Energy Metabolism Flashcards
1
Q
How many additional calories per day will lead to obesity?
A
25
Similarly will wither away if have -25
2
Q
What are the three different forms of energy that can be converted to heat?
A
- Chemical
- Mechanical
- Electrical
MEC.
3
Q
First Law of Thermodynamics?
A
- Energy cannot be created or destroyed
- Can be transformed from one form to another.
Plants depend on energy captured from the sun to synthesise proteins, carbohydrates and fats (macros via photosynethesis).
Animals meet their energy needs from chemical energy stored in plants and other animals ie food.
4
Q
Three things chemical energy from food is used for?
A
- Chemical work (synthesis of new macromolecules).
- Mechanical work (muscular contraction).
- Electrical work (maintenance of ionic gradients across membranes eg sodium-potassium pump (SPP).
SPP regulates fluid balance in cells. Cells = negatively charged on inside to outside which enables cells to do neg-pos charges.
5
Q
Metabolic syndrome symptoms?
A
Present with three of five things:
1. Elevated blood pressure
2. High blood sugar
3. High tryicglicerides
4. Abdominal adiposity
5. Low HDL cholesterol.
Sub-optimal energy metabolism or fuel mismanagement.
6
Q
Energy metabolism?
A
Balance between energy in, energy out and energy stored.
7
Q
What is energy balance?
A
Energy balance =
energy intake +
energy stores) -
energy expenditure.
8
Q
What happens if energy intake and expenditure are not equal?
A
- Negative energy balance = body uses energy stores ie glycogen, fat, protein.
- Positive energy balance = increase in body energy stores, primarily as fat.
9
Q
How can energy consumed as food/drink be stored?
A
- Glycogen in the liver and muscles.
- Fat (accounting for the majority of energy storage) in adopocytes.
10
Q
When energy is in short supply the body can source energy from where?
A
- Glycogen in the liver (100g) and muscles (400g).
- Fat
- Protein (a last resort in cases of starvation or malnutrition – amino acids are taken from skeletal muscle).
NB Liver glycogen keeps us going overnight.
11
Q
Which fuel does the body burn first and why?
A
Glucose as it is the easiest to burn.
Body likes to keep stored fat for emergencies.
12
Q
Second Law of Thermodynamics?
A
Second Law of Thermodynamics: All energy used by the body degenerates as heat.
Whenever energy is transferred or transformed (eg during cellular metabolic reactions) there is loss of energy in the form of heat.
When food is utilised in the body (chemical, mechanical or electrical work), this is always accompanied by loss of some energy in the form of
heat ie thermal energy that is no longer available for work inside the body).
13
Q
What is the heat-generating potential of a food better know as?
A
Caloric value
Or kcal (1,000 cal = 1kcal)
14
Q
What is a calorie?
A
Calorie = amount of heat to raise temperature
of 1g of water by 1°C.
In food we refer to 3k calories really. Ie 1 kcal.
Aussies use kilojoules.
Society focusssed on number of calories rather than the nutrient density.
15
Q
Caloric value of each macronutrient?
A
Per 1g:
1. Carbohydrate, proteins: 4 kcal
2. Fat: 9 kcal
3. Alcohol: 7 kcal (very fast burning carb). Can’t be converted to glycogen. either used immediately or stored as glycogen. Body burns alcohol before food in a meal.
4. Fibre: 2 kcal (yielded from bacterial fermentation)
16
Q
What is the energy currency that all life relies on?
A
ATP (adenosine triphosphate)
Used to fuel all cell processes.
17
Q
How is ATP produced?
A
Conversion of acetyl Co-A via the Krebs Cycle and the Electron Transport Chain.
18
Q
Which organelle in body doesn’t have mitrochondria?
A
Red blood cells
19
Q
Co-factors needed for Krebs cycle?
A
- Magnesium
- Manganese
- CoQ10
- Copper
- Vitamin B1, B2, B3, B5
- Alpha Lipoic acid
- Fe
- Sulphur
20
Q
What can damage mitochondria?
