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nutrition > chapter 14 > Flashcards

chapter 14 Flashcards

1
Q

research shows that children near school age respond more to _______

A

external influences and learn to bypass internal fullness cues

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2
Q

when is eating in response to boredom or stress learned

A

between age 5 and 9

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3
Q

triggers for overeating

A

more food set before us
smell or see appetizing food
boredom or stress

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4
Q

how can paents disrupt natural flow of feeding

A

putting pressur eon children to eat more or less at meals

underweight children who are coerced to eat tend to back away from food while childrens trsticted in diet to lose weight are prone to overeat

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5
Q

“thrifty” gene

A

help ancestors survive occasional shortages of food

work against us bc food is now abundantly plentiful year around

poor appetite regulation and those who have easil stimulated capacity to store body fat

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6
Q

modern facotrs that result in obesity

A

sedentary desk jobs
remote controls
elevators
cars
escalatores
time and energy-saving gadgets
24 hour available food
higher fast food and soft drink consumption
reduced freuqency of fmily meals and icnreased [ortion iszes
tv
video games
computers
smartphones
little physical activity

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7
Q

what gland controls hunger

A

hypothalamusw

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8
Q

what is leptin

A

recieves signal from fat and intestines to make body feel full so eating will stop

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9
Q

what is ghrelin

A

released from stomach and singal hypothalamus that its to eat

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10
Q

what are components of enery out

A

basal metabolic rate
physical acitvity
thermic effect of food

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11
Q

what are factors that affect BMR

A

age, height, growth cycle, body composition

temperature, fasting undereating, hypothyroidism

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12
Q

___% of US adults report they engage in regulare leisuze time physical acitivt (150 min per week of light-to-moderate activity)

A

31

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13
Q

bmr percent breakdown

A

resting energy expenditure: 50-65%
physical acitivty: 25-50%
thermic effect of food: 10%

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14
Q

___% of adults report no leizure physical acitvty

A

40

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15
Q

only ___% of audlts obtain 30 min of mod or greater intesinty physical acitivty at least 5 days a week when physical acitivty measured by device that detects movement

A

3-5

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16
Q

adults consume ___ more cal a day in 2010 compared to 1970

A

450

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17
Q

____ of the population has eating pattern low in veg and fruits

A

3/4

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18
Q

obesity rates _______ in adults and ____ in children and adolescents from 1980-2000

A

adults: doubled

children: tripled

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19
Q

rate of obesity in these demographcis increased

A

men
boys
african american
hispanic women
family in poverty

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20
Q

adults obesity and overwieght

A

34.9% obese
68.6% obese or overweight

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21
Q

chidlren obese and overeight

A

16.9% obese
31.8% overweight or obese

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22
Q

definition of obesity

A

excess fat accumulation udner skin and around organs in body

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23
Q

subcutaneous fat

A

lower body (pea shape)

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24
Q

visceral fat

A

badominal area (apple)

higher health risk such as CV disease, T2D, breast cancer risk, and gallbladder disease

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25
Q

bmi ranges

A

below 18.5 = underweight
18.5-24.9 = healthy weight
25-29.9 = overweight
30 or higher = obese

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26
Q

bmi limits

A

overwestimate body fat in athletes and muscular buuld

underestimate body fat in older person and others who lost muscle

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27
Q

Hamwi formula

A

men: 5ft at 106 and add/ subtract 6 lb for every inch above or below 5ft for medium frame man (small frame, deduct 10% and large fram add 10%)

women: 5ft at 100lb (add or subtract 5lb for every inch above or below 5ft) (small frame deduct 10% and for large add 10%)

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28
Q

wrist measurement for medium frame women and man

A

women - 6 in
man - 7 in

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29
Q

obesity inflammatory condition

A

inflamation turned on body from increaxing visceral or abdominal fat = cascade of cronic disease

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30
Q

being overweight and obese increase risk for

A

Coronary heart disease
insulin resistance and T2D
cancers (endometrial, breast, and colon)
hypertension (high bp)
dyslipidemia (high total cholesterol)
stroke
liver and gallbladder disease
sleep apnea and respiratory problesm
osteoarthritis
gynecological problems

low self esteem and negative body image

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31
Q

obese indv pay ___% moer in healthcare costs than normal-weight indv

A

42

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32
Q

cost of overweight and obesity in US is estimated at $______ per year

A

270 billion

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33
Q

what is more important to long-term survival, level of fitness or level of obesity?

A

level of fitness

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34
Q

methods for body fat assessment

A

skin fold measurement and bioelectrical impedance analysis (BIA) machiens or scales

x=ray analusis (DEXA scan)
water dispalcment methods

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35
Q

error rate for at home fat percentage machiens (BIA)

A

8%

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36
Q

diet industry worth

A

60 billion

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37
Q

safe weight loss numbrt

A

1-2lb a weekh

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38
Q

decrease cal how much to lose weight healthily?

