chapter 11; Energy Balance and Obesity Flashcards
(129 cards)
1
Q
Obesity - having excess body [..] - is considered American’s number one health crisis
A
fat
2
Q
obesity has been linked to a whole host of health problems, including cardiovascular disease, diabetes, dementia, infertility, hypertension, arthritis, and even certain cancers. It is also a major [..]
A
killer
3
Q
in the United States, only tobacco use causes more premature deaths per year, and obesity related cancers account for about 40% of all cancers diagnosed in the United States annually
A
4
Q
health consequences of obesity in the brain;
- Alzheimer disease, stroke
A
yes
5
Q
health consequences of obesity in the brain;
- heart disease,
- hypertension
A
yes
6
Q
health consequences of obesity in the liver and gallbladder;
- fatty liver disease
- gallstones
A
yes
7
Q
health consequences of obesity in the pancreas;
- type 2 diabetes
A
yes
8
Q
health consequences of obesity in the joints;
- arthritis
A
yes
9
Q
health consequences of obesity in the foot;
- gout
A
yes
10
Q
health consequences of obesity in the nasopharynx;
- sleep apnea
A
yes
11
Q
health consequences of obesity in the stomach;
- gastroesophageal reflux
A
yes
12
Q
health consequences of obesity in the boy;
- increased risk of some cancers (particularly colon, esophagus, uterus, breast, pancreas, kidney, gallbladder
A
yes
13
Q
health consequences of obesity in the uterus;
- infertility in women,
- increased risk of miscarriage and birth defects
A
yes
14
Q
health consequences of obesity in men penus;
- erectile [..] in men
A
dysfunction
15
Q
obesity increases the risk of number of [..] disease and ultimately increases the risk of [..] death. one study found that the risk of death was increased two - three fold in healthy middle aged individuals who never smoke
A
chronic
premature
16
Q
alarmingly, rates of obesity have sky rocketed over the past four decades , leading many to refer to an obesity “[..]”
A
epidemic
17
Q
as of 2018, over [..]% of US adults ages 20 and older were obese (42.4%) and more than 70% were overweight or obese
A
40%
18
Q
the prevalence of obesity in youth ages 2-19 is [..] at a similar rate (19.3%)
A
increasing
19
Q
The United States is not alone: Global obesity rates have almost […] since 1975, and in 2016, the World Health Organization (WHO) estimated that approximately 13% of the world population could be classified as obese.
A
tripled
20
Q
obesity is complex disease that is influenced by multiple factors; [..], [..], and [..] are the primary contributors.
A
behavior,
environment,
and genetics
21
Q
genetics is often viewed by many among the public as the primary factor determining an individual’s [..] to obesity. however, the rapid rise in the prevalence of obesity in the last few decades largely attributed to changing [..] factors, because human genes have essentially remained the same over this time.
A
susceptibility
environmental
for this reason, it is said that “genetics loads the gun, and environment pulls the trigger,” because the environment in which we live and work can strongly affect our behaviors and consequently our weight
22
Q
the built environment - our surroundings that are designed by [..] - can strongly affect how likely we are to engage in [..] activity, which in turn determines whether we maintain, increase, or decrease our body weight.
A
humans
physical
23
Q
the food environment (the social and physical factors that influence the foods we eat) can make it challenging for us to make healthy food choices. consequently, the dramatic rise of physical activity and the consumption of [..] dense foods that are particularly likely to promote weight gain in genetically susceptible individuals
A
energy
24
Q
obesity does not happen overnight. “obesity doesn’t occur over minute and hours, it occurs over years, decades, and generations”
A
what that mean sit hat even small changes in the way we eat or the way we move can seriously add up. (extra spoonful or two at each meal or the amount of time we spend sitting or standing - if multiple consistently across time - can profoundly affect how much energy we store or expend”
25
energy, defined as the capacity to do work, is required to perform all of the various functions that are necessary to sustain life, form breathing to moving to digesting food to maintaining a constant body temperature.
