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224 Cards in this Set
- Front
- Back
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Define genetic Susceptibility
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Having the genes that, given the RIGHT ENVIRONMENT, would allow a given trait or disease.
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What is a "caveman environment"
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alteration in genes --> decreased energy use and increased storage (don't use unnecessary E) --> increased survival --> increased reproduction --> altered genes are common in pop. --> increased survival of pop.
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What are "thrifty genes"
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genes selected through evolution.
- Increased storage of energy and decreased basal energy use. |
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thrifty genes were advantageous for what kind of environment.
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a caveman environment when going days without food was a possibility.
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What is an obesogenic environment?
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our environment is allowing us to store E and not use the E that we have inefficiently. -->we still store all our E efficiently causing adipose storage.
"it refers to an environment that promotes gaining weight and one that is not conducive to losing weight." |
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what are single gene conditions?
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a specific condition that leas a person to develop diabetes/obesity DESPITE their environment ex. live in environment scarce of food and still develop obesity.
- rare |
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Define heritability
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the state of being capable of being passed on from one generation to another.
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heritability is due to...
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genes
environment (including "taught" behaviors") Combo |
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Number of obese parents connected to lifetime risk for children
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1 parent - 20-50%
2 parents - 50-75% |
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Number of affected parents with T2DM and the lifetime risk for children
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1 - 40%
2 - 70% |
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Effects of an undernourished mother (PN environment)
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Decreased prenatal nourishment --> prime genes for efficient use and storage of energy) --> baby with low birth weight and PRIMED genes to be very efficient with it use of energy it gets --> increased of kcal and decrease of physical activity --> adult obesity
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Effects of an over-nourished mother (PN environment)
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increased prenatal nourishment --> prime genes for improper use and storage of energy --> baby with HIGH birth weight and primed genes --> increased kcal food and decreased physical activity --> adult obesity.
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Mother with DM and its PN effects
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Increased prenatal nourishment and/or prenatal insulin resistance --> prime genes for improper use of storage of energy --> baby with high birth weight and or PRIMED genes --> increase kcal food and decreased physical activity --> DM in adulthood
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High birth weight
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>9 lbs
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Obesogens do what
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disrupts our endocrine system making a person develop more fat cells.
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what is "toxic overload"
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something in our environment that is leading people to become overweight.
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define obesogen
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a synthetic chemical that is thought to "cause" obesity.
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What is the obesogen hypothesis
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obesogens bind to hormone receptors...
immature adipocytes --> exposed to obesogens --> increased adipocytes --> increased ability to store TG --> also with an increase in kcal food and decrease in physical activity |
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what product is seen as an obesogen?
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Bisphenol A (BPA products)
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what is BPA?
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used to make plastics and coatings
- in a 2012 study, there were higher levels of BPA in obese children. |
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what type of cells is BPA found in?
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adipose (Fat cells)
it is a estrogen hormone-like substance |
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some may say evolution is working against people to lose weight. How so?
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- caveman genes which encourages efficient storage of all energy.
- this was helpful for an environment where food is scarce. |
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what role does race/ethnicity play in the "causes of DM and obesity?"
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-shared genes
-shared environment - an environment that does/does not encourage physical activity |
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Explain how the prenatal environment can impact risk for DM and obesity in adulthood
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answer later
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Is BPA definitely an obesogen?
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No, it's a highly controversial theory.
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T/F Having a genetic susceptibility for T2DM means that a person is definitely be affected.
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False, your chances just increase.
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My mom is obese. How does this impact my risk for T2DM?
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My risk is higher because of genes and environment, etc.
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T/F Thrifty genes code for obesogens
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False
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High fat in your diet can be problematic because...
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increased kcal
easily processed to be stored |
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refined (processed) foods in your diet can be problematic because
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easily processed/stored
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over-sweetened food in your diet can be problematic because...
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increase in empty kcals
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how much more kcal (%) do we eat compared to ten years ago?
