NUTR 3336Exam # 1 Study Guide Lectures: 1 - 2Lecture 1 (Online 1/23/15)ObesityWhat do these terms mean: Pathophysiology, pathogenesis, epidemiology, and etiology? What is obesity? What are the assessments for measuring body fat? What is the formula for body mass index? What are the different body fat distribution types? What is the epidemiology of obesity? What is the etiology of Obesity? What is the pathogenesis/pathophysiology of obesity?1. What do these terms mean? Pathophysiology Pathogenesis Epidemiology Etiology2. What is Obesity An excess of adipose tissue A proportion of body wt composed of adipose tissue (percent body fat) that exceeds a range that is considered “healthy”3. Assessments for Measuring Body Fat Skinfold test Underwater weighing Bioelectrical impedance Air-displacement plethysmography Dual-energy x-ray absorptiometry4. Body Mass Index Body Mass Index (BMI) Kg/m² OR (weight in pounds x 703)/(height in inches)²► Body Mass IndexBMI Classifications:Underweight < 18.5Normal 18.5-24.9Overweight 25-29.9Obesity (class 1) 30-34.9Obesity (class 2) 35-39.9Extreme Obesity (class 3) > 405. Body Fat Distribution 2 Types Abdominal or Central► Usually in males► Apple or android shape Lower body► Usually in females► Pear or Gynoid► Epidemiology of Obesity6. Obesity is an “EPIDEMIC” “Globesity”According to WHO (World Health Organization) Less than 5% in some nations to greater than 75% in others.7. Obesity in America Epidemiology of Obesity Obesity in the United States► From 1976-1980 to 2011-2012 the percentage of obesity increased from 15-34.9%► 34.9% of US adults are obese► 17% of children (ages 2-19yr) are considered obese► Results from NHANES 1999-2002, indicate 65% of US adults are overweight or obese► JAMA. 2014;311(8):806-814. doi:10.1001/jama.2014.732.8. Epidemiology of Obesity Race/Ethnicity Socioeconomic Status Age Etiology of Obesity9. Etiology of Obesity The original theory is that obesity develops when chronic energy intake exceeds energy expenditure Etiology of obesity is very elusive! It seems like a simple concept but is actually a heterogeneous group of disorders Etiology of Obesity10. Obesity can be caused by: Medical Disorders Medical Treatments Genetics Obesigenic Environment11. Etiology of Obesity12. Obesity can be caused by: Obesigenic Environment Average Energy Consumption Increases Year 1971-1974 1999-2000US adult Males 2450 kcals 2618 kcalsUS adult Female 1542 kcals 1877 kcals13. Etiology of Obesity How does lack of energy expenditure contribute to obesity? Automated work environment Neighborhood environment Busy lifestyles► Convenient tools to assist with household Reduction in physical education programs in schools14. Pathogenesis/Pathophysiology of Obesity15. Multifactorial Effect of glandular conditions Hormonal involvement Genes= inconsistent results overconsumption of energy without adequate energy utilization16. Pathogenesis of Obesity17. Leads to MANY comorbidities including: Cardiovascular Disease Blood Lipid Problems Diabetes Hyperinsulinemia and Insulin Resistance► Pathogenesis of Obesity► Leads to MANY comorbidities including: Hypertension Respiratory Problems Gallbladder Disease ArthritisDiseases of the Cardiovascular SystemCV the leading cause of death in what group of people in the U.S.? What is the anatomy and physiology of the CV System? What is hypertension? What is the epidemiology of HTN? What is the Etiology of HTN? What is the pathogenesis/pathophysiology of HTN? What is atherosclerosis, and its epidemiology/etiology? Difference between LDL and HDL? Atherosclerosis pathogenesis and pathophysiology? What Is IHD, it’s epidemiology, etiology, pathophysiology, and pathogenesis? What is PAD and CHF: epidemiology, pathogenesis/pathophysiology?Cardiovascular Disease is the LEADING cause of death in both men and women in the US► Anatomy and Physiology of the Cardiovascular System The Heart►3 layers Epicardium Myocardium Endocardium Electrical activity of the heart►Through intercalated discs electrical impulses pass from one cell to the next Cardiac cycle►Repeating contraction and relaxation of the heart Contraction (the systole) Relaxation (the diastole) Cardiac Function►Stroke volume Amount of blood ejected with each contraction of the left ventricle Regulated by end-diastolic volume (EDV), mean arterial pressure (MAP), and strength of ventricular contraction Regulation of Blood Pressure►MAP determined by cardiac output and total peripheral resistance►MAP must be regulated so that it is high enough to force blood through systemic circulation without being so high that it causes vascular damage►Regulated by the sympathetic nervous system, the renin-angiotensin system, and renal function Regulation of MAP con’t:►SNS Short term regulation► 3 parts: Receptors, vasomotor center in the medulla of the brain, tissues► Renin- angiotensin system Long term regulation► Renin secreted when BP low► Angiotensin II- causes kidneys to decrease Na and H2O excretion; causes arterioles and viens to constrict; increases secretion of aldosterone►Regulation of MAP con’t Kidneys► Regulate BP by altering Na and H2O excretion such that extracelluar fluid volume remains constant despite a wide range of Na and fluid intake► Hypertension (HTN) Definition- the chronic elevation of BP►Measurement expressed using systolic/diastolic Systolic: Maximum Pressure Diastolic: Minimum Pressure Epidemiology►67 million American adults have high blood pressure►Nearly 1 in 3 American Adults are considered prehypertensive►In 2009, more than 348,000 American deaths included high blood pressure as the primary or contributing cause of death►CDC. Vital signs: awareness and treatment of uncontrolled hypertension among adults—United States, 2003–2010. MMWR . 2012;61(35):703–9.►Go AS, Mozaffarian D, Roger VL, et al. Heart disease and stroke statistics—2013update: a report from the American Heart Association. Circulation . 2013;127:e6–245. Etiology►primary HTN Idiopathic 90% of HTN cases►Secondary HTN Occurs as a result of another primary problem HTNReference Values:Normal: 120/80Prehypertension:120-139 or 80-89Stage 1:
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