A

500 to 1000 cal a day

39
Q

for very obese indv what is safe body weight

A

1$ body weight weekely

40
Q

healthy diets

A

therapeutci lifestyle changes from NIH
Ornish diet
medetarian diet
DASH (Dietart approach to stop hypertension) from NIH

eat highly nutritious fruits, veg, high-fiber grains, heart-healhy proteins such as seafood, beans, v lean poultry, low-fat diary, nuts, seeds, and small amt of oil

41
Q

hand size for food porition

A

v lean protien in palm of one palm
highe rfiber grain or healthy starchy veg/ starchy bean disk fit in other palm

fil rest of plate w nonstarchy veg in form of salass, soiupls, and steam or lightly sauteed veg (brocolli, spunach, tomatoes, green beans, cucumbers, mushrooms, carrots, cbbage, peeppers, summer squash (suzcchini lettuce) and onion

serving of friut, milk, and healthy fat

42
Q

popular diets

A

Mayo Clinic Diet
volumetric diet
weight watchers
the biggest loser diets

count cal or fat grams

weigh and measure foods

43
Q

pros and cons of low carb (<100g/day; Atkins, South Beach, Protein Power)

A

Pros: Rapid intial wt loss, low circulating glucose, drop in lipds

cons: most initail weight loss is water; poor stamin and ketosis; atkins high in unhealthy fat; high protein taxes kidnets; no higher wt loss compared to low fat; artificial sweetener; hard to followe

44
Q

extremelt low fat (<20% cal from fat; T-factor, Pritikins, Ornish)

A

pro: wide variety of wholesome foods allowed at normal portions; reduced risk of heart disease and cancer

cons: satiety and palatability may be of concern; decreased absopriton of fat-siltuion vitamins abd nuberaks

45
Q

novel diets promotng certain nturients, foods, or combinations

A

pros: may promote rapid wt loss

cons: nutritionally inadequate; doesnt promote permanent change in food habits or body weight

46
Q

paleo - hunter, gather diet

A

pros: makes you feel full, good wt loss and control of blodod sugar and bp

cons: low in calcium, vitmain D, b-vitamins, possbilty folate; expensive bc high meat, poultry, and seafood intake; nutritious food off limits such as legumes whole grains and dairy

47
Q

fit for life

A

pros: encourages veg

cons: teaches food combining and diet low in calcium, zinc, iron, vitamin B12 and D

48
Q

enter the zone

A

pros: six small eating session = steady supply of energy

cons: low in fiber, marginal in some nutrients, portrays some high-gylcemic foods as dangerous even if they may have merit nutritionally

49
Q

very low cal (<800 cal/day) or formula (optifast, mdifast, cambridge)

A

pros: quick wt loss, eliminate behavior cues and food decision

con: low cal diet can be dangerous if not monitored; doesnt foster long term behavior changepre

50
Q

premeasured (jenny craig, nutrisystem)

A

pro: get safe and effective; eliminate decision making abt eating

con: expensive; clients may have trouble transition to home-cooked meals

51
Q

plateu period

A

weight doesnt decrease further

52
Q

yo=yo effect

A

swings in binging and dieting

53
Q

motivational interviewing

A

evidence -based conversational counseling style to help ppl plan for and begin the process of changing

express empathy
rolling w resistance (reflect w clients resistance)
develop discrepancny (help client understand how deeply held vales are different than current behavior)
support self-efficiacy (biuld confidence that change is possible)

54
Q

bheavior patterns that influence energy balance

A

skipping breakfast
eating in front of tv
late night snacking
lack of adeqate sleep
being too rushed to exercise
eating to help manage stress or difficult emotons

55
Q

behavioral straegies for wt loss

A
  • specific realistic goals to address changes in eating and exercise
  • establish new routines
  • record of food intake and amt of physical activity
  • include emotions surrounding eating patterns + hunger and satiety levels
  • change surroundings to avoid overeating (avoid eating in front of tv, pantry of healthy foods, balance poritons of food to work)
  • reward success in a non-food way
  • support from healthcare provider, friend, or spouse
  • weight only once a weak (measure w tape measure if scared of tape)
56
Q

exercise benefits

A

loers risk of chronic disease + help improve bp
strenghtens lungs and help them to work more efficiently
builds and strehtnens muscles and keeps joint in hood conditions
may slow bone loss
increases energy levels and bilds self confidence
helps in relaxation and coping skills by reducing stress and possibly lessenign depression solid sleep havbits
boost immunity

