OBESITY Flashcards
1
Q
Current Obesity Statistics in Wales
A
- 58% classified as overweight (25-29.9kg/m2) or obese
- 22% classified as obese (>30kg/m2)
- 36% of men and 23% of women have PA levels to convey good health
2
Q
CMO Guidelines, 2012 - Benefits of PA for Adults and Older Adults
A
- benefits health
- improves sleep
- maintains health weight
- manages stress
- improves quality of life
3
Q
Following CMO Guideline Reduces
A
- T2D - 40%
- CVD - 35%
- Falls, depression and dementia - 30%
- joint and back pain - 25%
- Cancers (colon and breast) - 20%
4
Q
Morton et al., 2010 - Walking and Lipid Burning
A
- walking improves lipid burning
- 19% lipid contribution pre-train, 26% post-train
5
Q
Sources of Lipids in the Body
A
- plasma; NEFA ~0.4g; TG ~4g
- intramuscular TG; IMTG ~300g
- adipose tissue
- humans have a fuel reserve to complete between 43 (female elite) - 195 (female obese) marathons on lipids alone
6
Q
Goodpaster et al., 2000 - Athlete Paradox
A
- lipid accumulation within muscle fibres is significantly increased in obesity and is reduced by weight loss
7
Q
Goodpaster et al., 2001 - Athlete Paradox
A
- skeletal muscle of trained endurance athletes is markedly insulin sensitive and has a high oxidative capacity, despite having an elevated lipid content
8
Q
Coen et al., 2015 - Lipid Metabolites Interfere with GLUT-4 Mobilisation
A
- Fat/CD36 is increased in human IR skeletal muscles
- existing skeletal muscle can decrease intramuscular ceramides and sphingolipids
- ceramide content in muscle decreases with RYGB surgery - induced weight loss
9
Q
Bariatric Surgery
A
- derived from Greek words baros = weight and iatrokos = medicine
- currently referred to as metabolic surgery
- results in weight loss
- improves metabolic consequences of obesity
10
Q
All Wales Obesity Pathway: PA Component
A
- tier 1 - community based prevention early intervention
- tier 2 - community and primary weight management service
- tier 3 - specialist, multi-disciplinary weight management services; specialist dietary, PA and behavioural elements delivered through primary and secondary care; sometimes w drug therapy
- tier 4 - specialist medical and surgical services
11
Q
NICE (National Institute for Health Care and Excellence) Guidelines State
A
- BMI of 40kg/m2 or more
- all appropriate non-surgical measures have been tried but the person has not achieved or maintained adequate, clinically beneficial weight loss
- person has been or will be receiving intensive managements in a tier 3 service
- person is generally fit for anaesthesia and surgery
- person commits to the need for the long-term follow-up
12
Q
Types of Bariatric Surgery
A
- laparoscopic adjustable gastric bonding (LAGB)
- laparoscopic biliopancreatic diversion with duodenal switch
- laparoscopic sleeve gastrectomy (LSG)
- laparoscopic roux-en-Y gastric bypass (LRYGB)
13
Q
Wu et al., 2016 - Bariatric Surgery vs Exercise
A
- bariatric surgery results in significantly greater percentage loss of excessive fat deposits except for epicardial adipose tissue (EAT)
- EAT but not paracardial adipose tissue (PAT) was relatively preserved despite weight reduction in both groups
14
Q
ASMBS, 2012 - Pre-Surgical PA
A
- evidence of pre-surgical PA markers is poor but advocated
- mild ex for 20mins/day on 3/4days/week before surgery
- pre-surgery PA engagement may improve cardiorespiratory fitness, reduce risk of surgical complications, facilitate healing and enhance post-operative recovery
15
Q
Marcon et al., 2016 - Pre-Surgical PA
A
- pre-surgery ex programme significantly improved functional capacity and cardio-metabolic parameters in intervention group and worsened in control
- exercise adherence above 78%