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Energy Balance& Energy
Metabolism
Gaga IrawanNur Fatimah
Departement of Medical
Nutrition
EnergyRequiremen
t
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 !