Unit 14 FNDH

By 2044, some are predicting that the childhood obesity rate may be as high as _______%

100 Right! Good job! From Zimmerman & Snow (2012): "Some scientists predict that the childhood obesity rate will reach 100 percent by 2044."

The average fashion model has a BMI of _____ yet a BMI of less than ______ is considered underweight.

16 18.5 Right! Good job! The average fashion model has a BMI of 16, yet a BMI less than 18.5 is considered underweight. Only 25% of the women in this country even have a BMI less than 25

Overweight

25.0-29.9

Obese

30+

Men with a waist circumference greater than ____ inches and women with a waist circumference greater than ____ inches are predicted to face greater health risks.

40 35 Right! Good job! "Men with a waist circumference greater than 40 inches and women with a waist circumference greater than 35 inches are predicted to face greater health risks," (Zimmerman & Snow, 2012).

As of 2013, only Colorado has an obesity rate of less than 20% of its population. True False

False. Right! Good job! As of 2013, no state in the US has an obesity rate less than 20% of its population

Despite its limitations, BMI status is correlated with disease risk. True False

True. Right! Good job! "A BMI is a fairly simple measurement and does not take into account fat mass or fat distribution in the body, both of which are additional predictors of disease risk...[a] BMI is a useful inexpensive tool to categorize people and is highly correlative with disease risk, but other measurements are needed to diagnose obesity and more accurately assess disease risk..."

Which of the following is NOT TRUE about the relationship between genes, environment, and weight status? a. Genetic predispositions to obesity places you at risk for developing overweight/obesity. b. If you're genetically predisposed to obesity, there's little you can do to avoid weight gain. c. Environmental factors play a large role in determining the health outcomes of those genetically predisposed to overweight/obesity. d. Human bodies/genetics have not changed significantly over the past 40,000 years.

b. If you're genetically predisposed to obesity, there's little you can do to avoid weight gain. Right! Good job! Genetics can account for some 60% of the difference in weight status amongst different people, but it doesn't mean that a person is destined to become overweight or obese. It just means that a person is more susceptible to obesity and an environment of abundant, inexpensive food

Which of the following statements about weight loss is false? a. A reduction of 5% to 10% of current body weight produces significant health benefits b. Only achieving your ideal body weight will result in health benefits. c. Weight loss reduces the number of calories a person needs daily d. Six months time for gradual weight loss is actually reasonable

b. Only achieving your ideal body weight will result in health benefits. Right! Good job! Ideal body weight doesn't actually exist (yes, there's a calculation you can do, but the results have little relationship with reality).

Which of the following is NOT something an individual can do at the national level to improve obesigenic environments? [mark all correct answers] a. Support policies that increase the walkability of cities. b. Patronize local farms and fruit-and-vegetable stands. c. Watch less television. d. Support policies that support local farmers.

b. Patronize local farms and fruit-and-vegetable stands. c. Watch less television. Right! Good job! From Zimmerman & Snow (2012): "National Level: Support policies that increase the walkability of cities; Support national campaigns addressing obesity, such as America on the Move; Support policies that support local farmers and the increased access and affordability of healthy food."

Which of the following is TRUE of specific methods used to assess body fat content? a. Weighing people underwater to assess body density is called flotation mass index. b. Skinfold measures require multiple measurements on bare skin by a skilled practioner who accuratly measure the placement areas of the caliphers prior to beginning skinfold measures. c. Bioelectric impedance cannot be used in subjects under 18 years old due to the risk of nerve damage d. Sitting inside a chamber to displace the air within the chamber as a means of determining body composition is not an accurate technique

b. Skinfold measures require multiple measurements on bare skin by a skilled practioner who accuratly measure the placement areas of the caliphers prior to beginning skinfold measures. Right! Good job! Skinfold measures need to be done by skilled practioners who measure multple sites on the body. Prior to using the skinfold caliphers, they actually need to measure the body to determine where the caliphers need to be placed. Measures must be done on bare skin for accuracy.

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

b. The rate of obesity has been rising while the gene pool has remained relatively constant Right! Good job! Human genes take quite some time to really change yet our dietary and physical activity habits have changed rapidly and coincided with a rise in obesity levels.

Which of the following environmental influences is most likely responsible for our obesity epidemic? a. our genetics b. increases in food abundance and availability c. decreases in physical activity d. the introduction of genetically modified foods

b. increases in food abundance and availability Right! Good job! An increase in calories appears to be primarily responsible for the obesity epidemic with American diets increasing by ~760 calories since the 1950's. There are no scientifically established risks to the consumption of GMOs and genetics are not an environmental factor.

