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IFM Study > ABCD Nutrition Guide > Flashcards

ABCD Nutrition Guide Flashcards

1
Q

What does ABCD stand for?

A

Anthropometrics(and Body Composition), Biomarkers, Clinical Indicators and Diet/Lifestyle.

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2
Q

What part of the GOTOIT is ABCD a part of?

A

Gather

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3
Q

What measurements are included in Anthropometrics?

A

Height/Length and Weight, waist and hip circumference, BMI, Waist to Hip ratio, and determination of body composition. Also, blood pressure, peak expiratory rate, O2 sat, temperature, respiratory rate and heart rate.

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4
Q

What makes up body composition?

A

Fat free mass, skeletal muscle mass and total body water

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5
Q

How do you determine body composition?

A

Thru BIA(bioelectrical impedence)

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6
Q

When do you check recumbent height?

A

In patients that are under 24 months of age or are bedbound at any age.

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7
Q

What is Frankurt horizontal plane?

A

It is position to check height where head is in neutral position. This plane is defined by a line the lowest point of the orbit of the eye and the tragion(the notch above the tragus, which is the cartilaginous projection just anterior to the external opening of the ear)

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8
Q

How is body weight obtained?

A

On digital or balance beam scale w/o detacable weights. Patients should remove coats, excess clothing and shoes and pockets should be emptied.

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9
Q

Do height and weight tables give information on body composition?

A

No. For this reason, should get additional measurements such as waist/hip ratio, BIA and skinfold measurements.

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10
Q

Up to what age do the standard physical growth measurements in height/weight from CDC go up to?

A

Birth to age 20 and vary by race or medical condition(such as down syndrome)

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11
Q

How do you measure a waist circumference properly?

A

Have the patient stand. Use consistent location. Measure the waist midway between the bottom of 10th rib and top of the iliac crest. (look at image on ABCD Nutrition Guide - pg 5) Record when patient exhales.

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12
Q

Where do you measure hip circumference?

A

Over the greater trochanter.

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13
Q

What grams of tension does the WHO recommend you put on tape measure?

A

100

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14
Q

Is an elevated waist circumference assoicated with all cause mortality?

A

Yes.

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15
Q

What waist in cm/inches is considered an increase health risk to Ethnic South/Central American Males?

A

> 90 cm, > 35.5 inches

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16
Q

What waist in cm/inches is considered an increase health risk to Ethnic South/Central American Females?

A

> 80 cm, >31.5 inches

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17
Q

What waist in cm/inches is considered an increase health risk to Chinese, Japanese Males?

A

> 90 cm, >35.5 inches

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18
Q

What waist in cm/inches is considered an increase health risk to Chinese, Japanese Females?

A

> 80 cm, >31.5 inches

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19
Q

What waist in cm/inches is considered an increase health risk to Europids, Sub-Saharan African, Eastern Mediterranean, Middle East(Arab) population Males?

A

> 94 cm, >37 inches

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20
Q

What waist in cm/inches is considered an increase health risk to Europids, Sub-Saharan African, Eastern Mediterranean, Middle East(Arab) population Females?

A

> 80 cm, >31.5 inches

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21
Q

What waist in cm/inches is considered an increase health risk to USA(mixed ethnicity) Males?

A

> 102 cm, >40 inches

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22
Q

What waist in cm/inches is considered an increase health risk to USA(mixed ethnicity) Females?

A

> 88 cm, >35 inches

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23
Q

What is the standard to check BIA?

A

Use portable supine position devices as they are preferred and protect against multiple confounders including unstable central venous pressure, incorrect arm angle, temperature variations of hands/feet, moisture variation of hands/feet and callouses on hands/feet.

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24
Q

What type of readings(units) does a BIA machine measure?

A

Whole body resistance(R), reactance(Xc) which are 2 components of impedence(Z). The raw numbers are not clinically relevant as they are processed in body composition software with appropriate equations.

25
Q

How does body composition give clues in to the patient?

A

It tells us how patient’s history is connected to patient’s physical exam and how it may be affecting past, current and future biomarkers. Studies have shown that learning about body composition can increase the rate of patient’s interest in lifestyle modification to lose weight from 13% to 60%.

26
Q

What is a standard starting place of epidemilogic and clinical evaluation of body composition?

A

BMI

27
Q

What is formula for BMI?

A

weight(kg)/(height(meters))2 or weight(lbs)/(height(inches))2 x 703

28
Q

What is the main tool to clinically evaluate body composition?

