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PATHOPHYSIOLOGY > Childhood Obesity > Flashcards

Childhood Obesity Flashcards

1
Q

Prevalence of obesity is so high that the World Health organization (WHO) and the Centers for Disease Control and Prevention (CDC) now refer to the matter as what?

A

Obesity Epidemic

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2
Q

World Watch Institute released a report a report in the year 2000 stating “For the first time in human history, the number of overweight people rivals who?

A

the number of underweight people

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3
Q

How much are the U.S adults are considered obese?

A) 1/2
B) 3/4
C) 1/3
D) 1/4

A

C

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4
Q

The rates of childhood obesity have ____________ since 1980 in the U.S.

A) doubled
B) tripled
C) quadrupled
D) declined

A

B

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5
Q

According to the WHO, “_____ million children under five are estimated to be overweight worldwide”

A

22 million

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6
Q

Unless effective population-level interventions to reduce obesity are developed, the steady rise in life expectancy observed in the modern era may soon come to an end and the youth of today may, on average, live less healthy and possible even shorter lives than their parents.

True or False?

A

True

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7
Q

Parents and their children could, in the future could by vying for a limited number of hospital beds.

True or False?

A

True

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8
Q

Canadian Community Health Survey conducted between 2009-11 revealed that a reported ___________% of 5-11 year olds were overweight or obese (CCHS).

This is relatively stable from 2005-2013

No update since 2013 by stats Canada

A

32.8% (one third)

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9
Q

Do obese children and adolescents typically outgrow childhood obesity?

A

No

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10
Q

Data from studies show that obese children aged 10-13 have an _____% chance of becoming obese adults.

Many more children who are not overweight or obese will gain excess weight in adulthood.

A

80%

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11
Q

Trends in weight gain forecast that approximately _______ of normal weight 20 year olds will become overweight within 8 years and approximately ______ of overweight 20 year olds will become obese within 8 years

A

1/3

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12
Q

In 20 years, we can expect ______% of the 35-44 year olds in Canada to be overweight or obese vs. 57% who are currently overweight or obese.

A

70%

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13
Q

The burden on the healthcare system due to obesity-related illnesses, will be enormous, which is why there is so much at stake in halting these trends now.

True or False?

A

True

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14
Q

How is overweight and obesity in adults is measured?

A

using Body Mass Index (BMI)

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15
Q

How is a person’s Body Mass Index determined?

A

weight (in kg) divided by the square of their height in meters squared

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16
Q

According to BMI, at what point is an adult considered obese?

A

BMI greater than 30 kg/m2

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17
Q

According to BMI, adult ideal BMI lies between what “kg/m2”?

A

18.5-24.9 kg/m2

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18
Q

According to BMI, what would one be if they were defined as 25-30 kg/m2?

A

Overweight

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19
Q

According to BMI, what would one be if they were defined as over 30 kg/m2?

A

Obese

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20
Q

Since children grow at different rates based on age, and because they also vary in growth patterns by gender, ideal weight is based on what?

A

growth charts

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21
Q

You will likely see a number of different measurement styles for growth charts, but they will all be based on growth charts specific for a child’s age and gender.

True or False?

A

True

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22
Q

The Centers for Disease Control and Prevention (CDC) growth charts are used to assess the weight of who?

A

children in the U.S.

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23
Q

The Centers for Disease Control and Prevention (CDC) growth charts are used to assess weight in children in the U.S. Plotting a child’s BMI on the growth chart appropriate for age and gender will allow you to see what ________________ the child’s weight falls within.

A

percentile

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24
Q

Children with BMIs below the 5th percentile are considered to be what?

A

underweight

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25
Q

Children with BMIs on or between the 5th and 85th percentile are considered to be what?

A

at their ideal weight

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26
Q

Children with BMIs above the 85th but below the 95th percentile are considered to be what?

A

overweight

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27
Q

Children with BMIs at or above the 95th percentile for their gender and age are considered to be what?

A

obese

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28
Q

What are known as the “gold standard” for assessing growth in Canadian children, as of 2010?

A

WHO (World Health Organization) growth charts

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29
Q

The World Health Organization (WHO) growth charts are the “gold standard” for assessing growth in Canadian children, as of 2010. These are thought to more accurately reflect growth in Canadian children and were created based on populations in a number of different countries.

True or False?

A

True

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30
Q

The World Health Organization (WHO) growth charts are the “gold standard” for assessing growth in Canadian children, as of 2010.

