Student%20Lecture%2019%20%28Diabetes%29 - Lecture 19...

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Unformatted text preview: Lecture 19 Obesity/Inactivity, Diabetes Obesity/Inactivity, Thursday 3­25­09 Extra Credit Proof of completion of online course evaluation. Due 5­7­10. Proof of attending a Purdue Sporting event (ticket stub and picture) plus ½ page summary of applying concept learned in HK368 to what you observed. Due 5­7­10. Ultrasound practice subject. Contact: [email protected] Monday and Friday – 8:30am to 12:30pm Tuesday and Thursday – 9:30am Wednesday – 8:30am to 11:30am Seminar – April 14th, 3:30pm, Armstrong 1109 Discuss Grant Assignment #4 Lecture Finish Obesity and Inactivity Diabetes Outline Outline Dual Energy X-Ray Absorptiometry (DEXA) (DEXA) 2 distinct X­ray beams (low radiation) 30 cm depth penetration Scan rate 1cm/sec Results – – – Strong Correlation between DEXA and Hydrostatic Weighing McArdle, Katch and Katch Bioelectrical Impedance Analysis Bioelectrical Measures the time for electrical current to pass from one extremity to another. How would dehydration affect results? McArdle, Katch and Katch Air Displacement Plethysmography Air BOD-POD Measures pulmonary gas volume which are then subtracted from body volume measurements. McArdle, Katch and Katch Strong Correlation between BOD POD and Hydrostatic Weighing McArdle, Katch and Katch Skinfold Thickness Skinfold Thickness of subcutaneous fat is measured – Body density is calculated using specific equations – Percent body fat calculated from body density What are the disadvantages and advantages of this technique? McArdle, Katch and Katch Skinfold Thickness Sites Skinfold McArdle, Katch and Katch Strong Correlation between Skinfolds and Hydrostatic Weighing McArdle, Katch and Katch Standard Values of Percent Body Fat Standard McArdle, Katch and Katch Why are standards for body fat higher in women then in men? higher McArdle, Katch and Katch Fat Cells Fat billion fat cells in normal individuals billion fat cells in obese individuals Hypertrophic obesity – – Hyperplastic obesity Increase in Increase from kg of body fat McArdle, Katch and Katch – Increase in – Increase from kg of body fat – Reduced ability to lose and maintain weight loss. Figure 18.3 Set Point Theory Set The tendency of a person to return to a certain weight suggests that there is a biological set point for body weight, much like the set points for any negative feedback biological control system Physiological Cognitive Figure 18.4 Figure 18.5 Nutrient Balance Nutrient Static energy balance – Increase intake of ____ kcals•day­1 would lead to __ pound weight gain over one year change of = energy - energy energy stores intake expenditure Nutrient Balance Nutrient _________ energy balance – Increase in energy intake results in increased body weight – Energy expenditure also increases and weight is maintained at a new, higher level – Results in weight gain of only ___ pounds in a year rate of change rate of change of rate of change of = of energy stores energy intake energy expenditure What are the three components of energy expenditure? energy ____________ ____________ ____________ Basal Metabolic Rate (BMR) Basal ____________________________________ ____________________________ – Supine position, immediately after rising, 12­18 hours following a meal – Similar to resting metabolic rate (RMR) Represents ____________ total energy expenditure – Lower in women, declines with age – Related to fat­free mass Reduced in response to reduced caloric intake (dieting or fasting) – Exercise can maintain BMR Thermogenesis Thermogenesis “Heat generation” associated with: Small part of total energy expenditure Not associated with obesity – Ingestion of meals (thermic effect of feeding) Physical Activity Physical Accounts for _________ total energy expenditure Important in determining obesity – Depends on activity level – __________________ __________________ ____________ Figure 18.8 Effect of Exercise on Appetite Effect Most humans – Energy intake is increased across a broad range of energy expenditure – _________________ Formerly _______ individuals – Net loss of appetite on an exercise program – Facilitates weight loss Figure 18.10 Exercise and Body Composition Exercise _________________ _________________ _________________ _________ Weight loss in conjunction with exercise – Less lean body mass is lost – More fat mass is lost McArdle, Katch and Katch Study: Genetics and Obesity Study: Bouchard et al. 1990 12 pairs of twins _____ calories per week in excess of baseline energy requirements Differences in body mass change between twin pairs exceeded differences within twin pairs. ____________________ ____________________ ______________ McArdle, Katch and Katch Study: Nonexercise activity thermogenesis (Levine et al, 1999) thermogenesis 18 nonobese subjects 1000 kcals excess per day 8 weeks ________________________________ Study: Effects of Weight Gain on Walking (Levine et al. 2008) Walking Subjects – 10 lean, 12 obese 1000 kcals excess per day 8 weeks _________________________________ Diabetes Mellitus Diabetes First reported: 100 AD Diabetes (Greek): going through Mellitus (Greek): sweet or honey Prevalence of Diabetes Over 25 Year Period in the United States Year Prevalence of Diabetes in the United States as of 2007 United ___ million people in United States ____ of population Diagnosed Undiagnosed ____ leading cause of death Risk of death is doubled with diabetes – 17.9 million – 5.7 million Diabetes Rates Per County Diabetes California Indiana San Diego 6.0% Tippecanoe 6.4% Ohio Illinois Prevalence of Diabetes by Age Prevalence Group Over 25 Year Period in the United States United 2007 2007 – Age 20­39 2.6% – Age 40­59 ______ – Age 60+ 23.8% Prevalence of Diabetes by Gender Over 25 Year Period in the United States 25 2007 – Men – Women 12 million ______ 11.5 million ______ Prevalence of Diabetes by Prevalence Race/Ethnicity Over 25 Year Period in the United States the 2007 2007 – Non­Hispanic Whites – Non­Hispanic Blacks 3.7 million ______ 14.9 million ______ Rate of new cases of type 1 and type 2 diabetes among youth aged <20 years, by race/ethnicity, 2002–2003 2002–2003 2002­2003 – _______ Rate (per 100,000/year) 50 – ________ 15,000 newly diagnosed Highest in Non­ Hispanic whites 3,700 newly diagnosed Highest in American Indians 40 Type 1 Type 2 30 20 10 0 ALL NHW AA H API AI ALL NHW AA H API AI <10 years 10–19 years CDC. National Diabetes Fact Sheet, 2007. Source: SEARCH for Diabetes in Youth Study NHW=Non-Hispanic whites; AA=African Americans; H=Hispanics; API=Asian/Pacific Islanders; AI=American Indians What is Diabetes Mellitus? What Diabetes mellitus is a disorder of __________________________________ brought about by impaired ______ synthesis or release of insulin, or the inability of tissue to use glucose. Classification of Diabetes Classification Type I diabetes – Results from loss of _____ function and an absolute insulin deficiency Autoimmune disorder linked to genetics Primarily manifests itself in early childhood Type II – Results from _____________________________ accompanied by a relative lack of insulin or impaired release of insulin in relation to blood glucose levels Results from poor lifestyle (nutrition and inactivity) Primarily manifests itself in adulthood Pancreas (Normal) Pancreas _________ – Regulates glucose entry into all cells. – Lypolysis – Produced in the Islets of Langerhans by the beta cells. – Regulates release of glucose into blood from liver. – Produced in the Islets of Langerhans by the alpha cells. _________ McArdle, Katch and Katch Transport of Glucose into Skeletal Muscle Cells (Normal) Muscle Rest­ – _____________________ _____________________ ______________. – Insulin concentrations decrease but demand for glucose increases. – Muscle contraction stimulates GLUT 4 translocation to the membrane. Exercise McArdle, Katch and Katch How does diabetes affect pancreas and skeletal muscle? and Type I – Beta cells do not produce insulin – Blood glucose high – __________________ – Insulin dependent – Initially skeletal muscle becomes insulin resistant (Why?) – ________________________ __________________ – Constant production of insulin causes Beta cells to decrease production of insulin. Normal Type II Insulin Resistant Type II Diabetes McArdle, Katch and Katch Testing for Diabetes Testing _________________ – Infuse insulin into circulation to maintain a constant concentration. – Infuse known amount of glucose and measure the uptake. – Drink a glucose drink – Measure blood glucose 2 hours after – Measure blood glucose following 8­hour fast. _________________ _________________ Classification Categories For Fasting Blood Glucose Fasting Normal Impaired Range – <110mg/dL Suspected Diabetes – >125mg/dL – __________mg/dL What impact does exercise have on diabetes? have Effects of exercise and diet on diabetes (6 year follow up) diabetes McArdle, Katch and Katch What are the underlying mechanisms? mechanisms? Proposed Mechanisms Underlying Beneficial Effects of Exercise on Diabetes Beneficial McArdle, Katch and Katch Majority of data suggests that glucose transport is increased within skeletal muscle transport EJ Henriksen JAP 2002 ...
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This note was uploaded on 02/17/2011 for the course HK 458 taught by Professor Newcomer during the Spring '10 term at Purdue.

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