What is Metabolic About Metabolic Surgery? The New ADA Recommendations
|
|
- Brendan Griffith
- 5 years ago
- Views:
Transcription
1 What is Metabolic About Metabolic Surgery? The New ADA Recommendations Obesity Symposium September 16, 2017 Timothy Howland, MD Lourdes Endocrinology
2 Bariatric from the Greek root bar- ("weight" as in barometer), suffix -iatr ("treatment," as in pediatrics), suffix -ic ("pertaining to")
3 n engl j med 376;3 nejmn engl j med 376;3 nejm.org January 19, 2017.org January 19, 2017n engl j med 376;3 nejm.org January 19, 2017
4
5
6
7 Bariatric Surgery versus Intensive Medical Therapy for Diabetes 5-Year Outcomes n engl j med 376;7 nejm.org February 16, 2017
8 Vol 386 September 5, 2015
9
10 Weight Independent Antidiabetic Effects of Bariatric Surgery Rapid post-op remission of diabetes pts undergoing RYGB. Average inpatient LOS of 3 days. - 1/3 of T2DM pts discharged with normal blood sugar on no diabetes meds. ( Similar remission not seen with restrictive procedures.) Obes Surg :
11 Distal Bowel Hypothesis Expedited delivery of nutrient chyme to the distal intestine Enhanced release of a physiologic signal that improves glucose metabolism
12 Lower Gut Theory With bypass surgery, there is expedited delivery of nutrients to the distal small bowel (shortened length of small bowel) Increased nutrient exposure causes increased release from the L cells GLP-1 and PYY
13 Enteroglucagons GLP-1 GLP-1 levels increased 6x following RYGB, but unchanged in obese subjects with similar weight loss on hypocaloric diet. GLP-1 levels rise progressively for 12 months following gastric bypass surgery
14 Continuously Infused GLP-1 Improves the Defects of T2D T2D Defects 1 Continuously Infused GLP-1 1,2 Insulin production First-phase insulin response Glucagon; glucose output Gastric emptying Food intake 1. Aronoff SL, et al. Diabetes Spectrum. 2004;17: ; 2. Nielsen LL, et al. Regul Pept. 2004;117:77-88
15 Duodenal Exclusion Hypothesis Exclusion of the duodenum may prevent secretion of a signal that promotes insulin resistance.
16 Duodenal Exclusion
17
18
19 Weight Independent Antidiabetic Effects of Bariatric Surgery Occasional late onset of beta cell hyperactivity. - late onset following RYGB typically 1-9 years following surgery hyperinsulinemic hypoglycemia nesidioblastosis on pathology. Occasionally requires partial pancreatectomy.
20 Diabetes Care 2016;39: DOI: /dc
21 Diabetes Care 2016;39: DOI: /dc
22
23
24
25
26 Benefits of Weight Loss Delay progression from prediabetes to type 2 diabetes Positive impact on treatment of type 2 diabetes Most likely to occur early in disease development Improves mobility, physical and sexual functioning & health-related quality of life American Diabetes Association Standards of Medical Care in Diabetes. Obesity management for the treatment of type 2 diabetes. Diabetes Care 2017; 40 (Suppl. 1): S57-S63
27 Overweight/Obesity Treatment Treatment Diet, physical activity & behavioral therapy Pharmacotherapy 23.0* or Body Mass Index Category (kg/m 2 ) * or Metabolic surgery * Asian-American individuals Treatment may be indicated for selected, motivated patients. American Diabetes Association Standards of Medical Care in Diabetes. Obesity management for the treatment of type 2 diabetes. Diabetes Care 2017; 40 (Suppl. 1): S57-S63
28 Recommendations: Diet, physical activity & behavioral therapy Diet, physical activity & behavioral therapy designed to achieve >5% weight loss should be prescribed for overweight & obese patients with T2DM ready to achieve weight loss. A Interventions should be high-intensity ( 16 sessions in 6 months) and focus on diet, physical activity & behavioral strategies to achieve a kcal/day energy deficit. A American Diabetes Association Standards of Medical Care in Diabetes. Obesity management for the treatment of type 2 diabetes. Diabetes Care 2017; 40 (Suppl. 1): S57-S63
29 Recommendations: Diet, physical activity & behavioral therapy Diets should be individualized, as those that provide the same caloric restriction but differ in protein, carbohydrate, and fat content are equally effective in achieving weight loss. A Patients who achieve short-term weight loss goals should be prescribed long-term maintenance programs. A American Diabetes Association Standards of Medical Care in Diabetes. Obesity management for the treatment of type 2 diabetes. Diabetes Care 2017; 40 (Suppl. 1): S57-S63