Jody is taking a nutrition class, and has been assigned to evaluate a popular diet plan. She finds a description of a plan for her assignment in a magazine at the grocery store. Which of the following statements in the magazine would suggest that this plan is an unsound, fad diet? a. "Keep fresh fruit or carrot sticks in the fridge at work so you won't be tempted to raid the vending machine for a snack." b. "Starting an aerobic exercise plan may seem daunting, but you can start out with shorter, easier sessions and then build up to 3 or more hours a week." c. "Once you complete this 6-month plan, you'll never have to diet again." d. "On this plan, you can lose up to 1/2 pound per week!"

c. "Once you complete this 6-month plan, you'll never have to diet again." Right! Good job! Healthy eating is a lifelong journey, one without any clear end, you don't get to do it once & then never have to worry about it again; 1/2 pound weight lost per week is actually reasonable :)

In the United States, being underweight is most likely NOT caused by... a. ...an eating disorder. b. ...an underlying medical condition such as cancer. c. ...food insecurity. d. ..drug or alcohol addiction.

c. ...food insecurity. Right! Good job! The paradox of hunger in the United States as that the most food insecure among us are the most likely to be overweight and obese. This is due to the fact that most cheap food is relatively unhealthy while the cost of fresh, healthy food is often out of reach for many Americans.

Adipose cells can expand to over ___________ times their original size. a. 10 b. 100 c. 1,000 d. 10,000

c. 1,000 Right! Good job! Adipose tissue increases by increasing its size or number of cells. Hypertrophy is the most common way that adipose tissue increases in size (that is, the cells just get bigger). Adipose cells can become over 1000 times their beginning size.

In what region of the body is the storage of excess body fat associated with the highest risks for cardiovascular disease and diabetes? a. hips b. thighs c. abdomen d. buttocks

c. abdomen Right! Good job! Excess visceral fat that is stored around the organs of the abdomen is referred to as central obesity or upper-body fat. Independently of BMI or total body fat, central obesity is associated with increased risks of heart disease, stroke, diabetes, insulin resistance, hypertension, gallstones, and some types of cancer.

Worldwide, obesity and overweight is _____ leading cause of death.

fifth Right! Good job! "The WHO reports that overweight and obesity are the fifth leading cause for deaths globally, and estimates that more than 2.8 million adults die annually as a result of being overweight or obese," (Zimmerman & Snow, 2012).

In order to improve blood glucose levels and blood pressure, overweight/obese people benefit from... a. ...losing 5 to 10% of their current body weight. b. ...going on a strict diet. c. ...undergoing gastric bypass surgery. d. ...none of these.

a. ...losing 5 to 10% of their current body weight. Right! Good job! As little as 10% of current body weight lost and kept off for a year can cause improvements in chronic disease risk! This is very important because few obese people are ever able to achieve, much less maintain, dramatic weight losses. This is not due to a failure of willpower, but to the complex combination of genes and environment that is the original cause of the obesity in the first place!

As of 2013, which states had the highest obesity rate? [mark all correct answers] a. Mississippi b. Colorado c. Louisiana d. West Virginia

a. Mississippi d. West Virginia Right! Good job! According to the 2013 BRFSS, both West Virginia and Mississippi had greater than 35% of their population as obese (this does not include overweight AND obese, just obesity).

What is the definition of "weight cycling"? a. the cycle of dieting, losing weight, ending the diet, and regaining lost weight. b. a method of strength training involving various poundages of weight equipment. c. a fasting diet that alternates fasting days with unrestricted days. d. none of these are the definition

a. the cycle of dieting, losing weight, ending the diet, and regaining lost weight. Right! Good job! "Weight cycling" or "yo-yo dieting" is the cycle of dieting, losing weight, ending the diet, and regaining lost weight.

Which of the following is an example of a reasonable, achievable, and specific lifestyle change goal? a. ""My family and I will go from never eating a meal together to eating a meal together once a day every day." b. "My family and I will have a meal together at least three times per week for the next two weeks." c. "I'm going to achieve my ideal body weight." d. "I will eat less meat."

b. "My family and I will have a meal together at least three times per week for the next two weeks." Right! Good job! The correct answer: "My family and I will have a meal together at least three times per week for the next two weeks," is a goal that is specific, reasonable, and achievable. ""My family and I will go from never eating a meal together to eating a meal together once a day every day," is a specific goal but not particularly reasonable/achievable. "I'm going to achieve my ideal body weight," is a goal that is too broad and with limited likelihood of achievability. Finally, "I will eat less meat," is a reasonable goal but fails to be specific.

