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47 Cards in this Set
- Front
- Back
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What is bariatrics?
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The field of medicine that specializes in treating obesity.
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What is metabolic syndrome?
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A combination of risk factors-insulin resistance, hypertension, abnormal blood lipids (high triglycerides, high cholesterol, low HDL), and abdominal obesity- that greatly increase a person's risk of developing coronary heart disease. Also indicates that there is a change in the body's metabolism. Also called: Syndrome X, insulin resistance syndrome, or dysmetabolic syndrome.
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What is the female athlete triad?
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A potentially fatal combination of three medical problems--disordered eating, amenorrhea, and osteoporosis.
Disordered eating- Eating behaviors that are neither normal nor healthy, including restrained eating, fasting, binge eating and purging. Due to unsuitable weight standards, body composition differences, pressure to have a certain weight at a certain time. Amenorrhea- (66% women athletes suffer from this) The absence of or cessation of menstruation. Due to decreased body fat there are low estrogen levels. Can effect mineral & bone loss. Osteoporosis- Strenuous activity can impair bone health (combined with inadequate food intake). Stress fractures: low estrogen, disordered eating, more likely to suffer stress fractures |
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Goal of treatment for a patient with anorexia?
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Stop weight loss while establishing regular eating patterns. Restoring their nutritional status is most important because in order for their treatment to be effective, they need a healthy diet to be able to think straight, make decisions and they need to be able to be apart of their treatment.
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Amount of calories in alcohol?
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7 kcal/gram
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What does "proof" mean?
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The amount of alcohol in distilled liquor. “Proof” is twice the alcohol percentage. 100 proof liquor is 50 percent alcohol.
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Are there any benefits to moderate alcohol consumption?
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Moderate drinking has been associated with reduced mortality.
Reduces the risk of heart disease. French paradox: red wine Antioxidants & polyphenols? Help raise HDL levels |
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What are the kinds of alcohol?
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Beer: 5–6% alcohol
Wine: 8–14% alcohol Liquor/Spirits: 35–45% alcohol |
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What are the deficiencies associated with alcohol abuse?
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Vitamin deficiencies: Alcohol interferes with vitamin metabolism particularly B vitamins. Ex: Folate, thiamin, and vitamin A
Mineral deficiencies: From an inadequate diet; fluid losses. Calcium, magnesium, iron, and zinc are common deficiencies. Some mineral levels are elevated. |
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What is Wernicke Korsakoff syndrome?
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A neurological disorder typically associated with chronic alcoholism and caused by a deficiency of the B vitamin Thiamin. Alcohol induced thiamin deficiency called alcohol-related dementia.
Characteristics: paralysis of eye muscles, poor muscle coordination, impaired memory, damaged nerves. |
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What are considered to be serving sizes of alcoholic drinks?
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1 serving size= 15 g of beer.
A "Drink": 5 ounces of wine 10 ounces of wine cooler 1.5 ounces of 80-proof distilled spirits (hard liquor: whiskey, rum, vodka) 12 ounces of beer |
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What are the dangers of alcohol intake in pregnancy?
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Fetal alcohol syndrome:
Physical abnormalities (especially facial abnormalities), smooth line over lip, nose is flat & wide, distinct eyes, mental retardation, behavioral difficulties (and attention), coordination problems, low birth weight and poor growth. There is no SAFE amount of alcohol consumption for pregnant women. |
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Differences in hunger and appetite?
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Hunger- the painful sensation caused by a lack of food that initiates food-seeking behavior. A physiological response to a need for food triggered by nerve signals and chemical messengers originating and acting in the brain, mainly the hypothalamus.
Appetite- the integrated response to the sight, smell, thought or taste of food that initiates or delays eating. Prompts a person to eat or not to eat. |
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What are the most satiating foods?
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Protein is most satiating, low-energy density foods are more satiating, high-fiber foods are more satiating, high-fat foods – strong satiety signals
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What are the factors involved in the differences of individual’s BMR?
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Age, height, growth, body composition (gender, lean tissue, fat tissue), fever, stresses, environmental temperature, fasting/starvation, malnutrition, hormones (gender), smoking, caffeine, sleep
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What is BMI? What are the categories for under, normal, over weight?
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BMI: Body mass index- an index of a person's weight in relation to height. Determined by dividing the weight (in kg) by the square of the height (in meters). Not a measure of body composition.
Underweight: BMI below 18.5 Normal: BMI between 18.5-24.9 Overweight: BMI 25-29.9 Obese: BMI 30 or higher |
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Normal body fat percentages for men and women?
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Men: 13-21% body fat
Women: 23-31% body fat |
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Difference in visceral and subcutaneous fat.
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Visceral fat, "upper body fat"- fat stored within the abdominal cavity in association with the internal abdominal organs. Also referred to as central obesity. Associated with increased risks of heart disease, stroke, diabetes, insulin resistance, hypertension, gallstones, cancer. More common in men.
