjusted using a port placed beneath the skin
2) Gastric bypass (gastroplasty or stomach stapling) reduces the
stomach capacity, leading to rapid satiety
b. Patient selection criteria
1) BMI > 40
2) BMI > 35 accompanied by serious obesity-related health
concerns
3) History of obesity (at least five years) with previous attempts at
weight loss
4) No history of alcoholism or untreated psychiatric disorders
c. Health risks
1) Bleeding
2) Blood clots
3) Hernias
4) Severe infections
5) Nutrient deficiencies (e.g., iron, calcium)
6) Death (as high as 2%)
10
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Wardlaw’s Contemporary Nutrition, 10th Edition Instructor’s Manual Chapter 7

d. Other concerns
1) Surgery costs $17,000–$35,000
2) May not be covered by insurance
3) Follow-up surgery may be required to correct stretched skin
4) Major lifestyle change
e. Results
1) 75% of patients lose and keep off 50% or more of excess body
weight
2) Reductions in blood sugar, cholesterol, and blood pressure
common.
3. Lipectomy
a. Surgical removal of fat via suction
b. Risks include infection, lasting depressions in skin, blood clots, kidney
failure, and possibly death.
c. Expensive
7.10 Treatment of Underweight
A. Overview
1. BMI < 18.5
2. Potential causes
a. Cancer
b. Infectious disease
c. Digestive tract disorders
d. Excessive dieting
e. Excessive physical activity
f. Genetics
g. Growth spurts in active children and adolescents
3. Risks associated with being underweight
a. Loss of menstrual cycle and bone mass
b. Complications with pregnancy and surgery
c. Slow recovery after illness
d. Increased death rate, especially in combination with cigarette smoking
4. Treatment
a. Rule out medical conditions
b. Increase consumption of energy-dense foods and increase portion size
c. Encourage a regular meal and snack schedule
B. Gaining Weight as Muscle, Not Fat
a. Resistance training (weightlifting) program slows muscle loss that
comes with dieting and age.
b. Fitness trainer can help
c. Consume adequate protein and carbohydrate to fuel workout and repair
muscles
d. Consume 15 kcal per pound body weight if working out 3 days per
week.
e. Consume 20 kcal per pound body weight if working out 5 days per
11
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Wardlaw’s Contemporary Nutrition, 10th Edition Instructor’s Manual Chapter 7

week.
Nutrition and Your Health: Popular Diets—Cause for Concern
A. Overview
1. Goal should be gradual weight loss rather than immediate
2. Monotony leads to reduced calorie intake
3. FDA only involved with products suspected of doing harm
4. Size-acceptance nondiet movement, “Health at Every Size”
B. How to Recognize an Unreliable Diet
1. Promote quick weight loss
2. Limit food selections, prescribe rituals
3. Use testimonials
4. Cure-alls
5. Recommend expensive supplements
6. No permanent change in eating habits
7. Criticize the scientific community
8. Overlook role of physical activity
C. Types of Popular Diets (see Table 7-7)
1. High protein, low- carbohydrate approaches
a. Recommend 30–50% total kcal from protein
b. Urinary loss of essential ions
c. Use fat for fuel leading to ketosis
d. Liver must produce glucose leading to protein tissue loss
2. Carbohydrate-focused diets
a. Emphasize “good” (low glycemic index or low glycemic load)
carbohydrates instead of “bad” (high glycemic load) carbohydrates
b. Moderating swings in blood glucose help to control appetite
3. Low-fat approaches
a. 5% to 10% of energy intake as fat
b. High carbohydrate intake
c. Eat grains, fruits, and vegetables
d. May become monotonous
4. Novelty diets
a. Emphasize one food or food group
b. Exclude large amounts of food
5. Meal replacements
a. Beverages, frozen or shelf-stable entrees, meal, or snack bars
b. Emphasize portion and calorie control
D. Quackery is characteristic of fad diets
1. People taking advantage of others
2. Reputable journals
a. Journal of the Academy of Nutrition and Dietetics
b. Journal of the American Medical Association
c. New England Journal of Medicine

12
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Wardlaw’s Contemporary Nutrition, 10th Edition Instructor’s Manual Chapter 7

BEST PRACTICES: TEACHING STRATEGIES, DEMONSTRATIONS, ACTIVITIES,


ASSIGNMENTS, AND MORE

1. Assign students the Rate Your Plate activity, "A Close Look at Your Weight Status."
They should complete the calculations and the interpretation and application sections. They
should turn this assignment in to be graded.
2. Have students read a popular diet book or current magazine article describing a weight-loss
plan. Have them read the book and do the following:
a. Write a report evaluating the book/article, using the principles of a sound weight-
loss program and characteristics of fad diets listed in the chapter as guides. Have
them address weaknesses and strengths of the diet approach, faddist tendencies, and
violations of sound weight-loss principles.
b. Evaluate the diet described by the book, using the Daily Food Guide for
comparison.
c. These reports could be used as a basis for making oral reports on various diets.
3. Have students revise their own dietary record that they kept in chapter 1 to make it
nutritionally adequate and to provide 1,200 kilocalories. Some will need to add and others
eliminate or decrease foods to reach 1,200 kilocalories. Have them use the Dietary
Guidelines for Americans to determine nutritional adequacy of the diet they have created.
4. Have students select three food products for which claims are made like "low calories,"
"light," "reduced calories," or "dietetic," and compare that product to a similar one for
which no claim is made for energy and nutrient content. For example, comparing reduced
calorie mayonnaise to regular.
5. Have students bring an advertisement for a weight-reduction aid to class. Select from these
and have the class evaluate, in writing or as a class discussion, the rationale, effectiveness,
cost, and potential hazards.
6. Have students get menus from area restaurants and fast-food establishments. Put these
menus on an overhead transparency. Use the overheads for class discussion. Ask students
to choose foods and meals from these menus that would be appropriate for weight control.
7. Use a class period to allow students to go to a campus facility to have their body fat
assessed using skinfold thicknesses. If there are no campus resources, ask someone from a
local fitness center to do it, or do it yourself with the help of another faculty member of the
opposite gender (so the female and male could assess same-gender students). Most exercise
physiology books have formulas and instructions for doing skinfold measurements.
8. Ask a resource from the community to lecture in your class about various weight control
issues:
a. Ask a physician to discuss treatment for morbid obesity.
b. Ask leaders from TOPS or Weight Watchers to discuss their approaches and
programs.
9. Divide students into groups. Have each group compile three lists. The first list should
contain healthful eating tips; for example, trim fat from meat before cooking. The second
list should contain helpful dieting tips; for example, cut vegetables, dried fruit, and pretzels
are good snack choices when traveling in a car. The third list should contain dieting traps
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Wardlaw’s Contemporary Nutrition, 10th Edition Instructor’s Manual Chapter 7

and ways to prevent being "trapped." An example would be the restaurant ordering trap.
The prevention tip would be to think of what would be healthful food choices before
entering the restaurant. And, once in the restaurant, be the first to order if you are with
others so their choices will not influence yours. Use the lists as a springboard for discussing
behavior modification. Collect the lists, consolidate information, have someone type
resulting lists, and either photocopy for students or make a copy available for interested
students to photocopy.
10. Ask students to wear pedometers for five days to track the number of miles they walk.
Have them calculate the number of calories burned based on the distance walked.
(Students can use their diet analysis software if you prefer.)

c. Formatted: No bullets or numbering

14
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manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
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