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KNES 237 > KNES 237 Midterm 1 > Flashcards

KNES 237 Midterm 1 Flashcards

1
Q

What is nutrition

A

A n interdisciplinary science that studies food and health with a focus on the nutrient and chemical properties of foods.

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2
Q

How long can you survive without food or water

A
  • 2 weeks without food and 3 days without water, but depends on amount of fat stored and muscle in the body
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3
Q

Food security:

A

Access at all times to sufficient supply of safe, nutritious foods (don’t have to scavenge or steal food)

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4
Q

Food insecurity:

A

Limited or uncertain availability of safe, nutritious foods- or ability to acquire them in socially acceptable ways.

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5
Q

Food insecurity can lead to…

A
  • Can lead to poor quality diet
  • greater risk of chronic disease
  • maybe due to: poverty, absence of supermarkets, access to inexpensive, high calorie (low nutrition) foods, limited cooking facilities
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6
Q

Food insecurity percents:

A

36.7% in nunavet
8.0% in alberta
8.1% in Canada
14.3% in USA

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7
Q

What are calories?

A

A unit of measure that represents of the amount of energy supplied by food, kilocalorie (kcal, C)

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8
Q

Nutrients:

A
  • Chemical substances used by the body
  • Help sustain growth and development
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9
Q

What are the 6 categories of nutrients?

A
  1. Carbohydrates (CHO) Energy nutrient
  2. Protein- Energy nutrient
  3. Fat- Energy nutrient
  4. Vitamins
  5. Minerals
  6. Water
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10
Q

Vitamin A inadequate intake:

A
  • Reduced liver stores, blood levels
  • impaired ability to see in dim light
  • Long term: lead to loss of vision
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11
Q

Vitamin A high intake:

A
  • Hypervitaminosis A (500,000 IU or 50,000 IU long term
  • Nausea, irritability, blurred vision, headache
  • liver damage
  • birth defects
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12
Q

Estimated average requirement (EAR)

A

The average daily intake level estimated to meet the needs of half the people in a certain group. Scientists use it to calculate the RDA.

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13
Q

Recommended dietary allowance (RDA)

A

The average daily intake level estimated to meet the needs of nearly all people in a certain group. Aim for this amount!

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14
Q

Adequate intake (AI)

A

the average daily intake level assumed to be adequate. It is used when an EAR cannot be determined. Aim for this amount if there is no RDA!

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15
Q

Tolerable upper intake level (UL)

A

The highest average daily intake level like to pose no health risk. Do not exceed this amount on a daily basis!

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16
Q

Malnutrition…

A

can result from poor diets, disease, genetic factors, or a combination of these factors

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17
Q

3 nutritional deficiencies:

A
  1. Under consumption= developing nations (famine)
  2. Over consumption= typical western diet (contributes to obesity)
  3. Under nutrition= from refined foods, lack of micronutrients
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18
Q

Some groups of people are at higher risk of becoming malnourished than others…

A

Infants, pregnant women, elderly, ill or recovering from illness

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19
Q

Bad nutrition…

A

can influence the development of certain chronic diseases

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20
Q

Key points

A
  • adequacy, variety, and balance are key point of a healthful diet
  • There are no “good” or “bad” foods
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21
Q

What is Orthorexia Nervosa

A
  • Unhealthy fixation with eating healthy
  • can lead to nutritional deficits
    No specific category in DSM (Diagnostic and statistical manual) but falls under avoidant/restrictive food intake disorder (ARFID)
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22
Q

Strawpoll, percent of deaths In the world/Canada

A
  1. heart disease 33%
  2. cancer 18%
  3. Pneumonia 4.4%
  4. neurological diseases 3.9%
  5. Diabetes 2.7%
  6. HIV/AIDS 1.5%
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23
Q

Risk factors: a condition or behaviour associated with an increased frequency of a disease but not proved to be casual

A

Dietary, genetics, age, sedentary lifestyle, smoking and tobacco use, stress, environmental containments

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24
Q

Mortality rate attributable to diet and # of deaths at the global level attributable to diet

A

Diet high in sodium
diet low in whole grains
diet in low in fruits

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25
Q

Western diets…

A
  • promote chronic diseases
  • diets high in salt, refined grains (white flour)
  • diets in processed meats, refined sugars (white sugar)
  • diets low in fruits, vegetables and fiber
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26
Q

Unhealthy weight in adults

A

36.3% have overweight + 26.8% have obesity= 63.1% unhealthy weight
- greatest recent increase in obesity is in 20 to 39 year olds

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27
Q

Unhealthy weight in children

A

17% have overweight + 9% have obesity= 26% unhealthy weight
- obesity is a complex, multifactorial chronic disease. Calorie intake is just one contributor

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28
Q

Are ancient diets best?

