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31 Cards in this Set
- Front
- Back
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Obesity in Canada |
Highest in the Northwest Territories, and lowest in British Columbia followed closely by Quebec - May be related to the availability of fresh fruits and vegetables |
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Problems with Excessive Body Fat |
1) Psychiatric and psychological problems (depression and self-esteem) 2) Asthma and breathing problems at night (sleep apnea) 3) Cardiovascular disease 4) Cancer of breast, colon, prostate, uterus 5) Gallstones 6) Type 2 Diabetes 7) Gynecological problems (irregular menstrual cycle and infertility) |
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Healthy Weight |
A weight that minimizes health risks, often used to determine health status - Body Mass Index for example (weight in kilograms/height in meters squared) > less than 18.5 = underweight > 18.5 to 25 = healthy weight > 25+ = overweight > 30+ = obese - BMI does not take into account body composition (lean boy mass and minimal levels of fat are ideal) > BMI can be misleading for some people |
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Methods for Determining Body Composition |
1) Skinfold Thickness 2) Underwater Weighing 3) Air Displacement 4) Bioelectric Impedance 5) Dual Energy Xray (DXA) |
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Body Fat Distribution |
"Apples" carry excess weight around abdomen (higher CVD risk), "pears" carry fat around lower body - Waist circumference is indicative of the amount of visceral fat (that around organs) > WC and BMI are used to determine health risk > If BMI = obese and WC >102cm for men and 88cm for women, means increased health risk > Excess visceral fat compresses organs |
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Energy Balance |
According to the principle of energy balance, for a person's weight (specifically content of their weight) to remain the same, energy in must equal energy out Energy In: calories from carbs, fat, protein, alcohol Energy Out: basal metabolic rate (60-70%), thermic effect of food (10%), physical activity (15-30%) |
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Basal Metabolic Rate |
The amount of energy expended while at rest in a neutrally temperate environment - The largest component of energy expenditure - Mostly determined by genetics - Other factors that cause increase... 1) Higher lean body mass (especially muscle) 2) Exercise 3) Greater height and weight 4) Male Gender 5) Pregnancy 6) Lactation 7) Growth 8) Fever 9) Elevated Thyroid Hormone levels 10) Stimulant Drugs (caffeine and tobacco) |
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Storing and Retrieving Energy |
Caloric intake is the primary dietary factor to manage weight - Excess energy is stored as fat within adipocytes - When fat is gained, adipocytes increase in size and number - When fat is lost, adipocytes decrease ONLY in size - Ability to store fat is limitless |
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Energy Imbalance |
Only 15% of Canadians meet the new recommendations for physical activity - Recommendation is 150 minutes of moderate to vigorous physical activity per week (accumulated in 10 minute bouts) - Motorized transport and technological developments promote sedentary lifestyles > Recommendation is to sit < 2 hrs at a time - Decrease in physical activity doesn't explain the dramatic weight increase - It is easy to out-eat exercise but almost impossible to out-exercise eating |
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Genes |
Genetics have a significant role in determining body shape and size - If one or both parents are obese, risk increases 2-3 times - 75% of BMI variations attributed to genes and 25% to lifestyles (twin studies) - More than 300 genes linked to obesity (regulate BMR, hunger, appetite, fat deposition) |
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Factors Stimulating Hunger/Appetite |
1) Thoughts, sights, smells, and sounds of food 2) Appealing tastes 3) Contraction of an empty stomach and release of ghrelin hormone 4) Low levels of nutrients in the intestines 5) Low levels of circulating nutrients |
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Factors Causing Satiety |
1) Food in stomach, which causes stretching, or pressure 2) Intestinal distension and nutrient presence in intestines, it causes the release of satiety hormones 3) High blood levels of nutrients (glucose, amino acids, fatty acids, ketones) |
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Molecules Involved in Acute Regulation of Energy Balance |
1) Neuropeptide Y: promotes feeding, energy storage 2) Ghrelin: levels vary throughout day, promote appetite at certain times of day, levels increase without sleep 3) Peptide YY: reduces apetite following the intake of calories |
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Molecules Involved in Chronic Regulation of Energy Balance |
1) Lipoprotein Lipase: an enzyme on adipocytes which captures triglycerides and promotes fat storage, more fat cells more LPL which increases following weight loss, making it hard to keep off > Men store at abdomen, women store at hips, thighs, breasts 2) Leptin: released by adipocytes, inhibits, appetite, and promotes energy expenditure > Obese individuals may have leptin resistance |
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Fat Loss |
Theoretically, to lose fat, individuals must expend more energy than they consume - Eat less, move more often doesn't work - Ecological, psychological, and physiological factors causing excess caloric consumption, and decrease caloric expenditure should be considered - Some people have to restrict/burn more kcal to lose fat than others - 5 - 15% reduction in body weight is associated with reduced risk of disease > 200lb person (10-30lb) > 150lb person (7.5-22.5lb) - Losing 0.5-2lb per week is recommended > Losing too quick is associated with physiological changes that promote re-gain such as high drops in basal metabolic rate |
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National Weight Control Registry |
5000+ members who intentionally lost a minimum of 30lbs and kept it off for a minimum of 5 years 1) Half with support from nutritionist, program, MD 2) Half on their own 3) 10% through diet alone 4) 1% through exercise alone - 83% reported a trigger for weight loss > Medical (higher loss, less regain), reaching an all-time high, visual feedback of their weight |
