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Chapter 10 Disorders of Nutritional Status

Essentials of Pathophysiology. Chapter 10 Disorders of Nutritional Status. The incidence of childhood obesity has remained stable over the last 10 years. More then 90% of body energy is stored in the skeletal tissues of the body. Energy requirements are decreased during growth periods.

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Chapter 10 Disorders of Nutritional Status

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  1. Essentials of Pathophysiology Chapter 10Disorders of Nutritional Status

  2. The incidence of childhood obesity has remained stable over the last 10 years. • More then 90% of body energy is stored in the skeletal tissues of the body. • Energy requirements are decreased during growth periods. • Both anorexia nervosa and bulimia nervosa involve weight fluctuations that may drop to dangerously low levels. • Vitamins A, D, E, and K are known as fat-soluble vitamins. PRE LECTURE QUIZ (TRUE/FALSE) F F F F T

  3. The ______________ Dietary Allowances (RDAs) define the average daily intakes that meet the nutrient needs of almost all healthy persons in a specific age and sex group.   • The body mass index (BMI) uses ____________ and weight to determine healthy weight. • ______________ is defined as a condition characterized by excess body fat. • Waist ______________ is used to determine the distribution of body fat. • _______________, a condition of malnutrition, represents a progressive loss of muscle mass and fat stores owing to inadequate food intake that is equally deficient in calories and protein. PRE LECTURE QUIZ • circumference • Height • Marasmus • Obesity • Recommended

  4. Caloric intake is controlled by appetite • Hunger and satiety centers in hypothalamus • Calorie use is controlled by • Thyroid hormones and • Activity levels • Calories are storedin • White adipose tissue • Brown adipose tissue Calories In = Calories Used + Calories Stored - Set by: metabolic rate Exercise, physical activity, etc. adipose tissue

  5. Tell whether the following statement is true or false. A calorie measures the energy used to break down nutrients. Question

  6. False Rationale: A calorie is simply energy measured in heat units (the amount of heat or energy required to raise the temperature of 1 g of water 1° Celsius). Metabolism is the breakdown of nutrients. Answer

  7. You just ate a big dinner. Question: • How did you know when to stop eating? • How do you know you are still full? • What will make you feel hungry again? Scenario:

  8. Short-termRegulation Food detected by GI tract GI tract secretes hormones oral receptors insulin stomach glucagon-like detect tasting, peptide-1 stretches chewing, cholecystokinin swallowing hypothalamus satiety center feeling of “fullness”

  9. IntermediateandLong-termRegulation EAT excess calories adipose cells Feeling of Well Being Decreasess increased increased release blood blood hormones glucose ketoacids leptin Feeling of Well Being hypothalamus satiety center Stresses of Life feeling of “fullness”

  10. IntermediateandLong-termRegulation Hypothalamus Hunger Center (+) Neuropeptide Y Leptin (-) Feeling of Well Being (-) Adipose cells release leptin Triglycerides (-) Stresses of Life EAT excess calories (+)

  11. What part of the brain controls both hunger and the feeling of fullness? • Cerebral cortex • Hypothalamus • Reticular formation • Thalamus • b and d Question

  12. b. Hypothalamus Rationale:The feeding center for hunger and satiety is contained in the hypothalamus. The hypothalamus takes in information from the GI tract, blood, and cerebral cortex in order to determine when to begin eating and when to stop. Answer

  13. Body weight • Relative weight = actual weight/desirable weight • Body mass index = weight (kg)/height (in meters)2 • 1M= 39.4 in 1 kg = 2.2 lb • Percentage of body fat AssessingNutritionalStatus

  14. If your BMI >= 25 Overweight If your BMI>= 30 Obese If your BMI>= 40 Morbidly Obese Calculate your Body Mass Index (BMI) Weight in Pounds 2.2 Weight in Pounds Divide this by this and put it here this is your BMI 2 Height in inches 39.4 then square it Height in inches

  15. Courtesy of Ahmed Kissebah, M.D., Ph.D., Medical College of Wisconsin, Milwaukee Uppervs. LowerBodyObesity

  16. Clinical Manifestations of Obesity

  17. Tell whether the following statement is true or false. A BMI that is greater than normal increases an individual’s risk of developing type 2 diabetes mellitus. Question

  18. True Rationale:Normal BMI = 18.5 – 24.9. BMI >25 places individuals at increased risk for type 2 diabetes, cardiovascular disease, and hypertension. The higher the BMI is above normal, the greater the risk of health problems. Answer

  19. Marasmus [muh-raz-muhs] • Too few calories in diet and • Too little protein in diet • Kwashiorkor (kwah-shee-awr-kawr) • Adequate calories in diet but • Too little protein in diet Malnutrition

  20. Clinical Manifestations of Kwashiorkor Adequate Calories but a lack of protein

  21. Basic Starvation lack of protein and Calories Clinical Manifestations of marasamus

  22. Question: • Based on your knowledge of organ functions, what might happen if protein production decreases in the: • Liver • GI tract • Heart • Diaphragm Protein-CalorieMalnutrition

  23. Anorexia nervosa • Bulimia nervosa • Binge eating Question: • Which would be the least serious? Why? • Which would be the most serious? Why? EatingDisorders

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