EPHE 155 quiz 3

what does BMI stand for?

body mass index

what are some risks of being underweight?

cancer, heart disease, wasting disease, famine

what are some risks of being overweight?

chronic diseases such as hypertension, heart disease and diabetes

visceral fat

Accumulates within the abdominal cavity, Fat is readily released into the bloodstream, Increases risk of death from all causes

subcutaneous fat

Accumulates just below the skin surface

Fat distribution

Apple vs. pear, Factors affecting distribution

what are some factors that affect body fat distribution?

smoking, alcohol intake, physical activity, menopause

fat located where can be unhealthy?

The fat deep within the body's abdominal cavity may pose an especially high risk to health

what is the BMI for?

General guidelines to evaluate the health risks of an individual (underweight, overweight, obese)

what are the requirements to diagnose obesity?

BMI in combination with a measure of body composition and fat distribution is needed for a diagnosis of overweight obesity

positive vs negative energy balance

positive- gain weight (energy)
negative- lose weight (energy)

basal metabolism

- Minimum energy expended to keep a resting, awake body alive
- Includes energy needed for maintaining heartbeat, respiration, body temperature
- Approximately 1 kcal/minute

factors that affect BMR?

age: BMR higher in youth
height: taller people have higher BMR
body composition: people with more lean tissue have higher BMR

physical activity

- Increases energy expenditure
- More activity = more energy burned
- Lack of activity is a major cause of obesity

thermic effect of food (TEF)

- Energy used to digest, absorb, and metabolize food nutrients
- TEF is highest for protein >carbohydrate > fat

adaptive thermogenesis

Nonvoluntary physical activity ex. fidgeting and shivering

how do you determine the REE (required energy estimate)?

Multiply body weight in lbs. by 10 for women or 11 for males

what is hunger triggered by?

-Contracting empty stomach
-Empty small intestine
- Stomach hormone (grehlin)
-Chemical and nervous signals in the brain

appetite vs hunger

appetite can override hunger resulting in over eating

satiation

- Various organs are involved, including the stomach, small intestine, and brain(hypothalamus)
- Receptor nerves and hormones are involved in the process

satiety

- Perception of fullness
- Hunger outweighs satiety in the appetite control system

which nutrient is the most satiating of the macronutrients

protein

what influences obesity?

- Genetic inheritance strongly influences a person's tendency to become obese
- Lifestyle choices can also influence tendency of obesity

what are 3 external cues to overeating?

available foods, human sensations, stress

strategies for weight loss/maintenance

- Choose moderate activities
- Invest longer times in physical activity
- Adopt informal strategies to be more active

strategies for building lean body mass

- Choose strength-building exercises
- Perform exercises with increasing intensity

what might a 1-2 pound change in body weight indicate?

- change in body fat
- Shift in body fluid content, bone minerals ,lean tissue
- Contents in the bladder or digestive tract

is body weight affected by the time of day?

yes

what are some benefits of exercise?

- increase energy expenditure
- Preservation of lean tissue
- increase fat utilization

why is gradual weight loss preferred?

This will spare lean tissue, and fat is lost

fasting- early deprivation

- The nervous system cannot use fat as fuel
- Body fat cannot be converted to glucose
- Body protein can be converted to glucose

fasting- later deprivation

Ketone bodies help feed the nervous system and so help spare tissue protein

what are the 2 types of diseases?

infectious and degenerative

infectious diseases

Caused by bacteria, virus, parasite, or other microbe
ex. Tuberculosis, polio, influenza

degenerative diseases

- Chronic, irreversible
- Due to personal lifestyle choices (food, smoking, alcohol, lack of physical activity)
- Leading causes of death in Canada

describe the relationship between malnutrition and disease

Malnutrition worsens disease, and disease worsens malnutrition

what are the effects of PEU (protein-energy undernutrition) on skin?

skin becomes thinner, less connective tissue

what are the effects of PEU on digestive tract membrane?

antibodies secretions and immune cell numbers reduced

effects of PEU on lymph tissues?

immune system organs are reduced in size, immune cells are depleted

what are some toxicities that impair immunity?

iron and zinc

what are some deficiencies impairing immunity?

energy, protein, vitamins AEDK, B vitamins, folate

atherosclerosis

Hardening of the arteries caused by plaques, body's inflammatory response to tissue damage

what contributes to the build up of plaque? and what does this cause?

High saturated fat diet, causes cardiovascular disease

how does atherosclerosis develop?

High LDL cholesterol, Hypertension, Toxins from cigarette smoking, Elevated homocysteine levels in blood, Viral or bacterial infections

thrombus

stationary blood clot

thrombosis

Large clot that closes off a blood vessel

Embolus

A clot that breaks loose

Embolism

A clot that becomes stuck

diet to reduce CV risk

- Controlling dietary lipids
- Reduce saturated and trans fats
- Limit dietary cholesterol
- Diet rich in omega-3 fatty acids
- Fibre, nutrients, and phytochemicals

what are some examples of viscous (soluble) fibre?

oats, barley, legumes

effects of alcohol on blood clots

middle age/older people that drink 1-2 drinks per day: raise HDL cholesterol concentrations and reduce risk of blood clots

systolic pressure

Ventricular contraction

diastolic pressure

relaxation

describe the relationship between salt and blood pressure

Direct relationship between salt intake and blood pressure

how does alcohol affect blood pressure?