A
- Nutrient deficiencies
- Toxins (inc poor liver detoxification and elimination pathways)
- Heavy metals (eg Mercury, Arsenic & Aluminium - oxidise very easily) can damage mitochondria and interfere with energy production
21
Q
EIGHT factors that influence how much energy a person has? Clue, nutrition is only one factor!
A
- Good nutrition: sufficient intake (fuel). Crucial for cell respiration (Krebs cycle).
- Digestion & absorption: crucial for liberation of nutrients from food. Good GI health vital for nutrient absorption.
- Respiratory (iie lung) health: Oxygen intake. Consider lung diseases, smoking, chronic hyperventilation.
- Heart & circulation health. Key in nutrient (‘fuel’) delivery to cells.
- Antioxidants to protect against mitochondrial damage, as well as minimal toxic load.
- Thyroid health: upregulates metabolism.
- Adrenal health Adr and NorAdr increase energy delivery ie get us up in morning (stimulate glycolysis, increase HR and BP, dilating airways).
- Healthy detoxification: to prevent mitochondrial damage, optimise liver detoxification and routes of elimination (bowel, kidneys, skin, lungs) and minimise toxic exposure. If liver busy detoxing won’t be creating energy.
- Sleep hygiene: promote melatonin production (a potent antioxidant).
- Stress:: having a goal; acts of kindness; being in love – all these things can create energy.
Grief, a lack of sense of purpose and unresolved problems can reduce one’s energy
22
Q
In terms of nutrition what can affect energy production?
A
- Glycemic load - refined v. unrefined
- Micronutrient content - how much how quality?
- Fats: n-3, EVOO or damaged fats?
- Fresh fruit and veg v. boxed foods
- Hydration
23
Q
What three factors does energy expenditure depend on? NB not food!
A
- Basal Metabolic Rate (BMR) - 65-75% energy depends on this. Includes everything non-physical, body temp, CV system, CNS, ANS, breathing. Keeping the lights on.
- Physical Activity (20%) - excercise but also NEAT (non-exercise activity thermogenesis) eg walking around the house, typing, brushing teeth, restless legs, fidgeting.
- Thermic Effect of Food (10%) different foods require different energy requirements to digest
24
Q
What is Basal Metabolic Rate (BMR)
A
Minimum level of energy required to sustain life ie energy used to maintain basic physiological functions such as cardiac contractions, ventilation and cell growth.
25
How much does BMR account for as pc of energy expenditure?
BMR accounts for 60-75% of total energy expenditure, mostly from the metabolic activity of lean tissue (i.e. non-adipose tissue) collectively referred to as fat-free mass (FFM).
26
What FIVE factors can impact BMR?
1. BMR varies between individuals, mostly due to **muscle mass**. BMR will increase with more lean muscle.
2. **Physical activity** can also impact BMR: exercise can elevate metabolic rate for up to 48 hours and can also increase fat free mass (FFM) which further elevates BMR.
3. Other factors that can affect BMR include **stress, caffeine, nicotine, medications, fever, injury,etc**.
4. **Genetics**
5. **Thyroid hormones** (endocrine organ) - command centre for energy metabolism. Literally responsible for turning up the heat. All body cells have thryroid receptors.
27
What is thyroid gland responsible for?
Regulating **energy metabolism**
By secreting **hormones that control metabolic rate of cells**.
28
Where is TSH produced?
Anterior pituitary gland
29
What hormones does TSH trigger release of?
1. Thyroxine (T4)
2. Triiodothyronine (T3)
From thyroid gland.
T4 = primary thyroid hormone; less potent than T3.
30
Co-factors for T3 and T4 production?
ITSZI
1. Iodine
2. tyrosine
3. Zinc
4. Selenium
5. Iron
31
Where is T4 converted to T3?
Liver and kidneys.
32
Sub-clinical thyroidism symptoms?
Found in 8-10% of the population (60% are unaware) – more common in women.
1. Can present as low energy
2. Reduced appetite
3. Weight gain
4. Feeling cold
5. Dry skin
6. Thinning hair
7. Constipation
8. Irregular periods
9. Depression
10. Goitre
33
What nutrient deficiences cause sub-clinical hypothyroidism?
