Term
| Primary Concerns of Obesity |
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Definition
health Not appearence
-stronke, sleep apnea, respitory problems, heart disease, high chloresterol, liver and gallbladder problems, type 2 diabetes, gynocological problems, cancers, osteoarthritis, hypertension |
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Term
| Psychological consequences of obesity |
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Definition
-poor health related quality of life
-low self esteem
-clinical depression |
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Term
| Obesity Comorbidities 3 features to qualify |
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Definition
1. increase in frequency and severity of disease occurs when andiposity is present
2. improvement or resolution for disease occurs with weigt loss
3. plausible explanation exists for association of obesity with disease state |
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Term
| Obesity and Metabolic Syndrome |
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Definition
-metabolic disfunction not soley related to BMI
-influenced by degree of abdominal adiposity
-abdominal fat associated with insulin resistance
--reduced cell sensitivity to insulin hormone
-person with MetS has 2x the risk for coronary heart disease
-5x risk for type 2 diabetes |
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Term
Conditions associated with Metabolic Syndrome
(need 3) |
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Definition
-waist measurement
--males >40, fmales .35
-triglyceride
--> 150 mg/dL
-HDL chloresterol
--males < 40 mg/dL
--females < 50 mg/dL
-blood pressure
-->130/85 mmHg
-fasting blood glucose
-->100 mg/dL |
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Term
Nonalcoholic Fatty Liver Disease
NAFLD |
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Definition
-obesity and insulin resistance increase risk
-liver pathology that may include steatosis (excess fat in liver) inflammation, cirrhosis (hardening of liver) and liver cancer
-resembles alcoholic liver disease but occurs in people who do not over consume alcohol
-leading cause of chronic liver disease
-1/3 US population affected |
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Term
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Definition
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Term
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Definition
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Term
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Definition
-1/3 US population
-occurs in people who are overwieght or obese
-people with elevated blood lipids
-people with diabete or abnormal glucose levels |
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Term
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Definition
-increase sensitivity to insulin
--exercise
--diet
--medication |
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Term
Polycystic Ovary Syndrome
PCOS |
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Definition
-group of metabolic abnormalitis associated with insulin resistance, type 2 diabetes, adn obesity
-most common hormonal disorder in women of reproductive age
-ovaries are enlarged and contain numerous small cycts
-can lead to infertility |
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Term
| dieeases associated with PCOS |
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Definition
-infertility
-acne, hirsutism (abnormal hair growth), increased risk of cardiovascular disease and cancer |
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Term
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Definition
| abnormal hair growth on face/body |
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Term
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Definition
-characterized by hyperglycemia
--results from defects in productino and use of insulin
-progressive disease hat affects multiple organs |
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Term
| diseases type 2 diabetes is most common cause of |
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Definition
-adult blindness
-limb amputation
-kidney failure
-coronary artery disease |
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Term
| type 2 diabetes and obesity |
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Definition
-over 80% people with type 2 are overwieght or obese
--weight gain of 11-18 lb increases risk to 2x that in individuals who have not gained weight
--losing as little as 11 lbs reduces risk same amount |
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Term
| increase in diabetes in US |
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Definition
DOUBLED in last 3 years among people with BMI > 30
--occurs most in elderly, african americasn,american indians, haiwaiians, pacific islanders, latinos |
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Term
| reasons type 2 diabetes in US will likely increase |
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Definition
-americans are overwieght and sedentary
-large segment of population is aging
-minority groups at increased risk make up fast growing part of population |
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Term
| Adolescent type 2 diabetes |
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Definition
-previously adult disease that now occurs with increasing frequency in adolescents
--have increased risk for cardiovascular disease
--adverse events such as heart attack or stoke can occur earlier
-gov estimates type 2 db will affect 1 in 3 people born in 2000 in US
--increase as much as 165% by 2050 |
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Term
Cardiovascular disease
CVD |
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Definition
-narrowed blood vessels that initiate heart attack, chest pain, or stroke
-leading cause of disease in US |
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Term
| risk for cardiovascular disease increased by |
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Definition
-hypertension
-low density lipoproteins HDL
-elevated low density lipoproteins LDL
-inflammation |
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Term
| low HDL chlorestorol levels and BMI |
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Definition
-bmi increases prevalence of low HDL
-low = < 35 mg in men, < 45 mg/dL in women |
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Term
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Definition
-condition 2x as common in adults that are obese
-progressively increases with higher levels of BMI for men and women
