PUBHLTH 310 Exam #3 Flashcards

Question

Obesity and Puberty: Females

Answer 1

Observed decreased in the age of puberty onset *decrease in age coincided with increase in obesity

Answer 2

Observed weight for onset of menarche - around 105 lbs and 22% body far Children reaching thresholds sooner in life: breast bud, height gain, menarche Fat is considered to be an endocrine tissue *sufficient amount needed to trigger GnRH release, obesity alters many hormonal systems

Answer 3

Age range of thelarche onset for females of overweight and obese BMI: 8-9.6 years of age Earliest cases around 6 years of age *due to abnormal estrogen production from increased fat tissue *aromatase converts androgens to estrogen (alternate mechanism of estrogen production)

Answer 4

Insulin resistance - increasing circulating insulin results in *increase growth factors: insulin-like growth factor (stimulate linear growth) *stimulate production of androgens

Answer 5

Other risk factors - endocrine disruptor exposure *Polybrominated biphenyls (PBB): crosses placenta and breast milk

Answer 6

1973 Livestock Exposure: livestock ate PBB-contaminated feed, exposed to humans High-exposed population: daughters in farmer families *menarche occurred significantly earlier *more likely to experience miscarriage

Answer 7

Endocrine disruptors *Bisphenol A - estrogen mimicking chemical (targets early activation of GnRH production, release)

Answer 8

Livestock treated with hormones *excess estrogen found in liver and kidney, metabolized before consumption *further concerns about treatment with antibiotics

Answer 9

Livestock treated with hormones *excess estrogen found in liver and kidney, metabolized before consumption *further concerns about treatment with antibiotics

Answer 10

Short stature - bone mass development peaks earlier Increased risk of breast cancer Psychological effects *increased eating disorders, lower self-esteem, increased depression, risky behavior, effects persist into adulthood

Answer 11

Childhood BMI trajectory has a positive association with age of pubertal onset in males *as BMI increase, age of puberty onset increases

Answer 12

Mechanism remains unknown *limited data in low GnRH release and testosterone production *testosterone produced in converted to estrogen

Answer 13

Psychological effects - not long term *lower self-esteem *increased depression

Answer 14

Females: Early puberty *variety of mechanisms explored Long lasting psychological effects Males: Later puberty Shorter term psychological effects

Answer 15

Generally, physical activity has positive impacts on growth and development *promote bone development, maintain healthy weight Intense physical activity alters *nutritional status, maturation (puberty)

Answer 16

Additional lean body mass development *protein needs, increased mineral requirements Males need more calories per day

Answer 17

Increased cortisol through exercise suppresses GnRH production Female athlete triad *failure of LH, FSH, and estrogen production -> delayed menarche, amenorrhea, osteoporosis Relative energy deficiency in sports (RED-S) *failure of LH, FSH and testosterone production -> delayed lean tissue deposition, linear growth

Answer 18

Increasing independence from parents Dietary intake coming from outside sources *restaurants, workplace, etc.

Answer 19

Low dietary quality of food consumed outside home Factors contributing to meals/snacks outside of home *low economic status, employment, athletics

Answer 20

Busy life style limits nutrient intake *leads to increased snacking Breakfast - most frequently missed meal *due to sleeping in, lack of hunger cues *causes limitation of nutrients "Grazing Patterns" - correlated to TV, studying, video games

Answer 21

20-50% of adolescents will try to lose weight *response to bodily change, females more likely Restrictive practices *skipping meals, diet pills, smoking, fasting, food substitutes, intense physical activity

Answer 22

Strategies to change body shape differ among sexes *females: restrict food intake; males: increase muscle mass Different types of dieters: "overweight", "depressed", "feeling fat"

Answer 23

11% have experimented, 3-4% are established vegetarians Adolescent vegetarians: *increased intake of fruits and vegetables, decreased added sugar intake *need particular supplementation

Answer 24

Behavioral *dietary restriction, compensatory behavior, binge eating Physical *low body weight Cognitive *body image issues

Answer 25

Behavioral attempts to restrict food intake for wight control

Answer 26

Inappropriate behaviors to compensate for food consumed

Answer 27

Consumption of a large amount food in a short period of time and a sense of lack of control over eating during the eating episode

Answer 28

Low body weight considering one's age, gender, development, physical status

Answer 29

Severe body dissatisfaction or concern with body size/shape or weight; undue influence of body shape and weight on one's self-evaluation