57
Q

how much activity necessary

A

good health and reduce risk of disease - 30 min of mod physical activity daily
maintain body weight - 60 min mod to vigourous
weight loss - 60-90 min daily mod activity

break exercise into 15 min increments

58
Q

who are prescirption weight loss drugs for

A

BMI above 30
BMI above 27 w associated sieases (hypertension, T2D, dyslipidemia)

appetite suppressants aproved for only short use
reevalulate every.3 monthsm

59
Q

Orlistat

A

Xenical (prescription)/ Alli (OTC)

lipase inhibitor that prevents absorption of fat from food in body

side effects: gassiness, oily bowel movement, bowel-related changes, liver malfunction, yellow skin or eyes, itching, loss of appetite

modest reuslts

60
Q

Lorcaserin

A

Belviq

acts on receptors in brain that promote feeligns of fullness, encouraging users to eat less

cant be used w SSRIs

sid effects = drowsiness, headche, and constipiation

when combined w diet and exercise, users lost 3-3.7% moreP

61
Q

Phentermine + Topiramate

A

sold under name Qsymia

phentermine - stimulate that decreases appetite
Topiramate: antis-eziure and migrain drug thatalso decrease appetiet due to feeling of early satiety

women of child-bearing age must use birh contorl due to issues w possible birth defects

lost on avg 9% of ody weiht

62
Q

Bupropion + Naltrexone

A

Contrave

targets brain’s hypothalamus

controls hunger and brain circuity involving reward activity incuding eating

initially rejected bc risk of long-term effects on heart and CV system
black box warning (increased risk of suicidal thoughts)

42% lost at leazt 5% body weight

63
Q

Liraglutide

A

sold under Saxenda

black box warning as animal studies sow it cuases thyroid tumrs

62% of uers lost 5% or more of body weight

64
Q

adjustable gastric band (AGB) surgery

A

smal lbracelet-like band is placed around top of stomach to rstrict size of opening from throat to stomach, reducing food intake (size of opening cotrolled via balloon)

65
Q

Roux-en-Y gastric bypass (RYGB)

A

food intake limited as surgeous create small pouch for stomach

pouch (size of walmut) connect diff pat of intestine (bypass the stomach and duodenum) therby changing the way food is absorbed

66
Q

Vertical sleeve gastrectomy (VSG)

A

newer proceudre
remove much of stomach in vertical fashion allowing only tubular sleeve shaped stomach that empties into duodenum

bc so much stomach rremoved there is less ghrelin which reduces hunger more than banded gastroplasty

67
Q

Biliopancreatic diversion w duodenal switch (BPD-D)

A

done 6-18 month after sleeve surgery (staged approach)

rerout sleeve from much of small itnestine and diverting bile and gastric juices to change digestion and absorption

68
Q

whio is bariatric surgery an option for

A

BMI > 40
BMI > 35 w serious health problem (linked to obesity - T2D, heart diesae, severe sleep apenea)
gastric band for pt w BMI ? 30 w at least one other condition linked to obesity

69
Q

before bariatric surgery

A

clients must show proof they tried traditional methods of weight loss and failed
psych eval to determine if proper candiate and can respond well to wt loss and change in body image

require clients to demonstrate full understanind of undertakng and motivation to follow extensive food, exercise, and medical guidance

70
Q

side effects to bariatric suergery

A

bleeding
infection
leaks from site where intestines are sewn together
diarrhea
blood clots in legs that can move to lungs and heart

nutrient deficienct - vitamin B12, iron, vitamin D, and folate

(200% of daily value of nutrient given in multi vitamin along w sufficient calcium a d vitamin D; B12 fiven sublinguily)

dumping sydrnome - cramping after higher-fat, higher-sugar foods
lactose intolerance, hair loss, taste changes

15% complication rate

71
Q

after bariatic surgery

A

1 oz size stomach pounc htath takes 6-8 weeks to health

begin high protein liquid diet for 2-3 weeks then trnsition to soft-solid protein for another 4-6 weeks

then soft, moist whole foods

musust comsume fliuds spereatel y from meals and take 30-60 kin to eat

72
Q

barietric pt daily diet after 6087 week healing period

A

64oz fluid

protein at 60-80g via soft, chopped, or ground meat, fish or poultry, or other protein source (intoleranct to red meat)
- three sevings of fruit and veg (difficulty w raw forms)
- three sevings of whoel grain (1/2 c is one serving) (some may have difficulties w rice, pasta, or doughy breads)
- overall focus is low-fat, low-sugar, high-rptoein

73
Q

when is wt los surgery considered successulf

A

50% excess wt loss and loss is sustained up to 5 years

74
Q

bariatrci sugery cost

A

20k to 25k

75
Q

baloon procuedre for weight loss

A

temporary implanted balloon device

endoscopically two-conencted ballons are insertedinto stomch and filled w saline

cause full sensatio nwhen only small amt is eating = weight loss

device is allowed to stay in stomch for 6 months then removed

another one is balloon in a pill w tiny cathether attached which is swalloed and saline is pumped to fill baloon (naturally passes thorugh GI tract over time)

