chapter 11; Energy Balance and Obesity Flashcards
Obesity - having excess body [..] - is considered American’s number one health crisis
fat
obesity has been linked to a whole host of health problems, including cardiovascular disease, diabetes, dementia, infertility, hypertension, arthritis, and even certain cancers. It is also a major [..]
killer
in the United States, only tobacco use causes more premature deaths per year, and obesity related cancers account for about 40% of all cancers diagnosed in the United States annually
health consequences of obesity in the brain;
- Alzheimer disease, stroke
yes
health consequences of obesity in the brain;
- heart disease,
- hypertension
yes
health consequences of obesity in the liver and gallbladder;
- fatty liver disease
- gallstones
yes
health consequences of obesity in the pancreas;
- type 2 diabetes
yes
health consequences of obesity in the joints;
- arthritis
yes
health consequences of obesity in the foot;
- gout
yes
health consequences of obesity in the nasopharynx;
- sleep apnea
yes
health consequences of obesity in the stomach;
- gastroesophageal reflux
yes
health consequences of obesity in the boy;
- increased risk of some cancers (particularly colon, esophagus, uterus, breast, pancreas, kidney, gallbladder
yes
health consequences of obesity in the uterus;
- infertility in women,
- increased risk of miscarriage and birth defects
yes
health consequences of obesity in men penus;
- erectile [..] in men
dysfunction
obesity increases the risk of number of [..] disease and ultimately increases the risk of [..] death. one study found that the risk of death was increased two - three fold in healthy middle aged individuals who never smoke
chronic
premature
alarmingly, rates of obesity have sky rocketed over the past four decades , leading many to refer to an obesity “[..]”
epidemic
as of 2018, over [..]% of US adults ages 20 and older were obese (42.4%) and more than 70% were overweight or obese
40%
the prevalence of obesity in youth ages 2-19 is [..] at a similar rate (19.3%)
increasing
The United States is not alone: Global obesity rates have almost […] since 1975, and in 2016, the World Health Organization (WHO) estimated that approximately 13% of the world population could be classified as obese.
tripled
obesity is complex disease that is influenced by multiple factors; [..], [..], and [..] are the primary contributors.
behavior,
environment,
and genetics
genetics is often viewed by many among the public as the primary factor determining an individual’s [..] to obesity. however, the rapid rise in the prevalence of obesity in the last few decades largely attributed to changing [..] factors, because human genes have essentially remained the same over this time.
susceptibility
environmental
for this reason, it is said that “genetics loads the gun, and environment pulls the trigger,” because the environment in which we live and work can strongly affect our behaviors and consequently our weight
the built environment - our surroundings that are designed by [..] - can strongly affect how likely we are to engage in [..] activity, which in turn determines whether we maintain, increase, or decrease our body weight.
humans
physical
the food environment (the social and physical factors that influence the foods we eat) can make it challenging for us to make healthy food choices. consequently, the dramatic rise of physical activity and the consumption of [..] dense foods that are particularly likely to promote weight gain in genetically susceptible individuals
energy
obesity does not happen overnight. “obesity doesn’t occur over minute and hours, it occurs over years, decades, and generations”
what that mean sit hat even small changes in the way we eat or the way we move can seriously add up. (extra spoonful or two at each meal or the amount of time we spend sitting or standing - if multiple consistently across time - can profoundly affect how much energy we store or expend”
energy, defined as the capacity to do work, is required to perform all of the various functions that are necessary to sustain life, form breathing to moving to digesting food to maintaining a constant body temperature.
work
humans and other animals obtain energy through the breakdown of [..], [..], [..], and [..] in food and beverages. the energy contained in the chemical bonds of these molecules is released by the chemical reactions of [..] and captured a form that can be used to do the bodies work
carbohydrates, fats, proteins, alcohol
metabolism
one way scientists measure energy is units called calories. a calorie is defined as the [..] required to raise 1 gram (g) of water 1 degrees celsius (C). the energy in food is measured in units of kilocalories (kcal = 1000 calories). a kilocalorie is the energy required to raise 1 kilogram (kg) of water 1 degrees celsius. all food labels in the United States report the energy in foods in [..], although these are usually just referred to as “calories”
energy, kilocalories
obesity results from a chronic [..] of energy intake and expenditure. according to the laws of thermodynamics, energy is neither created nor destroyed but merely changes form. this principle, known as the conservation of energy, means that when we consume more energy than we expend, the excess has to go somewhere. Most often, it seems to end up in the [..] cells in our hips, thighs, and bellies.
