Chapter 9

Question 1

Prevalence of Underweight Overweight, and Obesity, U.S Adults:

Answer 1

Underweight (BMI < 18.5) — 1.5%
Obese (BMI 30-39.9)—42.4%
Severely obese (BMI> or equal to 40) —- 9.2%

Question 2

Increases risk of death for surgical patients and for anyone fighting a wasting disease. Affect fewer than 2 percent of adults in the US also poses health threats to those who drop below a healthy minimum. People with cancer often die not from the cancer itself but from starvation. Thus, these people with this weight ae urged to gain body fat as an energy reserve and to acquire protective amounts of all the nutrients that can be stored.

Answer 2

Underweight

Question 3

At what weight are people among the first to die during a siege or in a famine? Also, they are at a disadvantage in the hospital, where their nutrient status can easily deteriorate if they have to go without food for days at a time while undergoing tests or surgery.

Answer 3

Underweight

Question 4

The progressive, relentless loss of body’s tissues that accompanies certain diseases and shortens survival time.

Answer 4

wasting disease

Question 5

Present very high risks of health; the condition of having a BMI of 40 or above; also called morbid obesity.

Answer 5

severe obesity

Question 6

With what form of obesity does the risk of dying equal that from smoking?

Answer 6

severe obesity

Question 7

Major obesity-related chronic disease risks include:

Answer 7

• Arthritis
• Cancers of breast, colon, endometrium, and others
• Diabetes
• Heart disease
• Kidney disease
• Nonalcoholic fatty liver disease
• Stroke

Question 8

What BMI indicates starvation?

Answer 8

BMI of 15

Question 9

The reason why the body presents an extra risk to the heart. These are protein hormones released by adipose tissue. They help regulate inflammatory processes and energy metabolism in body tissues, among other roles. In obesity, a shift occurs in these hormones that favors both tissue inflammation and insulin resistance often leading to diabetes, heart disease, and other chronic diseases.

Answer 9

Adipokines

Question 10

Acts as an endocrine organ, orchestrating important interactions with other vital organs such as the brain, liver, muscle, heart, and blood vessels in way that influence overall health. It is in any number of body organs that secrete hormones that travel in body fluids to other organs where they influence diverse critical functions, such as glucose metabolism, growth and development, and food intake.

Answer 10

Adipose tissue

Question 11

What 2 things can you do to reduce inflammation and improve health to reduce adipokines and obesity being a risk to health?

Answer 11

Calorie-restricted diets and weight loss

Question 12

A person with obesity faces a long list of threats in addition to the chronic diseases already named: abdominal hernias, cancers (many types), complications in pregnancy and surgery, flat feet, gallbladder disease, gout, high blood lipids, medication dosing errors, psychological depression, reproductive disorders, skin problems, sleep disturbances, sleep apnea (dangerous abnormal breathing during sleep), varicose veins, and even a high accident rate. So great are the harms that obesity itself is classified as a chronic disease called what?

Answer 12

Adiposity-based chronic disease–> Adiposity (fat cells and tissues, identifying them as the source of the disease)

Question 13

Modulates the risks from obesity. The pattern of fat deposition in various body areas.

Answer 13

Body fat distribution

Question 14

Excess fat in the abdomen and the trunk. Excess visceral fat = this. Associated with the metabolic syndrome and, independently of BMI, contributes to heart disease, cancers, diabetes, and mortality. A measure of this is among the indicators that physicians use to evaluate chronic disease risks.

Answer 14

central obesity

Question 15

Fat collected deep within the central abdominal area of the body. Fat stored within the abdominal cavity associated with the internal abdominal organs. Produces more inflammatory compounds than subcutaneous fat that increases chance of chronic disease.

Answer 15

Visceral fat

Question 16

What form of fat along with central obesity, poses greater risks of major chronic diseases and death than does excess fat lying just beneath the skin (subcutaneous fat-stored directly under the skin) ?

Answer 16

Visceral fat

Question 17

A combination of central obesity, diabetes or prediabetes, high blood glucose (insulin resistance), high blood pressure, and altered blood lipids that greatly increases the risk of heart disease.

Answer 17

metabolic syndrome

Question 18

Males of all ages and females who are past menopause are more prone to develop what profile around the waist that characterize central obesity? Whereas, females in their reproductive years typically develop what profile (fat around the hips and thighs), which poses less risk? At menopause the typical female shape often changes

Answer 18

“apples”, “pears”
At menopause the typical female shape often changes, and life-long “pears” may suddenly become “apples,” and face additional associated risks.

Question 19

A way to measure how much fat is too much fat. An indicator of health risk from obesity or underweight in people older than 20 years, calculated by dividing the weight of a person by the square of the person’s height. Correlates significantly with adiposity and risk of death and diseases such as heart disease, stroke, diabetes, and nonalcoholic fatty liver disease. Disease and Risk Factors if this measure exceeds include: -CVD, blood lipid profile that indicates CVD risk, Type 2 or prediabetes, Impaired glucose tolerance, and hypertension

Answer 19

body mass index (BMI)

Question 20

What BMI indicates risk factors and a need to stop gaining weight?

Answer 20

25-29.9

Question 21

What BMI has a risk for more than one disease, such as cardiovascular disease, diabetes, or high blood pressure indicates a need for treatment?

