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evaluate-latest-diet--->on webmd I found this:
http://www.webmd.com/diet/diet-health-check/default.htm


we will have a guest lecturer from Thorne on week 7

WEIGHT MANAGEMENT
balancing energy intake and expenditure
exercise vs portions and food types
manage portion sizes by having plates that measure amounts

HCG DIET
taking small amounts of human chorionic gonadotropin (same hormone produced in preg)
off label use, big diet fad right now
eating only 500 cals/day
when dieting, body harvests sugars first, proteins next, fats
one pound fat = 3500 calories
she's frustrated with us (just said so) because she thinks we should know stuff that we don't know
Mark Phelps (swimmer) was eating 10,000 calories/day ???
on HCG diet can easily loose 1lb/day

I moved away from the center of the room in the 3rd row where I normally sit, and she is standing right where I normally sit. I feel better being farther away from her. She is not making eye contact with me nor demanding that I answer all the questions anymore. I think that she may feel less threatened by me now that I'm in the periphery.

THYROID DURING PREGNANCY
an aside, she says:
incr est-->incr thyroglobulin-->need more med because protein is binding it all ???
I don't trust what she says off the top of her head
she says can't lose wt after give birth dt incr binding prot dropping thyroid levels
I find this: postpartum thyroiditis is blamed on an autoimmune process like Hashimotos
http://thyroid.about.com/cs/pregnancy/a/postpartum.htm

BMI WEIGHT CLASSIFICATION
underwt under 18.5
normal 18.5-24.9
overwt 20-29.9
obes I 30-34.9
obes II 35-39.9
obes class III over 40

FAT STORAGE
stored in marrow, liver, spleen, kidney, muscle
men need 3% women need 12%
I question all of this
white: TGs, cushion abd organs, insul
brown: color dt vascularization???, mostly in infants, adults have around scapulae
adipocytes can expand x1000
fatness most at 6mo normally
cell numbers incr thru life
after adolescents: fat cells enlarge
wt loss doesn't decrease number of cells, only size

REGULATORS OF APPETITE
fasting-->decr nor, dopa-->adrenals release epi
low serotonin-->carb cravings
endorphins-->??
neuropeptide Y-->incr appetite after food deprivation
ghrelin-->stims appetite, slows metab, ox, hi in lean pts, dieters, low in obese, gastric bypass
leptin from adipocytes-->suppress appetite, high levels-->resistance to wt loss
lots of leptin in breast milk so babies not breast fed may have dysreg
according to this link leptin making depends on genetics, fat pts may not make enough
but supplementation doesn't seem to help
I think this is dt leptin resistance in obese
http://www.thehealthyvillage.com/weight-loss/leptin-supplements-and-weight-loss.html
adiponectin from adipocytes modulate gluc and fatt acid metab, levels inverse to BMI
Michael Conley from OHSU now in Aus worked on adipose as endocrine organ
interesting illus in notes

IODINE
many populations are deficient
she recommends urine measurement
says women with breast CA have low levels
order kit for $100 from http://www.vrp.com/ProductPage.aspx?ProdID=9137 must be physician
more on loading test:
http://www.optimox.com/pics/Iodine/loadTest.htm
more on thyroid connection:
http://www.drgarysnyder.com/iodine_test.htm
instructions here on running the test yourself:
http://www.iccidd.org/pages/technical-resources/assessing-iodine-status/fast-b-test.php
they say measure a population, find the median value, treat whole pop accordingly
over 50% of Americans are deficient: http://www.naturalnews.com/023107.html

OBESE
causes risks in:
HTN, CAD, hi lipids, DM2, CA, joint dz, gallbladder dz, resp probs, PCOS, sleep apnea

SURGERY FOR OBESITY
bariatric surgery for BMI over 45 after failing wt management
gastric resection is aggressive
lap band as moderate option that allows nutrient absorption
insurance companies like it
it's adjustable

NUTRITIONAL CONCERNS POST-GASTRIC-BYPASS
def in acids and panc enzymes
malabsorption
if prox part removed: Ca, Mg, Fe, Vit A&D
distal: B vits, minerals, fats, prots

UNDERWEIGHT
15-20% below accepted weight standards
5'10" 150 lbs was normal
US has new normal
BMI under 20 higher risk for mortality
TX:
take a diet hx
eat 500 more cal/day
may need oral formula or tube feeding if eating disorder
TPN only if life-threatening malnutrit
if pt was ever anorexic may result in long term deficiencies
dxs: anorexia nervosa, bulimia nervosa, binge eating disorder (BED) 2x/week
psychotherapy, spiritual counseling
food attitudes: aversions, safety, magical thinking, riggers, ideas of portion
behaviors: ritual, combos, atypical seasoning or utensils
other stuff
whenever she sees me typing what she has on the screen
she immediately changes the screen even if she hasn't covered it

TX FOR BINGE EATING
Zn & Cu
K, Omega 3&6
Vit D 50,000 IU/wk (A&E mb normal)
boost serotonin levels w/ 5HTP


FTC regulates claims of health benefits
FDA regulates labels: http://www.fda.gov/Food/LabelingNutrition/LabelClaims/ucm111447.htm

Comments

liveonearth
Feb. 3rd, 2010 01:44 am (UTC)
Atta girl! Congrats on your progress! And you did it in spite of the bakery effect. No need to do anything "heavy", you can get fit just walking fast and living life. It's OK to get really hungry, as long as you fill up on veggies and good proteins instead of carbs and junk. I know the challenge of it, personally. I just filled up on corn chips. =-/

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