Health Behavior Theories, Nutrition (Exam 3 PSYC262) Flashcards
Health Belief Model
Whether person practices health behavior depends on perceived..
1. susceptibility of diease
2. severity of diseas
3. benefits of health-enhancing behaviors
4. barriers to health-enhancing behaviors
Strengths and Weakness of Health Belief Model
Strength: balance between barriers and benefits make it a strong predictors of behavior
Weakness:
- does not predict adherence well
- does not account for habitual health behaviors
- does not include belief about personal control
Theory of Planned Behavior
Bubble chart
3 factors shape intention:
- attitude (Positive/ negative)
- subjective norm (lay referral reaction)
- perceived behavioral control
Strengths and Weakness of Theory of Planned Behavior
Strength:
- good at guiding internet based intervention
- most successful at predicting exercise and eating behaviors
Weakness:
- bad at predicting risk-taking behaviors
- intention does not always predict behavior
Continuum Behavior Models Strength (TPB and HBM)
Continuum Models predict a person at one place in time deciding to engage in a behavior / not. They are…
- very researched
- identify beliefs that should motivate anyone to change behavior
- better than chance at predicting behavior
Transtheoretical Model
“Spiral Model” with Five stages
1) Precontemplation (unaware of issue but other push for treatment)
2) Contemplation (aware, but no commitment to change, thinking about pros and cons)
3) Preparation (intention to change has been made, no behavior behind it yet though)
4) Action (commitment to change, modify lifestyle)
5) Maintenance (action for 6+ months, relapses can occur)
*Common to relapse throughout model. Is a PROCESS and explains why many interventions are not successful
How do you help someone at each different stages of the Transtheoretical Model?
- Precontemplation – give information
- Contemplation – help assess how think/feel about selves with respect to problem
- Preparation – helping people make commitments re: when and where to change
behaviors - Action – focus on skills
Strengths and Weakness of Transtheoretical Model
Strengths:
- “spiral” is a visual description
- different interventions at each stage
- works best for quitting smoking
Weakness:
- transitions between stages might not be easy to influence
- could have fewer stages to explain the same thing
Health Action Process Approach
Newest model that combines continuum and stage models. Has 2 stages:
1) Motivational Phase – person is forming INTENTION
2) Volitional Phase – Behavior change (and maintenance
attempts)
*self efficacy plays a role in both stages!
HAPA Model Motivational Phase considering 3 factors…
First phase
- their personal risk
- positive outcomes/ expectancy
- self efficacy (belief that you can engage in behavior in multiple circumstances)
HAPA Model Volitional Phase considering 2 factors…
Second Phase
- planning! and action
- self efficacy (belief that you can engage in behavior in multiple circumstances)
HAPA Strengths and Weaknesses
Strength:
- includes the idea of “planning” (transferring behavior to action) which TPB does not include
Weakness:
- New, so not much research
Intention-Behavior Gap
Intention does not equal behavior.
“wanting to do something does not mean you will always follow through”
What are Implementation Intentions?
specific plans identifying
what, where, when, and how they intend to engage in a
behavior
- pursuit of goals become more automatic
- reminder of intentions
Example of Implementation Intentions: Increasing Fruit and Veggie Intake
- I will eat one serving of fruit at breakfast and one serving of vegetables at lunch
and dinner, M-F. - One serving of fruit = one medium piece of fruit or
1⁄2 cup of fruit - One serving of vegetables = 1⁄2 cup
- Where? Breakfast in my room, Lunch at HWCC, Dinner at Smith
COVID 19 social distancing study looking at intention-behavior gap
- considered 3 factors that predict intention (Theory of planned behavior): Subjective Norm, Attitude, Perceived behavioral control, +intention, + behavioral engagement.
