Lec 10: Nutrition (Pt 2) (copy)

Other Lifestyle Treatments for Obesity:

• What are 7 other lifestyle treatments for obesity:

  • Adapt what goals?

  • Reduce calories by how much?

  • Eat which foods?

  • Eat what portions? How fast? Drink what?

• Adapt reasonable weight goals

• Reduce calories by about 250-500 per day

• Eat nutrient dense foods

• Eat small portions, slowly, drink lots of water

Other Lifestyle Treatments for Obesity:

• What are 7 other lifestyle treatments for obesity:

  • Stick to what?

  • Exercises 2 types?

  • Lastly? Notes?

• Stick to a consistent eating schedule

• Exercise

  • (Cardio + Strength Training)

• Journaling

Other Lifestyle Treatments for Obesity:

• Adopt reasonable weight goals:

  • AKA:

  • How much weight lost per week is appropriate?

    • Never exceed how much?

• AKA:

  • Gradual weight loss

  • How much: ½ to 1 lb per week

    • Never exceed 2 lbs

Other Lifestyle Treatments for Obesity:

• Reduce Calories:

  • What type of diets do not work and are harmful?

  • Reduced calories causes what to happen?

• Emphasize Nutrient Dense Foods:

  • Limit what types of food? (3)

• Reduce Calories:

  • Very low calorie diets (<1200 kcals)

  • Metabolism to lower

• Emphasize:

  • Limit: High Fat Foods, Alcohol, Sweets

Journaling:

• Journaling for weight loss is valuable how? (3)

• Journaling also helps with identifying what? (3)

• Valuable:

  • Track progress

  • Builds awareness of eating habits

  • Improved accountability

• Identifying:

  • Patterns

  • Triggers

  • Areas for Improvement

Journaling:

• Research shows that for people interested in losing weight, journaling can be very effective in doing what 2 things?

• One weight loss study of nearly 1,700 participants, those who kept daily food records lost how much weight as those who kept no records?

• 2

  • Changing behaviors

  • Making weight loss more sustainable

• Twice as much

Is weight loss as simple as “calories in” and “calories out”?

• The lack of sleep increases the “hunger hormone” called ____.

  • What 3 things increases this hormone?

• At the same time, _____, the appetite suppresser hormone is reduced

• Ghrelin

  • Sleep, Fasting, Restricting Calories

• Leptin

Is weight loss as simple as “calories in” and “calories out”?

• Lack of sleep (even for a few days) increase what?

  • Presenting what?

• Given the evidence, sleep deprivation appears to be an important, yet modifiable, risk factor for what 3 occurrences?

• Blood glucose levels

• Pre-Diabetes Diagnosis

• 3:

  • Metabolic Syndrome

  • Diabetes Type 2

  • Obesity

What is considered the BEST DIET?

Mediterranean Diet

Is there a specific diet for patients with Parkinson’s?

• Is there a specific “Parkinson’s Diet”?

  • What is this diet based on?

• Some people find what 2 diets helpful for managong symptoms and potentially slowing disease progression?

• Naur

  • Balanced diet of whole foods, fruits, veggies, while grains

• Mediterranean or MIND

Is there a specific diet for patients with Parkinson’s?

• Levodopa is often used to treat PD, and while it can be taken with any type of food, what can sometimes interfere with its effectiveness?

  • This effect is AKA?

• What is it called when a physician considers shifting the majority of protein intake into the end of the day.

• Medication Timing:

  • When is optimal time to take Levodopa?

• Dietary Protein

  • AKA Protein effect

• Protein Redistribution

• Meds:

  • At least 30 min before

    • OR

  • 1-2 hours after meal (esp with meal high in protein)

What pt population do you recommend keto to?

• Avoid for what type of weight loss?

• T/F: Yes, people lose weight early on BUT the long term effects of the keto diet may be DETRIMENTAL and SHORT LIVED

• What is a MUST on Keto diets?

  • T/F: It is required because it does not provide all the necessary nutrients to help the body sustain itself.

  • Keto diets can lead to ____ and ____ due to the lack of ____ and ____.

  • Also, _____ is NOT part of the program, but most likley, people are too tired to exercise.

  • Remember, _____ are the body’s source of energy!

• General Weight Loss

• TRUE

• Supplements

  • True

  • Weakness/Dizziness; Carbs/Glucose

  • Exercise

  • Carbs

What pt population do you recommend keto to?

• Clinically, the keto diet is used to reduce what in children?

