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NFS284 > Section 3-2: Energy Balance and Weight Management > Flashcards

Section 3-2: Energy Balance and Weight Management Flashcards

1
Q

BMI: underweight

A

<18.5

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2
Q

BMI: normal

A

18.5 - 24.9

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3
Q

BMI: overweight

A

25 - 29.9

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4
Q

BMI: obese

A

> 30

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5
Q

Globesity

A

The whole world is going obese

  • developed counties: poor is fat
  • developing counties: rich is fat
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6
Q

__% of Canadians are overweight or obese

A

60

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7
Q

Consequences of obesity (6)

A
  • Diabetes
  • CVD
  • Cancer: colon & breast
  • Joint disorders
  • Gall bladder disease
  • sleep apnea
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8
Q

Which type of men respond better to prostate cancer treatment?

A

Lean, fit men

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9
Q

Which common cancer is not linked to obesity?

A

Prostate

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10
Q

Steps of cancer

A
  1. normal
  2. single mutated cell (reverse differentiation)
  3. small tumour
  4. large tumour
  5. malignancy
  6. metastasis
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11
Q

Cancer is a disease characterized by ________

A

a series of genetic mutations

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12
Q

Characteristics of cancer cell

A
  • Un-differentiated
  • Proliferative: cannot respond to stop signals
  • Cannot repair damaged DNA
  • Resistant to apoptosis
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13
Q

Cancer cells secrete ____, which are ____ factors that promote cell growth

A

insulin & estrogen;

growth

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14
Q

Why does cancer secrete insulin?

A
  • stimulate cell growth

- suppress apoptosis

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15
Q

Why does cancer cells secrete estrogen?

A
  • growth of breast tissue

- post-menopause: stimulate growth of breast tumour

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16
Q

what form of estrogen is damaging to post-menopausal breast tissue?

A

free (unbound to SHBG)

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17
Q

Adipose tissue is a source of ___

A

estrogen

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18
Q

What % of people to attempt to lose weight fail?

A

90%

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19
Q

why is body weight important to health?

A
  1. unhealthy body weight = increased health risks

2. weight stigmatization

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20
Q

Basal metabolism = ___% of TEE

A

60-75

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21
Q

Voluntary activity = __% of TEE

A

15-30

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22
Q

Thermic effect of food / diet-induced = __% of TEE

A

10%

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23
Q

which component of TEE changes depending on how active you are?

A
  • activity

- basal metabolism

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24
Q

TEE

A

total energy expenditure

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25
Q

Steps of cellular metabolism:

A
  1. glycolysis / B-oxidation / deamination
  2. TCA
  3. electron transport chain
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26
Q

which food has the highest TEF? lowest?

A

High -> low

proteins > carbs > fats

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27
Q

how much glucose do we store “just in case”?

A

24h supply

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28
Q

how much TG do we store “just in case”?

A

57 day supply

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29
Q

FA from diet is stored as…

A

TG

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30
Q

stored TG reflect ___ composition of the diet

A

FA

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31
Q

How is energy expended in the body?

A
  1. cellular metabolism
  2. TEE: maintain life, move body, absorb food
  3. extra energy (positive energy balance) stored as dietary fats
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32
Q

what can be made into TG?

A
  • glucose (minor)
  • AA (minor)
  • Fatty acids (major)
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33
Q

what is used to measure amount of calories in food?

A

bomb calorimeter

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34
Q

EER

A

estimated energy requirement

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35
Q

EER variables

A
  • gender
  • age
  • PA
  • weight (kg)
  • height (m)
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36
Q

Lean tissue is defined as…

A
  • fat-free mass (including bone)

- EVERYTHING but fat

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37
Q

Which (age) group has the most body fat? The least?

A

Most: old, women
Least: adult men
(Babies are somewhere in between)

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38
Q

Sacropenia

A

loss of muscle mass with aging

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39
Q

Most common tool for assessing healthy body?

A

BMI

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40
Q

Healthy body weight depends on…

A
  • weight
  • % body fat
  • location of fat
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41
Q

which location of fat is dangerous?

