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Type II diabetesI. PathologyObesity leads to dyslipidemia (elevated
triglycerides, decreased HDLc, increased small dense LDL, increased lipid oxidation), increasedblood pressure, decreased insulin sensitivity= metabolic syndromeincreased platelet reactivity considered by some to be part of metabolic syndrome
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 II?
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 II 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 fat food companies
always promoting larger servings
supersizing type II 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 II 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 II diabetes tends to affect allclasses-money or lack thereof
is not an issue
More on socioeconomic factors
Global economyno real impact given that type II diabetesis increasing- rampant all over the world
Government-anti-obesity campaigns- physical activity
guide and Canada’s food guide
More on socioeconomic factorsBusiness
advertisingsupersizing type II 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 II 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 II 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 II diabetes ?
Daily food record/Diary-same measures of interest
as per nutrient intakeanalysis
How is nutritional assessment made for type II diabetes ?
Retrospective data
food frequency questionnaire24-hour recall
do both to act as cross check against each other
How is nutritional assessment made for type II diabetes ?
Anthropometry
waist measurement-central obesityweight and height giving BMI
How is nutritional assessment made for type II diabetes ?
Nutrition focussed physical examobesity is the focus here particularly
central obesity
blood pressure
How is nutritional assessment made for type II diabetes ?
Skin testingirrelevant in type II diabetes
How is nutritional assessment made for type II diabetes ?Biochemical analysis
Blood concentrations of:HDLc downmore small dense LDLmore oxidised LDLtriglycerides (VLDL and CM) upfree fatty acidshigh sensitivity c-reactive protein?leptin ?lipoprotein (a)?
How is nutritional assessment made for type II diabetes ?Biochemical analysis
Blood concentrations of:glycated proteinsfasting insulin is higherfasting blood glucose is higherpost-prandial insulin and blood
glucose is higherpost-prandial lipemia is higher