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Winter 2021 > EXSC 480 Exam 2 > Flashcards

EXSC 480 Exam 2 Flashcards

1
Q

Things that need to be evaluated before beginning a weight loss program

A 
Risk
Motivation
Medical History 
Body weight history 
diet history 
Repro history 
Social history 
Drug history
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2
Q

Risk is based off of

A 
BMI
Wasit circumference
Coronary Risk
Diabetes 
Dyslipidemia
Cigarette smoking
Sleep apnea
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3
Q

Motivation steps

A 
Precontemplation
Contemplation
Preparation 
Action
Maintenance
Termination
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4
Q

Medical history

A

Risk factors

CVD, diabetes, hypertension, gallstones, etc

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5
Q

Physical Exams

A

Vital signs
BMI
BP/HR, fasting lipids, blood sugar levels
sleep apnea

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6
Q

sleep apnea symptoms

A 
STOP BANG
snoring
tired
apnea
pressure

BMI >35
age >50
neck circumference >16 in
Gender

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7
Q

Body weight history

A 
weight gain/loss over time
previous weight loss attempts
diet history
PA 
family history
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8
Q

Social history

A

cigarette smoking

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9
Q

Body compartments

A

Fat mass

Fat Free mass

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10
Q

Fat-free mass

A

everything excluding fat

bone, body water (73%), protein

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11
Q

Anthropometric clinical tools

A

height/weight
skinfold thickness
bodily circumference

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12
Q

Body composition clinical tools

A

BIA
DXA
BOD POD
Hydrostatic weighing

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13
Q

Imaging clinical techniques

A

MRI
CT Scan
Ultrasound

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14
Q

BMI strengths

A

easy to use on large populations

quick, effective, inexpensive

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15
Q

BMI weaknesses

A

only assesses weight not % body fat

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16
Q

Skinfolds strengths

A

easy to use, quick, effective, inexpensive

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17
Q

Skinfold weaknesses

A

age/gender, skill of person giving test, prediction equations

greatest error

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18
Q

BIA strength

A

easy to use, quik, effective

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19
Q

BIA weaknesses

A

hydration
temp
menstruation
not as good as skinfold

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20
Q

hydrostatic weighing strengths

A

more accurate than skinfolds or BMI

2 compartment

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21
Q

hydrostatic weighing weaknesses

A

varies w/menstruation

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22
Q

BOD POD strengths

A

retest reliability
suited for many people
quick
easy to use

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23
Q

BOD POD weaknesses

A

expesnive

not common

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24
Q

DXA strengths

A

GOLD STANDARD

high validity, closest to CT/MRI

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25
Q

DXA weaknesses

A

expensive
type of beam
hydration

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26
Q

CT/MRI strengths

A

noninvasive
most accurate
measures all body compartments

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27
Q

CT/MRI weaknesses

A

high cost
time consuming
need experts

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28
Q

optimal method for research studies would…

A

correlate w/dietary intake
 Be free of social bias
 Be independent of patient memory
 Not be limited by subject’s ability to describe the food
 Not influence how the patient eats normally
 Be inexpensive

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29
Q

is there a gold standard for dietary assessment?

A

no

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30
Q

Duplicate diet approach

A

collection of duplicate diet samples

ACTUAL INTAKE

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31
Q

Duplicate diet strengths

A

measurement of dietary exposures possible

actual intake

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32
Q

Duplicate diet weaknesses

A

expensive

not suitable for large groups

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33
Q

Food consumption record

A

household’s normal diet is assessed/viewed by trained staff

actual intake info

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34
Q

Food consumption strengths

A

ease of application

actual intake

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35
Q

Food consumption weaknesses

A

doesn’t focus on the individual, focuses on group

only works if they eat at home

interviewers

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36
Q

24-hour dietary recall

A

subjective
open-ended
trained interviewer asks questions about food eaten over the past day

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37
Q

24-hour dietary recall strenghts

A

small respondent burden
detailed
easy

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38
Q

24-hour dietary recall weaknesses

A

recall bias
trained interviewer
expensive and time-consuming

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39
Q

Dietary record

A

subjective mesure

self-administered, questionnaire

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40
Q

Dietary record strenghts

A

no interviewer required
no recall bias
detailed, actual intake info

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41
Q

Dietary record weaknesses

A

large respondent burden

can influence intake over a few days

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42
Q

Dietary history

A

subjective
open and closed questions
trained interviewer
USUAL intake over long time

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43
Q

Dietary history strengths

A

usual dietary intake

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44
Q

Dietary history weaknesses

A

high cost and time consuming

not suitable for epidemiological studies

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45
Q

Food frequency questionnaire

A

subjective mesure that asks what foods have been eaten and how often
self or interviewer
USUAL intake for longgg time periods