Answer 30

Full syndrome cases are relatively rare and represent only a fraction of those who struggle *eating disorder symptoms/behaviors exist on a continuum

Answer 31

Term used to describe behavioral symptoms of eating disorders that do not meet diagnostic criteria

Answer 32

Primary Prevention *prevent occurrence of eating disorders before they begin (promote healthy development) Secondary Prevention *programs or efforts that are designed to promote the early identification of an eating disorder

Answer 33

Prevalent: 3-5% with eating disorders, 15-20% with disordered eating Serious: high mortality, psychiatric morbidity, organs Modifiable: media exposure, thin ideal internalization, food insecurity, abuse history

Answer 34

Traditional undergraduate college years directly coincide with median age of onset for eating disorders and disordered eating

Answer 35

Population-level Administered to a randomly selected sample of undergraduates and graduates Two academic years, 12 colleges

Answer 36

Examined: Elevated dietary restrain and concerns about eating, weight and shape Binge eating Compensatory behaviors

Answer 37

Examined: Elevated dietary restrain and concerns about eating, weight and shape Binge eating Compensatory behaviors

Answer 38

Undergrads and younger students were at highest risk of all disordered eating symptoms Few differences according to race/ethnicity Elevated dietary restraint and concerns among sexual minority men Compensatory behaviors were common in female athletes Weight was consistent predictor of disorder eating

Answer 39

The majority of individuals never get diagnosed or treated *if left untreated, associated with physical, psychological, social and academic consequences

Answer 40

Disordered eating is prevalent on college campuses, yet under-diagnosed and under-treated *assumptions drive disparities, may continue to disadvantage those who already feel excluded Additional attention must be paid to improving detection, identification and referral

Answer 41

18-25 years New focus as a distinct period of life: *delay of marriage, child bearing *decline in teen pregnancies, increasing higher education

Answer 42

New independence and responsibilities Time of new and/or solidified identity Perry's Intellectual Model: Relativism -> Commitment *relativism: role models; commitment: own beliefs Changing social relationships Shape food and health-behavior choices

Answer 43

Majority of height reached by 16 for girls and 18 for boys Continued changes in body composition *bone density increases until age 30, and then begins to decline around age 40 ~ if there is calcium, Vitamin D intake + adequate levels of high/ow impact exercise

Answer 44

Muscle strength peaks from 25-30 Adiposity (fat) increases through adulthood *fat tends to redistribute to intra-abdominal space

Answer 45

DRI: ages 19-30 Caloric recommendations: less for women than men

Answer 46

Fat: 20-35% of calories Carbohydrates: 45-65% of calories Protein: 10-35% of calories

Answer 47

Energy expenditure begins to decline starting in early adulthood *2-3% per decade *corresponds to decreases in physical activity *decline accelerated due to chronic conditions *compensatory trend with caloric intake

Answer 48

Fast food/ready made food is common *52% of 20-40 report eating fast food recently Dietary quality declines *fruit/vegetable intake decline following high school *red meat intake increases Dietary quality predicts cardiovascular health in mid-adulthood

Answer 49

No nutritional value Moderate intake has not demonstrated adverse outcomes *benefits to cognition 800+ is considered dangerous *dependence, bone health, acid reflux, heart problems, sleep

Answer 50

Normative during early adulthood *63% report drinking in the last month Underage drinking - public health problem *20% of 12-20 year olds report drinking in last month *unnecessary deaths, costly, alcohol dependence, etc.

Answer 51

39% of college freshman report eating less on days they drink *women more likely to eat less before drinking *for weight control, drunk faster

Answer 52

Rate of weight gain is highest during young adulthood than other adult period Higher rate of weight gain in emerging adulthood associated with: *steeper trajectory of weight gain, diagnoses of diabetes, hypertension and inflammation

Answer 53

15 lbs on average for college freshmen (myth) Weight gain is expected True: gain between 4-8 lbs during freshman year

Answer 54

Children and adults tend to eat more with others than alone Time extension Hypothesis: socializing extends time of meals Arousal Hypothesis: sight and sound of eating makes people eat more extending time of meal Weight status influences intake

Answer 55

Traditional not well represented in weight control trials Many obesity interventions have begun in past 5 years

Answer 56

60% of middle schoolers have insufficient sleep *70% of US high schoolers

Answer 57

80% of Michigan high schoolers sleep-deprived

Answer 58

Academic performance Mental health Motor vehicle accidents Risky behavior Lower immunity Poor diet quality Higher body size Adverse cardiometabolic health

