OVERWEIGHT AND OBESITY

Question 1

how do you calculate BMI?

Answer 1

weight (Kg)/ height (M squared)

Question 2

BMI accounts for variations in height, but what factors does it not account for?

Answer 2

sex, age, pregnancy, athletes, or muscle mass

Question 3

which guides give us a rough index of how much of each food groups we should eat?

Answer 3

the eatwell guide and the food pyramid

Question 4

whats wrong with our diet in the UK?

Answer 4

we dont eat enough fruit and veg or oily fish. we eat too much free sugar, saturated fat, red and processed meat.

Question 5

what percentage of adults are classified as overweight or obese?

Answer 5

63%

Question 6

is the prevalence of obesity linked to deprivation?

Answer 6

yes they are directly correlated

Question 7

is there a ‘best diet’?

Answer 7

The best diet is to eat a sensible number of calories, eat a variety of foods, eat plenty of fruits and vegetables and to eat plenty of food rich in starch and fibre.
or the Mediterranean diet

Question 8

what is the Mediterranean diet?

Answer 8

High fruit, veg, whole grain, olive oil

High micronutrient, fibre, unsaturated fat

Question 9

what are the impacts of being overweight or obese?

Answer 9

high bp, low HDL, high LDL, high risk of diabetes, cardiovascular disease, premature mortality rate, high cancer rates, high fasting free fatty acids, high fasting glucose and high plasma TGs

Question 10

what are plasma TGs?

Answer 10

plasma triglycerides

Question 11

describe the difference between men and women body shapes?

Answer 11

men- apple-shaped with abdominal obesity

women- pear-shaped with gynoid obesity

Question 12

is there a worse place to put on fat?

why?

Answer 12

yes the abdomen
the fat accumulated here tends to be more visceral fat which secretes more adipokines and fatty acids. Visceral adipose fat can also drain into the hepatic portal system which directly affects the liver and can be rapidly transported around the body.

Question 13

what width of the waist should you stay below in men and women?

Answer 13

men- 94cm
women- 80cm
(very high risk is men above 102cm and women above 88cm)

Question 14

what diseases is abdominal fat associated with?

Answer 14

higher risks of heart disease, insulin resistance and diabetes, higher mortality

Question 15

how much does risk of mortality increase with central obesity and a BMI 30+?

Answer 15

men x2

women increase by 40%

Question 16

how do you keep a healthy weight?

Answer 16

an energy balance where energy intake=energy output

Question 17

what happens when you’re in a negative energy balance?

Answer 17

we get a loss of energy store, body weight, carbohydrates, fats and proteins

Question 18

what happens when you’re in a positive energy balance?

Answer 18

gain in energy store, body weight, carbohydrates, fats and proteins

Question 19

what is leptin?

Answer 19

a hormone released from adipose tissue which acts on the hypothalamus to derease food intake by reducing hunger. it inhibits ghrelin being released from gastric cells

Question 20

what gene encodes leptin?

Answer 20

the ob gene

Question 21

what is ghrelin?

Answer 21

a hormone released from cells in the GI tract which increases hunger

Question 22

which group of people have higher ghrelin?

Answer 22

those with anorexia nervosa, particularly the purging type

Question 23

describe insulins action after a meal?

Answer 23

insulin secretion increases to stimulate glucose uptake by GLUT4, glycogen synthesis and fatty acid synthesis.

Question 24

why is insulin an anorexigenic signal?

Answer 24

it reduces appetite

Question 25

whats the problem with constantly worrying about dieting?

Answer 25

stress produces cortisol which can ause weakened immune system, anxiety, depression, headaches, nerve problems, digestive issues, high blood sugar, high blood pressure and heart disease.

Question 26

why was being obese an evolutionary survival advantage?

Answer 26

The ability to store energy when food is plentiful as food supplies were irregular

Question 27

why is a crash diet not efficient?

Answer 27

you lose glycogen which has water molecules conjugated to each glcose so the weight you lose is mostly water

Question 28

what should the food industry do to reduce obesity prevalence?

Answer 28

advertise variety and have clarity in packeging labels

Question 29

what should the government do to reduce obesity prevalence?``

Answer 29

regulate the food industry

Question 30

what should the clinicians do to reduce obesity prevalence?

Answer 30

They should be non-judgemental, supportive, subscribe exercise and reinforcing messages about making conscious choices

Question 31

what should the individual do to reduce obesity prevalence?

Answer 31

make conscious choices, avoid dieting and exercise more reguarly

Question 32

how can clinicians measure someones food intake?

Answer 32

food diaries, surveys, nutritionist interview, photographing food, weigh food, doubly-labelled water or calorimetry

Question 33

how can we boost energy expenditure?

Answer 33

by maintaining lean muscle mass

Question 34

whats the problem with trying to measure a patients food intake?

Answer 34

many under-report