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Kines Final Exam

Terms in this set (143)

How does body size impact longevity?
The approx range for longest life is in the BMI range of 20-30 roughly
Health Risks Associated With Obesity
Overweight: Type 2 diabetes, heart disease, hypertension cancer, stroke
Underweight: undernourishment, lack of nutrients, immune deficiency
What is the secret to weight management?
-Negative energy balance: less enegry in compared to out
-lifestyle changes: more exercise and diet management
What component of expenditure utilizes the greatest amount of daily calories?
Basal Metabolic Rate (60-65%)/ Resting Metabolic Rate
-breathing, heartbeat, chemical reactions, cellular processes
-Speed of metabolism
BMR to RMR Comparison
-Resting Metabolic Rate (RMR) ~ 10% greater than BMR
- Includes sitting, eating, very sedentary state
3 Energy Expenditures
-Basal Metabolic Rate- (60-65%)
-Thermic Effect of Food (5-10%), digestion, absorption, transporting, storing food.
-Physical Activity (20-35%)
BMI Equation
Weight in Kilograms/ Height in meters^2
BMI values
< 18.5 underweight
18.5-24.9 normal
25.0-29.9 overweight
30.0-34.9 obesity, class I
35.0-39.9 obesity, class II
> 40.0 morbid obesity, class III
Can you describe what has happened to intake of calories from 1900-1985 and 1985 to present?
• 1900-1985: Decreased
• 1985-Present: Increased
Where is our caloric intake today in comparison to 1900?
Higher, 300 more
What has happened to expenditure of these calories over the past century?
• 1900-1985: Decreased x2
• 1985-Present: Decreased
What is the current percent of our population identified as being overweight/obese by the standards established by the National. Heart, Lung, & Blood Institute (BMI <25)?
Overwight-68%
Obese- 35%
What does the term overweight imply?
Increase in health risks, BMI 25-27
Obesity Today
-Estimated 300,000 obesity-related deaths/year
-Surgeon General's prediction: Obesity may soon be the #1 cause of death in the United States
What age has the highest increase in obesity
18-29 at 70% increase
What are "energy in" changes that have occurred, over the past number of years, that are adversely impacting the energy in vs energy out balance?
-23% increase in caloric intake
-1733% increase in spending at fast food
- Eating out
-High caloric meals
-Sugary beverages
When it comes to meals, what do over 50% of the U.S. population do?
Eat out
What are potential problems with this practice?
• There is no control of caloric density
• Restaurants rarely/incorrectly share caloric content
What are "energy out" changes that have occurred over the past number of years that are adversely impacting this side of the equation?
• Cars
• Public transportation
• Drive thrus
What is the success rate of dieting for weight loss?
3%
What do we mean by set point?
Optimal weight range at which the body can operate
What effect does dieting have on BMR?
-Lower metabolism
-Short term effects: Cumulative impact
-Long term effects: Gluconeogenesis, Loss of lean tissue (muscle)
Why are carbohydrates considered a necessary part of a weight loss diet program?
When enough carbs are ingested, proteins are sparred
What happens to lean tissue during weight loss if I don't exercise?
Loss of lean tissue
What is the typical weight loss outcome (can you identify the curve)?
Decrease then around 6 months increases
What is shown to be the most effective weight loss strategy (with long term effect)?
Moderate restriction:
-Sustainable for longer
-Negative energy balance
-Maintain BMR
-Increase physical activity
-Modifications to diet and exercise works best
What is the suggested meal frequency?
• 3-4 per day
• keeps the motor running
• carbs necessary, Why?
How to maintain the Metabolism?
-Regular carbohydrate-containing meals
-Protein-sparing effect of CHO
-Prevent short term effects
-Prevent long term effects (lean tissue loss)
-3 meal eaters weigh less than 2 meal eaters
Which food choices should we try to minimize if weight loss is desired?
-High energy foods,
-fats,
-sugars, alcohol
Besides containing a great deal of simple sugars, what else is of concern about getting simple sugars from soda?
• Body struggles to regulate liquid sugars
What is the fat content of whole milk?
4% fat which makes up 50% of the calories
What are two reasons that alcohol consumption can lead to an increase in body fatness?
• Similar to liquid sugar
• Empty calories
What are food choice options that should be considered to replace higher energy dense food sources?
-Fiber rich foods,
-complex carbs,
-lean proteins
-low-fat dairy products
Benefits of Exercise
-positive effect on resting metabolism
-increased kcal expenditure
-maintain elevation of metabolism post exercise
-exercise burns calories
Exercise Prescription: Weight Loss
Mode- focus on aerobic exercise, wt bearing most impact
Frequency- daily
Intensity- 40-70% of Max
Time- 60 minutes
Exercise Prescription: Weight Control
Mode- mix of aerobic and wt training
Frequency- 3 days aerobic, 2 days weights
Intensity- 60-75% of max
Time- 30-45 minutes
Diet and Exercise effect on the BMR/RMR- Donahue et. al
-Diet (1000kcal)- decreased by 4.4%
-Exercise (mod. vig intensity)- increased by 5%
-largest component of energy expenditure
What type of weight is lost with each method? (Pavlow et al. study)
-Diet group lost 20.24 lbs, lost 36% lean mass and 64% fat


