Nutrition and Wellness: Obesity Unit

How is obesity measured?
BMI, body weight, body fat

What has the main impact on obesity?
consumption of more calories than you burn, eating too much and exercising too little

Factors that impact obesity
age, gender, genetics, environmental factors, physical activity, psychological factors, illness, medication

health problems
cardiovascular diseases, endocrine diseases, gastrointestinal diseases, liver disease, renal and urinary diseases, skin and appendages diseases, musculoskeletal disease, respiratory disease, psychological disease, reproductive diseases

What does BMI stand for?
Body Mass Index

Treatments for obesity
dietary changes, exercise, behavior modification, medication, weight loss surgery

What are the dangers of cardiovascular diseases? (Ex: Hypertensive Heart Disease, Diabetes)
fatigue, shortness of breath, irregulr pulse, frequent urination, unusual thirst, extreme hunger, unusual weight loss, fatigue.

What are the dangers of Endocrine diseases? (Ex: Hypertension, abnormal lipid levels)
artery pressure, high blood pressure

What are the dangers of Gastrointestinal diseases (Ex: gastro-esophageal reflux disease, appendicitis)
acid can go into esophagus or food pipe, swelling of the abdomen, internal infection, vomiting

What are the dangers of liver diseases? (Ex: cirrhosis, nonalcoholic fatty liver disease)
scarring of liver disease, decreased liver function, liver fat excess, confusion, loss of appetite, nausea, vomiting, weakness, weight loss, yellowing of skin, mucus on eyes

What are the dangers of renal and urinary diseases? (Ex: kidney stones, urinary tract infections)
permanent damage to kidneys

What are the dangers to skin and appendages diseases? (Ex: acanthosis nigricans, cellulitis)
light brown to black markings, usually on your neck, under arm, swollen red area of the skin, feels very hot, tender, fever, chills, hair loss, changes in appearance, can cause tissue death, bone infections, meningitis, and shock

what are the dangers to musculoskeletal diseases? (Ex: arthritis, osteoporosis)
joint tissues become less able to take stress, bones develop holes, swelling, pain, loss of mobility, lack of calcium

What are the dangers to respiratory diseases? (Ex: asthma, C.O.P.D)
sensitization to irritants and allergens, being overweight, rapid breathing rate, inflamed lung tissue, asthma attacks, life threatening, wheezing

What are the dangers to reproductive diseases? (Ex: polycystic ovary syndrome, dyslipidemia)
inbalance of sex hormones, lack of menstrual cycle, excess hair growth, infertility, hypothyroidism, too many or too few lipids in your bloodstream

What are the dangers to psychological diseases? (Ex: depression, binge eating)
low self esteem, over eating, obesity, suicide, type 2 diabetes

What are the treatments to some of these diseases?
counseling, healthy eating, prescribed medication, surgery, rehabilitation, oxygen therapy, losing weight, removal, exercise

How does age affect obesity?
– as you age, metabolism slows
– calorie needs change
– eating and activity habits change

How does gender affect obesity?
– more women are overweight
– men have a higher metabolic rate
– women go through menopause

Why may genetics be at fault for obesity?
– it tends to run in families
– adoptive studies: environment
– increases chances: predisposed

What are the psychological factors?
– response to emotions
– binge eating

What type of illnesses affect obesity?
– hormone problems
– hypothyroidism: slows metabolism
– rare brain diseases

What kind of emotions can affect obesity?
– boredom
– anger
– sadness
– stress
– depression

What are the different types of weight loss surgeries?
Gastric Bypass Surgery, Adjustable Gastric Banding, Sleeve Gastrectomy, Biliopancreatic Diversion

What are the pros and cons to Gastric Bypass Surgery?
Pros: helps to lose excess weight, reduces your risk of potentially life-threatening, weight-related health problems, improves your ability to perform one’s daily activities and routines.

Cons: excessive bleeding, infection, adverse reactions to anesthesia, blood clots, lung or breathing problems, leaks in your gastrointestinal system, death (rare), bowel obstruction, dumping syndrome, gallstones, hernias, low blood sugar, malnutrition, stomach perforation, ulcers, vomiting.

What are the pros and cons to Adjustable gastric banding?
Pros: Safer than Gastric Bypass, and other weight loss procedures, routinely done as minimally invasive, requires special instruments, recovery time is faster, reversible if necessary by removing the band, requires small incisions.

Cons: May be likely to regain some of the weight over the years, people who get this procedure usually do not have dramatic weight loss, vomiting; a result of eating too much too quickly, complications with the band are not uncommon, such as slipping out of place, becoming loose, or leaking, infection is a factor just like with any surgery, some complications can be life threatening.

What are the pros and cons to sleeve gastrectomy?
Pros: For people who are obese or very sick Gastric Bypass can be too risky, and so can biliopancreatic diversion, more simple, lower risk surgery, after 12-18 months after surgery if weight loss has improved they can go for a second operation if wanted, result in weight loss of 50% or greater, does not affect absorption of food, this means nutritional deficiencies are not a problem.

