L13-Weight Management Flashcards

(71 cards)

1
Q

BMI.
Describe.
List categories.

A

-Most common tool to determine weight status
-Categories of BMI:
1. under weight <18.5
2. normal 18.5-24.9
3. overweight 25-29.9
4 obesity >30

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2
Q

BMI.

Who can it not used for?

A
  • it applies to ages 20-65 (not outside)

- does not apply to infants, children, adolescents, preg, BF

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3
Q

How to reduce weight?

A
  • NRG intake < NRG expenditure
  • safe weight loss <2 lbs/wk
  • aerobic exercise 45 min= reducing cal intake by 40 kcal
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4
Q

Describe Brazil Food Guide.

A
  • golden rule: always prefer natural or minimimally processed foods and freshly made dishes and meals to ultra processed foods
  • want to use oils, fats, salt and sugar in small amounts; limit processed foods
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5
Q

over _____ CNDs try to lose weight via _____

A

1/4, dieting

F>M

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6
Q

Trade settlement w weight loss settlement in 2007.

WHAT IS IT?

A

they were making claims of effectiveness wo reliable scientific evidence

> since then: weight loss industry has tried to make some changes, but they have not been very successful (at least there are more studies being done)
-note: they can no longer claim HOW much weight loss a pill has (BUT they still make claims like mirable use, easy way to lose weight, sold out fast-> ppl see these claims and then beleive it!

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7
Q

OTC Products.
Are they recommended?
List some effects.

A

NO!

  • increase nrg expenditure
  • modulate CHO metab
  • incrase satiety
  • increase fat ox or reduce fat synthesis
  • block dietary fat absorption
  • increase water eliminaiton
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8
Q

OTC Products.

List types.

A
  1. Fat burners
  2. CHO burners
  3. Fat blockers
  4. Appetite sups
  5. Lose water
  6. Metabolism booster
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9
Q

FAT BURNERS:

claim, evidence, risks, examples

A
  • Claim: “Melt away fat” and increase muscle
  • Evidence: Insufficient
  • Risks: some products are not authorized for use
  • Examples: Conjugated linoleic acid, Vitamin B5
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10
Q

CHO BURNERS

claim, evidence, risks, examples

A

Claim: burns carbs
Evidence: lacking
Risks: potentially serious
Examples: chromium, ginseng

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11
Q

FAT BLOCKER

claim, evidence, risks, examples

A
  • Claim: absorption of fat decreased
  • Evidence: Weak, wnt work unless low calorie diet
  • Risk: some agents induce diarrhea and block vitamin absorption. AR risk for chitosan because contains shellfish
  • Examples: Chitosan, Hydroxycitric Acid*
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12
Q

APPETITE SUPPS

claim, evidence, risks, examples

A
  • Claim: feel full, so eat less
  • Evidence: Few studies done
  • Risk: unknown due to lack of studies
  • Examples: Guar gum, psyllium, hoodia gordonii, glucomannan
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13
Q

LOSE WATER

claim, evidence, risks, examples

A

Claim: increased water elimination
Evidence: weak
Risks: dehydration, diarrhea, allergy
Examples: Dandelion

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14
Q

METAB BOOSTER

claim, evidence, risks, examples

A

• Claim: burn more calories and fat
• Evidence: may help use more energy
• Risk: SIGNIFICANT as will increase hr and bp
• Examples: ephedra, bitter orange, DMAA, caffeine, green coffee, 7-Keto- DHEA, catechin, capsaicin, raspberry ketones
-> these are known as the thermogenic agents

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15
Q

METAB BOOSTER
Describe Ephedra.
____ is where the active compound is.

A
  • shrub native to china and mongolia
  • bitter orange and country mallow contain related chemicals
  • active cmpds in stem
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16
Q

METAB BOOSTER
Ephedra.
List some phenylalanine derived alkaloids.

A
  • Ephedrine
  • Pseudoephedrine
  • Phenylpropanolamine (norephedrine)
  • Cathine (norpseudoephedrine)
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17
Q

METAB BOOSTER

Ephedra results in wight loss because the muscles are burning more cals. Describe the specific effects on the body.

