Obesity and Malnutrition

By: Ruchi Shah

Objectives

u Discuss:
u The prevalence of obesity in the United States
u Factors that contribute to obesity
u Malnutrition and diagnosis
u Micronutrient deficiencies those with obesity have
u Deficiencies and their relation to the onset of diabetes
Prevalence of Obesity in the United States
BMI Categories
Malnutrition
Malnutrition
and Nutrition
Care Pathway
“It is interesting to note that the prevalence of
nutrient deficiency is higher in overweight, obese,
and morbidly obese compared to normal weight
patients, suggesting that obese patients may
consume an excess of dietary energy, but they may
not meet their entire essential nutrient needs.
Moreover, the absorption, distribution, metabolism,
and/or excretion of these nutrients in overweight
and obese individuals might be altered, as in the
bioavailability of these nutrients.”
Obesity + Malnutrition
Important Things to Consider

u ask the patient if they have had unintentional weight loss

u Determine significance
u Are they experiencing fluid retention?
u When an obese person gets sick, they are at risk of the same protein-wasting
that comes from acute illness as a non-obese person,”
Vitamin Deficiencies

Vitamin D
 Vitamin C
u Studies have shown:
u Vitamin C is inversely related to BMI
u Decrease concentrations of antioxidants in
obese patients
u Fat oxidation is significantly lower in
individuals with lower vitamin C
u Carnitine
 Thiamine
u Catalyzes several key factors in glucose metabolism
u Krebs cycle -> ATP
u Critical in Pentose Phosphate Pathway
u 30% of bariatric patients (pre-op) are thiamine deficient
u Studies found thiamine deficiencies in obese patients :
u Through consumption of diets high in simple sugars and low in
whole grains, legumes, and other foods that naturally contain
thiamin
Mineral
Deficiencies
--
Iron
Other Mineral Deficiencies in Obesity

u Chromium
u Zinc
u Selenium
u Magnesium

u Risk for type 2 Diabetes

References
u Carlin, Arthur M., et al. "Prevalence of vitamin D depletion among morbidly obese patients
seeking gastric bypass surgery." Surgery for Obesity and Related Diseases 2.2 (2006): 98-103.
u Kaidar-Person, Orit, et al. "Nutritional deficiencies in morbidly obese patients: a new form
of malnutrition?." Obesity surgery 18.8 (2008): 1028-1034.
u Kerns, Jennifer C., Cherinne Arundel, and Lakhmir S. Chawla. "Thiamin deficiency in people
with obesity." Advances in Nutrition: An International Review Journal 6.2 (2015): 147-153.
u Moizé, Violeta, et al. "Nutritional intake and prevalence of nutritional deficiencies prior to
surgery in a Spanish morbidly obese population." Obesity surgery 21.9 (2011): 1382-1388.
u Mutt, Shivaprakash J., et al. "Vitamin D and adipose tissue—more than storage." Frontiers in
physiology 5 (2014).
u Via, Michael. "The malnutrition of obesity: micronutrient deficiencies that promote
diabetes." ISRN endocrinology 2012 (2012).
u Https://www.cdc.gov/obesity/adult/defining.html
u http://www.who.int/nutrition/double-burden-malnutrition/en/