Answer 59

Lack of time Distraction & growing independence Sleep difficulties

Answer 60

When a person's sleep is delayed by 2 hours or more beyond a conventional bedtime *7-16% of teens/young adults Sleep that is out of sync with underlying body rhythms may lead to metabolic dysfunction

Answer 61

Highly correlated with duration, thus difficult to disentangle analytically

Answer 62

Older age Screen time Higher maternal education Alcohol consumption Male sex

Answer 63

Those with later bedtimes had higher risk of developing elevated blood pressure *early bedtimes also had higher risk Sex differences

Answer 64

Evidence beginning to accumulate that delayed sleep timing has an effect on metabolic health, independent of sleep duration Potential mechanisms - alterations in metabolism through circadian misalignment, diet quality, eating patterns, body size

Answer 65

Diet can affect sleep in adolescents Fatty fish consumption (DHA -> higher sleep quality) Findings in pediatric populations are mixed Confounders: age, sex, SES, BMI

Answer 66

Linear regression Continuous sleep or midpoint as outcome Quartiles of DHA levels Adjustment for potential confounders

Answer 67

Higher DHA levels related to healthier sleep in adolescents Non-linear association explained by toxicants? RCTs are needed to evaluate causality

Answer 68

Sex-specific associations; girls affected by caffeine Benefits of milk and 100% fruit juice? *through melatonin Micro-longitudinal studies are need

Answer 69

Aim for 7-9 hours Same time for bed and wake up everyday Natural light Avoid caffeine, alcohol, large meals

Answer 70

Emerging Adulthood: 18-25 Young Adulthood: 25-40 Midlife: 40 Sandwich Generation: 50-60 Later Adulthood/Senior: 60 and above

Answer 71

Young Adulthood *career, community, single -> married, parenthood Midlife *midlife crisis, empty nester Sandwich Generation *multigenerational caretakers (especially females)

Answer 72

Bone mass increases until age 30 and then begins to decline around age 40 *precent loss: calcium and weight-bearing exercise *risk of osteoporosis dependent on peak bone mass achieved Adiposity increases through adulthood

Answer 73

Energy expenditure generally includes *65-70% is basal metabolic rate *10% energy expended by thermic effect of food *20-40% from activity thermogenesis

Answer 74

Bodily movement produced by skeletal muscles that substantially increases energy expenditure

Answer 75

Planned physical activity with purpose of improving physical fitness or leisure-time physical activity

Answer 76

Energy expenditure related to daily activities including posture and movement PA energy expenditure = exercise + NEAT

Answer 77

Lean adults expend more NEAT per day If individuals having obesity adopted the NEAT behaviors of lean, they could expend addition 350 cal/day *promote 7lb weight loss over a year

Answer 78

Energy expenditure begin to decline starting in early adulthood *corresponds to decrease in PA/loss of muscle *corresponds to development of chronic conditions 20-35% fat 45-65% carbohydrate 10-35% protein

Answer 79

Calcium and Vitamin D *vitamin D increases bioavailability of Ca, preventing loss of calcium from bones Vitamin A and E - strong antioxidant functions Folic acid, Choline, Vitamin B12 - involved in genotype expression, nucleotide synthesis Potassium and Sodium - complementary roles in blood pressure Magenesium - chronic inflammation

Answer 80

Factors early in this life-stage impact health through adulthood Modifiable factors: physical activity, food choice, weight *associated with high caloric intake, physical inactivity, saturated fatty acids

Answer 81

Education, economic stability, neighborhood, community Health disparity: differences in the incidence and prevalence of disease among specific populations

Answer 82

Almost all adult Americans have one or more chronic disease *greater than 50% of deaths from cardiovascular events *target modifiable risk factors to prevent chronic disease

Answer 83

Choose nutrient-dense foods Limit portion sizes Minimize refined grains/processed foods Eat culturally-appealing foods Exercise Minimize caloric beverages Drink water

Answer 84

Whole milk -> skim Non-diet soda -> diet soda Sports drinks -> water

Answer 85

Genetic predisposition Psychological Social determinants Obesogenic environment (sedentary jobs, advertising, etc.)

