Final - Exercise and Weight Control/Obesity

Question 1

obesity

Answer 1

excess accumulation of body fat

final common pathway is chronic energy imbalance and energy intake exceeds energy expenditure

Question 2

BMI and obesity classification

Answer 2

20 - 24.9: desirable range for men and women
25 - 29.9: Grade 1 obesity (overweight)
30 - 40: Grade 2 obesity
> 40: grade 3 obesity

Question 3

obesity increases incidence of:

Answer 3

• coronary heart disease
• gallbladder stones
• hypertension, stroke
• cancer –> post menopausal breast, colon, kidney, endometriosis
• OA
• Type II diabetes/ glucose intolerance
• infertility

Question 4

at 30- 35 BMI, survival is reduced by

Answer 4

2 to 4 years

Question 5

at 40- 45 BMI, survival is reduced by

Answer 5

8-10 years

comparable to smoking

Question 6

weight change and relative risk

Answer 6

even if weight remains in “healthy” range, an increase in body weight of > 10 since early 20’s increases risk of developing obesity- associated disease

Question 7

regional fat distribution and health risk

Answer 7

• where the fat resides, independent of total stored fat, affects the health risk of obesity
• waist to hip ratios and waist circumferences –> increased health risk from abdominal (visceral) storage rather than hip/buttocks

Question 8

current guidelines for waist circumference and risk for men

Answer 8

high risk: 100 - 120 cm

very high risk: >120 cm

Question 9

current guidelines for waist circumference and risk for women

Answer 9

• higher risk: 90-109

- very high risk: >110 cm

Question 10

increased health risk with abdominal (visceral) fat storage

Answer 10

• risk may be related to metabolically active state of this storage depot
• greater waist girth associated with higher risk of mortality regardless of BMI

Question 11

high visceral fat is associated with:

Answer 11

• adverse lipid profile
• higher insulin/ insulin resistance
• hypertension
• left ventricular hypertrophy
• increased risk for endometrial and colorectal cancers

Question 12

Energy balance =

Answer 12

energy intake - energy expenditure

Question 13

what is normal physiologic response to an energy intake > energy expenditure

Answer 13

lipid storage

Question 14

1 lb (0.45 kg of fat) = how many kcal?

Answer 14

3500

Question 15

what factors affect intake of energy

Answer 15

• total energy intake, energy density and diet composition, timing and composition of diet relative to physical activity, current body weight and composition

Question 16

what factors affect expenditure of energy?

Answer 16

• resting metabolic rate
• ADL/level of sedentary behavior
• metabolic cost of digestion and metabolism
• amount, type, timing, intensity of physical activity
• current body weight and composition
• thermogenesis

Question 17

Energy balance:

Answer 17

• interaction of metabolic, neuronal, hormonal, and physiological factors
• environment, behavior and lifestyle factors
• epigenetic and genetics

Question 18

what does energy balance ultimately influence?

Answer 18

weight, body composition, and overall health

Question 19

obesity: interaction between genes and environment

Answer 19

• genetics: about 25% of inter-individual body fat variability is inherited
• culture: about 30% of variability due to environmental, cultural, learned

Question 20

what is susceptibility to obesity affected by?

Answer 20

• genetic factors

- but environment determines the phenotypic expression of whether or not obesity occurs

Question 21

obesity prevalence increases when cultures adopt:

Answer 21

• higher fat, highly energy/dense diets (western)
• change in physical activity
• other cultural and behavioral factors

Question 22

how does reduced physical activity affect obesity?

Answer 22

• often an inverse relationship between daily physical activity and level of body fat (TV watching is a strong predictor of future obesity in children)
• obese individuals do not necessarily have a greater absolute caloric intake than non-obese controls, they just move less

Question 23

how many extra kcals/day could obese sedentary individuals burn if they matched the non-exercise activity of leaner folks?

Answer 23

about 350 kcal

Question 24

as far as food goes, studies in active humans suggest that regular exercise helps regulate what?

Answer 24

appetite

- in other words, improve the matching of intake to expenditure

Question 25

in sedentary and/or obese population, what does regular exercise result in

Answer 25

net loss of weight as energy intake did not keep up with the new level of energy expenditure --> a net suppression of appetite (shocking)

Question 26

negative side of exercise and food intake

Answer 26

- if you have been regularly active then become sedentary, food intake is slow to decrease to match the decrease in expenditure --> then ya get tubby tubs

Question 27

what does exercise as a part of a weight loss program do?

Answer 27

- increases daily energy expenditure | - improves weight loss when added to a moderate caloric restriction program

Question 28

what is important regarding exercise as a part of weight loss program?

Answer 28

the total amount of energy expended per day (intensity x duration)

Question 29

difference between ACSMs definition of weight maintenance and change in body weight

Answer 29

- weight maintenance: <3% change | - clinically signifiant change in body weight: >5% change

Question 30

how much physical activity for weight loss?

Answer 30

- work up to 300-500 kcal/day (minimum of 150 min/week) | - BEST results with 300 min/week, >2000 kcal/week of mod and 150 min/week of vigorous activity

Question 31

when initiating physical activity for weight loss, what intensity should you start with?

Answer 31

moderate | 40-60% VO2R

Question 32

what exercise progression can overweight and obese adults benefit from?

Answer 32

- progression from 250-300 min/week or 50-60 min for 5 days/week (moderate to vigorous intensity - for some individuals, progression to 60-90 mins of daily moderate exercise may be necessary - intermittent activity ok

Question 33

how much physical activity prevents weight regain after weight loss?

Answer 33

- scare evidence for specific recommendations - suggestions is 250-300 min/week - more like prevention of weight gain guidelines than minimum guidelines for weight loss

Question 34

metabolic adaptation to weight loss

Answer 34

"long term weight loss requires vigilant combat against persistent metabolic adaptation that acts to proportionally counter ongoing efforts to reduce body weight"

Question 35

resistance training will not:

Answer 35

- promote clinically significant weight loss | - add to weight loss when combines with diet restriction

Question 36

resistance training increases:

Answer 36

- fat free mass when used along

Question 37

what is resistance training more likely to do?

Answer 37

attenuate to or prevent loss of fat free mass (rather than increase fat-free mass) when combined with diet restriction

Question 38

when might resistance training increase fat loss?

Answer 38

when combined with aerobic training compared to resistance training alone

Question 39

health benefits of resistance training

Answer 39

- improved muscular endurance/ strength - increase HDL, insulin sensitivity - decrease LDL and triglycerides - reduce blood pressure

Question 40

other health benefits of physical activity other than changes in body composition

Answer 40

reduces or reverses: - development of insulin resistance - hyperinsulinemia - dyslipidemia - hypertension - risk of developing type II diabetes