Test 3 Notes/Study Guide
Test 3 Notes/Study Guide FDNS 2100
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This 132 page Study Guide was uploaded by alk88738 on Tuesday April 5, 2016. The Study Guide belongs to FDNS 2100 at University of Georgia taught by Tracey Brigman in Spring 2016. Since its upload, it has received 46 views. For similar materials see Human Nutrition and Food in Child and Family Studies at University of Georgia.
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A FEW QUESTIONS TO PONDER… How might the University environment contribute to disordered eating behaviors? What are some sources of support for dealing with stress on and off campus? U NDERSTANDING E ATING D ISORDERS Health Promotion Department University Health Center email@example.com LEARNING OBJECTIVES Describe “normal eating” and offer some definitions of Health Name a few possible causes of disordered eating. Identify behaviors associated with disordered eating. Learn how to help a friend and what resources we have on campus and throughout the community. AreY ouA Healthy Dawg? A Healthy Dawg seeks to improve health in ALL areas of life: Emotional (feelings) Intellectual (learning) Physical (body) Environmental (nature/Earth) Social (relationships & community) Spiritual (guiding beliefs/values) Why do you think the Healthy Dawg is juggling? How do I keep up IT’S ALL with all the ways to stay healthy? ABOUT BALANCE. Sometimes balls will drop, but with planning, practice, patience, and perseverance, they can be picked up again. N ORMAL EATING IS… Being able to eat when you are hungry and continue eating until you are satisfied. Under eating at times and wishing you had more Overeating at times: feeling stuffed and uncomfortable. Giving yourself permission to eat sometimes because you are happy, sad or bored, or just because it feels good. Satter pp.69-70; http://www.boulevardmall.com/Content/img/featured/dining_standard.jpg N ORMAL EATING IS… Takes up some of your time and attention but keeps its place as only one important area of your life. Flexible. It varies in response to your emotions, your schedule, your hunger and your proximity to food. Bridging the Gap Vs . Definition of ® Health At Every Size • HAES supports people in adopting health habits for the sake of health and well-being (rather than weight control). • HAES encourages: – Eating in a flexible manner that values pleasure and honors internal cues of hunger, satiety, and appetite. – Finding the joy in moving one’s body and becoming more physically vital. – Accepting and respecting the natural diversity of body sizes and shapes. Every Size® Curriculum HAES = Weight Neutral • Encouraging healthy habits and attitudes • Taking the focus off of weight – Let a person’s weight settle where it may • Supporting people to feel good about themselves, no matter the outcome Every Size® Curriculum Take 90 seconds to write down the most important points of the first section. D EFINITIONS Anorexia nervosa Bulimia nervosa Binge eating disorder Eating disorder not otherwise specified Disordered eating behaviors EATING D ISORDERS ARE … Individual Preoccupation with food A serious medical problem A product of many factors http://hol-solutions.com/images/Puzzle-Color-NO-SHADOW-clerbkgd.gif-competition, http://www.georgiahighlandsmedical.org/images/medic.jpg; W HAT D OED’ SL OOK LIKE? http://media.kickstatic.com/kickapps/images/85283/photos/PHOTO_8004390_85283_7900887_ap_320X240.jpg, W HATDO EDS SOUNDLIKE? UGA S TATISTICS NCHA 2014 SURVEY BEHAVIORS IN THE LA30 DAYS Vomiting, taking laxatives or diet pills to lose weight Men and Women 4% Dieting behaviors in past 30 days Women 48% Men 36% W HY DOES OUR SPEECH MATTER ? Judging food choices Complimenting others BIOPSYCHOSOCIAL D ISEASE Biological Social Psychological B IOLOGICAL Genetics Chemical imbalances NEDA, 2004 P SYCHOLOGICAL Issue of control Feelings of inadequacy Stressors Anxiety Self-esteem NEDA, 2004; What’ one of the biggest stressors in your life? How can you deal with it effectively? S OCIAL Cultural pressures Researchers estimate the average adolescent sees over 14 “attractiveness messages” per day “Cultural norms” Perceived use of cigarettes in last 30 days: 73% Actual use of cigarettes in last 30 days: 12% Perceived never use of cigarettes: 7% Actual never use of cigarettes: 65% Narrow definitions of beauty