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Nutrition 207 > Eating disorders and Alcohol > Flashcards

Eating disorders and Alcohol Flashcards

1
Q

How many women do not like their body?

A

70%

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2
Q

How many women control their weight with unhealthy behaviours?

A

50%

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3
Q

How many men are not satisfied with their body

A

43%

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4
Q

What is happening with the percentage of eating disorders right now?

A

Increasing in younger ages and postmenopausal
More prevalent as wealth increases
Unrealistic ideals from social media

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5
Q

What is eating disorder?

A

General term for abnormal or atypical eating behaviours associated with efforts to control weight.
Psychiatric conditions that must be diagnosed by a psychiatrist, then the people are in mental condition

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6
Q

Name some examples of feeding and eating disorders.

A

 Anorexia Nervosa  Bulimia Nervosa  Binge-Eating Disorder  Other Specified Feeding or Eating Disorder  Unspecified Feeding or Eating Disorder

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7
Q

What population group is at high risk for disordered eating?

A

Risk is high in university students with stress and pressures

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8
Q

Risk for Eating disorders

A
  • Environmental stress/Socio-cultural/Media
  • Family, situational
  • Individual factors(genetic, Biology,Temperamental/personality traits
  • Psychological/Self-esteem/Body image
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9
Q

Monozygotic twins risk of having both eating disorders vs dizygotic twins

A

50-80%

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10
Q

What are warning signs for disordered eating?

A

 Severe self-criticism  Depressed mood  Belief that only worthwhile when thin  Preoccupation with weight, shape and dieting

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11
Q

What % of female university students suffer from disordered eating?

A

 4% of struggle with Anorexia Nervosa plus 4% suffer from Bulimia Nervosa  61% have some kind of subclinical eating problem, including chronic dieting, binge/purging and subclinical bulimia

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12
Q

What % of male university students suffer from disordered eating?

A

10-20% suffer from disordered eating plus 2% have clinical Bulimia Nervosa

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13
Q

Proportion of eating disorders in men and women

A

women 90%

Men 10 %

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14
Q

What is the lifetime risk for anorexia nervosa,bulimia nervosa, Binge Eating disorders(BED),OSFED?

A

Anorexia - 0.9% women ,0.3 % men
Bulimia- 1.5% women and 0.5% men
BED- women 3.5% and 2% men
OSFED- 3-10%

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15
Q

The widespread of eating disorders that start in adolescence

A

85%

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16
Q

Incidence of ED increases when

A

Central to self-worth is the body image

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17
Q

If you recognize sooner the ED, then

A

There is a bigger chance of successful recovery, 50-70% will recover

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18
Q

Warning signs of ED

A

Increased fatigue, injury; prolonged training
Decreased concentration/school or work performance; energy, muscle function, coordination, speed
Complaints of dizziness, abdominal pain
Increased isolation
Increased impatience, crankiness, perfectionism
Preoccupation with food, weight, body image, hydration
Avoidance of social eating
Trips to the bathroom after meals; weight changes, etc

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19
Q

What is anorexia characterized by?

A

distorted body image and excessive dieting that leads to severe weight loss with a pathological fear of becoming fat, despite being underweight. - Intense fear of becoming obese by losing control over eating - Dissatisfaction with body shape

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20
Q

What kind of personality traits do patients with anorexia nervosa have?

A

• Sense of powerlessness over own life situations • High expectations of self and others • Obsessive-Compulsive personality traits (perfectionism) • “Black or White” thinking • Fear of age, sexuality, independence

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21
Q

What are some unusual eating behaviours for patients with anorexia nervosa?

A

measuring, vegetarianism, eat in small dishes, excessive consumption of water or gum, eating very slowly

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22
Q

What does anorexia nervosa result in?

A

Protein-energy malnutrition

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23
Q

What criteria was taken off the DSM for anorexia?

A

Amenorrhea in females (no menses for 3 months)

BMI<17 for 3 months

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24
Q

What is the age of onset for anorexia nervosa? How long does it usually last? What % are male?

A
  • Ages 11-20 (young) - 1 to 10 years - 10% are male
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25
Q

What other disease does anorexia look like? Why?

