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MD 4910 NCP I > 4910:C12 Energy Balance & Body Weight > Flashcards

4910:C12 Energy Balance & Body Weight Flashcards

1
Q

kilojoule

A

The amount of work required to move 1 kilogram for 1 meter with the force of 1 newton. 1kcal = 4.2kJ.

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2
Q

Ghrelin

A

A peptide hormone produced in the stomach & stimulates appetite. Levels increase during fasting.

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3
Q

adiponectin

A

Hormone released by adipocytes, signals that the body has capacity to store more fat, low levels are associated with obesity

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4
Q

leptin

A

A peptide hormone released by adipocytes, signals that the body has enough fat stored. Acts on hypothalamus to suppress appetite. Influences reproduction. Inhibits action of NPY. Down regulated in obesity.

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5
Q

Overweight BMI in adults

A

25.0-29.9kg/m^2

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6
Q

Healthy Weight BMI (adult)

A

18.5-24.9kg/m^2

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7
Q

Underweight BMI (adult)

A

<18.5kg/m^2

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8
Q

Overweight BMI for children

A

BMI for age range ≥ 85th percentile but < 95th percentile.

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9
Q

Obese BMI for children

A

BMI-for-age ≥ 95th percentile

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10
Q

Waist Circumference in males and females

A

40in males; 35in females. High waist circumference is associated with increased cardio metabolic disease. Useful in assessing risk in those within healthy to overweight BMIs.

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11
Q

Waist-to-Hip Ratio (WHR)

A

Calculated by dividing waist circumference by hip circumference. WHR > 0.95 in males & > 0.8 in females = higher risk.

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12
Q

steatosis

A

increased accumulation of fat in the hepatocytes.

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13
Q

Hormones that have an anorexigenic effect

A

CCK, glucagon-like peptide-1, Peptide YY

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14
Q

Adiposity rebound

A

The increase in % body fat in children haver decreasing between 1 & 6 years of age.

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15
Q

Regulation of food intake is controlled by what hormones?

A

Leptin, adiponectin, ghrelin, neuropeptide Y (NPY)

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16
Q

Factors that contribute to obesity

A

Hormonal regulation of food intake. Meta-inflammation. Genetics. Food intake. PA. Sleep disturbances.

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17
Q

NPY

A

Synthesis is increased with food deprivation; it is released during starvation &/or fasting. Promotes storage & synthesis of fat.

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18
Q

Ghrelin

A

Hormone produced in the stomach that stimulates hunger and decreases energy expenditure.

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19
Q

Theory of why ghrelin levels increase in obesity?

A

Possibly sensitivity increases or receptors increase.

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20
Q

adiponectin

A

Protein hormone produced by adipocytes. Causes sensitivity of peripheral tissues to insulin. Synthesis is down regulated in obesity and insulin resistance.

21
Q

Meta-inflammation

A

Imbalance of pro-inflammatory (interleukin, TNF a, CRP) cytokines with anti-inflammatory cytokines (adiponectin) produced by adipose tissue.

22
Q

The main source of obesity related pro-inflammatory cytokines?

A

Adipose tissue macrophages, they’re numbers increase with visceral fat.

23
Q

How does inflammation impact the glut-4 transporter.

A

The glut-4 transporter is inhibited by inflammation leading to insulin resistance, hyperglycemia, and DM2.

24
Q

Mechanisms for circadian disruption & obesity

A

High snacking frequency. Reduction in total daily sleep. Increased exposure to bright light during the night. The brain losing “feeling” for internal vs. external rhythms

25
Q

Factors used to assess weight status and health risk

A

BMI, body composition, body fat distribution

26
Q

What does an at risk waist circumference put one at risk for?

A

2DM, metabolic syndrome, HTN, dyslipidemia, CHD. >40in males, > 35 in females. Central adiposity = increased risk factors.

27
Q

At risk W:H?

A

> 0.95 men. > 0.8 women

28
Q

Recommended treatment for BMI 25-26.9

A

Diet, PA, and behavior therapy with comorbidities

29
Q

Recommended treatment for BMI 27-29.9

A

Diet, PA, and behavior therapy with comorbidities. Rx- with comorbidities

30
Q

Recommended treatment for BMI 30-34.9

A

Diet, PA, & behavior therapy. Pharmacotherapy.

31
Q

Recommended treatment for BMI 35-39.9

A

Diet, PA, behavior therapy. Pharmacotherapy. Surgery with comorbidities.

32
Q

Recommended treatment for BMI > 40

A

Diet, PA, behavior therapy. Pharmacotherapy. Surgery with comorbidities.

33
Q

Outcome measures for interventions in overweight?

A

Weight. Biochemical labs - improvement in glucose, lipids, & CRP. Self-image.

34
Q

EAL recommendations for creating an energy deficit?

A

An individualized reduced calorie diet. Reducing fat &/or CHOs is practical way. 500-1000kcal deficit. 1-2 lb./week wt loss is goal.

35
Q

Nutrition Intervention of Overweight & Obesity

A

Avoid wt gain once goal is reached. Reduce energy intake. Decrease intake of energy dense foods.

36
Q

EAL Recommendation for Pharmacotherapy in Nutrition Intervention?

A

Research indicated that in some individuals Rx aid in wt loss. Follow NHLBI criteria. Are part of comprehensive wt management program.

37
Q

Pharmacologic treatment for wt loss is indicated at what BMI?

A

BMI > 30 or >27 w/ comorbidities.

38
Q

Types of wt loss Rx

A

Lipase inhibitors - orlistat-xenical. Appetite suppressants. Others prescribed off-label - anti-depressants; anti-seizure

39
Q

Appetite Suppressant Drugs

A

Qsymia. Belviq. Sibutramine. phentermine. phendimetrazine. diethylpropion

40
Q

Roux-en-Y

A

The most commonly preformed gastric bypass surgery. A small pouch is created, the jejunum is attached to this, then the duodenum is attached to the jejunum to allow for secretions to enter, and the stomach is by passed. Deficiencies are common

41
Q

Vertical Sleeve

A

Restricts stomach’s capacity, but stomach function remains intact. Less deficiency, dumping syndrome.

42
Q

Duodenal Switch

A

Intestinal pathways is re-routed to separate the flow of food from the flow of bile and pancreatic juices to inhibit absorption of energy-yielding nutrients. Pylorus is intact,

43
Q

Gastric banding

A

Silicone ring or band is laparoscopically introduced into the abdominal cavity & secured around the upper part of the stomach - creates a small pouch with a narrow opening at the bottom of the pouch.

44
Q

Medical complications of wt loss

A

Electrolyte abnormalities - arrhythmias. Catabolism of heart. If on diuretic - Hypokalemia - monitor and supplement as needed.

45
Q

Why is hyperuricemia a complication of wt loss surgery?

A

Pt is in ketosis which increases uric acid and incidence of gout. A low purine diet is recommended to prevent

46
Q

Why is cholecystitis a common complication of wt loss surgery?

A

The very low-fat diet post op cause bile to build up in the gallbladder.

47
Q

Medical complications of wt loss surgery: Fatty liver disease

A

wt loss may result in inflammation - increased liver enzymes.

48
Q

Drugs to decrease absorption of energy?

A

Block lipoprotein lipase Alli - OTC. Orlistat- Rx - is controlled substance and only prescribed for 12 wks.

MD 4910 NCP I (15 decks)

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