Unit 7: Energy Balance and Healthy Body Weight Flashcards
what are 2 types of energy imbalances
- feasting
- fasting
describe the relation between feasting & energy imbalance
- it is excess energy consumption
what is excess carb consumption stored as/used for (3)
- glycogen in the liver & muscles
- once the limited glycogen stores are full, the excess is used for energy
- excess carbs, proteins, and fats beyond that are stored as fat
what is carb broken down into? and then stored as?
- broken down into glucose
- then stored in the liver and muscle as glycogen stores
- and the rest as body fat stored
what is fat broken down into? stored?
- into FA
- then contributes to body fat stores
what is protein broken down into? stored? (3)
- into amino acids & is first used to replace body proteins
- or converted into glucose or fat
- or nitrogen that is lost in urine
what is fasting
- voluntary energy deficit
describe how fasting affects the body for energy (2)
- body will use glycogen & fat for energy
- eventually may resort to using body tissue for energy
what body stores are first used for energy during fasting (2)
- liver & muscle glycogen stores –> glucose –> energy for brain, NS, RBC, and other cells
- body fat stores –> FA –> energy for other cells
what stored energy is used if the fast continues past glycogen depletion
- body protein –> amino acid –> glucose for energy or nitrogen lost in urine or ketone bodies
- body fat –> FA –> ketone bodies & energy for other cells
what are ketone bodies
- biproducts of FA breakdown
what do ketone bodies do
- supply energy to the brain, NS, and RBC , and other cells
what does fasting typically result in at first
- rapid initial weight loss (often water weight)
- and loss of lean body mass
what happens upon resumuption of eating during fasting? why?
- weight is quickly regained
- bc the body’s BMR has been lowered due to loss of lean muscle mass
define energy balance
- change in energy stores equals the food energy taken in minus the energy spent on metabolism & physical activity
- occurs when the calories coming into our body equals the calories that iur body is expending
where does energy intake come from
- foods & beverages we come
for each ____ calories that you eat in excess of expenditure, you stores ___ amount of body fat
- 3500 cal
- 1 lb
and vice versa
what are 3 ways we expend energy
- to fuel the BMR
- to fuel voluntary activity
- thru the body’s metabolic response to food
what is BMR
- the sum of calories burned thru all the involuntary activities necessary to maintain life
ex. circulation, resp, temp maintenance, hormone secretion, nerve activities, new tissue synthesis
what does BMR exclude (2)
- digestion
- voluntary activities
who si BMR highest in
- growing humans
- people w high, lean body mass
describe the effect of age on BMR
- lean body mass diminishes w age = slowed BMR
describe the effect of height on BMR
- tall, thin people have higher BMR
describe the effect of growth on BMR; list 3 populations w higher BMR
- more growth = higher BMR
- BMR higher in children, adolescents, and pregnant women
describe the effect of gender/body comp BMR
- high in males bc they often have more lean tissue
- lower BMR w more fat tissue
describe the effect of fever on BMR
- increases BMR
describe the effect of stresses on BMR
- stress (including disease & drug) can increase
describe the effect of enviro temp on BMR
- both heat & cold raise BMR
describe the effect of fasting/starvation on BMR
- lowers BMR due to loss of lean muscle
describe the effect of malnutrition on BMR
- lowers BMR
describe the effect of thyroid hormone on BMR; premenstrual hormones
- thyroid = slows or speeds up BMR
- premenstrual = slightly raise
describe the effect of smoking & caffeine on BMR
- both increase energy expenditure (increase BMR)
describe the effect of sleep on BMR
- BMR lowest when sleeping
list examples of voluntary activities that expend energy
- walking
- sitting
- running
- things conducted thru voluntary muscle movement s
what is meant by the body’s metabolic response to food
- the thermic effect of food
- calories our body burns while digesting, absorbing, and process the nutrients
- due to celll activity required for secretion of digestive enzymes, peristalsis, absorption, and metabolism
describe the effect of eating on BMR
- increases for approx 5 hours after a meal
list from highest to lowest, what accounts for the largest energy expenditure
- basal metabolism
- voluntary activity
- thermal effect of food
what determines the amt of energy burned thru voluntary activity (3)
- muscle mass
- body weight
- activity
what can be used to determine the # of calories ur body needs? what is it?
