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HLTH 230 > Chapter 9 Energy Balance and Body Weight > Flashcards

Chapter 9 Energy Balance and Body Weight Flashcards

1
Q

What is body composition?

A

Proportions of muscle, bone, fat and other tissues that make up a person’s total body weight.

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2
Q

What is more important than controlling for body weight?

A

Controlling for body composition

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3
Q

T or F, we can control our weight?

A

F, We can control behaviours, not weight.

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4
Q

When are people who are underweight most at risk? x3

A
  1. During Famine
  2. When Hospitalized
  3. When fighting a disease (die from starvation not disease)
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4
Q

T or F, Too little body fat is a wide spread problem in Canada?

A

False, Obesity is the problem

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5
Q

Underweight people often have the problems? x4

A
  1. Undernutrition
  2. Osteoporosis
  3. Infertility
  4. Impaired Immunocompetence
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5
Q

How may underweight people benefit from gaining weight? x2

A

-Energy Reserve
-Reserves of nutrients that can be stored

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6
Q

What are the problems associated with overweight/obesity? x7

A
  1. T2D
  2. Dyslipidemia
  3. Hypertension
  4. CHD
  5. Gallbladder Disease
  6. Sleep Apnea
  7. Certain Cancer
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7
Q

What are the most common diseases associated with obesity?

A
  1. Hypertensions
  2. Diabetes
  3. Heart Disease
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7
Q

What contributes to more preventable diseases and premature death?

A

Tobacco

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7
Q

What is Central Obesity?

A

Visceral fat is the fat that collects deep within the central abdominal area of the body

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8
Q

What does visceral fat increase the risk of?

A

-Diabetes
-Stroke
-Hypertension
-Coronary artery disease

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9
Q

Why is visceral fat bad?

A

Readily released into the blood stream

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9
Q

What is the worst place to hold fat, most increased risk?

A

Central Obesity

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10
Q

What is subcutaneous fat?

A

Fat just below the skin
(Abdomen, thighs, hips, legs)

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11
Q

Who is most prone to central obesity (apple shape)? x4

A
  1. Males and Females postmenopausal
    2.Smokers
  2. Moderate to high alc. users
  3. Low PA
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12
Q

What is the pear shape?

A

Females are more prone to carrying fat around hips and thighs prior to menopause.

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13
Q

How to measure Bodyweight/Fat Assesment?

A
  1. BMI kg/m2
    2.Waist Circumference
    3.Disease risk profile
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14
Q

What does BMI correlate to? x2

A
  1. Degree of body fatness and disease risk
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15
Q

What does waist cirumference coorelated to?

A

Reflects the amount of visceral fatness

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16
Q

What is Disease risk profile correlated to?

A

-Hypertension, Diabetes, High Cholesterol

-The more risk factors, the greater the obesity

-The more significant the body fatness and the higher the disease profile the greater the risk

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17
Q

How to calculate BMI?

A

Weight (in KG) / Height (M2, take hight in m and square it)

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18
Q

How may pounds (lbs) in a Kg?

A

2.2 lbs = 1 Kg

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19
Q

How many times to move decimal over cm to M?

A

twice to right

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19
Q

How many inch to 1 cm?

A

1 Inch = 2.54 cm

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20
Q

What are the 2 limitations to BMI?

A
  1. No indication about how much of the weight is fat.
    2.No indication of location of body fat
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21
Q

Who is BMI not appropriate or effective for? x5

A
  1. Athletes
  2. Preggo and lactating women
  3. Adults over 65 (Og based on people under 65 )
    4.Need more research on cutoffs for different races and ethnic groups (made for white Europeans and Americans)
  4. Under 18
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22
Q

BMI does not reflect?

A

Body composition (only height and weight)

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23
Q

BMI needs consideration/grain of salt for what groups of people?

A
  1. Young adults who have not fully grown
  2. Adults who naturally have a very lean body build
  3. Highly muscular adults
  4. Adults over 65 years of age
  5. Certain ethnic and racial groups
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24
Q

What is the most practical indicator of fat distribution and abdominal fat?

A

Waist circumference

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25
Q

An increased risk of developing health problems such as diabetes, health disease and high blood pressure is associated with a waist circumference at or above males and females.

A

Males 102 cm (94 cm)
Females 88cm (80 cm)
-WC just below these values should also be taken seriously

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26
Q

What may be a greater determinant of the risk of death for obese people than body fat?

A

Physical Activity/ Fitness

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27
Q

Who exhibits the lowest risk of death from chronic diseases?

A

Seen in normal weight fit people.

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28
Q

What improves health and longevity, independent of BMI?

A

Cardiovascular Fitness

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29
Q

What are 4 ways people with elevated BMI’s are treated unjustly?

A

-Are sometimes judged on their appearance
-Less often hired
-Pay higher insurance premiums
-Less often admitted to college or Universities

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30
Q

What is weight bias?

A

Refers to neg, attitudes and views about obesity and about people with disability

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31
Q

What is weight Stigma?

A

-Refers to social stereotypes an misconceptions about obesity

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31
Q

What are the social stereotypes and misconceptions that may occur due to weight stigma? x7

A

-lazy
-awkward
-sloppy
-non-compliant
-unintelligent
-unsuccessful
-lacking self-discipline or self-control

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32
Q

What is weight discrimination?

