open energy balance part2 Flashcards

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1
Q

Calories consumed through eating and drinking

A

Energy In

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2
Q

– provides moisture to allow taste buds to function

– contain enzymes that digest starch

A

salivary glands

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3
Q

food lubricated by saliva, formed into soft lump/swallowed and passes thru the pharynx and esophagus to stomach

A

bolus

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4
Q

____ is rhythmic contraction and relaxation of
the circular muscles of the digestive system that
propels the food through

A

peristalsis

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5
Q

Bolus enters stomach
– Stomach secretes the enzyme pepsin that starts protein digestion
– Little absorption of nutrients occurs in the stomach(Only alcohol, aspirin, & fat-soluble drugs are absorbed)
– Major function is to mix food particles with gastric juices to prepare for absorption in the small intestine (duodenum)

A

Digestive Process

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6
Q

secreted by the pancreas into the
duodenum to decrease acidity and help in digesting carbohydrates and fats
– Pancreas produces insulin facilitating entry of glucose into bodily
tissues

A

pancreatic juices

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7
Q
primarily in small intestine (duodenum)
• Starch finished from saliva
• Proteins finished from stomach
• Carbohydrates and fat
• 90% of water (allows absorption of vitamins & electrolytes)
A

absorption of food

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8
Q

____produces bile salts that are stored in the gall bladder and are released into the duodenum to break down fats that are further broken down by pancreatic enzymes

A

liver

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9
Q

Peristalsis propels food mixture from duodenum to the large intestine(colon)

  • peristalsis is more sluggish and irregular in colon
  • bacteria inhabit the colon and produce vitamins
A

typically absorbs only water, a few minerals, and the vitamins proudced by its bacteria

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10
Q

(feces left over after digestion)peristalsis carries feces thru colon, rectum, and then anus when

A

eliminated

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11
Q

– Stomach flu (norovirus - 50% of all gastroenteritis around the world )
– Inflammation of lining of stomach & small intestine
– Vomiting, diarrhea, abdominal cramps, & nausea
– Excessive food or water, contaminated food or water, or food
poisoning

A

gastroenteritis

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12
Q

– Watery & frequent BMs
– Lining of intestines can’t properly absorb water & food
– Chronic may result in serious fluid & electrolyte disturbances

A

diarrhea

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13
Q

– Like diarrhea except mucus, pus, & blood are also excreted
– Protozoan attacks large intestine or a bacterial organism
– Common cause of death in less developed countries

A

dysentery

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14
Q

• Open sore in the stomach or duodenum lining
• Cause
– Hypersecretion of hydrochloric acid
– Pepsin (enzyme) digests part of the lining
– H. pylori bacterium contributes to development
– Stress aggravates ulcers but is not necessary

A

Peptic Ulcer

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15
Q

• 20% of the US population has weekly reflux
• Muscle between the esophagus and the
stomach does not work properly
• Stomach acid flows back up and irritates the
esophagus
• This backward flow is reflux or heartburn

A

Gastroesophageal Reflux Disease

GERD

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16
Q

• Cholecystis
– Infection & inflammation of gallbladder

• Gallstones
– Made up of cholesterol, calcium, bile, & inorganic 
salts
– Move into duct of gallbladder
– Cause painful spasms
A

Gallbladder

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17
Q

• Bacterial infection in appendix caused by
obstruction due to wastes and bacteria
• Pain, increased peristalsis, nausea
• If appendix ruptures, bacteria are released into
abdomen or peritoneum & further infection &
death can occur

A

Appendicitis

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18
Q

Viral inflammation & damage to liver=

A

hepatitis

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19
Q

– Contagious & serious
– Transmitted thru food & water
– Bilirubin can’t pass thru ducts & collects in blood (jaundice)
– Fatigue, fever, pain, nausea, vomiting, & diarrhea

A

heptatitis A

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20
Q

– Similar to Hep A but more serious

– Spread by blood, needles, sexual contact, mother-to-infant

A

hepatitis B

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21
Q

– Spread by blood & needles

A

hepatitis C

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22
Q

– IV drug users

– Must have Hep B infection first

A

hepatitis D

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23
Q

– Like Hep A but caused by different virus

A

hepatitis E

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24
Q

– Protein hormone secreted by fat (adipose) cells
– Signals hypothalamus about stores of fat
– Inhibits neurons that stimulate appetite
– Activates neurons that suppress appetite

A

Leptin

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25
Q

– Hormone produced by beta cells in the pancreas
– Allows body cells to take in glucose for their use
– High insulin leads to intake of more glucose than the cells can use and the excess is converted into fat
– Therefore, the higher the insulin levels, the more fat
– Receptors in the hypothalamus detect insulin levels

