Eating Disorders PDF

Eating Disorders Define Disordered Eating ○ Unhealthy eating behaviors and worries about food and body image Define Eating Disorders ○ Extreme cases of disordered eating ○ Based upon specific criteria related to body weight and eating behaviors Define Body Image ○ Perso...

Eating Disorders Define Disordered Eating ○ Unhealthy eating behaviors and worries about food and body image Define Eating Disorders ○ Extreme cases of disordered eating ○ Based upon specific criteria related to body weight and eating behaviors Define Body Image ○ Person’s perception and feelings about his or her’s body’s appearance and functioning Can be negative or positive, or both Influence by individual and environmental factors Can play a role in developing eating disorders and disordered eating patterns Understand the difference between disordered eating and an eating disorder. What do they have in common? What differences do they have? ○ Disordered eating Chronic dieting Restrictive eating Binge eating Food avoidance unhealthy eating patterns Food addiction Over exercising to control weight Differences: Degree of severity, this can be less frequency or severity then eating disorder  ○ Eating disorders a psychiatric condition that involves extreme body dissatisfaction and long term eating patterns that negatively affect body functioning diagnosed by a medical professional Using specific criteria related to body weight and eating behavior DSM-5 Diagnosis ○ A manual that is used for assessment and diagnosis for mental health disorders by doctors or mental health professionals Influenced by many factors including genetics, temperament, and environment Define common triggers for disordered eating patterns. How frequently do they occur? ○ Cultural obsession with being thin or healthy ○ aka diet culture Refers to a rigid set of expectations about valuing thinness and attractiveness over physical health and emotional well being Emphasizes good versus bad foods, focuses on calorie restriction, and normalizes self deprecating talk What role does exercise play in disordered eating & eating disorders? Define body image. What role does it play in disordered eating and eating disorders? ○ a person’s perception and feelings about his or her’s body appearance and functioning  Can be negative or positive, or both Influence by individual and environmental factors Factors ○ Early life experience of our parents mentioning how body should look ○ Internal elements moods and emotions ○ Cultural and social factors Can play a role in developing eating disorders and disordered eating patterns a person’s body image strongly influences their behavior Define the commonly known eating disorders as discussed in lecture ○ anorexia nervosa Restrictive eating disorder that leads to severe weight loss due to one’s own judgment of weight being too large Self starvation ○ Bulimia nervosa Repeated episodes of binge eating and purging to maintain body weight ○ Binge eating disorders Recurring episodes of eating significant amounts in a short period of time that most people ○ AFRID (avoidant/restrictive food intake disorder) Eating disturbances manifested by persistent failure to meet appropriate nutritional needs ○ OSFED (other specified feeding or eating disorders) Subacute cases of anorexia nervosa or bulimia nervosa ○ Orthorexia Obsessive behavior to pursue a healthy lifestyle with food restrictions that might not be necessary  What is the etiology of eating disorders? ○ Risk factors Dieting Early childhood eating and GI problems Increased concern about weight and size Negative self evaluation Sexual abuse Other traumas ○ Precipitating factors Onset of puberty Parents divorce Death of a family member Ridicule of weight ○ Other mental health issues Depression Anxiety Substance abuse Body dysmorphic disorder ○ Coping mechanism Managing uncomfortable or painful emotions ○ Non discriminating All genders Ages Abilities Races Ethnicities Body shapes Weights Sexual orientations socioeconomic status ○ Not always visible Someone may look healthy, yet may be extremely ill  Define body dysmorphic disorder and describe it role in eating disorders ○ A mental disorder in which you can’t stop thinking about one or more perceived defects or flaws in your appearance Understand the characteristics and health risks of anorexia nervosa, bulimia nervosa, binge eating disorder ○ Anorexia nervosa Characteristics Restrictive eating patterns Intense fear of weight gain Distorted body image of being “too big” Health risk Deficiency in total calories and eating behaviors Body uses fat storage and lean tissue for energy Reduction in non vital bodily functions Electrolyte imbalances Late stages associated with increased risk for organ failure 10-20% mortality rate Signs and Symptoms Eliminating food groups, limiting intake Deficiencies of essential nutrients that can become life threatening Intense fear of weight