Nutrition Final

Anorexia nervosa

-Life-threatening disorder characterized by self-starvation and excessive weight loss -Fear of getting fat, fear of eating certain foods -Some individuals exercise excessively to control weight.•Health consequences -Electrolyte imbalances -Drop in heart rate and blood pressure, weakness and fatigue, hair loss -Slowing of the digestive process -Inadequate nutrient intake and possible deficiencies -Inability to regulate internal body temperature

Bulimia nervosa

-Individual consumes larger than normal amounts of food in a short period of time, followed by purging •Health consequences -Tears in the esophagus -Tooth decay and gum disease from stomach acid -Electrolyte imbalances -Dehydration and constipation -Impaired normal bowel function through laxative use -Depression and low self-esteem

Which minerals are of concern for highly active people?

-Iron ▪Necessary for energy metabolism and oxygen transport ▪Levels may be low due to menstruation in women ▪Inadequate iron intake may require supplementation •Calcium -Reduces risk for injury to bone -Lost in sweat, thus losses may be high in athletes -Supplementation is not recommended unless intake from food and beverages is inadequate to meet the RDA.

Name some of the factors that affect your BMR.

-Lean body mass -Age -Gender -Body size -Genes -Ethnicity -Emotional and physical stress -Thyroid hormone levels -Nutritional state -Environmental temperature -Caffeine and nicotine intake

How many servings of fruit/veggies for kids

2 fruit servings 3 vegetable servings Dark green, red and orange vegetables

How much water after exercise

20-24 fl ounces per Pound of body weight loss

How many calories are in a pound of fat

3500

What are some of the key nutrients for pregnant women? What is one of the best ways to make sure they are meeting their nutrient needs?

50% increase in needs for folate, zinc, iron, and calcium ▪Folate -Need 600 micrograms daily ▪Iron -Needed to make additional red blood cells -Prevents anemia -Essential for fetal growth and development -Needed for the growth of the placenta -Fifty percent increase in needs for folate, zinc, iron, and calcium ▪Zinc and copper -Increased need due to inhibited absorption by iron ▪Calcium and vitamin D -Needed to support fetal bone growth -Prevent low bone mass in the mother -avoid too much Vitamin A and D ▪A prenatal vitamin supplement is needed

How does the energy density of food affect the number of calories we take in?

Foods with a lower energy density provide fewer calories per gram than foods with a higher energy density. Low: .7 to 1.5 vegetables (tomatoes, broccoli) Med: 1.5 - 4 bagels, hard cooked eggs, whole wheat bread High: 4 to 9 chips, cookies, crackers, pastries

What are some of the key nutrients that toddlers need?

Iron, calcium, and vitamin D are particularly important to a young child's development and growth.

What is TEE?

Thermic effect of exercise (TEE): Increase in muscle contraction that occurs during physical activity which produces heat contributes to total daily energy expenditure -Amount of kilocalories you need for TEE depends on the activity performed, duration of the activity, and how much you weigh.

over hydration

Too much fluid -Excess water consumption without sufficient electrolytes can dilute the blood and cause hyponatremia. ▪Symptoms of hyponatremia include rapid weight gain, nausea, vomiting, swollen hands and feet, headache, dizziness, and confusion.

TASTE

Try something new often All forms of fruits and veggies count Shop smart Turn it into a family activity Explore the bountiful variety

BMI definitions

Underweight: <18.5 Normal Weight: 18.5-24.9 Overweight: > 25-29.9 (10-15 pounds above normal weight) Obese: >30- 39.9 Morbidly Obese: >40 In US, 35% of adults are obese

What are ergogenic aids

any substance that is used to improve athletic performance. •Most commonly used aids include: -Creatine -Caffeine -Bicarbonate -Amino acids -Sports shakes and drinks

energy balance

energy balance: the state at which (kilocalorie) energy intake from food and beverage is equal to energy output from basal metabolism, thermic effect of food, and thermic effect of exercise •An energy imbalance can result in weight gain or loss .-Positive energy balance: Energy intake is more than energy expended ▪Weight gain from increased muscle mass, increased adipose tissue, or both ▪Periods of growth: Pregnancy, childhood, and adolescence •Negative energy balance: Energy expended is more than energy intake -Food intake is reduced, more energy is expended through exercise, or both -Results in weight loss ▪Fat loss ▪Muscle loss ▪Loss of glycogen or water

The prevalence of "obesity" has been increasing for decades in our country. Why?

the environment around us has changed in ways that have made it easier for people to gain weight -lack of time (less food prep) -An Abundant Food Supply and Portion Distortion -Lack of Physical Activity

mindful eating

the nonjudgmental awareness of the emotional and physical sensations one experiences while eating or in a food-related environment 1. PLATE IT. 2. SIT. 3. SAVOR. 4. DISCOVER SATISFACTION. 5. PUT SCREENS ASIDE. 6. PRACTICE GRATITUDE. 7. THOUGHTS AND EMOTIONS. ACCEPT AND LET THEM GO.

