Lecture 18

Question 1

What are the drugs used as a weight loss medication?

Answer 1

• Epinephrine and norepinephrine class
• Serotonin class
• Cannabinoid receptor class
• Orlistat (Xenical)

Question 2

What are the drugs in the serotonin class? Why was it taken it off the market?

Answer 2

Phen-fen and Redux

- Taken off market 1997 due to damage to heart valves

Question 3

What do cannabinoid receptor class do? Is it still in the market?

Answer 3

Block endogenous CB1 signals; taken off market

Question 4

What does Orlistat do?

Answer 4

• inhibits fat digestion (lipase)

- Reduces absorption of fat in the small intestine

Question 5

What is semaglutide?

Answer 5

a GLP-1 analog (incretin type drug)

Question 6

What did semaglutide cause?

Answer 6

it caused unexpected weight loss in T2D being treated

Question 7

How was the study for incretin analogue semaglutide set up?

Answer 7

A direct controlled double blind study done on obese and over weight non-diabetic individuals to directly test its weight loss actions

Question 8

What were the findings in the incretin analogue semaglutide study?

Answer 8

Placebo had no effect on weight loss

Semaglutide caused weight loss

Question 9

What lifestyle modifications can improve T2D?

Answer 9

A lifestyle-modification program with the goals of at least 7% weight loss and at least 150 min of physical activity per week

Question 10

What effect does Lifestyle changes compared to Metformin have on T2D?

Answer 10

Lifestyle- lowered the risk of T2D more than Metformin

Question 11

What is the logic of lowering glycemic index and load of foods in T2D treatmeant?

Answer 11

Lower glycemic index lowered the blood sugar response curve and lowering glycemic load reduces the risk for T2D

Question 12

What is the effect of fruit consumption on T2D risk? Is juice effective?

Answer 12

Studies showed that fruit consumption reduces the risk for T2D
No

Question 13

According to the BJM study which is the best fruit?

Answer 13

blueberries

Question 14

What are the 5 types of diets discussed?

Answer 14

Vegan
Lacto-ovo
Pesco-vege
Semi-vege
Non-vege

Question 15

What is a vegan diet?

Answer 15

Beef- none
Poultry/fish- none
dairy/eggs- none

Question 16

What is a lacto-ovo diet?

Answer 16

beef- none
poultry/fish- none
Dairy- yes

Question 17

What is a peco-vege diet?

Answer 17

beef- none
poultry/fish- yes
dairy/eggs- yes

Question 18

What is a semi-vege diet?

Answer 18

beef- very little
poultry/fish- yes
dairy/eggs- yes

Question 19

What is a non-vege diet?

Answer 19

beef- yes
poultry/fish- yes
dairy/eggs- yes

Question 20

What is the difference in T2D rish between non-vege and vegan?

Answer 20

Vegan: 2.9% risk

Non-vege: 7.6% risk

Question 21

What was the Lifestyle Heart Trial of Dean Ornish MD about?

Answer 21

Intensive lifestyle changes for reversal of coronary heart disease

Question 22

What were the experimental group treated by?

Answer 22

An intensive lifestyle program that included a 10% fat vegetarian diet, moderate aerobic exercise, stress management training, smoking cessation, and group psychosocial support

Question 23

What were the control group treated by?

Answer 23

Asked to follow the advice of their personal physicians regarding life-style changes

Question 24

What was the 1 and 5 year result for the experimental group from Lifestyle Heart Trial?

Answer 24

More regression of coronary atherosclerosis occurred after 5 years than after 1 year

Question 25

What results were found in the control group?

Answer 25

coronary atherosclerosis continued to progress and more than twice as many cardiac events occurred

Question 26

Who is Michael Gregor MD?

Answer 26

- a lifestyle physician | - Found of nutritionfacts.org

Question 27

What is the resource of nutritionfacts.org

Answer 27

- entirely evidence-based questions on every aspect of nutrition and health

Question 28

What are the benefits of bariatric surgery (BS)?

Answer 28

- restricts the amount of food that can be consumed - significant long-term weight loss - produces favorable changes in gut hormones that reduce appetite and enhance satiety - produces changes to microbiota

Question 29

What risks come along with BS?