What are the three categories the set of parameters are broken down into?

A

Birth - age 2, 2-5 years, and 5-19 years

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31
Q

The World Health Organization (WHO) growth charts are the “gold standard” for assessing growth in Canadian children, as of 2010.

In the Ages 5-19 years category, what is assessed as BMI-for-age above the 85th percentile, specific for gender?

A

Overweight

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32
Q

The World Health Organization (WHO) growth charts are the “gold standard” for assessing growth in Canadian children, as of 2010.

In the Ages 5-19 years category, what is it known as if one is at or above 97th percentile for their age and gender is considered obese for 5-19-year-old group?

A

Obesity

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33
Q

The World Health Organization (WHO) growth charts are the “gold standard” for assessing growth in Canadian children, as of 2010.

In the Ages 5-19 years category, what is it known as if one is at or above the 99.9th percentile?

A

Severe Obesity

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34
Q

In Canada, what age group is most affected by overweight and obesity?

A

adolescents

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35
Q

In Canada, adolescents are the age group most affected by overweight and obesity.

From 1978/1978 to 2004, the proportion of overweight children between 2 and 5 years old remained the same, although obesity, previously unseen in this age group, rose to 6% in 2004.

True or False?

A

True

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36
Q

Combined, Overweight and obesity rates doubled in those 6-11 years old, from 1978/1979 to 2004, and almost tripled in 2011 compared to levels reported in 1978/1979.

True or False?

A

True

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37
Q

Obesity in the 12-17 year-old group _____________, while the population of overweight and obese more than doubled since the previous measurement in 1978/1979.

A

tripled

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38
Q

What are two factors identified with obesity risk by the Canadian Community Health Survey?

A
  • More than 2 hours of screen time per day (either TV viewing, computer time or video gaming) and
  • consumption of less than 5 servings of fruits and vegetables per day
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39
Q

Obesity is caused by an imbalance between what two things?

A

Energy In (in the form of intake of nutrient dense foods) and Energy Out (in the form of activity)

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40
Q

What type of energy is this? Energy In or Out?

Energy in the form of intake of nutrient dense foods.

A

Energy In

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41
Q

What type of energy is this? Energy In or Out?

Energy in the form of activity

A

Energy Out

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42
Q

There are many variables that dictate what the intake/output ratio will look like.

Obesity is therefore a simple problem with a single cause and there are many simple solutions.

True or False?

A

False (Obesity is therefore not a simple problem with a single cause and there are no simple solutions.)

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43
Q

Which of the following can contribute to obesity?

A) Conditions in the family and home
B) Availability of facilities for leisure-time activities can have an impact.
C) Public transportation
D) Safety and quality of healthcare
E) Education level may impact food and nutrition choices regionally or nationally
F) All of the above

A

F

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44
Q

National perspective on education, healthcare and nutrition can also complicate the picture.

True or False?

A

True

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45
Q

Internationally, what two things are especially important for child nutrition?

A

media and particularly food advertising

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46
Q

A study in the U.S on January 6, 2004 established that:

30% (6212 children and adolescents over five years of age) of US children and adolescents will eat what everyday?

A

fast food

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47
Q

Children who eat fast food consume how many additional calories daily?

A

187

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48
Q

Children who eat fast food consume 187 additional calories daily.

This totals how many pounds of weight gain per year?

A

6 (six)

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49
Q

What is a factor of obesity since overweight and obesity occurs more than often in the African-Hispanic and Native-American population than in Caucasian children in the US; Aboriginal children are more often affected in Canada?

A

Ethnicity

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50
Q

Adolescent males of ____________ descent and adolescent ______________ ________________ females predisposed to the development of obesity, given the right condition.

A

Hispanic and African American

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51
Q

What is a factor of obesity since the biggest predictive factor in childhood obesity appears to be obesity in one or both parents and is related more strongly with ____________ obesity?

A

Genetics and maternal

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52
Q

Children obviously consume the same diet as their parents and have also been shown to do what?

A

mirror their activity level

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53
Q

What are risk factors among African American children?

A

frequent sweets and sugar sweetened drinks

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54
Q

What are risk factors among Caucasian children?

A

(higher risk with frequent) consumption of snacks with high fat content

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55
Q

What are risk factors among Hispanic children?