30 Metabolic Surgery Evidence supports gastrointestinal operations as effective treatments for overweight T2DM patients. Randomized controlled trials with postoperative follow-up ranging from 1 to 5 years have documented sustained diabetes remission in 30 63% of patients, though erosion of remission occurs in 35-50% or more. With or without diabetes relapse, the majority of patients who undergo surgery maintain substantial improvement of glycemic control for at least 5 to 15 years American Diabetes Association Standards of Medical Care in Diabetes. Obesity management for the treatment of type 2 diabetes. Diabetes Care 2017; 40 (Suppl. 1): S57-S63
31
32
33 Current Biology 26, , February 8, 2016
34 Current Biology 26, , February 8, 2016
35
36
37
38
39 CMAJ JULY 17, 2017 VOLUME 189 ISSUE 2CMAJ JULY 17, 2017 VOLUME 189 ISSUE 288
40
41 USDA Dietary Guidelines for Americans Emphasize consumption of fruits, vegetables, whole grains, protein Limited consumption saturated fats, sugars, salt, refined grains
42 Federal Agricultural Subsidies $170 billion spent on 7 commodities and programs (corn, soybeans, wheat, rice sorghum, dairy, livestock) 30-40% corn; 50% soybeans; nearly all sorghum feed for cattle and livestock 5% corn for high fructose corn syrup
43 Subsidy Score Proportion of intake (in calories ) derived from the 7 major subsidized commodities (corn, soybeans, wheat, rice sorghum, dairy, livestock) 0.0 = 0% 1.0 = 100%
44
45
46 Recommendations: Metabolic Surgery Metabolic surgery should be recommended to treat T2DM for all appropriate surgical candidates with BMIs > 40 (37.5*) and those with BMIs ( *) when hyperglycemia is inadequately controlled despite lifestyle & optimal medical therapy. A Metabolic surgery should be considered for the treatment of T2DM in adults with BMIs ( *) when hyperglycemia is inadequately controlled despite optimal medical control by either oral or injectable medications (including insulin). B Metabolic surgery should be performed in high-volume centers with multidisciplinary teams that understand and are experienced in the management of diabetes and gastrointestinal surgery. C American Diabetes Association Standards of Medical Care in Diabetes. Obesity management for the treatment of type 2 diabetes. Diabetes Care 2017; 40 (Suppl. 1): S57-S63
47
Treating Type 2 Diabetes with Bariatric Surgery. Goal of Treating T2DM. Remission of T2DM with Bariatric
Treating Type 2 Diabetes with Bariatric Surgery Number (in Millions) of Persons with Diagnosed Diabetes, United States, 198 25 The number of Americans with diabetes increased from 5.6 to 15.8 million Guilherme
More informationSTATE OF THE STATE: TYPE II DIABETES
STATE OF THE STATE: TYPE II DIABETES HENRY DRISCOLL, MD, CHIEF of ENDOCRINOLOGY MARSHALL U, CHERTOW DIABETES CENTER, HUNTINGTON VAMC HEATHER VENOY, RD, LD, CDE DIETITIAN, DIABETES EDUCATOR, CHERTOW DIABETES
More informationTreating Type 2 Diabetes by Treating Obesity. Vijaya Surampudi, MD, MS Assistant Professor of Medicine Center for Human Nutrition
Treating Type 2 Diabetes by Treating Obesity Vijaya Surampudi, MD, MS Assistant Professor of Medicine Center for Human Nutrition 2 Center Stage Obesity is currently an epidemic in the United States, with
More informationtype 2 diabetes is a surgical disease
M. Lannoo, MD, University Hospitals Leuven Walter Pories claimed in 1992 type 2 diabetes is a surgical disease Buchwald et al. conducted a large meta-analysis THE FIRST OBSERVATIONS W. Pories 500 patients
More informationObesity Management in Patients with Diabetes Jamy D. Ard, MD Sunday, February 11, :15 a.m. 11:00 a.m.
Obesity Management in Patients with Diabetes Jamy D. Ard, MD Sunday, February 11, 2018 10:15 a.m. 11:00 a.m. Type 2 diabetes mellitus (T2DM) is closely associated with obesity, primarily through the link
More informationRoux-and-Y Gastric Bypass and its Metabolic Effects
Roux-and-Y Gastric Bypass and its Metabolic Effects Nicola Di Lorenzo President elect of SICOb Italian Society for Bariatric Surgery and Metabolic Diseases Dept. of General Surgery-Università di Roma Tor
More informationDiabetes and Nutrition. Spencer Johnson, O.D., F.A.A.O. Northeastern State University Oklahoma College of Optometry
Diabetes and Nutrition Spencer Johnson, O.D., F.A.A.O. Northeastern State University Oklahoma College of Optometry johns137@nsuok.edu Diabetes Classifications People who self-reported having been told
More informationHow does the LIFESTEPS Weight Management Program support diabetes prevention?
