Obesity Flashcards
(86 cards)
1
Q
Define overweight
A
excess bodyweight (includes muscles, bone, fat, water, organs)
2
Q
Define obese
A
excess adiposity
3
Q
Event at a healthy___ an increased ____ could pose health risks
A
BMI
Waist circumference
4
Q
Normal BMI and waist circumference
A
Low risk
5
Q
Normal BMI and high WC
A
Increased risk
6
Q
High WC and Obese Class I
A
Highest risk
7
Q
High WC and overweight
A
High risk
8
Q
Obese Class I and normal WC
A
High risk
9
Q
Overweight and normal WC
A
Increased risk
10
Q
Asian overweight BMI
A
> 23
11
Q
Asian obese BMI
A
> 27
12
Q
Asian men WC
A
> 90
13
Q
Asian women WC
A
> 80
14
Q
Males have __ obesity than females
A
less
15
Q
Males have __ overweight incidences than females
A
more
16
Q
Some states have obesity rates as high as?
A
30%, some self-reported at 35% which may actually be higher.
17
Q
Canada national average of obesity?
A
27%
18
Q
What provinces are below Canadian avg?
A
- BC
- ON
19
Q
What province are above Canadian avg?
A
- NW territories
- SASK
- Manitoba
- Newfoundland
20
Q
Normal weight =
A
mostly women
21
Q
Overweight (gender) =
A
mostly men
22
Q
Obese (gender) =
A
similar rates of men and women
23
Q
In US men, increased income is correlated with _____ obesity in hispanics and AA?
A
increased
24
Q
In us men, is increased income associated with increased obesity in white men?
A
No
25
In US women, an increase in obesity is associated with ___
a decrease in income
26
At all income levels for US women there is ___ obesity in _____ than in whites
More
| Hispanics and AA
27
Obesity increases ___ which means that there is excess mortality that is contributed to obesity
all-cause
28
Increasing what 3 factors will increase cardiometabolic risks?
- Cardiovascular disease
- Hypertension
- Diabetes
29
What was the key point in the BMI and all-cause mortality study?
After a BMI of 27-28, each increase of BMI by5 units will increase risk of mortality of 30%
30
What were the 3 key points in the relative risk of CHD, mortality and TTDM study?
- Risk of CHD is elevated very much before BMI of 30
- Mortality increases around BMI of 20
- TTDM risk has a linear relationship
31
What was the key point in the intra-abdominal fat is an independent predictor of all cause mortality study? What happens when we increase IA from 0.5-1kg? 1.5kg?
Intra-abdominal fat will increase all-cause mortality in men even when excluding all other factors (including BMI)
0.5-1 kg doubles rate of death, and will the continue to increase exponentially
32
What was the key point in the intra-abdominal fat increasing risk of TTDM in women study?
Obese individuals with high IA will have a increased basal glucose level and increased blood glucose and insulin levels in the post-prandial phase, indicating insulin resistance. This was not observed in healthy body weight or obese with little IA
33
Why does cancer increase with obesity?
Adipocytes are in a state of constant positive energy balance, are always receiving fuels for cell growth and differentiation
34
Most common cancers linked with obesity women (OBE-C)
Ovarian
Breast
Endometrium
Cervix
35
Most common cancers linked with obesity men
Prostate
36
Most common cancers linked with obesity men and women (LCK-G)
Liver
Colon
Kidney
Gallbladder
37
Obesity increases the risk of ____
gallstones (cholelithiasis)
38
Discuss the association with obesity and gallstones
- 3x more risk when BMI>30
- related to abdominal obesity
- risk may be common to rapid weight loss
39
Name the progression of liver failure, which is associated with those with obesity
Steatosis --> Steatohepatitis -> Cirrhosis --> Liver Failure
40
What hormonal changes occurs in men with respect to reproductive system? What may this cause?
Increased estrogen and decreased testosterone
| May cause gynecomastia (development of breasts)
41
What hormonal changes occurs in women with respect to reproductive system?
Development of PCOS (5-10% of obese women)
42
What risks in pregnancy are higher in obese women?
- gestational diabetes
- Pre-eclampsia
- High fetal birth weight (complications)
- Higher risk of maternal and fetal death
43
REE and TEE in obese people compared to sedentary/moderately active individual with normal BMI
REE is higher
| TEE is higher
44
REE and TEE in obese people compared to active individual with normal BMI
TEE is lower
| REE is higher
45
Sedentary/Moderately active person REE %?
