Obesity & Nutrition
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
|
|
||||
---|---|---|---|---|---|
ATP | Adenosine triphosphate is in cytoplasm of all cells and provides energy for cellular needs
🗑
|
||||
kcal | measurement of ATP
1 kcal = amt of energy required to raise 1 kg of water 1 degree
40% converted to ATP
60% used for heat
🗑
|
||||
Basal Metabolic Rate (BMR) | Rate of energy used in resting tissue after 12-hour fast
BMR in children > adults
Declines with age ~2% per decade
Body composition: lean vs. fat mass
Other:
Nutritional status, sleep, fever, temp, stress
🗑
|
||||
Carbohydrates | 4 kcal per gram
2 Sources: Milk & Plants
100% converted to glucose (used for energy)
Protein-sparing
50-60% of diet
Glycemic Index (GI): the rate at which blood glucose levels rise
🗑
|
||||
Monosaccharides (type/examples) | Glucose, fructose: fruits, roots, corn, honey
🗑
|
||||
Disaccharides (type/examples) | Sucrose, Lactose, Maltose: sugar cane, sugar beets, molasses, maple sure
🗑
|
||||
Polysaccharides (type/exmaples) | Complex CHO, Starch, Dietary Fiber: grains
seeds
legumes
vegetables
Eat these!
🗑
|
||||
Benefits of Dietary Fiber | Aids regular bowel elimination
Aids in weight control-increases satiety
Reduces glycemic index-possibly slows the rate in which blood glucose levels rise
Aids in reducing serum cholesterol levels
Reduces risk of cancer
🗑
|
||||
Hormonal Actions on Carbohydrates (4 types) | Insulin, Glucagon, Catecholamines, Cortisol
🗑
|
||||
Hormonal action by insulin on CHO | glucose uptake by insulin-sensitive cells
stimulates glycolysis.
gluconeogenesis
🗑
|
||||
Hormonal action by glucagon on CHO | Stimulates glycogen breakdown in liver
gluconeogenesis.
🗑
|
||||
Hormonal action by catecholamines on CHO | Maintain glucose levels.
glucose uptake at liver and muscle cells
glycogenolysis
🗑
|
||||
Hormonal action by cortisol on CHO | gluconeogenesis.
cellular glucose uptake
🗑
|
||||
Info about Proteints | 1 gram PRO = 4kcal
20% of diet
Found in all foods: highest in meats, nuts, legumes
Contains nitrogen
Tissue growth and repair
Synthesis/maintenance
Hormones, collagen, antibodies, DNA & RNA, hemoglobin
Prevents edema: maintains vascular osmotic pre
🗑
|
||||
Hormones and Protein Metabolism | Insulin
Amino acid transport into cells.
Protein synthesis.
Glucagon
Increases amino acid movement into hepatic cells.
Cortisol
Protein breakdown
🗑
|
||||
Fats | Most calorie-dense
9 Calories per gram
Digested slowly: only @10% converted to glucose
Limit to 30% of total calories:
Promotes absorption of fat-soluble vitamins
Insulate organs in body
Steroid, cell membrane synthesis
Adds flavor
🗑
|
||||
Dietary fats (types and examples) | Saturated
solid at room temperature
meat/dairy and coconut/palm oils
Hydrogenated or trans fats
Polyunsaturated
safflower,sunflower oils, fish, walnuts
Monounsaturated
Lowers LDL/maintains HDL
canola/olive oil, nuts, avocados
🗑
|
||||
Hormonal Actions on Fats | Insulin
fatty acid uptake into cells.
glucose uptake into fat cells.
Glucagon
Promotes fat cell lipolysis.
Catecholamines
fat mobilization.
serum FFAs
Cortisol
fat cell membrane permeability.
🗑
|
||||
Nutrient Deficiencies (types) | Vitamin B12 & Folate deficiency
Iron
Calcium
Vitamin D
🗑
|
||||
Vitamin B12 & Folate deficiency | RBC formation, cell growth, tissue repair, DNA synthesis
Macrocytic, megaloblastic anemias
Vitamin B12 deficiency: neuropathy
Folate deficiency in pregnant women:
Low birth weight, prematurity, neural tube defects
🗑
|
||||
Iron deficiency | Most common nutrient deficiency in U.S.
