Exam 1: Energy and Weight loss Flashcards
1
Q
Involuntary energy needs
A
circulation, respiration, digestion, absorption
2
Q
Types of energy
A
chemical, electrical, mechanical, thermal
3
Q
Voluntary energy needs
A
conscious activities of daily living and physical exercise
4
Q
Kilocalorie or Calorie is
A
the heat necessary to raise the temperature of 1 kg of water by 1 C
5
Q
calorie
A
heat necessary to raise the temperature of 1 g of water by 1 C
6
Q
Kilojoules (kJ)
A
1 kcal= 4.184 kJ
7
Q
Main source of ATP
A
carbs- 4 kcal/g
8
Q
Secondary source of ATP
A
Lipids- 9 kcal/g
9
Q
Last source of energy
A
Proteins= 4 kcal/g
10
Q
foods with high energy density
A
candy, chips, avocados, butter
11
Q
foods with low energy density
A
veggies
12
Q
Foods with high nutrient density
A
veggies, fruit, nuts
13
Q
Foods with low nutrient density (empty calories)
A
Soda, donuts, cake, cookies
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
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
16
Q
Energy intake in diet
A
food, beverages, supplements
17
Q
Stored energy
A
Glycogen- 12-48 hr reserve
Adipose- Tens of thousands of Cal stored
Muscle- used for Energy during fasting
18
Q
Basal metabolism
A
energy required to maintain life with body at complete rest
19
Q
BMR represents ______ of total energy expenditure
A
60-75%
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
21
Q
Body composition affect on BMR
A
Males have a higher lean mass= higher BMR
Fat tissue = decreased BMR
**Greatest impact on BMR
22
Q
BMR increases _____ for every __F
A
7% for every 1 degree F
23
Q
PMS hormones ______ BMR
A
increase
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
25
Harris- Benedict BMR calculation
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)]
26
Daily activity represents ______ of total energy expenditure
20-40%
27
Daily activity is a combination of
activity thermogenesis (AT) and Nonexercise activity thermogenesis (NEAT)
28
Activity Thermogenesis
energy used during sports or fitness exercise
29
Nonexercise activity thermogenesis (NEAT)
activities of daily living and energy expended during leisure activities (chewing gum)
30
Factors affecting AT
Body size
fitness level
Excess post-exercise oxygen consumption (EPOC)
31
Body size affect on AT
as your body size decreases you're burning less
32
EPOC
increased metabolic rate that occurs after exercise as ceased (related to lean mass)
- more lean mass, more EPOC
33
thermic Effect of Food (TEF)
Represents about 10% of total energy expenditure
34
Factors affecting TEF
- Meal consumption (protein>carbs>lipids)
| - Meal timing (energy expenditure is raised 30-90 minutes after meal)
35
Thermic effect of proteins
Most affect
| increases 20-30%
36
Thermic effect of carbs
increases 5-10%
37
Thermic effect of lipids
increases Energy 0-5%
38
a mixed macronutrient meal is estimated to have a thermic effect of
10% of Calories
39
Dietary guidelines for energy
- 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
40
10% of calories must be for
Thermic effect of foods
41
Percent of healthy of underweight people in the U.S
29%
42
Percent of overweight people in the US
31%
43
Percent of obese people in the US
34%
44
A good assessment of body weight includes
- BMI
- Waist circumference
- Neck circumference
- Waist to hip ratio
- Waist to height ratio
- Neck to waist ratio
45
Normal BMI ranges between
18.5- 24.9
46
Unhealthy waist circumferences
Men > or 40 inches
| Women > 35 inches
47
Unhealthy Neck circumferences
Men > 14.57 inches
| Women > 13 inches
48
unhealthy Waist to hip ratio
Men > 0.95
| Women >0.80
49
Neck to waist ratio
no cutoffs set
50
Body composition is made up of
fat mass and lean body mass (Fat-free mass)
51
Fat mass includes
```
essential fat (CNS, kidneys, not in adipose)
storage fat
```
52
Lean body mass includes
muscle, bone, and fluid
53
Ways to measure body composition
Calipers, hydrostatic weighing, bioelectric impedance, air displacement, dual energy x-ray absorptiometry
54
body fat calipers have an error rate of
3-4%
55
Hydrostatic weighing is
the weight of water displaced determines body fat using density
56
Bioelectrical impedance
