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EXS 450 > Endocrine and Metabolic Conditions > Flashcards

Endocrine and Metabolic Conditions Flashcards

1
Q

Normal BMI

A

18.5 to <25 kg/m2

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2
Q

Overweight BMI

A

25 to <30 kg/m2

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3
Q

Class 1 Obesity

A

30 to <35 kg/m2

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4
Q

Class 2 Obesity

A

35 to <40 kg/m2

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5
Q

Class 3 Obesity

A

≥40 kg/m2

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6
Q

BMI parameters

A

Set based on measured adiposity and the levels at which risk of adverse outcomes increase

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7
Q

Elevated BMI linked with

A

Greater risk of fatal and combined fatal and nonfatal CHD

Greater risk of fatal stroke, ischemic stroke, and hemorrhagic stroke

Greater risk of combined fatal and nonfatal CAD

Greater risk for T2DM

Greater risk of all-cause mortality

Risk of hypertension and dyslipidemia, musculoskeletal and functional limitations

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8
Q

Pear shape

A

Wider hips, smaller top half

Common in women

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9
Q

Apple shape

A

Smaller hips, wider top half

Common in men

Makes it more difficult to breath due to the organs being pressed together

Lower limb stress (bad knees)

CVD risk due to abdominal fat

Lower back pain

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10
Q

Overweight and obesity

A

Risk of abdominal adiposity

Excessive abdominal adiposity is associated with greater health risk

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11
Q

Adults with a BMI of 18.5 to <25 kg/m2 or with a BMI of 25 to <30 kg/m2 without indicators of increased health risk

A

Should be counseled to engage in behaviors that will avoid weight gain

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12
Q

Adults with a BMI of 25 to <30 kg/m2 with indicators of increased health risk or a BMI ≥30 kg/m2

A

Should be counseled to engage in behaviors to lose weight

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13
Q

Adults with a BMI of 27 to <30 kg/m2 with a comorbidity or a BMI ≥30 kg/m2 who have been unsuccessful with weight loss

A

May require pharmacotherapy as an adjunct to a comprehensive lifestyle weight loss program

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14
Q

Adults with a BMI of 35 to <40 kg/m2 with a comorbidity or a BMI ≥40 kg/m2 who have been unsuccessful with weight loss

A

Should be referred to a bariatric surgery specialist to consider this treatment option as an adjunct to a comprehensive lifestyle weight loss program

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15
Q

Creating goals

A

Don’t center goals that are regarding weight

Instead, make goals that pertain to promoting health

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16
Q

Dietary approaches for weight loss

A

Achieved when a diet resulted in a sufficient energy deficit regardless of the specific composition of the diet

CEPs DON’T PRESCRIBE DIETS

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17
Q

High glycemic-load and low glycemic-load diets

A

Research is mixed for support of either diet

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18
Q

High protein diets

A

Have shown more promise but the evidence is still unsure

More concerned about adequate protein diet before high protein diets

Need about 1.2-2.0 grams of protein/day; minimum is 0.8 grams

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19
Q

Mediterranean diet

A

Ideal cardiovascular diet

Less red meat, poultry, butter, and sugar

Increased fish, olive oil, grains, fruits, vegetables, cheese, and yogurt

Heart disease and cancer prevention

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20
Q

Meal replacements

A

Shakes

Nutrition bars

Frozen food

We know the calories and nutritional values making it easier to track calories

21
Q

Very-low calorie diets (VLCDs)

A

Highly engineered powdered supplements that are rich in protein and average in the range of 600-800 kcal/day

Administered under medical supervision out-patient or in-patient

The problem is there is no good transition time to get out of the VLCDs diet

Designed to achieve weight loss goal in a short time frame

22
Q

Physical activity (exercise training) for weight loss

A

Not a great way to lose weight due to the time it takes

There was no significant change in weight in studies in which physical activity was <150 minutes per week

150+ minutes/week there is significant weight loss

Only a modest weight loss occurs with physical activity

23
Q

RT for weight loss

A

Not a lot of studies have done

RT can increase a person’s overall physical function which increases total daily energy expenditure

24
Q

Physical activity (lifestyle changes)

A

Increasing someone’s physical activity can aid in weight loss

25
Q

Short term adherence to physical activity

A

2-6 lbs improvement over time in weight reduction

No improvement in other areas like cardiac health, etc

26
Q

Long-term adherence to physical activity

A

Lifestyle behavior changes is the main goal

200-300 minutes/week of moderate to vigorous PA to increase total energy expenditure overall

