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Health PSYCHOLOGY. E ating, N utrition, W eight management, and O besity. “[People] dig their graves with their own teeth and die more by those fatal instruments than the weapons of their enemies.” -- Thomas Moffett, 1600. Food and Wellness (Psychological and Physical).

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Health psychology
Health PSYCHOLOGY

Eating, Nutrition, Weight management, and Obesity


Health psychology

“[People] dig their graves with their own teeth and die more by those fatal instruments than the weapons of their enemies.”

-- Thomas Moffett, 1600


Food and wellness psychological and physical
Food and Wellness more by those fatal instruments than the weapons of their enemies.”(Psychological and Physical)

  • “What to eat” (M. Nestle)

  • “Positive eating”

  • “In defense of food” (M. Pollan)

  • USDA’s MY Pyramid vs. Healthy Eating Pyramid (Harvard)

  • Slow food, fast food, no food, ???

WHAT’S A PERSON TO DO??!!!


Food and wellness psychological and physical1
Food and Wellness more by those fatal instruments than the weapons of their enemies.”(Psychological and Physical)

  • Nutrition and Wellness

    • Eating to feel well (as opposed to simply getting calories) -- mens sana in corpore sano

      • Eating for psychological and physiological wellness

      • Eating for disease prevention

      • Eating for _________________ (lots of reasons)


What we eat
What we eat more by those fatal instruments than the weapons of their enemies.”

  • Macronutrients

    • Carbohydrates

    • Fats

    • Proteins

  • Micronutrients

    • Vitamins

    • Minerals

    • Phytochemicals


What we eat1
What we eat more by those fatal instruments than the weapons of their enemies.”

  • Vitamins

    • 13 known vitamins, classified as either fat-soluble (A, D, E, K) or water-soluble (B and C)

    • C & E are antioxidants

  • Minerals

    • Inorganic elements (e.g., calcium -- for muscle contractions, nerve transmission)

  • Phytochemicals

    • Bioactive chemicals found in plants (e.g., sterols, flavonoids, beta-carotene) with potential health-promoting qualities (e.g., anti-oxidant activity)


How we eat
How we eat more by those fatal instruments than the weapons of their enemies.”

Michael Pollan NYTimes article(quiz)

  • Eat food

  • Mostly plants

  • Not too much


Weight management
Weight Management more by those fatal instruments than the weapons of their enemies.”

  • Caloric needs

    • Vary by age, sex, height, weight, activity level, & basal metabolic rate (BMR)

    • Rough guideline (men = 2500 kcal, women = 2000 kcal)

  • Regular physical activity


Health psychology

ENERGY IN more by those fatal instruments than the weapons of their enemies.”

ENERGY OUT

BODY MASS

GENES


Assessing body composition
Assessing body composition more by those fatal instruments than the weapons of their enemies.”

  • Bioelectrical impedance — determining body fat percentage by analyzing electrical resistance (fat is a poor conductor)

  • Hydrostatic weighing — comparing underwater weight with dry weight

  • Body mass index (BMI) – calculating a ratio of height to weight


Calculating bmi
Calculating BMI more by those fatal instruments than the weapons of their enemies.”

http://www.nhlbisupport.com/bmi/

BMI Categories:

  • Underweight = <18.5

  • Normal weight = 18.5-24.9

  • Overweight = 25-29.9

  • Obesity = BMI of 30 or greater


When we eat too much or move too little
When we eat too much… more by those fatal instruments than the weapons of their enemies.”or move too little

  • Obesity (particularly “apple-pattern”) linked to atherosclerosis, hypertension, diabetes

  • Increased risk of several cancers, sleep disturbances, degenerative joint disease

  • Impact on psychological well-being

  • Increased mortality rates (next slide)


Relationship between bmi and mortality
Relationship between BMI and Mortality more by those fatal instruments than the weapons of their enemies.”


Factors that contribute to obesity
Factors That Contribute more by those fatal instruments than the weapons of their enemies.”to Obesity

  • Heredity / biological factors

  • Cultural factors

  • Emotional / behavioral factors


Hypothalamus and eating
Hypothalamus and eating more by those fatal instruments than the weapons of their enemies.”

  • Lateral Hypothalamus (LH)

    • Stimulation leads to hunger

    • Lesioning leads to self-starvation

  • Ventromedial Hypothalamus (VMH)

    • VMH lesioning leads to hunger

    • VMH stimulation causes an animal to stop eating


Metabolism and weight
Metabolism and weight more by those fatal instruments than the weapons of their enemies.”

  • Basal Metabolic Rate (BMR)

    • base rate of energy expenditure

    • influenced by heredity, age, activity level, and body composition (fat tissue has a lower metabolic rate)

  • Set Point

    • the point at which an individual’s “weight thermostat” is supposedly set

    • when the body falls below this weight, an increase in hunger and a lowered metabolic rate may act to restore the lost weight


Is it genetic
“Is it genetic?” more by those fatal instruments than the weapons of their enemies.”

  • ob gene

    • Regulates production of leptin

    • Leptin is secreted by fat cells and has dual activity of decreasing food intake and increasing metabolic rate

    • Mice born without the ability to make leptin (ob/ob mice) eat without restraint


Health psychology

ob/ob mouse more by those fatal instruments than the weapons of their enemies.”

normal mice


Health psychology

ob/ob mouse more by those fatal instruments than the weapons of their enemies.”


Health psychology

ob/ob mouse more by those fatal instruments than the weapons of their enemies.”

ob/ob mouse

injected with

leptin


So just give obese humans leptin
So, just give obese more by those fatal instruments than the weapons of their enemies.”humans leptin!!!