Cons: irreversible, risks are still being evaluated, because it is a new procedure, leaking of sleeve, infection, blood clots.

What are the pros and cons to biliopancreatic diversion surgery?
Pros: the surgeries are usually effective; most people lose 75% to 80% of their excess weight, most people stay at that weight.

Cons: there is a risk of infection, dumping syndrome, a higher risk of osteoporosis, bad smelling stools and diarrhea, poor nutrition.

What is Gastric bypass surgery?
The stomach is divided into a large portion, and a much smaller portion. The small part of the stomach is then sewn or stapled together to make a small pouch. The small stomach pouch can only hold a cup or so of food. With such a small stomach, people feel full quickly and eat less.

What is adjustable gastric banding surgery?
This surgery is among one of the least invasive procedures for weight loss treatments. This surgery uses an inflatable band to squeeze the stomach in two different sections (the smaller upper pouch, and a larger lower section.) These two sections are still connected; it’s just that the channel between them is really small. This slows down the emptying of the upper pouch of the stomach. Gastric Banding physically restricts the amount of food you can take in when you eat. Most people can only eat about a half cup to one cup of food before feeling full or sick after having this procedure done.

What is sleeve gastrectomy?
Another form of restrictive weight loss surgery. Operation is usually done with a Laparoscope, and about 75% of the stomach is removed. What is left of the stomach is a small narrow tube or sleeve, which connects to the intestines. Sometimes a sleeve gastrectomy is a first step in the sequence of weight loss surgeries. It can be followed with gastric bypass or with Biliopancreatic Diversion. In some cases this operation may be the only one you need.

What is biliopancreatic diversion surgery?
a treatment for morbid obesity, consisting of resection of two thirds of the stomach and attachment of the ileum to the proximal stomach.

Nutrition: Chapter 8

Sara requires 2100 kcalories each day. Currently, she is consuming between 2200 and 2300. What is her state of energy balance?
Positive

When someone is in severe negative energy balance, what serves as the body’s primary energy source?
Adipose Tissue

If John wants to lose one pound of body fat, how many kcalories will he have to expend in activity and/or omit from his usual intake?
3,500 kcalories

What happens when a person increases his or her energy intake?
There is usually a corresponding increase in body weight.

Negative energy balance is when?
Energy intake is less than (<) energy consumption

One pound of stored body fat is equivalent to about _____ kcal.
3500

You have gained weight, and your adipocytes are filling with triglycerides. This is called:
Hypertrophic growth

What is the process called when adipocytes grow in number?
Hyperplastic growth

What happens when a person loses body fat?
Adipocytes shrink in size

Which type of fat found deposited between internal organs and the torso is otherwise known as intra-abdominal fat?
Visceral adipose tissue (VAT)

What is the physiological response to having eaten enough called?
Satiety

How is energy intake regulated?
By specific neural connections to and within the brain

What “control center” in the body responds to hunger and satiety cues?
Hypothalmus

How do neurotransmitters differ from hormones?
They regulate activities mainly in the central nervous system

What primarily influences short-term food intake?
Neural and hormonal signals from the gastrointestinal (GI) tract

What happens when the brain releases anabolic neurotransmitters?
Weight gain is promoted

What is the branch of medicine that is concerned with treating obesity and obesity-related conditions called?
Bariatrics

Gastric banding involves?
A and C (Reducing the size of the stomach, and creating a small stomach pouch)

All of the following statements about gastric bypass surgery are true except
gastric bypass reroutes the GI tract to bypass the stomach.

Experts recommend that patients be considered for bariatric surgery only if they have a BMI of?
≥40 kg/m2 or ≥35 kg/m2 with a serious weight-related medical condition.

How much food can the stomach hold after gastric banding?
2-3 Tablespoons

Which of the following is not a symptom of dumping syndrome, a possible side effect of gastric bypass?
Hyperglycemia

A rise in what in the blood following a meal seems to stimulate satiety?
Glucose and amino acids

What two foods are good sources of tryptophan and thus may promote both satiety and sleepiness?
Turkey and dairy products

Why would 2 cups of grapes increase satiety more than ¼ cup of raisins?
The volume of grapes is greater than that of raisins

What recently discovered hormone appears to increase food intake by signaling the release of anabolic neurotransmitters?
Ghrelin

Which hormone whose level is increased after tryptophan intake helps people feel calm and relaxed?
Seratonin

_____ can be defined as the longing or desire for food.
Appetitie

Melanie is pregnant and is having a craving for chocolate brownies. What do scientists think may be causing her to crave the brownies?
Scientist do not have a clear explanation.

Which of the following food choices reflect(s) the most commonly craved foods?
Hot fudge sundae and nuts

All of the following contribute to causing food cravings except
Too much sleep

What do the appearance, taste, and aroma of food stimulate?
Appetite

What are the three main components of total energy expenditure?
Basal metabolism, physical activity, and thermic effect of food.

