Weight Management and Disordered Eating Flashcards
what is the source of energy in our food?
macronutrients
Storing _______ as energy is the most energy efficient
dietary fat
what percentage of the energy from fat is used to store it?
2-3%
Converting excess macronutrients for storage is a multistep process that requires what?
energy
how is dietary protein used for energy storage?
- Used to synthesize proteins
- Excess is converted into glucose (gluconeogenesis) and used for energy or stored as glycogen
how is dietary carbs used for energy storage?
- Used to maintain blood glucose levels and stored as glycogen
- Excess is used for energy
how is dietary fats used for energy storage?
- Used for energy
- Excess is stored as fat
how much kcal of glycogen is stored in the liver an muscle?
1400 kcal
how much kcal of glucose or free fatty acids is stored in the body fluids (blood)?
100 kcal
how much kcal of triglycerides is stored in the adipose tissue?
115, 000 kcal
how much kcal of functional protein is stored in the muscle?
25, 000 kcal
what is the total amount of kcal for glycogen, glucose, free fatty acids, triglycerides and functional protein?
141, 500 kcal
Energy Intake - Energy Requirements =
0
Positive Energy Balance = Extra Energy =
energy storage
Negative Energy Balance = Insufficient Energy =
depletion of stores
Consuming more energy then needed will results in:
energy storage
Consuming less energy then needed will result in:
use of energy reserves
Energy needs will directly impact:
energy balance
what is Estimated Energy Requirements (EER)?
EER = Basal Metabolic Rate (BMR, REE) + Activity Level (Exercise and Non-exercise) + Thermic Effect of Food (TEF)
what factors influence BMR?
Age and Gender
Height and Weight
Life Stage (Pregnancy, Lactation, Infancy, Childhood and Adolescence)
Hormones (i.e. Thyroid Hormone)
Stress, Fever, Illness
Genetics
Drugs and other compounds (e.g. caffeine)
Starvation and Fasting
what are external cues for energy intake?
Time
Food Availability
Food Quality
Social Norms and Influences
what are internal cues for energy intake?
Hunger and Satiety
Emotions (e.g. Stress, Boredom)
what hormone is associated with hunger?
ghrelin
what factors/hormones decrease food intake?
Vagal stimulation
Leptin
GLP-1
CCK
Insulin
what is the percentage of normal wt, overwt and obese in Canada?
normal: 40%
over: 34%
obese: 27%
Obesity is associated with increased risk of what chronic diseases?
T2D
sleep apnea
gall bladder disease
joint disorders
breast cancer
colon cancer
CVD
in CVD, high levels of VLDL affect normal metabolism of:
lipoproteins
how does CVD develop?
- Transfer of cholesterol and triglycerides between lipoproteins
- Production of small dense-LDL which can infiltrate vascular tissue and become oxidized, starting a plaque
how do you calculate the BMI?
BMI = wt (kg) / [ht(m)]^2
why is BMI is less effective at the individual level?
- Doesn’t factor in lean muscle mass vs. adipose tissue
- Location of adipose tissue is an important consideration
- Ignores metabolic markers of disease risk and mental health
what is Leptin?
critical regulator of energy intake and expenditure
- Serves as an indicator of energy stores
Adipose cells have an average lifespan of what?
9.5 years
- its impact on energy intake can make weight management difficult
what happens when the body goes into energy saver mode?
BMR decreases (conserve energy)
Activity decreases (conserve energy)
Leptin decrease = increased hunger (increase food intake)
- These factors make it easier to regain a positive energy balance, allowing adipose cells to refill
what behaviour modification factors assist in weight management?
Substitutions as opposed to eliminations
Protein to increase satiety
Water as a drink of choice
Nutrient dense as opposed to energy dense foods
Reduced processed foods
what is suggested in weight loss programs?
Low Calorie (e.g. Weight Watchers)
Prepared Meals/Drinks
Low Fat
Low Carbohydrate (e.g. Paleo, Keto, Atkins)
Intermittent Fasting
Gluten-Free
what pharmacotherapy treatments are offered in Canada?
Orlistat – pancreatic lipase inhibitor
Liraglutide and Semaglutide – GLP-1 agonists
Naltrexone and bupropion – hunger suppression
what weight loss surgeries are available?
Bariatric Surgery
- Gastric Banding (top)
- Gastric Bypass (bottom)
- Sleeve Gastroectomy
after wt loss surgery, what needs to be maintained?
Requires lifelong changes in diet and lifestyle to accommodate changes in absorption
how does the American Psychiatric Association Definition of an eating disorder?
“a disorder characterized by a persistent disturbance of eating or eating-related behavior that results in the altered consumption or absorption of food and that significantly impairs physical health or psychosocial functioning.”
Societal pressures, psychological factors combine to develop what?
distorted body image
what factors are associated with the causation of eating disorders?
distorted body image
genetics can play a factor
- Personality, body type
when do eating disorders typically arise?
in adolescence
CCHS reports that what percentage of Canadian girls and women (aged 15-24) were at risk of an eating disorder?
3.8%
are incidence of eating disorders among males increasing or decreasing?
increasing
what percentage of girls in grade 9 and 10 have reported trying to lose weight in the last year?
30%
what is Anorexia Nervosa?
- Persistent restriction of energy intake that leads to significant low body weight
- Intense fear of gaining weight or becoming fat
- Disturbed body image
what are the subtypes of Anorexia Nervosa?
Restricting Type
Binge-eating/Purging Type
what is Bulimia Nervosa?
- Repeated binging episodes with a feeling of lack of control over eating
- Repeated compensation after binging of vomiting, misuse of laxatives, or excessive exercise to prevent weight gain
- One episode of binging and compensatory behavior per week
- Disturbed Body Image
- Does not occur exclusively during episodes of anorexia nervorsa
what is Binge-eating Disorder?
- Most common eating disorder
- Binge eating without compensatory behaviors
- Characterized by eating more than needed and intense feeling of guilt and shame
what is the female athlete triad?
- Disordered eating due to pressures to maintain lean, thin and athletic bodies
- Energy restriction paired with excessive exercise can upset hormonal balance
- Low estrogen levels can lead to amenorrhea (stopping of menstruation)
- Low food intake and low estrogen can impact nutrient intake, especially calcium
Adipose tissue releases
Adipokines
Adiponectin
Anti inflammatory and insulin sensitizing
Resistan and TNF alpha
Pro inflammatory and increases insulin resistance
