Exam 2 Quizlet

Distribution of fat matters

"apple-shaped" = body with excess weight around upper body/abdomen "pear-shaped" = body with excess weight on thighs/hips. Abdominal fat measured by waist to hip ratio Apple shaped = higher abdominal fat Associated with hypertension,atherosclerosis, diabetes, some cancers, and mortality

Basal Metabolic Rate (BMR)

# calories your body needs to maintain normal bodily functions-Influenced by heredity, age (higher in younger people), activity level, and body composition (fat tissue = lower metabolic rate)

Preventing Obesity in Infancy & Childhood

(Paul et al., 2009) Breast feeding = may protect against obesity. Promotes self-regulation. Exposure to different tastes. Composition of breast milk. Parent feeding practices: Linked to food acceptance and self-control over eating. Infants need to be exposed to new tastes multiple times before they willingly eat new foods. Parent feeding practices - (0 - 3 yrs). Overt control of eating does not work. Use of food for reward (e.g., get desert if eat veggies). Rewards for eating less preferred foods lead to dislike of the "access foods" ("I'm being rewarded to eat veggies, so veggies must be bad"), and to greater liking of the reward foods. Restricting access increases desire and liking for restricted food. Dysregulation of intake. Covert control may be ok. E.g., control what a person eats by not having junk food available.

Secondary Prevention

(intervention)Increasing cancer screening behaviors to identify localized tumors before they have a chance to spread.

Primary Prevention

(prevention)Prevention programs that keep children and adolescents from starting smoking.

Tertiary Prevention

(rehabilitation) Developing an exercise program for patients who had coronary bypass surgery for heart disease.

Relapse Prevention Programs

-Controlled Drinking -Drink refusal training -Stress management training -Coping and social skills training

Alcohol Use Among U.S. Adults

2/3 of adults in U.S. currently drink alcohol. 10% are binge drinkers. 5% are heavy drinkers

Reduce Mortality

7 Health Behaviors. 7-8 hrs sleep; not smoking; breakfast daily; < 2 alcohol drinks daily; exercise; avoid snacks; < 10% overweight. Cross-sectional: Better self-reports of health. Longitudinal (followed for 12 years):Lower mortality. Additive effects

Delirium Tremens (DTs)

A symptom of alcohol withdrawal that can occur if you stop drinking after excessive and prolonged use. sweating, trembling, anxiety, and hallucinations

Fetal Alcohol Syndrome

A cluster of birth defects (facial abnormalities, low intelligence, and retarded body growth) caused by the mother's use of alcohol during pregnancy

Risk Behaviors

A health-compromising behavior or habit. Smoking, excessive or unhealthy eating, substance use and abuse, dangerous driving, risky sexual behavior

Health Behaviors

A health-enhancing behavior or habit. Exercising re. gularly, using sunscreen, healthy eating, practicing safe sex, wearing seatbelts, sleep hygiene.

Body Mass Index (BMI)

A measure of an adult's weight in relation to his or her height. Weight (kg)/Height2 (m). On-line BMI calculators http://www.cdc.gov/healthyweight/assessing/bmi

Psychosocial Consequences

Abbey, Zawacki, & McAuslan (2000): 176 college students (88 M/F pairs). 2 alcoholic or nonalcoholic drinks/10-minute absorption period. 15-minute conversation. Trained observers code for attentive cues and sexual interest cues. Results: drinkers exaggerated sexual interest cues and ignored ambiguous, attentive cues. Alcohol allows people to concentrate on salient cues that fit their current beliefs. These factors may contribute to risky sexual behaviors, Increased # sexual partners, Decreased use of condoms, Increased STDs and unwanted pregnancies.

Who drinks alcohol?

Adults age 25-44 have highest rates of drinking. Men are more likely to drink than women. People with more education are more likely to drink. However, HS dropouts are more likely to develop drinking problems. College drinking: 60.3% college students drank alcohol in past month. 51.9% non-college peers.40.1% college students binge drink. 35% non-college peers. European Americans higher alcohol consumption than other race/ethnic groups. Native Americans highest rates of heavy and binge drinking. Asian Americans lowest rates of drinking.