60-75%
46
Active persons REE %?
50-60%
47
Sedentary obese REE%?
70-80%
48
Hunger =
physical sensation indicating need or intense desire to feed
49
Satiety =
feeling of fullness after eating
50
Satiation =
feeling of fullness between meals
51
Appetite=
desire to eat
52
What control is appetite under?
Hormonal and hedonic control
53
What controls orexigenic pathway?
Neuropeptide Y neurons
54
What controls anorexigenic pathway?
CART, regulated by POMC
55
How do the orexigenic and anorexigenic pathways communicate within the brain?
Through the paraventricular nucleus an lateral hypothalmus to secrete peptides into circulation
56
Signals within GI tract?
Distention of GI (vagus nerve) stimulates fullness
57
Gut peptide hormones to decrease hunger? COP-G
CCK
Oxyntomouldin
PYY-36
GLP-1
58
Gut peptide hormones that increase hunger?
Ghrelin
59
Anorexigenic peptides from pancreas? (IPA)
Insulin
Pancreatic polypeptide
Amylin
60
Powerful hunger inhibitor that is secreted constantly, less sensitive to food intake and proportional to amount of adipose tissue?
Leptin
61
Explain why genetics don't cause obesity
The rapid onset of obesity epidemic means that genetic evolution could not have occurred, must be due to environment
62
Are genes involved in obesity?
YES, but are not the full picture
| May be some genes involved in appetite, metabolism and distribution of body fat which may influence onset of obesity
63
Key point in family studies in genes & obesity
Adopted children's BMI reflects biological parents and in separated identical twins, 50-90% of BMI explained by genetics
64
Key point in overfeeding twins study in genes/obesity
Overfeeding twins resulted in similar utilization of energy and efficiency
65
Key point in genome wide associate studies? Which genes were found to be contributors to ~6% of cases?
Mapped the genome to find genes associated with obesity.
- Fat Mass & Obesity gene
- Melanocortin-4-receptor
66
Genes are ___ high contributors of obesity
not
67
BMI & quantity of subcutaneous fat predicted by genes? non-transmissible variation?
```
Genes = 5%
NTV = 65%
```
68
BMI and total fat/distribution predicted by genes? non-transmissible variation?
Genes = 30%
| NTV=45%
69
What are the most common medical conditions and pharmacological agents that increase risk of obesity?
Stem from congenital, neuroendocrine and pharmacological agents
70
What neuroendocrine disorders increase risk of obesity?
Hypothyroidism
| Cushings
71
What pharmacological agents increase risk of obesity?
- Drugs to treat depression
- Hormonal contraceptives
- Progesterone agents
- Corticosteroids (most weight gain = water)
- Anti-histamine agents
- Anti-diabetic agents
72
Which anti-diabetic agents increase risk of obesity? (TIS)
- Thiazolidinediones
- Insulin
- Sulfonylureas
73
Name other factors that may increase risk of obesity
- Sleep deprivation
- Low or High birth weight
- Breastfeeding (is protective, less breastfeeding ...)
- Smoking cessation
- Viruses, toxins, microbiota
74
Definition of Obesity (2018 Obesity Society Position Statement)
Obesity is a multi-causal, chronic diseased recognized across the life-span resulting from a long-term energy balance with development of excess adiposity which leads to structural abnormalities, physiological derangements and functional impairments.
75
What is important in dietary assessment of obese client?
To understand weight history, diet history and relapses as this may increase their chances of remaining obese or having an unsuccessful nutrition intervention.
76
How could we motivate obese clients with PA positively?
Using pedometer, setting baseline goals
| Accelerometer could be more accurate
77
Physical activity =
Leisure or non-leisure body movement that results in an increase in energy expenditure
78
Exercise
Form of PA that is planned, structured and repetitive.
79
What is the goal of exercise?
To improve or maintain physical fitness
80
Physical fitness
Set of attributes that are either health-performance or skills related.
81
What is the goal of physical fitness?
Ability to carry out daily tasks with vigor, alertness and without fatigue. Also to provide ample energy to enjoy leisure pursuits and unforeseen emergencies.
82
Active living =
When physical activities are an integral part of daily living
83
Low active?
1.3
84
Moderate active?
1.5
85
High active?
1.8
86
High active individuals perform ___
standing work
