HSC503 EXAM2

Acitivity LEvels Vary by Age

-40% of adults >65 are inactive -20% of young adults are inactive

The South Bronx

-37% of the south bronx said it lacked money to buy food at some point in the last 12 months (national average is 18.5%) Examples of food insecurity -simply being able to afford the basics -unable to get to the grocery store -unable t find fresh produce -stealing food -lack of reasonably priced supermarkets -reliance on cheap unhealthy foods New York is attacking the problem on 3 fronts -providing income supports -increasing healthy options -encouraging nutritious behavior Unemployment rate in the south bronx is 14.1% -poor people work longer hours and multiple jobs therfore eating on the run; less time to exercise

What causes overweight and obesity?

-A lack of energy blance most often causes overweight and obesity -overweight and obesity happen over time when you take in more calories than you use -It's the balance over time that helps you maintain a healthy weight -a lack of energy most often causes overweight and obesity

Resistin

-higher levels of resistin in obese animals with insulin resistance -part of the inflammatory response of obesity

Case Study: Obesity-treatment Program (80s)

-Kaiser Permanente's department of preventive medicine obesity treatment progem had a problem-those who were both the most obese and losing the most weight-kept dropping out -Why? -instead of being happy, subjects were having anxiety attacks and was terrified -sexual abuse as a child -paranoid that new slimmer weight as a provocation

Why study the genetics of obesity?

-Main goal is to identify genes related to disease states (obesity) 1. Identify genes that can be used as prognostic factors -indicates who is likely to become obese -preventative therapy 2. personalized medicine -determines what types of intervention may be most effective in treating obesity

Thrifty Gene Hypothesis

-humans are designed to promote the storage of nutrients because of food scarcity -particularly you store cabohydrates as fat -but in modern times, when food is plentiful, this genetic make-up has resulted in the current obesity epidemic -evidence supporting identification of thrifty genes has proven to be elusive

Hypothyroidism

-Underactive thyroid -condition in which the thyroid gland doesnt make enough thyroid hormone -lack of thyroid hormone will slow down your metabolism and cause weight gain and make you feel tired and weak -main cause worldwide is insufficient dietary iodine; in western countries main cause is an autoimmune condition, injury, or medical side-effect -determined by determining thyroid-stimulating hormone (TSH) in your blood -in western countries with sufficient dietary iodine, 0.3-0.4% of the population have hypothyroidsm

Adipsin

-^adipsin, lower appetite -animals that are obese for genetic or metabolic reasons have less adipsin

Endocannaboid System

-appetite-inducing effects of cannabis -levels of endocannaboids decrease during feeding and increasing during fasting

Pima Indians

-arizonas pima indians exceed the type 2 diabetes rate (83) of the genetically similar pima indians in mexico (6.9%) by 5x -the US government began subsidizing the tribes food (late 19th century)--much of it containing sugar and white flour, and obesity and diabetes rates soard -the pima who relocated to the sierra madre mountains of mexico continued traditional farming and have mainly maintained healthy weights -the pima predisposition to store fat efficiently due to survival mechanisms evolved in the harsh southwestern desert *-illustrates the impact of lifestyly on obesity and its comorbitites* -is it possible to reduce the obesity rate in pimas of arizona by returing to some of their traditions, including more physical activity and a diet with less fat and more starch?

Weight goes in pregnancy...

-bay: 8 lbs -placenta: 2-3 lbs -amniotic fluid: 2-3 lbs -breast tissue: 2-3 lbs -blood supply: 4 lbs -stored fat for delivery and breastfeeding: 5-9 lbs -larger uterus: 2-5 lbs TOTAL: 25-35 lbs -after giving birth, some women find it hard to lose the weight, which may lead to overweight or obesity, especially after a few pregnancies

Inactivity in China

-between 1991 and 2006, work-related physical activity in china dropped by about 35% in men and 46% in women -women also cut back on physical activity around the house--washing clothes, cooking, cleaning--by 66% -transportation-related physical activity has also dropped since car ownership is on the rise: sales of new cars in china have fone up by about 30% per year in recent years