A

Insulin

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26
Q

– Peptide hormone secreted by cells in the stomach
– Spikes just before meals, drops afterwards
– When given ghrelin injections, people feel extremely hungry
– Acts in the hypothalamus to activate production of other neurochemicals
involved in the regulation of eating, such as neuropeptide Y (that stimulates Agouti-related peptide) and the orexins
– Melanin-concentrating hormone is another brain peptide that increases
food intake and interacts with ghrelin

A

Ghrelin

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27
Q

– Peptide hormone produced by intestines
– Acts on the brain and produces feelings of satiation
– Short-term use is to tell us to stop eating
– Other peptide hormones produced by the intestines to produce satiation are glucagon-like peptide 1 and peptide Y

A

Cholecystokinin (CCK)

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28
Q

– Large role in controlling eating
– Ventromedial hypothalamus
• When damaged, rats eat excessively
• May play a role in some cases of human obesity

A

hypothalamus

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29
Q

excessive body fat
– Women: fat should be 20% to 27% of body tissue
– Men: fat should be 15% to 22% of body tissue

A

Obesity

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30
Q

Create tables of weight based on height, frame
size, and mortality rates (Met Life)
• Calculate an index of weight and height (BMI)
– Body Mass Index (BMI) = kg/m2
– Overweight = 25-29.9
– Obese ≥ 30
• Determine percentage and distribution of body fat
– Imaging (computer tomography, ultrasound, magnetic
resonance imaging, and PET scanning)
– Skinfold test
– Bioelectrical impedance measurement
• Fat distribution as ratio of waist to hip size
– Particular risk to “apples” rather than “pears” (fat
localized in abdomen)
• More psychologically reactive to stress
• Greater cardiovascular reactivity
• Risk factor for metabolic syndrome

A

How we measure obesity

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31
Q

Americans are fattest in the world
• 33% obese
• Another 34% overweight

A
Epidemic stems from
– Genetic susceptibility
– Increasing availability of high-fat, high-energy foods
– Increased portions
– Low levels of physical activity
32
Q
Prevalence of overweight children in the past 20 
years
– Doubled among those 6 to 11 years
– Tripled among those 12 to 17 years
– Rates
• 17% overweight
• 31% at risk
A

80% of all people who were overweight as

children go on to be overweight as adults

33
Q

– Relationship is due to genetic and dietary factors
– Number of fat cells determined early in life by genetic
factors or early eating habits
– Metabolic rate
– Still rates vary

A

family hisotry and obesity

34
Q
– Voluntary or disordered sleeping
– Leads to insulin resistance causing increased glucose 
and insulin levels
– Decreases leptin levels
– Increases ghrelin levels
A

risk factor for obesity:sleep

35
Q
– High basal insulin levels prompt overeating due to 
increased hunger
– Obese have larger fat cells
– Cycles of dieting lower metabolic rate
• Yo-Yo dieting
• Loss and regain affects abdominal fat
A

obesity and dieting as risk factors [obesity risk factor for obesity]

36
Q

1 kilogram = 2.20462262 pounds

A

Definition of Weight Cycling

– Cooper Clinic: ≥5 episodes of weight loss of ≥2.3 kg/episode

37
Q

– Each person has ideal biological weight
– Deviations from setpoint are achieved with difficulty
– Leptin signals the hypothalamus to regulate eating
– Genetics may determine setpoint

A

Setpoint Theory

38
Q

– Positive reinforcers of eating control weight
– Learn to regulate eating based on
• Biological factors (time since eating; blood glucose)
• Personal pleasure (taste & pleasure)
• Social context (culture & social setting)
• Evolutionary factors (adaptive to eat when food is present)
– Variety in food selection increases eating
– Advertising promotes desirability
– Diets high in fat and sugar may disrupt satiation signals and increase appetite

A

positive incentive model

39
Q

• Chief cause of disability
– number of people aged 30-49 who cannot care for
themselves has jumped by 50%

A

Problems with health care
– May not fit in standard wheelchairs
– X-rays may not penetrate far enough
– Blood pressure cuffs may not fit

40
Q

A U-shaped relationship exists between weight and poor

health

A

Greatest risk for poor health occurs with obesity and

especially morbid obesity

41
Q

– All-cause mortality (especially due to CVD)
– Increased use of health care
– Development of diseases such as Type 2 diabetes, high blood
pressure, CVD, gallbladder disease, migraine headache, kidney
stones, sleep apnea, respiratory problems, liver disease,
osteoarthritis, reproductive problems in women, colon cancer

A

obesity is risk factor

42
Q

– Normal BMI but an accumulation of fat in the
belly and around internal organs
– Causes low-level inflammation that gradually
damages tissue and blood vessels

A

Normal weight obesity (NWO)

43
Q

– BMI overweight
– Body-fat percentage is lower than 30% (20% for
men) and blood chemistry is normal
– Many athletes are in this category.
– Continue to eat smart and exercise, but not
unhealthy

A

Fat and Fit:

44
Q

– Emphasizes fruits, vegetables, whole grains, and fatfree or low-fat milk and milk products;
– Includes lean meats, poultry, fish, beans, eggs, and nuts; and
– Is low in saturated fats, trans fats, cholesterol, salt (sodium), and added sugars.