Answer 21

25-29.9 plus

Question 22

What BMI indicates a need for treatment?

Answer 22

over 30

Question 23

What are the 3 ways to indicate and measure how much fat is too much?

Answer 23

BMI, waist circumference, and a disease risk profile

Question 24

A measurement of abdominal girth that indicates the degree of visceral fat. Reflecting the degree of central obesity in proportion to total body fat. A person whose BMI ranks as overweight or moderately obese is likely to face additional heart disease and mortality risks if, for a woman, her measurements of this exceeds 35 inches (40in for a man). For those with greater obesity, waist circumference becomes less meaningful because their obesity alone imposes high risks.

Answer 24

waist circumference

Question 25

Can a Person with Obesity Be Healthy?

Answer 25

Generally yes. In obesity, having lower blood pressure without taking medication, a smaller waistline relative to hip size, and normal glucose tolerance may indicate metabolic health. A person with these traits may have a genetic tendency to store excess fat subcutaneously, protecting the liver and other critical organs. However, some experts warn that those who are healthy today may be silently developing chronic diseases that will emerge later on, particularly if excess fat collects in the abdomen.

Question 26

Are All Healthy Weight People Healthy?

Answer 26

About 20 percent of people whose weight falls within the healthy BMI range suffer from metabolic diseases, such as heart disease, insulin resistance, and hypertension. For comparison, these conditions afflict over 50 percent and 75 percent of people in the overweight and obese ranges, respectively. Metabolically unhealthy but normal-weight individuals may have a genetic tendency to deposit fat in the abdomen and internal organs, or perhaps their diet and exercise patterns are subpar. Whatever the cause, yearly blood tests and other tests from a health-care provider can reveal metabolic problems before they become severe.

Question 27

What happens inside your body when you take in more or less food energy than you spend. Like a cash budget, accumulates excess savings (in the form of fat gain) or draws own reserves (fat loss). Moreover, if more food energy is stored than can be spent over days or weeks, fat continues to accumulate in the adipose tissue. In contrast, if less energy is consumed than the amount used up, then fat is lost from the adipose tissue.

Answer 27

unbalanced energy budget

Question 28

Change in energy stores equals food energy taken in minus energy spent on metabolism activities.
- Change in energy stores=energy in - energy out

Too much or too little fat on the body today does not necessarily reflect today’s energy budget. Small imbalances in the energy budget compound over time.

Answer 28

daily energy balance

Question 29

This side of the body’s energy budget is measured in calories taken in each day in the forms of foods and beverages.

Answer 29

“energy in”

Question 30

No easy method exists for determining this side of a person’s energy balance equation of what an individuals spends and needs. In the past, it was said that for each 3,500 calories you expend in activity or eliminate from the diet, you lose one pound of body fat, but this was an oversimplification. A single number cannot accurately predict weight change in every individual because energy dynamics vary, both between individuals and within a single person at different phases of weight change. Estimating an individual person’s need requires knowing something about the person’s lifestyle and metabolism.

Answer 30

“energy out”

Question 31

You need to take in enough calories to cover your energy expenditure each day—your energy budget must balance. What are ways to estimate your energy needs:

Answer 31

• monitor personal food intake
• monitor own body weight over a period of time in which your activities are typical and are sufficient to maintain your health.

Question 32

Of energy output, the two major ways in which the body spends energy (energy expenditure) are what?

Answer 32

• to fuel its basal metabolism
• to fuel its voluntary activities (intentional activities (such as walking, sitting, or running) conducted by voluntary muscles.

Question 33

The largest component of the average person’s daily energy expenditure. The sum total of all the involuntary activities that are necessary to sustain life, including circulation, respiration, temperature maintenance, hormone secretion, nerve activity, and new tissue synthesis, but excluding digestion and voluntary activities. Requires energy to support the body’s work that goes on all the time without a person’s conscious awareness.

Answer 33

Basal metabolism

Question 34

A third energy component, the body’s metabolic response to food. In other words, the body’s speeded-up metabolism in response to having eaten a meal; also called diet-induced thermogenesis. Uses up about 10 percent of a meal’s energy value in stepped-up metabolism in the 5 or so hours after finishing a meal. This amount is believed to exert negligible effects on total energy expenditure.

Answer 34

thermic effect of food

Question 35

The rate at which the body uses energy to support its basal metabolism. Varies from person to person. Depending on activity level, a person whose total energy need is 2,000 calories a day may spend as many as 1,000 to 1,600 of them to support basal metabolism.

Answer 35

basal metabolic rate (BMR)

Question 36

What is the iodine-dependent hormone that directly controls basal metabolism? -the more secreted, the greater the energy spent on basal functions. The rate is lowest during sleep.

Answer 36

Thyroxine

Question 37

Factors that Affect BMR:

Answer 37

Age: BMR is higher in youth; as lean body mass declines with age, BMR slows. Physical activity may prevent some of this decline.

Height: Tall people have a larger surface area, so their BMRs are higher.

Growth: Children and pregnant women have higher BMRs.

Body Composition:
The more lean tissue, the higher the BMR. A typical man has greater lean body mass than a typical woman, making his BMR higher.

Fever: Fever raises BMR.

Stress: Stress hormones raise BMR.

