Week Three Flashcards
What is the key to weight maintenance?
-The key to weight maintenance is:
o Energy In = Energy Out
-If energy intake is > energy output = ↑↑ in body mass
-If energy output is > energy intake = ↓↓ in body mass
What are the prevalence statistics worldwide in 2014 for obesity?
-Worldwide obesity has doubled since 1980
-In 2014:
o >1.9 billion adults were overweight
o 39% overweight (38% Men and 40% Women)
o 13% obese (11% Men and 15% of Women)
-> 42 million children under 5 were overweight or obese in 2013
What are the prevalence statistics in Australia from 2007-2008 for obesity?
-Closer to home – Australia
-2007-2008
o 62% of adults in Australia were overweight
o 1 in 4 children are overweight or obese
What are the predictions for obesity in Australia in the future?
- By 2020 – 75% of Australians will be overweight or obese
- By 2020 – 50% of young Australians will be overweight or obese
Define overweight and obesity
-Overweight
o “Body weight that exceeds the normal weight for a person based on height and frame size”
-Obesity
o “Having an excessive amount of body fat”
-Obesity – is multifactorial
o Excessive amounts of body fat
o Excessive accumulation of adipose tissue
What is the aetiology of obesity and its theories?
-Complex and multifactorial
-Theories
o Hormonal imbalances
-Endocrine system doesn’t regulate body weight properly
o Improper diet and lack of exercise
o Genetics
o Emotional trauma
o Cultural habits
How much does genetics account for obesity?
-Genetics – accounts for 25% o Inherited factors -RMR – Resting metabolic Rate -Fat distribution -Appetite
What are the cultural transmissions of obesity and the percentage?
-Cultural differences and norms
o Food Collection
o Daily activities and rituals
-30%
What are the non transmissible factors and its percentage?
-Lifestyle Factors
o Imbalance between energy consumption and energy expenditure
-Socioeconomic Factors
o Lower socioeconomic groups more likely to be overweight/obese
-45%
When someone has obese syndrome what are the symptoms?
- Glucose intolerance
- Insulin resistance
- Dyslipidemia (hypercholesterolemia)
- Type 2 Diabetes
- Hypertension
- Elevated plasma Leptin concentrations
- Visceral adipose tissue accumulation
- Increased coronary heart disease risk
- Increased cancer risk
What are co-morbidities caused by?
-Co-morbidities
o Medical diseases that are either caused by or contributed to by another factor
What is Type 2 Diabetes as a co-morbidity?
-Modifiable disease
-Usually developed later in life > 40 years
-Have the capability to produce insulin however the body has become insulin resistant
o Receptors on cells are resistant to insulin
What is the link between obesity and type 2 diabetes?
-Constant ingestion of high GI foods, which cause surges in blood glucose and insulin secretion thus overtime becoming resistant
What is Hypercholesterolemia as a co-morbidity?
- High cholesterol levels in the blood
- Potentially lead to atherosclerosis and coronary heart disease
What is the link between obesity and Hypercholesterolemia?
-Eating foods high in cholesterol and limited exercise
What is Cardiovascular disease as a co-morbidity?
-Incorporates many diseases involving the heart and blood vessels
o e.g. Coronary Artery Disease, Hypertension
What is the link between obesity and Cardiovascular disease?
-Similar causes to hypertension and hypercholesterolemia
What is Hypertension as a co-morbidity?
- High blood pressure
- Systolic > 140 mmHg
- Diastolic > 90 mmHg
- Chronic and persistent hypertension damages the arteries and can lead to heart disease or stroke
What is the link between obesity and Hypertension?
-Increased salt intake, high fat intake, high alcohol consumption limited exercise
What is Osteoporosis as a co-morbidity?
-A progressive disease as the bone losses its calcium and mineral content
What is the link between obesity and Osteoporosis?
-Limited exercise, high sodium intake, high protein intake, excessive alcohol consumption
What is Sleep Apnoea as a co-morbidity?
- A sleep disorder that causes pauses in breathing during sleep.
- Can result in tiredness during the day, impaired alertness, slower reaction times, effects on cognitive and behavioural state
What is the link between obesity and Sleep Apnoea?
-Absence of muscle tone and soft tissue around the airway
What is the link between obesity and Cancers?
-Possible link to obesity:
o Fat tissue produces oestrogen which has been associated with certain cancers
o High levels of insulin may promote certain tumours
o Leptin promotes cell proliferation
What is the link between obesity and Reproductive Abnormalities/Fertility?
-Possible Link to Obesity:
o Affected fertility
o Birthing complications
o Gestational Diabetes
What is the Metabolic Syndrome?
-Syndrome X
-Now listed as a disease
-Defined as having any three of the following;
o High blood sugar
o High triglycerides
o Low HDL “good cholesterol”
o High BP/hypertension
o High waist circumference
o Android obesity
o Increased LDL “bad cholesterol”
o Insulin resistance
o Impaired glucose metabolism
What is Mortality and Morbidity?
