HN210 Final

Eating Disorder

-A clinically diagnosed psychiatric disorder characterized by severe disturbances in body image and eating behaviors. -Become ill from bad eating practices

Disordered Eating

-A general term used to describe a variety of abnormal or atypical eating behaviors that are used to keep or maintain a lower body weight. -On and off diets; refusal to eat certain food groups; don't specifically disrupt a normal routine

Female Athlete Triad

-A serious syndrome that consists of three clinical conditions: low energy availability, PMS dysfunction, and low bone density. -Skaters, gymnasts, dance teams -Due to body size/shape expectations S/S Stress fractures, weight loss, extreme exercise

Risk factors of metabolic syndrome

-Abdominal obesity -High BP -High fasting blood sugar

Responsible Weight Gain

-Add 500-1000 extra kcals a day; gain 1-2lbs a week -Eat frequently: meals and snacks often -Quit tobacco products -Resistance training and aerobics for muscle mass and heart health -Energy dense foods: smoothies and milkshakes

Normal weight

-BMI 18.5-25 -Lowest disease risk

Overweight

-BMI 25-30 -Lowest mortality rate -Having a moderate amount of excess body fat -Increased risk of high BP and osteoarthritis, obese possibility -Encouraged to adopt good eating habits and sufficient physical activity

Obese

-BMI 30-40 -Having an excess of body fat that adversely affects health -Can lead to: hypertension, T2D, heart disease, stroke, sleep apnea, cancer, depression, infertility

Morbid Obesity

-BMI greater than 40 -A condition in which a person's body weight exceeds 100% of normal -Highest risk of serious health consequences -Experiences metabolic syndromes

Underweight

-BMI less than 18.5 -Having too little body fat to maintain health -Increased risk of illness/infection, impairs body's ability to recover -could be due to disease: cancer, AIDS, eating disorder

Decrease Satiety

-Beta Endorphins that enhance pleasure while eating -Neuropeptide Y (amino acid) -Decreased blood glucose levels from overnight fast

Limitations of Genetics

-Cannot account for body's resistance to weight loss -When people overeat by the same amount of food, they gain very different amounts of weight. -Genetic differences may explain why some people are better able to maintain a certain weight set point.

Health Risks of Bulimia

-Electrolyte imbalance from dehydration and loss of potassium and sodium in vomit -Irregular heartbeat, heart failure, death -GI problems: inflammation, ulcers, chronic IBS -Dental problems: tooth decay and stains

Health Risks of Anorexia

-Energy and nutrient Deficiency -Body uses organ and muscle tissue for energy to maintain brain tissue and vital body functions -Anemia, dehydration, amenorrhea, infertility -Constipation, low bone density

Signs of Muscle Dysmorphia

-Engaging in rigid and excessive exercise routines -Avoiding social engagements -Using muscle enhancing drugs or supplements

Characteristics of Anorexia

-Extremely low body weight achieved thorugh self starvation, eventually leading to a severe nutrient deficiency -85-95% of people with anorexia are women; .5-3.7% of american females will develop anorexia; 20% of women with anorexia will die due to complications

Diets Don't Work

-Fad diets don't use: healthful eating, physical activity, or behavior changes -Not good for long term maintenance of lower body weight

Approach to health change

-Gradual changes -Physical activities: regular exercise -Behavior Modification -Set Realistic Goals: Specific, Reasonable, Measurable -Eat smaller portions

MESSY

-How it is supposed to work -Does it work? How much? How? -Cause harm? Side effects? - Dictated by authorities that govern the sport

Signs of Bulimia

-Inflamed sore throat -Swollen glands in neck and jaw -Worn tooth enamel and decaying teeth -Acid Reflux -Intestinal distress and irritation from laxatives -Kidney Problems from diuretics -Severe Dehydration

Decrease BMR

-Low lean body mass -Lower height -Female Gender -Older age -Starvation/fasting

Characteristics of Bulimia

-Recurrent episodes of binge eating, compensatory behavior to prevent weight gain -More prevalent than anorexia: 1-4% of women have it; 4% mortality rate

Signs of Anorexia

-Refusal to maintain body weight -Intense fear of gaining weight or becoming fat -Disturbance in body shape, denial of seriousness of low body weight -Females feel fat; males fear "getting fat again" -Females are concerned with weight; males are concerned with composition