A
  1. alpha and beta aognist
    - alpha: PVR increases, bp increases; receptors on smooth muscle cells in bladder to increase resistance to outflow of urine
    - beta: stimuate rate and force of contraction; promotes bronchodilation in lung
  2. CNS stim
    - enhances release of NE from sympathetic neurons
    - act as anorectic by acting on satiety center
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18
Q

METAB BOOSTER
Ephedra - efficacious?
Recommend?

A

there were very slight benefits from (couple pounds/ month) BUT severe AE

  • linked to serious AE (heart attack, arrythm, stroke, psychosis, seizure, death)
  • HC recalled all products marketed for weight loss w ephedra (only allowed for nasal decongestant)
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19
Q

METAB BOOSTER

Ephedra - list SE.

A
  • Hypertension
  • Cardiac arrhythmias
  • Insomnia
  • Tachyphylaxis (acute, sudden decrease in response to drug after its admission)
  • Anxiety and changes in mood
  • N/V

there were very slight benefits from (couple pounds/ month) BUT severe AE

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20
Q

METAB BOOSTER - Caffeine.

Describe.

A
  • alkaloid
  • occurs naturally in leaves, seeds and fruit of tea, coffee, cacae, kola trees, ect
  • Botanicals: guarana, yerba mate, kola nut, and green tea extract
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21
Q

METAB BOOSTER - Caffeine.
Described as “thermogenic”, what does that mean?
MOA?

A
  • inhibits degradation of cAMP thereby stims lipolysis by stimulating lipase;
  • antagonizing the neg modulatory effect of adenosine on increased noradrenalin release
  • reduced food intake after caffeine intake
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22
Q

METAB BOOSTER - Caffeine & Ephedra.

Safety?

A
  • ephedrine serious health risks (not recommended whether w or wo caffeine bc risks»> benefits)
  • caffeine probably safe but shows no long term efficacy
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23
Q

METAB BOOSTER - Caffeine.

Recommend?

A

NAH - safe but not LT efficacy.

-admin (3x200mg/d) for 24wks w nrg restricted diet showed no greater weight loss than placebo

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24
Q

METAB BOOSTER - Dimethylamylamine (DMAA).
T/F: HC has authorized use it for use.
Sources?
Recommend?

A

FALSE!

