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Nutrition > Exam 1: Energy and Weight loss > Flashcards

Exam 1: Energy and Weight loss Flashcards

1
Q

Involuntary energy needs

A

circulation, respiration, digestion, absorption

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2
Q

Types of energy

A

chemical, electrical, mechanical, thermal

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3
Q

Voluntary energy needs

A

conscious activities of daily living and physical exercise

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4
Q

Kilocalorie or Calorie is

A

the heat necessary to raise the temperature of 1 kg of water by 1 C

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5
Q

calorie

A

heat necessary to raise the temperature of 1 g of water by 1 C

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6
Q

Kilojoules (kJ)

A

1 kcal= 4.184 kJ

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7
Q

Main source of ATP

A

carbs- 4 kcal/g

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8
Q

Secondary source of ATP

A

Lipids- 9 kcal/g

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9
Q

Last source of energy

A

Proteins= 4 kcal/g

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10
Q

foods with high energy density

A

candy, chips, avocados, butter

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11
Q

foods with low energy density

A

veggies

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12
Q

Foods with high nutrient density

A

veggies, fruit, nuts

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13
Q

Foods with low nutrient density (empty calories)

A

Soda, donuts, cake, cookies

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14
Q

External energy cycle

A

Plants transform sun’s energy, carbon dioxide and water into glucose
- movement up food chain with animals eating plants

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15
Q

Internal energy cycle

A

Consumption of plant and animal energy yields building blocks
- metabolism of nutrients produces carbon dioxide water that are excreted

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16
Q

Energy intake in diet

A

food, beverages, supplements

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17
Q

Stored energy

A

Glycogen- 12-48 hr reserve
Adipose- Tens of thousands of Cal stored
Muscle- used for Energy during fasting

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18
Q

Basal metabolism

A

energy required to maintain life with body at complete rest

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19
Q

BMR represents ______ of total energy expenditure

A

60-75%

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20
Q

Factors affecting BMR

A
  • Age (decreases with age)
  • Body size (increases with size; tall thin people have highest)
  • Body composition (gender)
  • Hormonal status (thyroid, PMS)
  • Other: caffeine, fever, extreme temperature, stress
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21
Q

Body composition affect on BMR

A

Males have a higher lean mass= higher BMR
Fat tissue = decreased BMR

**Greatest impact on BMR

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22
Q

BMR increases _____ for every __F

A

7% for every 1 degree F

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23
Q

PMS hormones ______ BMR

A

increase

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24
Q

Mifflin- St Jeor BMR calculation

A

Women: [10 x weight(kg)] + [6.25 x (cm) - [5 x age (y)] -161

Men: same as women except replace the (-161) with a +5

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25
Q

Harris- Benedict BMR calculation

A

Women: 655 + [4.35 x weight (lb)] + [4.7 x heigh (in)] - [4.7 x age (yr)]

Men: 66 + [6.23 x weight (lb)] + [12.7 x height (in)] - [6.8 x age (yr)]

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26
Q

Daily activity represents ______ of total energy expenditure

A

20-40%

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27
Q

Daily activity is a combination of

A

activity thermogenesis (AT) and Nonexercise activity thermogenesis (NEAT)

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28
Q

Activity Thermogenesis

A

energy used during sports or fitness exercise

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29
Q

Nonexercise activity thermogenesis (NEAT)

A

activities of daily living and energy expended during leisure activities (chewing gum)

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30
Q

Factors affecting AT

A

Body size
fitness level
Excess post-exercise oxygen consumption (EPOC)

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31
Q

Body size affect on AT

A

as your body size decreases you’re burning less

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32
Q

EPOC

A

increased metabolic rate that occurs after exercise as ceased (related to lean mass)
- more lean mass, more EPOC

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33
Q

thermic Effect of Food (TEF)

A

Represents about 10% of total energy expenditure

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34
Q

Factors affecting TEF

A
  • Meal consumption (protein>carbs>lipids)

- Meal timing (energy expenditure is raised 30-90 minutes after meal)