A

We enact our personal biases and social stereotypes about obesity and treat people with obesity unfairly

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33
Q

What contributes to weight discrimination? x2

A

Weight Bias and Weight Stigma

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34
Q

What is the Edmonton Obesity Staging System? EOSS

A

-5 Stage system of obesity classification
-Considers the metabolic, physical and psychological parameters in order to determine the optimal obesity treatment.

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35
Q

T or F EOSS has been reported to be a better predictor of mortality than BMI

A

True

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35
Q

What is stage 0 of EOSS?

A

-No apparent risk factors:
-BP, serum lipid, and fasting glucose levels are normal.

-Physical systems

-Psychopathology

-Functional limitation and/or impairments leading to disability

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36
Q

What is Stage 1 of EOSS?

A

-Presence of obesity-related subclinical risk factors:
-Borderline Hypertension, Impaired Fasting Glucose Levels, Elevated Levels of Liver Enzymes

-Mild Physical Systems:
-Dyspnea on moderate exertion, occasional aches and pains, fatigue

-Mild Psychopathology

-Mild Functional Limitation and/or mild impairment of well-being

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36
Q

What is Stage 2 of EOSS

A

-Presence of established obesity-related chronic disease
-Hypertension, T2D, Sleep Apnea, Osteoarthritis

-Moderate Limitations in activities of daily living and/or well-being

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37
Q

What is Stage 3 EOSS?

A

-Established end-organ damage :
-Myocardial infarction, Heart Failure, Stroke

-Significant Psychopathology

-Significant Functional Limitations and Impairment of Well-Being

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38
Q

What is Stage 4 EOSS?

A

-Severe (End-Stage) disabilities from obesity-related chronic diseases

-Severe Disabling Psychopathology

-Severe Functional Limitations and Impairment of Well-Being

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39
Q

What percentage of Canadians in 2019 -18-70 where overweight, based on what scale?

A

59.8%, BMI

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40
Q

What are the 4 Recommendations of the clinical practice guidelines for weight bias for health care professionals working with people with obesity?

A
  1. Healthcare providers need to assess their attitudes and beliefs regarding obesity and consider how their attitudes and beliefs may influence care delivery
  2. Healthcare providers should recognize that internalized weight bias in people living with obesity can affect behavioural and health outcomes
  3. Healthcare providers should avoid using judgmental words, images and practices when working with people with obesity

4.Healthcare providers avoid making assumptions that an ailment of complaint a patient presents with is related to body weight

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41
Q

What is the point of the Canadian Adult Obesity Clinical Practice Guidelines (CPGS)?

A

Reduce Weight Bias in Obesity Management, Practice and Policy

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42
Q

What are the CPGS for healthcare providers of indigenous people living with obesity? x5

A
  1. Engage with patient social realities
  2. Validate the patient’s experiences of stress and systemic disadvantage influencing poor health and obesity, exploring elements of their environment where reduced stress could shift behaviours
  3. Advocate for access to obesity management resources with publicly funded healthcare systems, recognizing that resources beyond may be unaffordable and unattainable for many

4.Help patients recognize that good health is attainable, and they are entitled to it

  1. Self-reflect on anti-indigenous sentiment common within healthcare systems, explore patient motivations and mental health as alternative understandings of causes and solutions to their health problems (explore own bias of racism)
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43
Q

When we use BMI do we know where body weight is being held?

A

No, cant tell if its subcutaneous fat or visceral fat

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44
Q

Where does excess fat accumulate?

A

Fat Cells of bodies Adipose Tissue

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45
Q

How many kcal is 1 pound of body fat?

A

3500kcal = 1 pound of body fat

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46
Q

Daily energy balance is?

A

Change in energy stores = Energy in - energy out

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47
Q

How do we burn food?

A

bomb calorimeter

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47
Q

What is the equation of weight maintenance?

A

Energy Input = Energy Output

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48
Q

What is direct calorimetry?

A

When food is burned energy is released in the form of heat

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49
Q

What is Indirect Calorimetry?

A

CO2 and H2O are produced. The amount of O2 used gives a indirect measure of heat produced

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50
Q

What contributes to NRG in?

A

Food and Drink

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51
Q

What are 3 contributors to energy output?

A

Basal Metabolism
Voluntary Activities (PA)
Thermic effect of food

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52
Q

What is Basal Metabolism?

A

Sum total of energy expended on all of the involuntary activities needed to sustain life

Excludes digestion and voluntary activities

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53
Q

What are voluntary activities?

A

-Intentional activities
-Very changeable

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54
Q

What is the most variable element of energy output (day to day, person to person)?

A

Voluntary Activties

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55
Q

What is the Thermic Effect of Food? (TEF)

A

-5-10% of a meal’s energy is expended in stepping-up metabolism following meal

-Total amount of energy needed to digest, absorb metabolize and store the food you eat?

-Eating - GI tract muscles speed activity, enzymes produce, produces heat

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56
Q

Is TEF counted in energy output?

A

NO

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57
Q

What is TEF infuenced by? x3

A
  1. Meal Size
  2. Meal Frequency
  3. Meal composoition
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58
Q

Is there research of no calorie foods in TEF?