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31% more
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why do we eat so much? (12 things)
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1. biologically programmed to eat a lot
2. food tastes much better (infused with salt, fat, and sugar). 3. Increased availability/access 4. increased variety (types, quantity, and quality) 5. Decreased relative cost. 6. portion distortion (serving does not equal appropriate portion. 7. eat out more (higher kcal/meal) 8. Marketing: supersize me! ($ value vs. nutrition). 9. Maladaptive meal patterns. 10. Social/cultural meaning of food/eating. 11. Unmet psychological needs (eating your feelings) 12. Takes herculean effort not to overeat. |
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How we should move (two ways to have an active lifestyle)
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1. aerobic exercise
2. muscle strengthening |
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How to have a moderate/vigorous aerobic lifestyle
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moderate - 150 minutes/week.
vigorous - 75 minutes/week |
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How to properly strengthen muscles for an active lifestyle
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2x week - lifting, carrying, etc.
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% of people that do physical activity during leisure time.
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40%
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% adults that meet minimum physical activity requirement.
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3%
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2010 - % of people that have a job with physical labor
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<20%
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50s - % of people that have a job with physical labor
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50%
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six reasons why we don't move
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1. we don't have to
2. less time for "play" 3. concerns about safety 4. concerns about other's viewing them. 5. Fuss factor 6. It's work - our bodies want to relax |
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discuss factors that lead us to consume "too much" often without knowing it
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portion size has increased
cheaper to buy foods in bulk it's difficult to refrain from overeating etc. |
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discuss how changes in physical activity norms are related to obesity and T2DM
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physical activity is not encouraged as much as relaxing is which can directly effect a person's motivation to lose weight/how they feel when they try to lose weight.
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T/F americans consume about the same amount of kcal/day now, as they did about 30 years ago.
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False
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T/F per meal, American generally consume more kcal when they eat out that if they were to eat food prepared at home
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True.
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James walk 15 minutes to and from class at a moderate pace on M, W, and F. Is this enough physical activity to meet the US PA Guidelines
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It should be at least 150 minutes/week of moderate exercise of 75 minutes of vigorous exercise.
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define mortality
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death, my friend
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% of deaths due to poor diet and inactivity
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16.6%
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define morbidity
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health problems
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define diabetes
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medical condition resulting from the lack of insulin or the inability of insulin to work properly.
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types of eye problems that occur with diabetes
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blurred vision
retinopathy |
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define lens
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transparent body that focuses light on retina.
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retina
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back part of the eye that sense light and tells brain what you are seeing.
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how does diabetes cause eye problems
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glucose binds to proteins in the eye cells
the eye cells weaken/do not function properly. |
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how does diabetes cause blurred vision
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fluid changes in lens
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how does one resolve blurred vision
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resolves with sustained glucose control
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define diabetic retinopathy
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damage to cells/tissue of the retina
- capillaries - neurons |
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% of people with T2DM also have retinopathy
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>50%
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definitive characteristic of retinopathy
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"cotton wool spots" dotting the lens.
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types of retinopathy
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Nonproliferative
Proliferative |
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if not under control, what doe retinopathy lead to?
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retinal detachment
blindness |
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prevention/treatment for eye problems
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good glucose control
laser surgery other types of eye surgery |
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function of the kidneys
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organs that detoxify our blood
nephrons filter your blood and puts it into the urine to be flushed out. |
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what is the kidney problem that can occur if you have diabetes
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diabetic nephropathy
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define diabetic nephropathy
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damage to kidney capillaries due to exposure to high glucose levels.
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what does diabetic nephropathy result in (three things)
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- wastes/toxins stay in blood
- proteins/nutrients excreted in urine - long term --> kidney failure (ESRD) |
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% DM have symptoms of kidney damage
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30%
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% with ESRD because of DM
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~40%
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symptoms of diabetic nephropathy (4)
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fluid build up
sleep problems vomiting weakness |
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dialysis is...
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a machine that cleans up the blood for you.
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how do you cure diabetic nephropathy
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kidney transplant.