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35
Q

Thermic effect of proteins

A

Most affect

increases 20-30%

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36
Q

Thermic effect of carbs

A

increases 5-10%

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37
Q

Thermic effect of lipids

A

increases Energy 0-5%

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38
Q

a mixed macronutrient meal is estimated to have a thermic effect of

A

10% of Calories

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39
Q

Dietary guidelines for energy

A
  • choose healthy eating pattern that is energy appropriate for healthy weight and decrease chance of chronic disease
  • meet nutrients within limits
  • choose nutrient dense foods of all groups
  • Meet requirements by eating whole foods
  • Limit Calories from added sugars and saturated fats
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40
Q

10% of calories must be for

A

Thermic effect of foods

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41
Q

Percent of healthy of underweight people in the U.S

A

29%

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42
Q

Percent of overweight people in the US

A

31%

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43
Q

Percent of obese people in the US

A

34%

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44
Q

A good assessment of body weight includes

A
  • BMI
  • Waist circumference
  • Neck circumference
  • Waist to hip ratio
  • Waist to height ratio
  • Neck to waist ratio
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45
Q

Normal BMI ranges between

A

18.5- 24.9

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46
Q

Unhealthy waist circumferences

A

Men > or 40 inches

Women > 35 inches

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47
Q

Unhealthy Neck circumferences

A

Men > 14.57 inches

Women > 13 inches

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48
Q

unhealthy Waist to hip ratio

A

Men > 0.95

Women >0.80

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49
Q

Neck to waist ratio

A

no cutoffs set

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50
Q

Body composition is made up of

A

fat mass and lean body mass (Fat-free mass)

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51
Q

Fat mass includes

A 
essential fat (CNS, kidneys, not in adipose)
storage fat
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52
Q

Lean body mass includes

A

muscle, bone, and fluid

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53
Q

Ways to measure body composition

A

Calipers, hydrostatic weighing, bioelectric impedance, air displacement, dual energy x-ray absorptiometry

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54
Q

body fat calipers have an error rate of

A

3-4%

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55
Q

Hydrostatic weighing is

A

the weight of water displaced determines body fat using density

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56
Q

Bioelectrical impedance

A

electrical conductivity measured in extremities

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57
Q

To do a bioelectrical impedance test the patient must

A

be well hydrated, not exercised for 4-6 hours and not have had caffeine, alcohol or diuretics for 24 hours

58
Q

Air displacement measures

A

chance in press due to volume of person

59
Q

Dual energy X-ray absorptiometry (DEXA)

A

scans with X-rays to 2 energy levels. also determines bone density

60
Q

Causes of obesity

A
  1. Genetics
  2. Sedentary lifestyle
  3. Inflammation
  4. Sleep patterns and stress
  5. Taste, satiety, and portions
  6. Obesogens
  7. Viruses
  8. Gut microflora
61
Q

The higher the income of a country the _______ the country was

A

more sedentary

62
Q

Overeating induces

A

inflammation

63
Q

_____ sleep alters hormones

A

shortened

64
Q

Stress induces _____ release which _____ appetite

A

cortisol, increases

65
Q

Portions sizes have ______ in 30 years

A

doubled

66
Q

Obesogens

A

endocrine disrupters (BPA, phthalates)

67
Q

There are at least 10 known

A

adipogenic pathogens (viruses)

68
Q

Gut microflora influence on obesity

A

an imbalance of microflora

Firmicutes > bacteriodetes

69
Q

Signals in weight management

A

Neurotransmitters, gut hormones, and other hormones

70
Q

Neurotransmitters involved in weight management

A

Norepinephrine, dopamine, serotonin, orexin

71
Q

Gut hormones involved in weight management

A

Leptin, gherkin, incretins (GLP-1, GLP), CCK, insulin, glucagon, resistin

72
Q

Other hormones involved in weight management

A

thyroid, visfatin, adrenomedullin

73
Q

Lepin in obesity

A
  • produced by adipocytes
  • signals satiety in hypothalamus
  • 3% of those with severe early-onset obesity lack working leptin receptors
74
Q

Gherkin in obesity

A
  • secreted from GI Tract to signal hunger in hypothalamus

- able to cross BBB

75
Q

2 types of adipose tissue

A

White adipose tissue (WAT)

Brown adipose tissue (BAT)

76
Q

WAT

A
  • Store excess E at TG in unilocular adipocyte
  • Release FFA when needed
  • Visceral and subcutaneous adipose
  • Oxidation heat is ATP generation coupled with heat release
77
Q

BAT

A
  • Stored TG in moltiocular adipocyte as quick-access fuel for heat production in thermogenesis
  • High rates of active uncoupling proteins
78
Q

BAT is found in

A

high concentration in infants, some healthy adults contain BAT (inversely related to age, outdoor temperature and BMI)
- founding cervical and supraclavicular regions

79
Q

All adipose tissue contains genes for

A

BAT

80
Q

What could get WAT to express BAT genes?

