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Winter 2021 > EXSC 480 Exam 3 > Flashcards

EXSC 480 Exam 3 Flashcards

(107 cards)

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1
Q

How does thermodynamics relate to weight maintenance?

A

reducing thermodynaic efficiency results in increased weight loss

a calorie isn’t always a calorie (2nd law)

you have to decrease consumption or increase expenditure (1st law)

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2
Q

What are some factors that influece weight loss?

A 
satiety
age
behaviors
body composition
food supply
diet
economics
medications
genes
gut microbiota
hormones
metabolic rate
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3
Q

Energy density

A

differences due to fat, water, and fiber content

macronutrients can also hvae differeing effects on satitaion/satiety

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4
Q

Which macronutrient has the greatest effect of satiety?

A

Protein

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5
Q

Very low calorie diets

A

Less than 800 kcal
hard to maintain for longer than 6 months

can negatively bone health, possible eating disorders

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6
Q

Results of VLCD

A

10-40% of weight loss

1.5-2.5 kg lost per week

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7
Q

Low-calorie diets

A

800-1500 kcals

or can be classified as decreasing 500-750 kcal in obese and 300-500 in overweight

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8
Q

LCD results

A

improve cholesterol, LDL, triglycerides, HDL

8% body weight loss

can be used after a VLCD

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9
Q

Low fat diet

A

less than 30% of total kcal comes from fat

weight loss of about 5.41 kg

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10
Q

Very low fat diet

A

15% from fat

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11
Q

Low fat diet results

A

4 months to a year 6% to 12% body weight loss

improvement in total cholesterol, LDL. Variable effects on HDL and triglycerides

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12
Q

Fat diets and weight loss

A

fat energy is dense but has weak satiating effect
low fat diet may induce greater weight loss
helps to reduce total energy intake
heart-healthy approach

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13
Q

Low-fat to low-carb diets

A

difference is not significant

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14
Q

Low-carb diets

A

there isn’t a set definition

can range from 10-20% of kcals from carbs

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15
Q

Very low carb diet

A

less than 10% total kcal from carbs

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16
Q

Why does a low carb diet work?

A

 Increased thermogenic effects of protein intake
 Greater protein turnover for gluconeogenesis
 Loss of energy through excretion of ketones
 Increased satiety, allowing lower energy intake w/out hunger
 Specific metabolic advantage

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17
Q

Low carb drawbacks

A

greater change at 6 months than low fat
but same results at a year (33% vs 34%)

only 59% were able to do a whole year

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18
Q

Two year low carb

A

HDL cholesterol higher than low calorie diet

but more adverse symptoms than other low diets

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19
Q

Negatives of low carb diet

A

less fat loss even with more weight loss

lots of adverse side effects

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20
Q

Positives of low carb diet

A

8-12 kg at 6 months
5 kg at a year
increased energy expenditure
decreased triglycerides, increased HDL

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21
Q

Carb Insulin Model

A

increased insulin levels and high carb levels don’t lead to oxidation but to fat storage

this causes increased hunger and food cravings, lower energy expendture, weight gain.