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46
Q

Food frequency questionnaire strengths

A

suitable for epidemiological studies
simple
cost effective

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47
Q

Food frequency questionnaire weaknesses

A

low accuracy
recall bias
close ended
relies on memory

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48
Q

RMR

A

resting metabolic rate or energy required to keep your body functioning

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49
Q

RMR supports

A

breathing, blood movement, organs, and neuro functions

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50
Q

RMR increases with

A

BMI

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51
Q

RMR is determined by

A

weight
height
age

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52
Q

equations used to figure out RMR

A

harris-benedict

mifflin st. jeor

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53
Q

TDEE activity factors

A

increases as you become more active or injuries/illness can increase RMR

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54
Q

indirect calorimetry

A

amount of oxygen consumed under resting conditions

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55
Q

Recommendations for diets/calories

A

500-750 kcal per day deficit
1200-1500 for women
1500-1800 for men

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56
Q

Energy deficits

A

BMR/RMR
adjust for activity and stress levels
estimate nutrition needs
energy deficit level

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57
Q

Why is PA essential for weight loss?

A

exercise only accounts for 15-30% of energy expenditure

PA increases/multiplies the METs

EE quantifies PA and measures PA

58
Q

1 MET

A

3.5 mL/kg/min

59
Q

5 kcal

A

1 L of oxygen

60
Q

1 KG

A

2.2 lbs

61
Q

how to calculate energy expenditure?

A

intensity (METS) x Duration (time) x Body Mass

62
Q

Direct measures of EE

A

direct calorimetry

doubly labeled water

63
Q

Indirect measures of EE

A

Oxygen uptake

Heart Rate

64
Q

Doubly labeled water

A

gold standard of EE
estimates daily EE by average
person consumes water; 1-4 weeks. Differences between elimination rates of different isotopes

65
Q

Doubly labeled water strengths

A

good estimation of energy balance
no participant work needed
free living environment
not reactive or intrusive

66
Q

Doubly labeled water weaknesses

A

expensive
not day to day variations
expensive analysis
invalid if body isn’t stable

67
Q

Heart rate indirect measurements

A

useful for cycling, swimming
doesn’t work well w/heart conditions
discomfort

68
Q

Physical Activity Compendium

A

METs

69
Q

METs importance

A

o Helps you know how to compare the physical activity of one person to another
 Quantify dose-response relationships with health outcomes
 Document changes and differences within and between individuals
 Validate intervention programs
 Compare physical activity levels between populations/cultures

70
Q

PA questionnaire global

A

short, 1-4 items, asessing status

71
Q

PA questionnaire global pros

A

simple and easy

72
Q

PA questionnaire global cons

A

difficult to measure compliance and dose-response

73
Q

PA questionnaire short-term

A

7-20 items, over past week/month

frequency, duration, type

74
Q

PA questionnaire short-term pros

A

easy to measure compliance and establish dose-response

75
Q

PA questionnaire short-term cons

A

math/average

hard to figure out frequencies and durations during the time

76
Q

PA questionnaire quantitative

A

60+ items over past year/lifetime

77
Q

PA questionnaire quantitative pros

A

can estimate long-term impact of PA

78
Q

PA questionnaire quantitative cons

A

difficult to recall PA details from year/lifetime

79
Q

PA logs

A

usually a checklist of activities that are checked as completed

80
Q

PA logs pros

A

simple to use, don’t need duration

81
Q

PA logs cons

A

subject burden, it’s a daily task

82
Q

PA diaries

A

recording details of PA as completed

frequency, intensity, duration, mode

83
Q

PA diaries pros

A

allow for a breadth of detail

84
Q

PA diaries cons

A

over and under reporting, subject burden

85
Q

Pedometers

A

attached to arm

86
Q

Pedometers pros

A

low cost, behavioral feedback and motivation. reliable

87
Q

Pedometers cons

A

can’t measure anything besides walking

88
Q

Accelerometers

A

measure change in velocity/accleration

can assess multiple planes

89
Q

Accelerometers pros

A

detailed, precise. minimally invase. can be used for days, weeks, or longer

90
Q

Accelerometers cons

A

poor in compared to doubly-labeled water. not sensitive to different types of PA

91
Q

HR monitors/multi-system

A

combine multiple bodily functions. may include HR, skin response, core temp, accelerometry

92
Q

HR monitors/multi-system pro

A

high precision

93
Q

HR monitors/multi-system cons

A

expensive, complex, no gold standard

94
Q

Gold standards for EE and PA

A 
EE = doubly labeled water
PA = no gold standard
95
Q

how much weight loss produces benefits?

A

3 to 5%

96
Q

how much weight loss is recommended?

A

5-10% to help lower CVD risk

97
Q

Patients expectations

A

on average, women believed that they were going to lose 32% of their weight

98
Q

Patient’s expectations/acceptable weight loss

A

their acceptable weight loss goals are usually 2-3x more than achieved

99
Q

How much weight percentage was lost?

A

15%

47% didn’t even reach their disappointed goals

100
Q

Did those who needed bariatric surgery have realistic expectations?