--high BP = > 140 mm/Hg sustolic pressure, > 90 mm/Hg diastolic pressure
---140/90 |
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Term
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Definition
-individuals in overwieght catagory had lowest risk for CVD
-obesity stage 1 patients had no increased risk for mortality
-obesity alone is not a major predictor of death from CVD once other risk factors that correlate with obesity are removed
---most important issue is metabolic consequences that can occur along with obesity |
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Term
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Definition
-metabolically healthy but obese persons do not show factors associated with inculin resistance syndrome
-insulin sensitivity in MHO individuals may be due to less distribution of fat in abdomin
-obese men and women who do not have hypertension, dyslipidemia, or type 2 diabetes may not be at increased risk of CVD |
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Term
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Definition
-obesisty is predictor of respitory disorders such as
--obstructive sleep apnea
--asthma
--breathing problems |
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Term
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Definition
-neck circumference
--> 17" in men, > 16" in women
-excessive daytime sleepiness
-memory/concentration problems
-hypertension
-most people with OSA have BMI > 30 |
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Term
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Definition
-recurrent attacks of breathlessness and wheezing
-inflamed airways
--lung volume restriction
--adipocyte-related systemic inflammation
-prevalent strong in obese women |
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Term
| Breathing problems associated with obesity |
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Definition
occur due to
-mechanical issues
--soft tissue in throat collapses and closes during sleep
-increased inflammatory response
--lung volume restriction |
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Term
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Definition
deaths from cancer due to obesisty
-men= 14%
-women= 20%
--weight gain of >20 lb after age 18 doubles risk of postmenopausal breast cancer
-obesity associated with increased risk for hormone dependent and gastrointestinals cancers including endometrial, colon,prostate, and breast cancer |
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Term
| possible explanations for link between obesity and cancers |
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Definition
-increased body fat, alterations in sex hormones, and increased levels of oxidative stress
-linked to DNA mutation and abnormal cell growth
-no evidence intentional weight loss affects risk for cancer |
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Term
| Musculoskeletal Disorders |
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Definition
-positive association b/w musculoskeletal disorders, physical ability, and obesity
--especially in back, knee, hip, ankle, and foot
--stress placed on the tendons and joints from extra wieght
--bioshemical adaptions in response to increased fat mass and altered center of gravity |
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Term
| obesity and musculoskeletal disorders |
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Definition
-osteoarthritis
--joint inflammation, degenerative joint disease
-leads to pain and stiffness
-common in knee hips joints (hand, spine)
-for every 2 lb increase in weight, risk of OA increase 9-13%
-symptoms often improve with weight loss |
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Term
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Definition
-life expectancy is increasing in US
-trend may reverse due to comorbid disorders associated with obesity
-increase in child obseity = adult diseases being diagnosed more often in children
-for first time next generation may not outlive their parents |
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Term
| Psychosocial correlates of obesity and quality of life |
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Definition
3 domains
-physical
-social
-pshological |
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Term
| physical domian (quality of life) |
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Definition
-obesity assocaited with mobility problems that limit activities of daily living
-health professionals assess ability to preform daily activities to define if person is disabled |
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Term
| low ability to preform ADLs result in |
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Definition
-being defined as disabled
-physical constraints make personal hygiene difficult
-obese women report difficulties with housework requiring squatting, stooping, or lifting |
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Term
| social domain (quality of life) |
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Definition
-disrcimination and bias
-stereotyping obeses persons is common in US
-negative attitudes and bias towards obese are frequently reported by
--employers, coworkers, teachers, friends, family, and healthcare workers |
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Term
| psychological domain (quality of life) |
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Definition
-weight discriminatoin can lead to psychological problems
--anxiety, depression, and low self esteem
-psychological symptoms may improve with weight loss
-caution: do not assume all obese individuals are depressed or have mood disorders |
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Term
| economic costs of obesity |
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Definition
-CDC estimates cost of treating obese was $147 billion
-nearly 10% of all medical spending in US
-total is measured in direct and indirect costs |
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Term
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Definition
-are preventative, diagnostic, and treatment services
--doctor visits, meds, hospital and nursing home care, purchase of bed, scales, operating tables, stretchers, wider doors, overhear hoists, converting wall mounted toilets to floor mounted ones, larger gowns, linenes, and wheelchairs
-not due to obesity alone, but obesity comorbidities
--cancer, heart disease, type 2 diabetes, arthritis, ect |
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Term
| Indirect costs of obesity |
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Definition
