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CNM Nutrition Year 1 Semester 2 > Energy, Metabolism, Control of Food and Weight loss > Flashcards

Energy, Metabolism, Control of Food and Weight loss Flashcards

1
Q

What is the 1st law of thermodynamics?

A

Energy cannot be created or destroyed, but it can transfer from one form to another

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2
Q

In which 3 ways is the energy obtained from from food used in the body?

A

Chemical work-synthesis of new macromollecules
Mechanical work- (muscular contraction)
Electrical work-maintenance of ionic gradients across membranes (e.g. the sodium/potassium pump)

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3
Q

How is the energy cosumed stored?

A
  1. Glycogen- in the live and muscles
  2. Fat (this accounts for the majority of energy storage)
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4
Q

When low on fuel, where can the body source it’s energy from?

A

Glycogen
Fat
Protein (a last resort in cases of starvation of malnutrition-amino acids are liberated from tissues e.g. skeletal muscle)

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5
Q

What is the second law of thermodynamics?

A

All energy used by the body degenerates as heat

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6
Q

How many calories does 1g of alcohol have?

A

7 kcal

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7
Q

How many calories does 1g of fibre have?

A

2 kcal

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8
Q

What is the energy currency of the body

A

ATP Adenosine Triphosphate

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9
Q

Where is ATP manufactured in the body?

A

In the mitochondria

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10
Q

What might interfere with the production of ATP?

A

Nutrient deficiencies
Toxins
Poor detoxificatiion and elimination pathways
Heavy metals can damage mitochondria

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11
Q

How can energy production be optimised?

A

-Sufficient nutrient intake
-Good GI health
-Optimal oxygen intake
-Heart and circulation (key in the delivery of nutrients to cells)
-Mitochondrial health- nutrients and anti-oxidants
-Thyroid health
-Detox
-Sleep hygiene

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12
Q

What 4 variables effect energy expenditure?

A
  1. Basal metabolic rate
  2. Thyroid Hormones
  3. Disease states
  4. The thermic effect of a food
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13
Q

What is the thermic effect?

A

The amount of energy used to digest and process foods.

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14
Q

What macronutrient has the
a. highest
B. lowest

thermic effect?

A

a. Protein 20-30%
b. Fat 0-3%

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15
Q

What percentage of the energy in carbohydrates is used for digestion and processing (the thermic effect)?

A

5-10%

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16
Q

What is DNL?

A

de novo lipogenesis. The metabolic pathway that sythesises fatty acids from excess carboydrates.

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17
Q

Why is the consumption of excess calories from carbohydrates problematic?

A

It forces the metabolism into DNL. This is a key driver for metabolic syndrome. This process requires up to 30% of the Carbohydrate energy.

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18
Q

How is fructose metabolised differently from other CHOs?

A

The liver converts fructose easily into fatty acids

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19
Q

Why would you advise against chronic calorie restriction?

A

It slows down metabolism
It may lead to nutrient deficiencies

Thus it results in an inability to continue to lose weight

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20
Q

What advice would you give a client who has been on a calorie controlled diet and has reached a plateau?

A

Eat nutrient dense foods to help re-establish a healthy metabolism.

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21
Q

In a nautopathic diet, what is more important than balancing macronutrients?

A

The quality of food.

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22
Q

Describe the process of ketosis in fat loss

A
  1. When glucose intake is insufficient to maintain glucogen stores in the liver and muscles, the brain experiences this as a stressor.
  2. This stress causes a spike to cortisol and a sharp drop in insulin production
  3. This liberates the excess supply of fatty acids from adipose tissue.
  4. Ketones are then produced for the brain to use as fuel.
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23
Q

Why is glucose especially important to the brain?

A

Fatty acids can’t penetrated the blood/brain barrier.

24
Q

Name 3 pros and 3 cons of calculating macros and counting calories?

A

Pros-
1. It makes you aware and accountable and therefore can drive positive behaviour change
2. Provides structure and discipline.
2. Macronutrients and calorie targets can be adjusted according to one’s goal

Cons-
1. Fails to account for the quality of the food (including micronutrients and phytonutrients)
2. Doesn’t account for different metabolic rates, genes, gut bacteria and one’s hormonal response to food.
3. Tracking can be too cumbersome and therefore unsustainable long-term.

25
Q

What is CCK’s role in weightloss?

A

It acts on the satiety centres in the brain stem

26
Q

What macronutrients stimulate CCK the most?

A

Fat and protein

27
Q

What is insulin’s role in weightloss?

A

It is responsible for controlling the storage and release of fatty acids in and out of the adipose tissue.

Fat cannot be stored without insulin.

28
Q

What causes insulin resistance?

A

Chronic excess energy intake combined with a sedentary lifestyle, leads to the body creating excess insulin. Over a period of time this leads to cells no longer responding to insulin, which in turn leads to chronic high blood sugar levels and type 2 diabetes.

29
Q

What is visceral fat?

A

Fat deposits in the abdomen, around the internal organs.

30
Q

What is Adiponectin?

A

A protein hormone specific to adipose tissue that increases the oxidation of fatty acids, promotes the clearance of excess fat in tissues and improves insulin sensitivity.

31
Q

Why is excess central adiposity tissue (visceral fat) problematic?

A

It increases inflammation ( by producing inflammatory cytokines including TNF-a and interleukin-6

It can produce excess oestrogen

It decreases adiponectin which improves insulin sensitivity and helps clear fat in tissues.

