Nutrition and weight loss principles

Question 1

The cornerstone of treatment for overweight and obese individuals is ____

Answer 1

lifestyle modification

Question 2

Commonly, the three major components of a successful obesity treatment program are:

Answer 2

Physical activity
Nutritional programming
Exercise programming

Question 3

Increased Risk for Obesity-Related Diseases With Higher Body Mass Index

Answer 3

arthritis
heart disease
diabetes (type 2)
gallstones
hypertension
stroke

Question 4

Increased risk of chronic illness and disease with high %BF levels:

Answer 4

Greater than 32% in women
Greater than 25% in men

Question 5

Desirable Body Fat Percentage
Lower Limits:

Answer 5

12% in women
> A range of 12% to 17% body fat is necessary for normal menstrual function
> Lower levels can lead to amenorrhea

3% in men = for vital body function

Question 6

BMI is calculated as the ratio of one’s weight to height:

Answer 6

BMI = Weight (kg)/Height2 (m)

Question 7

Uses of BMI in the Clinical Setting:

Answer 7

Approximate degree of body fat

Baseline measure against which progress can be compared

Provides potential health-risk factors

Starting point for discussion about the relationship between body fat and chronic disease

Question 8

Body Fat Percentage Based on BMI

Answer 8

Men average:
20-39 yrs = 8-18%
40-59 yrs = 11-21%
60-79 yrs = 13-24%

Women average:
20-39 yrs = 21-32%
40-59 yrs = 23-33%
60-79 yrs = 24-35%

Question 9

Limitations of BMI

Answer 9

BMI fails to consider the body’s proportional distribution of body fat and lean tissue

False positives = body builder

False negatives = frail stature

BMI is not a measure of body composition (i.e., percentage of body fat) per se but merely a calculated ratio using height and weight

Question 10

Body Composition Models

Answer 10

Two-component, whole-body model
1) Fat mass (FM)
2) Free fat mass = body mass – FM = FFM

73.8% water
19.4% protein
6.8% mineral
Organs, bone, muscle…..

Question 11

Hydrostatic Weighing

Answer 11

Assumed proportions and their respective densities can be used to convert an individual’s total body density (Db) into his or her relative %BF

Question 12

Calculate fat free weight

Answer 12

Need to know persons % body fat

100% - % body fat= fat free weight

Useful for weight loss planning

Goal weight=fat-free weight

(1−goal % fat)

Question 13

Example:
Female college student has 30% body fat and weighs 142 lbs. She wants to be at the low end of the healthy range, so her goal is 20% fat

Answer 13

100%-30%=70% fat free (current % fat)
70% x 142 lbs= 99.4 fat-free weight (current)
Goal of 20% body fat= 99.4/1-.20= 124 lbs (goal weight)

Question 14

Using Caloric Information to Affect Weight

To change weight by 1 pound (0.45 kg), caloric intake must be decreased or increased by ___

Answer 14

3,500 calories

Reduce caloric intake by 250 calories per day and increase daily expenditure (through physical activity) by 250 calories

500 calorie deficit x 7 days = 3500 calories per week or 1 pound

Double for 2 pounds per week:
Weight-loss rate of 1 to 2 pounds per week

Question 15

Diet and nutrition are key components of primary, secondary, and tertiary prevention of many conditions managed by physical therapists

Answer 15

It is within the professional scope of the physical therapist practice to screen for and provide information on diet and nutritional issues to patients, clients, and the community

This includes appropriate consultation or co-management with or referrals to a registered dietitian when seeking the expert opinion of another provider with specialized knowledge or skills, or to obtain services for

Question 16

Dietary Guidelines for Americans- Department of Health and Human Services and the U.S. Department of Agriculture

Answer 16

Follow a healthy eating pattern across the lifespan

Focus on variety, nutrient density, and amount

Limit calories from added sugars and saturated fats and reduce sodium intake

Shift to healthier food and beverage choices

Support healthy eating patterns for all

Question 17

Follow a healthy eating pattern across the lifespan. All food and beverages choices matter