Shivering when you are cold at an event outdoors is an example of:
Nonexcercise activity thermogenesis

About how much of one’s total energy expenditure is due to one’s basal metabolic rate (BMR)?
50-70 percent

The majority of Total energy expenditure (TEE) is accounted for by
Adaptive thermogenesis

Basal metabolism is the energy expended to sustain all the following functions except?
Digestion

In order to use the Harris-Benedict equation to calculate an individual’s Resting energy expenditure (REE), you will need all of the following except the individual’s:
Activity level

What is the definition of resting energy expenditure (REE)?
The amount of kcalories required for a 24-hour period by the body during a non-active period

What is the Harris-Benedict equation used to calculate?
Resting energy expenditure(REE)

What two factors are not accounted for in the formula for calculating one’s resting energy expenditure (REE)?
Physical fitness and body composition

Even though they are the same age and have the same height and weight, Matt has more lean mass than Rob. Which of the following is true in this case?
Matt has a higher metabolic rate than rob

Your Asian-American, female client is 25 years old, weighs 110 pounds, and is 61 inches tall. According to the Harris-Benedict equation, her REE (in kcal/day) is:
1296

Sheila is 20 and her mother, Donna, is 50 years of age. Which statement accurately describes the relationship between their basal metabolic rates (BMR)?
Donna’s BMR is 4 to 10% less than Sheila’s.

What effect does hyperthyroidism have on basal metabolic rate (BMR)?
It causes BMR to increase

Why is it difficult to lose weight by simply eating fewer kcalories?
The body’s response to fewer calories is to reduce the BMR

Physical activity can be quite variable, accounting for, at most, _____% of TEE.
30

Which of the following is a list of energy expenditure factors arranged in order, left to right, from the one that requires the most to the one that requires the fewest kcalories?
Basal metabolic rate, energy for physical activity, thermic effect of food

What is the energy expenditure called the “thermic effect of food” used for?
Digestion, absorption, transport, metabolism, and storage of nutrients following a meal

Ramón consumed 2700 kcalories yesterday. What was his thermic effect of food (TEF) estimated to be?
135-270 kcalories

Which food combination would have the highest thermic effect of food (TEF)?
6 ounces of roast turkey, baked sweet potato, and skim milk

What does indirect calorimetry measure?
The exchange of oxygen and carbon dioxide

Which technique is considered to be the “gold standard” for estimating total energy expenditure (TEE)?
Use of doubly labeled water

Stan participated in a scientific study in which he had measurements of oxygen and hydrogen taken. What did Stan experience?
Use of doubly labeled water

jdljslajslsja
A;ldl;jljda;l

What is the definition of “obesity”?
Abundance of body fat

Juan-Juan is an elite athlete who runs a marathon 3-5 times each year. Would relying on her BMI to assess body weight be appropriate?
No, because she has a high lean mass relative to fat.

What is the approximate BMI for a person who weighs 220 pounds and is 5 feet 11 inches tall?
31 kg/m2

Your client is 69 inches tall and weighs 185 pounds. His BMI is?
27.3

Assessing your client’s BMI (69 inches, 175 pounds), you find that she is?
Underweight

What is considered to be the healthy range for an adult’s BMI?
18.5-24.9 kg/m2

Your female client has 28 percent body fat. She is
Normal

What body fat percentages for males and females, respectively, indicate obesity?
males, > 25%; females, > 33%

What principle is hydrostatic weighting based upon?
The more fat a person has, the less dense, and the they weight under water

What is the technique for determining body composition that relies on measuring the conduction of weak electric currents by adipose and lean tissue called?
Bioelectrical impedance (BIA)

Which body composition assessment method is considered the “gold standard”?
Dual-energy X-ray absorptiometry (DEXA)

What are the characteristics of central adiposity?
Accumulation of adipose tissue in the abdominal region

What type of obesity is associated with increased risk for developing cardiovascular disease, type 2 diabetes, and hypertension?
Central adiposity

Ryan has a waist circumference of 43 inches and a hip circumference of 40. What might a clinician conclude about Ryan?
He has central adiposity

Approximately what percentage of adults in the United States are classified as obese?
35%

By approximately how many kcalories has the daily energy intake of American adults increased over the last 40 years?
200-300

What have researchers found when studying portion sizes?
When larger portions are served people tend to eat more

A super-sized “value” fast-food meal can provide _____ of the calories required in a day.
More than half

What percentage of adults and children, respectively, are estimated to eat fast food daily?
37, 42 percent

Choose the list that correctly orders the following groups of Americans from the greatest prevalence of obesity (left) to the least (right).
African americans, hispanic, and white

What type of relationship is there between the level of physical activity and the risk of being overweight?
Inverse

If Sal added an extra mile of walking to his routine every day for one month, how much weight could he expect to lose by making only this change?
One pound

Which of the following recommendations is not included in the Physical Activity Guidelines for Americans?
Every U.S. adult should get 30 minutes or more of moderate-intensity activity twice a week.