A
  • Marasmus - Both result in protein energy malnutrition
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26
Q

Name some anorexia warning signs.

A

 Sudden and drastic weight loss that is not otherwise explainable, (i.e. not due to illness or surgery)  Irregular or absent periods  The development of narrow, weird food preferences  The development of abnormal rituals surrounding food and meal times  Refusal to eat in front of others  Cooking eagerly for others while refusing themselves to eat prepared food  Overdoing exercise and showing signs of anxiety when a workout is interrupted or missed  Always feeling cold, even in warm weather  Wearing baggy clothes to hide body

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27
Q

The results of anorexia nervosa

A
  • Starvation, feeling cold( hair in the body can grow very long)
  • Physiological changes ( heart,brain,Gi tract)
  • Amenorrhea(loss of periods)
  • Loss bone density-osteoporosis( crucial for children 12-13 when calcium is supposed be storing)
  • Not reach the max height
  • Causes confusion and delirium
  • Death from multiple organs failure
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28
Q

What is bulimia nervosa characterized by?

A

Characterized by frequent episodes (at least once per week)of binge eating followed by inappropriate behaviors such as self-induced vomiting to avoid weight gain. Feeling of lack of control over binges - Self-induced vomiting, laxative or diuretic use, strict dieting or fasting, vigorous exercise

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29
Q

Which eating disorder may the individual be of normal weight?

A

Bulimia

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30
Q

What is the bing eating cycle?

A

Negative self-perception -> restrictive dieting -> bing eating -> purging

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31
Q

Bulimia nervosa: compensatory behavior

A
  • Self-induced vomiting
  • Laxative(poop more) or diuretic abuse(pee more)
  • Strict dieting or fasting
  • Diet pills
  • Vigorous exercise
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32
Q

Dangerous and comorbidities of bulimia

A

Dangerous: subclinical malnutrition, electrolyte imbalances,GI,heart, death

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33
Q

What happens to the salivary glands during bulimia

A

-Swelling because of the regular vomiting

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34
Q

Name some BN warning signs.

A

 Binge eating; It is usually done in secret but evidence may present itself in the form of missing food or empty containers.  Finding excuses to leave the table after meal  Signs of vomiting in bathroom  Evidence of excessive laxative or diuretic use  Chipmunk-cheeks, repeated vomiting causes glands around the jaw to swell.  Pattern of weight fluctuations that are usually in the ten to twenty pound range(yoyo dieting)  Excessive exercise  Burst blood vessels in eyes

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35
Q

What is binge eating disorder characterized by?

A

recurring episodes of eating significantly more food in a short period of time than most people would eat under similar circumstances,

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36
Q

How often does binge eating disorder happen?

A

occurs, on average, at least once a week over three months

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37
Q

What percentage of people who have bariatric surgery have binge eating disorder

A

25%

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38
Q

What is the behaviour of wrestlers striving to be a lower weight class to have an advantage over small opponents?

A

 Restrict food and fluid intake before match  Practice in rubber suits  Sit in saunas  Take laxatives and diuretics  Replenish fluids, glycogen and lean tissue between weigh in and competition (a few hours)

39
Q

What is the truth behind wrestlers losing water weight?

A

 Reestablishing fluid and electrolytes can take 1-2 days  Replenishing glycogen stores can take 2-3 day  Replacing lean tissue may take even longer

40
Q

Risk factors for eating disorders in athletes

A
  • Food deprivation and dehydration practices
  • Impair physical performance
  • Muscle dysmorphia( people are taking steroids)
  • Orthorecia nervosa( preoccupation with healthy food- organic grapes not have money for other food,, )
41
Q

What does amenorrhea lead to?

A

Diminished hormones

42
Q

What are symptoms and warning signs of orthorexia

A

Compulsive checking of ingredient lists and nutritional labels
An increase in concern about the health of ingredients
Cutting out an increasing number of food groups (all sugar, all carbs, all dairy, all meat, all animal products)
An inability to eat anything but a narrow group of foods that are deemed ‘healthy’ or ‘pure’
Unusual interest in the health of what others are eating
Spending hours per day thinking about what food might be served at upcoming events
Showing high levels of distress when ‘safe’ or ‘healthy’ foods aren’t available
Obsessive following of food and ‘healthy lifestyle’ blogs on Twitter and Instagram
Body image concerns may or may not be present

43
Q

Two other EDs

A

Diabulemia- People with T1DM skip/reduce insulin to lose weight
-Drunkorexia- heavy drinking combined with restricting , purging, not eating before drinking , because alcohol are calories

44
Q

What are therapy options for individuals with eating disorders?