A

inactivity, consumption of multiple servings of fruit

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56
Q

Studies have shown that parents may not recognize their child as overweight and may not be aware of the associated health consequences and seriousness of the situation.

True or False?

A

True

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57
Q

Since parents are responsible for food purchases and meal preparation, their lack of awareness may worsen the problem.

True or False?

A

True

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58
Q

Which figures in a child’s life have the greatest opportunity to make the lifestyle changes?

A

Parents

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59
Q

When parents refuse to recognize the problem, it may lead to continued weight gain over the remaining years and maintenance of overweight or obese status into when?

A

Adulthood

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60
Q

Besides the risks to the child’s health, their quality of life may suffer due to their extra pounds.

Dr. Jeffrey Schwimmer and his associates examined quality of life questionnaires from children and adolescents and discovered that obese children give a quality of life score similar to who?

A

cancer patients

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61
Q

The Economist magazine cover from the year 2003 shows that we have evolved into humans over thousands of years, yet it has only taken a few decades to develop into an overweight society.

True or False?

A

True

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62
Q

The article in The Economist, talks about days gone by when the rich were fat and the poor were thin, as opposed to today’s situation where the rich are _______ and the poor are ________ and there is great concern over the epidemic of obesity that is sweeping the globe.

A

thin and fat

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63
Q

With the invention of personal computers and video games, children are far more active! After school is and always has been a time to play ball in the park or hide and seek in your neighbourhood. Everything is fine!

True or False?

A

False

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64
Q

the problem of inactivity is compounded by the fact that playing video games or watching TV is often accompanied by snacking on what?

A

high fat, calorie-dense foods

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65
Q

Obesity can lead to what psychological issue?

A

poor self-esteem and in some cases depression

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66
Q

Those who are _____________ are more likely to be diagnosed with cancer, liver disease, osteoarthritis, stroke, type 2 diabetes, and any number of cardiovascular diseases.

A

obese

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67
Q

For years, what was considered somewhat passive?

A

adipose tissue

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68
Q

What is the main storage deport for triglycerides, which are the most common form of lipid consumed in a meal?

A

adipose tissue

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69
Q

It was discovered a decade ago that adipose tissue synthesizes and secretes a number of substances including what two things?

A

hormones and inflammatory molecules (now referred to as adipokines)

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70
Q

It was discovered a decade ago that adipose tissue synthesizes and secretes a number of substances including hormones and inflammatory molecules (now referred to as adipokines)

These secreted substances allow different tissues in the body to interact to maintain what?

A

lipid homeostasis

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71
Q

Chronic exposure of tissues to high levels of __________ and their sometimes toxic ________________ ______-___________________ is now considered the root cause of many of the health problems associated with obesity

A

lipids and metabolic by-products

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72
Q

Obesity is a known risk for cardiovascular disease in general but manifestation as what is less clear?

A

ischemic stroke

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73
Q

What type of obesity causes the greatest risk of stroke?

A

central obesity

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74
Q

Greater waist-to-hip ratio increased the risk of ischemic stroke in both men and women, although the risk was greater in who?

A

Men

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75
Q

Risk of stroke from greater waist-to-hip ratio was shown at all ages but there appeared to be a greater risk among those younger or older than 65?

A

younger than 65

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76
Q

Fat deposited around central organs is associated with higher risk of stroke. What is this called?

A

Visceral adiposity

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77
Q

Obesity may lead to type II diabetes over time because of what two factors?

A

dysregulated lipid metabolism (which can then cause) and Insulin resistance

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78
Q

Insulin resistance is common in obesity, and cannot be reversed by lifestyle changes.

True or False?

A

False (Insulin resistance is common in obesity, but can be reversed by lifestyle changes)

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79
Q

Insulin resistance can eventually lead to _____________________ when the pancreas fails to be able to produce sufficient insulin to affect glucose uptake in cells.

This could lead to ____________________ and diabetes if not corrected

A

hyperinsulinemia and hyperglycemia

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80
Q

Hyperglycemia with altered blood flow and vascular endothelial damage may lead to what?

A

diabetic retinopathy (and eventual blindness)

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81
Q

What are two of the biggest risk factors in the development of atherosclerosis?

A

Obesity and inactivity

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82
Q

Obesity and inactivity are two of the biggest risk factors in the development of atherosclerosis, which can cause what two diseases?

A

coronary artery disease and peripheral artery disease

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83
Q

Altered lipid metabolism that results from a constant excess of nutrients as well as a diet high in fat leads to what?