  • no good trials done (too short/small) but no benefits found
  • found in weight loss and pre-workout supps
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25
METAB BOOSTER - Dimethylamylamine. Safety? AE?
-not allowed to be sold in canada -potential AE: >HTN, SOB, chest pain, stroke, psych disorders -1 product containing DMAA linked to serious AE (csv, metabolic, NS, psych); acute hep/liver failure
26
METAB BOOSTER - Catechin. Describe. ____ is the most abundant catechin in tea.
=green tea • All types of tea (green, black, oolong) produced from Camellia sinensis plant using different methods. • Epigallocatechin gallate (EGCG)
27
METAB BOOSTER - Catechin. | MOA?
- thermogenic | - beleived to have role in increasing nrg metab, which may lead to weight loss
28
METAB BOOSTER - Catechin. | Safety?
SAFE IN MOD AMOUNTS - AE: insomnia, anxiety, irritability, upset stomach, n/d, freq urination; high doses increase bp, seizures, delirium or irregular heart rhythms - cases of hepatic failure/injury following consumption of green tea has been documented
29
METAB BOOSTER - Catechin. | DI?
Anticoags - makes them less effective b/c has Vit K
30
METAB BOOSTER - Catechin. Efficacy? Recommend?
-causes small, statistically non-significant weight loss in overweight or obese adults -no signift effect on the maintenance of weight loss. -most adverse events were judged to be mild to moderate. NO
31
METAB BOOSTER - GREEN COFFEE. AI? Effect?
chlorogenic acid (from raw coffee beans before they are roasted) Thought to: 1. help control glucose metabolism >May decrease glucose conc & absorption in intestines after a meal 2. inhibit fat accumulation and alter and body fat distribution
32
METAB BOOSTER - GREEN COFFEE. | AE?
-well tolerated w no signif se | some produts are decaf, others have caffeine
33
METAB BOOSTER - Capsaicin. Source? MOA?
Red hot peppers - Thought: 1. if you eat spicy foods you will eat smaller portions 2. dose dependently enhancing catecholamine secretion from the adrenal medulla - likely based on beta-adrenergic stim
34
METAB BOOSTER - Capsaicin. | AE
minor: - skin inflam - contact derm - skin blister
35
METAB BOOSTER - Capsaicin. | Efficacy.
Human studies • Short and long term fat oxidation • Energy expenditure increases nearly 25% after meal including capsaicin (as chili) • Satiety appears to be affected as well • Effects are more pronounced with a high fat meal • One long-term study: no improvement in weight maintenance or suppressed fat gain
36
METAB BOOSTER - Raspberry ketones. | Describe.
- compound that gives raspberries their odor | - structurally similar to capsaicin
37
METAB BOOSTER - Raspberry ketones. Claims to burn fat all over body - how? (Based on shitty studies)
- Increased production of adiponectin (hormone that is secreted by fat cells; said to regulate insulin sensitivity)) - may inhibit fructose-associated accumulation and inhibition of fat absorption through reduction of pancreatic lipase activity
38
METAB BOOSTER - Raspberry ketones. | AE.
-Antiandrogenic effect high adiponectin levels associated w low bone density -pt may need higher warfarin for maintainence of therapeutic INR -reports of palps
39
? - Forskolin. Describe. MOA?
- part of the mint family - theorized MOA: activate cAMP --> triggers lipase resulting in release of fa from adipose tissue (but lack of evidence and conflicting results)
40
? - Forskolin. | AE
-signif ae BUT >tachycardia and arrhytm been reported -avoid in pts w polycystic kidney disease -IV formulation can cause flushing and hypotension
41
? - Forskolin. | DIs
``` Major: (Avoid combining with) • Calcium channel blockers • Nitrates Moderate: (Caution with combining) • Anticoagulants/antiplatelets • Antihypertensives • CYP P450 2C9 substrates ```
42
CHO metabolism - CHROMIUM. | Which one is trivalent? Hexavalent?
Essential mineral • Trivalent (chromium 3+)= is biologically active, in food • Hexavalent (chromium 6+)= toxic, from industrial pollution • Often as chromium picolinate
43
CHO metabolism - CHROMIUM. | MOA?
- Enhances action of insulin | - Involvement in CHO, fat and pro metab
44
CHO metabolism - CHROMIUM. | Efficacy?
- No effect in enhancing body fat reduction found | - statistically signif neg evidence (ie lack of evidence of benefit)
45
CHO metabolism - CHROMIUM. | SE?
- many supps are far over the adequate intake of 20-35mcg/d | - concerns of free radical damange; rhabdomyolysis; renal failure
46
CHO metabolism - Ginseng. | Describe.
- traditionally used to support overall health, boost IS | - also used for weight loss
47
CHO metabolism - Ginseng. | Effect?