Alcohol Use Disorders

Alcohol Abuse Alcohol Dependence

The Effects of Alcohol

Alcohol is metabolized by two enzymes Alcohol dehydrogenase (ADH) Aldehyde dehydrogenase (ALDH)

Social Learning Model

Alcohol use is a learned behavior that can be unlearned. Often start drinking for social reasons. Observing others' drinking (e.g., social modeling; parents, friends, movies). Beliefs about social norms. Drinking becomes reinforcing and habitual-Negative reinforcement = escape from unpleasant situations Tension Reduction Drinking may reduce stress and tension. Self-Awareness-Drinking may make you less self-critical. Role of expectations-Beliefs about alcohol predict its effects on you.

Korsakoff's Syndrome

Alcohol-induced neurological disorder where cannot lay down new memories. Related to thiamin deficiency.

Self-Help Groups

Alcoholics Anonymous. Abstinence based program. Goal is to never drink again. Once an alcoholic, always an alcoholic

Low Carbs vs Low Fat?

Bazzano et al. (2014). 150 men and women. Low carb vs low fat diet. Low carb more effective: Greater weight loss. Lower body fat. Better cholesterol profile. Lower triglycerides.

Behavioral and Social Interventions

Behavioral interventions teach people skills so they can adopt and maintain physical activity. "Gym" classes in schools increase physical activity during school but not necessarily outside of school. Social interventions create an environment that makes it easier for people to adopt and maintain physical activity. "Buddy systems"/ social support are effective ways to increase exercise. Individually tailored programs can be effective but are not as successful at maintaining activity levels

Aversion Therapy

Behavioral therapy that pairs an unpleasant stimulus (emetic drug) with an undesirable behavior (drinking). Antabuse

Obesity

Body Mass Index (BMI) of 30 or higher.

Other Biological Processes

Brain responds to food cues with spike in dopamine-related neurons in reward regions of the brain. Freshman 15 study (Demos et al., 2012). Scanned brain responses to food cues. Measured weight gain at 6 months (M = 7.7 lbs). Those with highest activation in response to food cues showed largest weight gain.

Alcohol and the Brain

Breaks down into chemicals that affect neurotransmitters in the brain. Emotional and behavioral control. Memory

Preventing Obesity and Living a Healthy Lifestyle

Change the toxic environment. Policy changes e.g., banning sale of large sugared beverages. Promote availability of affordable healthy food. City/urban planning e.g., build neighborhoods with sidewalks. Structure environment to support healthy choices. Dietary Recommendations for a healthy life-5 a day = 5 servings of fruits and vegetables/day-2-3 portions of vegetables; 2 portions of fruit. Make half your plate fruits or veggies. 6-7 oz whole grain. Make half your grains whole grains-6 oz protein. Eat varied protein (poultry, fish, beans, nuts or seeds)-6 tsp oil.

Treatment and Prevention of Alcohol Dependence

Change without therapy. Many people can change on their own. Drug Treatment. Aversion Therapy Self-Help Groups Relapse Prevention Programs

Direct Physical Effects of Excessive Alcohol Consumption

Cirrhosis of the liver. Cardiovascular disease. Acetaldehyde is a carcinogen. Fetal Alcohol Syndrome. Korsakoff's Syndrome.

Genes and Alcohol Dependence

Clear evidence of genetic factors. Among males, alcoholism in a first-degree relative is the single best predictor of alcoholism. Adopted children are more susceptible to dependency if one or both biological parents was alcohol-dependent. Identical twins have twice the concordance rate of fraternal twins.

Barriers to Improving Health Behaviors

Cognitive Barriers Emotional Barriers Immediate vs delayed gratification Environmental Barriers Physiological Barriers Socioeconomic Barriers

Treating Overweight & Obesity

Cognitive-Behavioral Approaches: Set specific achievable "behavioral" goals. Self-monitoring-Stimulus Control: Identify the situations that make you eat the wrong things and then change those situations Contingency Contracting: Set up reinforcements for achieving behavioral goals-Relapse Prevention: Effectiveness of cognitive behavioral approaches?Moderate effects for weight loss. But even with health benefits, less than desired by individual. Modest maintenance effects. Effects improved if. Dietary changes AND aerobic exercise. Social support.

Adipocytes

Collapsible body cells that store fat

Alcohol Poisoning

Consuming toxic amounts of alcohol in short time (toxic blood alcohol levels). Liver can only process about one unit of alcohol/hr Symptoms: Confusion, low body temperature, pale (bluish) skin, stupor (unresponsive but conscious), passes out, slow or weird breathing, vomiting. Rates: 50,000 cases annually in US (1 death / week). What to do? CALL 911

Isometric exercise

Contracting muscle against an immoveable object. E.g., pushing against a solid wall. Benefit: can improve muscle strength

Isotonic exercise

Contraction of muscles and the movement of joints. E.g., weight lifting. Benefit: can improve muscle strength and endurance

Sociocultural Factors of Obesity

Cultural norms for body weight. Norms for ideal body weight have changed throughout history and across cultures. African-Americans may be less preoccupied with thinness than European Americans. Culture-specific food preferences. Acculturation of dietary customs. Immigrant effects

Drug Treatment

Detoxification agents, opiate antagonists to reduce alcohol's reinforcing properties.