According to the Physical Activity Guidelines for Americans, how much time, at a minimum, should children spend being physically active per week?
60 minutes a day, preferably 7 days a week

What is the definition of moderate-intensity physical activity?
Exertion that is 3.0-5.9 times as intense as rest

What have researchers learned about the causes of obesity from studying identical twins separated at birth?
Genetics contributes 50% risk, lifestyle contributes 50% risk

What hormone, discovered in mice in 1994, is thought to be a potent satiety signal
Leptin

Why hasn’t the hormone originally thought to be a potent satiety signal in mice been a miracle cure for obesity in people?
Few humans actually have a deficiency of this hormone

What does the set point theory suggest with regard to the body’s regulation of weight?
When the amount of adipose tissue increases beyond a “set point” a signal causes food intake to decrease and/or energy expenditure to increase.

Which tissues generate signals communicating information about the body’s energy reserves?
Brain and adipose tissue

Which of the following hormones appears to work in opposition to leptin?
Adiponectin

James is 5’8″ and weighs 235 pounds. What total level of weight loss is considered a realistic goal for James?
12-24 pounds

If Lynn, who now weighs 170 pounds, achieves the recommended rate of weight loss, what will she weigh (in pounds) in 8 weeks?
154-162

Which of these foods are considered high-energy-density foods?
Brownies, candy bars, crackers with cheese

Maria has lost 30 pounds. How many fewer kcalories does she now need every day just to maintain her new, lower body weight?
240

Typically, what is the ingredient that replaces the fat in low-fat snack products?
Refined carbohydrates

What accounts for much of the initial weight loss associated with a low-carbohydrate diet?
Loss of stored glycogen, and associated water

What are the long-term weight loss differences between those following low-carbohydrate diets and those following low-fat diets?
Those on low-carbohydrate diets lose the most.

What is most likely to be lacking in low-carbohydrate diets?
Essential macronutrients, dietary fiber, and phytochemicals

Adipocytes decrease in number as an individual loses weight.
False

An individual is satiated when he or she has satisfied his/her hunger.
True

Expansion of the stomach signals satiety to the brain.
True

Obese individuals tend to have larger stomachs than lean individuals.
True

Bariatric surgery is designed only for those with serious medical problems.
False

An elevated body temperature temporarily increases your BMR.
True

Loss of body tissue associated with fasting and starvation increases your basal metabolic rate.
False

Direct calorimetry measures the exchange of oxygen intake and carbon dioxide output.
False

Direct calorimetry is inexpensive to do and routinely used by registered dietitians in a practice setting.
False

The energy required to process food is called the processing load.
False

A BMI of 30 kg/m2 or greater is indicative of obesity.
True

DEXA uses X-ray beams to assess body composition.
True

Hydrostatic weighing uses a sealed chamber to measure air displacement.
False

Central adiposity is characterized by an apple shape.
True

Central obesity is more common in men and is characterized by subcutaneous fat deposits in the hips and thighs.
False

The waist-to-hip ratio or waist circumference can be used to determine one’s body fat distribution pattern.
True

Foundations of Nursing Exam 3 Nutrition

water soluble vitamins
Vitamin C and B complexes that the body cannot store, therefore people must get a daily supply in their diet

fat soluble vitamins
A, D, E, and K vitamins that the body can store.

Clear Liquid Diet
This diet is limited to water, tea, coffee, clear broths, ginger ale, or other carbonated beverages, strained and clear juices, and plain gelatin.
This diet provides the client with fluids and carbohydrates, but does not supply adequate protein, fat, vitamins, minerals, or calories.
It is short term and provided for clients after certain surgeries or acute stages of infection.

Clear Liquid Diet
Coffee, tea, carbonated beverages, bouillon, fat-free broth, clear fruit juices, popsicles, gelatin, sugar, honey, hard candy.

full liquid diet
This diet contains liquids or foods that turn to liquid at body temperature.
Often eaten by clients who have gastrointestinal disturbances or are otherwise unable to tolerate solid or semi-solid foods.

full liquid diet
All foods on the clear liquid diet plus: milk and milk drinks, puddings, custards, ice cream, sherbet, vegetable juices, refined or strained cereals, cream, butter, margarine, eggs, smooth peanut butter, and yogurt.

soft diet
This diet is easily chewed and digested. It is often ordered for clients who have difficulty chewing and swallowing. It is a low residue diet containing very few uncooked foods.

soft diet
All foods on full and clear liquid diets plus: meat, fish, or poultry, spaghetti with sauce, scrambled eggs, cottage cheese, vegetables, mashed potatoes, squash, uncooked or canned fruits, oatmeal, and soft cake.

pureed diet
A modification of the soft diet. Liquid may be added to the food, which is blended to a semisolid consistency.

Diet As Tolerated
Ordered when the client’s appetite, ability to eat, and tolerance for certain foods may change.

NPO
Stands for “nothing by mouth”

dysphagia
Due to this condition, these clients may have inadequate solid or fluid intake, be unable to swallow their medications, or aspirate fluid or food into their lungs- causing pneumonia. Clients at risk for this include: older adults, clients who have had a stroke, clients who have cancer and have had radiation therapy around the head or neck, and others with cranial nerve dysfunction.

dysphagia diet
Liquids: thin, nectar, honey, spoon thick and Semisolid/solid foods: Pureed, mechanical soft, regular/general

Body Mass Index
An indicator of changes in body fat stores and whether a person’s weight is appropriate for height, and may provide a useful estimation of malnutrition. Weight in kilograms/ Height in meters.