Affecting both men and women PHYSICAL EFFECTS OF ANOREXIA PHYSICAL EFFECTS OF BULIMIA W HAT W ILLNOT H ELP Conflicts or arguments Placing blame or shame Offering simple solutions Isolation Telling someone they look “healthy” because they are thin H OW CAN Y OU H ELP AF RIEND? Set a time to talk Voice your concerns clearly Ask your friend to share their feelings Call Counseling and Psychiatric Services (CAPS) Express support Who’s Healthier? You can’t tell how healthy someone is by looking at them Every Size® Curriculum U NIVERSITY H EALTH C ENTER E ATING D ISORDER EVALUATION Initial contact: phone consultation with Counseling & Psychiatric Services 706-542-2273 Appointment with psychologist Psychological testing Physical exam with Physician Assistant Nutritional assessment and counseling Follow-up sessions or referral ******************************************* Online Resources National Eating Disorders Association: www.nationaeatingdisorders.org Academy for Eating Disorders: www.aedweb.org National Eating Disorders Information Centre: www.nedic.ca Medline Plus, Keyword: Eating disorders IWILL BE AROUND AFTER CLASD ISCUSS How to help a friend Professional help in town Other related topics R EMEMBER ,WE ARE HERE TO HELP YOU ! Thanks for listening Benjamin Gray, MS, RD, LD Health Promotion Department University Health Center 706-542-8690 firstname.lastname@example.org R EFERENCES Academy of Eating Disorders. Prevalence of Eating Disorders. 2011. Internet. http://www.aedweb.org/Prevalence_of_ED.htm (Accessed August 18th, 2011). American College Health Association. American College Health Association-National College Health Assessment II. University of Georgia Executive Summary Fall 2014. American College Health Association. American College Health Association-National College Health Assessment II. University of Georgia Executive Summary Fall 2014. Health at Every Size Curriculum. 2014. Internet. Accessed from www.haescurriculum.com . (Accessed January 26 , 2016) National Eating Disorders Association. The media, body image and eating disorders. 2005. Internet . http://www.nationaleatingdisorders.org/nedaDir/files/documents/handouts/MediaBI.pdf (Accessed August 19th, 2011). National Eating Disorders Association. What Causes Eating Disorders? 2004. Internet . http://www.nationaleatingdisorders.org/nedaDir/files/documents/handouts/WhatCaus.pdf (Accessed August 18th, 2011). National Eating Disorders Association. What should I say? Tips for talking to a friend who may be struggling with an eating disroder. 2005. Internet . http://www.nationaleatingdisorders.org/nedaDir/files/documents/handouts/WhatISay.pdf (Accessed August 19th, 2011). Satter E. How to Get Your Kid to Eat… But Not Too Much. 1987. Bull Publishing Company. Boulder, CO. U.S. Departement of Health and Human Services Office of Women’s Health. Publications. Anorexia nervosa fact sheet. 2011. Internet. http://www.womenshealth.gov/publications/our-publications/fact-sheet/anorexia- nervosa.cfm (Accessed August 19th, 2011). U.S. Departement of Health and Human Services Office of Women’s Health. Publications. Bulemia nervosa fact sheet. 2011. Internet. http://www.womenshealth.gov/publications/our-publications/fact-sheet/bulimia- nervosa.cfm (Accessed August 19th, 2011). UNDERSTANDING EATING DISORDERS Are You A Healthy Dawg? A healthy dawg seeks to improve health in ALL areas of life: Emotional, Intellectual, Physical, Environmental, Social, Spiritual It’s all about balance which needs planning, practice, patience, and perseverance. NORMAL EATING IS…. Being able to eat when you are hungry and continue eating until you are satisfied. Under eating at times and wishing you had more Overeating at times: feeling stuffed and uncomfortable Giving yourself permission to eat sometimes because you are happy sad or bored, or just because it feels good Takes up some of your time and attention but keeps its place as only one important area of your life. Flexible. It varies in response to your emotions, your schedule, your hunger and your proximity Definition of Health at Every Size HAES supports people in adopting health habits for the sake of health and well-being (rather than weight control) HAES Encourages: o Eating in a flexible manner that values pleasure and honors internal cues of hunger, satiety, and appetite o Finding the joy in moving one’s body and becoming