A

No

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59
Q

TEF for Fat

A

0-5%

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60
Q

TEF Carbs

A

5-10%

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61
Q

TEF Protein?

A

20-30%

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62
Q

TEF Alcohol

A

15-20%

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63
Q

What is Basal Metabolic Rate (BMR)?

A

The rate at which the body uses energy to support its basal metabolism
-Varies person to person
-Varies with activity level
-Lowest during sleep

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64
Q

Will BMR increase with short term PA?

A

No

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65
Q

Will BMR increase with long term PA?

A

yes

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66
Q

Which tissues has higher BMR: Lean Tissue or Fat Tissue?

A

Lean Tissue

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67
Q

BMR is higher in which groups of people/situations x8?

A
  1. Younger People (lean body mass declines with age)
  2. Taller People (Larger SA)
    3.People who are growing (children, preggo)
  3. People with more lean muscle mass (Physically fit people and men)
    5.Fever
    6.During Stress
  4. Environment temp- adjusting to heat and cold
  5. Hyperthyroidism
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68
Q

What is lean body mass?

A

Weight of body-fat

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69
Q

BMR is lower in? x4

A
  1. Older people -lean body mass declines with age
  2. Fasting - Body slows to perceive energy
  3. Malnutrition
  4. Hypothyroidism
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70
Q

What are the conditions needed to measure BMR?

A

BMR: Rate of energy use for metabolism under specific conditions
-12 hour fast and restful sleep
-Without PA or Emotional Excitement
-Comfortable temp/setting

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71
Q

What are the differences between BMR and RMR (resting metabolic rate)?

A

BMR:Rate of energy use for metabolism under specific conditions

RMR: Measure of energy use of person at rest in comfortable setting but LESS STRINGENT CRITERIA FOR FOOD INTAKE AND PA

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72
Q

What is the equation for estimated energy requirements for women?

A

kg body weight x 22 =kcal/day

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73
Q

What is the equation for estimated energy requirements for men?

A

kg body weight x 24 =kcal/day

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74
Q

EER often include x4?

A
  1. Sex (females have less lean body mass than males)
  2. AGE (BMR declines by average 5% per decade)
  3. PA (generally cluster activities according to their typical intensity)
    4.Body weight and size (higher BMR of taller and heavier people need to be factored)
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75
Q

What is Anthropometry?

A

Fatfold Measures -caliper

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76
Q

What is density?

A

Underwater weighing or air displacement plethysmography

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77
Q

Lean tissues is more/less dense than fat tissue?

A

More

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78
Q

What is conductivity?

A

Bioelectrical impedance

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79
Q

What is radiological techniques?

A

DEXA

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80
Q

What are the 4 ways to measure body composition and fat distribution?

A
  1. Anthropometry
    2.Density
    3.Conductivity
    4.Radiological Techniques
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81
Q

% body fat of males should be?

A

12-20%

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82
Q

% body fat for females

A

20-30%

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83
Q

What contributes to determining how much body weight is ideal for health? x4

A
  1. Sex
  2. Age (increases after 40)
  3. lifestyle (athletes, fishing)
  4. Stage of life (pregnancy, elderly benefit from higher)
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84
Q

What percentage of eating disorder start in adolescents?

A

85%

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85
Q

What is the female athlete triad?

A

1) Disordered eating/eating disorder
2)Amenorrhea
3)Osteoporosis

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86
Q

Why are athletes at high risk for eating disorders?

A
  • Ultra-slim appearance has ling been considered desirable in some sports and activities
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87
Q

Why may a eating disorder be prevalent in males x2?

A

1) Making Weight Practices, compromise athletic abilities and endanger their lives (diminished strength and reduced endurance)

2) Muscle Dysmorphia
-Athletes with well-muscled bodies can sometimes see themselves and underweight and weak

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88
Q

What are the characteristics of anorexia nervosa? x5

A

1) Often come from middle or upper-class families
2)Men account for 5-10 % of cases (most female)
3)Distorted body images that overestimate body fatness (malnutrition is known to affect brain functioning and judgment)
4)May be a way of gaining control
5)Self-Starvation

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89
Q

What are characteristics of self-starvation?

A
  1. Discipline is used to strictly limit portions of low-calorie foods
  2. Hunger is strong but denied
  3. Person is starving, but doesn’t eat (extreme self control)
  4. Calorie contents of foods are often memorized
  5. Exercise excessively and/or use laxatives
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90
Q

What are the physical perils of anorexia nervosa similar to?

A

Same damage as classic protein-energy undernutrition

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91
Q

What are the physical perils of anorexia nervosa?

A
  1. Body tissues depleted of needed ft and proteins
  2. YOUTH: Growth ceases and normal developmental falters; BMR slows
  3. Heart pumps inefficiently and irregular
  4. Low BP
  5. Imbalance of electrolytes
    6.Deaths due to heart failure
    7.Brain looses tissue
    8.Nerves function abnormally
  6. Intestinal tract lining shrinks
    10.Pancreatic production of digestive enzymes slow
    11.Food is not adequately digested
  7. Diarrhea
  8. Anemia
  9. Dry Skin
  10. Impaired Immune Response
  11. Altered blood lipids
  12. Low body temp.
  13. Fine body hair
  14. Loss of sex drive in adults
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91
Q

What are the 3 things a person with anorexia nervosa demonstrates?