- estimated energy requirement (EER)
= the dietary energy intake lvl that is predicted to maintain energy balance in a healthy adult of a defined age, gender, weight, and physical activity
what does EER take into account to ensure an accurate result (6)
- gender
- growth
- age
- physical activity
- height
- weight
why is it important to consider gender for EER
- bc body comp differs between men & women = will effect energy requirements
why is it important to consider growth for EER
- bc BMR is higher during periods of growth
why is it important to consider age for EER
- bc energy requirements decrease as we age
why is it important to consider physical activity for EER
- bc physical activity will use more energy
why is it important to consider height & weight for EER
- bc energy requirements are higher from those taller & heavier
what should be stressed as goals during weight loss
- health & fitness
- with weight as only a gauge for progress
what are 2 things we consider for weight loss rather than simply weight alone
- for every height there is an ideal weight range
- look at the amt of lean tissue versus body fat
see table 6-3 for tips for accepting a healthy body weight
- theyre all kinda common sense tho
what is a weight normaitive approach
- approach that focuses on weight loss & management to prevent and treat health problems
what is a weight inclusive approach
- approach that takes the focus off a pt’s weight & focuses more on overall health
what is the “size” belief in weight normative vs weight inclusive approach
- normative = expect pt to be one size
- inclusive = expect range of sizes
what is the goal during a weight normative vs inclusive approach
- normative = goal to attain the size defined as worthy/ideal
- inclusive = accomodate the needs of people of all sizes
what is the belief regarding diet/hunger in a normative vs inclusive approach
- normative = if people must maintain restriction/hunger to maintain lower weight, then it is prescribed
- inclusive = no one is expected to be hungry, all sizes are prescribed adequate nutrition
what is the belief regarding quality of life in a normative vs inclusive approach
- normative = if people need to organize their lives around weight loss, then it is prescribed
- inclusive = no one is expected to sacrifice major quality of life for weight loss
what is the belief regarding people who differ from normative size during normative vs inclusive approach
- normative = people who differ from a normative size have a “disease” or require explanation
- inclusive = no body sized is inherently healthy or unhealthy
what is the focus of change in a normative vs inclusive approach
- normative = fat tissue/weight loss focus of change & presumed as the most powerful factor for better health
- inclusive = how people are treated & determinants of health are the focus of change & presumed to be powerful factors
what is HAES
health at every size
- weight inclusive approach used in north america
what does HAES focus on (3)
- weight inclusivity (accept & respect)
- health enhancement
- respectful care
what is included in health enhancement in HAES
- improving & equalizing access to info & services
- personal practices that improve human well being
what is meant by respectful care in HAES
- acknowledge biases
- work to end weight discrimination, stigma, and bias
list 9 weight inclusive approaches
- eat well (enough, variety)
- be active
- good sleep
- stress management
- quit smoking
- have fun (social connection)
- see ur doctor
- help accept weight is not a behavior to control
- meaningful change may or may not lead to weight change
what is the purpose of BMI
- effective in assessing degree of overweight & obesity
- used to evaluate a person’s health risks associated w being under or over weight
what is the formula for BMI
BMI = weight in kg / (height in m)2
how do you convert lb to kg
- divide weight in lb by 2.2
how do you convert height in inches to cm
- multiply height in inches by 2.54
what is considered an underweight BMI
<18.5
what is a normal BMI
18.5-24.9
what is an overweight BMI
- 25 - 29.9
what is an obese (class 1) BMI
30-34.9
what is an obese (class 2) BMI
35-39.9
what is an extreme obesity BMI (class 3)
- > 40
what is considered a health risk
- being underweight or overweight –> therefore, lower or higher the BMI = greater risk
how is being underweight a health risk (3)
- may not be able to preserve lean tossue in situations like cancer, surgery
- can cause infertility in women
- associated w bone fractures & osteoporosis
how is being overweight a health risk (2)
- increased risk for HTN
- increased risk of DM
what are 3 drawbacks to BMI
- fails to show how much weight is actually fat
- fails to show where fat is located
- not suitable for some grousp
list 4 groups that BMI is not suitable for (4)
- some athletes
- for non-obese
- pregnant & lactating women
- adults over 65
why is BMI not good for athletes
- muscle mass weighs more than fat
= athletes may have a higher BMI, but their total body fat may be low
ex. body builder’s BMI is often in the obese range
why is BMI not good for pregnant & lactating indiviudals
- increased weight is normal during childbearing
why is BMI not good for adults over 65
- BMI values are based on data collected from younger people
- people tend to lose height as they age
is BMI a good indicator of health
- noooo
what is antrhopometry? list 2 types
- method to assess body weight/composition
- involves direct body measurement
ex. waist circumference, fat fold test
what kind of fat is associated w increased risk of disease
- visceral fat stored in the abdominal cavity
what do individuals w central obesity (fat stored in the abdominal cavity) have a higher risk of (5)
- CVD
- diabetes
- stroke
- HTN
- death
how does visceral fat increase the risk of diseases?