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22
Q

Atkins, Zone, Weight Watchers

A

all achieve modest and similar long-term weight loss

all low carb

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23
Q

Intermittent Fasting

A

Insulin levels drop w/out snacking

because of low insulin levels, fat cells release energy and are burned

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24
Q

Fasting protocols

A

fasting every other day

7 AM to 3 PM or 7 Am to 7 PM eating pattern

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25
Mediterranean Diet
eat rarely red meat | eat in moderation poultry, eggs, cheese, yogurt
26
Mediterranean vs low fat
more effective | at 6 years, MD had lost 3.1 kg vs .06 kg
27
Glycemic index diet
limit refined grains and sweets 3 meals a day and 1-2 snacks.. Eat slowly and stop when full
28
Who should do a glycemic index diet?
those with high insulin secretion | beneficial for HDL and not LDL
29
Problems w/gluten free
expensive processed foods fewer nutrients doesn't induce weight loss
30
Low sugar
decrease in .8 kg | doesn't necessarily help you to lose weight because you intake other carbs
31
Dieting problems
``` preoccupation w/food food is the enemy slowed metabolism weight rebound dissatisfaction w/body ```
32
Intuitive eating attitudes
body acceptance | dieting is harmful
33
Intuitive eating behaviors
learn to not eat for emtional, environmental or social reasons learn to interpret body singals and respond in a positive way
34
Intuitive eating principles
``` Reject diet mentality honor your hunger make peace with food challenge food police discover satisfaction feel your fullness cope w/emotions with kindess respect your body love exercise honor you health ```
35
Efficacy of intuitive eating
``` lower BMI more evident w/time less weight cycling improves mental health and mindfulness increases internal cues to eat ```
36
Drawbacks of intuitive eating
little evidence for weight reduction not related to increased PA influence on healthy diet is mixed
37
PA for maintaining or improving health
150 min/week
38
PA for prevention of weight gain
150-250 min/week
39
PA for clinically significant weight loss
225 to 420 min/week
40
PA for preventing weight gain after weight loss
200 to 300 min/week
41
Heterogeneity of weight loss/exercise in research studies
PA is defined and recorded differently | weight loss or benefits of PA can differ from study to study
42
Clinical trials w/no or modest weight loss still have benefits
``` glucose control endothelial function lipoportein particle size HDL quality of life CVD risk ```
43
Pedometer weight loss
0 to 1 kg, not significant
44
Aerobic exercise training
0 to 2 kg. only high exercise volumes
45
Resistance training
no weight loss, effects visceral fat. Increases strength and confidence
46
Aerobic and resistance
0 to 2 kg. only high exercise volumes
47
Caloric restriction and aerobic exercise
9 to 13 kg
48
Randomized groups and PA
majority of studies don't show a correlation between PA and weight loss
49
Exercise compliance and PA
most show no idfference between groups of exericse amount. | 50% compliance showed best correlation w/weight loss
50
Only when actual weight loss was recorded...
was there an actual correlation between weight loss and PA
51
Obesity and Preconception
``` INFERTILITY lower peak estradiol worse hormone and metabolic profile PCOS risk miscarriages ```
52
How much reduction in weight can improve infertility?
5-10%
53
Obesity and Prenatal
``` fetal anomalies congenital heart disease insulin resistance preeclampsia diabetes preterm and stillbirth ```
54
Gestational Diabetes
increased risk of 17% if obese | risk of developing type 2 later
55
Preeclampsia
higher risk for obese 2.2 RR and overweight 1.7 RR
56
Obesity and Birth
hormones distorted induction is needed prolonged labor c-section
57
Depression and obesity
6-8 weeks postpartum | risk is 7.5 fold greater
58
How to reduce risk of pregnancy complications
EXERCISE | active a year before = reduction by 60% of issues
59
PA and preeclampsia
reduces risk by 35% to 70%
60
PA and pregnancy
150 min/wk of moderate can begin after giving brith If you did vigorous activity before, you can continue to be active
61
pregnancy weight gain for underweight women
28 to 40 lbs
62
pregnancy weight gain for normal weight
25 to 35 lbs
63
pregnancy weight gain for overweight women
15 to 25 lbs
64
pregnancy weight gain for obese women
11 to 20 lbs
65
Average retention weight after pregnancy
11.8 lbs
66
Obese and postpartum weight
Those that were obese that gained within or less than recommended maintained postpartum weight below pre-pregnancy weight
67
underweight for kids
below 5th percentile
68
normal weight for kids
5th to 85th percentile
69
overweight for kids
85th to 95th percentile
70
Obese class 1 for kids
abover 95th percentile
71
Obese class 2 for kids
