Lecture 30 Flashcards
What is the number 1 therapeutic to treat obesity?
Bariatric surgery
How does bariatric surgery effect blood pressure and weight loss?
It has a positive effect on weight loss an an ambivalent effect on blood pressure
Why are a lot of drugs for weight loss withdrawn from the market?
Because there were too many side effects
What can you change about your lifestyle to reduce weight?
You can reduce your consumption of energy dense food and do more exercise
What is the obesity paradox?
Obesity is associated with increased survival/reduced mortality among patients with CVD. This means that if you are overweight, the more likely you are to get CVD but once you have it, the more likely you are to survive
What percentage of the determinants of weight does genetics make up?
40-70%
What are 7 ways to measure obesity?
- Body mass index (BMI)
- Waist circumference (WC)
- Waist to hip ratio (WHR)
- Bioelectrical impedance (BIA)
- Densitometry (underwater weighing)
- Dual Energy X-ray Absorptiometry (DEXA)
- Computerised Tomography (CT) and Magnetic Resonance Imaging (MRI)
What are some ways that obesity level can differ between different populations?
Women vs. men
Adults vs. children
Body composition (untrained vs. athletes)
Hydration status
What are some benefits of using waist circumference to measure obesity?
Easy to measure, inexpensive, strongly correlate with body fat, predicts risk for CVD
What are the pros and cons of using waist to hip ratio as a measurement for obesity?
Pros: Relative easy to measure, inexpensive, strongly correlate with body fat, predicts risk for CVD
Cons: hip measurement and interpretation difficult.
What is a bioelectrical impedance?
Small imperceptible safe electric current through your body and measures your resistance to the current, which is different for water and fat - %fat is calculated.
What are the pros and cons of bioelectrical impedance?
pros: Relative easy to measure and inexpensive, correlate with body fat, predicts risk for CVD
cons: difficult to calibrate, hydration-dependent
How does densitometry work?
Subjects weight in air and underwater
What are the pros and cons of densitometry?
Pros: body volume/density and %fat; very accurate
Cons: cumbersome and expensive
How does a dual energy X-ray absorptiometry work?
X-rays pass differently to different body tissues
How does a dual energy X-ray absorptiometry work?
X-rays pass differently to different body tissues. It measures at- free mass, fat mass, bone density
What are the pros and cons of using dual energy X-ray absorptiometry?
Pros: Accurate, simple
cons: expensive, includes low level radiation
What does computerised tomography and magnetic resonance imaging measure? What are the pros and cons?
Tissue, organ and whole body fat; lean muscle mass, bone mass.
pros: it is the most accurate
cons: very expensive, radiation
When does the location of fat matter?
You don’t want fat around your organs because this increases the atherogenic cardiometabolic risk profile
What is meant by a positive energy balance?
You are taking in more energy that you are burning
What is healthy and what is unhealthy adipose tissue?
Healthy adipose is subcutaneous tissue and you have an absence of metabolic syndrome clinical criteria
Unhealthy adipose tissue is visceral obesity which leads to altered FFA metabolism, altered release of adipokines. There is the presence of metabolic syndrome criteria
How does an ultrasound work?
it sends out a sound wave, it hits an object and is reflected back
How does an echocardiography work?
You can look at the heart from the apex (not from the top as the thorax is in the way)
What are the two ways to look at the heart in the echocardiography? What do you see in each of them?
4C which shows LV, LA, RV, RA and 2C which shows LV and LA
How can epicardial adipose tissue cause cardiac arrythmias?
The secretions from fat tissue such as adpiokines and adiponectin can cause the heart to contract spontaneously (either putting it in fat or cultures) which shows that it can cause arrythmias
