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lesson 5 Flashcards

1
Q

What are the priorities for a balanced diet?

A

– Create energy deficit

– Avoid nutritional deficiencies

– Preserve lean mass (exercise+ sufficient protein)

– Promote long-term adherence (avoid hunger) -> no extreme restrictions Change behavioral and dietary habits for life

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2
Q

High-protein diets for weight loss - Results

A

Greater reduction in:

  • Body weight
  • Fat mass
  • Serum triglycerides

Less reduction in fat-free mass

No difference in changes in: Total cholesterol, LDL-C, HDL-C, systolic and diastolic BP, fasting glucose and insulin

  • Less reduction in REE
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3
Q

What are the 5A of obesity management for adults

A

ASK for permission to discuss weight and explore readiness

ASSESS obesity related risks and ‘root causes’ of obesity

ADVISE on health risks and treatment options

AGREE on health outcomes and behavioural goals

ASSIST in accessing appropriate resources and providers

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4
Q

What are the therapeutic objectives of weigth loss?

A
  • Changes in eating behaviours- number ONE goal!!
  • Weight Loss / weight stabilization
  • Prevention of weight regain
  • Reduction in risk factors (diabetes, hyperlipidemia, hypertension, …)
  • Eligibility for surgery
  • Psychosocial adjustment
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5
Q

What are the improvements of diabetes control through weight loss

A

Improved Glucose tolerance

Improved Insulin sensitivity

Decreased Need for glucose lowering medications

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6
Q

Cardiovascular benefits of weight loss

A
  • Normalizes triglyceride levels
  • Raises HDL cholesterol
  • Lowers LDL cholesterol
  • Improves CHD risk profile
  • Reduces need for antihyperlipidemic medication
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7
Q

Benefits of weight loss on hypertension

A

Decreased Systolic blood pressure

Decreased Blood volume

Decreased Cardiac output

Decreased Sympathetic activity

Decreased Need for antihypertensive medication

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8
Q

Benefits of a 10 kg weight loss in terms of mortality

A

Decreased total mortality, diabetes-related mortality, obesity-related cancer deaths

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9
Q

Weight Loss Phase diet, physical activity and other recommendations

A

Diet

  • Hypocaloric
  • Nutrients adequate, balanced

Physical activity- should be promoted- for lean mass conservation especially

Behavior modification

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10
Q

Weight maintenance Phase diet, physical activity and other recommendations

A

Diet

  • Isocaloric vs. the new weight
  • Nutrients adequate, balanced P

hysical activity is important for LBM maintenance Behavior modification

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11
Q

Estimate Daily Energy Requirements and Intake calculation

A

TEE (kcal/d) = REE x activity factor (Low=1.3, Moderate= 1.5, high= 1.8)

or

TEE (kcal/d) from IOM equations

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12
Q

How to calculate how many calories to loose per day to achieve a certain fat loss per week What do we have to remember during this calculation?

A

1lb (454g) of adipose tissue is 87% fat= 395g fat= 3500kcal

To lose 3500 kcal per week = - 500 kcal per day however, there will also be protein and water loss, thus more than 1 pound may be lost with 500 kcal restriction

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13
Q

What is the weight loss approach when quite a bit of weight is to be lost?

A

could be step wise: loss -> stable -> loss -> stable decreases the risk of relapse

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14
Q

What should we aim for when setting a target weight?

A

Realistic weight goal and time to achieve it ex: if goal is loss of 10 kg at 0.5 kg/wk-> 20 weeks

  • Aim to reach healthy BMI (upper range) or
  • Aim for more modest weight loss (5-10%)
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15
Q

table of

PRO

CHO

Fat

Multivitamin and mineral supplement

to be consumed when consuming certain amount of calories

A
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16
Q

What are the DRIs that have to be met durign calory resticitve diet?

A

Meet DRIs: Na 1500 mg/d, K 4.7 g/d, Ca 1000 mg/d, Fe 8/18 mg/d, ≈2 L fluid

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17
Q

Which was the diet in term of fat and GI that resulted in no weigth regain?

Which resulted in the most regain?

A

High protein, low GI

Most: LP-HGI

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18
Q

A modest increase in __ content and modest reduction in _favored maintenance of body weight

A

A modest increase in protein content and modest reduction in GI index favored maintenance of body weight

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19
Q

Which gender is more likely to participate in a health-related study?

A

women

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20
Q

What are the habbits of successful weigth control

A

– Most continue low energy, low fat diet, minimal variation

– 78% eat breakfast
– 90% exercise on average 1 hour per day
– 75% weigh themselves once a week
– 62% watch less than 10 hours TV per week

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21
Q

Management of obesity – Key messages

A
  • A modest weight loss of 5-10% is beneficial
  • Weight maintenance and prevention of weight regain should be considered as long term (even life-long) goals
22
Q

What are the protein distribution ranges for weight loss, normally and maintenance

A

normally 10-35%

25-30% during weight loss

15-20% for maintenance

23
Q

What are the fat intake recommendation for weight loss

A

For some, better ≤ 30% total fat
• include good sources of essential fatty acids

• low intake of saturated and trans fatty acids

24
Q

WHat do clients need to be educated on for weigth loss?