- gave participants assessments looking at each: 7 or 5 pt scale
- RESULTS:
- Over 3 months, attitude became more positive, social norms became weaker (fewer family/ friends emphasize social distancing), perceived behavioral control is unchanged, increase in intention BUT decrease in actual behavior (intention-behavior gap),- older adults and white participants had stronger intention-behavior relationship than younger adults and participants of color (might be due to fewer options for working from home)
Calorie
Unit of energy –Amount of energy it takes to raise 1 gram of water 1 degree C
Carbohydrates
–Glucose, fructose, sucrose, lactose, starch “-ose”
–4 C/gram
–50%-60% diet from carbs
Fats (lipids)
–9 C/gram
–10%-30% diet from fat (< 60g for 2000 C/day diet)
- 2 main types: saturated and unsaturated
Saturated fat
- Often solid at room temp (butter, cheeses)
- Tropical oils (coconut and palm kernel)
- Raises BAD cholesterol (LDLs)
Unsaturated fat
- Healthier= Often liquid at room temperature (olive oil)
- Includes most plant-based fats (avocado, nuts)
- useful for gaining weight in g a healthy manner
LDL vs HDL
LDL: low density lipoprotein
- build in blood vestless and cause blockages= bad in high amounts.
- Immune cells go to damaged and blocked area; get stuck. :(
HDL: high density lipoprotein
- can remove LDL particles :)
- raised by aerobic activity, not diet
Trans fat (trans fatty acids)
- “Hydrogenated” (longer shelf life modification)
- Most concerning for health
- Raises BAD (LDLs), lowers GOOD (HDLs) cholesterol
- Required on food labels starting 2006
Protein (Amino acids are “building blocks”)
–Synthesis of new cell material
–4 C/gram
–0.8 G/kg of body weight
–about 15% diet from protein
protein = carbs in caloric density
Fiber
- helps with digestion
- contributes to feeling full/ satisfied
- people in the US tend to not consume enough fiber, and overconsume protein
Food labels have been updated in 2021 to include
(1) serving size bolded and larger
(2) calories are much larger and bolded
(3) fat section has not changed much
(4) new line that subdivides total sugar into natural sugars and added sugars (added sugars are concerning: there is a lot in sodas)
Metabolism differs because of…
- age: old tend to require less energy consumed
- genetics
- muscle mass: more muscle = more energy needed to maintain
Leptin hormone
– hormone secreted by fat cells (not endocrine gland) and monitored by the hypothalamus
- **helps maintain a stable weight **
- larger our fat cells = more leptin is secreted
- Gain weight: increased leptin. brain is aware that we are storing extra energy, but don’t want to continue storing energy, so eat less and move more
- Lose weight: decrease leptin. eat more and move less
Ghrelin hormone
(the “hunger hormone”)
–produced by stomach cells
–Indicator of energy insufficiency
–Stimulates appetite
–Increased after weight loss from traditional methods (diet/physical activity)
–Decreased after weight loss surgery (gastric sleeve, Roux en Y)
Explain Vertical Gastric sleeve, Roux en Y, and Gastric band surgery
VSG:
- removes portion of stomach: permanent
- get fuller sooner, not getting as hungry = ghrelin is reduced
Roux en Y:
- attach lower part of intestine to new stomach pouch: permanent
- lose weight because smaller stomach, feel fuller sooner, not absorbing as much nutrients per calorie
- have vitamin and mineral deficiency
Gastric Band:
-much safer. less invasive and damaging. Not permanent
- looser “belt” = the more food is able to move. tighter “belt”= less food is able to be moved.
- does not affect ghrelin production= no change in hunger
Insulin
–Secreted by pancreas
–Moves glucose into cells
–Helps hypothalamus understand when enough food has been eaten (insulin = satiety)
Type 1 Diabetes vs Type 2
Type 1 Diabetes- (used to be childhood onset) cells stop secreting insulin, so cells cannot get access to glucose. Must take insulin from the outside: injection or pump.
Type 2 Diabetes- (used to be adult onset) your cells become less sensitive to insulin “insulin resistance”. Increased levels of insulin but not helping cells access needed glucose. Treated by diet, physical activity, and oral medications which increase insulin sensitivity .
Why does taking medications to lose weight not really work well?
Hormones all work together. changing level of one hormone drastically makes other hormones change to try to maintain weight
Experimental Starvation
- rationale: try to understand how people in WW2 concentration camps that experienced food deprivation, how it would effect them and how to safely re-feed them.
- conscientious objectors of going to war: 36 men. Initially fed well, then calorie intake halved.
