EXSC 480 Exam 2 Flashcards
(142 cards)
1
Q
Things that need to be evaluated before beginning a weight loss program
A
Risk Motivation Medical History Body weight history diet history Repro history Social history Drug history
2
Q
Risk is based off of
A
BMI Wasit circumference Coronary Risk Diabetes Dyslipidemia Cigarette smoking Sleep apnea
3
Q
Motivation steps
A
Precontemplation Contemplation Preparation Action Maintenance Termination
4
Q
Medical history
A
Risk factors
CVD, diabetes, hypertension, gallstones, etc
5
Q
Physical Exams
A
Vital signs
BMI
BP/HR, fasting lipids, blood sugar levels
sleep apnea
6
Q
sleep apnea symptoms
A
STOP BANG snoring tired apnea pressure
BMI >35
age >50
neck circumference >16 in
Gender
7
Q
Body weight history
A
weight gain/loss over time previous weight loss attempts diet history PA family history
8
Q
Social history
A
cigarette smoking
9
Q
Body compartments
A
Fat mass
Fat Free mass
10
Q
Fat-free mass
A
everything excluding fat
bone, body water (73%), protein
11
Q
Anthropometric clinical tools
A
height/weight
skinfold thickness
bodily circumference
12
Q
Body composition clinical tools
A
BIA
DXA
BOD POD
Hydrostatic weighing
13
Q
Imaging clinical techniques
A
MRI
CT Scan
Ultrasound
14
Q
BMI strengths
A
easy to use on large populations
quick, effective, inexpensive
15
Q
BMI weaknesses
A
only assesses weight not % body fat
16
Q
Skinfolds strengths
A
easy to use, quick, effective, inexpensive
17
Q
Skinfold weaknesses
A
age/gender, skill of person giving test, prediction equations
greatest error
18
Q
BIA strength
A
easy to use, quik, effective
19
Q
BIA weaknesses
A
hydration
temp
menstruation
not as good as skinfold
20
Q
hydrostatic weighing strengths
A
more accurate than skinfolds or BMI
2 compartment
21
Q
hydrostatic weighing weaknesses
A
varies w/menstruation
22
Q
BOD POD strengths
A
retest reliability
suited for many people
quick
easy to use
23
Q
BOD POD weaknesses
A
expesnive
not common
24
Q
DXA strengths
A
GOLD STANDARD
high validity, closest to CT/MRI
25
DXA weaknesses
expensive
type of beam
hydration
26
CT/MRI strengths
noninvasive
most accurate
measures all body compartments
27
CT/MRI weaknesses
high cost
time consuming
need experts
28
optimal method for research studies would...
correlate w/dietary intake
Be free of social bias
Be independent of patient memory
Not be limited by subject’s ability to describe the food
Not influence how the patient eats normally
Be inexpensive
29
is there a gold standard for dietary assessment?
no
30
Duplicate diet approach
collection of duplicate diet samples
| ACTUAL INTAKE
31
Duplicate diet strengths
measurement of dietary exposures possible
| actual intake
32
Duplicate diet weaknesses
expensive
| not suitable for large groups
33
Food consumption record
household's normal diet is assessed/viewed by trained staff
| actual intake info
34
Food consumption strengths
ease of application
| actual intake
35
Food consumption weaknesses
doesn't focus on the individual, focuses on group
only works if they eat at home
interviewers
36
24-hour dietary recall
subjective
open-ended
trained interviewer asks questions about food eaten over the past day
37
24-hour dietary recall strenghts
small respondent burden
detailed
easy
38
24-hour dietary recall weaknesses
recall bias
trained interviewer
expensive and time-consuming
39
Dietary record
subjective mesure
| self-administered, questionnaire
40
Dietary record strenghts
no interviewer required
no recall bias
detailed, actual intake info
41
Dietary record weaknesses
large respondent burden
| can influence intake over a few days
42
Dietary history
subjective
open and closed questions
trained interviewer
USUAL intake over long time
43
Dietary history strengths
usual dietary intake
44
Dietary history weaknesses
high cost and time consuming
| not suitable for epidemiological studies
45
Food frequency questionnaire
subjective mesure that asks what foods have been eaten and how often
self or interviewer
USUAL intake for longgg time periods
46
Food frequency questionnaire strengths
suitable for epidemiological studies
simple
cost effective
47
Food frequency questionnaire weaknesses
low accuracy
recall bias
close ended
relies on memory
48
RMR
resting metabolic rate or energy required to keep your body functioning
49
RMR supports
breathing, blood movement, organs, and neuro functions
50
RMR increases with
BMI
51
RMR is determined by
weight
height
age
52
equations used to figure out RMR
harris-benedict
| mifflin st. jeor
53
TDEE activity factors
increases as you become more active or injuries/illness can increase RMR
54
indirect calorimetry
amount of oxygen consumed under resting conditions
55
Recommendations for diets/calories
500-750 kcal per day deficit
1200-1500 for women
1500-1800 for men
56
Energy deficits
BMR/RMR
adjust for activity and stress levels
estimate nutrition needs
energy deficit level
57
Why is PA essential for weight loss?
