ECR Nutrition

Question 1

What is the normal BMI?

Answer 1

19-25

Question 2

What percent of U.S. adults are overwieght or obese BMI>25

Answer 2

60%

Question 3

what percent of US children and adolescent are overweight

Answer 3

> 14%

Question 4

What ethnicity has highest prevalence of being overweight or obese in adolsencent?

Answer 4

Mexican-American boys, black girls, white boys from lower-income families

Question 5

What is prevalence of white vs black women (obesity)

Answer 5

black women-69%
white women 47%
women with income <130% of poverty threshold are 50% more likely to ve obese than those at higher icome leels`=

Question 6

what is prevalence of white vs black men (obesity>)

Answer 6

black men -58%

white men 62%

Question 7

What does overweight and obeisty increase risk of?

Answer 7

heart disease, numerous types of cancers, type 2 diabetes, sstroke, arthritis, sleep apnea, depression

Question 8

What percent of peopel with non-insulin-depenent diabites are overweight or boses?

Answer 8

more than 50%

Question 9

what precent of people are hypertensive or have elevated cholesterol are overweight or obese?

Answer 9

20%

Question 10

how many obese US adults reprot htat health care professionals have advised them to lose weight?

Answer 10

only 42%

Question 11

Reducing weight by what percent can improve BP, lipid levels, and glucose tolerance and reduce risk of diabetes or hypertension.

Answer 11

Reducing 5-10%

Question 12

What are 4 tips for promoting optimal wieght and nutritoin

Answer 12

1. Measure BMI and waist cricumference, identify risk of overwieght and obseity
2. establish additoanl risk factors for heart disease and obesity related diseases
3. assess dietary intake
4. assess the patient’s motivation to change; provide counseling about nutrition and exercise

Question 13

If BMI> 25, assess for WHAT additioanl risk factors?

Answer 13

heart disease and otehr obsiety related diseass: hypertention, high LDL, cholesterol, how HDL cholesterol, high TAGs, high blood glucose, family history of premature heart disease, physical inactivity, cigarette smoking

Question 14

Patients with BMI >25 and two or more risk factors should pursue wegith loss, esp if wasit circumference is elevated.

Answer 14

yes

Question 15

What BMI is considered underweight

Answer 15

<18.5 kg/m2

Question 16

What is normal BMI

Answer 16

18.5-24.9

Question 17

What is overweight BMI

Answer 17

25-29.9

Question 18

What is obsesity class I BMI

Answer 18

30-34.9

Question 19

What is obesity class II BMI

Answer 19

35.0-39.9

Question 20

What is extreme obesity III

Answer 20

> or = to 40

Question 21

What percent of weight loss is recommended for individuals with BMIs between 27-35?

Answer 21

10% weigth reduction over 6 months or decrease of 300 to 500 kcal/day

Question 22

Does a weight loss goal of 1/2 to 1 lb per week okay?

Answer 22

yes b/c more rapid weight loss does not lead to better results at 1 year

Question 23

Once you assess food intake, nurtitional status, and motivation to adopt healthy eating behaviors or lose weight, what are the “nin major messages” to give to patients

Answer 23

1. consume a variety of foods within and among the basic food groups while staying within energy needs
2. control calorie intake and protion size to manage body weigth
3. maintian moderate physical activity for at least 30 mins each day ,walking 3-4 miles per hours
4. increase daily intake of fruits and veggies, whole grains, and non fat or low-fat milk and milk producets
5. choose fats wiesely, keeping intake of saturated fats, trans fat, dfound in partially hyddrogenated vegetable oils, and cholesterol low
6. choose and prepare foods with little salt
7. if youd rink alcoholic beverages, do so in moderation
8. keep food safe to eat

Question 24

waht is the RDA (recommended daily allowance)of sodium?

Answer 24

<5% f RDA of 2400 mg or less

Question 25

What does body fat consist of and where?

Answer 25

primarly adipose in teh form of TAG and is stored in subcutanesou , inter-abdominal, and intramuscular fat depoists that are difficult to measure direclty.

Question 26

what does BMI measure>

Answer 26

incorporates estimated but more accurate measures of body fat than weight alone BMI criteria for overweight and obse ar not rigid cut points abut guidelines for estimating increasing risks to patient health and well-being form both excess and low weight

Question 27

where are BMI standards dervided from?

Answer 27

two surveys: National Health Examination Survey, consisting of three survey cycles between 1960-1970 and National Health and Nutritiona Examination Survey, conducted over 3 cycles between 1970s and 1990s

Question 28

If the BMI is 35 or highger, you should measure

Answer 28

the pateint's waist circumference (wasist just above the hip bones) Patiente may have excess body fat if waist circumference is >35 for women >40 for men

Question 28

What aprat of the lower back is the most vulnerable?

Answer 28

L5-S1, where sacral vertebrae take a sharp posterior angle

Question 29

What precent of the population experiences low back pain at lest onece in a lifetime

Answer 29

60-80%

Question 30

how many american's have osteoporosis?

Answer 30

10 million and 34 million are at increased risk

Question 31

waht percent of men are at risk for osteoporosis?

Answer 31

42% of those at risk are men

Question 32

What does bone strength reflect?

Answer 32

both BONE DENSITY and BONE QUALITY

Question 33

what is bone density?

Answer 33

determined by the interaction of bone mass (highest in send decade) , new bone formaiton, and bone resorption or loss

Question 34

what is bone quality?

Answer 34

architecture, turnover, damage accumulation from microfratures and mineralization

Question 35

whawt is osteoporosis?

Answer 35

skeletal disoder characterized by compromised bone strength predisposing a person to an increased risk of fracture

Question 36

How is bone strength measured?

Answer 36

there is no direct measuremten of bone strength bone mineral density, which accounts for approx 70% bone strenght, is used to proxy meausre

Question 37

What is Osteopenia

Answer 37

Bone density 1.0-2.5 standard deviations below mean for young adult white women (T score between -2.5 and -1.0)

Question 38

Wht is Osteoporosis?

Answer 38

Bone density 1.0-2.5 or more standard deviations below the mean for young adult white woment (T score less tahn -2.5)

Question 39

what part of body is bone density measured?

Answer 39

1 hip, femoral neck, Ward's triagnle at the femoral neck, greater trochanater, an dtotal hip

Question 40

What is a 10% drop in bone density, equivaletn to in fractures?

Answer 40

10% drop in bone density is 1.0 standard devtiatino, is ass. with 20% increase risk for fracture

Question 41

What are basic screening questinos for older women?

Answer 41

``` Have you ever had a fracture Did either parent ever have a fracture? Do you smoke? What is your weight? Have you ever taken estrogen replacement therapy? ```

Question 42

What are risk factors for osteoporosis?

Answer 42

Postmenopausal status in white women Age odler than 50 years weight lass than 70 kg Family Hx of fracture in a first degree relative Hx of fracture Higher intakes of alcohol Women with delayed menarche or early menopause current smokers low levels of 25 hydroxyvitamin D Use of corticosteroids for more than2 months Inflammatory disorders of MC, pulmoanry or gasstrointestinal systems, including celiac sprue, chrhonic renal disease, organ tranplantaiotn, hypognoadism, anorexia nervosa

Question 43

What are some therapeutic uses of avaialbe agents for treating osteoporosis?

Answer 43

increase clacium intake to reduce age-related hyperparathyroidism and increase minearlization of newly formed bone 2/3 of patients with hip fractures are deficient in Vitamin D (for Ca absorption and muscle strength) antiresportpive agents anabolic agents such as parathyroid hormone stimulate bond formation by acting priamrly on osteoblasts Exercise