If consumed in high doses, increases blood pressure

which micronutrients can prevent hypertension?

Calcium, potassium, magnesium, vitamin C

energy balance and cancer

Cancer prevention only

fat/fatty acids and cancer

A cancer promoter (in animal studies)

alcohol and cancer

Strong correlation with head and neck cancers

meat and cancer

Diets high in red meat have been linked with increased cancer risk

Acrylamide and cancer

Carcinogenic effect seen in lab animals, Found in carbohydrate-rich foods (e.g., potatoes)cooked at high temperatures

folate/vitamins and cancer

Folate deficiency linked with cervical and colon cancer

calcium/minerals and cancer

- High-calcium intake linked with prevention of colon cancer
- High iron intake associated with colon cancer

what are some effects of alcohol?

impairing balance, motor coordination, decision making, memory impairments beginning after just one or two drinks

what is alcohol made from?

made from carbohydrates and is an energy source

who has the largest influence on kid's alcohol consumption?

parents

describe alcohol absorption

Absorbed rapidly via simple diffusion, Depends on rate of stomach emptying

what is the rate of absorption for different alcohols?

1. wine (fastest)
2. hard liquor
3. beer (slowest)

where is alcohol found in the body?

wherever there is water

how does alcohol move through the body?

Easily moves through the cell membrane (damaging it)

what does alcohol metabolism depend on?

Gender, ethnicity, size, food, physical condition, alcohol content

where is alcohol metabolized?

in the liver

can alcohol be stored?

no

What does MEOS stand for?

microsomal ethanol oxidizing system

describe the genetics of metabolism

- Variations of the ADH & ALDH
- Impact how much someone drinks
- A fast ADH and slow ALDH, buildup of acetaldehyde

describe what one drink is for different kinds of alcohol

- 12 oz beer or wine cooler
- 5 oz wine
- 3 oz sherry or liqueur
- 1.5 oz 80-proof distilled spirits

what are the benefits of 1-2 drinks per day?

- increase HDL
- Decrease chronic inflammation
- Improves body use of insulin &glucagon
- Improves cognitive function
- Phytochemical content

what are the negatives of alcohol consumption?

- high blood pressure
- stroke
- dementia
- cancer
- vitamin and mineral deficiencies

describe how females metabolize alcohol

- Females cannot metabolize much alcohol in the cells that line the stomach (less ADH in stomach cells)
- less body water to dilute the alcohol
- Fluctuations in female hormones affects alcohol metabolism

how much alcohol is metabolized per hour?

- Metabolize 5-7g of alcohol/hr
- Amt in about ½ 12oz beer, 5 ounce glass of wine or 1.5 oz shot

alcohol abuse + tobacco

Increases the risk for esophageal and oral cancer

what are some effects of alcohol abuse?

Heart damage, arrhythmia, hypertension, stroke, osteoporosis, brain damage, colorectal cancer, breast cancer, nutritional deficiencies, fetal damage, obesity

Cirrhosis

- Fatty infiltration of the liver
- Increased synthesis of fat
- Destruction of vital tissues regardless of diet
- Enlarged fat cells: choke off nutrient and O2 supply to liver cells

Guidance Regarding Alcohol

- Drink with meals
- Don't drink and drive
- Avoid drinking while pregnant

blackouts

- Interferes with transfer of knowledge from short to long term memory
- Caused by disruption of activity in the hippocampus region of the brain
- related to the rate of alcohol ingestion

what is the average age kids start drinking?

14

alcohol dependence

- Most common psychiatric disorder
- Affects 13% of North Americans

nutrient deficiencies related with alcohol consumption

Thiamin, niacin, B12, A, C, D and folate

effects of the lack of thiamin?

Lack of thiamin impairs brains utilization of glucose

what is niacin used for?

alcohol metabolism

Korsakoff's syndrome

Permanent damage to short term memory

"Self-medication" with alcohol

- Alcohol may increase serotonin and dopamine
- Alcohol is actually a depressant

Diagnosis of alcohol dependence

-Physiological dependence on alcohol
-Tolerance to the effects of alcohol
-Alcohol-associated illnesses (memory loss, liver disease, etc.)
-Continued drinking in defiance of medical and social contraindications
-Depression and blackouts
-Flushed face/reddened skin

CAGE Screening

C: Have you ever felt you ought to CUT down on drinking?
A: Have people ANNOYED you by criticizing your drinking?
G: Have you ever felt bad or GUILTY about your drinking?
E: Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover? (As an EYE OPENER)

Screening

- Have you had memory lapses or blackouts?
- Do you continue to drink even though you have health problems caused by alcohol?
- Do you get withdrawal symptoms?
- Do you take part in high-risk behaviors?

binge drinking

4-5 or more drinks in 2 hours (BAC = 0.08or above)

what did Twiggy & Karen Carpenter eat?

Lived on lettuce, water & a single serving of steak/day

eating disorder

psychiatric condition involving extreme body dissatisfaction and long term eating patterns harming the body

disordered eating

variety of abnormal or atypical eating behaviors used to reduce weight

what types of families do eating disorders occur in more often?

in families with a history of OCD, anxiety disorders& depression