Underweight

18.49-less

"Normal" Weight

18.5-24.9

Calculate the BMI of a woman weighing 150 pounds who is five foot nine inches tall and 21 years of age. (This a numerical answer. example: "15" or "15.0", not "fifteen").

22. Right! Good job! The BMI calculation is weight in pounds divided by height in inches, the total divided by height in inches again, and then that total multipled by 703.

The Rock's cousin Fred has a BMI of 24.0. Fred doesn't work out and has a waist circumference of 41 inches. His BMI indicates that he is of normal weight and therefore at little risk of chronic disease. True False

False. Right! Good job! "Normal" weight does not necessarily equal healthy weight or someone who consumes an adequate diet and is physically active.

The majority of people who enter a weight loss program are able to keep their weight off afterwards. True False

False. Right! Good job! "Results from lifestyle intervention studies suggest fewer than 20 percent of participants are successful at weight loss. An evaluation of successful weight loss, involving more than fourteen thousand participants published in the November 2011 issue of the International Journal of Obesity estimates that more than one in six Americans who were overweight or obese were successful in achieving long-term weight loss. However, these numbers are on the high end because many similar studies report fewer than 10 percent of participants as successful in weight loss," (Zimmerman & Snow, 2012).

The only way for people to improve their health is to make drastic changes in physical activity levels and dietary patterns. True False

False. Right! Good job! Check out the section in Zimmerman & Snow (2012), entitled 'The "Small-Change" Approach'--though this theme is also brought up throughout the reading.

According to the article, the primary reason we've had an increase in obesity both worldwide and in the US is that people do not have enough willpower to stop eating so much. True False

False. Right! Good job! From Zimmerman & Snow (2012): "The Centers for Disease Control and Prevention (CDC) defines obesogenic as 'an environment that promotes increased food intake, nonhealthful foods, and physical inactivity'...[n]umerous obesogenic agents that contribute to this immense public health problem have become a part of everyday life in American society...[f]ood portions have been getting bigger since the 1960s...[b]etween 1960 and 2000 more than 123 million vehicles were added to the American society. Escalators, elevators, and horizontal walkways now dominate shopping malls and office buildings, factory work has become increasingly mechanized and robotized, the typical American watches more than four hours of television daily, and in many work places the only tools required to conduct work are a chair and a computer..."

Duane "the Rock" Johnson's BMI is 34.3. This means that he is obese and at risk for chronic disease. True False

False. Right! Good job! In the case of athletes, it is not uncommon to have elevated BMIs while having low levels of body fat.

Around 40% of US pets are considered obese or overweight. True False

False. Right! Good job! Over half of all US pets are considered overweight or obese.

The "non-diet" approach just means that people will give up on dieting and exercise and return to eating whatever they want. True False

False. Right! Good job! The non-diet approach takes the emphasis off weight monitoring, but it DOES involve making healthy changes for the sake of their health benefits rather than out of a drive to look better or to lose weight.

The current medications available for weight loss are 100% effective at helping people achieve their ideal body weight. True False

False. Right! Good job! There are no medications that contribute to permanent weight loss. In fact, most weight loss medications only work best in conjunction with dietary changes and exercise.

Only men have excess visceral abdominal fat while only women have excess thigh & hip fat. True False

False. Right! Good job! Visceral fat is most common in men but does appear in women as well. However, even when total body fat is similar, men have more visceral fat than women. Regardless of gender, the risks of cardiovascular disease, diabetes, and mortality are increased for those with excessive visceral fat.

During weight loss, both the size and the amount of fat cells decreases. True False

False. Right! Good job! While the size of adipose cells can decrease the number doesn't actually decrease. One of the issues with childhood obesity is that overweight and obese children lay down more fat cells as they grow than normal weight children. The more fat cells one has, the easier it is for fat to be deposited back which is why it is very hard to keep gained weight off and why prevention of childhood obesity is so critical

A successful weight loss and weight maintenence program requires both changes in diet AND physical activity. True False

True. Right! Good job! "In most scientific studies successful weight loss is accomplished only by changing the diet and by increasing physical activity. Doing one without the other limits the amount of weight lost and the length of time that weight loss is sustained," (Zimmerman & Snow, 2012).

Worldwide, overweight and obese people outnumber underweight people. True False

True. Right! Good job! "The number of people considered overweight and obese in the world has now surpassed the number that are starving, with some officials estimating that the number of overweight people is nearly double the number of underweight people worldwide. Countries that have more recently modernized, industrialized, and urbanized are experiencing a surge in their overweight and obese populations," (Zimmerman & Snow, 2012).