Exercise Addiction

Engaging in exercise that detrimentally alters lifestyle causing physical, medical, financial, or social problems (Terry, Szabo, & Griffiths, 2004)

Hazards of Physical Activity

Exercise Addiction Injury from exercising

Aerobic Exercise

Exercise that involves increased oxygen use. E.g., jogging, cycling. Benefit: works out both respiratory system and cardiovascular system

Mortality Rates and BMI

Generally speaking, thinner people live longer; however, very thin people do not have the lowest mortality rates.

Genes and Alcohol Use

Genetic factors may affect alcohol metabolism.Fast ADH and slow ALDH = high levels of Acetaldahyde when drink. Unpleasant (facial flushing; nausea; increased HR).May explain ethnic differences in alcohol use

Depression

Habitual physical activity has NOT been shown to prevent depression onset, but in general people who exercise are less depressed than those who don't. Increase aerobic exercise and strength training have shown to significantly reduced depression symptoms. Acute anxiety responds better to exercise than chronic anxiety.

Behavioral Theory

Health behaviors are learned and maintained through principles of conditioning and learning. Classical conditioning...think Pavlov's dogs. Operant conditioning...think Skinner boxes.

Causes of Obesity:A Biopsychosocial Perspective

Heredity-Genes contribute approximately 50 percent to the likelihood of obesity. Body weights of adopted children correlate more strongly with weights of biological parents than of adopted parents. Body weights of adopted siblings weakly correlated.

Taste preferences

Humans are born with preferences for energy-dense foods (preferences for fat and sugar)

Strengths of the Theory of Planned Behavior

Identifies beliefs that shape behavior. Most successful at predicting physical activity and dietary behaviors.

Health Behavior Theory

Importance of theory. Identifies key constructs. Guides interventions to improve. Theory-based interventions are more effective. Types of health behavior theory. Continuum theories. Explain motivation to engage in a behavior -Stage theories. Focus on the process of behavior change

Transtheoretical or Stages of Change Model

Important Features. Movement back and forth between stages. Early stage changes are important. Treatment Matching. Focus on Maintenance. Includes need for relapse prevention.

Food neo-phobia

Infants and children need to be exposed to new tastes multiple times before they will be willing to eat. Children need to be "taught" to like many foods that are good for them

Set Point Hypothesis and the Hypothalamus

Lateral Hypothalamus (LH): Stimulation leads to hunger. Destruction of the LH leads to self-starvation. "Hunger center"? Ventromedial Hypothalamus (VMH)-Stimulation causes an animal to stop eating. Destruction of the VMH leads to hunger. "Satiety center"?

Are there benefits of alcohol use?

Light or moderate drinking has been associated with: Reduce mortality. Lower heart disease deaths. Lower risk of developing Type 2 diabetes. Decrease risk for ulcers and digestive tract cancers. Decrease risk for Alzheimer's disease.

Alcohol Abuse

Maladaptive drinking pattern that results in harm to health, relationships, and role obligations. Cannot fulfill responsibilities. School or work affected; relationships affected. Drink in dangerous situations. Experience legal problems because of drinking-E.g. DUI or DWI. Health-Losing time or blacking out. Continue to drink despite problems in living.

Role of dieting?

Many people diet to lose weight. Miracle diets don't work. Dansinger et al (2005) compared popular diets-Weight Watchers, Atkins diet (low carb), Ornish diet (low fat). After one year: Weight watchers - 6.6 lbs (35% dropped out). Atkins - 4.62 lbs (47% dropped out) Ornish - 7.26 lbs (50% dropped out)

Alcohol Consumption

Moderate Drinking: < 1 drink/day females; < 2 drinks/day males Binge Drinking: Having 4+ drinks at once for females; 5+ drinks at once for males. At least 1 day in past month. Heavy Drinking: >5 drinks at once for 5 or more days in past month. Low risk for developing an alcohol use disorder. Women: < 3 drinks in a single day AND < 7 drinks per week. Men: < 4 drinks in a single day AND < 14 drinks per week. BUT it depends on how quickly you drink and other health issues you may have and age (Elderly should drink less)

Weaknesses of the Health Belief Model

Modest or weak predictive effects. Does not include a belief about personal control.

