Flashcards in Atherosclerosis risk factors: Diet and exercise Deck (24):
-30 is obese
->35 is morbidly obese
BMI and atherosclerosis
-increase BMI= increase risk
First line rx of metabolic syndrom
-lifestyle change: diet and exercise
Among equally obese patients, subjects with an excess of ______ adipose tissue have the most deteriorated metabolic risk profile.
6 CV benefits of healthy diet, weight loss, and exercise
-improved lipid profile
-dec insulin resistance/reduced risk of DM
-dec metabolic syndrome parameters
-dec blood pressure
-dec inflammatory markers like CRP
-improved endothelial function
Choosing which diet is best for a patient depends ultimately on the _______.
-goal: mainly wt loss or health benefits, too? short term or long term effects?
Standard dietary recommendations
-reduce intake by 500-1000 kcal/day to lose 0.5-1.0 kg/wk
-balance this diet with >/55% carbs, ~15 protein, 30% fat (<10% sat fat)
-since less calories per gram of protein and carbs than fat
Thought process behind low fat diet
Laboratory-based studies have shown that adults tend to eat a similar amount of food (by weight) each day, regardless of the dietary energy density of that food. Reducing the energy density of a meal (e.g., by adding water or fiber, or substituting carbohydrate or protein for fat) allows dieters to consume fewer calories without sacrificing the size of the meal.
Low Carb diets were seen to offer greater wt losses compared to low-fat diets, but this trend evened out over time, why?
-people could not adhere to the low-carb diets and eventually gave up
In terms of lowering overall CV risk, does low-fat or low-carb win?
-according to framingham, low carb wons: inc HDL and lower TGs but low fat does lower total-C and LDL more so.
Compare wt loss between low-fat, mediterranean, and low-carb diets
-low carbs win, but mediterranian also lost a lot of wt and maintains loss
-low fat lost least amount
Best diet depends on the goal: wt loss or CV effects. _________ may be optimal for both
-reduces risk of DM and cholesterol, reduced risk of CV events, wt loss, good adherence!
Dose and Intensity definitions of exercise
-dose: total amount of energy expended (kJs or kCals)
-intensity: absolute (METs) vs relative (% of max aerobic power maintained)
T/F: many US adults are physically inactive.
-true: 38% irregularly active, 25% sedentary
Physical activity vs exercise vs physical fitness
-PA: bodily movement produced by contraction of skeletal muscle
-exercise: subset of PA that is planned, purposeful, structured, and repetitive
-PF: cardiorespiratory fitness, muscle strength, body composition, flexibility (MET)
CVD mortality rates and CV fitness
-regardless of risk factors or gender, high CV fitness decreases risk of CVD and death
-becoming unfit can cut risk of CVD mortality in half!
Greater frequency of activity decreases rates of CV events. But does intensity matter?
-mortality rates in high LTPA intensity were similar to moderate intensity
-high amount high intensity > low amount high intensity, but low amount high intensity was similar to low amount moderate intensity; walking vs running 1 mile doesnt make a huge diference, just go do it!
If you want to lose weight intensity is less important than if you want to lose wt and get fit.
-regardless of intensity, everyone lost weight, but those with high intensity got more fit!
Exercising at a level of 19 km/wk at 40 to 55% of peak VO2is sufficient to increase aerobic fitness levels, and increasing either exercise intensity or the amount beyond these parameters will yield additional separate and combined effects on markers of aerobic fitness. Therefore, it is appropriate to recommend mild exercise to improve fitness and reduce cardiovascular risk yet encourage higher intensities and amounts for additional benefit.
Life-threatening events during endurance sports, like marathons
-heat stroke is more deadly and likely to kill you than arrhythmias
Biologial mechanisms (6) for the benefits of exercise
-endothelial function alteration
-autonomic functional changes
Antiatherogenic effects of exercise
-PA is associated with less severe CAD, larger CA diameter, and reduced atherosclerosis progression
-reduction in adiposity, reduced in HTN, reduction in TGs, increase in HDL, improvement in insulin sensitivity and glucose use and reduction in T2DM
Execise _______ not _______ improves HDL
Fit vs Fat
-even if you're in obese BMI range, being fitter is better; adjusting for BMI does not remove fitness effect on reducing CVD; even obese and fit can be better off than normal and unfit