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clinical nutrition > chapter 6 book notes > Flashcards

chapter 6 book notes Flashcards

1
Q

Many people maintain their weight within a range between ? and ?lbs:

A

10-20 pound range

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2
Q

When people consume more energy than they expend, much of the excess is stored as:

A

-body fat

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3
Q

Excess energy from what nutrients can lead to weight gain?

A

-carbs, proteins, and fats

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4
Q

Excess energy from alcohol is stored as :

A

-fat
-alcohol slows down the bodys use of fat for fuel causing more fat to be stored.
-mainly abdominal fat

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5
Q

Excess carbohydrates can be stored as:

A

-glycogen in liver & muscles, BUT IT STORAGE IS FUEL..
-excess glucose is converted to fat, this conversion is not energy efficient.

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6
Q

Excess carbs may also be burned for:

A

-energy; displacing the bodys use of fat for energy allowing the body fat to accumulate.
-thus excess carbs can lead to obesity.

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7
Q

WHEN A PERSON OVEREATS (FEASTING)
Carbs are broken down in the body to: &
contribute to:

A

-glucose
-liver & muscle glycogen stores and body fat stores

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8
Q

WHEN A PERSON OVEREATS (FEASTING)
Fats are broken down in the body to:
& contribute to:

A

-fatty acids
-body fat stores

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9
Q

WHEN A PERSON OVEREATS (FEASTING)
Protein is broken down in the body to: &
contributes to:

A

-amino acids (first used as body proteins, then excess contributes to body fuel, then can be converted to glucose or fat for energy)
-nitrogen lost in urine & body fat stores(less efficient)

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10
Q

2/3 of total energy=
1/3 of total energy=

A

-cellular work
-involuntary work of muscles

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11
Q

The body makes no distinction between what metabolically?

A

-fasting (choosing not to eat) & starving (having no choice)

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12
Q

What is used first for energy during fasting/starving?

A

-glucose from the livers glycogen storage and fatty acids from bodys adipose tissue

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13
Q

Within a day, liver glycogen is exhausted, and:

A

-most of the glucose is used up
-so low blood glucose conc. serve as a signal to promote further fat breakdown.

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14
Q

What organs cannot use fatty acids for energy?

A

-brain and nervous system
-red blood cells

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15
Q

How much kcals does the nervous system use each day?

A

400-600kcals

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16
Q

What does the nervous system use for energy if glucose is not available?

A

-body proteins are broken down into amino acids & converted to glucose (first few days they provide about 90% of needed glucose and glycerol provides 10%)

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17
Q

if body proteins were to be used at this rate what would happen?

A

-death would happen

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18
Q

So after a while instead of breaking down body proteins for fuel, the body then uses what?

A

-ketone bodies
-combined fatty acids to provide fuel for brain

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19
Q

As fasting continues & body depends on ketone bodies for energy, metabolism shifts and it:

A

-reduces (slow) metabolism and conserves both fat and lean tissue

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20
Q

Hazards of fasting:

A

-wasting of lean tissue
-impairment of disease resistance
-lowering of body temperature
-disturbances of the bodys fluid and electrolyte balances

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21
Q

How much weight is lost in the first week of fasting?

A

-50%

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22
Q

Fasting=
Intermittent Fasting=

A

-not the best way to lose weight
-sustains optimal nutrient and promotes good health

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23
Q

People with what condition should consult their physician before starting intermittent fasting?

A

-people wit type 2 diabetes

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24
Q

A person in energy balance is:

A

-their energy intakes cover energy expenditures with no deficits or excesses

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25
Q

Change in energy stores=

A

energy in (kcal)- energy out (kcal)

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26
Q

3500 kcal rule:

A

-for every 3500 kcalories eaten in excess of need, a pound of body fat is stored.
IN CONTRAST
-a pound of fat is expected to be lost for every 3500 kcalories expended

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27
Q

Many weightloss programs recommend lowering energy intake by how many kcalories per day?

A

-500kcal to lose a pound per week

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28
Q

Limitations of 3500 kcal rule:

A

-fails to account for changes in metabolism that occur as weight is lost
-fails to account for influence of body composition on energy needs

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29
Q

Body weight includes:

A

-fat, fluid, and lean tissues (muscle proteins & bone minerals)

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30
Q

What are the only contributors to the “energy in” side of the equation?

