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ClinE 470 > Obesity > Flashcards

Obesity Flashcards

1
Q

What percentage of Men and Women are classified as obese in the UK

A

23% Men

23% Women

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2
Q

What percentage of men and women are classified as overweight in the UK

A

44% Men

34% Women

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3
Q

What classification BMI under weight, healthy, overweight and obese under

A

<18kg/m2 - underweight
18.5-24.9 kg/m2 - healthy
25-29.9kg/m2 –> Overweight
> 30kg/m2 –> Obese

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4
Q

Which category is showing the greatest increase

A

Obese

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5
Q

What is the most common long term reason for individuals putting on weight

A

energy in (food) vs Energy out (Exercise) imbalance

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6
Q

What is the highest lifetime food intake

A

Water

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7
Q

What are the components of daily energy expenditure, and what is the percentage for sedentary and PA

A

1) thermic effect of feeding (8% sedentary | 8% PA)
2) EE of PA (17% sedentary | 32% PA)
3) Resting EE (75% sedentary | 60% PA)

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8
Q

What is the relationship between BMI and CVD mortality

A

Those with a higher BMI are dying at an earlier age

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9
Q

What are the medical complications with obesity?

A

Pulmonary disease, non alcoholic fatty liver, gall bladder disease, gynecologic abnormalities, Osteroarthritis, Cancer (breast, uterus, colon, cervis, oesophagus, pancreas, kidney and prostate), coronary heart disease, diabetes, dyslipidemia, hypertension, stroke and idiopathic intracranial hypertension

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10
Q

Excess fat on the thorax causes problems how

A

difficult to breath, and reduces lung volume

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11
Q

What can the increase in body fat (BF) % cause

A

orthopaedic implications

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12
Q

for every 5kg increase in weight, how much knee arthritis % increases

A

35%

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13
Q

what is the relationship between obesity and orthopaedic problems the can occur in a sedentariness

A

atrophy of the muscles

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14
Q

What conditions can the impact of obesity have on health

A

gall stones, strokes, cancers (colon and breast), and reproductive problems

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15
Q

What mechanical consequences does obesity have on health

A

osteoarthritis, chronic low back pain, breathlessness. sleep problems.

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16
Q

What percentage of obese are classed as MHO

A

15-30%

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17
Q

If an obese individuals metabolic function and response is fine, what does this mean

A

Their risk is no higher than normal weighted adults

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18
Q

What are the main causes of obesity

A

Genetics, metabolic, over-eating and decreased PA

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19
Q

What occurs if an individual has a faulty Leptin production or resistance

A

Suppresses appetite, leading to a decrease in fat and therefore leptin production. Effecting energy in and out of the body

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20
Q

Where is leptin produced

A

adipose tissue

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21
Q

If both parents are obese, what is the percentage that the child will be too, and who is more critical mother or farther?

A

70-80% - mother

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22
Q

If neither of the parents are obese, what is the percentage of the child being obese?

A

7-14%

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23
Q

what is the relationship in obesity and metabolic factors; and what defects can it be caused by

A

hypothyroidism, cushion’s syndrome

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24
Q

What is Cushing’s syndrome

A

overproduction of cortisol

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25
Q

What occurs when metabolic control of appetite goes wrong?

A

1) controlled by orosensory, gastrointestinal, and neuroendocrine factors
2) defects in pathways lead to dysregulation of appetite

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26
Q

What are the individual differences in metabolic factors

A
  • Diet induced thermogenesis
  • Energy Storage (> efficient fat cells)
  • settling point
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27
Q

What is the settling point theory

A

Body defends a certain weight likes thermostat regulates temperature

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28
Q

Minnesota experiment 1940’s - what was found

A

25% of body weight lost, referring as adlib or on low fat diet, and both groups regained weight and body composition to original set point

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29
Q

What is Passive Over consumption

A

individuals allowed to eat ad-lib diets containing difference fat levels will consume more energy with high fat diet than on high CHO diet

30
Q

what occurs when individuals consume the same weight/volume of food at each meal?

A

can’t sub-consciously adapt to varying energy densities

31
Q

what does the same volume of high fat provide?

A

Energy densed

and more calories than the same volume of a high CHO meal

32
Q

what did Fox and Hillsdon et al (2007) find within inactive lifestyle?

A

houses without car reduced from 41-26%
20% all journeys <1mile by car
~ 6% of adults walk to work
daily EE has decreased 250-500kcal.d-1 over the last 50 years

33
Q

What are the main methods of treating obesity?

A
  • diet
  • exercise
  • surgical
  • pharmacological
  • behavioural
34
Q

what are the benefits of 10% weight reduction?

