Obesity

Question 1

BMI

Answer 1

weight over height^2 -> normal = 18.5 - 24.9; overweight = 25-29.9

Question 2

Obesity epi

Answer 2

prevalence is worldwide, ethnic group is a determinant (blacks more obese in US), increasing in children, women > men in US -> prevalence has stabilized in women and possibly in men

Question 3

Obesity in children

Answer 3

may have stopped rising in many rich nations but trends are still upwards in lower socioeconomic groups to give overall plateau

Question 4

Overweight

Answer 4

occurs concurrently with underweight in developing countries -> this may divert limited health resources and perpetuate health inequalities

Question 5

Etiology of obesity

Answer 5

complex and multifactoral -> self environment and built environment -> obesogenic environment and obesogenic behavior (elevators, cars, sedentary lifestyle, cheap high fat food, large portion sizes) -> biological predisposition (22 strongly associated and 127 associated genes) -> positive energy balance (EI>EE) = weight gain

Question 6

Obesogenic environment

Answer 6

costs of fruit and vegetables have increased while costs of fats and oils, starches and sugars have decreased; Portion sizes 38% larger at a restaurant, females eat more when with males, meals eaten with close friends are larger

Question 7

Obesity etiology

Answer 7

unlikely to result from impaired metabolism or generalized inactivity -> metabolic rates are HIGHER because they are heavier, measured levels of physical activity are the same as non-obese (may fidget less)

Question 8

Daily balance error

Answer 8

16 kJ (4kcal), .2% of daily intake/expenditure -> 6 corn flakes/1 minute of walking -> USUALLY UNDETECTABLE

Question 9

Australian nutrition students

Answer 9

physical activity had no change, energy intake was increased overall (less fats) -> prevalence of overweight in this group was more related to increased energy intake

Question 10

Thrifty genotype

Answer 10

low metabolic rate and insufficient thermogenesis (Pima Indians -> increases susceptibility to obesogenic environment)

Question 11

Hyperphagic genotype

Answer 11

poor regulation of appetite and satiety and propensity to overfeed

Question 12

Sedentary genotype

Answer 12

propensity to be couch potato or physically inactive

Question 13

Low lipid oxidation genotype

Answer 13

propensity to be a low lipid oxidizer

Question 14

Adipogenesis genotype

Answer 14

ability to expand complement of adipocytes and high lipid storage capacity

Question 15

Physical activity

Answer 15

provides the greatest scope of improvement of obesity -> >3 hours of TV doubles exposure, 40% of boys and 50% of teenage girls fail to adequately maintain this -> 60 seconds to consume 300kcal but 60 minutes to expend it

Question 16

Drive signal

Answer 16

for eating is much stronger (hunger), cessation signal is weaker for physical activity -> bias towards overeating and under activity

Question 17

Negative beliefs

Answer 17

exercise increases hunger and food intake, exercise is futile for weight loss

Question 18

Exercise

Answer 18

does not induce an automatic drive in hunger and food intake -> being sedentary does NOT diminish drive to eat and may encourage poor eating habits

Question 19

1 hour

Answer 19

this much moderate intensity exercise burns 250-300 kcal

Question 20

Management of obesity

Answer 20

all diets equally effective in practice -> find diet that works best for individual

Question 21

Carbohydrate exclusion diets

Answer 21

high protein diets are highly satiating, effective way of reducing energy intake -> safe if fruit and veggie intakes maintained, fat quality is appropriate (low in saturates -> canola, olive, fish oil)

Question 22

Lifestyle clinics

Answer 22

holistic approach aiming to improve overall health -> very expensive -> work as last resort

Question 23

Orlistat

Answer 23

inhibitor of gastrointestinal lipases: reduces fat absorption from the gut -> SE: fatty stools with possibility of anal leakage

Question 24

Sibutramine

Answer 24

serotonin and noradrenalin reuptake inhibitor acts centrally to reduce appetite and may have some thermogenic activity -> SE: raised blood pressure, CVD risks outweigh benefits

Question 25

Needs protein to needs to minimize nitrogen loss

Answer 25

27 year old trauma -> given TPN -> what was the purpose of giving him protein

Question 26

Kwashiorkor

Answer 26

malnutrition with edema