2. energy balance and energy metabolism by dr. gaga irawan (29 september 2011).pptx

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Page 1: 2. Energy Balance and Energy Metabolism by dr. Gaga Irawan (29 September 2011).pptx

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Energy Balance& Energy

Metabolism

Gaga IrawanNur Fatimah

Departement of Medical

Nutrition

EnergyRequiremen

Energiintake

EnergyStatus

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Energy: Fuel for or!

Energy source Chemical energy in carbohydrates, fat, protein

Food energy to cellular energy

Stage 1: digestion, absorption, transport Stage 2: breakdown of molecules

Stage 3: transfer of energy to a form cells canuse

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Cell is the metabolic

processing center  ucleus

Cytoplasm

• Cytosol ! organelles

 "#$ is the body%s energy currency  "#$ & adenosine triphosphate

Form of energy cells use

"' and F"': transport shuttles

 "ccept high energy electrons for use in "#$ production

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(etabolism is an integrated set ofchemical reactions occuring in the

body that enable us to e)tract

energy from the en*ironment and

use it to synthesi+e building blocks

that are used to make essential

proteins, carbohydrates and lipids

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Catabolism -eactions that

breakdowncompounds into smallunits

 "nabolism -eactions that build

comple) moleculesfrom smaller ones

e a o sm pa ways can e c ass e aseither catabolism or anabolism

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Catabolism pathways names end islysis meaning to breakdown

glycogenolysis: glycogen breakdownproteolysis: protein breakdown

lipolysis: lipid breakdown

glycolysis: glucose breakdown

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 "nabolic pathways names end in

genesis meaning to create

glycogenesis: glycogen synthesislipogenesis: fatty acid synthesis

gluconeogenesis: glucose synthesis

protein synthesis

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#he transfer of energy in reactions:

when chemical bond breaks, energy

can be released as heat, captured in

another chemical bond, or both

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#he site of reactions: metabolic work isgoing on all the time within the cells

Catabolism of energy.rich compound

/carbohydrate, protein 0 fat: anaerobic reactions /cytosol

aerobic reactions /mitochondria

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-egulations of pathways: metabolic

reactions almost always reuire en+yme

/or hormone to facilitate their action

En+ymes need coen+ymes #he en+ymes

are subect to strict regulation to ensurethat: #he rate of the pathway is adapted to the

cell%s needs  "nabolic 0 catabolic pathways are not

acti*e at the same time

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$roduction of 425 0 Energy in the mitochondria:

#he energy potential produced, could form highenergy phosphate molecules /"#$ 0 6#$

 ADP + phosphate + energy ATP 

GDP + phosphate+ energy  GTP 

 H 2 + O2  H 2O+ energy

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6lucose: brain, red blood cells, adrenal gland and muscle

in anaerobic acti*ity and high intensity aerobic acti*ity

Fatty acids: heart, li*er, smooth muscle and skeletalmuscle in low intensity aerobic acti*ity

7etone bodies: heart, skeletal muscle and after adaptation

of star*ation, by the brain

8ranch chain amino acids /8c"": skeletal muscle5ther amino acid: li*er

Each organ has a preferential fuel" that is# the substrate

that it prefers to use for energy production$

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Brea!down and %elease of Energy

E)tracting energy from carbohydrate

6lycolysis• $athway splits glucose into 2 

pyru*ates

• #ransfers electrons to "'

• $roduces some "#$

$yru*ate to acetyl Co"

• -eleases C52

• #ransfers electrons to "'

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Brea!down and %elease of Energy

E)tracting energy from carbohydrate

Citric acid cycle• -eleases C52

• $roduces 6#$ /like "#$

• #ransfers electrons to "'

and F"'

Electron transport chain•  "ccepts electrons from "'

and F"'

• $roduces large amounts of "#$

•$roduces water 

End products of glucose

breakdown•  "#$, 425, C52

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E)tracting energy from fat

Split triglycerides into glycerol and fatty acids

8eta.o)idation•

8reaks apart fatty acids into acetyl Co"• #ransfers electrons to "' and F"'

Citric acid cycle•  "cetyl Co" from beta.o)idation enters cycle

Electron transport chain End products of fat breakdown

•  "#$, 425, C52

Brea!down and %elease of Energy

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E)tracting energy from protein

Split protein into amino acids

Split off amino group• Con*erted to urea for e)cretion

Carbon skeleton enters breakdown

pathways

End products•  "#$, 425, C52, urea

Brea!down and %elease of Energy

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Functions of the energy released:

 to conduct ner*e impulse /electric

 actin 0 myosin contraction /mechanic

 transfer of molecules across membrane

/osmotic to produce heat /thermic

 anabolism /chemical

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Biosynthesis and torage

(aking carbohydrate /glucose

6luconeogenesis• 9ses pyru*ate, lactate, glycerol, certain amino acids

Storing carbohydrate /glycogen i*er, muscle make glycogen from glucose

(aking fat /fatty acids ipogenesis

• 9ses acetyl Co" from fat, amino acids, glucose Storing fat /triglyceride

Stored in adipose tissue (aking ketone bodies /ketogenesis

(ade from acetyl Co"•

;nadeuate glucose in cells (aking protein /amino acids  "mino acid pool supplied from