A

 Multi-disciplinary team  Cognitive behavioural therapy  Group / family therapy  Inpatient / outpatient  Nutrition counseling  Pharmacological intervention

45
Q

Prevention of eating disorders

A

Avoid labeling food “bad,” “sinful,” or “junk food.”
Encourage intuitive eating & healthy weight for best performance
Criticize the culture that promotes unhealthy body image, not your self or others. Speak out against the media
Do not encourage or laugh at jokes that make fun of a person’s size, race or body.
Help others to develop self-esteem based on qualities other than physical appearance
Teach how to identify and manage stress
Model a healthy lifestyle
Encourage health at every size
Family meals

46
Q

One drink is

A

0.6 oz (18 ml) of pure ethanol (12 oz beer, 10 oz wine cooler, 1 1/2 oz liquor, 5 oz wine)

47
Q

What are the findings about the safe level of consumption of alcohol

A

The risk of all-cause mortality, and of cancers specifically, rises with increasing of alcohol consumption
-The level of consumption that minimizes health loss is zero

48
Q

What are the max drinks per week and per day for women and men

A

Males – 15 drinks per week NO more than 3 drinks a day

Females –10 drinks/wk NO more than 2 drinks per

49
Q

What is the max drink amount on special occasion

A

Max 3 for woman

4 for men

50
Q

Who should avoid alcohol?

A

Avoid if pregnant, operating machinery, can’t control intake

51
Q

What does alcohol has to be consumed with?

A

With food

52
Q

Why you should eat CHO and fat before drinking?

A

CHO- slows absorption

Fat-reduces peristalsis

53
Q

Is alcohol stored and what is the consequence for that?

A

Cannot be stored and that is why alcohol is the priority over anything else in the body

54
Q

What does the conversion of alcohol to acetyl CoA require?

A

The B vitamins in its role as the coenzyme NAD.

55
Q

What is NAD+?

A

NAD+ = niacin

56
Q

Where is ethanol absorbed from?

A

If we don’t eat, will absorb fast from the stomach Absorbed quickly from the stomach and duodenum

57
Q

What is ADH? Where is it found?

A

Alcohol dehydrogenase and acetaldehyde dehydrogenase - Located in liver and in the stomach (ONLY IN MEN)

58
Q

What is microsomal ethanol oxidizing system found?

A

Mitochondria of liver

59
Q

What is inducible? What is non inducible?

A
  • Microsomal Ethanol Oxidizing System is inducible - ADH is non inducible
60
Q

Acetyl CoA molecules are blocked from getting into the TCA cycle by high levels of what? What does that cause?

A
  • By NADH - Become building blocks for fatty acids - increased serum TG, increased risk of fatty liver - cirrhosis, ketones,
61
Q

How does alcohol disturb metabolism?

A
  • Less NAD+ - More H+ (generating acid) - Acetyl CoA produced produces fatty acids and ketones rather than entering TCA cycle - Decreased gluconeogenesis - Decreased protein synthesis - Liver damage
62
Q

How does less NAD+ compromise metabolism?

A

pyruvate produces lactate rather than acetyl CoA Slows down glycolysis and TCA cycle

63
Q

How does more H+ compromise metabolism?

A

acidosis along with lactate and increased ketone bodies

64
Q

How does decreased gluconeogenesis compromise metabolism?

A

Ketosis

65
Q

When do people experience hangovers?

A

When accumulating acetaldehyde

66
Q

What happens to drugs when consumed with alcohol

A

Drug tolerance is created, because it stays more in the body

67
Q

70 % of the ethanol is metabolized by____, and 20% of the ethanol is metabolized with ____

A

70 %- by Alcohol dehydrogenase

20% by Microsomal Ethanol Oxidizing System

68
Q

How is ethanol metabolized with ADH?