Answer 86

High levels of blood glucose *insulin resistance and defective production of insulin by the pancreas *high circulating insulin Chronic disease *multitude of risk factors, associated with central adiposity

Answer 87

Physical inactivity History of GDM Family history Genetic history Age Obesity Race

Answer 88

Prevalence is increasing Health effects and costly Preventative and intervention

Answer 89

45 or older Before 45 if overweight and have risk factor: *family history, GDM, race, inactive, high cholesterol, hypertension

Answer 90

Blood glucose levels are higher than normal *not high enough to be classified as type 2 diabetes, reversible Pre-diabetes: 5x to 20x higher risk of Type 2 diabetes

Answer 91

HbA1c = glycated hemoglobin *develops when hemoglobin joins with glucose in blood, becoming glycated *long term measurement

Answer 92

Short-term, untreated *frequent urination, increased thirst, fatigue Long-term, untreated *kidney failure, loss of limbs, neurological problems, loss of eyesight, heart disease, hypertension

Answer 93

Lifestyle changes *weight loss, physical activity, diet Medication

Answer 94

Nationwide randomized trial 3,200 overweight/obese adults with pre-diabetes Compared 3 preventative interventions *brief education + placebo, brief education + pill, intensive lifestyle program

Answer 95

Goal: weight loss of at least 7% of initial body weight *150 mins of moderate physical activity *education, training, strong support

Answer 96

Medication *metformin, recommendations for lifestyle change Placebo *fake, recommendations for lifestyle change

Answer 97

Physical Activity - controls blood glucose levels *stimulates glucose uptake without an insulin response *calcium release upon contraction triggers an AMPKinase response -> GLUT4 translocation

Answer 98

Carbohydrates do not cause diabetes *underlying etiology that insulin signal is disrupted No specific diet *spacing of meals, portion sizes, high fiber

Answer 99

Treatment of chronic conditions in older adults is complicated *each condition can affect another

Answer 100

Oral Health Hypertension Osteoporosis Cognitive Health (depression, Parkinson's, Dementia)

Answer 101

High blood pressure = greater than 130/80 Hg *new guidelines Non-modifiable and modifiable risk factors *age, family history, race, excess weight *diet: high fat, high salt, low potassium, low magnesium, low calcium

Answer 102

Study AIM: reduce hypertension by diet Control: typical westernized diet Intervention 1: high in fruit and vegetables Intervention 2: high in fruit and vegetable + low fat, dairy, etc

Answer 103

DASH diet made most improvements to blood pressure (intervention 1) Diet rich in fruits and vegetables also reduced BP but to a lesser extent (intervention 1) DASH-sodium trial *different levels of sodium, better results from lower sodium than DASH diet

Answer 104

Prevalence is much higher in women than men Non-modifiable: female, race, history of restrictive diet Modifiable: phosphorus, calcium, vitamin D deficiency, inactivity

Answer 105

Maintaining bone health *calcium and vitamin D rich, exercise, limit caffeine intake, medication option Effects *shrinking height (kyphosis), falls and fractures (don't heal as well, more time in hospital)

Answer 106

Late-life depression Prevalence: 15% in community, 50% in assisted living Diagnosis: Geriatric Depression Scale + Cog. functioning tools Treatment: anti-depressants, EPA and DHA

Answer 107

Overarching term for progressive loss of memory and cognitive function *loss of independence, impaired judgement, impaired linguistic ability Symptom of alcoholism, Vascular disease, Alzheimer's, Parkinson's

Answer 108

Neurodegenerative disease *affects dopamine production, altered motor function Prevalence: 1% of older adults Cause: genetics and environmental exposures Early signs: tremors on one side, slouched/shuffled gain, word loss

Answer 109

Prevention: dopamine too far disrupted by the time symptoms are present to prevent Interventions: medicine (in absence of protein), Deep Brain Stimulation therapy, exercise, nutrition, monitor mental health

Answer 110

Awareness of the aging and diverse population Understand complex, multiple diagnoses Support cognitive functioning

Answer 111

Entire range of factors and interlinked activities involved in production, aggregation, processing, distribution, consumption and disposal of food products that originate from originate from agriculture, etc. and parts of the broader environments in which they are embedded

Answer 112

Production -> Processing -> Distribution -> Consumption -> Disposal

Answer 113

Key drivers: economic and population factors broadly, any sector that requires energy When: half of cumulative emissions between 1750-2011 have been in last 40 years Where: Cumulative rise in all regions of the world, including oceans Affects: water supply, biodiversity, crop yields, disease and extreme weather events

