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clinical nutrition > Chapter 7 book notes > Flashcards

Chapter 7 book notes Flashcards

1
Q

what causes obesity?

A

-many interrelated causes

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2
Q

Two major contributing and interacting factors that cause obesity:

A

1)genetics
2)environment

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3
Q

Prader-Willi syndrome

A

-genetic disorder characterized by excessive appetite, massive obesity, short stature, and often intellectual disability.

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4
Q

How many sites in the human genome is associated with obesity & fat distribution?

A

-more than 300 sites

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5
Q

For someone with at least one obese parent, the chance of becoming obese is estimated to fall between…

A

30-70%

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6
Q

An individuals genetic inheritance may make obesity likely, it will not necessarily develop unless gives a push by

A

-environmental factors that encourage energy consumption and discourage energy expenditure.

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7
Q

Lipoprotein lipase

A

-enzyme mounted on the surface of fat cells
-hydrolyzes triglycerides in the blood into fatty acids and glycerol for absorption into the cells.

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8
Q

LPL promotes..

A

-fat storage in fat cells and muscle cells
-people with high LPL activity are especially efficient at storing fat

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9
Q

leptin:

A

-a hormone produced by fat cells under the direction of the obesity gene
- it is in proportion to the amount of fat stored.
- It decreases appetite and increases energy expenditure.

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10
Q

A gain in body fatness stimulates the production of…? And what stimulates the release of leptin?

A

-leptin
-hypothalamus

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11
Q

Fat loss produces the opposite effect—

A

-suppression of leptin production
-increased appetite
-decreased energy expenditure

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12
Q

Because leptin is a protein, it would be destroyed during digestion if given orally, so it must be given through a?

A

-injection

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13
Q

Obese people do not have leptin deficiency, they produce plenty of leptin, but

A

-they fail to respond to it.
-condition known as “leptin resistance”

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14
Q

Ghrelin

A

-a hormone produced primarily by the stomach
cells.
-It signals the hypothalamus of the brain to stimulate appetite by increasing smell sensitivity, stimulating appetite, and promoting efficient energy storage.

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15
Q

Ghrelin powerfully triggers the desire to..

A

-eat

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16
Q

Blood levels of ghrelin typically rise..

A

-before a meal and fall after a meal

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17
Q

High ghrelin levels correlate with..

A

-lower body weight
-when body is in negative energy balance (low-kcal diet)

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18
Q

Low levels of ghrelin correlate with..

A

-higher body weight
-positive energy balance

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19
Q

Ghrelin and sleep duration:

A

-a lack of sleep increases levels of ghrelin
-helps explain the associations between inadequate sleep, higher energy intakes, and weight gain.

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20
Q

The amount of fat in adipose tissue reflects both..

A

-the number and size of fat cells

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21
Q

The # of fat cells increases most rapidly during..

A

-the growing years of late childhood and early puberty.

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22
Q

Obesity causes fat cells to get bigger, but after they reach their maximum size..

A

-more cells can develop to store more fat.

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23
Q

With fat loss, the size of cells shrink, but

A

-their number cannot
-because of this people with extra fat cells may tend to regain lost weight rapdily

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24
Q

When is prevention of obesity most critical?

A

-during the growing years if childhood and adolescence when the # of fat cells increases to the most profound extent.

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25
Q

Excess fat first fills..
if fat is still abundant, the excess if then deposited..

A

-bodys natural storage site (adipose tissue)
-in organs such as the heart and liver

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26
Q

set-point theory:

A

-the theory that the body tends to maintain a certain
weight by means of its own internal controls (physiologically related)

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27
Q

The theory suggests that the body somehow chooses

A

-a preferred weight and defends that weight by regulating eating behaviors and hormonal actions.

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28
Q

Microbiota may affect..

A

-many body systems (brain, adipose tissue, and muscles) that can alter the bodys use and storage of energy.

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29
Q

When the mix of bacterial species falls out of balance, potentially…

A

-harmful bacteria proliferate
-producing substances that increase inflammation and are associated with obesity, diabetes, etc.

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30
Q

Determining whether certain bacteria might be the cause or consequence of weight change is difficult, because…

A

-colonies quickly grow or diminish with changes in diet.

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31
Q

obesogenic environment:

A

-all the factors surrounding a person that promote weight gain
-such as an increased food intake—especially of unhealthy choices—and decreased physical activity.

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32
Q

FDA requires chain restaurants with 20 or more locations, including fast food, to provide..

A

-kcalorie information on menus and menu boards for each standard menu item.