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T/F as one's BMI increases one's risk for death decreases
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False
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T/F the longer the person with DM's blood sugar is "out of control", the higher her risk for developing diabetic retinopathy
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True
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T/F a nephron is a damage neurons
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False, it filter blood out of our kidneys.
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Define diabetic neuropathy
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Damage to nerves in the body due to high glucose
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% of people with DM have some degree of neuropathy
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60-70%
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explain how one obtains diabetic neuropathy
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glucose increases (binds to neurons; upsets neuronal chemical balance; damage blood vessel cells feeding neurons) --> decreased function/ neuron death --> neuropathy
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types of diabetic neuropathy
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peripheral
autonomic focal |
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explain autonomic diabetic neuropathy
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problems with neurons taking signals from heart, gut, lungs, bladder, bowel, etc --> problems controlling such organs.
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explain focal diabetic neuropathy
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just one part of your body that is affected by the neuropathy
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symptoms of diabetic neuropathy
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pain
numbness/tingling of hands and feet problems controlling a certain body part |
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describe relationship between obesity and mortality
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if obesity is not kept under maintenance, it can cause severe issues ranging from kidney disfunction to organ failure, which can lead to death.
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Deepika is a 24 year old woman who is obese. She has no other chronic health condiitons. Should she be concerned about her weight? Why or why not?
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Yes.
No current issues does not mean no future issues. |
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describe how glucose levels are linked to eye and kidney for persons with DM.
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eyes: glucose binds to proteins in the eye cells --> eye cells weaken/do not function properly (blurred vision; retinopathy; etc.)
kidneys: damage to kidney capillaries due to exposure to high glucose levels (toxins stay in blood; proteins excreted into urine; etc.) |
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what is a peripheral neuropathy?
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meaning nerve damage in the peripheral nervous system. Only nerves outside of the brain and spinal cord are involved, so peripheral neuropathy does not include nerve damage in the central nervous system.
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% people with DM have DM-related skin problem
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30%
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explain the connection between DM and infections
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blood glucose (decreased immune response; optimal environment bacteria growth; decreased blood flow) --> increased risk of infection.
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if an infection spreads beyond care, what is the last option a doctor has to stop the spread?
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amputation.
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why does amputation occur?
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uncontrolled, spreading infection.
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% of non-traumatic lower-limb amputations occur in people with DM.
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>60%
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% of men over 50 with DM that experience Erectile dysfunction
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50-60%
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cause of Erectile Dysfunction in men
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blood vessel and nerve damage
psychological factors |
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% of women who have trouble with glucose levels during their period
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70%
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How does DM create pregnancy problems
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pregnancy alters the ability to process glucose.
- changes diabetic management Higher maternal blood sugar - increased fetal risk; maternal risk |
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% risk of birth defects due to DM
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3-5%
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what trimester can be effected the most with high blood sugar
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first trimester
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types of birth defects caused by DM
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neural tube defects (spina bifida)
heart defects large sized babies fetal death |
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T/F children of women with DM do not have a larger probability of developing DM themselves.
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False, they are at an increased risk compared to a child with a mother w/o DM.
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What are the pregnancy risks from DM
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Pre-eclampsia (High BP, protein in urine)
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c-section vs. vaginal birth
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c section has more possible complications
- longer recovery time, big womb that is at risk of infection. |
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How does increased blood glucose increase risk for infection/skin problems?
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high blood glucose decreases immune responses, and creates an optimal environment for bacteria to grow which increases risk of infection.
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How common is ED in men with DM?
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Very common. Men over the age of 50 have a 50-60% chance of having erectile dysfunction.
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What types of reproductive consequences does DM have for women?
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your period is messed up...answer later.
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Nephrons are damaged in DM by thrifty genes
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False
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Yeon has T2DM. Should she get a flue shot? why or why not?
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yes, she is more susceptible to varied illnesses.
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T/F Women may have prenatal testing to see if their baby has DM.