Subcutaneous fat, "lower body fat"- fat stored directly under the skin. Usually found around hips and thighs, more common in women. Not usually associated with chronic diseases. |
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What are the health implications associated with waist circumference? What are the appropriate or risky measurements?
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Waist circumference is a good indicator of fat distribution and central obesity. Women with a waist circumference of greater than 35 inches & men with a circumference greater than 40 inches have a high risk of central obesity and related health problems (diabetes, cardiovascular disease). As waist circumference increases, disease risks increase. It is a preferred method for assessing abdominal fat.
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Differences in android, central, gynoid, obesity. What are the health implications?
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Android- manlike obesity. Shaped as an apple. Indicator of more upper-body fat. Higher chance of heart disease and diabetes. More likely MEN.
Gynoid- womanlike obesity. Shaped as a pear. Lower-body fat is more common in women and is not usually associated with chronic diseases. This shape is more desirable. |
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What is chronic inflammation? Relationship to health? What increases inflammation?
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An immunological response to cellular injury characterized by an increase in white blood cells. Accompanies obesity and inflammation contributes to chronic diseases. And obesity contributes to the metabolic syndrome. Body fat correlates positively with chronic inflammation.
As a person grows fatter, lipids first fill the adipose tissue and then migrate into other tissues such as the muscles and liver. This changes the body's metabolism. Fat accumulation, especially in the abdominal region, activates genes that code for proteins involved in inflammation. Weight gain significantly increases immune cell numbers and their role in inflammation. |
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What are basic behavior modification techniques for weight loss?
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Behavior modification: how to change behaviors to increase energy expenditure and decrease energy intake.
A positive matter-of-fact attitude helps to ensure success. Becoming aware of behaviors (that create problems), keeping a record of intake, learn desired eating & exercise behaviors & eliminating unwanted behaviors, using a reward system, cognitive restructuring requires a person to replace negative thoughts that derail success with positive thoughts that support behavior change, personal attitude, understanding your relationship with food, support groups. |
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What drugs are being used to help with weight loss? How do they work?
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Sibutramine- used to suppress appetites. Slows the reabsorption of serotonin in the brain, thus suppressing appetite and creating a feeling of fullness.
Orlistat- inhibits pancreatic lipase activity in the GI tract, thus blocking dietary fat digestion and absorption by about 30%. Limits kcalorie intake. Phentermine and diethylpropion- enhance the release of neurotransmitter norepinephrine which tends to reduce food intake. "Off-Label" use- drugs approved for other conditions and incidentally cause modest weight loss. |
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Exercise recommendations of DRI
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Moderate intensity of physical activity for 60 minutes/day
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What is considered to be safe rates of weight loss?
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0.5-2 lb/week
10% body weight/6 months |
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What is Leptin?
What enzymes and hormones are related to obesity? What is their relationship to obesity? |
Leptin- a protein produced by fat cells under direction of the ob gene that decreases appetite & increases energy expenditure. Higher in obesity?
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What is Adiponectin?
What enzymes and hormones are related to obesity? What is their relationship to obesity? |
Adiponectin- correlates inversely with body fat: lean people have higher amounts than obese people. Beneficial effects of inhibiting inflammation and protecting against insulin resistance, type 2 diabetes & heart disease. Lower in obesity?
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What is Ghrelin?
What enzymes and hormones are related to obesity? What is their relationship to obesity? |
Ghrelin- secreted primarily by the stomach cells and promotes a positive energy balance by stimulating appetite and promoting efficient energy storage. Triggers the desire to eat. Lean people have high ghrelin levels & obese people have low levels. Ghrelin fights to maintain a stable body weight. Increases after fasting, decreases after a meal.
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What is PYY?
What enzymes and hormones are related to obesity? What is their relationship to obesity? |
PYY- GI cells secrete this after a meal in proportion to the calories ingested. PYY signals satiety and decreases food intake. May be an effective treatment for obesity.
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Are there any dangers of mixing energy drinks and alcohol?
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Yes! The sedative effect of alcohol is negated by the caffeine and other stimulants in energy drinks. Causes people to drink more.
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How is the energy in foods measured? (two ways)
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Direct calorimetry- measures the amount of heat released. A bomb calorimetry burns the food and energy is released.
Indirect calorimetry- measures the amount of oxygen consumed. Can also measure the energy by computing the amounts of carbohydrate, fat and protein is in the food |
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What are the factors in the development of eating disorders?
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Sociocultural, psychological, neurochemical. Excessive pressure to be thin, depression, anxiety. As weight issues become more of a focus, psychological problems worsen.
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Characteristics of individuals with Anorexia nervosa?
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Distorted body image which is central to diagnosis; cannot be self-diagnosed because anorexics don’t see themselves as being sick.
Unaware of undernourishment/malnutrition, insistent upon losing weight. Malnutrition impacts brain function and judgment, causes lethargy, confusion, and delirium. In denial, have a need for self-control “When I’m hungry and don’t let myself eat, I’m in control." Protein-energy malnutrition (PEM), body is wasting away, metabolism slows. Growth ceases and normal development falters, changes in heart size and strength, other bodily consequences: thin, dry skin, lenugo/fuzzy hair (body trying to keep itself warm), low blood pressure, very cold. |
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Characteristics of individuals who have bulimia. What are common practices of bulimics and do they help with weight loss? Why or why not?
