Nutrition -Covasa

Question 1

How is BMI calculated?

Answer 1

weight in kg divided by the square of the height in meters

Question 2

What waist circumference is considered obese in men? Women?

Answer 2

Men > 102 cm (40”)

Women >87 cm (34.3”)

Question 3

Factors influencing what 4 feelings/desires can lead to obesity? (I don’t know how to ask this)

Answer 3

• 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.

Question 4

True or false: Meal initiation is controlled by metabolic or hormonal signals

Answer 4

False

Question 5

True or false: Meal cessation (meal size) is controlled by pre-absorptive gut signals

Answer 5

True

A person will eat less with food in their gut than they will without food in their gut

Question 6

What are the long term adiposity signals? What do these control?

Answer 6

Leptin (from adipocytes) and insulin

–> control catabolic and anabolic pathways to regulate energy homeostasis

Question 7

What are the short term satiety signals? What do these control?

Answer 7

Gut secreted things (mechanical, chemical signals)

control meal size

Question 8

True or false: Disturbance of any short term or long term controls from the gut can lead to obesity

Answer 8

TRUE

Question 9

What is necessary to determine the status of a meal (i.e. when to stop eating)?

Answer 9

Intestinal nutrients MUST release intermediary substances that activate VAGAL sensory neurons

(absorption of nutrients is not necessary for reduction of intake)

Question 10

What effect will giving CCK shots injections have on meals?

Answer 10

Decrease the amount consumed in a meal but increase the number of meals==> no change in the 24 hour daily intake

Question 11

What are the two types of body fat distribution? Which one is more harmful?

Answer 11

Abdominal (android) is more harmful than Lower body (gynoid)

Question 12

What is the gut micro-biome theory?

Answer 12

• 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

Question 13

What can disrupt the gut micro biome?

Answer 13

• diet (high fat can decrease diversity)
• disease state
• antibiotics (esp important in kids)
• Bariatric surgery

Question 14

What % loss in body weight can change metabolic profile?

Answer 14

10%

dec: CV risk, blood glucose, BP, LDL and Triglycerides, sleep apnea, degenerative joint disease

Question 15

Is exercise an effective means of losing weight?

Answer 15

NO!

It can help maintain weight though

Question 16

What is the idea behind volumetrics weight-control?

Answer 16

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)

Question 17

What is the only treatment that shows real maintenance of weight loss?

Answer 17

Bariatric surgery

Question 18

How does bariatric surgery induce weight loss?

Answer 18

• 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

Question 19

Is the decrease in DM dependent on weight loss after bariatric surgery?

Answer 19

NO

DM decreases due to changes in metabolic regulation

Question 20

Vitamin A deficiency is common after which bariatric surgery? What symptoms might a pt have?

Answer 20

BPD +/-DS

may cause xerophthalmia, nyctalopia (night blindness) and follicular hyperkeratosis

supplements of 5000-10000IU/day

Question 21

Vitamin B12 deficiency is common after which bariatric surgery? What symptoms might a pt have?

Answer 21

RYGB
(due to the loss of IF)

-deficiency causes pernicious anemia, paresthesias, neuropathy, depression, paranoia, delirium and dementia