A
  • Some claim the healthiest diet is one that was eaten during the palaeolithic era 10000 years ago
  • the paleo diet restricts what you eat to foods the hunter-gathers of the Stone Age ate
  • They would overeat when food was available to protect them during famine
  • Very common to cycle through period of feasting or famine
  • “Feast or famine”
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29
Q

Diets have changed but the body has not..

A
  • There are biological processes in the body that make it difficult to stay healthy in the current food environment
  • We get hungry every 4-6 hours even in the presence of excess body fat stores, today this can lead to consuming more calories than we burn
  • Our bodies conserve sodium – historically, diets were low in sodium and there was lots of vigorous activity, sweating, and diarrhea – so it was advantageous to conserve sodium for survival.
    – Today, this conservation of sodium in the context of a high sodium (salt) diet, leads to high blood pressure.
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30
Q

Sweet taste and bitter taste…

A

We naturally prefer fatty and sweet-tasting foods:
– sweet taste – we evolved to associate sweet taste with calories and
nutrients that are safe for human consumption; help orient our
behavior to seek out and consume these foods
– bitter – associated with toxic products (a lot of good vegetables taste
bitter therefore people consume fewer)
– Today, we overconsume sugary foods and eat fewer vegetables.

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31
Q

were they healthier during the Stone Age?

A
  • Many died of starvation
  • vitamin deficiencies and food poisoning
  • died younger so less degenerative diseases
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32
Q

Should we eat like they did?

A

Not necessarily..
- meat differs (leaner back then)
- fruits and vegetables differ ( different types, nutrient levels may vary)
- Environment is different (more pollution, sedentary behaviour)
- Strive for more exercise and wholesome foods

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33
Q

Nutrition in the media… typical problems

A
  • tight deadlines
  • limited understanding
  • single study
  • report scientific findings prematurely
    half- truths and hype are common in books, newspapers, magazines, tv, radio, pamphlets, internet, speeches, etc.
    • but we have the right to free speech…
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34
Q

Laws about nutrition in media..

A
  • It is unlawful to state false claims on a product label or in an advertisement
  • it is unlawful to use the U.S. or Canadian mail systems to send fraudulent products or receive payments for fraudulent products
  • BUT RARELY ARE THESE LAWS ENFORCE, AND PENALTIES ARE MINIMAL
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35
Q

What is the primary reason for nutrition misinformation?

A
  • Profit
  • As long as people think there is a quick and easy way to lose weight, build muscle, slow aging and reduce stress, there will be a huge market for “nutritional” products and services
  • The world market for vitamins alone is over 3 billion dollars.
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36
Q

Identifying Nutrition experts: Register dietitian

A
  • B.Sc. in nutrition
  • Internship
  • National licensing exam
  • Registration (College of Dietitians of Alberta)
  • RD
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37
Q

Identifying nutrition experts: Nutritionist

A
  • Before September 2016 the title ‘Nutritionist’ could be used by anyone in Alberta to describe themselves as a professional in the Nutrition industry.
  • As of September 2016, the title ‘Nutritionist’ can only be used by members of the College of Dietitians of Alberta.
    – Registered Dietitian
  • Registered Nutritionist
    – RD
  • Dietitian
    – Nutritionist *
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38
Q

What are sources of reliable nutrition information?

A
  • Health organizations (eg. Heart and Stroke Foundation; Canadian Diabetes Association)
  • Scientific organizations (eg. Canadian Nutrition Society)
  • Professional organizations (eg. Dietitians of Canada)
  • Government publications (eg. Health Canada)
  • Registered, licensed or certified dietitians
  • Nutrition textbooks (not diet best sellers)
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39
Q

Importance of research

A

Facts and evidence provided by scientific studies: used to develop nutrition information and guidelines that affect publics health.
- peer-reviewed paper published in scientific journals

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40
Q

Identifying nutrition Quakery

A
  1. too good to be true or a quick fix
  2. Testimonials (before and after pictures)
  3. Make you suspicious of food supply
  4. Fake credentials
  5. elimination of whole food groups
  6. Use of the word ‘natural’
  7. supplements needed by all; megadoses
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41
Q

What foods must be labeled?

