Ch 7 Flashcards
Background
• Recent estimates indicate that approximately __% of the US population are classified as overweight or obese (BMI ≥___kg m−2)
• Approximately ___% classified as obese (BMI ≥30 kg m−2)
– ___% as severely obese (BMI ≥ ___kg m−2)
• Obesity rates among children (18%) and adolescents
(21%) have ____since the 1980s.
• Higher rates of ____ are found in African American, Hispanic, and Mexican American populations compared with non-Hispanic Whites.
Overweight & Obesity
• Characterized by high amounts of body fat in relation to overall lean body mass.
– linked to numerous chronic diseases
• Typically the result of excess caloric consumption and/or
inadequate energy expenditure.
• Obesity is associated with premature mortality from cardiorespiratory disease and other diseases such as ____.
• Central (abdominal) obesity is associated with the______ and increased risk for cardiorespiratory disease.
\_\_\_\_\_\_\_\_ • A set of noninvasive, quantitative techniques for determining body size – measuring, recording, and analyzing specific dimensions of the body, such as height, weight, and body \_\_\_\_. • Height and Weight – BMI: Body weight (kg) / Height (m2) • Circumference – Waist circumference – \_\_\_\_\_ (WHR)
Body Mass Index • BMI classifications: – Underweight (<18.5 kg m−2), – Normal weight (18.5 to 24.9 kg m−2) – Overweight (25.0 to 29.9 kg m−2) – Obese (≥30 kg m−2) – Also to identify individuals at risk for obesity-related diseases
ObSity : low lean mass compared to fat mass.
.68, 25, 34, 6, 40, tripled , obesity,
Cancer, metabolic syndrome, anthropometrics,
Circumference, waist to hip ratio,
Body Mass Index (cont.)
• Children and adolescents can be classified using BMI + BMI for age growth chart provided by CDC.
• In children and adolescents, overweight is defined as the _____ to less than ____ percentile of BMI for age and sex.
– ______ is ≥95th percentile for age and sex
• BMI does not differentiate between fat and fat free mass
– Individuals with high levels of muscle mass can be misclassified as overweight or obese
– BMI can _______ body fatness in those who have lost muscle mass
• BMI is a useful tool for _______-based assessments.
Table
Circumference Measures
• Easily understood by clients
• Can be used with extremely obese individuals
• Determines______ as a risk of obesity
• Central obesity (_____) is linked to a greater risk of cardiovascular than ____ obesity (hip and thigh region)
Chart
Waist to Hip Ratio (WHR) • (Waist) / (Hips) Sample Calculation: – waist circumference (WC) = \_\_\_in – hip circumference (HC) = \_\_\_\_in • WHR is 35/42 = \_\_\_\_ • Health risks increase as WHR increases – standards for risk vary with age and \_\_\_ • Waist Circumference alone reflects abdominal obesity – High risk: ≥\_\_\_\_\_in (\_\_\_cm) for women – ≥\_\_\_\_\_in (\_\_\_\_cm) for men
Picture
.85th, 95th, obesity, underestimate, population,
Fat distribution, Android, gynoide,
35, 42, .83, sex, 35, 88, 40, 102,
email professor about quiz test.
Percent Body Fat Methods
• Determining body composition, or percent body fat, helps the EP-C:
1) identify individuals with high and low levels of body fat that are associated with increased health risks
2) design appropriate exercise prescriptions
3) formulate dietary recommendations
4) assess the progress of a client in response to a weight management program
5) estimate weight-loss goals.
• A range of________% for men and _______% for women is considered satisfactory for health.
Skinfold Measurements
• Used to determine the amount of ____ fat.
• Based on the following assumptions:
– 1) approximately _____ of total body fat is located subcutaneously
– 2) the amount of subcutaneous fat is ____ to total body fat
• The accuracy of predicting the percent body fat from skinfolds is ±____% assuming use of proper technique and an appropriate regression equation.
• See How To Measure Skinfolds box for instructions.
Table s + pictures
Bioelectrical Impedance Analysis (BIA)
• Bioelectrical impedance analysis (BIA) is a rapid, _____ body composition assessment tool.
• A harmless electrical current is passed through the body, and the ____ to that current is measured.
– _____ is a good electrical conductor, whereas fat tissue_____ the electrical current.
• BIA estimates total _____ and relies on regression equations to estimate percent ____.
• The accuracy of predicting the percentage of body fat from BIA ranges between ±______%
BIA (cont’d)
• Guidelines for accurate prediction of %BF from BIA:
– No eating and drinking within ____hrs, no alcohol within
___hours, no exercise within_____hours of the test
– No diuretic meds within ____days of the test (must be approved by physician)
– Void the bladder within ____minutes of the test
– Avoid BIA prior to menstruation due to water _____
– Measure in a thermoneutral environment
– Use the same BIA instrument for repeat measures over time
.10-22, 20-32, subcutaneous, 1/3, proportional,
3.5, non invasive, impedance, lean tissue, impedes,
Body water , body fat, 2.7-6.3, 4, 48, 12, 7
30, retention,
Lab Methods for Measuring Body Comp. • Requires more expensive and specialized equipment • Hydrostatic weighing – Uses land and water measurements – Percent fat calculated through \_\_\_\_\_\_ • Air displacement plethys\_\_\_\_\_ – Non-\_\_\_\_\_ and can be performed on all ages.
