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Wardlaw’s Contemporary Nutrition, 10th Edition Instructor’s Manual Chapter 7
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
1
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Wardlaw’s Contemporary Nutrition, 10th Edition Instructor’s Manual Chapter 7
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
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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manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
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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manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
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
Copyright © 2016 McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any
manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
Wardlaw’s Contemporary Nutrition, 10th Edition Instructor’s Manual Chapter 7
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
13
Copyright © 2016 McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any
manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
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.)
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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