HLTH 230 Final (Weeks 6-12) Flashcards
What is Hunger?
Unpleasant sensation that signals need for food
* Happens about 4 to 6 hours after eating.
* By this time, food has left the stomach, and most nutrients have been absorbed.
* Hunger is triggered by an empty stomach and small intestine.
* The stomach hormone ghrelin, produced between meals, along with signals from the brain, also plays a role.
* Other factors, like emotions and habits, can influence hunger too.
What is Appetite?
- Appetite is the psychological desire to eat.
- You can feel appetite even if you’re not hungry.
- Seeing or smelling food can trigger brain chemicals (endorphins) that make you want to eat, even if your stomach is full.
- Stress or illness can reduce appetite in some people who need food, while others may feel hungrier under stress.
What is Satiation?
- Typically determines how much food is eaten at one
sitting - Feeling full during a meal builds up until you’re satisfied enough to stop eating.
What is Satiety?
- The feeling of fullness after a meal that keeps you from eating again until the next mealtime.
- Suppresses hunger
What is Sensory Specific Satiety (SSS)
- SSS it is the concept that we tend to get bored of a food as we eat it.
- The more variety there is, the more likely it is that we will increase overall consumption.
Which is stronger, Hunger or Satiety?
Hunger is stronger
What is Leptin?
A Satiety Hormone
* An appetite suppressing hormone
* May also contribute to satiety
* Produced by adipose tissue and the stomach
* Travels to the brain
* Directly linked to appetite control & amount of body fat
Is obesity primarily caused by genetics?
No, it is rarely caused by genetics alone.
How do genes influence obesity?
Genes affect how the body stores and uses energy but don’t act alone.
What is the likelihood of a child becoming obese if at least one parent is obese?
40-70%
Are adopted children’s body weights more similar to their adoptive or biological parents?
Biological parents.
How likely are identical twins to weigh the same compared to fraternal twins, even if raised apart?
Identical twins are twice as likely as fraternal twins to have the same weight.
Why can’t genetics alone explain the rising obesity rates?
The gene pool hasn’t changed significantly, so environmental and lifestyle factors play a major role.
Does genetics influence a person’s tendency to become obese?
Yes, but it’s not the only factor
External Cues to Overeating
- Variety can make people eat even when they’re not hungry, like at a buffet or with a variety pack of snacks.
- Overeating can also happen due to emotions like loneliness, cravings, addiction, stress, depression, or even the time of day.
- Fast-food is acssible, cheap, highly adversited, & arguably delicious
Physical Inactivity
- Reported intake often inaccurate (for everyone)
*
What is E.A.T?
Physical activity is actually made up of “exercise related
activity thermogenesis (EAT)
What is N.E.A.T?
non exercise activite
thermogenesis
* NEAT refers to the energy used in everyday activities like working, exercising, sitting, standing, walking, dancing, cleaning, and even small actions like toe tapping.
HOW THE BODY LOSES AND GAINS WEIGHT
The balance between energy intake & energy output
determines whether you gain, lose, or maintain body fat
* A small or sudden change in body weight might not mean a change in body fat. It could be due to changes in:
Body fluids (drinking 2L will gain pounds)
Bone minerals
Muscle
Bladder or digestive contents
Weight changes often depend on the time of day.
How do energy-yielding nutrients contribute to weight gain?
They can be stored as body fat.
What contributes to Weight Gain?
Energy yielding nutrients contribute to body
fat stores
What happens to excess amino acids from protein?
They are used for energy or converted to glucose or fat.
How are fatty acids from fat used in the body?
They are either used for energy or stored as body fat efficiently.
What happens to excess sugars from carbohydrates?
They are stored as glycogen, used for energy, or converted to fat and stored.
How does alcohol affect the body’s use of fat?
Alcohol slows down fat use by about 33% and increases fat storage, mostly as visceral fat.
What type of diet leads to large initial weight losses?
Low-carbohydrate, high-protein diets and “ketogenic” diets.
What are the DRI recommendations for carbohydrate intake?
Minimum of 130 grams/day (RDA for those over 1 year old).
45–65% of total energy intake is recommended for health.
What should nutrition recommendations for adults include?
- They should be personalized to meet individual values and preferences.
- Support a dietary approach that is safe, effective, nutritionally adequate, culturally acceptable, and affordable for long-term adherence.
- These principles also apply to weight loss.
How is obesity traditionally defined in weight loss intervention studies, and what is the limitation of this approach?
Obesity is traditionally defined using BMI classification, but this overlooks its true definition as a chronic, progressive, and relapsing disease characterized by excess adiposity that impairs health and social well-being.