Environmental temperature: Adjusting to either heat or cold raises BMR.

Fasting/Starvation: the hormones lower BMR.

Malnutrition: lowers BMR

Thyroxine: The thyroid hormone thyroxine is a key BMR regulator; the more thyroxine produced, the higher the BMR.

Question 38

People often wonder whether they can speed up their metabolism to spend more daily energy. The answer is both “no” and “yes.” You cannot increase your BMR very much today. You can, however, amplify the second component of your energy expenditure— what is it? If you do, you will spend more calories today, and if you keep doing so day after day, your BMR may also increase somewhat as you increase your lean body mass because lean tissue is more metabolically active than fat tissue.

Answer 38

voluntary activities

Question 39

Energy spent on voluntary activities depends on what 3 factors?

Answer 39

-weight
-time
-intensity

Question 40

The weight of the body’s lean tissues; body weight, minus fat tissue.

Answer 40

lean body mass

Question 41

A person wishing to know how much energy he or she needs in a day to maintain weight might look up this. The DRI value for average dietary energy intake in a healthy adult of a certain age, gender, weight, height, and level of physical activity that is predicted to maintain an energy balance consistent with good health. The printed values, reflect the average needs of only those people who exactly match the BMI, height, weight, and sex specified in the DRI table. People who deviate in any way from these characteristics must use other methods for determining their energy needs, and almost everyone deviates.

Answer 41

Estimated Energy Requirement (EER)

Question 42

DRI committee provides a way of estimating EER values for individuals. These calculations take into account the ways in which energy is spent and by whom. The equation includes:

Answer 42

Age:
The BMR declines with age, so age helps determine EER values.

Female or male:
Females generally have less lean body mass than males; in addition, female hormone fluctuations influence BMR, raising it just prior to menstruation.

Body size and weight:
The higher BMR of taller and heavier people calls for height and weight to be factored in when estimating a person’s EER.

Physical activity:
To help in estimating the energy spent on physical activity each day, activities are grouped according to their typical intensity

Growth:
BMR is high in people who are growing, so pregnant women and children have their own sets of energy equations.

Question 43

Learn:
Unhealthy underweight for adults is defined as a BMI of less than 18.5, overweight as a BMI of 25.0 through 29.9, and obesity as a BMI of 30 or more.

Question 44

What do BMI values fail to do:

Answer 44

• fail to indicate how much of a person’s weight is fat
• where fat is located
  These drawbacks limit the value of the BMI for use with:
  Athletes (because their highly developed musculature falsely increases their BMI values).

Pregnant and lactating females (because their increased weight is normal during child bearing).

Adults older than age 65 (because BMI values are based on data collected from younger people and because people “grow shorter” with age).

Females older than age 50 and others with too little muscle tissue (they may be overly fat for health yet still fall into the normal BMI range).

Question 45

The percentage of fat in a person’s body can be estimated by this. Researchers needing more precise measures of body composition may choose to perform this test. measurement of the thickness of a fold of skin and subcutaneous fat on the back of the arm (over the triceps muscle), below the shoulder blade (subscapular), or in other places, using a caliper; also called fatfold test.

Answer 45

skinfold test

Question 46

Body fat distribution can be determined by radiographic techniques, such as this. method of determining total body fat, fat distribution, and bone density by passing two low-dose X-ray beams through the body. Also used in evaluation of osteoporosis.

Answer 46

dual-energy X-ray absorptiometry (DEXA)

Question 47

The physiological need to eat, experienced as a drive for obtaining food; an unpleasant sensation that demands relief. Demands food, but the signals that oppose food consumption—that is, signals for satiation and satiety—are weaker and more easily overruled. Many signaling molecules, including hormones, help to regulate food intake.

Answer 47

Hunger

Question 48

the perception of fullness that builds throughout a meal, eventually reaching the degree of fullness and satisfaction that halts eating. Generally determines how much food is consumed at one sitting.

Answer 48

Satiation

Question 49

Makes itself known roughly four to six hours after eating, after the food has left the stomach and much of the nutrient mixture has been absorbed by the intestine. The physical contractions of an empty stomach trigger hunger signals, as do chemical messengers acting on or originating in the brain’s hypothalamus

Answer 49

Hunger and process

Question 50

Described as the central hub for energy and body weight regulation, and i can sense molecules representing all three of the energy nutrients.

Answer 50

Hypothalamus

Question 51

Hormone that is a powerful hunger stimulant that opposes weight loss. Is secreted by stomach cells but works in the hypothalamus and other brain tissues to stimulate appetite and increase body weight and body fat. Help regulate other diverse body functions such as blood glucose, inflammation, and sleep. Also influences sleep, and a lack of sleep causes an increase in the blood ghrelin. his may help explain why too little sleep, a heightened desire for high-calorie foods, and weight gain often occur together.

Answer 51

ghrelin

Question 52

A person can experience this without hunger. For example, the aroma of hot apple pie or the sight of a chocolate fudge brownie after a big meal can trigger a chemical stimulation of the brain’s pleasure centers, thereby creating a desire for dessert despite an already full stomach. Here is the answer to the question at the start of the chapter: “Why do you feel tempted by a favorite treat when you don’t feel hungry?” Your brain chemistry responds to cues, such as sight or aroma, about the availability of delicious foods. In contrast, a person who is ill or under sudden stress may physically need food but not have this.

