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Nutrition 2 (Semester I) > 8a. Obesity > Flashcards

8a. Obesity Flashcards

1
Q

What is the definition of obesity?

A

Abnormal or excessive fat accumulation that presents a risk to health

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2
Q

What’s the BMI range for a healthy weight?

A

18.5-24.9

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3
Q

What’s the BMI range for overweight?

A

25-29.9

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4
Q

What’s the BMI range for obesity?

A

30-39.9

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5
Q

What, in society, has led to the rise in obesity?

A

Larger portion sizes
Abundance of food
Rise of convenience food
Food palatability/density
Snacking
Speed of eating

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6
Q

How many kcals daily are needed in deficient for an adult to lose weight?

A

500-750/day

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7
Q

Examples of conditions obesity increases the risk of

A

Diabetes
Arthritis
Endometriosis
Cancer
CV disease

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8
Q

What are the common drivers of obesity?

A

Sedentary lifestyle
Sleep disruption
Processed foods
Microbiome
Long-term cortisol
Genetics
Chronobiology

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9
Q

Why is a sedentary lifestyle a driver of obesity?

A

Leads to reduced energy expenditure

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10
Q

Why does exercise help with obesity?

A

Increased energy expenditure
Increased cellular AMPK
Increased GLUT4 activation/glucose uptake
Enhanced ATP production

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11
Q

Why is sleep disruption a driver of obesity?

A

Creates a hormonal imbalance that promotes overeating and weight gain

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12
Q

What are the hormonal imbalances associated with sleep disruption?

A

Reduced glucose tolerance and insulin sensitivity
Increased ghrelin levels - promoting hunger and unhealthy food choices
Activation of inflammatory pathways

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13
Q

Why is chronobiology a driver of obesity?

A

Shift work, sleep deprivation and exposure to bright light at night increase the prevalence of adiposity

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14
Q

What conditions/signs are more likely to increase for shift workers?

A

Triglycerides and cholesterol dysregulation
Abdominal obesity
T2D
CV disease

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15
Q

Why are shift workers more at risk of becoming obese?

A

Exposure to bright light
Sleep deprivation
Irregular eating patterns
Late night eating

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16
Q

Why can late night eating cause obesity?

A

Higher peak post-prandial glucose levels
Reduced lipolysis
Dysbiosis
Circadian rhythm misalignment

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17
Q

What should shift workers try to do to avoid obesity?

A

Regular eating pattern
Avoid stimulants - sugar, caffeine
Nourishing snacks

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18
Q

Why can processed foods be a driver for obesity?

A

Fats, salt, sugar, caffeine, starches all stimulate dopamine
Activate reward system to trigger cravings for more
Reward system and food palatability override satiety signals

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19
Q

Which artificial sweetener has a strong association with obesity, NAFLD and metabolic syndrome?

A

High fructose corn syrup

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20
Q

Why are high cortisol levels a driver for obesity?

A

Cortisol levels are elevated in obese individuals
Associated with enhanced abdominal fat deposition
Altered eating habits - more food, and energy dense food

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21
Q

Why is the microbiome a driver for obesity?

A

Low plant fibre content of Western diet = reduced SCFAs and increased mucus utilising bacteria
Lack of Akkermansia linked with obesity

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22
Q

Why is a lack of Akkermansia linked with obesity?

A

Low Akkermansia can contribute to damaged mucosal barrier
Leads to metabolic endotoxaemia
Leads to disrupted insulin signalling/low grade inflammation

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23
Q

SNPs on which genes are associated with obesity?

A

FTO
VDR - ongoing inflammation/gut permeability
SLC2A2 - habitual consumption of sugar
ADIPOQ - adiponectin deficiency

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24
Q

What is adipose tissue?

A

Metabolically active organ which regulates whole-body energy homeostasis

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25
Q

What are the three types of adipose tissue?

A

White adipose tissue
Brown adipose tissue
Beige-white adipose tissue

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26
Q

What is white adipose tissue used for and where is it stored?

A

Use: long term energy usage
Found: subcutaneous adipose tissue - under skin (wobbly bits)
Visceral adipose tissue - around organs

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27
Q

When is brown adipose tissue more abundant?

A

Early life

28
Q

Which adipose tissue is associated with obesity and why?

A

White adipose tissue
Persistent energy surplus = increase in size and number of adipocytes = WAT expansion = obesity
(like a balloon)

29
Q

What conditions is hypertrophy (increased size of adipocytes) associated with?

A

IR
T2D
NAFLD
Dyslipidaemia

30
Q

What physiological factors create satiety?

A

Mechanical stretch of the stomach via Vague nerve
Hormones and peptides - CCK, GLP-1
Neuropeptides and neurotransmitters - serotonin, neuropeptide Y
Thyroid hormones, oxytocin, cortisol, insulin, glucagon

31
Q

Which cells produce satiety hormone leptin?

A

Adipocytes

32
Q

How does leptin work?

A

Released from adipose tissue to CNS
Regulates food intake and energy expenditure
Released in diurnal pattern (during day)

33
Q

What is leptin resistance?