imbalance, fat
there are two types of fat, or adipose tissue: [..] adipose tissue (WAT) and [..] adipose tissue (BAT). WAT stores [..] energy in the form of fatty acids in triglycerides intake is low. In contrast, BAT [..] fatty acids and glucose to produce [..] by a process called non shivering thermogenesis (heat production)
white, brown
excess, burns, heat
infants are born with significant amounts of BAT ([..] adipose tissue) that is localized primarily between the [..] blades in concentrated and identifiable depots, and the heat produced there is critical for the maintenance of body [..] in the infant
brown , shoulder
temperature
it was previously thought that adults had little if any BAT ([..] adipose tissue), but recent studies have found that some adults have significant amounts. but unlike BAT in infants, in adults, it does not exist in [..] depots, but brown fat cells, or adipocytes, are found scattered within depots of WAT.
brown, specific
another difference is that brown fat cells in adults appear to arise primarily from the conversion of WAT ([..] adipocyte tissue) into [..] fat cells (in contrast to infants), which is referred to as WAT “[..]”. because these cells are similar but not identical to the brown adipocytes found in infants, they are often called “beige” adipocytes
white, brown
“browning”
because the amount of beige fat cells present in adults has been shown to correlate with body [..] and the browning of WAT ([..] adipocyte tissue) in adults can be induced with [..] exposure, it is thought that the heat produced by these cells may make significant contributions to the maintenance of [..] balance in some adults.
leanness, white, cold
energy
to be in energy balance means that the amount of energy we take in (“energy in”) [..] the amount of energy we use (“energy out”). when this occurs, our body weight is [..]. any increase in our body weight indicates that “energy in” is [..] than “energy out”
equals, stable
greater
fundamentally, the only way to gain weight is through [..] energy balance (to consume calories [..] of what is expended), and the only way to lose weight is through [..] energy balance (to consume [..] calories than what is expended). obesity always results from chronic [..] energy balance.
positive , excess
negative, fewer
positive
(this discussion reveals something unique about energy nutrients compared with other nutrients: body weight provides us with an easily monitored indicator of adequacy, excess, or insufficient energy nutrients)
energy balance;
- weight loss (negative energy balance) ; energy intake is [exceeds, equal, less] than expenditure
- maintain weight (energy balance); intake and expenditure are [exceeds, equal, less]
- weight gain (positive energy balance); energy intake [exceeds, equal, less] expenditure
less
equal
exceeds
although it is true that some problems such as sleep apnea can result from being physically large, most of the negative health consequences of obesity stem from the effects that excess adiposity, or body fat, has on the function of [..] throughout the body. Fat, or adipose tissue, is not just inert yellow gobs of flesh distributed within our bodies; rather, its dynamic [..] with an active life all its own.
cells
tissue
adipocytes secrete an abundance of different [..] and [..] like messengers that exert effects on other tissues in the body. these hormone cause a low grade chronic [..] state throughout the body that is believed to be primary means by which obesity causes health problems and contributes to the development of many chronic diseases
hormone x2, inflammatory
basically, since adipocytes release hormones, those hormones cause inflammation and hence many get diseases and health problems from having too much adipocytes.
obesity, low grade inflammation, and chronic disease;
- adipose tissue of lean individuals contain few [..] cells, however as obesity develops, fat cells enlarge as [..] energy balance increase the amount of energy that must be stored
- those enlarged fat cells produce and release excessive amounts of [..] and [..] like messengers that attract [..] cells and cause low grade [..] in adipose tissue
- then hormones and messengers are transported throughout the body in blood. the increase in the presence of [..] cells in adipose tissue of obese individuals results in further increases in the production of hormones and other messengers, these substances enter the blood and cause low grade [..] throughout the body, causing many chronic [..]
- low grade chronic inflammation occurs as fatty liver, Alzheimer disease and stroke, heart disease, hypertension and atherosclerosis, insulin resistance and decreased insulin secretion (type 2 diabetes), and increased risk of certain cancers
- immune , positive
- hormone(s) x2, immune, inflammation
- blood, immune, diseases
our bodies have built in mechanisms that let us known when we are hungry and when we have eaten enough (if ew pay attention). through this complex physiological control system, which involves a constant dialogue between our brains and our gastrointestinal tract, we are able to obtain and maintain sufficient energy stores to power activities.
yes
basically, there is communication between the brain and the GI tract that lets us know when we get full and when we get hungry
two different systems regulate energy balance and food intake - a short term and a long term system. the short term system, mediated by [..] and stomach [..], triggers hunger and satiety (the opposite of hunger, (respectively before and after individuals meals. the long term system, mediated by a different set of [..], adjusts food [..] and [..] expenditure to maintain [..] fat stores (adipose cells and tissue)
hormones, pressure
hormones, intake, energy, adequate
basically;
the two different systems are short and long term. the short term manages the immediate aspects of the hormones triggering hunger and when feeling satiated. long term, is more of a longer aspect where a different set of hormones considers food intake and energy expenditure
when we haven’t eaten for a while, our stomach begins to grumble. that grumbling is a sign that a hormone called Ghrelin is racing into action. Ghrelin, nicked the “[..] hormone,” is a 28 amino acid peptide hormone that is produced primarily in the [..] it is the only hormone that has been found to [increase or decrease] hunger
hunger , stomach
increase
circulating ghrelin levels in the blood surge just [..] meals and decrease [..] eating. Ghrelin stimulates hunger by activating specific [..] in the brain. Ghrelin secretion deceases only when nutrients from the meal are [..] into the blood. the secretion of ghrelin is most effectively inhibited by [..] and then by [..]; dietary fat is [..] effective at decreasing ghrelin secretion.
