Name Fisher Partial KEY

Metabolism – A Balancing Act – 75 Informal PointsIntroduction

In any cell, two basic processes, catabolism and anabolism, work together to balance what is being built with what is being broken down. In catabolism, energy rich fuel molecules are broken down to release their energy to supply the cell’s needs. Anabolism, on the other hand, takes simple building blocks and uses them to build up more complex molecules a cell may need for growth and repair. Together, anabolism and catabolism make up metabolism, the sum of all of the chemical reactions that occur within body cells. These important reactions help convert the fuel in the food we eat to power for everything we do.

Last year in PBS, you learned that the calorie is a measure of energy. Calories are stored in the molecules that make up the food that we eat. We burn these molecules through the process of cellular respiration and release energy that can be used by the body. To remain fit, you must balance the amount of calories you ingest with the amount you spend completing daily activities. If what is being consumed is not balanced by what is being burned, you’ll notice the difference on the bathroom scale.

So how much energy do you use in a day? Remember that even when you are sleeping or watching TV, your body is using energy. Energy cannot be seen or touched, but it keeps your heart beating, your neurons firing and your muscles pumping. Basic metabolic functions and chemical reactions that break down and build new materials are always occurring. Your total energy expenditure includes energy used at rest and during physical activity.

In this activity, you will play the role of a registered dietician or a nutrition counselor and meet with a client hoping to adopt a more healthy lifestyle. You will analyze the diet of your client and balance the energy he or she consumes with the energy expended in daily activities. Examining standard measures of weight and fitness, as well as the theory behind gaining and losing weight, will help you see how too many or too few calories will impact the health of many body systems. Report your findings to your client and suggest ways he or she can better utilize energy for optimum performance and health.

ProcedureJeremy Brown is a 24-year-old man who has always been in good health. A busy law student, Jeremy finds he has less and less time to exercise. He used to cook most of his meals at home, but now he grabs whatever he can when he is on the way to the library or to class. His doctor just called him to let him know that his routine physical results revealed a mildly elevated LDL and a low HDL level. Both his mom and his dad have shown early signs of heart disease.

Trisha Knowles is a19-year-old sophomore majoring in Biology. Trisha gets up to go running every morning before class and sometimes adds a second workout in after dinner. She is a strict vegetarian and she has recently cut all carbohydrates (except for an occasional slice of wheat toast) out of her diet. Trisha is convinced she needs to lose at least 10 more pounds. She drinks plenty of water and consumes a sugar-free energy drink when she needs to stay up and study, but she still feels tired and run down.

Hans Spielman is a 22-year-old senior who has not worried much about his weight in the past four years. He does not want to lose his scholarship so most of his focus is on his GPA and his internship at the local hospital. Hans knows he has gained weight over the past four years, but he did not realize how

bad it was until his doctor referred to him as obese at his last appointment. Hans wants to lose weight, but his doctor fears that he will not lose the weight in a safe manner unless he consults with an expert.

All three individuals begin to worry about their health and decide to see the campus nutritionist (that’s you!)

1. Note that you will be assigned one of the three clients.

2. Use the Internet to research a career as a dietician or a nutritionist. These careers are similar, but there are some differences. Fill in the table below to compare the two professions.

Similarities Differences

Both experts in food and diet

Know how diet, nutrition and supplements affect

the body and overall health

Both considered to be healthcare professionals

Dieticians are considered to be nutritionists but

not all nutritionists are dieticians

Dietician has a slightly higher ranking due to

more education and licensing

Nutritionists do not necessarily have any

professional training and may be self-proclaimed

nutritionists; therefore it is important to check their

credentials before trusting them; Nutritionists

should not diagnose diseases

3. Create two career journals: 1) Dietician and 2) Nutritionist. Describe the education required for the position and the standard salary range for individuals in this field. List at least five duties of this biomedical professional. Under your list, write a short paragraph describing how a dietician and nutritionist might help the patient you have been specifically assigned.

In the first session with either Jeremy, Trisha, or Hans, you collect basic information from the client and record height and weight. The patient has been asked to keep a detailed food log, chronicling all of his or her meals, drinks, and snacks, for the past week.

4. You have a partially completed Client Report relating to your specific patient. Your task will be to analyze the patient’s diet and complete this report. Bulleted items describe the tasks you will need to complete to finish your assessment. You will receive more instructions as you complete each step.