work
26
humans and other animals obtain energy through the breakdown of [..], [..], [..], and [..] in food and beverages. the energy contained in the chemical bonds of these molecules is released by the chemical reactions of [..] and captured a form that can be used to do the bodies work
carbohydrates, fats, proteins, alcohol
metabolism
27
one way scientists measure energy is units called calories. a calorie is defined as the [..] required to raise 1 gram (g) of water 1 degrees celsius (C). the energy in food is measured in units of kilocalories (kcal = 1000 calories). a kilocalorie is the energy required to raise 1 kilogram (kg) of water 1 degrees celsius. all food labels in the United States report the energy in foods in [..], although these are usually just referred to as "calories"
energy, kilocalories
28
obesity results from a chronic [..] of energy intake and expenditure. according to the laws of thermodynamics, energy is neither created nor destroyed but merely changes form. this principle, known as the conservation of energy, means that when we consume more energy than we expend, the excess has to go somewhere. Most often, it seems to end up in the [..] cells in our hips, thighs, and bellies.
imbalance, fat
29
there are two types of fat, or adipose tissue: [..] adipose tissue (WAT) and [..] adipose tissue (BAT). WAT stores [..] energy in the form of fatty acids in triglycerides intake is low. In contrast, BAT [..] fatty acids and glucose to produce [..] by a process called non shivering thermogenesis (heat production)
white, brown
excess, burns, heat
30
infants are born with significant amounts of BAT ([..] adipose tissue) that is localized primarily between the [..] blades in concentrated and identifiable depots, and the heat produced there is critical for the maintenance of body [..] in the infant
brown , shoulder
temperature
31
it was previously thought that adults had little if any BAT ([..] adipose tissue), but recent studies have found that some adults have significant amounts. but unlike BAT in infants, in adults, it does not exist in [..] depots, but brown fat cells, or adipocytes, are found scattered within depots of WAT.
brown, specific
32
another difference is that brown fat cells in adults appear to arise primarily from the conversion of WAT ([..] adipocyte tissue) into [..] fat cells (in contrast to infants), which is referred to as WAT "[..]". because these cells are similar but not identical to the brown adipocytes found in infants, they are often called "beige" adipocytes
white, brown
"browning"
33
because the amount of beige fat cells present in adults has been shown to correlate with body [..] and the browning of WAT ([..] adipocyte tissue) in adults can be induced with [..] exposure, it is thought that the heat produced by these cells may make significant contributions to the maintenance of [..] balance in some adults.
leanness, white, cold
energy
34
to be in energy balance means that the amount of energy we take in ("energy in") [..] the amount of energy we use ("energy out"). when this occurs, our body weight is [..]. any increase in our body weight indicates that "energy in" is [..] than "energy out"
equals, stable
greater
35
fundamentally, the only way to gain weight is through [..] energy balance (to consume calories [..] of what is expended), and the only way to lose weight is through [..] energy balance (to consume [..] calories than what is expended). obesity always results from chronic [..] energy balance.
positive , excess
negative, fewer
positive
(this discussion reveals something unique about energy nutrients compared with other nutrients: body weight provides us with an easily monitored indicator of adequacy, excess, or insufficient energy nutrients)
36
energy balance;
- weight loss (negative energy balance) ; energy intake is [exceeds, equal, less] than expenditure
- maintain weight (energy balance); intake and expenditure are [exceeds, equal, less]
- weight gain (positive energy balance); energy intake [exceeds, equal, less] expenditure
less
equal
exceeds
37
although it is true that some problems such as sleep apnea can result from being physically large, most of the negative health consequences of obesity stem from the effects that excess adiposity, or body fat, has on the function of [..] throughout the body. Fat, or adipose tissue, is not just inert yellow gobs of flesh distributed within our bodies; rather, its dynamic [..] with an active life all its own.
cells
tissue
38
adipocytes secrete an abundance of different [..] and [..] like messengers that exert effects on other tissues in the body. these hormone cause a low grade chronic [..] state throughout the body that is believed to be primary means by which obesity causes health problems and contributes to the development of many chronic diseases
hormone x2, inflammatory
basically, since adipocytes release hormones, those hormones cause inflammation and hence many get diseases and health problems from having too much adipocytes.
