lesson 5 Flashcards
What are the priorities for a balanced diet?
– Create energy deficit
– Avoid nutritional deficiencies
– Preserve lean mass (exercise+ sufficient protein)
– Promote long-term adherence (avoid hunger) -> no extreme restrictions Change behavioral and dietary habits for life
High-protein diets for weight loss - Results
Greater reduction in:
- Body weight
- Fat mass
- Serum triglycerides
Less reduction in fat-free mass
No difference in changes in: Total cholesterol, LDL-C, HDL-C, systolic and diastolic BP, fasting glucose and insulin
- Less reduction in REE
What are the 5A of obesity management for adults
ASK for permission to discuss weight and explore readiness
ASSESS obesity related risks and ‘root causes’ of obesity
ADVISE on health risks and treatment options
AGREE on health outcomes and behavioural goals
ASSIST in accessing appropriate resources and providers
What are the therapeutic objectives of weigth loss?
- Changes in eating behaviours- number ONE goal!!
- Weight Loss / weight stabilization
- Prevention of weight regain
- Reduction in risk factors (diabetes, hyperlipidemia, hypertension, …)
- Eligibility for surgery
- Psychosocial adjustment
What are the improvements of diabetes control through weight loss
Improved Glucose tolerance
Improved Insulin sensitivity
Decreased Need for glucose lowering medications
Cardiovascular benefits of weight loss
- Normalizes triglyceride levels
- Raises HDL cholesterol
- Lowers LDL cholesterol
- Improves CHD risk profile
- Reduces need for antihyperlipidemic medication
Benefits of weight loss on hypertension
Decreased Systolic blood pressure
Decreased Blood volume
Decreased Cardiac output
Decreased Sympathetic activity
Decreased Need for antihypertensive medication
Benefits of a 10 kg weight loss in terms of mortality
Decreased total mortality, diabetes-related mortality, obesity-related cancer deaths
Weight Loss Phase diet, physical activity and other recommendations
Diet
- Hypocaloric
- Nutrients adequate, balanced
Physical activity- should be promoted- for lean mass conservation especially
Behavior modification
Weight maintenance Phase diet, physical activity and other recommendations
Diet
- Isocaloric vs. the new weight
- Nutrients adequate, balanced P
hysical activity is important for LBM maintenance Behavior modification
Estimate Daily Energy Requirements and Intake calculation
TEE (kcal/d) = REE x activity factor (Low=1.3, Moderate= 1.5, high= 1.8)
or
TEE (kcal/d) from IOM equations
How to calculate how many calories to loose per day to achieve a certain fat loss per week What do we have to remember during this calculation?
1lb (454g) of adipose tissue is 87% fat= 395g fat= 3500kcal
To lose 3500 kcal per week = - 500 kcal per day however, there will also be protein and water loss, thus more than 1 pound may be lost with 500 kcal restriction
What is the weight loss approach when quite a bit of weight is to be lost?
could be step wise: loss -> stable -> loss -> stable decreases the risk of relapse
What should we aim for when setting a target weight?
Realistic weight goal and time to achieve it ex: if goal is loss of 10 kg at 0.5 kg/wk-> 20 weeks
- Aim to reach healthy BMI (upper range) or
- Aim for more modest weight loss (5-10%)
table of
PRO
CHO
Fat
Multivitamin and mineral supplement
to be consumed when consuming certain amount of calories
What are the DRIs that have to be met durign calory resticitve diet?
Meet DRIs: Na 1500 mg/d, K 4.7 g/d, Ca 1000 mg/d, Fe 8/18 mg/d, ≈2 L fluid
Which was the diet in term of fat and GI that resulted in no weigth regain?
Which resulted in the most regain?
High protein, low GI
Most: LP-HGI
A modest increase in __ content and modest reduction in _favored maintenance of body weight
A modest increase in protein content and modest reduction in GI index favored maintenance of body weight
Which gender is more likely to participate in a health-related study?
women
What are the habbits of successful weigth control
– Most continue low energy, low fat diet, minimal variation
– 78% eat breakfast
– 90% exercise on average 1 hour per day
– 75% weigh themselves once a week
– 62% watch less than 10 hours TV per week