A
  • Foods containing more than one ingredient (mostly processed foods)
  • Dietary supplements
  • If a claim is made- “low fat,” “low calorie,” etc.
  • must display nutrition information backing the claim but beware:
    -Light: no guideliens
  • Low sugar: no guidelines
  • Reduced fat or calories: 25% less than the original
  • Fat free: <0.5g
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42
Q

Foods that are not required to be labeled

A
  • fresh fruits and vegetables
  • raw, single-ingredient meat, poultry, fish and seafood
    seafood
  • very small packages, such as one-bite candy
  • items with insignificant calories and nutrients, such as
    herbs and spices
  • food sold at farmer’s markets
  • food sold only in grocery stores where the product is
    prepared or packaged in-store (e.g. bakery, salads)
  • alcoholic beverages: water, tea or coffee without anything added to it
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43
Q

New nutrition labels in Canada…

A
  • Calories is larger and stands out more with bold line below
  • Serving size stands out more
  • Daily values updated
  • New % daily value for total sugars
  • mg amounts are shown
  • Updated list of minerals of public health concern
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44
Q

Organic food labels

A

Financial penalties can be imposed on companies that use the label inappropriately.
Should be lower in hormones, antibiotics, and pesticide and herbicide residues.

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45
Q

Only products with organic content of can be labelled as organic.

A

greater than or equal to 95%

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46
Q

‘Organically grown’, ‘organically raised’ or ‘organically produced’ all mean the same as organic and meet the same requirements.

A

True

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47
Q

If a multi-ingredient product has 70 to <95% organic content

A
  • Must declare the percentage of organic
    content on the label
  • May NOT use the organic logo nor the claim
    organic
  • If <70% organic content, can only indicate
    which ingredients are organic in the
    ingredient list
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48
Q

Is organic food always healthier than non-organic?

A

Nutrient-wise (protein/vitamins/etc.) they are similar. One difference is that organic fruits & vegetables can have higher antioxidant content. Organic diets do lead to less pesticide exposure.

  • Avocados, cantaloupe, pineapple, broccoli, cabbage and corn have low levels of pesticides, so less advantage to buyingorganic.
  • Strawberries, spinach, grapes, apples, tomatoes and celery have higher levels of pesticide residues.

Given the cost of organic foods, it may not be feasible for many Canadians — we should encourage Canadians to eat more fruits & vegetables – closing that gap would be
equally or more important for health.

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49
Q

Enriched or fortified

A
  • Vitamin and mineral content of food is increased by enrichment and fortification
  • Definitions established more than 50 years ago
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50
Q

Enrichment:

A
  • Pertains only to refined grin products where thiamin, riboflavin, niacin, and iron lost in milling are added
  • Producers of bread, cornmeal, pasta and crackers from refined grains must use enriched flours
  • Example: robin hood flour
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51
Q

Fortification:

A
  • Is the addition of a vitamin or mineral nor normally found in the food
  • Example: simply orange juice
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52
Q

The ingredient label

A
  • All ingredients must be listed in descending order of amount present (by weight)
  • Ingredients causing allergic reactions (peanuts, tree nuts, milk, eggs, fish, shellfish, wheat, soy, sesame and sulphites) must also be listed on the ingredient label
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53
Q

food additives on the label

A
  • Food additives must be listed
  • 3000 chemicals are added to food to enhance its flavor, color,
    texture, cooking properties, shelf life, or nutrient content
  • Food additives with “GRAS” can be used without pre-approval
    (Generally Recognized As Safe)
    – Sodium chloride, sucrose, cornstarch, many vitamins/minerals
  • New additives must be approved by Health Canada prior to use
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54
Q

Irradiated foods

A
  1. must contain radar symbol
  2. Uses: prevent sprouting, delay ripening, kill insects/mold/bacteria, potatoes, onions, wheat, flour, spices, ground beef
  3. Foods do not retain radioactive particles
  4. Doses: 10-20x higher than lethal dose in humans
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55
Q

Dietary supplement labeling

A
  • Dietary supplements must be labeled
  • Dietary supplement labels cannot claim the products treat, cure, or prevent disease
  • Not classified as a drug, so no vigorous testing
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56
Q

We are not born knowing what to eat…

A
  • Don’t generally seek nutrients we are deficient in
  • Select food based on preference, culture, nutrition knowledge and beliefs, cost, hunger, availability, convenience
  • Humans and most animals will seek water and food, but not generally the best foods, unless they have learned how to eat a well-balanced diet
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57
Q

How do we decide when and how much to eat?