more physically vital o Accepting and respecting the natural diversity of body sizes and shapes. HAES = Weight Neutral Encouraging healthy habits and attitudes Taking the focus off of weight o Let a person’s weight settle where it may Supporting people to feel good about themselves, no matter the outcome DEFINITIONS Anorexia Nervosa: less than 85% of ideal weight; intense fear of gaining weight or being fat; thinking that you are bigger than you actually are; body dysmorphia; extreme undereating and underweight Bulimia Nervosa: uncontrollable urge to eat; binge and purge – no weight component; feels guilt/shame after eating; no physical signs Binge eating disorder: uncontrollable urge to eat Eating Disorder Not Otherwise Specified: catch all for the rest Disordered Eating Behaviors: go to DSM website for more info EATING DISORDERS ARE: Individual Preoccupation with food A serious medical problem A product of many factors o Eating disorders left untreated have highest fatality rate What do EDs look like? Excessive exercise Calorie restriction o Up to 25% eating disorders in men What do ED’s SOUND LIKE? A separate voice in their head I would never eat that My body looks disgusting I just want people to notice me I have to have perfect control over my body Why Does Our Speech Matter? Judging food choices Complimenting others Biopsychosocial Disease Biological: o Genetics o Chemical Psychological: o Issue of control o Feeling of inadequacy o Stressors o Anxiety o Self-esteem Social: o Cultural Pressures: researchers estimate the average adolescent sees over 14 “attractiveness messages” per day o “ Cultural norms’: Perceived use of cigarettes in last 30 days: 73% Actual use of cigarettes: 12% Perceived never use of cigarettes:7% Actual never use of cigarettes: 65% o Narrow definitions of beauty o Affecting both men and women WHAT WILL NOT HELP Conflicts or arguments Placing blame or shame Offering simple solutions Isolation Telling someone they look “healthy because they are thin HOW TO HELP A FRIEND? Set a time to talk Voice your concerns clearly Ask friend to share feelings o Call Counseling and Psychiatric Services (CAPS) Express support Metabolism Extraction of energy from food (absorbed molecules) Energy: Fuel for Work • Energy source Chemical energy in carbohydrates, fat, protein • Food energy to cellular energy Stage 1: digestion and food Stage 2: absorption and transport of molecules to tissues and organs Stage 3: breakdown of molecules and production of energy within cells What is Metabolism? • Catabolism Reactions that break down compounds into small units • Anabolism Reactions that build complex molecules from smaller ones Chemical Reactions in the Body Transfer of Energy in the Body Coupled Reactions: energy released from the breakdown of one compound is used to create another compound Energy can be captured by some molecules and transferred to other molecules e.g. ATP (cell’s energy source; “the currency of cells”) What is Metabolism? • Cell is the metabolic processing center Nucleus Cytoplasm Cytosol + organelles • ATP is the body’s energy currency Form of energy cells use • NAD and FAD: transport shuttles Accept high energy electrons for use in ATP production Adenosine Triphosphate (ATP) Breakdown and Release of Energy • Extracting energy from carbohydrate Glycolysis Pathway splits glucose into two pyruvate Transfers electrons to NAD Produces some ATP Pyruvate to acetyl CoA Releases CO2 Transfers electrons to NAD No energy produced Glycolysis Breakdown and Release of Energy • Extracting energy from carbohydrate Citric acid cycle (=TCA cycle) Releases CO2 Produces GTP (like ATP) Transfers electrons to NAD and FAD Electron transport chain Accepts electrons from NAD and FAD Produces large amounts of ATP Produces water End products of glucose breakdown ATP, H2O, CO2 Pyruvate to Acetyl CoA Breakdown and Release of Energy • Extracting energy from fat Split triglycerides into glycerol and fatty acids Beta-oxidation Breaks apart fatty acids into acetyl CoA Transfers electrons to NAD and FAD Citric acid cycle Acetyl CoA from beta-oxidation enters cycle Electron transport chain End products of fat breakdown ATP, H2O, CO2 Triglyceride Hydrolysis Fatty Acid Oxidation Breakdown and Release of Energy • Extracting energy from protein Split protein into amino acids Split off amino group Converted to urea for