Lecture |
Study Guide | Major Assignments
Lecture
Chapter 10 Energy Balance, Weight Control, and Eating
Disorders
(pp. 329-359)
Key Concepts:
 | A person of healthy weight shows good
health and performs daily activities without
weight-related problems. A body mass index of 18.5 to 25
is one measure of healthy weight, although weight in
excess of this value may not lead to ill health. This
suggests that healthy weight is best determined in
conjunction with a thorough health evaluation by a
physician. |
| Obesity is usually defined as total body
fat percentage over 25% in men and about 35% in women. A
body mass index over 30 also represents obesity. |
| Fat distribution partially determines
health risks from obesity. Upper-body fat storage
distribution (waist circumference greater than 40 inches
in men and greater than 35 inches in women) suggests
higher risks of hypertension, cardiovascular disease, and
type 2 diabetes associated with obesity than does
lower-body fat distribution. |
| Genetic factors influence the tendency
toward obesity. Basal metabolism and body-fat distribution
both have genetic links. How a person is raised (or
nurtured) also influences the tendency toward obesity
because family members often develop similar eating habits
and activity patterns. Obesity can be viewed as nurture
allowing nature to be expressed. |
| Those in search of a treatment for
obesity should remember these five points: (1) A focus on
healthy lifestyle rather than weight loss per se is more
appropriate for many potential and current dieters; (2)
the body resists weight loss; (3) the emphasis should be
on preventing obesity because curing the disorder is very
difficult; (4) weight loss should represent mostly a loss
of fat storage and not primarily the loss of muscle and
other lean tissues; and (5) rapid weight loss and quick
regain can be especially harmful to emotional health. |
| A sound weight-loss program meets the
dieter's nutritional needs by emphasizing a wide variety
of low-fat and nonfat food choices from the food Guide
Pyramid; it adapts to the dieter's habits, consists of
readily obtainable foods, strives to change poor eating
habits, stresses regular physical activity, and stipulates
the participation of a physician if weight is to be lost
rapidly or if the person is over 40 (men) or 50 (women)
years of age and plans to perform substantially greater
physical activity than usual. |
| A pound of fat contains about 3500 kcal.
A pound of adipose tissue-the fat itself plus lean support
tissue-lost or gained represents approximately 2700
kcal. Thus, if energy output exceeds energy intake
by about 500 kcal/day, a pound of fat storage can be lost
per week. Decreasing the intake of high-fat foods is
probably the best way to obtain this energy deficit, along
with increasing physical activity. |
| Physical activity as part of a
weight-loss program should be focused on duration rather
than intensity. Ideally, vigorous activity should be part
of each day. |
| Behavior modification is a vital part of
a weight-loss program because the dieter may have many
habits that encourage overeating and thus discourage
weight maintenance. Specific behavior-modification
techniques, such as stimulus control and self-monitoring,
can be used to help change problem behavior. |
| Medications to blunt appetite, such as
phenteramine (Fastin) and sibutramine (Meridia), can aid
weight-reduction strategies. Orlistat (Xenical) reduces
fat absorption in a meal when taken with the meal. Use is
reserved for those who are obese or have weight-related
problems, and they must be administered under strict
physician supervision. |
| The treatment of severe obesity may
include surgery to reduce stomach volume to approximately
30 ml or very-low calorie diets containing 400-800 kcal
per day. Both these measures should be reserved for people
who have failed at more conservative approaches to weight
loss. They require close medical supervision. |
| Underweight can be caused by a variety of
factors, such as excessive physical activity and genetic
background. Sometimes being underweight requires medical
intervention. a physician should be consulted first to
rule out ongoing disease. The underweight person may need
to increase portion sizes and learn to like energy-dense
foods. In addition, encouraging a regular meal and snack
schedule aids in weight gain and maintenance. A physically
active person can reduce excessive activity and substitute
some resistance exercise (weight training). |
|
More than half of adult Americans are overweight.
Most people succeed in short-term weight loss but, in the long term,
regain all the weight they have lost.
Excess body fat increases the risk of chronic diseases such as
diabetes, heart disease, high blood pressure, gallbladder disease,
and certain types of cancer.
The risks of obesity are related to the degree of overweight, the
location of the excess body fat, and the presence of other risk
factors and disease conditions. Risk can be assessed by
determining BMI, measuring waist circumference, and evaluating other
risk factors.