-Mortality – rate of deaths related to a particular disease
-Morbidity – presence of a disease
o Even though the risk for premature illness and death is greater for those who are overweight, the risk also increases for individuals who are underweight
How do you change the prevalence of obesity?
- 3 ways to lose weight by unbalancing the equation;
1. Reduce caloric intake below daily energy requirements
2. Maintain caloric intake and increase EE
3. Decrease caloric intake and increase DEE
What are some dangerous fad diets?
- The Soup Diet – Eat breakfast then fill up on soup for the rest of the day.
- Grape Juice Diet - Eat what you want, then have 64 ounces (~2 L) of juice per day supposed to combine with protein to rev up fat burning abilities.
- Baby Food Diet - Eat 14 jars of baby food and enjoy a real dinner
- The Cookie Diet - Specially made cookies, eat 6 a day then dinner.
- The Kimkins Diet - Eat 800 calories a day and take laxatives.
- The Tongue Patch Diet - Insert a device that makes eating uncomfortable
What is HDL Cholesterol (healthy)?
- Build & maintain cell membranes
- Necessary to manufacture bile
- Necessary to absorb fat & vitamins A, D, E & K
- Insulates nerve fibres
- Aids in the production of adrenal gland hormones
- Aids in the production of sex hormones
What is LDL Cholesterol (unhealthy)?
- Can clog arteries
- Can lead to a coronary heart disease
- Can lead to a heart attack
- Can lead to a stroke
- Can ultimately lead to death
What are the Australian Guidelines to achieve a healthy weight?
- To achieve and maintain a healthy weight, be physically active and choose nutritious food and drinks to meet your energy needs.
- Enjoy a variety of nutritious foods every day from the 5 groups
- Limit intake of foods containing saturated fat, added salt, added sugars and alcohol
- Encourage, support and promote breastfeeding
- Care for your food; prepare and store it safely
What are the practical tips to reduce the daily kJ intake?
-Cut down on FAT intake o Grill, Steam and Dry roast don’t fry o Trim off visible fat o Limit Takeaways -Low joule drinks -Reduce sugar intake o Leave out of tea and coffee -Choose the healthy options -Drink plenty of water -Eat more during the day not at night -Eat breakfast -Eat as naturally as you can
What are the nutritional recommendations for sodium and alcohol?
-Sodium intake
o Sodium is found naturally in foods
o We require sodium for normal functioning
o We can obtain our daily requirement naturally without adding salt
o Aim for 120 mg/100g
-Alcohol intake
o Current recommendations = no more than 2 standard drinks on any day and increase the number of alcohol free days
What are the current recommendations for health promotion and disease prevention?
-Recall – Holistic approach incorporating;
o Aerobic
o Resistance
o Flexibility
What are the current exercise guidelines for aerobic, flexibility and resistance?
-Aerobic
o At least 5 days per week for 30-60 min/day (≥ 150 min per week) of moderate intensity exercise
-Flexibility
o ≥ 2 – 3 days/week, target all primary joints, minimum 10 seconds aim for 30 seconds
-Resistance
o Each major muscle group should be trained 2-3 days/week, 48 hours rest b/w sessions
What is the prevention of weight gain/weight maintenance?
-Primary prevention = maintenance
-Weight maintenance = change ≤ 2.3 kg or < 3% change in body weight
o Clinically significant = > 5% change
-Inverse relationship b/w PA and BMI/body mass
-PA recommendations for prevention of weight gain:
o 150-250 min per week of moderate intensity
Why lose weight?
o Improved CVD risk
- Decreased BP
- Decreased LDL, increased HDL, decreased triglycerides
- Improved glucose tolerance
How much weight should be lost?
o 10%
-Studies have shown improvement in CVD risk from less than 10%
-Reduced chronic disease risk reported with weight loss of 2-3%
-Negative energy balance = weight loss
o Greater the negative balance = greater the weight loss
-If individuals require substantial weight loss additional interventions may be required
o e.g. Diet restriction
How much exercise should be done to lose weight?
- Less than 150 min/wk of PA = minimal weight loss
- PA > 150 min/wk = 2-3 kg (modest)
- PA b/w 225-400 min/wk (> 250 min/wk) = 5-7.5 kg
- Dose response relationship exists whereby greater amounts of PA can achieve the 3% from initial weight
- 150-250 min/wk mod intensity will improve weight loss when moderate diet restriction
How do you prevent weight regain after weight loss?
-PA recommendations o “More the better” o Greater amounts = lower level of regain o > 250 min/wk -Sitting time = less energy expenditure = contribution to obesity epidemic -Include/increase PA into one’s lifestyle o Non supervised exercise o Structured exercise o Occupation activity o Active commuting o Energy expenditure around the home o Leisure time PA
How do you increase energy expenditure (psychology)?
- Goal setting
- Relapse prevention strategies
- Health Belief Model
What are the advantages of doing and combination of diet and exercise?
-Advantages for doing a combination of diet and exercise:
o Increase RMR
o Increase muscle mass
-More metabolically active than fat
o Increase fitness
o Decrease stress
o Increase in kJ expenditure therefore no reason for dangerous diets