Food jag

when a child will only eat one food item meal after meal

How does hydration affect your exercise performance? How can you maintain adequate hydration when working out?

•Adequate fluid intake optimizes performance and prevents dehydration and electrolyte imbalances. -Exercise induces greater losses of water and electrolytes .-Electrolyte imbalance leads to: ▪Heat cramps ▪Low blood pressure ▪Nausea ▪Edema in hands and feet -Electrolytes can be replaced with food and sports drinks. •Greater fluid losses occur in hot, humid weather. -In extreme humidity the body can't cool down, which may lead to hyperthermia. -Increased risk for heat stroke or heat exhaustion •Exercising in cold weather increases risk for hypothermia. •Fluids are needed before, during, and after exercise.-To determine fluid needs for exercise: ▪Weigh yourself before and after exercise. ▪Consume 20 to 24 ounces of fluid for every pound of body weight lost during exercise.

For how long is breastfeeding recommended?

•American Academy of Pediatrics and Academy of Nutrition and Dietetics recommendations -Exclusive breastfeeding for the first six months -Breastfeeding with a combination of appropriate foods during at least the first year

How do we regulate food intake?

•Appetite: is the desire to eat food whether or not there is physical hunger. -Triggered by factors such as time of day, social occasions, emotions, or the sight or smell of food •Hunger and satiety affect the desire to eat and to stop eating. -Hunger is the physical sensation associated with the need or intense desire for food. -Satiety is the feeling of ''fullness'' produced by the consumption of food.•

What is intuitive eating?

-A way of eating and living that focuses on trusting and listening to our own bodies. -NOT another diet -Includes mindful eating but also addresses: rejecting the diet mentality, respecting your body, emotional eating, physical activity (Know at least two) 1.Reject the Diet Mentality 2.Honor Your Hunger 3.Make Peace with Food 4.Challenge the Food Police 5.Respect Your Fullness 6.Discover the Satisfaction Factor 7.Honor Your Feelings Without Using Food 8.Respect Your Body 9.Exercise—Feel the Difference 10. Honor Your Health

How do we measure fat distribution? (waist circumference)

-Because abdominal fat can be particularly detrimental to health, measuring a person's waist circumference can quickly reveal whether he or she is at increased risk (Figure 14.9). -A woman with a waist measurement of more than 35 inches or a man with a measurement of more than 40 inches is at a higher risk for disease than people with slimmer middles

Genetic "set point" theory

-Body fights to remain at a specific body weight and opposes attempts at weight loss -Given the rapid rise in weight in the United States, this theory either isn't true or the set point is easily overridden. •Populations which are genetically prone to having obesitycan overcome their genetic predisposition by engaging in regular exercise and eating healthy.

What are some of the key nutrients that many adolescents fall short on?

-Calcium and Vitamin D for Bone Development -Iron for Muscle Growth and Blood Volume (especially females)

What are the 5 components of physical fitness?

-Cardiorespiratory endurance: Ability to sustain cardiorespiratory exercise for an extended length of time -Muscular strength: Ability to produce force for a brief period of time -Muscular endurance: Ability to exert force over a long period of time without fatigue -Flexibility: Range of motion around a joint, improved with stretching -Body composition: The proportion of muscle, fat, water, and other tissues in the body

Binge eating disorder

-Characterized by recurrent episodes of binge eating without purging or regard to physiological cues -May eat for emotional reasons ▪Leads to out-of-control feeling while eating and physical and psychological discomfort after eating -May eat in secret and feel ashamed about the behavior -Health consequences ▪May cause high blood pressure, high cholesterol, heart disease, type 2 diabetes, and gallbladder disease

How do intensity and duration affect the use of glucose and glycogen? How does it affect the use of fat?

-Depletion of glycogen stores during exercise ▪High intensity: 20 minutes ▪Low intensity: 90 minutes •Muscle glycogen is the preferred source for muscle cells, but liver glycogen is also used .-Blood glucose is the energy source for the brain. -Lactate produced during low-intensity exercise is shuttled to the liver and converted to glucose. •Factors that affect use of fat during exercise -Duration ▪20+ minutes of low- to moderate-intensity exercise uses the greatest amount of fat. -Conditioning ▪Highly trained individuals use more fatty acids for energy .•Amount of fat needed for exercise -25 - 35% of calories from fat -Athletes should not consume < 20% of total calories from fat

What is gastric bypass surgery? What are some of the risks involved?