Isokinetic exercise

Moving muscles and joints against a variable amount of resistance. E.g., using specialized equipment that adjusts the amount of resistance according to the amount of force applied. Benefit: important in physical rehabilitation.

Weaknesses of the Theory of Planned Behavior

Not as successful at predicting risk-taking behaviors. Intention does not always predict behavior.

Improving Adherence to Physical Activity

Only 33% of Americans meet the current guidelines. Interventions to increase physical activity: Informational interventions. Behavioral and social interventions. Environmental interventions. Informational interventions. Social norms and health behavior. Burger & Shelton (2011). "Did you know? Taking the stairs is a good way to get some exercise. Why not try it?""Did you know, more than 90% of the time, people in this building take the stairs instead of the elevator. Why not you?"

Medically Supervised Approaches

Only for severely obese (BMI > 40). Bariatric Surgery-Change the structure of the stomach such as through gastric banding or gastric bypass-Reduces weight, cardiovascular disease and mortality Liposuction?-Cosmetic only. Not a weight loss technique

Importance of Health Behavior

Patterns of disease in the U.S. have changed from acute infectious disorders to "preventable" disorders. Half the deaths in the U.S. are caused by "lifestyle" or behavioral factors. Tobacco use - #1 preventable cause of death. Obesity and lack of exercise. About to overtake tobacco as the most preventable cause of death in the U.S.

Intention - Behavior Gap

People may intend to behave in one way but forget about their intentions in the moment. Behavioral Willingness - a person's motivation at a given moment to engage in a risky behavior. Reaction to a situation rather than a deliberate, planned choice. Teens especially may be prone to engage in risky behaviors due to their social image.

Reasons for Exercising

Physical Fitness. Increasing muscle strength. Increasing muscle endurance Increasing flexibility Increasing aerobic fitness, which helps lower heart disease risk Weight Control

Hazards of Obesity

Physical Health Consequences: Increases mortality. Increases likelihood of other risk factors. Blood Pressure, Cholesterol. Independent risk factor for specific illnesses,coronary heart disease, type 2 diabetes. Increases disability. Increases health care costs Psychosocial Consequences: Anti-fat bias; Stigma. Obese rated as less likeable, possibly because perceived as responsible. Young children rate obese drawings as less likeable. Distress and negative emotions. Less education, get lower grades, less $$, less likely to be married, etc.

Physical Activity and Cognitive Functioning

Physical activity can improve attention, processing speed, memory, and executive functioning in adults. Physically fit children show better memory performance and greater volume of the hippocampus. Physical Activity: Protects against neurodegenerative diseases. Alzheimer's (Lautenschlager et al., 2008). Dementia (Laurin et al. 2001)

Physical Activity and Cancer

Physical activity protects against a variety of cancers-Strongest evidence for breast and colorectal. Physical activity may reduce cancer risk by influencing tumor initiation and growth-Women with breast cancer also show higher recovery rates.

Physical Activity and Health

Physically active people can live about 2 years longer. Harvard Alumni Health Study. Reported physical activity levels in 1977. Moderate and vigorous activities predicted lower mortality rates 15 years later. Physical activity also improves well-being, mental health, and cognitive functioning. Depression.

Strengths of the Health Belief Model

Predicts simple health behaviors. Perceived barriers and perceived benefits are consistent predictors of health behavior

Strategies for Intervention

Prevention Approaches: Primary Prevention Secondary Prevention Tertiary Prevention Levels of Intervention: Individual Group Organizational Community Population (Societal) Social engineering

Leptin

Produced by adipose tissue and signals whether there are low or high fat stores -high levels = high fat stores = satiety

Insulin

Produced in pancreas & signals satiation (feeling full)

Ghrelin

Produced in stomach; increases before meal and decreases after meal; short term appetite regulation

Transtheoretical Model(stage theory - process of change)

Proposes that people pass through 5 stages of readiness to change a health behavior Stage 1: Precontemplation-Stage 2: Contemplation Stage 3: Preparation Stage 4: Action Stage 5: Maintenance Spiral Model of Change

Matching processes to stages

Pros increase across stages. Cons decrease across stages. To move beyond contemplation, pros > cons. Pros increase more than cons decrease.