- psychologically, the men were more angry, aggressive, and interested in food. Not very active or engaged. ==metabolism were slowing down to conserve energy
- refeeding: gave access to as much food as possible.
results:
- most men regained weight and had improvements in psychological well being
- some men maintained a preoccupation with food and were moody
Experimental Overfeeding
- 20 incarcerated participants. voluntarily gained 20-30 lbs over 4-6 months.
- Found it hard to consume enough food to keep increasing weight == loss of interest in eating food
After study:
- most lost weight easily to baseline
- 10% had a harder time losing the weight (genetics)
- Conclusion: our bodies want to maintain weight.
Assess obesity: Imaging methods
MRI/ DEXA look at percent of body composition (bones, water, fat, muscle)
Pros: one of the most accurate ways
Cons: expensive and inaccessible
Assess obesity: Skin-fold
looks at percent body fat with calipers.
Pros: accessible, easy to train, not expensive.
Cons: significant variability
Assess obesity: bioelectrical impedance
harmless electrical current through body to estimate percentage of fat.
Pros: Inexpensive, accessible bathroom scale.
Cons: can be inaccurate.
Assess obesity: Fat Distribution: Waist to hip ratio (WHR)
W and H equal = 1.0
W>H= greater than 1.0
W<H= less than 1.0
pear shape are less risky of cardiovascular disease than apple shape
Assess obesity: BMI: body mass index
(kg/m 2) metric measure that was never was meant to be a metric to look at individuals, was meant to look at population.
Pros: quick and easy
Cons: does not take into account body composition (muscle, bone, body fat)= over classifies people
Setpoint Model looking at weight control
- each person has an internal set point narrow range of weight where weigh fluctuates
- Hard to deviate from set point
- evidence: leptin, ghrelin, and other hormones.
- setpoints could be hereditary. (supported by over/ undereating studies because regardless of eating, when they ate normal, their bodies reverted back to their original “setpoint”)
Genetics looking at weight control
- familial trends in obesity
- weight, BMI, and fat distribution are heritable
- “thrifty metabolism” (efficient at getting energy, storing excess energy, and are conservative when it comes to using energy= Good evolutionarily, when famine was more common. But, now a thrifty metabolism is not as necessary )
Positive Incentive Model
Positive consequences of eating promote more eating
- Personal pleasure from taste, social interactions, biological factors
Why are Sleep and weight are negatively correlated ?
negative correlation: higher levels of sleep are associated with lower levels of weight.
sleep deprivation promotes weight gain because…
- not the case that people are eating more in those hours
- sleep deprivation leads to a decrease in leptin and increase in ghrelin = promote eating by making us hungrier
- evolutionarily: your body thinks you are not sleeping because of a threat, so it wants to store energy just in case. sleep deprivation= preparation for threat
Obesity Trends
- 43% of US adults have BMIs 30 or higher
- In Ohio, ~ 38% of adults have obesity (2021)
- In 2011, 29% of adults had obesity and ~ 20% of children have obesity
How much does weight loss improve health?
- lose 7-10% of baseline body weight will improve health concerns.
- Being overweight shows an increase in mortality, Heart Disease, Type 2 Diabetes, Insulin Resistance, Stroke, Colon cancers, and Sleep apnea
What is an Obesogenic Environment? How did previous generations eat different than we do?
Obesogenic Environment: encourages obesity (encourages consumption of energy and discourages expenditure of energy)
previous generation
- ate less processed foods, snacked less, had certain times/ places to eat, ate slower, had less accessible calorie dense food,
How can we treat obesity at the individual level?
3 options:
- decrease energy consumed
- increase energy expended
- combination of above
Why should you be physically active?
- research shows that doing only physical activity is difficult for weight loss
- necessary for MAITENANCE of weight loss
at least 200 min/ week at moderate or intense
60-90 min daily.
can meet PA goal through short movement thought-out day
** very beneficial to build in exercise into you day with a class, organized sport, regular walk with a friend **
Why is dieting culture not healthy? Why is dieting ineffective?
Diet culture makes lots of money promoting dieting as a cycle to keep getting money.
- main goal is not to be healthy, it is to make money.
Diets fail because people need training about portion sizes and it is challenging
= Small, permanent changes are best for treating obesity/ gaining weight
How can you help someone modify their behavior to lose weight?
- focus on strategies that reinforce healthy habits
- meet with professional
- monitor (keep diary)
- identify circumstances around eating habits