before, after
neurons, absorbed
carbohydrates, proteins, least
basically; the hormone Ghrelin which is also referred to as the hunger hormone is released before you eat and when hungry, the releasing of the hormone doesn’t decrease until the nutrients of food are absorbed. 1st; carbs, 2nd, protein, 3rd; dietary fat
satiate is the process that leads to the [..] of a meal and refers to the sense of [..] that we feel while eating. satiety is the effect the meal has on our interest in food after a meal; it operates in the interval between meals and affects when we feel hungry again.
termination , fullness
the primary factors affecting these two processes (satiation & satiety) are gastric distention - how much our stomach has [..] to take in food - and the release of [..] produced by specialized [..] in the gastrointestinal tract. nerves in the stomach sense its expansion and relay signals to the brain to communicate satiation , a sense of fullness. at the same time, several gut peptide hormones are produced by specialized [..] in the small intestine in response to the detection of nutrients in the gut
expanded, hormones , cells x2
importantly, calories in beverages appear to bypass mechanisms of satiation. a number of studies have demonstrated that soft drink calories are less satiating than calories from solid foods.
yes
over the long term, [..] balance is affected by a hormone called leptin. Leptin is produced primarily by adipose tissue. the circulating concentration of leptin in our blood is closely associated with total body [..]. when stores increase, [..] leptin is produced. the leptin level increase in the blood acts on the brain to [..] hunger and increase energy [..] to avoid excess weight [..]
energy, fat
more, suppress, expenditure, gain
hormones help regulate energy balance and food intake;
short term; hormones signal low [..] status, the [..] increases ghrelin, the brain signals an increase in [..], eat
long term; adipose tissue increases leptin, the brain signals [..] hunger, gradually eat [..], [..] energy expenditure
energy, stomach, hunger,
less x2, increase
basically; short term is for immediate eat, signaling when low energy, increase in ghrelin production, eat. long term is for more finishing eating, a feeling of getting full using the leptin hormone.
obese individuals have [higher or lower] levels of circulating leptin than lean individuals, but the obese individuals seem to be [..] to the hunger suppressing effects of leptin. thus, they don’t experience the same [..] hunger or increased [..] of energy as their lean counterparts.
higher, resistant
diminished, expenditure
some evidence suggests that a high fructose diet (primarily through excess consumption of sweetened beverages) may contribute to leptin [..] in humans and contribute to increased [..] and food [..].
resistance
appetite , intake
it is critical to differentiate between hunger and appetite. hunger is the [..] impulse that drives us to seek out food and consume it to meet our energy [..]. appetite, however, is often viewed as the liking and wanting of food for other reasons other than, or addition to, hunger. appetite is often a product of sensory stimuli (the sight or smell of appealing foods) and the perceived pleasure we will experience when we eat the desired food.
biological , needs
hunger is certainly not the only reason (and perhaps not the dominant one) that motivates us to eat on many occasion. we often eat because it is pleasurable to do so .
yes,
furthermore, food manufacturers spend billions of dollars in research designing foods that will trigger our “bliss point” - with just the right balance of salt, fat, and sugar that we find nearly irresistible and often readily accessible. similar large sums of money are spent marketing these products.
because we are often surrounded by cues (such as advertisements) that stimulate our appetite and make us not only want to eat specific foods - and we eat more of these appetizing foods as portion and package sizes increase; in the end, we often eat when we are not hungry, causing consumption of [..] calories than will be expended, and therefore, we gain weight over time. this is often referred to as the “[..] food environment” because the easy accessibility of highly palatable, energy dense foods, and the resulting overconsumption of those foods, is a significant factor in the obesity epidemic.
more
toxic
we also eat for many other reasons, such as in response to stress, boredom, and emotions. all of these reasons for eating can, to some degree, [..] the satiety signals that are designed to keep us in energy balance.
override
studies have looked at weight gain in response to overfeeding have shown that people vary greatly in how much body fat they [..]. the biological mechanism that allows some individuals to resist weight gain more than others, however, has not been identified
accumulate
a persons total energy expenditure (TEE) is the combination of three main components: (1) basal metabolism, (2) the thermic effect of food, and (3) activity energy expenditure.
left off on page 361, “understanding energy expenditure”
