Food and behaviour

Question 1

What are some different factors that can lead to excessive energy intake?

Answer 1

Genetics, employment (shift work), early developmental factors, TV viewing/ advertisements, characteristics of food (energy density, macronutrient composition, satiety and satiation, portion size), reduced physical activity, sleep, environmental cues, psychological factors

Question 2

What is malnutrition?

Answer 2

Malnutrition refers to deficiencies, excesses or imbalances in a person’s intake of energy and/or nutrients. The term malnutrition covers 2 broad groups of conditions. ‘Undernutrition’ and ‘overweight’

Question 3

What does undernutrition encompass?

Answer 3

It includes stunting (low height for age), wasting (low weight for height), underweight (low weight for age) and micronutrient deficiencies or insufficiencies (a lack of important vitamins and minerals).

Question 4

What are some chronic medical conditions that need nutritional support?

Answer 4

Cancer
• Cystic Fibrosis
• Coeliac disease
• Inflammatory bowel diseases
• Type1 Diabetes Mellitus– “diabulimia”
• Type II Diabetes
• Failure to thrive
• Eating disorders
• Overweight, obesity
• Management of sarcopenic obesity in elderly patients

Question 5

What are some early influences on feeding behaviour?

Answer 5

Maternal diet and taste preference development
Role of breastfeeding for taste preference and bodyweight regulation
Parenting practices
Age of introduction of solid food, types of food exposed to during the weaning period and beyond…

Question 6

How does the maternal diet influence the baby’s taste?

Answer 6

Amniotic fluid is influenced by the maternal diet
• In utero environment influences taste exposure
• Might not be taste exposure per se but exposure to variety…

Question 7

When is colostrum in the breast milk and what does it have in it?

Answer 7

Up to 3 days after birth.

< fat, > protein; >‘protective’ factors

Question 8

What is foremilk and hindmilk?

Answer 8

Foremilk beginning of a feed (watery);

Hindmilk end of a feed (> energy dense)

Question 9

What is in breastmilk to aid efficient digestion?

Answer 9

Enzymes: lipase, lysozyme

Transfer factors: lactoferrin

Question 10

What is in breastmilk to aid anti-infection?

Answer 10

Bifidus factor
White cells
Oligosaccarides

Question 11

What is in breastmilk to aid gut protection?

Answer 11

Epidermal growth factor
Secretory IgA
Anti-inflammatories

Question 12

What practices and behaviours can parents do to improve infant feeding behaviours?

Answer 12

Modeling “healthful” eating behaviours
• Responsive feeding: Recognizing hunger and fullness cues
• Providing a variety of foods
• Avoiding pressure to eat
• Restriction
• Authoritative parenting/ Authoritarian parenting
• Notusingfoodasareward
• Indulgent/ neglectful feeding practices

Question 13

What is an eating disorder?

Answer 13

Clinically meaningful behavioural or psychological pattern having to do with eating or weight that is associated with distress, disability, or with substantially increased risk of morbidity or mortality

Question 14

What is disordered eating?

Answer 14

Restraint; strict dieting; disinhibition; emotional eating; binge-eating; night eating; weight & shape concerns; inappropriate compensatory behaviours that do not warrant a clinical diagnosis

Question 15

What are the three basic types of dieting associated with restriction of food intake?

Answer 15

1. Restrict the total amount of food eaten
2. Do not eat certain types of food
3. Avoid eating for long periods of time

Question 16

What are the problems with dieting?

Answer 16

Risk factor for the development of eating disorders (bulimia, anorexia)
Dieting results in a loss of lean body mass, not just fat mass
Dieting slows metabolic rate and energy expenditure
Chronic dieting may disrupt ‘normal’ appetite responses and increase subjective sensations of hunger

Question 17

Why is dieting so difficult for overweight patients?

Answer 17

Unresponsive to internal cues that signal satiety (when overconsuming) and hunger (when dieting)
Vulnerable to external cues that signal availability of palatable food

Question 18

What are the points behind the externality theory of obesity?

Answer 18

Overweight individuals eat according to:
• External cues
• No compensation after preload
• Time of day
• Offer lurid descriptions of desserts
• Sensory food cues

Question 19

What is restrained eating?

Answer 19

The deliberate attempt to inhibit food

intake in order to maintain or to lose weight

Question 20

What is the restraint theory in a normal eater?

Answer 20

Food consumption is regulated by biological processes to keep food intake within a set range
Hunger keeps intake of food above a specific minimum level
Satiety (feeling of satisfaction/fullness) keeps intake of food below a specific maximum level
Your hunger and satiety levels are determined by your body weight set point (your biology)
Within this set range, eating is regulated by social, environmental and psychological factors

Question 21

What is the restraint theory in a restrained eater?

Answer 21

Dieters tend to have a larger range between hunger and satiety levels than normal eaters as it takes them longer to feel hungry and more food to satisfy them.
Dieters also have a self-imposed, desired intake of food – a cognitive dietary boundary (what they think they should eat and how much)
If they exceed this diet boundary they continue to eat until they reach satiety (which is higher than that of a normal eater)
This consequently leads to overeating and weight gain over time

Question 22

What is the boundary model?

Answer 22

Unrestrained eaters are intuitive and regulate food intake without conscious effort
Restrained eaters rely on consciously controlled processes to regulate food intake
Break down of dietary restraint leads to “what-the-hell” cognitions
Disinhibitors:
High energy preloads or merely belief of high energy preload
Large portion size, Alcohol Cognitive load: Stress Strong emotion

Question 23

What is the critique of the restraint theory?

Answer 23

Restraint theory suggests a link between food restriction and overeating
Dieters, bulimics and anorexics report episodes of overeating
Cannot explain restricting behaviour in anorexics (i.e. avoiding meals, carefully weighing and portioning food) as according to restraint theory, this should result in overeating and weight gain, not severe weight loss

Question 24

What is the goal conflict theory?

Answer 24

Chronic dieters experience conflict between 2 incompatible goals:
• Eating enjoyment and weight control