Health Behavior Theories, Nutrition (Exam 3 PSYC262)

Question 1

Health Belief Model

Answer 1

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

Question 2

Strengths and Weakness of Health Belief Model

Answer 2

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

Question 3

Theory of Planned Behavior

Answer 3

Bubble chart

3 factors shape intention:
- attitude (Positive/ negative)
- subjective norm (lay referral reaction)
- perceived behavioral control

Question 4

Strengths and Weakness of Theory of Planned Behavior

Answer 4

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

Question 5

Continuum Behavior Models Strength (TPB and HBM)

Answer 5

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

Question 6

Transtheoretical Model

Answer 6

“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

Question 7

How do you help someone at each different stages of the Transtheoretical Model?

Answer 7

• 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

Question 8

Strengths and Weakness of Transtheoretical Model

Answer 8

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

Question 9

Health Action Process Approach

Answer 9

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!

Question 10

HAPA Model Motivational Phase considering 3 factors…

Answer 10

First phase
- their personal risk
- positive outcomes/ expectancy
- self efficacy (belief that you can engage in behavior in multiple circumstances)

Question 11

HAPA Model Volitional Phase considering 2 factors…

Answer 11

Second Phase
- planning! and action
- self efficacy (belief that you can engage in behavior in multiple circumstances)

Question 12

HAPA Strengths and Weaknesses

Answer 12

Strength:
- includes the idea of “planning” (transferring behavior to action) which TPB does not include

Weakness:
- New, so not much research

Question 13

Intention-Behavior Gap

Answer 13

Intention does not equal behavior.

“wanting to do something does not mean you will always follow through”

Question 14

What are Implementation Intentions?

Answer 14

specific plans identifying
what, where, when, and how they intend to engage in a
behavior
- pursuit of goals become more automatic
- reminder of intentions

Question 15

Example of Implementation Intentions: Increasing Fruit and Veggie Intake

Answer 15

• 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

Question 16

COVID 19 social distancing study looking at intention-behavior gap

Answer 16

• 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)

Question 17

Calorie

Answer 17

Unit of energy –Amount of energy it takes to raise 1 gram of water 1 degree C

Question 18

Carbohydrates

Answer 18

–Glucose, fructose, sucrose, lactose, starch “-ose”
–4 C/gram
–50%-60% diet from carbs

Question 19

Fats (lipids)

Answer 19

–9 C/gram
–10%-30% diet from fat (< 60g for 2000 C/day diet)
- 2 main types: saturated and unsaturated

Question 20

Saturated fat

Answer 20

• Often solid at room temp (butter, cheeses)
• Tropical oils (coconut and palm kernel)
• Raises BAD cholesterol (LDLs)

Question 21

Unsaturated fat

Answer 21

• Healthier= Often liquid at room temperature (olive oil)
• Includes most plant-based fats (avocado, nuts)
• useful for gaining weight in g a healthy manner

Question 22

LDL vs HDL

Answer 22

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

Question 23

Trans fat (trans fatty acids)

Answer 23

• “Hydrogenated” (longer shelf life modification)
• Most concerning for health
• Raises BAD (LDLs), lowers GOOD (HDLs) cholesterol
• Required on food labels starting 2006

Question 24

Protein (Amino acids are “building blocks”)

Answer 24

–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

Question 25

Fiber

Answer 25

• helps with digestion
• contributes to feeling full/ satisfied
• people in the US tend to not consume enough fiber, and overconsume protein

Question 26

Food labels have been updated in 2021 to include

Answer 26

(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)

Question 27

Metabolism differs because of…

Answer 27

• age: old tend to require less energy consumed
• genetics
• muscle mass: more muscle = more energy needed to maintain

Question 28

Leptin hormone

Answer 28

– 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

Question 29

Ghrelin hormone

Answer 29

(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)

Question 30

Explain Vertical Gastric sleeve, Roux en Y, and Gastric band surgery

Answer 30

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

Question 31

Insulin

Answer 31

–Secreted by pancreas
–Moves glucose into cells
–Helps hypothalamus understand when enough food has been eaten (insulin = satiety)

Question 32

Type 1 Diabetes vs Type 2

Answer 32

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 .

Question 33

Why does taking medications to lose weight not really work well?

Answer 33

Hormones all work together. changing level of one hormone drastically makes other hormones change to try to maintain weight

Question 34

Experimental Starvation

Answer 34

• 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

Question 35

Experimental Overfeeding

Answer 35

• 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.

Question 36

Assess obesity: Imaging methods

Answer 36

MRI/ DEXA look at percent of body composition (bones, water, fat, muscle)
Pros: one of the most accurate ways
Cons: expensive and inaccessible

Question 37

Assess obesity: Skin-fold

Answer 37

looks at percent body fat with calipers.
Pros: accessible, easy to train, not expensive.
Cons: significant variability

Question 38

Assess obesity: bioelectrical impedance

Answer 38

harmless electrical current through body to estimate percentage of fat.
Pros: Inexpensive, accessible bathroom scale.
Cons: can be inaccurate.

Question 39

Assess obesity: Fat Distribution: Waist to hip ratio (WHR)

Answer 39

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

Question 40

Assess obesity: BMI: body mass index

Answer 40

(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

Question 41

Setpoint Model looking at weight control

Answer 41

• 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”)

Question 42

Genetics looking at weight control

Answer 42

• 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 )

Question 43

Positive Incentive Model

Answer 43

Positive consequences of eating promote more eating
- Personal pleasure from taste, social interactions, biological factors

Question 44

Why are Sleep and weight are negatively correlated ?

Answer 44

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

Question 45

Obesity Trends

Answer 45

• 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

Question 46

How much does weight loss improve health?

Answer 46

• 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

Question 47

What is an Obesogenic Environment? How did previous generations eat different than we do?

Answer 47

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,

Question 48

How can we treat obesity at the individual level?

Answer 48

3 options:
- decrease energy consumed
- increase energy expended
- combination of above

Question 49

Why should you be physically active?

Answer 49

• 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 **

Question 50

Why is dieting culture not healthy? Why is dieting ineffective?

Answer 50

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

Question 51

How can you help someone modify their behavior to lose weight?

Answer 51

• focus on strategies that reinforce healthy habits
• meet with professional
• monitor (keep diary)
• identify circumstances around eating habits