Obesity part 1 Flashcards
what is the def of obesity
obesity is a chronic progressive and relapsing disease characterized by excess or abnormal adiposity that impairs health and social well being
patterns of body fat distribution in man vs woman
men : apple shape
woman: pear shaped
what is the advantage of beige/brown depots
people who have more are less prone to be obese
hin a fat molecule what are the 2 things it could arrive for an accumulation and lipotoxicity
- hypertrophy ( bigger in size)
- hyperplasia ( higher in number)
how can a fat molecule increase in number
de novo
the increase in number and size can lead to
inflammariob, fibrosis which can lead to insulin resistance
the waist circumference cut off depends on ethnicity. Which ethnicity has a higher waist circumference and which has a lower
higher : caucasian europe, US,
lower : african
what happened to the prevalence of obesity from 1980 to 2011
it has doubled
the difference of the prevelance of obesity between man and women
men are more overweight and obese class 1, than women. However, women are more obese class 3 than men
before obesity was a condition of
people who were rich. They had money so they ate more
now obesity is related to
socio-economic status: ethinicity, sex/gender, education
obesity is lower on what type of groups
- higher income groups
- more educated
- women more than men
what are the 3 most related increases cause of mortality in people who have obesity
- cardiovascular disease
- hypertension
- diabetes
BMI and cause of mortality
lower BMI has an increase risk of mortality
lowest risk is the normal BMI
after an BMI of 25 the increase of mortality increases almost linear
true or false
mortality, Coronary Heart Disease and diabetes increase as the BMI increase
true
intra-abdominal fat is a predictor of what in men
predictor of all-cause mortality
an increase of 500grams increases how much in terms of risk of death
2x risk
20%
intra abdominal fat increase what in premenopausal women
increase the risk of type 2 diabetes
in a graphic where it shows 3 curbs of nonobese women, obese with low intra abdominal fat, and obese with a high intra abdominal fat what would the curbs be if we give a drink that has sugar
normal: the glucose will go up, but after it would go down
obese low abdo fat: the glucose will go up but it will not go down completely (insulin will be high)
obese with high abdo fat: a big spike of glucose in the blood and it would not go down complete ( insulin resistance)
what is insulin resistance and where do we see insulin resistant people
insulin resistance is when the person cannot respond to insulin, so they would have a high glucose sugar because the glucose is not going into the cell. However the body is still making insulin but the body is not responding
obesity increases what types of cancer in females/males and both
females: endometrium, ovary, cervix and breast
male: prostate, pancreas, oesophagus
both: colon, gallbladder, kidney and liver
obesity and hepatobiliary disorder
abdominal obesitity can increase non alcoholic fatty liver disease
what are the process of a non alcoholic fatty liver disease
steatosis-> seteatohepatitis -> cirrhoris -> liver failure
what is the risk of obesity and gallstones
the risk increases when the person has a BMI over 30 and if the person has a rapid weight loss it can also increase the risk
what are the risk of obesity and reproductive disorders in male and women
risk in males are: reduced testosterone and increased estrogen levels. Plus Gynecomastia ( bigger breast)
risk in women: Polyastric ovary syndrome. Plus during pregnancy, they can have gestational diabetes/ labor and delivery complication/ fetal and maternal death
what is the etiology (causes ) of obesity
- energy balance
- appetite and body weight regulation
- genes
- env factors
- medical conditions and medication
how is our physiology not prepared for the modern world
our genes and metabolism evolved in a context of starvation, to conserve and store energy - critical to survive. Therefore, our body is not apt to the amount of food and the sedentarism- our body wants to keep and store that energy
how is the energy balance of a person who is obese
high energy intake: high fat, energy dense foods, low cost, available foods and large portion sizes
low energy expenditure : sedentary behaviours - less work related physical activity and less activities of daily living
energy expenditure components in sedentary obese
they have a higher resting energy expenditure. They have a bigger body and more fat free mass therefore they will expand more energy
what is the difference between satiety, satiation and appetite
satiety: feeling of fullness after eating
satiation: state of being satisfactorily full associated with the length of time between meals
appetite: desire to eat
which pathways in the hypothalamus stimulates appetite and decrease appetite
NPY, AgRP : stimulates
CART,aplhaMSH : inhibits
what are the hormones that stimulate hunger and the hormones that inhibit hunger
stimulates: ghrelin
inhibits: gut - CCP , fat : leptin (some people ar resistant to this), insulin, amulin
how are genes and obesity related to
obesity is a polygenic disease : multiple genes have small effect on predisposition
how can gene affect obesity
genes may affect is several aspects : regulation of appetite, metabolism and distribution of fat
Explain some studies of how are genes related to obesity in identical twin
in identical twin they have 50-80% of their BMI is explained by genetic.
true or false
antidepressants are widely used to different conditions and they an lead to obesity
true
what are some things in the environmental factors that won’t let a person lose weight ( promote a sedentary life and high cal food)
obesogenic env : physcal, social cultural and econimic factors that promote weight gain and barriers to weight loss
- neighbourhood, workplace, transported and screen time can promote a sedetary life
- accessibility to food at low cost, large portion and energy dense food - high caloric
true or false
is sleep deprivation associated with obesity
true
how do we assess obesity
- dietary history and habits
- physical act
- medical, psychosocial, cultural
- behavioural aspects
give examples of how dietary history and habits affect obesity
- weight history and diet can affect the metabolism
- food intake
- patterns of meals (what time food is consumed, with whom, what reason)
- ability to cook
- allergies, intolerances
- medications
- emotional eating - eat to punish yourself
what is the number of physical activity level when it is
- low
- moderate
-high
low : 1.3
moderate: 1.5
high: 1.8
examples of medical, psychosocial, cultural aspects for people with obesity
- physical examination, blood pressure, lab test
- complications with diabtetes
- pregnancy, age
- psychological disorders
- practices and belies
- patient’s readiness
what are some aspect of behavioural aspects
readiness to change (right time, social support, long term changes)