Metabolic Factor

-Relatively low BMR: weight gain and resistance to weight loss -Low level of spontaneous activity: fidgeting -Low sympathetic Nervous system: prone to obesity and more resistant to weight loss -Low fat oxidation: more carb oxidation+low fat oxidation= weight gain; if you oxidize more fat, you are more successful at maintaining weight loss

Helping Suspected Individuals

-Schedule a time to talk -Communicate conerns -Ask them to explore concerns with a health professional -Avoid conflicts or "battle of the wills" -Avoid placing shame/guilt/blame -Avoid giving "simple solutions" -Express continued support

Muscle Dysmorphia

-See body as small (dismorphed) -Body image and eating disorder -Muscle gain pursuit: change in diet -Wrestlers, weight lifters, jockeys, weight based sports

Increase Satiety

-Serotonin and cholecystokinin -High blood glucose levels -Stomach expansion -Nutrient absorption from small intestine

Behavior Changes

-Shop when full -Don't deprive yourself -Take time and enjoy your food (meals last 20min) -Keep a food log -Share food

Thermic Effect of Food

-The energy expended as a result of processing food consumed. -Energy we expend to digest, absorb, transport, metabolize, and to store nutrients -If a meal contains 500 kcal, the TEF will be about 25-50kcal -Applies only to mixed diets: combination of proteins, carbs, and fats

Physical Activity

-The energy that is expended on body movement and muscular work above basal levels. -NEAT( non exercise activity thermogenesis) -Excludes volitional sporting activities -Includes Spontaneous physical activity (fidgeting, shifting seating position) -Increased through extended physical activity. -Amount of energy expended depends on: body size, intensity of activity, duration of activity

Basal Metabolic Rate

-The energy the body expends to maintain its fundamental physiological functions - Decreases with age at 3-5% per decade after 30 -Energy expended to maintain fundamental physiological functions (respiration, circulation, body temp, hormone secretion, nervous system activity) -Primary determinant is lean body mass -60-75% of energy expenditure

Thrifty Gene Theory

-The theory that some people possess a gene that causes them to expend less energy at rest and during physical activity. -Purpose: to protect a person from starving to death during times of food shortage -"Found" in Native Americans: due to feast or famine, so those who had the gene survived when little food was available. -If true, those who possess the gene would face significant weight gain in our society and be resistant to weight loss.

Set Point Theory

-The theory that the body raises or lowers energy expenditure in response to increased or decreased food intake and physical activity. -Fasting and strict dieting may contribute to rebound weight gain dieters face. -Since we don't eat the same way each day, energy intake fluctuates, this maintaining result may support this theory.

Dangers of Ergogenic Aids

-Unsafe dosage -Unintended age group -Effects underlying disease -If take with medications or other substance could have adverse effects

Increase BMR

-Young age -High lean body mass -Greater height -Male gender -Pregnancy -Caffeine/tobacco -Stress/illness/fever

Scope of Practice

1. Principles fo good nutrition and food preparation 2. Food to be included in the normal daily diet 3. Essential nutrients needed by the body 4. Recommended amounts of the essential nutrients 5. The actions of nutrients on the body 6. The effects of deficiencies or excess of nutrients 7. Food and supplements that are good sources of essential nutrients.

Leptin

A hormone produced by body fat, that acts to reduce food intake and to decrease body weight and body fat. Increase Satiety.

Body Image

A person's perception of his or her body's appearance and functioning.

Anorexia

A potentially life threatening eating disorder that is characterized by self starvation and leads to a deficiency in energy and essential nutrients.

Peptide YY

A protein produced in the GI tract that is released after a meal in amounts proportional to the energy content of the meal. Decreases appetite and increases satiety.

Ghrelin

A protein synthesized in the stomach that acts as a hormone and plays an important role in appetite regulation by stimulating appetite. Decreases Satiety.

Bulimia

A serious eating disorder characterized by binge eating and purging.

Metabolic Syndrome

Abdominal Obesity Higher than normal triglyceride levels Lower than normal HDL cholestrerol levels Higher than normal blood pressure Fasting blood glucose level greater than 100

Media Fantasy

Adolescents are more vulnerable to unrealistic media images of the perfect body than adults because they can't always distinguish between reality and ______.

