Overweight and obesity

Question 1

How is BMI calculated?

Answer 1

Weight/ (height in m) squared

Question 2

What is a healthy weight?

Answer 2

A BMI of 18.5 to 24.9 kg/m2

Question 3

What is an unhealthy weight?

Answer 3

A BMI under 18.5kg/m2 or above 24.9m2

Question 4

What is BMI?

Answer 4

An index for body weight

Question 5

What is obese BMI?

Answer 5

Above 30kg/m2

Question 6

What is overweight BMI?

Answer 6

25kg/m2 to 29.9kg/m2

Question 7

What is underweight BMI?

Answer 7

Below 18.5kg/m2

Question 8

What are the limitations of BMI?

Answer 8

Does not take into account muscle mass, fat distribution, age, pregnancy or sex.

Question 9

What is obesity?

Answer 9

Having BMI over 30kg/m2. It is given classes where the higher the number is the worst. Obesity class 1, 2 and 3 are those that exist.

Question 10

What are the diet guides in the UK?

Answer 10

Eat well guide and food pyramid.

Question 11

What is the prevalence of obesity?

Answer 11

Higher in males than females of all age groups, in more deprived areas and in the north of England and in Scotland.

Question 12

What is the concept of a best diet?

Answer 12

Variety of foods, rich in starch and fibre, with high number of fruit and veg and a moderate number of calories.

Question 13

What is the Mediterranean diet?

Answer 13

High fruit and veg, whole grain, olive oil and high microntrients, fibre and unsaturated fat.

Question 14

What is metabolic syndrome?

Answer 14

Cluster of health conditions. It is hypertension, insulin resistance and visceral obesity

Question 15

What are the health risks of being overweight?

Answer 15

Increased risk of cardiovascular disease, type 2 diabetes, metabolic syndrome, preterm birth, fetal growth restriction. There is also a higer mortality.

Question 16

What is the accumulation of fat in men?

Answer 16

Generally in an apple shape where most fat is stored in the abdomen. Increased risk of visceral/central obesity and metabolic syndrome.

Question 17

How does the hypothalamus control food intake?

Answer 17

Ventral and arcuate medial nucleus respond to ghrelin, leptin, glucose .

Question 18

What is the accumulation of fat in men?

Answer 18

Generally in an apple shape where most fat is stored in the abdomen. Increased risk of visceral/central obesity and metabolic syndrome.

Question 19

What is the accumulation of fat in women?

Answer 19

Generally in a pear shape where fat is stored in the thighs. Lower risk of visceral/central obesity and metabolic syndrome.

Question 20

What is the concerning waist circumference for men and women?

Answer 20

37 inches for men and 31.5 inches for women.

Question 20

What are adipokines?

Answer 20

Cytokine molecules produced by adipose tissue.

Question 21

What is high risk waist circumference for men and women?

Answer 21

40 inches and 34 inches

Question 22

What is visceral adipose tissue?

Answer 22

Subcutaneous fat below the skin surrounding the organs, generally stored in the mesentery or omentum. It is also known as central obesity and is promoted by dysregulation of cortisol. The visceral adipose tissue is drained by the hepatic portal vein into the liver and may cause liver inflammation and fibrosis.

Question 23

How does central obesity affect the body?

Answer 23

Increases hypertension, LDL, free fatty acids, fasting glucose release, plasma triglyceride levels, liver inflammaiton and fibrosis and risk of atherosclerosis and cardiovascular disease and diabetes. Reduces levels of HDL.

Question 24

What is the importance of waist circumference?

Answer 24

Higher waist circumference is associated with increased diabetes and mortality.

Question 25

How is energy balance maintained?

Answer 25

Equal intake of output vs input.

Question 26

What is negative energy balance?

Answer 26

Lower energy input than output so there is a loss of body weight, carbs, fats and proteins.

Question 27

What is positive energy balance?

Answer 27

Higher energy input than output so there is a gain in body weight, carbs, fats and proteins.

Question 28

What are the hormones involved in appetite?

Answer 28

Leptin and ghrelin and peptide YY, glucagon and insulin.

Question 29

What is leptin?

Answer 29

Secreted by the endocrine organ of the adipose tissue to promote satiety following a meal. It acts on the hypothalamus to reduce the production of

Question 30

How are leptin levels related to obesity?

Answer 30

Deficient levels of leptin lead to obesity. However, leptin resistance may occur in obese patients.

Question 31

What is ghrelin?

Answer 31

Produced predominately by the stomach and to a lesser extent the episorelin cells in the pancreas to increase appetite when there is a negative energy balance. It causes hunger and stimulates lipid storage.

Question 32

What are the effects of ghrelin?

Answer 32

Increases gluconoegogenesis, lipid storage, fatty acid synthesis, growth hormone release and decreases insulin. Increases cardiac output and decreases BP. It stimulates gastric motility and acid secretion.

Question 33

What is the effect of insulin?

Answer 33

Increases glucose uptake by GLUT4, increases glycogenesis and fatty acid synthesis and reduces appetite.

Question 34

How does insulin affect appetite?

Answer 34

Reduces appetite.

Question 35

What is adiponectin?

Answer 35

Adipokine released by adipose tissue whch regulates glucose levels and fatty acid breakdown. It is released along with leptin after a meal to promote satiety.

Question 36

What is the endocrine control of positive energy balance?

Answer 36

High levels of ghrelin and low leptin and adiponectin. There is increase in anabolism and causes increased food intake and weight gain.

Question 37

What is the endocrine control of negative energy balance?

Answer 37

High levels of leptin and adiponectin and low ghrelin promote catabolism and reduce anabolism which causes reduced food intake and weight loss.

Question 38

How does low ghrelin affect metabolism?

Answer 38

Increase in catabolism and causes negative energy balance and weight loss.

Question 39

How does low leptin affect the body?

Answer 39

Increase in catabolism and causes positive energy balance and weight gain

Question 40

What is the metabolic defect in obese people?

Answer 40

Low levels of leptin

Question 41

What is the effect of cortisol?

Answer 41

Hypertension, heart disease, weakened immune system, nerve problems, digestive issues.

Question 42

How can food intake be measured?

Answer 42

Food diary, weighing food, nutritionist interview. We can use the doubly labelled water method to measure energy expenditure of a subject in their normal environment using wearable tech.

Question 43

How can energy expenditure be measured?

Answer 43

Doubly labelled water method.

Question 44

What is the doubly-labelled water method?

Answer 44

Wearable tech of a wrist accelerometer to measure energy expenditure of a subject after giving water with uncommon isotopes of hydrogen and oxygen and measuring samples through saliva. We can measure indirect calorimetry through oxygen consumption and measure body heat output through direct calorimetry. It determines that energy intake rather than energy expenditure is the cause of weight gain.

Question 45

What experiemnt of the doubly-labelled water method can determine the cause of metabolism defects?

Answer 45

Difference between the turnover rates of hydrogen and oxygen in body water. This will indicate CO2 producton via respiration.

Question 46

Ketoacidosis

Answer 46

Caused by severe insulin deficiency, and excess ketones are produced that leads to metabolic acidosis

Question 47

Signs/sympotms of ketoacidosis

Answer 47

Sweet breath, blurred vision, high BP, polyuria