39
obesity, low grade inflammation, and chronic disease;
- adipose tissue of lean individuals contain few [..] cells, however as obesity develops, fat cells enlarge as [..] energy balance increase the amount of energy that must be stored
- those enlarged fat cells produce and release excessive amounts of [..] and [..] like messengers that attract [..] cells and cause low grade [..] in adipose tissue
- then hormones and messengers are transported throughout the body in blood. the increase in the presence of [..] cells in adipose tissue of obese individuals results in further increases in the production of hormones and other messengers, these substances enter the blood and cause low grade [..] throughout the body, causing many chronic [..]
- low grade chronic inflammation occurs as fatty liver, Alzheimer disease and stroke, heart disease, hypertension and atherosclerosis, insulin resistance and decreased insulin secretion (type 2 diabetes), and increased risk of certain cancers
- immune , positive
- hormone(s) x2, immune, inflammation
- blood, immune, diseases
40
our bodies have built in mechanisms that let us known when we are hungry and when we have eaten enough (if ew pay attention). through this complex physiological control system, which involves a constant dialogue between our brains and our gastrointestinal tract, we are able to obtain and maintain sufficient energy stores to power activities.
yes
basically, there is communication between the brain and the GI tract that lets us know when we get full and when we get hungry
41
two different systems regulate energy balance and food intake - a short term and a long term system. the short term system, mediated by [..] and stomach [..], triggers hunger and satiety (the opposite of hunger, (respectively before and after individuals meals. the long term system, mediated by a different set of [..], adjusts food [..] and [..] expenditure to maintain [..] fat stores (adipose cells and tissue)
hormones, pressure
hormones, intake, energy, adequate
basically;
the two different systems are short and long term. the short term manages the immediate aspects of the hormones triggering hunger and when feeling satiated. long term, is more of a longer aspect where a different set of hormones considers food intake and energy expenditure
42
when we haven't eaten for a while, our stomach begins to grumble. that grumbling is a sign that a hormone called Ghrelin is racing into action. Ghrelin, nicked the "[..] hormone," is a 28 amino acid peptide hormone that is produced primarily in the [..] it is the only hormone that has been found to [increase or decrease] hunger
hunger , stomach
increase
43
circulating ghrelin levels in the blood surge just [..] meals and decrease [..] eating. Ghrelin stimulates hunger by activating specific [..] in the brain. Ghrelin secretion deceases only when nutrients from the meal are [..] into the blood. the secretion of ghrelin is most effectively inhibited by [..] and then by [..]; dietary fat is [..] effective at decreasing ghrelin secretion.
before, after
neurons, absorbed
carbohydrates, proteins, least
basically; the hormone Ghrelin which is also referred to as the hunger hormone is released before you eat and when hungry, the releasing of the hormone doesn't decrease until the nutrients of food are absorbed. 1st; carbs, 2nd, protein, 3rd; dietary fat
44
satiate is the process that leads to the [..] of a meal and refers to the sense of [..] that we feel while eating. satiety is the effect the meal has on our interest in food after a meal; it operates in the interval between meals and affects when we feel hungry again.
termination , fullness
45
the primary factors affecting these two processes (satiation & satiety) are gastric distention - how much our stomach has [..] to take in food - and the release of [..] produced by specialized [..] in the gastrointestinal tract. nerves in the stomach sense its expansion and relay signals to the brain to communicate satiation , a sense of fullness. at the same time, several gut peptide hormones are produced by specialized [..] in the small intestine in response to the detection of nutrients in the gut
expanded, hormones , cells x2
46
importantly, calories in beverages appear to bypass mechanisms of satiation. a number of studies have demonstrated that soft drink calories are less satiating than calories from solid foods.
yes
47
over the long term, [..] balance is affected by a hormone called leptin. Leptin is produced primarily by adipose tissue. the circulating concentration of leptin in our blood is closely associated with total body [..]. when stores increase, [..] leptin is produced. the leptin level increase in the blood acts on the brain to [..] hunger and increase energy [..] to avoid excess weight [..]
energy, fat
more, suppress, expenditure, gain
48
hormones help regulate energy balance and food intake;
short term; hormones signal low [..] status, the [..] increases ghrelin, the brain signals an increase in [..], eat
long term; adipose tissue increases leptin, the brain signals [..] hunger, gradually eat [..], [..] energy expenditure
energy, stomach, hunger,
less x2, increase
basically; short term is for immediate eat, signaling when low energy, increase in ghrelin production, eat. long term is for more finishing eating, a feeling of getting full using the leptin hormone.
