170 likes | 264 Views
Endocrine System 2. CO Mendivil. Part 2: Metabolism. The concept of obesity. Obesity is an increase in body adipose tissue up to a level that negatively affects health. Which is that level?. Overweight or obesity. B.M.I. above normal. Adiposity. Body fat greater than normal.
E N D
Endocrine System 2 CO Mendivil
The concept of obesity Obesityisanincrease in bodyadiposetissue up to a levelthatnegativelyaffectshealth Which is that level?
Overweightorobesity B.M.I. above normal Adiposity Bodyfatgreaterthan normal Central obesity Abnormaldistribution of bodyfat risk of disease and death
= DM2 = Colelitiasis = HT = CVD Are overweight and obesityrisky? Women 8 7 6 Relative risk 5 4 3 2 1 26 27 28 29 30 <21 22 23 24 25 BMI (Kg/m2) NEJM 1999 321:427-33
Are overweight and obesityrisky? Osteoarthritis Sleep apnea Menstrual irregularities Anovulation Infertility Cancer
Cancertypesassociatedwithobesity: 1. Esophageal 2. Stomach 3. Colorectal 4. Liver 5. Gallbladder 6. Pancreas 7. Prostate 8. Kidney 9. Non-Hodgkinlymphoma 10. Multiplemyeloma 11. Leukemia 12. Breast 13. Uterus 15. Ovary
Whatisthe cause of obesity? 3 BIG FACTORS Economic, social and cultural aspects Genetic susceptibility Energy imbalance
Thebody’ s bankaccount Out In Almostfixed BASAL METABOLIC EXPENDITURE ADAPTATIVE THERMOGENESIS PHYSICAL ACTIVITY STOCK (ADIPOSE T.) Food intake We can intervenehere
NPY Energy expenditure Appetite Central regulation of appetite LEPTIN Leptin
NPY Appetite Energy expenditure Central regulation of appetite WHAT HAPPENS IN OBESITY? Leptin
Diagnosis of overweight and obesity Dx IMC (Kg/m2) Underweight <18,5 Normal 18,5-24,9 Overweight 25,0-29,9 Grade 1 obesity 30,0-34,9 Grade 2 obesity 35,0-39,9 Grade 3 obesity >=40
Diagnosis of central obesity Waistcircumference Men > 90 cm > 80 cm Women Waist/hip ratio Increased risk > 0,95 > 0,8 Men Women
Planning a diet Caloriccontent of: Cal/g Fats 9 Proteins 4 Alcohol 7 3,85 Carbohidrates Lean mass 1 Adiposetissue 7
Planning a diet Characteristics of macronutrients Fat CH Prot Ability to induce the end of feeding Medium High Low Ability to supress hunger Low High High Energetic density High Low Low Ability to be stored in the body High Low None
Long termefficacy of dietalone Suspension of dietary intervention 0 2 4 6 Weightloss (Kg) 8 10 12 14 0 2 4 6 8 10 12 14 16 18 Time (months) Med Sci Sports Exerc 1985 17:466-71