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Clinical Nutrition 1 > Obesity > Flashcards

Obesity Flashcards

1
Q

Define overweight

A

excess bodyweight (includes muscles, bone, fat, water, organs)

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2
Q

Define obese

A

excess adiposity

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3
Q

Event at a healthy___ an increased ____ could pose health risks

A

BMI

Waist circumference

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4
Q

Normal BMI and waist circumference

A

Low risk

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5
Q

Normal BMI and high WC

A

Increased risk

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6
Q

High WC and Obese Class I

A

Highest risk

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7
Q

High WC and overweight

A

High risk

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8
Q

Obese Class I and normal WC

A

High risk

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9
Q

Overweight and normal WC

A

Increased risk

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10
Q

Asian overweight BMI

A

> 23

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11
Q

Asian obese BMI

A

> 27

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12
Q

Asian men WC

A

> 90

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13
Q

Asian women WC

A

> 80

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14
Q

Males have __ obesity than females

A

less

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15
Q

Males have __ overweight incidences than females

A

more

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16
Q

Some states have obesity rates as high as?

A

30%, some self-reported at 35% which may actually be higher.

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17
Q

Canada national average of obesity?

A

27%

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18
Q

What provinces are below Canadian avg?

A
  • BC

- ON

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19
Q

What province are above Canadian avg?

A
  • NW territories
  • SASK
  • Manitoba
  • Newfoundland
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20
Q

Normal weight =

A

mostly women

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21
Q

Overweight (gender) =

A

mostly men

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22
Q

Obese (gender) =

A

similar rates of men and women

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23
Q

In US men, increased income is correlated with _____ obesity in hispanics and AA?

A

increased

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24
Q

In us men, is increased income associated with increased obesity in white men?

A

No

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25
Q

In US women, an increase in obesity is associated with ___

A

a decrease in income

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26
Q

At all income levels for US women there is ___ obesity in _____ than in whites

A

More

Hispanics and AA

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27
Q

Obesity increases ___ which means that there is excess mortality that is contributed to obesity

A

all-cause

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28
Q

Increasing what 3 factors will increase cardiometabolic risks?

A
  • Cardiovascular disease
  • Hypertension
  • Diabetes
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29
Q

What was the key point in the BMI and all-cause mortality study?

A

After a BMI of 27-28, each increase of BMI by5 units will increase risk of mortality of 30%

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30
Q

What were the 3 key points in the relative risk of CHD, mortality and TTDM study?

A
  • Risk of CHD is elevated very much before BMI of 30
  • Mortality increases around BMI of 20
  • TTDM risk has a linear relationship
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31
Q

What was the key point in the intra-abdominal fat is an independent predictor of all cause mortality study? What happens when we increase IA from 0.5-1kg? 1.5kg?

A

Intra-abdominal fat will increase all-cause mortality in men even when excluding all other factors (including BMI)
0.5-1 kg doubles rate of death, and will the continue to increase exponentially

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32
Q

What was the key point in the intra-abdominal fat increasing risk of TTDM in women study?

A

Obese individuals with high IA will have a increased basal glucose level and increased blood glucose and insulin levels in the post-prandial phase, indicating insulin resistance. This was not observed in healthy body weight or obese with little IA

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33
Q

Why does cancer increase with obesity?

A

Adipocytes are in a state of constant positive energy balance, are always receiving fuels for cell growth and differentiation

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34
Q

Most common cancers linked with obesity women (OBE-C)

A

Ovarian
Breast
Endometrium
Cervix

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35
Q

Most common cancers linked with obesity men

36
Q

Most common cancers linked with obesity men and women (LCK-G)

A

Liver
Colon
Kidney
Gallbladder

37
Q

Obesity increases the risk of ____

A

gallstones (cholelithiasis)

38
Q

Discuss the association with obesity and gallstones

A
  • 3x more risk when BMI>30
  • related to abdominal obesity
  • risk may be common to rapid weight loss
39
Q

Name the progression of liver failure, which is associated with those with obesity

A

Steatosis –> Steatohepatitis -> Cirrhosis –> Liver Failure

40
Q

What hormonal changes occurs in men with respect to reproductive system? What may this cause?

A

Increased estrogen and decreased testosterone

May cause gynecomastia (development of breasts)

41
Q

What hormonal changes occurs in women with respect to reproductive system?

A

Development of PCOS (5-10% of obese women)

42
Q

What risks in pregnancy are higher in obese women?

A
  • gestational diabetes
  • Pre-eclampsia
  • High fetal birth weight (complications)
  • Higher risk of maternal and fetal death
43
Q

REE and TEE in obese people compared to sedentary/moderately active individual with normal BMI

A

REE is higher

TEE is higher

44
Q

REE and TEE in obese people compared to active individual with normal BMI

A

TEE is lower

REE is higher

45
Q

Sedentary/Moderately active person REE %?

