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ACE ® Health Coach > Chronic Diseases and Comorbid Conditions: Obesity > Flashcards

Chronic Diseases and Comorbid Conditions: Obesity Flashcards

Upon completion of this deck, the learner will be able to list the major factors that contribute to obesity, identify the diagnostic criteria for overweight and obese classifications, explain the chief components of a behavioral weight loss plan, outline dietary strategies for weight loss, and discuss the role of physical activity and exercise in the prevention and treatment of obesity.

1
Q

How do you convert inches to meters?

A

Inches x 0.0254 = meters

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2
Q

An average body fat percentage for males is ____ and for females is ______.

A

Males - 18-24%

Females - 25-31%

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3
Q

In addition to reducing calorie intake by 500 to 1000 kcals, what other tools are important to the nutritional component of weight loss?

A
  • Portion control
  • Eating frequency
  • Nutrient density
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4
Q

Maria is a 34-year-old woman who is 5’4” and weighs 180 lbs. What is her resting energy expenditure?

A

REE = 1,503.76 kcal/day

Convert lbs to kg: 180 / 2.2 = 81.82kg
Convert inches to cm: 64 inches x 2.54 = 162.56 cm
(10 x 81.82) + (6.25 x 162.56) - (5 x 34) - 161
818.2 + 1016.56 - 170 - 161 = 1,503.76

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5
Q

By being physically active you can decrease the chance of obesity due to genetic predisposition by ______%.

A

40%

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6
Q

Adipocytes function like what other kind of organ in the body?

A

Endocrine

Endocrine organs are glands that secrete hormones. Fat cells act like these glands by sending signals to the brain that affect other mechanisms of the body that control energy expenditure regulation, insulin sensitivity, and metabolism.

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7
Q

What is leptin’s role in the body?

A

Inhibits hunger and regulates energy balance

Leptin is released from fat cells; the more fat you have, the more leptin you have. In overweight people, there is an overdominance of leptin which can lead to leptin resistance, meaning more levels of leptin are needed to trigger the correct hunger response. When an individual loses weight, their body will assume they are hungry because with fewer fat cells, less leptin is present.

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8
Q

Calculate the BMI of a client who is 216 lbs and 5’6”. What class of weight would this person be in?

A

BMI = 34.8, Obesity class 1

5’6” = 66 inches
216 lbs / 2.2 = 98.18 kg
66 inches x 0.0254 = 1.68 m
BMI = 98.18 / (1.68)² = 98.18 / 2.82 = 34.8

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9
Q

How much weight would the client listed below need to lose in order to reach their desired weight?

Weight: 202lbs

Percent BF: 39%

Fat-Free Mass: 61%

Target Percent BF: 22%

Target Fat-Free Mass: 78%

A

Weight loss = 44.1 lbs

FFM lbs = weight x %FFM = 202 x 61% = 123.2lbs
Target body weight = FFM in lbs / target %FFM = 123.2 / 78% = 157.9
Current body weight - desired body weight = 202-157.9 = 44.1lbs

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10
Q

How do you calculate resting energy expenditure?

A

Males: (10 x body weight in kg) + (6.25 x height in cm) - (5 x age in years) + 5

Females: (10 x body weight in kg) + (6.25 x height in cm) - (5 x age in years) - 161

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11
Q

What are some environmental factors that could cause obesity?

A
  • Avaliability and quantity of healthy foods
  • The energy density of available foods
  • Availability of labor-saving devices
  • More time spent sitting
  • Access to parks, gyms, or recreational facilities
  • Stress
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12
Q

What is the role of cytokines in the body?

A

Cytokines are hormone-like proteins that are responsible for inflammation when there is an infection or injury to the body.

Overweight individuals have an overreaction to the release of cytokines which leads to chronic low-grade inflammation - a key facet in heart disease.

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13
Q

What kind of cells store fat?

A

Adipocytes

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14
Q

What is the recommended time of resistance training for overweight or obese clients?

A

It depends - however most resistance training sessions should only require 20-30 minutes to complete.

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15
Q

What are some factors that regulate and influence energy balance?

A
  • Lack of physical activity
  • Weight bias and stigma
  • Delayed satiety
  • Stress
  • Increased sedentary time
  • Adverse childhood experiences
  • inadequate access to healthcare
  • Genetics and epigenetic factors
  • Environmental food cues
  • Energy-dense nutrient-poor foods
  • Socioeconomic status
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16
Q

What is the recommended amount of time for aerobic exercise for obese clients?

A

30 to 60 minutes per day in one or multiple sessions.

Research shows that exercise in small bouts throughout the day has the same benefits as one longer period of time, assuming the intensity remains the same.

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17
Q

What is the RDA of protein?

