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NUTR 3090 > obesity > Flashcards

obesity Flashcards

1
Q

what are the 2 perspectives of body weight

A

bmi and %body fat

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2
Q

ideal body weight range in bmi

A

18.5-25 kg/m2

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3
Q

define obesity/OW

A

body weight above a standard relative to height

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4
Q

explain the relationship between all cuase mortality and bmi

A

j shape relationship
low bmi = increased risk mort.
high bmi = increased risk mort

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5
Q

why does high bmi = higher mortality risk?

A

increased risk for developing diseases
major risk is heart disease
biggest player is hypertension and dyslipidemia
= cvd risk = death risk

but there are diff types of disorders and risk of morbifities depending on disease

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6
Q

examples of conditions that you are greatly increased risk for morbidity when obese

A

-sleep apnea
breathing issues
t2d, ir
dyslipidemia
galbladder disease

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7
Q

bmi classifications

A

uw 18.5
normal 18.5 - 24.9
ow 25-29.9
ob1 30-34.9
ob2 35- 39.9
ob3 > 40

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8
Q

which anthro measures DO NOT correlate with fatness?

A

height
waist: hip ratio

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9
Q

measures for assessment of fatness

A

wHtR
weight
hip
waist
bai
bmi
weight: height

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10
Q

explain why its important to look at other indictators ALONG with bmi when analyzing fatness

A

whtr sensitive to risk of cvd
bmi considered some people at no risk but same ppl considered at risk with whtr

you can have a normal bmi but still be at risk with whtr value

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11
Q

value of whtr = increased risk of what?

A

> 0.5 = risk for obesity related cvd

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12
Q

what is BAI

A

body adiposity index
=hip circ and height

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13
Q

what to remember about BAI?

A

not a better measure of adiposity compared to bmi, waist or hip circ

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14
Q

genes that are associated with obesity related traits

A

BDNF
brain develipment neurotropic factor

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15
Q

BDNF and obesity

A

bdnf = Appetite regulation via supression
also acts on brain for neuro development

obesity = less bdnf levels and responsivness

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16
Q

why does bdnf have low bioavailablity

A

short half life
low brain penetration

=via injection solution

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17
Q

define epigenetics

A

variations in gene expression that are not caused by changes in dna sequences

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18
Q

bi directional relationship bet?

A

epigenetics and obesity

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19
Q

4 developmental contributors to increasing the risk of obesity + pathways

A
  1. maternal preconception body composition = mismatch
  2. maternal undernutrition = mismatch
  3. maternal obesity/gd = fetal hyperinsulinimia , more fat cells
  4. low birth weight = mismatch
  5. post natal nutrition = apetite control/ preferences
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20
Q

theories of overnutrition

A
  1. genetic
  2. lipostatic
  3. thermogenetic
  4. diabetes associated
  5. psychlogical causation
  6. thermostatic
  7. sleep deprivation
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21
Q

thermostatic vs thermogenetic theory

A

static = dipping below body temp set point = apetite change = h response

genetic = obese = low brown fat cells = less excess energy burning

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22
Q

lipostatic theory

A

theory of overnutrition
= obese indiv have higher hypothalmic set point
=body fights to bring u back to this range when you step outside of it
=harder to lose weight

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23
Q

pns vs sns in food intake

A

pns = increase intake
sns = decrease intake

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24
Q

role of hypothalamus

A
  1. feeding behaviours
  2. energy expenditure
  3. food intake
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25
Q

explain the concept of yoyo diet and body weight set point

A

see ipad diagram

26
Q

where is PYY secreted

A

L cells of ileum, rectum and colon

27
Q

where is CCK secrted

A

i cells of small int

28
Q

where is glp1 secreted

A

L cells small intes

29
Q

long term regulators of apetite

A

insulin
leptin

30
Q

explain exclusive Breastmilk feeding effects on apetite regulating hormones

A

BF = apetite supressing nature
less ghrelin, leptin , insulin and pyy
lactose, protein and fat combo = apetite suppressed
good insulin sensitivity

31
Q

short term regulators of apetite

A

cck
ghrelin
pyy

32
Q

how do weight loss surgeries impact apetite regulating hormones?

A

impacted in how the hormones respond

decreased satiety bc trying to compensate for weight loss
=more ghrelin = less satiety

33
Q

ghrelin levels post RYGB?

A

less ghrelin bc loss of parietal cells from stomach

34
Q

what are some predictors of weight loss?

A

high:
-bmi
-adipocyte hyperplasia / fat levels
-male
RMR/expernditure levels
early weight loss, counselling, support, goal setting

adipocyte hyperplasia = # fat cells

35
Q

mechanisms of weight regain

A
  1. changes in energy expenditure
  2. neuroendocrone pathways
  3. gut physiology
  4. sibjective apetite
  5. nutrient metabolism
36
Q

to maintain weight loss

A

need behavioral interventions
= diet
= PA

37
Q

best type of diet to maintain weight loss?

A

high protein
more low gi foods

38
Q

3 main counselling approaches to managing obesity

A
  1. diet/kcal focus
  2. food, exercise, beh mods
  3. hea;thy lifesty;e approach/health @ every size
39
Q

when assessing an obese indiv, what are some things to remember

A

-ABCDE
-Assess 4 Ms
assess knowledge
= unrealistic goals.
= pa importance
=diet role and options

40
Q

how much kcal defecit?

A

100-200 per day

41
Q

how many kcal def do u need to burn 1 kg

A

5000-7000

42
Q

strategies to reduce kcals in foods

A
  1. high intensity non nutritive sweetners
  2. sugar subs, bulking agents
  3. more fibre
  4. fat replacers/reducing energy from fats
43
Q

example of a fat replacer

A

olestra
=0 kcal
=replaces function and flavoour of fat
causes gi issues and loose stool tho

44
Q

example of sugar sub

A

inulin
polyols
polydextrose

dont really taste like anything so mixed with sweetners, more for sensory properties

45
Q

weight loss drugs

A
  1. pancreatic lipase inhibitors (orlistat)
  2. saxenda (glp1 agonist)
  3. metformin
46
Q

ozempic vs saxenda

A

ozempic = 1x / wek
saxenda =1 x / day

47
Q

why dont nasal PYY sprays work for WEIGHT LOSS DRUGS

A

immune cells block pyy into bloodstream

48
Q

types of bariatric surgeries?

A
  1. adjustable gastric band
  2. sleeve gastromy
  3. rygb
  4. bpd/ds
49
Q

3 main mechanisms of bariatric surgery

A

restriction
malabsorption
both

50
Q

which bariatric surgeries are both restrictive and malabsorptive

A

rygb
bpd/ds

51
Q

pre surgical care

A

assessment
assess defeciences
education - expect, complications, reinforce pa and diet

52
Q

post surgical care

A

diet care
long term nutri complications

53
Q

example of a post surgery nutrition plan

A

supplements
diet progression

54
Q

post op diet consists of

A

slow progression
1. clear fluids
2. full fluids
3. pureed
4. soft
5. solid

proteins = immunity and healing
supplements =malabsorption

55
Q

long term issues post op

A

context of rygb and bpd
1. dumping syndrome
2. gallstones
3. nutr defiences

56
Q

what things slow gastric emptying

A

slow kcal needs
small meals
more protein and fat

57
Q

what increases gastric emptying

A

more cho
solids and liquids

58
Q

what condition also happens with dumping syndrome

A

hypoglycemia

59
Q
A
60
Q
A

NUTR 3090 (9 decks)

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