Nutrition -Covasa Flashcards
How is BMI calculated?
weight in kg divided by the square of the height in meters
What waist circumference is considered obese in men? Women?
Men > 102 cm (40”)
Women >87 cm (34.3”)
Factors influencing what 4 feelings/desires can lead to obesity? (I don’t know how to ask this)
- appetite response to food or desire for food, depends on duration of deprivation and energy expenditure
- Hunger: physiological drive for food that initiates food-seeking behavior
- Satiety: feeling of satisfaction that inhibits further eating of a meal. Determines inter-meal time interval
- satiation: the termination of a meal, sensation of fullness.
True or false: Meal initiation is controlled by metabolic or hormonal signals
False
True or false: Meal cessation (meal size) is controlled by pre-absorptive gut signals
True
A person will eat less with food in their gut than they will without food in their gut
What are the long term adiposity signals? What do these control?
Leptin (from adipocytes) and insulin
–> control catabolic and anabolic pathways to regulate energy homeostasis
What are the short term satiety signals? What do these control?
Gut secreted things (mechanical, chemical signals)
control meal size
True or false: Disturbance of any short term or long term controls from the gut can lead to obesity
TRUE
What is necessary to determine the status of a meal (i.e. when to stop eating)?
Intestinal nutrients MUST release intermediary substances that activate VAGAL sensory neurons
(absorption of nutrients is not necessary for reduction of intake)
What effect will giving CCK shots injections have on meals?
Decrease the amount consumed in a meal but increase the number of meals==> no change in the 24 hour daily intake
What are the two types of body fat distribution? Which one is more harmful?
Abdominal (android) is more harmful than Lower body (gynoid)
What is the gut micro-biome theory?
- Our gut hosts billions of microorganisms
- The micro-biome performs digestive and metabolic functions, and “evolves” over our life course
- The micro-biome “talks” to the liver, the brain, organs controlling metabolism, inflammation and the immune system
- The micro-biome is affected by what we put into our mouths
What can disrupt the gut micro biome?
- diet (high fat can decrease diversity)
- disease state
- antibiotics (esp important in kids)
- Bariatric surgery
What % loss in body weight can change metabolic profile?
10%
dec: CV risk, blood glucose, BP, LDL and Triglycerides, sleep apnea, degenerative joint disease
Is exercise an effective means of losing weight?
NO!
It can help maintain weight though
What is the idea behind volumetrics weight-control?
eating less dense foods, regardless of the macronutrient composition, is associated with reductions in energy intake (allows you to eat bigger portions with less calories)
(eat food with more water in it)
What is the only treatment that shows real maintenance of weight loss?
Bariatric surgery
How does bariatric surgery induce weight loss?
- alters the endogenous regulators of body weight, body fat and metabolic function -CNS involved reduction in hunger and appetite drives
- physiological changes –> no underweight will occur
- changes in food preferences, inc satiety, dec hunger and reward based eating
NO change in GI hormones
Is the decrease in DM dependent on weight loss after bariatric surgery?
NO
DM decreases due to changes in metabolic regulation
Vitamin A deficiency is common after which bariatric surgery? What symptoms might a pt have?
BPD +/-DS
may cause xerophthalmia, nyctalopia (night blindness) and follicular hyperkeratosis
supplements of 5000-10000IU/day
Vitamin B12 deficiency is common after which bariatric surgery? What symptoms might a pt have?
RYGB
(due to the loss of IF)
-deficiency causes pernicious anemia, paresthesias, neuropathy, depression, paranoia, delirium and dementia
