OBESITY (cont.

)
Arun to edit Click ThulasiMaster subtitle style MD (Y&R) 2ND Semester

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General Introduction

Environmental forces Vs. Individual gene substrate = OBESITY Remember

Overweight Obesity

BMI above 27 kg/m2. BMI above 30 kg/m2.

Fat topography has a profound influence on the health risk. White adipose tissue (WAT) is the physiological site of energy storage 4/28/12

PREVALENCE

As of 2008, The World Health Organization claimed that 1.5 billion individuals over the age of 20 are considered obese . The rate of obesity also increases with age at least up to 50 or 60years old . By 2015, WHO estimates that approximately 2.3 billion adults will 4/28/12 overweight and more than 700 be

PATHOGENESIS
1)

Gene susceptibility Fat cell & obesity Environmental factors Pro-inflammatory factors

1)

1)

1)

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1.

Gene susceptibility

Extensive studies have indicated that 30-50 % of the fat variability is believed to be genetically determined. Mainly 4 genes have been identified that is believed to be causing obesity:
i. ii. iii.

Leptin gene TNF gene small

(mainly) overall contribution is

3 adregenic receptor gene

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Leptin gene

Leptin is one molecule that provides for this coupling between energy intake and energy expenditure. Leptin protein is normally secreted from fat cells its circulating levels are high in obesity. 4/28/12

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2. Fat cell & obesity

Most forms of obesity are associated with enlarged fat cells. Fat cells fat storage + secretory organ Fat cell generates lots of lactate glucose metabolism glycerol-3phosphate TG synthesis

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3. Environmental factors:

Environmental factors interact with genetic susceptibility. E.g.: hypothalamic injury (trauma) lesion in ventromedial nucleus hyperphagia OBESITY

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4. Pro-inflammatory factors: What is adiponectin?

o

It is an insulin-sensitising effector, which helps to counteract the effects of obesity. circulating adiponectin levels are decreased in obesity-related insulin resistance, type 2 diabetes and coronary heart disease. It inhibits liver neoglucogenesis and promotes fatty acid oxidation in skeletal muscle.

It counteracts the pro-inflammatory effects 4/28/12 of TNF- on the arterial wall

WAT infiltrated by macrophages Pro-inflammatory cytokines produced (leptin,TNF-,IL-6,resistin) Insulin resistance

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adiponectin

Hypothyroidism

Other factors that affect obesity

Medications such as birth control pills, antidepressants, and antipsychotics. Menopause (oestrogen affects obesity). Pregnancy (glucose homeostasis & fat oxidation are all disrupted by maternal obesity) Quitting smoking ( nicotine

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Some researches

Risk for Alcoholism Linked to Risk for Obesity (reward centre) -Science Daily (Dec. 31, 2010)

How Fatty Diets Cause Diabetes (damage of glycosyltransferase) -ScienceDaily (Aug. 15, 2011)

Link Between Brain Molecule and Obesity and Diabetes Discovered 4/28/12

Related with yoga.

Yoga Reduces Cytokine Levels Known to Promote Inflammation ScienceDaily (Jan. 14, 2010)
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Many of the metabolic disturbances associated with obesity and the metabolic syndrome may be due to cytokine production by adipocytes. Particularly IL-6, associated with stress, reduced with yoga practice.

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Regular Yoga Practice Is Associated With Mindful Eating ScienceDaily (Aug. 16, 2009)
o

Mindful Eating- those were aware of why they ate and stopped eating when full. A strong association between yoga practice and mindful eating

no association between other types of physical activity, such as walking or running, and mindful eating 4/28/12
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Yoga's Ability to Improve Mood and Lessen Anxiety Is Linked to Increased Levels of a Critical Brain Chemical, Research Finds - [ ScienceDaily (Nov. 12, 2010)]
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GABA is the chief inhibitory neurotransmitter which regulates neuronal excitability; associated with anxiety.

Brain GABA increases with fat feeding; balances between energy dense diet & 4/28/12 suppression of food.
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Thank you
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