-exercise lost 25.96 lbs, lost 5% lean, 95% fat
Strategies that often end in failure
-Excessive Caloric Restriction Strategies
-Restrict variety of foods
-Decrease meal frequency
-Control portion size
What does the national registry of individuals who have lost 60+ lbs and kept it off for 2 + years show as a common thread?
• Regular exercise and good dieting habits
What do we know about the role of genetics with regard to obesity?
• Many genes linked to obesity
-40%
• Bouchard- Ex/Diet programs lose 1 lb per week.
• Within a set of twins=similar
-between sets of twins=different
What are key ingredients of the exercise prescription and what is the bottom line that needs to be met?
Total Calories burned is what matters
Does exercise guarantee weight loss and why does this reflect a problem with BMI tables for athletic populations?
-muscle gain may mask fat loss
What is body composition?
-% body fat
-Males: 8-19%
-Females: 21-33%
Genetics and Obesity
-Many genes linked to obesity
-40% of obesity explained by genetics
-Thrifty Metabolism
-Small changes only
Bouchard Research
- 16 sets of identical twins
-diet and exercise intended for significant and similar weight loss
-Results: everyone lost weight
-within sets of twins similar wt. loss
-between sets of twins dissimilar wt. loss
What are other things to consider when determining your "ideal body weight" besides body composition?
• Small goals, don't want to lose weight too fast
• Genetics,
-medical issues,
-hypertension,
-cholesterol history
-develop good habits
Weight loss-How Fast?
-no more than 1-2 pounds a week
-Research supports 1/4-1/2 lb a week
-Focus on fat loss and eating and exercise behaviors than the scale.
Can you do a calculation of body weight loss using body composition as a starting point?
-No!
-doesn't take into account water retention, muscle gains, medical history, genetics
3 Fat Depots
-subcutaneous fat
-visceral fat
-intermuscular fat
Too little food:
Is psychological distress associated with caloric restriction or caloric intake?
• Caloric restriction
Caloric intake is associated with
-"emotional eating"
-feeling better
College wrestlers who lost weight quickly (approx. 10 lbs) had significant changes in what psychological variable?
• Group that had to lose weight, increased anxiety while losing weight
-reversed after wt. loss period ended.
Which group of college swimmers showed elevated psychological distress during a training study after the swim season?
• intake of 3,631 kcal showed elevated distress
-No distress- intake of 4682 kcal
What is the female athlete triad?
• Energy Deficiency: Disordered eating
• Menstrual Disturbances/Amenorrhea
• Osteoporosis/Bone Loss
Did the CDC find significant differences between college men and women for:
1)Prevalence of overweight?

2)Percentage of individuals who had dieted in the past 30 days to prevent weight gain?