Underweight
BMI less than 18.5

Normal
BMI 18.5-24.9

Overweight
BMI 25-29.9

Obesity
BMI 30.0-39.9

Extreme Obesity
BMI 40 or greater

nasogastric Tube
A tube is inserted through one of the nostrils down the nasopharynx, and into the alimentary tract. Traditional firm, large-bore tubing will be placed into stomach.Used for feeding clients who have adequate gastric emptying, and who require short-term feedings.

nasogastric tube
They are not advised for feeding clients without intact gag and cough reflexes since the risk of accidental placement of the tube into the lungs is much higher in these clients.

Nasoenteric Tube
A longer tube than the nasogastric tube. It is inserted through one nostril down into the upper small intestine. These are used for clients who are at risk for aspiration. These clients include:
Decreased level of consciousness
Poor cough or gag reflexes
Inability to participate in the procedure
Restlessness or agitation

Gastrostomy
A tube that is surgically placed directly into the client’s stomach and provides another route for administering nutrition and medications.

Jejunostomy
A tube that is placed surgically or by laparoscopy through the abdominal wall into the jejunum for long-term nutritional support.

ch.9 nutrition exam

positive vs negative energy balance
positive energy balance equals weight gains, negative energy balance leads to weight loss

visceral adipose tissue located in the abdomen poses
heart problem

when a person loses weight, changes in body fat include
-waist circumference
-apple vs pear

waist circumference and an increased risk of type 2 diabetes
-men 40 inches or greater
-women 35 inches or greater

the hypothalamus is the region of the brain that regulates
hunger and satiety

hunger vs appetite
hunger describes a psychological drive to consume food, whereas appetite describes a psychological desire for food

stimulated by smell
appetite

3 true statements about ghrelin
1. Referred as the hunger hormone
2. blood levels of ghrelin decrease following a meal
3. if someone overproduced ghrelin, that person would not experience a feeling of satiety after a meal

gastric bypass surgery entails
diminishing the size of the stomach and bypassing a segment of the small intestines

3 components of total energy expenditure
1. basal metabolism
2. physical activity
3. thermic effect of food

BMR is the amount of energy expended per hour to
carry out basic functions such as breathing and beating of the heart

what percentage of TEE is BMR
50>70%

what factors affect BMR
body shape, body consumption, age, sex, nutritional status and genetics

Body mass index
a persons weight divided by the square of their height

gold standard for assessing body consumption
dual-energy x-ray absorptiometry

leptin participates in body weight regulation
-communicates energy reverses to the brain
-reflects change in adipose tissue
-defects in leptin signaling pathways

set point theory
when someone gains weight beyond his or her set point, signals are produced that cause an increase in energy expenditure and a decrease in food intake such that weight loss is induced

3 components of a healthy weight loss program
1. set reasonable goals
2. choose nutritious foods in moderation
3. increase energy expenditure

1-2 pounds per week
if a friend of yours wants to lose 15 pounds in 2 weeks on a very low calorie diet, what might you suggest is a more realistic goal?

the premise of low fat, high carbohydrate weight-loss diets
1. lower fat intake results in lower energy intake since fat contains more calories than carbohydrates or protein
2. high fat foods are more flavorful leading to a greater intake
3. storage fat is extremely efficient; therefore consuming less means less efficient fat storage

most successful weight loss strategy is to combine
a reduction in energy intake with an increase in daily physical activity

Nutrition Quiz 9 – Weight Management

An estimated ______% of the adult population(2010) has a BMI greater than 25 (overweight and obese)
-68%
-34%
-20%
-10%
68%

The major function of lipoprotein lipase is to
-removes triglycerides from blood for storage.
-release triglycerides from storage within adipocytes
-assist bile in the digestion of dietary lipids.
-trigger adipokine release from adipose tissue.
removes triglycerides from blood for storage.

What is the rationale for the fat cell theory of obesity?
-Fat cell number increases most readily in late childhood and early puberty
-Weight gain from overeating in adults takes place primarily by increasing the number of fat cells
-Fat cell number increases dramatically after puberty
-Fat cell number in an adult can decrease only by fasting
Fat cell number increases most readily in late childhood and early puberty

Hyperplastic obesity is related to a(n)
-increase in fat absorption.
-decrease in ketone formation.
-increase in the size of fat cells.
-increase in the number of fat cells
increase in the number of fat cells

Which of the following defines the body’s set point?
-Point above which the body tends to lose weight and below which it tends to gain weight
-Point at which a person’s weight plateaus before dropping again quickly
-Minimum weight of a person
-Maximum weight of a person
Point above which the body tends to lose weight and below which it tends to gain weight