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False, cannot test for Prenatal diabetes
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% of women who have Polycystic Ovary Syndrome (PCOS)
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5-10% of women
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what causes PCOS?
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increased production of androgens in the body
also increased adiposity --> increased size of fat cells --> fat cells can secrete hormones at a higher level --> increases influence of development of PCOS> |
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What is coronary heart disease
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narrowing of the blood vessels that bring blood to the heart muscle itself.
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what causes a narrowing of the heart vessels
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atherosclerosis
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What is peripheral artery disease
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diseased vessels that bring blood to non-heart parts of the body.
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what causes Peripheral artery disease
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atherosclerosis and HTN
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what can peripheral artery disease lead damage to...
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kidneys
legs arms feet |
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% T2DM related deaths due to CVD
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50-80%
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T/F CVD occurs after DM
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False. CVD begins before DM is diagnosed
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what is blood pressure?
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BP - measure of the force pushing outwards on the arterialwalls
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healthy BP
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<120/<80
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unhealthy (HTN) BP
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>=140/>=90
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HTN link to athersclerosis
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higher BP --> blood vessel damage --> great environment for atherosclerosis --> plaque formation
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HTN link to kidney disease
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increased BP --> Rena caps get damaged --> decreased kidney functioning --> renal disease
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How is HTN the silent killer?
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generally no clinical signs
only diagnostic by BP check |
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WHat is a myocardial infarction?
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Heart attack
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define MI
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death of/damage to the heart muscle b/c heart muscle's blood supply is severely lowered or stopped.
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cause of MI?
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Thrombosis in coronary arteries
- blood clot blob that clogs the artery - athersclerosis |
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How common is PCOS and what are the symptoms
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relatively commom - about 5-10% of women have it.
symptoms include abnormal menstrual cycle; increased acne, excess body hair, "dirty skin" |
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Tara was just diagnosed with PCOS. As treatment, her doctor prescribed her both BC pills and DM medication. Why?
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BC to help regulate her menstrual cycle
DM to assist with her possible insulin resistance. |
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T/F obesity, but not DM, increases one's risk for CVD
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True
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Anita has no known medical problems and feels "great". However, she recently had her blood pressure checked. It was 153/87. SHould she be concerned?
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Yes, anything higher than 140/90 is HTN.
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T/F coronary arteries bring blood the brain
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false, the heart
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T/F MI are caused by thrombosis
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true
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Define strok
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death of/damage to the brain beause the brain's blood supply has severely decreased or stopped.
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what is stroke due to?
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atherosclerotic embolus
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types of stroke
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ischemic/TIA
hermorrhagic |
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what is ischemic/TIA stroke
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mini-stroke - blockage but blood vessels don't actually explode
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what is a hermorrhagic stroke
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the blood vessel actually bursts
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Acronym for stroke symptoms
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FAST
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Deconstruct FAST
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it's for the signs of stroke...
F - face drooping A - arm weakness S - speech difficulty T - time to call 911 |
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What's a syndrome
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constellation of clinically important features that are often found together
-physical - biochemical |
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what is metabolic syndrome (MetS)
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constellation of clinical features that increase risk for CVD, MI, and stroke
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prevalence of MetS in the US
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20-40% adults in US (20+ years)
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in your sixties, who is more at risk for MetS, women or men?
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women
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what are lipoproteins
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complex proteins that transport fats to body cells
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what is the components of lipoproteins
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TG
Protein Cholesterol |
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is cholesterol needed by the body?
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yes
20% in from our diet 80% is made from our liver |
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is more cholesterol in your body because you ate it or made it?
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made it
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what are cholesterol-lowering drugs meant to target?
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suppress cholesterol production in the liver.
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Is HDL good or bad?
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good - HDL brings loose lipids and cholesterol back tot he liver
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is LDL good or bad
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bad - drops cholesterol and lipids into cells
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a diagnosis of MetS means that the patient had to have # of the specific clinical features
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3 or more
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synergistic
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the three risks (of MetS) work in tandem will increae the risk rather than just one risk plust another risk plust another
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what is the MetS diagnostic riteria
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increase abdominal obesity
increased TG decreased HDL Increased BP increased blood sugar |
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for men and women, what signifies as abdominal obesity?