What are the option for weight loss for those with obesity?
- Medical Nurition Therapy (MNT)
- Physical activity
- Psychological Intervention
- Pharmacological Therapy
- Bariaric Surgery
What should diets for weight management fall within?
The AMDRs (Acceptable Macronutrient Distribution Ranges).
What is the AMDR for carbohydrates in weight management?
45–65% of total calorie intake.
What is the AMDR for fat in weight management?
20–35% of total calorie intake.
What is the AMDR for protein in weight management?
10–35% of total calorie intake.
How should fats be chosen in a weight management diet?
Avoid trans fats.
Limit saturated fats.
Include enough healthy fats to provide satiety.
What is the goal of Intensive Lifestyle Intervention (ILI) programs for weight loss?
To achieve a weight loss of 5–15%.
What can Spot Reducing do?
Exercising a particular area cannot target fat from that area
What are the There are 3 pillars to support medical nutrition
therapy and physical activity?
- Psychological intervention
- Pharmacotherapy
- Obesity surgery
When is surgery an option for obesity management?
- For BMI ≥ 40.
- For BMI ≥ 35 with a coexisting disease (as per CPG).
- For BMI ≥ 30 with poorly controlled Type II diabetes or severe obesity-related diseases not responding to medical management.
What is Gastric Banding?
- Not in the top 3 for recommend
- Provides a restrictive method to weight loss
- An adjustable “band” is placed where the esophagus and the
stomach meet
What is Gastric Bypass?
- Most common
- Provides a** restrictive and malabsorptive** method to weight loss
- A small stomach pouch is created to hold only a few bites of food, and part of the intestines, including the duodenum and part of the jejunum, is bypassed.
What is Duodenal Switch?
- Provides a restrictive and malabsorptive method to weight
- The stomach reduction is less than the gastric bypass but more
of the small intestine is bypassed. - Most common to see Vitamin and mineral defectiocy
Sleev e Gastrectomy (Gastric Sleeve)
- Provides a restrictive approach
- Uses staples
- stomach is cut into the shape of a banana
When is prescription medication recommended for obesity management?
- For individuals with:
- BMI ≥ 30, or
- BMI ≥ 27 with obesity-related complications or elevated disease risk, alongside diet and exercise.
What are all the drugs used for obesity?
- Xenical Orlistat
- Contrave naltrexone & bupropion
- Saxenda liraglutide
- Wegovy Semaglutide
What is Xenical Orlistat?
*How:
Stops some fat eaten from being absorbed by the body
What is Contrave naltrexone & bupropion?
- controls hunger and cravings
What is Saxenda liraglutide?
How: decreases appetite and and slow gastric emptying
Helps control amount eaten
What is Wegovy Semaglutide?
- AKA Ozempic
- Use for diebtes
- Decreases appetite and slows stomach emptying
Helps control amount eaten
Importance of Herbal Products?
*“Natural” does not mean safe: Belladonna, hemlock & sassafras all contain
toxins
Importance of Ephedrine/Ephedra?
Health Canada warns against unapproved products sold for:
* weight loss
* increased energy
* body building
* euphoria
NUTRITION MANAGEMENT FOR WEIGHT GAIN
- Physical Activity to Gain Muscle & Fat
- Diet alone can bring about weight gain fat
- Eat enough to support activity, to gain muscle and fat
- Choose Foods with High Energy Density
- Portion Size & Meal Spacing
- Weight Gain Supplements (Use ith phsyical actcity)
- Avoid Tobacco
What percentage of Canadian adults (18 to 79) were overweight or obese in 2019?
59.8%
What Category is < 18.5 for BMI
Underweight
What Cateogory is 18.5-24.9 for BMI
“Normal Weight”
What Cateogory is 25-29.9 for BMI
Overweight
What cateogory is 30 and over for BMI
Obese
What Cateogory is 30-34.9 for BMI?
Obese class 1
What Cateogory is 35-39.9 for BMI?
Obese class 2
What Cateogory is > or = 40 for BMI?
Obese class 3
What are the limitations of BMI (Body Mass Index)?
- Doesn’t show how much weight is fat or where fat is located.
- Not suitable for athletes, pregnant or lactating women, or adults over 65.
- Needs more research on cutoffs for different races.
- Originally based on people under 65, mostly white Europeans and Americans.
What is the most practical indicator of fat distribution and abdominal fat
Waist circumference
What is the risk of the Waist circumference be for males and females?
- 102 cm for males
- 88 cm for females
how many stages does EDMONTON OBESITY STAGING SYSTEM have?