Factors leading to obestiy in the South Pacific:

-calorie consumption has been increasing -nutritional status has decreased, reflecting the change in diets from traditional fare to mainly imported, low-quality foods -climate change-induced weather events -more intense storms -sea-level rise -warmer air and water temps -ocean acidification -all of which will have negative impacts on the health and productivity of regional crops, livestock, fisheries, and water resources, in turn, bolstering the islanders reliance on commercial markets for food supply

Polycystic Ovarian Syndrome (PCOS)

-complex syndrome with multifactorial causes (ie. genetics, hyperandrogenism, insulin resisance, obesity) -common endocrine disorder and a leading cause of femaile subfertility -affects 5-10% of women of reproductive age (6-9 million US) -obesity not considered a primary cause, however, 70-90% of those with PCOS are obese -2003 Rotterdam criteria (2 of the following): 1. oligomenorrhea (8 or fewer menses a year) or anovulation 2. clinical manifestations of androgen excess and/or elevated levels of circulatory androgens (ie. total or free testosterone) 3. polycystic ovaries on ultrasound eveluation Complaints -iregular menses -hirsutism (excessive hair growth) -acenthosis nigricans (skin) -resistant acne -alopecia -weight gain -trouble losing weight -signs and symptoms appears around the onset of puberty

Cushing's Syndrome

-condition in which the bodys adrenal glands make too much of the hormone cortisol -often triggered by use of glucocorticoids for treatment of asthma, arthritis -sometimes due to adrenal tumors -caused by prolonged exposure to elevated levels of either endogenous glucocorticoids or exogenous glucocoticoids Symptoms -abdominal obesity but with then arms and legs -high blood pressure -reddish stretch marks -round red face -fat lump between the shoulders -weak muscles and bones weak bones -acne and fragile skin that heals poorly -women may have more hair and irregular menstruation -chronic feelings of tiredness

Dopamine System

-control of feeding, arousal, and motor function -decreased dopamine signaling in obese humans and animals (ie. need more food to achieve adequate level of food reward)

Soial Ecological Model

-depicts how health behaviors of an individual are influenced by the interpersonal, organizational, community and public policy contexts and environment in which that person exists

Pregnancy

-during pregnancy, women gain weight to support their babies' growth and development -not neccassary to "eat for two". The average pregnant woman needs only about 300 healthy calories more a day than she did before she was pregnant -average weight before getting pregnant should gain 25-35 lbs -underweight women 28-40 lbs -overweight women 15-25 lbs -in general, you should gain about 2-4 lbs during the first three months youre prgnant and 1 lb a week during the rest of your pregnancy

Cycles of food deprivation and overeating

-eating less or skipping to stretch food budgets leads to overeating when food does become available -resulting in chronic ups and downs in food intake that can contribute to weight gain -cycles of food restriction can lead to an unhealthy preoccupation with food -metabolic changes that promote fat storage -the feast or famine situation is especially a problem for low income parents, particulalarly mothers -who sacrifice their own nutrition in order to protect their children from hugner

Supersizing and Portion Control

-eating out-less control over how much fat, sugar, and salt they are eating -fast food resaurants also encourage super-sizing of meas, adding unnecessary calories -marketing strategy of "added value"-larger quantity for little or no incremental cost -adults will eat more when larger portions are ordered -portion size is an external cue that encourages over-eating -were all born with the ability to self regulate food intake -b/w ages 3-5 that ability can be overridden by the presentation of larger portion sizes, in the absence of hunger

Appetite Regulation

-energy balance is not a passive process -"setpoint" maintains body weight within a relatively narrow range given constant environmental conditions -mechanisms that must resist both decreases and increases in body weight

Designs of human studies

-family studies-can address whether a disease aggregates in families -higher risk among relatives (especially 1st degree) indicates disease may be genetic -is it b/c of genes, shared environment, or both?

Why is a fast food meal cheaper than a healthy food?