Which of the following is a feature of ghrelin?
-It is a metabolic antagonist of leptin
-The blood level in the fasting state correlates directly with body weight
-It stimulates appetite and energy storage
-It is released in high amounts from adipocytes during periods of excess energy intake
It stimulates appetite and energy storage

Which of the following is a characteristic of the risk for obesity?
-It is higher in fraternal than identical twins
-It is associated more with environment than genetics
-It is usually higher in people with more brown adipose tissue
-It is higher in people who have obese friends, siblings, or a spouse
It is higher in people who have obese friends, siblings, or a spouse

Which of the following is NOT a feature of fat cell metabolism in men and women?
-Fat storage in men develops primarily across the abdomen whereas in women it is found chiefly around the hips and thighs
-Lipoprotein lipase enzyme activity is regulated by a gene that responds to weight loss
-The rate of fat breakdown is higher in women than in men
-The release of lower-body fat is more active in men than in women
The rate of fat breakdown is higher in women than in men

Which of the following is the best evidence that environment must play a role in obesity?
-The recognition that identical twins reared apart have body weights similar to their biological parents
-The development of precise body composition methodologies that define adipose storage sites based on gender
-The rate of obesity has been rising while the gene pool has remained relatively constant
-The discovery of uncoupling proteins that explain the variations in energy metabolism among lean and overweight people
The rate of obesity has been rising while the gene pool has remained relatively constant

Which of the following is NOT a characteristic of food portion sizes?
-They have increased in general and this change parallels the increasing prevalence of obesity
-They are both high in fat and large in size at restaurants
-They have increased most notably at fast-food restaurants compared with conventional eating establishments
-Reducing portion size has a bigger impact than reducing energy density as a means of lowering total energy intake
Reducing portion size has a bigger impact than reducing energy density as a means of lowering total energy intake

Besides portion size and overeating what is a very important environmental factor which has led to an increase in overweight and obese individuals
-eating too much processed foods
-physical inactivity
-drinking too much liquids
-eating too much carbohydrates
physical inactivity

Compared with non-obese people, obese people have a lower
-thermic effect of food
-physical activity level
-higher thyroid hormone level
-metabolic response to exercise
physical activity level

To help prevent body fat gain, the DRI suggests daily, moderately intense, physical activities totaling
-20 minutes
-60 minutes
-3 hours
-1 1/2 hours
60 minutes

What is the best approach to weight loss?
-Reduce daily energy intake and increase energy expenditure
-Avoid foods containing carbohydrates
-Eliminate all fats from the diet and decrease water intake
-Greatly increase protein intake to prevent body protein loss
Reduce daily energy intake and increase energy expenditure

The classification of underweight is achieved when the BMI first drops below
-18.5.
-14.
-20.
-22.5.
18.5

Which of the following would NOT be part of a successful program of weight gain in an underweight individual?
-Drink energy-dense beverages
-Engage in regular physical exercise
-Eat energy-dense foods
-Eat a large number of small meals
Eat a large number of small meals

Which of the following is generally NOT a strategy associated with successful weight loss efforts?
-Limiting television viewing time to <10 hrs. /week -Weighing yourself infrequently -Eating breakfast -Consulting a support person or group
Weighing yourself infrequently

What are the observed effects of sleep deprivation on leptin and ghrelin?
-Leptin decreases while ghrelin increases
-Leptin and ghrelin both decrease
-Leptin increases while ghrelin decreases
-Leptin and ghrelin both increase
Leptin decreases while ghrelin increases

Which of the following is NOT a feature of the effect of food accessibility on food intake?
-People underestimate the amount of a snack eaten when it is a short distance away
-People eat more of a snack when it is on their desk than when situated only 6 feet away
-People at home would rather travel to the store to obtain new food than eat the leftovers
-Keeping food out of sight is an effective way to eat less
People at home would rather travel to the store to obtain new food than eat the leftovers

Which of the following is a feature of gastric surgery for the treatment of clinically severe obesity?
-It is always an irreversible medical procedure
-Weight regain almost never occurs
-It is less effective than traditional liposuction
-It diminishes the amount of food that can be eaten without GI distress
It diminishes the amount of food that can be eaten without GI distress

The prescription drug phentermine acts by regulating the utilization of
-adipocyte lipoprotein lipase
-norepinephrine
-blood insulin
-hormone-sensitive lipase
norepinephrine

Approximately how many kcalories are expended per kilogram body weight when walking a mile at a moderate pace?
-0.1
-2.5
-1
-5
1

If a person weighs 176 lbs. and walks 3 miles per day for 7 days, how many kcalories would they spend by end of week?
-1680
-240
-2000
-560
1680

Approximately what percentage of overweight people who intentionally lose weight are able to maintain at least a 10% weight loss for at least one year?
-5
-85
-50
-17
17

To qualify for successful weight-loss maintenance, a 200-pound person who intentionally lost 20 lbs must hold the loss for at least
-2 years.
-6 months.
-1 year.
-3 months.
1 year.

