HSC 503 Exam 2

What is biologically disordered in obesity?

Genetic factors -Single gene mutations (ex. Leptin receptor) -Polygenic factors - multiple genes that together enhance the susceptibility to obesity -Parental transmission Hormone alterations -Alterations of the hormonal mechanisms involved in weight regulation (ex. resistance) -Aging, menopause Pharmacological effects -unintended effects of drugs targeting other health conditions

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 cassava tubers with rice, beans, meat and fish added "When you are fat, it makes you look healthy." "People respect you. People honor you. Wherever you go, they say, 'your husband feeds you fine." "If you go to a 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.

what did other studies suggest about obesity?

In the late '80s study of 286 obese people, and discovered that 50% had been sexually abused as children. Rate is more than 50% higher 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

what are reasons for inactivity?

Increased screen time lack of sidewalks and places for recreation work schedules reliance on cars misconception of physical activity

Case Study: Obesity-treatment Program (early 80s)

Kaiser Permanente's Department of Preventive Medicine Obesity Treatment program 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

Researchers have found a link between chemicals that mess with our hormones such as bisphenol A (BPA) and obesity.

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 receipts, and even wine. "The chemicals are so common that nearly every person on Earth has been exposed to one or more,"

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

Limited resources and lack of access to healthy, affordable foods Fewer opportunities for physical activity Cycles of food deprivation and overeating High levels of stress Greater exposure to marketing of obesity-promoting products Limited access to health care

High levels of stress

Low-income families may face high levels of stress 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 depression, which are both associated with child and adult obesity Stress may lead to weight gain through stress-induced hormonal and metabolic changes as well as unhealthful eating behaviors

Why are there 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 nutritional quality If available, fresh produce is often of poorer quality in lower income neighborhoods Low-income communities have greater availability of fast food restaurants

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

why are there fewer opportunities for physical activity?

Lower income neighborhoods have fewer physical activity resources When available, physical activity resources may not be attractive places to play or be physically active Crime, traffic, and unsafe playground equipment are common barriers to physical activity in low-income communities Low-income children are less likely to participate in organized sports Students in low-income schools spend less time being active during school

6.) 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

Mississippians attribute "most obese" ranking to state culture

Mississippi was the most obese state in the U.S. in 2013 (35.4%) and has ranked among the top 10 obese states in the nation since 2008. "We're used to fried food so much it's just an old school thing." The state's 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."

Where did the lay theories of obesity study take place?

Multiple countries (USA, France, South Koreas, Hong Kong), in lab questionnaires

what was the purpose of lay theories obesity article?

Obesity is such a large scale problem, but scientist have neglected lay peoples personal beliefs about it

Bardet-Biedl Syndrome (<1/100,000 births)

Obesity mental retardation, pigmentry retinopathy, polydactyly, hypogonadism, renal abnormalities

Cohen Syndrome (Finnish)

Obesity, mental retardation, microephaly, characteristic facial features, myopia

Prader-Willi Syndrome - 1/25,000 births

Obesity, reduced fetal activity, muscular hypotonia at birth, short stature, small hands and feet, mental retardation, hypogonadism, hyperphagia

Alstrom Syndrom

Obesity, retinal cone dystrophy, dilated cardiomyopathy, type 2 diabetes, hypothyroidism, small size, hypogonadism, renal abnormalities, mental retardation

Albright Hereditary Osteodystrophy (AHO) (1/139,000 in Japan)

Obesity, short stature, round face, brachydactyly, bone formation in non-bone tissue, mental retardation, low blood calcium

Opioid system

Opioid agonists enhances intake of food Antagonists reduce body weight and fat, and increase fat oxidation

Genetics: 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 if it Now it's 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)

Poverty income ratio (PIR)

"The ratio of household income to the poverty threshold after accounting for inflation 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 $77,000 for a family of four PIR of 130% was equivalent to approximately $29,000 for a family of four In 2008, median household income was approximately $50,000 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.

Designs of human 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?

Social 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.