A

Lower levels of HDL (high-density or “good cholesterol) and Higher levels of LDL (low-density or “bad cholesterol”)

84
Q

VASCULAR DISEASES

The inflammatory process, that is also a result of lipid dysregulation, compounds the problem by increasing the influx of ______________________ into vascular tissues where they remove LDL cholesterol from circulation, creating ___________ ______________ and advancing the atherosclerotic process.

A

macrophages and foam cells

85
Q

Over-nutrition leads to fat deposition in __________ cells, which is further enhanced by what? (another consequence of constant overeating and inactivity)

A

liver cells; insulin resistance

86
Q

There is an increased risk of fatty liver disease amongst obese individuals and diabetes patients but is present in virtually all who are what two things?

A

Morbidly obese AND diabetic.

87
Q

Fatty liver disease may start out ______________________, however these fat deposits can lead to increases in _______________________ activity, fibrosis and eventually cirrhosis in some cases.

A

asymptomatic and inflammatory

88
Q

Although those with fatty liver disease may start out asymptomatic, these fat deposits can lead to increases in inflammatory activity, fibrosis and eventually cirrhosis in some cases.

Liver failure can result and the chances of hepatocellular carcinoma are increased as well.

True or False?

A

True

89
Q

Obesity increases your risk for what type of cancer cancer?

especially central obesity.

A

colon cancer

90
Q

High/low BMI is correlated with higher risk of colon cancer, especially in males/females?

A

High and males

91
Q

Increasing waist circumference was even more strongly correlated with the chance of colon cancer and linked to increased risk was found to increase linearly with increasing waist size in only men.

True or False?

A

False (Increasing waist circumference was even more strongly correlated with the chance of colon cancer and linked to increased risk was found to increase linearly with increasing waist size in both men and women.)

92
Q

It seems that visceral adiposity, or fat deposits around the central organs creates an even greater risk of colon cancer than elevated BMI ALONE

True or False?

A

True

93
Q

Is Apple shape (visceral or central adiposity) associated with higher or lower risk than pear shape (subcutaneous fat deposits, usually around hips and thighs)?

A

Higher risk

94
Q

What disease is used to be associated with advanced age, but it Is now being seen at earlier ages, as is diabetes (another former disease of old age, especially in those with elevated BMIs.)?

A

Osteoarthritis

95
Q

Increased weight adds extra stress to what two things?

A

Bones and joints

96
Q

What inflammatory molecule secreted by adipose tissue may play a role in causing and advancing osteoarthritis?

A

Adipokines

97
Q

Investigation into inflammation related to adipokines was instigated when it was noticed that there was also an increase in osteoarthritis with high BMI in non-weight bearing joints such as the hands.

True or False?

A

True

98
Q

Inflammatory cytokines, such as _______________ promote cartilage degradation and the advance of osteoarthritis

A

TNF-alpha (tumour necrosis factor-α or TNF-α),

99
Q

If a mother has __________________ diabetes, this can have a profound effect on a child’s propensity for weight gain down the road

A

gestational

100
Q

Children born large for gestational age are predisposed to what two things?

A

obesity and diabetes

101
Q

Children born small for gestational age are also predisposed to obesity and diabetes and they may manifest characteristics during what stage of life (when triggered by the environmental factors of inactivity and poor diet)?

A

adolescence

102
Q

Fetal environment may permanently alters metabolic processes to a more “thrifty phenotype” so that _________________ ____________________ malfunctions during overabundance of nutrients

A

glucose homeostasis

103
Q

Fetal environment may permanently alters metabolic processes to a more “thrifty phenotype” so that glucose homeostasis malfunctions during overabundance of nutrients
This may results in what two things (other evidence of metabolic syndrome).

A

insulin resistance and (increased risk of) cardiovascular disease

104
Q

What two things may predispose children to weight gain that leads to central obesity and therefore, insulin resistance?

A

Ethnicity and genetic makeup

105
Q

The onset of ____________ results in reduced insulin sensitivity and compensatory increase in insulin secretion.

A

puberty (This was first discovered because of the increase by about 30% for insulin by type I diabetics entering puberty.)

106
Q

The onset of puberty results in reduced insulin sensitivity and compensatory increase in insulin secretion.

This is only a transitory situation and insulin sensitivity and secretion returns to normal once the child has reached full adolescence

True or False?