  • In fact, this works in leptin-deficient humans, but…

  • 99.99% of obese humans have HIGH levels of leptin, but have become insensitive to it.


Hereditary factors
Hereditary factors more by those fatal instruments than the weapons of their enemies.”

  • The genetic contribution to body weight is estimated to be between 40 and 70 percent (with some rare cases of severe obesity linked to specific gene errors)

  • Body weights of adopted children correlate more strongly with weights of biological parents

  • The epigenetics of increasing weight through the generations (“One hypothesis is that maternal obesity before and during pregnancy affects the establishment of body weight regulatory mechanisms in her baby. Maternal obesity could promote obesity in the next generation." (Waterland, 2008)


Obesity trends
Obesity Trends more by those fatal instruments than the weapons of their enemies.”

  • http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/index.htm

  • Go to other PP slide show

  • Will the trend continue?

    “Most adults in the U.S. will be overweight or obese by 2030, with related health care spending projected to be as much as $956.9 billion, according to researchers at Johns Hopkins (July 2008, online issue of Obesity).


Obesity trends1
Obesity Trends more by those fatal instruments than the weapons of their enemies.”

Why?


Factors that contribute to obesity1
Factors That Contribute more by those fatal instruments than the weapons of their enemies.”to Obesity

  • Heredity / biological factors

  • Cultural factors

  • Emotional / behavioral factors


Health psychology

10,000 years ago – more by those fatal instruments than the weapons of their enemies.”

who survived during a famine?


Health psychology

ENERGY IN more by those fatal instruments than the weapons of their enemies.”

ENERGY OUT

Increase in

availability of

high density foods

(sugar/fat are cheap)

Increase in size

Decrease in cost

Decrease in work-

related activities

Decrease in activity

of daily living

BODY MASS

Genetic predisposition to store fat


Health psychology

Just as more by those fatal instruments than the weapons of their enemies.”

our jeans no longer fit our waist,

our genes no longer fit our environment


Social cultural factors in obesity
Social/Cultural Factors more by those fatal instruments than the weapons of their enemies.”in Obesity

We live in a toxic environment. It’s like trying to treat an alcoholic in a town where there’s a bar every ten feet. Bad food is cheap, heavily promoted, and engineered to taste good. Healthy food is hard to get, not promoted, and expensive.

If you came down from Mars and saw all this, what else would you predict except an obesity epidemic?

Kelly Brownell, Yale, 2004 (Nat’l Geo. Article: The heavy cost of fat)


Social cultural factors in obesity1
Social/Cultural Factors more by those fatal instruments than the weapons of their enemies.”in Obesity

  • Food-toxic environment (cheap, hi-cal, lo-quality food available)

    • Absence of supermarkets in lo-income neighborhoods

    • Way too many of our calories are coming from junk food (and in the car). (Sugar: 172 lbs/pp per year)

    • Governmental contribution (ABC News video): dependence on Zea Mays (a giant tropical grass)

    • We are simply eating more! (next slide)


Health psychology

Humongasize it!! more by those fatal instruments than the weapons of their enemies.”

Past Today

French Fries 2.4 oz 7 oz

210 kcal 610 kcal

(1955)

Soda 6.5 oz 20.0 oz

79 kcal 250 kcal

(1916)

Hershey’s Bar 2 oz 7 oz

300 kcal 1000 kcal

(1900)


Popcorn
POPCORN more by those fatal instruments than the weapons of their enemies.”

20 Years Ago

Today

270 calories

5 cups

1700 calories21 cups buttered


Social cultural factors in obesity2
Social/Cultural Factors more by those fatal instruments than the weapons of their enemies.”in Obesity

  • Pounds consumed per person

    • 1970 – 1,497 lbs.

    • 2000 – 1,775 lbs.

  • 2004: The "Monster Thickburger" — two 1/3-pound slabs of Angus beef, four strips of bacon, three slices of cheese and mayonnaise on a buttered sesame seed bun

  • 1420 calories!


Social cultural factors in obesity3
Social/Cultural Factors more by those fatal instruments than the weapons of their enemies.”in Obesity

  • Cultural variation in ideal body image (overemphasis on thinness  yo-yo dieting and eventual weight gain)

  • Japanese-American men are 3 times as likely to be obese as men living in Japan

  • Pima Indians (next slide)


Social cultural factors in obesity4
Social/Cultural Factors more by those fatal instruments than the weapons of their enemies.”in Obesity

Pima Indians (in Mexico vs. in U.S.)


Emotional behavioral factors
Emotional / behavioral factors more by those fatal instruments than the weapons of their enemies.”

  • Disinhibition— overeating triggered by an event, emotion, or behavior

  • Eating used as coping

  • Internality / Externality hypothesis

    • Sensitivity to cues

    • Overweight people often more sensitive to external:

      • Time of day

      • Commercials

      • “Golden arches”


Dieting concerns
Dieting concerns more by those fatal instruments than the weapons of their enemies.”

  • Dieting

    • In U.S., 72% of women and 44% of men have dieted at some point in their adult lives

    • Yo-yo dieting associated with progressive wt gain

    • Chronic dieting influence BMR negatively

    • Fad diets and health problems

    • Trend is improving, with fewer people on “diets” these days


Healthy weight loss
Healthy Weight Loss more by those fatal instruments than the weapons of their enemies.”

  • Cognitive-behavioral program

    • Goal-setting, monitoring, social support

    • L.E.A.N.

      • Lifestyle changes (stimulus control, self-monitoring, speed, etc.)

      • Exercise

      • Attitude

      • Nutrition


Stepped care for obesity
Stepped Care for Obesity more by those fatal instruments than the weapons of their enemies.”