Eating daily meals from sources outside the home does not significantly impact obesity risk. True False

True. Right! Good job! About 1/3 of our calories come from ready-to-eat foods prepared outside of home. Frequent dining out associated with higher BMI.

Body weight is not an indication of nutrient adequacy. True False

True. Right! Good job! Body weight can be a measure of energy adequacy or inadequacy but CANNOT reflect the adequacy of macro- and micro-nutrient intake. Nor can it tell you if a person is eating a healthy diet. In other words being skinny does not equal being healthy anymore than being curvy does not mean you don't eat healthy.

In adopted children living in the homes of normal weight parents, if their biological parents are overweight/obese, they are still more likely to be at risk for overweight/obesity. True False

True. Right! Good job! We know that genetics relates to obesity from studies of adoptive children which showed that they tend to be closer in weight status to their biological parents rather than their adoptive and studies of identical twins separated at birth which showed they tend to have similar weights even though they grew up indifferent environments.

Athletic ideals in males have grown more muscular over time. True False

True. Right! Good job! Women aren't the only ones feeling the pressure of unrealistic body image ideals. Men are increasingly under pressure to become more "cut", often leading to unhealthy practices.

Which of the following environmental factors contribute to excessive caloric consumption and inadequate calorie expenditure? [mark all correct answers] a. 32% of our daily calories come from outside our homes. b. 40% decline in time spent in food preparation at home. c. Decrease in availability of organic foods. d. Increase in the variety of foods available. e. Increase in jobs requiring manual labor. f. Increase in technology which decreases calories expended during work and activities of daily living.

a. 32% of our daily calories come from outside our homes. b. 40% decline in time spent in food preparation at home. d. Increase in the variety of foods available. f. Increase in technology which decreases calories expended during work and activities of daily living. Right! Good job! Environmental influences on obesity include: overeating: abundant foods, variety of foods, energy-dense foods, and larger portion sizes; reduction in physical activity: change in work activity, change in activities of daily living, and technology & transportation changes.

Which of the following are part of the Heathy at Every Size Live Well pledge? [mark all correct answers] a. Today, I will try to honor my body's signals of fullness. b. Today, I will try to find an enjoyable way to move my body. c. Today, I will try to be attentive to how foods taste and make me feel. d. Today, I will keep my focus on what I want to look like rather than what I look like now.

a. Today, I will try to honor my body's signals of fullness. b. Today, I will try to find an enjoyable way to move my body. c. Today, I will try to be attentive to how foods taste and make me feel. Right! Good job! The last possible answer is incorrect. The non-diet approach doesn't involve restricted calorie diets and weight goals so much as focusing on achieving health through lifestyle changes and acceptance of size and the diversity of body shapes and sizes.

Which of the following appears to contribute to the global obesity epidemic? [mark all correct answers] a. urbanization b. modernization c. environmentalization d. industrialization

a. urbanization b. modernization d. industrialization Right! Good job! "Similar to other public health organizations, the WHO states the main causes of the obesity epidemic worldwide are the increased intake of energy-dense food and decreased level of physical activity that is mainly associated with modernization, industrialization, and urbanization," (Zimmerman & Snow, 2012).

A healthy body weight... [mark all correct answers] a. ...is your Ideal Body Weight (100# plus 5# for every inch over 5 foot for women & 106# plus 6# for every inch over 5 feet for men). b. ...is considered a body weight that doesn't increase your risk of developing weight-related health issues. c. ...is a weight at which you feel energetic and fit. d. ...is a realistic weight that you can maintain naturally through a healthy diet. e. ...is defined by the fashion industry.

b. ...is considered a body weight that doesn't increase your risk of developing weight-related health issues. c. ...is a weight at which you feel energetic and fit. d. ...is a realistic weight that you can maintain naturally through a healthy diet. Right! Good job! A healthy weight differs for each and every person. People can be healthy and live healthy lifestyles even if their body composition and looks do not match that of the current fashion ideal. The "ideal" body weight (while there still exists a calculation for it) doesn't apply to majority of the population (it's based on upper-class European-Americans who lived on the east coast during the 1920's!). The ideal body weight of a female fashion model is so low that most women wouldn't even be fertile with that little body fat. Most obese and overweight people will never obtain an "ideal" weight, but if they can lose 10% of their current body weight AND keep it off, they will experience reduced risk of chronic disease.

