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Winter 2021 > EXSC 480 Exam 3 > Flashcards

EXSC 480 Exam 3 Flashcards

1
Q

How does thermodynamics relate to weight maintenance?

A

reducing thermodynaic efficiency results in increased weight loss

a calorie isn’t always a calorie (2nd law)

you have to decrease consumption or increase expenditure (1st law)

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2
Q

What are some factors that influece weight loss?

A 
satiety
age
behaviors
body composition
food supply
diet
economics
medications
genes
gut microbiota
hormones
metabolic rate
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3
Q

Energy density

A

differences due to fat, water, and fiber content

macronutrients can also hvae differeing effects on satitaion/satiety

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4
Q

Which macronutrient has the greatest effect of satiety?

A

Protein

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5
Q

Very low calorie diets

A

Less than 800 kcal
hard to maintain for longer than 6 months

can negatively bone health, possible eating disorders

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6
Q

Results of VLCD

A

10-40% of weight loss

1.5-2.5 kg lost per week

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7
Q

Low-calorie diets

A

800-1500 kcals

or can be classified as decreasing 500-750 kcal in obese and 300-500 in overweight

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8
Q

LCD results

A

improve cholesterol, LDL, triglycerides, HDL

8% body weight loss

can be used after a VLCD

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9
Q

Low fat diet

A

less than 30% of total kcal comes from fat

weight loss of about 5.41 kg

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10
Q

Very low fat diet

A

15% from fat

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11
Q

Low fat diet results

A

4 months to a year 6% to 12% body weight loss

improvement in total cholesterol, LDL. Variable effects on HDL and triglycerides

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12
Q

Fat diets and weight loss

A

fat energy is dense but has weak satiating effect
low fat diet may induce greater weight loss
helps to reduce total energy intake
heart-healthy approach

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13
Q

Low-fat to low-carb diets

A

difference is not significant

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14
Q

Low-carb diets

A

there isn’t a set definition

can range from 10-20% of kcals from carbs

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15
Q

Very low carb diet

A

less than 10% total kcal from carbs

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16
Q

Why does a low carb diet work?

A

 Increased thermogenic effects of protein intake
 Greater protein turnover for gluconeogenesis
 Loss of energy through excretion of ketones
 Increased satiety, allowing lower energy intake w/out hunger
 Specific metabolic advantage

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17
Q

Low carb drawbacks

A

greater change at 6 months than low fat
but same results at a year (33% vs 34%)

only 59% were able to do a whole year

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18
Q

Two year low carb

A

HDL cholesterol higher than low calorie diet

but more adverse symptoms than other low diets

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19
Q

Negatives of low carb diet

A

less fat loss even with more weight loss

lots of adverse side effects

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20
Q

Positives of low carb diet

A

8-12 kg at 6 months
5 kg at a year
increased energy expenditure
decreased triglycerides, increased HDL

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21
Q

Carb Insulin Model

A

increased insulin levels and high carb levels don’t lead to oxidation but to fat storage

this causes increased hunger and food cravings, lower energy expendture, weight gain.

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22
Q

Atkins, Zone, Weight Watchers

A

all achieve modest and similar long-term weight loss

all low carb

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23
Q

Intermittent Fasting

A

Insulin levels drop w/out snacking

because of low insulin levels, fat cells release energy and are burned

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24
Q

Fasting protocols

A

fasting every other day

7 AM to 3 PM or 7 Am to 7 PM eating pattern

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25
Q

Mediterranean Diet

A

eat rarely red meat

eat in moderation poultry, eggs, cheese, yogurt

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26
Q

Mediterranean vs low fat

A

more effective

at 6 years, MD had lost 3.1 kg vs .06 kg

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27
Q

Glycemic index diet

A

limit refined grains and sweets
3 meals a day and 1-2 snacks..
Eat slowly and stop when full

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28
Q

Who should do a glycemic index diet?

A

those with high insulin secretion

beneficial for HDL and not LDL

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29
Q

Problems w/gluten free

A

expensive
processed foods
fewer nutrients
doesn’t induce weight loss

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30
Q

Low sugar

A

decrease in .8 kg

doesn’t necessarily help you to lose weight because you intake other carbs

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31
Q

Dieting problems

A 
preoccupation w/food
food is the enemy
slowed metabolism
weight rebound
dissatisfaction w/body
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32
Q

Intuitive eating attitudes

A

body acceptance

dieting is harmful

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33
Q

Intuitive eating behaviors

A

learn to not eat for emtional, environmental or social reasons
learn to interpret body singals and respond in a positive way

