Nutritional Disorders Flashcards
Primary undernutrition:
Inadequate supply of food.
Secondary undernutrition:
Malabsorption
Adaptative changes in metabolism occurs during Starvation:
- Na/K pump (losing K)
- Temperature homeostasis (body temperature can drop)
- Reproduction (infertility)
- Inflammatory and immune responses decreased
After a period of starvation, we cannot give normal nutrient bc:
Adaptative change cannot cope with the sudden influx of nutrients and ions. Need to do it gradually.
Protective adaptation during starvation:
- Energy need decrease
- Metabolic rate decreases 20-25kcal
- Using Energy from fat storage (>90% of total)
- Using energy from protein (<10% of total glyconeogenesis)
- Proteins store protected
During starvation, the resting metabolic rate progressively?
Decrease by about 25% (to keep you alive)
Nutrition and Height principles:
- Height increased with good nutrition
- Height reaches a plateau
- Height curtailed with poor nutrition (suboptimal nutrition)
- Deficiency in vitamin D –> Rickets (bones and height alters)
Anorexia nervosa:
Distorted body image
Refusal to maintain minimally normal weight
Pathological fear of gaining weight.
Bulimia nervosa risk
Alkalosis (losing HCL)
Lose K, Na, Cl –> cardiac arrest risk (electrolyte imbalance)
Gastric rupture
Aspiration Pneumonia
Anorexia nervosa patterns:
Normal individual + cultural pressure –> Starvation + exercise –> Altered neurochemistry in the brain (body adaptation to famine, so not feeling desperate for food anymore) –> Increase 20% mortality (osteoporosis, fracture)
Apple shape vs Pear shape:
Apple shape: Accumulation in central cavity
Pear shape: fat in periphery on hips and thighs
(Intra-abdominal (visceral) fat more dangerous than subcutaneous fat)
Obesity quantified:
Body mass index (BMI) (>25–> overweight/ >30 –> obesity)
Waist to hip ratio (WHR)
Causes of obesity:
25% genetics
75% Lifestyle, environment and culture.
Obesity is:
Accumulation of adipocytes
What happens during obesity with our adipocytes?
- Normal adipocytes become Hypertrophy
- Once reach is maximum size, Hyperplasia form (more fat cells)
- During adipogenesis, cytokines are releases and alter many things such as insulin sensitivity, food intake, energy utilization, fertility, inflammation, angiogenesis, and vasoregulation.
What happens when losing the weight after a severe obesity?
The cell shrinks and signal the body that wants to get back to their normal size (hungry)
Extra cells are not going away, it results in a new set point (which is above the normal weight)
Adipocyte communication by secreting:
Lipoprotein lipase, leptin and respond to others.
Adipokines:
- Chemical communication from fat cells to hypothalamic nuclei that control appetite.
- Very proinflammatory (recruit monocytes/macrophages)
Obese persons and their adipokines:
LEPTINS: They have more leptin secreted (bc more adipocytes) but cells become resistant to leptin.
ADIPONECTIN: Deficiency from obesity.
Adiponectin:
Release by adipocytes, effects on macrophages, endothelial cells and smooth muscles with a decrease inflammation.
Obesity leading to Type II diabetes:
Insulin resistance –> metabolic syndrome –> diabetes with hyperglycemia.
Adipose tissue macrophages release exosomes with miRNAs:
- miRNAs are transported into the circulation everywhere.
- Metabolic syndrome (diabetes: polyuria…): Increase plasma triglycerides, glucose, insulin.
Obesity related to energy imbalance:
- Fats has more calories
- In e rapid change weight, lose water first (4 H2O on 1 glycogen)
Energy expenditure:
- Resting metabolic rate (RMR) is proportional to lean body mass (muscles) –> more muscles, more basal metabolic rate.
- Physical activity
- Thermogenesis (cold–> more energy use)
Obesity is a cultural factors because:
You eat what your parent eat.
The problems with diets:
- Body goes into starvation mode
- Losing skeletal muscles (loosing a lot of proteins)