-During gastric bypass surgery, the stomach is reduced in size by making a small pouch at the top of the stomach with surgical staples. reduces the size of the stomach so that it holds less than 1/4 cup of food and also reduces the small intestine's ability to absorb food Post-surgery -Consume small, frequent meals. -Supplement: Iron, vitamin B12, calcium and vitamin C •Weight loss -Five to 15 lbs per week in the first 2 to 3 months -One to 2 lbs per week after first 6 months •Eliminates -Diabetes (76.8 percent) -Hypertension (70 percent)

What factors have contributed to the rise in childhood obesity?

-Genetics: A small percent of cases -Overconsumption of kilocalories -Sedentary lifestyle (more car time, more screen time) -Family environment -Environments outside the home -Advertising and peer influence ▪Regular soda, candy bars, and potato chips -Many of these products are sold within school buildings through vending machines or the cafeteria .-Also available in most convenience stores and shopping centers

Should you feed toddlers 3 big meals a day or several smaller meals?

-May need several meals and snacks

What are some of the benefits of breastfeeding?

-Mother provides food that is uniquely tailored to meet her infant's nutritional needs in an easily digestible form. •The nutritional composition of breast milk changes as the infant grows. •Right after birth -Breast milk contains colostrum, a yellowish fluid that is lower in fat but higher in protein, vitamin A, minerals, and immune factors. •Four to seven days after birth -Breast milk is high in lactose, fat, and B vitamins and lower in fat-soluble vitamins, sodium, and other minerals. Protects against infections, allergies, and chronic disease -Decreases :▪Risk and severity of diarrhea and other intestinal disorders ▪Respiratory and ear infections ▪Meningitis ▪Urinary tract infections -Protects against bacteria, viruses, fungi, and inflammation -Provides antioxidants, hormones, enzymes, and growth factors •Reduced childhood obesity risk (continued past 6 months) •Brain development (Breast-fed infants may have greater cognitive function.)

What is NEAT?

-Non-exercise activity thermogenesis (NEAT) ▪Included under TEE component ▪The energy expended from activities not considered exercise (e.g., maintaining posture or body position, fidgeting)

How do nutrients pass between mother and fetus?

-Nutrients are delivered to and wastes are transported from the developing embryo through the placenta .-Prevents passage of red blood cells, bacteria, and many large proteins from mother to fetus -Alcohol, drugs, and other potentially harmful substances can cross the placenta. -Releases hormones required to support the physiological changes of pregnancy

Nutrigenomics and Epigenetics

-Nutrigenomics: The study of how your genetic makeup interacts with your diet -Epigenetics: The changes that may occur in gene activity and gene expression without altering DNA sequence -Food and nutrients are a factor that can activate or repress certain genes.

How should you feed a picky eater?

-Offer a variety of food items within the preferred food type. -Gradually wean the child from the food item.

What are the health benefits of physical fitness?

-Reduced Risk of Cardiovascular Disease -Improved Body Composition -Reduced Risk of Type 2 Diabetes -Reduced Risk of Some Forms of Cancer -Improved Bone Health -Improved Immune System -Improved Mental Well Being -Improved Sleep

breast feeding benefits cont.

-Reduces blood loss in the mother after delivery -May help mothers return to their prepregnancy weight and manage their post-pregnancy weight -May reduce risk for breast and ovarian cancer -May reduce risk for hip fractures later in life, increase bone density, and reduce risk for type 2 diabetes -returns uterus to shape -cheaper than formula -•Stress reduction and bonding

What are some good foods to eat 2-4 hours before going for a 5-mile run or playing a soccer game? What about 30 minutes before? When do you want simple carbs vs. complex carbs?

-Simple carbohydrates: Immediately and during exercise -Complex carbohydrates: Few hours before exercise -small meal a few hours before (white toast with jam and low-fat yogurt) (easy-to-digest carbohydrate and protein) -Consuming simple carbohydrates (1 gram per kilogram of body weight) immediately before exercise (about 15-30 minutes prior to the start), especially if the carbohydrate is in liquid form, may be beneficial. (i.e. cracker, half a banana) The extra glucose gives muscles an immediate source of energy and spares glycogen stores, which allows for exercise for a longer duration or at a higher intensity without the body becoming tired as quickly

What are some foods/products/drinks that are good to consume during a long run or soccer game?