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men - waist circum of > 40 in.
Women - waist circum. of > 35 in. |
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amount of TG in body that is dangerous for M and W
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M and W - >/= 150 mg/dl
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amount of HDL in body that is dangerous for M W
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decreased to
M - <40 mg/ dl W - <50 mg/dl |
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BP that is dangerous for M and W
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M and women >/= 130/85 mmHG
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blood sugar level that is dangerous for M and W
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M and women >/= 100 mg/dl
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How does waist circumference increase CVD risk
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increase lipids in blood --> increased abdominal uptake of "loose" fat --> increase form of atherosclerotic plaque.
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How does increased TG increase CVD risk
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increased abdominal risk "loose fat" --> increases atherosclerotic fat
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how does decreased HDL increase CVD risk?
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Decreased HDL --> less HDL to pick p loose lipids --> increased chance for "loose" lipids to cause damage --> increased form of atherosclerotic plaque.
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High blood pressure causes increased CVD risk...
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increased chance for blood vessel damage --> increased chance of immune response --> increased formation of atherosclerotic plaque
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how does high blood sugar increase CVD risk?
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increased blood sugar --> good conditions for fomatin of atherosclerotic plaque
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if LDL is bad why does the body make it?
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because our cells need cholesterol. Just too much cholesterol in the body can cause too much of it in the cells.
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- Bonus: Warren has high LDL’s. He eats a low cholesterol diet for 6 months and then has his LDL levels checked again. The result shows that his LDL level is virtually the same. How can this be? (Hint: where does MOST cholesterol come from?)
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he needs medication to suppress the cholesterol production in his liver. That is the real problem
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T/F MetS increases one's lifetime risk for stroke and MI
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true
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T/F most cholesterol in the boy comes from our diet
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false, liver
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T/F high LDL level is one of the 5 clinical features of MetS
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false.
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which lipoprotein is thought to protect against CVD? Why?
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HDL, picks up loose lipids left by VLDL
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how does cancer "come about"
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carcinogenesis
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cause of all cancers
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mutations in genes for cell division control.
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define carcinogen
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substance that initiates cancer by causing mutation in gene.
- changes o the gene |
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what's a cancer promoter
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a substance that promotes caner cell development.
- promotes the cancer cell development (doesn't necessarily change the genome). |
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Phase 1 of cancer development
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initiation.
- organ/tissue with normal growing cells ---> exposed to carcinogen --> mutation in growth control genes --> organ/tissue with abnormally growing cells. |
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Phase 2 of cancer development
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Promotion
Abnormally growing cells --> promoter comes in --> increases division/growth of abnormal cells and daughter cells --> lots of abnormal cells to organ/tissue. |
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Phase 3 of cancer development
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progression
lots of abnormal cells in organ/tissue --> promoter --> some abnormal cells migrate (METASTASIZE) --> cancer cells in multiple tissues/organs. |
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what is benign cancer
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growth only in one place.
danger if presses on vital organ once removed, usually won't come back |
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malignant cancer
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ability to metastasize/invade and destroy surround tissues.
fast, uncontrolled growth comes back |
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cancer death due to OW/obesity?
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M - 14%
W - 20% |
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fraction of ALL cancer in the US that could be prevented if adults were at a healthy weight.
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1/3
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DM med that is linked to decreased cancer risk
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metformin
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CA linked to DM in what types
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pancreas
bladder liver |
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CA linked to obesity/ow in what types
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breast (post-meno)
colorectal endometrial |
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what three effects does obesity and DM influence which can lead to cancer?
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increased # and size of adipocytes.
Increased #, types, and activity of immune cells. increased insulin resistance |
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how is increased # and size of adipocytes linked to cancer
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abnormal hormone levels (estrogen and leptin)
Hormones promote abnromal growth |
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how is increased #, types, and activity of immune cells linked to cancer
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abnormal release lipids and immune cell-derived oxidants.