A

visceral fat (between abdominal muscle and organs)

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42
Q

limitations of BMI

A
  • not perfectly correlated with % body fat
  • very lean body = high BMI (athletes)
  • cannot be used for pregnant / lactating women
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43
Q

How are BMI limitations overcome?

A

used in combination with waist circumference

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44
Q

High visceral fat indicates…

A

high risk for diabetes & heart disease

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45
Q

why is visceral fat more harmful than fat in other areas?

A
  • surround organs
  • tend to release a lot of FFA → diabetes
  • release proteins that leads to inflammation
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46
Q

Apple shape vs. pear shape (in terms of fat distribution)

A

apple: high visceral fat
pear: high subcutaneous fat

47
Q

gold standard for measuring visceral fat

A

MRI

48
Q

waist circumference measurement correlates well with ____ measurements

A

MRI

49
Q

subcutaneous fat

A

fat between abdominal muscles and skin

50
Q

Health Canada vs. Canadian Medical Association cut-offs for waist circumference

A

CMA: set cut off lower (more strict)
HC: gives range

51
Q

waist circumference cut off between different groups

A

men > women

white people > asians

52
Q

how is a healthy body weight assessed?

A
  • BMI

- waist circumference

53
Q

Mechanisms for regulating body weight

A

1) hunger
2) satiety
3) satiation

54
Q

satiety vs. satiation

A

satiety: feeling full after a meal → determines when next meal will happen
satiation: feeling full during a meal → determines when meal ends

55
Q

Obesity genes regulate…

A
  • food intake
  • energy expenditure
  • fat metabolism
56
Q

Set-point theory / Adaptive Thermogenesis

A

There is a genetically pre-determined body weight (body tries to keep the same weight)

57
Q 
Twin study (Laval University): correlation between obesity and genetics
→ result?
A

identical twins who were fed the same diet & had same physical activity did not gain similar amount of weight

  • very wide range
  • adaptive thermogenesis & metabolism was different in different people
58
Q

Hormones that stimulate hunger

A

Ghrelin

59
Q

Ghrelin is secreted by…

A

stomach

60
Q

Functions of ghrelin

A

stimulate eating at set times

61
Q

high serum ghrelin = (what time)?

A

before a meal

62
Q

low serum ghrelin = (what time)?

A

after a meal

63
Q

hormones that supress hunger

A
  • CCK
  • Peptide PYY
  • GLP-1
64
Q

1 drug used to treat diabetes mimics the action of ___ (hormone). Why?

A

GLP-1

  • stimulate insulin release
  • suppresses hunger → weight loss of diabetics
65
Q

Hormone differences in lean vs. obese people

A

Obese:

  • ghrelin levels do not decline as much after meals
  • OVERALL ghrelin levels are lower, but the CHANGE is less
  • GLP-1 found in lower levels
66
Q

Short-term regulation of food intake is done by…

A 
Based on food;
Hormones
- ghrelin
- CCK
- Peptide PYY
- GLP-1
67
Q

long-term regulation of food intake is done by…

A

Based on amount of adipose tissue we have;
Hormone:
- leptin
- insulin

68
Q

Leptin is secreted by ___ to ___

A

adipose tissue → blood

69
Q

leptin levels are directly proportional to…

A

amount of adipose tissue

70
Q

leptin acts on ____

A

hypothalamus

71
Q

purpose of lectin

A

regulate food intake

  • more leptin = less food intake
  • less leptin = more food intake
72
Q

what is “leptin resistance”?

A

less leptin = INTENSE hunger

more leptin = small signal to stop eating

73
Q

why is leptin a problem during weight loss?

A

lose weight = less leptin = hungry

leptin resistance goes down = more sensitive to hunger

74
Q

Leptin resistance goes up =

A

more resistant = less sensitive to hunger

75
Q

leptin resistance goes down =

A

less resistant = more sensitive to hunger signals sent by leptin

76
Q

Insulin acts on…

A

hypothalamus

77
Q

evidence that insulin suppresses food intake

A

type I diabetes = low insulin = always every hungry

78
Q

lean vs. obese: insulin

A

obese people have more insulin

- high risk for developing insulin resistance (can’t sense stop signal)

79
Q

Genetic contribution to obesity

A

1) thrifty metabolism

2) adaptive thermogenesis

80
Q

what gene contributes to thrifty metabolism?