-Sports drinks (VitaminWater, Powerade, Gatorade) and gels are one way to take in carbohydrate immediately before or during activity, but foods such as crackers and sports bars are also commonly eaten. -Many sports drinks and gels contain only carbohydrate and electrolytes, while some also contain protein. For endurance athletes, consuming both carbohydrate and protein during exercise has been shown to improve net protein balance at rest as well as during exercise and postexercise recovery

Around what age is it safe to introduce solids to an infant? What are the best foods to start with?

-The milestones typically occur around 4-6 months of age. -When body systems are physiologically ready to process solid foods -Infant should be physically ready to eat; this is specific to each child. ▪Tongue-thrust reflex should have faded .▪Infant has head and neck control. ▪Infant can sit without support and can turn his or her head. -start with rice cereal

What are the benefits of consuming foods rich in antioxidants after exercising? What are examples of antioxidants?

-antioxidants help protect your cells from damage caused by exercise -Intense, prolonged exercise increases the production of free radicals. -Vitamins E and C protect cells from the damage of free radicals. (nuts, whole grains, fruits, vegetables, strawberries) -Supplementation above the RDA does not improve athletic performance or decrease oxidative stress.

What is the best way to lose weight? Is there a best way?

-avoid fad diets -For successful, long-term weight loss, people can reduce their daily kilocalorie intake -increase their physical activity, - improve their eating behaviors -Choosing low-energy-density, high-volume vegetables, and fruits, along with lean-protein foods, can help increase satiety and reduce unplanned snacking. -Incorporating approximately 60-90 minutes of physical activity daily -Establishing healthy eating and exercise habits by restructuring the environment to minimize or eliminate unhealthy eating behaviors can also help shed extra pounds.

When does morning sickness usually occur? What herb has been shown to help alleviate morning sickness?

-first trimester - nausea ▪Can occur at any time of the day ▪The heightened sense of smell can trigger nausea and vomiting. ▪Emotional stress or traveling can aggravate the problem. -Vitamin B6 may reduce nausea and vomiting. -Ginger may reduce nausea and vomiting.

Why is it so hard to maintain weight loss?

-set point theory -One problem with maintaining weight loss is that once the weight has been lost, individuals revert to the unhealthy eating habits that caused the excess weight in the first place

What are growth charts? What do they show?

-track physical development. -Typically, measures of head circumference, length, weight, and weight for length are used to assess growth. -These measures are taken at each pediatric wellness check, about once a month for the first year. -The information obtained from the measurements is plotted on a growth chart, placing the child into a percentile. - Percentiles rank the infant with regard to other infants of the same age in a reference group

How many exposures for someone to like a new food

10-15 times

Orthorexia

An obsession with "healthy or righteous eating"-Often begins with a person's desire to live a healthy lifestyle -Characteristics of the individual ▪Spends most of his or her time thinking about food and how it was prepared, processed, and overall health benefits of the food ▪Typically does not obsess over calorie content of foods -Contributors to healthy food obsession ▪Eliminates foods based on learning about a negative health effect from eating the food -Restrictive nature can develop into anorexia

At what age is it ok to introduce cow's milk into a child's diet?

Avoid whole cow's milk until after one year of age.

What are some of the benefits of classifying obesity as a disease? What are some of the downsides?

Benefits: -Provides a warning of the potential health hazards of being overweight -May make it easier for individuals to get insurance coverage for treatment -More research funding may be allocated to addressing the obesity problem in the United States. Cons: -It may encourage more use of drugs and medical procedures to address the epidemic rather than encouraging lifestyle changes. -Negative psychological or social stigma -May lead to medical bias -Increased risk of eating disorders

When might creatine be used? What are some of the side effects? What about caffeine?

Creatine -Improves athletic performance in high-intensity, short -duration activities such as weight training -Shown to increase muscle strength and muscle mass -Side effects: Water retention -Some reports of liver and kidney problems when taken at higher than recommended doses for several months •Caffeine -Stimulates the central nervous system and decreases perception of effort ▪May increase metabolism of fatty acids for energy and spare glycogen stores -Enhances athletic performance during endurance events-No effect for short-duration events -NCAA classifies caffeine as a banned substance when urine concentrations exceed 15 micrograms per milliliter.

How are carbs, fat, and protein used during exercise?

Fat fuels aerobic energy production, carbohydrate fuels both aerobic and anaerobic production, and protein is used for energy production when kilocalorie needs haven't been met. Carbohydrate is the Primary Energy Source during High-Intensity Exercise •Factors that affect use of fat during exercise -Intensity ▪Low-intensity exercise uses free fatty acids in the blood from stored adipose tissue. ▪Moderate-intensity exercise uses more free fatty acids from muscle triglycerides and less from the adipose tissue.

