Hoofdstuk 8

Question 1

5 types of chemicals that provide specific nutrients for body functioning

Answer 1

1) carbohydrates (glucose/fructose/sucrose/starch)
2) lipids “fats” (saturated/polyunsaturated/ cholesterol)
3) proteins (amino acids)
4) vitamins (organic) Fat Soluble (ADEK) or water soluble (BC)
5) minerals (inorganic) calcium/sodium/phosphorus/potassium/Iron/Iodine and Zinc
6) Fiber (not used in metabolism, but essential for digestion)

Question 2

6 Environmental influences food

Answer 2

1) newborns learn from mother
2) availability of certain foods
3) more fast food available, more eaten
4) other people’s response to certain foods
5) portion sizes are often supersized
6) person’s skills to regulate/manage food

Question 3

Cholesterol

Answer 3

is main dietary culprit in atherosclerosis (deposit of fatty plaques in blood)
- depends on presence of lipoproteins (fats and proteins)

Bad LDL = Low Density Lipids (related to increased plaque deposits)
Good HDL = High Density Lipids (decreased likelihood of plaque build-up)

Question 4

Triglycerides

Answer 4

fats that increase the risk of heart disease

Omega 3 Fatty Acids = reduce serum triglycerides and raise HDL

Trans Fatty Acids = increase LDL, lower HDL

LDL’s risk depends on 5 other risk factors
-age (45+ men 55+ women)
- cigarettes
- high-risk - much lower LDL
- Low HDL (<40mg)
- family history of cardiovascular disease

• people with low risk should keep LDL below 160 mg
• high risk should be lower LDL
• with heart disease the levels should be below 100mg

Statin drugs greatly lower LDL and raise HDL levels (Crestor/Lipitor/Zocor)

Question 5

Sodium & Caffeine affect blood pressure

Question 6

Most effective dietary interventions incorporate or address elements of the theories of health related behavior:

Answer 6

• person’s perceived barriers and benefits of change (Health Belief Model)
• one’s self-efficacy, readiness and intention to change (Stages of Change Model/ Theory of Planned Behavior)

Question 7

BMI

Answer 7

overweight BMI 25+/ Obese BMI 30+

Question 8

The body stores excess calories as fat in Adipose Tissue

Answer 8

which increases throughout childhood and adolescence in cell size and cellnumber

Question 9

Specific genes linked to obesity

Answer 9

FTO - affects the feeling of satiation and causes calories to be stored as adipose tissue rather than burned
MC4R - associated with preferring and consuming high amounts of dietary fat

Question 10

Set-Point Theory

Answer 10

proposes that each person’s body has a certain (SET) weight that it strives to maintain
- the body tries to maintain its weight near the set-point (with hypothalamus)
- Hypothalamus: monitors the blood for levels of specific hormones (ghrelin/leptin/insulin)

Ghrelin - secreted and carried in the blood to the hypothalamus when energy intake is low or the stomach is empty

• the other 2 hormones increase/decrease in proportion to the amount of body fat the person has
• Leptin regulates circuits in the hypothalamus that stimulate and inhibit eating and metabolism
• Insulin is produced by the pancreas and has a similar, smaller effect on the hypothalamus, but it also regulates the amount of glucose in the blood. The conversion of glucose to fat and the storage of fat in adipose tissue.
• Obsese people tend to have high serum levels of insulin - a condition called hyperinsulinemia - which increases one’s sensations of hunger, perceived pleasantness of sweet tastes and food consumption
• when people lose weight, these hormones signal a need for food (at least a year)
• Ghrelin increase with stress and decrease when stress is reduced

Question 11

Individuals who develop too many fatcells (fat-cell hyperplasia)

Answer 11

may be doomed to struggle against a high-set-point for the rest of their lives (fat-cells do not decrease)

Question 12

Research has found higher rates of hypertension/diabetes/CHD and mortality among people with high, rather than low, central adiposity (usually measured as a waist to hip ratio

Answer 12

waist measurement compared to hip measurement

Question 13

LIfestyle Interventions

Answer 13

designed to modify diet and exercise in overweight people
* nutrition and exercise counselling
* self-monitoring
* stimulus control
* altering the act of eating
* behavioral contracting (rewards system)

• motivation interviewing (cognitive method to use with weight loss programs for commitment and self-efficacy)
• problem-solving strategies (dealing with difficulties)

Question 14

Medical Approach for weightloss (when obese)

Answer 14

Orlistat: decreases intestinal absorption of ingested fat, produces moderate weight loss and approved for long-term use

Protein-Sparing-Modified- Fast = short term (800 cal)

• Bariatric Surgery (BMI 40+)
  1) restricts the holding capacity (band around the upper part of the stomach)
  2) surgically creating a small chamber at the top (also modifies the intestine)

Question 15

Reasons why people, who have lost weight, overeat

Answer 15

1) Biological (hormones keep signalling for food)
2) Lack of reinforcement
3) Existence of food cues
4) negative emotions (Stress/depress)
5) Boredom

• problem-solving training after weight-loss with behavioral methods (self-monitoring stimulus control) = effective in maintaining the loss

Question 16

DSM5 Anorexia + Bulimia

Answer 16

psychiatric disorders (high levels of perfectionism)

Question 17

Psychotherapy more effective for treating bulimia

Answer 17

especially when it includes behavioral + cognitive methods (self-monitoring, reinforcement) and cognitive structuring (focus on reducing binging and purging behaviors)

• sometimes drugs for reduction of depression

Question 18

3 psychosocial benefits of exercise

Answer 18

1) engaging in regular vigorous exercise is associated with lower feelings of stress and anxiety
2) people who engage in aerobic exercise show improved cognitive processes (fewer errors and better memory)
3) regular exercise is linked to enhanced self-concepts (especially in children). In childhood, aerobic exercise improves agility and cardiovascular function

Question 19

People’s beliefs can influence exercise

Answer 19

1) underestimate enjoyment of exercise (positive affect during exercise makes future exercise more likely)
2) high self-efficacy = more likely
3) perceived susceptibility to illness = more likely
4) perceived barriers = reduced exercise
enjoyment = increased exercise

Question 20

Strategies to promote exercise

Answer 20

1) rewards for increased activity
2) physicians = verbal advise + written plans for specific behavior and goals
3) high frequency ipv high intensity for sedentary people
4) high exercise levels –> higher incomes
5) reduces risk of depression
6) stick with it if they can deal with lapses and setbacks

Question 21

2 succesfactoren

Answer 21

1) contact (telephone)
2) readiness in terms of the Stages of Change Model (Contemplation Stage bv)

Question 22

Accidental injury

Answer 22

3rd most frequent cause of death overall and leading cause of death for 1-45 year olds

Question 23

Sunscreen

Answer 23

information has a greater influence on the likelihood of using sunscreen if it has gain-framed messages (behoud je jonge huidje)