1. Iodine
2. Selenium
3. Zinc
4. vitamin D
34
What non-nutrient factors contribute to sub-clinical hypothyroidism?
1. Autoimmunity,
2. Fluoride / chlorine (halogens) displace iodine
3. Mercury (amalgams, tuna) so displaces iodine and therefore disables T4.
4. Exposure to endocrine disruptors such as BPA.
5. Gluten
NB Often an AI issue ie Hashimotos - antiobidies can be tested on a full thyroid panel. If elevated know they are being attacked. Big connection between gluten and hypothyroidism. Antiobidies remain for six months.
35
Why is a full thyroid panel beneficial?
We need to know root cause why the thyroid isn't performing ie:
1. Iodine deficiency? Seaweed… govt fortification eg livestock feed so it hits us indirectly.
2. Selenium deficiency? (Brazil or South America only) deficiency? Depleted soils.
GPs do same test with same action ie thyroxin... blunt instrument
3. AI?
Full panel = TSH, T4, T3 and thyroid antibodies. Docs only do TSH.
36
What kinds of diseases and traumas can affect energy metabolism upwards or downwards?
1. **Infection and fever** (thermogenesis in action!) raises one’s metabolic rate. Trying to make body inhospitable. Starve a fever and feed a cold... body's metabolic rate increases. Need to provide more energy.
2. **Surgery**: Increase requirements to aid recovery (amino acids, vit C to make collagen) or an injury.
3. BMR of patient with **severe burns** can more than double during recovery. Immune system and tissue repair.
4. **Anorexia Nervosa** patients need energy intake up to 2.5 times their BMR during re-feeding.
5. **Cancer patients** energy requirements may reach 145% of BMR.
37
What is the thermic effect of food?
Amount of **energy required to digest and process the food you eat** (done in lab). Also referred to as **thermogenesis**.
TEF accounts for approx. 10% of the total daily energy expenditure in an average diet.
38
What are the thermic rates for macros?
Different foods have different thermic dffects (TEF):
Fats = 0-3%
Carbohydrates = 5-10%
Proteins = 20-30%
While proteins take more energy to digest and be absorbed, fats barely take any. Proteins better for weight loss programmes.
Wholefoods have a higher thermic TEF (thermic effect of food) than processed foods.
39
Caloric guidelines for men and women?
Women: 2000kcal/day
Men: 2500kcal/day for men.
40
What do govt caloric guidelines ignore?
1. Body size
2. Muscle mass
3. Current state of metabolic health
4. Sedentary v. active lifestyle.
41
What is DNL?
de novo lipogenesis (DNL) = metabolic pathway that synthesises fatty acids from excess carbohydrates ie new fat generation
42
What happens metabolically when we eat each macro?
1. **Carbs:**
a) Immediate energy conversion under normal conditions (preferential).
b) Excessive carbs, especially when refined (combined with a sedentary lifestyle), will force metabolism into DNL - a key driver of ‘Metabolic Syndrome’.
2. **Fructose** = carb exception. Unlike glucose, which can be metabolized by most cells in the body, fructose is mainly metabolized in the liver. Liver easily **converts fructose into fatty acids**. High amounts of fructose result in **high levels of de novo lipogenesis**.
3. **Fats** in excess stored in adipose tissue under normal metabolic conditions.
Think: *we burn the easy stuff and store the precious stuff*.
When you consume fructose, it's absorbed in the small intestine and transported to the liver. Enters the glycolytic pathway, where they can be further metabolized for energy production or converted into fat. Excess fructose consumption can lead to adverse metabolic effects, including increased fat synthesis and insulin resistance.
43
What happens metabolically if undereat?
**Negative energy balance** forces body to use stored fat for energy - weight loss.
Chronic calorie restriction may lead to:
- **slowing down of metabolism**
- **micronutrient deficiencies**.
Can make it more difficult to continue losing weight. Thyroid kicks in. Slows us down. Won't fidget ie NEAT activities, will get colder.
Nutrient dense food necc to help re-establish healthy metabolism for weight loss to continue.
