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252 - intro to phys act final > Chapter 9 : Designing weight management and body comp programs > Flashcards

Chapter 9 : Designing weight management and body comp programs Flashcards

1
Q

What is the definition of obesity?

A
  • An excessive amount of body fat relative to body weight
  • BMI 95th percentile for age and sex and more for kids/teens
  • 30 kg/m2 in adults
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2
Q

Risks of obesity?

A
  • Cardiovascular ischemic HD
  • Stroke
  • Dyslipidemia
  • Hypertension
  • Glucose intolerance
  • Insuline resistance
  • Diabetes mellitus
  • Obstructive pulmonary disease
  • Osteoarthritis
  • Cancers (colon, prostate, ovary, breast, endometrium, cervix, esophagus, gallbladder)
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3
Q

Risks of being underweight?

A
  • Fluid-electrolyte imbalance
  • Osteoporosis
  • Osteopenia
  • Bone fractures
  • Muscle wasting
  • Cardiac arrhytmias
  • Sudden death
  • Pulmonary edema
  • Renal disorders
  • Reproductive disorders
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4
Q

What are the different types of obesity?

A

Android and gynoid obesity

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5
Q

Characteristics of android obesity?

A
  • Upper body obesity
  • Apple-shaped
  • More typical in males
  • Post menopausal women
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6
Q

What are the characteristics of gynoid obesity?

A
  • Lower body obesity
  • Pear-shaped
  • More typical in females
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7
Q

What are the different subtypes of obesity?

A
  • Metabolically healthy, but obese (MHO)
  • Metabolically obese, but normal weight (MONW)
  • Metabolically unhealthy and obese (MUHO)
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8
Q

What are the differences between MONW and MUHO?

A
  • MONW: Low BMI

- MUHO: High BMI

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9
Q

Causes of obesity and overweight?

A

Physiological ( metabolism and energy balance, hormones), developmental, genetic, life style and psychosocial factors

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10
Q

What is the difference between direct and indirect calorimetry?

A
  • Direct calorimetry: used to measure the energy yield and caloric equivalent of various foods
  • Indirect calorimetry: Used to measure energy expenditure during basal, resting or activity states. And energy expenditure estimates from O2 utilization (1L O2 = 5kcal)
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11
Q

What is energy or caloric need dependent upon?

A

Metabolic rate and physical activity level

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12
Q

What is the energy yield of carbohydrates, protein and fat?

A
  • Carbohydrate: 4.1 kcal/g
  • Protein: 4.3 kcal/g
  • Fat: 9.3 kcal/g
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13
Q

What is basal metabolic rate (BMR)?

A

A measure of the minimal amount of energy (kcal) needed to maintain basic and essential physiological functions such as breathing, blood circulation and temperature regulation

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14
Q

What is the resting metabolic rate (RMR)?

A

The energy required to maintain essential physiological processes in a relaxed, awake and reclined state (10% higher than BMR)

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15
Q

When are BMR and RMR measured?

A
  • BMR (actually RMR that is assessed): at least 12 hours rested and fasted in a controlled environment
  • RMR: measured 3-4 hours after a light meal without prior physical activity
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16
Q

How can TEE be measured or estimated?

A
  • Doubly-labeled water method (gold standard)
  • Prediction equations (age and gender specific)
  • Indirect calorimetry
  • Digital activity log
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17
Q

Which factors affect RMR?

A
  • Heredity and environment
  • Hormones
  • Age
  • Gender
  • Body composition
  • Body size
  • Weight loss /gain
  • Exercise
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18
Q

Factors that increase RMR?

A
  • Hot, humid environments
  • GH, epinepherine, norepinepherine, sex hormones
  • Men higher than women
  • More muscle
  • Larger body surface area
  • Weight gain
  • Exercise
19
Q

Factors that decrease RMR

A
  • Underproduction of thyroxine
  • Age (decrease 2-5% every decade after 25)
  • Weight loss
20
Q

What is energy balance?

A
  • Static energy balance approach:
    Assumes that a change in one side of EB equation does not influence the other
  • Dynamic energy balance approach:
    numerous biological and behavioural factors regulate/influence both sides
21
Q

What are the assumptions of the static and dynamic energy balance approaches?

A
  • Exclusive loss of adipose tissue
  • Each lb of adipose tissue contains 87% fat (395g)
  • 1lb= 454 g
  • 1lb= 3555 kcal
22
Q

What is the importance of energy balance relative to the design of weight management and body composition programs?

A

Negative energy balance (more out than in) or

Positive energy balance (more in than out)

23
Q

What is Wishnofsky’s Rule?