Why is food insecurity is at historic highs and getting worse

-some regions of the country where the child food insecurity rate can go as high as 41% -the major hot spots for hunger tend to be rural counties -least hungry county: Slope County, N.D., 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—live in households which are ineligible for food stamps, the main public assistance program dedicated to combating hunger

How many Americans eat fast food several times a week?

1 in 5

why do environmental cues make us over-eat?

1) It biases our "Consumption Norms" 2) It effects our "Consumption Monitoring"

NCHS Data Brief Summary

1) Relationship between obesity and SES differs by sex, race, and ethnicity non-Hispanic white women, obesity↑ as PIR↓ non-Hispanic black and Mexican American men, obesity ↓ as PIR↓ 2) Between 1988-1994 and 2005-2008 the prevalence of obesity increased in adults at all levels of income and education

What are some key findings from human studies?

1) Studies of identical twins who have been raised apart show that genes have a strong influence on a person's 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 parents. A child who has overweight parents who eat high-calorie foods and are inactive will likely become overweight too

Why do some people gain weight after smoking?

1) enhancement of senses food often tastes and smells better after quitting smoking 2) oral fixation substitute food for cigarettes 3) nicotine raises the rate at which your body burns calories so you burn fewer calories when you stop smoking *However, smoking is a serious health risk, and quitting is more important than possible weight gain.

How might 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 maintain a healthy balance of the hormones that make you feel hungry (ghrelin) or full (leptin). -When you don't get enough sleep, your level of ghrelin goes up and your level of leptin goes down. This makes you feel hungrier than when you're well-rested. Sleep also affects how your body reacts to insulin, the hormone that controls your blood glucose (sugar) level. -Lack of sleep results in a higher than normal blood sugar level, which may increase your risk for diabetes.

How much did excess calories consumption increase over the years?

25%

On average how much time to people spend in their car?

31% increase, almost 3 hours 18.5 hours on the road

Case Study: 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%)

HBO weight of the Nation

5% of adults meet the physical activity guidelines Increased screen time, 7.5hrs/daily for children Food environment is hostile Portion size People are too busy Obesity appears to be a result of several trends in moving in the same direction Easier to consume/difficult to expend

What causes overweight and obesity?

A lack of energy balance most often causes overweight and obesity.

What causes overweight and obesity?

A lack of energy balance most often causes overweight and obesity. Same amount of energy IN and energy 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 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.

How much exercise will it take to work off a burger? Menus may soon tell you. What were the results?

A study was 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 two groups had no difference in calories consumed. How is it relevant to the topic of obesity? 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 doesn't greatly deter overeating.

adipokines

Adiponectin Adipsin Resistin

what are the 8 sneaky things that may feed obesity

Air pollution - PAH (polycyclic aromatic hydrocarbons), parental exposure would make kid obese by age 7 (exhaust, smoking, grills) Altitude - closer you are to sea level the 5.1x more likely to be obese Antibiotics - correlation b/w early use in children and obesity Gut bacteria - those with less "bacterial diversity" BPA - Bisphenol A (plastic additive), exposure in bottles, sippy cups Fast food salads - generally around 1200kcal Car dependence Lack of sleep

What hormone alterations lead to obesity?

Alterations of the hormonal mechanisms involved in weight regulation (ex. resistance) -Aging, menopause

Case Study- Pima Indians

Arizona's Pima Indians (pop. 19,000) exceed the type 2 diabetes rate (38%) of the genetically similar Pima Indians in Mexico (6.9%) by 5x The US government began subsidizing the tribe's food (late 19th century) -- much of it containing sugar and white flour, and obesity and diabetes rates soared 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 lifestyle on obesity and its comorbidities Is it possible to reduce the obesity rate in the Pimas of Arizona by returning to some of their traditions, including more physical activity and a diet with less fat and more starch?

where does the weight go during pregnancy?

Baby: 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 pounds After giving birth, some women find it hard to lose the weight, which may lead to overweight or obesity, especially after a few pregnancies.

what are the physical inactivity stats 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 gone up by about 30% per year in recent years

what Main unhealthy diet and eating habits that contribute to weight gain:

Consume a diet high in calories Skipping breakfast Break the fast, body hangs on to calories Eating most of your calories at night Eating oversized portions Eating fast/convince foods

Consumption norms

Consumption norms determine how much we should eat Based on packaging, plate-size, restaurant portions (etc.)

