Diet, Exercise, Obesity

Question 1

Obesity Epidemic

Answer 1

Obesity is mainly observed in First-World countries.
Increased obesity relates to higher obesity-related diseases.

Question 2

Diabetes

Answer 2

Food turns into glucose, which can be converted into energy by insulin created in the pancreas.
Diabetic people lack insulin.
Continuous build-up of insulin results in heart disease, amputations, and eye disease.

Question 3

Type 1 Diabetes

Answer 3

The pancreas is unable to create insulin

Question 4

Type 2 Diabetes

Answer 4

The pancreas builds insulin resistance

Question 5

Insulin resistance

Answer 5

Genetic and Behavioral
A high-carb diet releases increased amounts of sugar/glucose in the blood, requiring constant high insulin demand from the pancreas. It results in insulin receptors becoming resistant.
Cycle emerges as resistance leaves starving cells that promote hunger and carvings which lead to unhealthy high-carb diets that release more glucose demanding more insulin.

Question 6

Atherosclerosis

Answer 6

Constriction of blood vessels
Irritants promote LDLs in the blood, they first create endothelial dysfunction as they decrease their permeability. This allows macrophages residing in the cell to flow into the tunica intima where, after eating LDLs they convert into foam cells. As this process continues, the build-up of foam cells in the Tunica intima constricts the blood vessels.
Caused by irritants such as smoking, hyperlipidemia
Causes cardiovascular issues.

Question 7

Metabolic Obese, Normal Weight (MONW)

Answer 7

Physically skinny appearing individuals who have high levels of visceral fat.
They are at risk of obesity-related diseases.

Question 8

Obesity Paradox

Answer 8

MONW individuals are at higher risk of cardiovascular disease and type 2 diabetes than obese and overweight individuals.
Higher BMI individuals have lower morbidity and mortality rates if in cardiovascular disease intervention/coronary artery disease.
Higher mortality risk for diabetes if at “normal” weight.

Question 9

Increased abdominal obesity

Answer 9

Promoted by increased amounts of adipose tissue
Increases inflammation: increased amounts of cytokines such as IL-6, TNF-alpha, and CRP. They increase with stress levels.
Whitehall study: Hierarchy of workplace relates to increased abdominal fat. It is influenced by lower ranks and their lack of agency and control.
Sapolsky study: Baboon’s social status influenced chronic stress levels which can lead to cardiovascular problems and immune deficiency.
Human exposure to chronic stress leads to health problems. Social factors such as control, social support, and environment prediction can aid in suppressing stress.

Question 10

Obesity-Inflammation-Depression Cycle

Answer 10

Obesity promotes inflammation.
Inflammation promotes pain and fatigue. It promotes depression as well (both ways).
Pain, fatigue, and depression sickness behavior promote inactivity and diet changes
Inactivity and diet changes promote obesity.

Question 11

Stress role

Answer 11

Inflammation
Stress increases cortisol, which increases pro-inflammatory cytokines, which increases pain, which increases sickness behavior, which increases diet, which increases obesity.
Adipose tissue
Stress increases adipose tissue. Adipose tissue normally increases lepting but with high levels of this tissue, leptin resistance occurs. This leaves the individual feeling hungry and leads to overeating and obesity.

Question 12

Obesogenic environment

Answer 12

Normalizing product sizing as bigger size into regular/small size.
High sugar levels in food, prioritizing taste.
Socio-economic demographic factor: healthy food availability is for higher economic status groups, leaving lower groups only affording processed, convenient, and reachable unhealthy foods.

Question 13

Sugar

Answer 13

Food is saturated in sugar, where WHO guidelines recommend 25g of free sugar per day but most servings are over recommendation.
Free sugar: monosaccharides/disaccharides added to foods that already contain natural sugar.

Question 14

Just eat less: Energy Surfeit Theory

Answer 14

A lower caloric intake than what it is used will promote weight loss.

Question 15

Energy Balance Equation

Answer 15

Energy intake = internal heat produced + external work + energy stored
Calories are burned differently because of different metabolic processes for different types of nutrients

Question 16

Just exercise more

Answer 16

Exercise needed for long-term loss maintenance far exceeds capacity for most people

Question 17

Hall: Mathematical Model of Weight Loss

Answer 17

Base energy by weight takes a prolonged amount of time to burn off weight.

Question 18

Changing the environment

Answer 18

Smoking used graphic design to lower smokers
The sugar tax on soda tried to prevent sugar intake but resulted in an angry response.
The ban on obesity, started with fast food commercial ban where they only appeared after 9 pm, to decrease exposure.

Question 19

TLC intervention

Answer 19

Kaluli Tribe
Despite high infant mortality and parasitic infections, they experience a low rate of clinical depression due to their physically active, socially connected, and outdoor-oriented lifestyles.
Physical activity: 30 mins 3 times a week.
Omega 6(inflammatory):Omega 3(anti-inflammatory) ratio: 2:1 or 1:1 whilst American ratio is 1:17.

Question 20

Physical activity

Answer 20

An increase in exercise shows a decrease in mortality.
It aids cardiovascular and muscular/mobility.
Prevents mental health and cognitive issues.

Question 21

Physical health impact on the stress system

Answer 21

Physical activity triggers the HPA axis ( central stressor system)
Activating the axis through moderate activity strengthens stress response leading to adaption where cortisol levels decrease in response to stress.
It reduces allostatic load and stress-related illnesses.

Question 22

Physical activity reduces inflammation

Answer 22

The inverse relationship between physical activity/aerobic exercise and pro-inflammatory markers.
The intensity of activity relates to stress on activity, therefore little amounts of activity will aid the body whilst high amounts will create more strain on the body.

Question 23

Physical activity and mental health

Answer 23

Engaging in exercise has beneficial effects on mood, trait anxiety, and perceived stress.
Reduction of pro-inflammatory cytokines, which relate to bad mood, improves mood.
Intervention to regulate mood in mild to moderate depression relates to a higher trait in mindfulness.
Mindfulness is associated with lower depressive and anxiety symptoms.

Question 24

Physical activity and cognitive function

Answer 24

Exercise stimulates neurogenesis, the development of neurons in the brain, particularly in the hippocampus resulting in increased hippocampal volume. Increasing working and long-term memory.
Sapolsky: stress in the hippocampal region results in shorting of dendrites and cell death.
Exercise increases blood flow to the prefrontal cortex, increasing planning and reasoning and increasing learning and attention.
Reduces age-related decline in hippocampal volume and lowers the risk of Alzheimer’s disease and dementia.

Question 25

Impact on exercise behavior

Answer 25

Environmental: urban design and access
Socio-environmental: Increased technology, safety, and accessibility.
Sociocultural: Cultural norms and ideals, values, health education