A
  • Hunger, satiety(feeling full or satisfied) and thirst centres are located in the “primitive” brain: Hypothalamus- appetite centre
  • Inborn attraction to sweet and salty tasting foods, dislike of bitter and sour foods
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58
Q

What do infants prefer?

A

Infants like sweets, more than sour or bitterness

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59
Q

What makes us like or dislike?

A
  • The strongest influence is “food preference,” a learned behaviour
  • Food preference is shaped by memory and memories are based on culture and the pleasure associated with memory
  • we reject foods that bring us discomfort, guilt and unpleasant memories (e.g. eating something that gave us food poisoning; as a child having to eat vegetables before leaving the table.
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60
Q

Food marketing:

A

Can influence food choices it is designed to:
- create food trends
- encourage you to:
buy certain foods or drinks
buy foods in order to get promotional items such as loyalty points, tickets to movies or sports events, coupons for future food purchases
- create links between certain foods or brands and a particular lifestyle
- build brand loyalty so you will continue to purchase from a particular store or products with a brand name

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61
Q

Red food colour

A

enhances appetite; increases heart rate

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62
Q

Green food colour

A

healthy; eco-friendly; natural

63
Q

white food colour

A

reduced calories

64
Q

Yellow food colour

A

happiness and youthfulness; brain processes yellow very rapidly

65
Q

Orange food colour

A

good value; stimulates appetite and conversation

66
Q

Brown food colour

A

rich flavour

67
Q

Blue food colour

A

suppress appetite; most unappetizing color

68
Q

Adequate diets

A
  • Variety of foods provide sufficient levels of calories and essential nutrients
  • an adequate diet contains all nutrients necessary for long-term survival but it may not necessarily be optimal or have any variety.
69
Q

Balanced diets

A
  • provide calories, nutrients, and other components in the right proportions
  • A balanced diet has the six classes of nutrients in good proportion
70
Q

Essential nutrients

A

Nutrients the body cannot produce, or produce in sufficient amounts; must be obtained in the diet. example: iron, calcium

71
Q

Nonessential nutrients

A

Nutrients the body can manufacture in sufficient quantities. Example: cholesterol

72
Q

Recommended amount: Carbohydrates

A

45-65%

73
Q

Recommended amount: Fat

A

20-35%

74
Q

Recommended amount: Protein

A

10-35%

75
Q

Recommended amount: Fiber

A

25g for women
38g for men

76
Q

Western diet overloaded with…

A

Refined sugars
saturated fats
salt
High intakes of fat (saturated fat and trans fat) are risks for heart disease and metabolic syndrome

77
Q

Western diet low in…

A

Essential fatty acids
dairy products
vegetables and fruits
fiber
Low intake of dairy products and vitamin D are risks for osteoporosis

78
Q

Vegetables:

A

Only 6% of adults regularly consume broccoli, cauliflower, Brussels sprouts, or dark, leafy green vegetables
– These are associated with reduced cancer risk
– Most commonly consumed vegetable in the U.S. is the potato

79
Q

Whole grains:

A

More whole grains are needed
– Whole grains reduce the risk of certain types of cancer, type 2 diabetes and heart disease
* Americans consume an average of one serving of whole-grain
products daily

80
Q

Old food guide

A

Focused on 4 food groups:
1. grain products
2. vegetables and fruit
3. milk products
4. meat and alternatives

81
Q

New food guide

A

focuses on broader statements and no longer uses the food group categories

82
Q

USDA MyPlate

A

Grains: Make half your grains whole grains.
Protein: Vary your proteins.
Vegetables: Make half your plate fruits and vegetables; vary your vegetables.
Fruits: Make half your plate fruits and vegetables; focus on whole fruits.
Dairy: Move to low-fat or fat-free dairy milk or yogurt.

83
Q

Mediterranean diet pyramid

A
  • WHO developed guide in 1994 to help popularize a diet associated with reduced risk of heart disease and cancer
  • Emphasizes olive oil, breads, whole-grain cereals,
    nuts, fish, dried beans, vegetables, and fruits; and wine in moderation
  • Intake of red meats is limited to monthly, and sweets
    and poultry to weekly intake
  • Key features: rich in plant foods, olive oil, limited red meat
84
Q

The Gut

A
  • Approx. 92-99% of the protein, fat and carbohydrate that we consume is digested and absorbed
  • Most of the dietary fiber is not digested, most is fermented by bacteria
85
Q

Mechanical digestion

A
  • Physical breakdown of food
  • chewing, grinding and mixing food with mouth, tongue and teeth
86
Q

