Nutrition for Obesity

Question 1

Based on a survey by the association of pet obesity prevention in 2018, what percentage of dogs are overweight? Cats?

Answer 1

56% of dogs are overweight or obese
59% of cats are overweight or obese

Question 2

How to determine if a pet is obese?

Answer 2

BCS
- Cats 5/9 is ideal
- Dogs 4-5/9
- Every point difference is 10% shift in weight.
Most used scale is purina bcs scale (9 point scale)

Question 3

When is a pet obese?

Answer 3

A body condition score 8/9 or 9/9 is considered obese and corresponds to 30% excess body weight.

Question 4

what happens when a patient has 50% or more excess?

Answer 4

The Healthy Weight Protocol/ Morphometric System allows determine the adiposity of patients with a BCS exceeding 9/9

Question 5

Why is it important to recognize obesity?

Answer 5

• Obesity has a lower longevity ( 2 years less than the control in the study)
• There is also earlier signs of aging and age related disease ( such as osteoarthritis)

Question 6

Which of the following hormones promotes hunger? Where is it secreted from?

Answer 6

Ghrelin
- Ghrelin is a hormone secreted from
the enteroendocrine cells in the
stomach and small intestines and
acts on cells in the pituitary and the
thalamus to increase food intake

Question 7

What are the other hunger hormones?

Answer 7

Other hunger hormones include
cortisol and orexin

Question 8

What hormones suppress hunger?

Answer 8

Multiple hormones suppress hunger
including leptin, insulin, CCK, GLP-1
and more

Question 9

What are the Metabolic implications of obesity?

Answer 9

Adipose tissue is active and secretes
hormones called adopokines.

Question 10

What are the adipokines?

Answer 10

• Steroid hormones
• Growth factors
• Cytokines
• Eicosanoids
• Complement proteins
• Binding proteins
• Vasoactive factors
• Regulators of lipid and glucose metabolism

Question 11

What does adiponectin and leptin do? What occurs with obesity?

Answer 11

Work synergistically to decrease food
intake and increase energy expenditure

• With obesity, there is an eventual
decrease in response to these hormones
(leptin) or a decrease in production
(adiponectin)

Question 12

Why is obesity considered an inflammatory condition?

Answer 12

• Other adipokines such as TNF-α and IL-
6 promote inflammation • Therefore chronic obesity is an inflammatory condition

Question 13

What are some of the mechanisms that contribute to a reduction of insulin response and eventually to diabetes mellitus?
What do they cause?

Answer 13

• Reduced expression of insulin signaling molecules in skeletal muscle
• Downregulation of a major insulin-responsive glucose transporter (GLUT4) in
adipocytes

They cause:
- These decrease insulin-stimulated glucose transport and metabolism in
adipocytes and skeletal muscle
- Impaired suppression of hepatic glucose output
- The increased demand for insulin secretion can result in amyloid deposition in the pancreas and decrease in the functional secreting tissue

Question 14

What is secondary obesity?

Answer 14

While obesity is the result of energy intake vs. energy expenditure, there are
several endocrine diseases that negatively affect metabolism and can increase the
risk for obesity:
• Hypothyroidism (dogs)
• Cushing’s disease (hyperadrenocorticism)

Question 15

What are metabolic implications found in obese animals?

Answer 15

• Altered lipid metabolism
• Changes in membrane fluidity
• Microbiome differences?

Question 16

What are concurrent diseases associated with diabetes?

Answer 16

Obesity is associated with an increased risk
for a variety of diseases in dogs and cats,
including:
• Neoplastic disease (chronic inflammation)
• Pancreatitis
• Diabetes mellitus
• Hyperlipidemia
• Dermatological disease (folds)
• Renal disease
• Urinary disease
• Cardiovascular/pulmonary disease
• Orthopedic disease

Question 17

How to achieve intentional weight loss?

