Chp 11 - obesity

Question 1

Obesity is the ____ leading cause of death, e.g. 1st, 2nd, 3rd

Answer 1

2nd

Question 2

Cause of obesity (source Nguyen and El-Serag)

Answer 2

complex interaction b/n the environment, genetic predisposition, and human behavior – ENVIRONMENTAL FACTORS - probably the MAJOR contributing factor to epidemic

Question 3

Environmental factors – EI and EE

Answer 3

EI - availability, quantity, and energy density of foods consumed

EE - labor saving devices, more time spent sitting, less availability of facilities for activity

Question 4

Chronic psych stress impact to hunger

Answer 4

Stimulated – high calories, hyper palatable foods

Question 5

Genetics - specific genes associated with BMI and body fat account for _____% to total variation

Answer 5

less than 5% - genes are important but not as much as lifestyle

Question 6

Genetic predisposition to obesity can be reduced by ____% by being physically active

Answer 6

40%

Question 7

Leptin

Answer 7

in fat cells
communicates directly with the hypothalamus – how much energy is currently stored in the body’s fat cells

Negative feedback loop - fat cells decrease in size, leptin decreases, hypoth directs body to eat more and vice versa

Question 8

Primary biological role of leptin is….

Answer 8

facilitate energy intake when energy storage is low

Question 9

Adiponectin

Effect on glucose and insulin sensitivity

TG levels?

With higher body fat, result?

Answer 9

insulin synergist

sends blood glucose into body’s cells for storage or use as fuel - INCREASING insulin sensitivity or glucose metabolism

Decreases TG levels - stimulates fat breakdown

Higher body fat - lower levels

Question 10

Ghrelin, aka

Secreted by the _________

Chief role in regulation of ___________

Answer 10

“hunger hormone”

stomach

appetite

Question 11

Peptide YY - release in response to…..

Stimulated by both ________ and ________

Effect on appetite…..

Provides a feeling of fullness, aka

Answer 11

food intake

lipids and CHO

cessation

satiety

Question 12

What % of moderate to severe OSA is DUE to obesity?

Answer 12

58%

Question 13

Amount of weight gained/lost depends on

Answer 13

1) number of calories consumed
2) composition of diet
3) type of exercise performed
4) level of daily physical activity

Question 14

BMI Underweight

Normal

Overweight

Obesity

Answer 14

<18.5

18.5-24.9

25-29.9

30-34.9 — Class I

35-39.9 — Class II

Question 15

Waist circumference - men and women tipping points

Answer 15

Men - <40 in less risk

Women <35 in less risk

Question 16

BMI math - pound formula

Answer 16

Weight in lb DIVIDED BY Height squared (inches) (X) 703

Question 17

BMI math - kg formula

Answer 17

a) Weight in kg (lbs/2.2)

b) Ht in meters squared – inches TIMES 2.24, divided by 100

FORMULA
a) DIVIDED by b)

Question 18

Men and women increased waist circumference threshold – RISK

Waist circumference is superior to BMI in predicting CVD - T/F

Answer 18

Men >40/equal to and women >/equal to 35

T

Question 19

WHR - good clinical measurement to predict …..

Answer 19

all cause cardiovascular disease mortality

Question 20

WHR Men - excellent, at risk

Answer 20

Excellent = <0.85
At risk = >0.95

Question 21

WHR women - excellent, at risk

Answer 21

Excellent - 0.75
At risk = >0.86

Question 22

BIA and lean tissue – % of tissue that is water

Answer 22

70%

Question 23

Essential body fat, women/men

Answer 23

Women - 10-14%

Men - 2-5%

Question 24

Chief components of behavioral weight loss program

Answer 24

1) calorie reduction – 500-1000 kcal deficit

2) Physical activity - minimum 150 minutes/week, maintenance of weight loss 200-300 minutes/week, strength train 2x/week, increase NEAT

3) Behavioral strategies – self monitoring, stimulus control, support group (models), behavioral substitution, set SMART goals

Question 25

Wt loss program, calorie deficit plus 3 other things…

Answer 25

1) portion control
2) eating frequency
3) consume high NUTRIENT density foods

Question 26

REE

Answer 26

60-70% of the body’s Total Energy Expenditure (TTE) - measured at REST in the morning

Question 27

REE formula MALES

Answer 27

(10 x wt in kg) + (6.25 x height in cm) - (5 x age in years) + 5

Question 28

REE formula FEMALES

Answer 28

(10 x wt in kg) + (6.25 x height in cm) - (5 x age in years) - 161

Question 29

Energy expenditure (EE)

Answer 29

total distance covered, e.g. walked or run, determines the EE

Question 30

FITT principle components

Answer 30

F = frequency

I - Intensity

T = time

T = type

Question 31

FITT - aerobic

Answer 31

F = active most days of week, at least 3-4
I = talk test or RPE (12-14 on 6-20 scale OR 4 on 0-10)
T = 30-60 minutes/day
T = wt bearing or non, low impact, rhythmic

Question 32

FITT - resistance training

Answer 32

F = 2 days per week
I = moderate (8-15 reps), or high intensity (6-8 reps)
T = 20-30 minutes generally
T = All mm groups – free weight, machines, resistance bands, body weight

Question 33

Pharma interventions - when to consider

Answer 33

Engage in lifestyle change BUT have BMI >/equal 30

-OR-

> /equal to 27 with at least one obesity related comorbidity

Question 34

Bariatric surgery - when to consider

Answer 34

BMI >/equal 40

-OR-

> /equal to 35 with at least one obesity related comorbidity