76
Q

—-% of diets fail

A

95

77
Q

approx __% of overweight indv find success in long term wt loss when defined as losing at least 10% of intian body weight

A

20

78
Q

___% of obse indv are successful at 1 year wt loss maintenance

A

29.7

79
Q

solid habits by those who mainted sigfniciant weight loss

A

78% eat breakfast daily
75% eight themselves at least once a week
62% watch less than 10 hours of tv per week
90% exercise on vg about 1 hour a day

80
Q

1 in __ chuldren in america are overweight or obese

A

3

81
Q

overweight adolescents have ___ change of being overweight or obese adults, increasing to ___% if at leat one parent is overweight or boese

A

70

80

82
Q

in AA nd hispanic communities nearly ___% of children are overweih or obese

A

40

83
Q

average media time per.US children is ___ hr a day

A

7.5

84
Q

bmi percentiles for obesity

A

btw 85 and 95 pecentile overweight

95th percentil is obese

85
Q

contributors to overweight and obesity

A
  • skip breakfast
  • low fruit and veg intake
  • sweetned beverage intake
  • excess media time (esp TV in bedroom)
  • low physical activity level (sedentary behavior)
  • not eating meals together as family
  • parnental restirctoin of palatable foods
86
Q

strateies for childgood weight loss

A
  • provide reliable meals and snacks at table w no food handouts at other times
  • model slow, midnful eatings w chidlren being allowed to trust themselves to eat til stisfied
  • prepare fresh andbalanced meals w small amounts of treats several tumes a week to prevnet feeling deprived
  • consider fiber and nutrient desnitry are esp important for kids experiecning insulin resistance
  • plan fun home based activies and encouarge partciapting in sporting activites
  • understand need for parental limits on media time = more activity
  • healthy habit hcanges are faimly affair
87
Q

popular programs to improve fitness and health while hatlgin weight gain in cihldren

A

CATCH program (child and adolescent trial for Cardiovascular health)
LEAP (lifestyle education for activity program)
Project SPARK (Sports, play, and active recreation for KIDS)
youth porogramming at local YMCAs

88
Q

bariatric surgery for v obese youth

A

extreme obesity w BMI > 40

adult height (13 yo for girls, 15 yo for boys)

serious health problems linked to weight (T2D, seep apnea)

candidates emotional stabiltiy and his or her willingness to follow through w lifestyle changes

gastric bypass surgery

adjusted gastric banding not approved for those under age 18

89
Q

how is robert wood honson foundation reversing childgood obesity

A
  • ensure all food and beverages served in school meet or exceed dietary guidleins for americans
  • increase access to high-quality and affordable food through new or improved grocery stores and healthier corner stores
  • increase time intesnity and duration pf physical tivity during school day and in after-school programs
  • increae pysical acitivty by imrpvoing built environment in communities
  • using pricing stategies to promote purhcase of healthier food
  • reduce youth exposre to marketing of unhealth foods
90
Q

what causes underweight

A

anorexia
depression
cancer
tissue wasting
poor absorption of nutrients
infection
excessive activity
hyperthyroidism
faliure to thrive from illness, issues related to swallowing and digestion, lack of feeding support, or imbalanced diet, genetics

may have weaker immune systems, lower muscle mass, compromised bone stats, subtandard nutrition stores

<18.5 BMI (below 5th percentile on BMI)

91
Q

treat underweight

A

high cal diet

1lb per week (500 extra cal a day, gain wt lowley, eat a bmit more w every meal and ack, extra vitamin or mineral supplement)

limit high volumic food s(too much bulk, fiber, or water) : salads, broth-based soups, raw veg, ultra-high fiber cereals, light or diet products made w artifical sweeteners, high consumption of water

92
Q

tips to help w underweight

A
  • eat frquently (5-6 meals per day) to avoid feelign full
  • eat foods that are dense in nutrients and cal (nuts, seeds, dried fruit, egg, avo, yogurt) (limit heavy amounts of sugar or unhealthy fats)
  • add healthy fat to food such as olive or canola oil or mayo (butter, whole milk, and cheese should be used w more discretion in those w cholesterol concerns)
  • pack foods to eat when away from home
  • check out high cal snacks like milk shakes, puddlings, dense foods like homeade peantus butter granola
  • supplement drinkks to boost cal
  • encourage parents of underwt childfen to provide support but not threaten bribe or force feed child
  • nvestigate root cause of underweight status
93
Q
A

nutrition (21 decks)

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