5. Know that body Mass Index (BMI) is a measure of body fat based on both height and weight of an individual. BMI is a simple numeric measurement that can be used to determine whether an adult is overweight. View the Howard Hughes Medical Institution video clip on BMI at http://www.hhmi.org/biointeractive/body-mass-index-bmi Record important information from the video clip in the space below.

Standard BMI values:

What is considered a healthy BMI?

What BMI values are associated with being overweight or obese?

A BMI below 18.5 (shown in white) is considered underweight.

A BMI of 18.5 to 24.9 (green) is considered healthy. A BMI of 25 to 29.9 (yellow) is considered overweight. A BMI of 30 or higher (red) is considered obese.

6. Refer to information found on the Client Report and calculate your client’s BMI using the formula shown below. Show all work neatly in the space below. Make sure to use the correct units. Remember, there are 0.454 kilograms per pound, 2.54 centimeters in an inch, and 100 cm in a meter.

o BMI = weight (kg) _________________

[height (m)]2

7. Record BMI and discuss the implications of this value directly on the Client Report.

8. Read the information presented under Activity Level on the Client Report.

9. Note that Basal Metabolic Rate (BMR) is the baseline rate at which your body uses energy. This value takes gender, height, weight and age into consideration to calculate the number of calories needed to fuel the basic functions of life. Calculate your client’s BMR using the appropriate formula shown below. Neatly show all work.

o Men: BMR = 66.5 + (13.75 x W) + (5.003 x H) – (6.775 x A)o Women: BMR = 655.1 + (9.5663 x W) + (1.85 x H) – (4.676 x A) o W = actual weight in kilogramso H = height in centimeterso A = age in years

10. Record BMR directly on the Client Report.

11. Notice that BMR only accounts for the body’s resting energy needs. To get an accurate value for the amount of energy a person spends per day, you need to factor in your level of physical activity. The more you exercise, the more calories you burn and thus, the more calories you need to consume.

12. Once you know your client’s BMR, calculate his or her caloric needs based on level of activity using an approximation called the Harris-Benedict equation. Use information about this equation found at BMI-Calculator.net http://www.bmi-calculator.net/bmr-calculator/harris-benedict-equation/ to determine activity factor and record your findings in the space below.

13. Multiply the BMR you calculated by this activity factor to determine the number of calories your client should consume daily to maintain his or her current weight. This value is referred to as the Total Daily Energy Expenditure (TDEE). Show your work in the space below and record the final TDEE on the Client Report.

14.

15. Read the information presented in the Food Intake portion of the Client Report.

16. Compare how much energy your client uses during a typical day (the TDEE) to how much energy he or she consumes (average calorie consumption per day). Calculate a difference, showing all work in the space below.

According to these values, is your client consuming too many or too few calories?

17. Record the calorie deficit or surplus directly on the Client Report.

18. Predict your client’s expected weight loss or gain if he continues these activities and eating patterns for one month. Neatly show all work in the space below. Use the information below to help you estimate this value and record your findings directly on the Client Report.

o To lose weight, you need to create a calorie deficit. To gain weight you need to increase your calories about your TDEE.

o There are approximately 3500 calories in a pound of stored body fat. o If you create a calorie deficit of 500 calories per day, you will be down 3500

calories in a week, and thus lose 1 pound. If you consume an extra 500 calories a day, you will be up 3500 calories in a week, and thus gain 1 pound. NOTE: This assumes a constant activity level (as controlled for by your activity factor).

Things to know and be able to do regarding the calculations:

Formulas will be given, but conversion factors will NOT be given. Focus on calorie numbers and how they correlate to weight gain and

loss Know that BMR multiplied by the activity factor gives the Total Daily

Expenditure (TDEE) and is the amount of calories a person needs to sustain themselves and not change weight each day; know how to use

o Activity factor values will be given and do not need to be memorized

There are 3500 calories in a pound Small amounts of extra or deficit calories add up over time

19. Analyze your client’s food choices. Explore the components of a healthy day’s eating at the USDA ChooseMyPlate site http://www.choosemyplate.gov/.

20. Click on each section of the plate piece to view recommendations on the components of a healthy diet. Review healthy food choices in each section.

21. Analyze your client’s food choices in the space below.

22. Write a detailed paragraph describing what you have found and what you will say to your patient in the space below. (You may use separate paper if you wish, or even type this.)

As a dietician or nutritionist you must have advice for your patient regarding:

o Their current diet and health situationo Prediction of weight and health in one month if no changes are

madeo Plan to improve diet and healtho Prediction of weight and health if improvements are made

23. Complete the remaining sections of the Client Report sheet. Report your findings in a clear succinct conclusion and make recommendations to your client about improving lifestyle. Take all aspects of health history into account.

