student presentations 22 october and 19 november- no lectures on those days
TRANSCRIPT
Student presentations 22 October and 19 November- no lectures on those days
Coxsackievirus B (CVB) but also rotavirus mumps virus and cytomegalovirus . Rubella virus has been suggested to cause type 1 diabetes, but so far only congenital rubella syndrome has conclusively been associated with the disease . The prime viral candidates for causing type 1 diabetes in humans are enteroviruses. Flu virus also implicated.
A note-taker has been requested for NUTR 2101.
The note-taker is a student the Nutrition 2101 class who simply photocopies (a photocopier is available here at the centre) their notes or emails them to the Centre if they are typed, from the beginning of the term and continues to do so for the remainder of the fall term 2013. They will be paid $100 at the end of the term for hand written notes or $150 for typed notes. Any interested students to come to the Jennifer Keeping AccessAbility Centre, where Ms. Campbell will further explain the process.
The
Lecture 4- 1 October 2013
Type 2 Diabetes
Outline of today’s talk
I. Pathology
2. Socioeconomic factors contributing to the diseases
2I. Elementary nutritional approaches to be taken to avoid and treat type 2 diabetes including foods
available to those at risk
IV. First Nations and other Cape Breton individuals at risk
V. How is nutritional assessment made for type 2diabetes?
VI. How would one assess from a nutritional perspective the socioeconomics, pathology and success of
nutritional interventions relative to type 2 diabetes?
Type 2 diabetesI. PathologyObesity leads to dyslipidemia (elevated
triglycerides, decreased HDLc, increased sd-LDL-c, increased lipid oxidation), increased blood pressure, decreased insulin sensitivity = metabolic syndrome(increased platelet reactivity considered by some to be part of metabolic syndrome)
metabolic syndrome may lead to T2D
Food and hence nutritional choices depend on:
Personal preference
acceptance of certain foods-implicationsversus type I?
Habit-caregiver should be careful here- why?
how different from type I?
Food and hence nutritional choices depend on:Ethnic heritage or tradition
which groups would be more susceptible to type 2 diabetes?
Social interactionimpact of social interaction on obesity?
Food and hence nutritional choices depend on:Availability of food
if only offending foods available this can be concern-fast foods, ready prep foodsthat are calorie including fat laden
Convenience of food
fast foods-hamburgers,chips,pizza, donuts, ice cream
ready prep foods-those that are calorie including fat laden
Food and hence nutritional choices depend on:
Economy of food-this may discourage type 2 diabetes
can eat well on a low budget-how?
Positive and negative association-positive –obesity
-negative- examples of implications foravoidance of weight gain or inducing weight loss
Food and hence nutritional choices depend on:
Emotional conflict-comfort food-suggestions for this?
risk of obesity
Values-implications for obesity?
-implications for weight loss?
Food and hence nutritional choices depend on:Body image
may encourage slimness-emphasis onthin is beautiful in our society
Advertisingfood companies and fast food companies
always promoting larger servings
supersizing type 2 diabetes
More on socioeconomic factors
Prestige-occupational
-decisions on healthy foods- obesity is the central issue here
-societal perceptions-who is to be listened to about various diets, nutraceuticals and functional
foods-education
-informed choices about foods that willprevent or reduce obesity
More on socioeconomic factors
Powerinfluence on government policy-what is
considered to be fair advertising-this appliesto major food companies including fast foodcompanies
Incomesometimes poorer people tend to buy junk
food that is rich in empty kcal-however richer people can also do the same
More on socioeconomic factors
Wealthcomment about power fits in here regarding type 2 diabetes
Educationusually, but not always, better educated
persons make healthier choices about foodsthat increase or reduce obesity
More on socioeconomic factors
Social stratification-ancestry-gender-race-aboriginals and convenience stores-ethnicity-mobility-ability to get to quality food
-ability to exercise-mental and physical illness
mental illness-comfort food issuephysical illness- lack of exercise inducing
obesity
More on socioeconomic factors
Class-uppers-lower uppers-upper middles-average middles-working class-lower class
type 2 diabetes tends to affect allclasses-money or lack thereof
is not an issue
More on socioeconomic factors
Global economyno real impact given that type 2 diabetesis rampant all over the world
Government-anti-obesity campaigns- physical activity
guide and Canada’s food guide
More on socioeconomic factorsBusiness
advertisingsupersizing type 2 diabetes
Psychologyeating simply for something to do-obesity-group dynamics- eating more in social
settings
History-history of development of fast foods and easy prep high fat foods has played a huge role in the development of type 2 diabetes
Elementary nutritional biochemistry of nutritional approaches that use foods available to those at risk
Planning a healthy diet
To do this bear in mindAdequacy
BalanceEnergy controlNutrient densityModerationVariety
Elementary nutritional biochemistry of nutritional approaches that use foods available to those at riskPrevention-obesity
Post-onset-obesity-carbohydrate-simple sugars
-sweeteners if in fats an issue
-fibre-may inhibit glucose uptake but effect is not significant
Elementary nutritional biochemistry of nutritional approaches that use foods available to those at riskPost-onset-obesity
-protein-conversion to carbohydrate depends on insulin resistance
-fat- an issue- dyslipidemia compared to non-diabetics
-alcohol-blocks gluconeogenesis-not an issue
-sodium-hypertension-an issue-vitamins and minerals-not indicated as
supplements except chromium and magnesium which boost insulin sensitivity-perhaps also antioxidants
IV. First nations and other Cape Breton individuals at risk.
Aboriginals-thrifty genes and a move away from traditional dietary habits-cause obesity
Genetics-some individuals predisposed to weight gain- eg low leptin
Others?
How is nutritional assessment made for type 2 diabetes?
Nutrient intake analysiscaloric intake and particularly thefat intake is an issue- why?
vitamins and minerals relative tolow antioxidant chemicals in blood
How is nutritional assessment made for type 2 diabetes?
Daily food record/Diary-same measures of interest
as per nutrient intakeanalysis
How is nutritional assessment made for type 2 diabetes ?
Retrospective data
food frequency questionaire24-hour recall
do both to act as cross check against each other
How is nutritional assessment made for type 2 diabetes ?
Anthropometry
waist measurement-central obesityweight and height giving BMI
How is nutritional assessment made for type 2 diabetes ?
Nutrition focussed physical examobesity is the focus here particularly
central obesity
blood pressure
How is nutritional assessment made for type 2 diabetes ?
Skin testingirrelevant in type 2 diabetes
How is nutritional assessment made for type 2 diabetes ?Biochemical analysis
Blood concentrations of:HDLc downmore small dense LDLmore oxidised LDLtriglycerides (VLDL and CM) upfree fatty acidsc-reactive protein?leptin ?lipoprotein (a)?
How is nutritional assessment made for type 2 diabetes ?Biochemical analysis
Blood concentrations of:
glycated proteinfasting insulin is higherfasting blood glucose is higherpost-prandial insulin and blood
glucose are higherpost-prandial lipemia is higher
How is nutritional assessment made for type 2 diabetes?
CLASSIFYING MALNUTRITION
-obesity is the central issue here-obesity is considered to be a form of
malnutrition
VI. GROUP DISCUSSION-HOW WOULD ONE ASSESS FROM NUTRITIONAL PERSPECTIVE THE SOCIOECONOMICS, PATHOLOGY AND SUCCESS OF NUTRITIONAL INTERVENTIONS RELATIVE TO TYPE 2 DIABETES ?