A

Cold weather or introduction of cold stimulus (beiging)

81
Q

Android- type obesity

A

Male type
apple shaped
more visceral adipose, associated with more health risks

82
Q

Gynoid-type obesity

A

female type
pear shaped
fat accumulation in hips, butt and thighs

83
Q

Visceral fat

A

stored around organs. Main cause of central obesity and very metabolically active

84
Q

Subcutaneous fat

A

stored around hips, thighs, or exterior of abdominal muscle (beneath skin)

85
Q

Visceral fat is _________ than subcutaneous fat

A

easier to lose

86
Q

Exercise (with or without weight loss) leads to

A

reduction of VAT (

87
Q

Lipoprotein Lipase is a major determinant in

A

obesity development

- more active in obese people than lean people

88
Q

Activity of Lipoprotein lipase

A
  • makes fat storage more efficient
  • varies in different parts of body (males: abdomen; Females: breasts, hips, thighs)
  • increases after weight loss
89
Q

Body’s response to nutritional overload

A

Adipotoxicity

Lipotoxicity

90
Q

Adipotoxicity

A

negative effects of storage of excess fat in adipose tissue

TNF- alpha and IL-6

91
Q

TNF- alpha

A
  • Phosphorylates IRS-1 causing insulin resistance
  • Promotes beta cell apoptosis
  • Stimulates lipolysis
92
Q

IL-6

A
  • 30% of plasma IL-6 from adipose (visceral)
  • Linked to insulin resistance
  • Protective effect against beta cell apoptosis
  • Stimulates lipolysis
93
Q

Adipotoxicity is increased secretion of

A

adipokines from adipose tissue

94
Q

Leptin inhibits

A

insulin secretion from beta cells

- leptin resistance is seen in obese individuals

95
Q

Adiponectin is

A

decreased during obesity

- induces insulin sensitivity in muscle and adipose tissue

96
Q

Resisting increases during

A

obesity

  • decreases muscle ability to take up fatty acids
  • stimulates lipolysis
97
Q

Lipotoxicity is the

A

leakage of nutrients that accumulate in other organs

98
Q

Non-adipose tissue accumulation of FFA results in

A 
Pancreas: beta cell failure
Liver: non-alcoholic fatty liver disease
Muscles: insulin resistance
heart: heart disease
Endothelium vasoconstriction: HTN
99
Q

Fasting increases likelihood of

A

ketoacidosis, low BP, electrolyte imbalance and catabolism of lean muscle
*After resuming food intake, body has tendency to store MORE fat

100
Q

Fad Diets ______ scientific evidence to support cause and ________ address behaviors and food habits

A

don’t have, fail to

101
Q

Paleo diets are deficient in

A

Ca and vitamin D

102
Q

South beat diet practicality

A

first phase is very restrictive, later phases are more practical

103
Q

Zone diet practicality

A

Plain/ unappealing meals, veggie portions are very large

104
Q

Atkins diet is very ______ and patients usually follow for _____

A

restrictive, 6 months max

105
Q

hCG diet increases likelihood of

A

thromboembolism, hypothyroidism, bone mineral loss and anxiety

106
Q

Specific Macronutrient restrictions can lead to ______-

A 
micronutrient deficiencies 
(no need to avoid certain food groups)
107
Q

Clothing and body wraps may

A

decrease body weight for a bit, but can’t melt off fat

108
Q

Amphetamines have ______ side effects

A

cardiovascular

109
Q

Obesity drugs usually work by

A
  1. reducing energy intake by suppressing appetite
  2. Increase energy expenditure by stimulating BMR
  3. Reduce absorption of food in the gut
  4. Alter lipogenesis and lipolysis
110
Q