A
  1. Restriction of energy intake relative to requirements
  2. Intense fear of gaining weight or becoming fat/ persistent behaviour that interferes with weight gain (already at a low body weight )
  3. Disturbance in the way in which one’s body weight or shape is experienced (dont relize skinny)
92
Q

What are the 2 types of anorexia?

A
  1. Restricting Type
    2.Binge eating/purging
93
Q

What is the restricting type of anorexia?

A

-During the last 3 months, the individual has not engaged in recurrent binge eating or purging episodes.
-Presentations in which weight loss is accomplished primarily through dieting, fasting and/or excessive exercise

94
Q

What is the Binge eating/purging type of anorexia?

A

During the last 3 months, has engaged in self induced vomiting or the misuse of laxatives, diuretics, or enemas

95
Q

What are the treatments of anorexia?

A

1)Supplemental formulas (tube feeding may be needed)
2)Denial makes treatment difficult
3)Many relapses
4)Require many different healthcare professional and supports working together
-Approaches relating to relationships, food and weight as well as to oneself and others

96
Q

What is more common Bulimia or Anorexia?

A

Bulimia
Often secret and may deny the behaviours

97
Q

What is bulimia nervosa? x6

A

Binge Eating and Purging
-Food is not consumed for its nutritional value
-Binge is a compulsion
-Eating is often accelerated by hunger from previous caloric restriction
-Large binges (often exceed 1000kcal)
-Easy to eat, low fibre, smooth, high-fat and high-carb
-Several binges a day

98
Q

What is RED-S

A

-Another better term for female athlete triad
-Olympic Committee

-Impaired physiological function caused by relative energy deficiency:
-Metabolic Rate
-Menstrual Function
-Bone Health
-Immunity
-Protein Synthesis
-Cardiovascular health

99
Q

What are the 4 aspects of the binge/purge cycle?

A
  1. Negative self-perception
  2. Dieting/severe energy restriction
  3. Binge
    4.Purge
    cycle
100
Q

What occurs after a binge in bulimia nervosa and how?

A

Purge the food using CATHARTIC (strong laxative) and EMETIC (agent that causes vommiting)

101
Q

After a binge and purge what are symptoms? x3

A
  1. Hands scrapped and cute from the teeth during induced vomiting
  2. Swollen neck glands and reddened eyes from straining to vomit
  3. Bloating, fatigue, headache, nausea, pain
102
Q

What are the physical and psychological perils that may occur in bulimia nervosa?

A

1)Fluid and electrolyte imbalances caused by vomiting or diarrhea
-abnormal heart rhythm and injury to the kidneys

2) Vomiting Symptoms
-irritation and infection of the pharynx, esophagus, and salivary glands
-Erosion of teeth and dental cavities
-The esophagus or stomach may rupture or tear
-Overuse of emetic can lead to death by heart failure

103
Q

Who is more likely to recover anorexia or bulimia?

A

Bulimia: Less likely to be in denial and more likely to recover than those with anorexia

104
Q

T or F, everyone with bulimia vomits?

A

False, lots of possible way, excessive exercise

105
Q

What are the 4 criteria for bulimia nervosa diagnosis?

A
  1. Recurrent episodes of binge eating
    -Eating in a discrete period, amount of food larger than normal in that period
    -A sense of lack of control and inability to stop or know how much one is eating
  2. Recurrent inappropriate compensatory behaviours to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting or excessive exercise
  3. binge eating and inappropriate compensatory behaviours both occur, on average, at least once a week for three months

4.Self evaluation is unduly influence by body shape and weight

106
Q

What are the 4 treatments of bulimia?

A
  1. Multidisciplinary team
  2. Regain control over doos and establish regular eating patterns requires adherence to a structured eating plan
  3. Regular exercise may be of benefit
  4. Restrictive eating forbidden
107
Q

What are the goals of bulimia treatment? x3

A

1)Steady maintenance of weight
2)Learning to consistently at enough food to satisfy hunger is a major step towards recover
3)Medication, such as antidepressants, may be used in treatment

108
Q

T or F obesity is a eating disorder

A

False

109
Q

What is Binge Eating Disorder BED?

A

Recurrent episodes of eating large quantities of food and then experiencing shame, distress or guilt afterward

110
Q

How is BED different from BN?

A

-Consume less during a binge
-Rarely purge
-Exert less restraint during times of dieting

111
Q

What eating disorder responds best to treatment?

A

BED

112
Q

What are the criteria for a BED x5

A

1)Recurrent episodes of binge eating:
-Eating in a discrete period of time, any amount of food that is larger than usual
-Lack of sense of control over eating during episode

2)Associated for 3 of the following:
-Too much more rapidly than usual
-Eating until uncomfortably full
-Eating large amounts when not hungry
-Eat alone due to embarassment

3)Marked distress regarding binge eating is present

4)The binge eating occurs, on average once a week for 3 months

5) Does not occur solely in BN or AN and not associated with recurrent use of inappropriate compensatory behaviours

113
Q

How is BED different then BN?

A

No recurrent use of inappropriate compensatory behaviours like drugs to vomit

114
Q

What is EDNOS?

A

Eating disorder not otherwise specified

115
Q

What is orthorexia?