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)

Obesity - 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 excessively fat"

Pregnancy and weight gain

During pregnancy, women gain weight to support their babies' growth and development. Not necessary 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 you're pregnant and 1 lb a week during the rest of your pregnancy.

how does environmental factors influence consumption?

Eating environment Eating atmospherics eating effort eating with others eating distractions Food environment prominence of food structure and variety of food assortments size of food packages and portions stockpiling of food serving containers

3.) Cycles of food deprivation and overeating

Eating less or skipping meals 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, particularly mothers who sacrifice their own nutrition in order to protect their children from 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

"Consumption Monitoring"

Environment is distracting We often find it to be a nuisance to accurately measure/monitor consumption When people pay close attention to how much they eat, they eat less Obese people have a greater tendency to underestimate the calories in their meals

What were the three main causes of obesity identified in the lay theories of obesity article?

Exercise 40%, diet 50%, genetics 8%

What was the main finding from the study of the lay theories of obesity article?

People's beliefs of what causes obesity might actually impact their likelihood of being overweight/obese

Unemployment rate in the South Bronx is 14.1%

Poor people work longer hours and multiple jobs therefore eating on the run; less time to exercise

Syndrome obesity disorders

Prader-Willi Syndrome - 1/25,000 births Bardet-Biedl Syndrome (<1/100,000 births) Albright Hereditary Osteodystrophy (AHO) (1/139,000 in Japan) Cohen Syndrome (Finnish) Alstrom Syndrom

Age and Obesity

Prevalence of obesity in older population (65-74) is greater than rest of population

how is New York is attacking the problem on 3 fronts:

Providing income supports increasing healthy options encouraging nutritious behavior

How does the traumatic experience influence obesity?

Psychological being abused or otherwise traumatized is painful, and food can be a numbing or comforting escape (ie. over-eating) 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 "slows down" to deposit fat and store energy to prepare for what the body is expecting will be a challenging and stressful life

If you had to cut calories, what is the easiest way?

Reduce consumption, particularly liquid calories

Appetite-body weight regulation model

Short-term component - Controls onset and cessation of feeding on a meal basis Long-term component - monitors and regulates body nutrient stores over extended periods These 2 components modulate intake such that body weight is maintained within a stable range; based within the central nervous system

Examples of food insecurity:

Simply being able to afford the basics unable to get to the grocery store unable to find fresh produce stealing food lack of reasonably priced supermarkets reliance on cheap unhealthy foods

what genetic factors contribute to obesity?

Single gene mutations (ex. Leptin receptor) -Polygenic factors - multiple genes that together enhance the susceptibility to obesity -Parental transmission

What did the obesity: We're not overeating, we're under-exercising, study suggest?

Stanford School 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 increased 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 Doesn't prove "cause and effect" just associations From a public health perspective - more information regarding benefits of PA needed

what is the appeal of convenience foods?

Taste of food enhanced through strategic used of fat, salt, and sugar Good value regardless of budgetary constraints Eliminates planning, shopping, preparing, cleaning up after meals Marketing which casts cooking as laborious Parental attitudes where each family member can eat what they want Cultural changes which promote TV time over family time/dinners

Grocery options: Detroit no longer a food desert

The Detroit Economic Growth Corporation's Green Grocer Project sponsored 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 stores in Detroit, at least 65 of which are independently owned. A Kroger is coming to Eight Mile Road and Woodward after the first of the year (2016).

why are antibiotics linked to childhood obesity

The JAMA Pediatrics report Researchers reviewed the health records of more than 64,500 American children between 2001 and 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 not show antibiotics cause obesity directly and recommend children continue using them.

what was the reason for individuals who believed lack of exercise was the main reason of obesity?