A

46-56 g/day

10-35% of total caloric intake

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18
Q

The number of kilocalories required for 1 pound of fat loss changes depending on what factors?

A
  • How long the diet period lasts
  • Type of diet
  • Engaging in physical exercise
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19
Q

Is normal weight obesity just as bad as BMI obesity?

A

Yes.

Even at a normal weight for height, people with a higher percentage of body fat are at risk for altered blood lipids, high cholesterol, high levels of the hormone leptin, and increased risk of metabolic syndrome (which is a precursor to diabetes and heart disease).

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20
Q

Calculate a healthy body weight for the client listed below:

Weight: 170lbs

Percent BF: 33%

Fat-Free Mass: 67%

Target Percent BF: 30%

Target Fat-Free Mass: 70%

A

Healthy Desired Body Weight: 162.7

FFM lbs = weight x %FFM = 170 x 67% = 113.9lbs
Target body weight = FFM in lbs / target %FFM = 113.9 / 70% = 162.7

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21
Q

According to WHO, an excellent waist to hip ratio for males is _____ and females is _____.

A

Males - less than 0.85

Females - less than 0.75

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22
Q

After measuring your female client’s waist to hip ratio (WHR), you determine her WHR to be 0.87. Based on this assessment, you advise your client to:

A - Lose abdominal weight

B - Stay the same weight

C - Lose weight in the hips

D - Do nothing; a health coach is not allowed to access body weight in reference to health.

A

A. Lose abdominal weight

With a WHR of 0.87, your client is considered at risk for metabolic disease and cardiovascular disease. In order to reduce this risk, your client should lose abdominal weight (which would be achieved by diet and exercise).

23
Q

_____% of moderate-to-severe obstructive sleep apnea is caused by obesity.

A

58%

24
Q

Steven is a 56-year-old male who is 5’9” and 200lbs. What is his resting energy expenditure?

A

REE = 1,729.48kcal/day

Convert lbs to kg: 200 / 2.2 = 90.91kg
Convert inches to cm: 69 x 2.54 = 175.26cm
(10 x 90.91) + (6.25 x 175.26) - (5 x 56) + 5
909.1 + 1095.38 - 280 + 5 = 1,729.48kcal/day

25
Q

What is the primary reason for someone having increased body fat?

A

A higher energy intake vs a lower energy expenditure

This is an oversimplification of a complex interaction between various body systems and other factors.

26
Q

According to NHLBI, a BMI of ____-_____ is considered normal

A

18.5-24.9

27
Q

BMI is calculated by:

A

Weight (in kg) / Height² (in meters)

28
Q

What is the type of aerobic exercise recommended for obese clients?

A

Low-impact, rhythmic exercises using large muscle groups such as swimming, dancing, walking, or cycling

29
Q

How long would it take the client below to reach her target body weight, assuming she cuts 250kcal per day and exercises to burn 250kcal per day?

Weight: 168lbs

Percent BF: 33%

Fat-Free Mass: 67%

Target Percent BF: 30%

Target Fat-Free Mass: 70%

A

A little over 7 weeks

FFM lbs = weight x %FFM = 168 x 67% = 112.6lbs
Target body weight = FFM in lbs / target %FFM = 112.6 / 70% = 160.8
Weight loss = Current body weight - desired body weight = 168-160.8 = 7.2lbs
Current suggested defecit = kcal defecit from food + kcal from exercise = 250kcal + 250kcal = 500kcal
500kcal x 7 days per week = 3,500kcal per week (or 1 lb per week because 1 lb of fat is 3,500 kcals)
Weight loss goal in lbs x lbs lost per week = 7.2 x 1 = 7.2 weeks.

30
Q

What is the frequency of aerobic exercise recommended for obese clients?

A

At least three to four days per week with lifestyle activities done several times every day (such as walking the dog)

31
Q

What are some things a health coach could recommend in order to foster calorie reduction goals that could lead to weight loss?

A
  • Reducing calories by 500-1000kcals per day
  • Assess caloric intake and support the client in making a strategy to cut calories every day
  • Practice portion control
  • Reduce consumption of calorie-dense foods with little nutritional value
  • Increase variety of fruits and vegetables
32
Q

How do you calculate waist to hip ratio?

A

Waist measurement / hip measurement

33
Q

What are the chief components of a weight loss program?

A
  • Calorie reduction
  • Physical activity
  • Behavioral strategies
34
Q

Resting energy expenditure is roughly what percentage of a person’s total energy expenditure?

A

60-75%

35
Q

Specific genes associated with body fat account for ____% of the total heritability variation.

A

Less than 5%.

36
Q

Calculate the BMI of a client who is 154 lbs and 5’11”. What class of weight would this person be in?

