Health benefits

Question 1

What are the latest recommendations for exercise?

Answer 1

30 minutes moderate intensity at least 5 days a week
150 minutes

Question 2

Why is PA regarded as a bigger risk factor to health than smoking?

Answer 2

65% males and 76% females do not achieve the weekly guidelines for exercise

Question 3

When is the build up of fatty plaque first present in life?

Answer 3

1st decade of life

Question 4

When is cholesterol dangerous?

Answer 4

When it has been modified, e.g. oxidised

Question 5

What protein wraps around LDL and HDL?

Answer 5

Apolipoprotein
A - HDL
B - LDL

Question 6

What initiates plaque formation?

Answer 6

Damage/infection to endothelial layer

Question 7

Why is there more adhesion molecules at the branch points of the arteries?

Answer 7

Less laminar flow
Less flow over eNOS
Less production of nitric oxide
Reduced vasodilation and increased adhesion molecules

Question 8

What is the role of apolipoproteins?

Answer 8

To interact with other tissues
A - liver
B - less specific

Question 9

Fatty plaque formation and atherosclerosis

Answer 9

Damage/infection to endothelial layer
WBC release cytokines attracting monocytes
Monocytes interact with adhesion molecules
Enter endothelial layer via diapedesis
PLGF promotes smooth muscle in intima
Monocytes mature into macrophages
Consume modified cholesterol forming foam cells
Macrophages release proteolytic enzymes and free radicals
Enhancing necrotic core
Leading to further inflammation

Question 10

What happens if cholesterol levels drop?

Answer 10

Cells produce more LDL receptors
LDL binds to receptor
Cell cholesterol level increases

Question 11

Why do macrophages consume cholesterol in an uncontrolled way

Answer 11

Scavenger receptors on membrane identifies pathogen - modified LDL
Scavenger cells can not turn off

Question 12

What makes HDL an atherogenic? (3)

Answer 12

Slows the modification of cholesterol
Reduces expression of adhesion molecules
Promotes cholesterol efflux

Question 13

What is cholesterol efflux?

Answer 13

Free cholesterol taken up by HDL
Binds by LCAT enzyme
Transported to liver and binds via apolipoprotein A
Excreted as bile

Question 14

What are the benefits of exercise on HDL levels?

Answer 14

TG in circulation for a shorter period

Question 15

Why does it take longer for fats to appear in the bloodstream?

Answer 15

Fats packaged into chylomicrons in intestine
Assembled in lacteals and drained from lymphatic system
Chylomicron broken down and enters liver - monoglycerol and FFA
Apolipoprotein B100 repackages fat into VLDL

Question 16

What happens when VLDL ‘bumps’ into LDL/HDL?

Answer 16

Exchange of TAG and CE
Via CEPT
HDL catabolised in kidney

Question 17

What are the effects of TG rich VLDL on lipoprotein profile?

Answer 17

VLDL increases
HDL decrease

Question 18

What test can we do to measure fat levels?

Answer 18

Oral fat tolerance test

Question 19

What happens to fat during exercise? (2)

Answer 19

LPL break down FFA and enters muscle
Liver oxidises more fat, less being repackaged into VLDL

Question 20

What effect does prior exercise have on blood flow?

Answer 20

Blood flow is redistributed towards the liver

Question 21

What is a benefit of regular exercise training on fat?

Answer 21

Increased LPL due to capillarisation
Decreasing LDL and VLDL

Question 22

What enzymes breakdown/reform fat stores?

Answer 22

LPL
HSL

Question 23

What is insulins effect on fat storage enzymes?

Answer 23

LPL - activates
HSL - inhibits

Question 24

What action does insulin have on the hepatocytes?

Answer 24

Inhibits apoB100, therefore decreasing repacking into VLDL

Question 25

What effect does training have on LCAT and CEPT?

Answer 25

LCAT increases CEPT decreases

Question 26

What are the best methods to assess body composition?

Answer 26

MRI DEXA Underwater weighin

Question 27

How many years does obesity reduce lifespan by?

Answer 27

Approx. 8-10 years

Question 28

What are increased disease risks associated with obesity?

Answer 28

CVD Hypertension Stroke Cancer Diabetes

Question 29

Does fat or CHO have a larger store of energy in adipose tissue?

Answer 29

Fat Fat 9kcal/g, CHO 4kcal/g

Question 30

What proteins does adipose tissue produce? (4)

Answer 30

Adipokine Leptin Adiponectin aP2

Question 31

What cytokines does adipose tissue produce?

Answer 31

TNF-a Il-6

Question 32

What happens in the proximal insulin cascade?

Answer 32

Insulin binds to receptor Tyrosine exposed becoming phosphorylated IRS-1 binds to beta unit becoming phosphorylated Activates PI3 kinase Phosphorylating PIP2 to PIP3

Question 33

What effect does fat derivatives and TNF-a have on the insulin cascade pathway?