A

What is a “Healthy Diet”?

45
Q

Stress has a direct effect on eating

– Especially true for adolescents

A
Greater stress tied to 
– Eating more fatty foods
– Eating less fruit and vegetables
– Skipping breakfast
– More between-meals snacks
46
Q

• 50% eat more when under stress
– Women more likely to eat more under stress
– Stress removes self-control in dieters/obese
– Choose foods containing more water, “chewier”
– Choose salty, low calorie foods
– Negative emotions – sweet, high-fat foods
• 50% eat less when under stress
– Men, compared to women, eat less under stress
– Non-dieting, non-obese suppress hunger cues

A

Weight Control:

Stress and Eating

47
Q

Obese individuals attempt to lose weight because

A

– It is considered unattractive (a primary reason)
– It carries a social stigma (a primary reason)
– They perceive that it is a health risk
– It is coupled with psychological distress

48
Q
  • Reduce portion size
  • Restrict types of food
  • Increase exercise
  • Rely on drastic medical procedures
  • Use a combination of these approaches
A

Approaches to Losing Weight

49
Q

– Eliminate certain foods
• Low-carbohydrate (Atkins, South Beach, Zone, Sugarbusters)
– Potentially unhealthy
– 50% dropout
• High-carbohydrate (complex) and low-fat (Ornish, Mediterranean)
– Often vegetarian or modified vegetarian
– Easy, can eat more food because complex carbs have fewer
calories than fat
– Lose weight but dropout is high (crave fatty foods)
– Only eat certain foods
• Monotony leads to decreased caloric intake
• Very unhealthy!
• Liquid diets may be nutritionally better but still monotonous and lack
fiber

A

diet:Restrict types of food

50
Q

– Variety of foods with smaller portions
– Reasonable and healthy
– Best combination of weight loss and low dropout rate
– Example: Weight Watchers

A

Reduce portion size

51
Q

– Small losses, rarely maintained for long
– Many are bad nutritional choices
– Risk of yo-yo dieting to CHD > risk of obesity alone

A

Dieting

52
Q

– Dangerous – start losing muscle and organ tissue
– Protein-sparing modified fast (high protein in limited amounts)
– Usually employed with other techniques

A

Fasting

53
Q

– Stomach stapled or banded to reduce capacity
– Gastric bypass
– Drastic weight loss

A

surgery

54
Q

– Behavior modification is used to change lifestyle with
emphasis on eating right and exercise (vs. weight loss)
– Screening, self-monitoring, control over eating, exercise
– Controlling self-talk, social support, relapse prevention

A

The multimodal approach

55
Q

• Efforts are somewhat successful
– Losing 2 pounds/ week for 20 weeks
– Maintenance for 2 years
– Programs emphasize self-direction, exercise, and relapse prevention

A

Evaluation of Cognitive-Behavioral

Techniques

56
Q

• Health psychologists suggest

A

– Sensible eating and exercise

– Rather than specific weight reduction techniques

57
Q

Public Health Approach for prevention with fam at risk training involves…

A

sensible meal planning and helping children develop healthy eating habits

58
Q

public health approach of behavioral treatment

A

adult obesity is diff to modify and childhood obesity is impressive succeses[reinforcement for exericse is effective and reduced tv]

59
Q

– Women at menopause: exercise and good eating
habits may prevent the weight gain that is very
common
– Special “junk food tax” on foods high in sugars and fats
– Restriction of advertising to children
– Health warnings regarding foods high in sugars and
fats

A

weight gain prevention

60
Q

– In response to specific health risk
– Education and self-monitoring are key
– Cognitive-behavioral interventions

A

Individual interventions to modify diet

61
Q
  • Precontemplation
  • Contemplation
  • Preparation
  • Action
  • Maintenance
A

Transtheoretical Model of Change - Different

interventions are required for each stage

62
Q

– Easier for target member to change when other family
members change also
– Wives usually shop and prepare food
– Husband’s food preferences likely to determine what the
family actually eats