gain Distorted body image Amenorrhea ○ Loss of menstrual cycle for 3 months or more Approximately 90% female, 1-2% of the population ○ Bulimia nervosa Characteristics Binge eating in a discrete amount of time, followed by purging purging - compensatory behavior to prevent weight gain ○ Vomiting ○ Laxatives  ○ Diuretics ○ Diet or weight loss medication ○ Fasting ○ Excessive exercise Large amount of food Recurrent episodes of binge eating Recurrent inappropriate compensatory behaviors to prevent weight gain Health risk Organ problems 80% are females, 3-5% of the population Signs and symptoms recurrent episodes of binge eating Recurrent inappropriate compensatory behavior in order to prevent weight gain Chronically inflamed and sore throat Swollen glands in the neck and jaw Worn tooth enamel Health Risks electrolyte imbalance Dental problems Kidney problems GI problems common on all eating disorders ○ Binge Eating Disorder Recurring episodes of eating significant amounts of food in a short period of time than most people would eat Episodes marked by feelings of lack of control Differs from common overeating More severe Subjective distress, physical, and physiological problems Focus of treatment Normalizing eating behaviors and focusing on satiety cues Understand the primary goals of nutrition therapy for each eating disorder type ○ Anorexia Nervosa  Nutrition therapy Prevent further weight loss Gradually reestablish normal eating behavior Gradually increase weight ○ Very slowly increase the amount of food because they are at risk for refeeding syndrome ○ Refeeding syndrome is life threatening Need to teach the body to receive nutrients slowly Maintain agreed on weight goal ○ Bulimia nervosa Tend to have fewer serious medical complications Nutritional counseling focuses on identifying and correcting food misinformation and fears Interrupting the binge/purge cycle Diet with adequate fat and fiber so person can feel full Ensure adequate calories for weight maintenance What is ARFID and what are its characteristics? What group does it impact most? ○ ARFID (avoidant/ restrictive food intake disorder) Eating or feeding disturbance as manifested by persistent failure to meet appropriate nutritional needs Impacts children, boys may be higher risk, kids on the spectrum Often related to fears around food ○ Choking ○ Vomiting ○ GI pain ○ Sensory issues Leads to extreme food restriction, malnutrition, weight loss, and apathy towards food Does not include body image disturbance Not explained by lack of available food or attributes to a medical disorders  Eat very high processed foods ○ Pizza ○ Fries ○ Chips Low desire to eat Skip meals Under eating What is OSFED and what types of disorders are associated with it?Define orthorexia, is characteristics and what groups are most impacted by this disorder ○ OSFED ( other specified feeding or eating disorders) Represents Subacute cases of anorexia nervosa or bulimia nervosa Food disorders that don’t fall into the typical diagnostic categories for standard eating disorders Examples Atypical anorexia nervosa Atypical bulimia nervosa Purging disorder Night eating syndrome Chewing and spitting behaviors Orthorexia ○ Condition that includes symptoms of obsessive behavior in pursuit of a healthy diet ○ Often displays signs and symptoms of anxiety disorders that co-occur with anorexia nervosa or other eating disorders ○ Addicted to health ○ Can begin with legitimate medical diagnosis but goes too far  For example: if a patient has a medical diagnosis and they start removing certain types of food can lead to malnutrition Nutrition for Older Adults Understand the physiological changes that occur with age that affect nutrition status. Know the categories of changes and specific examples. ○ BMR decreases Rate at which we burn calories Gaining more weight Loss of bone mass and muscle mass Decrease in general physical activity ○ Oral cavity issues Teeth decay Missing teeth Difficult for them to eat raw fibrous foods Hard to chew ○ GI issues Increase in constipation Decrease in peristalsis and muscle tone Less fiber We make less hydrochloric acid and this is needed to break down protein ○ Helps absorb B12, iron, and calcium Less digestive enzymes Glucose tolerance declines  Synthesizing vitamin D declines CNS Slows down Memory impacted ○ Kidney issues Kidney works harder Difficult to concentrate urine Sodium is not able to clear as well Blood pressure increases ○ Sensory losses Vision and hearing declines Loss of taste or sense of smell ○ Other changes Mobility declines This can have a negative impact on nutrition How do nutritional needs (calories, protein, micronutrients, fluid) change with aging? ○ Calories decrease with age Have less metabolic energy to eat as much Micronutrients stay the same ○ Protein increase to 1.0-1.2 gm/kg/day Increased protein intake accounting for 8% muscle mass loss Able to break down less protein due