A

-energy in food and beverages

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31
Q

USDA food composition database (ndb.nal.usda.gov) tells you:

A

-the amount of energy in foods and beverages

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32
Q

how many calories in an apple? candy bar?

A

-apple=70
-candy bar=250

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33
Q

The body expends energy (“energy out”) in two major ways:

A

-to fuel is basal metabolism (over a period of time can also change)
-to fuel its voluntary activities (can be changed to expend less or more)

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34
Q

basal metabolism:

A

-the energy needed to maintain life when a person is at complete digestive, physical, and emotional rest.
-Basal metabolism is normally the largest part of a person’s daily energy
expenditure.

35
Q

Examples of basal metabolism:

A

-beating of heat
-inhaling and exhaling air
-maintience of body temperature
-transmission of nerve and hormonal messages

36
Q

EX: if a persons total energy needs are 2000kcal per day, what amount of kcal is used to support basal metabolism:

A

-1000 to 1300kcal
-2/3 of total energy

37
Q

basal metabolic rate (BMR):

A

-the rate of energy use for metabolism under specified conditions: after a 12-hour fast and restful sleep, without any physical activity or emotional excitement, and in a comfortable
setting.
-It is usually expressed as
kcalories per kilogram of body weight
per hour.

38
Q

resting metabolic rate (RMR):

A

-a measure of the energy use of a person at rest in a comfortable setting—similar to the BMR but with less stringent criteria for recent food intake and physical activity.
-Consequently, the RMR is slightly
higher than the BMR.

39
Q

Factors affecting BMR and their effect on it:

A

-AGE: lean body mass diminishes with age=slows BMR
-HEIGHT: in tall, thin people=BMR is higher
-GROWTH: children, adolescents, and pregnant women= higher BMR
-BODY COMPOSITION(SEX): males tend to have more lean tissue=higher BMR
-FEVER: raises BMR
-STRESSES: raise BMR
-ENVIRONMENTAL TEMP: both heat & cold raise BMR
-FASTING/STARVATION: lower BMR
-MALNUTRITION: lower BMR
-HORMONES (SEX): thyroxin= slow or speed up; premenstrual hormone= raises BMR
-smoking and caffeine= increases energy expenditure
-sleep=BMR is lowest when sleeping

40
Q

kcalories spent on voluntary activities depends on 3 factors:

A

-muscle mass, body weight, and type activity

41
Q

What factors of the activity also influence energy costs?

A

-activity’s duration, frequency, and intensity.

42
Q

To calculate kcalories spend on an activity…

A

-multiply your weight by the number of kcal burned doing that specific exercise per minute
-then multiply that number by the amount of time spent doing it.

43
Q

thermic effect of food:

A

an estimation of the energy required to process food (digest, absorb, transport, metabolize, and store ingested nutrients).

44
Q

Typically the thermic effect of food represents about what % of total food energy taken in?

A

-10%

45
Q

The body’s weight reflects its proportions of

A

-bone, muscle, fat,
fluid, and other tissue

46
Q

The first step toward making healthy changes may be

A

self-acceptance.

47
Q

the most important criterion for determining how much a person should weigh and how much body fat a person needs is not
appearance but

A

good health and longevity

48
Q

body mass index (BMI):

A

an index of a person’s weight in relation to height;
-weight(lb)/height(in) x 703

49
Q

Notice that a healthy weight falls between a BMI of

A

18.5 and 24.9

50
Q

underweight BMI=

A

18.5

51
Q

Overweight BMI=

A

above 25

52
Q

Obese BMI=

A

above 30

53
Q

health risks increase as BMI falls below– and rises above–

A

-18.5
-24.9

54
Q

BMI values are most accurate in assessing degrees of — and less useful for evaluating —-

A

-obesity
-nonobese people’s body fatness

55
Q

BMI values fail to provide two pieces of info:

A

1)does not reveal how much of weight is body fat
2)does not indicate where fat is located

56
Q

a diagnosis of obesity or overweight requires a BMI value plus:

A

some measure of body composition and fat distribution.

57
Q

The distribution of fat on the body influences health as much as, or more than,

A

the total amount of fat alone.

