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NUTR 207 > Midterm 2 Section 1 > Flashcards

Midterm 2 Section 1 Flashcards

1
Q

types of energy

A

capacity to do work: heat, mechanical and electrical

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2
Q

percentages of energy expenditure

A

basal metabolism (50-65%)
thermic effect of food (5-10%)
physical activity (25-50%)

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3
Q

basal metabolism =

A

activities to keep the body functioning to maintain homeostasis

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4
Q

factors that affect BMR

A

fasting/starvation/malnutrition - lowers BMR
lean body mass, thin tall people and some life stages (children, adolescents and pregnancy) - increases BMR

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5
Q

Conditions for measuring BMR
If conditions are not met, what are you measuring?

A

indirect calorimetry used
relaxing, reclining, awake, thermo-neutral environment, post absorptive state, and no heavy physical activity in last 12 hours
RMR - resting metabolic rate

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6
Q

physical activity =
exercise =

A

voluntary muscle movement
structured voluntary movement with goal of improving fitness parameters

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7
Q

what is the 3500 rule?
Why is it not accurate?
where does the rule come from?

A

1 lb of fat = 3500 kcal
water loss first, adaptation to restriction
metabolic adaptation - BMR lowers in response
gender differences
1lb/454g body fat is 87% fat

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8
Q

Why is EER based on EAR not RDA?

A

accounts for weight, height, age, gender, and physical activity giving +/- 20% error
avoid people over consuming

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9
Q

EER = TEE

A

Estimated Energy Requirement = Total Energy Expenditure
Men: 662 - (9.53 x years) + PA x [(15.91 x kg) + (539.6 x meters)]
Women: 354 - (6.91 x years) + PA x [(9.36 x kg) + (726 x meters)]

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10
Q

PA values sedentary - very active

A

1.00- 1.39 sedentary
1.40 - 1.59 low activity
1.6 - 1.89 active
1.9 - 2.5 very active

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11
Q

definition of hunger and influences

A

physiological influences: empty stomach, gastric contractions, absence of nutrients in small intestine, endorphins
sensory influences: endorphins triggered by sensory input of food which enhances desire
hunger produces impulse to eat
size and composition of meal

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12
Q

cognitive influences on why we continue to eat

A

social stimulation, perception of hunger or awareness of fullness, favorite foods or foods with special meaning, time of day, abundance of food

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13
Q

satiation definition and influences

A

definition - short term feeling of fullness
post-ingestive influences: food in stomach triggers stretch receptors
nutrients in small intestine elicit hormones (like cholecystokinin which slows gastric emptying)

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14
Q

definition of satiety and influences

A

long term feeling of fullness
post-absorptive influences: nutrients in blood signal to brain that they are available
decreasing nutrients in blood signals hunger again

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15
Q

3 areas that influence appetite control
hormones that influence appetite

A

both psychological and sensory influenced
cognition (knowing what is good or bad for us), homeostasis (hunger cues) and reward systems (strong, craves foods we like for quick energy)
ghrelin, insulin, leptin, GLP-1, and serotonin

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16
Q

leptin function, production and regulation

A

function: suppresses appetite and food intake between meals
production: hormone made by adipose tissue, some produced in stomach
regulation: negatively regulated, increased adipose tissue stimulates leptin (decreases appetite)
decreased body fat suppresses leptin production

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17
Q

leptin resistance

A

body becomes desensitized to leptin signaling
normally high leptin signals hypothalamus to decrease food intake and increase energy expenditure

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18
Q

ghrelin function, production and regulation

A

Function: increases food intake by signaling hunger, prepares for consumption by increasing gastric motility and gastric acid secretion
Production: produced in the GI tract, especially the stomach
Regulation: levels are highest before meals when hungry and lowest after

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19
Q

satiating foods

A

protein - amino acids sensed by the brain and has a high thermogenic effect
fat, dietary fibre, water and puffed up with air

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20
Q

BMI definition
classifications

A

kg/m^2
definition: BMI is a cheap, easy and available generalized screening tool to categorize people into weight related risk categories
classifications: underweight < 18.5, healthy 18.5 - 24.9, overweight 25.0-29.9, class 1 obese 30-34.5, class 2 35-39.5, class 3 > 40+
normal weight gives the least health risk

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21
Q

higher BMI for people over 65

A

healthy BMI from 22-27 to act as protective reserves for injury and illness

22
Q

limits of BMI

A

does not distinguish body comp (muscular vs over fat)
no reference to where fat is
ethnicity differences ignored
level of health risk from other factors (smoking, family history…etc)

23
Q

definition of healthy body weight

A

a weight that does not increase risk of disease

24
Q

fat distribution and types

A

subcutaneous vs visceral (central obesity) vs ectopic
android body fat distribution - apple shape, increased fat in chest and abdomen
gynoid body fat - pear shaped, increased lower body fat, lower risk of disease compared to android

