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Concept of Energy Balance and the Health Hazards Associated with Underweight, Overweight

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The human body is constantly using energy which needs to be replaced. For this, a constant supply of energy is required.
Energy is used for basal metabolism, specific dynamic action, and physical activity. The energy from the food we eat, mainly carbohydrates and fats, is used to meet the energy demands of the body. When food is not available during fasting or starvation, the body draws upon its own stores to meet the energy needs of the body.

Energy Store

The body has three types of energy store:

Glycogen
The form is which carbohydrate is stored in the muscle and liver is adequate to last for 12-48 hours. Approximately 300g glycogen is stored in the muscle and 100g in the liver.

Muscle
Protein is stored in limited amounts in the muscle.

Adipose tissue
Fat is stored in the adipose tissue and the amount stored varies vastly from one person to another.

Energy Balance

A person in energy balance neither gains weight nor loses weight.
Excessive consumption of calories as compared to the output or activity leads to a condition called overweight, which in severe cases is called obesity. The deficient intake of carbohydrates and fats in the diet leads to underweight or undernutrition. Both underweight and obesity are undesirable conditions that need timely correction.

Definition

Energy balance is a condition in which the energy provided by food is nearly equal to the total energy expended by the body resulting in steady body weight.

Energy balance:
Energy output = Energy input

Overweight

Overweight and obesity affect over 25% of adults in developed countries and can lead to serious health consequences if not treated early. When an individual’s energy intake consistently exceeds energy expenditure, weight gain occurs initially, leading to obesity. Since energy can neither be created nor destroyed but can be changed from one form to another, the excess chemical energy from food is converted into fat and stored as potential energy in the adipose tissues.

Overweight: A person whose body weight is 10% more than the prescribed height for weight standards for his age and sex is considered as overweight.

Obese: A person whose body weight is 20% or more than that of the prescribed standard is considered as obese.

Grossly obese: A person who weighs 45kg or 100% more than accepted standards.

Causes of obesity

• Family food habits – rich high-calorie foods
• Ignoring the calorific value of food
• Skips breakfast, gobbles high-calorie snacks
• Sedentary lifestyle
• Lower metabolism with increasing age but failed to reduce intake
• Emotional outlet: eats more to overcome worry, stress, etc.
• Attend many social events
• Distress eating ( to avoid wastage)

Risks of being overweight

Excess weight may increase the risk for following health problems

  • type 2 diabetes
  • high blood pressure
  • heart disease and strokes
  • certain types of cancer
  • sleep apnea
  • osteoarthritis
  • fatty liver disease
  • kidney disease
  • pregnancy problems, such as high blood sugar during pregnancy, high blood pressure, and increased risk for cesarean delivery (C-section)

Remedies

  • Make half of your plate fruits and vegetables.
  • Replace unrefined grains (white bread, pasta, white rice) with whole-grain options (whole wheat bread, brown rice, oatmeal).
  • Enjoy lean sources of protein, such as lean meats, seafood, beans and peas, soy, nuts, and seeds.
  • Drink plenty of water.
  • Avoid carbonated and sugary beverages.
  • Getting some extra exercise also helps in losing weight.

Underweight

People having a body mass index (BMI) of under 18.5 or a weight 15% to 20% below that normal for their age and height group are considered to be underweight.

Causes

Underweight is caused due to under-nutrition which is the result of ingesting an insufficient quantity of food.
An energy intake less than the need, are the most common cause.
Other causes for underweight are poor assimilation of food due to digestive disorders, faulty absorption, intestinal infections, poor food habits, stress and tension, poverty and lack of nutrition knowledge.

Risks of being underweight

Not all people who are underweight experience adverse side effects or symptoms from being underweight. However, some people, experience the following symptoms related to being underweight:

Osteoporosis: Being underweight increases a woman’s risk of osteoporosis, which is where the bones are brittle and more prone to breaking.

Skin, hair, or teeth problems: If a person does not get enough nutrients in their daily diet, they may display physical symptoms, such as thinning skin, hair loss, dry skin, or poor dental health.

Getting sick frequently: If a person does not get enough energy from their diet to maintain healthy body weight, they may also not be getting enough nutrients to fight off infections. As a result, a person may get sick more frequently, and common illnesses, such as a cold, can last longer than they usually would.

Feeling tired all the time: Calories are a measurement of the energy a particular food can give a person. Not getting enough calories to maintain a healthy weight can make a person feel fatigued.