Biology always wins. 5/6 people who calorie restrict will put weight back on. Survival instinct... body wants us to get back to previous levels.
44
How to calculate ideal macronutrient split?
Calculate energy requirements using online calculator so you can calculate how many grams of carbohydrate, protein and fat they should be eating to maintain energy balance.
45
Which micronutrient deficiencies can make us gain weight?
1. Vit D deficiency pre-disposes to weight gain.
2. Low cal diet is usually low fat diet. Fat soluble vit deficiencies A, D, K low.
3. If vegan poss iodine, B12, Fe and Zn deficiencies.
46
One exception to recommending eating moderate healthy saturated fat?
Someone with APEOE4 gene. Need to lead a really anti-inflamm life.
47
Blue zone macro split?
65pc carbs
20pc fats
15pc protein
But 80pc plant-based so high quality carbs.
48
What is pc macro split in ketogenic diet?
65pc fat
25pc protein
10pc carbs
49
What pathologies can ketogenic diets be used for?
1. Epileptic seizures (over 100 years)
2. Obesity
3. Metabolic syndrome
4. T2DM
5. Alzheimer’s
6. Parkinson’s
7. Certain cancers such as malignant brain tumours
50
What fuel does brain run on?
1. Glucose (glycogen)
2. Ketones - made by liver during fasting, starvation or carb restriction
51
Name the three ketone bodies
1. Acetone
2. B-hydroxybutryate
3. Acetoacetic acid
52
What don't calorie counting diets take into account?
1. Individual metabolic rates
2. Genes
3. Gut bacteria
4. Hormonal response to food.
53
Benefits and pitfalls of working out macros?
**Benefits**
1. Someone who needs to **put on weight**
2. Someone not interested in food to educate them for a short period
3. Ascertain how much and how often one eats
4. Body composition goals eg ketogenic diet
**Pitfalls**
1. Can lead to food disorders eg anorexia
2. People become obsessive - anxiety around food.
3. Calorie counting results usually short-lived.
54
What are the key players in satiety?
1. CCK (duodenum)
2. Liver (via vagus nerve up to brain) to give signal of satiety
3. Hippothalamus
4. Hormones
55
Relationship between vagus nerve and brain
80pc of vagus nerves go from gut to brain (not vice versa).
Receives satiety signals from liver to pass to brain.
56
What role does hippothalamus play in appetite regulation?
1. Neurons in **arcuate nucleus** of hypothalamus stimulate or inhibit food intake and **influence energy homeostasis**.
2. Gut hormones act peripherally to modulate digestion and nutrient absorption reaching hypothalamus via circulation or Vagus nerve.
57
Name the hormones and neurotransmitters that control satiety
**Down regulators of food intake ie satiety**
1. **Cholecystokinin (CCK)** ↓ Produced by the duodenum; promotes satiety.
2.. **Insulin** ↓ Potentiates (amplifies) satiating effect of CCK.
3. **Glucagon** ↓ Major role in glucose metabolism. Decreases appetite.
4. **Glucagon-like peptide 1** (GLP-1) ↓ Similar in function to Glucagon. Promotes satiety.
5. **Bombesin** ↓ Peptide found in brain and GI tract; acts same as CCK.
6. **Leptin** ↓ Made by fat cells. Promotes satiety
NB role of liver too in satiety
**Up-regulators of appetitie**
1. **Neuropeptide Y** (NPY) ↑ Potent stimulant of food intake.
2. **Ghrelin** ↑ Made by the stomach, increases with food deprivation and may trigger hunger.
Grelin, leptin, CCK, insulin - most important
58
What role does CCK play in satiety?
1. CCK secreted in response to prescence of food in duodenum:
2. Stimulates:
- **gall bladder** to release **bile**.
- **pancreas to release pancreatic juice** (digestive enzymes).
3. **Delays gastric emptying**.
4. Acts on **CCK receptors throughout CNS** and satiety centres in brain stem.
5. Meals rich in **protein and fat** stimulate CCK more than meals that just contain carbohydrates.
59
Role of insulin in satiety?
Released by pancreatic beta-cells in response to **elevated blood glucose**.