-occur when people are unable to work or do not receive wages due to illness, disability, or injury
-costs account for loss of productivity and future earnings |
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Term
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Definition
-costs of treament must be balanced with potential outcomes
-5-10% wieght loss may lower blood pressure, glucose, and triglycerides
-these improvements could offset costs of obesity therapy over long time |
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Term
| chronic conditions strongly associated with obesity |
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Definition
| -type 2 db, hypertension, musckuluskeletal disorders, some cancers, and premature death |
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Term
| Key to maintaining energy balance |
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Definition
| match calories consumed from food and drink with energy expenditure |
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Term
| Energy Requirements for Weight Management |
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Definition
-the kcals a person needs vary depending on age, gender, height, weight, level of PA, and personal health goals
-body weight most straight forward way to gauge appropriate number of calories
--adjust as weight changes over time |
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Term
| Average energy requirement for women |
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Definition
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Term
| Average energy requirement for men |
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Definition
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Term
| Calorie goals for weight loss |
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Definition
-dietary guidelines advocate weigth loss of 10% by overall calorie reduction
--1 lb body fat = 3,500 kcal
-reduce daily intake by 500 to 1,000 cal = 1-2 lb of weight loss per week
-use mifflin st jeor equation |
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Term
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Definition
1,200 cal for women
1,600 cal for men |
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Term
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Definition
-recognizing food as source of calories is critical to energy reduction plan
-most americans are unaware of food calorie content
-consumers look for simple dietary guidelines as alternative |
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Term
| Simple dietary guidelines |
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Definition
-published every 5 years based on evidence
-2010 DGA emphasizes:
--fruits, vegs, whole grains
--fat free or low fat milk
--lean meats poultry fish beans eggs and nuts
--low saturated fats, trans fats, cholesterol, and added sugars
--stay within individual calorie needs |
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Term
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Definition
myplate messages helpful for weight management:
-enjoy your food, but eat less
-avoid oversized portions
-make half your plat fruits and vegs
-switch to fat free or low fat milk
-drink water instead of sugary drinks |
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Term
| Myplate Fruit and Vegetable Group |
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Definition
-most are low in fat and calories and filling
-most people eat consistent weight of food regardless of energy content (volumetrics) |
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Term
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Definition
| -volume of food is what makes people feel full and stop eating regardless of calories |
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Term
| Food groups and Energy Density |
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Definition
| -energy density is number of calories in food in relation to its wieght |
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Term
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Definition
-high calories relative to food weight
-fats/oils |
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Term
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Definition
-few calories relative to food weight
-fresh fruits and vegs
- > volume of low energy dense vs high energy dense foods for same number of calories
-substitute f/v for higher cal food for weight control |
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Term
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Definition
-fiber is diet component only found in plants, especially whole grains
-fiber not digested in the small intestine
--metabolized in large intestine
--fiber cal = 0-2 cal
-average american consumes 15 g/day
--mostly refined grains
-recommended levels
--25 g for women
-- 38 g for men
-make 1/2 your grains whole |
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Term
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Definition
-switch to nonfat or low fat milk
-neutral association of dairy group with weight management
-yogurt consumption was associated with lower weight
--intestinal bacteria enhanced by yogurt cultures may influence energy harvesting |
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Term
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Definition
-no independent relationship between long term body weight and intake of proteins
-protein is important source of essential nutrients needed in healthy diet |
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Term
| MyPlate Solid Fats and Added Sugars |
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Definition
-solid fats = solid at room temp
--butter, beef fat, shortening
--occur naturally or added to processed or preparded foods
added sugars
-sugars adn syrups
-added to food during processing, preparation, or at table
SoFAS compromise > 1/3 of cals consumed by average american |
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Term
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Definition
empty calorie catagory
-may not cause weight gain if total cals are within limits
--no more than 15% cal from SoFAS for weight management |
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Term
| Added sugars in american diet |
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Definition
contribute to 16% total cals in American diet
-sodas, energy/sports drinks
-grain based desserts
-sugar sweetened fruit drinks
-dairy based desserts
-candy |
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Term
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Definition