A

True

107
Q

Dyslipidemia

Constant excess caloric intake leads to an increased size of what type of cell?

A

adipocytes (enlarged cells in adipose or fat tissue)

108
Q

Adipocytes will produce and secrete excess what?

a combination of hormones and cytokines - which are small immune system molecules such as TNF-α

A

adipokines

109
Q

Enlarged adipocytes, filled with fat, produce and secrete excess adipokines and this causes problems in what type of metabolism?

A

lipid

110
Q

Enlarged adipocytes, filled with fat, produce and secrete excess adipokines and this causes problems in lipid metabolism.

The enlarged adipocytes have little capacity to take in more lipids, so fat may begin to be deposited into what type of cells?

A

muscle cells (because the fat cells are full)

111
Q

Enlarged adipocytes, filled with fat, produce and secrete excess adipokines and this causes problems in lipid metabolism.

The excess TNF-α causes an increase in free fatty acids in the bloodstream by causing some of the fat in adipose tissue to do what?

A

breakdown

112
Q

Enlarged adipocytes, filled with fat, produce and secrete excess adipokines and this causes problems in lipid metabolism.

The excess TNF-α also inhibits clearance of what type of cholesterol?

A

VLDL (which is the main transporter of triglycerides - and some cholesterol in the bloodstream)

113
Q

TNF-α also is involved in increased production of more VLDL by the liver and lowering levels of high-density lipoprotein (HDL) in the circulation in response to increased adiposity, or weight gain.

All of these extra circulating triglycerides and free fatty acids interfere with insulin signaling in muscle and liver tissue.

True or False?

A

True

114
Q

Insulin that is released after meal, binds to receptors on cells in what type of cell and tissue?

A

skeletal muscle and adipose

115
Q

Insulin that is released after meal, binds to receptors on cells in skeletal muscle and adipose, and signals them to take up what type of substance?

(that is flooding into the bloodstream from the digestive system.)

A

glucose

116
Q

High concentrations of _______-________ __________ in the blood interfere with the signaling in the cells that allow the cells to take up glucose.

This prevents the cells from taking up the glucose in response to insulin. This is the beginning of what?

A

free-fatty acids and insulin resistance

117
Q

The pancreas produces more and more insulin in response to this insulin resistance. The pancreas is able to overproduce insulin to compensate for insulin resistance for a while.

True or False?

A

True

118
Q

This is why the first signs of impending type II diabetes are what two things?

A

elevated triglycerides and impaired glucose tolerance (since the body has to produce so much to take up glucose)

119
Q

Beta cells eventually become exhausted from producing so much insulin and failure of the beta cells is the point at which glucose levels in the blood begins to rise and ___________________ results.

A

hyperglycemia

120
Q

Type II diabetes happens over a period of years.

This results from the metabolic disturbances that occur when the body is constantly overwhelmed by trying to deal with an overabundance of food, especially when this is compounded by what?

A

lack of activity (or sedentary lifestyle)

121
Q

Dyslipidemia, or disturbed lipid metabolism, does not typically increase the risk for cardiovascular disease.

True or False?

A

False (This dyslipidemia, or disturbed lipid metabolism, also greatly increases the risk for cardiovascular disease)

122
Q

Pathophysiology of Metabolic Syndrome

The levels of good cholesterol (HDL) (rise/drop), the levels of triglycerides and the bad cholesterol (LDL) (rise/drop)?

A

drop and rise

123
Q

Pathophysiology of Metabolic Syndrome

The levels of good cholesterol (HDL) drop, the levels of triglycerides and the bad cholesterol (LDL) are elevated.

Oxidation of this excess of LDL in the bloodstream is taken up by immune cells that deposit in the arteries, beginning what process?

A

atherosclerosis

124
Q

Pathophysiology of Metabolic Syndrome

Oxidation of this excess of LDL in the bloodstream is taken up by immune cells that deposit in the arteries, beginning atherosclerosis.

This process can begin very early in those eating a diet high in fat, especially what two types of fats?

A

saturated and trans fats

125
Q

What are the first signs of the atherosclerotic process?

A

Fatty streaks in an organ are associated with

126
Q

Fatty streaks, which are the first signs of the atherosclerotic process have even been found in coronary arteries in children at what age?

A

9

127
Q

When, adipocytes release angiotensinogen (RAA system), what does this cause?

A

Hypertension

128
Q

Blood pressure is maintained in the body through what system?

