L13-Weight Management Flashcards Preview

AIII-Natural Health Products > L13-Weight Management > Flashcards

Flashcards in L13-Weight Management Deck (71):
1

BMI.
Describe.
List categories.

-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

2

BMI.
Who can it not used for?

-it applies to ages 20-65 (not outside)
-does not apply to infants, children, adolescents, preg, BF

3

How to reduce weight?

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

4

Describe Brazil Food Guide.

-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

5

over _____ CNDs try to lose weight via _____

1/4, dieting
F>M

6

Trade settlement w weight loss settlement in 2007.
WHAT IS IT?

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!

7

OTC Products.
Are they recommended?
List some effects.

NO!
-increase nrg expenditure
-modulate CHO metab
-incrase satiety
-increase fat ox or reduce fat synthesis
-block dietary fat absorption
-increase water eliminaiton

8

OTC Products.
List types.

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

9

FAT BURNERS:
claim, evidence, risks, examples

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

10

CHO BURNERS
claim, evidence, risks, examples

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

11

FAT BLOCKER
claim, evidence, risks, examples

• 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*

12

APPETITE SUPPS
claim, evidence, risks, examples

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

13

LOSE WATER
claim, evidence, risks, examples

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

14

METAB BOOSTER
claim, evidence, risks, examples

• 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

15

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

-shrub native to china and mongolia
-bitter orange and country mallow contain related chemicals
-active cmpds in stem

16

METAB BOOSTER
Ephedra.
List some phenylalanine derived alkaloids.

• Ephedrine
• Pseudoephedrine
• Phenylpropanolamine (norephedrine)
• Cathine (norpseudoephedrine)

17

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

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

18

METAB BOOSTER
Ephedra - efficacious?
Recommend?

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)

19

METAB BOOSTER
Ephedra - list SE.

• 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

20

METAB BOOSTER - Caffeine.
Describe.

-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

21

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

-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

22

METAB BOOSTER - Caffeine & Ephedra.
Safety?

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

23

METAB BOOSTER - Caffeine.
Recommend?

NAH - safe but not LT efficacy.
-admin (3x200mg/d) for 24wks w nrg restricted diet showed no greater weight loss than placebo

24

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

FALSE!
-no good trials done (too short/small) but no benefits found
-found in weight loss and pre-workout supps

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