excretion Carbon skeleton enters breakdown pathways End products ATP, H2O, CO2, urea • Can enter at numerous spots of the cycle depending on the amino acid • Can produce glucose Urea Excretion Urea Synthesis Break- down and Release of Energy Biosynthesis and Storage • Making carbohydrate (glucose) Gluconeogenesis: uses pyruvate, lactate, glycerol, certain amino acids • Storing carbohydrate (glycogen) Liver, muscles make glycogen from glucose • Making fat (fatty acids) Lipogenesis: uses acetyl CoA from fat, amino acids glucose • Storing fat (triglyceride) Stored in adipose tissue Biosynthesis and Storage • Making ketone bodies (ketogenesis) Made from acetyl CoA Inadequate glucose in cells • Making protein (amino acids) Amino acid pool supplied from Diet, protein breakdown, cell synthesis Special States • Feasting Excess energy intake from carbohydrates, fats, proteins Promotes storage Special States • Fasting Inadequate energy intake Promotes breakdown Prolonged fasting Protects body protein as long as possible Energy Balance and Weight Management The problems of too little or too much body fat What are the risks for underweight? Not enough reserves Cannot fight wasting disease (e.g. cancer, AIDs) How fat is too fat? Increased risk for chronic diseases with obesity The Problems of Too Little or Too Much Body Fat Obesity in the U.S. is an escalating epidemic 66 percent of U.S. adults are overweight or obese 33 percent of children and adolescents are overweight or on their way. Energy In Regulation of intake Hunger: prompts eating; physiological desire Satiation: signals to stop eating Satiety: lack of hunger Appetite: psychological desire Energy In Factors that regulate hunger and desire Feeding Signals Energy balance Energy intake - Expenditure = Energy Balance Energy Expenditure: Basal Metabolic Rate Thermic effect of food Genetics Environment Behavior Energy Out: Fuel Uses Major components of energy expenditure Basal Metabolic Rate (BMR) Energy for basic body functions Affected by body size, composition, age, gender Physical activity Highly variable Affected by body size, fitness level, type of activity Thermic effect of food (TEF) Energy to digest, absorb, metabolize foodz To Estimate Energy Needs (Energy Out) BMR = 0.9 x 24 hr x weight (kg) (females) BMR = 1.0 x 24 hr x weight (kg) (males) Total Energy Needs: = BMR x Thermic Effect x Activity Level = BMR x 1.1 x Activity Level (see chart) To Estimate Energy Needs Activity Levels: Sedentary: 1.3 men, 1.3 women Light: 1.6 men, 1.5 women Moderate: 1.7 men, 1.6 women Heavy: 2.1 men, 1.9 women Exceptional: 2.4 men, 2.2 women Body Composition: Understanding Fatness and Weight Assessing body weight Height weight tables (1940s) Body Mass Index (BMI) BMI = weight(kg)/height^2(m) Assessing body fatness Body fat distribution Estimating Body Fatness Anthropometry: skinfold test; not very accurate; has to be highly trained Underwater weighing: weight in water vs. weight in air; gold standard; highly accurate Bioelectrical Impedence (electrical current): fat has differ electrical resistance than water; somewhat accurate DEXA (x-rays): fat responds different to x- rays than water Underwater Weighing Measuring Body Fatness Average Body Composition Obesity Promoting Environment Fitness Promoting Environment When Energy Balance Goes Awry Definitions Overweight: BMI between 25-30 Obesity: BMI > 30 Underweight: BMI < 18.5 Health risks of overweight and obesity Heart disease, heart stroke, hypertension, diabetes, cancer, joint diseases When Energy Balance Goes Awry Early theories of weight regulation Fat cell theory: obesity increases # and size of fat cells Set point theory Influences on weight gain and obesity Heredity and genetic factors Sociocultural influences Age and lifestyle Gender and ethnicity Socioeconomic factors Psychological factors Fat cell development Set Point Theory: the point at which controls are set; the body tends to maintain at a certain weight by means of internal control Weight Management How do I know if I need to lose weight? Height weight tables Family history Individuality Current health parameters BMI Body fat analysis Weight Management Perception of weight Setting realistic goals Weight management lifestyle Diet and eating habits Reduce total calories Reduce fat calories Increase intake of complex carbohydrates Improve eating habits Increase