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Metabolic and Clinical Aspects of Weight Management FSHN 420

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Atkins Diet Revolution. Protein Power. South Beach. The Zone. Weight Watchers. USDA Food Guide Pyramid. Pritikin. Ornish ... the U.S. Diet. decreased intakes ... – PowerPoint PPT presentation

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Title: Metabolic and Clinical Aspects of Weight Management FSHN 420


1
Is a calorie a calorie?
or are all foods created equal?
Donald K. Layman Department of Food Science
Human Nutrition University of Illinois
Urbana-Champaign
2
Obesity 1 public health problem in U.S.
Popular diets
Atkins Diet Revolution Protein Power South
Beach The Zone
Weight Watchers USDA Food Guide
Pyramid Pritikin Ornish
3
The Great Diet Debate
What is the ideal balance of macronutrients?
fats carbohydrates protein
4
The Environment of Obesity
Physical activity
availability
lifestyle
Food
Stress
taste
cost
5
U.S. Nutrition Policy
1970 - 2000 The Era of Heart Disease
fat is the root of all evil
Currently, nutrition practice is driven by public
opinion
The Low Carb Craze
6
Dietary Guidelines for Americans
  • consume a variety of foods
  • control calorie intake to manage body weight
  • be physically active
  • increase daily intake of fruits, vegetables,
  • whole grains, and low fat dairy
  • choose fats wisely
  • choose carbohydrates wisely
  • choose and prepare foods with little salts
  • drink alcohol in moderation
  • keep food safe to eat

7
USDA Food Guide Pyramid
fats
milk cheese
meat fish, eggs
2-3 servings
2-3 servings
vegetables
fruits
3-5 servings
2-4 servings
bread, cereal, rice pasta 6-11 servings
8
The Myths of Macronutrients
fats the root of all evil
carbohydrates the more the merrier
protein everybody eats too much
9
Changes in U.S. diet (1970 2000)
  • red meat (25)
  • dairy (30)
  • eggs (40)
  • grains (decreased vegetables)
  • fruit juices (decreased fruits)
  • sodas
  • snack foods (refined carbohydrates)

10
Impact on the U.S. Diet
  • cholesterol
  • (from 650 mg/d to
  • total fat
  • (from 40 of calories to 33)
  • saturated fat
  • (from 17 of calories to 12)

11
Impact on the U.S. Diet
increased total calories!!!
decreased intakes of iron, zinc, calcium,
B-vitamins, fiber and vitamin A
average protein intake women 68
grams/day men 90 grams/day
12
Dietary Reference Intakes (DRI)
RDA
UL
Risk of Adverse Affects
Risk of Inadequacy
safe
deficiency
toxicity
metabolic balance
13
Personal choices … metabolic outcomes
Male athlete, 22 y.o., 180 lbs, 7 body fat, 3700
kcal/d
15 protein 138 g/d 55 CHO 508 g/d 30 fat
123 g/d
Female CPA, 57 y.o., 180 lbs, 39 fat, 2100 kcal/d
15 protein 74 g/d 55 CHO 289 g/d 30
fat 70 g/d
14
The right diet for the right person … how do we
chose?
U.S. Population ( 300 million)
blood lipid profiles
normal
27 m
46 m
hypercholesterolemia
dyslipidemia
Syndrome X
15
Syndrome X (metabolic syndrome)
In 1988, Dr. Reaven reported that individuals
with impaired glucose tolerance and compensatory
hyperinsulinemia had increased risk for Coronary
Heart Disease (CHD).
stability of blood sugar
16
Weight loss diets (at 1700 kcal)
RDA
Upper Limit

250
170
350 g ??
CHO 130 g
70
120
protein 65
250 g ??
USDA Food Guide Pyramid 250/70 3.5
Moderate Carb/moderate protein diet 170/120 1.5
17
Findings with moderate protein diets
  • weight loss
  • loss of body fat
  • sparing of muscle protein
  • triglycerides
  • HDL
  • stability of blood sugar
  • Layman et al. J. Nutrition 133411, 2003

18
Moderate Protein Diet (10 weeks)
Weight loss CHO 15.3 lbs Prot. 16.6 lbs
fat as of loss CHO 69 Prot. 75
Layman J. Nutr. 133411, 2003
19
Is a calorie a calorie?
Yes, but …
  • thermogenesis
  • satiety
  • biological function

20
Protein needs vs. requirements
Protein structures RDA 0.8 g/kg
Metabolic roles 60 to 70 g/day
Physical activity 10 g/hour of activity
21
Carbohydrate quantity and quality
  • glycemic index and glycemic load
  • fiber source, type, form
  • fructose
  • Net Carbs

22
A calorie is a calorie
  • Weight management is determined by
  • portion control
  • physical activity

but … each macronutrient has different
biological functions
What is the nutrient tolerance for each
individual?
23
Dietary Guidelines for Americans
  • consume a variety of foods
  • control calorie intake to manage body weight
  • be physically active
  • increase daily intake of fruits, vegetables,
  • whole grains, and low fat dairy
  • choose fats wisely
  • choose carbohydrates wisely
  • choose and prepare foods with little salts
  • drink alcohol in moderation
  • keep food safe to eat

24
Personal choices …
lifestyle
Physical activity
Food intake
25
Personal choices … metabolic outcomes
Male athlete, 22 y.o., 180 lbs, 7 body fat, 3700
kcal/d
protein 17 161 g/d additional energy
3056 kcal fat 26 106 g CHO 57
527 g
Female CPA, 57 y.o., 180 lbs, 39 fat, 1700 kcal/d
protein 31 131 g/d additional energy
1176 kcal fat 30 57 g CHO
39 166 g
26
The Future …
Individualization of diets the right diet for
the right person
Food quality … not quantity
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