• Studies suggest possible benefits for what 3 conditions?

• Hard to Control Seizures

• 3:

  • Bipolar Disorder

  • PD

  • Alzheimers

Intermittent Fasting:

• Define Fasting:

• During fasting, does one have to give up favorite foods, eliminating entire food groups, or count calories?

• Fasting:

  • Eating occurs in short amounts of time

• Naur

Intermittent Fasting:

• What are the 3 types of Intermittent Fasting?

• Which one has MOST metabolic benefits?

  • Most beneficial EATING Window:

  • Most beneficial FASTING Window:

NOTE: When a patient says they participate in Intermittent Fasting, make sure to ask a follow up question of “what type of Intermittent Fasting do you participate in?”

• 3

  • Time Restricted Feeding

  • Once a Month Fasting

  • Twice a Week Fasting

• Time Restricted Feeding

  • Eating: 8-10 hr window

  • Fasting: 14-16 hrs

Intermittent Fasting:

• Define Time Restricted Feeding:

• All kcals for the day are consumed over a few hours (ex. 8am - 6pm)

Intermittent Fasting:

• Define Once a Month Fasting:

• During the fasting days, how much % of normal kcals are consumed?

• Healthy eating the remaining ____ days

• Define:

  • Fasting occurs on 5 consecutive days each month

• 35-50%

• 25 days

Intermittent Fasting:

• Define Twice a Week Fasting:

• How many kcals per day for:

  • Men

  • Women

• Define:

  • Fasting occurs 2x/week (on NON consecutive days) followed by 5 days of healthy eating w/o kcal restriction

• kcals/day

  • M: ~ 500

  • W: 600

Intermittent Fasting:

• A Fasting Mimicking Diet is a type of fasting where a specific meal plan is provided to…

• Simulate the fasting state while providing nutrients and calories on fasting days

Intermittent Fasting: Clinical Results

• Conclusion from 2020 SR:

  • Intermittent fasting shows promise for the treatment of what?

• Bottom line with fasting - there is a ___ ___!

• Obesity

• Calorie Restriction

Pros and Cons of Current Weight Loss Meds:

• New Obesity Drugs (GLP-1 Antagonists): Ozempic, Wegovym, Moujaro

  • GLP-1 hormones is normally found where?

  • GLP-1 secretion suppresses what?

  • GLP-1 ___ ___ the movement of food in the gut so one stays fuller ___.

• In the gut

• Suppresses the appetite

• Slows down; longer

Pros and Cons of Current Weight Loss Meds:

• Drugs that mimic the action of GLP-1 is used for what condition?

• But an ___ weekly can manage obesity.

• Type 2 Diabetes

• Injection weekly

Pros and Cons of Current Weight Loss Meds:

• In clinical trials, these drugs are shown to REDUCE BW in people with what BMI?

  • Mounjaro reduces BMI by how much %?

• Overall, these drugs help reduce what? (2)

• BMI of 27 or greater by ~15%

  • Mounjaro: ~ 20% in one year

• Reduces:

  • Food Noise

  • Risk of Chronic Conditions associated with Obesity

Pros and Cons of GLP-1 Antagonists:

• Does NOT address why a person is ____

• Does not change ___ or ___ ___

• ____ is very common

• Those taking GLP-1 are at greater risk for what 5 conditions?

• Overweight

• Eating or Exercise Habits

• Constipation

• 5:

  • Ileus

  • Gallstones

  • Gastroparesis (delayed gastric emptying)

  • Bowel obstruction

  • Pancreatitis

Pros and Cons of GLP-1 Antagonists:

• Weight loss includes what 2 things?

• Concerns about what 2 conditions?

• T/F: Pts that stop these obesity drugs will pack pounds back on after they stop taking them

• Muscle mass loss and decrease in bone density

• Depression and dementia

• TRUE

Which foods can naturally trigger GLP-1 secretion:

• Foods with (2)

  • Examples:

• T/F: Certain herbal based constituents, such as berberine, tea, curcumin, cinnamon, soybean, reservatrol, and gardenia can exert influence on GLP-1 Secretion

• Foods with:

  • Good Fats (Avocado or Nuts)

  • Lean Protein (Egg and Fish)

• True

Which foods can naturally trigger GLP-1 secretion:

• Foods high in what feed our gut bacteria which the produce short chain fatty acids able to trigger GLP-1 secretion:

  • Food Ex:

• Fermentable Fibers

  • Veggies and Whole Grains