What does FITT stand for?

Frequency, intensity, time, and type -Frequency: How often an activity is performed (number of times per week) -Intensity: The degree of difficulty at which the activity is performed ▪Low, moderate, and vigorous (high) ▪Rating of perceived exertion (RPE) -Time: How long the activity is performed -Type: The specific activity performed •The amounts that are right for you depend on what you are trying to achieve.

What percent of us children are obese or overweight

More than 17 percent

What is RED-S

Relative Energy Deficiency in Sport (RED-S)•A combination of interrelated health conditions including: -Low energy availability -A variety of physiological impairments ▪metabolic rate, menstrual function, bone health, immunity, protein synthesis, and cardiovascular function, along with reduced psychological health •Reduces the performance of the athlete •May have serious medical and psychological consequences •Affects males and females

How is total daily energy expenditure (TDEE) calculated?

TDEE: Total kilocalories needed to meet daily energy requirements -BMR (50-70%) -Thermic effect of food (TEF) (10%) -Thermic effect of exercise (TEE) and non-exercise activity thermogenesis (NEAT) (20-35%)

How long should you wait before introducing each new food to a baby?

The best practice is to introduce only one new food per week

Food allergy

a response by your immune system to the proteins in certain foods 1. Sensitization stage 2. allergic reaction stage

How do intensity and duration affect the use of glucose and glycogen? How does it affect the use of fat? cont.

as the intensity of exercise increases, the percentage of energy derived from glucose and glycogen also increases. At the start of low- to moderate-intensity exercise, stored muscle glycogen is the main source of energy. As muscle glycogen stores diminish, the liver also contributes its glycogen to be converted to glucose for energy and to prevent hypoglycemia. During prolonged exercise, the body relies more on blood glucose (generated from stored liver glycogen) and less on muscle glycogen as its carbohydrate source of energy.

What are factors that affect weight

genetics, environment, socio-economic status, mental health, access to health care, education, access to fruits and veggies, diet, physical activity •Environmental factors involved with obesity -Lack of time ▪Most kilocalorie intake is from foods eaten away from home. ▪Dining out frequently is associated with a higher BMI. ▪Individuals who dine out are less likely to choose fruits and vegetables when they order. -An abundant food supply and portion distortion ▪People have easier access to food. ▪People eat or drink more when given larger portions. ▪People eat or drink more when the food is presented in a larger bowl, plate, or package. -Lack of physical activity and increased sedentary behavior ▪People do less manual labor in their jobs .▪The more people drive, the less they engage in physical activity. ▪More time is spent in front of the TV or computer.

What is physical fitness?

good health or physical condition as a result of exercise and proper nutrition.

For someone who wants to lose weight, what is a healthy weight loss goal?

less than 2 pounds per week or 5-10% of body weight over 6 months

mother lifestyle

•Avoid botanicals. -Not enough research has been done to determine their safety. •Manage chronic conditions. •Drinking alcohol during pregnancy can lead to: -Fetal alcohol spectrum disorders (FASDs); pregnant women are advised to abstain completely from alcohol. •Illicit drugs can increase the risk of miscarriage, preterm labor, low birth weight, and birth defects. •Eat safe fish. -Some fish have high levels of methylmercury. -Limit albacore tuna to no more than 6 oz weekly .•Consume moderate amounts of caffeine. -Limit caffeine intake: < 150 mg per day -Avoid smoking; smoking increases the risk of:-Infertility, a low birth weight baby, stunted growth or intellectual development, and sudden infant death syndrome (SIDS) •Underweight women are at risk of delivering low birth weight or small for gestational age babies •Consume adequate folic acid.-Reduces risk of neural tube defects-Needed for new cell synthesis-Recommendation: 400 micrograms daily •Being in a larger body is associated with -Infertility -Pregnancy complications (diabetes and hypertension; induced labor and C-section) -Birth defects, preterm delivery, and difficult deliveries -Children are more likely to develop childhood obesity and develop diabetes and hypertension later in life.

What are some of the flaws of the BMI scale?

•BMI is not a direct measure of percent of body fat. •BMI is not be accurate for everyone. -Athletes and some individuals: BMI > 25 but have high muscle mass and low body fat -Older adults with chronic weight loss: May have healthy BMI but significant loss of muscle mass and depletion of nutrient stores -Individuals less than 5 feet in height may have a high BMI, but not be unhealthy. •Poverty is associated with a larger body size -Rural areas have a higher percentage of "obese" people, which is why states with more rural areas appear to have more obesity (they have a higher rate, but not total number) •Trying to lose weight can lead to additional weight gain in up to ⅔ of people •If using BMI chart it should be just one of many measurements used to assess health

Is BMI a good indicator of health?

