Obesity part 3

Question 1

What are the 5 As of obesity management?

Answer 1

Ask for permission to discuss, 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

Question 2

What are therapeutic objectives, individually tailored about obesity?

Answer 2

Changes in eating behaviours

Weight loss/ weight stabilization

Prevention of weight regain (or weight gain)

Reduction in risk factors (diabetes, hyperlipidemia, hypertension…)

Eligibility for surgery

Psychosocial adjustment

Question 3

What are the effects of weight loss on diabetes control?

Answer 3

Increase glucose tolerance

Increase insulin sensitivity

Decrease need for glucose lowering medications

Question 4

What are some effects of weight loss on cardiovascular diseases?

Answer 4

Normalizes triglyceride levels

Raises HDL cholesterol

Lowers LDL cholesterol

Improves CHD risk profile

Reduces need for antihyperlipidemic medication

Question 5

What are benefits of weight loss on hypertension?

Answer 5

Decrease in:

• Systolic blood pressure
• Blood volume
• Cardiac output
• Sympathetic activity
• Need for antihypertensive medication

Question 6

What are the 2 phases in weight management, how do they differ?

Answer 6

Weight loss phase
- hypocaloric diet

Weight maintenance phase
- isocaloric diet

When weight loss, decrease REE. 3-4 months after energy deficit diet, the diet becomes iso-caloric => you no longer loose weight. PLateau phase If you want to loose further, readjust diet.

Question 7

What are the priorities in the balanced diet?

Answer 7

1. Create energy deficit
2. Avoid nutritional deficiencies
3. Preserve lean mass
4. Promote long-term adherence (avoid hunger)

=> change behavioural and dietary habits for life

Question 8

What diet is the most efficient in weight maintenance after weight loss?

Answer 8

High protein, low GI => combination effect

Question 9

What are some advantages of a high protein diet for weight loss vs standard protein diet for weight loss?

Answer 9

HP diets have greater reduction in:

• Body weight
• Fat mass
• Serum TGs

Less reduction in fat free mass

Question 10

What are the recommendations for the balanced diet in terms of macronutrients?

Answer 10

Weight reduction diet for 6-12 months: high protein and low/moderate fat

Within acceptable macronutrient distribution range:

• 10-35% protein: 25 -30% during weight loss, 15-20% for maintenance
• 45-65% carbohydrates (favor whole grains, limit added sugars)
• Better < or = 30% total fat (include good sources of essential FA, low intake of saturated and trans FA)

Question 11

What are nutritional education tools good for?

Answer 11

educate on:

• Content of a plate
• Normal portion sizes
• Read food labels

Question 12

What is the recommendation for amount of proteins in a weight reduction diet?

Answer 12

in a diet 600-1200 kcal/day => 1.2-1.5 g/kg/d

in a diet of >1200 kcal/day => 1.0-2.0g/kg/d

Question 13

What is the recommendation for CHO in a weight reduction diet?

Answer 13

45-65% of diet in diet from 600 and more kcal/day

Question 14

At what point (how many kcal in diet) would you recommend multivitamin and mineral supplements?

Answer 14

In a diet under 1200 kcal/day