24. Note the following websites (along with the MyPlate site) may be helpful in the completion of your report:

o Food and Drug Administration: How to Understand and Use the Nutrition Facts Label (Note: contains an example label showing recommended daily values) http://www.fda.gov/Food/IngredientsPackagingLabeling/LabelingNutrition/ucm274593.htm

o NutriStrategy: Nutrients, Vitamins, Minerals and Dietary Information http://www.nutristrategy.com/nutritioninfo2.htm

Conclusion Questions1. What are the limitations of using BMI as a measure of weight and overall health? How might

muscle tone affect BMI?

BMI is a measurement that describes a person's weight relative to height. When used with a large number of

people (e.g. a population), BMI values correlate with body fatness. However, for a specific individual BMI is of limited value because it does not provide information about his or her percent body fat or where the fat is distributed. The BMI of athletes with well-developed muscle and dense bones may be high even though their percent body fat is not high.

2. What are factors that can increase or decrease BMR? Explain each.

Gender males have a higher BMR than females cute to higher rate of lean active body tissue compared to adipose tissue

Body Size the larger the body the greater the metabolism rate , as more energy is required to move a larger heavier mass

Lean Body Tissue compared to fat greater lean body tissue increases your metabolism rate as it is active tissue that burns kilojoules at a faster rate

Hormones certain hormonal conditions affect basal metabolic rate people with an overactive thyroid have a greater metabolic rate

Infection & Illness increase basal metabolic rate as the body works harder to fight the infection

Fasting decreases BMR as the body conserves energy to keep vital organs functioning

Drugs caffeine and nicotine increase BMR whilst others decrease it such as Anti-depressents , social and prescription drugs

Climate cold climates increase BMR as the body uses kilojoules to maintain a stable body temperature

Age later years often see a decline in BMR due to less activity and reduced lean muscle tissue

Exercise BMR is increased during any exercise and it remains high for several hours after intense and prolonged exercise. the more exercise a person does the greater lean active body tissue and increased BMR

3. What are the health risks associated with high levels of saturated fat and cholesterol in the diet? Think back to what you learned in PBS.

Clog the arteries by building up along the walls and making the vessel “hard” or cause a blot clot. This increases risk of stroke and heart attack and causes heart disease.

4. Each gram of fat you consume provides over twice as many calories as a gram of protein or carbohydrates. What does this tell you about your body’s ability to burn off these three fuels? Which would require the most energy to burn?

Since each gram of fat you consume provides over twice as many calories as a gram of fat, this tells us that it requires more energy to burn off fats than it does to burn off protein or carbohydrates. It takes the longest amount of time to burn off fats, then proteins and carbohydrates are the easiest to burn off.

Carbohydrates and protein both have 4 calories per gram of the food Fats have 9 calories per gram of the food

5. Discuss at least two health risks faced by people with a BMI above 25.

• cardiovascular (heart and blood circulation) disease.• gallbladder disease.• high blood pressure (hypertension)• type 2 diabetes.• osteoarthritis.• certain types of cancer, such as colon and breast cancer.

6. Discuss at least two health risks faced by people with a BMI below 20.

People with a BMI above 25 are classified as “underweight.” Health risks caninclude hormone dysregulation, anemia, low bone density, a low functioning

immune system and cardiac problems

7. Describe how being overweight affects at least three other body systems.

-Cancers (IMMUNE) -Depression (NERVOUS) -Type II Diabetes (ENDOCRINE) -Sleep Apnea (RESPIRATORY) -Asthma (RESPIRATORY)-Osteoarthritis ("swelling of bones/joints") (SKELETAL) -Heart attack or stroke due to CARDIO -High cholesterol-High blood pressure -Arteriosclerosis ("artery hardening") (Circulatory)

8. Describe how being underweight affects at least three other body systems.

-Anemia & nutrient deficiencies (CARDIO) -Bone loss & osteoporosis (SKELETAL) -Heart irregularities & blood vessels - disease (CARDIO) -Vulnerability to infection/disease (IMMUNE) -Delayed wound healing (IMMUNE)

9. Explain how a nutritionist or dietician might help an athlete train for a major competition, race, or game.

They can give guidance and meal plans to ensure the athlete is eating the right amount of nutrients and calories for enough energy, weight maintenance, and muscle growth.