1. Role = to lower blood glucose by facilitating its storage predominantly in **muscle tissue** and **liver as glycogen**.
2. Controls storage and release of fatty acids in and out of adipose
tissue. **Fat cannot be stored without insulin**. (Type 1 diabetes need to inject insulin to make them store fat). Will get skinnier and skinnier.
When we eat, blood sugar rises and insulin is released to lower it. Insulin is **fat and glucose storage hormone**.
60
Mechanisms of action for insulin storing fat?
1. Regulation of several lipase enzymes.
2. Activation of glucose transport into fat cells via recruitment of glucose-transport protein 4 (**GLUT4**).
61
Which two things does every cell in body have receptors for?
Vit D
Thyroid.
62
Gluconeogenesis?
Biosynthesis of glucose from non-glucose precursors.
63
What is the storage form of glucose and fatty acids?
Triglycerides
64
Metabolic actions of Insulin?
1. Stimulates triglyceride synthesis (storage form of glucose) from free fatty acids.
2. Inhibits release of free fatty acids from triglycerides (so consumed food is used rather than fat stores).
3. Increases synthesis of liver glycogen, thereby increasing glucose uptake and storage. Store as glycogen.
4. Inhibits gluconeogenesis (ie glucose production from non-carb sources)
5. Stimulates glucose uptake in skeletal muscle.
6. Reduces hunger via the hypothalamus.
65
Why does insulin resistance lead to adiposity?
1. Chronic **excess food** (energy) intake (combined with a **sedentary** lifestyle) leads to the body producing excessive amounts of insulin.
2. Normal insulin levels **inhibit lipolysis** – the breakdown of fat from adipose tissue.
3. However, with insulin resistance, **lipolysis not inhibited** leading to visceral fat deposition ie around vital organs;. Also referred as central adiposity)
4. As visceral fat increases, **adiponectin production decreases**.
66
Adipotectin?
A goodie!
Adipose-specific **protein hormone** that:
1. Increases oxidation of fatty acids
2. Promotes clearance of excess fat in tissues
3. Improves insulin sensitivity.
67
Visceral fat?
Fat deposits around internal organs in main body cavities esp in abdomen:
- liver
- gallbladder
- pancreas
- stomach
- small intestine, colon
- kidneys
- spleen
68
Key physical feature of insulin resistance
Central adiposity
69
Why does insulin resistance result in non-alcoholic fatty liver disease?
Normally, insulin sends two signals to the liver:
1. Stop making glucose – i.e. inhibit gluconeogenesis.
2. Instead, Store the (new) available blood glucose as glycogen – i.e. glycogenesis.
However, in insulin resistance signalling = impaired.
IR leads to
1. increased lipolysis in adipose tissue leading to increased circulating triglycerides.
2. increased hepatic uptake and synthesis of fatty acids, 3. inflammatory processes. These factors together cause the liver to accumulate excessive fat,
*IR can lead to fatty liver because when the body becomes resistant to insulin, it has trouble using glucose effectively for energy. This leads to high levels of glucose in the blood, which triggers the body to produce more insulin. Excess insulin promotes the storage of glucose as fat in the liver, leading to fatty liver disease.*
70
How does body process fructose and dangers?
Differently to glucose - either used immediately or when glycogen stores are full, fructose is converted directly to liver fat
Excess fructose intake leads to:
- NAFLD (non-alcohol fatty liver disease)
- Obesity
- Hypertension
- Excess uric acid levels (associated with gout),
- Elevated Advanced Glycation End products (AGEs) linked with accelerated ageing and diabetes complications
71
What is glycated haemoglobin?
Very sticky. Sticks to proteins in the body… therefore sticks to RBC. We can work out how much of our haemoglobin has been glycated over a period.
72
What does ghrelin do?
**Increases hunger**.
Produced by **stomach cells** when stomach is empty to **stimulate food intake**. Secretion suppressed after a meal.
Obese subjects have reduced post-prandial ghrelin suppression.
Ghrelin levels increase after weight loss – might explain why it is harder to keep weight off.
73
What can + and - affect ghrelin secretion?