Oxidants initiate DNA damage. Abnormal lipids binding to enzymes promote abnormal growth. |
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How is increased insulin resistance linked to cancer
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increase glucose ad increase insulin and other metabolic changes
creates and environment that promotes abnormal growth. |
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which cancers are more common in people with DM?
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pancreas
bladder liver |
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which cancers are more common in people with obesity?
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breast (post-meno)
endometrial colorectal |
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what i the difference between benign and malignant CA?
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benign is concentrated in one area - once removed, it should not come back.
malignant spreads through the body and can come back. |
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T/F carcinogenesis is the production of synthetic chemical to treat CA
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False, they cause cancer.
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T/F people with obesity are at an increased risk for colorectal CA
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true
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how does excess adipose lead to cancer
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increased hormone secretion
increased number and types of immune cells increased insulin resistance |
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morbidity
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health problems
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mortality
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death
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what is osteoarthritis
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joint disease that affects the cartilage mostly
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what is cartilage
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hard, slippery coating on the end of each bone.
allows bones to glide absorbs and shock of movement. |
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explain the process that causes osteoarthritis
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thinning of cartilage --> bones rub --> joint damage --> pain; swelling; loss of mobility
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affects joints with obesity
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knee
lower back hands hips |
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Sleep apnea definition
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1+ pauses in breathing or shallow breaths during sleep
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symptoms of sleep apnea
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snoring
pauses in snoring --> gasping sleepiness during the day |
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obesity and sleep apnea
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increased fat stored around neck
- decreased airway size - increased risk for airway blockage. |
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obesity hypoventilation syndrome chain of events
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severe obesity -->
apnea --> blood oxygen low, carbon dioxide high --> increased strain on heart |
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What does CPAP stand for?
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continuous positive airway pressure
Tx for apnea |
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define gallstones
|
solid deposits that form int he gallbladder
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medical term for gallstones
|
cholelithiasis
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how do gall stones form?
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form when bile components join together and make crystals
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% of adults affected by gallstones
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10-15%
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what tissue is damaged in OA?
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cartilage
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T/F Dementia is linked to obesity but not DM
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false, both
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T/F all obese persons have psychological problems
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false, our society is built to make us heavy
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people with DM are (# of times) more likely to suffer from depression that unaffected persons
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two times more
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does obesity/DM affect men and women the same way, from a psychological point of view? Why or why not?
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body image is more negative in women than men.
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define stigma
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label that associates a person to a set of characteristics that form a stereotypes
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weight bias definition
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stigmatization of overweight and obese persons because of their weight status
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in a OW/obese study on weight bias...
% weight bias from a physician % weight bias from nurses % weight bias from dietitians |
69% physician
46% nurses 31% dietitians |
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stunkard's classic silhouettes were what
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pictures of different physiques to identify a person's self body perception
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results of the Stunkard silhouette study
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adults can't accureately tell someone's health status by physique alone.
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NHANES created an assessment on
perception of weight status weight-loss attitudes diet physical activity what were the results? |
most subjects accurately perceive weight status
- 23% reported misperception. |
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why are misperceptions of weight bad?
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misperception
less motivation to improve own health behaviors less awareness of overweight/obese children's risks/needs less overall public health/psych |
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which groups assessed int he Rudd Report were most frequently reported as showing weight bias?
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health professionals
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how can health professionals reduce weight bias
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being more sympathetic towards patients of a heavier weight
- do not immediately make assumptions due to a person's weight. [ physically accommodating waiting room. |
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T/F the media promotes weight bias
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true
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how does culture/ethnicity influence weight perception
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varied perceptions of what "healthy weight" looks like
- in some cultures obesity does not necessarily equal bad. |
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Definition of vanity sizing
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change to standardized measurements for clothes, as a means to increase sales.
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estimated amount of money that is directed towards obesity-related conditions in healthcare
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~ $147-210 billion/year
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