greater than 120% of 95th or BMI is greater than 35
72
Obese class 3 for kids
greater than 140% of 95th or BMI is greater than 40
73
Prevelance of childhood obesity
1/2 of adult | less than 20%
74
adiposity rebound
o At age 5-7, children should be at the lowest weight | o If the child begins to gain weight at age 2 or it’s the lowest weight for them, they will be overweight/obese
75
Intrauterine effects on kid's weight
 Gut microbiome  Genes  Metabolic syndrome, insulin resistance, CVD  Diabetes.  Famine, increased risk to rapid weight gain
76
Postnatal effects on kid's weight
Low birth weight --> abdominal obesity breastfeeding type of breast milk (formula, real milk, etc)
77
breastfeeding effects on kids
30-50% reduction in risk for obesity introducing food before 3 months increases risk by 30% scheduled feeding doubles risk of rapid infant weight gain kids 2-14 have a 15% lower risk for being obese
78
Familial situations on kids weight
```  PA patterns and eating patterns  Preferences for food  Degree of parental control over intake  Stress  Strong familial component ```
79
Obesity begins in adolesvence
30% of females | 10% of males
80
How parents can have an positive effect on child's weight
``` o Dietary change o Physical activity o Parental involvement o Psychological o Structure of environment, encourage/discourage, not exerting pressure ```
81
Psychological things parents can help w/weight
 Praise good behaviors  Don’t use food as rewards  Remove temptations  Be a role model and consistent
82
Interventions that families can do to improve weight
stable meal times healthy food options model desired behaviors
83
When should medication be prescribed for obesity?
greater than 30 BMI | greater than 27 w/comorbities
84
Orlistat
GI lipase inhibitor impairs digestion of dietary fat oily discharge from rectum don't use w/birth control, seizure meds, thyroid meds
85
Orlistat important things
APPROVED for use in kids | 3% reduction in weight
86
Phentermine
sympathomimetic amine increases satiety can cause high BP and heart problems interacts with antidepressants, alcohol
87
Phentermine important things
Oldest approved drug (not FDA approved) | most commonly prescribed
88
Lorcaserin
stopped/discontinued due to increased risk for cancer
89
Ligraglutide
glucagon peptide 1 receptor agonist lower blood sugar stimualtes pancreatic function lose 5-10% can become hypoglycemic increased suicide risk and gastric emptying
90
Naltrexone and Bupropion
lose 5-10% of weight helps with addiction and depression should not be used in non-adults
91
Phentermine and Topiramate
anti obesity and seizures/migraines 5-10% of body weight birth defects possible w/topir
92
When should bariatric surgery be suggested?
``` class 2 and 3 obesity people w/2 or more comorbities ```
93
Has the amount of people for bariatric surgery increased or decreased?
increased over the past 20 years
94
Bariatric surgery is considered a
consistent or sustained weight loss method
95
Malabsorptive
Duodeno-jejdunal bypass helps w/type 2 diabetes avoids issues w/gastric bypass hyperlipidemia improvement
96
Restrictive
laparoscopic banding greatest result w/sleep apnea constant readjusting needed doesn't obtain nearly as much weight loss
97
Restrictive and Malabsorptive
Roux-en-y gastric bypass you can't eat sweet things with it used to be the most common stomach pouch = golf ball drains outside of stomach and duodenum 2 parts: sleeve and switch
98
Sleeve of bypass
creates sleeve in stomach part A very common, most popular. Provides great results
99
Switch of bypass
not used often but provides the best results jejunum is attached instead of duodenum have to stay up on vitamins and supplements
100
12 years after surgery
27% still have less weight diabetes, hypertension, and dyslipidemia remain improved
101
Which ones are the most popular surgeries?
ROUX SLEEVE LAP BAND
102
Which are the most effective surgeries?
1. Roux 2. Sleeve 3. Band
103
Which surgery is reversible?
Lap band | requires post-surgical adjustments for best results
104
Given that nutritional deficiencies (i.e. protein malnutrition, vitamin B12, vitamin D, iron, calcium, and folate insufficiencies) are more likely to occur with malabsorptive procedures, which would have a greater need for regular post-surgical vitamin/mineral supplementation?
SWITCH > SLEEVE < RYGB > BAND
105
Compared to a usual diet in studies that last longer than a year, low fat diets ...
produce an average weight loss of ~5 kg. are thought to be a heart-healthy approach to weight loss. may not be statistically different from weight loss achieved via low carb diets.
106
Pains from ED
``` headaches Chest pain Abdominal pain mental health neuropathic pain m/s pain ```
107
Refeeding syndrome
decreased phosphorus decreased potassium decreased magnesium

Winter 2021 (6 decks)

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