3)Percentage of individuals who had exercised in the past 30 days to prevent weight gain?
1)-Overweight:20% W, 21% M
2)-Dieted- 42% w, 17% M
3)-Exercised- 63% W, 42% M
What are the "risky eating behaviors" on college campuses identified by the CDC?
-Anorexia,
-Bulimia,
-Binge eating disorder
-caloric restriction
What happens to caloric intake and expenditure after college?
• Obesity tends to become more common/problematic
-intake goes up, expenditure goes down
-huge problem of obesity in adults and children
Is caloric restriction or caloric intake associated with "feeling better"? What did the 2013 poll of psychologists indicate?
Caloric Intake- emotions play a significant role in food intake
What psychological change occurred following eating lunch (study by Wilson)?
• Eating lunch associated with reduction in anxiety
Creeping obesity was observed in the Wisconsin Longitudinal Study of Athletes and Non-Athletes. How much weight was gained? Which group gained significantly less weight?
• Those who werre physically active gained less weight regardless of athlete or non athlete
• What is creeping obesity? 1 lb per year
How much physical activity is needed according to the Institute of Medicine to avoid weight gain?
• 60 minutes a day
Is the prevalence of overweight and obesity higher or lower in the Amish community compared to the general population? What factor seems to influence these prevalence rates?
• They have high levels of physical activity
• Obesity: 4% vs 31%
• Overweight: 26% vs. 65%
A new field has emerged which examines psychological factors associated with heart disease - what is this field called?
-Psychocardiology
What is the difference between Type A and Type B personalities? Are Type A personalities at a higher risk of developing heart disease? Which group (Type A's or Type B's) had the highest survival rate following a heart attack?
-Type A: sense of time urgency, impatient, hard driving, competitive, workaholic
-Type B: goes with the flow and laid back
-Idea that Type A gets heart disease has been DEBUNKED
-Survival rate was twice as great for Type A's 20 years after a heart attack
What other psychological variables are being examined with regards to heart disease?
• Anger
-Hostility
• Depression
Heart disease progression is more rapid in people who score high on what psychological variable?
• Hostility
What type of event often precedes a heart attack (reported by survivors of heart attacks)?
• Anger provoking event
What is the relationship between depression and cardiac events (Cohen study)? How does depression impact mortality after cardiac surgery?
• Depressed individuals twice as likely to have a cardiovascular event compared to non-depressed.
-31% higher chance of cardiovascular events
-increase risk of mortality
The American Heart Association (AHA) Science Advisory Panel recommends routine screening for what psychological variable in patients with heart disease?
Depression
What behavioral programs were found by Blumenthal & colleagues (2014) to reduce depression and improve markers of cardiovascular risk in patients with heart disease?
-Exercise training
-stress management training
What is the prevalence of heart disease in the U.S. ?
• 1 in 3 (80 million)
-leading cause of death in US
What has been happening to heart disease, regarding cause of death, especially for about the last 10 years?
• General decline in deaths due to heart disease
-medical advances
What is the % of premature death due to ht. disease?
32% of deaths are premature (age 75 or under)
What treatment options are available?
-Prevention
-Medication/surgery
-Rehabilitation
What is congestive heart disease?
• Hearts function as a pump to deliver blood is inadequate to meet the bodys needs
What is congenital heart disease?
Heart disease present at birth
What is coronary artery disease?
-Narrowing of the small blood vessels that supply oxygen and blood to the heart.
What is the cause of coronary artery disease?
-Atherosclerosis
-leading cause of death in heart disease
What is atherosclerosis?
-Degenerative changes in the arterial walls involving buildup/ deposit of plaque
Autopsies in the 1950's of Korean War casualties made apparent that heart disease is a life long process. What did these autopsies reveal?
- Identified early onset
-young individuals 18-35
What are results of these other arteries being compromised?
-Heart (Coronary arteries)
-Neck (Carotid arteries): lead to strokes
-Legs (Intermittent claudication) - chronic leg pain
-Kidneys (renal failures)- kidney failure
What does asymptomatic mean?
No symptoms present
What is angina?
Pain in the chest
If heart disease is present, what abnormality in the EKG often presents itself during a stress test?
-S-T segment depression
-Angina
What is myocardial infarction? Major and Minor?
-heart attack
-Typically caused by a thrombus (blood clot)
-causes obstruction of coronary blood flow
-myocardium dies due to lack of oxygen.
-Major: Larger, upper branch; significant damage
-Minor: Small branch; insignificant damage
Why are there primary and secondary risk factors and what determines if a risk factor is primary or secondary?
Primary: significant impact, direct impact, modifiable