A

A colloquial term referring to problematic eating behaviours that can seriously impact someone’s life

116
Q

Is orthorexia a diagnosable DSM 5 disorder?

A

NO

117
Q

What are examples of orthorexia? x7

A

-Eating only foods regarded as healthy
-Relying on only natural products to treat illness
-Finding more pleasure in eating correctly than enjoying tastes and textures
-Leads to an obsessive focus on food
-Weight is a measure of success
-Can become AN
-Social Isolation and Ill Health

118
Q

What are the common causes of eating disorders x4?

A

-Sociocultural
-Known only in developed nations
-Becomes more prevalent as wealth increases and food becomes plentiful

-Psychological

-Heredity

-Probably Neurochemical

119
Q

What are the 2 things that eating behaviour is regulated by?

A

1)Signals and Mechanisms that stimulate eating
2)Signals and Mechanism that stop eating or lead on to refrain from eating

120
Q

What does hunger stimulate?

A

Eating Behaviour

121
Q

Is satiation and satiety a weaker stimulus that hunger?

A

Yes, can be ignored

122
Q

What is Hunger?

A

Unpleasant sensation that signals need for food

123
Q

How often does hunger occur?

A

4-6 hours after eating

124
Q

What hormone triggers hunger?

A

Ghrelin: produced between meals as well as chemical and nervous signals in the brain

125
Q

What triggers hunger?

A

1) Contracting empty stomach and empty small intestine
2)Ghrelin

126
Q

What are the factors influencing hunger? x6

A
  1. Nutrients in the bloodstream
  2. Size and composition of the previous meal
  3. Weather: heat reduce, cold induce
    4.Exercise
    5.Sex Hormones
  4. Illness
127
Q

What is the result of the restriction of hunger?

A

-Hunger Lessen but does return
-Can lead to bouts of overeating that overcompensate for the calories lost during the deprivation period

128
Q

How is the stomach adaptive?

A

-Can adapt to small and larger quantities of food

129
Q

What is appetite?

A

The psychological desire to eat
-Sight and smell of food can stimulate the brain’s endorphins, molecules hat create an appetite despite an already full stomach

130
Q

T or F appetite can be experienced without hunger?

A

true

131
Q

What is the result of illness or stress on appetite?

A

Result in loss of appetite in a person in physical need of food

132
Q

What are the factors that affect appetite? x7

A
  1. Hormones
  2. Inbrone Appetites (salty, fatty, sweet)
  3. Learned preferences, aversions, timings
  4. Customary eating habits
  5. Social Interactions
  6. Appetite stimulants, depressants, mood-altering drugs
  7. Environmental conditions (prefer cold foods in hot weather)
133
Q

What is satiation?

A

The perception of fullness that builds throughout a meal eventually reaches the degree of fullness and satisfaction that halts eating.

134
Q

How does satiation occur? x2

A
  1. Stretch receptors in the stomach send signals to the brain that tell it that the stomach is full
  2. The brain also detects nutrients in blood
135
Q

What is Satiety?

A

The perception of fullness that lingers after a meal and inhibits eating until the next mealtime
-Suppresses Hunger

136
Q

What determines the length of time between meals?

A

Satiety

137
Q

What is sensory-specific satiety (SSS)?

A

-SSS is the concept that we tend to get bored of food as we eat it.
-More variety, the more likely it is that we will increase overall consumption

138
Q

What is the satiety hormone?

A

Leptin, produced by adipose tissue and stomach

139
Q

What hormone is directly related to appetite control and body fattness?

A

Leptin

140
Q

Body fatness gain has what effect on leptin?

A

Body fat stimulates leptin production.

141
Q

What is the effect of reduced body fat and leptin?

A

Reduced leptin production = increased appetite

142
Q

Which of the energy-yielding nutrients is the most satiating?

A

Protein

143
Q

Fat is known to effect satiety or satiation?

A

Satiety

144
Q

What hormone does protein and fat intake release and what is its role?

A

Intestinal Hormone (CCK), slows stomach emptying and prolongs feelings of fullness

145
Q

High-fibre foods and water have water effect on hunger?

A

Delay Hunger

146
Q

Protein effects satiety or satiation?

A

Both

147
Q

What are the 3 selected metabolic theories?

A
  1. Set Point Theory
  2. Fat cell number theory
    3.Thermogenesis 1: Brown Fat theory
148
Q

What is the set point theory?

A

Body somehow attempts to maintain a stable body weight

149
Q

What is the fat cell number theory?

A

Fat cells may increase faster in children who are obese contributing to obesity as adults

150
Q

What is the thermogenesis 1: Brown fat theory?

A

Brown fat has abundant energy-wasting proteins:
-Lean ppl may have more brown fat
-Infants may have abundant brown fat

151
Q

How does intestinal microbiota contribute to inside-the-body causes of obesity?

A

Investigation undergoing looking for links btwn intestinal bacteria and body weight

152
Q

Do genetics have a role in obesity?

A

Genetics influence a person’s tendency to become obesity, lifestyle choice determine if the tendency is realizes

153
Q

What are 2 external cues to overeating?

A
  1. Variety leads people to eat when not hungry (sweets/appealing food)
  2. Response to loneliness, craving, addiction, compulsion, depression, time of day, stress
154
Q

How do food price, availability and advertising contribute to overeating?