49
obese individuals have [higher or lower] levels of circulating leptin than lean individuals, but the obese individuals seem to be [..] to the hunger suppressing effects of leptin. thus, they don't experience the same [..] hunger or increased [..] of energy as their lean counterparts.
higher, resistant
diminished, expenditure
50
some evidence suggests that a high fructose diet (primarily through excess consumption of sweetened beverages) may contribute to leptin [..] in humans and contribute to increased [..] and food [..].
resistance
appetite , intake
51
it is critical to differentiate between hunger and appetite. hunger is the [..] impulse that drives us to seek out food and consume it to meet our energy [..]. appetite, however, is often viewed as the liking and wanting of food for other reasons other than, or addition to, hunger. appetite is often a product of sensory stimuli (the sight or smell of appealing foods) and the perceived pleasure we will experience when we eat the desired food.
biological , needs
52
hunger is certainly not the only reason (and perhaps not the dominant one) that motivates us to eat on many occasion. we often eat because it is pleasurable to do so .
yes,
furthermore, food manufacturers spend billions of dollars in research designing foods that will trigger our "bliss point" - with just the right balance of salt, fat, and sugar that we find nearly irresistible and often readily accessible. similar large sums of money are spent marketing these products.
53
because we are often surrounded by cues (such as advertisements) that stimulate our appetite and make us not only want to eat specific foods - and we eat more of these appetizing foods as portion and package sizes increase; in the end, we often eat when we are not hungry, causing consumption of [..] calories than will be expended, and therefore, we gain weight over time. this is often referred to as the "[..] food environment" because the easy accessibility of highly palatable, energy dense foods, and the resulting overconsumption of those foods, is a significant factor in the obesity epidemic.
more
toxic
54
we also eat for many other reasons, such as in response to stress, boredom, and emotions. all of these reasons for eating can, to some degree, [..] the satiety signals that are designed to keep us in energy balance.
override
55
studies have looked at weight gain in response to overfeeding have shown that people vary greatly in how much body fat they [..]. the biological mechanism that allows some individuals to resist weight gain more than others, however, has not been identified
accumulate
56
a persons total energy expenditure (TEE) is the combination of three main components: (1) basal metabolism, (2) the thermic effect of food, and (3) activity energy expenditure.
yes
57
basal metabolism is the energy expenditure required to maintain the [..] functions that sustain life. this energy is required for the [..] reactions in our cells; the maintenance of [..] tone; and the work done by our heart, lungs, brain, liver, and kidneys - with much of this work depending on the [..] transport of electrolytes and other nutrient in our cells.
essential , chemical, muscle, active
58
in research studies, basal metabolism is measured while the person is lying completely still but awake at a comfortable temperature following an overnight [..] and without any physical activity for the preceding [..] hours. for most individuals, basal metabolism is the largest component of total daily energy expenditure, accounting for about 66% of TEE in a typical individuals with a low level of physical activity.
fast, eight
59
Thermic effect of food (TEF) is the energy needed to digest, absorb, and metabolize [..] in our food. TEF is generally equivalent to 10% of the energy content of the food ingested and does not vary greatly between people.
nutrients
60
activity energy expenditure (AEE) is the amount of energy individuals expend in [..] activity per day, both planned and spontaneous. It includes all of the energy expended in the contraction of [..] muscles to [..] our body and to maintain [..] (sitting or standing versus lying down). AEE is the most variable component of TEE
physical
skeletal
move , posture
61
although people can and do vary in the amount of energy expended by their basal metabolism, having a "low metabolism" is rarely the initial cause of obesity.