Which of the following is a characteristic of most fad diets?
-They limit food choices, thereby reducing energy intake
-They are balanced and therefore do not require a dietary supplement
-They produce long-lasting results just like healthy diets
-Their success depends on the ratios of macronutrients more so than the total energy value
They limit food choices, thereby reducing energy intake

All of the following are characteristics of the results of weight-loss surgery EXCEPT
-medical supervision in the post-surgery period is required only for the first 6-9 months
-deficiencies of vitamins and minerals are common in the long term.
-dramatic improvements are seen in blood lipids, diabetes, and blood pressure.
-hunger is suppressed.
medical supervision in the post-surgery period is required only for the first 6-9 months

What is the principal reason that the FDA has banned the sale of products containing ephedrine?
-The products were found to be ineffective for weight loss
-The products were implicated in several cases of heart attacks and seizures
-The products were found to contain contaminants that were believed to be responsible for inducing liver failure
-The costs are prohibitive
The products were implicated in several cases of heart attacks and seizures

Kirima is a Native Eskimo who lives in one of the coldest regions in the world. What type of adipose tissue is most effective at helping her to maintain warm body temperatures during the coldest parts of the year?
-White
-Yellow
-Brown
-Black
Brown

Which of the following is not a risk factor assoicated with obese and overweight individuals
-impaired glucose tolerance
-sleep apnea
-infertility
-hypertension
infertility

Human Nutrition and Health Study Essay Sample

Human Nutrition and Health Study Essay Sample

1) Nutrients are chemical substances, found in foods, which are utilized in the human body.

2) Minerals, proteins, lipids, carbohydrates, and vitamins are essential nutrients in the human diet. Specifically, amino acids, fatty acids, and water are essential.

3) Non- essential amino acids are synthesized from other simpler nitrogen compounds. For instance, tyrosine, a non- essential amino acid, is synthesized from phenylalanine, an essential amino acid.

4) Protein deficiency malnutrition predominantly causes stunting, wasting, and general developmental disabilities. Other symptoms include: distended abdomen; alternating sections of light and dark hair; & dermatitis.

5) Phenylketonuria (PKU) is an inherited disorder which increases the amount of phenylalanine (an amino acid) in the blood to harmful levels. Effects of untreated PKU may include mental retardation, behavioral issues, seizures, delayed development, movement disorders, a musty odor, lighter skin and hair, and skin disorders such as eczema. Mild cases may not require treatment with a special diet. The main treatment for PKU consists of permanently reducing the amount of protein in the diet. For few people, medicine may help reduce phenylalanine blood levels when used with a PKU diet. Although any brain or nervous system damage that develops is irreversible, problems are less likely to occur if a PKU diet commences by 3 weeks of age.

6) Fatty acids have many variations in molecular structure. One variation is in the length, or how many carbon atoms are in the molecules. Another variation is whether there are double bonds between carbon atoms in the hydrocarbon chain or not. If there is a double bond, the fatty acid is unsaturated because the number of hydrogen atoms it can bond to is reduced. If there is solely one double bond in the hydrocarbon chain, the chain is monounsaturated; whereas, if there are more than one double bonds, the chain is considered polyunsaturated. Another variation in molecular structure which occurs with double bonds is the cis or trans orientation of the hydrogens attached to the double bonded carbon atoms. In the cis structure, both hydrogen atoms are bonded on the same side. In the trans structure, the hydrogen atoms are bonded on opposite sides. Refer to the image below for further clarification:

Image I: Cis vs. Trans

7) Dietary trans fatty acids (hydrogenated fat) increase LDL cholesterol levels, though they have little effect or decrease HDL cholesterol levels. Thus, there is a greater difference in the LDL cholesterol/HDL cholesterol ratio (which is unfavourable). Lipoprotein (a) levels incline with increased trans fatty acid consumption. Lp(a) is a putative risk factor for atherosclerotic diseases such as coronary heart disease (CHD) and stroke. Trans- fat also causes inflammation, which is thought to occur through damage to the cells lining of blood vessels. In autopsies post- CHD caused deaths, the majority of fat in arterial plaque is reported to be trans- fat. Cis-monosaturated fatty acids have been reported to decrease CHD. However, other factors related to cis-monosaturated fatty acids may vary (such as genetic factors) which may explain differences in the rate of CHD. Excessive consumption of saturated fatty acids has also been correlated with increased cardiovascular disease and CHD mortality. Omega-3 fatty acid deficiency is predicted to impair brain and eye development (because much of the tissues of these organs are composed of long- chain fatty acid, which are synthesized by omgea-3 fatty acids, among others).

8) Minerals are chemical elements (except C, H, N, and O which are present in common organic compounds), generally in ionic form, whereas vitamins are organic compounds.

9) One method of determining the recommended daily intake of vitamin C (ascorbic acid), occurred during WWII in England and the United States, in which volunteers ingested varying levels of vitamin C for an nearly ten months. Volunteers who consumed 70mg of vitamin C for six weeks and were deprived of the vitamin for the remainder of the trial developed survey, failed to heal when wounded, bled from hair follicles and gums, and multiple subjects developed cardiovascular problems. Trial subjects who ingested between 10 and 70mg remained healthy. Another procedure utilized to determine essential ascorbic acid intake was preformed on guinea pigs, as they, similarly to humans, cannot synthesize this vitamin. Concentrations in blood plasma and urine were monitored and collagen in skin and bone were evaluated.

