KINE 1020 Exam

Formula for Obesity

BMI = weight (kg) / height (m2)

Relationship between Mortality Risk and BMI

Underweight (BMI)

Normal Weight (BMI)

18\.5-24.9 - least risk

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Overweight (BMI)

25\.5-29.9 - increased risk

Obesity

>30

Class I

30\.0 - 34.9 - High risk

Class II

35-39.9 - Very high risk

Class III

>40 - Extremely high risk

What is body comp broken down into?

fat and fat free mass

* fat free is everything that is not fat
* bone, organs, muscles, etc.

densitometry

* Archimedes’ Principle
* Density = mass/volume

MRI

Magnetic Resonance Imaging

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CT

Computed Tomography

Dual energy x-ray absorptiometry (DEXA)

* how easy radiation passed through the body

Bioelectric Impedance Analysis

* how well body can conduct electricity
* more water = better
* affected by hydration
* provides regions of body fat

Ultrasound

Subscious fat

Skinfold measures

* measures of skin and fat thickness at various sites
* can predict body fat

Common sites for Anthropometric Measures

BF prediction - Yuhasz Male and Females

BF prediction - Durnin

Female vs Male BF

females have higher body fat than males

Characteristics of Yuhaz formula

* 6 sites
* lower body site
* M/F diff in formula
* Age in formula

Durnin formula characteristics

* 4 sites
* no lower body site
* M/F diff in formula
* Age diff in formula

Others BF formula

* up to 12 sites
* lower body
* M/F diff
* Age diff

Body Comp pros and cons

Pro - ese of use, protability, time

Cons - cost, radiation, testing requirement

A body mass index:

from 18.5 to 24.9 has the lowest health risk

What body composition test uses magnetic properties of the body?

MRI

What are factors that influence skinfold fat equations?

* age
* Sex
* Physical activity
* A and B above
* All of the above

A and B

Obesity Trends

Obesity has been in an upward trend throughout the years

Parental Identification of Overweight

* 60% of mothers underestimate the weight of their child
* 80% do not see that their child is overweight

Obesity in kids trend

going down throughout the years

Cons of too much fat

1. Serious health risks - hypertension, diabetes, cancer, etc
2. limited physical due to lack of movement
3. stress on bones and joints


1. hip and knee replacements but some people don’t qualify because they are overweight
4. psychologically damaging - stereotypes of overweight people

medical complications of increased weight

* COVID 19 & H1N1
* Gall bladder disease
* Gynecologic abnormalities

Different types of fat

* visceral and subcutaneous
* not all fat is equal

what is visceral fat

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small contribution to total obesity but large contribution to obesity related disease

Absence of the effect of Lipo on insulin action and risk factors for coronary heart disease

* lipo = not helpful and does not target visceral fat
* 10-12 weeks post op results
* fat loss = 10 kg
* 13 cm waist circumference
* 44% abdominal sat

Waist Circumference - Gynoid

* not associated with health risk facts

Waist circumference - Android

* enhances risk for high BP, CVD, diabetes and abnormal blood lipids

BMI and WC

Increased BMI + Increased WC = Increased health risk

Components of Energy Expenditure

* Resting metabolic rate (RMR, 60-75%)
* # of calories needed on a daily to stay alive
* Thermic effect of food (TEF, 10%)
* eating, chewing, digesting
* Non exercise activity thermogenesis (NEAT, 15-50%)
* leisure, shopping, talking
* Exercise related activity thermogenesis
* negligible or zero in developed countries

BW and shape

40-70% genetics

genetics of obesity

>140 genetic regions that influence obesity traits

Higher risk of obesity

* platics
* pests
* textiles
* air pollution
* immigration
* etc.

Obesity Triggers

usually pregnancy or there is no specific trigger

Prenatal weight gain

mothers to be that had a bmi of 27 and over are 4 times more likely to have an overweight child at age three

* dietary traits to children
* diet iin the womb

Canada’s pregnancy weight gain guidelines

Advantages of Fat

* energy storage
* insulation
* sports: swimming
* appearance - limited amount is desirable
* improved survival rates for chronic and infectious disease

Body Energy stores of a lean 70-kg man

Obesity Paradox

* obesity survived longer because of metabolic reserves

Average weight gain per year

1\.8 - 2 ibs per year

What signals are reponsible for satiety messengers to brain

* Hunger - Grehlin
* Full - Leptin

Prader-Willi

Excess Ghrelin

* increased hunger and food consumption
* obesity
* does not shut off
* no meds

Satiety Hormone - Leptin

* regulating appetite (decrease) and increase metabolism

Deficiency of leptin in humans

* rare
* normal weight at birth
* constant hunger with chronic extra eating (hyperphagia)
* hoarding food, eating in secret

Leptin Resistance

* people with obesity have higher leptin level
* signal not receive
* increased food intake

Gut satiety hormones

* released in intestines in response to food and goes to the brain to decrease urges to eat
* high fibre diets stimulate greater gut hormone production = bulk travels through intestines
* people with obesity secrete less appetite reducing gut hormones
* given injections to be broken down in stomach