Answer 52

Appetite

Question 53

Factors affects appetite include:

Answer 53

Appetite stimulants or depressants, other medical drugs.

Cultural habits (cultural or religious acceptability of foods).

Environmental conditions (people often prefer hot foods in cold weather and vice versa).

Hormones (for example, sex hormones).

Inborn appetites (inborn preferences for fatty, salty, and sweet tastes).

Learned preferences (cravings for favorite foods, aversion to trying new foods, and eating according to the clock).

Social interactions (companionship, peer influences).

Some disease states (obesity may be associated with increased taste sensitivity, whereas colds, flu, and others, as well as zinc deficiency reduce taste sensitivity and appetite).

Question 54

Involved in satiation. Sensations of pleasure and satisfaction here diminish with repeated exposure to a particular texture or taste during a meal.

Answer 54

Mouth

Question 55

Involved in satiation. These in the stomach sense the stomach’s distention with a meal and fire, sending a signal to the brain that the stomach is full.

Answer 55

Nerve stretch receptors

Question 56

Involved in satiation. As nutrients enter here, they stimulate other receptor nerves and trigger the release of hormones signaling the hypothalamus about the size and nature of the meal.

Answer 56

small intestine

Question 57

Involved in satiation. This detects absorbed nutrients delivered by the bloodstream, and it responds by releasing neurotransmitters hat suppress food intake.

Answer 57

Brain

Question 58

Learn:
A dieter may report “My stomach has shrunk,” but the stomach has simply adjusted to smaller meals. At some point during food deprivation, hunger returns with a vengeance and can lead to bouts of extensive overeating.
Just as quickly, the stomach’s capacity can adapt to larger meals until moderate portions no longer satisfy. This observation may partly explain the increasing U.S. calorie intakes: popular demand and food industry marketing have led to larger and larger food portions, while stomachs across the nation have adapted to accommodate them.

Question 59

Active during satiety. One of adipokine hormones produced by adipose tissue in direct proportion to body fat content. An appetite-suppressing hormone produced in the fat cells that conveys information about body fat content to the brain; believed to be involved in the maintenance of body composition (leptos means “slender”).
travels from the adipose tissue via the bloodstream to the brain’s hypothalamus, where it triggers signals that suppress appetite, dampen sensitivity to sweet taste, and increase energy expenditures, factors that shift the body toward fat loss. A loss of body fat, in turn, brings the opposite effects—suppression of this leads to increased appetite, reduced energy expenditure, and accumulation of fat. Operations on a feedback mechanism—the fat tissue that produces this is ultimately controlled by it. In rare cases, human obesity arises from an inherited inability to produce it but giving injections of this can quickly reverse both obesity and insulin resistance.

Answer 59

Leptin

Question 60

Of the three energy-yielding nutrients, what generally has the greatest satiating effect during a meal?

Answer 60

Protein

Question 61

What energy-yielding nutrient tends to hold insulin steady between meals, minimizing dips in blood glucose that prompt eating?

Answer 61

Carbohydrates

Question 62

What energy-yielding nutrient is famous for triggering a hormone that contributes to long term satiety, goes almost unnoticed by the appetite control system during consumption of a meal. This makes this nutrient the least satiating among the energy nutrients.

Answer 62

Fats

Question 63

A theory stating that the body’s regulatory controls tend to maintain a particular body weight (the set point) over time, counteracting efforts to lose weight by dieting. The body may reset its metabolism to counteract fluctuations in body fat. This may also explain why some people so easily regain lost weight, while some others maintain their losses over time.

Answer 63

set-point theory

Question 64

Some people tend to expend more energy in metabolism than do others. The body’s working enzymes normally “waste” a small percentage of energy as heat in a process called this. It is the generation and release of body heat associated with the breakdown of body fuels. Certain enzymes expend copious energy in this, producing heat but performing no other useful work. As more heat is radiated away from the body, more calories are spent, and fewer calories are available to be stored as body fat. Does not assist in weight loss. At a level not far above normal, energy-wasting activity is lethal to cells. Sham “metabolic” diet products may claim to increase t, but no this tricks of metabolism can produce effortless fat loss.

Answer 64

thermogenesis

Question 65

One tissue extraordinarily gifted in thermogenesis is this. A type of adipose tissue abundant in hibernating animals and human infants and recently identified in human adults. Abundant pigmented enzymes of energy metabolism give this a dark appearance under a microscope; the enzymes release heat from fuels without accomplishing other work. Also called brown fat. In other words, a well-known heat-generating tissue of animals and human infants that that expends energy liberally. Intriguingly, muscular work or even shivering from cold exposure appear to trigger a normally dormant type of adipose cell to act more like this metabolically, but the significance of this finding to weight management is unknown.

Answer 65

brown adipose tissue (BAT)

Question 66

Particular strains of bacteria commonly populate the intestinal tract of people who maintain a healthy body weight, while other strains more often occur with obesity. This can be healthy by consuming the fiber-rich whole foods that support species of bacteria associated with leanness and health

Answer 66

Intestinal microbiome

Question 67

Learn:
Is Obesity Genetic?
It stands to reason that it might at least be influenced by genes, because genes carry the instructions for making enzymes, and enzymes control energy metabolism. “I’m fat because my father is fat,” says one person, and another agrees: “Everyone in my family is fat.” Data from family histories reveal that obesity often persists for generations. For someone with at least one obese parent, the chance of becoming obese is estimated to fall between 30 and 70 percent.