Chemical digestion

A
  • Chemical breakdown of food using enzymes, bile and hydrochloric acid
  • There are over 100 enzymes that are secreted by the digestive system
87
Q

Digestive system is made up of:

A

Mouth
Pharynx
epiglottis
esophagus
stomach
small intestine
large intestine
rectum
anus

88
Q

Accessory organs in digestive system

A

Liver
gall bladder
pancreas

89
Q

Heartburn notes 1

A
  • Caused by excessive stomach acid or defective lower esophageal sphincter – causes burning sensation in the esophagus.
  • Acid reflux is a common medical condition that can range in severity from mild to serious. Gastroesophageal reflux disease
    (GERD) is the chronic, more severe form of acid reflux. Heartburn is a symptom of acid reflux and GERD.
  • Stress, anxiety, frequent use of aspirin and other anti-inflammatory medicines, fatty foods, spicy foods, coffee, alcohol, citrus fruits, soft drinks, and other foods are involved.
  • Weight gain and eating within 3 hours prior to going to bed increase symptoms
    – weight gain of 10-20 pounds associated with a 3-fold increase in heartburn symptoms
90
Q

Heartburn treatment

A
  • High-fiber diets protect against development of heartburn
  • Treatments include: stress reduction, elimination of offending foods, eating small and frequent meals
    – mild occasional heartburn can use over-the-counter antacids but with persistent symptoms, prescription medication may be needed (e.g. H2 blockers, proton pump inhibitor)
91
Q

Ulcers:

A
  • Develop when protective stomach or duodenum lining is damaged
  • HCl lowers the ph of the stomach to about 1.5-2
  • Stomach acid and digestive enzymes erode the lining(s) and cause an “ulcer”
92
Q

Duodenal ulcers

A
  • 10x more common than stomach ulcers and are closely associated with helicobacter pylori (H. pylori) bacteria conditions
  • Classified as class 1 carcinogen-stomach cancer
93
Q

Class 1 Carcinogens

A
  • Known human carcinogens:
    – Alcoholic beverage consumption
    – Asbestos
    – Cadmium
    – Engine exhaust, diesel
    – Epstein-Barr virus (infection with)
    – Human papilloma virus (HPV)
    – Ionizing radiation: CT scans, continuous
    – Workplace exposure as a painter
    – Tobacco smoke, secondhand, smokeless
    – Radon: leading cause of lung cancer
94
Q

Stomach to small intestine

A
  • Stomach percolates chyme into the small intestine
    – Solid foods stay in stomach for about 2-4 hours, liquids pass through in
    about 20 minutes
    – Solid food is passed to the small intestine about 1 to 2 teaspoons at a time
  • The small intestine is about 6 meters long and composed of 3 segments: duodenum, jejunum, and ileum
  • Available surface area of small intestine is about the size of a baseball infield, 675 square feet
  • Intestinal cells turn over every 4-5 days
    – High nutrients needs
95
Q

The exocrine pancreas

A
  • The enzymes produced by the pancreas act to breakdown all of the major energy nutrients: Carbohydrates (Amylases), Proteins (Proteases), Fat (Lipases)
  • Absorption also begins to take place. Small molecules are transported into cells lining the small intestine.
96
Q

Absorption: Blood vessels

A

Carbohydrate and protein breakdown products, for distribution to the body

97
Q

Absorption: Lymphatic vessels

A

Fatty acids from fat breakdown, empty into the subclavian veins that feed back to the heart

98
Q

The liver

A

Many functions:
* Detoxification ( amino acid catabolism yields ammonia – neurotoxin - liver converts ammonia to urea)
* Protein synthesis (clotting factors, IGF-1)
* Metabolic control (glucose, lipids)
* Glycogen formation and storage
* Triglyceride and cholesterol production
* Produces bile (stores in gallbladder)
* Red blood cell degradation
* Hormone production
* Amino acid synthesis
* Stores vitamin A, D, B12, iron & copper
* Synthesizes angiotensinogen

99
Q

The large intestine:

A
  • Water, sodium, and some of the end products of bacterial digestion are absorbed from the large intestine
  • Bacteria digest fiber and complex carbohydrates that we can’t digest
  • These bacteria excrete gas and short chain fatty acids that can be absorbed in large intestine
  • Substances that cannot be absorbed are excreted as feces
100
Q

Constipation and hemorrhoids

A

-Are due to diets with too little fiber
- Adults need fiber intakes of 25g/day (females) to 38g day (males) plus plenty of fluids
- this regiment will help prevent constipation and hemorrhoids in healthy people

