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Clinical Nutrition 1 > Obesity P2 - Metabolism of weight loss and adaptations > Flashcards

Obesity P2 - Metabolism of weight loss and adaptations Flashcards

1
Q

What does the brain require per day?

A

500kcal of water-soluble fuels

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2
Q

What do catecholamines and growth hormones stimulate?

  • glycolysis
  • proteolysis
  • lypolysis
  • glucogenesis
A

lypolysis

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3
Q

2 keto acids are:

A
  • aceto acetate

- beta-hydroxybutyrate

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4
Q

Which ion does the body prefer to excrete?

- K or NH4 ?

A

K

but NH4 would be ideal

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5
Q

What is hypokalemia?

A

decreased levels of potassium in the circulation

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6
Q

Where do these hormones come from?

  • leptin
  • insulin
A
  • leptin : adipose tissue
  • insulin : pancreas

they are involved in long term regulation of energy balance

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7
Q

What are examples of short term signals that send information to the brain ?

A

grelin, CCK, GLP1, amylin, PP (pancreas polypeptide), PYY (peptide YY)

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8
Q

Which pathways can override the homoeostatic system, increasing the desire to consume palatable energy-dense food even when energy stores and food supply are abundant?

A

The hedonic pathways

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9
Q

What are the key components of TEE (Total Energy Expenditure)

A
  • TEF (thermic effect of feeding) 10%
  • REE (resting energy expenditure) 60%
  • NREE (non-resting energy expenditures) = mainly PA 30%
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10
Q

According to energy expenditure, why is it hard to maintain weight lost?

A

Because REE declines (which decreases TEE) with a reduced body weight

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11
Q

Cortisol excess can lead to weight gain, this is the case for which syndrome?

A

Cushing’s Syndrome

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12
Q

Diet-induced weight loss is accompanied by __ which collectively promote weight regain and restoration of energy balance

A

hormone changes

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13
Q

__ acts in the hypothalamus to reduce food intake andincrease energy expenditure by reducing the expression of AgRP, and NPY and stimulating that of POMC

A

Leptin

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14
Q

What are miracle diets based on?

A

On the fact that you use more glycogen and protein stores

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15
Q

Why is insulin important?

A

Helps keep blood glucose levels within a narrow range

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16
Q

What determines the production of ketones?

A

The level of fatty acids in the circulation

17
Q

What does high insulin inhibit?

A

Lipolysis and proteolysis

18
Q

What stimulates gycogenolysis and gluconeogenesis?

A

Low insulin and high glucagon

19
Q

During ketosis what fuel does the brain use?

A

glucose and keto acids

20
Q

When are ketone acids produced?

A

As a result of fatty acid oxidation

21
Q

True or false according to Forbes:

during fast obese individuals will lose more nitrogen than will thin people

A

FALSE

they lose less N thus less lean body mass than thin people (with low body fat)

22
Q

During severe weight loss, tachycardia will increase or decrease?

A

increase at the beginning due to decreased blood volume

23
Q

With which patients (taking medication) should you be considered for a severe weight loss?

A

Patients taking blood pressure medication (the BP would decrease after severe weight loss)

24
Q

What is steatorrhea?

A

Fat in stool (due to less lipid absorption after severe weight loss)

25
Q

What are some physiological changes to severe weight loss?

A
  • Electrolyte changes: potassium losses
  • GI Function: less lipid absorption, less villous surface area, less pancreatic and bile secretion
  • CNS Functions
  • Decreased Immune Function
  • Cardiovascular and renal systems: High stress on kidney, high tachycardia, low cardiac output
26
Q

During the referring syndrome, what happens to insulin?

A

Insulin increases because glucose is used as a fuel

27
Q

During repletion (after starvation) what happens to Resting Energy Expenditure? Why?

A

It increases.

Due to lean body mass rebuilding.

28
Q

True or False

It is important to provide abundant fluids to a patient when refeeding in the first few days..

A

FALSE

Sodium and fluids should be limited to prevent edema in the first few days

29
Q

Why should thiamin (B1) be supplemented during refeeding?

A

Because vitamin B1 and B6 are cofactors in CHO metabolism

30
Q

How much carb and protein should be provided at the BEGINNING of refeeding period?

A
  • CHO: 25g-37.5g

- PROT: 20g

31
Q

After diet induced weight loss, thyroid hormones increase or decrease?

A

Decrease

32
Q

Why does leptin decrease after diet-induced weight loss?

A

Because leptin is related to adipose tissue mass (since adipose tissue decreases, leptin decreases)

33
Q

Why to energy expenditure decrease after diet-induced weight loss?

A

Because both fat mass and lean mass decrease

34
Q

How many kcal per kg does REE decrease by?

A

15kcal per kg

Clinical Nutrition 1 (13 decks)

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