contributes 7 cal/p
-one drink = 15 g of alcohol
-moderate consumption not related to weight gain
-- 1 drink/day for women
-- 2 drink/day for men
higher alcohol consumption associated with increased weight |
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Term
| Portion Size and Consumption |
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Definition
-larger the portions more people consume
-sandwich study
--women ate 31% more
--men ate 56% more
popcorn test |
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Term
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Definition
-increased body weight with increased frequency of eating out
-due to greater portion size and/or higher energy density
-higher odds of being overweight with regular fast food consumption |
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Term
| Food labels/Nutrtion Facts |
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Definition
-food labels can help determine cals in food portions
-need to check serving size
-some restuarants provide cal and other nutrtition info on menues
-- places with > 20 locations have to disclose cals clearly and prominantly |
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Term
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Definition
-people who eat more times a day were less likely to be overweight
-eating breakfast especially associated with weight control
--low energy breakfast associated with lower BMI
--high energy breakfast more negative effect than not eating breakfast |
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Term
| Academy of Nutrtion and Dietetics Meal Timing Advice |
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Definition
-research does not support absolute meal frequency or breakfast recommendations
-distribute total cal intake throughout day
-include breakfast |
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Term
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Definition
cal intake is vital for weight management but its important to consider essential nutrients and other healthful aspects
-recommended macronutrient distribution
--carbs= 45-65%
-- fat= 20-35%
-- proteins = 10-35%
-popular diets focus on effects of individual macronutrients as components that can make weight management easier or more effective |
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Term
Low fat, High Carb, High Fiber diets
Orninsh and Pritikin diets |
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Definition
-whole grains,fruits, vegs, beans and peas, and low fat meat protein
-reduce fat to as low as 10% daily cal
-reducing fat alone will not produce weight loss unless total cal are also reduced |
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Term
High Protein, Low carb diets
Atkins, Zone, South Beach |
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Definition
-protein makes up 30-40% of cals
-carbs are severly reduced
-replace startches and sugars with lean protein and low fat dairy
-include fruit, veg, and whole grain
-use unsaturated fats found in seafood, nuts, seeds, oils |
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Term
Very low calorie diets (VLCD)
Optifast and Medifast |
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Definition
-medically supervised plans
-limited to ~ 800 cal per day
-liquids and nutrtiion bars replace food
patients lost 15-25% of initial wieght adn maintain loss of 8-9% at 1 year
weight regain in women greater after VLCD than low cal diet |
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Term
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Definition
-no evidence shows any diet, food, or macronutrient is more effective than another in the long run
-any eating plan that restricts cals can lead to successful weight loss
-adherence to diet, not diet itself, makes the difference |
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Term
| Increasing diet adherence with group support |
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Definition
-increases adherence to diet
-self help groups and commercial franchises
-websites may increase adherence |
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Term
| increasing diet adherence with structured meal plans |
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Definition
-packaged meals, controlled portions and energy content
-meal time choices simplified
-drop out rates lower for meal replacement plans |
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Term
| energy balance and physical activity |
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Definition
energy expenditure is essential to determine whether person is able to:
-maintain healthy wieght
-sustain weight loss
-loss excess body weight
inactive people are twice as likely to gain wieght over 10 year period as more active people |
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Term
| Defintion of Physical Activity |
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Definition
| all activities of daily living plus purposeful activity (exercise) |
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Term
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Definition
amount of energy burned is influenced by:
-weight
-exercise intensity
-gender
-age |
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Term
| trends in physical activity |
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Definition
- 50% adults don't get recommended amount of PA
- more than 25% do not engage in leisure time PA
- activity is low due to contemporary life
--navigating urban sprawl
-- labor saving technology |
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Term
| necessary daily steps to maintain healthy weight |
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Definition
-10,000 steps (5 miles)
-majority americans walk less than 5,000 a day
-using pedometers increases PA |
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Term
| Bureau of Labor Statistics and the American Time Use Survey |
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Definition
-gathers data about american physical activity
-tv is most popular activity |
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Term
| PA trends in children adn teens |
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Definition
-most youth dont meet recommended 60 mins of moderate to vigorous PA each day
-fewer children walk or bike to school and p.e. in schools is decreasing |
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Term
| PA declines as children age |
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Definition
-90% of kids age 9 got 60 mins of PA
--31% met level at age 15
-47% ninth graders attend daily p.e.