Lab Methods for Measuring Body Comp.
• DXA
– Very low current_____at two energy levels
– Measures bone mineral content, body fat, and lean soft tissue mass
Weight Management
• A healthy diet and regular physical activity are critical for attaining and/or maintaining a healthy weight.
• _____% weight reduction results in improved overall health.
• Knowing a person’s body fat percentage and current body weight are needed to develop weight loss goals.
• Safe and effective weight loss should occur at a rate of ____ lb/week.
• Depending on the weight loss goal multiple (i.e., 3 to 4) goals may need to be created until the person reaches the desired body fat percentage and weight.
Chart
Energy Balance
• The management of body weight is dependent on energy balance
– energy intake (the amount of calories consumed) and energy expenditure (the amount of calories expended)
• Total Energy Expenditure (TEE) is the total number of ____ expended each day and reflects the amount of energy required to carry out all_____processes within the body.
– Resting Energy Expenditure (REE or RMR or BMR): ______% TEE
– Thermic Effect of Food (TEF): ___% TEE
– Physical Activity Expenditure: _____% TEE
Energy Balance (cont’d)
• Resting Energy Expenditure (REE): largest component of TEE and is the energy required to maintain normal regulatory balance and body functions at ___.
– The amount of calories a person would expend if there were no activity throughout the day.
• REE influenced by ____, ____, age, gender, and _____.
• _____of Food: accounts for the energy required for the acts of eating and digesting food.
• Physical Activity Expenditure: most ____ part of energy expenditure.
.water displacement, mography, invasive,
Xrays, 5-10, 1-2, calories, metabolic, 60-70
10, 20-30, rest, genetics, ethnicity, lean mass
Thermic effect, controllable,
Calculating Total Energy Needs
• REE can be measured using indirect_____, which measures an individual’s oxygen consumption.
– REE can also be calculated using ____ equations (Table 7.9).
• Predictive equations take into account an individual’s age, gender, height and weight or fat free mass.
• A physical activity factor is then used to calculate TEE from REE (Table 7.11)
Table
REE Prediction using ____-Benedict:
35 year old male (6ft tall,180 lbs) who is moderately active
REE (kcal/day) = 66.47 + 13.75 (wt in kg) + 5 (ht in cm) – 6.8 (age in yr)
= (66.47 + 13.75 (81.6) + 5 (182.9) – 6.8 (35) = 1865 kcal/day
TEE Prediction using ___:
35 year old male (6ft tall,180 lbs) who is moderately active
REE = 1865 kcal/day TEE = (REE) × (PAL)
= (1865) × (1.55) = 2890 kcal
For maintenance: 2,890 calories needed
For weight loss: 2,390 calories needed (500 kcal daily deficit)
ACSM Position Stand
• Regarding weight loss, the combination of diet and MVPA (≥150 minutes per week) produces the largest weight loss compared to diet or physical activity only.
• It is well established that regular MVPA is necessary to prevent weight regain after weight loss has occurred.
• The ACSM position stand indicates that engaging in more than ___minutes per week of MVPA would result in better weight maintenance.
Weight Loss & the FITT Principle
• Types of exercise activities that work well for the overweight and obese include walking, swimming, water aerobics, jogging/walking in water, biking, and elliptical and rowing machines.
• The FITT principle can be adjusted to meet the needs of the client.
• For extremely obese or sedentary individuals initially doing exercise in ___ minute bouts at least ___times a day may be necessary.
Weight Loss &; the FITT Principle (cont.)
Frequency: ≥___d wk−1 to maximize caloric expenditure.
Intensity: Progression from moderate (i.e., ___% to <60% of HRR) to vigorous (i.e., ≥___% of HRR) may result in greater health benefits.
Time: A minimum of 30 min d−1 (i.e., 150 min wk−1) progressing to 60 min d−1 (i.e., 300 min wk−1) of moderate intensity aerobic activity. Accumulating intermittent activity of 10-minute bouts is an acceptable alternative.
Type: Aerobic activities that involve large muscle groups. As part of a balanced exercise program, resistance training and flexibility exercise should be incorporated.
Demonstrating Exercises
• Demonstrating exercises to clients is a critical element to program implementation.
• Allows the client to see what has been verbally explained and also allows key aspects of the exercise to be highlighted.
• Some equipment has a maximum weight limit or the person may not fit or be comfortable while exercising on the equipment.
• All these aspects should be considered when designing an exercise program for an overweight and obese client.
