Nutrition

• study in which individuals are observed or certain outcomes are mesaured
• no attempt (treatment) given to affect the outcome

• study thtat compares a particular outcome in groups of individuals who are alike in many ways but differ by a certain characteristic
• ex female nurses whos smoke compared those who dont

• compares two groups of people
• with disease or condition under sdudy(cases) and a very similar group of people who do not have the disease or condition (control)
• study medical,lifestyles
• learn factors
• ex. one given a substance that other was not

• the branch of medical science that deals with the study
• incidence
• distribution
• control of a disease in a population

• study in which the participants are assigned by chance to seperate groups that compare idfferent treatments
• rsearchers nor the participants can choose group
• patients choice to be randomized trial

• analysis studies the relationship between different variables at a point in time
• relationship between income,locality,and personal expenditure
• related to how variables affect each other at same time and period

• correlation research study involves repeated observations of the same items over ling periods of time
• often many decades
• type of observational study
• used in psychology developmental trends
• track same people
• also used in medicine

• follows over time groups of individuals who are alike in many wasy but differ by certain characterisics
• ex female nurses smoke and dont
• compares them in a particluar outcome
• may be combined as prospective cohort study

• detailed report of the diagnosis treatment and follow up of an individual patient
• contain some demorpgraphic information
• age,gender,ethnic origin

• compares two groups of people
• those with the disease or condition under study (cases) and a very similar group of people who do not have the disease or condition (controls)
• study medical,lifestyl histories, factors may be associated with disease

• combines the reults of several studies that address a set of related research hypotheses.
• Will include number of articles reviewed and otucome sof each to reach a summar conlusion

summary of research on a particular subject

• Pure fundamental
• increase a body of knowledge
• explore unknown
• not necessarily solve a problem
• ex- studying the structure of a vitamin

• takes known information and attempts to solve
• ex- effects of a low fat diet on hear disease

• is given the traditional or standard care or medication
• may be given placebos

receives the treatmetn or medication that is being tested

• the variable that is of interest to researchers
• ex HDL cholesterol

• the variable that is being manipulated by researchers
• ex fiber intake

• is the distortion of results caused by some factor other than the study itself
• can be caused by researchers
• or by subjects

situation when both the researcher and the participant know the study

opposite of double blind neither hte researcher nor the participant knows

• subjects are unawar if in control or experimentak
• only researcher knows

both the subjects and researchers are unaware

this happens when subjects feel better just because they are involved in the study even if they are receiving the placebo

same study but different researchers and participants

same study same results

more calories you eat more you gain weight

• Abstract
• introduction
• review of literature
• methodology
• results
• conclusions
• references

• position papers explain the associations stands on issues that affect the nurtitional status of the puplic.
• positions staements and support paper based on sound scientific data

• measure what you should be measuring
• real accurate results

• scientist rigoursly evaluates a research study to assure
• original article

• professional oganizations
• american dietetic association
• american society for nutrition sciences
• american soceity for clinical nutrition
• society for nutrition education
• american college of sports medicine
• nort american association for study obesity

• journals
• educational instituions
• persons with credible credentials
• hospitals and clinica
• libraians books

nutritional schemes

• become vary popular temp
• special apeal or prestige
• sound easy
• little responsibilities
• distort or ingore basci nutition
• seldom include full variety of foods

• is something being sold
• does if offer a quick fix
• are catchy
• are testimonalrs
• does it sound to good to be true
• is money back gurantee offered

• experts have crtically reviewed articles for you
• summary and conlusions
• strenghts and weakness of each article

• appropriate for tour age and physical development
• maintained withoud dieting
• family hostory of body shape and weight
• good eating habits and physical activity
• acceptable to you

habing too little body fat to maintain health

habing a moderate amount of excess body fat

having an excess of body fat that adversely affects health

body weight exceeding 100% of normal, creating a very hogh risk for serious health complications

• expresses the ratio of a persons weight to their height
• BMI values below 18.5 or above 30 have increased health risk

Weight (lbs)x703/height in inches²

• it may overestimate body fat in athletes and others who have a muscular build
• underestimat body fat in older persona ans others who have less muslce mass

• BMI below 18.5kg/m²
• increases the risk of infections and illness and can even be fatal
• can be just as unhealthy as overweight

• BMI between 25 and 29.9 kg/m²
• health risk
• hogh blood pressure
• heart disease
• type 2 diabetes
• sleep disordors

• Obesity BMI between 30 to 39.9kg/m²
• Morbid obesity exeeds 100% of normal and or BMI>40

• epidemic in US linked to many chronic disease
• hypertension
• dyslipidemia
• type 2 diabetes
• heart disease and stroke
• gallbladder disease
• sleep apnea
• steoarthritis
• gestational diabetes
• depression

• heart disease
• all cancers: colon breast endometrial and gallbladder
• stroke

measuement of body fat and lean muscle mass

underwater weighing

measurment of skinfold thickness using skinfold calipers of body circumferences

bioelectric impedance

considered the most accurate

air displacemetn (plethysmography) expensive

• Skinfold measurement
• dependent on person taking measurements and degree of training