•BMI is not an accurate way of determining health as it does not look a the whole picture. Additionally: -The BMI chart is derived from the Quetlet index, developed by a Belgian astronomer in the 1800s as a statistical exercise -it was never intended for human use -It was developed based on data from an exclusively white, male, European, population -It was adopted by US insurance companies in 1899 -In 1998, the NIH changed what is considered "overweight" and "obese"--people moved into new, higher BMI categories without having gained weight -The BMI is very imprecise as it does not tell you: -about a person's body composition -what a person's health outcomes will be• -Research shows that weight stigma is a greater risk to poor health than the weight itself

Basal metabolic rate (BMR) vs resting metabolic rate (RMR): What is the difference and which is usually used?

•Basal metabolic rate (BMR): Amount of energy spent to meet the body's basic physiological needs -Because BMR is difficult to measure, resting metabolic rate (RMR) is often used. -The RMR is the amount of energy used by the body, measured when the person is lying calmly after only a 3- to the 4-hour fasting period. The RMR is about 6 percent higher than the BMR, as it reflects increases in energy expenditure related to any recent food intake or physical activity. -a person's BMR is usually measured in a laboratory setting in the morning while the person lies motionless in a controlled (no shivering or sweating) environment after a 12-hour overnight fast. Neither the digestion of food nor physical activity (which both require energy) is factored into the BMR. (precise circumstances make It difficult to obtain)

What are some risks that are associated with being underweight?

•Being underweight increases health risks. -Symptomatic of malnutrition, substance abuse, or disease -Higher risk of anemia, osteoporosis and bone fractures, heart irregularities, and amenorrhea -Correlated with depression and anxiety, inability to fight infection, trouble regulating body temperature, decreased muscle strength, and risk of premature death -May be unintentional and due to malabsorption associated with diseases such as cancer, inflammatory bowel disease, or celiac disease ▪Also may be due to certain medications, smoking, and substance abuse

Body Composition - what is it? How can we assess it?

•Body composition: The ratio of fat tissue to lean body mass (muscle, bone, and organs) -Usually expressed as percent body fat -There are several indirect measurements used to estimate the percentage of body fat and lean body mass in the body. -The most popular indirect techniques are found in laboratory settings and include hydrostatic weighing, air displacement, dual-energy X-ray absorptiometry (DEXA), bioelectrical impedance, and skinfold measurement

What is BMI?

•Body mass index (BMI) calculates body weight in relation to height. -•Body mass index (BMI) calculates body weight in relation to height. BMI= Body weight (in kilograms)/height (squared, in meters)

How does fat distribution affect health? (Apple vs. Pear Shape) How do we measure this? (waist circumference)

•Central obesity(android/apple obesity) -Excess visceral fat in the abdomen -Increases risk for heart disease, diabetes, and hypertension -Visceral fat releases fatty acids that travel to the liver, causing insulin resistance, increased LDL, decreased HDL, and increased cholesterol. •Gynoid obesity (pear) -Excess fat around the thighs and buttocks -More common in women than men

What are some optimal foods to eat after exercise? How soon after exercise should you try to eat? Why is it so important to eat a combination of protein and carbohydrates after a workout?

•Consume carbohydrate to replenish muscle and liver glycogen .-It is most effective 30 to 45 minutes after exercise. •Consume protein and carbohydrate to increase muscle protein synthesis. -Low-fat chocolate milk is a low-cost option to provide whey protein and carbohydrate to assist in recovery. •A high-carbohydrate, moderate-protein, low-fat meal should be consumed within 2 hours

What is Health at Every Size (HAES)?

•Current healthcare culture focuses on obesity (weight centric) •Leads to weight bias and weight stigma •The number on the scale is not the whole story •Health at Every Size® (HAES) -a movement that shifts the focus from weight management to health promotion -affirms a holistic definition of health, which cannot be characterized as simply the absence of physical or mental illness, limitation, or disease HAES® includes the following basic principles: 1.Respect - body, age, ethnicity, etc. 2.Critical Awareness - challenge assumptions; value body knowledge and lived experiences 3.Compassionate Self-Care - finding joy in moving one's body and being active; intuitive eating approach

What are some of the nutritional issues that affect adolescents?