- 22% twelth graders attend daily p.e. |
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Term
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Definition
-important factor in overall health
-guidelines focus on cardiovascular and muscular fitness
-do not address activity required to improve performance related fitness |
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Term
| 3 Groups of current PA recommendations |
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Definition
1. good health, fitness, reduce risk of chronic disease
2. prevent weight gain
3. prevent weight gain after weight loss |
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Term
| PA for health, fitness, and prevention of obesity |
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Definition
regular and consistent PA can produce long term health benefits
PA can protect against cancer, type 2 diabetes, and coronary heart disease
increase longevity
increasing normal lifestyle activities suggested as primary way to get recommended minutes per week |
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Term
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Definition
2 hours and 30 mins of moderate intensity aerobic activity (150 mins)
-muscle strengthening activities 2 or more days a week
--work all major muscle groups (legs, hips, back, abs, chest, shoulders, and arms) |
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Term
| Adult PA and weight Maintenance |
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Definition
weight maintainence = weight change less than 5 lbs
-individual variability in response to PA
--some need more to prevent gain and over 300 to intiate or maintain loss
-study of 30,000 women
--those who didnt restrict food did atleast 1 hour moderate activity a day to maintain weight |
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Term
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Definition
-PA < 150 min/week results in minimal weight loss (1-3%)
-dose response effect of PA on weight loss
-greater loss/prevention of regain with 250-300 min per week
-atleast 2000 cal/week of moderate intensity PA |
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Term
| Adult PA to prevent weight regain |
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Definition
-200-300 min/week helps minimize weight regain after loss
-no eveidence concerning amount of PA needed to prevent weight regain
-consensus is more PA is required to prevent weight regain compared with weight maintainence |
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Term
| Resistance training for weight management |
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Definition
-RT is ineffective for weightloss with or without diet restriction
-muscle strengthening activities may help weight maintainence but not as well as aerobics
-RT may protect lean mass during energy restriction
-RT may reduce risk of chronic disease
--abnormal cholesterol
--insulin resistance |
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Term
| benefits of PA for children and youth |
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Definition
-improve strength adn enduracne
-build healthy bones and muscles
-help control weight
-reduce anxiety adn stress
-increase self esteem
-improve blood pressure and cholesterol levels |
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Term
| Children PA recommendations |
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Definition
-60 mins or more moderate to vigorous activity a day
-muscle strengthening activities at least 3 days a week |
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Term
| why are PA recommendations so high |
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Definition
-moderate exercise alone is ineffective in reducing body fat
-1 lb fat = 3,500 cal
--energy deficit of 500 to 1000 cal/day needed to loss 1-2lb per week
--individual may burn additional 1000 cal/week by exercising 30 mins 5 days a week
--1000 cal easily consumed with one or two extra snacks/drinks |
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Term
| mathematics of cals burned/consumed |
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Definition
-average cal per half hour of exercise = 150-200 cal
-estimated time to burn a lb of fat = 8-12 hours |
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Term
| PA and national weight control registry (NWCR) |
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Definition
-surveys individuals successful at long term weight maintainence
-participants use variety of methods to lose weight
- for more than 90% PA is key aspect of long term weight loss management
--average week energy expenditure = 28 miles moderate walking
--variability in amount of PA reported
--difficult to set recommendations for opitimum PA for weight loss management |
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Term
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Definition
-physically active obese adults have health benefits associated with optimal body weight
-- lower rates of all-cause mortality, coronary heart disease, hypertension, stroke, type 2 db, colon cancer, and breast cancer
-nurses study of women for 24 years
--increased body fat and low PA are both strong predictors of death
--compared with lean active women
---155% for inactive
--- 191% for obese active
--- 245% for obese inactive |
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Term
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Definition
-excess visceral adipose tissue is linked to abnormal blood glucose, insulin, and lipids
-increads VAT is associated with type 2 diabetes, cardiovascular disease, and stroke
-regular PA can reduce VAT
--measured in decrease in waist circumference |
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Term
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Definition
-advantages of activity at any size
-helath benefits of exercise should be promoted independent of body wieght
-focus should shift from changes in body weight to changes in overall physical health and psychological well being |
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