Geneticists have identified more than 300 genes likely to play roles in obesity development. For example, one genetic disorder afflicting a small percentage of people produces excessive appetite and severe obesity, but this is rare; common obesity does not arise from a single gene. Genetic differences do not account for the great majority of human obesity. Today, researchers are focusing beyond the genes to molecules that modify DNA activity—the epigenome.

Question 68

A collection of molecules associated with chromosomes that modulate protein replication at the level of the genes. Molecules that modify DNA activity. When critical changes occur in this before birth, they may have a lifelong impact on body weight and health.

Answer 68

Epigenome
Epi is a Greek prefix, meaning “above” or “on.”

Question 69

Pleasure-evoking experiences of all kinds cause brain cells to release this neurotransmitter. Facilitates many important functions in the brain, including cognition, pleasure, motivation, mood, sleep, and others. Stimulates the reward areas of the brain. The result is feelings of pleasure and desire that create a motivation to repeat the experience. Our highly palatable, fat- and sugar-rich food supply could change the brain’s reward system and make overeating and weight gain likely. It happens reliably in the brains of rats fed on a changing variety of cookies, cheese, sugar, and other tasty items, and authorities debate whether this effect may occur in people, too.

Answer 69

Dopamine

Question 70

accompanies complex human sensations such as loneliness, yearning, craving, addiction, and compulsion. Any kind of prolonged stress may also cause this and weight gain. Perception of size also influence this.

Answer 70

Overeating

Question 71

Some people may be obese not because they eat too much but because they move too little—both in purposeful exercise and in the activities of daily life. Sedentary screen time has all but replaced outdoor play for many people. This is a concern because the more time people spend in sedentary activities, the more likely they are to be overweight—and to incur the metabolic risk factors of heart disease (high blood lipids, high blood pressure, and high blood glucose).

Answer 71

Physical inactivity

Question 72

Learn:
According to the American College of Sports Medicine–
- 150 to 250 minutes per week of physical activity of moderate intensity can help prevent initial weight gain.
- More than 250 minutes per week, particularly when combined with a lower calorie intake, promotes weight loss and may help prevent regain after loss.
- Both aerobic (endurance) and muscle-strengthening (resistance) activities are beneficial, but most people must also restrict calorie intakes to achieve meaningful weight loss.

Question 73

To lose fluid, for example, you can take this (diuretic), causing the kidneys to siphon extra water from the blood into the urine, or you can exercise while wearing heavy clothing in hot weather to cause abundant fluid loss in sweat. Not recommended.

To gain water weight, you can overconsume salt and water; for a few hours, your body will retain water until it manages to excrete the salt. (This, too, is not recommended.) Most quick weight-change schemes produce large losses of body fluids that register dramatic, temporary changes on the scale.

Learn: nicotine e-cigarettes can suppress appetite.

Answer 73

“water pill”

Question 74

The Body’s Response to Fasting:

Answer 74

If a person doesn’t eat for, say, three whole days, then the body makes one adjustment after another. Less than a day into the fast, the liver’s glycogen is essentially exhausted. Where, then, can the body obtain glucose to keep its nervous system going? Not from the muscles’ glycogen because that is reserved for the muscles’ own use. Not from the abundant fat stores most people carry because these are of no use to the nervous system. The muscles, heart, and other organs use fat as fuel, but at this stage, the nervous system needs glucose. Fat cannot be converted to glucose—the body lacks enzymes for this conversion. The body does, however, possess enzymes that can convert protein to glucose. Therefore, an underfed body sacrifices the proteins in its lean tissue to supply raw materials from which to make glucose.
If the body were to continue to consume its lean tissue unchecked, death would ensue within about 10 days. After all, in addition to skeletal muscle, the blood proteins, liver, digestive tract linings, heart muscle, and lung tissue—all vital tissues—are being burned as fuel. (Fasting or starving people remain alive only until their stores of fat are gone or until half their lean tissue is gone, whichever comes first.) To prevent this, the body puts a key strategy into action: it begins converting fat into ketone bodies, which some nervous system tissues can use for energy, and so forestalls the end. This metabolic strategy is ketosis, an adaptation to fasting or carbohydrate deprivation.

Question 75

In this, instead of breaking down fat molecules all the way to carbon dioxide and water, the body takes partially broken-down fat fragments and combines them to make ketone bodies, compounds that are normally kept to low levels in the blood. It converts some amino acids—those that cannot be used to make glucose—to ketone bodies, too. These ketone bodies circulate in the bloodstream and help to feed the brain; about half of the brain’s cells can make the enzymes needed to use ketone bodies for energy. Under normal conditions, the brain and nervous system devour glucose—about 400 to 600 calories’ worth each day. After about 10 days of fasting, the brain and nervous system can meet most, but not all, of their energy needs using ketone bodies. Thus, indirectly, the nervous system begins to feed on the body’s fat stores. reduces the nervous system’s need for glucose, spares muscle and other lean tissue from being quickly devoured, and prolongs the starving person’s life. Thanks to this, a healthy person starting with average body fat content and given only water can live totally deprived of food for as long as 6 to 8 weeks.