yes
62
the majority of the variation in basal metabolism from person to person is account for by individual differences in fat free mass (FFM), which is total body mass minus the fat mass (adipose tissue). the greater a persons FFM, the higher his or her basal metabolic rate (BMR). although increasing fat mass will also increase BMR to some degree, adipose tissue is far less metabolically active than other tissues.
in other words;
Most of the differences in basal metabolism between individuals are explained by variations in fat-free mass (FFM), which is a person’s total body weight minus their fat (adipose) tissue. People with more FFM tend to have higher basal metabolic rates (BMR). While an increase in fat mass can also slightly raise BMR, fat tissue is much less metabolically active than other types of body tissue.
63
our organs such as the brain, kidney, heart, and liver, have the highest metabolic activity, but even at rest, skeletal muscle is about three times more metabolically active than adipose tissue. what this means is that a lean individual expends more [..] at rest than someone of the [..] weight who has more body fat.
three , more, same
basically, you use more energy if you have less fat than someone who weighs the same and has more body fat. you burn more fat because skeletal muscle is active.
64
Women usually have more body fat and less lean muscle than men, and this is the main reason why their bodies burn [..] calories at rest (lower BMR). As people get older, they tend to gain more fat and lose muscle, which also [..] their BMR. But this change isn’t just because of aging — it's mostly because people become less [..] as they get older. Other things like how much [..] we drink or whether we [..] can also change how fast our body burns calories.
fewer, lowers, active, caffeine, smoke
65
estimating BMR; a reasonable estimate of BMR in individuals with a normal body weight for women and men;
women; weight (in kg) x 23.3
men; weight (in kg) x 24
66
fat free mass effect on basal metabolism rate; is body weight minus the weight of adipose tissue. FFM is the single most important factor affecting BMR because adipose tissue is metabolically much [..] active than most other tissues. Our organs have the highest metabolic activity while we at rest, with the liver, brain, heart, and kidneys accounting for about two thirds of our BMR. although at rest skeletal muscle is far [..] metabolically active than our organs, it is still about [..] times more so than adipose tissue.
less, less , three
67
age affect on basal metabolism rate; decreased about [..]-[..]% per decade after [..] adulthood. the vast majority of this decrease is due to the decreased mass of both our [..] and [..] muscle.
1-2% , young
organs, skeletal
68
sex affect on basal metabolism rate; a women will generally have a [greater or lower] BMR than a man with the [..] body weight because FFM (fat free mass) generally makes up a [..] percentage of a woman's total body weight than a man's. women also tend to be [larger or smaller] than men
lower, same , lower, smaller
69
growth affect on basal metabolic rate; the energy demands of growth [increase or decrease] BMR from infancy through adolescence, but only during the first six months of life do the energy demands of growth cause a [..] increase in BMR.
increase, significant
70
hormones effect on basal metabolic rate;
elevated levels of [..] hormone and [..] (released in response to stress) increase BMR.
thyroid, epinephrine
71
starvation affect on basal metabolism rate;
fasting or low calorie diets [increase pr decrease] BMR to [..] energy when it is scarce
decrease, conserve
72
illness effect on basal metabolic rate; a fever, burns, and trauma will [increase or decrease] BMR
increase
73
pregnancy and lactation affect basal metabolic rate; during pregnancy, DMR [increase or decrease] because of the increased work required to support the maternal circulation, respiration, and kidney function, as well as to support the increased [..] mass. during lactation, BMR [..] to meet the energy demands of milk production.
increase, tissue, increases
74
ethnicity affect basal metabolic rate; the BMR of [..] may be 5-10% higher than that of other ethnic groups.
whites
75
caffeine affect basal metabolic rate; [increase or decrease] BMR. the amount of caffeine equal to that of a typical soft drink has been shown to raise BMR by about [..]%, whereas an amount approximately equivalent to that in three to four 8 ounce cups of coffee has been shown to raise BMR by about [..]%. those who regularly consume high amounts of caffeine may develop tolerance to its effect
increases, 5%, 10%, tolerance
76
smoking affect basal metabolic rates; nicotine tends to [..] BMR
increase
77
sleeping affect basal metabolic rates; sleeping metabolism is about [..]% less than basal metabolic rate.
