Nutritional Disorders (1)

7/31/2019 Nutritional Disorders (1)

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OBESITY


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is a medical condition in which excess body fathas accumulated to the extent that it may havean adverse effect on health, leading to reducedlife expectancy and/or increased health

problems.CAUSES

Diet

Sedentary lifestyle

Genetics Other illnesses

Social determinants

Infectious agents


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DIET AND HEALTHY LIFESTYLE

EXERCISE

XENICAL

BELVIQ

BARIATRIC SURGERY


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refers to the effects of excessive vitamin A

(specifically retinoid) intake.

SIGN AND SYMPTOMS nausea

vomiting

headache

dizziness

blurred vision

loss of muscular coordination.


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Hypervitaminosis A occurs when themaximum limit for liver stores of retinoids isexceeded

The excess vitamin A enters the circulationcausing systemic toxicity. Betacarotene aprecursorform of vitamin A typical ofvegetable sources such as carrots, isselectively converted into retinoids, so it

does not cause toxicity; however,overconsumption can cause carotenosis abenign condition in which the skin turnsorange.


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Vitamin A causes cells to swell with fluid; too

much vitamin A causes them to rupture in

hyposmotic environments, hence the toxicity.

Toxicity has been shown to be mitigatedthrough vitamin E (tocopherol), cholesterol,

zinc, taurine, and calcium. Cholesterol has

been shown to prevent retinol induced golgi

fragmentation.


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03 years: 600 g or 2000 IU

48 years: 900 g or 3000 IU

913 years: 1700 g or 5665 IU

1418 years: 2800 g or 9335 IU 19+ years: 3000 g or 10,000 IU


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is a nervous system ailment caused by a

thiamine (vitamin B1) deficiency in the diet.Thiamine is involved in the breakdown of

molecules such as glucose and is also foundon the membranes of neurons.


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severe lethargy

fatigue

together with complications affecting the

cardiovascular nervous,

muscular

gastrointestinal systems


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Dry beriberi and Wernicke-Korsakoff

syndrome affect the peripheral and central

nervous system respectively.

Wet beriberi affects the cardiovascular

system, as well as other bodily systems.

Infantile beriberi affects mostly children indeveloping countries.


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By the time significant edema occurs, the hearthas been exposed to a severely high workload inorder to pump the required cardiac outputneeded to satisfy end organ requirements.

Parts of the heart muscle undergo overuse injury,which results in the physical symptoms oftachycardia, edema, and high arterial andvenous pressures.

These changes can lead to myocardial injury,

expressed as chest pain.

A more rapid form of wet beriberi is termedacute fulminant cardiovascular beriberi, orShoshin beriberi.


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The predominant injury is to the heart, and rapiddeterioration follows the inability of the heartmuscle to satisfy the body's demands because of itsown injury. In this case, edema may not be present.

Instead, cyanosis of the hands and feet, tachycardia,

distended neck veins, restlessness, and anxietyoccur.

Treatment with thiamine causes low-output cardiacfailure, because systemic vasoconstriction isreinstated before the heart muscle recovers.

Support of heart function is an added requirement atthis stage, and recovery is usually fairly quick andcomplete if treatment is initiated promptly.However, if no treatment is available, death occursjust as rapidly (within hours or days).


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Dietary thiamine

Food that are rich in thiamine are as

follows[1] (see Table 1, below):

Whole-grain foodsMeat/fish/poultry/eggs

Milk and milk products

Vegetables (ie, green, leafy vegetables;

beets; potatoes)

Legumes (ie, lentils, soybeans, nuts, seeds)

Orange and tomato juices


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is a vitamin deficiency disease most

commonly caused by a chronic lack of niacin

(vitamin B3) in the diet.

It can be caused by decreased intake ofniacin or tryptophan and possibly by

excessive intake of leucine.