exercise only accounts for 15-30% of energy expenditure
PA increases/multiplies the METs
EE quantifies PA and measures PA
58
1 MET
3.5 mL/kg/min
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5 kcal
1 L of oxygen
60
1 KG
2.2 lbs
61
how to calculate energy expenditure?
intensity (METS) x Duration (time) x Body Mass
62
Direct measures of EE
direct calorimetry
| doubly labeled water
63
Indirect measures of EE
Oxygen uptake
| Heart Rate
64
Doubly labeled water
gold standard of EE
estimates daily EE by average
person consumes water; 1-4 weeks. Differences between elimination rates of different isotopes
65
Doubly labeled water strengths
good estimation of energy balance
no participant work needed
free living environment
not reactive or intrusive
66
Doubly labeled water weaknesses
expensive
not day to day variations
expensive analysis
invalid if body isn't stable
67
Heart rate indirect measurements
useful for cycling, swimming
doesn't work well w/heart conditions
discomfort
68
Physical Activity Compendium
METs
69
METs importance
o Helps you know how to compare the physical activity of one person to another
Quantify dose-response relationships with health outcomes
Document changes and differences within and between individuals
Validate intervention programs
Compare physical activity levels between populations/cultures
70
PA questionnaire global
short, 1-4 items, asessing status
71
PA questionnaire global pros
simple and easy
72
PA questionnaire global cons
difficult to measure compliance and dose-response
73
PA questionnaire short-term
7-20 items, over past week/month
| frequency, duration, type
74
PA questionnaire short-term pros
easy to measure compliance and establish dose-response
75
PA questionnaire short-term cons
math/average
| hard to figure out frequencies and durations during the time
76
PA questionnaire quantitative
60+ items over past year/lifetime
77
PA questionnaire quantitative pros
can estimate long-term impact of PA
78
PA questionnaire quantitative cons
difficult to recall PA details from year/lifetime
79
PA logs
usually a checklist of activities that are checked as completed
80
PA logs pros
simple to use, don't need duration
81
PA logs cons
subject burden, it's a daily task
82
PA diaries
recording details of PA as completed
| frequency, intensity, duration, mode
83
PA diaries pros
allow for a breadth of detail
84
PA diaries cons
over and under reporting, subject burden
85
Pedometers
attached to arm
86
Pedometers pros
low cost, behavioral feedback and motivation. reliable
87
Pedometers cons
can't measure anything besides walking
88
Accelerometers
measure change in velocity/accleration
| can assess multiple planes
89
Accelerometers pros
detailed, precise. minimally invase. can be used for days, weeks, or longer
90
Accelerometers cons
poor in compared to doubly-labeled water. not sensitive to different types of PA
91
HR monitors/multi-system
combine multiple bodily functions. may include HR, skin response, core temp, accelerometry
92
HR monitors/multi-system pro
high precision
93
HR monitors/multi-system cons
expensive, complex, no gold standard
94
Gold standards for EE and PA
```
EE = doubly labeled water
PA = no gold standard
```
95
how much weight loss produces benefits?
3 to 5%
96
how much weight loss is recommended?
5-10% to help lower CVD risk
97
Patients expectations
on average, women believed that they were going to lose 32% of their weight
98
Patient's expectations/acceptable weight loss
their acceptable weight loss goals are usually 2-3x more than achieved
99
How much weight percentage was lost?
