Regulation of postnatal growth and adiposity Flashcards

1
Q

What does postnatal growth depend on?

A

‘growth’ vs ‘development’

Catch-up growth

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2
Q

What things come under adiposity?

A
  • Adipogenesis
  • Measuring adiposity
  • Body fat distribution
  • Programming of adiposity
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3
Q

Is Growth related to development?

A

Yes but is not synonymous

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4
Q

Define growth

A

Quantitative increase in physical size or mass

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5
Q

Everyone begins like with their own genetic potential. What will this determine?

A

This determines its target mature size

Genetic potential is determined by environment

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6
Q

In what two ways does growth occur?

A

Cell hyperplasia/ proliferation: increase in cell number

Cell hypertrophy: enlargement of cells or accumulation of extracellular material

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7
Q

Define development

A

A progression of changes (quantitative or qualitative) that lead form an undifferentiated or immature state to a highly organise, specialised and mature state

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8
Q

Where is there a switch in the relative importance of growth versus development?

A

Switch from lots of development in early life to more growth in later life

Stem cells are pluripotent which can become different types of cells

Excess growth e.g., obesity, muscle, tumours, in animals (wrong sort of growth)

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9
Q

How is growth measured?

Tell me about this

A

Growth charts (centile charts)

Each of these curved lines are called ‘centiles’ and show how your child is growing and developing in relation to other children their age

Boys and girls use different charts due to different growth rates over childhood

Weights and heights that are anywhere within the centile line on the chart are considered normal

Based on population norms

50 percentile line is bang on track for growth

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10
Q

Tell me about ‘catch-up’ growth and the centile charts

A
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11
Q

Why is catch-up growth bad news in the long-term?

A

Catch up growth can affect metabolism and the type of growth that’s going on

Refeeding causes the effects seen on the diagram as was used to delayed and then suddenly get influx which the body wasn’t expecting

Seen in animal studies as well

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12
Q

Accelerated post-natal catch-up growth is related to what in childhood?

A

Obesity

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13
Q

Define adipogenesis

A

The formation of fat or fatty tissue

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14
Q

What are the types of fat?

A

White fat

Brown fat

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15
Q

Tell me about white fat

A

White fat- store lipids

Have a scant ring of cytoplasm surrounding a single large lipid droplet (uniocular)

Nuclei are flattened and eccentric within the cell

Some mitochondria

Main function is to store energy in the form of triglycerides

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16
Q

Tell me about brown fat

A

Brown fat

Are polygonal in shape

Contain multiple lipid droplets of varying size (multiocular)

Nuclei are round and almost centrally located

High content of mitochondria

Burn lipids to produce heat due to presence of UCP1 protein

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17
Q

What are some factors which determine the prevalence, mass and activity of brown adipose tissue (BAT)?

Does it increase or decrease BAT?

A
  • Outdoor temperature; increases cold
  • Sex; female increase (more BAT in females)
  • Adiposity; excess fat decrease
  • Diabetes status; diabetes decrease
  • Age; aging decrease

In children 5% of body mass is brown fat

Obese people have more white and brown fat

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18
Q

How is BAT activated?

A
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19
Q

What can be used to measure adiposity and what is the formula for that?

A

BMI (body mass index)= weight (Kg) / Height (m) x Height (m)

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20
Q

What are some other methods used to measure body fat?

A

Bioelectrical impedance: uses an electrical current to estimate fat based on its reactance and resistance properties

Skin-fold thickness: measure amount of subcutaneous fat

Dual-energy X-ray absorptiometry (DEXA)

Underwater weighing: computes body volume as the difference between body weight measured in air and weight measured during water submersion

Computerise tomography (CT)

21
Q

Its the body fat distribution that counts, tell me about the different body shapes and which ones are better?

A

Apple shape vs Pear shape

More fat in abdomen is more damaging that fat below the waist

Apple shape is more metabolically damaging than pear shape

Hip to weight ratio can give idea of relative ratio

Apple shape

  • More visceral fat
  • Higher risk of weight-related health problems

Pear shape

  • ​Less visceral fat
  • Lower risk of weight related health problems
22
Q

Compare Visceral vs Subcutaneous fat

A

More visceral fat= higher risk of metabolic and cardiovascular diseases

Subcutaneous fat is not as metabolically damaging as one with more visceral fat

23
Q

Name the adipokines that are released from the adipose tissue and their physiological functions

A
24
Q

What can visceral obesity lead to?

Provide examples?

Why is this the case?