Anemia: A person who is underweight is more likely to have low blood counts, known as anemia, which causes dizziness, headaches, and fatigue.

Irregular periods: Women who are underweight may not have regular periods, they may find menstruation stops or an adolescent’s first period may be delayed or absent.

Treatment

Adding snacks: High-protein and whole-grain carbohydrate snacks can help a person gain weight. Examples include peanut butter crackers, protein bars, trail mix, pita chips and hummus, or a handful of almonds.

Eating several small meals a day: Sometimes a person may be underweight because they cannot tolerate eating large meals. Instead, a person can eat several small meals throughout the day.

Incorporating additional foods: A person can add calorie-dense food sources to their existing diets, such as putting slivered almonds on top of cereal or yogurt, sunflower or chia seeds on a salad or soup, or nut butter on whole-grain toast.

Avoiding empty calories: Eating high-calorie foods may cause a person to gain weight, but they also have excess fats that could affect a person’s heart and blood vessels. A person should avoid foods that are high in sugar and salt.

Body Mass Index (BMI)

The concept of ideal or desirable body weight has been changing from time to time and ideal weight for different body frames was initially computed. Today the weight of an individual is assessed on a more scientific basis known as the body mass index (BMI).
BMI is the measure of body fat based on height and weight and applies to an adult man or woman.
It is defined as the body mass divided by the square of the body height and is measured in kg/m².
Body mass index = weight in kilograms / (height in metres)2 = W/H2
Normal BMI is 18.5- 25
On the basis of BMI, obesity is graded as follows:

Obesity                    BMI
Grade 1                   25-29
Grade 2                   30-40
Grade 3                     >40

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Syllabus BHM116

01 Basic Aspects

  1. Definition of the terms Health, Nutrition and Nutrients
  2. Importance of Food – (Physiological, Psychological and Social function of food) in maintaining good health.
  3. Classification of nutrients

02 Energy

  1. Definition of Energy and Units of its measurement (Kcal)
  2. Energy contribution from macronutrients (Carbohydrates, Proteins and Fat)
  3. Factors affecting energy requirements
  4. Concept of BMR, SDA, Thermodynamic action of food
  5. Dietary sources of energy
  6. Concept of energy balance and the health hazards associated with Underweight, Overweight

03 Macro Nutrients

Carbohydrates

  1. Definition
  2. Classification ( mono, di and polysaccharides)
  3. Dieteary Sources
  4. Functions
  5. Significance of dietary fibre (Prevention/treatment of diseases)

 Lipids

  1. Definition
  2. Classification : Saturated and unsaturated fats
  3. Dietary Sources
  4. Functions
  5. Significance of Fatty acids (PUFAs, MUFAs, SFAs, EFA) in maintaining health
  6. Cholesterol – Dietary sources and the Concept of dietary and blood cholesterol

Proteins

  1. Definition
  2. Classification based upon amino acid composition
  3. Dietary sources
  4. Functions
  5. Methods of improving quality of protein in food (special emphasis on Soya proteins and whey proteins)

04 Micro Nutrients

Vitamins

  1. Definition and classification (water and fats soluble vitamins)
  2. Food Sources, function and significance of:
  3. Fat soluble vitamins (Vitamin A, D, E, K)
  4. Water soluble vitamins (Vitamin C, Thiamine, Riboflavin, Niacin, Cyanocobalamin Folic acid

Minerals

  1. Definition and Classification (major and minor)
  2. Food Sources, functions and significance of :
    Calcium, Iron, Sodium, Iodine & Flourine

05 Water

  1. Definition
  2. Dietary Sources (visible, invisible)
  3. Functions of water
  4. Role of water in maintaining health (water balance)

06 Balanced Diet

  1. Definition
  2. Importance of balanced diet
  3. RDA for various nutrients – age, gender, physiological state

07 Menu Planning

  1. Planning of nutritionally balanced meals based upon the three food group system
  2. Factors affecting meal planning
  3. Critical evaluation of few meals served at the Institutes/Hotels based on the principle of meal planning.
  4. Calculation of nutritive value of dishes/meals.

08 Mass Food Production

  1. Introduction
  2. Effect of cooking on nutritive value of food (QFP)

09 Newer Trends in Food Service Industry in Relevance to Nutrition and Health

  1. Need for introducing nutritionally balanced and health specific meals
  2. Critical evaluation of fast foods
  3. New products being launched in the market (nutritional evaluation)