Answer 33

Exposure of serine inhibits phosphorylation of IRS-1

Question 34

What effect does obesity have on insulin and fat storage?

Answer 34

Decreased activation of LPL Decreased inhibition of HSL

Question 35

What is the role of adipokines - which one is the odd one out?

Answer 35

Make cells insulin resistance Adiponectin is insulin sensitive

Question 36

What effect does obesity have on adipokines?

Answer 36

Increases insulin resistance Decreases insulin sensitivity

Question 37

What molecule inhibits the action of CPT-1 and therefore the oxidation of fat in the mitochondria?

Answer 37

Malonyl-coA

Question 38

Describe the pathway that inhibits the action of malonyl-coA on CPT-1?

Answer 38

Adiponection binds to receptor Phosphorylating AMPK Phosphorylating ACC Inhibits conversion of acetyl-coA Preventing fat accumulation

Question 39

What effect does training have on adipokines?

Answer 39

Insulin resistance adipokines decrease Adiponectin increases

Question 40

What components contribute to energy expenditure?

Answer 40

Exercise Non-exercise activity (NEAT) Thermal effect of feeding (TEF) Basal metabolic rate (BMR)

Question 41

What is BMR?

Answer 41

The amount of energy required by the body when lying down - largest contributor to energy expenditure

Question 42

What happens to energy balance when exercise intensity increases?

Answer 42

Overall greater negative energy balance Increase in energy consumption

Question 43

What happens to BMR if undertaking a diet?

Answer 43

Decrease in fat AND muscle Decreasing BMR

Question 44

What hormone is responsible for regulation metabolic rate?

Answer 44

T3 - produced in the thyroid

Question 45

Name the hunger hormones and their functions. (2)

Answer 45

Ghrelin - increases drive to eat Leptin - decreased drive to eat

Question 46

What is the effect of obesity on ghrelin?

Answer 46

Increased drive to eat

Question 47

What is the effect of obesity on leptin?

Answer 47

The brain desensitises activity of leptin Therefore, ghrelin not switched off Leading to insulin resistance

Question 48

What hormone release glucose into the bloodstream?

Answer 48

Glucagon

Question 49

What methods are used to measure insulin sensitivity/resistance?

Answer 49

Hyperinsulinemia euglycemic clamp Oral glucose tolerance test HOMA

Question 50

Describe the process of the hyperinsulinemia euglycemic clamp protocol

Answer 50

Flood the body with large amount of insulin Translocation of GLUT4 Measure through back of hand Glucose infusion altered to steady state

Question 51

When is the golden period to consume CHO?

Answer 51

Within 30 minutes post exercise as GLUT4 transporters are still present on membrane

Question 52

What activates AMPK enzyme?

Answer 52

AMP Calcium

Question 53

What drug can be given to replicate AMP and 'trick' to activate AMPK?

Answer 53

AICAR drug - phosphorylated to become ZMP

Question 54

Describe the distal insulin cascade pathway.

Answer 54

PKB phosphorylates TBC1D4 Conversion of Rab-GPD to Rab-GTP GLUT4 translocated to membrane

Question 55

Describe the insulin-independent cascade pathway.

Answer 55

AMP and calcium increase Activating AMPK Phosphorylating TBC1D4 Converting Rab-GDP to Rab-GTP Translocation of GLUT4

Question 56

What drug can be given to reduce the risk of type 2 diabetes?

Answer 56

Metformin

Question 57

How does regular training promote mitochondrial biogenesis?

Answer 57

Increase AMP and calcium Activates AMPK Activating transcription factor Enters nucleus and attaches to PGC1-a

Question 58

How does training alter glycaemic control?

Answer 58

Expression of GLUT4 Production of GLU4 Insulin signalling Increase glycogen synthase

Question 59

What are the 4 actions of AMPK?

Answer 59

GLUT4 translocation GLUT4 production Fat transport into mitochondria Mitochondrial biogenesis

Question 60

What does Syndrome X relate to?

Answer 60

The resistance to insulin-stimulated uptake of glucose

Question 61

What is the action of insulin on ghrelin?

Answer 61

Decreases release of ghrelin

Question 62

What is de novo lipogenesis?

Answer 62

Conversion of glucose into TG

Question 63

What are thiazolidinediones?

Answer 63

Family of drugs that correct insulin resistance - pioglitazone

Question 64

What is the action of thiazolidinediones?

Answer 64

Activates PPAR-g to store TG in adipose Increases adiponectin

Question 65

How does insulin vasodilate blood vessels?

Answer 65

Insulin binds to receptor IRS-1 activates IP3K Activates eNOS Increased release of nitric oxide Vessel dilates

Question 66

Why is PAI-1 more active in obese people?

Answer 66

Blood is more likely to clot, therefore PAI-1 required