Weight loss surgery reduces _________ but increases risk of ________-

A

likelihood of death, increases risk of dumping syndrome

111
Q

Deficiencies caused by bariatric surgery

A

Iron, calcium, vitamin D, Vitamin B12

112
Q

ABC’s of behavior modifications

A

Antecedent- what stimulates the behavior
Behavior- what is the behavior
Consequence- what happens after the response to the behavior that reinforces it

113
Q

Ways to modify behaviors

A

Goal setting, self-monitoring, stimulus control, cognitive restructuring

114
Q

SMART goals

A

Specific, Measurable, Attainable, Realistic, Timely

115
Q

Self-monitoring includes

A

food diaries, regular weigh-ins, etc.

116
Q

Cognitive restructuring

A

identify, challenge and correct negative thoughts

117
Q

Claims for food fads

A
  • food cures
  • harmful foods
  • food combinations
  • natural foods
118
Q

Causes of underweight

A
  • wasting bc of chronic infection
  • poor food intake
  • malabsorption
  • hormonal imbalance (thyroid)
  • increase in physical activity w/o increase in E intake
  • poor living situation
119
Q

Treatment of underweight

A
  1. higher Calorie intake

2. nutrient dense foods

120
Q

upping Calorie intake to treat underweight should be done with

A

High protein to rebuild tissues
high carbs (easily digestible)
moderate fat

121
Q

Normal eating involves

A
  • Eating when hungry, stopping when full
  • Demonstrating restraint with food selection
  • Recognizing over and under eating are something acceptable
  • Having ability to be flexible with eating schedule
122
Q

Disordered eating is ____________ and most likely to occur in

A

any eating that is not normal, Most likely to occur in perfectionists with negative emotionality, impulsivity, possible serotonin imbalance

123
Q

Screening for eating disorders

A

SCOFF (sick, control, one, fat, food)

124
Q

SCOFF

A
  1. Do you make yourself SICK because you feel uncomfortable full
  2. Do you worry you have lost CONTROL over how much you eat?
  3. Have you recently lost more than ONE stone (14 lb) in a 3 month period
  4. Do you believe yourself to be FAT when others say you are too thin?
  5. Would you say FOOD dominates your life?
125
Q

2-3 “yes” answers in a SCOFF screening

A

Likelihood ratio of 6.2

126
Q

4 or 5 “yes” answers in a SCOFF screening

A

yields likelihood ratio of 11

127
Q

Prevalence of anorexia nervosa

A

0.9% of women; 0.3% of men

128
Q

Features of Anorexia nervosa

A

genetics involved, restrictive eating patterns, high level of exercise, body dysmorphic disorder, OCD, perfectionism, negative self-evaluation

129
Q

Bulimia Nervosa prevalence

A

Women: 1.5%
Men: 0.5%

130
Q

Bulimia nervosa

A

episodes of binging followed by a compensatory behavior

131
Q

Russell’s sign

A

marks on knuckles of those with bulimia nervosa from hitting their teeth when inducing vomit

132
Q

Patients with anorexia nervosa have more

A

heart problems due to hypokalemia

133
Q

Patients with bulimia nervosa have more

A

GI side effects

134
Q

Patients with _______ may develop lanugo

A

anorexia nervosa

135
Q

Binge eating disorder prevalence

A

Women: 2.9%
Men: 3.0%

136
Q

Binge eating disorder involves

A

binging without the compensatory behavior

137
Q

Pica is often found in

A

kids, pregnant women, and autistic patients

138
Q

Ice cravings are associated with

A

iron deficiency (ONLY known nutritional deficiency)

139
Q

Most common things eaten with Pica

A

ice and dirt

140
Q

Specified feeding or eating disorders

A
  • Atypical anorexia nervosa
  • binge eating disorder of low frequency
  • bulimia nervosa of low frequency
  • purging disorder
  • night eating syndrome
141
Q

Treatment of eating disorders

A
  • team therapy
  • neurologic imbalance due to weight loss
  • weight regain is most important
  • eating habits
  • continued social support

Nutrition (10 decks)

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