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Successful Weight Loss Maintainers |
1) Keeping weight off for 2+ years are much higher likelihood to maintainer lower weight 2) Similar eating patterns throughout week are 1.5x more likely to keep weight off 3) Have less dietary flexibility around holidays 4) Rarely lose control of eating behaviour 5) Lower levels of depression 6) Restricted certain foods, decreased quantities, counted calories, ate breakfast 7) Self monitored, 8) Performed 1hr/day of moderate intensity activity |
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Strategies for Reducing Energy Intake |
1) Portion control 2) Eating breakfast 3) Eating foods that promote satiety/satiation 4) Know caloric value of foods 5) Control hunger (eating patterns) 6) When overeating occurs, eat less the following meal/day/week 7) Avoid mindless eating |
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Reason for Weight Re-gain |
1) 10% decrease in body weight is associated with 20-25% decrease in energy expenditure 2) Weight reducers have lower satiety 3) Decreased EEE, thyroid hormones, leptin 4) Increase in fat storing enzyme lipoprotein lipase 5) Fat cells shrink when weight is lost but don't go away 6) Formerly obese individual requires approximately 300-400kcal less per day to maintain weight as person who never gained weight |
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Psychological Modification |
Must think of all behaviour change as long-term commitment so goals should be SMART - Changing behaviour requires a change in the thought process that lead to that behviour > Self-talk, positive thinking/reinforcement are strategies - Must reduce barriers (why do you overeat? why don't you exercise?) - Cognitive behavioral therapy might work |
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Weight Gain |
Some people have just as hard time putting on weight, must intake extra calories to put on weight - Sometimes people underestimate how many calories they actually take in > Make sure these calories from nutrient dense choices that don't increase disease risk - Some people are naturally skinny regardless of how much they eat |
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Dieting |
Any strategy that promotes a caloric deficit through decreased energy intake or increased expenditure will typically produce a decrease in weight - The more extreme a weight loss regime is, less likely it will be sustainable > Losing weight quick can produce accelerated reductions in BMR and hormonal changes that promote weight gain |
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Health vs. Fad |
1) Variety of foods (large - little) 2) Rate of weight loss (gradual - rapid) 3) Physicaly activity (promotes - opposes) 4) Flexibility (easy to follow - rigid) 5) Supplements (not required - purchase of special products) 6) Behaviour (promotes change - opposes change) 7) Basis (scientific principles - anecdotal evidence) |
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Weight Loss Drugs and Supplements |
Fat Blockers: promote weight loss through decreased fat absorption (caloric intake) - Associated with decreased intake of fat-soluble vitamins and abdominal cramping, flatulence, diarrhea, if fat isn't avoided Amphetamines: (sibutramine (Meridia), ephedra and phetemine), suppresses appetite, increases heart - Increased risk cardiovascular complications especially if no take as prescribed Diuretics: promote water loss, but not fat loss |
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Weight Loss Surgery |
Only recommended for patients with BMI >40 or over 35 with life threatening complications - Weight loss is typically required before surgery can take place - Can promptly reduce diabetic complications promptly Gastric Bypass: bypasses the greater part of the stomach, only a small amount of a food can be accepted (promotes satiety) - more permanent Gastric Banding: places a band around the stomach to restrict stretch, promotes satiety - less permanent |
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Weight Bias |
Negative attitude towards obese individual, affecting interactions - Third leading form of adults discrimination - Typically from family, medical practitioners, work environmental, community, and media > Obese children are less likely to have parents help them pay for things > Obese adults are less likely to get job or promotion they are equally qualified for |
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Individual Subject to Weight Bias |
1) More likely to binge 2) More likely to consume excess calories 3) Less likely adhere to a weight loss program 4) More likely gain more weight |
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Eating Disorders |
Genetic, psychological, sociocultural; sometimes associated with childhood abuse 1) Anorexia Nervosa 2) Bulimia Nervosa 3) Binge-Eating Disorders |
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Anorexia Nervosa |
Prevalence: 1% females, 0.3% males Body Weight: below normal (<85% of recommended) Binge Eating: Possibly Purging, excessive exercising, laxatives: Possibly Restricts Food Intake: Yes Body Image: Dissatisfaction with body and distorted image of body size Fear of Being Fat: Yes Self-esteem: Low Menstrual Abnormalities: absence of at least three consecutive periods Typically Onset: Preadolescence |
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Bulimia Nervosa |
Prevalence: 1.5% females, 0.5% males Body Weight: usually normal Binge Eating: yes, at least twice a week for three months Purging, excessive exercising, laxatives: yes, at least twice a week for three months Restricting Food Intake: Yes Body Image: dissatisfaction with body distorted image of body size Fear of Being Fat: Yes Self-esteeming: Low Menstrual Abnormalities: No Typical Age of Onset: Adolescence/young adults |
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Binge-Eating Disorder |
Prevalence: 3.5% females, 2% males Body Weight: Above normal Binge-Eating: Yes, at least twice a week for six months Purging, excessive exercising, laxatives: No Restricting Food Intake: Yes Body Image: Dissatisfaction with body and distorted image of body size Fear of Being Fat: Possibly Self-esteem: Low Menstrual Abnormalities: No Typical Age of Onset: Adults of all ages |
