Post on 02-Jan-2016
description
EndocrineEndocrineSystem 2System 2
Part 2: Metabolism
Overweight or obesityOverweight or obesity
AdiposityAdiposity
Central obesityCentral obesity
B.M.I. above normalB.M.I. above normal
Body fat greater than normalBody fat greater than normal
Abnormal distribution of body fatAbnormal distribution of body fat
risk of disease and death
Are overweight and obesity risky?Are overweight and obesity risky?
Women
NEJM 1999 321:427-33
1
Rela
tive r
isk
BMI (Kg/m2)<21 22 23 2524 29 3026 27 28
4
3
5
6
7
8
2
= DM2
= Colelitiasis
= HT= CVD
Cancer
AnovulationMenstrualirregularitiesInfertility
Osteoarthritis
Sleep apnea
Are overweight and obesity risky?Are overweight and obesity risky?
Cancer types associated with obesity:
1. Esophageal2. Stomach3. Colorectal4. Liver5. Gallbladder6. Pancreas7. Prostate8. Kidney9. Non-Hodgkin lymphoma10. Multiple myeloma11. Leukemia12. Breast13. Uterus15. Ovary
What is the cause of obesity?
3BIG FACTORS
Geneticsusceptibility
Geneticsusceptibility
Energyimbalance
Energyimbalance
Economic,social and
culturalaspects
Economic,social and
culturalaspects
The body’ s bank accountThe body’ s bank account
In Out
Foodintake
BASALMETABOLIC
EXPENDITURE
BASALMETABOLIC
EXPENDITURE
ADAPTATIVE
THERM
OG
ENESIS
ADAPTATIVE
THERM
OG
ENESIS
PHYSICAL
ACTIVITYPH
YSICALACTIVITY
STOCK
(ADIPO
SE T.)
Almost fixed
We can intervene here
Leptin
Appetite
Energyexpenditure
NPY
Leptin
Appetite
Energyexpenditure
NPYResistencia
a
leptina
Resistencia
a
leptina
Leptinresistance
Dx IMC (Kg/m2)
Underweight <18,5Normal 18,5-24,9Overweight 25,0-29,9Grade 1 obesity 30,0-34,9Grade 2 obesity 35,0-39,9Grade 3 obesity >=40
Diagnosis of overweight and obesity
> 90 cm> 80 cm> 90 cm> 80 cm
Waist circumference
MenWomen
> 0,95
> 0,8
> 0,95
> 0,8
Increased risk
Waist/hip ratio
Men
Women
Diagnosis of central obesity
Planning a dietPlanning a diet
Caloric content of:
Fats
Adipose tissue
ProteinsAlcoholCarbohidrates
Cal/gCal/g
473,85
71
9
Lean mass
Characteristics of macronutrients
Ability to induce the end offeeding
Ability to supress hunger
Energetic density
Ability to be stored in the body
Fat CH ProtLow Medium High
Low HighHigh
High LowLow
High NoneLow
Planning a dietPlanning a diet
Time (months)
Wei
ght l
oss
(Kg)
1412108
6
24
0
141210862 4 16 180
Med Sci Sports Exerc 1985 17:466-71
Suspension of dietaryintervention