10) Typically, the recommended adult dosage of ascorbic acid it 30- 60mg per day. This level is higher than necessary in order to maintain a safety margin. This is the recommended dosage in order to prevent scurvy.

11) There are few dietary sources of vitamin D. Oily fishes including herring, mackerel, sardines, and tuna are rich sources. Eggs and liver also contain low levels of vitamin D. Margarine and milk are artificially fortified with vitamin D.

12) Fibre is important in a balanced diet for three predominant reasons:

a. It aids your digestive system in processing food and absorbing nutrients.

b. It decreases blood cholesterol.

c. It maintains blood sugar levels and increases the bulk in the stomach, which in turn controls appetite.

d. It may reduce risk of diseases of the large intestine including appendicitis, cancer, and haemorrhoids.

e. It may decelerate the rate of sugar absorption, thereby preventing or treating diabetes.

13) 100g of carbohydrate or protein contains approximately 400 calories of energy, whilst 100g of fat generally contains 900 calories of energy.

Table I: Nutritional Energy

Nutrient

Energy (kJ/100g)

Carbohydrate

1760

Protein

1720

Fat

4000

14) In cases of anorexia nervosa, the individual does not consume enough carbohydrates or fats for use in cellular respiration. Therefore, protein is broken down. Consequently, muscles lose mass and become weaker; the individual experiences fatigue; hair becomes more brittle; the epidermis becomes dry; bruises are formed easily; there is a growth of fine hair on the body, blood pressure declines; circulation becomes poor and the heart rate decelerates; and in females, menstrual cycles often haul, yielding the individual infertile. Ultimately, chronic and extreme anorexia nervosa causes death.

15) Table II: Breast milk vs. Artificial milk

Breast milk

Artificial milk

Carbohydrate

Lactose

Lactose or glucose polymers

Protein source

65% human whey proteins; 35% casein

18% bovine whey; 82% bovine casein or soya proteins

Fatty acids

Human butterfat

Palm, coconut, soy, or safflower oils

Antibodies

Antibodies present in the colostrum

No antibodies present

16) Advantages of breast feeding:

a. Promotes bonding between mother and infant

b. Serves as a natural birth- control method, reducing the probability of conception while the mother is lactating

c. Aids the mother in post- pregnancy weight loss

d. Avoids the allergies to proteins in cows’ milk or soya that can develop when infants receive artificial milk

e. Breast milk is naturally sterile, and thus, is safer in areas where it is not feasible to attain sterile water for artificial milk.

f. Provides newborn infants with essential antibodies.

17) There is an absolute connection between cardiovascular problems (such as atherosclerosis, hypertension, and CHD) and blood lipid concentrations. Consumption of lipids in large quantities carries a significant risk of obesity and CHD (refer to question 7). The type of fat is a determining factor. Trans fats are the most associated with obesity and CHD. Because trans- fatty acids have been identified as factors which increase LDL concentrations and decrease HDL concentrations, high dietary trans- fat levels are attributed to obesity and CHD.

18) Food miles are a measure of how far a food item has been transported from where it was produced to where it is consumed. It is necessary to reduce food miles as they cause air pollution, traffic congestion, release greenhouse gases, and increased use of energy and fertilizer for year long production. A reduction in food miles would also instigate an increase in local market and economy.

19) Malnutrition refers to a medical condition caused by an insufficient diet. Specifically, the condition is generally caused by inadequate consumption, absorption, or retention of nutrients. It can also encompass the medical consequences of consuming an excessive amount of certain nutrients.

Resources:

http://children.webmd.com/tc/phenylketonuria-pku-treatment-overview

http://www.medicinenet.com/phenylketonuria/index.htm

http://www.madsci.org/posts/archives/2006-02/1139385004.Bc.r.html

http://www.ncbi.nlm.nih.gov/pubmed/10860195

http://en.wikipedia.org/wiki/Lipoprotein(a)

http://www.jlr.org/cgi/reprint/33/10/1493

http://en.wikipedia.org/wiki/Fatty_acid#Unsaturated_fatty_acids

http://en.wikipedia.org/wiki/Saturated_fat#Dietary_recommendations

http://www.netdoctor.co.uk/focus/nutrition/facts/lifestylemanagement/fibre.htm

http://www.merck.com/mmhe/sec12/ch152/ch152b.html

http://en.wikipedia.org/wiki/Malnutrition

http://membership.acs.org/C/carb/Glc.jpg

http://staff.jccc.net/PDECELL/biochemistry/phospolips1.gif

http://www.biosci.ohio-state.edu/~prg/protein1.gif

http://content.answers.com/main/content/wp/en-commons/thumb/2/29/250px-Periodic_table_of_the_chemical_elements_(1-118)Dietary_minerals.PNG

http://www.3dchem.com/imagesofmolecules/vitaminBc.jpg