Obesity And Eating Disorders Flashcards
What is meant by obesity?
Medical term for accumulation of body fat which may have a negative effect on health.
List 8 things which high body fat increases the risk of.
Depression, asthma hypertension, CHD, dyslipidemia, type 2 diabetes, arthritis, stroke, infertility
What are 8 causes of obesity?
Calories - portion size, energy density Food -more refined carbs/processed food Physical activity -more sedentary Reduction in sleep - alters glucose metabolism, increases appetite, decreases energy expenditure Greater mental stress - people change their eating habits Micronutrient deficiencies Alteration to microbiome - dysbiosis Genetic factors
Explain why sleep deprivation contributes to insulin resistance.
Increases catecholamines and contributes to insulin resistance
Explain why alterations to the microbiome may cause obesity.
Increased energy harvest via fermentation, bacterial endotoxins can alter hosts metabolism
What is the difference between hyperplastic and hypertrophic obesity?
Hyperplastic is increased number of fat cells that exist throughout the body caused by the mother eating and excess of calories during pregnancy, it is difficult for the child to develop new fat cells.
Hypertrophic is increase in the size of each fat cell. Linked to diabetes, heart disease and high blood pressure. Fat distribution is around the waist.
What are intra abdominal adipose Or VAT tissue?
More metabolically active, large insulin resistant adipocytes, higher density of adrenergic receptors.
What 2 things cause increase circulation of fatty acids?
Decreased in insulin mediated anti-lipolysis and increased catecholamine mediated lipolysis
What does VAT produce?
Large number of hormones (adipokines - cytokines, leptin, adiponectin, resisting and TNF-alpha, IL-6
What does leptin do? What produces leptin and why is it produced?
Satiety hormone, regulates appetite, energy balance
Adipocytes when they are full of triglycerides
What is the link between leptin and neuropeptide y?
Leptin down regulates neuropeptide y leading to decreased hunger, increased activity and increased thermogenesis.
What is peripheral leptin resistance?
Leptin can modify insulin sensitivity, tissue metabolism, stress so overtime changes in metabolisms lead to abdominal weight gain.
What are 5 factors that involved the feeling of satiety?
Mechanical stretch receptor of stomach via vagus nerves Ghrelin, leptin and adiponectin produces Glucagon like peptide in GIT Neuropeptide y Insulin, glucagon
How does ghrelin regulate satiety?
When ghrelin is low it indicates fullness and when it is high it increases hunger. Dieting increases ghrelin which is why it stimulates hunger.
How does adiponectin regulate hunger?
Lean subjects have more adiponectin than obese people so it trigger satiety.
What are the 7 metabolic actions of insulin?
Stimulates synthesis of triglycerides from free fatty acids Inhibits release of free fatty acids Increases glycogen in liver Inhibits glucogenesis Stimulates glucose uptake Stimulates glycogen synthesis Reduces hunger
What happens during insulin resistance?
Lipolysis is not inhibited which causes an excess of fatty acid
As Visceral fat increases adiponectin production decreases so less oxidation of fatty acids and less clearance of excess fat in tissues and insulin is less sensitive.
Increases making glucose from glycogen and prevents glucose from being converted and stored as glycogen
What is a source of HFCS? What are 5 health effects of excessive fructose?
Sweetened carbonated soft drinks.
metabolic syndrome, elevated triglyceride levels, hypertension, non-alcoholic fatty liver disease, excess uric acid levels
What are 5 things someone can do to help with overeating?
small servings (small plate), protein at each meal/snack, chew food well, turn off stimulators whilst eating, energy ritual of foods
What are 5 nutritional therapy suggestions that can be given to someone to stimulate fat loss?
educate about low GL (before 3 pm), breakfast is vital (include protein), exercise daily, food diary, regular contact with practitioner, meal replacement formulas (good quality)
What is the link between 5-HT and eating?
Increased 5-HT significantly reduces food intake
What are 5 function of omega 3, which support obesity?
stimulates fatty acid oxidation in liver, down regulates lipogenic gene expression, inhibits lipogenesis, increase saturation of muscle membrane with omega 3 fatty acids and improve insulin sensitivity, anti-inflammatory
How does green tea support with obesity?
stimulates thermogenesis and fat oxidation
how does carnitine support with obesity?
help to transport fatty acids across the mitochondrial membrane and improve lipid metabolism
How can chromium support with weight loss?
lowers body weight, increases lean body mass and increases insulin sensitivity
how can leptin resistance be improved?
excessive leptin levels are produced so vit D (inhibits leptin secretion), exercise and calorie restriction also improve leptin sensitivity, carnitine, conjugate linoleic acid (CLA) and omega 3 also support leptin resistance
What is an eating disorder?
unhealthy relationship with food that takes over and severely effects a persons health and wellbeing.
What are 5 reasons eating disorders occur?
Emotional trauma, abuse, media pressure, fears about being overweight, stress, depression
What are 4 signs of having anorexia nervosa?
Intense fear of gaining weight or becoming obese, refusal to maintain body weight, disturbance in the perception of ones body weight or shape, amenorrhea
What is the difference between restrictive type and binge-purge type?
Restrictive type is when you use dieting, exercise to weight control resulting in low body weight where as binge-purge is when you binge eat and then have to purge.
What are 5 symptoms of anorexia nervosa?
distorted body image, perfectionism, OCD, excessive exercise, secretive about eating or exercise.
What are 4 factors which increase risk of AN?
Lack of control over life or situations, dysfunctional families, positive reinforcement that fatness makes you unlovable, nutritional deficiencies
What is the biochemistry of starvation?
1- glycogen storage is used up so insulin in low and glucagon is high
2- muscle tissue is broken down for maintain blood sugar levels
3- energy production is used by oxidation of fats
4- beta oxidation of fatty acids produce acetyl COA which can be oxidized via TCA cycle
5- beta oxidation of fatty acids in liver produce excess of acetyl CoA which is converted to ketone bodies. Body uses ketosis for energy.
6- Starvation makes more glucose available to the brain
What nutrient is important for anorexia?
Zinc
What is the orthodox treatment for anorexia?
Psychotherapy, self-help groups, regular weight monitoring, aim for 0.5-1kg weight gain, refeeding (if necessary – dangerously low BMI)
What are the consequences of re-feeding syndrome?
Odema – increase insulin resistance and increased phosphate, glucose, potassium mg and water causes oedema
Hypophosphatemia
Thiamine deficiency – wernickes encephalopathy or Korsakoff’s syndrome because when a patient is refed cards this increases cellular thiamine utilization
Hypomagnesaemia
Hypokalaemia – kidney loses its ability to conc urine and neuromuscular symptoms (weakness, paralysis)
What should be supplemented during re=feeding syndrome?
thiamine
What 3 client types should you suspect AN?
Client at an unreasonable BMI approaches for weight loss, clients with low BMI and amenorrhoa issues, young girls in high risk situation (dancing and elite sport)
What are some nutritional aims for AN?
Gradual raise in BMI, encourage a healthy relationship with food, re-educate the client with their eating habits and nutritional beliefs, optimal absorption of nutrients and health gut function, harm minimization
Why is exercise important for AN treatment?
bone density but under supervision
What are 5 common post-anorexia problems?
Gut dsybiosis, low intolerance, low absorption capability, reproductive problems, poor immunity
What is bulimia nervosa?
secretive eating (bingeing) then purging via laxative, vomiting, diuretics
What are 5 signs and symptoms of bulimia?
Normal weight to slightly overweight Loss of control over eating Binge eating Depression, anxiety Sore throat, tooth erosion and swollen parotid glant