A
  • decreased > 20% mortality (related to cancer deaths)
  • decreased 10mmHg systolic BP
  • decreased 20mmHg diastolic
  • decreased fasting blood glucose
  • decreased 10% total cholesterol
35
Q

What 3 factors does the decreased 10% of total cholesterol effect

A
  • decreased 15% LDL cholesterol
  • decreased 30% triglycerides
  • increased 8% HDL cholesterol
36
Q

What does preventing further weight gain, reducing body weight and maintain a lower body in LT come under

A

Goals of weight management/ treatment

37
Q

Within losing weight what are the ST goals?

A

5-10% or 0.5kg (1-2Ibs) per/wk

38
Q

What are the LT goals

A

Additional weight loss if wanting and long term weight maintenance

39
Q

What background knowledge needs to be known before starting a regime with them?

A

occupation, family history, motivation - why, what they’re hoping to achieve and are they realistic, have they got the confidence to purse the goal, knowledge in nutrition, and body health with weight loss, previous diet, exercise likes / dislikes

40
Q

What findings has PA had as a weight loss therapy had?

A
  • modestly contributes to weight loss strong evidence
  • decreases abdominal fat - good evidence
  • increases CV fitness - strong evidence
41
Q

What are the benefits of regular PA in an obese person

A
  • decreased FFM associated with weight loss
  • improves maintenance of weight loss
  • improves CV and metabolic health, independent weight loss
42
Q

PA preserve FFM during weight loss, What was found in Ballor and Poehlman study?

A

there was a significant difference between diet alone and diet plus PA in loss of FFM

43
Q

How much weight loss can be achieved from exercise alone?

A

2-3kg

- if energy intake is held at a constant level, > weight loss is seen

44
Q

Which intervention is better alone?

A

Diet

45
Q

what is the mean weight loss with diet only?

A

1-12kg

46
Q

What occurs when exercise and diet are combined?

A

> reduction in fat mass (3-15kg)

47
Q

within exercise considerations what are aggravations of pre-eating conditions

A

hypertension, angina, arthritis etc.

48
Q

What other exercise implications need to be considered?

A

orthopaedic problems

49
Q

Why is it important to avoid HIT and high impact exercise?

A
  • energy cost and orthopaedic problems
50
Q

What other exercises needs to be considered to avoid?

A
  • agility and balance exercises
51
Q

Why does inappropriate food choices post exercise need to be “monitored”

A

extra food intake as a reward of exercise

52
Q

Why is it important to sensitive with body image, what at solutions to this

A
  • Exercise at home
  • Swimming
  • Exercise at quieter times
  • what to wear
53
Q

What else is important to avoid?

A
  • exercising high ambient temperatures

- habit of weighing before and after every exercise session

54
Q

What is the aim for exercise guidelines for overweight or obese people?

A
  • increase calorie expenditure = increase duration x increase frequency x decrease intensity
  • Expend an accumulated 1000-2000kcal. wk-1
  • expend 200-500 each exercise session
55
Q

What was found in the effects of long vs short bouts of exercise on total amount of activity and weight loss

A

short bouts of exercise ( 4 x 10min) increase weight loss

56
Q

How many times should a obese or overweight individual train?

A

3d/wk but preferably 5-7d/wk

57
Q

How long should their session last?

A

20-60 min or broken up into 3-10min sections

58
Q

What is the intensity?

A
  • 40-70% VO2 or HRR
  • 55-65% Hrmax
  • Borg RPE 11-14
59
Q

What type of exercise is preferred?

A
  • aerobic activity
  • weight bearing or non-weight bearing
  • Resistance training 2d.wk (1-2 sets of 8-15 reps)
60
Q

What is PA a key element of?

A

Treatment for obesity and overweight or prevention

61
Q

Why is obesity data ecological and why is it limited?

A

not a high level of inference as individual-level data, and PA in contrast to obesity, is not simple to asses as it is a complex, multi-dimensional behaviour.

62
Q

in addition to the different domains, what needs to be considered?

A

frequency, duration, type of activity performed

63
Q

What has HSE data suggested between 1997-2003?

A

individuals achieved a PA target of a minimum of 30min or more of moderate intensity activity of 5d/wk –> raising prevalence of obesity

64
Q

What was found in five studies using the self-report method?

A

No association was found of PA or sedentary behaviour with weight gain

65
Q

What did five studies in a longitudinal in children find?

A

association between measured PA and weight gain

66
Q

observational studies in activity and weight gaining adults and children are affected by what?

A

issues of measurement errors, residual and unmeasured confounding and reverse causality

67
Q

What are the PA guidelines for an obese individual?

A

60-90min of moderate intensity activity or less amount if vigorous activity

68
Q

How much PA is required to prevent overweight and obesity?

A

moderate intensity of 45-60min per day

69
Q

Why are further studies required?

A

To address the deficiencies in evidence base, public health authorities have to make recommendations using evidence available now.

70
Q

What did CMO find?

A

impact on PA and relationship to health follow the lines with respect to weight gain

71
Q

What is the CMO’s PA recommendations?

A

accumulate at least 5 episodes p/wk of moderate activity lasting 30min

ClinE 470 (9 decks)

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