Chp 16 - addl diseases/conditions/consideration Flashcards by Jennifer Allen

From CDC, chronic diseases affect how many US adults

1 in two

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Lipid parameters associated with CVD

Elevated LDL and total cholesterol
Low HDL
Elevated TGs

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Chronic elevated TGs associated with….

endothelial dysfunction AND an independent risk factor for CVD

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Primary lipoproteins are…

LDL - major carrier, 60-70% of cholesterol

VLDL - major carrier of TG, 10-15% of total chol

IDL - formed from the b’down of VLDL, similar to LDL

HDL - made in SI and LIV – 20-30% of chol – TRANSPORTS lipids to the liver for recycling and removal. INVERSELY correlated with CVD

Non-HDL - TOTAL chol MINUS HD —OR— sum of LDL, VLDL, and IDL; STRONGLY associated with CVD

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LDL chol values - optimal & very high

HDL, low and high

Total cholesterol

<100, >/equal to 190

HDL Low = <40

HDL High = >/= to 60

TOTAL = desirable, <200
High = >/= 240

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TG normal

High

Very high

<150

High = 200-499

Very High = >/= 500

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Prevalence of high cholesterol (>/= 240)

28.5 million
11.9% US adults

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Most likely secondary cause of elevated/high - for those genetically predisposed

Sedentary
Excessive saturated fat, cholesterol, and trans fats

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Dietary recs for managing dyslipidemia…

Lower LDL – 5-6% calories from sat fat, LIMIT sweets, sugar sweetened bevs, red meats

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Exercise and lipid issues - type of exercise best? Plus what other factor?

Aerobic exercise PLUS weight loss - significant improvement

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Typical problems contributing to dyslipidemia..

Sedentary lifestyle PLUS excess sat and trans fats, and cholesterol

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Cancer, referred to as…

collection of approx 200 related diseases characterized by uncontrolled spread & growth of abnormal cells

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Classification of different cancers based on…

cell type from which they orginate

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Prevalence…

one of the leading causes of morbidity and mortality worldwide

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Three general phases of cancer survivorship…

1) tx and recovery

2) living after recovery - survivors dz free or have stable dz

3) advanced cancer and end of life

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Causes of cancer..

1) environmental exposures
2) lifestyle practices
3) medical interventions
4) viral infections
5) genetic traits
6) gender
7) aging

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30% of deaths related to five leading behavior and dietary risks:

1) high BMI

2) low intake of fruits and veggies

3) physical inactivity

4) tobacco use

5) alcohol intake

Goals of nutritional care with cancer…

1) prevent/resolve nutrient deficiencies
2) achieve/maintain health weight
3) preserve LBM
4) minimize nutrition related side effects
5) max quality of life

Physical activity protection against acquiring cancers…how?

e.g. which cancers

balancing caloric intake with EE

other means = changes affecting hormonal environment(s)

colon, endometrial, ovarian, breast

Exercise in the TREATMENT of cancer is to….

maintain and improve CV conditioning
prevent MSK deterioration
reduce symptoms, e.g. nausea, fatigue
improve mental outlook and quality of life

American Cancer Society nutrition guidelines

Limit processed meat and red meat

Consume 2.5 cups of veggies and fruits daily

Choose whole grains vs. refined

Alcohol — limit consumption to no > than 1 drink/day for women and 2 drinks/day for men

Most common forms of arthritis

OA - leading cause of disability in the US

Majority of cases d/t…

secondary to trauma and/or obesity

Joints most often affected by OA

C and L spine, hip, knee, distal joints of hand

Classification of functional status for RA

I = able to do self care and ADL, vocational and avo II = able to do self care and vocational, lmtd avo III - able to do self care, lmtd vocational and avo IV = limited in self care, vocational and avo

Optimal approach to OA

exercise and weight loss

Primary goals of exercise

1) improve CV fitness and lower CAD risk 2) increase mm endurance and strength 3) maintain or improve ROM and joint flexibility

special considerations for exercise

Acute flare ups, pain --> avoid STRENUOUS exercise, gentle ROM is fine Pain lasting longer than 2 hours post exercise, higher than pre session = reduce duration or intensity

LBP defn

recurring or persistent condition with a fluctuating course over time Acute = < 3 mos Chronic = > 3 mos

Typical age

45-64 years 80% of people will have a bout in their lifetime

Acute LBP is usually ______________ in nature

mechanical -- yet underlying cause is unknown so tx is uncertain

Strategies for enhancing back health

a) prevent deconditioning of mm around spine b) avoid painful ROM c) choose low or nonimpact activities - cardiorespiratory endurance, e.g. walking, recumbent biking

Osteoporosis defn

bone mineral density (BMD) that is 2.5 standard deviations or more below the mean Characterized by low bone mass and disrupted microarchitecture

Most common fracture sites

proximal femur, vertebrae spinal, distal forearm

Why are hip fractures most devastating?

associated with severe disability and increased mortality

Osteopenia bone density

between 1.0-2.5 standard deviations below the mean

Two most important nutrients are

Calcium and Vit D

Alcohol association, and servings 3 risks

More than 2 drinks/day for women 3 drinks/day for men Impaired bone health Increased risk of falling Potential alcoholism

Vit D recs dosage

Under age 50 = 400-800 IU 50 and older = 800-1000 IU Safe upper limit is 4,000 IU/day

Healthy range vit d in blood

30-60 ng/mL

Exercise and osteoporosis - 2 primary goals

1) retain and/or prevent loss of bone minerals 2) decrease the risk of falls/fractures