15%
| 47% didn't even reach their disappointed goals
100
Did those who needed bariatric surgery have realistic expectations?
no
101
Weight loss maintenance
o Maintenance therapy for at least a year
o Acknowledging lifetime challenge
o Monthly contact with therapist
o Frequent self-weighing (at least weekly)
o Reduced-calorie diet
o High levels of physical activity (more than 200 min per week)
102
Max weight is...
lost at 6 months
| followed by a plateau and then a regain period
103
Obesity is caused by
long-term energy balance
104
kcals to pounds
3500 kcals for one pound
105
Energy balance
between energy intake and energy expenditure
106
Energy expenditure
* Thermic effect of feeding
* Energy expenditure of physical activity
* Resting energy expenditure
107
Is energy expenditure of PA more important for energy balance
PA
increases expenditure by more than 50 fold
causes 15 fold increase in total energy expenditure
108
Why does increasing PA help a person maintain lower weight?
o Those that are obese expend more energy when exercising
o 100 kcal per day would prevent weight gain in most people
o Kids = 150 kcals
o Weight loss = 200 kcals
109
Energy density
kcal/g
Amount of energy or calories in a particular weight of food and is generally presented as the number of calories in a gram kcal/gram
110
Examples of high density food
```
butter
bacon
chips
dressings
cheese
pretzels
```
111
Examples of low density foods
lettuce
soup
apple
fish
112
how to calculate energy density?
calculate by dividing calories by grams per serving
113
Volumetrics
humans tend to eat about the same weight of food every day
| maintaining volume and changing density can help w/weight control
114
What affects the energy density of foods most?
water, fiber, dietary fat
High water = lower energy density
High fat = higher energy density
115
Having a salad before a meal...
decreased meal intake by about 100 caloreis
116
How to passively under-consume calories
large portions of fruits and veggies
starchy healthy foods
portion sizes
satiety/satiation
117
Satiety
how long you can wait to eat
118
Satiation
feeling full
119
Environmental reasons for why it's hard to maintain weight
```
Industrialization of food system
Inexpensive unhealthy foods
Fewer meals at home
Occupations more sedentary
Less walking, more driving
```
120
Physiological reasons it's hard to maintain weight
Reduced energy expenditure: 20-30 kcals decrease per kg lost
Increased appetite: 100 kcals increase
Decreased satiety
121
Regainers
more than half of weight lost is regained within 2 years
5 years; more than 80% of weight loss regained
waning efforts as time progressed
122
Maintainers
had a deficit of 100 kcals even with appetite rising by 400-600 kcals
intakes increased of both
123
Predictors of weight maintenance
```
Self-monitoring
low-cal, low-fat diet
eat breakfast daily
regular PA (2500-3000 kcal)
weight-maintenance counseling
```
124
Self-monitoring
Diet: record food intake daily, limit certain foods or quantity
Weight: check body weight more than 1x week
125
Low-cal, low-fat diet
Total energy intake: 1300-1400 kcal
| Energy intake from fat: 20-25%
126
Weight-maintenance counseling
```
Helps to build satisfaction
Relapse prevention
Cognitive restructuring
Deeper motivations
Manage expectations
```
127
National dietary data trends
o Carbohydrate intake has increased
o Fat increase stayed the same
o Increase in energy intake could explain the obesity epidemic
128
Portion sizes have
increased
129
Bowl size
increased, and has slightly increased food intake. Only .2 effect
130
Provided more food
ate higher percentages of food when offered more
131
Front box serving size
the larger it is, it can increase portion size or how much is eaten
132
Single food offered
decreases how much food was eaten by 60%
133
Things that increase how much is eaten
```
portion size
provided more food
increased fast food
bowl size
serving size on box
multiple foods
proximity/visbility
friend's weight
obese people present
```
134
Obese friend
57% increased chance of becoming obese
135
Obese person in proximity
lower health requirement
136
Which body assessments total body fat percentage?
DXA
Bod Pod
Hydrostatic weighing
Bioelectrical impedance
137
Which are direct measures of energy expenditure?
doubly labeled water
| whole-room calorimeter
138
Energy flux
encourages increasing physical activity to assist in regulating body weight
Too little physical activity results in a reduced ability to match intake with expenditure to regulate body weight
Adjusting energy intake and/or expenditure results in compensatory metabolic and behavioral changes
139
Intervention effort is
what determines if you gain back weight
energy intake increases, energy expenditure decreases, and appetite increases. so intervention is the best prevention
140
Food frequency tech
questions that ask for multiple details, ability to submit photos
ability to collect complex data
141
24-dietary recall tech
software/internet
| standardized data collection possible
142
Dietary record tech
software, internet, phone
standardized real-time dat collection possible
improves feasibility