Answer 75

Ketosis

Question 76

Summary to copy down of the body’s response to fasting:

Answer 76

The brain and nervous system cannot use fat as fuel and demand glucose.

Body fat cannot be converted to glucose.

Body protein can be converted to glucose.

Ketone bodies made from fat can feed some nervous system tissues and reduce glucose needs, sparing protein from degradation.

Question 77

This form of prolonged calorie restriction has been reported to extend life, fend off chronic diseases, and improve cognition. Over time, it can become harmful when tissues lack the nutrients they need to assemble new enzymes, red and white blood cells, and other vital components; when it causes lean tissue loss; or when ketosis leads to excessive mineral losses in the urine. A warning about this is in order; many people with eating disorders report that fasting or severe food restriction was associated with their loss of control over eating.

Answer 77

fasting

Question 78

Any of a number of temporal patterns of consuming no or little food energy during some portion of a 24-hour day, interspersed with days of normal eating. say, a day or two a week—has not proven superior to ordinary calorie restriction for weight loss.

Answer 78

intermittent fasting

Question 79

Four sources of energy—the three energy-yielding nutrients and alcohol—may enter the body, but they become only two kinds of energy stores known as what?

Answer 79

glycogen and fat

Question 80

the alcohol of alcoholic beverages, slows down the body’s use of fat for fuel by as much as a third, causing fat to be stored. Body tissues preferentially metabolize this for energy in place of relatively benign fat as a strategy to defend themselves against damage from too much of this.

Answer 80

This strategy may help to explain the excess abdominal fat tissue of the “beer drinker’s belly,” actually fat on the thighs, legs, or anywhere the person tends to store surplus fat. Alcoholic beverages are therefore fattening, both through the calories they provide and through alcohol’s effects on fat metabolism. Once alcohol addiction sets in, however, people often become thin and malnourished as their body organs fail and their normal appetite for food is replaced by an appetite for alcohol.

Question 81

Learn:
Almost any food can make you fat if you eat enough of it. A net excess of energy is almost all stored in the body as fat in fat tissue.

Fat from food is particularly easy for the body to store as fat tissue.

Protein is not held in the body in a storage form. It exists only in muscle and other working proteins.

Muscle protein is broken down to yield glucose when the brain runs out of carbohydrate energy.

Dietary protein in excess of need contributes to body fat accumulation.

Alcohol both delivers empty calories and facilitates storage of body fat.

Question 82

Identifying fad or weight loss scams:

Answer 82

Bases evidence for its effectiveness on anecdotes and testimonials.

Blames weight gain on a single nutrient, such as carbohydrate, or constituent, such as gluten.

Claims to “alter your genetic code” or “reset your metabolism.”

Eliminates an entire food group, such as grains or milk products.

Fails to include all costs up front.

Fails to mention potential risks.

Fails to plan for weight maintenance following loss.

Guarantees an unrealistic outcome, such as losing 10 pounds in 3 days.

Promises easy weight loss with no change in diet or activity; for example, “Lose weight while you sleep.”

Promotes devices, drugs, products, or procedures not approved by the U.S. Food and Drug Administration (FDA) or not scientifically evaluated for safety or effectiveness.

Specifies a proportion of energy nutrients not in keeping with DRI ranges.

Recommends using a single food, such as grapefruit, as the key to the program’s success.

Requires you to buy special products not readily available in ordinary supermarkets.

Has any of the other characteristics of quackery

Question 83

A currently popular low–carbohydrate diet. At first, a person on any low-carbohydrate diet may lose a few more pounds, largely of water weight associated with glycogen loss, than those consuming a balanced diet, a fact that helps explain the enduring popularity of such schemes. Given time, however, this low-carbohydrate diets perform no better than balanced, calorie-restricted diets and people often find them difficult to follow for months on end. Health risks accompany diets too low or too high in carbohydrate. A diet with less than 40 percent of its calories from carbohydrate may increase mortality risk, particularly when animal protein or fat replaces the carbohydrate in the diet. Effects from this diet are: Constipation, Elevated uric acid (which may exacerbate kidney disease and cause inflammation of the joints in those predisposed to gout), Fatigue, In pregnant women there can be fetal harm and stillbirth, Low blood pressure, muscle cramps, nausea, and bad breath.

Answer 83

keto diet, or ketogenic diet

Question 84

This energy nutrient can produce enough satiety to help prevent between meal hunger from derailing a diet plan. This along with exercise can help minimize muscle loss and side effect of calorie restriction and fat loss. Research suggests this can facilitate weight loss and maintain muscle mass, so long as the dieter can stick with a reduced-calorie diet over time. In higher intakes though it can facilitate weight gain.In contrast, plain yogurt, peanut butter, walnuts, other nuts, chicken without skin, low-fat cheese, and seafood are associated with a healthy body weight.