101
Q

Diarrhea

A
  • Severe diarrhea leads to dehydration, heart and kidney malfunction, and death
  • Most due to bacterial - or viral contaminated food or water, lack of immunizations against infectious diseases, and deficiencies of various nutrients
  • 3.5 million deaths from diarrhea occur annually to children five years old or less
102
Q

Bacteria discovery:

A
  • Late 1800’s discovered bacteria can cause infections
  • 1928 penicillin was discovered
  • Before antibiotics, 90% of children with bacterial meningitis died
  • higher antibiotic use coincided with higher childhood asthma and obesity
103
Q

Microbiota gut

A

The most densely colonized ecosystem of the human body

104
Q

Human Gut microbiota in health

A
  • Break down dietary fiber
  • Produce certain vitamins (vitamin K, B vitamins)
  • Trains the immune system
  • Suppress growth of pathogenic bacteria
  • Motility and intestinal function
  • Drug metabolism (>50)
  • Affect mood
  • 40 trillion microbes
  • Very important for enfants, the gut trained the immune system
105
Q

Diet is a major modifier of the gut microbiome

A

Promote symbiosis-health
- high fiber
- whole natural foods

106
Q

Dysbiosis- imbalanced microbiota

A

High fat, high sugar
Artificial sweeteners
Dietary emulsifiers
ultra-processed foods

107
Q

Calorie are a unit of measure

A
  • A dietary calorie is one kilocalorie (kcal)
  • the amount of heat required to raise the temperature of 1kg of water 1 degree Celsius
108
Q

Calories from carbohydrates and protein

A

4 kcal/gram

109
Q

Calories from alcohol

A

7kcal/gram

110
Q

Calories from fat

A

9 kcal/gram

111
Q

calculate % calories

A

A food item has 15 g carbohydrate, 10 g protein and 5 g fat and a total of
145 total calories. How many percent of calories are contributed by each
nutrient?
15 g Carbohydrate x 4 kcal/g= 60 kcal
10 g Protein x 4 kcal/g = 40 kcal
5 g Fat x 9 kcal/g = 45 kcal
Total: 145 kcal
Carbohydrate: 60 kcal/145 kcal = 0.41 X 100 = 41%
Protein: 40 kcal/145 kcal = 0.28 X 100 = 28%
Fat: 45 kcal/145 kcal = 0.31 X 100 = 31%
100%

112
Q

How much energy do we really need?

A

20% physical activities
10% of basal + physical activity, thermic effect of food
90-75% basal metabolism

113
Q

Basal metabolic rate (BMR)

A

The rate at which the body uses energy during rest to keep vital functions going, such as breathing and keeping warm

114
Q

Factors to BMR

A
  1. Age- higher age then the basal rate drops
  2. Height- the taller the bigger the BMR
  3. Growth- during growth higher
  4. Body composition- More muscle, higher BMR, but more fat means lower BMR
  5. Fever- higher BMR
  6. Stress- higher BMR
  7. Environmental temperature- higher BMR temporally
  8. Fasting/starvation- decrease BMR
  9. Malnutrition- Decrease BMR
  10. Thyroxine- increase BMR when hyper, decrease when hypo
115
Q

(very) approximate basal caloric need

A

Men = Body weight (lbs) x 11 kcal/lb
Women = Body weight (lbs) x 10 kcal/lb
(e.g. 130 lbs x 10 kcal = 1300 kcal per day)

116
Q

adding PA to basal caloric need

A

Physical activity:
* kcal/min with body weight – converse is true
e.g. cycling 15 mph [110 lb. = 5.4; 200 lb. = 9.8]
1. Activity tables (sum all activity for the day)
2. Activity factors (simply multiply by a factor)
Inactive = basal metabolism x 1.3
Average = basal metabolism x 1.5
Active = basal metabolism x 1.75

117
Q

Physiological influences for hunger

A

Empty stomach
Gastic contractions
Absence of nutrients
GI hormones (elevated gherkin)
Endorphins (brain’s pleasure compounds)

118
Q

Why do we stop eating?

A

Presence of food triggers stretch receptors
Nutrients in intestine elicit satiety hormones: GLP-1 or CCK

119
Q

Why do we not start eating yet?