1. Improving the health of people recovering from illness 2. Increasing a sense of well-being and stamina, and improving both mental and physical performance 3. Lowering blood glucose and controlling blood pressure
48
CHO metabolism - Ginseng. | MOA?
* Ginsenosides * CHOs are one of the main fuel sources for activity (stored in liver and skeletal muscle as glycogen) * Ginseng appears to mimic insulin * Improve glucose tolerance * Lowers blood glucose levels * Lack of evidence
49
CHO metabolism - Ginseng. | SE?
- ususally well tolerated but suggested to not be used for more than 3m - most common se: headache, GI, sleep - allergic reactions - caution in DM bc it mimics insulin
50
APPETITE SUPPS - Psyllium | Describe
- increase satiety - derived from seed husk of plantago psyllium, leafy plantain - e.g. found in Metamucil - soluble fiber
51
APPETITE SUPPS - Psyllium | MOA
- combines w water in stomach to form gel - provides sense of fullness - bulk-forming
52
APPETITE SUPPS - Psyllium | Efficacy
- most studies in obest show superiorty to diet alone; lowers chol - no effect on weight, just gives feeling of fullness
53
APPETITE SUPPS - Psyllium | SE
* Bloating * Allergy -> allergy from inhalation of powder * N/D/C (while it is a laxative, too much can cause constipation) * Dyspepsia * Flatulence * Abdominal Pain
54
APPETITE SUPPS - Guar gum | Describe.
- increase satiety | - several studies, but does not help w weight loss
55
APPETITE SUPPS - Glucomannan | Describe.
- increase satiety - fibrous polysacch from konjac plant - more research needed
56
APPETITE SUPPS - Hoodia | Describe.
-increase satiety >appetite supp through P57, an oxypregnane steroidal glycoside -NON-stimulating appetite suppressant
57
APPETITE SUPPS - Hoodia | SE
allergy
58
FAT BLOCKER- hydroyxcitic acid/ garcinia | Describe.
- Increase fat oxidation or reduce fat synthesis - plant from india - efficacy: contradictory evidence
59
FAT BLOCKER- hydroyxcitic acid/ garcinia | MOA.
- increase hepatic glycogen synthesis, inhibiting lipogenesis, increased lipid oxidation - decreased food intake, decrease weight gain
60
FAT BLOCKER- hydroyxcitic acid/ garcinia | SE
- well tolerated | - headache, GI
61
FAT BURNER - conjugated linoleic acid | Describe
-Increase fat oxidation or reduce fat synthesis, induce apoptosis of fat cells • Mix of isomers of linoleic acid • Marketed alone or in combo with triacyglycerol or FFA • NS: mostly in beef and dairy
62
FAT BURNER - conjugated linoleic acid | Efficacy
-seems to signif decrease body fat & might increase lean body mass BUT doesnt seem to reduce total body weight or BMI -seems to reduce hunger and improve satiety and feeling of fullness, but does not lower nrg intake or improved body weight maintenance
63
FAT BURNER - conjugated linoleic acid | SE
-GI: nausea, dyspepsia, loose stools
64
FAT BURNER - conjugated linoleic acid | caution if:
person already has HIGHER glc | -can increase hyperproinsulinemia & insulin resistance in pts w abdominal obesity
65
FAT BLOCKER - Chitosan | Describe
- block dietary fat absorption (binds to fats to reduce their absorption... similar to orlistat) - Deacetylated chitin- chitin is a polysaccharide found in the exoskeleton of shellfish (shrimp, lobster and/or crabs) - Cationic mucopolysaccharide of glucosamine and N-acetyglucosamine
66
FAT BLOCKER - Chitosan | MOA
- Plausible BUT probably ineffective at reasonable doses (in effective for weight loss) - May block fat soluble vits
67
FAT BLOCKER - Chitosan | SE
- safe, except for indivs allergic to shellfish | - constipation, flatulence
68
LOSE WATER - Dandelion | Describe.
-increase water eliminiaton -Tx: liver & kidney diseases & spleen problems >root=hepatic stimulant; leaves=diuretic & choleretic action >less common: digestive probs & skin conds -Monitor for: minor digestive problems
69
LOSE WATER - Dandelion | MOA?
Contains: potassium & theophylline • Inhibits reabsorption of Na+ and increases glomerular filtration rate • Only modest effects-> NOT comparable to an Rx diuretic
70
LOSE WATER - Dandelion Safety? SE?
- safe - SE: upset stomach/ diarrhea; some allergic (rare) - Avoid in: ppl w inflamed or infected gallbladder or blocked bile ducts
71
the 7 gut check claims for products you are unsure of:
1) causes weight loss of 2lbs+/ wk for a month or more wo diet/exercise 2) causes substantial weght loss no matter what/how much you eat 3) causes permanent weight loss even after stpping product 4) blocks absorption of fat/cals to enable loss of substantial weight 5) safely enables consumers to lose more than 3+lb/wks for more than 4wks 6) causes substantial weight loss for all uses 7) causes substantial weight loss by wearing product on body or rubbing it in