• depends upon several factors
• hydration
• least invasibe and fairly accurate

measured by waist to hip ratio and waist circumference

• upper body
• increased risk for chonic deseases
• android-men-visceral fat apple

• lower body
• no significant increased risk for chornic desease
• ganoid-woman

• WHR= waist circumference/hip cicumference
• desirable values
• <0.80 women
• <0.90 men
• high= central obesity

• risk of death
• chronic disease from all causes appears to be highest for individuals with central obesity which
• > 40 in males
• >35in females

• depens on
• energy intake vs energy expenditure
• genetics
• childhood weight
• behavior/lifestyle
• social factors

occurs when energy intake =energy expediture

• calcualting energy that is in a particular food
• grams of prtoein or carbs or fat x kcal of coresponding energy
• add together which = total kcal

• when total daily energy intake exceeds the amount of energy they expend
• an excessive intake of aprox 3,500 kcal will result in a gain of one pound
• without exercise will be likely fat

• energy expended to maintain basal ,or resting functions of the body
• the highest protion of energy expenditure

• more lean body mass,during stress, and period of growth
• hogher lean body mass
• greater height
• younger age
• elevated levels of thyroid hormone
• stress fever ilness
• male gender
• pregn and lactation
• drugs caffeine tobacco

• older age and during energy restriction
• fasting or starvation
• lower lean body mass
• lower height
• depressed levels of thyroid hormone
• female gender

• energyt used to maintain life when the awake body is at complete rest
• circulation
• respiration
• temperature maintenance
• synthesis of new tissue
• nerve activity
• hormone secretion

• BMR=60-75%
• TEF(thermic EFfect of foods)= 5-10%
• Physical Activ=15-35%

• 1. Direct calorimetry is the method that amount of heat the body releases
• 2. Indirect Calorimetry estimates energy expenditure by measuring oxygen consumption and carbon dioxide production
• used in hospitals

• nearly two thirds of US adults are overwieth
• Nearly one third of US adults are obese
• 1 in 5 children are obese
• less than 1/2 have a healthy weight

• Diet
• Inactivity
• physchological factors
• genetics/environment
• age
• medication
• medical problems

• about 25%
• thrify gene theory
• set-point theory

• proposes that a gene or genes cases people to be energetically thrifty
• expend less energy than other people and therfore gain weight

proposes that each persons weight stays within a small or narrow range set point

leptin is a hormone produced by fat cells that casues reduced food intake reduced weight ,decreased body fat

• Hunger vs appetite
• leptin - reduce food intake/less effect in obese
• Ghrelin-stimulate appetite hour later hungry after eating
• Peptide yy(pyy)- decreases appetite relasased in the GI

• environmental factors in childgood can influence
• childhood overweight inceases the risk of heart desease and premature death as an adult

theory states that overeating dietary fat promotes storage as adipose tissue / as well as carbs and protein

• influencing our diet
• family
• culture
• holidays
• easy acess
• less physical act
• societal expectations perfect body

• hypertension
• diabetes
• dyslipidemia abnormal blood fats- usually from diet hogh in saturated fat high ldl,low hdl, hogh triglycerides

• coronary artery disease
• stoke
• gall stones
• gout
• osteoarthritis
• sleep apnea
• cancer

fads that do not results in long term healthful weight changes

• basic conepts is all sugars, including sugar derived form colplex varbohydrates and starches ar toxic
• potatoesmcornmcarrots
• recommended for children prengant women diabetics
• protein and fats should be limited

• cooked food lose the natural vitamins nutrients and enxyme snecessary to build a strong immune system
• only fruits and vegetable picked ripe
• professional anaylysis of this diet
• restrictions make difficult to get nurtients needed
• example b12 and D

• type A vegetarians
• type b omnivores
• groups people based only on blood type and does not consider individual variences

• workd to sudue appetit on two levels
• flavor
• minimally processed foods
• nutritionally sound but avoid taking the concept too far and becoming too restrictive

• high fat low carboydrates,high on protein diets
• cause ketosis
• nutritionally inadequate,require supplements

• mostly protein
• high protein
• low carbs
• major restrictions on cabohydrates
• ketones buildup
• increased intake of sat fat and cholest
• contradicts everhting we know about health promotion and disease prevention

• gradual weight loss
• effective in weight loss
• decrease in ldl
• decrease in TG
• decrease in Blood presur
• nutritionaly adequate if follow general guidelines

• 3 phases
• theory is that faster sugars and starches are digested the more weight is gained
• 1400-1500 calorie intake
• first phase unhealthy
• compliant many fo the foods and recipes are not common to all areas

• 40 cho 30 pro 30 fat 4:3
• closer to what most dietetic profesionas recommend

• Most successful of all therapies
• self monitoring
• control
• cognitive restructuring
• aims change lifestyle

• helpful for figuring meal preration new recipes
• nurtrient and k cal count s
• may be expensive