10%
78
although a lower BMR does not appear to contribute signification to the initial [..] of obesity, it may contribute to the difficulty that most individuals encounter in preventing weight [..] following weight [..]
cause ,
regain , loss
79
recent studies involving former participants in the "biggest loser" competition found that BMR is about [..]% (500 kcal) lower than expected (for a particular body weight and composition) six years following weight [..]
20%
loss
80
contestants who were successful in maintaining weight loss were engaging in very high levels of [..] activity, amounting to about [..] minutes of additional moderate daily activity above per weight loss levels. these results indicate that continually high levels of physical activity may be necessary for maintenance of weight loss .
physical , 80
81
NEAT is short for non exercise activity thermogenesis
82
NEAT (non exercise activity thermogenesis) includes al activities of daily living , such performing household chores, doing yard work, shopping, carrying out occupational activities, walking the dog, and playing a musical instrument. it also includes the energy expended to maintain posture and spontaneous movements such as fidgeting, pacing, and even chewing gum.
83
in other words, NEAT encompasses all of the activities we do as part of [..] living but separate from planned, intentional [..] such as going for a run, taking an aerobics class, or hopping on an exercise bike
daily,
exercise
84
in Levines study, NEAT varied greatly among individuals (fewer than 100kcal to more than 700 kcal per day), more important, changes in NEAT were inversely correlated with changes in weight gain. in other words, NEAT proved to be the principal mediator of resistance to fat gain in these individuals
yes
basically; the amount of daily living movements that you make such as walking, chores, etc. burns calories, but of course the more you do of more energy needing activities (that are not exercise) the more you burn
85
lean individuals sit the same amount of time even after they are forced to gain weight, and obese individuals sit the same amount of time even after they are forced to lose weight. Levine thinks that its not only that people are eating more than they did a few decades ago but also that we have been "seduced" (his word) by our environment into expending less energy by sitting more.
yes
86
can food environment contribute to the development of obesity
yes;
the availability of cheap, palatable, energy-dense food appears to be a major factor contributing to the rise in obesity in the US
87
can portion sizes contribute to the development of obesity?
yes;
when we are served larger portion sizes we tend to eat more
88
is fewer home cooked meals contributing to the development of obesity ?
yes;
those who frequently eat at restaurants or purchase take out meals are at a higher risk of obesity
89
is sleep deprivation a risk factor contributing to the development of obesity?
yes;
sleep deprivation has been shown to increase food consumption
90
can pregnancy be a factor contributing to the development of obesity
yes;
some women have difficulty lose the weight they gained during pregnancy
91
can emotions be a factor contributing to the development of obesity?
yes;
boredom, anger, or stress can result in overeating
92
can a sedentary lifestyle be a risk factor in contributing to the development of obesity?
yes;
decreased energy output promotes a positive energy balance and weight gain
93
can television be a factor contribution to the development of obesity ?
yes ;
besides contributing significantly to the time we spend sitting each day, television viewing negatively affects our diet, often causing us to eat more at meals, snack more often, and choose less healthy foods.
94
can prescription drugs be a factor contributing to the development of obesity?
yes;
some prescription drugs can cause weight gain, perhaps by increasing appetite or decreasing metabolism or physical activity
95
can smoking cessation be a factor contributing to the development of obesity?
yes;
individual often eat more and gain weight once they quit smoking
96
can genes be a factor contributing to the development of obesity ?
yes ;
our genetic makeup can potently affect how well we regulate food intake and how easily we gain weight when we overeat
97
not everyone who lives in our modern society becomes obese, because some people naturally have higher NEAT than others. these high NEAT individuals are the toe tappers and fidgeters among us who just can seem to sit still
98
it is possible for a thin person to be less healthy than an overweight person (especially if the thin person smokes cigarettes).
yes
99
although some research does suggest that being slightly overweight is associated with higher longevity than being underweight, a recent studying involving 1.3 million men found that the risk of early death was higher for physically fit obese individuals than for unfit normal weight idnvidiauls.
basically;
people who are a little bit overweight live longer, but more fit obese individuals die first than unfit normal weight individuals
100
of all deaths globally that there were associated with excess body fat, 40% of them occur in people who were overweight but not obese. nevertheless, the link between obesity and health risks is irrefutable, and health professionals need a guide for action.