Most common anemia
🗑
|
||||
Calcium (dfn and sources) | Most abundant mineral
99% stored in bones/teeth
Muscle contraction
Vascular regulation
Sources
Dairy: 8 oz. low-fat milk/yogurt, 1.5 oz unprocessed cheese
Kale, broccoli
Fortified products
🗑
|
||||
Calcium deficiency: reasons and results | Adequate vit. D necessary 4 ca absorb
Most Americans do not meet recommended intake
Calcium deficiency:
Loss of bone mass-osteopenia/osteoporosis
Possible risk for HTN, CA
Adequate calcium intake:
High Ca++ may decrease risk for stones
Weight man
🗑
|
||||
Vitamin D | Fat-soluble vit
Necessary 4 Ca absorb in gut
Bone growth/remodeling
Neuromuscular & immune fcn
Inflam
Sources:
food: fatty fish, beef liver
Sunlight, added to foods, dietary supplement in inactive form
🗑
|
||||
Vitamin D deficiency | Deficiency
Ricketts in children-rare, seen in AA
Osteomalacia in adults
Obesity-sequestered in fat and less entering blood
🗑
|
||||
Nutriton-related Chronic Disease | Cardiovascular disease
Type 2 diabetes
Hypertension
Overweight & Obesity
🗑
|
||||
Obesity background and dfn | >100 mil american adults
1.6 bil adults worldwide
20 mil children worldwide
Having a very high amount of body fat in relation to lean body mass, or Body Mass Index (BMI) of 30 or higher.
🗑
|
||||
disease obesity can contribute to | Hypertension
Type 2 diabetes
Coronary heart disease
Gallbladder disease
Certain cancers
Dyslipidemia
Stroke
Osteoarthritis
Sleep apnea
🗑
|
||||
Obesity as a disease state | Chronic, relapsing neurochemical disease
Deranged neural circuitry responding inappropriately to a toxic environment
🗑
|
||||
Abdominal Obesity and Insulin Resistance | Fat compartments: Intra-ab (visceral fat) Ab subQ (peripheral fat)
Products of abdominal adipose tissue causing insulin resistance
Excess free fatty acid release
Adiponectin
Inflammatory cytokines
🗑
|
||||
Adipose tissue | Connective tissue made up of adipocytes
expands by
Hypertrophy: the normal, 1st response 2 incr caloric intake & growth
Hyperplasia: when hypertrophied adipocytes reach a critical vol hyperplasia occurs & the number & size of adipocytes increases signi
🗑
|
||||
FFA: dfn | Lipolysis is the breakdown of stored fat into FFA
Insulin blocks this
In states of insulin resistance (caused by gen & environ factors) FFA secretion is up.
FFA are taken up by the liver.
🗑
|
||||
FFAs: results | The liver packages FFA into TG rich lipoproteins (VLDL) ->hypertriglyceridemia. Met of high levels of VLDL lead to drops in HDL & sm dense more atherogenic LDL particles.
🗑
|
||||
Products of Adipose tissue: cytokines and plasminogen activator inhib 1 | Inflam cytokines (TNF alpha & IL-6)
– Enhance endothelial inflam
– Incr C-reactive prot (CRP)
Plasminogen activator inhibitor 1 (PAI-1):
prothrombotic substance
🗑
|
||||
Products of Adipose tissue: Adiponectin & Leptin | Adiponectin – adipose tissue product that fights insulin resistance. Decreased in obesity.
• Leptin – protein that affects satiety. Obesity possibly r/t “leptin resistance”
🗑
|
||||
Weight Assessment: BMI | BMI: weight Lbs./height (in)2 x 705
weight in Kg/height in meters2
18.5-24.9 kg/m2 Healthy weight
25 - 29.9 kg/m2 Overweight
> 30 kg/m2 Obese
🗑
|
||||
Weight Assessment: Waist circumference and waist-hip ratio | Waist circumference:
men < 102 cm or 40 in, women < 88 cm or 35 inches
Waist-to-hip ratio
0.95 men 0.8 women
waistline measurement (in)
Hip measurement (in)
🗑
|
||||
Hypertension | Despite insulin resistance in adipose & muscles kidneys remain insulin sensitive.
