NDFS 201 Exam 2

What is the concept of developmental plasticity? What are the possible consequences? How is this advantageous? When does it occur?

1. Organisms respond to the surrounding environment, especially during early development when cells are differentiating and tissues are developing. The developmental period is influenced by the environment. 2. Possible consequences include the increased risk for disease and some functions of the body due to gene expressions that may be suppressed due to environmental factors. 3. Could allow fine-tuning of gene expression and allow the organism to adapt to changing environments in order to maintain or improve reproductive capability in part by sustaining health through the reproductive period. 4. Sensitivity of the epigenetic system to environmental factors occurs primarily during the period of developmental plasticity.

Given the precision of current methods (for free-living people outside of metabolic wards), how much error can there be in estimating baseline (REE) energy needs? ______ kcal/d

250 kcal/d

What are the recommendations for physical activity and sedentary time?

Adults should do at least 150 min of moderate-intensity physical activity per week. For children and teenagers it is recommended that they receive 1 hour of daily physical activity.

What components of energy balance vary between and within individuals?

Biological and physiological factors such as satiety cues, energy expenditures, meal patterns, intestinal facts, how foods are prepared, components of storage, etc.

What specific changes in our environment and behaviors have contributed to the increase in obesity?

Consuming too many calories and little physical exercise, diets consisting of energy dense foods, stress, genes, metabolism, and culture are all contributing to the increase of obesity.

What mechanisms (or rationale) have been proposed to explain the food insecurity-obesity relationship?

Cyclical food restriction is associated with an increase in body fat and decrease in lean body muscle mass, and a quicker weight gain. This weight cycling due to food insecurity could result in the body increasing fat storage in response to food shortage. And third, energy-dense foods are often less expensive and may result in a greater intake and lead to obesity. Food insecurity is associated with low food expenditure, low fruit and vegetable intake, and a less-healthy diet. Finally, food insecurity is associated with negative psychological consequences, some of which can contribute to obesity.

What are the psychological consequences linked with weight bias? (pp 953-955)

Depression, low self-esteem, body image dissatisfaction, and poor coping abilities.

What potential harms are associated with dieting? What are the authors' conclusions about the benefits and harms of dieting?

Dieting usually leads to many fluctuations of weight which can be hard on the body and increase all-cause mortality and cardiovascular disease, stroke, diabetes, increased cholesterol and blood pressure, and even suppressed immune system. Dieting has little benefits, however, it can prove beneficial for people at risk of type 2 diabetes and relief of osteoarthritis.

Consider what an ethical approach is for you as a health professional to take when interacting with overweight and obese clients/patients.

Don't focus on the pounds, focus on the indicators of health such as blood pressure, etc. Look to change your lifestyle not just lose weight.

What are examples of weight bias in health care settings: Health professionals' attitudes, Providers' weight management practices, Patients' views of biased treatment, Impact of weight bias on health-care utilization? (pp 943-949 top)

Health professionals' attitudes: Many of the health professionals endorsed negative stereotypical assumptions about obese patients such as they were lazy and ate too much. They also claimed that obese patients were noncompliant and unmotivated to change health habits. Providers' weight management practices: Many of the providers felt inefficient and insufficiently prepared to treat overweight and obese patients. Patients' views of bias: Patients are frustrated by inappropriate comments from doctors about their weight and the stigmas that come with that. Impact of weight bias: Patients who experience stigma in health-care settings may delay or forgo essential care.

In this research, how did the diet and health-at-every-size approaches to weight differ? (Consider both goals for participants and the program activities.)

Health-at-every-size encouraged the participants to change their thinking and behavior, not just their eating habits. This change in thought process resulted in a long-term change compared to the diet approach that merely asked people to do checklist restrictions until they had lost the desired amount of weight.

What are some environmental factors related to a healthy weight? to overweight?

Healthy weight: Limiting television viewing time as well as time spent on technological devices, a more physically active environment, less stress and well organized meal plans. Overweight: sedentary lifestyle, lots of time watching television and on technology, unhealthy foods readily available, etc.

What nutrition factors are related to a healthy weight? to overweight?

Healthy weight: more fruits, vegetables, whole grains, and lean proteins are consumed. Controlled portions, drink more water, low-fat or non-fat dairy products, and reduction of energy dense foods that primarily contain added sugars or solid fats. Overweight: high calorie foods, large portion sizes, sugar-sweetened beverages, and drinking less water and non-fat milk.

