Obesity - Week 3 Flashcards
How many people in world are obese?
2.1 billion
How many obesity deaths?
300k/yr in us
What is the cost of obesity?
147 millin
Who has the highest rates of obesity?
non hispanic blacks
Who has the lowest rates of obesity?
non-hispanic asain
How much does obesity increase risk of death from all causes?
50-100%
How much can obesity decrease life span?
2-13 yrs
What shape confers the highest risk?
apple shape
What does adipose tissue secrete?
inflammatory mediators IL TNF resistin adiponectin leptin "adipocytokines"
What is apple shape?
android
What is pear shape?
gynoid
What waist hip ratio give greatest risk?
> .85 women, >.9 men
What specific group has the highest rate of being overwt or obese?
AA women
What are medications associated with obesity?
atherosclerosis DM type II osteoarthritis gout obstructive sleep apnea POS incontinence cancer depression
How does atherosclerosis relate to obesity?
low fruit and veggies
red meat raises risk
What does higher fiber diet =
reduced risk of atherosclerosis and obesity
How much does red meat daily increase morality?
15-20%
What amount of DM is linked to obesity?
80%
What is the highest risk BMI for DM?
> 35
What waist circumference has higher risk of DM?
> 40 men and >35 women
What occurs with DM and obesity?
impaired ability of insulin to regulate gluconeogenesis increase glucose increase LDL reduce HDL Hyperinsulinemia INFLAMMATION
How does obesity relate to osteoarthritis?
increase load –> articular cartilage
loss of skeletal muscles –> articular shock absorption
adipocytokines w/ synovial fluid
Is osteoarthritis just wear and tear?
no, also inflammatory
What is the most common type of osteoarthritis in obesity?
knee
What BMI range accounted for nearly half of 730 cases of gout over 12 yrs?
> 25
What happens in insulin resistance?
increase urate and decrease excretion
How can you improve gout?
wt loss
What is the strongest risk factor for OSA?
obesity
What are the two things in OSA?
neck and waist ratios
10% wt increase =
6x OSA increase
What happens in PCOS?
hirsutism, amenorrhea, infertility, polycystic ovaries
What % of premenopausal women have PCOS?
6-10%
What is a big issue for PCOS?
infertility
Do all PCOS pt have obesity?
no
What does a 5 point increase in BMI result in?
20-70% increase in incontinence
What is the common type of incontinence?
stress incontinence
What is incontinence due to?
intra admonial pressure and intravesicle pressure, increase urethral mobility
acne inversa results in formation of follicular occlusion, probably induced by occlusion/shear stress and increased insulin like growth factors in high glycemic diets, can be difficult to cure, sometimes surgery is needed
Hidradenitis suppuritiva
What causes interigo?
yeast
What types of cancers does obesity make it hard to detect?
pelvic and breast
How is cancer related to obesity?
Increased estrogen produced by adipose tissue
Insulin like growth factor increases = tumor development
Adipokines, such as leptin, promotes cell proliferation
Inflammation
Cancer of endometrial lining of uterus?
endometrial cancer
What % of endometrial cancer attributed to wt?
40%
What are the risk factors for endometrial cancer?
elevated levels of androgens, estrogen, hyperinsulinema related to obesity and increased adipose tissue
What is the relationship with breast cancer and premenopausal obese women?
less cases
When does wt gain increase risk of breast cancer?
40
How does wt loss after 40 yo affect breast cancer risk?
NO AFFECT
What diet is linked to colon cancer?
sugar and low fiber
High refined sugar diet → hyperinsulinemia and insulin resistance increased levels of free insulin-like growth factor 1 (IGF-1)→ results in decrease in apoptosis and increase in cellular growth → cancer development
Yeah
What directly stimulates colon cancer?
insulin
Who gets colon cancer more?
obese men and premenopausal women
What cause RCC with obesity?
hypoxia + hormonal changes + inflammatory changes
What cancers are associated with increase meat intake?
prostate, colorectal, pancreatic, esophageal cancer
What is the USPST recommendation for adults who are overwt or obese and have CVD risk factors for treatment recommendations?
B
USPST recommendation for General adult population without a known diagnosis of hypertension, diabetes, hyperlipidemia, or cardiovascular disease for diet and exercise
C
What is the diet and exercise recommendation from USPST for ALL adults?
B, screen all for obesity BMI>30
What is the recommendation for diet and exercise USPST in children 6-18 yo?
B, >6 yo for obesity
What is the USPST recommendation for pharmacotherapy inteventions in adults?
IP
What are the exercise goals of health people 2020?
Reduce the number of adults who do not engage in leisure-time physical activity
Increase number of adolescents and adults who meet federal physical activity guidelines
Increase physical education programs in public schools
Increase regularly scheduled recess in elementary school
Decrease computer/TV/video game screen time to
What is the american college of sports medicine recommendation?
150 minutes of exercise per week can be broken into 3-5 days
Incorporate resistance training into regimen
Flexibility training 2-3 days per week
Neuromotor exercises 2-3 days per week that focus on balance or agility, such as tai chi or yoga