to decreased amount of HCL in stomach ○ Fluid higher risk for dehydration Multiple medication to create sense of thirst and change muscle in bladder tone to make urination more frequent and inconvenient ○ Vitamins and mineral don’t change with age Exceptions Calcium Vitamin D Iron Sodium decreases  Blood pressure increases with age to combat hypertension Vitamin b12 deficiency With HCL being not as available vitamin b12 can’t be absorbed as much ○ Needs to be supplemented Why does nutrient density become more important for older people?Which vitamins and minerals are of concern for older people? ○ Focus on adequate calories with appropriate levels of macronutrients ○ Maintain nutrient density to prevent deficiencies in micronutrients, supplement when necessary ○ Support digestion and absorption ○ Adaptable meal structure small frequent meals vs 3 meals per day ○ Lots of fluids Prone to dehydration ○ Vitamins and minerals are of concern Calcium Vitamin D Iron Sodium Vitamin B12 Know the MyPlate recommendations for older adults, and which foods older adults tend to eat less of and why. ○ ○ Simple and easy to prepare ○ Nutrient dense foods ○ Affordable ○ More convenient oriented foods Canned foods Eat less of sodium use herbs and spices in place of salt ○ Due to hypertension Frozen foods  Packaged foods ○ Fluids is emphasized To avoid dehydration ○ Ample amounts of protein Nutrition related concerns in older adults ○ Alzheimer's disease and cognitive decline ○ Malnutrition ○ Obesity ○ Frailty ○ sarcopenia What is frailty and how can it impact nutrition and health status in older adults? ○ Diminished strength, endurance, and physiologic function that increase an individual’s vulnerability for developing dependency ○ They become more vulnerable and dependent on others Challenging to not being able to get adequate nutrition They don’t have control over their diet What is sarcopenia and how does it impact older adults? What is the nutrition approach to managing this disease state? ○ Extreme loss of muscle mass, strength and function that occurs with age Related to sedentary lifestyle and less than optimal diet Commonly seen in 50% of people in the age of >75 yrs old Increasing protein intake can be helpful to maintain muscle mass 1.0-1.2 g/kg for older adult to offset loss of muscle mass What does a nutritional approach to osteoporosis & osteopenia look like in older adults? ○ Osteopenia Low bone mass ○ Osteoporosis Extreme loss of bone mass Skeletal frame vulnerable to break Risk factors ○ Low body weight ○ Petite frame  ○ Low muscle mass ○ Female lose estrogen during menopause this keeps bones strong and dense Nutrition therapy ○ Calcium, vitamin D, and K2 supplementation Vitamin D and Vitamin K help to get calcium into the bone ○ Other bone minerals Phosphorous Zinc Magnesium boron Collagen Made up of proteins and found in hair, skin, nails, soft tissues, and bones Collagen is like the glue that holds all these minerals together ○ Adequate amount of protein 1.0-1.2 g/kg for older adults like taking ensure or making your own protein shake ○ weight bearing and weight resistance exercise to maintain bone strength Review the screening criteria for malnutrition in older adults. What questions can you ask an older patient to assess their nutrition status? ○ Nurses do the malnutrition screening ○ we should ask, “have you gained or lost weight in the past 6 months?” If this is a yes this is a red flag ○ by assessing this can help an older adult to avoid a malnutrition ○ medications 51% of older adult are using 5 or more medications this is known as polypharmacy polypharmacy  cause dry mouth changes in taste and smell GI upset PPIs ○ nutrient deficiency decrease stomach acid lower B12, iron, and calcium Statin ○ significantly reduce CoQ10 which is needed for the heart vitamin D calcium potassium BP medications ○ reduce all of the electrolytes magnesium calcium potassium Metformin ○ reduces B12 Goals of nutrition intervention A care plan is created we want to maintain or restore health with adequate nutrition increase in protein putting them on multivitamin suggest foods that are affordable, convenient, and accessible maintain the client’s sense of dignity and imposing less restrictive Weight, Energy Science & Health at Every Size Understand the characteristics of healthful body weight Nutrition science  ○ macronutrients contain calories that the body uses for energy carbohydrates fat protein ○ micronutrients iron vitamin A vitamin D helps the body absorb calcium, fight infection, and move muscles vitamin E vitamin K helps with blood clotting and bone health food quality ○ different types of foods contain different nutrient levels, some foods may benefit, some food may not chronic disease ○ overconsumption of poor quality nutrients can contribute to chronic disease states Know the three components that contribute to total energy expenditure (Basal Metabolic