What is considered a healthy weight? overweight? obese?

Healthy weight= 5th to the 85th percentile Overweight= 85th to the 95th percentile Obese= >95th percentile

What are examples of weight bias in employment settings? (pp 941-943)

Job discrimination, weight stigmas such as being the target of derogatory humor and pejorative comments from co-workers and supervisors, and differential treatment because of weight such as not being hired, being denied promotions, or fired.

What were the long term outcomes of the two weight management approaches?

Long term the participants in the Health-at-every-size remained healthier longer and kept the weight off with sustained improvements, being the opposite of the diet approach.

Why is dieting likely to be even less effective than is reported in the reviewed studies?

Most often in studies weight loss comes as a result of multiple interventions besides diet such as exercise. Dieting itself isn't as effective as creating a healthier lifestyle all around. Researchers can remove participants from their study results and skew the data in order to make the diet look more successful than it was.

What health consequences are associated with obesity?

Obesity has been found to increase the risk for various diseases in adulthood including diabetes, heart disease, and childhood atherosclerosis.

What non-communicable diseases have their origins in developmental influences?

Obesity, diabetes, hypertension, cardiovascular disease, asthma and allergy, immune and autoimmune diseases, precocious puberty, infertility, some cancer types, osteoporosis, depression, schizophrenia, and sarcopenia.

In general, what can you tell clients about the accuracy of energy intake and expenditure calculations, especially in terms of expected weight loss with a given calorie deficit?

Our ability to measure precisely individual components of energy expenditure or energy intake is relatively poor in light of the potential impact of small changes in body weight.

What are examples of weight bias in media? (pp 950 bottom - 953)

Overweight people are the highest targets of humor and ridicule in media.

What are the potential problems associated with children's use of energy drinks?

Potential problems of children's use of energy drinks are excessive sugar and caloric intake that may encourage dental erosion, overweight, and obesity. It can also lead to excessive ingestion of potentially large amounts of caffeine or other stimulant substances.

What are implications of the DOHaD for health policies and professionals? For consumers' understanding of health priorities?

Risk assessments will need to include considerations on potential developmental disruption and its consequences so that prevention will not be unreasonably delayed because of scientific uncertainty. Consumers must know that diseases can be induced very early in the life course and that it is modifiable by nutrients and environmental chemical exposures.

In overweight and obese individuals, what other health risk factors besides BMI should be assessed?

Risk factors such as blood pressure, blood sugar, and blood fats, and measurement of waist circumference should be assessed.

Under what circumstances are sports drinks appropriate for children?

Small amounts of sports drinks may be given to children exercising in hot, humid conditions for more than an hour.

What does the AAP recommend regarding children's use of sports and energy drinks?

Sports drink consumption should be restricted and avoided, and energy drinks should never be consumed. Parents should promote water, nor sports or energy drinks.

To what extent does obesity cause other health problems?

The association between obesity and a specific disease may be confounded by numerous factors. Potentially, any association between obesity and the disease may be due to factors leading to both rather than being a genuine causal effect of obesity itself.

Overall, what is the authors' point of view in this article?

The author believes that the word "epidemic" should not be used when describing the rising level of obesity trends. They argue that the effects of overweight and obesity rising trends still have to be better evaluated at a population level.

What are the general differences between sports drinks and energy drinks, and how well is this distinction understood by children, parents, and school administrators?

The general differences include the ingredients of sports drinks vs. energy drinks. Sports drinks are flavored beverages that are intended to replenish water and electrolytes lost through sweating during exercise, and often contain carbohydrates, minerals, electrolytes, and sometimes vitamins or other nutrients. Energy drinks on the other hand typically contain stimulants, such as caffeine and guarana, with varying amounts of carbohydrates, protein, amino acids, vitamins, sodium, and other minerals. The distinction is generally unrecognized by children, parents, and school administrators. Many children and adolescents perceive the need to increase their energy intakes and therefore drink a lot of the high calorie drinks.

What are the individual vs. population consequences of obesity? Why is this distinction important?