LIFESTEPS and Diabetes Prevention How does the LIFESTEPS Weight Management Program support diabetes prevention? The LIFESTEPS Weight Management Program (LIFESTEPS ) is a cognitive-behavioral program designed
More informationWhat s New in the Standards of Medical Care in Diabetes? Dr. Jason Kruse, DO Broadlawns Medical Center
What s New in the Standards of Medical Care in Diabetes? Dr. Jason Kruse, DO Broadlawns Medical Center Learning Objectives By the end of this presentation, participants should be able to: Discuss updates
More informationObesity Management in Type 2 Diabetes
Obesity Management in Type 2 Diabetes Clare J. Lee, MD, MHS Assistant Professor of Medicine, Division of Endocrinology, Diabetes & Metabolism, Johns Hopkins University Disclosures None Objectives Describe
More informationBARIATRIC SURGERY AND TYPE 2 DIABETES MELLITUS
BARIATRIC SURGERY AND TYPE 2 DIABETES MELLITUS George Vl Valsamakis European Scope Fellow Obesity Visiting iti Associate Prof Warwick Medical School Diabetes is an increasing healthcare epidemic throughout
More informationType 2 DM in Adolescents: Use of GLP-1 RA. Objectives. Scope of Problem: Obesity. Background. Pathophysiology of T2DM
Type 2 DM in Adolescents: Use of GLP-1 RA Objectives Identify patients in the pediatric population with T2DM that would potentially benefit from the use of GLP-1 RA Discuss changes in glycemic outcomes
More informationThe Mediterranean Diet: HOW and WHY It Works So Well for T2DM
The Mediterranean Diet: HOW and WHY It Works So Well for T2DM Susan L. Barlow, RD, CDE. Objectives 1. Discuss the effects of meal size on GLP-1 concentrations. 2. Compare and contrast the specific effects
More informationStandards of Care in Diabetes What's New? Veronica Brady, FNP-BC, PhD, BC-ADM,CDE Karmella Thomas, RD, LD,CDE
Standards of Care in Diabetes 2016-- What's New? Veronica Brady, FNP-BC, PhD, BC-ADM,CDE Karmella Thomas, RD, LD,CDE Terminology No longer using the term diabetic. Diabetes does not define people. People
More informationBariatric Surgery MM /11/2001. HMO; PPO; QUEST 05/01/2012 Section: Surgery Place(s) of Service: Outpatient; Inpatient
Bariatric Surgery Policy Number: Original Effective Date: MM.06.003 09/11/2001 Line(s) of Business: Current Effective Date: HMO; PPO; QUEST 05/01/2012 Section: Surgery Place(s) of Service: Outpatient;
More informationUsing the Nutrition Facts Table to Make Heart Healthy Food Choices
Using the Table to Make Heart Healthy Food Choices Most packaged food products that you purchase contain a Table on the label. The Table lists information on nutrients that are found in the food product.
More informationGastric Emptying Time after Laparoscopic Sleeve Gastrectomy
International Journal of Current Research in Medical Sciences ISSN: 2454-5716 P-ISJN: A4372-3064, E -ISJN: A4372-3061 www.ijcrims.com Original Research Article Volume 4, Issue 7-2018 Gastric Emptying Time
More informationAppetite, Glycemia and Entero-Insular Hormone Responses Differ Between Oral, Gastric-Remnant and Duodenal Administration of a Mixed Meal Test After
Appetite, Glycemia and Entero-Insular Hormone Responses Differ Between Oral, Gastric-Remnant and Duodenal Administration of a Mixed Meal Test After Roux-en-Y Gastric Bypass June 2018 How a surgical complication
More informationTRUTH: On average, Canadians consume 11% of energy from added sugars, and consumption has been declining
Uncover the truth about sugar: consumption Myth: Canadians are eating more and more sugar TRUTH: On average, Canadians consume 11% of energy from added sugars, and consumption has been declining Three
More informationDiabesity. Metabolic dysfunction that ranges from mild blood glucose imbalance to full fledged Type 2 DM Signs
Diabesity Metabolic dysfunction that ranges from mild blood glucose imbalance to full fledged Type 2 DM Signs Abdominal obesity Low HDL, high LDL, and high triglycerides HTN High blood glucose (F>100l,
More informationSubject Index. postprandial glycemia and suppression in serum 51 recommendations 119, 120 supplementation pros and cons 118, 119
Acarbose, diabetes prevention trials 32, 33, 40 42 Accelerator hypothesis accelerators beta cell autoimmunity 140, 141, 147, 150, 151 insulin resistance 140, 142 144, 150 obesity 145 148 diabetes risk
More informationIndex. Note: Page numbers of article titles are in boldface type.
