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Nutrition > Weight Management & Eating Disorders > Flashcards

Weight Management & Eating Disorders Flashcards

1
Q

What is BMI?

A
  • body mass index
  • calculated by dividing weight in kg by height in m
  • healthy range is 18.5 to 24.9
  • overweight defined as 25 to 29.9
  • obesity is >30
  • kids use growth charts
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2
Q

Are those with a higher BMI always at risk for chronic diseases?

A
  • no; sometimes people just have a high muscle mass

- BMI does not measure body composition or fat percentage

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3
Q

Why is location of body fat important?

A
  • health risks increased when fat stored in abdominal region (visceral fat)
  • pear-shaped better than apple-shaped
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4
Q

What dictates where fat is deposited?

A
  • mainly genes

- influenced by stress, smoking, and alcohol use

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5
Q

Why is visceral fat harmful?

A
  • metabolically active, pumps out adipokines and TNF-alpha
  • close to surrounding organs, between and around organs
  • subcutaneous fat around hips and thighs less harmful
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6
Q

What waist circumference is correlated with increased health risk?

A

Men: >102 cm/40”
Women: > 88 cm/35”
- Asian ethnicity targets are lower because cannot tolerate as much visceral adiposity without adverse effects

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7
Q

What determines our weight?

A
  • balance between energy taken in and energy expended
  • if we expend more than we consume, we lose weight, and vice versa
  • also more complex than this as well
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8
Q

What is the minimum amount fo weight loss to recommend for health?

A

5% of body weight - will return client to normal glycemic state

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9
Q

What nutrients are used first in a meal?

A
  • protein first, they provide substrates for protein synthesis in cells
  • next, carbs are used to replenish glycogen stores and provide glucose to tissues
  • extra converted to TGs
  • fat is last
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10
Q

Why is fat favourable to store?

A
  • provides the most calories per gram

- no process to change it when ingested

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11
Q

Why do physically active people have greater caloric needs?

A
  • need more energy

- muscle uses more energy than fat

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12
Q

What is total energy expenditure (TEE)?

A
  • total amount of calories used

- includes basal metabolic processes, metabolism of food and activity

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13
Q

Energy used for activity includes…

A

Exercise and non-exercise activity thermogenesis (NEAT)

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14
Q

What is the thermic effect of food?

A
  • energy expended in digestion, absorption, metabolism and storage of ingested macronutrients
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15
Q

What effect does starvation or fasting have on BMR?

A

Decreases BMR

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16
Q

Can we determine if someone needs to make lifestyle modifications based on weight?

A

No; should also measure waist circumference

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17
Q

Stress, fever, and illness have what effect on BMR?

A

Increases BMR

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18
Q

What is the correlation between excess body fat and disease risk?

A
  • overweight have 1-1.5x greater risk

- risk sharply increases with obese or extremely obese individuals

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19
Q

What is leptin?

A

Hormone that signals whether or not to take in more food and expend more or less energy

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20
Q

Leptin levels are proportionate to…

A

Fat levels in the body

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21
Q

How is leptin related to insulin?

A

Insulin levels are thought to affect the release of leptin and work with leptin to control body fat levels

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22
Q

Leptin in obese individuals?

A

There is plenty of leptin, but it does not seem to inhibit food intake or increase energy output as in normal weight individuals

23
Q

What is the leptin feedback mechanism ?

A
  • weight loss decreases leptin, results in increased intake and decreased expenditure
  • weight gain increases leptin, results in decreased intake and increased expenditure
24
Q

What hormones are involved in food intake regulation?

A
  • leptin
  • GLP-1 (similar to glucagon)
  • ghrelin (stimulates hunger)
  • CCK
25
Q

Why is there an increase in obesity, and why are children affected?

A
  • increase amount of food consumed, along with decrease in exercise
  • processed fast food is becoming normalized
  • children affected due to the diet and activity of their parents
  • reduction in physical education, computer and video games, parental concern for safety
  • proportion distortion
26
Q

If BMI < 25…

A

No weight loss needed

27
Q

If BMI 25-29.9 and waist circumference > 35 or 40…

A

Assess for at least two obesity-related risk factors; if present weight loss recommended

28
Q

If BMI > 30…

A

Weight loss recommended

29
Q

What tool can be used to stage people with obesity?

A
  • EOSS (Edmonton Obesity Staging System)
  • stage 0-4
  • based on obesity-related risk factors, physical symptoms, psychological symptoms, and functional limitations
30
Q

What is yo-yo dieting?