A

RAA System (Renin-angiotensin-aldosterone)

129
Q

Hypertension: adipocytes release angiotensinogen (RAA system)

Adipocytes release ________________________ along with the other adipokines, and the amount is related to _____________.

A

angiotensinogen and adiposity

130
Q

Body mass index is positively/negatively correlated with plasma concentrations of angiotensinogen?

A

positively

131
Q

Renin is positively/negatively correlated with angiotensinogen?

A

positively

132
Q

Renin is positively/negatively correlated with angiotensin-converting enzyme activity?

A

positively

133
Q

What is common in obesity, and usually caused by insulin resistance?

A

Acanthosis Nigricans

134
Q

What is Acanthosis Nigricans?

A

Area of hyperpigmentation (usually found in body folds (the back of the neck, under the arms, and in the groin area))

135
Q

Acanthosis Nigricans can be brown to black and is an area of thicker, velvety skin.

True or False?

A

True

136
Q

How can Acanthosis Nigricans be treated?

A

through diet change and increase in activity

137
Q

Polycystic Ovary Syndrome (PCOS) is associated with

what three things?

A

obesity, hyperandrogenism, and hyperinsulinemia (related to insulin resistance)

138
Q

What results in excess body hair, acne, and often elevated levels of testosterone?

A

Hyperandrogenism

139
Q

What seems to be the cause of cysts that develop on the ovaries

The condition is usually accompanied by what?

A

Failure of ovulation and menstrual irregularities

140
Q

What is related to obesity as well and may be caused by dysregulation of lipid metabolism?

A

NAFLD (non-alcoholic fatty liver disease)

141
Q

NAFLD (non-alcoholic fatty liver disease) can be asymptomatic but may eventually progress to cirrhosis and could ultimately lead to liver failure.

True or False?

A

True

142
Q

Both Polycystic Ovary Syndrome (PCOS) and Nonalcoholic Fatty Liver Disease (NAFLD)
can improve with what two strategies?

A

weight loss and exercise

143
Q

What is a main goal of the Children’s Exercise and Nutrition Centre Program?

A

Modification of eating behaviour

144
Q

Modification of eating behaviour is a goal of the Children’s Exercise and Nutrition Centre Program.

This must be accomplished ______________ and result in a permanent change in dietary choices to be effective

A

gradually

145
Q

Choosing to be physically active after school and breaking the habit of sitting in front of the TV with an unhealthy snack is one way to modify a behaviour that leads to excess weight gain.

True or False?

A

true

146
Q

Failure of Diets

Basal metabolic rate (rises/drops) in response to a (increased/decreased) availability of food through dieting.

This causes weight to be quickly (regained/lost) when previous food levels are reinstated

A

drops and decrease and regained

147
Q

The only way to permanently reduce weight is to do what?

A

change the eating behaviours for good and increase levels of physical activity

148
Q

Glucose could be normal or high, depending on the degree of metabolic derangements.

True or False?

A

True

149
Q

High LDL and low HDL could lead to deposition of oxidized LDL cholesterol in the artery walls (atherosclerosis) which put these individuals at a higher risk for what?

A

heart disease

150
Q

High LDL and low HDL could lead to deposition of what and where?

A

oxidized LDL cholesterol in the artery walls

151
Q

High triglyceride levels would compound problem of _______________ and ________________ dysregulation and could eventually lead to type II diabetes mellitus, if left unchecked.

A

glucose and insulin

152
Q

Abnormal values for lipids and glucose are seen in about ____% of program participants, so even though some participants are deemed obese by their height and weight, their blood may not show any metabolic abnormalities.

A

70%

153
Q

To blood glucose levels within range, what three things can be done?

A

Healthy eating habits, active lifestyle, medication

154
Q

What is the most common fat in the body?

A

Triglycerides

155
Q

What is total amount of cholesterol in the blood (LDL and HDL)?

A

Total cholesterol

156
Q

High levels of what can cause a buildup of plaque in arteries narrowing increased risk of heart attack and stroke?

A

LDL cholesterol

157
Q

What helps protect from atherosclerosis, heart disease and stroke?

A

HDL cholesterol

158
Q

High levels of what is linked to low levels of HDL, excess body weight, and poorly controlled diabetes?

A

Triglycerides

159
Q

What type of fats are a good choice?

A

Unsaturated

160
Q

What type of fats are a poor choice?