•Desire for independence and individuality -Making own food choices -Having own transportation to access food•Influence of peers, media, and nonparent role models -Exposure to unrealistic or unsafe eating practices -May lead to adoption of damaging habits •Eating family meals is associated with better nutrition intake and more healthful eating patterns .•Establish good eating habits early.

What is disordered eating vs. an eating disorder? Who is at risk for an eating disorder?

•Disordered eating describes abnormal and potentially harmful eating patterns. (Refusing to eat, Compulsive eating, Binge eating, Restrictive eating (dieting!), Vomiting after eating, Abusing diet pills, laxatives, or diuretics) (do not meet criteria for clinical eating disorder) -Eating disorders are psychological illnesses diagnosed by meeting specific criteria that include disordered eating behaviors and other factors. -Most common in young adults and adolescents, predominantly in white upper-middle- and middle-class families-Increasing among males, minorities, and other age groups

What are some of the risks of dieting?

•Focuses on and values weight, shape, and size over well-being. •Thin is desirable and healthy •Promotes over-restrictive or rigid eating patterns •Claims to be in the name of health, but in reality are about weight, shape, or size .•Eating a certain way is "Good" or "Bad" -Fad diets promise quick weight loss by means that are typically unproven and unhealthy.. A diet high in saturated fat and low in fiber and phytochemicals is a recipe for heart disease, cancer, constipation, and deficiencies in many vitamins and minerals - more than 20 percent of the dieters quit just two months into the study, and more than 40 percent of them dropped out after 1 year. - people give up on them long before they meet their weight-loss goals. A fad diet doesn't fix anything in the long term. -money spent

How does someone gain weight?

•Gaining weight is challenging for those who are underweight. •Goal is to gain muscle, not all fat. •Methods to do this -Add 500 kilocalories in addition to daily energy intake .▪Adds about one pound of extra body weight per week -Choose more energy -dense foods. -Include regular exercise and resistance training.

What is gestational diabetes? What are some risk factors?

•Gestational diabetes occurs when a woman develops high blood glucose levels during her pregnancy .-Typically onsets after the 20th week -Increased risk for jaundice, breathing problems, birth defects -Increased risk for hypoglycemia after birth -Risk factors ▪Being in a larger body ▪Being over 25 years old ▪History of higher-than-normal blood glucose levels ▪Being Hispanic, African-American, Native American, or Pacific Islander ▪Previously gave birth to a very large baby or a stillborn baby ▪Having had gestational diabetes in the past

How do fat cells form and expand?

•Growth of fat cells (adipocytes) occurs in two ways .-Can expand to store more fat (hypertrophy) -Once filled to capacity, stimulate the production of more fat cells (hyperplasia) (division) -Fat growth and production of cells continue throughout life, but hyperplasia slows with age -Fat growth and production of cells continue throughout life, but hyperplasia slows with age -The enzymes lipoprotein lipase (Increases fat in cell) and hormone-sensitive lipase influence the balance between lipolysis and lipogenesis, and thus the growing or shrinking of fat cells. •average adult has 30 to 50 billion adipocytes, which hold 0.4 to 0.5 micrograms of fat each. -Adults in larger bodies are thought to have larger adipose cells (hold 0.6 to 1.2 micrograms of fat each)

How does one maintain weight loss over time?

•Many people who lose weight gain it back within 5 years •Research shows that successful weight maintainers-Maintain the energy -gap reduction in kilocaloric need to maintain the weight loss. ▪Decrease portions and intake of fatty foods. ▪Eat smaller, more frequent meals; but make sure it does not turn into "grazing." ▪Maintain a high level of physical activity. -Weekly self-weighing can help individuals maintain their weight loss but is not recommended by intuitive eating dietitians.

OSFED/EDNOS

•OSFED: Other Specified Feeding or Eating Disorders -a serious, life-threatening, and treatable eating disorder -includes all those individuals who did not meet strictdiagnostic criteria for anorexia nervosa or bulimia nervosabut still have a significant eating disorder -Previously known as EDNOS (Eating Disorder Not Otherwise Specified) (video)

mother lifestyle cont.

•Older mothers may have special concerns. -Age > 35 years old -Higher risk for complications ▪Difficulty conceiving ▪Gestational diabetes and pregnancy -induced hypertension ▪More likely to have a baby with Down syndrome or other developmental disabilities -Prior to pregnancy ▪Maintain healthy body weight, avoid smoking, and eat a balanced diet •Low-income mothers may need food assistance. -Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) ▪Designed to ensure that pregnant women and mothers of young children have access to nutrition information and nutritious foods -Criteria ▪Low-income pregnant women ▪Low-income postpartum women ▪Children up to age five who are at nutritional risk

What about women who consume fortified cereal + prenatal vitamin + fortified orange juice? Is there a risk of going over the recommended nutrients?

