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100 Cards in this Set
- Front
- Back
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LBM |
Lean Body Mass |
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LBM consists of |
Skeletal muscles, water, bone, essential fat in internal organs, bone marrow, and nerve tissues |
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LBM is higher in _____ than ______ |
Men than women |
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LBM increases with __________, Decreases with _____ |
exercise, age |
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LBM is a major determinant of _____ |
RMR |
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______ is the most variable component of LBM and makes up _____ to ______% or LBM. |
Water, 60-65% |
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Essential body fat is _________________________ |
Necessary for physiological function
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Essential body fat is about _____% of body weight in men and _____% in women |
3, 12 |
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Storage body fat: |
energy reserve under the skin, primarily triglycerides in adipose tissue |
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Storage body fat is around |
the internal organic to protect them form trauma |
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Most of storage body fat is considered |
expendable |
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In storage body fat good health is associate with ____ to ___% of body weight in men and _____ to _____% in women |
10-25 % 18-30% |
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Adipose tissue Composition |
White and brown adipose tissue Adipocytes, hypertrophy, and hyperplasia Fat cell development |
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Its nearly impossible to decrease the ______ of adipocytes |
number |
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SVOCs |
Semi-volatile organic compounds |
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LPL |
Lipoprotein lipase |
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HSL |
Hormone-sensitive lipase |
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Fat storage effects |
estrogen and sex steroid hormones |
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Fat storage is dietary |
triglycerides and lipogenesis |
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RMR |
Resting metabolic rate |
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RMR is _____ to _____% of total energy expenditure |
60-70% |
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AT |
Activity thermogenesis |
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NEAT |
non exercise activity thermogenesis |
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Short and long term body weight regulation |
-factors affecting hunger, appetite, and satiety -Hypophagia and hyperphagia in response to changes in caloric intake. -Adipocytokines |
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Set-Point theory |
Preservation of specific body weight: Genetically determined. |
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Brain Neurotransmitters |
Norepinephrine and Dopamine Serotonin |
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Gut Hormones |
Insulin, Leptin, Ghrelin |
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Weight imbalance |
imbalance between food consumed and PA |
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Weight imbalance is a |
complex issue related to lifestyle, environmental, and genetics |
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IBW |
ideal body weight |
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BMI |
Body mass index |
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Quetelet index |
W/H2 |
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WHR |
Waist-to-hip ratio |
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BMI classifications of obesity |
Overweight: 25-29.9 Obesity Class I: 30-34.9 Obesity, Class II: 35-39.9 Extreme Obesity, Class III: >40 |
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Waist circumference for Obesity |
>40 in Men >35 in Women |
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Etiology of Overweight and Obesity |
1.Enviornmental, genetic, psychological, culture, and physiologic factors. 2.Heredity and Nutrigenomics 3.Inadequate PA 4.Inflammation 5.Sleep, stress and circadian rhythms 6.Taste, satiety, and portion sizes 7. Viruses and pathogens |
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Inflammation with Overweight and Obesity |
-Cytokine polymorphisms: Insulin insensitivity, hyperlipidemia, muscle protein loss, and oxidant stress -Chronic inflammation |
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Sleep, Stress, and circadian rhythms |
-Chronic sleep deprivations -Cortisol |
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Health risks and longevity |
Diabetes Heart disease hypertension hyperlipidemia Gallbladder disease some cancers mortality NASH |
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NASH |
Nonalcoholic fatty liver disease |
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Fat distribution and metabolic syndrome |
Genetic, differ between men and women |
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Android |
Apple shape: excess subcutaneous truncalabdominal fat -More common in men, increases with age -correlated with insulin resistance, metabolic syndrome |
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Gynoid |
Excess gluteofemoral fat (Pear shape) -More common in women, especially premenopausal |
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MetS |
Metabolic syndrome |
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MetS includes three or more of the following |
-waist circumference (40 in) M and (35 in) W -Serum triglycerides of at least 150 mg/dL -HDL level <40mg/dL in M <50mg/dL in W -Blood pressure 135/85mmHg or higher -Serum glucose 110 mg/dL or higher |
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FFM |
Fat free mass |
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FFM: |
Water, Protein, Minerals |
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Total Body Fat= |
Essential + Storage |
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VAT: |
Visceral Adipose Tissue: -WAT : white Adipose tissue -BAT: Brown adipose tissue |
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Adipocyte |
Mature fat cell -large central lipid droplet surrounded by a thin rim of cytoplasm, containing the nucleus and mitochondria -can store fat equal to 80-95% of their vol. |
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Hypophagia |
under eating |
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hyperphagia |
overeating |
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Overweight |
Results of imbalance between food consumed and PA |
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Obesity |
complex issue related to lifestyle, environment, and genes, with complex interactions with psychological, cultural, and physiologic influences |
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Overweight assessment |
exceeds standard based on height |
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Obesity assessment |
excessive generalized or localized fatness |
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Deurenberg equation |
% Body fat=(1.2 x BMI) + (0.23 x age)- (10.8 x G)-5.4 G= 1-M, 0-F |
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ABSI |
A body shape index |
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ABSI formula |
WC/(BMI ^2/3 x Height ^ 1/2) |
