Prelim #1 Flashcards
(101 cards)
1
Q
Health
A
state of physical, mental, and social well-being; not merely the absence of disease.
2
Q
Biological Determinants of Health
A
Innate (genetics), Structural (anatomy), Functional (physiology)
3
Q
Genetics
A
genes, genetic variation, heredity
4
Q
Anatomy
A
study of structure
5
Q
Physiology
A
study of functioning
6
Q
Disease
A
deviation from the normal structural and functional state of an organism; associated with symptoms
7
Q
Socioecological model
A
individual, interpersonal, organizational, community, public policy
8
Q
Causes of health disparity
A
poverty & LES, injustice, and culture
9
Q
Economics
A
study concerning the allocation of resources among competing ends
10
Q
Opportunity Cost
A
forgone benefit from the option not chosen
11
Q
Non-biological factors Affecting Health
A
Occupation, Education, Income
12
Q
LARA
A
Listen, Affirm, Respond, Add info
13
Q
Obesity Origins
A
19th-century life insurance companies needed to determine what type of people die at what ages.
They used the correlation b/w (Wt/Ht) ratio and life expectancy.
Later on, the correlation b/w subcutaneous fat and (Wt/Ht) ratio called the Quetelet Index became BMI.
14
Q
BMI Formula
A
(kg/m2) = (lbs/in2)*703
15
Q
Underweight BMI
A
> 18.5
16
Q
Normal BMI
A
18.6-24.9
17
Q
Overweight BMI
A
25-29.9
18
Q
Obese BMI
A
</= 30
19
Q
BMI Advantages
A
- ease of use
- inexpensive
- non-invasive
- easily understood
20
Q
BMI Criticisms
A
- predominantly white male population sample
- does not account for lean mass to total BW
- %Body fat and BMI correlation not perfect
- Asian population have risk at lower BMI
- better methods
21
Q
BMI Survey
A
NHANES
22
Q
Obesity Prevalence Trends
A
Sex, race, education, income
23
Q
% of people obese worldwide
A
13%
24
Q
% of people obese and overweight
A
39%
25
Causes of Obesity
changes in food systems
- sweet beverages
- cheap fast food
- ease of access
individual behavior
- reduced activity
- less meal prep
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Economic Costs of Obesity
direct medical costs, economic productivity costs, higher medical premiums
27
Characteristics of Disease
1) organs, systems affected
2) nutritional, environmental, and genetic causes
3) group of symptoms
4) deviates from normal function
28
Is obesity a disease?
meets essential criteria for a disease, ICD code assigned, and increases the risk of other diseases.
29
Obesity
disproportionate body weight for height due to excess accumulation of adipose tissue
30
Metabolic Syndrome
a cluster of symptoms that increase the risk of CVD, stroke, and diabetes.
HIGH BP, HIGH TG, LARGE WAIST, LOW HDL, HIGH BLOOD SUGAR
31
Diagnosis of Obesity
requires body composition assessment
32
Body Composition Assessments
densitometry, image-based methods, anthropometry
33
Densitometry: Hydrostatic Weighing
fat less dense than lean mass; displaces less water
34
DEXA
measures fat, lean mass, and bone. (gold standard)
- informs fat distribution
35
Direct Measurement Disadvantages
- expensive
- trained professionals
- inaccessible
- invasive
36
WHR
better predictor of CVD
37
Compartments of Adipose Tissue
subcutaneous, visceral
38
Subcutaneous Fat
- under the dermis of the skin
- <80% of total body fat
39
Visceral
- surrounding organs
- intra-abdominal, perirenal, and pericardial
- CVD risk increases
40
Android Obesity
increase in intra-abdominal AT, decrease in subcutaneous AT -> altered metabolic profile -> CVD risk increases
41
Gynoid Obesity
increase in subcutaneous AT, decrease in intra-abdominal AT -> normal metabolic profile -> CVD risk decreases
42
1st Law of Thermodynamics
Energy is not created nor destroyed: conserved.
43
Energy Balance
Intake = Energy Expenditure
44
Deviation from Energy Homeostasis (obesity)
low activity, high intake
45
energy intake factors
nervous system, endocrine system, microbiota
46
EE factors
REE, thermic effect of food, activity-related EE
47
Physiological Influences
hunger
48
Sensory Influences
seek food & start meal
49
Cognitive Influences
keep eating
50
post-ingestive influences
satiation: end meal
51
post-absorptive influences
satiety: several hours later
52
gut
digest and absorbs nutrients (ghrelin)
53
pancreas
facilitates digestion and produces insulin
54
adipose
releases stored nutrients and releases leptin
55
endocrine network
involving peripheral organs and the CNS
- hormones maintain balance between intake and EE
56
negative feedback system
food intake is counter-regulated to offset deviation in energy balance
57
hypothalamus
control center; receives chemical signals and coordinates a response.