A

High calorie fast foods are inexpensive, widely available an heavily advertised, and delicious

155
Q

How does physical inactivity contribute to obesity?

A

Lack of PA
-Lack of physical work is required for most people resulting from a built enviroment

156
Q

What is a built environment, and how does it contribute to obesity?

A

Enviroment the buildings, roads, utilities, homes, fixtures, parks and human-made entities that form the physical characteristic of a community.
-Do they promote/ allow for PA to occur? (Stairs, Sidewalks, Public Transport)

157
Q

T or F Diet histories of those who are obese often report energy intakes similar to or even less than others?

A

True
-Reported intake often inaccurate (lies)
-Sedentary people: Low energy requirement

158
Q

What are the 2 things PA is made up of?

A
  1. EAT: Exercise-related activity thermogenesis
  2. NEAT: non-exercise activity thermogenesis
159
Q

What is NEAT?

A

Corresponds to all of the energy expended with occupatiom, leisure time activity, sitting, standing, stair climbing, ambukation, toe-tapping, dancing, etc,

160
Q

What is an obesogenic environment?

A

All the factors surrounding a person that promote weight gain

161
Q

What are the 5 best ways to maintain optimum body weight?

A
  1. Maintain a healthy and balanced diet
    2.Engage in daily PA
  2. Practice behaviour modication
    4.Maintain a healthy relationship with food
  3. Consider pharmacological therapy or bariatric surgery in addition to the above
162
Q

What is the issue with the statement “eat less and move more”?

A

Simplified
-Issues surrounding body weight and weight changes are extremely complex

163
Q

What determines if you gain, lose, or maintain body fat?

A

Balance between energy intake and output

164
Q

A change in body weight may not reflect change in body fat; it could be the result of? x4

A
  1. Body fluid content
  2. Bone Minerals
  3. Muscle
  4. Bladder or digestive tract contents
    -Changes often coorelate with time of day
165
Q

Why do smokers weigh less than non-smokers?

A

Nicotine blunts feelings of hunger

166
Q

Why is moderate weight loss better than a restriction fast?

A

Moderate calorie restriction promotes fat loss and better retention of lean tissue

167
Q

How does a body respond to a fast?

A

Less than day into fast:
-Liver glycogen stores are used up
-Protein is broken down in order to meet brains need for glucose

Continues:
-Breakdown of protein (muscle: skeletal, heart, liver)
-To slow breakdown, the body converts fat into KETONE Bodies: a. fuel the nervous system can adapt to using

168
Q

What is Ketosis?

A

-The body takes partially broken-down fat fragments and combines them to form ketone bodies
-After 10 days of fasting, most of the nervous systems energy needs are met by ketone bodies
-Survival mechanism: a healthy person starting with average body fat content can live totally deprived of food for 6-8 weeks

169
Q

T or F: Fasting cleanses body?

A

False, no evidence, the body tolerate short-term fasting

170
Q

How does fasting harm the body x5?

A
  1. ketosis upsets the acid-base balance of the blood, promoting excessive mineral loss in urine
  2. 24 hours of fasting and the intestinal lining looses integrity
  3. Food deprivation can lead to binge eating (could last)
  4. Fasting degrades the body’s lean tissues
  5. Body adapts to fasting by decreasing metabolic rate
171
Q

What are 3 diets that bring about large initial weight loss? and why

A
  1. Low Carb
  2. High Protein
  3. Ketogenic Diet
    -Primarily the water and glycogen losses when carb is laking
    (Glycogen holds lot water, water loss to urinate )
172
Q

Why is weight loss reversed when low-carb, high protein and ketogenic diets when these diets stop?

A

Restore glycogen stores
Reinforces the diea that carbs are bad

173
Q

What are the 4 reasons that low-carb, high protein and ketogenic diets cause rapid weight loss?

A
  1. Limited Variety
  2. Protein-rich foods are often slow to prepare
  3. Energy-rich desserts and snack are often high in carbs (removed in these diets)
    4.- Primarily the water and glycogen losses when carb is laking
    (Glycogen holds lot water, water loss to urinate )
174
Q

What is the bodies response to a low carb diet?

A

Similar to fasting
-Body breaks down fat and protein for energy and ketones form to feed brain

175
Q

What is the DRI recommendation fro carbs?

A

-Min. 130g/day (RDA 1 yr)
-45%-65% of total energy intake is recommended for health

176
Q

What is weight gain the result of?

A

Energy-yielding nutrients contributing to excess body fat stores

177
Q

How do excess proteins result in weight gain?

A

Excess AA have their nitrogen removed and re used for energy or converted to glucose or fat

178
Q

How do excess fat result in weight gain?

A

fatty acids are broken down for energy pr converted to triglycerides and stored as body fat with great efficiency

179
Q

How do excess carbs result in weight gain?

A

Excess sugars may be built up to glycogen and store, used for energy, or converted to fat and stored

180
Q

How does alc result in weight gain?

A

Used for fuel or converted to body fat and stored
-Slows down the body’s use of fat for fuel by 33%, causing more fat to be stored, primarily visceral fat

181
Q

What is the safest diet?

A

Balanced Diet
-Adequate essential nutrients and limiting saturated, trans fat and refined carbs

182
Q

How to get weight loss?