Secondary: age, gender, non-modifiable
What is a dose-response relationship? Can you provide an example?
-As dosage increases, the response pattern is consistent
-Example: The higher the total cholesterol, the greater risk of mortality from heart disease
What is synergism?
-There can be an exponential increase with each added risk factor
Why do we need blood pressure in the body?
-Circulation
What is the cholesterol level (total) that is typically used to define at risk individuals?
?
What happens to blood pressure during exercise? Why?
-Systolic increases
-Diastolic remains fairly constant
What is the definition and relationship of systolic b.p. and diastolic b.p.?
-Systolic (focus): blood pressure against the arterial walls when the heart contracts
-Diastolic: blood pressure between heart beats; constant pressure
-Greater the pressure gradient between systolic and diastolic the faster the blood circulates
What systolic and diastolic numbers are associated with the various normal and risk classifications?
-Normal BP: 120/80
-Pre hypertension: 130/85
-Borderline hypertension: 140/90
-Essential hypertension: 160/95
Risk of Sedentary Lifestyle
-sedentary men and women were found to be more than twice as likely to die prematurely due to heart disease than active men and women 9 year study
Indirect support for activity & heart disease
-Fewer symptoms of heart disease
-Better survival rate after heart attack
Direct support
Larger, heavier, healthier hearts
Larger coronary arteries
Less plaque buildup in arteries
With regard to cholesterol, what does exercise do that other strategies typically cannot do?
Raises HDL, lowers LDL
Cardiac Output equation
Heart Rate x Stroke Volume
What other heart healthy benefits are provided by exercise?
-Improved myocardium circulation
-increased metabolism
-Enhanced vascularization
-Increased glycogen stores
-Less likely to clot
-Ability to dissolve clots
-Alters heart rate and blood pressure
-Decreased heart workload
How often should you have your cholesterol and blood pressure checked?
-Chol: at least once every 5 years beginning at age 20
-BP at least once every year
To what does the Jim Fixx syndrome refer?
-Asymptomatic
-Predisposition
-Being active, but never getting checked
What are chylomicrons?
-Lipoprotein particles

-consist of triglycerides, phospholipids, cholesterol, and proteins.

-Transport dietary lipids
Very Low Density Lipoprotein
-Deliver endogenous Triglycerides to the cell
Low Density Lipoprotein
-"bad cholesterol"
-Carry certain lipids to certain cells and arteries
-High levels cause buildup on arterial walls
High Density Lipoprotein
-"Scavenge cholesterol"
-Pick up from cells and arteries that don't need it & transport to liver for excretion
-Remove cholesterol from arteries/protective against heart disease
-"good cholesterol"
What gender-related factor decreases LDL?
Estrogen
What levels of LDL do we consider to be at risk? HDL? Total cholesterol?
-<130
->40
-<200
Does dietary cholesterol affect risk?
-indirectly influences cholesterol levels in the body
-if levels are low to moderate
-higher levels- adverse impact
In what foods is cholesterol found?
-Saturated Fats and oils
How does saturated fat affect cholesterol fractions and total cholesterol?
-bigger effect on cholesterol
-greatest impact on blood lipid levels
What are the two types of poly-unsaturated fatty acids (PUFAs)? What foods are they found in?
Omega-3, fish oils
Omega-6, veggie oils
How do polyunsaturated vegetable fats affect total cholesterol? LDL? HDL? Total cholesterol?
-lower LDL
-Lower total cholesterol
-lower HDL
How do fish oils help prevent heart attacks?
Omega-3
-fish oil; help healing after attack; reduces blood pressure response; thins blood
What are examples of mono-unsaturated fats? How do they affect total cholesterol? LDL? HDL?
-canola oil, olive oil
-lower LDL
lower total cholesterol
-No change in HDL
How does soluble fiber effect blood cholesterol levels?
-increases excretion of cholesterol
What is the dietary culprit with regard to hypertension?
-makes arteries more vulnerable
What diet/nutrient manipulation occurs with the DASH diet
-Control Group-K, Mg, Ca @ 25%

-F/V Group-K, Mg @ 75%, Ca @ 25%, lowered BP by 7/3

-Combo Group- K, Mg, Ca at 75 %, lowered BP by 11/6
Is this an effective strategy to lower blood pressure?
-After 8 weeks
F/V Group blood pressure went down 7/3 from 140/90 to 133/87
Combo group blood pressure went down 11/6 from 140/90 to 129/84
What are the two key bone cells involved in bone remodeling?
-Osteoblasts build bone by laying down matrix and mineral
-Osteoclasts dissolve bone/ release calcium into bloodstream
Why is blood calcium so tightly regulated?
-calcium needed for many bodily functions
What are negative dietary factors associated with negative calcium balance?
-Caffeine/alcohol intake