Note: Page numbers of article titles are in boldface type. A Abdominal pain, enteral therapy in acute pancreatitis and, 812 Abscess(es), pancreatic, nutritional support for, 814 815 Acute Physiology and
More information4. Mechanisms Mediating Weight Loss and Diabetes Remission After Bariatric/ Metabolic Surgery
4. Mechanisms Mediating Weight Loss and Diabetes Remission After Bariatric/ Metabolic Surgery David E. Cummings, MD Francesco Rubino, MD Rationale for Understanding the Mechanisms of Bariatric Surgery
More informationNutrition Basics. Chapter McGraw-Hill Higher Education. All rights reserved.
Nutrition Basics Chapter 12 1 The Body s Nutritional Requirements Essential nutrients The Six Essential Nutrients: Proteins, Fats, Carbohydrates, Vitamins, Minerals, Water Defined as : Nutrients one must
More informationNew Insights into Mechanism of Action
Remission of Diabetes after Bariatric Surgery New Insights into Mechanism of Action Peng (Charles) Zhang, MD, PhD Shanghai Pudong Hospital Fudan University Pudong Medical Center March 20, 2015 Orlando,
More informationObesity and Bariatric Surgery Michel M. Murr, MD, FACS
Obesity and Bariatric Surgery Michel M. Murr, MD, FACS Director of Bariatric Center Chief of Surgery, TGH Professor of Surgery, USF Disclosure Covidien: educational grants Obesity and Bariatric Surgery
More informationObesity Who is suitable for surgery? Professor Rob Andrews University of Exeter / Taunton NHS trust
Obesity Who is suitable for surgery? Professor Rob Andrews University of Exeter / Taunton NHS trust Investigator on BYBAND study Conflict of interest 3 Diet and Exercise studies (ACTID, EXTOD, STAMP2)
More informationAll About Carbohydrates and Health CPE Questions
All About Carbohydrates and Health CPE Questions 1. Which of the following statements is not true of carbohydrates? a) They are the main source of energy for the body; b) They are comprised of carbon,
More informationGRACE C. PAGUIA, MD DPPS DPBCN
Nutrition Dilemmas, WEIGHT MANAGEMENT IN CHILDREN AND ADOLESCENTS: THE EXISTING GUIDELINES GRACE C. PAGUIA, MD DPPS DPBCN Overweight & Obesity in Pediatrics Nutrition Dilemmas, q results from a chronic
More informationAll About Carbohydrates and Health
All About Carbohydrates and Health CPE Questions 1. Which of the following statements is not true of carbohydrates? a) They are the main source of energy for the body; b) They are comprised of carbon,
More informationOther Ways to Achieve Metabolic Control
Other Ways to Achieve Metabolic Control Nestor de la Cruz- Muñoz, MD, FACS Associate Professor of Clinical Surgery Chief, Division of Laparoendoscopic and Bariatric Surgery DeWitt Daughtry Family Department
More informationMacronutrients and Dietary Patterns for Glucose Control
제 20 회대한당뇨병학회춘계학술대회 Macronutrients and Dietary Patterns for Glucose Control 2017.5.13 서울대학교병원임정현 Conflict of interest disclosure None Committee of Scientific Affairs Contents Review of Nutrition Recommendation
More informationChief of Endocrinology East Orange General Hospital
Targeting the Incretins System: Can it Improve Our Ability to Treat Type 2 Diabetes? Darshi Sunderam, MD Darshi Sunderam, MD Chief of Endocrinology East Orange General Hospital Age-adjusted Percentage
More informationFact Sheet #55 November Program on Breast Cancer. and Environmental Risk Factors (BCERF)
Program on Breast Cancer Environmental Risk Factors Fact Sheet #55 November 2006 TOPICS Carbohydrates in our diet Carbohydrates and breast cancer risk Carbohydrates and glycemic index Glycemic index and
More informationBariatric Surgery vs. Intensive Medical Therapy in Obese Diabetic Patients: 3-Year Outcomes
Bariatric Surgery vs. Intensive Medical Therapy in Obese Diabetic Patients: 3-Year Outcomes Results of the STAMPEDE Trial Philip R Schauer, Deepak L Bhatt, John P Kirwan, Kathy Wolski, Stacy A Brethauer,
More informationWhat You Need to Know Sugar, Carbs & Sodium. Lisa Brown, RD,LD,CDE BrownFox Solutions, LLC October 30, 2010
What You Need to Know Sugar, Carbs & Sodium Lisa Brown, RD,LD,CDE BrownFox Solutions, LLC October 30, 2010 Diabetes in Youth Most common disease in school aged children 186,300 youth in 2007 have diabetes
More informationThis presentation was supported, in part, by the University of Utah, where Patricia Guenther has an adjunct appointment.