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34
Q

Intuitive eating principles

A 
Reject diet mentality
honor your hunger
make peace with food
challenge food police
discover satisfaction
feel your fullness
cope w/emotions with kindess
respect your body
love exercise
honor you health
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35
Q

Efficacy of intuitive eating

A 
lower BMI
more evident w/time
less weight cycling
improves mental health and mindfulness
increases internal cues to eat
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36
Q

Drawbacks of intuitive eating

A

little evidence for weight reduction
not related to increased PA
influence on healthy diet is mixed

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37
Q

PA for maintaining or improving health

A

150 min/week

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38
Q

PA for prevention of weight gain

A

150-250 min/week

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39
Q

PA for clinically significant weight loss

A

225 to 420 min/week

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40
Q

PA for preventing weight gain after weight loss

A

200 to 300 min/week

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41
Q

Heterogeneity of weight loss/exercise in research studies

A

PA is defined and recorded differently

weight loss or benefits of PA can differ from study to study

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42
Q

Clinical trials w/no or modest weight loss still have benefits

A 
glucose control
endothelial function
lipoportein particle size
HDL
quality of life
CVD risk
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43
Q

Pedometer weight loss

A

0 to 1 kg, not significant

44
Q

Aerobic exercise training

A

0 to 2 kg. only high exercise volumes

45
Q

Resistance training

A

no weight loss, effects visceral fat. Increases strength and confidence

46
Q

Aerobic and resistance

A

0 to 2 kg. only high exercise volumes

47
Q

Caloric restriction and aerobic exercise

A

9 to 13 kg

48
Q

Randomized groups and PA

A

majority of studies don’t show a correlation between PA and weight loss

49
Q

Exercise compliance and PA

A

most show no idfference between groups of exericse amount.

50% compliance showed best correlation w/weight loss

50
Q

Only when actual weight loss was recorded…

A

was there an actual correlation between weight loss and PA

51
Q

Obesity and Preconception

A 
INFERTILITY
lower peak estradiol 
worse hormone and metabolic profile
PCOS risk
miscarriages
52
Q

How much reduction in weight can improve infertility?

A

5-10%

53
Q

Obesity and Prenatal

A 
fetal anomalies
congenital heart disease
insulin resistance
preeclampsia
diabetes
preterm and stillbirth
54
Q

Gestational Diabetes

A

increased risk of 17% if obese

risk of developing type 2 later

55
Q

Preeclampsia

A

higher risk for obese 2.2 RR and overweight 1.7 RR

56
Q

Obesity and Birth

A

hormones distorted
induction is needed
prolonged labor
c-section

57
Q

Depression and obesity

A

6-8 weeks postpartum

risk is 7.5 fold greater

58
Q

How to reduce risk of pregnancy complications

A

EXERCISE

active a year before = reduction by 60% of issues

59
Q

PA and preeclampsia

A

reduces risk by 35% to 70%

60
Q

PA and pregnancy

A

150 min/wk of moderate
can begin after giving brith

If you did vigorous activity before, you can continue to be active

61
Q

pregnancy weight gain for underweight women

A

28 to 40 lbs

62
Q

pregnancy weight gain for normal weight

A

25 to 35 lbs

63
Q

pregnancy weight gain for overweight women

A

15 to 25 lbs

64
Q

pregnancy weight gain for obese women

A

11 to 20 lbs

65
Q

Average retention weight after pregnancy

A

11.8 lbs

66
Q

Obese and postpartum weight

A

Those that were obese that gained within or less than recommended maintained postpartum weight below pre-pregnancy weight

67
Q

underweight for kids

A

below 5th percentile

68
Q

normal weight for kids

A

5th to 85th percentile

69
Q

overweight for kids

A

85th to 95th percentile

70
Q

Obese class 1 for kids

A

abover 95th percentile

71
Q

Obese class 2 for kids

A

greater than 120% of 95th or BMI is greater than 35

72
Q

Obese class 3 for kids

A

greater than 140% of 95th or BMI is greater than 40

73
Q

Prevelance of childhood obesity

A

1/2 of adult

less than 20%

74
Q

adiposity rebound

A

o At age 5-7, children should be at the lowest weight

o If the child begins to gain weight at age 2 or it’s the lowest weight for them, they will be overweight/obese

75
Q

Intrauterine effects on kid’s weight

A

 Gut microbiome
 Genes
 Metabolic syndrome, insulin resistance, CVD
 Diabetes.
 Famine, increased risk to rapid weight gain

76
Q

Postnatal effects on kid’s weight

A

Low birth weight –> abdominal obesity
breastfeeding
type of breast milk (formula, real milk, etc)

