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Nutrition > Overnutrition > Flashcards

Overnutrition Flashcards

1
Q

Obesogenic behaviour

A

Increased energy intake- gluttony

Decreased energy expenditure- sloth. This is the primary determinant.

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2
Q

Obesity etiology

A

complex and multi-factorial
Some genes are linked, but environment and behaviors are obesogenic and increase prevalence.
Small imbalance between intake and expenditure is responsible.

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3
Q

Management of Obesity

A 
Special diets
Lifestyle clinics
CBT
Drugs
Enforced intake restriction: jaw wiring, fixed stomach belts, surgery.
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4
Q

Carb restricted diets

A

Highly satiating
Reduce energy intake.
Safe when:
- fruit and veg intakes are maintained
- Fat quality is appropriate (low in saturates)

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5
Q

Orlistate

A

Inhibits gastrointestinal lipases
Reduces fat abs from gut
Side effects: steatorrhea, with possible anal leakage.

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6
Q

Phentermine

A

appetite suppressant like amphetamine

SEs: raised BP

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7
Q

Lorcaserin

A

Serotonergic appetite suppressant
SEs: few. Moderately effective.
aka Belviq in US

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8
Q

Liraglutide

A

GLP-1 agonist

Increases satiety and reduces food intake

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9
Q

Naltroxene/buproprion

A

Noradrenergic and dopaminergic reuptake inhibitor and opioid receptor antagonist.
Reduces hunger

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10
Q

Obesity increases mortality in what diseases?

A 
Ischemic heart disease
Stroke
Diabetes
Some cancers
Liver disease
It shortens the lifespan
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11
Q

Obesity is assoc with a decrease in which diseases?

A

Respiratory diseases in both men and women

and cancer of lung, mouth, pharynx, larynx or esophagus in men

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12
Q

Diseases with a relative risk >3 for obesity

A 
Type II DM (insulin resistance)
HTN
Breathlessness
Gallbladder disease
Dyslipidemia
Sleep apnea
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13
Q

Diseases w relative risk 2-3

A 
Coronary heart disease/Heart failure
Osteoarthritis
Hyperuricemia and gout
Pre-eclampsia
Cancer
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14
Q

How obesity increases risk for CVD

A

overweight/obesity causes increase BP and dyslipidemia- the 2 main risk factors for CVD

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15
Q

Cholesterol and obesity

A

Increased BMI is associated with increased LDL cholesterol
and decreased HDL
as well as increased LDL/HDL ratio

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16
Q

TAGs as an indicator of CHD risk

A

Better indicator for CHD risk and dyslipidemia
Increased TAG:
- intolerance to dietary fat
- reduced cardioprotective HDL
- Pro-Inflammatory and pro-thrombotic
- Increase in small, dense atherogenic LDL

17
Q

Pathophys changes in CVD

A

abnormal clotting, HTN, dyslipidemia, inflammation, vascular endothelial dysfxn.

18
Q

CVD and diet

A 
Main risk factors:
Salt- too much
Fat- too much/wrong kind
Carbs- too much/wrong kind
Fibre- not enough
Fruit, veg and nuts- not enough
19
Q

Processed foods

A

increase salt intake and decreased potassium intake.

XS salt and low K increase risk of HTN

20
Q

Dietary fat effects on clotting

A

n-3 PUFAs decrease clotting and increase bleeding time but decrease inflammation and TAGs

n-6 PUFAs increase clotting and inflammation, but decrease cholesterol

21
Q

Foods assoc w a lower risk of CHD

A

PUFAs
Whole grain carbs
MUFAs

22
Q

Glycemic index

A

Low GI diets (low glucose) improve blood lipids, especially TAGs

23
Q

CVD and dietary carbs

A

Carbs give excess fructose.
Have low GI but are metab’d in the liver and XS is converted to TAGs–> increase CVD risk.
Doesn’t signal satiety like glucose–> obesogenic

24
Q

Fiber and CVD

A

High fiber and low GI carb diets improve dyslipidemia and decrease risk of CVD

Red lentils
Pinto beans
Spaghetti
Yellow Split peas

25
Q

Foods assoc with high GI and low fibre

A

Provide XS fructose
Glutinous rice
Short grain white rice
Fresh mashed potatoes

26
Q

Diabetes Mellitus

A

Group of disorders comprising abnormalities of metabolism, characterized by hyperglycemia, resulting from insulin deficiency or resistance

27
Q

Type I/ Insulin-dependent

A

Weight loss, polyuria, polydipsia
Ketosis
Normally develops in childhood, before 40y

28
Q

Type II/Non-insulin dependent

A

Often asx
Overweight
Infections:UTI, vulva
Thirst, rarely coma

Normally appears >40y in whites, but is becoming more common in children now.

29
Q

Gestational Diabetes

A 
asx or presents like type II
Risks:
overweight/obese
had GDM before
Had large baby previously (10lb)
FHx of DM
Black, Hispanic, Am Indian, S Asian, M E background
30
Q

Complications of DM

A 
Blindness
Kidney damage
CVD
Lower-limb amputations
Dementia

Controlling glucose, BP and blood lipids decrease these risks

31
Q

Type I factors

A

mainly a Tcell-med AI disease
HLA linked.
Environmental factors:
- Viruses: Rubella, enterovirus, coxsackie, CMV
- Dietary: Cows milk proteins (BSA), gluten before 3 months.
VitD intake and breast feeding protect from it.

32
Q

Hygiene hypothesis for DM

A

Environment for children is too clean–> deficiency in immunoregulation –> DM type I

33
Q

Risk factors for Type II DM

A 
Age, FHx, Ethnicity, Social class
Diet (SFAs)
No physical activity
Central obesity
Metab syndrome
34
Q

Weight and risk for DM-2

A

for each 1kg increase in weight, risk for DM increases by 4.5%.
Pts w central adiposity have higher insulin levels and are more insulin resistant than those w peripheral obesity.

35
Q

Metabolic syndrome

A

Cluster of disorders:
1- Glucose intolerance
2- Central adiposity (insulin resistance)
3- HTN
4- Dyslipidemia (either increase TAGs or decrease HDL)

Causes increase risk for CVD
CHD death and non-fatal MI risk increased w the # of metabolic syndrome disorders a pt has.

36
Q

Why central obesity causes insulin resistance

A
  • Fat drains directly to liver via portal system
  • More NEFA produced than gluteal-femoral fat: NEFA goes to mm. and causes IR
  • More inflammatory cytokines
  • Central adipocytes are larger and more IR than peripheral ones
  • Hyperinsulinemia is directly related to waist circumference
37
Q

Major cause of Metabolic syndrome

A

Central obesity

38
Q

DM treatments

A

Type 1: diet/lifestyle change + insulin

Type 2 and GDM: diet/lifestyl +/- oral hypoglycemics (metformin) +/- insulin

Nutrition (5 decks)

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