Weight (Bariatric Surgery, GI disorders, Eating out)

Question 1

Risk assessment for obesity

Answer 1

Women > men
All ethnic/racial groups vulnerable
Rise exceeds genetics

Question 2

Physiological risk factors

Answer 2

Heightened adrenocortical response to daily living (stress)

Forfeiting lactation protection against obesity for mother/infant

Stressors in the fetal environment that increase obesity risk

Question 3

Lifestyle risk factors

Answer 3

Exposure to chemicals that act as endocrine disruptors

Indoor living (less sun, decreased physical activity, altered circadian rhythm)

Question 4

Exacerbating conditions

Answer 4

Chemosensory disorders: diminished/altered taste/smell (cancer treatment)

Asthma: interferes with aerobic activity

Depression/emotional eating: endorphins from fats/sugars, antidepressants (weight gain)

Sleep disturbance (sleep apnea)

Type II diabetes: eating to regulate insulin/cravings

Peripheral edema: worsened by intake of sodium

Muscle atrophy

Question 5

Medical conditions

Answer 5

Sex hormone imbalance

• obesigenic fertility medications
• obesity can exacerbate hormone imbalances

Subclinical hypothyroidism

Question 6

Treatments for obesity

Answer 6

Weight loss medications
Orlistat (Xenical and Alli)
-reduces fat digestion by 30%
-side effects: reduction in fat-soluble vitamin absorption, oily shit

Question 7

Liposuction

Answer 7

Surgical method of suctioning excess fat out of the body

NOT a treatment for obesity, more of a cosmetic procedure to improve body contours

Question 8

Bariatric Surgery

Answer 8

Reduces size of stomach
Weight loss –> normal blood pressure, glucose/triglyceride levels
Complications: intestinal blockage/bleeding, ulcers, extra skin

Question 9

Lactose Intolerance

Answer 9

Loss or reduction of enzyme lactase that digests lactose
Symptoms: diarrhea/gas
Diet: milk consumed with food, aged cheese, yogurt, lactose free milk

Prevalent among certain ethnic groups (Asian, African Americans, Native Americans, latinos)

Question 10

Pancreatitis

Answer 10

Pancreatic tissue is destroyed by activated enzymes –> severe abdominal pain

Acute

• causes: gallstones, excessive alcohol, high triglycerides
• withhold food/fluids

Chronic

• permanent damage to tissue
• 70% alcohol induced
• Diabetes ensues (80%)
• malabsorption –> weight loss/malnutrition

Question 11

Cystic Fibrosis

Answer 11

Viscous exocrine secretions (more prevalent in Caucasians)
Lungs/pancreas/sweat glands –> respiratory infections, malabsorption of protein/fat/fat-soluble vitamins

Nutrition therapy

• energy needs 20-50% higher than DRI
• high fat foods, frequent meals/snacks
• Lots of salt (sweat –> losses)

Question 12

Celiac Disease

Answer 12

Abnormal immune response to protein fraction
Symptoms: diarrhea, statorrhea
Consequences: damage to intestinal mucous, malabsorption, underweight in children

NO wheat, barley, rye, oats

Question 13

Inflammatory bowel Diseases

Answer 13

CHRONIC inflammatory conditions

Treatment
-Drugs: antidiarrheals, anti-inflammatory agents
-Medical nutrition: high calorie/protein, multivitamins (Crohn’s)
Low fiber, restore fluids/electrolytes (Colitis)

Question 14

Crohn’s Disease

Answer 14

Occurs in any region of the GI tract
Ulcerations, fissures, fistulas –> thick scar tissue causes obstructions
Malnutrition from reduced intake/malabsorption, surgical resections

Question 15

Ulcerative colitis

Answer 15

Only affects rectum/colon
Frequent urgent bowel movements –> nutrient losses due to tissue damage/bleeding/diarrhea

Weight loss, fever, weakness, anemia, dehydration, protein losses

Question 16

Short Bowel Syndrome

Answer 16

Consequence of small intestine resections, needs intestinal adaptation to improve absorptive capacity

Diet

• small frequent meals
• vitamin/mineral supplements
• exact diet depends on how much was removed

Question 17

Irritable Bowel Syndrome

Answer 17

Chronic/recurring intestinal symptoms (diarrhea/constipation, bloating)
Women > men

Medicine: antidiarrheal, laxatives, relaxing oils

Diet: more fiber, less caffeine/alcohol/fat/milk, frequent meals

Question 18

Diverticulitis

Answer 18

Pebble sized outpockets in intestinal walls, inflammation/infection
Prevalence increases with age
High-fiber diet = preventative
No nuts/popcorn/seedy foods, antibiotics/surgery

Question 19

Most nutrient dense pie

Answer 19

PUMPKIN PIE over apple/pecan

Question 20

Highest calorie Chili appetizer

Answer 20

Texas cheese fries with chili/ranch = 2120 calories

others - 1610, 1490, 490

Question 21

Highest protein Chili’s appetizer

Answer 21

Texas cheese fries with chili/ranch because of cheese, beans, meat (97g protein)

Question 22

Highest sodium IHOP

Answer 22

White chocolate mint pancakes with eggs and ham because the ham is brined in salt

Question 23

Highest saturated fat on kids menu

Answer 23

Grilled cheese sandwich because of butter and cheese

Question 24

What sandwich will have the most cholesterol

Answer 24

Roast beef because roast beef is famously high in cholesterol