-farm subsidy actively supports a diet that consits of high fructose corn syrup (HFCS), soybean oil, corn oil and grain fed cattle -junk foods are made even cheaper through the use of unhealthy filler ingrediants and perervatves that prevent spoiling -its possible to eat healthy on a limited budget but 1. you have understand what constitues a healthy meal and 2. you have to access to such foods

Food Reward System in the Brain

-feeding is not just driven by hunger, but its also rewarding -might over-ride energy based CNS processes

It is likely rhat there are numerous causes of obesity working together

-genetic -physiological -metabolic -hormonal -sociocultural -environmental -behavioral -psychological

Inactivity in the US

-in 1950, 30% of americans worked in high-activity occupations; by 2000, that proportion had dropped to only 22% -conversely, the percentage of people working in low-activity occupations rose from about 23-41% -driving cars increased from 67% trips to work 1960 to 88% in 2000, while walking and taking public transit to work decreased -about 40% of US schoolchildren walked or rode their bikes to school in 1969; only 13% on 2001

Fattening Rooms in Nigeria

-in some parts of nigeria, being fat remains a symbol of status and power -Efik tribe, the rich can pay for special "fattening rooms" to put on extra weight -future brides are fed a porridge made from cassave tubers with rice, beans, meat, and fish added -when you are fat it makes you look healthy -people respect you. people honor yu. wherever you go they say your husband feeds you fine -if you go to village, people can come out to look at you because you are healthy -despite the risks of heart disease, diabetes and other health problems associated with being overweight

Appetite control from fat-Adipokines

-leptin (greek leptos=thin) -increase in leptin leads to drop in appetite and more rapid calorie burning -protein produced in fat cells -Jefferson Medical School (philadelphia) study: 136 normal and 139 obese subjects; obese had 4x leptin as normal weight subjects -Harvard study: men with the most leptin had high body weight, little exercise, and more high fat and high cholesterol foods -perhaps obese people have enough leptin but cannot process it in the brain (leptin resistance)

High levels of stress

-low income families may face high levels ofstress due to: -the financial and emotional pressures of food insecurity -low wage work -lack of access to health care -inadequate and long distance transportation -poor housing -neighborhood violence -chronic stress may trigger anxiety and depressionl which are both associatted with child and adult obesity -stress may lead to weight gin through stress-induced hormonal and metabolic changes as well as unhealthful eating behaviors

Limited resources and lack of access to healthy affordable foods

-low income neighborhoods frequently lack full-service grocery stores and farmers markets -when available, healthy food is often more expensive, whereas less expensive, energy-dense foods typically have lower nutrititional quality -if available fresh produce is often of poorer quality in lower income neighborhoods -low income communities have greater availability of fast food resturaunts

Greater exposure to marketing of obesity-promoting products

-low income youth and adults are exposed to disproportionately more marketing and advertising for obesity-promoting products that encourage the consumption of unhealthful foods and discourage physical activity -this has a particularly strong influence on the preferences, diets, and purchases of children, who are the targets of many marketing efforts

Adiponectin

-lowers blood glucose levels by blocking glucose producion in the liver and increases metabolism in the muscle -Adiponectin levels fall as fat levels increase

Limited access to health care

-many low income people lack access to basic health care -if health care is available, it is lower quality this results in lack of diagnosis and treatment of emerging chronic health problems like obesity and its comorbidities

Cohen Syndrome (Finnish)

-obesity, mental retardation, microephaly, characteristic facial features, myopia

Alstrom Syndrom

-obesity, retinal cone dystrophy, dialated cardiomyopathy, type 2 diabetes, hypothyroidism, small size, hypogonadism, renal abnormalities, mental retardation

Detroit

-opens first meijer -new parkway foods in an empty strip mall on east jefferson opened with little fnfare, but it has support from one key group: funders. state and city economic officials beleive the independent grocer could be another vital step in erasing the citys image as a food desert -the detroit economic growth corportations green grocer project sponsered a grocery crawl to highlight the growing number of food options in detroit and grocery investments being promoted by the project -there are around 77 full-service grocery stored in detroit, at least 65 of which are independently owned -a kroger is coming o eight mile road and woodward after the first of the year