A

saturated and trans

161
Q

What is the gold standard to measuring percent body fat?

A

Underwater Weighing

162
Q

Why is Underwater Weighing not used very often?

A

You need specialized equipment and it is hard to do with children

163
Q

What method of measuring percent body fat is not as reliable and can be variable depending on who is doing the measurement?

A

Triceps Skinfold Thickness

164
Q

What method of measuring percent body fat can be done easily, using either a stand-on device or a hand held one?

A

Bioelectrical Impedance

165
Q

Bioelectrical Impedance gives an accurate measure of body fat that correlates well with values derived by underwater weighing, so the stand-on device shown on the far right is used Children’s Exercise and Nutrition Centre.

True or False?

A

True

166
Q

What has been shown to increase insulin sensitivity, even in those with type II diabetes mellitus?

A

exercise

167
Q

What has been shown to reduce glucose production in the liver?

A

exercise

168
Q

Studies also showed that a bout of exercise, ____ hour(s) before consumption of a high fat meal, reduced blood __________________ levels versus the high-fat meal with no exercise

A

1 and triglyceride

169
Q

Glucose transporters migrate to the surface of muscle cells in response to signals transmitted by what?

A

insulin binding to its receptor

170
Q

Translocation of these glucose transporters to the cell surface has also been shown to occur with exercise alone, independent of insulin binding.

(This allows for more glucose to be taken up by the muscle cells to further activity.)

True or False?

A

True

171
Q

A combination of what two things improved dyslipidemia by improving blood lipid profile?

A

low-fat diet and exercise

172
Q

Forgoing sweet drinks is one of the pieces of nutritional advice offered in the CENC program.

As mentioned even 100% fruit juices contain a considerable amount of sugar.

True or False?

A

True

173
Q

Consumption of excess calories, combined with inactivity have led to what?

A

obesity epidemic

174
Q

The whole family needs to be invested in this goal and the earlier they start the better

True or False?

A

True

175
Q

FROM TUTORIAL:

Which of the following statements concerning childhood obesity is/are correct?

A) It can largely be attributed to inheritance of “bad” genes
B) It is not a concern as <10% of Canadian children are considered obese
C) Children often outgrow their “baby fat” and their dietary patterns rarely create problems in adulthood
D) Factors encountered in utero may predispose one to developing childhood obesity

A

D

176
Q

FROM TUTORIAL:

The longer you have the weight issues, the bigger the consequences.

True or False?

A

true

177
Q

FROM TUTORIAL:

On average, how long does it take for signals of satiety to reach the brain?

A) 10 minutes
B) 20 minutes
C) 30 minutes
D) 60 minutes

A

B

178
Q

FROM TUTORIAL:

Which factor is released by stomach when empty and levels decline when the stomach fills?

Released to a lesser extent by small intestine as well.

A

Ghrelin

179
Q

FROM TUTORIAL:

Which factor(s) increase food intake?

A

Ghrelin

180
Q

FROM TUTORIAL:

Which factor decrease food intake due to stretch of gastric lining?

A

Vagal stimulation

181
Q

FROM TUTORIAL:

Which factor released by fat cells when fat stores increase - signals overall body energy status?

A

Leptin

182
Q

FROM TUTORIAL:

Which factor is released by distal small intestines especially when carbohydrate present?

A

GLP-1 (glucagon-like peptide 1)

183
Q

FROM TUTORIAL:

Which factor is released in response to fat in duodenum - gallbladder contracts?

A

CCK

184
Q

FROM TUTORIAL:

Which factor is released by pancreatic beta cells during a meal - suppress feeding signals in hypothalamus?

A

Insulin

185
Q

FROM TUTORIAL:

Which three actions also suppress the feeling of hunger?

A

tasting, chewing, swallowing

186
Q

FROM TUTORIAL:

Interestingly, keto-acids also suppress hunger.

This is due to basis of ketogenic weight-loss diets (high protein, low carb -> e.g. Atkins diet)

True or False?

A

True

187
Q

FROM TUTORIAL:

Which factor(s) decrease food intake?

A

Vagal stimulation, leptin, GLP-1, CCK, Insulin, tasting, chewing, swallowing

188
Q

FROM TUTORIAL:

More than 2 hours of screen time a day is bad; risk of what?

A

..

189
Q

FROM TUTORIAL:

More than 4 hours of screen time, risk of what?