Volumetric - Energy Density

* choose lower calorie foods that fill you up

Fibre Pills

* Throught: decrease index of food and increase satiety
* Results: no significant effects on BW
* reductions for total and LDL cholesterol
* diarrhea and abdominal bloating

social factors that influence food intake

* portion size
* taste
* ads
* variety
* plate size
* availability

Fat burning zone

* does not exist

weight loss success rate

* 9 out of 10 adults who have tried to lose weight have attempted to do so on their own through diet and exercise
* \~50% of those who have ever used diet or exercise methods to lose weight report having done so at least 5 different times throughout their lives
* 20% of Americans with obesity have made 20 or more attempts to lose weight through diet or exercise methods
* 95% of people will not maintain reduced weight

Gilosis

* scar tissue in hypothalamus
* causes chronic obesity
* set point theory

are a little bit less

stores more fat overtime

weight loss with increases in skeletal muscle work efficiency

becomes more effective

PA and choice

due to genetics some people enjoy physical activity

Decreases in energy balance with weight loss

1. immediate, thermic effect on metabolism (digestion, transport, storage)
2. Changes in body com


1. weight loss, bm, skeletal muscle mass is loss and RMR goes down
3. Decreases RMR


1. excessive cal consumption RMR increase by 10-15%
2. servere cal restriction causes RMR to decrease (over 2-3 weeks = 20-30%)
3. decrease is more than expected given body comp changes
4. Increase energy efficiency

Successful Weight loss maintenance

cal consumption - 1400 kcal

exercise expenditure - 400 kcal

non-exercise activity- 1000 kcal

physiological consequences of repeated cycles of weight loss and weight gain

Increased:

* preference for dietary fat
* efficiency of fuel utilization
* ratio of total fat and lean mass
* redistribution of fat to abdominal area
* CHD and cancer risk factors

Decrease

* metabolic rate

Prescription weight loss drugs

* Xenical
* Saxenda

Prescription weight loss drugs - Bupropion/naltrexone combo

* Bupropion - depression and smoking
* Naltrexone - opioid/alcohol dependence
* appetite suppressant
* 8.1% WL
* $250/month

Semaglutide (wegovy)

* injectible for GLP-1 hormone
* Approved in Canada and USA
* 15% WL
* $1627 per month

How much wright do most people lose with these meds

* Xenical (orislate)
* 3%
* Contrave (naltrexone and bupropion)
* 8.1
* Saxenda (liraglutide)
* 8
* Wegovy (semaglutide)
* 15

Gastic surgery

* target food intake (size of stomach) or absorption (length of intestine)
* covered by OHIP

surgical weight loss and mortality risk

* 89% reduction in risk of death over 5 years
* 77% of weight management patients are not interested in bariatric surgery

weight times for weight loss surgery

* can range from a couple months up to 15 years

Hormonal changes with bariatic surgery

* unless you change physiology, nothing will change

top reasons for not being interested in bariatric surgery

* feat of other complication
* don’t need surgery to lose weight
* fear of surgery
* pain
* cost

health care professionals do not listen

* late diagnosis
* told not to eat as much

weight loss products

* a scam

Anorexia Nervosa

* body image distortion
* extremely low body weight
* fear of gaining weight
* see themselves as larger
* more common in women
* excessive eercise
* misuse of laxatives, dirt aids
* self-induced vomiting

Anorexia Nervosa - signs and symptoms

* insomnia
* weight loss
* abdominal pain
* anaemia
* disguise body
* denies hungerv

Anorexia Nervosa consequences

* heart problems - consumes body mass
* anaemia
* kidney stones
* lack of periods
* higher risk for miscarriage
* high death rate

Bulimia Nervosa

* periods of food restirctions then binge eating cycle
* lack of control of what they are eating - feeling
* normal or overweight
* 1-3% of pop
* 90% cases are female

Bulimia Nervosa signs and symptoms

* weight change
* tooth pain
* swelling in cheeks and jaw
* dehydration

Differences between anorexia and bulimia

eating disorders - deadliest mental health condition

* depression shortens life by 10 years
* Anorexia
* age of death = 36 years
* 16 years from disorder to death
* BN
* age at death = 42 years
* 19 years from disorder to death

Risk factors of eating disorders

* genetics
* body dissatisfaction
* low self-esteem
* personality traits
* influence of social media

eating disorders in athletes

* 0-19% in males
* 6-45% in females

Chisty Henrich

* told to lose weight because she was too fat
* age 16, 147cm, 93ibs, 19.8 kg/m^2
* died at age 22 - 13.0 kg/m^2

treatment for eating disorder

* accept the have a problem
* nutritional therapy
* psychotherapy
* support groups
* medicine

recovery eating disorder

* most patients will replase

death - eating disorders

* males have higher mortality rate

ideal balanced blood sugar

* 5 mmol before meal
* 5-7 idea balanced blood sugar
* 9 mmol should go down after the meal

amount of glucose in the bloodstream

* 5 mmol before meal
* 4 grams before meal
* 7.3 grams after meal

raises blood surgar

* carbs
* illness and stress hormones
* growth and growth hormones
* hormone glucagon -→ anti insulin hormone

lower blood sugar

* hormone insulin
* mild to moderate PA

Insulin and Glucagon

* comes from pancreas
* glucose homeostasis is controlled by liver
* picks up chemical signals of insulin and glucagon from pancreas via portal veins

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alpha cells

glucagon

beta cells

insulin

Insulin and Glucagon regulates glucose levels

* liver has receptors
* glucagon makes liver flood stored glycogen into blood stream from sugar