Nutrition Disorders: Overnutrition Flashcards
What is NICE definition of malnutrition?
- a state in which a deficiency of nutrients such as energy, protein, vitamins and minerals causes measurable adverse effects on body composition, function or clinical outcome
What is the definition of obesity accoridng to the WHO?
- a disorder in which excess body fat has accumulated in a patient
- fat may then have adverse health affects
What is are diagnosis cut offs of obesity and overweight using BMI accoridng to the WHO?
- BMI >25kg/m2 overweight
- BMI >30kg/m2 obese
What is are diagnosis cut offs of obesity using waist circumference accoridng to the WHO?
- > 94cm /37 inches in men
- >= 80cm/31.5 inches in women
How do we calculate BMI?
- weight (kg) /height in cm2
- 80kg / 1.86m2 = 24kg/m2
Is waist circumference a measure of central (fat around belly) or general obesity (fat everywhere)?
- central obesity
What is central and general obesity?
- central = fat is centred around chest and abdomen
- general = fat is everywhere
Central obesity (fat centres around the abdomen and chest) are at higher risk of what diseases when compared with general obesity?
- T2D
- CVD
- increased morbidity and mortality
Is BMI validated on <18 and >80 year olds?
- no
Why is it important to use age and gender specific standards and centrile charts?
- age and gender both influence body composition
Instead of using BMI and waist circumference in <18 years olds, what would we use instread?
- age & gender specific standards and centile charts
Can being obese come with an associated stigma?
- yes, can affect the following:
- character = if obese does it mean they are lazy
- intelligence = if obese are they not bery clever
- social class = lower class may be more likley to be obese
- job role = inability to do their job properly
Do patients with a low income consume more or less fruit and vegetables than those with a higher incomes, and total calories?
- low income less fruit and vegetables BUT more total calories
Do patients who are well educated have higher energy expenditure than those who are less well educated?
- educated and energy expenditure are inversely associated
Do obese patients tend to marry earlier or later, and marry oberse or non obese people than those who are not obese?
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- obese people marry later
- obese are more likely to marry obese partners
Do married or single men weight more?
- married men weigh more than single men
If women have more than one child, do they generally return to their previous weight, or do they generally gain weight with each baby?
- weight increases with each child
Are older people who live alone more likley to be underweight than older people livving with someone?
- older people who live alone are more likely to be underweight
Is being obese just down to eating and low physical activity?
- no
- mental health plays a role
According to the WHO what has happened to obesity levels since 1975?
- tripled
In 2016, accoridng to the WHO what % of the worlds population that were >18 years were obese and overweight?
- 39% were overweight
- 13% were obese.
In the majority of the world, is being overweight or underweight associated with higher mortality rates?
- overweight
is obesity and overweight only a problem in high income countries?
- no it is now present in middle and low income countries
In England between 1993 and 2000, what has happened to obestiy and overweight numbers?
- both have increased
- have slowed since 2003, but still rising
In England between 2017 and 2018, what % of adults were obese and overweight?
- 67% men
- 60% women
In England between 2017 and 2018, what % of year 6 school children were classified as obese?
- 20%
At what age in men and women does obesity peak in England according to NHS stats?
- men = 55-64 years old
- women = 65-74 years old
- obesity generally increases with age
According to the WHO how many children under 5 years old globally were obese?
- 38 million
According to the WHO how many adolescents (5-19) years old globally were obese or overweight?
- >340 million
How does obesity affect cellular and metabolic mechanisms?
- causes cellular changes due to fat deposits
- impairs metabolic function
How does obesity affect joints?
- increased weight increases wear and tear
How does obesity affect the airways?
- increases fat around airways
- increases risk of asthma and sleep apnoea
In children what what does fat increase the risk of?
- T2D
- asthma (risk increases by 40-50%)
- increases CVD risk in adult life
- mental health, low self esteem and emotional issues
Does obesity affect the risk of disease in adults?
- can affect any organ in the body
Accoridng to the NICE guidelines, if a patient presents with a BMI <35kg/m2, what other measure would you be required to take to determine the health risks to the patient?
- waist circumference
Accoridng to the NICE guidelines, if a patient presents with a BMI >35kg/m2, does a waist circumference affect the the health risks to the patient?
- no BMI is so high already
- waist circumference becomes secondary to BMI
What is one of the most common diseases that is associated with central obesity?
- diabetes
- always test patients who are obese for diabetes
If a patient has a high BMI and waist circumference what disease should they be tested for?
- diabetes
To treat obesity what is the main aim of any obesity interventions?
- to reduce calories consumed
- increase energy expenditure
To treat obesity the aim is to reduce calorie intake and increase energy expenditure, what are the 4 mains ways this can be achieved?
- motivational interviewing and behaviour change
- diets
- drugs
- bariatric surgery
The NICE guidelines have identified how to assess and identify and manage patients with obesity based on their risk factors that encompass BMI, wasit circumference and co-morbidities. What are the 4 levels of the intervention plan?
- level 1 = general advice healthy weight and lifestyle
- level 2 = diet and physical health
- level 3 = diet and physical activity, drugs
- level 4 = diet and physical activity, drugs, surgery
When discussing diets, does one diet work for everyone, and what is the overall aim of any diet?
- no, specific to individual
- calculate basal metabolic rate and subtract 500 calories
- overall aim is just to reduce calories
When a patient attends a clinic who is very overweight, what should the overall weight loss targets be?
- 5-10% of overall weight
- 0.5-1kg/week
- 5% weight loss improves health outcomes
What is bariatric surgery?
- group of procedures aimed at facilitating weight loss
- GIT is manipulated to reduce calorie intake
- can include stomach stapling, gastric bypasses and sleeve gastrectomy
Bariatric surgery is a surgical procedure aimed at reducing the amount of calories an individual is able to eat. At what BMI would a patient be considered for bariatric surgery?
- BMI of >40
- BMI between 35 and 40 with comorbidities
What is meant by obesogenic enviroments?
- enviorments that encourage obesity
- food delivery
- fast food close to schools