Answer 17

• Step 1: Determine BCS, ideal BW
• Step 2: Determine current intake
(kcal)
• Step 3: Calculate RER= BW(kg)0.75 X70
• Step 4: Select diet
• Step 5: Calculate new daily energy
intake
• Check that protein intake is sufficient
• Step 6: Weigh every two weeks
• Bodyweight monitoring is crucial
• Step 7: adjust intake to reach desired
weight loss rate (1-2% BW per week in
dogs is typical)
- Remember to include treats.
- For weight loss, you can use the current RER in dogs, or 80% RER in cats OR decrease current intake by 20%
• Check that protein intake is sufficient
- Monitor body weight

Question 18

What are veterinary weight loss diets? What are the aspects they utilize to assist with weight loss?

Answer 18

• There are multiple veterinary weight
loss diets
• Not the same as ‘lite’ OTC diets • Unique aspects that help with weight
loss:
• Increased fiber
• Increased protein
• Increased sodium
• Kibble ‘shape’ ( usually more for owner so they dont feel bad like they are under feeding their pet)
• Nutrient density vs. energy density

Question 19

Why must we calculate protein requirements ?

Answer 19

Calculating protein requirements:
• Avoid protein malnutrition due to
energy restriction

Dont need to remember:
• The protein requirement for an adult
dog is 3.28 g BW(kg)0.75
• The protein requirement for an adult
cat is 4.96 g BW(kg)0.75

Question 20

What are lite foods? Are they weight loss food? What can they do?

Answer 20

• Lite food is NOT weight loss food
• Lower caloric density
• “lite” or “low calorie” dry dog food
cannot contain more than 3100
kilocalories per kilogram
• Canned foods contain much more
moisture, so the maximum allowable
calories are even lower 900 kcal/kg • Can help avoid overfeeding and
maintain weight post weight loss

Question 21

What is important about giving feeding instructions to owners?

Answer 21

• Include a goal for main meal,
  supplements (ie fish oil), treats
• Provide a gram amount- much more
  accurate than cups

Question 22

What is important to remember about treats?

Answer 22

• Treats can be incredibly important to owners and to their pets
• Treats are allowed, but have to be included in the overall intake calculations
• Treats should not exceed 10% of the daily energy intake
• Low calorie treats allow increasing the number of treats that can be given per day

Question 23

What is the correlation between excess weight and musculoskeletal disease?

Answer 23

• Osteoarthritis is more prevalent in
overweight dogs compared to lean
littermates (Kealy et al. 1992)
• Overloading the joints is the main driver
of clinical signs of OA in dogs
• Hormonal imbalances due to obesity such
as increase IGF-1 and decreased GH may
also contribute to OA

Question 24

What is the outcome of weight loss as a treatment for musculoskeletal disease?

Answer 24

A decrease in bodyweight in obese
dogs by 11-20% provides a significant
improvement in force plate analysis ( measures how much weight they are placing on their joints) ( they will place more weight on joints when less painful)
(Burkholder et al. 2000)
• Improved locomotion can be visually
assessed in a weight loss of 6%,
improved Force plate measurable at
9% (Marshall et al 2010)

Question 25

What are potential causes of orthopedic disease?

Answer 25

• Puppies until the age of 6 months are unable to regulate calcium absorption. This can result in excess bone mineralization • Excess vitamin D, excess phosphorus or
deficiency or a skewed Ca:P ratio may all
result in orthopedic disease
• Large breed dogs are more sensitive to excess calcium compared with small breed dogs.
• AAFCO maximum Ca for large breed
puppy is 4.5 g/1000 kcal whereas small
breed puppies its 6.25 g/1000 kcal
• Expedited growth and weight gain may also predispose dogs to orthopedic disease

Question 26

What is important to remember about fish oil? What can it help?

Answer 26

• Fish oil does improve inflammation. It can help alot in dogs with orthopedic disease.
• Products vary considerably in quality,
  concentration, purity, and concentration of
  fat-soluble vitamins (Vit D)
  • Products that undergo third party QC are
  recommended
  • The amount may be considerable [310 mg
  *BW^0.75]

Question 27

What other supplements may help in management of orthopedic disease?

Answer 27

Glucosamine - Limited proof
Chondroitin S
EPA and DHA- studies showing this is helpful.
Green Lipped Muscle - sourced from new Zealand.