A

BIA

29
Q

What is BIA?

A

It is a class 2 medical device to assess body compostioin and fluid distribution. Has been utilized to quantify somatotyping. The AMA has assigned CPT code 0358T for BIA with interpretation and report. BIA has been used in several medical practice and research areas. It offers a quick 3-5 minute and accurate assessment of composition of the body(fat, muscle, cellular fluid distribution). It can also determine BMR, energy expendture and phage angle in a safe, reliable and cost effective manner.

30
Q

Are there any contraindications for BIA?

A

No, but difficult to measure in pregancy so not recommended in pregnancy. The US FDA warns against use of BIA device in patients with pacemakers and ICDs. Fever and febrile illness can alter results d/t insensible losses. BIA is for use on healthy individuals but there are algorithms for kidney and liver disease. If patient has joint replacement, it is accurate but if has amputation or limb replacement or silicon breast implants, then it is not accurate.

31
Q

What are the body compositions that are reported with BIA?`

A

See chart page 8 in ABCD Nutrition guide.

32
Q

What does TBW represent?

A

The total body water in the entire body including blood, bone, organs and muscle.

33
Q

As fat decreases, TBW will ___?

A

Increase.

34
Q

As muscle increases, TBW will ___?

A

Increases.

35
Q

What percent of fat is water?

A

10%

36
Q

What percent of muscle is water?

A

73%

37
Q

What is the average TBW% of total body weight for women?

A

45-60%

38
Q

What is the average TBW% of total body weight for men?

A

55-70%

39
Q

What causes a decrease in TBW?

A

Aging and increased adiposity.

40
Q

What is ICW?

A

Intracellular water. The water located within the cell. Majority of TBW is intracellular.

41
Q

Where is the majority of ICW?

A

Within muscles and organs?

42
Q

What is ICW associated with?

A

Anabolic processes, greater lean body mass and skeletal muscle mass, improved nutrient retention/use and overall good cellular health and integrity.

43
Q

What is ECW?

A

Extracellular water. The water found outside your cells.

44
Q

What is high levels of ECW associated with?

A

Abnormally high levels are usually indicative of toxicity, excess body fat, inflammation, water retention related to trauma or injury or malnutrition.

45
Q

What ICW:ECW ratio do practitioners strive for?

A

60:40% of TBW.

46
Q

What food considerations should be considered if you have an elevated ECW?

A

Consider inadequate omega 3:6 balance, inadequacy of magnesium and insufficient B vitamin rich foods.

47
Q

What are lifestyle considerations for patients with high ECW?

A

Toxin exposure, increased or chronic stress and inadequate recovery, etoh intake, caffeine intake, pro-inflammatory intake.

48
Q

What are physiologic considerations for patients with high ECW?

A

Renal evaluation, biotrasformation balance, increased inflammation, evaluate chronic stress and its cortisol/aldosterone levels.

49
Q

What type of fat does BIA measure on limbs and just beneath the skin?

A

Subcutaneous fat.

50
Q

What type of fat does BIA measure centrally/hepatic?

A

Visceral Fat(VAT)

51
Q

What is VAT?

A

A type of fat that collects around the abdomen and organs and is associated with many disease risk factors, inflammation and secretion of harmful hormones. It is associated with increase CV risk, higher insulin, blood sugar, blood cholesterol, TGL, BP, gynecological conditions and symptoms of arthritis.

52
Q

Do skin calipers measure VAT?

A

No.

53
Q

What are food considerations in patients with high fat body composition?

A

Consumption of high fat foods, inadequate plant fiber(should increase to 40 gm day). Improve omega 3:6 balance.

54
Q

What are lifestyle considerations in patients with high fat body composition?

A

Improve sleep hygiene. Increase activity, strength, stamina and stretching. Decrease/eliminate alcohol. Improve disordered eating habits.

55
Q

What are physiologic considerations in patients with high fat body composition?

A

Endocrine imbalance(adrenal, thyroid, reproductive - communication node), Liver(biotransformation) dysfunction, microbiome imbalance(immune).

56
Q

What are food considerations in patients with low fat body composition?

A

Chronic consumption of low calorie dense foods.

57
Q

What are lifestyle considerations in patients with high fat body composition?

A

Over exercising in setting of inadequate food/energy intake.

58
Q

What are physiologic considerations in patients with high fat body composition?

A

Liver(biotransformation), endocrine(communication) and assimilation(malabsorption), and hyper-metabolic conditions.

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