A
  • process of repeatedly going on fad diets to achieve rapid weight loss
  • results in decreased in BMR, fatigue, and food cravings
  • when person returns to former eating habits, will gain weight back due to low BMR and overeating
  • cyclic, repetitive nature
  • better to adopt small, healthy, realistic habits and eating patterns
31
Q

Are overweight clients always overnourished?

A

No; if eating unhealthy foods then can be undernourished at the same time

32
Q

Behaviour modification is…

A
  • the goal of any lifestyle intervention
  • short-term fad diets unlikely to permanently change behaviour or maintain weight loss
  • fad diets generate money for the inventor
  • slow, sustainable changes have better results
33
Q

Plant-derived protein and fat…

A

Is associated with lower mortality

34
Q

Both high and low carbohydrate diets…

A

Are associated with high mortality

35
Q

What is an effective strategy for monitoring eating behaviours?

A

Keeping a diet log or journal

36
Q

What is bariatric surgery?

A
  • GI tract is altered to reduced food intake and nutrient absorption
  • gastric banding or gastric bypass
37
Q

When is bariatric surgery indicated?

A
  • indicated for extremely obese persons with BMI > 30
  • need to have some sort of limitation to which other attempts at weight loss have failed
  • more and more of these surgeries being done
38
Q

What is gastric banding?

A
  • band tightened or loosened over time to change size of opening from esophagus to stomach
  • allows less food to be consumed at one time, comfortably, and slows the rate of stomach emptying
39
Q

What is gastric bypass?

A
  • most common type of bariatric surgery
  • size of stomach is effectively decreased to limit intake
  • length of the small intestine is shortened, which limits absorption
  • reattached to upper new stomach pouch
  • lifelong changes must be made in eating habits and sufficient nutrients ingested, since absorption is decreased
40
Q

What is gastric sleeve?

A
  • 85% of outer stomach portion is removed
41
Q

Why are eating disorders a problem today?

A
  • constantly bombarded with images of thin, muscular models
  • difficult to achieve with normal food intake
  • inability to achieve this ideal leads to poor self image and self esteem
42
Q

How have cultural body ideals changed?

A
  • changed drastically from early 1900s, when fuller, more curvaceous figures were sought after
  • models have become thinner and thinner
  • the incidence of EDs have increased
  • weights of models are about 25% lower than the average women, as opposed to 8% diference 40 years ago
43
Q

What is distorted body image?

A
  • difference between ideal and attainable causes individual to see themselves as fat
  • leads to reduced food intake and weight restriction
44
Q

Can individuals be genetically predisposed to eating disorders?

A
  • yes; inherited susceptible personality traits, a body type that may not meet their ideal, hunger and satiety
  • combines with societal pressures and ideals, low self-esteem, need for self-control, and distorted body image
  • manifested as an ED during adolescence
45
Q

What proportion of girls in grade 9 and 10 had tried to lose weight in last year?

A

30%

46
Q

How many females will be affected by EDs in their lifetime?

A

3%

47
Q

What are OSFEDs?

A
  • other specified feeding or eating disorders
  • covers disorders where clinically significant distress and impairment of functioning are present but criteria for other disorders not met
48
Q

Malnourished individuals are at risk for…

A

Ongoing infections

49
Q

What are the three main categories of eating disorder?

A
  • anorexia nervosa
  • bulimia nervosa
  • binge eating
50
Q

What is anorexia?

A
  • persistent restriction of energy intake that leads to significantly low body weight
  • intense fear of gaining weight or becoming fat
  • disturbed body image
  • new DSM-5 criteria have changed to drop amenorrhea
  • subtypes include restricting and binge-eating or purging type
51
Q

What is bulimia?

A
  • repeated binging episodes, with a feeling of lack of control over eating
  • repeated compensation after binging by vomiting, misuse of laxatives, or excessive exercise to prevent weight gain
  • new guidelines say one episode per week for 3 months
  • disturbed body image
52
Q

What is the female athlete triad?

A
  • pressures in certain sports, such as gymnastics, to maintain a lean, thin body can lead to energy restriction
  • energy restriction and excessive exercise can upset hormonal balance
  • low estrogen levels can cause amenorrhea
  • osteoporosis is also a result of low estrogen levels due to low peak bone mass, premature bone loss, increased stress fractures
53
Q

What are visible signs of vitamin C deficiency?

A
  • bruising and bleeding under the skin

- due to collagen deficiency

Nutrition (21 decks)

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