A

no

101
Q

Weight loss maintenance

A

o Maintenance therapy for at least a year
o Acknowledging lifetime challenge
o Monthly contact with therapist
o Frequent self-weighing (at least weekly)
o Reduced-calorie diet
o High levels of physical activity (more than 200 min per week)

102
Q

Max weight is…

A

lost at 6 months

followed by a plateau and then a regain period

103
Q

Obesity is caused by

A

long-term energy balance

104
Q

kcals to pounds

A

3500 kcals for one pound

105
Q

Energy balance

A

between energy intake and energy expenditure

106
Q

Energy expenditure

A
  • Thermic effect of feeding
  • Energy expenditure of physical activity
  • Resting energy expenditure
107
Q

Is energy expenditure of PA more important for energy balance

A

PA
increases expenditure by more than 50 fold
causes 15 fold increase in total energy expenditure

108
Q

Why does increasing PA help a person maintain lower weight?

A

o Those that are obese expend more energy when exercising
o 100 kcal per day would prevent weight gain in most people
o Kids = 150 kcals
o Weight loss = 200 kcals

109
Q

Energy density

A

kcal/g
Amount of energy or calories in a particular weight of food and is generally presented as the number of calories in a gram kcal/gram

110
Q

Examples of high density food

A 
butter
bacon
chips
dressings
cheese
pretzels
111
Q

Examples of low density foods

A

lettuce
soup
apple
fish

112
Q

how to calculate energy density?

A

calculate by dividing calories by grams per serving

113
Q

Volumetrics

A

humans tend to eat about the same weight of food every day

maintaining volume and changing density can help w/weight control

114
Q

What affects the energy density of foods most?

A

water, fiber, dietary fat
High water = lower energy density
High fat = higher energy density

115
Q

Having a salad before a meal…

A

decreased meal intake by about 100 caloreis

116
Q

How to passively under-consume calories

A

large portions of fruits and veggies
starchy healthy foods
portion sizes
satiety/satiation

117
Q

Satiety

A

how long you can wait to eat

118
Q

Satiation

A

feeling full

119
Q

Environmental reasons for why it’s hard to maintain weight

A 
	Industrialization of food system
	Inexpensive unhealthy foods
	Fewer meals at home
	Occupations more sedentary 
	Less walking, more driving
120
Q

Physiological reasons it’s hard to maintain weight

A

 Reduced energy expenditure: 20-30 kcals decrease per kg lost
 Increased appetite: 100 kcals increase
 Decreased satiety

121
Q

Regainers

A

more than half of weight lost is regained within 2 years

5 years; more than 80% of weight loss regained

waning efforts as time progressed

122
Q

Maintainers

A

had a deficit of 100 kcals even with appetite rising by 400-600 kcals

intakes increased of both

123
Q

Predictors of weight maintenance

A 
Self-monitoring
low-cal, low-fat diet
eat breakfast daily
regular PA (2500-3000 kcal)
weight-maintenance counseling
124
Q

Self-monitoring

A

 Diet: record food intake daily, limit certain foods or quantity
 Weight: check body weight more than 1x week

125
Q

Low-cal, low-fat diet

A

 Total energy intake: 1300-1400 kcal

 Energy intake from fat: 20-25%

126
Q

Weight-maintenance counseling

A 
	Helps to build satisfaction
	Relapse prevention
	Cognitive restructuring 
	Deeper motivations
	Manage expectations
127
Q

National dietary data trends

A

o Carbohydrate intake has increased
o Fat increase stayed the same
o Increase in energy intake could explain the obesity epidemic

128
Q

Portion sizes have

A

increased

129
Q

Bowl size

A

increased, and has slightly increased food intake. Only .2 effect

130
Q

Provided more food

A

ate higher percentages of food when offered more

131
Q

Front box serving size

A

the larger it is, it can increase portion size or how much is eaten

132
Q

Single food offered

A

decreases how much food was eaten by 60%

133
Q

Things that increase how much is eaten

A 
portion size
provided more food
increased fast food
bowl size
serving size on box
multiple foods 
proximity/visbility 
friend's weight
obese people present
134
Q

Obese friend

A

57% increased chance of becoming obese

135
Q

Obese person in proximity

A

lower health requirement

136
Q

Which body assessments total body fat percentage?

A

DXA
Bod Pod
Hydrostatic weighing
Bioelectrical impedance

137
Q

Which are direct measures of energy expenditure?

A

doubly labeled water

whole-room calorimeter

138
Q

Energy flux

A

encourages increasing physical activity to assist in regulating body weight

Too little physical activity results in a reduced ability to match intake with expenditure to regulate body weight

Adjusting energy intake and/or expenditure results in compensatory metabolic and behavioral changes

139
Q

Intervention effort is

A

what determines if you gain back weight

energy intake increases, energy expenditure decreases, and appetite increases. so intervention is the best prevention

140
Q

Food frequency tech

A

questions that ask for multiple details, ability to submit photos
ability to collect complex data

141
Q

24-dietary recall tech

A

software/internet

standardized data collection possible

142
Q

Dietary record tech

A

software, internet, phone
standardized real-time dat collection possible
improves feasibility

Winter 2021 (6 decks)

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