- visceral fat promotes inflammation & insulin resistance
what is waist circumference
- measures visceral fatness & disease risk
how is waist circumference measured
- measure around the body at a point near the belly button
- person should exhale normally while the measurement is taken
what is a higher waist circumference indicate
- increased risk of disease even if BMI is normal
what are skin fold measures? what does it use? what does it provide?
- calculates the thickness of a fold of skin at areas on the body
- uses callipers
- providers an estimate of total body fat & where fat is located
where are skin folds often measured (3)
- back of arm
- below shoulder blade
- skin from the waist
who should complete a skinfold measure
- done by a trained technician & by the same one if the test is repeated
describe the role of genetics in weight (2)
- influences how efficiently our body uses & stores energy
- may cause a tendency towards obesity, but is not the only determinant
list 3 proteins that may play a role in the development of obesity
- lipoprotein lipase (LPL)
- leptin
- ghrenlin
describe the role of LPL in obesity
- LPL enables fat storage in fat & muscle cells
- those w high LPL activity will store fat more easily
- LPL activity is higher in obese people
what is leptin
- an appetite suppressing hormone that is produced in the fat cells
describe how leptin works
- conveys info about body fatness to the brain, working to suppress appetite & food intake between meals
- operates ona feedback mechanism
describe the role of leptin in obesity
- lack of leptin = increased risk of obesity
what is ghrelin
- an appetite stimulating hormone that is made & secreted by stomach cells
- stimulates the urge to eat
how does ghrelin work
- works in the hypothalamus to promote efficient energy storage
what are 3 other theories regarding the role of genetics in obesity
- fat cell development
- set point theory
- intestinal bacteria
what is the theory of fat cell development
- theory that body fatness is determine by the # and size of fat cells
what can cause fat cell #s to increase
- increase in # of childhood & typically taper off in adulthood
- increase when energy intake exceeds energy output ( also increases size)
describe the role of fat loss on fat cells
- causes the size of fat cells to shrink
- but not the number
what is set point theory
- theory that the body tends to maintain a certain weight by means of its own internal controls
describe how set point theory works
- when weight is gained or lost, the body’s energy expenditure shifts to restiore the “chosen” body weight
- metabolic rate adjusts to food intake
describe the role of intestinal bacteria in obesity
- intestinal bacteria produces compounds that communicate w tissues to alter use & storage of energy
describe how the intestinal bacteria influences energy balance (4)
- regulation of energy availability & storage
- interaction w signaling molecules involved in metabolism
- modification of intestinal permeability
- release of intestinal hormones
describe how the intestinal bacteria may change & the impact it has on weight
- makeup of intestinal microbiota can change when body weight or diet changes
- changes in the makeup of intestinal microbiota accompanies changes in body weight
what are 6 enviro stimuli that play a role in obesity
- overeating
- learned behavior
- physical inactivity
- screen time
- convenience systems such as elevators
- infrastructure (such as no sidewalks) can discourage physical activity
what can contribute to overeating (2)
- being presented with a wide variety of food (esp sweets, snacks)
- emotional reasons
what 2 mechanisms play a role in eating behavior
- stop & go mechanisms
what role do “go” mechanisms play in eating? what are 2 examples
- stimulate eating
- hunger & appetite
what role do “stop” mechanisms play in eating? what are 2 examples
- mechanisms that signal the body to cease/refrain from eating
- satiation & satiety
define hunger
- a physiological need to eat
define appetite
- a psychological desire to eat
define satiation
- the perception of fullness that builds throughout a meal
- eventually reaches the degree of fullness/satisfaction that stops eating
define satiety
- perception of fullness that lingers after a meal
- inhibits eating until the next meal
is hunger or satiety a more powerful stimulus
- hunger
which nutrient is the most satiating
- protein
what are some treatments for obesity (4)
- meds
- surgery
- aggressive treatment depending on the medical problems it is causing
- NPH
what are some examples of misuse of weight-loss products (5)
- ordering prescription drugs that have not been prescribed
- taking several different kids of weight-loss products together
- buying products online from unreliable sources
- using health products “off label” (using it for a purpose other than its authorized purpose)
- assuming a weight-loss product is safe bc its natural
list 2 examples of surgery for obesity
- bypass or gastric banding
- to reduce stomach capacity
what are the 3 lifestyle components needed to achieve a healthy body weight
- diet
- physical activity
- behavior modification
what is considered a healthy weight loss
- slow weight loss
- 1-2 lbs per week
what kind of weight loss is easier to sustain
- slow weight loss
what kind of goals should someone aiming to lose weight set? why?
- appropriate goals
- if the goal is unreasonable & difficult to obtain, it leads to frustration & feelings of failure
what kind of changes to your diet is best to make? why?