Answer 84

Protein

Question 85

A popular diet intended for weight loss. Claim that modern day dieters should eat like their hunter-gatherer forebears of the Paleolithic Period (Old Stone Age) some 2.5 million years ago. Today, these diets allows consumption of meat, fish, eggs, certain fruits and vegetables, nuts, and seeds, but prohibits processed, ultraprocessed, and refined foods, and products of agriculture. People consuming this diet take in far less sodium and sugar than the average eater. However, in eliminating whole grains, dairy, and legumes, they miss out on valuable fibers, phytochemicals, plant-based protein sources, and some key vitamins and minerals, all factors associated with good health in study after study. Most people associate the “cave man” diet with red meat, but the real denizens of the Paleolithic Period ate any foods at hand, which varied greatly with season and location. They ate no beef or pork as we know it today—more than 2 million years would pass before people domesticated livestock. Instead, their primary foods included plants, insects, and small animals, but evidence suggests that some ate barley and legumes, and may have ground barley into flour. They also swallowed dirt and rocks, and often died young from the effects of starvation and malnutrition. They labored physically every day to survive.

Answer 85

Paleo diets

Question 86

For some weeks or months, weight loss may proceed rapidly. Eventually, these factors may contribute to a slowdown in the rate of loss:

Answer 86

Metabolism may slow in response to a lower calorie intake and loss of metabolically active lean tissue.

Less energy may be expended in physical activity as body weight diminishes.

Question 87

Learn:
Dietary patterns should also be moderate in red and processed meat and refined grains and low in salty foods and sugar-sweetened foods and beverages. Such patterns, including Healthy Vegetarian and Healthy Mediterranean-style patterns, provide nutrient adequacy, reduce inflammation, and are generally associated with health and leanness.

Question 88

a disturbance in the daily eating rhythm associated with obesity, characterized by eating more than half of the daily calories after 7 p.m., awakening frequently at night to eat, and overconsuming calories.

Answer 88

night eating syndrome

Question 89

A dietary pattern consisting mostly of foods that are high in this is often associated with being both undernourished and overweight. Its a measure of the energy provided by a food relative to its weight (calories per gram). urning this around, people who wish to be leaner and to improve their nutrient intakes would be well advised to select mostly foods of low energy density. In general, foods high in fat or low in water, such as fatty meats, cookies, or chips, rank high in energy density; foods high in water and fiber, such as fruit and vegetables, rank lower. Foods with lower energy density are bulkier, providing more bites for fewer calories, and thus may be more satisfying

Answer 89

energy density

Question 90

FDA approved but not often prescribed. For people who are overweight with a BMI of greater than 30 (greater than 27 with heart disease or its risk factors), the benefits of weight loss achieved with the help of these that may outweigh their substantial side effects. These only help temporarily while they are being taken.

Answer 90

Obesity Medications

Question 91

This is an option for a person with severe obesity- that is someone whose BMI is greater than 40 (greater than 35 with coexisting heart disease or its risk factors)—urgently needs to reduce body fat. Not a sure cure for obesity. Some people do not lose the expected pounds, and others who lose weight initially regain much of it in a few years’ time. Some people require additional treatments for acid reflux; gallstones; infections; nausea, vomiting, diarrhea, and dehydration; low blood glucose, and other conditions that may arise following this. Severe nutrient deficiencies often pose a major threat to health in the years following this. Vitamin D deficiency results in bone abnormalities, and vitamin A deficiency causes night blindness and other vision problems. Thiamin deficiency disease, once rare in this country, is becoming more prevalent today as obesity surgeries grow in number. Iron, copper, zinc, vitamin
, other B vitamins, and other deficiencies are also likely, but nutrient deficiencies can generally be corrected with appropriate supplements. Life-long nutrition and medical supervision following this is a must.

Answer 91

Surgery

Question 92

are associated with the onset of eating disorders. Many dietary supplement products pose substantial risks of toxicity because their ingredients are not strictly regulated. One previously healthy 28-year-old bodybuilder was hospitalized in a coma after taking a dietary supplement containing a known liver toxin, sold to her as a “fat burner.” A harmful supplement, ephedra (also called ma huang and banned by the FDA), is sold as a weight-loss “dietary supplement” but has caused cardiac arrest, abnormal heartbeats, hypertension, strokes, seizures, and death. These and many other risky weight-loss “supplements” remain available online.

Answer 92

OTC diet pills

Question 93

A collaborative, client-centered form of counseling to resolve ambivalence and strengthen motivation for change. A technique developed to help clients break through resistance, can lead to the personal decision of whether to change a behavior.
The following five principles of approach:

• Create discrepancy: help the client recognize differences between their goals and their present behaviors.
• Use empathy and reflective listening: reword what the client has said to ensure understanding.
• Avoid confrontation: avoid imposition of opposing viewpoints.
• Adapt to resistance: work with resistance and accept it.
• Support self-efficacy and optimism for success: facilitate self-discovery that leads to behavior change.

Answer 93

motivational interviewing (M)

Question 94

Once a person is ready to change, a popular meditation technique, this may help enact the change. A meditation technique of behavior change therapy that focuses awareness on the present moment with an attitude of curiosity, openness, and acceptance rather than judgment and control. When individuals become aware of their eating behaviors by focusing on the sensory qualities of food and the body’s sensations, they can fully experience each eating occasion, including appetite and satiety signals as they arise. Exploring one’s own eating behaviors and motivations with curiosity and acceptance but without judgment may ultimately help the individual abandon or reduce unhealthy eating behaviors, particularly those surrounding cravings and binge eating. In research, study subjects using these techniques lose about the same amount of weight as those using more traditional approaches.

