What is the definition and occurance of obestiy
What is the two-component model
A technique of masuring body composition based on two components: 🔺Fat Mass (FM) - Energy reserve (fat) - Homogeneous composition - Water and potassium free 🔺 Fat Free Mass (FFM) - Health state - Constant ratio of components (minerals, ec/ic water, glycogen)
What are different methods/modles we can use to describe body composition and nutritional status?
What does the body weight measure inform us about?
What does the body condition scoring (BCS) inform us about?
What are the basic causes of obesity
Describe the possible backgrounds of decreased BMR
Describe the connection between neutering and obesity
🔺Neutered dogs: prevalence of obesity 2x!!!
- BMR ⬇️
- Appetite ⬆️
- Physical activity ⬇️
🔺 Fe: castrated Male can dev most severe obesity!
Indoor neut. (diff in dog - female)
🔺 Energy demand 30% ⬇️ (must red. Intake!)
🔺 2-3 body weight and BCS
monitoring in the year following neutering!
Describe the connection btw hypothyroidism and obesity
What are causes of decreased physical activity
🔺Indoor lifestyle - Room dog: 31% - Garden dog: 23% 🔺Aging (Painful joint, bone diseases also a factor) 🔺Owner's lifestyle
Describe higher energy intake as cause of obesity
🔺 Polyphagia (pathology, hormones, drugs)
- Cushing’s syndrome!!, stress, (acromegaly)
- Medications: glucocorticoids, progestins, antiepileptics (phenobarbital)
🔺 Calories (fat and carbohydrates) in food ⬆️
- eg. Diet wrong proportion of nutrients, right amount of food.
🔺 Feeding problem/error
- Too big/frequent doses or ad libitum feeding
- Treats, “snacking” at family meals
- Competing for food, more pets in the family
- More family members are feeding
- Feeding ≠ love, voracity ≠ health, snacks ≠ boredom killing
What is the connection bwt Cushing’s syndrome and obesity
- Abdominal size increase/pot belly, muscle weakness (decr. Activity contr more to problem aswell!)
Describe the connection betweein higher calorie/fat content of food and obesity
🔺 The energy concentration of fat is highest 🔺 Satiety - Fat ☹️ - Carbohydrate 🙂 - Protein/amino acid 🙂 🔺 Utilization/digestebility of energy content (monogastric) - Fat 98% - Carbohydrate 94% - Protein 77% 🔺 Fat supplement: palatability ⬆️
How might obesity be a health risk?
🔺Physical
🔺 Endocrinologic and metabolic
🔺 Other
How does the physical consequences of obesity influence the health?
🔺 Increased load on joints/bones
- Ca: cruciate ligament rupture, discopathy
🔺 Tracheal collapse (ca)
🔺 Heatstroke (ca) (more “insulation”/fat tissue
How does the Endocrinologic and metabolic consequences of obesity influence the health?
🔺 Hypoxia in cell groups of fat deposits
🔺 Fat stores produce inflammatory mediators (adipokins which are released:)
🔺 TNF-α ⬆️, IL-6 ⬆️, leptin ⬆️, CRP , adiponectin ⬇️!! (Benefitial, reduce inflamm, decr insulin resistance)
- Chronic systemic inflammation (➡️ osteoarthritis)
- Hypertension (ca), atherosclerosis
- Insulin resistanceðtype-2 DM (fe! ca?)
🔺 Hyperlipidemia (TG ⬆️, cholesterol ⬆️)
- Pancreatitis
- Liver lipidosis (fe esp!)
Explain the connection between obesitas and hypertension
🔺 Circulating volume ⬆️, cause:
- adipokine release ➡️ RAA system activation ➡️ renal water retention
🔺 Peripheral resistance of blood vessels ⬆️, cause:
- Endothelial dysfunction
- Adipokins ⬆️ (inflamm mediators)
Mention the other risk factors we might see in connection to obesity
How does obesity increase the incidence of heart disease?
🔺Most common: myocardial hypertrophy
- Circulating volume incr ➡️ Preload increase
- Hypertension ➡️ Afterload increase
- adipokins ➡️ Myocardial hypertrophy and fibrosis
- ➡️ Coronary calcification
➡️➡️➡️ DECREASED LEFT VENTRICLE FUNCTION
Describe the connection btw obesity and nephropathy
Release of adipokins➡️ RAAS activated ➡️ Hypertension
➡️ increased GFR ➡️ Glomerulus expands, Bowman’s capsule is tight ➡️Glomerulosclerosis
What are the main points in the treatment of obesity
How do you approach starting a weight loosing diet?
🔺 Body weight (BW) – ideal body weight (IBW) – target body weight (TBW)
🔺 optimal body weight loss: 1-2% /week, 4-8% /month
🔺 Calorie intake ⬇️
- (40-)60% of target body weight maintenance energy demand
(set if lower if:)
- female: -15%
- Neutered: -15%
Don’t be drastic: rather too little than too muc!
- Hunger ➡️ behavior ➡️ owner gives up
- Excessive FFM ⬇️
- Increased risk of relapse (BMR ⬇️)
- Liver lipidosis (fe) due to fat mobilisation
How do you modify the nutrient proportion correctly while decreasing caloric intake?
🔺 Fat/calorie ratio ⬇️
- Fat: max. 25% of ME content (25-30g fat/Mcal ME)
🔺 Fiber ⬆️ (not too much!)
- Water soluble:
gastric emptying ⬇️, nutrient absorption ⬇️
- Insoluble: passage ⬆️
- Palatability ⬇️ but satiety⬆️ (full stomach)
- (Stool quantity ⬆️, frequency ⬆️)
- (Flatulence, diarrhea)
🔺 (Water ⬆️, air ⬆️) to increase volume!
🔺 Protein-to-calorie ratio ⬆️ (higher protein)
- Target body weight protein requirement
- FFM↔️, FM⬇️
- Protein energy is utilized worse
- Satiety ⬆️
🔺After ideal weight is met, we switch to maintenance diet
Things to add to a weight loss diet?
🔺 Vitamin/mineral supplementation +/-
➡️ Bc diet low in fat, fat soluble vits need to be absorbed in presence of fat!
🔺 Potentially slimming additives
➡️ Chitosan, green tea extract, L-carnitine, ginseng saponins, chromium, conjugated linoleic acid (t10, c12-CLA) … etc.