A

Family interventions/meet with dietary counselor

63
Q

– Initial success rates, but not impressive long term
change
– More effective – intervention directed toward particular
at-risk groups (Hispanic dietary study)
– Social engineering possibilities
• Banning snack foods from schools
• Making snack foods expensive; healthy foods less

A

Community interventions

64
Q

• Dissatisfaction with body
• Focus on body as a way to change dissatisfaction
• Preoccupation with food
• Negative family interactions
• Childhood sexual abuse
• Low self-esteem
• High levels of anxiety, depression, & negative mood
• Genetic or neuroendocrine predisposition (e.g.,
serotonin)

A

Risk Factors for Eating Disorders

65
Q

• An eating disorder amounting to self-starvation
• Dieting and exercising until body weight is grossly below
optimum level

A

Eating Disorders:

Anorexia Nervosa

66
Q

restricting type:eat almost nothing and lose lbs by dieting, fasting,exercising or combo/ bingepurge type:eat large quantities of food and then use vomit or laxatives

A

subtypes of anorexia nervosa

67
Q

• Physiological
– Amenorrhea, abnormal levels of neuroactive steroids, Turner’s syndrome, hypothalamic abnormalities, chronically overreact to stress
• Profiles show
– Depression, anxiety, low self-esteem, poor sense of
mastery
• Genetic contributions
• Family interaction patterns – lack of control, needfor approval

A

Factors in Developing Anorexia

Nervosa

68
Q
• Highest mortality rate of any psychiatric disorder
• 5-10% die of disorder
– Most suffer cardiac arrhythmia
– Suicide is also a problem
• Recovery rates:
– 50% recover
– 30% improve but still struggle
– 20% continue
A

Health Consequences of Anorexia

Nervosa

69
Q

• Initiation of treatment is hard because of distorted body image
• First treatment step: stabilize medical effects of starvation
• Bring weight up to safe level
• Improve healthy eating
• Improve body image
• Use
– Individual and group cognitive behavioral therapy
– Supervised meals
– Meal planning
– Nutrition education

A

Treatment of Anorexia Nervosa

70
Q

• An eating syndrome characterized by alternating cycles
of binge eating and purging through such techniques as Vomiting, Laxative abuse,Extreme dieting/fasting,Drug or alcohol abuse,Excessive exercising
• Problem with impulse control
• Not preoccupied with losing weight
• May become bulimic and not anorexic if can’t resist
impulse to eat and yet feels the body dissatisfaction common to both disorders

A

Bulimia

71
Q

– Binge phase – out of control

– Purge phase – attempt to regain control

A

Issues of control with bulimia

72
Q

• Control of eating shifts from internal sensations to
cognitively based decisions
• Families placing high value on thinness
– produce bulimic daughters
• Childhood sexual abuse, physical abuse, PTSD
• Genetic basis: Bulimia runs in families
-more common than anorexia nervosa
-equally prevalent among various social classes and ethnic groups but restricted to western cultures

A

bulimia

73
Q

• Very seldom fatal
• Hypoglycemia (low blood sugar) from intake of large quantities of sweets and overproduction of insulin
– Dizziness, fatigue, depression, cravings for more sugar
• Poor diet/nutrition results in lethargy and depression
• Obsessed with planning the next binge
• Hydrochloric acid from frequent vomiting erodes teeth enamel
• Hydrochloric acid also damages mouth and esophagus
• Anemia
• Electrolyte imbalance
• Alkalosis
• Laxatives & diuretics may cause kidney damage, dehydration, spastic colon, loss of control over bowel movements

A

Health Consequences of Bulimia

74
Q
• Cognitive behavioral therapy
• Interpersonal psychotherapy
• Drugs like the antidepressant Prozac
• Combination of drugs and psychotherapy
• Psychoeducational interventions aimed at 
preventing bulimia
A

Treatment for Bulimia

75
Q

• Same type of out-of-control eating as in bulimia
but people do not purge
• Not officially a DSM disorder yet
• Risk factor for obesity
• More common among women than among men
• Occurs in all ethnic groups and in Western and
non-Western cultures
• More common than anorexia or bulimia
• Also tend to have behavioral or psychiatric
problems

A

Binge Eating Disorder

76
Q

• Cognitive behavioral therapy (CBT) helps to
control binges
• Use another strategy for weight loss
• Prozac doesn’t add to CBT
• Adding a weight loss drug to CBT does help
• orlistat (Xenical; Alli) or sibutramine (Meridia)

A

Treatment for Binge Eating

77
Q

chemical gatekeeper, most ancient of the senses, important in selection and rejection of foods

A

taste