.calorimetry, predictive, Harris, PAL
250, 10, 3, 5, 40, 60,
Metabolic Equations
• The ACSM metabolic equations can be used to estimate the amount of _____ that will be expended during a workout or to estimate the length of ____ an individual has to exercise to expend a certain amount of calories.
• A calorie, also known as a kilocalorie (kcal) is an expression of energy _____.
• It takes approximately 3,500 calories to make and store 1 lb of body weight.
• See “How To Calculate Metabolic Equations (Weight Management)”
Weight Management Myths
Myth #1: Fat Turns into Muscle or Vice Versa
• Separate tissues; one does not change to the other Myth #2: Spot Reducing Works
• Fat reduction somewhat random
Myth #3: Gaining Weight at the Start of an Exercise
Program is from Increased Muscle
• More likely from increased _____
Nutrition
• General messages from 2015- 2020 Dietary Guidelines:
– Follow a healthy eating pattern across the lifespan.
– Focus on variety, nutrient density, and amount.
– Limit calories from added ____ and ____ and reduce ____ intake.
– Shift to healthier food and beverage choices.
– Support healthy eating patterns for all.
.calories, time, intake and expenditure
Caloric intake, sugars, saturated fats, sodium,
Other Methods to Treat Obesity
• While there are many methods available to treat obesity, many are ineffective, and even dangerous.
– electric stimulators, sweat suits, vibrating belts, body wraps, over exercising, very low calorie diets, fad diets, and dietary supplements.
• Appropriate weight loss methods include exercise, dietary changes, behavioral strategies, and ___ surgery.
– Bariatric surgery is effective at producing profound weight loss, and can be medically indicated due to severe obesity and/or co-___ threatening health.
Table
Nutritional Behavioral Strategies
• Self-monitor by keeping food or PA logs
• Set goals that are realistic and specific
• ____: modify the environment to support behavior change
• Problem solve: identify situations that are challenging and experiment with solutions.
Weight Loss Supplements
• The EP-C has a responsibility to encourage healthy weight loss.
• Many different weight loss products and supplements exist, often with little or no evidence to support their value.
• One of the most reputable resources for information on vitamins, minerals, supplements, and herbal products is the Office of _____.
• Herbs, supplements and the like are not regulated by the ___and should be addressed cautiously.
Weight Loss Supplements (cont.)
• Numerous safety concerns have been raised with some supplements (e.g., ephedra, bitter orange, chitosan).
• People of all ages experiment with weight loss products.
• Caffeine and energy drinks should be consumed with caution—particularly in the younger/adolescent population.
Dieting
• Most popular diets are to be approached with caution.
– Particularly those that ______ one
particular food group
– Individuals need a variety of foods from each food group to meet needs for growth and development.
• Individuals should seek the advice of a Registered Dietitian or other health care professional trained in nutrition, to determine the safety and effectiveness of the diet.
• Any client who wishes to ”go on a diet” should first consider their optimal health/dietary needs.
.bariatric, morbidities,
Stimulus control, dietary supplement , FDA
Eliminate or emphasize,
knownharris and other equation for exam
Medications
• Table 7.14 shows the effect of common medications on weight management and their physiological action.
• Many of these medications can actually promote____.
• It is important to know all the medications your client is taking, as they may inhibit your client’s weight loss attempts.
Table, Nutrition During Pregnancy
• Increased energy and nutrient demands up to ___extra calories per day needed, as well as a prenatal vitamin
• Prenatal vitamins provide folic acid and iron.
• ____ (a B vitamin) is important in the prevention of serious birth defects such as neural tube defect and congenital heart disease.
• Extra ____ is needed to help support the increased blood supply needed to carry extra oxygen throughout the pregnancy.
Nutrition During Pregnancy (cont.)
• Prenatal vitamin consumption should follow the advice of the health care provider.
• It is also recommended that pregnant women do not take ______ supplements since they are not FDA regulated.
• Because of nutrient demand, any form of dieting during pregnancy is inappropriate.
Nutrition for Children and Older Adults
• The Recommended Dietary Intake for Vitamin D for children ages 1 to 18 is ____ IU, and for adults over the age of 71 years is ____IU.
• Calcium is an important nutrient for bone and teeth during childhood and adolescence.
– 4-to-8 year olds need ____^mg/day. 9-to-18 year olds need ______mg/day.
• In aging adults the recommendation for calcium is ____ mg/day since calcium absorption declines with age.
• Adults >50 years should take a vitamin B12 supplement or consume sufficient amounts of fortified foods.
Summary
• The obesity epidemic is a crisis that calls for exercise and nutrition as an urgent intervention.
• Understanding obesity status and how to appropriately measure obesity is crucial for planning exercise for weight management.
• Proper nutrition is vital to support the effects of exercise in the obese individual.
• Different populations have different nutritional needs, which should be noted in nutrition planning.
.weight gain, 300, folic acid, iron,
Herbal or botanical, 600, 800, 1000
1300, 1200,