77
Q

breastfeeding effects on kids

A

30-50% reduction in risk for obesity

introducing food before 3 months increases risk by 30%

scheduled feeding doubles risk of rapid infant weight gain

kids 2-14 have a 15% lower risk for being obese

78
Q

Familial situations on kids weight

A 
	PA patterns and eating patterns
	Preferences for food
	Degree of parental control over intake 
	Stress
	Strong familial component
79
Q

Obesity begins in adolesvence

A

30% of females

10% of males

80
Q

How parents can have an positive effect on child’s weight

A 
o	Dietary change
o	Physical activity 
o	Parental involvement
o	Psychological
o	Structure of environment, encourage/discourage, not exerting pressure
81
Q

Psychological things parents can help w/weight

A

 Praise good behaviors
 Don’t use food as rewards
 Remove temptations
 Be a role model and consistent

82
Q

Interventions that families can do to improve weight

A

stable meal times
healthy food options
model desired behaviors

83
Q

When should medication be prescribed for obesity?

A

greater than 30 BMI

greater than 27 w/comorbities

84
Q

Orlistat

A

GI lipase inhibitor
impairs digestion of dietary fat
oily discharge from rectum

don’t use w/birth control, seizure meds, thyroid meds

85
Q

Orlistat important things

A

APPROVED for use in kids

3% reduction in weight

86
Q

Phentermine

A

sympathomimetic amine
increases satiety

can cause high BP and heart problems

interacts with antidepressants, alcohol

87
Q

Phentermine important things

A

Oldest approved drug (not FDA approved)

most commonly prescribed

88
Q

Lorcaserin

A

stopped/discontinued due to increased risk for cancer

89
Q

Ligraglutide

A

glucagon peptide 1 receptor agonist

lower blood sugar
stimualtes pancreatic function
lose 5-10%

can become hypoglycemic

increased suicide risk and gastric emptying

90
Q

Naltrexone and Bupropion

A

lose 5-10% of weight

helps with addiction and depression

should not be used in non-adults

91
Q

Phentermine and Topiramate

A

anti obesity and seizures/migraines

5-10% of body weight

birth defects possible w/topir

92
Q

When should bariatric surgery be suggested?

A 
class 2 and 3 obesity 
people w/2 or more comorbities
93
Q

Has the amount of people for bariatric surgery increased or decreased?

A

increased over the past 20 years

94
Q

Bariatric surgery is considered a

A

consistent or sustained weight loss method

95
Q

Malabsorptive

A

Duodeno-jejdunal bypass

helps w/type 2 diabetes
avoids issues w/gastric bypass
hyperlipidemia improvement

96
Q

Restrictive

A

laparoscopic banding

greatest result w/sleep apnea
constant readjusting needed
doesn’t obtain nearly as much weight loss

97
Q

Restrictive and Malabsorptive

A

Roux-en-y gastric bypass

you can’t eat sweet things with it
used to be the most common
stomach pouch = golf ball
drains outside of stomach and duodenum

2 parts: sleeve and switch

98
Q

Sleeve of bypass

A

creates sleeve in stomach
part A
very common, most popular. Provides great results

99
Q

Switch of bypass

A

not used often but provides the best results
jejunum is attached instead of duodenum

have to stay up on vitamins and supplements

100
Q

12 years after surgery

A

27% still have less weight

diabetes, hypertension, and dyslipidemia remain improved

101
Q

Which ones are the most popular surgeries?

A

ROUX
SLEEVE
LAP BAND

102
Q

Which are the most effective surgeries?

A
  1. Roux
  2. Sleeve
  3. Band
103
Q

Which surgery is reversible?

A

Lap band

requires post-surgical adjustments for best results

104
Q

Given that nutritional deficiencies (i.e. protein malnutrition, vitamin B12, vitamin D, iron, calcium, and folate insufficiencies) are more likely to occur with malabsorptive procedures, which would have a greater need for regular post-surgical vitamin/mineral supplementation?

A

SWITCH > SLEEVE < RYGB > BAND

105
Q

Compared to a usual diet in studies that last longer than a year, low fat diets …

A

produce an average weight loss of ~5 kg.

are thought to be a heart-healthy approach to weight loss.

may not be statistically different from weight loss achieved via low carb diets.

106
Q

Pains from ED

A 
headaches
Chest pain
Abdominal pain
mental health 
neuropathic pain
m/s pain
107
Q

Refeeding syndrome

A

decreased phosphorus
decreased potassium
decreased magnesium

Winter 2021 (6 decks)

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