Opioid System

-opioid agonists enhances intake of food -antagonists reduce body weight and fat, and increase fat, and increase fat oxidation

Maternal and Paternal Obesity Transmission

-paternal obesity is associated with 2x risk of obesity -maternal obesity is associated with a 4x risk of obesity -both parents obese, 10x increased risk -30 years ago, it was thought you could grow out of it -now its viewed as persistent and the presence of obesity in childhood predicts obesity in adulthood -important to target women of childbearing potential to maintain healthy body weight (for both practical reasons and for offspring)

Main unhealthy diest and eating habits that contribute to weight gain...

-portion size -fast food -social eating overly restircted diets -late night eating -high calorie diets -skipping breakfast -high calorie beverages

Age

-prevalence of obesity in older population (65-74) is greater than rest of population -people tend to "slowdown" as they age, resulting in: 1) reduced muscle mass -muscle loss can slow down the rate at which yourbody burns calories -gain weight if you dont reduce your calorie intake 2) increased fat mass -more circulating lipids, adipokines -midlife weight gain in women is maily due to aging and lifestyle, but menopause also plays a role -Natural process, end of feritlity -many women gain about 5 punds during menapause and have more fat around the waist than they did before -mechanism-lack of estrogen

Chemicals

-researchers have found a link between chemicals that mess with our hormones such as bisphenol A (BPA) and obeisty -known as endocrine-disrupting chemicals (EDCs) and they're found in a whole lot of items we touch daily, such as pesticides, food cans, cosmetics, cash register recipets and even wine. the chemicals are so common that nealry every person on earth has been exposed to one or more

Energy Balance

-same amount of energy IN and OUT over time=weight stays the same -More energy IN than energy OUT over time: weight gain -More energy OUT than energy IN over time=weight loss

Psychological/Emotional Factors

-some people eat more than usual when they're: 1. bored 2. angry 3. stressed -obesity is associated with increasing rates of major depression, bipolar disorder, panic disorder -subgroup specific increases -related to medications -trauma can contribute to over-eating -childhood sexual, physical or emotional abuse -loss of a parent during childhood -marital or family problems-can contribute to overeating

Food insecurity is at hisoric highs and getting worse

-some regions of the country where the child food insecurity rate go as high as 41% -the major hot spots for hunger tend to be rural countries -least hungry county: slope county, ND, which has a food insecurity rate of 4% -most hungry: humphreys county, miss., where about 1/3 of the population is food insecure -about 27% of food insecure people--including 32% of food insecure children--libe in households which are ineligable for food stampes, the main public assistance program dedicated to combating hunger

We are not over-eating, we are under exercising

-stanford shcool of medicine-summer 2014 -in the last 22 years striking drop in the time americans spend exercising -data from NHANES-self reported -from 1988-2010 no exercise in free-time increases from 19-52% in women, and 11-43% in men -no significant increase in calorie consumption over the same period -obesity increased from 25-35% in women and 20-35% in men -doesnt prove "cause and effect" just associates -from a public health perspective-more info regarding benefits of PA needed

Lack of sleep increases the risk of obesity

-study of teenagers showed that with each hour of sleep lost, the odds of becoming obese went up -lack of sleep increases the risk of obesity in other groups as well -spanish study >3500 older workers: sleeping 5 hours or less OR sleeping> 8 hrs was associated with obesity -8500 four year olds: if children get 10.5 hours or more of sleep a night, associated with prevention of obeisty -recreational screen time (ie. Tvs, texting) in the bedroom can delay bedtime or interrupt sleep

Inactivity in the US--BRFSS 2008 summary

-the 2008 estimates were from the behavioral isk factor surveillance system (BRFSS), which uses self-reported data: -high rates of leisure-time physcial inactivity -south and appalachia -most likely to be active: west coast colorado minnesota hawaii vermont