-Protein intake

-Phosphorus intake

-Smoking
What roles do Vitamin D and estrogen have on bone mineral density?
-Estrogen is protective of bone
-calcium absorption
What are risk factors (modifiable and non modifiable) associated with Osteoporosis?
Modifiable:
-Diet,
-surgical procedures and medications
-smoking, alcohol, inactivity

Non-modifiable:
-Women
-age, race
-family history,
-body frame size,
-hormone levels,
thyroid problems
What type of exercise, in particular, appears to be best at delaying the onset of osteoporosis?
-Weight bearing exercise
-1% loss Bone Mineral Density/day in non-weight bearing conditions
What are the bone cells that remove calcium from bone and what are the cells that deposit calcium in the bone?
Osteoblasts, Osteoclasts
What 2 non-weight bearing environments have been studied to show the effects of limited weight bearing stress on bone and osteoporosis?
-bed rest situations
-space travel/weightless situation
Specifically, what rate of bone mineral density loss (on a daily basis) was discovered when these "environments" were studied?
1% a day
In post-menopausal females, is there any hope of preventing or delaying the onset of osteoporosis through physical activity? Explain.
Yes, in a study done, individuals who were post menopause were able to have a higher bone mineral density than those who did not continue weight bearing exercise
What are the processes of osteoarthritis?
-Repetitive impulse loading (wear and tear)
-Breakdown of bone (small microfractures)
-Remodelling of bone (stiffer bone)
-Decreased shock absorption - leads to increased stress on articular cartilage
-Eventual cartilage breakdown
- Joint degeneration
What age groups are most likely to be afflicted with osteoarthritis?
...
What groups of individuals/activities are most susceptible to getting osteoarthritis at an earlier age?
-Overweight
-Collision sports
-Early competitive sport
Why is running commonly thought to be the "poster activity" for the promotion of osteoarthritis?
-Early competitive sport participation, extend shoe life
Does running promote osteoarthritis?
Yes
-Pre-existing injury
-Poor biomechanics
-Shoe life
-Running on concrete


No
-Increased blood flow to the joint
-Maintains integrity of synovial fluid
What are health concerns (ailments/disorders) associated with diabetes?
-Hyper/Hypoglycemia,
-foot, eye, kidney, nerve, gum and teeth problems,
-depression,
-heart attacks, heart disease,
-blindness,
-infections

2 out of 3 people with diabetes die of heart attack or stroke
What are differences between Type I and Type II diabetes?
-Type I: Total lack of insulin (5-10%)
-Type II: body doesn't get enough or can't effectively use insulin (90-95%)
What are receptor sites and where are they located?
proteins that are on the surface of each cell
What is the role of nutrition in prevention/management of Type II diabetes?
-Lower fat/lower calorie meals
-Variety of foods
-Ketogenic diets
What can exercise and wt. loss do to assist with, at least, a partial reversal of this disease?
-Acute exercise increases receptor site activity 48-72 hours
-5 days/week 45-60 min
-Low resistance, high frequency; walking
For how long does the impact of an acute bout of exercise last with regard to increasing insulin sensitivity of the cell?
...
What does the typical American Aging model look like with regard to physiological changes?
-Max Heart Rate ↓ ~ 3/4 beat/year
-VO2 Max ↓ 1 -mlO2/kg/min/year
-Blood Pressure ↑ ½ mmHg/year (systolic)
-Muscle Mass ↓ 1 pound/year
-Fat Mass ↑ 1 pound/year
Lung Capacity, Vision
-Hearing, Teeth, etc.; all ↓ each year
What is meant by the term "true aging and how does this compare to typical aging? "
-Impact when studied separate from all other variables
-when you look at age impacts independant of everything else
Why are costs often seen as outweighing the benefits of healthy lifestyle choices?
-Costs are very visible: Time, effort, scheduling, equipment/facility costs, etc.
-Benefits occur gradually, not as visible/immediate
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