Answer 17

Choose a healthy eating pattern at an appropriate calorie level to help achieve and maintain a healthy body weight, support nutrient adequacy, and reduce the risk of chronic disease

Question 18

Focus on variety, nutrient density, and amount

Answer 18

To meet nutrient needs within calorie limits, choose a variety of nutrient-dense foods across and within all food groups in recommended amounts

Question 19

Limit calories from added sugars and saturated fats and reduce sodium intake

Answer 19

Consume an eating pattern low in added sugars, saturated fats, and sodium

Cut back on foods and beverages higher in these components to amounts that fit within healthy eating patterns

Question 20

Shift to healthier food and beverage choices

Answer 20

Choose nutrient-dense foods and beverages across and within all food groups in place of less healthy choices

Consider cultural and personal preferences to make these shifts easier to accomplish and maintain

Question 21

Support healthy eating patterns for all

Answer 21

Everyone has a role in helping to create and support healthy eating patterns in multiple settings and support healthy eating patterns in multiple settings nationwide, from home to school to work to communities

Question 22

Healthy eating patterns includes

Answer 22

Variety of vegetables: dark green, red and orange, legumes (beans and peas), starchy, and other

Fruits: especially whole fruits

Grains: at least half of which are whole grains: Oats are a great option!

Fat-free or low-fat dairy: milk, yogurt, cheese, and/or fortified soy beverages

Variety of protein foods: seafood, lean meats and poultry, eggs, legumes (beans and peas), and nuts, seeds, and soy products

Oils: plant based, olive, peanut, coconut, palm, canola, soybean

Question 23

Healthy eating patterns limits:

Answer 23

Saturated fats, trans fats, added sugars, and sodium = less than 10% of calories per day

If alcohol is consumed, it should be consumed in moderation—up to one drink per day for women and up to two drinks per day for men—and only by adults of legal drinking age

Question 24

Three components of human daily energy expenditure:

Answer 24

> Basal metabolic rate
Thermic effect of food
Thermic effect of physical activity

Question 25

Basal metabolic rate =

Answer 25

Amount of energy required for core, resting bodily functions without food

it accounts for about 60% to 75% of daily energy expenditure in a sedentary person

Question 26

Thermic effect of food =

Answer 26

The energy required to digest, absorb, and store ingested food energy

it accounts for about 10% of daily energy expenditure in most people

Question 27

Thermic effect of physical activity =

Answer 27

The energy required for physical activity

it represents between 15% to 30% of daily energy expenditure

Question 28

Daily energy needs (caloric requirement) are determined by three factors:

Answer 28

1) Resting metabolic rate (RMR) between 60% and 75% of the total calories used daily

2) Thermogenesis (amount of calories needed to digest and absorb foods that are consumed

3) Activity energy expenditure – exercise + non-exercise activity thermogenesis (activity not sleeping, eating or sports like exercise)

Question 29

Estimate RMR

Answer 29

men: = (10 x weight in kg) + (6.25 x height in cm) - (5 x age in years) + 5

women: = (10 x weight in kg) + (6.25 x height in cm) - (5 x age in years) - 161

Question 30

BMR result may be multiplied by a factor that approximates an individual’s physical activity level (PAL) to estimate their total energy expenditure (TEE)

Answer 30

sedentary or light activity
> PAL = 1.53
> ex) office worker getting little or no exercise

active or moderately active
> PAL = 1.76
> ex) construction worker

vigorously active
> PAL = 2.25
> farmer

Question 31

Weight loss =

Answer 31

reduce caloric intake by 250 calories per day and to increase daily expenditure (through physical activity) by 250 calories

This 500-calorie difference, when multiplied by 7, creates a weekly negative caloric balance that results in a loss of 1 lb