Antibiotics linked to childhood obesity

-the JAMA Pediatrics report -researchers reviewedthe health records of more than 64,500 americans children between 2001 nd 2013 -almost 70% of them had been prescribed 2 courses of antibiotics by the time they were 24 months old -but those who had four or more courses in this time were at a 10% higher risk of being obese at the age of five than children who had been given fewer drugs -but scientists warn this does show antibiotics cause obeisty directly and recommend children continue using them

Poverty Income Ratio(PIR)

-the ratio of household income to the poverty threshold after accounting for inflamation and family size -PIR tertiles to indicate low (<130%), middle (350%<PIR>130%), and high (>350%) SES -in 2008 a PIR of 350% was equivalent to approximately $77000 for a family of four -PIR of 130% was equivalent to approximately $29000 for a family of four -in 2008, median household income was approximately $50000 -13.2% of the population lived below the poverty level -the cut point for participation in the supplemental nutrition assistance program (SNAP) is 130% of the poverty level

Other studies

-the the late 80s study 286 obese people, and discovered that 50% had been sexually abused as children. rate is more than 50% hgiher than the rate normally reported by women and more than triple the average rate in men -a 2007 study of more than 11,000 california women found that those who had been abused as children were 27% more likely to be obese as adults, compared with those who had not -a 2009 study of more than 15,000 adolescents found that sexual abuse in childhood raised the risk of obesity 66% in males in adulthood. that study found no such effect in women, but did find a higher risk of eating disorders in sexually abused girls -compared with a person with no adverse childhood experiences (ACEs) a person with four or more has almost 2x the risk of obesity

Wife-plumping Farms

-the trend of force-feeding young mauritanian girls is on the decline -but a BBC News report says about qq% of young girls there are still force fed in order to catch a husband -says the director of a fat farm: when they are small they dont understand but when they grow up they are fat and beautiful. they are proud and show off their good size to make men dribble. dont you thnk thats good?

Mississippi

-was the most obese state in the US in 2013 (35.45) and has ranked among the top 10 obese states in the nation since 2008 -we're used to fried food so much its just an old school thing -the states laid-back lifestyle may also be to blame -complacency is not only characteristic of the sedentary lifestyles leading to high obesity rates, it is also characteristic of a cultural attitude towards the issue itself -but they need to start in the schools to fix it

Smoking Cessation

-why do some people gain weight after smoking 1. enhancement of senses -food often tastes and smells better after quiting smoking 2. oral fixation -substitute food for cigarettes 3. nicotine raises the rate at which your body burns calories -so you burn fwer calories when you stop smoking -however smoking is a serious health risk, and quitting is more important than possible weight gains

Global Inacitivity Trends

-worldwide, people are less active today than they were decades ago -physical activity associated with work, home, and transportation has declined due to: 1. economic growth 2. technological advancements 3. social changes

What is biologically disordered in obesity?

1. Genetic factors -single gene mutations -polygenic factors-multiple genes that together enhance the susceptibility to obestiy -parental transmission 2. Hormone alterations -alterations of the hormonal mechanisms involved in weight regulation -aging, menopause 3. Pharmacological effects -unintended effects of drugs targeting other health conditions

8 Sneaky things that may feed obesity

1. air pollution--PAH (polycylic aromatic hydrocarbons), parental exposure would make kid obese by age 7 (exhaust, smoking, grills) 2. altitude-closer you are to sea level the 5.1x more likely to be obese 3. antibiotics-correlation b/w early use in children and obesity 4. gut bacteria-those with less bacterial diversity 5. BPA-Bisphenol A (plastic addivitive), exposure in bottles, sippy cups 6. fast foos salads-generally arond 12000kcal 7. car dependence 8. lack of sleep

Issues concerning genetics as a cause of obeisty?

1. genes do not always predict health 2. maybe not a single gene (influence of many?) 3. usefulness as a predictive factor (eg. look at parental adiposity; just guess correctly a 1/3 of the time) 4. expensive 5. prevention strategy is not known to work

Why do environmental cues make us over-eat?