High insulin increases renal na retention
50% of pts w/ essential htn have insulin resistance.
Insulin resis pts with HTN are at more risk of CVD than non-insulin resis p
🗑
|
||||
Polycystic Ovarian Syndrome | Sex specific metabolic Syndrome XX
5-10% prevalence.
Multigenetic characterized by hyperandrogenemia & insulin resis.
Muscle & adipose cells are resistant to insulin -> hyperinsulinemia, ovary is normal responsive to insulin. -> more ov testosterone pr
🗑
|
||||
Polycystic Ovary DiseaseHigh risk of other insulin resistant problems | • Glucose metabolism
– By 4th decade patients have
• 35% risk of IGT
• 10% risk of DM2
• Sleep Apnea
• Lipid abnormalities
• Coronary artery disease
🗑
|
||||
Nonalcoholic Fatty Liver Disease | • Resis of insulin action on adipose -> increased FFA release.
• If the liver takes up these FFA, converts them to TG but lags behind in packaging the TG in VLDL particles, fatty liver results.
• Correlates better with insulin resistance than obesity.
🗑
|
||||
Obesity Etiological Factors | Energy Density & Food Intake
– Energy density of diets is increasing.
– Avail of processed foods/super-sizing
Reduced phys activity, sedentary
Behavioral / Social factors
Poverty
🗑
|
||||
Increased Energy Density of food | Standard food portions have increased over the last 20 years
🗑
|
||||
Metabolic syndrome dfn | Cluster of mult metabolic risk factors
Atherogenic dyslipidemia
Elevated blood pressure
Elevated plasma glucose
Prothrombotic state
Proinflammatory state
🗑
|
||||
Underlying Risk Factors of the Metabolic Syndrome | Overweight/obesity (esp. abdominal obesity)
Insulin resistance
Additional underlying factors
Physical inactivity
Aging
Endocrine dysfunction
Genetic factors
🗑
|
||||
🗑
|
|||||
ATP III Definition of Cardiometabolic syndrome (CMS) | Must have three of the following:
Fasting glucose > 110
Waist circumference > 40" in men & > 35" in women
Triglycerides > 150 mg/dl
HDL Cholesterol levels <40mg/dL in men and < 50mg/dL in women
● Blood pressure > 130/85
🗑
|
||||
Metabolic Concomitants of Insulin Resistance | Atherogenic dyslipidemia
-High TG/HDL-C ratio
Higher bp
Hyperinsulinemia and hyperglycemia/impaired glucose tolerance
Prothrombotic and proinflammatory states
Endothelial dysfunction and microalbuminuria
Fatty liver
🗑
|
||||
Obesity therapy | Lifestyle changes
Behavioral Therapy
Pharmacological interventions
🗑
|
||||
Sibutramine (Meridia) | Seratonin-norepinephrine reuptake inhibitor
Contraindicated:
uncontrolled HTN
CAD, HF, arrhythmias, stroke
Patients on SSRIs or MAOs
🗑
|
||||
Orlistat (Xenical, Alli) | Pancreatic lipase inhbitor
Decreased intestinal absorption of fat
May interfere with absorption of fat-soluble vitamins
Severe GI side effects-require adherence to low-fat diet
🗑
|
||||
Nutrition and the Nursing Process Assessment | Anthropometrics; weight, BMI
Skin integrity
Lab values; glucose, cholesterol, albumin, hemoglobin
Physical/cognitive abilities
I & O’s
Diet history-cultural/religious preferences
Food preferences
🗑
|
||||
The Five A’s of Nutrition Intervention | Ask about current eating habits and knowledge
Advise about desirable changes and why
Assist in identifying/making changes that the patient is willing to make
Arrange for support
Adopt a follow up plan
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
Marissagostanian
Popular Science sets