Common Ergogenic Aids

Anabolic Steroids Creatine Caffeine Ephedrine Canitine Chromium Ribose Beta-alanine

Social Factors

Appetite motivated by social factors, timing, portions Overating: holidays, vending machines, large serving sizes Inactivity: less meal prep, watching tv, harsh weather conditions, too much technology Underweight: Overweight kids are bullied (60% of population), Media and "ideal" body type, young adults skip meals, crash diet, and exercise obsessively

Fat Distribution

Apple Shape: Upper body obesity increases risk for T2D, heart disease, high BP Waist to Hip ratio: increased risk in women .8 and men .9 Waist: increased risk in women greater than 35 and 40 in men Pear Shape: lower body obesity doesn't show increased risk but is common in women's legs

Healthy Body Weight

Appropriate for age and development Achieve and sustain without dieting Promotes good blood pressure Promotes healthy eating and exercise Acceptable to you

Drug Manufacturers

Are responsible for determining the safety of a dietary supplement.

Team management

Best approach to treating eating disorders

BMI

Cannot show body fat % Cannot asses body composition Ratio of body weight to height

Energy Requirements

Carbs: 45-65%: apples and crackers, nuts&raisins with skim milk Fat consumption 20-35% Protein 30%: lean meat, poultry, fish, eggs

Obesity

Children in Way Beyond Weight have developed T2D and high BP in response to

Binge Eating

Consumption of a large amount of food in a short period of time, usually accompanied by a feeling of loss of self control.

Sprint

Creatine helps enhance performance of ___ activities like spring swimming.

Limitations

Energy Balance Equation: -Doesn't account for many factors -Doesn't explain people gain/lose weight differently

Cultural Factors

Food at center of celebrations Customs/Religious Beliefs Fast food culture: both parents work Lack of motivation

Physiological Factors

Hunger and Satiety signals from the hypothalamus: Leptin, Ghrelin, Peptide YY

scope of practice

I am able to guide people to eat foods rich in micronutirents like Vit. E and Potassium

38

If robin's dinner contains 750 kcals, the minimum amount of kcals she will need to expend (TEF)

Ensure safety of the client

It's important to have the correct credentials so you can ______ from possible nutrient/ medication interactions

Wrestle

Male athletes are most likely to develop bulimia if they _____

MESSY

Mechanism Evidence Safe Substance legal for the Year

Factors Influence Body Weight

Metabolic Physiological Cultural and Economic Social

Genetics

No obesity gene FTO gene 44-65% people have and it stimulates excess food intake

Orthorexia Nervosa

Obsession of perfect eating Anxiety Fixation of righteous eating

Moderate Physical Activity

Running (10-12 mph) Stretching (yoga) Walking (Briskly) Bicycling (12-14 mph) (.058-.163)

Vigorous Physical Activity

Running (7mph) Weight Lifting (.205)

Economic Factors

Sedentary jobs Low income status: higher rates of obesity and chronic disease Healthful foods can be expensive

Light Physical Activity

Sitting Cooking Walking Weight Lifting (.022-.05)

Dietary Energy Sources

Sprint (0-3s): 100% ATP Dash (10-12s): 50% ATP 50% carbs Race (4-6min): 6%ATP, 94% carbs Race (30-40min): 35% fat, 65% carbs Marathon(2.5-3hrs): 65% carbs, 20% fat, 5% other Day long hike (5.5-7hrs): 65% fat, 35% carbs

Amenorrhea

The absence of PMS

Energy Intake

The amount of food a person eats; kilocalories consumed

Energy Expenditure

The energy the body expends to maintain its basic functions and to perform all levels of movement and activity.

Body Composition

The ratio of a person's body fat to lean body mass Undewater Skinfolds Bioelectrical Impedence Analysis Dual Energy XRay Absorptometry Bod Pod

Symbols to look for

U.S. Pharmacopeia Consumer Lab NSF International These agencies ensure the product was properly manufactured, contains the listed ingredients, and does not contain harmful levels of contaminants.

Purging

Vomit; laxatives; fasting; excessive exercise

Overall

Weight gain: eat more than expended Weight loss: eat less than expended Energy Expenditure can be measured using direct calorimetry, indirect calorimetry, and doubly labeled water

Weight Loss Supplements

Weight loss less than 2kg Adverse side effects Use stimulants to increas metabolism and reduce appetite Very few give any results