1. it biases our "consumption norms" -consumption norms determine how much we should eat -based on packaging, plate-size, restaurant portions 2. it effects out "consumption monitoring" -environment is distracting -we often find it to be a nuisance to accuratly measure/monitor consumption -when people pay close attention to how much they eat, they eat less -obese people have a greater tendancy to underestimate the calories in their meals

Why Low-income and Food Insecure People are Vulnerable to Overweight and Obesity

1. limited resources and lack of access to healthy affordable foods 2. fewer opportunites for physcial activity 3. cycles of food depervation and overeating 4. high levels of stress 5. greater exposure to marketing of obesity-promoting products 6. limited access to health care

Fewer opportunited for physical activity

1. lower income neighbors have fewer physical activity resources 2. when available, physical activity resources may not be attractive places to play or be hysically active 3. crime, traffic, and unsafe playground equipment are common barriers to physical activity in low-income communities 4. low-income children are less likely to participate in organized sports 5. students in low-income schools spend less time being active during school

How might the lack of sleep contribute to obesity?

1. people who sleep fewer hours also seem to prefer eating foods that are higher in calories and carbohydrates -which can lead to overeating, weight gain, and obesity 2. sleep helps maintian a healthy balance of hormones that make you feel hungry (ghrelin) or full (leptin) -when you dont get enough sleep your level of ghrelin goes up and your level of leptin goes down. this makes you feel hungier than when you're well-rested 3. sleep also affects how your body reacts to insulin, the hormone that controls your blood lucose (sugar) level -lack of sleep results in higher than noraml blood sugar level, which may increase your risk for diabetes

NCHS Data Brief Summary

1. relationships between obesity and SES differed by sex, race, and ethnicity -non-hispanic white women, obeisity rose as PIR lowered -non-hispanic black women and mexican american men, obeisty lowered as PIR lowered 2. between 1988-1994 and 2005-2008 the prevalence of obesity increased in adults at all levels of income and education

Appetite-body weight regulation model

1. short-term omponent: controles onset and cessation of feeding on a meal basis -feeding is stimulated by a) stimuli in environment (taste, smell) and b) internal biological stimuli (hormones) -food in the mouth and gut provide sensory (taste, distension) and hormonal feedback signals, and provide info regarding nutrient appearance and amount 2. Long-term component: monitors and regulates body nutrient stores over extended periods -unused calories (eg. not used for maintenance and activity) are stored as fat and provide sensory info regarding energy store to the brain (hypothalamus) -These 2 components modulate intake such that body weight is maintained within a stable range; based within the central nervous system

Key Findings From Human Studies

1. studies of identical twins who have been raised apart show that genes have a strong influences on a persons weight -overweight and obesity tend to run in families 2. your genes also may affect the how much fat you store and where you store it -apples and pears 3. children adopt the habits of their paretns -a child who has overweight paretns who eat high-calorie foods and are inactive will likely become overweight too

The appeal of convenience foods:

1. taste of food enhanced through strategic used of fat, salt, and sugar 2. good value regardless of budgetary constraints 3. eliminates planning, shopping, preping, cleaning up after meals 4. marketing which casts cooking as laborious 5. parental attitudes where each family member can eat what they want 6. cultural changes which promote TV time over family time/dinners

Albright Hereditary Osteodystrophy

1/139000 in Japan -obesity, short stature, round face, brachydactyly, bone formation in non-bone tissue, mental retardation, low blood calcium

Prader-Willi Syndrome

1/25000 births -obesity, reduced fetal activity, muscular hypotonia at birth, short stature, small hands and feet, mental retardation, hypogonadism, hyperphagia

Hunger Paradox

Counterintuitive concepts of hunger and obesity coexisting within the same person and within the same household -hungriest people in america today, statistically speaking, may well be not sickly skinny, but excessibely fat

Bardet-Biedl Syndrome

<1/100000 births -obesity mental retardation, pigmentry retinopathy, polydactyly, hypogonadism, renal abnormalities

How Much Exercise Will It Take to Work Off a Burger? Menus May Soon Tell You

About? -a study done on 18-30 year olds about ordering off of menus: -group 1: no calorie counts on menu -group 2: had calorie counts on menu -group 3: had number of minutes it would take to walk that meal off Finding: group 3 ate the least amount of calories. the other 2 groups had no difference in calories consumed According to this study, people are least likely to eat more calories if they knew how much time it would take to burn it off. only knowing about caloric content doesnt greatly deter overeating

