Obesity & Weight Management Flashcards

1
Q

1 lb body fat = cal

A

3500 cal

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2
Q

Carbs, protein and fat go in, and

A

RMR Physical activity and TEF go out

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3
Q

Balance of energy intake and expenditure

A

–» body weight stability

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4
Q

Birth: how many fat cells?

A

5-6 billion fat cells.

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5
Q

Critical Times for increase in fat cell #:

A

late childhood/early puberty & 3rd trimester of pregnancy;
Fat cell # set by age 20s, except for pregnancy.

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6
Q

Healthy adult: fat
Overweight adult: fat
Severe obesity: fat

A

25-40 billion fat cells
70-80 billion
Up to 250-300 billion (Obese individuals also have enlarged fat cells, up to 3x size of healthy weight person’s fat cells.)

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7
Q

do fat cells have a life span?

A

Fat cells do have a lifespan & undergo turn-over, but are replaced 1-for-1 immediately.
Therefore weight loss leads to reduction in fat cell size, but not #.

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8
Q

Classification of Overweight
and Obesity in Adults BMI

A

Underweight < 18.5
Normal Weight 18.5-24.9
Overweight 25-29.9
Obesity ≥ 30
Class I 30-34.9
Class II 35-39.9
Class III ≥ 40
(Obese = 20% or more above ideal body weight)

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9
Q

The problems with BMI

A
  1. “Michelin Man” vs. “The Terminator”
    Fat vs. muscle mass not distinguished – the latter classified as overweight/obese due to excess muscle. What % of general population look like The Terminator?
  2. “Apples” vs. “Pears”
    Fat in abdominal region associated with much greater risk of disease & early mortality, vs. peripheral or lower body fat. Two individuals of same BMI could have very different body shapes = different risk of disease & early mortality.
  3. Does not always change with lifestyle change
    Increased PA & improved health not always correlated with BMI ∆. Substantial health benefits even if no weight loss.
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10
Q

BMI is used to find weight status in

A

population studies

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11
Q

 Currently about 62% of Canadian adults (age 18-79) are living with

A

overweight/obesity:

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12
Q

 31% of Canadian youth ages 5-17 y

A

are living with overweight/obesity

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13
Q

Age & Sex differences (5-17)

A

Age 12-17: 37% overweight/obese
Age 5-11: 26% overweight/obese

Girls 12-17: 18% overweight, 12% obese
Girls 5-11: 19% overweight, 9% obese

Boys 12-17: 23% overweight, 21% obese
Boys 5-11: 14% overweight, 8% obese

Boys: 15% obese
Girls: 11% obese
Boys & Girls: 19% overweight

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14
Q

Underweight

A

15% or more below ideal BW
BMI < 18.5 kg/m2
Potential health problems: Respiratory conditions, reduced fertility, immune suppression, nutrient deficiencies
Anorexia nervosa & Bulimia nervosa
Inadequate reserves to fight wasting diseases e.g. cancer, digestive disorders
Menstrual irregularities
Risk of low birth weight babies
Osteoporosis

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15
Q

Increased BMI will lead to increased mortality rates in…

A

Cardiovascular disease (heart attack, failure)
Cerebrovascular disease (stroke)
Type 2 diabetes
Cancer (breast, colon, prostate, endometrial)

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16
Q

Waist Circumference

A

Estimates abdominal/visceral obesity, which has a stronger association with type 2 diabetes & CVD than BMI. Used in combination with BMI, provides a more robust index of overall obesity-related health risk than BMI alone.
WC cut-offs:
>102 cm men
>88 cm women
Canadian Avg:
Males: 97.5cm
Females: 90.5cm
Canada (2007-09)
BMI : 24% adults obese.
WC : 37% adults abdominally obese.

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17
Q

4 types of fat

A

Subcutaneous Fat
Visceral fat
Ectopic Fat
Intermuscular fat

18
Q

Subcutaneous Fat –

A

Located just beneath skin.