A

Nutrients in blood signal brain.
As nutrients diminish, satiety diminishes and hunger develops.
Hunger hormones increase- Gherlin

120
Q

Importance of body composition

A
  • Fat, muscle, bone & organs
  • Essential fat: men 3%; women 12%
    (bone marrow, central nervous system, internal organs)
  • Acceptable % body fat: men 18-25% (≥26% classified as obesity) women 25-31% (≥32% classified as obesity)
  • Fitness % body fat: men 14-17% women 21-24%
  • Below certain threshold may experience: infertility, develop depression, abnormal hunger regulation, unable to keep warm
121
Q

Body composition

A
  • excess fat in chest and stomach= higher risk for diabetes, heart disease, and hypertension than excess fat in the hips, thighs, and buttocks.
  • At risk when waist is:
    88cm< for women
    102cm< for men
122
Q

Metabolic syndrome:

A
  • Abdominal obesity
    – Waist circumference greater than 102 cm (40 inches) for men,
    – Greater than 88 cm (35 inches) for women.
  • Elevated levels of triglycerides (1.7 mmol/L).
  • Low levels of HDL (<1.0 mmol/L for men & 1.2 mmol/L for women)
  • High blood pressure/hypertension (> 130/85)
  • Impaired fasting glucose (> 6.1 mmol/L)
123
Q

Fat-fold measures:

A
  • Use caliper to gauge thickness of a fold of skin on back of arm (tricep), below shoulder blade (sub scapular), chest, abdomen, thigh
124
Q

Underwater weighing:

A
  • measure body density by weighing person first on land and then submerged in water. Uses the amount of water displaced and
    the known density of fat mass and lean mass. By volume, fat weighs less than muscle, and kg for kg, fat, and muscle each have a constant mass and displace a specific amount of water.
125
Q

Bioelectrical impedance:

A

use low-intensity electrical current. lean tissues conduct more current, fat more resistant to current

126
Q

DXA:

A

use low-dose x-ray absorption to measure lean and fat mass and bone density

127
Q

Limitation of BMI:

A

Two men have the same BMI but when is build and other is obsessed, different health risks

128
Q

Weight loss by dieting

A
  • Greatest weight loss is during the 1st week of dieting…
    – It is a loss of CHO and H 2 O (70% H 2 O, 25% fat, 5% lean mass)
    – We lose primarily glycogen: 1 gram glycogen: 3 g H 2 O
    – Rapid weight regain when you resume normal eating after 1 wk
  • Weight loss becomes increasingly difficult because you need fewer kcal to maintain new lower body weight (basal energy needs are tied to body weight – and they go down
    as body weight goes down)!
129
Q

2nd week dieting

A
  • 20% water
  • fat and lean mass
130
Q

3rd week dieting

A
  • Minimal water loss
  • fat and lean mass
131
Q

A critical enzyme affecting fat storage

A
  • LPL(lipoprotein lipase): promotes fat storage in adipose and muscle
  • people with high LPL store fat very efficiently
  • individuals with obesity have more LPL activity per fat cell and more fat cells - even modest excess in energy intake has more dramatic effect in an individual with obesity versus lean.
132
Q

LPL role in body fat storage

A
  • gender-specific hormones: in women fat cells in breasts, hips & thighs produce more LPL and in men cells in abdomen produce more LPL
  • after weight loss - LPL increases – explains why you lose weight and regain so easily – set point; the increase is more dramatic in individuals with obesity
133
Q

Increase in leptin

A

Negative energy balance

134
Q

Decrease in leptin

A

positive energy balance

135
Q

How do we gain adipose tissue

A

Lowering your temperature
adding iron into your diet

136
Q

Contrave( naltrexone and bupropion)

A

– low dose naltrexone (medication used to manage alcohol and opioid dependency) plus bupropion (antidepressant that’s also prescribed for smoking cessation)
– work on two separate areas of the brain that control hunger and cravings
– oral tablet

137
Q

Saxenda (liraglutide)

A

– GLP-1 (glucagon-like peptide-1) is a satiety
hormone found naturally in your body. Acts
by decreasing appetite
– pre-filled pen that you self-inject

138
Q

Xenical (orlistat)

A

– Blocks fat absorption in the intestine,
therefore you take in fewer calories
– capsule taken during or just following each
main meal

139
Q

Why are diets so unsuccessful?