A
  1. Energy in must be less than energy expended
  2. Increase PA
183
Q

3 Goals for weight loss?

A
  1. Prevent weight gain
  2. Reduce body weight 5-10% over a year
  3. Focus on healthy behaviours
184
Q

What are the best strategies for weight loss? x10

A
  1. Set Goals
  2. Keep Records
  3. Weight Loss needs to be individualized
  4. Choose realistic calorie intakes
  5. Balancing carbohydrates, fats and proteins
  6. Portion Sizes
  7. Limit Alcohol
  8. Reduce Energy Density
    9.Consider Milk and Milk Products for high calcium
  9. Meat spacing
185
Q

What goals should be made for weight loss?

A

-Determine if weight maintenance or loss is most appropriate
-Set goals
-Small goals for diet, PA an behaviour changes
-Slow weight loss is likely to result in rapid regain

186
Q

Why is keeping records important for weight loss?

A

A tool to spot trends and identify areas in need of improvement
-Measure waist circumference to track obesity changes

187
Q

Is a caloric intake lower than 800 calories sufficient and why x3?

A

No:
-Unsuccessful at achieving lasting weight loss
-Lack necessary nutrients
-May promote eating disorder

188
Q

What is the suggested caloric intake for waist loss BMI greater than 35?

A

Reduce kcalorie intake by 500-1000kcal/day

189
Q

What is the suggested caloric intake for waist loss BMI 27-35?

A

Reduce kcalorie intake by 300-500kcal/day

190
Q

How to balance carbs, fats and proteins recommendations?

A

Fall within AMDR
Carb: 45-65%
Fat: 20-35%
Protein: 1-=35%

191
Q

Why are high-fibre, unprocessed or lightly processed food important for weight loss?

A

Offer bulk and satiety for fewer calories than quickly consumed refined foods

192
Q

What are 2 ways to choose fats sensibly?

A

1)Avoid trans fat and limit saturated fat
2) Include enough of the health-supporting fats to provide satiety by not oversupply calories

193
Q

What proteins should be picked for weight loss?

A

Lean

194
Q

How to balance portion sizes for weight loss?

A

Eat until satisfied no more

195
Q

T or F eating large portions of reduced-calorie foods is not beneficial

A

true

196
Q

Why should milk products be considered for weight loss?

A

High calcium intake especially rm low-fat milk products correlates with low body fat

197
Q

What types of meal spacing are recommended for those wanting to lose weight?

A

-Small, frequent meals are reported to be more successful at weight loss and management
-Mild hunger should prompt eating not appetite

198
Q

Physical Activity for weight loss should be greater/less ?

A

Greater

199
Q

Why PA is important for weight loss?x3

A

-Diet in combo with PA promotes fat loss, promotes muscle retention and inhibits weight gain
-Helps follow diet plans more closely
-Improves BP, IR, Heart and lung fitness even without Weight loss

200
Q

PA _____ metabolism

A

Increases Metabolism
-Short-term increase in energy expenditure from exercise and a slight rise in metabolism
-Long-term increase in BMR from an increase in lean tissue

201
Q

Can PA reduce Spot by targeting fat and exercising a certain area?

A

NO PA cannot target fat from an area
-Aerobic promotes the release of abdominal fat
-Improves the strength and tone of muscle in the area

202
Q

What are 4 additional PA benefits?

A
  • Appetite control
  • Stress reduction & control of stress eating
  • Physical & psychological well-being
  • Improved self-esteem
203
Q

What are the 3 pillars to support medical nutrition therapy and PA?

A

-Psychological Intervention
-Pharmacotherapy
-Obesity Surgery

204
Q

Who is surgery for obesity management a option for?

A

1) BMI greater than 35 with co-existing disease, according to CPG

2)BMI greater than 30 with poorly controlled Type 2 diabetes or severe obesity-related disease not responding to medical management

205
Q

What are the benefits of surgery for weight loss? x6

A

-Sig. Weight Loss
-Improve Hypertension
-Improve High Cholesterol
-Improve Diabetes
-Improve sleep apnea

206
Q

T or F Surgery is a always a cure for excess adiposity?

A

F, some do not lose the expected weight or lose and then gain it back over time

207
Q

Long-term safety and effectiveness of gastric surgery depends on?

A

Compliance with dietary instructions

208
Q

Long-term complications of gastric surgery includes x2?

A

-Vitamin and mineral deficiencies
-Psychological Problems

209
Q

What is Gastric Banding?

A

-Provides restrictive methods for weight loss.

-An adjustable band is placed where the esophagus and the stomach meet
-The band is a silicone ring filled with saline with a port placed in the muscle of the abdominal wall adjusted with saline

210
Q

What is Gastric Bypass (roux-en-y)

A

Provides a restrictive and malabsorptive method for weight loss because the stomach and small intestines are reconfigured

-A small stomach is created by dividing the stomach, creating a stomach pouch that can hold a few bites
-The intestines are cut and the entire duodenum and part of the jejunum are bypassed

211
Q

What is a duodenal switch?

A

Provides a restrictive and malabsorptive method to weight loss because the stomach and small intestines are reconfigured

-The stomach reduction is less than the gastric bypass but more of the small intestine is bypassed

212
Q

What is a sleeve gastrectomy (Gastric Sleeve)

A

-Provides a restrictive approach

-A long slender sleeve is stapled
-Other part of stomach is removed
-Stomach is banana-sized

213
Q

What are the surgery options to treat obesity?