They ate the most

hunger

Uneasy or painful sensation caused by a lack of food. Usually a consequence of food insecurity.

food insecurity

Whenever the availability of nutritionally adequate and safe foods or the ability to acquire acceptable food in socially acceptable ways is limited or uncertain

what are the global inactivity 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

Does the percentage of calories from fast food differ by weight status?

Yes obese people consumed more calories in fast food than overweight and underweight/normal individuals

when was there a recent spike in obesity in the US?

between the 1980s-2000s

Factors leading to obesity 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 (Western Diet). climate change-induced weather events more intense storms sea-level rise warmer air and water temperatures 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 islander's reliance on commercial markets for food supply

What has changed in the last 30 years that has lead to the increase in obesity?

calories in: eat more processed foods with added sugar, technology = more delivery methods, media advertising, portions sizes got bigger calories out: more sedentary lifestyle, more ways of transportation

how did the misconception of physical activity lead to inactivity?

common belief that physical activity is limited to sports or health club exercise expensive no skills

Adoption studies

compare disease rate between adoptee and members of adoptee's biological family as well as their adoptive family

Twin studies

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

Polycystic ovarian syndrome (PCOS)

complex syndrome with multifactorial causes (i.e. genetics, hyperandrogenism, insulin resistance, obesity) common endocrine disorder and a leading cause of female 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

cushing syndrome

condition in which the body's 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

Personalized medicine

determines what types of intervention may be most effective in treating obesity

Why Is a Fast-Food Meal Cheaper Than Healthy Food?

farm subsidy system actively suppors a diet that consists 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 ingredients and preservatives that prevent spoiling it's possible to eat healthy on a limited budget, but 1) you have understand what constitutes a healthy meal, and 2) you have access to such foods

structures and systems

federal, states, and local regulations, laws, the built environment (public works, infrastrastructure

prominence of food

how in your face is it?

Eating effort

increased effort decreases consumption

Identify genes that can be used as prognostic factors

indicates who is likely to become obese preventative therapy

individual

individual attitudes, beliefs, knowledge, and behaviors

interpersonal

individual relationships, support groups, social networks, cultural context

what is the cause of crushing syndrome?

is caused by prolonged exposure to elevated levels of either endogenous glucocorticoids or exogenous glucocorticoids

what is causes Midlife weight gain in women?

is mainly due to aging and lifestyle, but menopause also plays a role. Natural process, end of fertility Many women gain about 5 pounds during menopause and have more fat around the waist than they did before. Mechanism - lack of estrogen?

Culture

language, thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups

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)

You snooze, you lose study

more than 1,000 participants in a study researchers found that roughly eight hours of sleep correlates with a lower body mass index, lower levels of ghrelin and higher levels of leptin

how does lack of sidewalks and places for recreation lead to physical inactivity?

not having area parks, trails, and sidewalks makes it hard for people to be physically active

eating distraction

obscure and extend consumption

Criteria for POS: need two of the following

oligomenorrhea (eight or fewer menses a year) or anovulation clinical manifestations of androgen excess and/or elevated levels of circulatory androgens (i.e. total or free testosterone) polycystic ovaries on ultrasound evaluation

size of food packages and portions

packages and portion size suggest consumption norms

how do work schedules lead to physical inactivity?

people often say that they don't have time to be physically active because of long work hours and time spent commuting

How does increased screen time lead to inactivity?

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

structure and variety of food assortments

perceived variety drives consumption

community

relationships and communications between organizations and institutions

institutions and organizations

schools health care administration, business, faith based organizations and institutions

How do medicines increase weight gain?

slow the rate at which your body burns calories increase your appetite cause your body to hold on to extra water fat cell proliferation

eating with others

socializing influences meal duration

What psychological and emotional factors lead to obesity

some people eat more than usual when they're: 1) bored, 2) angry, or 3) stressed obesity is associated with increasing rates of major depression, bipolar disorder, panic disorder subgroup specific increases (ex. BED) related to medications? Trauma (distressing events) 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

stockpiling of food

stockpiled food is quickly consumed

Rich state, Poor state, Slim state, Fat state

the face of the U.S. poverty isn't gaunt cheeks, but wide hips. Obesity is highest in the poorest states.