Weight management involves adjusting energy intake and expenditure
and modifying long-term behaviors. To lose a pound of fat,
expenditure must exceed intake by approximately 3500 kcals. Slow,
steady weight loss of 1/2 to 2 pounds per week is more likely to be
maintained than rapid weight loses.
There are thousands of programs and techniques for weight
management. All involve a decrease in energy intake and most
also target an increase in energy expenditure. An ideal
program involves a decrease in intake, an increase in expenditure,
and behavior modification to promote lifestyle change and maintain
the loss.
Prescription drugs are only recommended for individuals who are
significantly overweight or have accompanying health risks.
Those currently available act by suppressing appetite or blocking
fat absorption. Nonprescription weight-loss medications and dietary
supplements are also available. Some herbal weight-loss
supplements may cause serious side effects.
Surgery is a drastic measure that is considered only for those whose
health is seriously at risk because of their obesity. It
causes permanent changes in the GI tract that affect the amount of
food that can be consumed and the absorption of nutrients.
Surgery necessitates a lifelong change in eating patterns and
behavior.
Eating disorders are psychological disorders in which the perception
of body size is altered. Anorexia nervosa is characterized by
self-starvation and an abnormally low body weight. Bulimia is
characterized by repeated cycles of binge eating followed by purging
or other behaviors to prevent weight gain. Treatment involves
supplying an adequate diet and psychological counseling to change
body image and improve eating habits.
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Study Guide
1. Explain how each of the following can
contribute to being overweight: fat cell
development, fat cell metabolism, and set-point
theory. Explain how genetics,
overeating, and physical inactivity may cause
obesity. Which contributors can people
control?
2. What percent of the U.S. population is attempting to lose
weight at any given time?
How much money is spent annually on
weight-loss attempts? What percent of people
who lose weight are able to maintain the
weight loss? State the prejudices against
overweight people.
3. Under what conditions is gastric surgery justified as an approach
to weight loss?
Describe immediate post-surgical complications
associated with gastric surgery. What
is liposuction?
4. What parameters are more useful than body weight in denoting
successful weight loss?
Based on initial weight, what do experts
recommend as a reasonable percentage of
weight loss? What is considered a reasonable time
frame for a 10% loss of initial
weight? What are the only considerations that
need to be taken into account when
designing a personal eating plan? What is the
main characteristics of a weight-loss
diet? How many kcals per day should an adult
expend through exercise and reduced
food intake to support fat loss and retain lean
tissue? What is the lower limit of kcals
per day an adult should consume to provide
adequate nutrition when trying to lose
weight? What is the goal with regard to food
portions? What should be the center of
meals and snacks? How long does it take for the
satiety signal to reach the brain?
What effect does a high fat-diet have on leptin
levels? What effect does low kcal
diets have on ghrelin levels? What effect does
fat have on satiety? Why should people
drink adequate water when trying to lose weight?
5. Explain why the best approach to weight management is a
combination of physical
activity and dieting. Describe the effect of
activity on the following: BMR, body
composition, appetite, psychological well-being,
and spot reducing. What type of
activity is most effective for weight management?
6. State behavior techniques or strategies that people can use to
help with a weight-loss
program. At what point in time do most people
reach a plateau when losing weight? In
order to maintain weight loss, what is the
required number of kcals per week that
should be spent in physical activity?
7. What
are the risks associated with underweight? State strategies for
weight gain.
8. Describe the causes of, effects of, typical persons affected by,
and treatment for
anorexia nervosa, bulimia nervosa, and binge-eating disorder.
9. Explain methods for reducing the development of eating
disorders, including the use of
warning signs to identify early cases.
CH 8 Alcohol
Key Concepts:
| Ethanol is the type of alcohol in alcoholic
beverages. Unlike other types of alcohol, ethanol isn't
poisonous when ingested, but it can be toxic if consumed in
excess. Alcohol is not an essential nutrient. |
| Alcohol produces an initial euphoric,
pleasurable state of mind. Drinking alcohol in moderation may
help reduce the risk of heart disease in older adults; however,
overconsumption leads to numerous negative health effects. |
| Some alcohol is absorbed directly in the
stomach, and some is metabolized in the stomach by the enzyme
alcohol dehydrogenase (ADH). Most alcohol is absorbed in the
small intestine and metabolized in the liver. The MEOS is a
secondary pathway that takes over alcohol metabolism if the
liver is overwhelmed. MEOS is also the primary pathway for drugs
and pharmaceuticals, but alcohol takes precedence over these
substances. |
| Alcohol mixes with water and is distributed
in the watery tissues of the body. Women have less ADH and less
body water than men; both of these factors cause women to feel
the narcotic effects of alcohol sooner than men. The presence of
food will slow the movement of alcohol from the stomach to the
intestines. This is why drinking on an empty stomach is not a
good idea. |
| Some alcohol is lost in the breath and urine.