Environmental Interventions

Seek to enhance access to places for physical activity. Sidewalks, parks, playgrounds. Simply seeing people exercise can motivate a person to engage in physical activity

Informational interventions

Seek to increase public awareness of the importance of physical activity and its benefits. People do show increased awareness after these interventions. BUT, they do not actually increase people's physical activity. "Point of Decision" prompts may help increase physical activity.

Anaerobic exercise

Short, intensive bursts of energy with no increase in oxygen use. E.g., short-distance running. Benefit: can improve speed and endurance

Why people use and abuse alcohol

Social Learning Model.

Biological aspects of obesity

Some cautionary notes on genetic explanations of obesity. Does a genetic explanation mean that behavior doesn't matter?NO! Can genetic factors explain the rapid increase in rates of obesity?NO!

Injury from exercising

Sports, recreation, and exercise (SRE) account for: Drowning = 4,000 deaths per year. ER visits = 10,000 people PER DAY. 715,000 SRE injuries in school settings alone. Injury is one of the leading reasons people stop participating in potentially beneficial physical activity

Psychosocial Aspects of Obesity

Stress and Mood Regulation. Emotional Eating. Eating in response to emotions.For some (but not all) people: Stress and negative emotions increase amount of food consumed. Stress influences types of food consumed.Stress and HPA activation promotes abdominal fat deposition.

Physical Activity and Cardiovascular Health

Studies show link between physical activity and improved cardiovascular health: Paffenbarger's Harvard Alumni Study. Overall, physical activity reduces CVD risk by 35%. Active lifestyle reduces risk of diabetes, high cholesterol, high blood pressure-Physically active women lower risk of ischemic stroke.

Importance of health behaviors

Successful modification of health behaviors. Reduced deaths due to lifestyle related illnesses. Increased longevity."Compression of Morbidity". Expand years of life free from chronic disease complications. Reduce health care costs

Alcohol Myopia

Tendency of alcohol to increase concentration on immediate events, reducing awareness of distant events.

Operant conditioning

The context or situation (or environmental stimulus) that occurs after the behavior makes it more or less likely that the behavior will occur again in the future. Consequences of your behavior makes it more or less likely that you will continued engaging in that behavior.

Behavioral Disinhibition

The false sense of confidence and freedom from social restraints that results from alcohol consumption.

Set-Point Hypothesis

The point at which an individual's "weight thermostat" is supposedly set. When the body falls below this weight, an increase in hunger and a lowered metabolic rate may act to restore the lost weight. Obesity can increase the "set point," but hard to decrease

Classical conditioning

The stimulus (or environmental cue) that occurs before a behavior affects what you do. Behavior that occurs repeatedly in a specific context can become elicited by those contextual cues. Behavior is under "stimulus control" (i.e., you develop a habit). Eating while watching TV, smoking on a coffee break, eating when not hungry because you see appealing snacks.

Types of Physical Activity

There are five types of physical activity: Isometric Isotonic Isokinetic Anaerobic Aerobic

Psychosocial aspects of obesity: The "toxic" environment.

Unhealthy vs healthy food: Better tasting. Highly accessible More convenient Highly marketed Less expensive Modern world has many barriers to a healthy lifestyle, access to fast-food, sugared beverages, large portion sizes,"food deserts", lack of access to healthy food in areas of weak public transportation. Physical inactivity. Children are less active today than 30 years ago. Sleep debt: 1 to 2 hr less sleep/night compared to 50 yrs ago. Sleep duration negatively associated with obesity. Sleep deprivation reduces leptin (satiety) and increases ghrelin (appetite stimulant).

Indirect Effects of Excessive Alcohol Consumption

Unintentional injuries. Motor vehicle accidents. 40% linked to alcohol use.most frequent in 21-25 year olds. Suicidal ideation. Aggression. Crime. Risky decision-making

Alcohol Dependence

Use of alcohol is required to function normally. Tolerance. Withdrawal. Delirium Tremens (DTs)

Does it Work?

Wearables and Physical Activity. Limited research. Fitbits and other fitness trackers may actually reduce physical activity.

Fat-cell hyperplasia

When fat cells are full, they divide. Cannot decrease the number of fat cells. Can only decrease size

Punishment

the consequence decreases the likelihood that the behavior will occur. Many behavioral change programs focus on setting up a reward system.

Reinforcement

the consequence increases the likelihood that the behavior will occur

Positive reinforcement

the presence of something positive

Negative reinforcement

the removal of something negative.