101
the most common tool for assessing body fat is the body mass index (BMI). is calculated from a persons weight and height and provides an indirect estimate of body fat.
"underweight", "normal", "overweight", and "obese" are all labels for ranges of weight on the BMI scale. the [..] the BMI, the higher the risk of obesity-associated diseases such as coronary heart disease, hypertension, stroke, and type 2 diabetes
greater
102
although easy to use, BMI has limitations. For example, BMI does not distinguish between excess fat and muscle and bone mass. thus, it may overestimate body fat in muscular individuals, such as highly trained athletes who have increased muscle mass.
basically; the BMI isn't good because if you have big muscle mass, it won't be able to tell the difference between actual fat and the weight of muscle and bone
103
another way to assess whether a person's body fat level carries health risks is to measure waist circumference, which is an indicator of [..] obesity. waist circumference indicates body fat [..] - in particular, the presence of excess visceral fat located in the abdominal area that surrounds the body internal organs, which has been shown to be an independent health risk.
abdominal
distribution
104
the greater the waist circumference, the greater the risk of cardiovascular disease, type 2 diabetes, and premature all cause mortality. even individuals who are of normal weight (BMI less than 25) but with a [..] waist are at an increased risk of a number of chronic disease
large
105
considering waist circumference in addition to BMI is a better predictor of healthier risk than BMI alone. abdominal obesity is considered present when waist circumference exceeds [..] inches for women and [..] inches for men.
35
40
106
there appear to be ethnic differences in the association between waist circumference and the degree of abdominal adiposity. compared to those of European decent, asians tend to have more abdominal adipose tissue (and those of African descent less abdominal adipose tissue) at any given waist circumference.
yes
107
those who accumulate fat in the abdominal region (abdominal obesity) and have an apple shaped body have a higher risk of chronic disease than those who accumulate fat in their hips and thighs have a pear shaped body. the apple body shape is more common in [..], whereas the pear shaped body shape is more common in [..]
men , women
108
normal weight individuals (BMI<- 25) can also have [..] obesity and be at an increased risk of chronic disease
abdominal
109
BMI and waist circumference provide useful estimates of body fat in most people, but both are indirect measures; they do not actually measure an individual’s body composition in terms of fat, muscle, and bone, for example
yes;
does not actually consider fat with disregard to muscle mass, and bone mass
110
methods for determining body composition, dual energy X-ray absorptiometry (DEXA);
the differential absorption of x-rays of two different energy levels are used to calculate bone mineral mass, lean soft tissue mass, and fat mass. it is fairly accurate but the results are influenced by hydration status and the person body shape. also the tables cannot accommodate those who are severely obese.
111
methods for determining body composition, skin fold thickness;
calipers are used to measure the skin fold thickness at multiple sites, and these measurements are used to estimate body fat. because this method only measures fat that is just beneath the skin it underestimates body fat content in those with abdominal obesity. it is also inaccurate in those who are either very lean or very obese.
112
methods for determining body composition, air displacement;
the amount of air displaced from the test chamber when it is occupied by the subject is used to determine the persons body volume, and this is used to calculate body density. from body density, body composition can be estimated. accuracy is fairly good.