Rate, Thermic Effect of Food and physical activity) What influences each of these? What percentage of each is used by the body? BMR-Basal Metabolic Rate ○ represents the rate at which the body expends energy to sustain basic life processes, respiration, heartbeat, blood circulation, etc.. 60-75% of total energy expenditure more lean tissue increases your BMR BMR decreases with age, 3-5% per decade after age 30 ○ factors affecting BMR increase BMR higher lean body mass greater height younger age elevated levels of thyroid hormones  stress, fever, illness male gender pregnancy and lactation certain drugs ○ stimulants ○ caffeine ○ tobacco decrease BMR lower lean body mass lower height older age depressed levels of thyroid hormones starvation, fasting, or very low calorie diets female gender due to decreased lean tissue Thermic Effect of Food ○ represents the increase in energy expenditure associated with the body’s processing of food digestion absorption transport metabolism storage of energy from ingested food 10% of TEE smallest % of energy expenditure Physical Activity- energy expenditure ○ Exercise Activity Thermogenesis this is the calories we burn in physical activity ○ Non Exercise Activity Thermogenesis this is the calories we burn in daily movement including walking, standing, household activities, fidgeting, remaining postural, etc.. ○ energy expenditure is the most variable of components and the only component that is easily altered ○ account for 15-30 % of TEE ○ can be considerably less in an inactive person and considerably more in an active person  ○ Total Energy Expenditure What is BMI? What data points are measured in BMI? What are the limitations of BMI as an evaluation method for body weight (you will not need to calculate BMI) BMI- Body Mass Index ○ expresses the ratio of a person’s weight to the square of his or her height ○ BMI= weight in kilograms/ height m2 underweight is defined as BMI ○ 25 obesity is defined as BMI ○ >30 BMI values below 18.5 or above 30 are associated with risks of health problems BMI has flaws ○ results are distorted in people with high muscle mass (athlete) ○ less reliable for older people certain ethnic groups What tools are used to measure body composition? Body composition ○ measurement of body fat and lean body mass not a measurement of BMI ○ Can be measured underwater weighing skinfold measurements bioelectrical impedance analysis dual energy X-ray absorptiometry (DEXA) gold standard Bod Pod gold standard Know the fat distribution pattern associated with risk of chronic disease. What are its limitations and why? -What might be a better tool than fat distribution patterns to assess health risk? Fat distribution pattern ○ measured by waist to hip ratio and waist circumference ○ disease risk is associated with a waist to hip ratio of higher than 0.90 in men and 0.80 in women body shape fat distribution ○ apple shaped fat patterning- mid body increased risk of chronic diseases type 2 diabetes heart disease hypertension ○ pear shaped fat patterning-lower body some studies show less risk of chronic diseases ○ Body shape comparisons don’t indicate health risks Liver fat is better indicator Insulin resistance, cholesterol abnormalities, and cardiovascular problems ○ Fatty liver is more reliable indicator of health risk Identify factors that contribute to maintenance of body weight; gaining or losing weight Energy intake versus energy expenditure genetic factors composition of the diet metabolic factors physiologic factors cultural and economic factors social factors emotional factors How do our genes impact weight? Body shape and size has a strong influence genetic component more than 127 genes are associated with body weight twin studies in response to overfeeding or energy restriction have shown that some twin pairs lost weight or gained weight more easily than others genetic factors are estimated to account for 40-90% of the population variation in BMI Define the common genetic factor theories as discussed in lecture and explain how they impact weight (FTO gene, set point theory, thrifty gene theory) FTO gene ○ fat mass and obesity-associated gene ○ we now have isolated several genes that are associated with obesity Set point theory ○ proposes that each person’s weight stays within a small range Thrifty gene theory ○ proposes that a gene or genes causes people to be energetically thrifty What hormones impact hunger? What is its role in weight? Hormones play a strong role in weight and metabolism ○ hormones are chemical messengers that affect many processes including growth and development sexual function and reproduction mood metabolism ○ numerous hormones play a role in weight TSH Insulin suppresses hunger insulin resistance can lead to increased feeling of hunger increased fat storage Sex hormones  Cortisol Leptin satiety (Fullness) hormone when it is high you experience fullness and stop eating produced in