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33
Q

hunger:

A

-the physiological need to eat
-programmed into people by their heredity

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34
Q

Appetite

A

-the psychological desire to eat;
-a learned motivation
-can lead people to ignore hunger or respond to it

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35
Q

satiation:

A

-the feeling of satisfaction and fullness that occurs during a meal and halts eating.
-determines how much food is consumed during a meal.

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36
Q

satiety:

A

-the feeling of fullness and satisfaction that occurs after a meal
-inhibits eating until the next meal.
-determines how much time passes between meals.

37
Q

Satiation tells us to..
satiety reminds us to..

A

-stop eating
-not start eating again

38
Q

National goals to combat obesity:

A

-provide opportunities to help make physical activity an integral and routine part of life.
-Create environments that ensure healthy foods
and beverages are visible, attractive, and easy to
obtain.
-Encourage media messages that promote physically
active lifestyles and nutritionally healthy diets.
-Support health care providers in offering information
on weight management and employers in offering
wellness programs.
-Strengthen schools as centers that promote fitness
and health.

39
Q

The question of whether a person should lose weight depends on many factors such as:

A

-the extent of overweight, age, health, and
genetics,

40
Q

Weight-loss advice does not apply..

A

-equally to all people who are overweight.
-some people may risk more in the process of losing weight than remaining overweight.

41
Q

Millions of people in the United States, even some who are not overweight, use…

A

-over the-counter (OTC) weight-loss products

42
Q

OTC weight-loss pills, powders, herbs, and other “dietary supplements” are not..

A

-associated with successful weight loss and maintenance, and they may not be safe.

43
Q

FDA has found an alarming # of products that illegally contain prescriptions medications in OTC weight loss like..

A

-Strong diuretics
-unproven experimental drugs
-psychotropic drugs used to treat mental illnesses,
-and even drugs deemed unsafe and so banned from U.S. markets

44
Q

FDA has approved several drugs for treatment of obesity, these drugs should only be prescribed to those..

A

-people with medical risks, not cosmetic reasons, and should be accompanied by healthy eating and activity plans.

45
Q

Some physicians prescribe drugs that have not been approved for weight loss, a practice known as..

A

-“off-label” use
-These drugs have been approved for other conditions (such as seizures) and incidentally cause modest weight loss.

46
Q

clinically severe obesity:

A

-a BMI of 40 or greater,
-or a BMI of 35 or greater with one or more serious conditions such as hypertension.
-“morbid obesity”
-8% of US prevalence

47
Q

At this level of obesity the most effective treatment is:

A

-surgery

48
Q

3 major surgery’s that can be done:

A

1)gastric bypass (changes production of gastrointestinal hormones)
2)gastric banding
3)sleeve gastrectomy
ALL REDUCE STOMACH CAPACITY

49
Q

Results are significant, depending on type of surgery???to ???% of excess weight remains lost after 10 years.

A
  • 20 to 30%
50
Q

Efforts to combat obesity must integrate:

A

-healthy dietary patterns, physical activities, supportive environments, and psychosocial support

51
Q

Successful weight loss, then, is defined not by pounds lost but rather by

A

-health gained

52
Q

people who are overweight or obese who must reduce their weight to lower their disease risks
might set three broad goals:

A

1)reduce body weight by 5-10% in half a year
2)maintain a lower body weight over the long term
3)at minimum, prevent further weight gain

53
Q

weight loss is hard at first, and then it may

A

-get harder.

54
Q

Rapid weight loss usually means excessive loss of:

A

-lean tissue, a lower BMR, and a rapid weight regain to follow.

55
Q

Obesity experts recommend that reductions in energy intake should be based on
a person’s:

A

-BMI

56
Q

People who are overweight (BMI of 25 or greater) and those who are obese (BMI of 30 or greater) are encouraged to reduce their usual daily kcalorie intakes
by about:

A

-500 to 750 kcalories to produce a weight loss of about 1 to 2 pounds per week while retaining lean tissue

57
Q

Consulting with a ? can help a person develop personalized nutrition goals.

A

-registered dietitian nutritionist

58
Q

Weight loss may proceed rapidly for some weeks or months but will eventually slow
down. The following factors contribute to a decline in the rate of loss:

A

-Metabolism may slow down in response to a lower kcalorie intake and loss of metabolically active lean tissue.
-Less energy may be expended in physical activity as body weight diminishes.