• 'iet, protein breakdown, cell synthesis

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%egulation of Metabolism

(ay fa*or either anabolic or catabolic functions

-egulating hormones

;nsulin

6lucagon

Cortisol Epinephrine

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pecial tates

E)cess energy intake

fromcarbohydrate, fat,

protein

• $romotes storage

;nadeuate energy

intake

• $romotes breakdown

$rolonged fasting

• $rotects body protein

as  long as possible

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ENE%G' B()(N*E

 7ey #erm:

 Energy intake Energy e)penditure

 Energy reuirement

 Energy balance

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Energy inta!e

Food composition  8omb calorimeter 

Food intake:

4unger 

 "ppetite

Satiation Satiety

5*erriding hunger and satiety

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Euilibrium of energy intake and energy e)pendituredetermine the energy status

Energy st assessment for children   weight for age

Energy st assessment for adults   weight for height:8ody (ass ;nde) /8(;

 E N E R G Y

 E X P E N D I T U R  E

 E N E R G Y 

 I N TA K  E

ENERGY STATUS 

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8alanced energy: if energy intake sufficient with

the energy e)penditure

Surplus of energy: if energy intake larger than

energy e)penditure  energy storage increase:

C4  stored as glycogen /limited and as lipid/abundance

Fatty acids  stored as lipid

$rotein  stored as lipid

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Energy deficit & if energy intake insufficient

for energy e)penditure Storage molecules

will be used

< 7kal of energy similar to 1 gram of bodytissue

oss of energy: =>> 7kal?day or 3=>>

7kal?week  catabolism of body tissue:

3=>> : < & =>> g body tissue?week

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Energy intake obtain from the food

@arious amount of energy in the food, depends on

the composition of the foods

1 gram C4  A 7kal

1 gram $rotein    A 7kal1 gram fatty acid  B 7kal

@itamin, mineral and water do not pro*ide adeuate

energy

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'aily amount of energy intake depends on: foodclass, uantity per portion, and freuency of food

intake per day

utrient composition 0 amount of energy per 1>>gram food stuff are a*ailable in Food

Composition ist Food stuff weight comes from

4ousehold measurement

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#otal Energy E)penditure?#EE :

sum of 8asal Energy E)penditure /8EE, $hysical "cti*ity /$" and Spesific 'ynamic "ction of food

/S'" or #hermic Effect of Food /#EF

#he calculation:

TEE = BEE + PA + SDA (TEF)

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8EE is energy e)penditure in basal condition, the

ongoing acti*ity while the body rest: heart beat,peristaltic, hormone secretion, en+yme secretion,muscle contraction, etc

8asal condition: 12 1D hours after the last meal

ying position

o physical acti*ity an hour before the test

-ela)ormal body temperature

-oom temperature should be 21.2=oC

ormal humidity

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4arris 0 8enedict calculation for 8EE:

Simple calculation for 8EE:

Men : 66 + (13,7 x BW kg) + ( x B! "#) $ (6,% x &ge)

W'#en: 66 + (,6 x BW kg) + (1,7 x B! "#) $ (,7 x &ge)

Men : 1 Kk&* BW Kg - . Kk&* BW Kg /

W'#en: 0, Kk&* BW Kg - .1,6 Kk&* BW Kg /

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Factors that influence BEE 

Body weight# height# age# gender# growth# temperature#

muscle mass# sleep# endocrine acti+ity# nutrition status$ 

 "ge : abo*e 2>  8EE will decrease 2 e*ery 1> y

6ender : 8EE in men women /at age 1> y6rowth : highest for baby and adolescence

4eight : the taller the higher 8EE

(uscle mass : the greater the higher 8EE

#emperature : e*ery 1oC ele*ation of body temperature/body temp abo*e 3<oC8EE will increase 13

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Sleep : 8EE decrease 1>

Endocrine :. hiperthyroid: 8EE increase<=.1>>

 . hipothyroid : 8EE decrease

  3>.A> . right before menstruation 8EE

slightly increase and during

menstruation  8EE decrease

utrition status : 8EE decrease in $E(

$regnancy : 8EE increase 1=.2=

,h i l ( ti it -,(.

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,hysical (cti+ity -,(.

$" *ery light & 1>.3> 8EE

$" light & 3>.=> 8EE

$" moderate & =>.G> 8EE$" hea*y & G>.1>> 8EE

 "F *ery hea*y& 1>> 8EE

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)e+el of (cti+ity

@ery light: . "cti*ity in sitting position. 8edrest

ight: #eacher, lecturer, general practitioner,

housewife

(oderate: Farmer, student/! sport, office

worker 4ea*y : "thlete during #C, unskilled worker,

manual laborer, army during training

@ery hea*y : Sawyer of wood,blacksmith,

ricksaw carrier, becak dri*er

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D( or /EF

is the amount of energy used for digestion,

absorption and utili+ation of food consumed

. S'" of protein 3> 8EE

. S'" of carbohydrate H protein

. S'" of fat  the lowest

S'" of ;ndonesian food on the a*erage is 1>

of 8EE ! "F

/EE f h t b li

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/EE for hypermetabolism

#EE & 8EE ) SF ) $"

Simple calculation:

I#he rule thumbJ  2=.3> of kkal?kg 8K

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Stress Factor /SF$ostoperati*e /without comp1>>.11>

Fracture of long bone 11=.13>

Cancer 11>.13>

$eritonitis?sepsis 11>.13>

Serious infection?mult #rauma12>.1A>(ultiple organ failure syndr 12>.1A>

8urn 12>.2>>

$hysical acti*ity /$"

8edridden  11

 "mbulatory  12

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)0G0

Thank You !