electrical conductivity measured in extremities
57
To do a bioelectrical impedance test the patient must
be well hydrated, not exercised for 4-6 hours and not have had caffeine, alcohol or diuretics for 24 hours
58
Air displacement measures
chance in press due to volume of person
59
Dual energy X-ray absorptiometry (DEXA)
scans with X-rays to 2 energy levels. also determines bone density
60
Causes of obesity
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
The higher the income of a country the _______ the country was
more sedentary
62
Overeating induces
inflammation
63
_____ sleep alters hormones
shortened
64
Stress induces _____ release which _____ appetite
cortisol, increases
65
Portions sizes have ______ in 30 years
doubled
66
Obesogens
endocrine disrupters (BPA, phthalates)
67
There are at least 10 known
adipogenic pathogens (viruses)
68
Gut microflora influence on obesity
an imbalance of microflora
| Firmicutes > bacteriodetes
69
Signals in weight management
Neurotransmitters, gut hormones, and other hormones
70
Neurotransmitters involved in weight management
Norepinephrine, dopamine, serotonin, orexin
71
Gut hormones involved in weight management
Leptin, gherkin, incretins (GLP-1, GLP), CCK, insulin, glucagon, resistin
72
Other hormones involved in weight management
thyroid, visfatin, adrenomedullin
73
Lepin in obesity
- produced by adipocytes
- signals satiety in hypothalamus
- 3% of those with severe early-onset obesity lack working leptin receptors
74
Gherkin in obesity
- secreted from GI Tract to signal hunger in hypothalamus
| - able to cross BBB
75
2 types of adipose tissue
White adipose tissue (WAT)
| Brown adipose tissue (BAT)
76
WAT
- 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
BAT
- Stored TG in moltiocular adipocyte as quick-access fuel for heat production in thermogenesis
- High rates of active uncoupling proteins
78
BAT is found in
high concentration in infants, some healthy adults contain BAT (inversely related to age, outdoor temperature and BMI)
- founding cervical and supraclavicular regions
79
All adipose tissue contains genes for
BAT
80
What could get WAT to express BAT genes?
Cold weather or introduction of cold stimulus (beiging)
81
Android- type obesity
Male type
apple shaped
more visceral adipose, associated with more health risks
82
Gynoid-type obesity
female type
pear shaped
fat accumulation in hips, butt and thighs
83
Visceral fat
stored around organs. Main cause of central obesity and very metabolically active
84
Subcutaneous fat
stored around hips, thighs, or exterior of abdominal muscle (beneath skin)
85
Visceral fat is _________ than subcutaneous fat
easier to lose
86
Exercise (with or without weight loss) leads to
reduction of VAT (
87
Lipoprotein Lipase is a major determinant in
obesity development
| - more active in obese people than lean people
88
Activity of Lipoprotein lipase
- makes fat storage more efficient
- varies in different parts of body (males: abdomen; Females: breasts, hips, thighs)
- increases after weight loss
89
Body's response to nutritional overload
Adipotoxicity
| Lipotoxicity
90
Adipotoxicity
negative effects of storage of excess fat in adipose tissue
| TNF- alpha and IL-6
91
TNF- alpha
- Phosphorylates IRS-1 causing insulin resistance
- Promotes beta cell apoptosis
- Stimulates lipolysis
92
IL-6
- 30% of plasma IL-6 from adipose (visceral)
- Linked to insulin resistance
- Protective effect against beta cell apoptosis
- Stimulates lipolysis
93
Adipotoxicity is increased secretion of
adipokines from adipose tissue
94
Leptin inhibits
insulin secretion from beta cells
| - leptin resistance is seen in obese individuals
95
Adiponectin is
decreased during obesity
| - induces insulin sensitivity in muscle and adipose tissue
96
Resisting increases during
obesity
- decreases muscle ability to take up fatty acids
- stimulates lipolysis
97
Lipotoxicity is the
leakage of nutrients that accumulate in other organs
98
Non-adipose tissue accumulation of FFA results in
```
Pancreas: beta cell failure
Liver: non-alcoholic fatty liver disease
Muscles: insulin resistance
heart: heart disease
Endothelium vasoconstriction: HTN