Wife-plumping Farms

the trend of force-feeding young Mauritanian girls is on the decline but a BBC News report says about 11% 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 don't understand, but when they grow up, they are fat and beautiful. They are proud and show off their good size to make men dribble. Don't you think that's good?"

If environment influences risk

then adoptee should look more like adopted family

If genes influences risk

then adoptee should look more like biological family

Hypothyroidism

underactive thyroid is a condition in which the thyroid gland doesn't 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 hypothyroidism.

What pharmacological effects lead to obesity?

unintended effects of drugs targeting other health conditions

What does the caloric balance hypothesis tell us?

we are not active enough

serving containers

wide or large containers create consumption illusions

How does activity level vary by age?

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

According to the WHO, the rapid rise in obesity rates in recent years has occurred because....

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

People tend to slowdown at they age, resulting in

1) Reduced muscle mass muscle loss can slow down the rate at which your body burns calories gain weight if you don't reduce your calorie intake 2) Increased fat mass More circulating lipids, adipokines

Endocannaboid system

Appetite-inducing effects of cannabis Levels of endocannaboids decrease during feeding and increasing during fasting

Short-term component

Controls 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

How has supersizing and portion control lead to obesity?

Eating out - less control over how much fat, sugar, and salt they are eating. Fast food restaurants also encourage super-sizing of meals, 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 We're 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

Food Reward Systems in the Brain

Feeding is not just driven by hunger, but it's also rewarding Might over-ride energy based CNS processes

What are issues concerning genetics as a cause of obesity?

Genes do not always predict health Maybe not a single gene (Influence of many?) Usefulness as a predictive factor (eg. Look at parental adiposity; just guess correctly a 1/3 of the time). Expensive Prevention strategy is not known to work

Inactivity in the USA- BRFSS 2008 summary

High rates of leisure-time physical inactivity: South and Appalachia (i.e. Alabama, Kentucky, Louisiana, Mississippi, Oklahoma and Tennessee) Most likely to be active: West Coast (California, Washington, Oregon) Colorado Minnesota Hawaii Vermont

Thrifty Gene Hypothesis

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

What are the physical inactivity stats 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% to 41% Driving cars increased from 67% trips to work in 1960 to 88% in 2000, while walking and taking public transit to work decreased About 40% of U.S. schoolchildren walked or rode their bikes to school in 1969; only 13% in 2001

Which group in the study had the highest BMI in the lay theories of obesity article?

Individuals who said lack of exercise was the main reason for obesity

Complaints with POS

Irregular menses Hirsutism (excessive hair growth) Acanthosis nigricans Resistant acne Alopecia Weight gain Trouble losing weight Signs and symptoms appears around the onset of puberty

However, why does leptin not always control fat

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)

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

What are eating atmospherics?

Lighting Dimmed/soft lighting influences our consumption in 2 ways: By increasing eating duration By increasing comfort and disinhibition Odor Can influence consumption through taste enhancement or suppression Unpleasant odors are likely to shorten a meal and suppress food consumption Noise and music Soft music leads to slower eating, longer 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

Why study the genetics of obesity?

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

how much of the population is inactive?

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

what medicines cause you to gain weight?

Psychotropic medications (antipsychotics, antidepressants, mood stabilizers) Anticonvulsants Anti-diabetics Anti-hypertensives Steroid hormones and contraceptives Antihistamines HIV antiretroviral drugs

Research shows that 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 age groups as well: Spanish study >3,500 older workers Sleeping 5hrs or less OR sleeping >8 hrs was associated with obesity 8,500 four-year olds If children get 10.5 hrs or more of sleep a night, associated with prevention of obesity Recreational screen time (ie. TVs, texting) in the bedroom can delay bedtime or interrupt sleep

symptoms of cushing syndrome

abdominal obesity but with thin 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 feeling of tiredness

what percentage of calories consumed by adults comes from fast food?

about 11.3%

How did reliance on cars lead to physical inactivity?

less people walking because driving is often the easiest option