**Increase secretion**
1. Dysregulated **sleep** and elevated **cortisol**
2. **Weight loss**
**Decrease**
3. **Exercise**
4. **High-protein meals** (35% of calories) with moderate carbs (45%) better for suppressing ghrelin.
74
Adipokines?
Family of hormones and cytokines secreted by adipose tissue eg leptin
75
What is the opposing hormone to ghrelin?
Leptin
76
What is leptin?
Helps regulate **appetite and energy balance**.
Can upregulate and downregulate.
**Adipokine** produced by white adipose cells in proportion to overall body fat (adiposity).
Signals to brain when the body has enough energy stored as fat.
Plays crucial role icontrolling hunger, metabolism, and body weight.
When leptin levels are low, it can signal hunger and decrease energy expenditure, while high levels can suppress appetite and increase energy expenditure.
77
Which axis regulates leptin?
Hypothalamic-pituitary axis
78
What does leptin resistance do?
Leptin **regulates hunger and energy expenditure**.
Leptin resistance occurs when body doesn't respond to leptin properly ie brain doesn't get the signal that you're full, leading to overeating.
Resistance modifies:
1. Insulin sensitivity
2. Tissue metabolism
3. Stress responses
4. Reproductive function
Over time, these changes in metabolism produce:
- abdominal weight gain in both men and women
- as well as thigh and hip weight gain in females
- chronic fatigue
- sleep problems
- cardiovascular distress,
3. Additional adipose tissue then contributes further to leptin resistance (becoming a vicious cycle).
Leptin resistance uslly comes with insulin resistance.
79
How can you increase leptin sensitivity?
1. Diet: go GF, reduce sugar, eat anti-inflammatory diet
2. Improve gut flora
3. Exercise more
4. Sleep
—————————————
1. Go **Gluten-Free** Wheat gluten has been shown to stop leptin binding to the leptin receptor ie stop it signalling.
2. **Reduce sugar** consumption, especially fructose as this has been shown to induce leptin resistance.
3. Support **gut flora** with prebiotics. Some evidence to show that prebiotics can improve leptin sensitivity.
4. **Reduce Inflammation** Following an anti-inflammatory diet can contribute to restoring leptin sensitivity. SMASH, eat the rainbow. Stop seed oils.
5. **Regular exercise** Shown to increase leptin sensitivity.
6. **Sleep hygiene**: Poor sleep can adversely affect leptin sensitivity.
7. Eat less and move more!
80
Links between gut and obesity?
Microflora composition, GLP-2, intestinal permeability, endotoximia, LPS, IR, inflammation.
1. Different gut microflora compositions overweight v lean individuals (reduced **Bifidobacterium**) and higher **Firmicutes**.
What we eat affects which species of bacteria proliferate in the gut:
- phytonutrients - high in pre-biotics
- need diversity.
3. Healthy gut produces SCFAs:
1. Tight junctions
2. Increases secretion of **appetite-curbing neuropeptides** and **gut peptides** eg GLP-2 which support integrity of intestinal lining.
4. Intestinal permeability associated with metabolic endotoxemia (risk factor in obesity) characterised by:
a) Enhanced lipopolysaccharide (LPS) absorption. Generates inflammatory response.
b) Leads to low grade chronic inflammation.
c) Drives insulin resistance.
2 Also address oxidative stress by increasing antioxidants. Can see when people are inflamed.
81
Best way to modify gut flora for weight loss?
Pre- and pro-biotics = important part of effective weight management and metabolic health protocol.
Studies using **prebiotics** have been shown to:
- Change diversity of gut microbiome
- Promote satiety.
- Reduce hunger.
- Reduce food ingestion.
- Suppress ghrelin.
- Increase peptide YY (reduces appetite) and GLP-1.
82
Which strains of bacteria lead to healther gut to bring back insulin sensitivity?
1. Lactobacilli
2. Bifidobacteria
3. L. acidophilus
Alongside diet and we are all different and not one solution fits all.
83
Define appetite and hunger
**Appetite**: a psychological reaction that stimulates a **physiological response such as salivation**; ie. a **conditioned response to food**.
