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Dietetics and Nutrition in the Mediterranean,[object Object],By Dr. Alberto Fatticcioni,[object Object]
Obesity and BMI,[object Object],Obesityis a conditionof excess body fat.,[object Object],Obesity is currently defined using body mass index (BMI). BMI is calculated as weight (kg)/ height squared (m²) and is indipendent of sex. BMI is significantly correlated with total body fat content and it’s now internationally accepted as a means of identifying overweight and obesity. ,[object Object],The risks of developing type 2 diabetes, heart disease and cancer all increase as BMI increases, with the lower risk generally seen at BMIs of 22 to 25 kg/m². Mortality increases gradually above a BMI to 25 kg/m².,[object Object]
Obesity and BMI,[object Object]
Obesity: epidemiology,[object Object],Obesityis a conditionof excess body fat. ,[object Object],For the first time in history, most US adults are overweight or obese, and as such they have substantially increased morbidity and mortality from hypertension, stroke, coronary artery disease, dyslipidemia, type 2 diabetes, sleep apnea and numerous other conditions. ,[object Object],Higher BMI also increases all-cause mortality. ,[object Object]
Obesity: epidemiology,[object Object],According to NHANES 1999-2000 (National Health and Nutrition Examination Surveys), an estimated 64% of persons in the United States are overweight (BMI 25-30) or obese (BMI ≥30); that is 8% higher than 1988-1994 and 17% higher than in 1971-1974. Among adults 20 to 74 years old, the estimated prevalence of obesity (BMI ≥30) doubled between NHANES 1976-1980 AND NHANES 1999-2000 from approximately 15 to 31%. ,[object Object],The consequences for the health care system are important for the obesity-related comorbidities. ,[object Object]
Obesityas a disorderofenergybalance,[object Object],Obesity can develop only as a result of an imbalance between energy intake and energy expenditure.,[object Object],High energy intake leads to obesity only if it is not matched by high energy expenditure, and low energy expenditure leads to obesity only if it is not matched by low energy intake. ,[object Object],When intake is lower than expenditure, negative energy balance occurs, and body energy stores are reduced. When energy intake exceeds expenditure, positive energy balance occurs, and body energy stores are increased.,[object Object]
Obesityas a disorderofenergybalance,[object Object],COMPONENTS OF ENERGY BALANCE (positive or negative),[object Object],Energy intake We take in energy in the foods we eat. The major macronutrient sources of dietary energy are fat, carbohydrates, protein and alchool. ,[object Object],Energy expenditure,[object Object],Resting Energy Expenditure,[object Object],Physical Activity Energy Expenditure,[object Object],Thermic Effect of Food,[object Object]
Obesityas a disorderofenergybalance,[object Object],Energy expenditure Total energy expenditure (TEE) is the sum of resting energy expenditure, thermic effect of food and physical activity-related energy expenditure. ,[object Object],Resting Energy Expenditure REE The majority of human energy expenditure is through the body’s metabolism at rest, comprises 60 to 80% of (TEE) in most people. REE is the energy required by the body to maintain basic physiologic functions such as pumping blood, making hormones and maintaining body temperature (in average muscle 25%, brain 20% and liver 22% of REE),[object Object]
Obesityas a disorderofenergybalance,[object Object],Energy expenditure Total energy expenditure (TEE) is the sum of resting energy expenditure, thermic effect of food and physical activity-related energy expenditure. ,[object Object],Physical Activity Energy Expenditure PAEE,[object Object],Is the component of energy expenditure that is most under voluntary control because it is influenced most strongly by the amount of PA. PAEE is the most variable component of energy expenditure and can easily range from 10% of TEE in sedentary persons to 40% of TEE in active persons.  ,[object Object]
Obesityas a disorderofenergybalance,[object Object],Energy expenditure Total energy expenditure (TEE) is the sum of resting energy expenditure, thermic effect of food and physical activity-related energy expenditure. ,[object Object],Thermic Effect of Food TEF,[object Object],TEF is the increase in energy expenditure associated with digestion, absorption and storage of ingested macronutrients, usually 7 to 10% of the total caloric content of the meal. The energy cost of a meal is associated with the macronutrient composition of food consumed, with the TEF higher for protein, than for carbohydrates and fat. ,[object Object]
Lesson 9 obesity diabetes
Kcalories on 100 grams of vegatables,[object Object],9  Kcal Fennels,[object Object],11 Kcal Zucchine,[object Object],12 Kcal Chicory,[object Object],13 Kcal Red radicchio,[object Object],14 Kcal Cucumber,[object Object],15 Kcal Escarole,[object Object],16 Kcal Endive,[object Object],17 Kcal Chard,[object Object],18 Kcal Eggplant, Green beans, turnip,[object Object],19 Kcal Lettuce, Beetroot,[object Object]
Top 10 richest protein and lowest kilocalorie food/100g,[object Object],43 Kcal/11 g egg white,[object Object],57 Kcal/11 g octopus,[object Object],68 Kcal/13 g squid, /14 g ray,[object Object],71 Kcal/14 g shrimp, /17 g cod,[object Object],72 Kcal/14g cuttlefish, /11 g palourde,[object Object],78 Kcal/16 g John dory, /16 g ombrine,[object Object],80 Kcal/16 g dogfish, /19 g pike,[object Object],83 Kcal/17 sole,[object Object],84 Kcal/12 mussel,[object Object], 86 Kcal/15 trout,[object Object]
MediterraneanDietRules,[object Object],[object Object]
fruit (at least 4 pieces or 400 g a day)
legumes and pulses
grains, pasta and/or bread (mostlywhole)
 olive oil and nuts
 water (more than 2 liters per day)
 wine duringmeals ( maximum 2 glasses per day)
seafood (fish, shellfish, mollusc), 4-6 times a week
yoghurt, 2 - 4 times per week
cheese, 1 - 4 times per week
 milk, 1 - 2 times per week

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