A

Visceral obesity leads to inflammation and disease (All problems of having more adipose tissue in abdominal space)

  • Lot of adipose tissue in abdominal space have good access to good portal circulation i.e., liver which has important roles. If adipokines enter here, then it can affect the function of the liver
  • Pro-inflammatory state, prothrombic start, prohypertensive due to increased release of cytokines
  • Ectopic fat deposition is laying fat where there shouldn’t be fat stored
25
Q

How does obesity come into play with COVID?

A
26
Q

Tell me about the obesity epidemic in England and what is being done to tackle this?

A

Obesity epidemic in England

More adults and children becoming obese

This number is getting early in life i.e., in 4- and 5-year-olds

Trajectory of life course and disease is concerning

Costly for the wider society through treatment (more in this than the services)

Huge public health issue

High levels of obesity in Southampton

Campaigns at tackling obesity

Change 4 life

Sugary drink taxes

And more

Tried and tested but not doing very much. Are we tackling too late?

Thought that the early environment can set you up for obesity risk

27
Q

What are some factors which play a developmental role on the programming of adiposity?

A

Maternal malnutrition during pregnancy

  • Maternal undernutrition

Global undernutrition

Low protein diets

  • Maternal overnutrition

High fat diet

High protein diet

Man-made environmental chemicals

28
Q

Tell me about global undernutrition and what has a study on rat mothers observed?

A

Offspring from undernourished rat mothers have increased adiposity

UN offspring on the hypercaloric diet show highest adiposity even when BW is lower VS AD offspring on hypercaloric diet

29
Q

Tell me about the effects of a maternal low protien diet and what a study has observed?

A

Rat offspring from mothers fed a low-protein diet during pregnancy have the same body weight trajectory as those from mothers fed a control diet but have increased adiposity

30
Q

What does a maternal high fat diet lead to?

A

Obesity

31
Q

The interaction of prenatal maternal and postnatal offspring diet

A
32
Q

Multigenerational programming of adiposity by maternal high fat diet

A
33
Q

Maternal high protein diet

A
34
Q

Overview of nutritional exposure on adipose phenotype in adult offspring

A
35
Q

What type of relationship is there between foetal nutritional exposure and propensity to develop obesity in adulthood?

A
36
Q

Give examples of some man-made environmental chemicals which can alter the developmental programming of adiposity

A

Pesticides (herbicides, insecticides, fungicides)

Leaching of plasticisers in plastic/ vinyl products e.g., bisphenol A

Pharmaceuticals (contraceptives, drugs e.g., DES- has an effect on adiposity)

Detergents

37
Q

What are some chemicals that are found in everyday life?

A
  • Phenolic compounds
  • Polyaromatic hydrocarbons
  • Halogenated compounds
  • Heavy metals
  • Organochlorine pesticides
  • Perflourinated compounds
  • Phthalates

Many are known to cross the placenta and potentially influence foetal development

38
Q

Whats the potency of environmental agents?

A

Persistent and stable in the environment

Lipophilic resulting in bioaccumulation in body fat

Synergistic effects

Can induce ‘non-monotonic dose-response curves of biological effects’

39
Q

Prenatal exposure to Diethylstilbesterol (DES) can program what?

A

Postnatal growth and adiposity

40
Q

Prenatal exposure to low dose bisphenol A (BPA) increases what?

A

Offspring adiposity

41
Q

There are many mechanisms involved in the developmental programming of adiposity, one of them being epigenetic memory in the adipose tissue of offspring of malnourished dams.

Tell me about this

A
42
Q

Prenatal exposure to low-dose BPA disrupts what?

A

DNA methylation of the promotor site of a gene associated with adiposity

43
Q

Prenatal exposure to BPA disrupts DNA methylation of promotor site of a gene associated with adiposity continued…

A
44
Q

How does high fat maternal diet impair offspring mitochondrial function and prime adiposity?

A
45
Q

Maternal obesity alters offspring gut microbiota

A
46
Q

Maternal obesity by feeding a high fat/sucrose diet during pregnancy and lactation alters the relative abundance of offspring gut microbia in rats

A
47
Q

Altered abundance of gut microbiota in rat offspring from obese high-fat/sucrose diet-fed mothers leads to increased body weight and adiposity

A
48
Q

summary

A
  • The U-shaped relationship between foetal nutritional exposure and the predisposition to develop obesity in adulthood
  • The ‘priming’ effects of the intrauterine environment on mechanisms that increase fat accumulation in later life, and its interaction with offspring postnatal nutrition
  • It’s the body fat distribution rather than the amount of fat per se that determines susceptibility to obesity and cardiometabolic diseases