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Management of Obesity in adults |
Goal treatment -wt management, losing or maintaining -IBW: Losing weight is beneficial |
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Lifestyle modifications for obesity |
Behaviors mods: -goal settings -stimulus control -cognitive restructuring -relapse prevention |
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Dietary modification recommendations |
-Low cal, macronutrient adj, +PA, and lifestyle mods. -+pharmacotherapy -+surgery -wt gain prevention -mindset interventions |
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Restricted energy diets |
-50-55% Carbs -15-25% PRO -<30% fat |
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Diets |
-Restricted energy diets -Formula diets and meal replacement program -commercial programs -extreme energy restriction and fasting Very low-calorie diets |
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Very low calorie diets |
200-800 kcal advantage if: -hospitalized metabolic unit patient -<65 y/o -Condition such as congestive heart failure secondary to obesity -relatively rich in PRO -12-16 wks -ketoacidosis |
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Very low fat diets |
<10% |
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Mod fat diests |
20-30% fat 15-20% PRO 55-60% carbs |
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PA |
Most varible in energy adequate levels-60-90 min/d obese can benefit form 30 min/day wt loss/maintain >150 min/week |
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Catecholaminergic drugs |
increases availability of Norepinephrine |
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Serotoninergic agents |
Increases serotonin in brain |
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Orlistat |
inhibits gastrointestinal lipase 150-200 kcal/day Alli-50%/50% |
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Appetite stimulants |
orexin |
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Non-diet paradigm |
Body will attain natural wt and achieves healthy statue |
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Bariatric surgery |
-only long term effect medical treatment for: -->Class III obesity -->BMI of 35+ with comorbitites |
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Bariatric surgery failure of a comprehensive program must be demonstrated |
-inability of pt to reduce wt by 1/3 -inability of pt to recede fat by 1/2 -inability to maintain wt loss. |
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Gastroplasty |
reduces the size of the stomach to create a small gastric pouch, leaving only a small opening in the distal stomach (staples) -lap band procedure -->band can be adjusted -does not require supplementation |
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Gastric bypass |
-reduces the size of the stomach, staples, by then connects a small opening in the upper portion of the stomach to the DI by means of an intentional loop -lower part of stomach omitted -dumping sydnrome -Malanutrition-monitor assessment -1 liquid or 2 chewable vitamin/mineral necessary. |
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Gastric bypass diet progression |
2-3 days after surgery: Liquid diet Day 4-5 up to 4 weeks: Semisolids and pureed diet up to 8 weeks: soft foods 6 weeks+: regular small meals and snacks. |
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LSG |
Laparoscopic sleeve gastrectomy |
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LSG: |
currently the most pop in U.S. -sleeve created by removing part of stomach, reduces to 80% cap. |
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LSG complications |
gastric bleeding, stenosis, leak and reflux |
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Lipo |
involves aspiration of fat deposits by means of 1-2cm incision through which a tube is fanned out into adipose tissue, most successful operations performed on younger persons with only small amounts of fat. -not usually a weight reduction technique -cosmetic surgery |
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Common problems in obesity treatment |
-maintaining reduced body weight -plateau effect -weight cycling |
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Maintaining reduced body weight |
Energy requirement for weight maintenance 25% lower NWCR-common reported behaviors 1. eating a relatively low-fat 24% diet 2. eating a breakfast almost everyday 3. weighing themselves regularly, usually once per day to once per week 4. Engaging in high levels of PA |
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Plateau effect |
1. reflect a reduction of lipid in individual adipocytes to some level that signals metabolic adjustment and weight maintenance. 2. There is a release of toxins from adipose tissues that acts as an endocrine disruptors and inflammatory agent and affects subsequent weight loss |
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How to move out of plateau effect |
usually requires an increase in activity level or change in food choices to include more F & V |
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Any weight loss-fast or slow --> loss of __________________ that has developed to support excess adipose tissue |
extra muscle |
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Less LBM --> ______________ |
Lower RMR |
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RMR ___________ rapidly at the onset of weight-reduction diet suggests adaptions to the lower weight and threat of deprivation are taking place. |
decreases |
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decrease in Kcal--> ___________ |
decrease TEE |
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Less body weight --> __________ |
less energy expenditure to move around |
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Weight cycling |
repeated bouts of weight loss and regain, common in overnight and normal weight individuals. -effects at the end of each cycle: --increased body fatness --increased weight |
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about _____ of US children 2-19 are overweight or obese |
1/3 |
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Children with BMI __________ are 6x more likely to be over weight later. |
>85th |
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Primary goal in wt man. in children and adolescents |
achieve healthy eating and activity, goal is to slow the rate of wt. gain |
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Wt imbalance cause |
1. Inadequate oral food and beverage intake 2. excessive PA 3. Inadequate capacity for absorption and metabolism of food consumed 4. A wasting disease that increases metabolic rate and energy needs 5. Excessive energy expenditure during psychologic or emotional stress. |
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Assessment for wt imbalance |
-thorough history and pertinent medical tests -anthropometric -assessment body fatness especially helpful with ED -Biochemical measures. |
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High energy diets |
-meals should be scheduled and relaxed -frequently encouraged to eat, even if not hungry -individualize the program -snacks are necessary -high-calorie liquids -500-1000 extra kcal per day should be planned -intake increased gradually to avoid issues. |
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Wt Discrimination |
-Widespread Bias based on weight -Key areas of life: education, employment, and health care -lack of understanding -impact on children and adolescents |
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NIH recommends loss of ___ to ___ /wk for BMI 27 to 35 and ____ to ____ /wk for BMI >35 |
0.5-1 1-2 |
