1. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 8 Alterations in Body Nutrition

2. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Calories In = Calories Used + Calories Stored Caloric intake is controlled by appetite –Hunger and satiety centers in hypothalamus Calorie use is controlled by metabolic rate –Thyroid hormones –Activity levels Calories are stored in adipose tissue –White adipose tissue –Brown adipose tissue

3. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Tell whether the following statement is true or false. A calorie measures the energy used to break down nutrients.

4. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer False Rationale: A calorie is simply energy measured in heat units (the amount of heat or energy required to raise the temperature of 1 g of water 1° Celsius). Metabolism is the breakdown of nutrients.

5. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Scenario: You just ate a big dinner. Question: How did you know when to stop eating? How do you know you are still full? What will make you feel hungry again?

6. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Short-term Regulation insulin glucagon-like peptide-1 cholecystokinin hypothalamus satiety center feeling of “fullness” oral receptors detect tasting, chewing, swallowing stomach stretches GI tract secretes hormones

7. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Intermediate and Long-term Regulation leptin hypothalamus satiety center feeling of “fullness” increased blood glucose increased blood ketoacids adipose cells release hormones

8. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Question What part of the brain controls both hunger and the feeling of fullness? a.Cerebral cortex b.Hypothalamus c.Reticular formation d.Thalamus e.b and d

9. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer b. Hypothalamus Rationale: The feeding center for hunger and satiety is contained in the hypothalamus. The hypothalamus takes in information from the GI tract, blood, and cerebral cortex in order to determine when to begin eating and when to stop.

10. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Assessing Nutritional Status Body weight Relative weight = actual weight/desirable weight Body mass index = weight (kg)/height (in meters) 2 Percentage of body fat

11. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Upper vs. Lower Body Obesity Courtesy of Ahmed Kissebah, M.D., Ph.D., Medical College of Wisconsin, Milwaukee

12. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Tell whether the following statement is true or false. A BMI that is greater than normal increases an individual’s risk of developing type 2 diabetes mellitus.

13. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer True Rationale: Normal BMI = 18.5 – 24.9. BMI >25 places individuals at increased risk for type 2 diabetes, cardiovascular disease, and hypertension. The higher the BMI is above normal, the greater the risk of health problems.

14. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Malnutrition Marasmus –Too few calories in diet –Too little protein in diet Kwashiorkor –Adequate calories in diet –Too little protein in diet

15. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Protein-Calorie Malnutrition Question: Based on your knowledge of organ functions, what might happen if protein production decreases in the: –Liver –GI tract –Heart –Diaphragm

16. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Eating Disorders Anorexia nervosa Bulimia nervosa Binge eating Question: Which would be the least serious? Why? Which would be the most serious? Why?