0,1,2,3,4
What is Stage 0 of E.O.S.S?
- No apparent risk factors
What is Stage 1 of E.O.S.S?
- Presence of obesity obesity-related subclinical risk factors
- (e.g., borderline hypertension, impaired fasting glucose levels, elevated levels of liver)
What is Stage 2 of E.O.S.S?
- Presence of established obesity
- obesity-related chronic disease
- (e.g., hypertension, type 2 diabetes, sleep apnea, osteoarthritis),
- moderate limitations
What is Stage 3 of E.O.S.S?
- Established end-organ damage such as myocardial infarction, heart failure,
- stroke, significant psychopathology, significant functional limitations and/or
- impairment of well well-being
What is Stage 4 of E.O.S.S?
- Severe (potentially end-stage) disabilities from obesity obesity-related chronic
diseases, severe disabling psychopathology, severe functional limitations
What recommendations were made for healthcare providers regarding obesity care?
- Assess personal attitudes and beliefs about obesity and how they may influence care.
- Recognize that internalized weight bias in people with obesity can affect health outcomes.
- Avoid using judgmental words, images, and practices when working with patients.
- Avoid assuming that a patient’s ailment is related to their body weight.
What recommendations are given for healthcare providers working with Indigenous people living with obesity?
- Understand the patient’s social circumstances.
- Acknowledge the stress and disadvantages they face and explore ways to reduce stress to improve health.
- Advocate for access to affordable obesity management resources in public healthcare.
- Encourage patients to believe that good health is achievable and that they deserve it.
- Reflect on personal biases, including anti-Indigenous sentiment, and consider trauma or grief as factors affecting health.
- Explore how systemic racism may influence care.
What happens when more food energy is consumed than needed?
Excess fat accumulates in the fat cells of the body’s adipose tissue. 3500 kcal equals 1 pound of body fat.
Daily energy balance:
*
Change in energy stores = energy in energy out
How many kcal are in 1 gram of carbohydrate?
4 kcal.
How many kcal are in 1 gram of protein?
4 kcal.
How many kcal are in 1 gram of fat?
9 kcal.
How many kcal are in 1 gram of alcohol?
7 kcal.
What is the thermic effect of food for different macronutrients?
Fat: 0-5%
Carbohydrate: 5-10%
Protein: 20-30%
Alcohol: 15-20%
When is Basal Metabolic Rate (BMR) higher?
- In younger people (because lean body mass declines with age).
- In taller people (due to larger surface area).
- In people who are growing (e.g., children, pregnant women).
- In people with more lean muscle mass (e.g., physically fit individuals).
When is Basal Metabolic Rate (BMR) lower?
- Older people people-lean body mass declines with age
- Fasting – body slows to preserve energy
- Malnutrition
- Hypothyroidism
What are some methods for measuring body composition and fat distribution?
- Anthropometry: Fatfold measures (caliper)
- Density: Underwater weighing or air displacement plethysmography
- Conductivity: Bioelectrical impedance
- Radiological techniques: DEXA
Lean tissue is denser than fat tissue
Toxicity and Alcohol?
Toxic in relatively small amounts which makes alcohol
dangerous
What is the equivalent of one standard drink in milliliters for different alcoholic beverages?
- 142 ml of wine (approx. 12%)
- 43 ml of hard liquor (approx. 40%)
- 341 ml of beer (approx. 5%)
Values are sometimes written as 150ml, 45ml or 50 ml, and 350ml)
Distilled liquor is often stated in proof
* 80 proof refers to 40% alcohol
What type of substance requires no digestion and can diffuse through the stomach wall to reach the brain within a minute?
Alcohol
What is the role of the MEOS system in the liver?
- It metabolizes alcohol and some drugs.
- It handles about 10% of alcohol consumed.
- It becomes more efficient with higher alcohol concentrations or repeated exposure, resulting in better tolerance.
How does the MEOS system affect drug metabolism when alcohol and drugs are taken together?
- MEOS processes alcohol first, which can cause the drug to build up and its effects to be stronger.
- Heavy drinkers have more MEOS, helping to process drugs faster when not drinking.**
Brain centres on alcohol in a particular order:
- Frontal lobe– judgement and reasoning
- Midbrain– speech and vision centres become sedated
- Cerebellum – large muscle control is affected
- The conscious brain is completely subdued so the person passes out
- Deepest brain, medulla oblongata – respiration and heart rate
What is Fetal Alcohol Spectrum Disorder (FASD), and what support might individuals need?
- FASD refers to the impacts on the brain and body of someone exposed to alcohol in the womb.
- It’s a lifelong disability but can be prevented with proper support.
