SM_147b: Etiology of Obesity Flashcards
Physical activity level is comprised of ____ and ____
Physical activity level is comprised of posture and spontaneous activity
Resting expenditure ___ as fat-free mass increases
Resting expenditure increases as fat-free mass increases
Resting energy expenditure and total energy expenditure are ___ in lean patients than obese patients
Resting energy expenditure and total energy expenditure are lower in lean patients than obese patients
Lean people have lower ____, ____, ____, and ____ than obese people
Lean people have lower fat-free body mass, fat mass, resting metabolic rate expenditure, and total energy expenditure than obese people
Lean individuals expend ___ energy sitting and ___ energy standing and ambulating than obese individuals
Lean individuals expend less energy sitting and more energy standing and ambulating than obese individuals
Body weight stabilizes when ____ balances higher energy intake
Body weight stabilizes when higher energy expenditures balances higher energy intake
In an obese macroenvironment, ____ is easy
In an obese macroenvironment, energy in > energy out is easy
Physical activity level is comprised of ____ and ____
Physical activity level is comprised of posture and spontaneous activity
Resting expenditure ___ as fat-free mass increases
Resting expenditure increases as fat-free mass increases
Resting energy expenditure and total energy expenditure are ___ in lean patients than obese patients
Resting energy expenditure and total energy expenditure are lower in lean patients than obese patients
Lean people have lower ____, ____, ____, and ____ than obese people
Lean people have lower fat-free body mass, fat mass, resting metabolic rate expenditure, and total energy expenditure than obese people
Lean individuals expend ___ energy sitting and ___ energy standing and ambulating than obese individuals
Lean individuals expend less energy sitting and more energy standing and ambulating than obese individuals
Body weight stabilizes when ____ balances higher energy intake
Body weight stabilizes when higher energy expenditures balances higher energy intake
In an obese macroenvironment, ____ is easy
In an obese macroenvironment, energy in > energy out is easy
Summarize the energetics of obesity
Energetics of obesity
- Obesity is caused by an imbalance in the energy equation
- Weight gain is composed of increased fat mass and fat-free mass
- Obesity is associated with an increased total energy expenditue (BMR and PAL)
- Body weight stability is achieved when caloric intake = caloric expenditure
Intake matches energy expenditure under conditions of ____ lifestyle
Intake matches energy expenditure under conditions of moderate-active lifestyle
Obesity is a ____
Obesity is a complex multifactorial chronic disease that develops from an interaction of genotype and the environment
There is some ____ of body weight
There is some heritability of body weight
- Animal models: obese (ob) mouse (leptin deficient), diabetes (db) mouse (leptin resistant)
- Human inherited disorders: Prader-Willi syndrome, leptin deficiency, POMC deficiency, and melanocortin 4 receptor deficiency
- Adoption studies
- Twin studies
- Family metabolic studies
BMI increases as number of ____ increase
BMI increases as number of obesity alleles increase
Maternal weight is positively associated with ____
Maternal weight is positively associated with child’s risk of obesity
- Epigenetics: intrauterine environment alters DNA methylation and histone modification to change gene expression
Obesity and pregnancy are associated with ____ and ____ that exacerbate in combination, increasing ____
Obesity and pregnancy are associated with insulin resistance and inflammatory changes that exacerbate in combination, increasing lipid transfer earlier in gestation
- Reversal of dietary weight gain is influenced by duration and severity
In a high fat diet, neuron damage in hypothalamus results in ____ and ____ leading to ____
In a high fat diet, neuron damage in hypothalamus results in astrocyte activation and microglial activation leading to increased body weight
Transmission of ____ determines leaness
Transmission of gut microbiota determines leaness
Summarize the determinants of weight gain
Determinants of weight gain
- Obesity is caused by a multiplicity of factors: genetics, biology, habits, psychosocial, environmental influences
- Although monogenic obesity and syndromic obesity are prototypic, most common cause is polygenetic (multiple alleles)
- Obesity can be transformed to offspring by epigenetics: role and mechanisms of microbiota are uncertain
- Hypothalamic inflammation plays a role in persistence of chronic obesity
_____ occurs when someone loses a lot of weight
Adaptive thermogenesis (metabolic adaptation) occurs when someone loses a lot of weight
- Regulated production of heat in response to environmental changes in temperatuee and diet -> metabolic inefficiency
- Help defend body weight
Metabolic adaptation (adaptive thermogenesis) is primarily from ____
Metabolic adaptation (adaptive thermogenesis) is primarily from metabolic work efficiency of muscles
- Skeletal muscle work efficiency accounted for the majority of reduction in nonresting energy expenditure associated with weight loss - this is not significant with higher work loads
Maintenance of an obese state is caused by ____ and perhaps ____
Maintenance of an obese state is caused by excessive caloric intake and perhaps lower PA + NEAT
Energy requirements are higher in obesity due to increased ____ and overall higher ____
Energy requirements are higher in obesity due to increased fat free mass and overall higher total energy expenditure