physical activity Stress management Self acceptance Weight Management Weight management approaches Self help books and manuals (watch for signs of fad diets) Self help groups Commercial programs Professional counselors Prescription drugs OTC drugs and dietary supplements Weight Management Weight management approaches Surgery (at least 50lbs overweight) Creates digestive and absorption problems BMI changes across time How the Body Loses and Gains Weight Weight change can be due to water gain or loss Most quick weight-change schemes promote large changes in body fluids that accomplish little weight change in the long run How the Body Loses and Gains Weight When energy input is less than energy output, the body draws on its energy stores With exercise, moderate calorie restriction and a balanced diet, a body will use it stores of fat Gradual weight loss will occur How the Body Loses and Gains Weight The Body’s Response to Fasting Less than 1 day into fast: liver glycogen stores are exhausted Protein is broken down in order to meet the brain’s need for glucose How the Body Loses and Gains Weight Continued Fasting If left unchecked the breakdown of protein results in death within approximately 10 days To prevent this, the body converts fat into ketone bodies How the Body Loses and Gains Weight The body tolerates short-term fasting SKIPPED How the Body Loses and Gains Weight Fasting may harm the body Ketosis upsets acid-base balance of blood Promoting excessive mineral loss in the urine In as little as 24 hours of fasting, intestinal lining begins to lose its integrity How the Body Loses and Gains Weight Other effects of fasting Fasting degrades body’s lean tissues The body also adapts to fasting by slowing metabolic rate Therefore, a diet moderately restricted in calories results in a greater weight loss of fat than does a severely calorie restricted diet What to Look for in a Sound Weight Loss Diet Control of energy intake Satisfying/pleasurable Physical activity Slow and steady weight Acknowledgement of loss lifelong change Allows for adaptation to individuals Meet RDAs Adequate fluids Contains at least 1200kcal/day Fits into any social situation How the Body Loses and Gains Weight The Body’s Response to a Low- Carbohydrate Diet Low-carbohydrate diets bring about responses similar to those seen when fasting Achieving and Maintaining a Healthy Body Weight Motivation Is your goal health or to achieve a societally defined idea of attractiveness? More successful when your goal is health but meeting societal goals is unrealistic and difficult to maintain Goals Unreasonable vs. realistic goals: short term and easily attainable Rewards: do not reward with food; it defeats the purpose Achieving and Maintaining a Healthy Body Weight Weight loss takes time and patience Even modest weight loss, even for a person still overweight, can improve health To lose 1 pound per week, decrease intake by 500 kcal per day Exercise to keep metabolic rate up What Diet Strategies Are Best for Weight Loss? It’s Your Diet, So You’d Better Plan It No particular food must be included or excluded from diet Adopt a healthy eating plan What Diet Strategies Are Best for Weight Loss? Choosing Realistic Calorie Intakes SKIPPED http://www.dietsurf.com/ What Diet Strategies Are Best for Weight Loss? Of Critical Importance: Portion Sizes The enemy is large portions served Use a measuring cup to learn to judge portion sizes Demonstration Diet What Diet Strategies Are Best for Weight Loss? Meal Spacing People who eat small, frequent meals are more successful at weight loss Make sure that hunger prompts eating Eat regularly, before becoming extremely hungry To determine if you are really hungry, be active for 10 minutes to get mind away from food and 10 minutes after activity if you are still hungry then you are truly hungry What Diet Strategies Are Best for Weight Loss? Eat breakfast Eating breakfast may reduce food intake all day long People who skip breakfast are more likely to be overweight Physical Activity for Weight Loss ≈30 - 60 minutes of moderate physical activity per day are needed to prevent weight gain and support weight loss Physical Activity for Weight Loss Increasing Metabolism and Reducing Appetite Short term increase in energy expenditure from exercise and a slight rise in metabolism Long term increase in BMR from an increase