A
  • no single gene

- combination of genes alter metablism

81
Q

adaptive thermogenesis can alter energy expenditure up to…

A

250 kcal

82
Q

Mechanisms used by adaptive thermogenesis

A

1) futile cycling

2) uncoupling of ETC from cellular respiration

83
Q

futile cycling

A

opposing metabolic pathways happen at the same time

84
Q

uncoupling of ETC from cellular respiration

A
  • produce heat instead of ATP

- occurs in brown adipose tissue (most adult human adipose tissue is white)

85
Q

Adaptive thermogenesis in fat vs. skinny people

A

fat person weight loss: cause BMR to go down more than skinny people

fat person gain weight: cause BMR to go up less than skinny people

86
Q

brown adipose tissue can be found at ___. Why do we have it?

A

neck area;

lots of mitochondria →meant to conserve heat

87
Q

what happens to BMR when we lose weight?

A

goes down

88
Q

NEAT

A

non-exercise activity thermogenesis

  • walking
  • standing
  • sitting
89
Q

NEAT in lean vs. obese individuals

A

Obese people walk & stand less than lean individuals

90
Q

Units: NEAT

A

kcal / kg body weight

91
Q

Why are people getting fatter?

A
  • genes (prevent starvation)

- lifestyle (obesogenic environment & sedentary behaviour)

92
Q

Clinical practice guildlines for treating obesity

A
  • reduce weight by 10% over 6 months
  • slow weight loss to avoid muscle loss & adaptive thermogenesis
  • avoid weight cycling
93
Q

Benefits of reducing weight when obese?

A

improve serum lipids, BP, blood glucose

94
Q

What is a healthy amount to lose?

A

0.5-1 kg/week (cutting 500 - 1000 kcal / day)

95
Q

Is a weight loss treatment effective? Testing should be at least _____

A

2 years

96
Q

Most people can keep their “healthy, weightloss” diet for how long?

A

3-6 months, before rebounding

97
Q

modest weight loss of ___% of body weight is beneficial

A

5-10

98
Q

Lifestyle modifications used to treat obesity

A

1) nutrition: eat less
2) PA: 30 min every 3-5 days/week
3) CBT

99
Q

CBT used for weight loss: what is it used for?

A

used to promote changes in behaviour

  • new eating habits
  • social support
100
Q

CBT for weight loss: process

A

ABC:

1) Anecedents (cues that lead to behaviour)
2) behaviour
3) consequence

101
Q

1 lb adipose tissue = ___ kcal

A

3500

102
Q

composition of adipose tissue

A

80% fat vs 20% water

103
Q

Calculation: how many lbs of fat would be loss if you ate 7000 kcal less per month?

A

1 lb fat = 3500 kcal
7000 / 3500 = 2 lbs fat loss per month
(actual value is lower due to adaptive thermogenesis)

104
Q

units: energy density

A

kcal/g

105
Q

inducing satiation & satiety depend on…

A

how the food fills the stomach (does not depend on kcal!)

106
Q

Do you want to eat low // high energy dense foods?

A

low (kcal/g)

  • not dense in kcal
  • high in amount (g)
107
Q

do you want to eat low // high nutrient dense foods?

A

high

108
Q

Options if weight loss is not working

A

1) pharmacotherapy (drugs + lifestyle change)

2) Bariatric surgery

109
Q

when should pharmacotherapy be used?

A

if BMI > 27 + risk factors OR BMI > 30

110
Q

When should bariatric surgery be used?

A

If all else fails!

BMI > 35 + risk factors OR BMI > 40

111
Q

orlistat

A

drug used to treat obesity

112
Q

mechanism of orlistat function

A

Inhibit triglyceride digestion by lipase

- TG lost in feces

113
Q

Gastric bypass is ____. It works because ____

A

reduce stomach size & bypass portion of small intestines;

  • less absorption of food
  • feels full faster
114
Q

Complications of gastric bypass

A
  • micronutrient deficiencies
  • dumping syndrome (food enters small intestines too fast)
  • meals must be small & eaten very slowly

NFS284 (16 decks)

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