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Binge-purge cycle: A pattern of weight cycling. Lack of control, consume food for emotional comfort, cannot stop, done in secret. Purge. Either cathartic (laxatives) or emetic (making themselves throw up) and then feel shame and guilt and the cycle starts all over.
Not helpful with weight loss. Vomitting and diarrhea can cause fluid & mineral imbalances, abnormal heart rhythms, kidney failure, infections. Negative self-perceptions-->restrictive dieting-->binge eating-->purging |
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Diagnostic criteria for anorexia nervosa
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1. Refusal to maintain body weight at or above a minimal normal weight for age and height.
2. Intense fear of gaining weight or even becoming fat, even though underweight. 3. Disturbance in the way in which one's body weight or shape is experience, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight. 4. In females past puberty--amenorhhea: absence of at least 3 consecutive menstrual cycles |
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Diagnostic criteria for bulimia nervosa
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1. Recurring episodes of binge eating. An episode of binge eating is characterized by both of these:
a. eating, in a discrete period of time, an amount of food that is definitely larger than most would eat during a similar period of time & under similar circumstances b. sense of lack of control over eating during the episode 2. Recurrent inappropriate compensatory behavior to prevent weight gain, such as self-induced vomiting, misuse of laxatives, fasting or excessive exercise. 3. Binge eating & inappropriate compensatory behaviors both occur about twice a week for three months. 4. Self-evalutaion unduly influenced by body shape & weight 5. The disturbance does not occur exclusively during episodes of anorexia nervosa. |
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Diagnostic criteria for binge eating disorder
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1. Recurrent episode of binge eating.
2. Binge-eating episodes are associated with at least 3 of the following: eating rapidly, eating until uncomfortably full, eating large amounts of food when not hungry, eating alone because of embarassment, feeling disgusted with oneself after overeating. 3. Binge eating causes marked distress 4. Binge eating occurs at least twice a week for 6 months 5. Binge eating is not associated with the regular use of inappropriate compensatory behaviors (purging, fasting, excessive exercise) and does not occur exclusively during the course of anorexia or bulimia. |
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What is disordered eating?
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Eating behaviors that are neither normal nor healthy, including restrained eating, fasting, binge eating & purging.
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What is infantile anorexia?
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Found in babies 6 months-3 years. Severe feeding difficulties that begin with the introduction of solid foods to infants. Symptoms include: persistent food refusal for months, malnutrition and parental concern about the child's poor food intake. Caused by: parents fail to recognize their babies' body language. They feed their babies too rapidly or too slowly, they offer the baby foods they don't care for or persistently try to feed the baby when they are full and turning away.
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What is body dysmorphic disorder?
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Muscle dysmorphia. A psychiatric disorder, characteristic behaviors: very muscular, see themselves as weak needing to get stronger. Similarities to others with distorted body images. People who go to extremes to build muscle.
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What is baryophobia?
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Fear of becoming fat in children or in children's parents. The unreasonable fear that one's child will become obese. Parents tend to underfeed their children to "protect" them from becoming obese. The allowed diet may be insufficient to support the child's growth and development needs.
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What is the BMI to diagnose anorexia?
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Below 18.5
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What are the two pathways for metabolizing alcohol and drugs? What are the differences in the two pathways?
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Small amounts of alcohol:
Alcohol dehydrogenase (ADH) Alcohol--> acetaldehyde (very toxic substance) Aldehyde dehydrogenase Acetaldehyde-->acetate Acetaldehyde, acetate converted to acetyl CoA (just like other nutrients) Acetyl CoA molecules built into fatty acids in the liver. Large amount of alcohol: Overwhelms alcohol dehydrogenase system Uses microsomal ethanol-oxidizing system (MEOS) Used to detoxify substances Increases capability of body to handle toxic substances |
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What are the affects of alcohol abuse on the body?
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Alcohol in the brain and nervous system- acts as a depressant; affects all parts of brain.
Alcohol eats away at lining of GI tract. Causes a fatty liver, shows up in a simple blood test with elevated enzymes. Causes alcoholic hepatitis- persistent inflammation of the liver. |
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Understand the basics of fat cell development and the behavior of fat cells
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Energy in exceeds energy out, excess is stored in fat cells of adipose tissue. Amount of fat in a person's body reflects both the number and the size of the fat cells. Number of fat cells increases most rapidly during growing years (late childhood, puberty). Fat cell number may increase still due to positive energy balance.
When cells expand in size because of triglycerides, they stimulate cell proliferation so that their numbers increase again. Energy out exceeds energy in: Fat cell size decreases but there is no change in number of fat cells. |
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What does weight loss generally do to BMR?
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Rapid weight loss usually means a lower BMR
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What are the differences in the way women and men handle alcohol?
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LOOK AT PICTURE!
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