A

1.Gastric Banding
2.Gastric Bypass
3. Duodenal switch
4. Sleeve Gastrectomy (Gastric Sleeve)

214
Q

What is a example of gastric bypass nutrition supplement regimen?

A

-Multivitamin/mineral 2 tablets/day
-Vitamin B12
-Calcium Citrate
-Vit D
-Iron

-Crushed, chewable or liquid for the first 2 months
-Specific brands are generally recommended because of their vitamin and mineral make up

215
Q

What is the diet for the Bypass Surgery?
x5

A
  • Clear fluids for a day
  • Full fluids for about 10 days
  • Pureed diet
  • Overall, very small amounts - about 4 tablespoons per meal
  • Need to ensure adequate: Protein supplements, Liquids, Vitamins and minerals supplements
216
Q

True or False: Medications for obesity are prescribed far more infrequently than medication for other chronic conditions.

A

TRUE!

217
Q

Why do medications need to be considered early?

A

-Medications need to be considered early because obesity-related health conditions tend to increase or worsen over time.

218
Q

What are the clinical considerations that need to be made when starting obesity pharmacotherapy? x4

A

1) Identify individualized goals of therapy prior
2)Set reasonable expectations and time required to see these benefits
3) Targets of treatment should include outcomes that the patient identifies as important to them
4)Discuss whether treatment should be long term

219
Q

What are possible targets of treatment for obesity pharmacotherapy?

A
  1. Weight Loss
    2.Improvement in health parameters
  2. Weight maintenance after lifestyle-induced weightloss
    4.Control of Cravings
    5.Improve QofL
220
Q

T or F -Medications are not a quick fix. They are a long term strategy, that if stopped weight gain occurs.

A

True

221
Q

When can prescription medication to treat obesity prescribed?

A

BMI greater than 27 and obesity-related complication elevated disease risk may benefit from prescription medication, along with diet, exercise

222
Q

What is Sibutramine?

A

Suppresses appetite by inhibiting serotonin reuptake
-NOT on market in Canada (est. 2010)

223
Q

What is the problem with Herbal Products?

A

Effectiveness and Safety have not been proven

224
Q

T or F Ephedrine can be used for weight loss?

A

True

225
Q

What is the problem with ephedrine?

A

Side effects can include stroke or death.
-Not reccomendded

226
Q

What is known as dieters tea?

A

Herbal Laxatives: senna, aloe, rhubarb root, cascara, castor oil or buckthorn

227
Q

What is the problem with herbal laxatives?

A

-Cause temp. water loss of 1-2kg
-Nausea, Vomiting, Diarrhea, Cramping, Fainting

228
Q

What gimmicks to weight loss?

A

1) Steam baths and saunas do not melt off fat (dehydration resulting in water loss)
2) Brushes, sponges, wraps, and creams/massages intended to move burn or break up cellulite are useless for fat loss

229
Q

What is the the key to weight loss?

A

Key: Weight Maintenance is accepting it as a lifelong endeavour of healthy habits

-Healthy Diet
-Portion Control
-Exercise

However many factors which can influence PA and Food access/choices

230
Q

T or F an underweight person should not necessarily try to gain weight

A

T: If healthy should maintain current weight

231
Q

What are the ways to gain weight? x4

A

1)PA to gain muscle and fat
2)Choose food with high energy density
3)Portion Size and Meal Spacing
4)Weigh Gain Supplements

232
Q

What is a good way to choose foods with high energy density/ nutritious energy-dense foods?

A

Generally increasing fat but not sat or trans fat

233
Q

How to use portion size and meal spacing to increase weight?

A

1)Increase Portion sizes
2)Eat Frequently
(start with main course, drink milk/milk alt. or snoothies in btwn meals)

234
Q

T or F Weight Gain supplements have benefits without PA

A

F, Weight-gain supplements are useless without PA
-No benefits beyond adding calories and few nutrients

235
Q

T OR F To gain weight somebody should increase tabacoo use?

A

F, AVOID Tobacco
-Supresses appetite an dmakes taste buts and olfactory organs less sensitive

236
Q

How does XenicalⓇ Orlistat OTC Alli Ⓡ work?

A

Stops some fat eaten from being absorbed by the body

237
Q

How does SaxendaⓇ
liraglutide work?

A

Decreases appetite and amount eating

238
Q

How does Contrave®
naltrexone & bupropion work?

A

Controls hunger and craving

239
Q

How does WegovyⓇ Semaglutide work?

A

Decreases appetite and slows stomach emptying helping to control amount eaten

240
Q

What is ephedrine not approved for?

A

Weight Loss
Increased NRG
Body-Building
Euphoria

241
Q

What are the only ways to have ephedrine in Canada?

A

Nasal Decongestions
Products Carry a Drug ID Number

242
Q

What are the 4 prescribed drugs for weight loss?

A

1) XenicalⓇOrlistat, OTC Alli Ⓡ
2)SaxendaⓇ,liraglutide
3)Contrave® naltrexone & bupropion
4)WegovyⓇSemaglutide

HLTH 230 (10 decks)

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