- take ur current diet and make small changes
- causes a lifestyle change, rather than a short term diet, that is easier to sustain rather than big changes that dont fit ur lifestyle
list 6 strategies for weight loss
- moderate calorie diet
- watch portion sizes
- choose foods w lower energy density & high nutrient density
- avoid empty calories
- decrease time between meals & avoid skipping meals
- eat slowly
- drink water
- what is the minimum calorie level typically recommended per day for men vs women?
- women = 1200
- men = 1500
what happens if you consume calories below the minimum calorie level (3_
- becomes difficult to meet the DRI recommendations for nutrients
- loss of lean tissue
- lowered BMR = gaining back weight
what are strategies to lower portion sizes (2)
- use small plates & bowls
- do not order large quanities of food bc its a deal
what types of food are typically lower in energy density & calories? (3)
- foods w high fiber
- high water content
- lower fat content
what is the benefit to eating foods w lower energy density
- allows them to eat satisfying portions while still reducing energy intake
what are 2 things that contain empty calories
- high sugar items
- alcohol
how does decreasing the time between meals help w weight loss
- bc it prevents you from becoming extremely hungry which prevent overeating
see the notes for a bunch more weight loss strategies but too much for cards & lots are common sense
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what is the benefit of physical activity for weight loss (4)
- burns calories
- helps build muscle
- increases metabolism
- decreases appetite
what is the physical activity guideline for adults 18-64
- 150 mins of mod to vigorous intensity activity each week
- time span of each activity should be at least 10 min in length
what is moderate intensity activity? list some examples (4)
- activities that cause you to sweat a little & breath harder
- brisk walking
- water aerobics
- bike riding
- gardening
what is vigorous intensity activities? list 5 examples
- activities that cause you to sweat more & be out of breath
- jogging
- swimming laps
- aerobics
- hiking
- cross country skiing
what is the recommendation of muscle & bone strengthening activities
- include them at least 2 days / week
what can following the physical activity guidelines help reduce (8)
reduce risk of:
- premature death
- coronary heart disease
- stroke
- HTN
- colon cancer
- breast cancer
- type 2 DM
- osteoporosis
what can following the physical activity guidelines help improve (3)
- physical fitness
- body composition
- mental health
if you are currently inactive, what is the recommendation for physical activity
- start w smaller amounts
- slowly increase the duration, frequency, and intensity
how does physical activity effect BMR
- elevated during vigorous activity
- in the hours after, and over time, lean tissue development further increases BMR
describe the effect of exercise on hunger/eating (2)
- heighten satiation & decrease hunger
- help stop stress eating or eating due to boredom
weight gain prevention & weight loss occurs with at least how much physical activity?
- at least 2 hr & 30 min of at least moderate physical activity per week
what is behavior modification
- focuses on taking a look at the cues that are causing behavior which are resulting in consequences
what is an example of a cue that influences eating
- sitting in front of the TV is a cue for causing the behavior of eating chips
- and the consequence is weight gain
what does behavior modification focus on
- changing the cue & behavior to change the consequence
what are 6 ways to apply behavior modification
- eliminate inappropriate cues
- suppress the cues you cannot elimination
- strength cues to appropriate behaviors
- repeat desire behavior
- arrange negative consequences for negative behavior
- reward urself personally & immediately for positive behaviors
what are some examples of inappropriate cues to eliminate (6)
- do not buy problem foods
- eat only in one place
- do not shop when hungry
- replace large plates w smaller
- avoid fast-food restuarants
- measure out appropriate snack portions to eat during entertainment (instead of an entire bag)
see box 7-1 in the notes for more on how to apply behavior modification
- once again, too much for cards & mostly common sense
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what is an example of a cue that cannot be eliiminated but not suppressed and how to suppress it
- cue = going to a party where food is served
- suppress by not standing right by the food table
what is an example of a cue that should be strengthened or reinforces
- keeping a pair of running shoes at work to go for a walk on lunch hour
attaining and maintaining a __% weight loss in those w obesity brings impressive health benefits
10%
what are 2 recommended strategies for healthy weight gain
combo of
- physical activity
- and increased energy intake
to ensure weihgt gained is not solely fat mass
what type of foods hold the key to weight gain
- energy dense foods
- pick the highest kcalorie items from each food group
what else can individuals who are trying to gain weight consume to help?
- fat, since it contains more than twice as many kcalories per tsp than sugar
- but should select mono & polyunsaturated fats instead of sat & trans
in addition to eating calorie dense & foods w fat, what other strategies can help w weight gain
- eat at least 3 meals/day
- consume large portions
- consume lots of snacks
- drink juice & milk to increase kcalories
see table 7-8 for more weight gain strategies
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