A

BMI = 21.6, Normal

5’11” = 71 inches
154 lbs / 2.2 = 70 kg
71 inches x 0.0254 = 1.80 m
BMI = 70 / (1.8)² = 70 / 3.24 = 21.6

37
Q

Calculate the BMI of a client who is 169 lbs and 5’3”. What class of weight would this person be in?

A

BMI = 30, Obesity Class 1

5’3” = 63 inches
169 lbs / 2.2 = 76.8 kg
63 inches x 0.0254 = 1.6 m
BMI = 76.8 / (1.6)² = 76.8 / 2.56 = 30

38
Q

What is the role of peptide YY?

A

Peptide YY is released from the intestines and acts similar to other satiety hormones by telling the central nervous system to stop eating.

39
Q

What % body fat is considered to be essential for men and women?

A

Men - 2-5%

Women - 10-13%

A minimal amount of fat is needed for insulation, thermoregulation, hormone production, cushioning, and maintenance of body functions. Women need more fat than males to establish and have healthy menstrual cycles and to have appropriate fat reserves to nourish a fetus.

40
Q

What is the function of adiponectin?

A

Helps insulin by sending blood glucose into the body cells for storage or to be used as fuel.

If a person has a lot of body fat, he or she will typically have lower levels of adiponectin. With low levels of adiponectin, the risk for type 2 diabetes increases.

41
Q

What is the recommended frequency of resistance training for overweight or obese clients?

A

At least two days/week with a day of rest in between sessions.

42
Q

What factors combined often lead to obesity?

A
  • Environmental
  • Behavioral
  • Genetic
  • Hormone
43
Q

What is the intensity of aerobic exercise recommended for obese clients?

A

Moderate intensity

It is best to determine intensity via the talk test method or RPE.

44
Q

What are some things a health coach could recommend in order to foster physical activity goals that could lead to weight loss?

A
  • Increase activity weekly, starting at 50 minutes per week at low intensity
  • Gradually increase activity to 150 minutes per week
  • Strength train at least twice per week
  • Increase non-exercise physical activity throughout the day (standing more, taking the stairs, parking farther away, etc.)
45
Q

What is a more accurate way to determine the risk for cardiovascular disease and other conditions associated with being overweight - BMI or body composition tests such as WHR or body fat percentage?

A

Body composition.

When accessing risk, it is important to identify the client’s current lifestyle before determining a health status based on looks or weight measurements. For example, if you have a client who is currently active and enjoys weight lifting, BMI could be very misleading and read as obese when in reality they have a normal body fat % and just weigh more than what is optimal for their height because of their muscle mass. Furthermore, a client may look like they are at a healthy BMI, but in reality, they have a higher percentage of body fat.

46
Q

Excess body weight is associated with an increased risk for what other conditions?

A
  • Hypertension
  • Type 2 diabetes
  • Gallstones
  • Breathing problems
  • Musculoskeletal disabilities
  • Endometrial, breast, and colon cancer
47
Q

What is the recommended type of resistance training for overweight or obese clients?

A

Exercise all major muscle groups using free weights, machines, or bodyweight exercises.

The mode of exercise is dependent on personal preference, training experience, and goals.

48
Q

What is the recommended intensity of resistance training for overweight or obese clients?

A

A moderate intensity.

Moderate intensity for weight training is a weight that can be lifted safely with proper form 8-15 times.

49
Q

True or False

Genetics play a larger role in determining a person’s BMI than lifestyle.

A

False.

While 40-70% of body composition is genetic, less than 5% of those genes are associated with body fat. While genes are a factor, the more likely culprit of an individual’s body composition is lifestyle factors such as poor nutrition choices, overeating, and a sedentary lifestyle.

50
Q

How do you convert pounds to kg?

A

Lbs / 2.2 = kg

51
Q

What are some things a health coach could recommend in order to foster behavioral goals that could lead to weight loss?

A
  • Practice self-monitoring (record weight, log food, track activity, etc.)
  • Avoid tempting situations
  • Spend more time being around healthy and active individuals
  • Set SMART goals
52
Q

According to NHLBI, a BMI of ____ is considered obese.

A

Above 30.

Obesity class 1 is considered to be a BMI of 30-34.9. Obesity class 2 is a BMI between 35 and 39.9. Extreme obesity or obesity class 3 is a BMI greater than 40.0.

53
Q

What is the function of ghrelin?

A

Ghrelin is the hunger hormone that tells our brain it is time to eat.

54
Q

What is the rate of heritability for BMI?

A

40-70%

This means that BMI is 40-70% affected by genes. BMI is not solely determined by genetics; lifestyle choices have a larger impact on BMI.

ACE ® Health Coach (18 decks)

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