Chapter 23: Obesity and disorders of nutrition EVOLVE

Which actions are related to the metabolic syndrome associated with obesity? (Select all that apply.) A. Greater macrophage infiltration B. Increased vascularity C. Acute inflammation D. Insulin resistance

A. Greater macrophage infiltration B. Increased vascularity D. Insulin resistance Visceral WAT hypertrophy is associated with release of numerous adipokines, greater macrophage infiltration, increased vascularity, insulin resistance, a chronic proinflammatory state, and altered lipid metabolism, all characteristics of the metabolic syndrome associated with obesity.

Which situations occur during long-term starvation? (Select all that apply.) A. Increased glucagon B. Decreased insulin C. Increased cortisone D. Decreased epinephrine

A. Increased glucagon B. Decreased insulin C. Increased cortisone During long-term starvation, depressed insulin levels and increased levels of glucagon, cortisone, epinephrine, and growth hormones promote lipolysis in adipose tissue.

Which are consequences of anorexia of aging? (Select all that apply.) A. Malnutrition B. Increased oxidative stress C. Loss of vision D. Imbalanced hormones E. Malabsorption syndromes

A. Malnutrition B. Increased oxidative stress D. Imbalanced hormones The consequences of anorexia of aging include malnutrition, physical frailty, mitochondrial dysfunction, reduced regenerative capacity, increased oxidative stress, and imbalanced hormones. Risk factors for anorexia of aging include functional impairments and deficiencies (e.g., loss of vision, poor dentition, inability to prepare foods); medical and psychiatric conditions (such as malabsorption syndromes and depression); loneliness and grief; medications, including polypharmacy; social isolation; and abuse or neglect.

Which is a true statement regarding obesity? A. Non-Hispanic blacks have the highest rate of obesity. B. By 2030, 75% of the United States population will be obese. C. Obesity is defined as a BMI that exceeds 29 kg/m2. D. Two leading causes of death in the Unites States are related to obesity.

A. Non-Hispanic blacks have the highest rate of obesity. Non-Hispanic blacks have the highest age-adjusted rate at 48.1% followed by Hispanics (42.5%), non-Hispanic whites (34.5%), and non-Hispanic Asians (11.7%). It is projected that 42% of people in the United States will be obese by 2030. Obesity is defined as a body mass index (BMI) that exceeds 30 kg/m2in adults and a BMI greater than or equal to the age- and sex-specific 95th percentile of the 2000 Centers for Disease Control and Prevention growth charts in children. Three leading causes of death in the United States are associated with obesity: cardiovascular disease, type 2 diabetes mellitus, and cancer (liver, advanced prostate, ovarian, gallbladder, kidney, colorectal, esophageal [adenocarcinoma], postmenopausal breast, pancreatic, endometrial, and stomach [cardia]).

Which are the roles of leptin? (Select all that apply.) A. Regulates hepatic gluconeogenesis B. Stimulates release of growth hormone C. Regulates insulin sensitivity D. Stimulates lipogenesis E. Regulates lipid metabolism

A. Regulates hepatic gluconeogenesis C. regulates insulin sensitivity E. Regulates lipid metabolism Leptin regulates hepatic gluconeogenesis, insulin sensitivity and glucose, and lipid metabolism in liver, muscle, and adipose tissue. Ghrelin stimulates release of growth hormone (GH) from anterior pituitary cells, release of gastric acid, gastrointestinal motility, and pancreatic secretion of insulin. Endocannabinoids increase appetite, enhance nutrient absorption, stimulate lipogenesis, increase white adipose tissue accumulation by acting at both central (CB1 receptor) and peripheral sites (CB2 receptor).

Loss of visceral and subcutaneous adipose tissue as occurs in anorexia nervosa results in what? (Select all that apply.) A. The accumulation of MAT B. Osteoporosis C. Rheumatoid arthritis D. The accumulation of BAT E. Diabetes mellitus

A. The accumulation of MAT B. Osteoporosis Loss of visceral and subcutaneous adipose tissue as occurs in anorexia nervosa results in the accumulation of MAT and osteoporosis. Obesity is associated with diabetes mellitus and alterations in adipokines, activation of macrophages, and release of inflammatory mediators are associated with rheumatoid arthritis.

Most adipose tissue in the body is what? A. WAT B. BAT C. bAT D. MAT

A. WAT Most adipose tissue in the body is WAT. WAT is located in visceral (central) and subcutaneous (peripheral) stores. WAT also is found in muscle groups providing mechanical protection and sliding of muscle bundles, and bone marrow.

Obesity is associated with what? A. Increased CCK level B. Decreased PYY level C. Decreased AGT level D. Decreased ARC level

B. Decreased PYY level The level of peptide YY (PYY) decreases with increases in adiposity and decreased PYY level is associated with obesity. Cholecystokinin (CCK) is secreted by proximal small intestinal cells following food intake. Its actions include gall bladder contraction, release of pancreatic enzymes and insulin, satiation, and reduced food intake. CCK is reduced in obesity. Angiotensinogen (AGT) is produced in the liver and adipocytes and is increased in obesity. The arcuate nucleus (ARC) in the hypothalamus regulates food intake and energy metabolism by balancing the opposing effects of two sets of neurons. One set of neurons produce agouti-related protein (AgRP) and neuropeptide Y (NPY), collectively known as AgRP/NPY neurons. These neurons promote appetite, stimulate eating, and decrease metabolism (anabolic).

1. Which is a true statement regarding adipose tissue? A. Adipose tissue is classified according to weight. B. Adipose tissue has the same gene expression. C. Adipose tissue has different rates of lipogenesis. D. Adipose tissue is all from the same origin.

C. Adipose tissue has different rates of lipogenesis. Adipose tissue is found in different locations, has different gene expression patterns, different rates of lipogenesis and lipolysis, and different origins.

Protein deprivation in the presence of carbohydrate intake is associated with which clinical condition? A. Bulimia-nervosa B. Anorexia-nervosa C. Cachexia D. Kwashiorkor

D. Kwashiorkor Protein deprivation in the presence of carbohydrate intake is called kwashiorkor (loss of muscle mass with sustained body fat). Anorexia nervosa, bulimia nervosa, and binge eating are psychiatric disorders related to a distorted body image with a desire for thinness and a fear of fatness that results in extreme restrictions in eating habits. Cachexia (also known as cytokine-induced malnutrition) is physical wasting with loss of weight and muscle atrophy, fatigue, and weakness.