Physci 167- Chapter 6: obesity-associated common diseases of western civilization, diabetes, heart disease and cancer// chapter 7- biology of food choice and addition, hidden clues.
Identifying patients prior to the development of diabetes is one way to deal with the problem, as a result this diagnostic category called Dysmetabolic Syndrome X has been developed with the following diagnostic criteri
1) blood pressure 2) fasting blood sugar 3) waist circumference 4) triglycerides 5) HDL cholesterol
since most people exposed to potentially addictive food do not become addicted, there have been a number of factors proposed that might PREDISPOSE individuals to addiction, these include________
1) genetics 2) intrauterine exposure 3) early childhood 4) adolescent experiences.
This chapter is really focused on the question of food addiction and if____
is overeating a learned behavioral problem or a substance (addictive) related problem, does it stem from high risk PEOPLE prone to addiction or high risk FOODS (society?)// could obesity be the result of food addiction?
A variety of external factors including__________interacting with___influence the accumulation of mutations in the cells
nutrients •senvironment.
Migration data also demonstrates thatindividuals that migrate to a high risk for cancer country
take on the risk of the country to which they migrate within ONE generation.
dyslipidmeia
• a abnormality of lipid metabolism in which there is an overproduction of triglycerides with a depression of good HDL cholesterol adn normal or increased bad LDL cholesterol.
Current research points to the value of programs that provide___
• a degree of structuring of the personal food environment, while allowing room for flexibility in CHOICES and offer the possibility of a LONGER-TERM weight maintenance solution
there is evidence that childhood obesity confers___
• a lifelong increased risk of common forms of cancer.
Brains respond to food similarity the way to which they respond to drugs, an increase in dopamine release form nerve cells due to food cues in an environment is accompanied by____
• a relative lack of dopamine receptors, this down regulation, similar to cocaine or alcohol addictions, could lead to increased foodseeking and an inability to control cosnsumption.
the risk of age-adjusted relative risk of diabetes mellitus increases above a BMI if______which is_______
•27 •overweight but not obese.
type 2 diabetes is the cause of about ________in the U.s. and in the next ten year it is estimated that 70 to 80 percent of all _____will occur in patients with diabesity or type 2 diabetes with obesity
•50% of renal failure •heart disease
the brain stimulates eating and depends on the _____and_____for short and long-term signals to inhibit further eating
•GI tract •peripheral fat.
the progression of glucose intolerance to diabetes millitus involves____
•a period of insulin resistance and progressive beta cell failure.
the degree of_____may be essential in creating the opportunity for food addiction
•access and availability (fast food restaurants)
Dr. pter butler's group is concentrating on events at the beta cell where genetically susceptible obese individuals may be____
•accumulating insulin associated polypeptide which forms AMYLOID sheets leading to APOPTOSIS of beta cells and a failure to KEEP UP with the increased demand for insulin secretion (can't secret inuslin as much)
cancer is due to____
•accumulation of DNA mutations that confer a growth advantage and invasive properties on clones of cells.
there is evidence of sugar______and that sugared high fat foods contribute_____to weight gain
•addiction •most
Newer concepts and scientific discoveries of_____are being applied to food choices and addictive behaviors around foods
•addiction medicine.
Relationship between adult height to the age-adjusted rate of breast cancer
•adult height = marker of pre-pubertal nutrition •increase in childhood obesity incidence in a country, there is an associated INCREASE in adult height.
Chronic diseases, diabetes, hypertension, heart disease, and cancer, all increase in incidence with____
•aging.
the primary risk factor for cancer is___
•aging.
addiction is defined as____
•an acquired chronic and relapsing disorder that begins with some experimentation and pleasurable responses. •leads to continued use and abuse. •compulsory, can't stop, not voluntary
diabetes mellitus is defined as____
•an elevation in blood sugar levels.
for a sizable minority of consumes ________and______are associated with obesity
•biological food ADDICTION and psychological eating disorders
Only 5% of hypertension is due to salt sensitivity, but this disorder does occur. Salty foods will increase____
•blood pressure in patients where obesity is the primary poeblm.
obesity is a risk factor for common forms of cancer including___
•breast, prostate, colon, uterine, kidney, gallbladder, and pancreatic.
A diet rich in________which supply potassium will lower blood pressure significantly compared to the usual diet
•calcium, fruits and veggies.
Dr. Jack Wang and colleagues in New york reported low striatal dopamine D2 receptor availability in association with high BMI in a group of extremely obese subjects, these authors suggest that overeating in these individuals might be a way of___
•compensating for this deficit so that more food would increase DOPAMINE further.
Difficulties of weight control may reflect problems with_____rather than with____
•cues and motivations to eat (internal and external cues) •rather than heightened pleasure from eating. •may be individuals are susceptible to thoughts, emotions and envirnomental cues that prompt overeating and sabotage their attempts to control food urges.
lean body mass decreases with aging due to____
•decreased physical activity •decreased protein intake • hormonal changes in women at the time of menopause and in men with andropause (hormone changes in later life)
There may also be age-related decreases in_______which account for lean body mass decrease with aging
•decreases in hormones that mediate muscle growth and maitenance.
several studies have suggested a difference between liking and ______for foods
•desire
as body mass index (obesity) increases, the risk of hypertension, coronary heart disease and cholelithiasis increases, but the risk of___increases much more rapidly
•diabetes!!! •the relative risks of diabetes with obesity are in the 40 to 100 fold range compared to the 4 to 6 range for the OTHER ASSOCIATED diseases
International correlation data in the late 1960s demonstrated a relationship of age-adjusted breast cancer incidence to___Later studies pinpointed a correlation with ____protein rather than lean protein.