25
visceral fat indication waist circumference
men: >= 102 cm/40" women: >= 88cm/35"
26
ectopic fat
fat that accumulates in organs such as heart, liver, pancreas and muscles
27
women have what percent more body fat than men at the same BMI? BMI to percent body fat BMI 18.5, 30 and 40
12% more 18.5 BMI --> 12-19%/25-32% body fat 30 BMI --> 27-32%/40-44% body fat 40 BMI --> 34-38%/46-49% body fat
28
health problems associated with overweight and underweight
overweight: type II diabetes, dyslipidemia, hypertension, coronary heart disease, gallbladder disease, obstructive sleep apnea, cancer underweight: undernutrition, osteoporosis, infertility, immunoincompetance
29
stages of fat cell proliferation
during growth fat cells increase in number increased energy intake than expenditure, fat cells grow in size after fat cells have enlarged (20x original size), increase in # again with fat loss cells shrink in size but not number
30
fat cell hyperplasia definition fat cell hypertrophy definition
increased replication rate increase in cell size
31
liposuction weight gain side effects
new fat cells can develop again and as well as in weird places like ankles and wrists
32
LPL in obese people
higher LPL for hydrolyzes triglycerides passing in bloodstream for fat deposition LPL is higher in women in breasts, hips and thighs LPL is higher for men in abdomen
33
set point theory
body strives to achieve homeostasis, hypothalamus makes adjustments to return to set point of weight BMR slows when food intake decreases, adaptive energy expenditure leads to yo-yo dieting
34
US vs. Canada BMI categories
>40 in US, >35 in Canada is clinically severe
35
biggest loser study
began with DEXA scan and indirect calorimeter of the 14, only 1 kept weight off after 6 years Despite regaining weight, after severe weight loss RMR remains decreased Suggests the body adapts to significant weight loss shrinking fat cells produce less leptin. by end of competition, contestants were constantly hungry and thyroid had slowed none of this rebounded after drastic weight loss weight regain occurred easily despite eating less than ever
36
metabolic adaptation
if energy is restricted and there is weight loss, hypothalamus will direct metabolism to maintain energy reserves (slow metabolism and energy expenditure)
37
weight bias definition examples
negative attitudes, beliefs, judgements, stereotypes and discriminatory acts aimed at individuals because of their weight doctors responding negatively to patients, lack of access to appropriately sized medical amenities, prejudice from coworkers, stigmatized media
38
weight bias contributes to weight gain how?
people believe the bias and that being overweight is a moral failing, it is stressful, increasing eating induced by increased cortisol, increases weight gain and the cycle continues,
39
Obesity Canada 2020 Clinical practice Guide positives and negative
creating guidelines for healthcare practitioners to address weight bias focuses on improving health and well being, rather than focusing just on weight loss identifies obesity as a chronic disease which calls for multidisciplinary treatments no mention of food landscape
40
overweight and obesity stats
steady increase of obesity (all classes, especially 2 and above) since 1990 overweight category has remained consistent due to decreased levels of physical activity, epigenetics and increased processed food intake
41
definition of obesity
complex disease in which abnormal or excess body fat impairs health
42
steps in the patient journey in obesity management
1) ask permission to discuss it 2) assess their story (goals and severity) 3) nutritional therapy, exercise and other referrals (surgery, psychologist, meds) 4) agree on goals 5) assist with barriers and drivers
43
non weight related goals
improved blood glucose control, decreased blood pressure, blood lipids, and increased physical fitness health at every size, no diet approach, no counting kcal, healthy eating, physical activity, mindful eating
44
protein intake during weight loss
increased satiety, protects lean tissue, 1.2-1.6 g per kg body weight or 35% of energy
45
high GL ultraprocessed foods relating to obesity
increased fat deposition in the body resulting from hormonal response to high glycemic load/hyperpalatable diet drives positive energy balance (eat more and gain more) people eat less unprocessed foods at one time than ultraprocessed
46
physical activity advantages for weight loss
increased metabolism, improved body comp, increased health benefits, reduced appetite after exercising, stress reduction
47
types of bariatric surgery complications candidates
sleeve gastrectomy, gastric bypass, duodenal switch infections, nausea/vomiting, dehydration, nutrient deficiencies, psychological problems, reduction of immune system no metabolic adaptation as seen with weight loss with BMI over 40 or over 35 with an obesity related disease adjustable gastric band not accepted in Canada
48
sleeve gastrectomy
2/3 stomach removed leaving sleeve/tube behind affects metabolically active tissues and hormones produces smallest weight loss
49
gastric bypass
restrict stomach to smaller size (from football to egg sized) using a band (nothing removed), and reconnect SI to bypass first part middle weight loss effects reversible procedure if necessary risk of malabsorption of nutrients
50
duodenal switch
sleeve gastrectomy + bypassing 80% of SI risk of malabsorption of nutrients largest weight loss as a result very invasive, only for BMI over 70
51
Orlistat
AKA Xenical inhibits pancreatic lipase, blocks fat absorption by 30% side effects: gas, frequent bowel movements, reduced absorption of fat soluble vitamins

NUTR 207 (14 decks)

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