Lipolysis does not work properly, it is left to provide excess fatty acids into systemic circulation, increasing elevated blood fats and high cholesterol. These fats build up in the liver

32
Q

What is insulin’s role in weight gain?

A

It inhibits lipolysis (the breakdown of fat for energy)

33
Q

What happens in insulin resistance?

A

The cells become immune to insulin and lipolysis continues, this fat has nowhere to go so ends up as visceral fat or in the blood (increased serum triglycerides). It also deposits around the liver (causing fatty liver disease)

34
Q

Explain how insulin resistance affects the liver

A

Insulin gives 2 important signals to the liver-
1. Stop making glucose-gluconeogenesis
2. Store the available blood glucose-glyconeogenesis

In insulin resistance, both of these signals respond poorly to the insulin signal, putting patients at risk from chronically elevated glucose levels.

35
Q

How is fructose metabolised differently from glucose?

A

When glycogen stores are full, fructose is converted directly to liver fat.

36
Q

What diseases are the result of a high fructose diet?

A

NAFLD
Obesity
High uric acid (gout)
Elevated Advanced Glycation End Products (AGES)
These are linked with accelerated ageing and diabetes complications.

37
Q
A
38
Q

What is Ghrelin and what is it’s role in appetite regulation?

A

Ghrelin is a hormone created by stomach cells when the stomach is empty, it’s secretion is suppressed after a meal.

It is the hunger hormone

39
Q

What factors (apart from eating) can affect ghrelin levels?

A

Obesity-can cause reduced post-prandial ghrelin suppression
Weight loss- levels increase (explains why diets don’t work long term)
Dyregulated sleep and elevated cortisol- increase ghrelin secretion

High protein meals (35% of calories) with moderate carbohydrates (45%) can suppress ghrelin.

40
Q

What is Leptin and what is it’s effect on appetite?

A

Leptin is an adipokine produced by white adipose cells in proportion to overall body fat.

Leptin decreases appetite

41
Q

Are leptin levels higher or lower in obese people?

A

Higher

42
Q

Why are high leptin levels insufficient in obese populations?

A

They become leptin resistant because-
Obesity induces a number of inflammatory processes that weaken leptin signaling. This means that leptin fails to suppress appetite

43
Q

What is the effect of excess leptin in the body?

A

It induces insulin resistance, affects tissue metabolism, stress responses, and reproductive function, chronic fatigue, sleep problems, and CV distress.

Also weight gain, which contributes to further leptin resistance creating a vicious cylce.

44
Q

Name 5 ways in which we can increase leptin sensitivity

A
  1. Go gluten free-Wheat gluten has been shown to stop leptin binding to the leptin receptor
  2. Reduces sugar consumption- Especailly fructose, it induces leptin resistance
  3. Reduce inflammation
  4. Regular exercise
  5. Sleep hygiene
45
Q

What is the gut flora’s role in obestity

A

Overweight individuals have different gut microflora to lean individuals (e.g. reduced Bifdobacterium)

46
Q

What macronutrient, if too high can causes lower levels of bifobacteria?

A

A high fat diet causes increased levels of gram-negative bacteria which can reduce levels of bifidobacteria

47
Q

Which ratio of microbes is implicated in obesity?

a. a higher ratio of Firmicutes to Bacteroidetes?
b. a higher ratio of Bacteroidetes to Firmacutes?

A

a

48
Q

What are SCFAs role in appetite and weight control?

A

They increase the secretion of neuropeptides and gut peptides (e.g. GLP-2). These support the integrity of the intestinal lining and curb appetite

49
Q

What is metabolic endotoxemia and what causes it?

A

A peristant low-grade inflammatory response due to circulating endotoxins (mainly LPS)

Caused by intestinal permeability

50
Q

What pathology can metabolic endotoxemia cause?

A

Insulin resistance

51
Q

What foods strongly stimulate the dopamine reward system?

Why is this hardwired into our systems?

A

Foods with a high fat or high sugar content.

Because in hunter-gatherer times, these foods offered a survival advantage

52
Q

Explain dopamine’s role in weight gain.

A

Obese people have fewer dopamine receptors in the brain and therefore get less of a reward response from palatable foods, they need to eat more to get the same response. When they do eat more, the dopamine receptors get downregulated even further which can increase the risk of overeating.

53
Q

Why is keeping blood sugars even an important strategy in regulating food intake?

A

Sharp spikes lead to sharp drops. This stimulates the nucleus accumbens, an area of the brain that produces a desire to eat.

54
Q

Name 5 ways in which we can keep blood sugar stable.

A
  1. Protein with each meal
  2. Avoid refined carbs and high GI foods
  3. Don’t snack
  4. Walk after each meal
  5. Eat a whole foods organic diet
55
Q

What is Mindful Eating?

A

The process of paying attention to your food to help you to become aware of the reasons behind your hunger.

56
Q

Name 5 factors that can hinder weight loss

A
  1. Overeating
  2. Sedentaty lifestyle
  3. High blood sugar and insulin resistance
  4. Chronic stress (high cortisol elevates blood sugar and increases abdominal fat)
  5. Underactive thyroid
  6. Gut flora imbalances
57
Q

As a nutritional therapist, which 6 key points would you consider before devising a plan for a client?

A
  1. Does the plan address behavioural triggers or eating?
  2. Does the plan contain all the necessary nutrients?
  3. Is it a diet or a lifestyle change?
  4. What is the motivation?
  5. Does the plan offer education and support
  6. Does the plan include exercise?

CNM Nutrition Year 1 Semester 2 (10 decks)

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