46
Q

Active persons REE %?

47
Q

Sedentary obese REE%?

48
Q

Hunger =

A

physical sensation indicating need or intense desire to feed

49
Q

Satiety =

A

feeling of fullness after eating

50
Q

Satiation =

A

feeling of fullness between meals

51
Q

Appetite=

A

desire to eat

52
Q

What control is appetite under?

A

Hormonal and hedonic control

53
Q

What controls orexigenic pathway?

A

Neuropeptide Y neurons

54
Q

What controls anorexigenic pathway?

A

CART, regulated by POMC

55
Q

How do the orexigenic and anorexigenic pathways communicate within the brain?

A

Through the paraventricular nucleus an lateral hypothalmus to secrete peptides into circulation

56
Q

Signals within GI tract?

A

Distention of GI (vagus nerve) stimulates fullness

57
Q

Gut peptide hormones to decrease hunger? COP-G

A

CCK
Oxyntomouldin
PYY-36
GLP-1

58
Q

Gut peptide hormones that increase hunger?

59
Q

Anorexigenic peptides from pancreas? (IPA)

A

Insulin
Pancreatic polypeptide
Amylin

60
Q

Powerful hunger inhibitor that is secreted constantly, less sensitive to food intake and proportional to amount of adipose tissue?

61
Q

Explain why genetics don’t cause obesity

A

The rapid onset of obesity epidemic means that genetic evolution could not have occurred, must be due to environment

62
Q

Are genes involved in obesity?

A

YES, but are not the full picture

May be some genes involved in appetite, metabolism and distribution of body fat which may influence onset of obesity

63
Q

Key point in family studies in genes & obesity

A

Adopted children’s BMI reflects biological parents and in separated identical twins, 50-90% of BMI explained by genetics

64
Q

Key point in overfeeding twins study in genes/obesity

A

Overfeeding twins resulted in similar utilization of energy and efficiency

65
Q

Key point in genome wide associate studies? Which genes were found to be contributors to ~6% of cases?

A

Mapped the genome to find genes associated with obesity.

  • Fat Mass & Obesity gene
  • Melanocortin-4-receptor
66
Q

Genes are ___ high contributors of obesity

67
Q

BMI & quantity of subcutaneous fat predicted by genes? non-transmissible variation?

A 
Genes = 5%
NTV = 65%
68
Q

BMI and total fat/distribution predicted by genes? non-transmissible variation?

A

Genes = 30%

NTV=45%

69
Q

What are the most common medical conditions and pharmacological agents that increase risk of obesity?

A

Stem from congenital, neuroendocrine and pharmacological agents

70
Q

What neuroendocrine disorders increase risk of obesity?

A

Hypothyroidism

Cushings

71
Q

What pharmacological agents increase risk of obesity?

A
  • Drugs to treat depression
  • Hormonal contraceptives
  • Progesterone agents
  • Corticosteroids (most weight gain = water)
  • Anti-histamine agents
  • Anti-diabetic agents
72
Q

Which anti-diabetic agents increase risk of obesity? (TIS)

A
  • Thiazolidinediones
  • Insulin
  • Sulfonylureas
73
Q

Name other factors that may increase risk of obesity

A
  • Sleep deprivation
  • Low or High birth weight
  • Breastfeeding (is protective, less breastfeeding …)
  • Smoking cessation
  • Viruses, toxins, microbiota
74
Q

Definition of Obesity (2018 Obesity Society Position Statement)

A

Obesity is a multi-causal, chronic diseased recognized across the life-span resulting from a long-term energy balance with development of excess adiposity which leads to structural abnormalities, physiological derangements and functional impairments.

75
Q

What is important in dietary assessment of obese client?

A

To understand weight history, diet history and relapses as this may increase their chances of remaining obese or having an unsuccessful nutrition intervention.

76
Q

How could we motivate obese clients with PA positively?

A

Using pedometer, setting baseline goals

Accelerometer could be more accurate

77
Q

Physical activity =

A

Leisure or non-leisure body movement that results in an increase in energy expenditure

78
Q

Exercise

A

Form of PA that is planned, structured and repetitive.

79
Q

What is the goal of exercise?

A

To improve or maintain physical fitness

80
Q

Physical fitness

A

Set of attributes that are either health-performance or skills related.

81
Q

What is the goal of physical fitness?

A

Ability to carry out daily tasks with vigor, alertness and without fatigue. Also to provide ample energy to enjoy leisure pursuits and unforeseen emergencies.

82
Q

Active living =

A

When physical activities are an integral part of daily living

83
Q

Low active?

84
Q

Moderate active?

85
Q

High active?

86
Q

High active individuals perform ___

A

standing work

Clinical Nutrition 1 (30 decks)

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