What factors influence the impact of alcohol on a developing fetus?
- How often alcohol was consumed
- How much alcohol was consumed
- When during the pregnancy the alcohol was consumed
Fetal Alcohol Spectrum Disorder (FASD)
Prevention
- Health care provider (doctor, midwife, community health nurse)
- Local health centres (friendship centre, public health unit, community health/resource centre)
- Provincial or territorial health services (ministry of health, health and social services)
- First Nations or Inuit communities (local health centre, nursing station, community health nurse)
What are the cancres that happen due to long use of alcohol
mouth, throat, esophagus, breast, stomach,
pancreas, liver, colorectal
What is the safest amount of alcohol to consume during pregnancy?
None, as no amount of alcohol is safe during pregnancy.
What are the benefits of not drinking alcohol at all?
Better health
Better sleep
No risk of alcohol-related consequences
What is the risk associated with drinking 2 or fewer standard drinks per week?
Likely to avoid alcohol-related consequences for yourself or others.
What is the risk of drinking 3-6 standard drinks per week
Increased risk of developing several types of cancer, including breast and colon cancer
What happens if you drink 7 or more standard drinks per week?
Increased risk of heart disease or stroke.
What is the risk associated with consuming more than 2 standard drinks per occasion?
Increased risk of harms to self and others, including injuries and violence.
What is the safest approach to alcohol consumption when pregnant or trying to get pregnant?
There is no known safe amount of alcohol use during pregnancy or when trying to get pregnant.
What are hemoglobin and myoglobin, and what is their role in the body?
- Hemoglobin: Oxygen-carrying protein in red blood cells.
- Myoglobin: Oxygen-holding protein in muscles
What are the main roles of iron in the body?
- Carries oxygen.
- Helps enzymes use oxygen.
- Needed to make new cells, amino acids, hormones, and neurotransmitters.
How does the body recycle iron?
- The liver creates red blood cells with iron from bone marrow.
- Red blood cells live for 3–4 months.
- The liver and spleen break down dead red blood cells and recycle their iron.
Why is iron considered an essential nutrient?
Iron is necessary for oxygen transport, enzyme function, and creating essential components like new cells, hormones, and neurotransmitters. Deficiency is a common problem.
What percentage of dietary iron is typically absorbed by the body?
Approximately 10–15%
When does the body increase iron absorption?
When iron levels are low or the body needs more iron.
When does the body decrease iron absorption?
When iron levels are abundant.
How is iron absorbed and stored in the body?
Iron is absorbed in the small intestine and stored by ferritin in mucosal cells.
What happens to iron if it is needed by the body?
If needed, iron is released from ferritin to transferrin and transported through the blood to the body.
What happens to iron if it is not needed by the body?
If not needed, iron is shed with intestinal cells, which are replaced every 3–5 days.
What happens in Stage 1 of iron deficiency?
Decreased iron stores.
What happens in Stage 2 of iron deficiency?
Depleted iron stores.
What is iron deficiency anemia?
A severe stage of iron deficiency where hemoglobin levels are low, resulting in anemia.
What are common causes of iron deficiency and anemia?
- Malnutrition and inadequate iron intake.
- Overconsumption of sugar and fats.
- Blood loss, especially during menstruation and GI bleeding.
How does blood loss contribute to iron deficiency?
- 80% of the body’s iron is stored in blood.
- Blood loss reduces iron levels, leading to deficiency.
Who has increased iron needs?
- Women in reproductive years (due to menstruation).
- Infants, young children, adolescents, and pregnant women (due to growth).
What is the global impact of iron deficiency?
- Affects more than 1.2 billion people worldwide.
- Common in developing countries, especially in preschool children and pregnant women.
What non-nutritional causes contribute to iron deficiency anemia?
- Blood loss from conditions like GI bleeding.
- Parasitic infections or digestive tract ulcers in developing countries causing daily blood loss.
What happens if a person takes in too much iron?
Iron is toxic in large amounts and difficult to excrete. The body controls absorption to prevent overload. Hepcidin, a hormone, limits iron absorption.
How does the body protect against iron overload?
The small intestine traps excess iron, holding it until the intestinal cells are shed. When iron stores are full, less iron is absorbed.
What is hemochromatosis?
Hemochromatosis is an inherited disease where the body absorbs too much iron, most commonly in Caucasian men.
What are the early symptoms of hemochromatosis?
Early symptoms include fatigue, mental depression, and abdominal pain.
What are the later symptoms of hemochromatosis?
Later symptoms include liver failure, abnormal heartbeats, type II diabetes, and infections due to bacteria thriving on iron-rich blood.