Answer 114

Destroyed 80% of Puerto Rico's agriculture Climate change outlier: sea surface temperature increases hurricane intensity *climate change increases total rainfall, Maria had 30% more than the next most severe hurricane

Answer 115

200$ million worth of produce lost *only 24% of vendors had reliable electricity No fresh fruit, unhealthy food widely available High prevalence of chronic disease risk factors after Hurricane Maria

Answer 116

FEMA food distribution not appropriate for pregnant persons or infants Emergency foods must follow the DGA per 1990 National nutrition Monitoring Related Research Act

Answer 117

Pregnant persons had 200% higher exposure to phthalates (in bottled water, packaged foods) Higher exposure of certain phthalates linked to preterm birth (compound with maternal stress)

Answer 118

Those who adhere to diet tend to consume *more fruits and vegetables, less whole and refined grain, more red meat and less poultry/seafood, less added sugars

Answer 119

Age is arbitrary DRIs - 70 US census bureau - 65 WHO - 60 Elderly Nutrition Program - 60

Answer 120

Lifespan: length of life of any one individual Healthspan: length of time a person can perform activities of daily living Compression of Morbidity - shortening period of illness *increasing healthspan, target lifestyle factors Postponing change sin health is an important goal

Answer 121

All organisms lose cell function and number of cells over time *loss physiological function, increase disease, malnutrition risk Effects of aging go unnoticed for a long time *reserve capacity

Answer 122

Cells have pre-programmed limited number of divisions *as cells replicate, it increases the chances of being mutated, leading to cell death Cells death rate *too fast = loss of organ functioning *too slow = damage cells proliferate resulting in disease

Answer 123

20-40% reduction: expands life spans in animal models by 50% *less oxidative damage to cells

Answer 124

Rate of aging *influenced by exposures Different amount and length of exposures through lifetime (weathering hypothesis) *food, exercise, environment, stress, social

Answer 125

Born into lives with more opportunity and growing prosperity *more likely to experience chronic illness longer than previous elderly population

Answer 126

Current Life Expectancy: 76.6 years 85 and older: fastest growing of the population

Answer 127

Increase in fat mass percentage Decrease in lead body mass percentage *mineral loss, water loss

Answer 128

Weight increases until about 70 *decline in all energy expended Weight loss 70 and older *lower food intake, hormonal changes, loss of muscle mass

Answer 129

Build and maintain lean body mass Improves balance and flexibility Increases caloric need, chances of adequate nutrient intake Improves cognitive performance

Answer 130

65-75 years of age, less than 60 min per week Significant better outcomes on emory, verbal fluency, speed of information processing in exercise program

Answer 131

Muscle strengthening of all major muscle groups 2 or more times/week Moderate intensity aerobic activity at least 150min/week Drink water when exercising Intake of adequate protein throughout dah

Answer 132

45-65% of daily calories are carbohydrates *focus on whole grains/fiber in the diet: decrease cholesterol, constipation, healthy weight, reduces sugar intake, increases micronutrient intake

Answer 133

High saturated fat and trans fat intake are risk factors for chronic disease *keep fat intake between 20-35% of calories High intake of essential fatty acids associated with: *memory, cognitive functioning, slower development of neurodegenerative disease

Answer 134

Inadequate protein intake most abundant in older adults Elderly at risk: poverty, obese, functional limitations, living alone Risk of low protein: sarcopenia, weakened immune system, delayed wound healing 35% from calories is recommended

Answer 135

Recommendation is same as younger adults Reasons underlying dehydration: *thirst mechanisms decline, kidney function declines, swallowing difficulties Dehydration: confusion, weakness, body temperature

Answer 136

Affects bone health Possible deficit due to: *decreased ability of skin to synthesize vitamin D, more clothing worn, overall less food eaten

Answer 137

Blood coagulation Important to consider if taking blood thinners *target Vitamin K1, decreasing clotting factors, manage Vitamin K intake

Answer 138

Ability to cook Finances Ability to shop Habits Cognitive functioning Disease Senses

Answer 139

75+ years of age *fluoride treatment started in late 1940s Dentures, periodontal disease, cavities, can all lead to changes in nutritional intake *difficulties chewing, pain, enjoyment decreases To promote eating and enjoyment *cut foods down, stimulate saliva, cultural foods

Answer 140

Food borne illness as a concern in this population *compromised senses and immune system Factors contributing to food borne illness *contaminated food prep, hygiene, cooking, old food, improper temperatures