Obesity Flashcards
kwashiokor vs marasmus
basic definitions
2 types of food deficiencies:
kwashiorkor ( protein deficiency)
marasmus (protein and general energy deficiency)
who gets kwashiokor?
developing part of the world
typically seen in weaning infants (coming off protein rish breastmilk) and in an area where protein-rich food isnt available.
-lean or overweight people
who gets marasmus?
developing part of the world
protein and energy deficiency: where adequate quantities of food are not available
-muscle and fat wasting
onset and albumin levels for kwashiokor vs marasmus?
kwash: abrupt onset, low albumin
marasmus: slow onset, normal albumin (at times)
lower albumin =
proteins needs are outweighing the supply
in industrialized societies, protein-energy malnutrition is most often secondary to other diseases… what are these for kwashkiokor vs marasmus?
kwashkiokor-like secondary protein malnutrition: hyper metabolic acute illness like trauma, burns, sepsis
marasmus-like energy malnutrition: chronic diseases like COPD, CHF, cancer, AIDS
protein-energy deficiency malnutrition secondary to other diseases are present in at least ___ % of hospitalized pts.
20 %
main concern with re-feeding for kwash/marasmus malnutrition ?
mineral and electrolyte problems during refeeding
restoration of protein and energy must be slow and careful
anorexia vs bulemia?
anorexia involves actual weight loss, bulemia doesnt always
thiamine and/or niacin deficiency indicates what kind of issue?
alcoholism
what kind of vitamin deficeincy is scurvy? what is a key sign of it?
vit C deficiency- bleeding gums is a key
B vitamin deficiencies can cause what?
mouth-soreness
why do gastric bypass pts have different vitamin needs than healthy people?
b/c part of the stomach has been taken away.. lost part of the gut that takes up certain vitamins
Macrocytic anemia, what is it and how can you tell if its from vitamin B12 or folate deficiency?
RBCs cant undergo cell division (something B12 is key in) and therefore are large.
- folate: macrocytic anemia w/out neurological defects
- B12: macrocyctic anemia WITH neuropathy
… therefore: you can only fix neuro problems with folate if folate def. is the primary problem, its its B12 def. then neuro wont get better adding folate. so think B12 first then folate as its more important for neuro .
which does the body develop stores of, B12 or folate?
only B12
where is bound intrinsic factor–B12 taken up in the gut?
distal ileum
3 fat soluble vitamins
A, D, E
why does post-bariatric surgery require lifelong supplementation of vitamins? what vitamins are they?
reduced gut absorption in addition to gastric restriction
vitamins D, B12, calcium and iron.
what is the BMI for underweight, overweight, obese, and morbidly obese
<18.5
25-29
30-39
>40
simple explanation for obesity
energy imbalance: more calories in than out
-energy is being stored in adipocytes
leptin levels and their effect on weight
.. what theory does this coincide with ?
increased levels = eat less = weigh loss
decreased levels = eat more = obese
… theory: feedback regulation maintains appropriate body weight unless their is something “broken”
obesity is not a leptin deficiency, its…
a leptin resistance, too much leptin causes hypothalamus to become insensitive to it.
obesity can cause increased risk for…
metabolic syndrome, CVD risk, cancer risk, musculoskeletal problems/arthritis, obstructive sleep apnea, gall bladder disease, GERD, reduced life span
metabolic syndrome
cluster of conditions that inc. your risk for heart disease, stroke and DM.
CVD risk relates to level of _____ within the fat. what is the explanation for this?
inflammation
(some individuals have more inflammatory fat cells than others, but obese people without this increased inflammation- their risk for CVD is the same as with lean people)
=bottom line: not all obesity is equal
what 5 things work for obestity txt?
advice from provider, referrals to dietician, diet/exercise, drugs, surgery
how many calories burned to lose 1 lb?
3,500
3 types of bariatric surgery
restrictive (gastric banding)
malabsorptive (ex/biliopancreatic diversion- less bowl for uptake of nutrients)
combo (gastric bypass) - works better than either type alone
gastric bypass, what improves even before they begin to lose weight?
DM improves… we have no idea why
a deficit of ____ calories per day = 1lb loss per week
500