A
  • Content of a healthy plate
  • Normal portion sizes
  • Read food labels
  • Limit highly processed foods
  • Be aware of food marketing
  • Healthy eating habits
25
Physically inactivity __ with _ age
Physically inactivity increases with increasing age
26
What is the recommended diet for weight loss in terms of protein, fat and CHO
high-protein (25-30%) and moderate fat, 45-65% carbohydrates
27
What are the benefits of physical activity?
- reduces risk of premature mortality - Modest enhancement in physical activity/fitness in previously sedentary individuals have been associated with large improvement in health status. - small change in activity form being a low activity individual drastically decreases the number of death, however the improvement plateaus immediately after that
28
tips for weight loss
Eat plenty of vegetables and fruits, whole grain foods and protein foods. ... Limit highly processed foods. ... Make water your drink of choice. Use food labels. Be aware that food marketing can influence your choices.
29
What are the imrpovements cuased by strength training?
- imrpoved nerve function - increases muscle size and bone mass - improved strength and endurance - imporved phsyical performance and funciton
30
How do healh benefits and finteness benefits related to physical activity
Fitness- continuosly increases with increased intenstiy Health benefits- imporvement tapers of after a certain point
31
Benefits of excercise/fitness vs benefits of phsycially active lifestyle
Excercise/Fitness: Aerobic capacity, Muscular strength, Anaerobic threshold, Cardiac function phsycially active lifestyle: Blood glucose, Insulin resistance ,Blood lipids, Blood pressure, Body composition
32
Canadian physcial activity guidelines
* accumulate at least 150 minutes of moderate- to vigorous-intensity aerobic physical activity per week, in bouts of 10 minutes or more. * It is also beneficial to add muscle and bone strengthening activities using major muscle groups, at least 2 days per week. * More physical activity provides greater health benefits.
33
moderate vs vigorous activity
moderate- sweat a little vigorous- sweat a lot and be out of breath
34
physcial activity recommendations to prevent weigth gain
PA of 150 to 250 min/wk with a diet PA \<150 min/wk promotes minimal weight loss,- !!!activity doesn’t contribute to the weight loss greatly but does contribute to health greately!!!! Research evidence does not support Resistance Training as effective for weight loss with or without diet restriction
35
What are the benefits of using a stepc-ountign device
Pedometer or accelerometer can be used as: Motivational tool; Helps to track progress; Benchmark for goal setting; – Week 1: Find your baseline – Week 2: Set realistic goals (↑20%) – Track the progress
36
Steps per day for an adult for weigth loss
12000
37
What is to be considered when deciding to use pharmacological treatment for weigth loss?
• Adjunct therapy to diet, exercise, behavior- will have side effects, while diet and exercise have no, or very limited concentrate on diet and exercise first, then add meds, if required • Evaluatebenefits/risksratio: – About 5% weight loss vs. – Costs + side effects + weight rebound after use
38
What are the most common weight loss meds
– Lipase inhibitors – Appetite suppressants
39
Describe orlistat
* Orlistat : Lipase inhibitor (Xenical®) * Action: nonabsorbed inhibitor of lipase, produces malabsorption of ~30% of ingested fat, if taken before meals * Efficacy: ~50% of subjects overall, ~4 kg loss \> placebo, for up to 2 years. Improved comorbidities. * Side effects: fatty stools, fecal urgency & incontinence, losses in vitamins A,D,E, K (must take supplements)
40
Describe appetite suppressants
Action on CNS to decrease appetite and increase satiety – Serotonin agonists – Amphetamine derivatives Prescribed for short term, may cause addiction Side effects: nausea, dizziness, headaches, difficulty sleeping, constipation,... Sibutramine (Meridia®) was withdrawn in 2010 because of CVD events and strokes
41
What are the recommednations for behavior modifications?
* **Gradual, permanen**t changes in eating and exercise habits = the only way to change weight permanently * Different approaches work for different people – Registered Dietitians – Formal weight loss programs – Self-help groups – Community fitness centers
42
First goals of Behavior Modification in Weight Management
§ Increase awareness to change eating habits § Increase physical activity § Alter attitudes § Develop support systems § Educate about nutrition (Not weight loss on the scale)
43
Readiness Assessment
* Behavioral * Ability to increase physical activity * Success at previous weight loss attempts * Ability to practice self control skills Psychological * Attitudes about weight loss and changing behavior * Confidence in ability to lose weight Environmental * Social support * Life circumstances
44
recommendations for changing eatign habits
* Enhanceself-awareness * Minimize constant exposure to food • Interrupt negative behavior chains
45
path to desirable eating behavior
46
Nutrition Education tips
* Gradually modify eating habits: target diet quality * Know portion size, refrain from seconds * Develop skills to select healthy diets: * serving sizes, labels, cooking * Manage special situations: eating out, parties * Increase awareness of cues to eat * Avoid hunger: no meal skipping, include snacks + protein * Treat yourself with tasty foods * Take time to eat, in good company
47
weight bias vs weight stigma
weight bias- refers to negative attitudes toward others because of their weigth weight stigma- refers to stereotypes and labes we assign to peope with obbesity
48
Forms of a weight bias
- Implicity- unconcious - Explicit- overt - Internalized- self stigma
49
Impact of weigth bias on eatign behaviours
- predicts binge eating - way of coping: refusal to eat or overeating
50
cycel of weight bias and weigth gain
51
Impact of weigth bias on physical activity
52
Impact of weight bias on healthcare utilization

NUTR 344 (22 decks)

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