Blood alcohol concentration is a measure of alcohol in the
blood, and increases as more alcohol is consumed. A BAC of 0.08
is considered legal intoxication in most states. |
| Alcohol is a central nervous
system depressant. The brain is sensitive to the effects of
alcohol, and depending on the amount consumed, alcohol can cause
numerous mental, behavioral, and physical changes in the body.
Alertness, judgment, and coordination will initially be
affected. Higher BACs can result in impaired vision, speech,
reasoning, and balance. Alcohol poisoning (usually at a
BAC of 0.30 or higher) can result in impaired breathing and
heart rate, and can ultimately result in death. |
| Alcohol can lead to unintentional injuries,
disrupted sleep, hangovers, interference with hormones, excess
kilocalorie intake, and/or displaced healthier food choices from
the diet. Chronically consuming excessive amounts of alcohol can
harm the digestive organs, heart, and liver. The three stages of
alcohol liver disease are fatty liver, alcoholic hepatitis, and
cirrhosis. Many individuals die annually of alcohol-related
liver disease. Alcohol can put a fetus at risk for fetal alcohol
spectrum disorders. |
| Alcohol abuse occurs when people continue to
consume alcohol even though this behavior negatively affects
their lives. Binge drinking, underage drinking, and drinking and
driving are examples of alcohol abuse. Individuals who binge
drink, many of whom are also underage, are at risk for blackouts
and alcohol poisoning. Individuals who chronically drink alcohol
often develop alcohol tolerance, which occurs when the brain
becomes less sensitive to alcohol. Because alcohol affects
alertness and judgment, the only safe amount of alcohol to
consume when driving is none. |
| Alcoholism, also called alcohol dependence,
is a disease characterized by four symptoms: a craving for
alcohol, a higher tolerance for alcohol, the inability to
control or limit its intake, and a physical dependence on it.
Genetics plays a role in increasing the risk of certain people
developing alcoholism. Though alcoholism can't be cured, it can
be treated with medical and psychological support. |
| The 2005 Dietary Guidelines for Americans state that
the following individuals should avoid alcohol: women of
childbearing age who may become pregnant, women who are pregnant
or lactating; anyone under the age of 21; those taking certain
medications or with specific medical conditions; those engaging
in activities that would be impaired with alcohol consumption;
and those who cannot restrict their intake of alcohol. No one
needs to drink alcohol, but those who choose to drink should do
so in moderation.
Study Guide: |
1. What amounts of beer, wine, and hard liquor each contain
15 g
alcohol?
2. What ingredients are required for fermentation?
3. What process is used to increase the alcohol of fermented
beverages?
4. How does the body metabolize low to moderate amounts and
large
amounts of
alcohol?
5. What factors affect alcohol metabolism?
6. How quickly can most people metabolize one alcoholic
beverage?
7. Why does binge drinking increase the risk of alcohol
poisoning?
8. What are the guidelines for using alcohol safely?
9. What are some possible benefits of moderate alcohol intake
by
middle-aged and
older adults?
10. What levels of alcohol intake are associated with the
development
of cirrhosis?
11. How does alcohol abuse impair nutritional status?
12. What are the dangers of consuming alcohol during
pregnancy?
13. What are 3 factors that predispose a person to alcohol
dependency?
14. Why might women suffer more ill effects from alcohol
consumption
than men?
15. Why is tolerance to alcohol considered a risk factor for
alcohol
dependence?
16. How might the CAGE questionnaire be used to identify those with
alcohol problems?
17. What programs are available to help individuals with alcohol use
problems?
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Becky Alejandre,
Professor -
Nutrition
|
Instructor's contact information
Email: alejanb@arc.losrios.edu
Phone: (916) 484-8145
FAX: (916) 484-8030
|
ARC Homepage
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ARC Library |
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