Nutrition Module 7: Obesity - Basic and Clinical Flashcards
What % of adults are overweight?
66%
What % of adults are obese?
35%
What % of children are obese?
17%
By how much has obesity prevalence increased since 1960?
Tripled
How has the obesity of kids in difference age groups increased?
- 2-11 yo: 5 to almost 20%
- 12-19: 5 to 12%
How many obese adults worldwide?
1.4 billion
Is the rapid increase in obesity only seen in developed countries?
NOPE but rate of increase is faster
What is causing the global obesity epidemic?
- Rising incomes
- Urbanization
- Globalization of food supply
- Decreased physical activity because of technology
BMI for overweight?
25 or above
BMI for obese?
30 or above
How is obesity defined for kids?
BMI for age above 95th percentile
What are the 8 health risks of obesity?
- CV disease
- Hypertension
- Type 2 DM
- Cancer (breast, endometrium, prostate, and colon)
- Gallstone disease
- Hyperuricemia (gout)
- Joint degeneration
- Mental health problems
What is central obesity?
Excess fat in abdomen and upper body (apple shape): abdomen, back, arms, and chest
What can increase the health risks of obesity? Why?
Central obesity because:
- Impaired lipoprotein metabolism
- Impaired glucose handling
- Higher CVD risks
- Higher DM risks
- Higher cancer risks
What kind of weight loss can reduce the health risks of obesity?
Modest
What are the 10 leading causes of death in the US from most prevalent to least? Note those that obesity (*) and nutrition (#) contribute to.
- Heart disease*#
- Malignant neoplasms*#
- Chronic lower respiratory diseases
- Cerebrovascular diseases*#
- Accidents
- Alzheimer’s
- DM*#
- Nephritis, nephrotic syndrome, and nephrosis#
- Pneumonia and the flu
- Suicine
What determines body fat distribution?
Genetic variation
How can we determine body fatness in patients?
- Underwater weighing = hydrodensitometry
- Imaging techniques: CT scan, MRI, DEXA
- Bioelectrical impedance analysis (using differences in electroconductivity)
- Air-displacement plethysmography
- Doubly-labeled water method (radioactive water is ingested)
Which are more dangerous: intra-abdominal fats or subcutaneous fats?
Intra-abdominal fats
What are the 6 cancers that obese people are more at risk for?
- Breast (postmenaopausal)
- Endometrium
- Prostate
- Colon
- Kidney
- Esophagus
What are indirect measures of body fat?
- Weight
- BMI
- Waist circumference or waist-to-hip ratio
- Skinfold thickness measurements
- Others
Does W-T-H ratio apply equally to all pops?
NOPE
What are the units of BMI?
wt/ht^2= kg/m^2
In what 5 situations is BMI not appropriate to use?
- Pregnancy/lactation
- Competitive athletes and body builders
- Children under 2 yo
- Old people who are frail and sedentary
- Patients with conditions precluding accurate height measurement (kyphosis, scoliosis)
What is waist circumference an indicator of?
Intra-abdominal fat
What waist circumference suggests central obesity in males and females?
Males: 40 inches or above
Females: 35 inches or above
How to measure waist circumference?
- Locate uppermost border of iliac crest and draw a horizontal line
- Plane of the tape should be parallel to the floor and snug but should not compress the skin
- Measurement is made during normal minimal respiration
What is another way of saying central obesity?
People with mainly intra-abdominal fat
Do humans have a limited capacity to store fat?
NOPE
How can body weight stay constant?
Energy intake = energy expenditure
What is the equation to calculate energy expenditure?
Energy expenditure = resting metabolic rate (60-75%) + activity (15-30%) + thermic effect of food (5-10%)
Why is the rate of weight gain is often less than expected for the amount of excess calories? How can anyone gain weight then?
Because the higher body weight requires more energy
We gain weight because there is a regulatory response to excess intake that leads to metabolic ineffeciency
What are the 6 factors that lead to the development of obesity?
- Genetics
- Environment
- Physiology
- Metabolism
- Psychology
- Culture
Will individuals with a strong genetic obesity disposition lose weight when their energy expenditure exceeds intake?
YUP
What is one reason for increased CVD risk in obese people?
Obesity commonly elevates serum lipids.
Why is gallstone a risk for obese peeps?
Excess synthesized cholesterol is eventually excreted with bile and raises the risk of gallstone formation
What is gout?
Rich man’s disease
Uric acid crystallizes and causes joint inflammation in feet and toes
What are the 3 keys for a diet for weight management?
- Moderation
- Variety
- Balance
What are the consequences of following restricted and unbalanced diets?
Range from short-term dehydration and diarrhea to more serious problems like malnutrition, loss of muscle mass, and electrolyte imbalance
What are the 3 steps to successful weight management?
- Assess: BMI, co-morbidities, willingness to change, present intake and exercise, social support
- Provide: intervention, encouragement, therapeutic HW
- Plan: for long term follow up and possible relapse
What are the 4 benefits of physical activity in obese peeps?
- Maintains greater muscle mass
- Avoid excess body fat
- Improve mental health
- Avoid weight gain
What 6 health risks are reduced with regular physical activity?
- Cancer
- T2DM
- Metabolic syndrome
- CVD
- Hypertension
- Osteoporosis
What explains the importance of exercise for weight loss maintenance?
- Stimulates HSL
- Strengthens muscles
- Increases glycogen storage capacity of muscles
- Increases # of mito in muscle cells
=> muscles have greater peak metabolism
For what patients can the slighest over intake compared to expenditure cause weight gain?
Children
What ultimately results in weight gain?
Consistent intake that exceeds expenditure
What are the 6 components of TEE and their %? (Total Energy Expenditure)
- Physical Activity (15-30%)
- Basal energy expenditure (50-75%)
- Thermic effect of food (increase in energy expenditure due to digestion) - (5-10%)
- Growth (childhood, adolescence, or pregnancy) (less than 2%)
- Thermoregulation (only contributing to TEE under extreme environmental conditions)
- Lactation
Which is the most variable component of TEE in healthy people?
Physical activity
What is NEAT?
Nonexercise activity thermogenesis: component of physical activity which includes fidgeting, reading, typing,