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The Scale of the Problem—Overweight and Obesity
Published in Ruth Chambers, Paula Stather, Tackling Obesity and Overweight Matters in Health and Social Care, 2022
The main components of energy expenditure are basal metabolic rate, thermogenesis and physical activity. Thermogenesis includes: Any heat production required to maintain body temperatureHeat loss to do with the absorption, metabolism and transport of ingested foodHeat production to dissipate excess dietary energy In sedentary people, the relative proportions are about 60–75% expended as the basal metabolism, 10% for thermogenesis and 25% for physical activity. In sedentary people, the basal metabolic rate is about 5–10% higher than the minimum rate which occurs whilst asleep. Basal metabolic rate is higher in overweight and obese people than for people of ‘ideal’ weight, as weight gain increases the size of muscles and visceral organs as well as fat. There is no convincing evidence that obese people have extraordinarily low basal metabolic rates that account for their obesity.
Eating disorders
Published in Judy Bothamley, Maureen Boyle, Medical Conditions Affecting Pregnancy and Childbirth, 2020
The amount of energy used is also measured as calories. The body uses large amounts of energy just to maintain body functions such as breathing and cardiac function. This is known as the basal (or resting) metabolic rate (BMR) and varies according to gender (men have a higher BMR), age and weight. Contrary to common belief, people with higher weight have a higher BMR, although the energy needs of obese-prone individuals may be lower before or during the process of weight gain and may be a contributing factor in their weight gain (Lean, 2003; Yu, et al., 2006). BMR accounts for 50–75% of energy expenditure, so even if an individual stays in bed all day, large amounts of energy to maintain body function are still needed. A further 10% of energy expenditure is in thermogenesis, the energy required to maintain warmth, for digestion of food and for response to stress (Yu, et al., 2006). The remainder of energy expenditure is on physical activity, which includes the energy expended for daily activities as well as more vigorous activity that is required for manual work and sport.
Basic observations
Published in Barbara Smith, Linda Field, Nursing Care, 2019
The body’s production of heat can be affected by the following: The basal metabolic rate (BMR): this is the rate at which energy is used to maintain essential activities such as breathing. The metabolic rate tends to decrease with age.Muscle activity: any sort of muscle activity, including shivering, increases the metabolic rate and thus produces more body heat.Thyroxine: increased levels of thyroxine increase the cellular metabolism throughout the body, therefore producing more body heat.Adrenaline: when released in the body, this hormone causes an immediate increase in cellular metabolism in many body tissues, in particular in the liver and muscle cells.
Body composition and metabolic parameters in men with chronic traumatic paraplegia – A pilot study from India
Published in The Journal of Spinal Cord Medicine, 2022
Kalyani Sridharan, Shipra Rachna Singh, Kripa Elizabeth Cherian, Nitin Kapoor, Jane Elizabeth, Judy Ann John, Nihal Thomas, Thomas V. Paul
The immediate and profound skeletal muscle atrophy that follows SCI results in a decrease in lean mass below the level of injury.6 Studies have demonstrated lower fat-free mass and higher fat mass post SCI in comparison to able-bodied individuals in spite of similar BMIs.7 This decline in lean mass correlates inversely with age and duration of injury and depends on the level and completeness of injury.8 A more complete and a higher level of injury causes a greater decline in lean mass. Subjects with tetraplegia have a reduced lean mass in the upper limbs compared to those with paraplegia.5 The loss of metabolically active muscle mass combined with physical inactivity due to the disability decreases the basal metabolic rate and total energy expenditure resulting in obesity.9
Electrically induced cycling and nutritional counseling for counteracting obesity after spinal cord injury: A pilot study
Published in The Journal of Spinal Cord Medicine, 2021
David R. Dolbow, Daniel P. Credeur, Jennifer L. Lemacks, Dobrivoje S. Stokic, Sambit Pattanaik, Gevork N. Corbin, Andrew S. Courtner
Thanks to medical advances and improved injury surval rates, spinal cord injury (SCI) has essentially been converted to a long-term chronic disability.1 Consequently, increased longevity in this population has been accompanied by many negative health conditions, with obesity being a major health disparity.2,3 It is reported that about 66–75% of those with SCI are either overweight or obese.2–5 Additionally, because greater obesity is related to greater disability and chronic diseases, the risk of cardiometabolic diseases, including heart disease, stroke and type II diabetes, are elevated to more than twice that of the able-bodied population.6–9 One reason for the high rate of obesity after SCI is the loss of muscle mass. Shortly after the injury, those with SCI experience rapid and significant skeletal muscle atrophy below the level of injury10–13 resulting in skeletal muscle cross-sectional areas of 45–80% less than that of able-bodied individuals.11,14 Therefore, after SCI, the loss of metabolically active muscle mass results in a 26% reduction in basal metabolic rate.14–16 This is important because basal metabolic rate accounts for ∼65% of the total daily energy expenditure and plays a major role in the positive energy balance that results in obesity after SCI.16 In addition to decreased muscle mass, individuals with SCI are typically among the most sedentary, thus further lowering energy expenditure creating an unhealthy energy balance.17,18
BMI differences between different genders working fixed day shifts and rotating shifts: a literature review and meta-analysis
Published in Chronobiology International, 2020
Our meta-regression analysis results also revealed that in the long term the BMI differences between women working rotating shifts and those working fixed day shifts were significantly greater than those between men working rotating shifts and those working fixed day shifts. At present, there is no direct evidence of the influence of working rotating shifts on BMI in different genders. Relevant proof is still lacking, and further research is needed. Only some research has indicated that women inherently have more body fat than men because they need fat to generate and store estrogen (Palmisano et al. 2017). Male androgens have a significant effect on muscle growth because they promote protein synthesis and inhibit protein degradation. As a result, it is easier for men to build up their muscles than it is for women, and more muscle mass means a greater capacity to burn fat (O’Connell and Wu 2014). Furthermore, men generally have a higher basal metabolic rate than women, in which basal metabolic rate is a crucial factor of energy consumption (Varlamov et al. 2015). The findings of the various above-cited studies suggest some possible explanations why the BMI values of women working rotating shifts increase more and significantly so, than those of men working rotating shifts.