Disordered metabolism Flashcards
What are some modifiable risk factors for CVD?
- Dyslipidaemia –> raised levels of cholestero, triglyceride, LDL, VLDL and homocysteine
- Oxidation of LD
- Insulin resistance
- Hyperglycaemia
- Hypertension
- Obesity
- Smoking
- Sedentary lifestyle
What are some non-modifiable risk factors for CVD?
- Family history
- Increasing age
- Genetics
- Established diabetes/ renal disease
- Age at menopause
- Sex
Primary cause of dyslipidaemia?
Single or multiple gene mutation that result in either overproduction or defective clearance of TG and LDL cholesterol or in underproduction or excessive clearance of HDL
Secondary cause of dyslipidaemia
Contribute to most cases in adult
Most important cause in developed countries is a sedentary lifestyle with excessive dietary intake of saturated fat
Other common causes include diabetes, alcohol overuse, chronic kidney disease, cholestatic liver diseases and drugs
What is metabolic syndrome?
A group of risk factors that occur together and increase the risk of coronary artery disease, stroke and type 2 diabetes associated with central obesity, insulin resistance and elevated blood pressure characterised by low HDL and raised TG
What are healthy> cholesterol levels
Total cholesterol
- 5mmom/l or less for healthy adults
- 4mmol/l or less for at risk
LDL
- < 3mmol/l for healthy adults
- < 2mmol/l for high risk
Non-HDL (IDL, VLDL, lipoprotein a)
- <4mmol/l
What are some possible mechanisms of action of n-3 fatty acids?
- Antiarrhythmic
- Antithrombotic
- Antiatherosclerotic
- Anti-inflammatory
- Improved endothelial function
- Lowers blood pressure
- Lowers triglyceride concentration
What are the SACN recommendation for SFA intake?
SFA to be no more than 10% of dietary energy
Applies to adults and children 5 years and older
(2019)
https://www.gov.uk/government/publications/saturated-fats-and-health-sacn-report
Dietary advice for CVD?
- Maintain a BMI between 20-25
- Reduce intake of saturated fat: use low fat dairy products, lean meat, less sugar
- Increase intake of fish weekly, with at least 1 portion being fatty fish
- Use unsaturated fats, including PUFA and MUFAs
- Eat at least 5 portions of fruit and veg
- Eat moderate amounts of starchy carbohydrates, especially wholegrain sources
- Eat more dietary fibre, especially soluble fibre
- Reduce intake of salt
- Limit alcohol intake
What are some risk factors for obesity in children?
The health of a child’s mother during pregnancy
- Pregnant woman with insulin resistance stimulates the excessive growth of foetal adipocytes. Maternal insulin resistance predicts weight gain in infants from 0-12 months
C section delivery
- C-section alters the intestinal colonisation or gut flora of infants, which are important to the development and maturation of the neonatal immune system and in harvesting energy and essential vitamins and minerals during digestion
Antibiotic exposure in early life
- Effects gut flora and disrupts a person’s immune defences at the intestinal border and alters mitochondria, which are important for maintaining energy metabolism
Genetics
Lack of physical activity
Mental health issues
Is there a relationship between alcohol and obesity?
Phenolic compounds in red wine have shown to have an anti-obesity effect. It has shown to decrease adipocyte size and increase aromatase expression.
Alcohol alone, cannot be a predictor for obesity, however it can contribute to it, due to caloric and sugar intake.
Why is smoking harmful?
Shown to cause:
- Cancer
- Heart disease
- Strokes
- Lung disease
- COPD
Increases risk of
- TB
- Eye diseases
- Suppressed immune system
- Insulin resistance diabetes –> associated with central fat accumulation
- Reduced bone density
- Alteration in metabolism and absorption of calcium
- Dysregulation of sex hormone production and metabolism –> can reduce fertility
- Complications following dental implants
Influence on body weight
- Short term effects has shown to increase energy expenditure and decreases appetite
- Heavy smokers tend to have a higher body weight than light or non smokers. This is usually due to other associated lifestyle factors, low PA levels, poor diet and high alcohol consumption
Is there a relationship between depression and weight gain?
- People with obesity had 55% increased risk of developing depression
- People with depression has an 58% increased risk of obesity
- Disordered eating/ emotional eating can be seen in people with depression which can lead to obesity
- Lack of PA
Does sleep deprivation influence eating patterns and body weight?
Short sleep duration, poor sleep quality, and later bedtimes are all associated with increased food intake, poor diet quality, and excess body weight.
Mechanisms by which insufficient sleep may increase caloric consumption
1. More time and opportunities for eating
2. Psychological distress (emotional eating)
3. Greater sensitivity to food reward
4. Disinhibited eating
5. More energy needed to sustain extended wakefullness
6. Changes in appetite hormones
What are the NHS 12 tips for losing weight?
- Do not skip breakfast
- Eat regular meals
- Eat plenty of fruit and veg
- Get more active
- Drink plenty of water
- Eat high fibre foods
- Read food labels
- Use a smaller plate
- Do not ban foods
- Do not stock junk foods
- Cut down on alcogol
- Plan meals