in lean tissue Improved body composition Physical Activity for Weight Loss More physical activity benefits Appetite control Stress reduction and control of stress eating Physical and therefore psychological well being Improved self esteem Drugs and Surgery to Treat Obesity Herbal laxatives containing senna, aloe, rhubarb root, cascara, castor oil, or buckthorn Sold as “dieter’s tea” Can cause temporary water loss of 1-2 pounds Side effects include: nausea, vomiting, diarrhea, cramping, fainting Suspect in 4 deaths Drugs and Surgery to Treat Obesity Other Gimmicks Steam baths and saunas do not melt off fat May dehydrate you and result in water loss Brushes, sponges, wraps, creams, and massages intended to move, burn, or break up “cellulite” are useless for fat loss Drugs and Surgery to Treat Obesity Cellulite – rumpled, dimpled fat tissue on thighs and buttocks – is simply fat Drugs and Surgery to Treat Obesity FDA has sent letters warning supplement distributors to stop claiming that their products: SKIPPED Once I’ve Changed My Weight, How Can I Stay Changed? A reason why gimmicks fail is that they fail to produce lasting changes Gimmicks work for short term but not long term Once I’ve Changed My Weight... A key to weight maintenance is accepting it as a lifelong endeavor Prepare the mind for making permanent changes More physically active than the average person Monitor fat grams, calorie intake, and body weight Food Feature: Behavior Modification for Weight Control How Does Behavior Modification Work? Do not attempt too many changes at one time Chain breaking Separates behaviors that occur together Stimulus control Puts us in charge of temptations Bring own healthy snack Have healthy snacks prepared Don’t grocery shop when hungry Cognitive Restructuring Changes our frame of mind 80/20: Eat healthy 80% of the time Can have it but smaller portions Contingency Management Prepares us for potential pitfalls and high risk situations Holidays Birthday Social events Stress Self Monitoring Can reveal patterns Writing down when you eat, what you eat, and how you felt at that time Some things to think about: How do you deal with it when you “go off” your diet? Accept it and learn from it. Don’t give up! What happens to a person’s body composition, weight and metabolism when they end a fad diet? They are losing water weight and muscle weight. Their metabolism slows down. Their weight comes back as fat. They may be at some weight but less protein and more fat affecting their metabolism. What Strategies are Best for Weight Gain? If you eat enough to support the activity, you will gain muscle at the expense of body fat Calorie dense foods not unhealthy food If you eat more, you wil gaain both muscle and fat Gaining a pound of muscle and fat reuires and intake of approx. 3000 extra calories a week People wanting to build muscle are advised to eat approx. 700-1000 calories/day above normal energy needs Fast Food: The Axis of Evil? What are Some Concerns About Frequent Eating at Fast Food Restaurants? • Too much fat • Too much cholesterol • Too many calories • Too much sodium Obesity Trends* Among U.S. Adults BR FSS, 1993 Obesity Trends* Among U.S. Adults BRFSS, 1995 Obesity Trends* Among U.S. Adults BRFSS, 1997 Obesity Trends* Among U.S. Adults BRFSS, 1999 Obesity Trends* Among U.S. Adults BRFSS, 2001 Obesity* Trends Among U.S. Adults BRFSS, 2003 A Gloomy Forecast A recent article in the New England Journal of Medicine: In the next 50 years, obesity may shorten average life span (77.6yrs) by 2-5 years “We think today’s younger generation will have shorter and less healthy lives than their parents for the first time it modern history unless we intervene.” The “Obesogenic” Environment Obesogenic– a recently coined term meaning the environment that sets people up for weight gain These factors include: Increase in use of cars High number and variety of inexpensive, high calorie food options Physical Inactivity Many blame the fast food industry. Fast Food and Obesity • Adults who eat fast food 2 or mores times a week are 50% more likely to be obese and have double risk for abnormal glucose metabolism (leads to diabetes) • Adults who consume fast food 2 + times/day AND spend over 2.5 hours/day watching TV have triple the risk for obesity and abnormal glucose metabolism.
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