A

Reduced sensitivity or failure in response of the brain to leptin

34
Q

What are leptin levels like in obesity?

A

High
But don’t work efficiency due to leptin resistance
(High adipose tissue = increased leptin resistance)

35
Q

What does leptin resistance lead to overtime?

A

Metabolism
Abdominal weight gain
Chronic fatigue
Sleep dysregulation

36
Q

When are ghrelin levels usually high?

A

Before a meal

37
Q

When are ghrelin levels usually at their lowest?

A

Within 1 hour of eating

38
Q

What are ghrelin levels generally like in obesity?

A

Low

39
Q

What does losing weight do to ghrelin levels?

A

Increases them

40
Q

What is the role of adiponectin?

A

Increases glucose uptake
Beta-oxidation of fats
Increases insulin sensitivity
Anti-inflammatory

41
Q

Which conditions are reduced adiponectin associated with?

A

Insulin resistance
T2D
Obesity
CVD

42
Q

What are significant predictors of plasma adiponectin levels?

A

BMI
Visceral fat

43
Q

What is a low adiponectin:leptin ratio likely to increase?

A

Oxidative stress
Inflammation

44
Q

Natural solutions to increasing adiponectin levels

A

Blueberries
Turmeric
Green tea
Cold water therapy
Daily HIIT

45
Q

What drives insulin resistance?

A

Inflammation

46
Q

What does inflammation drive?

A

Insulin resistance

47
Q

Causes and risk factors for insulin resistance

A

High oxidative stress - poor sleep, toxins
Reduced physical activity - reduces GLUT4 expression
Chronic stress - increases glucose, lipids, cytokines
Mitochondria dysfunction - increased ROS, low ATP
Poor methylation - high homocysteine, hypertension
Dysbiosis - increased circulating LPS

48
Q

Signs and symptoms of insulin resistance

A

Lethargy (glucose not getting to target tissue)
Hunger
Overweight
Increased hip:waist ratio
Increased blood pressure
Increased cholesterol
Increased blood glucose levels
Acanthosis nigricans
Skin tags
Brain fog

49
Q

Naturopathic approach to insulin resistance

A

Stabilise blood glucose levels - reduced carbs, increased protein, increased fibre, Mg, Mn, Zn, B vits, chromium
Reduce inflammation - increase plant food, green tea, prioritise sleep
Optimise insulin sensitivity - TRE, moderate exercise, prebiotics (inulin/FOS)

50
Q

Nutrients to improve insulin sensitivity

A

D
Mg
Zn
ALA
CoQ10
Chromium
Cinnamon

51
Q

What training can be useful for individuals in improving IR?

A

Blood Glucose Awareness Training

52
Q

Naturopathic approach to reducing obesity

A

Smaller portions
Meal composition - low GI
Protein based breakfast
Protein with every meal
Fasting/TRE
Chew food well
Mindful eating
Exercise daily

53
Q

Which nutrients are often insufficient in obese individuals?

A

A
C
D
B9
Fe
Zn
Ca

54
Q

Why isn’t calorie restriction beneficial for reducing obesity?

A

Triggers several biological adaptations designed to prevent starvation
Decreased leptin levels = increased feeding and reduced energy expenditure
Pre-adipocyte proliferation = increased fat storage capacity
Changes in levels of circulating gut hormones for homeostatic regulation of body weight

55
Q

Nutrients for reducing obesity

A

5-HTP
Green tea
L-carnitine
Conjugated linoleic acid
Chromium
Gymnema sylvestre

56
Q

How does 5-HTP help with reducing obesity?

A

Increases feeling of satiety
Promotes sleep by enhancing melatonin production

57
Q

Dosage of 5-HTP to support reducing obesity

A

50-100mg twice/day

58
Q

How does green tea help with reducing obesity?

A

EGCG polyphenol stimulates thermogenesis and fat oxidation

59
Q

Dosage of green tea to support reducing obesity

A

600-900mg/day
(3-4 cups of brewed tea)

60
Q

How does L-carnitine help with reducing obesity?

A

Beta-oxidation of fatty acids in mitochondria
Improves leptin resistance

61
Q

Dosage of L-carnitine to support reducing obesity

A

2000mg/day

62
Q

How does conjugated linoleic acid help with reducing obesity?

A

Improves leptin resistance
Improves lipolysis in adipocytes

63
Q

Dosage of conjugated linoleic acid to support reducing obesity

A

Up to 3.4g/day

64
Q

How does chromium help with reducing obesity?

A

Lowers body weight
Increases lean body mass
May reduce carb cravings

65
Q

Dosage of chromium to support reducing obesity

A

200-1000mcg chromium picolate

66
Q

How does gymnema sylvestre help with reducing obesity?

A

Helps to lower blood glucose levels
Increased secretion of insulin
Increased utilisation of glucose
Inhibiting glucose absorption from the intestine

67
Q

How can we break clients’ habits to help reduce obesity?

A

Identify the cue - what happens at the same time and place every day?
Change the routine
Change the reward
Repetition

Nutrition 2 (Semester I) (15 decks)

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