our fat cells as body fat decreases leptin is reduced so appetite increases as body fat level increases leptin levels increase so appetite is reduced leptin keeps hunger and weight in balance when working properly leptin resistance ○ the body’s inability to properly respond to leptin plays a role in overeating and obesity ○ causes high stress poor sleep overeating high insulin and triglycerides processed foods, sugar, and HFCS toxins yo-yo dieting too little or too much exercise excessive snacking Ghrelin hunger hormone produced by the stomach and duodenum secretions increases between meals when the stomach is empty high levels of ghrelin make us feel hungry returns to normal after eating How do economic and social & cultural factors impact weight? Cultural and economic factors ○ Cultural customs and beliefs ○ changes in work and leisure activity levels ○ cultural norms related to body size ○ lack of health literacy ○ food environment ○ lack of access to affordable, healthful foods Social Factors ○ expectations of family and friends ○ holiday foods, fast foods, and serving sizes ○ television and other sedentary activities ○ work responsibilities ○ media images and social pressures to achieve unrealistic weight goals ○ feelings/emotions ○ trauma addiction, body image issues, chronic dieting, disconnection from the body, inability to feel body cues ○ social factors can override physical hunger/ satiety impacting weight What are the most common approaches to weight loss? Calorie reduction ○ aka “dieting” ○ most common approach to weight loss ○ often focused on limiting calories and may or may not focus on nutrient quality ○ examples keto atkins jenny craig weight watchers vegan low fat paleo  south beach Fad Diets ○ claims rapid weight loss ○ eliminates or severely restricts entire food groups/categories of food ○ requires the purchase of a product ○ involves restrictive calorie counting and/or counting of macronutrients ○ claims to new discovery, secret, or undiagnosed illness ○ may be promoted by a celebrity/ doctor ○ few people stick with fad diets long enough to harm themselves ○ results tend to be short term Pharmacotherapy ○ use of prescription medication to aid in weight loss ○ recommended for people with BMI >30 ○ recommended for people with BMI >27 with comorbid conditions ○ people with waist circumference >35 inches women and 40 inches men are also candidates for pharmacotherapy if comorbidities are present ○ FDA approved Alli Phentermine GPL-1 Wegovy Ozempic Contrave Surgery ○ Bariatric Surgery What are the most common outcomes of diets? Dieters usually lose weight in the short term 6-12 months long term 2-5 years that vast majority of dieters gain the weight back estimates are 95% of people who diet gain back all or more weight within 5 years researchers determined that most would be better off not going on diet at all Why do people have a hard time keeping weight off in the long run? What mechanisms within the body interfere with people's ability to keep weight off long term? Calorie deprivation leads to changes in hormones, metabolism and cognitive functions that make it difficult to enact the behaviors needed to keep weight off Recognize characteristics of fad diets Claim new discovery, secret, or undiagnosed illness Claim rapid weight loss Eliminates or restricts certain food groups Requires the purchase of specific products may be promoted by celebrity or doctor Identify types of bariatric surgery Surgery to reduce the capacity of the stomach or creating malabsorption of nutrients ○ sleeve gastrectomy staple the stomach and cause malabsorption ○ gastric bypass most restrictive and most complications where you reroute stomach to smaller section ○ gastric sleeve most flexible and least amount of death risk of a band over certain part of the stomach Which are restrictive and which lead to malabsorption Sleeve gastrectomy and gastric bypass are restrictive Can lead to malabsorption What is weight cycling? What are its impacts on the body? Attempts to lose weight typically result in weight cycling a decrease in weight followed by an increase in weight Is more common among obese individuals Results in increased inflammation which in turn increases the risk of many “obesity associated diseases Linked to ○ cardiovascular disease ○ stroke ○ diabetes ○ altered immune function may be as or more dangerous than obesity What are long term diet implications? Gain back the weight in the long run ○ results in increased inflammation leads to increase risk of “obesity associated” What is HAES and what are the principles of the HAES theory Health at Every Size supports people in adopting health habits for the sake of healthy and well being rather than weight control ○ encourages eating in flexible manner that is pleasurable and satiates hunger and appetite find joy in one’s own body and becoming more physically vital accepting and respecting natural