Medications

Certain medicines can cause weight gain: -psychotropic medications (antipsychotics, antidepressents, mood stabilizers -anticonvulsants -snti-diabetics -anti-hypertensives -steroid hormones and contaceptives -anthistamines -HIV antiretroviral drugs How? -slow the rate at which your body burns calories -increase your appetite -cause your body to hold on to extra water -fat cell proliferation

How Environmental Factors Influence Consumption

Eating Environment 1. eating atmospherics -influence eating duration 2. eating efferet -increased effort decreases consumption 3. eating with others -socializing influences meal duration 4. eating distraction -obscure and extend consumption Food Environment 1. prominence of food -how in your face is it 2. structure and variety of food assortments -perceived variety drives consumption 3. size of food packages and portions -packages and portion size suggest consumption norms 4. stockpiling of food -stockpiled food is quickly consumed 5. serving containers -wide or large containers create consumption illusions

Reasons for Inactivity

Increased screen time -people spend hours in front of TVs and computers doing work, schoolwork, and leisure activities -more than 2 hours a day of regular TV viewing time has been linked to overweight and obesity Lack of sidewalks and places for recreation -not having area parks, trails, and sidewalks makes it hard for people o be physically active Work Schedules -people often say that they dont have time to be physically active because of long work hours and time spent communting Reliance on cars -less people walking because driving is often the easiest option Fewer physical demands at work or at home -advances in modern technology and conveniences Misconception of physical activity -common belief that physical acitivty is limited to sports or health club exercise -expensive -no skills

Eating Atmospherics(ambient character)

Influence eating duration Lighting -dimmed/soft lighting influences our consumption in 2 ways -by increasing eating duration -by increasing comfort and disinhibition Odor -can influence consumption through tste enhancement or supression -unpleasant odors are likely to shorten a meal and suppress food consumption Noise and music -soft music leads to slower eating, loonger meal duration , and higher consumption of food and drinks -loud, fast music is discomforting can lead to people spending less time in a restaurant -but can cause people to eat more rapidly without monitoring their fullness

Trends in Physical Activity

Over 30% of the population reports NO involvment in any leisure time physical activity

How does the traumatic experience influence obesity?

Psychological -being abused or otherwise traumatized is painful, and foof can be a numbing or comforting escape -ACEs are also strongly linked with other types of unhealthy "self-medication": ex. cigarette smoking, and drug abuse (having four or more ACEs increases the risk of injectable-drug use by 10x) Physiological -biology of the stress-response system (stress=scarcity) -if your genes get the message that you are entering a stressful world, metabolism "skows down" to deposit fat and store energy to prepare for what the body is expecting will be challenging and stressful life

Adoption Studies

compare disease rate between adoptee and members of adoptees biological family as well as their adoptive family -if genes influences risk: then adoptee should look more like biological family -if environment influences risk: then adoptee should look more like adopted family

Twin Studies

compare disease rates between twins -if only one twin has the disease, then environmental factors must be influencing disease expression

Enterostatin

decreases dietary fat intake

According to WHO the rapid rise in obesity rates in recent years has occured...

in too short a time for there to have been any significant genetic changes within populations -focus should be on environmental and societal changes

Peptide YY3-36 (PYY) Glucagon-like peptide-1 (GLP-1) Apolipoprotein A-zziv (Apo A_IV Neuromedin B (NMB) Gastric-releasing peptide (GRP)

reduces feeding

Insulin Amylin Glucagon

reduces food intake

Ghrelin

stimulates feeding

Cholecystokinin (CCK)

stimulates satiety

Hunger

uneasy or painful sensation caused by a lack of food. usually consequence of food insecurity

Food Insecurity

whenever the avilability of nutritionally aequate and safe foods or the ability to acquire acceptable food in socially acceptable ways is limited or uncertain