Answer 94

Mindfulness Training

Question 95

works by altering both thought processes and behaviors. It is based on the knowledge that habits drive behaviors. Suppose a friend tells you about a shortcut to class. To take it, you must make a left-hand turn at a corner where you now turn right. You decide to try the shortcut the next day, but when you arrive at the familiar corner, you turn right as always. Not until you arrive at class do you realize that you failed to turn left, as you had planned. You can learn to turn left, of course, but at first, you will have to make an effort to remember to do so. After a while, the new behavior will become as automatic as the old one was.

A food and activity diary is a powerful ally to help you learn what particular eating stimuli, or cues, affect you. Such self-monitoring is indispensable for learning to control eating and exercising cues, both positive and negative, and for tracking your progress. Once you identify the behaviors you need to change, set your priorities, and begin with a few you can handle—practice until they become habitual and automatic, and then select one or two more. For those striving to lose weight, learning to say “No, thank you” might be among the first habits to establish. Learning not to “clean your plate” might follow.

Answer 95

Behavior Modifications

Question 96

Behavior researchers have identified six elements useful in replacing old eating and activity habits with new ones:

Answer 96

Eliminate inappropriate eating and activity cues.
-Don’t buy problem foods, Eat in one place at the designated time, Shop when not hungry, Replace large plates, cups, and utensils with smaller ones., Avoid vending machines, fast-food restaurants, and convenience stores., Serve individual plates; don’t serve “family style.”, Measure your portions; avoid large servings or packages of food.,

Suppress the cues you cannot eliminate.
- Remove food from the table after eating a meal., Create obstacles to consuming problem foods—wrap them and freeze them, making them less quickly accessible., Control deprivation; plan and eat regular meals., Limit screen time and other sedentary activities to one hour a day., Slow down eating—always use utensils and put them down between bites., Leave some food on your plate.

Strengthen cues to appropriate eating and activities.
- Choose to dine with companions who make appropriate food choices., Learn and use appropriate portion sizes., Join active groups; ask for reminders., Keep sports and play equipment by the door., Move more—shake a leg, pace, stretch often; join active groups.

Repeat the desired eating and physical activity behaviors.

Arrange or emphasize negative consequences of inappropriate eating or sedentary behaviors.
- Ask that others respond neutrally to your deviations (make no comments—even negative attention is a reward).

If you slip, don’t punish yourself.

Arrange or emphasize positive consequences of appropriate eating and exercise behaviors.
- Buy tickets to sports events, movies, concerts, or other nonfood amusement.
Get a massage; indulge in a small purchase; buy flowers.
Take a hot bath; read a good book; nap; relax.
Treat yourself to a lesson in a new activity such as handball or tennis.
Praise yourself; visit friends.

Question 97

a disturbance in eating behavior that jeopardizes a person’s physical or psychological health.

Answer 97

eating disorder

Question 98

an eating disorder characterized by extreme restriction of energy intake relative to requirements, leading to a dangerously low body weight and a disturbed perception of body weight and shape; seen (usually) in teenage girls and young women. People with this causes body tissues to deplete of needed vitamins and minerals, along with carbohydrate, fat, and protein. A young person’s growth ceases, normal development falters, and so much lean tissue is lost that basal metabolic rate slows and body temperature drops. Criteria of this focus on people who:
Restrict calorie intake to the point of developing a too-low body weight for health.

Have an intense fear of body fat or of weight gain (although they often deny it), or strive to prevent weight gain although underweight.

Hold a false perception of body weight or shape, exaggerate the importance of body weight or shape in their self-evaluation, or deny the danger of being severely underweight.

Answer 98

anorexia nervosa (anorexia means “without appetite”; nervos means “of nervous origin”).

Question 99

recurring episodes of binge eating combined with a morbid fear of becoming fat, usually followed by self-induced vomiting, misuse of laxatives or diuretics, fasting, or excessive exercise. The person that has this is aware that their behavior is abnormal unlike anorexia. Family counseling, structured eating and exercising plan are forms of treament.

Answer 99

bulimia

Question 100

an eating disorder whose criteria are similar to those of bulimia nervosa, excluding purging or other compensatory behaviors. Respond more readily to treatment than other eating disorders.

Answer 100

binge eating disorder

Question 101

a strong laxative. normally used by people with bulimia in purging process and anorexia nervosa.

Answer 101

cathartic

Question 102

psychological therapy aimed at changing undesirable behaviors by changing underlying thought processes contributing to these behaviors; in anorexia, a goal is to replace false beliefs about body weight, eating, and self-worth with health-promoting beliefs.

Answer 102

cognitive behavioral therapy

Question 103

an agent that causes vomiting. normally used by people with bulimia in purging process.

Answer 103

emetic

Question 104

a potentially fatal triad of medical problems seen in female athletes: low energy availability (with or without disordered eating), menstrual dysfunction, and low bone mineral density.

Answer 104

female athletic triad

Question 105

Treatment of anorexia nervosa requires a multidisciplinary approach that addresses two areas of concern:

Answer 105

the first relating to food and weight and the second involving psychological processes.