```
99
Fasting increases likelihood of
ketoacidosis, low BP, electrolyte imbalance and catabolism of lean muscle
*After resuming food intake, body has tendency to store MORE fat
100
Fad Diets ______ scientific evidence to support cause and ________ address behaviors and food habits
don't have, fail to
101
Paleo diets are deficient in
Ca and vitamin D
102
South beat diet practicality
first phase is very restrictive, later phases are more practical
103
Zone diet practicality
Plain/ unappealing meals, veggie portions are very large
104
Atkins diet is very ______ and patients usually follow for _____
restrictive, 6 months max
105
hCG diet increases likelihood of
thromboembolism, hypothyroidism, bone mineral loss and anxiety
106
Specific Macronutrient restrictions can lead to ______-
```
micronutrient deficiencies
(no need to avoid certain food groups)
```
107
Clothing and body wraps may
decrease body weight for a bit, but can't melt off fat
108
Amphetamines have ______ side effects
cardiovascular
109
Obesity drugs usually work by
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
Weight loss surgery reduces _________ but increases risk of ________-
likelihood of death, increases risk of dumping syndrome
111
Deficiencies caused by bariatric surgery
Iron, calcium, vitamin D, Vitamin B12
112
ABC's of behavior modifications
Antecedent- what stimulates the behavior
Behavior- what is the behavior
Consequence- what happens after the response to the behavior that reinforces it
113
Ways to modify behaviors
Goal setting, self-monitoring, stimulus control, cognitive restructuring
114
SMART goals
Specific, Measurable, Attainable, Realistic, Timely
115
Self-monitoring includes
food diaries, regular weigh-ins, etc.
116
Cognitive restructuring
identify, challenge and correct negative thoughts
117
Claims for food fads
- food cures
- harmful foods
- food combinations
- natural foods
118
Causes of underweight
- 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
Treatment of underweight
1. higher Calorie intake
| 2. nutrient dense foods
120
upping Calorie intake to treat underweight should be done with
High protein to rebuild tissues
high carbs (easily digestible)
moderate fat
121
Normal eating involves
- 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
Disordered eating is ____________ and most likely to occur in
any eating that is not normal, Most likely to occur in perfectionists with negative emotionality, impulsivity, possible serotonin imbalance
123
Screening for eating disorders
SCOFF (sick, control, one, fat, food)
124
SCOFF
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
2-3 "yes" answers in a SCOFF screening
Likelihood ratio of 6.2
126
4 or 5 "yes" answers in a SCOFF screening
yields likelihood ratio of 11
127
Prevalence of anorexia nervosa
0.9% of women; 0.3% of men
128
Features of Anorexia nervosa
genetics involved, restrictive eating patterns, high level of exercise, body dysmorphic disorder, OCD, perfectionism, negative self-evaluation
129
Bulimia Nervosa prevalence
Women: 1.5%
Men: 0.5%
130
Bulimia nervosa
episodes of binging followed by a compensatory behavior
131
Russell's sign
marks on knuckles of those with bulimia nervosa from hitting their teeth when inducing vomit
132
Patients with anorexia nervosa have more
heart problems due to hypokalemia
133
Patients with bulimia nervosa have more
GI side effects
134
Patients with _______ may develop lanugo
anorexia nervosa
135
Binge eating disorder prevalence
Women: 2.9%
Men: 3.0%
136
Binge eating disorder involves
binging without the compensatory behavior
137
Pica is often found in
kids, pregnant women, and autistic patients
138
Ice cravings are associated with
iron deficiency (ONLY known nutritional deficiency)
139
Most common things eaten with Pica
ice and dirt
140
Specified feeding or eating disorders
- Atypical anorexia nervosa
- binge eating disorder of low frequency
- bulimia nervosa of low frequency
- purging disorder
- night eating syndrome
141
Treatment of eating disorders
- team therapy
- neurologic imbalance due to weight loss
- weight regain is most important
- eating habits
- continued social support