- hunger and thirst
- satiety
58
arcuate nucleus (ARC)
primary site for integrating endocrine signals
- orexigenic
- anorexigenic
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orexigenic neurons
- appetite stimulating in a fasted state
- AgRP/NPY
60
anorexigenic neurons
- appetite suppressing in a fed state
- POMC/ α-MSH
61
Leptin
adipose hormone released proportional to fat stores
-> inhibits AgRP/NPY and activates POMC
-> inhibits food intake and increases EE
62
Insulin
- pancreas hormone that regulates glucose homeostasis
- binds to ARC and changes neuronal sensitivity
- potentiates satiety action of leptin
63
Ghrelin
- produced by stomach to stimulate food intake
- activates AgRP/NPY
64
Intestine Hormones & Function
- GLP-1, PYY, CCK
- inhibit food intake in fed state
65
Microorganisms
- trillions
- most are symbiotic
- benefit health: detoxify compounds, make Vit, yield SCFA's
66
Total Energy Expenditure (TEE) is a sum of:
1) Resting EE
2) Thermic effect of food
3) Activity-related EE
67
Resting EE
- RMR -> energy requirements of body
- Thermogenesis -> heat produced due to environment
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Thermic Effect of Food
post-prandial thermogenesis -> energy needed to metabolize food
-> Protein: highest TEF 20-30%
-> Fat: lowest TEF 0-3%
69
Activity-related EE
- non-exercise, exercise
- second-largest contribution to EE
- most modifiable component
70
Adipose Tissue Functions
- Binding, Protection, Storage
71
Adipose Tissue Types
WAT, BAT, Beige
72
WAT
- energy reservoir
- most abundant
- maintains energy homeostasis
- acts as endocrine organ
73
BAT
- thermogenic center (generates heat)
- least abundant
- important for EE
- lots of mitochondria
74
Beige AT
- energy storage and thermogenic based on environment
- aging reduces Beige AT
75
Healthy AT
- vascularization
- 60-70% AT, immune cells
- O2 increase, inflammation decrease
76
hypertrophy
- increase in size
- deleterious
77
hyperplasia
- increase in number
- protective against ectopic fat deposition
78
hypoxia
enlargement -> O2 down, Inflammation up
-> chronic low-grade inflammatory state
79
Fibrotic AT
- AT undergo cell death -> loss of normal function
80
Adipokines
proteins/hormones that regulate function
- paracrine local effect
- endocrine distant effect
81
adipokine pathway
dysfunctional AT -> pro-inflammatory adipokine
-> atherogenesis & insulin resistance
82
Why is only intra-abdominal fat accumulation associated with metabolic syndrome?
Pro-inflammatory adipokines are produced.
83
Ectopic fat deposition
accumulation of TG in non-adipose tissue -> dysfunction, impaired metabolism, lipoxicity
84
AT Impact on organ function
greater pharyngeal soft tissue, mechanical load on joints, intra-abdominal pressure
85
Adiposity Increase (Pathways)
adipokine synthesis -> pro-inflammatory cytokines -> insulin resistance -> type II diabetes -> CVD
-> lipid production
-> mechanical stress
-> metabolic syndrome
86
Genetics of Obesity
- 70% of BW due to genetic makeup
- MZ twins more similar in BW
87
gene
unit of heredity
- every person has two copies of each gene
88
Monogenic Obesity
- mutation in one gene
- rare
- characterized by early-onset obesity
- predominantly hyperphagic condition (hungry)
89
Polygenic Obesity
- SNP associated with obesity traits
- GWAS identified >300 genetic loci (small impact)
- FTO gene variants have largest, but overall small effect on obesity
90
EOSS
five stage system of obesity
91
Stage O (NO risks)
Stage 1 (Existing Risk)
lifestyle intervention
92
Stage 2 (Pronounced Risk)
- lifestyle intervention
- consider behavioral, drug, and surgical
93
Stage 3 (Significant End Organ Damage)
Stage 4 (Chronic Disease)
- lifestyle intervention
- drug and surgical interventions
94
First Line Therapy
Lifestyle intervention
- meal plan, physical activity, behavior
95
Drug Therapy
- adjunct to lifestyle changes
- combination has additive effect
- decreases appetite by mimicking GLP-1 (Wegovy, Ozempic)
- also for concurrent complications
96
Bariatric Surgery
- anatomical manipulation -> restrict size and nutrient absorption
sleeve (50-80%)
bypass (60-85%)
banding (40%)
duodenal switch (75-90%)
97
Case Report
description of individual report.
- unusual or novel occurance
98
Children BMI
expressed by same age and sex
5, 5-85, 85-95, 95
99
Body habitus
physical characteristics of body
100
Results of Case Study
Rapid Onset, sustained for long period
101
Does leptin result in weight loss for common obesity?
No. Obesity associated with increased leptin
- may cause leptin resistance