A

metabolic syndrome

190
Q

FROM TUTORIAL:

5 or more fruits and vegetable servings for day
3 meals a day, with family where possible
2 hours or less of screen time a day
1 hour physical activity/day
0 sugar sweetened beverages

True or False?

A

True

191
Q

FROM TUTORIAL:

Clients may need a doctor’s referral to be screened for what?

(These pulmonary function tests, such as, spirometry, asthma challenge testing are done by Respiratory Therapists.)

A

Exercise Induced Asthma

192
Q

FROM TUTORIAL:

Pulmonary function tests

Just know the vital capacity - they’ll look at this for asthma

You should get _____% of your vital capacity out in 1 second while working out

If you have asthma, Vital capacity is reduced and amount of air getting out is reduced to what?

A

80% and half

193
Q

FROM TUTORIAL:

What synrome can occur if the bones are growing faster than the quadriceps muscle, feels like pain in the knee?

A

patellar femoral syndrome

194
Q

FROM TUTORIAL:

The consequences associated with increased adiposity include (TRUE or FALSE?):

  • Elevated LDL, which contributes to atherosclerosis and increases the risk of developing CV disease and/or stroke
  • Increased insulin resistance with or without hyperinsulinemia
  • Arthritis in non-weight bearing joints such as the hands and neck
  • Increased angiotensinogen production contributing to hypertension
  • Development of fatty liver and/or liver cirrhosis in the absence of alcohol abuse
A

All true

195
Q

FROM TUTORIAL:

Metabolic syndrome is best defined as:

A) A disorder associated with decreased thyroid hormone levels and reduced BMR
B) An inflammatory disorder driven by pro-inflammatory cytokines such as TNF-alpha
C) A disorder characterized by insulin resistance, dyslipidemia, obesity and hypertension
D) A disorder characterized by excessive protein catabolism resulting in elevated blood urea nitrogen (BUN)

A

C (due to insulin resistance, dyslipidemia, obesity and hypertension)

196
Q

FROM TUTORIAL:

Hypothyroidism and DM1 often go hand in hand.

True or False?

A

False (Hypothyroidism and DM2 often go hand in hand.)

197
Q

FROM TUTORIAL:

Patients with Hypothyroidism are often fatigued making physical activity a challenge which can lead to weight gain.

True or False?

A

True

198
Q

FROM TUTORIAL:

A patient with arthritis often experiences pain with activity but they must stay active to maintain weight, bone density and joint function.

They may gain weight due to decreased activity related to their pain, stiffness and fatigue.
This possible wt. gain can lead to more stress and load on already compromised and painful joints…now add in the complicating effects of prednisone.

True or False?

A

True

199
Q

FROM TUTORIAL:

What is a common medication (corticosteroid) given to patients to suppress their immune system from attacking and damaging their own bodies?

A

Prednisone

200
Q

FROM TUTORIAL:

The side effects of Prednisone (again refer to the action of Cortisol in the body) can further potentiate Nikki’s wt. gain in the following ways:

Sodium and water retention, decreased bone density, increased blood glucose, increased insulin resistance, and changes in fat metabolism, increased appetite, etc.

True or False?

A

True

201
Q

FROM TUTORIAL:

Which of the following interventions would be most appropriate/effective in helping Juan achieve a health body wt?

A) A regimen that strictly limits caloric intake to 1200 calories/day
B) Increasing physical activity even by 5 more minutes each day
C) Eliminating all sweet drinks and snack foods as they are tools of the devil!
D) Discouraging excessive screen time (<2 hours) and eliminate all snacking after school

A

B

202
Q

Data shows that obese children aged 10-13 have a what percent chance of being obese as adults?

a) 70
b) 15
c) 25
d) 80

A

d

203
Q

Approx what number of normal weight 20 yr olds will be overweight within 8 years

a) 1/3
b) 3/4
c) 2/3
d) 1/4

A

a

204
Q

Approx what number of normal weight 20 yr olds will be obese within 8 years

a) 1/3
b) 3/4
c) 2/3
d) 1/4

A

a

205
Q

If this trend continues in 20 years we can expect what percent of people age 35-44yr to be overweight or obese

A

a) 60
b) 70
c) 25
d) 95

206
Q

metabolic syndrome is characterized by

A
  • insulin resistance
  • dyslipidemia
  • obesity
  • hypertension

PATHOPHYSIOLOGY (9 decks)

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