Question 32

Most health organizations recommend a weight-loss rate of ___ per week

Answer 32

1 to 2 lb (0.45-0.91 kg)

Question 33

To lose weight, data indicate that moderate-intensity exercise is the preferred level of exertion:

Answer 33

(~ 60% to 70% of maximal oxygen uptake and 11 to 13 on the ratings of perceived exertion scale (6–20 scale)

Question 34

Programming exercise for overweight and obese clients must take into consideration ___

Answer 34

their unique needs

Question 35

Exercise Guidelines:

Answer 35

Many individuals may be severely deconditioned and/or have orthopedic limitations

Establish a reduction in initial body weight of at least 5% to 10% over 3 to 6 months

Non-weight-bearing activities are encouraged = avoid orthopedic risk

Question 36

Primary mode of exercise should be ___ with resistance exercise included ___ per week

Answer 36

aerobic activities

2-3 times

Question 37

Initial emphasis of the exercise training should be on ___

Answer 37

duration and frequency

> keep intensity moderate and progressing gradually as tolerated

Question 38

Frequency of training should be ___

Answer 38

5 to 7 days per week

Progressively accumulate 250 to 300 min/week (~2,000 kcal/week) of moderate-intensity exercise for weight loss and prevention of weight gain

Create a negative energy balance of 500 to 1,000 kcal/day (which is equivalent to a 0.5-1 kg loss of weight per week) This reduction should be combined with a reduction in dietary fat to <30% of total energy intake

Include the use of behavior-management techniques = relapse prevention

Question 39

Exercise Programming for Overweight and Obese Clients:

Answer 39

Physical activity lasting <150 minutes/week has a minimal effect on weight loss

Physical activity lasting >150 minutes/week usually results in modest weight loss

Physical activity lasting between 225 and 420 minutes/week results in the greatest weight loss

Question 40

Biomechanical Considerations for Cardiorespiratory Exercise

Answer 40

Combination of weight-bearing (such as walking and elliptical exercise if orthopedically tolerated) and nonweight-bearing (such as cycling and swimming) modes

Individual’s preferences and exercise history

Monitoring of muscle soreness

Identifying any orthopedic problems

Walking as initial exercise

High-quality fitness shoes

Question 41

Resistance Training

Answer 41

> Increasing muscle mass elevates RMR

> Positive impact of maintaining, or increasing, fat-free body mass while encouraging the loss of fat body weight in a progressive-overload, resistance-training program

Question 42

Biomechanical Considerations for Resistance Training

Answer 42

Seated exercises are good options

The seats on some exercise machines are not designed for large persons, which may limit the feasibility of using some strength-training equipment

An overweight person may have difficulty getting down to and up from the floor

Certain supine exercises may cause breathing difficulty for some obese clients (by inhibiting the passage of air)

Question 43

Periodization

Answer 43

planned manipulation of training variables (load, sets, and repetitions) in order to maximize training adaptations and to prevent the onset of overtraining syndrome

Question 44

Form or resistance training that may be defined as:

Answer 44

strategic implementation of specific training phases

Question 45

Training phases are based upon increasing and decreasing volume =

Answer 45

reps times sets and intensity based on load or percentage of 1RM when designing a training program

Question 46

Inverse relationship between intensity (how hard) and total repetitions

Answer 46

Percentage of maximal effort correlates inversely with training volume, implying that, as the intensity increases, the number of repetitions decreases proportionally

Question 47

Aerobic exercise intensity can use HRR, max HR %, max aerobic capacity (VO2 max), or RPE

volume can be adjusted by duration of the session, as well as frequency of the sessions

Answer 47

Incorporate frequent CR workouts at low intensity for long duration

Include some CR workouts that are of higher intensity for a shorter period (one per week to minimize injury)

Cross train- use variety of exercise modes- minimizes fatigue and overuse of same ms but altering movement patterns

Vary work outs- change the stimulus