1 Like the 2005 version, the Healthy Eating Index-2010 is a result of a collaboration among staff at the USDA Center for Nutrition Policy and Promotion and the National Cancer Institute. This presentation
More informationMTE 4 and 9 Macronutrient Mix: Ideal Intake vs. Real-World Eating? References:
MTE 4 and 9 Macronutrient Mix: Ideal Intake vs. Real-World Eating? Bayview Room, Bay Level Marion J. Franz, MS, RDN, CDE Saturday, March 5, 2016 2:00 p.m. 3:30 p.m. and 3:45 p.m. 5:15 p.m. Research trials
More informationNutrition for Children with T1 Diabetes. Gail Spiegel, MS RD CDE Senior Instructor
Nutrition for Children with T1 Diabetes Gail Spiegel, MS RD CDE Senior Instructor 2018 ATDC Conference: Conflict of Interest I have no conflicts of Interest. I will not be speaking on off-label topics.
More informationFructose in diabetes: Friend or Foe. Kim Chong Hwa MD,PhD Sejong general hospital, Division of Endocrinology & Metabolism
Fructose in diabetes: Friend or Foe Kim Chong Hwa MD,PhD Sejong general hospital, Division of Endocrinology & Metabolism Contents What is Fructose? Why is Fructose of Concern? Effects of Fructose on glycemic
More informationOverall Implementation Strategy/Focus:
Worksheet 1. IMPLEMENTATION STRATEGY Overall Implementation Strategy/Focus: RAND 1 Key Guideline Element 1. Routine primary care screening for overweight and obesity. Gaps in Current Practices (Planning
More informationNew insights in metabolic surgery
New insights in metabolic surgery G.Hubens 11th Starters Package Who would have thought it? An operation proves to be the most effective therapy for adult onset diabetes W Pories 1995 222: 339-350 KEY
More informationChapter 2 Carbohydrates
216 Answer, K/A, page(s) Chapter 2 Carbohydrates K = knowledge question; A = application question True/False T K 34 1. Whenever carbohydrate is available to the body, the human brain depends exclusively
More informationModule 1 An Overview of Nutrition. Module 2. Basics of Nutrition. Main Topics
Module 1 An Overview of Nutrition Module 2 What is Nutrition? What Are Nutrients? Units of Energy Why we need energy? Maintaining energy balance Daily energy requirements Calorie Requirements for Different
More informationPractical Strategies for the Clinical Use of Incretin Mimetics CME/CE. CME/CE Released: 09/15/2009; Valid for credit through 09/15/2010
Practical Strategies for the Clinical Use of Incretin Mimetics CME/CE Robert R. Henry, MD Authors and Disclosures CME/CE Released: 09/15/2009; Valid for credit through 09/15/2010 Introduction Type 2 diabetes
More informationBenefits of Bariatric Surgery
Benefits of Bariatric Surgery Dr Tan Bo Chuan Registrar, Department of Surgery GP Forum 27 May 2017 Improvements of Co-morbidities Type 2 diabetes mellitus Hypertension Hyperlipidemia Degenerative joint
More informationMegan Lawless. Journal Club. January 20 th, 2011
Megan Lawless Journal Club January 20 th, 2011 Gut-expressed gustducin and taste receptors regulate secretion of glucagon-like peptide-1 Proceedings of the National Academy of Sciences September 2007 Abstract
More informationGastric By-Pass and Remission of Type II Diabetes in Obese Adults
Cedarville University DigitalCommons@Cedarville Kinesiology and Allied Health Faculty Presentations Department of Kinesiology and Allied Health 2-6-2014 Gastric By-Pass and Remission of Type II Diabetes
More informationDietary recommendations in Obesity, Hypertension, Hyperlipidemia, and Diabetes. Stephen D. Sisson MD
Dietary recommendations in Obesity, Hypertension, Hyperlipidemia, and Diabetes Stephen D. Sisson MD Objectives To review dietary recommendations in the following conditions: Obesity Hypertension Diabetes
More informationUnderstanding the Nutrition Label
Understanding the Nutrition Label Alyssa Atanacio, RD, LDN Registered Dietitian Reading the Nutrition Label Confusing? Not enough the time? Too many rules? Should I eat this food? 1 Why Read Labels? Key
More informationPart 1: Obesity. Dietary recommendations in Obesity, Hypertension, Hyperlipidemia, and Diabetes 10/15/2018. Objectives.