**Hunger**: a **physical reaction** that includes chemical changes in the body from a prolonged period without eating; i.e. the need for food (anything!).
84
Which foods stimulate the dopamine reward system?
High fat
High sugar
To hunter-gatherers, foods with a high fat or sugar content eg honey offered survival advantage. Consequently these foods strongly stimulate the dopamine reward system.
85
Dopamine receptors in obese people?
Reduced numbers of dopamine receptors in brains and get less of a reward response from palatable foods.
86
What non-food factors affect food intake eg cultural and social?
1. Religious traditions.
2. Celebrations eg Xmas
3. Meal patterns.
4. Family traditions
5. Work lunches/dinners.
6. Attitudes to leaving food on the plate.
7. Education eg Eatwell plate (not eating well!)
87
Sensory inputs to food intake
Sensory:
1. Appearance/smell of food.
2. Taste and palatability of food.
3. Addiction (sugar, cigarettes and coffee)
4. Packaging, advertising.
5. Surroundings and ambience.
6. Learned likes and dislikes.
7. Flavour fatigue
88
Factors that affect food intake?
Emotional:
• Comfort eating.
• Stress.
• Insomnia.
• Loneliness.
• Sadness.
"Other:
• Hormones.
• Disease states.
• Climate.
• Medications.
• Distractions; e.g. TV/computers (can eat up to 30pc more!)
• Value for money/cost
• Boredom"
89
How to maintain even blood sugar levels
1. Avoid refined carbs/sugar
2. Include protein with every meal
3. Include complex carbs / low GI/GL foods; e.g. beans, wholegrains, vegetables, etc.
4. Choose organic/whole foods for optimum nutrition.
5. Chew well, eat mindfully, don’t overeat, 3 meals-a-day
90
What drives sugar cravings?
Sharp spikes in blood sugar lead to drops in blood sugar.
These increase activity in brain’s **nucleus accumbens**, that produces desire to eat, often **manifesting as sugar cravings** ie ground zero for addiction.
Reward/motivation pathways. Dopamine (desire) and seratonin (affects satiety and inhibition).
91
How can you apply "adding in" foods rather than "taking away" in clinic
1. Add in more **nutrient dense** foods (colourful vegetables, fruit, pulses & wholegrains) that are high in fibre, water, phyto- and micronutrients…
2. This displaces “energy dense” foods that have high amounts of fat, sugar and starch and less water, fibre and micronutrients, such as processed foods, oils and confectionery.
Eating is a zero-sum game: The more you eat of one food, the less you eat of another.” Need to move slowly to change people's diet.
92
What factors hinder weight loss?
1. Over-eating and junk food (too many calories from energy-dense, nutrient-poor foods).
2. Sedentary lifestyle (not enough movement).
3. High blood sugar (often associated with high intake of refined carbohydrates and ‘Insulin resistance’).
4. Chronic stress (cortisol à ↑ blood sugar, ↑ abdominal fat).
5. Poor sleep (linked to ↑ waist circumference, ↑ fat mass).
6. Underactive thyroid function.
7. Gut flora imbalances (which can influence metabolism). Can change in a week - introduce the smelly veg (garlic, onions, leeks).
93
Five ways to reduce stress to aid weight loss?
1. Identify and address the *root cause** of stress. Pause and reflect on the stress causes can help client identify where it is coming from.
2. Diaphragmatic breathing exercises to stimulate Vagus nerve (and parasympathetic activity)
3. Eat to balance blood sugar (low blood sugar increases cortisol).
4. Use ‘adaptogenic’ and ‘nervine’ (relaxing) herbs such as ashwagandha, chamomile and passionflower. And Rhodiola. Calms the nerves without doping you.
5. Reduce reliance on stimulants eg coffee and alcohol.
6. Eat a diet high in Magnesium, B-vitamins and Vitamin C - get depleted really easily during stress. Need to supplement to get levels up.
7. Epsom Salt baths (500g of salts – add 10 drops of lavender oil)
94
Good sleep hygeine tips?
