Obesity Flashcards
What seven things do food and eating contribute to?
Nutrition - keeping you alive Identity Social interaction Politics Economics Socio-economic change Environment - how and where food is grown and carbon footprint
What six things determine the choices we make about eating?
Rational health choices - which are affected by health promotion
Cost
Availabilty
Habit and custom, tastes
Sensuous gratification (fulfilling emotional needs)
Other emotional and relational needs (sharing food helps to cement relationships)
What are some social and cultural factors which put constraints on choice of food?
Religious beliefs
Political beliefs
Advertising and retailers
Your own tastes and what you like
Identity in terms of gender, class, ethnicity
Disease status e.g special diet needed for diabetes, coeliac…
Meanings of food
Time and ability to prepare and cook food
Why might advertisers use food to display emotions?
Food is a way to articulate emotions people may find hard to verbalise
How are patterns of food consumption distributed across the world?
In the west people spend a lot more money on food and eat more processed high fat high sugar food and less fresh fruit and vegetables.
In developing countries people tend to spend much less thank the west on food and eat a lot more seasonal fruit and veg and barely anything processed.
What is the difference between the way middle class families and working class families look at their eating habits and health.
Middle class families feel relatively secure, so are future orientated and think about their health a lot. Teenagers have less autonomy over their own eating. In working-class families they are facing risks and insecurities and are more focussed on "here and now". Concerns about food, weight and health are less pressing than concerns about everyday health, and having enough food for today is a positive thing. Teenagers are given more autonomy over their eating which may mean bad choices.
What is food poverty?
A form of social exclusion which makes it hard for someone to obtain a nourishing diet, the inability to afford or access food to make up a healthy diet.
What are the consequences of food poverty?
Worse diet
Worse access to food
Worse health outcomes
A higher percentage of income is spent on food
Less choice from a restricted range of food
Less or no consumption of fruit and vegetables
30% of life years lost due to death and disability
What heath risks does food poverty contribute to?
Coronary heart disease Cancer Falls and fractures in older people Low birthweight Increased childhood morbidity and mortality Increased dental caries in children
For what reasons do people access food banks?
No evidence that it is “because they are there”
Low income
Unemployment
Delays in benefits
What is hidden food poverty?
Not needing food parcels from food banks but still not eating well enough.
What are the 4 reasons for the increase in food poverty?
1) Decline of urban and rural public transport - car ownership is assumed to allow access to big shopping centres, this particularly affects older people and single parents with young children
2) Collapse of the independent food retail sector and supermarket expansion in urban and rural areas
3) Commercial incentive for food manufacturers to push high-fat high-sugar low-nutrition food, especially at the value for money end of the market
4) Low incomes, which make filling cheap foods with high fat content more attractive than fruit and vegetables
What is undernutrition/malnutrition?
Deficiency in one or more nutrients, resulting from a poor diet (especially a lack of fruit and vegetables).
Affects 2 million people in the UK, and about 40% of patients admitted to hospital are undernourished.
10% of people over 65 living in the community are undernourished.
What were the four findings of the Food Survey in the UK?
Average consumption of fruit and vegetables was half the recommended 5 a day.
Intake of non-milk extrinsic sugars (particularly among children) and saturated fats were above the maximum UK recommendations.
Evidence of inadequate nutrition status for iron, folate, vitamin D.
Substantial number of men and women were overweight or obese (obesity epidemic).
What are some of the factors in the aetiology of obesity?
Food intake, physical activity, food oversupply, price, culture, marketing, poor customer choice, genetic potential.
What are the three socio-economic factors that contribute to obesity?
1) Commercialisation of energy intake and energy expenditure - a lot of money to be made in food
2) Overproduction of food in capitalist economies
3) A focus on food consumption, not production or preparation
All of these contribute to all sorts of eating disorders.
What factor makes it hard for the WHO to be in an authoritative position compared to companies like Coca Cola and McDonald’s when it come to dialogue about food?
Coca Cola and McDonald’s each spend $1.7 billion annually, which is more than the total annual expenditure of the WHO on everything, worldwide.
What is the term given to the environment encouraging bad foot habits which is centred on sedentary lifestyles, fast and convenient food, advertising?
Obesogenic environment
What is the problem with downstream policy responses to the obesogenic environment?
Downstream responses are addressed to individuals, but this gives an ideology of choice and assumes too much agency for the individual who is usually facing necessity, not choice.
Why did the upstream policy responses to the obesogenic environment change from voluntary to legislative?
There was resistance from the food companies, they made voluntary pledges so no tougher rule would be legislated, then returned only limited action to reduce fat, salt, sugar levels. The action needed to be enforced so food companies couldn’t resist it.
Why was the 5 a day campaign called “political fudge”?
`the number selected was arbitrary, it was aspirational but not impossible to reach, it was thought if it was any higher people wouldn’t even try. There is only thin evidence provided that 5 a day actually does any good, and that the number doesn’t need to be higher.
What is evolutionary medicine?
Tries to find evolutionary explanations to vulnerability to disease, and why some diseases are still seen in high prevalence in the population - determines if there are selective advantages that predispose us to certain illnesses.
Why is sickle cell anaemia not selected against (since it is a deleterious genotype) in certain areas?
It has HETEROZYGOTE ADVANTAGE in areas where malaria is common, as having the heterozygote genotype affords some protection against malaria and the symptoms are less severe, which means it persists in the gene pool especially in areas like west Africa.
What is another example of heterozygote advantage (other than sickle cell anaemia)?
Cystic fibrosis (the gene causing the deleterious mutation in CFTR also provides protection against the pathogen responsible for typhoid fever - salmonella typhi, or may protect against the diarrhoea resulting from lactose intolerance so allows Europeans to drink milk)
What are some possible causes of the obesity epidemic?
Western high-energy diets, increased fat and sugar intake, super-sizing Sedentary lifestyles Sleep deprivation Genetic predisposition Endocrine (e.g thyroid) disorders
What two classifications can the causes of obesity be split into?
Proximate - lifestyle choices
Evolutionary - genetics
For what two types of selection could fatness have been selected in humans?
1) Natural selection - fatter individuals have greater survival chances
2) Sexual selection - fatness preferred in populations where food has traditionally been scarce (e.g Polynesia), people with more fat have a higher status and greater access to food
What are the three observations that the Thrifty Genotype hypothesis was based on?
Type 2 Diabetes runs in families
Type 2 diabetes rates are higher than expected for a deleterious condition in the general population
Some populations have a higher prevalence of Type 2 diabetes than others
