IPHY 2420 1st Edition Lecture 34Outline of Last Lecture – December 3, 20141. HUNGER IN AMERICA2. Food Insecurity3. Pattern of Malnutrition4. US Programs to Address Food Security5. Private Food Sources6. 3 Step Burden7. What does $10.00 Buy?8. Food Desert9. Effects of Hunger10. SolutionsOutline of Current Lecture – December 5, 20141. Obesity and Surgery 2. Obesity Exacerbating Conditions3. Other Issues With Obesity4. Gut Microbiota5. What can you do to lose Weight?6. What if you can’t loose Weight?Current Lecture:1. Obesity and Surgery - Many different reasons for obesity- Epidemiology: How we study diseases- who is at risk?o Higher rates for women then meno All racial and ethnic groups are vulnerableo Rapid rise exceeds genetics – external and environmental causeso Childhood obesity rates are concerning- Modifiable Risk Factors: Dietaryo Increased calories from beverages – soda, free refills, empty calories and sugaro Shift to more saturated and processed fats – eating outo Decreased intake of fiber – fiber is bulking agent to fill you up fastero Portion size – eating huge amounts, so you eat everything on your plateThese notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.o Simple Sugars – easy translation into fat. - Modifiable Risk Factors: Physiologicalo Stress – body creates fato Forfeiting lactation – lose protection against obesity for mother and infant – breastfed children seem to have a lower body weight FOR life then formula fed babies.o Stressors in the fetal environment – thrifty gene/gestational diabetes/epigenetics.- Modifiable Risk Factors: Lifestyleo Exposure to chemicals that act as endocrine disruptors (BPA – heated bottle releases BPA into milk. The plastic/BPA acts as estrogen and increases how much fat our bodies holds onto.)o Indoor living- altered circadian rhythm – when you feel alert and when you feel tired. Staying inside and not getting physical activity – causes body to hold onto fat.o Amount of processed food eaten – lots of sugar and salt2. Obesity Exacerbating Conditions- Things that make obesity worse if you are already obese.o Amount of time sitting per day – how much you sit correlates with increased chance of cardiovascular disease.o Asthma- interferes with aerobic activity (Chronic and cold weather induced – some medications have steroids in them that may cause weight gain)o Depression/Emotional Eating- endorphins- fats/sugars, antidepressants may cause weight gain. When people are upset they cope with food. o Eating disorders- even anorexia, most disorders result in weight gain. Body thinksit is starving so short-term-thrifty gene. o Sleep disturbance- sleep apnea – contributes to insulin resistance, cycle betweenobesity and sleep apnea and diabetes type 2. o Restless leg syndrome: Not being able to sleep - when you don’t complete an entire REM cycle many get up and eat something.o Type 2 Diabetes: eating to regulate insulin, cravings – have to eat when not hungry.o Peripheral Edema: All around the ankles you become swollen. This results in a lack of exerciseo Muscle Atrophy: The more muscle you lose, you don’t need as much energy and lose ability to burn more calories (wheelchairs, elderly.) 3. Other Issues With Obesity- Sex hormone imbalanceo One third of Americans have trouble conceivingo Fertility medications cause weight gain – Obesigenic – the more you are obese the harder it is to conceive. o Pregnancy/Menstruation: Before/After PMS women eat more and this leads to obesity- most women do not lose baby weighto Hormone imbalances: fat produces estrogen- Subclinical Hypothyroidismo When your thyroids are not working fast enough you can’t lose weight as easilyo 1 in 10 Americanso Low in Iodine: Diet foods are low in salt, not getting enough salt.- Time of year birthed:o Born in cold months – more chance to be obeseo Born in warm months – less chance.4. Gut Microbiota- Are Americans overweight because they take antibiotics?- Family of gut bacteria that help people stay thin, if you have a high number of that bacteria it is 100% based on genetics.- HPylori – ulcers, but also regulates ghrelin (that is a hormone that increases appetite) - Without HPylori we don’t get a signal to stop eating. - Industrial farming: Cows/Animals on farms are full of antibiotics and are transferred to us through consumption (avoid with organic or grass fed beef)- 2/3 of gut bacteria due to antibiotics (then rest of world)- American Gut project: Gut Biota- plants/alcohol/exercise/sleepo Gut/mouth/skin $99 o Humanfoodproject.com/americangut/- The gut biota will reflect your lifestyle.5. What can you do to lose Weight?- More fiber and water – bulking effect- Lean proteins – no need for saturated fat- Less saturated fat – clogs arteries- REDUCING CALORIES - Superfoods- INCREASE ACTIVITES – Burning calories 6. What if you can’t loose Weight?1. Gastric Banding: Binds stretch receptors so you feel more full more often. Trocars- inserts so you don’t get cut open (surgical tube) – Does not alter digestive function – normal route of digestion. Band tightened with saline, creating small stomach pouch. Only kind that is removable – least success rate. People lose the weight, remove band and have bad eating habits and gain weight back. Cheapest and easiest. 2. Gastric Sleeve: Permanent solution that reduces side of the stomach – holds less then regular stomach. Only holds 1/10th of original stomach food. Makes you full after one banana.3. Gastric Bypass: Most extreme of all surgeries – removes most of stomach, and connects it directly to the small intestine – the rest of the stomach is left for whole life. Chemical interactions with bile happen in the intestines not the stomach. Highest success