Dietary recommendations in Obesity, Hypertension, Hyperlipidemia, and Diabetes Stephen D. Sisson MD Objectives To review dietary recommendations in the following conditions: Obesity Hypertension Diabetes
More information1. Which nutrient is so vital to health that you wouldn't live more than a few days without it? A) vitamins B) water C) minerals D) protein
Nutrition & You, 4e (Blake) Chapter 1 What Is Nutrition? Legend: For sentences / statements that DO NOT HAVE answer choices, Answer A if TRUE Answer B IF False 1. Which nutrient is so vital to health that
More informationGive yourself 4 points for every (a) answer, 3 points for every (b),
218 THE DIABETES RESET Diabetes Reset Target Strategy Quiz: What Should You Be Focusing On? Give yourself 4 points for every (a) answer, 3 points for every (b), 2 points for every (c), and 1 point for
More informationNational Position Statement
National Position Statement Weight Loss Surgery (Bariatric Surgery) and its Use in Treating Obesity or Treating and Preventing Diabetes Background Approximately twenty five per cent (25%) of Australian
More informationNutritional Recommendations for the Diabetes Managements
In the name of God Nutritional for the Diabetes Managements Zohreh Mazloom. PhD Shiraz University of Medical Sciences School of Nutrition and Food Sciences Department of Clinical Nutrition OVERVIEW Healthful
More informationWeighing in on Whole Grains: A review of Evidence Linking Whole Grains to Body Weight. Nicola M. McKeown, PhD Scientist II
Weighing in on Whole Grains: A review of Evidence Linking Whole Grains to Body Weight Nicola M. McKeown, PhD Scientist II Weighing in on Whole Grains: A review of Evidence Linking Whole Grains to Body
More informationDisclosures. Nutrition & Menopause. What changes? Mindless Eating 10/6/2017. I have no disclosures
I have no disclosures Disclosures Nutrition & Menopause Making changes when you can t eat like a 25 year old, and get away with it.. What changes? Social situation Family and family meals Activity levels
More informationFIBER HEALTH BENEFITS
FIBER FIBER HEALTH BENEFITS Normal Laxation: Increase stool weight from fiber, water retained by fiber and bacterial mass Eases defecation and prevents or relieves constipation Cereal fibers are best;
More informationPolicy Statement Low carbohydrate diets for the management of Type 2 Diabetes in adults
Policy Statement Low carbohydrate diets for the management of Type 2 Diabetes in adults Summary The role and the amounts of carbohydrate in foods as part of the diet of people with type 2 diabetes is often
More informationChapter 4: Sugars, Starches and Fibers. Copyright 2012 John Wiley & Sons, Inc. All rights reserved.
Chapter 4: Sugars, Starches and Fibers Copyright Student learning outcomes: At the end of this chapter, you should be able to: Compare and contrast whole grains and refined sugars Compare and contrast
More informationAligning Food Composition Tables with Current Dietary Guidance for Consumers
Aligning Food Composition Tables with Current Dietary Guidance for Consumers Suzanne P. Murphy, PhD, RD Professor Emeritus Cancer Center of the University of Hawaii Dietary Guidance for Consumers Several
More informationYour Guide to. Healthy Eating for Managing Diabetes
Your Guide to Healthy Eating for Managing Diabetes What is diabetes? A condition when the blood glucose level is higher than normal as described below. Stomach Bloodstream Pancreas 3 1 4 2 1. Food is broken
More informationTips for a Diabetes Diet
Tips for a Diabetes Diet Diet plays an important role in diabetes treatment. Majority of people affected with diabetes are overweight or obese. In fact, your risk of getting diabetes increases the more
More informationUNDERSTANDING TYPE 2 DIABETES
1 UNDERSTANDING TYPE 2 DIABETES PUTTING IT INTO REMISSION WITH A LOW-CARB HIGH-FAT DIET Jacqueline A. Eberstein, R.N. Director of Protocol, HEALcare The Scope of the Challenge 2 The People The Scope of
More informationViriato Fiallo, MD Ursula McMillian, MD
Viriato Fiallo, MD Ursula McMillian, MD Objectives Define obesity and effects on society and healthcare Define bariatric surgery Discuss recent medical management versus surgery research Evaluate different
More informationThe Science of Nutrition, 3e (Thompson) Chapter 2 Designing a Healthful Diet
The Science of Nutrition, 3e (Thompson) Chapter 2 Designing a Healthful Diet 1) The four characteristics of a healthful diet are adequacy, balance, moderation, and: A) Calories. B) color. C) value. D)
More informationHealthy Behavior: Lifestyle and Diet
NCD Workshop Nov 3 rd, 2010 Healthy Behavior: Lifestyle and Diet Jeongseon Kim Cancer Epidemiology Branch National Cancer Center Contents Global and regional food consumption patterns and trends Diet,
More informationPublic Health and Nutrition in Older Adults. Patricia P. Barry, MD, MPH Merck Institute of Aging & Health and George Washington University
Public Health and Nutrition in Older Adults Patricia P. Barry, MD, MPH Merck Institute of Aging & Health and George Washington University Public Health and Nutrition in Older Adults n Overview of nutrition
More informationIs mini bypass as mini as we think it is? Nutritional consequences
Is mini bypass as mini as we think it is? Nutritional consequences Mini/ single loop bypass What is a mini bypass? Single loop One anastomosis Mini Prevalence Increasing Who is the single loop bypass for?
