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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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