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    1.How do issues with energy balance and body weight regulation lead to obesity?
    2.What are the physical and psychological issues that influence energy balance?
    3.Is this related to a genetic or environmental cause, or both?
    Please give 2 references

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    Health and Nutrition Solution
    Background on Energy balance
    The first law of thermodynamics, states that" energy can be transformed from one form to another but cannot be created or destroyed". (Hall et.al 2012)
    This law is usually illustrated as the following equation:
    ES = EI - EO (where ES is the rate of change in the body's macronutrient stores, EI being the chemical energy from the food and fluids we consume and EO -the radiant, conductive, and convective heat lost; any work performed; and the latent heat of evaporation
    Rate of change of energy stores=rate of energy intake−rate of energy expenditure' (Galgani et.al 2008)
    Thus, the rate of change in body ES 10 is equal to the difference between the rates of EI and EO
    Stored energy will increase only if energy intake exceeds total body energy expenditure.
    Obesity results from a chronic imbalance between energy intake and energy expenditure
    1. How do issues with energy balance and body weight regulation lead to obesity?
    1.1. stored energy (leading to obesity)will increase only if energy intake exceeds total body energy expenditure
    1.2. Energy expenditure takes the form of physical activity(voluntary movement and activity), basal metabolism(body processes required for daily living), and adaptive thermogenesis(energy used in the form of heat in response to environmental changes, such as temperature changes(e.g. cold) and dietary changes)
    1.3. During overfeeding, the oxidation of carbohydrate and protein is increased to compensate for the increased intake. Fat from food is not oxidized but is instead stored in the body. As a result, fat stores will expand and the body weight is gained.
    1.4. Long-term overfeeding of carbohydrate results in a dramatic increase in daily carbohydrate oxidation and suppression of fat oxidation.
    1.4.1. Most of the dietary fat is stored as the body rapidly adjusts to oxidizing carbohydrates and protein to meet its energy needs, at the expense of fat oxidation.
    1.5. If energy intake exceeds expenditure, it is possible for an individual to become obese even on a low-fat diet

    2. What are the physical and psychological issues that influence energy balance?
    2.1.1. Exercise contributes to a significant improvement in energy and macronutrient balance regulation(Chaput et.al 2011)
    2.2. There are a large number of sensory and cognitive stimuli that affect food intake and physiology.
    2.3. The CNS has an influence on energy balance and body weight
    2.4. environmental factors such as social context, as well as liking and wanting food, play an important role in the energy consumed at a meal(Hall et.al 2012)
    2.5. The component of energy expenditure that is altered by changes in physical activity is TEPA (thermic effect of physical activity) which result in increase in the expenditure side of the energy balance

    3. Is this related to a genetic or environmental cause, or both?
    3.1. Both-genes and environment influence storage of fats (adiposity) as assessed by body mass index (BMI).(Galgani et.al 2008)
    3.2. Behavioural factors such as dietary and physical activity patterns interacting with genetic factors to explain the accumulation of excess body fat has been observed in a large portion of the North American population.(Melby et.al 1999)

    References:
    1. Chaput, J., Klingenberg, L., Rosenkilde, M., Gilbert, J., Tremblay, A., Sjödin, A, (2011). Physical Activity Plays an Important Role in Body Weight Regulation .Journal of Obesity. 2011. http://dx.doi.org/10.1155/2011/360257
    2. Hall, D., Heymsfield, S., Kemnitz, J., Klein, S., Scholeller, D., Speakman, J. (2012). Energy balance and its components: implications for body weight regulation. American Journal of Clinical Nutrition. 95 (4) 989-994
    3. Galgani, J., Ravussin, E. (2008) Energy metabolism, fuel selection and body weight regulation. International Journal of Obesity (2008) 32, S109-S119; doi:10.1038/ijo.2008.246

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