More informationManagement of diabetes with Bariatric surgery. Muhammad Jawad MD FACS FASMBS
Management of diabetes with Bariatric surgery Muhammad Jawad MD FACS FASMBS Obesity is common Obesity defined as person with BMI 30-35 Morbid obesity defined as BMI more than 35 BMI measured ;weight in
More informationDiabesita : integrazione tra terapia medica e terapia chirurgica Prof. Monica Nannipieri Dip. Medicina Clinica e Sperimentale Università di Pisa
Diabesita : integrazione tra terapia medica e terapia chirurgica Prof. Monica Nannipieri Dip. Medicina Clinica e Sperimentale Università di Pisa Dichiaro di non avere alcun conflitto d interesse Medical
More informationToday, grains provide 50% of global calories
Disclosures WebMD Board member: True Health Initiative; Cooking Matters Contributing editor: Food & Nutrition Magazine Consultant: Sabra, Bayer LEAD Network 1 Facts Today, grains provide 50% of global
More informationDietary intake and the risk of type 2 diabetes in Korea
2018 International Congress of Diabetes and Metabolism Dietary intake and the risk of type 2 diabetes in Korea Major of Food Science & Nutrition The Catholic University of Korea YoonJu Song Contents 1
More informationNovember National Diabetes Month
Diabetes can cause serious health problems, including blindness, nerve damage, and kidney disease. November 2017 It is one of the leading causes of disability and death in the United States. The disease
More informationSheri R. Colberg, PhD, FACSM. Professor Emerita, Exercise Science Old Dominion University
Sheri R. Colberg, PhD, FACSM Professor Emerita, Exercise Science Old Dominion University Issues for Discussion Optimal macronutrient distribution in diet Role of carbohydrates Role of protein Role of fat
More informationSue Cummings, MS, RD
Starting Principles: Causes of Obesity Obesity is a chronic disease that is: Dietary Causes of Weight Regain SUE CUMMINGS, MS, RD SCUMMINGS1@PARTNERS.ORG both biopsychosocially complex in its origins and
More informationDigestion and Nutrition. Chapter 40
Digestion and Nutrition Chapter 40 Impacts, Issues Hormones and Hunger Fat cells secrete leptin, which reduces appetite; an empty stomach secretes ghrelin, which makes you hungry the goal is healthy nutrition
More informationThe Nutritional Information Panel is a pretty technical looking piece of artwork and the main question people ask about it WHAT DOES IT ALL MEAN?
The Nutritional Information Panel is a pretty technical looking piece of artwork and the main question people ask about it is WHAT DOES IT ALL MEAN? Well, we want you to understand it as well as we do.
More informationIN THE GENERAL ASSEMBLY STATE OF. Competitive School Food and Beverage Act. Be it enacted by the People of the State of, represented in the General
IN THE GENERAL ASSEMBLY STATE OF Competitive School Food and Beverage Act 1 1 1 1 1 1 1 1 Be it enacted by the People of the State of, represented in the General Assembly: Section 1. Title. This act shall
More informationTargeted Nutrition Therapy Nutrition Masters Course
Targeted Nutrition Therapy Nutrition Masters Course Nilima Desai, MPH, RD Learning Objectives Review clinical studies on innovative, targeted nutrition therapies for: o Blood glucose management o Dyslipidemia
More informationGoals 1/9/2018. Obesity over the last decade Surgery has become a safer management strategy Surgical options for management
The Current State of Surgical Intervention in Management of Morbid Obesity Goals Obesity over the last decade Surgery has become a safer management strategy Surgical options for management 1 Goals Obesity
More informationDianne Kristine Joy Closa*, Armin Masbang, Dianne Shari Cabrera, Allan Dampil and Robert Mirasol
Cronicon OPEN ACCESS EC DIABETES AND METABOLIC RESEARCH Research Article Effects of Bariatric Surgery on Glucose Control, Weight Reduction and Disease Remission among Patients with Type 2 Diabetes Mellitus:
More informationNUTRITION 101 & CLEAN EATING
NUTRITION 101 & CLEAN EATING Macro-Nutrients vs Micro-Nutrients NUTRIENTS Carbohydrates 4 Calories/gram Fiber Fats 9 Calories/gram Proteins 4 Calories/gram Alcohol: 7 calories/gram NUTRITION LABEL Required
More informationThe U.S. Obesity Epidemic: Causes, Consequences and Health Provider Response. Suzanne Bennett Johnson 2012 APA President
The U.S. Obesity Epidemic: Causes, Consequences and Health Provider Response Suzanne Bennett Johnson 2012 APA President sbjohnson@apa.org Presentation Overview Epidemiology of obesity Consequences of obesity
More information2010 Dietary Guidelines for Americans