A

Every 1lb of fat is 3500kcal

24
Q

According to the Dynamic Energy Balance approach, does an energy deficit of 3500 kcal per week correspond to a 1-lb loss of body weight or fat?

A

Yes

25
Q

What is the difference between hypertrophy and hyperplasia of fat cells?

A

Hypertrophy is the increase in size, hyperplasia is the increase in number

26
Q

What are the key components of a weight management program?

A

Proper nutrition and daily physical activity

27
Q

What are the preliminary steps in the design of a weight management program?

A
  • Set Body Weight Goals

- Assessing Energy (caloric) intake/expenditure

28
Q

Setting body weight goals

A
  • Assess body weight, BMI or body fat levels

- Use body composition technique to estimate a clients healthy body weight and body fat levels (assess FFM and %BF)

29
Q

Assessing Energy Intake

A
  • Food record and RDA profile
  • record type and quantity of foods consumed each day for 3-7days
  • assess average daily caloric intake
  • compare average nutrient intake of each nutrient to recommend amounts
  • analyze dietary patterns
30
Q

Assessing Energy Expenditure

A
  1. Factorial Method

2. Total Energy Expenditure (TEE)

31
Q

Factorial method

A

TEE (kcal)= RMR+Occupational Activity + Physical Activity

32
Q

Total Energy Expenditure Method

A
  • Estimated using prediction equation derived from doubly-labeled water measures of TEE in free-living individuals
  • Equations predict TEE from a clients age, body weight, height and physical activity coefficient (PAC)
33
Q

How are a client’s RMR, occupational activity level, and physical activity level determined using the factorial method?

A
  • RMR: Indirect calorimetry
  • Occupational activity level: Work, household chores, personal daily activities and exercise
  • Physical activity: Physical activity log used to estimate additional caloric expenditure due to physical activity and exercise
34
Q

How can you obtain a quicker but less accurate estimate of RMR when using the factorial method to assess a client’s energy needs?

A

Prediction equations

35
Q

Which equations were widely used in the past to estimate RMR?

A
  • Body Surface Area (BSA)
  • Harris-Benedict Equation
  • Mifflin et al. Equations
  • FFM
  • Quick estimate from body mass
36
Q

Which equations are recommended to estimate the RMR of healthy individuals by the American Dietetic Association?

A

Mifflin equation

37
Q

Which equations that are used to estimate RMR take into account the gender, height, weight, and age of a client?

A
  • Harris-Benedict Equation

- Mifflin et al. Equation

38
Q

What is the physical activity coefficient (PAC)?

A
  • The physical activity coefficient depends on your clients physical activity level (PAL)
  • PAL= TEE/BMR
39
Q

How is a client’s physical activity level (PAL) determined?

A
  • Self reported physical activity level
  • Physical activity diaries
  • Pedometers
  • Accelerometers
  • Heart rate monitors
  • Digital activity logs
40
Q

What is the gold standard for determining PAL and measuring TEE?

A

Prediction equations derived from doubly-labeled water measures of TEE in free living individuals

41
Q

Weight management principles for weight loss

A
  • Well balanced diet for good nutrition
  • No more than 2 lbs per week
  • Caloric intake should not be less than 1200kcal/day
  • Caloric deficit should not exceed 1000 kcal/day
  • Calorie deficit of 3500kcal is needed to lose 1lb of fat
  • Weight loss due to fat not LBM
  • Weight loss rate decreases over time
  • Men lose weight faster due to higher RMR
  • Should eat at least 3 meals/day
  • Fast weight loss methods should be avoided
  • Carnitine supplementation does not promoted body fat loss
  • Compulsive eating disorders should be identified and modified
42
Q

What is the amount of weight loss in pounds recommended by CSEP?

A

1.1-2.2 pounds per week

43
Q

What are the reasons that exercise is an essential part of weight loss programs?

A
  • Maximizes energy expenditure
  • Larger negative energy balance
  • In creases fat loss when combined with diet
  • Maintains/slows loss of FFM that occurs while only dieting
  • Maintains weight loss after dieting
  • Positive effect on RMR
  • Counter the reduction in RMR that occurs while dieting
  • Increase post exercise RMR
44
Q

Exercise Program Design for weight loss

A
  • Moderate weight loss >150mins of PA and exercise/week
  • Significant weight loss:
    >250 mins of PA and exercise/week
  • Add resistance training to increase lean body mass, increase loss of fat mass and prevent declines in metabolic rate
  • Light intensity PA can make a substantial contribution to daily energy expenditure

252 - intro to phys act final (7 decks)

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