•dietary fat intake •marked a dietary pattern rather than a specific effect of dietary fat •meat protein
neoplastic conversion
•estimated to occur 10 to 15 years prior to diagnosis for most human cancers
prevention and nutrition have only been recently introduced into the curriculum of a minority of american medical schools but___
•form the basis of medical education in much of the rest of the world.
the tendency for the pancreatic beta cell to fail in the presence of chronic insulin resistance may be___
•genetically determined •how chronic insulin resistance leads to failure of pancreatic beta cells may be genetically determined.
Researchers have identified the metabolic syndrome as a disorder which____
•has different criteria than type 2 diabetes but is believed to be the PRECURSOR disease which lasts for 8 to 10 years PRIOR to the onset of diabetes mellitus,
A variety of different types of data support the proposition that obesity, weight concern and repeat dieting may be associated with___
•heightened feelings about or responses to, food or situational cues. •these may disproportionately stimulate overeating in this groups, WITHOUT heightened sense of actual eating pleasure.
Most american physicians today ignore the problem of obesity they will treat patients for___
•high blood pressure, high cholesterol or diabetes with drugs, WITHOUT addressing the UNDERLYING nutritional etiology of these diseases.
the hypertension that is seen in obesity is related to___
•hyperinsulinemia (excess insulin compared to glucose) and increased secretion of catecholamines.
obesity is related to the pathogenesis of heart disease through multiple pathways, including___
•hypertension, increased clottability of the blood and dyslipidmeia
current internal state refers to the___
•immediate momentary psychological (mood) or physiological state
it seems that repeated dieting and rigid all or nothing style contribute to___
•increasing susceptibility to breakdown of dietary restrait.
Food choice is not just about taste preferences and there is not clear evidence that problems of weight control directly reflect___
•individuals differences in food liking or enjoyment.
obesity and genetic susceptibility leads to _____
•insulin resistance
Insulin resistance caused by obesity is characterized by____
•insulin resistance and HIGH insulin levels with normal blood glucose •THEn insulin resistance and DECLINING insulin levels with INCREASED blood glucose.
_______leads to insulin resistance and declining insulin levels with increased blood glucose
•insulin resistance and high insulin levels + normal blood glucose AND impaired pancreatic insulin secretion function
efforts at diet and lifestyle change with aging to prevent chronic diseases including cancer need to include____
•interventions to maintain or increase LEAN BODY MASS !
Although "liking" or pleasure from eating is an important part of food choice, it may____
•make only a modest contribution to overall variation in food choice and eating beacvhiors.
the metabolic activation of potential carcinogens results from the action of____which are in turn affected by____
•metabolizing enzymes • diet and the ingestion of a wide variety of phytochemicals
The types of behavioral and physiological measures cited in this chapter may be useful research tools and may ultimately help to identify points where individuals with weight control problems___
•might be better helped through behavioral or targeted drug treatment!
the carcniogenesis process is often divided into____
•neoplastic conversion and neoplastic development and progerssion
obesity is associated with a dietary patter that is ___
•not only rich in fat and calories, but poor in phytochemicals so that a high risk dietary pattern can cause cancer in GENETICALLY susceptible individuals.
______is important at every stage of carcinogenesis from initiation to promotion to progression to metastasis
•nutrition
through primary prevention as well as nutritional effects on patients with early treated cancer, the hope is to___
•reduce the duration of morbidity as well as lengthen survival. •ultimate goal of research in nutrition and cancer
the reduction in lean body mass in both men and women with aging is associated with____.
•reduced calorie requirements and increased risk of developing common forms of cancer.
With age there is a reduction in lean body mass in both men and women, the decrease is associated with____. The reduced muscle mass may be associated with____
•reduced calorie requirements and increased risk of developing forms of CANCER •increased insulin and reproductive hormone levels in some aging individuals.
with age, there is a ____in lean body mass in both men and women
•reduction
the preventive effects of calorie reduction in animals are likely to be analogous to the prevention and treatment of obesity in humans by either___
•reduction in caloric intake or an increase in physical activity.
changes in body composition during aging affects the levels of _______
•sex hormones, insulin and growth factors which may effect chronic diseases (diabetes, CVD, common forms of cancer)
Dr. Bart Hoebel at Princeton has reported that sugar has____properties imilar to____
•sugar •psychostimulants and opiods
Researchers and subjects often confused liking food with___
•the DESIRE to eat.
It may be important to distinguish between the desire for or motivation to eat certain foods and___
•the actual PLEASURE derived from eating them.
The strong correlation between diabetes and obesity is not merely a coincidence but hightlights____
•the common underlying pathophysiology of obesity which causes the progression to a metabolic syndrome WHICH results in type 2 diabetes.
fast food companies have created foods that are consumed so quickly that____
•the consumption process is initiated and concluded before the stomach distention or psychologic feedback can be activated and intervene.
liking refers to___
•the general PLEASURE derived from a food or foods.
progressive beta cell failure is related to__
•the high secretory demands placed on the beta cell by insulin resistance.
Obesity is the most prevalent nutritional problem in the US today and is a major factor in____
•the pathogenesis of hypertension, diabetes, hypercholesterolemia, heart disease and common forms of cancer.
allopathy
•the use of drugs and surgery to treat disease •what our medical schools are based on.
Because of genetics and environment, children tend to have eating behaviors and attitudes that are similar to___
•their parents or others in their immediate household.
One of every_____americans is overweight, while one of _____is obese
•two •three •some ethnic groups have 1 of 2 women obese, while general population has one of three adults are obese.
perceived appropriateness refers to the ____
•usual use-context (where, when and with whom) in which a food is eaten
By better understanding_________steps can be taken to insulate individuals AGAINST the causes of failure
•why and where in the process of FOOD CHOICE weight control efforts get underminded.