A

Ethanol->( with ADH in liver and stomach(men)) to acetaldehyde by NAD+ to NADH and H+->( with acetaldehyde hydrogenase only in the liver) to Acetate via NAD+ to NADH and H+ reaction-> CoA is added->FA->Liver

69
Q

What happens with ethanol metabolism with MEOS? What is the other application of this circuit

A

Ethanol->( with MEOS in the mitochondria liver) NADPH and H+ and 1/2O2 to NADP+H2O->Acetaldehyde
The same circuit to utilize the drugs

70
Q

What is the rate of metabolism of alcohol

A

1 drink/hour

71
Q

Where is the rest 10% of ethanol go?

A

Excreted through urine and breath

72
Q

Why people black out when drinking?

A

Increased acidity in the blood-> cannot make glucose->black out

73
Q

Where does acetylaldehyde go?

A

to Acetyl coa
OR
It can decline protein synthesize and cause cell damage->fibrosis->cirrhosis

74
Q

What is fibrosis?

A

When the tissues in the liver start to collagenize

75
Q

What inducible means?

A

Inducible- the rate of metabolizing the alcohol can change

Non-inducible- cannot be changedd

76
Q

What happens with glucose part of metabolism with prolonged alcohol consumption?

A

-In liver increased glycolysis, decreased glycoenogenesis( from fat, AA)->low blood sugar->coma

77
Q

What happens with pyruvate part of metabolism with prolonged alcohol consumption?

A

Increased pyruvate conversion to lactate->lactic acidosis->damage of the liver

78
Q

What happens with fat part of metabolism with prolonged alcohol consumption?

A

Decreased fat breakdown,Increased fat synthesize->fatty liver

79
Q

How you get fatty liver?

A

Acetyl CoA->Fat synthesis or ketones->Fatty liver->cirrhosis

80
Q

What is cirrhosis? What is it caused by?

A

IRREVERSIBLE liver damage caused by alcohol, hepatitis B or C, iron toxicity (hemachromatosis)

81
Q

What is the fatty accumulation called in cirrhosis? Inflammation?

A

Fatty accumulation: steatosis Inflammation: hepatitis

82
Q

How does cirrhosis develop? What can it lead to? How do you treat?

A
  • As liver constantly repairs, accumulation of fibrosis tissue, scars and nodules and connective tissue – impaired function - Leads to carcinoma –> liver resection, transplant
83
Q

Can brain cells cure form alcohol damage ?

A

No

84
Q

What does alcohol do to the brain?

A
  • Sendates inhibitory nerves( central nerval system depressant )
  • Less muscle control, less balance
85
Q

Why do you want to pee more when drinking?

A

-Depression of antidiuretic hormone ->Loss of water and loss of important minerals

86
Q

Name some compromised vitamin status due to alcohol and malnutrition.

A

Wernicke-Korsakoff Syndrome – thiamin destruction Anemia – folate excretion Decreased vitamin D activation in liver B6 loss from binding protein

87
Q

1 oz of EtOH=

A

0.5g fat

88
Q

What happens to food consumption as alcohol consumption increases?

A

Less eating -> not eating a variety of other nutrients AND hard to break down alcohol

89
Q

What does the French Paradox study state?

A

France: low CVD despite high saturated fat intake France was the only country that did not have a high death rate from CVD despite high saturated fat intake

90
Q

What causes the French Paradox?

A

Very unclear, points to an association - Alcohol or flavinoids or combination - Resveratrol protects against LDL oxidation

91
Q

What does consuming alcohol in moderation increase the risk of?

A

hypertension stroke cirrhosis cancer - oral, stomach, colon, breast, prostate ulcers osteoporosis psychological depression fetal alcohol syndrome drunk driving insomnia Alcoholism Cost $200 billion/y

92
Q

What are personal strategies to prevent alcoholism?

A

drink non-alcoholic beverages drink in moderation drink slowly drink with food don’t drive seek help if needed

93
Q

What are medications used to treat alcoholism?

A

Antabuse (blocks AcAld DH) - higher sensitivity to alcohol, effects of a hangover are felt almost immediately after consumption Reviva (decrease craving and the high)

Nutrition 207 (17 decks)

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