1. Avoid coffee (a stimulant) and products containing caffeine. Also avoid alcohol (a sedative that leads to a less restorative sleep).
2. Plan for 8 ½ to 9 hours in bed – lights out before 11pm.
3. Ensure the bedroom is dark, cool and well ventilated.
4. 1-2 hours before bed:
- Minimise exposure to bright lights.
- Switch off devices (e.g. mobile, tablets, television).
7. Finish all eating and complete any aerobic exercise 3 hours before bed:
8. Aim to go to sleep and wake up at the same time each day
95
Weight loss strategies
1. Intermittant fasting eg alternate day fasting eg 5:2. Alternate between periods of normal eating and periods of fasting or significant caloric restriction
2. More extreme versions of ADF can be only eating every other day (i.e. 36-hour fast every 48 hours). Benefits include reduction in fat mass (particularly
trunk fat), LDL cholesterol and Triglycerides (TG)
96
How does intermittant fasting work (chemically)?
1. Lowers insulin levels so don't have to make so much of it, thereby training body to get better at using fat for fuel (metabolic flexibility - switch between).
2. Increases Growth Hormone (**autophagy** occurs - only when insulin is low) which is associated with lower body fat.
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Benefits of time-restrictive eating?
ie a defined eating window 6-12 hours per day.
1. Weight loss
2. Reduced caloric intake without calorie counting
3. Reduced blood pressure
4. Reduced fatty liver
5. Reduced LDL cholesterol
6. Reduced insulin resistance. Esp good for visceral fat.
12 hours not eating every day is good for everyone's health.
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Macros for low carb/high fat (ketogenic) diet?
High fat (e.g.65-75%)
Moderate protein
Very low carbohydrate (e.g.<50g/day)
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Difference between Intermittant Fasting and Ketogenic diet?
Similar to Intermittant Fasting (IF) lack of glucose intake (and resulting low levels of insulin) induces body to **burn ketones and fat for energy**.
However, **unlike IF, there is no calorie deficit**.
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Health benefits of ketogenic diet
1. Reduced body fat
2. Lower inflammatory and oxidative burden than when running on glucose.
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Therapeutic uses of ketogenic diet?
1. Type 2 diabetes
2. CVD
3. Cancer
4. Alzheimer’s
5. PCOS
6. Parkinson’s
7. Epilepsy
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What is HIIT?
High-Intensity Interval Training (HIIT)
Short bursts of intensive exercise alternated with low-intensity
recovery
10-30 minutes.
e.g. Cycling hard on a stationary bike at high resistance for 20
secs and resting for 40 secs before repeating for 20 minutes.
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How does HIIT work?
Creates an oxygen debt which is repaid via **Excess Post-exercise Oxygen Consumption* (EPOC) whereby oxygen intake increases post-exercise.
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HIIT benefits?
1. Increases metabolic rate (<36 hours post-exercise),
2. Lowers body fat
3. Lowers fasting blood sugar
4. Lowers BP and resting heart rate
5. Doesn't take long - great for busy people
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What is the best diet?
There isn’t one!
We are all unique, biochemical, psychological, constitutional and emotional
beings and what works for one person will not necessarily work for another.
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When devising a natrupathic nutriton plan what factors do we consider?
1. Does the plan address behavioural triggers or eating?
2. Does the plan provide all necessary micronutrients and macromolecules?
3. Is it a diet or a lifestyle change?
4. What is the motivation?
5. Does the plan offer education and support?
6. Does the plan include exercise?
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What are the naturopathic basics to eating right?
1. Whole, organic, seasonal.
2. Follow food combining principles.
3. Fit with one’s constitution.
4. Free of ultra-processed food.
5. Chew each bite well.
6. Avoid drinking with meals.
7. 3 meals a day max.
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Why walk after dinner?
Muscles store glucose… a walk post dinner will allow more room for the glucose in the blood to go into the muscle not into fat.
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How to increase energy?
1. Protein during the morning and focus every meal/
2. Dark green veg for the Mg (ATP production) - x2 the green.
3. Lemon water in the morning to try to detox the liver. Then the coffee.
4. Coffee only after breakfast not first thing.