113
methods for determining body composition, bioelectrical impedance;
this method exploits the fact that tissues conduct a currently differently depending largely upon their water content. because adipose tissue contains little water, current flows poorly through it. those with a high percent of body fat will have low total body water and display a higher level of resistance (for impedance). this technique is moderately accurate. the hydration level of the subject will significantly alter the results, and bioelectrical impedance poorly predicts fat content in severely obese subjects
114
methods for determining body composition, underwater weighing (hydrodensitometry);
fat is less dense and therefore more buoyant in water than is muscle. the density of the body is calculated from the difference in the person's body weight on land from that while completely submerged (after exhaling all the air possible from their lungs). this method is not suitable for children, the elderly, or disabled individuals. accuracy is fairly good but depends on the ability to exhale all air from the lungs
115
weight loss is recommended for anyone with a BMI of [..] or higher, for those who are overweight and have two or more risk factors, and for individuals with a large [..] circumference .
30, waist
116
examples of risk factors associated with high BMI include cardiovascular disease or a family history of it, smoking, hypertension, age (men: [..] years or older; women: [..] years or older or postmenopausal), diabetes, and physical inactivity.
45
55
117
dietary modification and increased physical activity are generally recommended to help people achieve and maintain a healthier body weight. but for very obese individuals, additional treatment options or interventions may be warranted.
118
there are several FDA approved antiobesity drugs can be prescribed as an adjunct to diet, exercise, and behavior therapy for these individuals.
119
medications to treat obesity function to aid in weight regulation by promoting [..] and [..] or by reducing [..] of calories from dietary fat. for those with extreme obesity (BMI of [..] or above or a BMI of [..] or above with additional risk factors), weight loss surgery may be recommended
satiety and sanitation
absorption
40, 35
120
in the case of extreme obesity, weight loss surgery (also known as bariatric surgery) is the most effective treatment to yield significant weight loss and reduction of weight related disorders. although not without significant risk , these procedures dramatically reduce stomach [..], limit food [..], and increase [..].
capacity, intake, satiety
121
a modest reduction in body weight can result in significant improvements in health for people who are overweight or obese. losing [..]-[..]% of body weight (and [..] that lower weight) can reduce the risk of chronic diseases (cardiovascular disease and diabetes, for example) and premature all cause mortality by about 50%
5-10%
maintaining
122
for those with less severe weight problems, dietary and lifestyle approaches weight loss may be enough. there are numerous dietary approaches to weight loss, as shown ny the number of "diet" books published each year, advertisements, etc.
dietary
lifestyle
123
studies demonstrate that most "diets" result in a reduction in a calorie intake and that ultimately they vary little in terms of weight loss. of course, some approaches are more nutritionally sound and conductive to sustaining changes and keeping weight off
rather, healthy weight management plans maximize nutrient density while reducing calorie intake, increase physical activity, incorporate behavioral strategies to enhance compliance, address individual health concerns, and consider not only the dropping of pounds but also the maintenance of a lower body weight.
124
one effective and healthful dietary approach seems to be a moderately low [..] diet (less than 30% of total calories from fat) coupled with a moderately high [..] intake (25-30% of total calories). including significant amounts of non [..] vegetables, fruit, minimally processed [..] grains that are high in fiber, and [..] sources of protein will decrease the energy density of the diet. this will allow for the consumption of greater quantities of food while keeping energy intake low, which may increase the perception of satiation while adhering to a reduced calorie diet
fat, protein
starchy, whole, lean
125
A common misconception about weight loss is that a person can simply reduce his or her food intake by a certain amount of calories and expect to lose a proportional amount of weight (assuming that a pound of body fat contains approximately 3500 kcal). For example, if a 700 kcal per day decrease in energy intake is made today and that new lower-calorie intake is maintained for 100 days, many would predict a body weight loss of 20 pounds (70,000 kcal/3500 kcal/lb of fat). In reality, only about half that weight would be lost in that time because a lighter body expends fewer calories while resting and while moving.
yes
126
As weight loss continues, the magnitude of the calorie deficit will be consistently [..] (along with the [..] body), and the rate of weight loss will continually [..].
shrinking x2, slow
127
weight loss maintenance from the national weight control registry (NWCR) ; share common strategies that include maintaining a lower fat and reduced calorie eating pan, eating breakfast, weighing themselves at least once a week, watching fewer than 10 hours of television per week, and exercising on average about one hour per day
128
129