Answer 29

- can lead to vitamin/mineral deficiencies - can lead to surgical complications and re-hospitalization - non-reversible (except gastric banding)

Question 30

What effect does BS have on obesity and T2D?

Answer 30

Results in T2D: helps makes it go away | Results in obesity: initially reduces BMI but over time 1/3 patients relapse within 5 years of initial remission

Question 31

Does the fat cell mass change in obesity?

Answer 31

Yes, the volume of fat cells changes after bariatric surgery

Question 32

Do the number of fat cells change in obesity?

Answer 32

No, the number of fat cells stays constant in adulthood in lean and obese individuals, even after marked weight loss - the number of adipocytes is set during childhood and adolescence

Question 33

How does CO2 exit the body?

Answer 33

2 ways: breathing out CO2 excretion of CO2

Question 34

What happens when CO2 is produced by metabolism?

Answer 34

it undergoes rapid equilibrium with H2O

Question 35

What is the measurement of CO2 used for?

Answer 35

A great way to gain a handle on human energy expenditure

Question 36

How does the double labeled water technique help measure human energy expenditure better?

Answer 36

If someone ingests doubly labeled water with deuterium and O-18 (both non-radioactive) the difference in the clearance rates of the two isotopes will report the CO2 production rate

Question 37

What was the Urlacher study about?

Answer 37

Study the underlying causes of changes in body composition and adiposity caused by change to market-integrated eating and lifeways between Shuar and Pari-urban individuals

Question 38

What findings resulted from the Urlacher study with rural and peri-urban Shuar people?

Answer 38

Suggest a leading role of changing dietary intake in transitions to overweight/obesity

Question 39

Does an indigenous lifeway of the hunter gatherer include a substantial change in energy expenditure?

Answer 39

No, it may play a relatively modest role in the epidemic of childhood OW/OB

Question 40

What is the major factor in foodborne illnesses?

Answer 40

industrialization and centralization of food processing

Question 41

What is the highest risk groups of foodborne illnesses?

Answer 41

infants and children (<5 yrs) elderly people with impaired immunity pregnant women (fetus)

Question 42

What are the common symptoms of foodborne illnesses?

Answer 42

- GI track distrss (abdominal cramps, vomiting, bloody diarrhea) - HEmolytic uremic syndrome (HUS)-> acute renal (kidney) failure (damanged RBC clog kidneys)

Question 43

What are the causes of foodborne illnesses?

Answer 43

Pathogens: | - bacteria, viruses, parasites, fungi and prions

Question 44

What are the symptoms of E.coli and salmonella?

Answer 44

severe GI distress and HUS (kidney failure)

Question 45

What are the sources of e.coli and salmonella?

Answer 45

food contaminated with fecal material (raw or undercooked meat, esp. poultry) raw eggs, raw milk, and produce

Question 46

Which pathogen is the leading cause of hospitalizations and death from food poisoning?

Answer 46

salmonella

Question 47

What does the pathogen Campylobacter do?

Answer 47

- toxin destroys epithelial lining of small and large intestines -> fever and diarrhea

Question 48

What is the biggest source of campylobacter?

Answer 48

uncooked poultry

Question 49

Which pathogen is the most deadly?

Answer 49

Listeria

Question 50

What are the sources of Listeria?

Answer 50

food contaminated with fecal material

Question 51

What is the pathogen listeria?

Answer 51

intracellular bacterium

Question 52

What is hepatitis A?

Answer 52

RNA virus that attacks liver

Question 53

How is Hep A transmitted?

Answer 53

Easily transmitted by food and water droplets

Question 54

What is a classic source of Hep A?

Answer 54

uncooked shellfish grown in areas exposed to human sewage but also raw veggies/fruits from infected food handlers

Question 55

Which pathogen is the second leading cause of hospitalizations in US?

Answer 55

Norovirus

Question 56

What does Norovirus cause?

Answer 56

most common cause of gastroenteritis

Question 57

Where is Norovirus the highest risk in?

Answer 57

Nursing homes, restaurants, dorms, and cruise ships

Question 58

What is the double label water technique based on?

Answer 58

is based on the rapid equilibrium of oxygen in water and CO2 in the body