Nutritional Disorders

Question 1

Primary undernutrition:

Answer 1

Inadequate supply of food.

Question 2

Secondary undernutrition:

Answer 2

Malabsorption

Question 3

Adaptative changes in metabolism occurs during Starvation:

Answer 3

• Na/K pump (losing K)
• Temperature homeostasis (body temperature can drop)
• Reproduction (infertility)
• Inflammatory and immune responses decreased

Question 4

After a period of starvation, we cannot give normal nutrient bc:

Answer 4

Adaptative change cannot cope with the sudden influx of nutrients and ions. Need to do it gradually.

Question 5

Protective adaptation during starvation:

Answer 5

• 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

Question 6

During starvation, the resting metabolic rate progressively?

Answer 6

Decrease by about 25% (to keep you alive)

Question 7

Nutrition and Height principles:

Answer 7

• 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)

Question 8

Anorexia nervosa:

Answer 8

Distorted body image
Refusal to maintain minimally normal weight
Pathological fear of gaining weight.

Question 9

Bulimia nervosa risk

Answer 9

Alkalosis (losing HCL)
Lose K, Na, Cl –> cardiac arrest risk (electrolyte imbalance)
Gastric rupture
Aspiration Pneumonia

Question 10

Anorexia nervosa patterns:

Answer 10

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)

Question 11

Apple shape vs Pear shape:

Answer 11

Apple shape: Accumulation in central cavity
Pear shape: fat in periphery on hips and thighs
(Intra-abdominal (visceral) fat more dangerous than subcutaneous fat)

Question 12

Obesity quantified:

Answer 12

Body mass index (BMI) (>25–> overweight/ >30 –> obesity)

Waist to hip ratio (WHR)

Question 13

Causes of obesity:

Answer 13

25% genetics

75% Lifestyle, environment and culture.

Question 14

Obesity is:

Answer 14

Accumulation of adipocytes

Question 15

What happens during obesity with our adipocytes?

Answer 15

1. Normal adipocytes become Hypertrophy
2. Once reach is maximum size, Hyperplasia form (more fat cells)
3. During adipogenesis, cytokines are releases and alter many things such as insulin sensitivity, food intake, energy utilization, fertility, inflammation, angiogenesis, and vasoregulation.

Question 16

What happens when losing the weight after a severe obesity?

Answer 16

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)

Question 17

Adipocyte communication by secreting:

Answer 17

Lipoprotein lipase, leptin and respond to others.

Question 18

Adipokines:

Answer 18

• Chemical communication from fat cells to hypothalamic nuclei that control appetite.
• Very proinflammatory (recruit monocytes/macrophages)

Question 19

Obese persons and their adipokines:

Answer 19

LEPTINS: They have more leptin secreted (bc more adipocytes) but cells become resistant to leptin.
ADIPONECTIN: Deficiency from obesity.

Question 20

Adiponectin:

Answer 20

Release by adipocytes, effects on macrophages, endothelial cells and smooth muscles with a decrease inflammation.

Question 21

Obesity leading to Type II diabetes:

Answer 21

Insulin resistance –> metabolic syndrome –> diabetes with hyperglycemia.

Question 22

Adipose tissue macrophages release exosomes with miRNAs:

Answer 22

• miRNAs are transported into the circulation everywhere.

- Metabolic syndrome (diabetes: polyuria…): Increase plasma triglycerides, glucose, insulin.

Question 23

Obesity related to energy imbalance:

Answer 23

• Fats has more calories

- In e rapid change weight, lose water first (4 H2O on 1 glycogen)

Question 24

Energy expenditure:

Answer 24

• Resting metabolic rate (RMR) is proportional to lean body mass (muscles) –> more muscles, more basal metabolic rate.
• Physical activity
• Thermogenesis (cold–> more energy use)

Question 25

Obesity is a cultural factors because:

Answer 25

You eat what your parent eat.

Question 26

The problems with diets:

Answer 26

• Body goes into starvation mode

- Losing skeletal muscles (loosing a lot of proteins)