2010 Dietary Guidelines for Americans Mary M. McGrane, PhD Center for Nutrition Policy and Promotion February 25, 2015 Agenda for Commodity Supplemental Food Program (CSFP) Brief history and description
More informationDepartment of Nutrition, University of California, Davis; University of California Agriculture and Natural Resources
Labels Food The United States Food and Drug Administration requires most packaged foods and beverages to have a Nutrition Facts label to help consumers make informed choices about the foods they eat. Serving
More informationNutritional Guidelines for Roux-en-Y and Duodenal Switch Gastric Restrictive Procedures. Phase III Regular Consistency
Nutritional Guidelines for Roux-en-Y and Duodenal Switch Gastric Restrictive Procedures Phase III Regular Consistency The University of Chicago Hospitals Center for the Surgical Treatment of Obesity (March
More informationLecture 4 Nutrition Part 2 Nutrition 1. Healthy Diet 2. Sugar 3. Consumer Concerns
Lecture 4 Nutrition Part 2 1 Nutrition 1. Healthy Diet 2. Sugar 3. Consumer Concerns 2 1 Healthy Diet! 3 Four basic behaviors that constitute a "healthy lifestyle" 1. A good diet, 2. Moderate Exercise,
More informationReducing added sugars:
Reducing added sugars: Will it reverse the trend toward overweight & obesity? John S. White, Ph.D. White Technical Research Argenta, IL USA Chicago, 23 October 2018 1 Disclosure statement 24-year industry
More informationCommonly Performed Bariatric Procedures in Singapore. Lin Jinlin Associate Consultant General, Upper GI and Bariatric Surgery Changi General Hospital
Commonly Performed Bariatric Procedures in Singapore Lin Jinlin Associate Consultant General, Upper GI and Bariatric Surgery Changi General Hospital Scope 1. Introduction 2. Principles of bariatric surgery
More informationA Bariatric Patient in my Waiting Room: Choosing the Right Patient for the Right Operation: Bariatric Surgery Indications
A Bariatric Patient in my Waiting Room: Choosing the Right Patient for the Right Operation: Bariatric Surgery Indications Shahzeer Karmali MD FRCSC FACS Associate Professor Surgery University of Alberta
More informationDiabetes Head To Toe May 31, Obesity in Canada. Six million Canadians are living with obesity
Medical & Surgical Options for the Bariatric Patient Michelle Mountain, RD, B.Sc Obesity in Canada 1 in 5 adults are obese Six million Canadians are living with obesity 1 in 10 children have clinical obesity
More informationCurrent Status of Bariatric Surgery in Asia
Emerald hall A, 1:2-1:5, November 7, 213 Current Status of Bariatric Surgery in Asia Go Wakabayashi, MD, PhD, FACS Professor and Chairman Department of Surgery Iwate Medical University Numbers of bariatric
More information6/23/2011. Bariatric Surgery: What the Primary Care Provider Should Know. Case Presentation: Rachelle
Bariatric Surgery: What the Primary Care Provider Should Know 2,000 B.C. 2,000 A.D. Case Presentation: Rachelle 35 year-old woman with morbid obesity. 5 1 236 lbs BMI 44.5 PMHx: mild depression obstructive
More informationDiabetes Mellitus Case Study
COLORADO STATE UNIVERSITY Diabetes Mellitus Case Study Medical Nutrition Therapy By: Emily Lancaster 9/28/2012 [Type the abstract of the document here. The abstract is typically a short summary of the
More informationNutrition Analysis Project. Robin Hernandez. California State University, San Bernardino. HSCL Dr. Chen-Maynard
Nutrition Analysis Project Robin Hernandez California State University, San Bernardino HSCL 365 - Dr. Chen-Maynard March 15, 2012 1. A) Personal Background: Summary of Findings Name: Pregnancy: Robin S.
More informationOat beta glucan: Multiple roles in the gut. A.R. Mackie, B.H. Bajka, B. Kirkhus
Oat beta glucan: Multiple roles in the gut A.R. Mackie, B.H. Bajka, B. Kirkhus Introduction Food is consumed Food resides in the stomach Chyme is gradually emptied into the duodenum Can oat beta glucan
More informationWhole Grains: Dietary Recommendations, Intake Patterns, and Promotion
Just Ask for Whole Grains Conference Kansas City, Missouri November 5, 2007 Whole Grains: Dietary Recommendations, Intake Patterns, and Promotion Dr. Robert C. Post, Deputy Director Center for Nutrition
More informationDiabetes is a condition with a huge health impact in Asia. More than half of all
Interventions to Change Health Behaviors and Prevention Rob M. van Dam, PhD Diabetes is a condition with a huge health impact in Asia. More than half of all people with diabetes live today in Asian countries,
More information