diversity of body sizes and shapes ○ research shows that weight loss programs aren’t effective and cause harm focus on what increases health and longevity targeting people for intervention  ○ reduce stigma against people of size; stigma can contribute to health risks What is weight stigma? How does weight stigma impact patients in the healthcare setting? Internalized negative attitudes about weight, increases the risk of ○ hypertension ○ diabetes ○ hyperlipidemia ○ metabolic syndrome ○ eating disorders ○ depression In healthcare ○ larger bodied people may not be able to get the healthcare they need because practitioners may be more focused on influencing their patients to lose weight they don’t focus on addressing their current concerns due to blaming weight ○ patients may feel shame and embarrassment about their weight ○ they may avoid regular medical care due to weight stigma, worsening their health conditions What does a HAES approach look like in a health care setting? Practitioners don’t weigh patients unless medically necessary may not calculate BMI don’t advocate for weight loss interventions ○ creating healthier patterns around food ○ promoting movement ○ treating specific health concerns ○ a do no harm approach ○ discussing behaviors vs body size ○ compassionate and respectful care for all  Food Insecurity & Public Health What is food insecurity and what are the two primary types Food insecurity is household inability to provide enough food for every person to live an active healthy life ○ lack of food ○ lack of healthy and nutritious food in sufficient and safe quantities What is the cycle of food insecurity and chronic disease Food insecurity drives chronic disease chronic disease drives further food insecurity which leads back to more food insecurity that causes disease ○ cyclical How does food insecurity affect adults? Children? Adults ○ cancer ○ heart disease ○ diabetes ○ functional limitations ○ hyperlipidemia ○ hypertension ○ obesity children ○ behavioral or social emotional problems ○ poorer developmental outcomes ○ iron deficiency anemia ○ frequent stomach problems ○ headache  ○ poorer educational performance and academic outcome ○ lower overall health related quality of life What are the social determinants of health and their role in disease? Conditions in which people are born, grow, live, work, and age that shape health ○ socioeconomic status ○ education ○ neighborhood ○ physical environment ○ employment ○ social support networks ○ access to health care a lot is based on the area that you live, not about willpower, money, etc.. addressing social determinants ○ improve health and reduce longstanding disparities in healthcare address overlapping challenges posed by social determinants of health What is the Food Environment and how does it impact our food choices?What does the food environment in the US look like? Where you live impacts what you eat Define food dessert, food swamp & oasis? Why do they occur? Food Desert ○ characterized as geographic areas where people lack access to affordable fresh and healthful food ○ rural, suburban or urban, minority, and low income areas often at risk ○ 23 million Americans live in food deserts ○ the relationship between location and food access is complex  ○ socioeconomic factors influence dietary quality and local food environment also plays a role convenience foods are often cheaper than fresh food fresh food selections may be poor or not culturally appropriate ○ unhealthy food is economically cheaper in the short term but translates to higher health costs in the long term Food Oasis ○ higher access to supermarkets and shops Food Swamp ○ overabundance of cheap food options ○ people’s choices about what to eat are severely limited by the options available to them and what they can afford What are signs of poor food quality in children? 11.4 % of children have ADD/ADHD 1 in 5 children are obese 1 in 5 adolescents has prediabetes 50% of schools has fast food served in cafeterias nearly 20% of calories for ages 12 to 18 comes from fast food, versus just 6.5 percent in the late 70s being underweight, overweight or obese constipation or changes in bowel habits being pale or lethargic tooth decay poor physical growth behavioural problems sleep issues problems with emotional and psychological development poor concentration or difficulties at school How does processed food impact our behavior? What is the role of processed food in disease? Understand common reasons for food processing. When might it be beneficial? When might it be harmful and why? What is ultra processed food and its primary characteristics?How does it impact the body? Ultra processed foods ○ Designed to be convenient and hyperpalatable and contain low cost ingredients that translate into bigger profits for food companies Made from substances extracted from foods and contain additives Example ○ Artificial colors ○ Stabilizers ○ fats ○ starches ○ added sugars Contain unevenly high ratio of calories to nutrients Understand the primary reasons why people choose processed food Cheap price easily accessible easy to prepare advertising biology of who we are food engineering to make us addicted to foods Define food engineering and describe how it impacts brain function and peoples choices around food. Food that is engineered to be more palatable as well as enticing as possible ○ sugars used can stimulate the brain’s reward centers through dopamine like other addictive substances  ○ PET scans show that high sugar and high fat foods work like heroin, opium, or morphine in the brain show that obese people and drug addicts have lower number of dopamine receptors this makes them more likely to crave things that boost dopamine stimulate release of body’s own opioids like morphine in the brain What role does food engineering play in weight and weight maintenance? Scientists create enhanced flavor profiles using highly palatable chemical additives terms like “mouth feel,” “maximum bite force,” “vanishing density,” “sensory specific satiety,” are used to rate the varying level of appeal highly palatable flavors keep us “engaged longer” with processed foods ○ we eat more There is NO DSM-5 diagnosis for food addiction Is Food Addicting Drugs used to block the brain’s receptors for opioids Naltrexone also reduce the consumption and preference for sweet, high fat foods in both normal weight and obese binge eaters People develop a tolerance to sugar. They need more and more of the substance to satisfy themselves obese individuals continue to eat large amounts of unhealthy foods despite severe social and personal negative consequences animals and humans experience “withdrawal” when suddenly cut off from sugar just like drugs after an initial period of enjoyment of the food the user no longer consumes them to get high, but to feel normal What is sugar's role in brain chemistry? Can have addictive properties that stimulate through brain’s dopamine receptors  ○ reward center that is excessively used by foods and sought after What is the role of public health policies & initiatives in food & nutrition? What are the benefits? What are the downsides? Food policy makers create policies that establish funding to support health promotion and food safety, promote program development, and provide health services often focus on the amount of calories given, but not the type of calories that are given What role do Big Food Corporations play in public health? Often lobby for benefits from food policy makers ○ large recipients of welfare stamps which our taxes pay for ○ make food as palatable as possible through food engineering and product design ○ promote consumption and misinform the consumers about their food products ○ make healthy foods less available while their processed foods are more available for cheaper ○ lower the cost to promote more sales contribute to campaigns to increase access to policy makers sponsor “research studies” about food information and studies give out more to increase credibility of organizations delay or block health litigations to promote their agenda or cases What are their common business practices? What are their common political practices? Marketing food more complex now since it’s predominantly on the internet 1 hour of TV viewing higher intakes of sugar sweetened beverages, fast food, and overall calories ○ children watch more than 3 hours of television 50% more likely to be obese than children who watched less than 2 hours ○ food ads 50% of all ad times on children shows How does advertising impact our food choices? What are the impacts on children? Food ads on television ○ make up 50% of all the ad time on children’s shows 34% candy and snacks 28% cereal 10% fast food 4% dairy products 1% fruit juices 0% fruits and vegetables What role does Big Food Corporation play in the environment?What steps can individuals take to help improve their health status via nutrition? Food Industry and Climate Change One of the primary drivers of climate change driving factors include ○ deforestation ○ chemical fertilizers ○ soil erosion ○ factory farming of animals ○ food transport ○ refrigeration ○ processing ○ packaging of food the food system influences what people eat, via intense advertising, self regulation and by offering highly addictive food at extremely low prices Solutions Take control of your food prepare and cook food at home as much as possible buy local support grocery stores, farmers markets when possible purchase frozen and canned fruits and vegetables, dried beans and whole grains to save money  add nutrient dense foods into your diet ○ nuts and seeds ○ herbs and spices ○ superfoods create meal plans and shopping lists keep your body “biologically fed” to decrease temptation for snacking don’t drink your calories, drink water over packaged beverages eat Whole Foods daily