A
  • They are often hard to follow
  • They are often very different from what we
    are accustomed to
  • It’s easy to slip off the diet and “cheat”
  • People want a quick fix that works
  • Persistent obesity changes the biology of the body
  • 3500 ~ 1 pound – a myth? YES!!!
140
Q

Full year after significant weight loss

A
  • Gherlin- 20% higher
  • PYY- 20% lower
  • body acted as if starving
  • “post-dieting syndrome”
141
Q

Post weight loss

A
  • Muscle biopsy: burns 20-25% less energy during low-intensity exercise and activities of daily living
  • skeletal muscle work efficiency increased
142
Q

Following calorie restriction

A
  • Functional Mri- activation in the attention and reward regions in response to food
  • Caloric deprivation increases the reward value of high-calorie foods more than low calorie foods
143
Q

Drastic measures during diet

A

-Prolonged fasting
-bariatric surgery
-Liposuction
-Each of these carries risks and the latter are expensive

144
Q

Prolonged fasting

A
  • Causes “intestinal starvation”
    – 50 - 80% of intestinal nutrients are provided by the food we eat
    – The balance is provided by the bloodstream
  • Mucus and cells are lost from the GI tract linings
  • Different from intermittent fasting – latest trend
    – “In clinical trials, caloric restriction and intermittent fasting result in similar degrees of weight loss and improvement in
    insulin sensitivity.” Curr Obes Rep 2018 7:172-185
145
Q

Surgery to loose weight

A
  • Only available to a certain clinical population
  • over 18 years old
  • BMI > 40 kg/m²
  • BMI > 35kg/m² plus 1 or more of high cholesterol, high blood pressure,
    sleep apnea, diabetes, or joint problems
  • have tried different ways to manage weight but it remains high
  • Can reduce weight by ~50% and most can maintain the weight loss
  • Risks of complications during and after surgery
  • Very expensive
146
Q

Gastric band

A
  • Safest type of bariatric surgery, but requires routine follow up for band adjustments.
  • 40% of excess body weight over 24+ months
147
Q

Gastric bypass

A
  • reduce stomach from size of small football to an egg; bypass first section of small intestine
    -60-85% of excess body weight within 12-18 months
148
Q

Sleeve gastrectomy

A
  • about 2/3 of stomach removed, leaving a sleeve/tube behind. Hunger cells are removed giving a metabolic response
  • 50-80% of excess body weight within 12 months
149
Q

Liposuction

A
  • Maximum amount of fat removed is 5 litres (about 4.5 kg)
  • Cosmetic surgery; not intended for weight loss
  • Risks including that your skin may appear bumpy, wavy or withered due to uneven fat removal, poor skin elasticity and unusual healing. These changes may be permanent.
  • Liposuction permanently removes fat cells from the targeted areas of the body. So, if you gain weight, the fat will still be
    stored in different parts of the body.
150
Q

Maintain weight loss

A

Those who maintain their weight loss:
* Exercise regularly.
* Make small and comfortable changes in diet and physical activity.
* Eat breakfast.
* Choose low-fat foods.
* Keep track of their weight, dietary intake, and physical activity level.

151
Q

Regain weight back

A

Those who regain weight:
* Exercise little
* Use popular/fad diets
* Make drastic and unpleasant changes in their diets and
physical activity levels
* Take diet supplements
* Cope with problems and stress by eating

152
Q

National weight loss registry history

A
  • Established in 1994 to try to identify behaviors associated with long term
    weight loss success.
  • Largest observational study of weight maintenance and includes
    individuals who have maintained a weight loss of at least 30 lbs for at least
    1 year.
153
Q

Winning patterns of national weight loss registry members:

A
  • 98% modify their food intake in some permanent way: portion control, low
    fat diet
  • 90% exercise at least 1 hour per day, burning at least 400 calories per
    session
  • 78% eat breakfast every day
  • 75% weigh themselves once a week
  • 62% watch less than 10 hours of TV per week
  • Average daily calorie intake for women = 1306 kcal
  • Average daily calorie intake for men = 1685 kcal
154
Q

Lquid vs solid food calories

A
  • Scientific evidence shows that although liquids count as calories, the body doesn’t
    detect them the same way as it would detect solid food.
  • When people eat calories in the form of solid food, they naturally compensate by
    reducing the rest of their food intake. But when people ingest liquid calories
    (alcohol, juice or soda), they don’t compensate for them by eating fewer calories.
  • The mechanisms controlling hunger and thirst are completely different, and liquids
    — even if they contain calories — don’t seem to satisfy hunger even if they quench
    your thirst.
  • Fluid calories do not hold strong satiety properties. “When the number and type of
    calories are the same, the calories in liquid form won’t suppress ghrelin as
    effectively as if the same calories were in solid form,” says David Cummings,
    Associate Professor of Medicine at the University of Washington.
  • Fortunately, fluids with food in them, such as soups, are very satiating

KNES 237 (3 decks)

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