19
Q

Visceral fat

A

(abdominal fat) – Located in abdominal cavity surrounding & protecting organs.

20
Q

Ectopic Fat

A

Located on or within organs e.g. heart, liver, brain.

21
Q

Intermuscular fat

A

fat stored in the muscle tissue

22
Q

Measuring types to find fat percentage

A

Hydrostatic (underwater) weighing
DEXA
Air-Displacement Plethysmography (“Bodpod”)
Bioelectrical Impedance Analysis (BIA)
Skinfold measurements

23
Q

Hydrostatic (underwater) weighing

A

Assesses body volume by H20 displacement, to calculate body density. Muscle more dense so it “sinks”, weighs more, vs. fat less dense so it “floats”, weighs less.

24
Q

DEXA

A

Body’s absorption of 2 different x-ray beams: fat, bone mineral, other fat-free mass have different absorption properties.

25
Q

Air-Displacement Plethysmography (“Bodpod”)

A

Similar principle to underwater weighing, but more variables that can affect results

26
Q
  1. Bioelectrical Impedance Analysis (BIA)
A

Fat-free mass contains mostly water (electricity conductor) vs. fat mass contains very little water.

27
Q

Skinfold measurements

A

Calipers used to measure at 3-9 sites, summed & age-based equation used for prediction of body density. Subcutaneous fat.

28
Q

Essential body fat men and women

A

Men: 3-5%
Women: 8-12%
Childbearing & hormonal functions

29
Q

Normal weight obesity?

A

Men: >25% body fat for men
Women: >39% body fat
Normal BMI 18.5-24.9
“Skinny Fat”

30
Q

Essential body fat uses

A

Needed for normal functioning of brain, liver, glands, hormones… energy & temp regulation

31
Q

Non-essential fats

A

storage fat, fat under skin and around organs

32
Q

“Adiposity Rebound”

A

look in notes

33
Q

Globally (IASO/IOTF, 2010):
obesity problem

A

1.0 billion adults overweight (BMI 25-29.9 Kg/m²); 475 million obese (BMI>30).
 When Asian-specific cut-off points (BMI>28) included, > 600 million obese.
* Up to 200 million school aged children overweight or obese: 40-50 million obese

34
Q

Excess body fat impacts

A

Higher mortality rates
Life expectancy reduced by 10-20 years
50-100% increased risk of death from all causes

Overweight and Obesity
Type 2 diabetes
Dyslipidemia
Hypertension
Coronary heart disease
Gallbladder disease
Obstructive sleep apnea
Certain cancers
Asthma
Psychological disorders
Incontinence
Osteoarthritis

35
Q

Obesity-related Comorbidities

A

Increased risk of illness & death from diabetes, stroke, heart disease, hypertension, high cholesterol, & kidney & gallbladder disease.

Obesity may increase risk for certain types of cancer.

Also a risk factor for development of osteoarthritis & sleep apnea.

35
Q

increased BMI disease percentage probability

A

Diabetes 60%
Coronary heat disease 20%
Hypertension 20%
Cancer 10-30%

35
Q

Obesity is both a direct & indirect risk factor for chronic disease
list them

A

notes

36
Q

Did we correctly recognize over weight or obese people

A

A majority failed to recognize the overweight female as overweight

Most perceived the overweight male as normal weight.

Obese bodies were unrecognized as obese until bodies reached BMI > 39

37
Q

What should we tell everyone

A

Ideal is to be healthy weight & physically active & fit.

Substantial weight reduction & long-term maintenance difficult for many OB individuals : OB-related health risks can be ↓ considerably with ↑ PA, especially if accompanied by ↑ fitness.

Risk for all-cause & CVD mortality is ↓ in Active/Fit-OB vs. Inactive/Unfit-HW.

PA/Fitness does attenuate (but may not
completely eliminate) ↑ in CVD risk
factors & type 2 diabetes in OB vs. HW.

38
Q
A