It may also result from alterations in protein

metabolism in disorders such as carcinoidsyndrome.(A deficiency of the amino acid

lysine can lead to a deficiency of niacin, as

well)


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Pellagra is classically described by "the four D's":

diarrhea, dermatitis, dementia and death.A

more comprehensive list of symptoms includes:

High sensitivity to sunlightAggression

Dermatitis

alopecia

edema

Smooth, beefy red glossitis

Red skin lesions


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Insomnia

Weakness

Mental confusion

Ataxia, paralysis of extremities, peripheralneuritis

Diarrhea

Dilated cardiomyopathy

Eventually dementia


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Pellagra can develop according to severalmechanisms, all of which ultimately revolve

around niacin deficiency.

The first is simple dietary lack of niacin.

Second, it may result from deficiency of

tryptophan, an essential amino acid found

in soybeans, meat, poultry, fish, and eggs

that the body converts into niacin.Third, it may be caused by excess leucine,

though the relationship is unclear.


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Alterations in protein metabolism may alsoproduce pellagra-like symptoms. An example iscarcinoid syndrome, a disease in which carcinoidtumors produce excessive serotonin.

In normal patients, only one percent of dietary

tryptophan is converted to serotonin; however,in patients with carcinoid syndrome, this valuemay increase to 70%.

The diversion of tryptophan to making serotonin

in patients with metastatic tumors can result intryptophan deficiency.

Carcinoid syndrome thus may produce decreasedprotein synthesis, niacin deficiency, and clinical

manifestations of pellagra.


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treatment is with nicotinamide, a chemical

related to niacin.

The frequency and amount of nicotinamide

administered depends on the degree towhich the condition has progressed.


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is a disease resulting from a deficiency of

vitamin C, which is required for the synthesis

of collagen in humans.

The chemical name for vitamin C, ascorbicacid, is derived from the Latin name of

scurvy, scorbutus, which also provides the

adjective scorbutic ("of, characterized by or

having to do with scurvy")


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malaise and lethargy

After 13 months, patients develop shortness

of breath and bone pain.

Myalgias may occur because of reduced

carnitine production.


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Other symptoms include skin changes with

roughness, easy bruising and petechiae, gum

disease, loosening of teeth, poor wound

healing, and emotional changes.

Dry mouth and dry eyes similar to Sjgren's

syndrome may occur. In the late stages,

jaundice, generalized edema, oliguria,

neuropathy, fever, and convulsions, andeventual death are frequently seen


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Ascorbic acid is needed for a variety of

biosynthetic pathways, by accelerating

hydroxylation and amidation reactions.

In the synthesis of collagen, ascorbic acid isrequired as a cofactor for prolyl hydroxylase

and lysyl hydroxylase.

These two enzymes are responsible for the

hydroxylation of the proline and lysine aminoacids in collagen.


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Hydroxyproline and hydroxylysine are

important for stabilizing collagen by cross-

linking the propeptides in collagen.

Defective collagen fibrillogenesis impairswound healing. Collagen is also an important

part of bone, so bone formation is also

affected.

Defective connective tissue also leads tofragile capillaries, resulting in abnormal

bleeding.


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Scurvy can be treated by eating food

containing vitamin C such as oranges,

papaya, strawberries, lemon, tablets with

vitamin C.


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Osteoporosis ("porous bones", from Greek:/ostoun meaning "bone" and/poros meaning "pore") is a disease ofbones that leads to an increased risk of

fracture.


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Osteoporosis itself has no symptoms

PATHOPHYSIOLOGY Vitamin D deficiency Low circulating Vitamin

D is common among the elderly worldwide.

Mild vitamin D insufficiency is associatedwith increased parathyroid hormone (PTH)production. PTH increases bone resorption,leading to bone loss. A positive association

exists between serum 1,25-dihydroxycholecalciferol levels and bonemineral density, while PTH is negativelyassociated with bone mineral density.[


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LIFESTYLE

NUTRITION

Calcium and vitamin D decrease the risk ofnon-vertebral fractures in those withpostmenopausal osteoporosis byapproximately 18%.High intake of vitamin Dreduces fractures in the elderly. Vitamin K

prevents bone loss and/or fractures in thosewith postmenopausal osteoporosis,

MEDICATION


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Nutritional Disorders (1)

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