The impact of obesity on population health is likely to differ from its consequences at individual levels. The latter are well described, e.g. hypertension, type 2 diabetes, CVDs, osteoarthritis, and several cancers as well as a probably depression. At the population level the impact of obesity is much more difficult to characterize. At most the increase of obesity may have increased mortality rates and lowered life expectancy.

What is food insecurity?

The limited ability to secure adequate food for an active, healthy lifestyle due to insufficient household resources.

What is the relationship between food insecurity and obesity?

The prevalence of food insecurity is highest among obese adults, and vice versa. Food insecure adults had 61% increased odds of being obese compared with food secure adults.

What maternal dietary and weight characteristics are associated with the eventual health problems of their offspring?

Under-nutrition (Inadequate and poor quality diets), maternal obesity, excessive weight gain in pregnancy, and gestational diabetes are factors that influence disease risks in the next generation.

What is the disparity in obesity between different population groups? What groups are at higher risk?

We see that the burden of obesity is disproportionately borne by some racial groups. Non-Hispanic Blacks and Hispanics are at a much higher risk of obesity than Non-Hispanic Whites. Also, obesity is more prevalent in persons with mental illness

What are examples of physical health consequences linked with weight bias? (pp 955-957 top)

Weight bias may increase vulnerability to maladaptive eating disorders and avoidance of physical activity, both of which may reinforce additional weight gain.

How effective is dieting, for sustained weight loss?

When it comes to sustained weight loss all of the studies seem to show that dieting only causes short-term weight loss. Most participants of a diet regain all of the weight they had lost, or sometimes even more weight than they had lost over time.

How is weight status determined in the pediatric population?

You can't use the BMI number for kids like you can adults, you have to use the percentile because they are growing and changing.

When including energy intake measurements by self-report, what is the possible combined error? ____ kcal/d

~100 kcal/d

What are the HAES principles?

• Accepting and respecting the diversity of body shapes and sizes • Recognizing that health and well-being are multi-dimensional and that they include physical, social, spiritual, occupational, emotional, and intellectual aspects • Promoting all aspects of health and well-being for people of all sizes • Promoting eating in a manner which balances individual nutritional needs, hunger, satiety, appetite, and pleasure • Promoting individually appropriate, enjoyable, life-enhancing physical activity, rather than exercise that is focused on a goal of weight loss

What measurement tools or questions to measure food insecurity are described?

• How often in the past 12 months would you say you were worried or stressed about having enough money to buy nutritious meals? • Measure the stress related to the ability to afford nutritious food. • Statistical methods and models

What are the "talking points" regarding sports drinks?

• Sports drinks add unnecessary calories to the diet • Sports drinks are for athletes engaged in high-intensity workouts lasting 60 minutes or more—not for routine consumption • Water is adequate for most hydration needs • Most school children do not have high-intensity physical education classes or participate in endurance sports at school, so it is not necessary to sell sports drinks there • Sports drinks add unnecessary sodium to the diet • Sports drinks erode dental enamel.

What is the benefit of implementing an evidence-based HAES paradigm in health care policy and service provision?

• The HAES model will ensure that individuals of all sizes are allowed access to healthcare coverage and to quality affordable health care prevention and treatment services • In education and employment, the HAES model will provide that all youth and adults have opportunities to learn the importance of eating nutrient rich foods and engaging in enjoyable physical activity from a weight-neutral perspective • In diversity training programs in employment, policy, and school environments the HAES model ensures that size-diversity is included in the human diversities to be valued and respected

What 4 popular beliefs are addressed in this consensus statement, and what is the correct information about each?

• The typically observed weight-loss plateau at 6 to 8 months after a weight-loss intervention is primarily due to a reduction in energy expenditure, slowed metabolism. → The failure may be attributed to failure to comply with the diet. • Obesity is due to low energy expenditure, ie, low metabolism. → A simple division of REE by total weight leads to a lower estimate of the mass-specific metabolic rate because obese people have an increased relative amount of body fat, which has a lower metabolic rate than does lean tissue. • It takes a reduction of 3500 kcal of energy intake to lose 1lb of body weight. → the origin of this claim is based on the calculated energy content of body weight change and is often misapplied to predict the weight-change time course after a given intervention. • Small changes in lifestyle can prevent or reverse obesity. → It is important to not have small lifestyle changes in either energy expenditure or intake as viable interventions and have unreasonable expectations about the impact of such interventions.