59
Q

Body weight lost early in dieting may be composed of a greater percentage:

A

-of water and lean tissue,

60
Q

Most people can lose weight safely on a dietary pattern
providing approximately ??? kcalories per day
for women and ?? kcalories per day for men

A

-1200 to 1500
-1500 to 1800

61
Q

What dietary patterns provide nutrient adequacy and are generally associated with improved health:

A

-vegetarian and maditerranean

62
Q

Which two vitamins/minerals, for women, can help follow a low-kcalorie dietary pattern to achieve nutrient adequacy:

A

-iron & calcium

63
Q

Foods high in fat and low in water (cookies, fatty meats,, chips) are:

A

-higher in energy density

64
Q

Foods high in water and fiber (fruits and veggies) are:

A

-lower in energy density
-they tend to be bulkier, providing more bites for fewer kcalories, and thus more satisfying.

65
Q

Consumption of which tree nuts are associated with lower BMI and smaller waist circumference:

A

-almonds, walnuts, & pecans

66
Q

People who eat small, frequent meals can be as successful at weight loss and maintenance as those who:

A

-only eat 3

67
Q

On average, sugar-sweetened beverages contribute about ?? kcalories a day

A

-140

68
Q

Simply replacing nutrient-poor, energy-dense beverages with water can help a person lower energy intake by at least:

A
  • 5 percent
69
Q

People who combine diet and physical activity are more likely to lose:

A

-more fat, retain more muscle, and regain
less weight than those who only diet.

70
Q

Current recommendations advise a weekly exercise
pattern that includes:

A

-150 to 300 minutes of moderate- intensity aerobic activity
-or 75 to 150 minutes of vigorous-intensity aerobic activity,
OR COMBO OF THE TWO

71
Q

Even without weight loss, physical activity can:

A

-reduces abdominal obesity, and this change improves blood pressure, insulin resistance, and fitness of the heart and lungs

72
Q

BMR is elevated in the hours after..

A

-vigorous physical activity

73
Q

Over the long term, however, a person who
engages in daily vigorous activity gradually develops more

A

-lean tissue, which is more active metabolically than fat tissue

74
Q

a physically active person may eat more than a sedentary person, but not so much as to:

A

-overcompensate for the energy expended in exercise

75
Q

What kind of physical activity is best?

A

-For health, a combination of moderate to vigorous aerobic physical activity along with resistance training at a safe level provides benefits

76
Q

resistance training:

A

-the use of free weights or weight machines to provide resistance for developing
muscle strength, power, and endurance;
-also called weight training.
-A person’s own body weight may also be used to provide resistance, as when a person does push-ups, pull-ups, or abdominal crunches.

77
Q

Health care professionals frequently advise people who want to manage their body weight and lose fat to engage in..

A

-low to moderate intensity for a long duration’
-EX: hour long fast paced walk
-because this allows for a person to stick to their activity for longer times and less likely to injure themseleves

78
Q

The conditioned body that is adapted to
strenuous and prolonged aerobic activity uses more fat:

A

-all day long, not
just during activity

79
Q

Does certain parts of the body give up fat in preference to another?

A

-NO
-fat cells all over body release fat in response to demand and the fat is then used by whatever muscles are active

80
Q

A key to weight maintenance is accepting it as a:

A
  • lifelong endeavor and not seeing it as a goal to be achieved and then forgotten
81
Q

self efficacy:

A

-a persons belief in their ability to succeed in an undertaking

82
Q

lapses:

A

-periods of returning tp old habits.

83
Q

Underweight is a far less prevalent then overweight, affecting only about ??% of U.S. adults:

A

-2%

84
Q

Those who wish to gain weight for appearance’s sake or to improve athletic performance should be aware that a healthful weight can be achieved only through:

A

-physical activity, particularly strength training, combined with a high energy intake
-eating extra food will then support a gain of both muscle and fat.

85
Q

Energy-dense foods (the very ones eliminated from a successful
weight-loss diet) hold the key to:

A
  • weight gain
    -so milkshakes instead of fat free milk, peanut butter instead of lean meat, avocados instead of cucumbers, whole wheat muffins instead of whole wheat bread
86
Q

eat more food within the first ??` minutes of a meal before you begin to feel full

A

-20

87
Q

6 cups of cranberry juice adds almost ??? kcalories to the day’s intake

A

1000

88
Q

What is best to eat for people who are underweight due to illness?

A

-concentrated liquid formulas
-a weak person can swallow them easily

89
Q

What kind of diet will a registered dietitian nutritionist recommend to help a weak underweight person due to illness ?

A

-high protein, high kcalorie formulas

clinical nutrition (26 decks)

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