Weight Loss Flashcards
What % of canadians are classified as overweight or obese?
26.8%
What is the BMI range for overweight individuals?
25-29.9
What is the BMI of obese?
> 30
What are ‘costs’ of obesity?
48 000 - 66 000 canadians die from conditions linked to excess weight.
4.6 billion to 7.1 billion paid annually in health care and lost productivity related to obesity.
what are some ‘costs’ of living with obesity?
increases risk of:
- joint pain related to knee & hips that may lead to osteoarthritis
- CVD/stroke
- hypertension
- diabetes type 2
- all-cause mortality: death for any reason is higher for someone with obesity
- sleep apnea
- morbidity, mortality, premature death
- decreased quality of life
When would weight loss be recommended?
for individuals overweight and with +1 indicator of increased:
- CVD risks
- obese
- WC: males >100; females >90
- if client has wt loss goal
how does clinically significant wt loss occur?
with ~5% reduction in body mass
What are the components of Total Energy Expenditure (TEE)?
activity energy expenditure (~30%)
TEF (~10%)
basal energy expenditure (~60%)
What is static energy balance?
equal amounts of energy in to energy out. ~ 3500kcals = 1lb of fat.
What occurs in a positive energy balance?
weight gain; food intake is higher than activity EE and basal EE
What occurs with a negative energy balance?
weight loss: food intake is less than activity ee and basal ee
What are some compensatory responses with PA induced weight loss?
increased drive to eat, reduced basal ee, changes in behaviour (reduced overall daily PA, reduced adherence, more sleep)
What is the additive energy management model?
assumes that PA increases TEE without a change in basal EE.
What is the performance model of energy management?
assumes that PA increases TEE and basal EE.
What is the compensatory model for energy management?
assumes increased PA with no change in TEE due to decrease in basal EE.
What is energy compensation?
reflects the discrepancy between amount of weight loss predicted from energy deficit and the actual weight loss.
Why is energy compensation controversial in terms of it’s significance but also its clinical relevance regarding weight regain?
studies with restricted calories show overall weight gain increased because BMR reduced during study. and energy consumption resumed to was pre-study.
what is recommended for quick and significant fat loss?
calorie restriction
If sustainable fat loss and prevention of disease is the goal which method achieves the best results?
combination of energy expenditure and caloric restriction.
What are other advantages of PA in weight loss?
maximizes fat loss, particularly visceral fat, minimizes muscle loss reduces risk of comorbid conditions like CVD, diabetes, some cancers. improves physiological funtion.
What does weight loss also result in?
increased appetite and thus energy intake
reduction in basal energy expenditure and changes in behaviour.
What is the most successful use of PA when creating weight lost prescription?
Dietary change + PA is the most effective at reducing weight and preventing weight regain.
If clinically significant weight loss is the goal, how much PA should be completed?
225-420 min/week (~2000kcal/week) is likely needed.
what is required for healthy weight loss?
negative energy balance through decreased calorie intake and increased PA
What is the recommended healthy weight loss?
1-2lb per week (~0.5-1.0kg/week)
What is considered a clients best weight?
sustainable and allows client to enjoy life. health benefits are achieved by moving to this weight.
What is the ideal weight?
predicted by BMI
What is a healthy weekly energy deficit?
3500kcal to lose 1lb.
ideally restrict 1750kcal from food and increase PA to energy expenditure of 1750kcal.
When assessing clients, what are some considerations for exercise testing?
body composition: determined by BMI + WC but can be determined with BMI or WC alone.
What is the risk of BMI 25-59.9 for women with WC <90?
increased
What is the BMI risk of 25-29.9 of women with WC >90?
very high
What is the BMI risk of 25-29.9 for men with WC of <100?
increased
What is the BMI risk of men with WC >100?
very high
What is the BMI risk of 30+ of women with WC <105?
high
What is the BMI risk of 30+ in women with WC >105?
extremely high
What is the BMI risk of 30+ in men with WC <110?
high
What is the BMI risk of 30+ in men with WC of >110?
extremely high
When should you advise weight loss?
overweight +1 indicator (smoker/hypertension/high BP/increased CV) or
obese or
WC >100M / >90F
and client has goal of wt loss
Are high intensity cardio or low/moderate intensity cardio effective for weight loss?
not very effective for wt loss and no difference in fat loss outcomes with different intensities.
What are the findings from HIIT and MICT(moderate intensity continuous exercise)?
- identical changes in fat loss and fat free mass gains
- results from HIIT accomplished in half time but require more effort of exertion
- absolute amount of fat loss from aerobic exercise is relatively small
- easier to lose from caloric restriction in diet
What does aerobic exercise help preserve?
lean mass, functional performance and prevention of weight gain.
how much weight can be lost from PA during interventions from 15 weeks to 1 year?
0-3kg
How much aerobic activity is required to lose ~5-7.5kg?
225-420 minutes per week.
What is an aerobic prescription FITT for weight loss?
F-starting at 3 progressing to 5-7 d/wk
I- light-moderate progressing to moderate-vigorous. variety of types/intensities
T- 10-60+ min/day (150min/wk to 300+) goal is to progress to 2000kcal/wk expended through PA
T- large muscle activities that reflect ADLs. mixed mode best.
What is a MET?
the VO2 associated with sitting at rest.
What is 1 MET the equivalent of?
3.5ml-kg-min or 1kCal-kg-hr
Why are METs a useful way to describe intensity?
They are simple for general public to understand;
provided on most cardio equipment;
easy to calculate expenditure once you know MET value for activity;
physicians understand what it means to exercise at METs
Why are MET’s not a useful way to describe intensity?
assumes that resting VO2 is same for everyone;
it is an absolute measure that doesn’t consider individual VO2max;
does not take into account environmental conditions such as altitude;
assuming you did pre-participation screening and asked clients permission to discuss weight, what other questions should be asked?
a. discuss activities client enjoys
b. consider fitness assessment results AND client’s history of PA to decide appropriate intensity, duration and mode
c. consult table with MET values for chosen activities/intensities
d. calculate energy expenditure per activity (based on duration) and ensure that it roughly equals (+-50kcal) your weekly target for PA energy expenditure
e. make sure to also educate client on importance of reducing sedentary time and increasing light PA.