•Overconsumption of some nutrients -Avoid consuming too much vitamin A and vitamin D. ▪Can be toxic in high amounts

What are some of the social or psychological risks of being obese?

•Overweight people are treated differently from people at a normal weight. -Suffer more discrimination -More likely to be denied job promotions and raises-Females with obesity are less likely to be accepted into college, especially higher ranked colleges. -People perceive them as lazy or weak-willed. •People with obesity have higher rates of suicide and are more likely to use drugs and alcohol. •Individuals who are underweight are more likely to be at greater risk for: -Irritability -Anger -Depression

How can adults influence young children's eating habits?

•Parents influence children's food preferences. -Children model adult behaviors, both healthy and unhealthy. -Include young children in food shopping, menu planning, and meal preparation to encourage variety in their food consumption. •Parents should set the example. -Plan meals with more fruits and vegetables in the family's diet. -Consume fruits and vegetables during meals .-Substitute pureed vegetables in traditional dishes.

Which hormones stimulate hunger? Which hormones signal satiety?

•Satiety is triggered by an area in the hypothalamus .-Cholecystokinin (CKK) and peptide YY (PYY) ▪Secreted by the small intestine to stimulate satiety -Leptin ▪Produced in adipose tissue ▪Decreases hunger and food intake ▪Regulates amount of fat stored ▪Decreases with weight loss and intake of certain vitamins and minerals •Certain macronutrients, especially protein, promote satiety and reduce food intake. •Hunger is controlled by the lateral hypothalamus .-Ghrelin ▪Secreted by the stomach ▪Increased production tells the hypothalamus the body needs energy .▪Stimulates hunger during fasting or on a low-kilocalorie diet ▪Lean individuals have higher ghrelin levels. -Neuropeptide Y ▪Produced in the hypothalamus and activated by ghrelin ▪Stimulates hunger and LPL activity -Leptin ▪Drop in leptin when adipose tissue shrinks stimulates hunger

When is plain water ok? When should you add a sports drink?

•Some beverages are better than others. -Sports drinks contain 6 to 8 percent carbohydrate as well as sodium and potassium. ▪Most beneficial for exercise lasting longer than 60 minutes -Water is adequate for exercise that is < 60 minutes. •Certain beverages are suboptimal for hydration during physical activity.-Juice and juice drinks-Carbonated drinks-Alcohol-Caffeine

? What is the female athlete triad?

•Syndrome of the three interrelated conditions occurring in some physically active females -Low energy availability (not enough kilocalories)—from disordered eating ▪Unintentionally low kilocalorie intake ▪Diagnosed anorexia nervosa or bulimia -Amenorrhea ▪Absence of three consecutive menstrual cycles -Decreased bone density or osteoporosis ▪Stress fractures are common.

Which vitamin needs to be supplemented for infants who are breastfed?

•The American Academy of Pediatrics recommends supplementing breast-fed babies with vitamin D. -Minimum of 400 IU vitamin D per day -Give in the form of drops

What is TEF?

•Thermic effect of food (TEF): Energy used to process the macronutrients and extract kilocalories from food -amount of energy expended by the body to digest, absorb, metabolize, transport and store energy yielding nutrients from food -10% of kilocalories in food consumed is used for TEF .▪Meals high in protein have greater TEF than those high in carbohydrate, which have greater TEF than those high in fat. -TEF is influenced by: ▪Type of nutrients consumed, composition of a meal, alcohol intake, age, and athletic training status

How is body fat stored?

•Two types of fat make up total body fat .-Essential fat ▪Essential for the body to function ▪Women have more essential fat (12%) than men (3%). -Stored fat ▪(most is stored in) Found in adipose tissue ▪Subcutaneous fat is located under the skin. ▪Visceral fat is stored around the organs in the abdominal area. -Insulates the body from cold temperatures -Protects and cushions internal organs

Who does the Supplemental Nutrition Program WIC help? How does it help?

▪Designed to ensure that pregnant women and mothers of young children have access to nutrition information and nutritious foods ▪Low-income pregnant women ▪Low-income postpartum women ▪Children up to age five who are at nutritional risk -Iron-fortified infant formula and cereal and iron-fortified adult cereal -Vitamin C-rich fruit or vegetable juice -Eggs, milk, cheese, peanut butter, dried beans/peas, tuna fish, and carrots -Every dollar spent on WIC saves between $1.77 and $3.13 in health care costs within the first 60 days after birth.