Which of the following is TRUE of weight-loss remedies? a. Body wraps and creams that have FDA approval are helpful for weight-reduction regimes b. Dietary supplements are not necessarily tested for safety or effectiveness c. Sauna baths may reach temperatures high enough to melt visceral but not subcutaneous fat stores d. Hot baths raise the metabolic rate by 5-10% for 1-2 hours and may serve as part of a general weight-loss program

b. Dietary supplements are not necessarily tested for safety or effectiveness Right! Good job! This is a review from Unit 2. The FDA has very little power to regulate anything labeled as a dietary supplement.

What is (are) the chief factor(s) that determines a person's susceptibility to obesity? [mark all correct answers] a. Willpower b. Genetics c. Living environment d. Gym membership

b. Genetics c. Living environment Right! Good job! Genetics appear to determine people's susceptibility to obesity and an environment of abundant, inexpensive food. Genes interact with the diet and activity patterns that lead to obesity and the metabolic pathways that influence satiety and energy balance. So the two have to be there together: the genes and the environment. Willpower on the other hand has a role in weight status, but there is much, much more going on.

Which of the following is NOT including in body weight measurements? a. Water weight b. Muscle weight c. Adiopose tissue weight d. All of these are part of body weight measurements

d. All of these are part of body weight measurements Right! Good job! "Water, organs, bone tissue, fat, and muscle tissue make up a person's weight," (Zimmerman & Snow, 2012).

Which of the following would a good example of a "stimulus control" behavioral intervention? a. Hiding the candy jar that one usually keeps on one's office desk. b. Taking a different route home from work that doesn't involve driving past one's favorite fast food restaurant. c. Placing a portion of chips in a bowl and putting the chips bag away in the cabinet before eating them rather than eating directly out of the bag. d. All of these would be good examples of stimulus control.

d. All of these would be good examples of stimulus control. Right! Good job! Controlling cues to eat can be an important part of weight loss efforts. "Out of sight out of mind" is an old saying that works rather well. If you're always hungry on your way home from work and generally give in to the temptation to whip through the drive through rather than cook a meal at home, (a) eating a snack before you leave work and (b) taking a different route home (if possible) to reduce the temptation of the drive-through will help you to be successful. Even something as simple as storing candy in an opaque (non-see-through) container can reduce consumption.

Which of the following is NOT true about the obesity epidemic? a. It affects both developing and developed countries. b. It tends to follow the Westernization of a country's dietary pattern. c. It is associated with increased risk of chronic disease and childhood obesity. d. It is only occuring in developed, not developing countries.

d. It is only occuring in developed, not developing countries. Right! Good job! The obesity epidemic has become global--even in developing countries. While among the poor of a developing country, underweight is still a problem, but among the upper-classes in these countries, obesity is on the rise.

All of the following are characteristics of the results of weight-loss surgery EXCEPT: a. deficiencies of vitamins and minerals are common even over the long term. b. dramatic improvements are seen in blood lipids, diabetes, and blood pressure. c. some people regain their weight and/or experience serious complications. d. special attention to diet is only required during the first 6-9 months after the surgery.

d. special attention to diet is only required during the first 6-9 months after the surgery. Right! Good job! What many people do not realize about bariatric surgery is that the restrictive diet and need for multiple supplements is a lifetime committment. In fact, bariatric surgery is only successful at reducing weight permanently ~50% of the time--the same dismal rate of success that every other weight loss approach has. Moreover, there are often mental health challenges faced by those who are obese enough to qualify for surgery and the weight loss cannot fix those. If people are dependant on their weight loss for their happiness, then lose the weight, find out they're not any happier, this places them at a high risk of self-harm.

Fad diets often produce weight loss, at least initially, because a. they dictate the correct distribution of energy among the macronutrients. b. they prevent rapid spikes and declines in one's blood glucose level. c. they don't require people to count kcal, and are thus easier to stick to. d. they are designed to limit energy intake.

d. they are designed to limit energy intake. Right! Good job! Whenever you eat less calories than you expend, you will lose weight. That is why fad diets work--they universally end up restricting caloric intake. However, the minute the fad diet is stopped and eating returns to normal patterns, the weight loss stops.

Which of the following influences our ability to live a healthy lifestyle? a. national agriculture policy b. individual choice c. social networks d. socioeconomic status e. all of these

e. all of these Right! Good job! Everything listed as a possible answer is also something that influences our food choices. It's hard to eat fruits and vegetables if one cannot afford them and/or does not have access to them. It's hard to sustain healthy changes if one is in a relationship with someone who is sabotaging his or her health efforts. It's hard to to be physically active daily if one's untreated clinical depression makes it impossible for him or her to even get out of bed. Making healthy lifestyle choices is far more than just an individual choice.