lecture 10 - Managing and preventing metabolic syndrome Flashcards
To avoid metabolic syndrome, you should avoid becoming..
obese
While certain genes increase the risk of obesity, the prevalence has almost doubled since 1980 meaning that ..
a purely genetic cause is unlikely
genes don’t mutate that fast..
High energy diets have the ability to change expression of genes, explained by..
epigenetics
methylation of promotor etc…
It is now clear that alot of obesity is due to epigenetics
A lot of _____ is due to epigenetics
A lot of obesity is due to epigenetics
Combating obesity
What are the details of the very low calorie diet?
limiting energy intake to 800 calories - lose weight rapidly
replace 2 meals a day
provide essential fatty acids and micronutrients
Arcuate nucleus in the hypothalamus, two classes of nerves (neuro-peptide Y and PomC). Determines whether you’re hungry. what controls these neurons?
Hormones in the blood. (approx. 10)
only 1 that makes us hungry -Ghrelin (released by the empty stomach)
Small bowel releases 9 that take hunger away (CCK, PYY, Amylin)
Leptin is increased from apidose tissue, what does it do?
reduces hunger - feedback system
Duromine
and
Topiramate (Topamax)
are examples of
weight loss pharmacological agents
+
for patients with Diabetes
Exenatide
If patients can’t tolerate weight-loss drugs, what is the next step?
consideration for surgery - though there’s a lack of funding
What are the operations?
Gastric banding (high failure rate)
sleeve gastrectomy - reduces level of Ghrelin
Rouz-en Y bypass - causes PYY release to decrease hunger
Managing Diabetes:
Diet
exercise
Drugs (metformin - controls for a while…)
Acarbose - slows the absorption of carbohydrates
GLP-1 enhancing drugs
Insulin
SGLT2 - makes sugar leak through the urine, doesn’t require insulin for their action
true or False
Meal replacements work before at medium term weight loss
true
Why do diets nearly always fail?
Body weight is defended by the body using hormones
even at 3 yeasr - the hormones have not returned to base-line - still more hungry
How do you manage blood pressure?
reduce in salt intake!
duiretics
ACE inhibitors
B-blockers
hwo do you manage dyslipidaemia(high triglyceride, low HDL)?
Diet exercise Fibrates Statins - for the cholesterol Ezetimibe