• regular physical activity is a key component
• effective at weight loss but difficult ot mantain over time because they are too restrictive
• about 11-19% of total

• Starvation
• Very low calore diets <800 kcal
• restricted diets 800-1600 kcals

• storage site of body fat
• 1lb of fat = 3500 kcal
• 5 lb = 17,500 kcal
• to lose 5 lbs of fat in a week
• 17,500kcal / 7 days = 2,500/day

• no more than 1-2 lbs per week
• to lose 1lb 3500/7=500 kcals per day
• to lose 2lbs 7000/7=1000 kcals per day

• should only be used if a person has
• BMI of 30kg/m2
• BMI of 27 kg/m2 and other health risk factors

• east 5500 to 1,00 extra kcal
• eat frequently
• limit fat 15-30%
• exercise regularly with resistance training in order to gain lean muscle tissue

• East less sugar and high sugar foods
• 1 less 12 oz can of soda per day = a weight loss of about 15lbs in one year

• increase metabolic rate or prevent decline due to calore restrictions
• rduce fat mass
• incrase in HDL-C

• low calorie diet
• regular exercise
• prescription medication
• surgery

for people with a BMI >30 or 27

• decreases appetite by altering brain neurtransmitters
• side effects = increased blood pressure,dry mouth, anorexia, constipation,insomnia, dizziness,nausea

• inhibits pancreatic lipase and decreases fat abosrption
• side effects = abdominal pain, fatty and loos stool,leaky stools, flatulence, decreased absorption of fat solubl nutrients

possible side effects the wall steet journal

• only for morid obesity
• new researth suggest that this surgery should be done before DM,CVD,etc are sever

• BMI 35+ and
• 2 co morbidities = diabetes,CVD or sleep apnea or
• BMI 40+

• uses a premeasur prosthetic device to restrict oral intake
• usually 0.5 com
• can adjust
• muche better with flexible band
• less consistent than other banded

• combines gastric resection with small amount of sub-clinical malabsorption
• iron, B12
• mean weight loss 35%

• modest amount of gasrtic restriction with intenstinal malabsorption
• entire jejunum is excluded
• metabolic complication in the first year
• anemia
• fat soluble vitamin deficiencies
• treatment of protein calore malnutrition

• sleeve is new stomach pouch no chang to the anatomy
• have less stomach stomach still attached to small intestine
• still post surgery diet requirements
• least amount of nutrient lost

• death
• lung problems
• infection
• heart complicatin
• leaks in GI
• blood clots
• post op ulcers
• obstruction and strictures

• wound infection
• dificiency anemia
• dumping sydrome
• blood colt
• walking blood thiners
• bowel obstruction

• respiratory problems biggest risk
• anastomotic leak

• Possible causes leakage
• uncontrolled pain
• hypervolemia
• hemorrahage

• primary cause of motrality after bariactric surgery
• early ambulation necessary
• stenosis

• narrowing bleeding at anastomosis
• rature or leakage from staple lines

• vitamin B12 deficiencies
• iron anemia
• hypoalbuminemia
• ulcer at the gastrojen
• bile reflux

at the site of the stomach or intestinal anastomosis or acid peptic ulcer in non functional large stomach pouch

related to rapid weight loss more than surgery

• most common cuases of morbidity after gastric surgery
• abnomality
• fatality
• gastriontestinal and vasomotor symptoms
• postprandial fullness
• crampy abdomonal pain
• nausea
• vomiting
• explosive diarrhea

• sweating
• diaphoresis
• weakness
• dizziness
• flushing
• palpitations
• intense desir to lie down

• starts 10-30 minutes after ingestion of a meal
• gastrointestinal and vasomoter compaints

• 2-3 hours postprandially
• mainly vasomotor response

• increase complex carbs
• increase dietary protein
• eat small frequent meals
• eat dry meals , liquids on half hour after meal
• avoid simple sugars
• add fiber to diet

• in bypass operationthe fat obsorbing intestine is bypassed, this leads to malbsorption
• high fat meal cause diarrhea
• explosive and fouls smelling can last
• best to aboid high fat or greasy foods

• eat healthy manner, snacking
• adequat fluid intake
• take the multiple vitamin/mineral

• several phases
• phase 1 liquids only
• phase 2 soft or puree foods
• phase 2 and 4 normal foods
• varies in physician

• 6 meals daily eat every 2-3 hours
• clear liquid 1-2 days after
• blended diet 2 weeks 1 month
• soft diet: 1 month 2 months
• solid diet 2 months
• meat size of pencil erasers

• 30 minuts before and afgter meals
• limit soups, yougart
• limit caffein due to dehydtation
• avoid carbonated beverages discomfort
• stop eating and drinking when feelings of fullness occur
• avoid food with more than 2 gm sugar alcohol

• increased energy
• less fatique
• improvements inbody image and self esteem
• emphasize walking and sweimming
• more otion available as weigh decreases

• 50% considered successful
• is the best treatment for morbility obese
• measured by weight loss and improvement of obesity related medical disorders

• possible leaks from first
• hernias are most common
• plastic surgery for excessive skin