58
Q

In healthy lean people, where is the major site of excess lipid storage?

A

-subcutaneous fat (fat stored directly under skin)
-also cushions bones and insulates body against body temperature extremes

59
Q

visceral fat:

A

fat stored within the abdominal cavity in association with the internal abdominal organs, as opposed to fat stored directly under
the skin (subcutaneous fat)

60
Q

central obesity

A

-visceral fat stored deep within the central abdominal area of body
-UPPER BODY FAT

61
Q

Much research supports the widely held belief that central Obesity—significantly and independently of BMI—contributes TO:

A

to heart disease, cancers, diabetes, and related deaths

62
Q

One possible explanation for why fat in the abdomen may increase the risk of
disease involves:

A

adipokines

63
Q

adipokines

A

-protein hormones made and released by
adipose tissue (fat) cells.
-help regulate inflammation and energy metabolism in tissues

64
Q

In central obesity, a shift occurs in the balance of adipokines, favoring those that increase both:

A

-inflammation and insulin resistance of tissues.
-thus contributes to diabetes, atherosclerosis, and other chronic diseases.

65
Q

Visceral fat “upper body fat” creates the – profile of central obesity.
subcutaneous fat around hips and thighs creates more of a – profile “lower body fat”

A

-apple, seen in men more than women & is closely associated with chronic diseases
-pear, seen more in women than men, not associated with chronic diseases

66
Q

Visceral fat is common is females past:

A

-menopause and even more common in males.
-risks of cardiovascular disease and mortality are increases

67
Q

Two other factors that may affect body fat distribution are:

A

-intakes of alcohol and physical activity.
-Moderate-to-high alcohol consumption may favor central obesity.
-In contrast, regular physical activity seems to prevent visceral fat accumulation

68
Q

waist circumference:

A

a measurement used to assess a person’s abdominal fat.
-women= greater than 35in & men= greater then 40in have a high risk of central obesity-related health problems

69
Q

skinfold measure:

A

a clinical estimate of total body fat and fats location
-thickness of a fold of skin on the back of the arm (over the triceps muscle), below the shoulder blade (subscapular), or in other places
-measured with a caliper.

70
Q

For athletes body fat might be:

A

5 to 10 percent for men and 15 to 20 percent
for women.

71
Q

major eating disorder seen in society today:

A

-anorexia nervosa

72
Q

What % of US adults are obese (BMI of 30 or greater)? What is the % among children and adolescents?

A

-42%
-18%

73
Q

excess weight contributes to half of all cases of

A

-hypertension, thus increasing risk of heart attacks and stroke

74
Q

a person with type 2 diabetes has central obesity and:

A

central body fat cells appear to be larger and MORE insulin resistant then lower body fat cells

75
Q

Tobacco us is most significant preventable death in the US, what’s the second?

A

-obesity

76
Q

Some people who are obese, however, have been described as

A

“metabolically healthy
obese” or metabolically normal obese”;

77
Q

“metabolically healthy
obese” or metabolically normal obese”;

A

-they have normal blood pressure, blood glucose,
and blood lipids.
-Most notably, they maintain their sensitivity to insulin.
-less central obesity and inflammation (protect them from type 2 diabetes and heart disease)

78
Q

3 indicators in identifying and evaluating the risks to health from overweight and obesity:

A

1)BMI
2)waist circumference
3)person’s disease risk profile

79
Q

BMI and overweight

A

-overweight adults is defined as BMI of 25-29.9
-obesity=30

80
Q

Overweight people and waist circumference

A

-“overweight” BMI range of 25-29.9 and those in obese BMI range of 30-34.9 often face a greater risk of heart disease and mortality is their waist circumference is more than 35in for women and more than 40in for men.

81
Q

For people with a BMI above 35, waist circumference is

A

-less meaningful because their degree of obesity incurs a high risk for health problems and mortality, regardless of their waist measurement

82
Q

disease risk profile

A
  • takes into account life-threatening diseases, family history, and risk factors for heart disease
    (such as blood lipid profile).
    -The higher the BMI, the greater the waist circumference, and the more risk factors, the greater the urgency to treat obesity
83
Q

Obese people pay higher..

A

-insurance premiums and more for clothing

clinical nutrition (26 decks)

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