Wearable monitors will aid in tracking activity

LIFESTYLE MODIFICATION IS A CRITICAL FACTOR IN WEIGHT MANAGEMENT AND RISK FACTOR REDUCTION

27
Q

Prevention of weight gain

A

2.2-4.4 lbs of annual weight gain

Inverse relationship between adiposity and PA

Modest increases in energy expenditure of 50-100 kcal/day may be sufficient to prevent or reduce average weight gain

28
Q

Diabetes

A

Screening recommended in asymptomatic people at any age who are overweight or obese or have one additional risk factor for diabetes

45+ and at least every 3 years after that age

29
Q

Diabetes risk factors

A

Lack of physical activity

First-degree relative with diabetes

High risk because of race or ethnicity (African American, Latino, Native American)

Hypertension

History of CVD

30
Q

Diabetes screening tests

A

Fasting plasma glucose

65-gram oral glucose tolerance test

Hemoglobin A1C

31
Q

Fasting plasma glucose

A

Measures glucose levels in a person who has been fasting for at least eight hours

32
Q

75 gram oral glucose tolerance test

A

OGTT requires fasting before drinking a glucose solution. Following a two-hour waiting period, blood is drawn

When sugar is consumed, insulin is released causing the levels to go up then right back down

Someone who’s glucose tolerant won’t have the level go back down and will stay elevated

33
Q

Hemoglobin A1C test

A

Does not require fasting, and measures the blood level of glycosylated hemoglobin over the past two to three months (90 days)

34
Q

Type 1 diabetes mellitus (T1DM)

A

Destruction of beta cells in the pancreas causes the production of insulin to be damaged=insulin deficiency

5-10% of all diabetic cases

More commonly diagnosed in children and adolescents

Genetic and environmental factors (viral infections)

Increased risk for other autoimmune disorders

35
Q

Type 2 diabetes mellituse (T2DM)

A

Insulin resistance with relative insulin deficiency

Can progress to an insulin secretory defect with insulin resistance

90-95% of all diabetic cases

Obesity and abdominal adiposity

Hyperglycemic develops gradually with no classic symptoms

36
Q

Type 2 diabetes mellitus obesity risk factors

A

Visceral fat accumulation (fat around the organs)

Central adiposity

37
Q

Type 2 diabetes mellitus risk factors👀👀👀👀

A

Age ≥ 45 years
BMI ≥ 25 kg/m2 or central adiposity (defined by waist circumference)
Habitual physical inactivity
Having a first-degree relative with DM
African American, Latino, Native American, Asian American, or Pacific Islander race/ethnicity
If a female, delivering a baby weighing > nine pounds or having a past diagnosis of GDM
Having polycystic ovary syndrome
Presence of HTN
Presence of a low level of HDL cholesterol
Presence of a high TG level
Previous diagnosis of IGT or IFG
A history of vascular disease

38
Q

Diabetes complications

A

Affects all normal metabolic actions of insulin, including glucose transport, hexokinase activity, glycogen synthesis, and glucose oxidation

Have multiple comorbidities

The increase of the production of glucose by hepatocytes and portal adipocytes are key factors in the development of the complications

39
Q

Macrovascular complications of diabetes

A

Coronary artery disease

Stroke

Peripheral artery disease

40
Q

Microvascular complications of diabetes

A

Renal disease

Diabetic retinopathy

Diabetic neuropathy

41
Q

Treatment of T2DM lifestyle approaches

A

Implementation of an intensive lifestyle modification of increased PA and adoption of heart-healthy diet

Similar to weight management approaches

Reduce body weight by 5-10%

42
Q

Prevention of T2DM lifestyle approaches

A

Weight loss

Lifestyle group

Compare medication or lifestyle approach focused on weight loss to reduce onset of developing T2DM

43
Q

Pharmacotherapy in diabetes

A

Insulin

Glucosidase, Metformen, etc.

44
Q

Exercise and PA in patients with T1DM

A

Benefits of physical activity on endothelial function

Favorable changes in lipid, lipoprotein, and apolipoprotein levels

Improvements in HbA1c levels and reduced insulin requirements

45
Q

Exercise and PA in patients with T2DM

A

RT can improve insulin activity

Higher rates in Westernized environments than other environments

46
Q

Metabolic syndrome

A

A disorder characterized by IGT, dyslipidemia, and HTN, which together were associated with an increased risk of T2DM and CVD

Primary underlying mechanism for the syndrome was attributed to insulin resistance at the level of the skeletal muscle

47
Q

Criteria for metabolic syndrome (WHO)

A
48
Q

Risk factors and comorbidities of metabolic syndrome

A

Puts individual at risk for other diseases like CHD

49
Q

Metabolic syndrome physical activity

A

PA individuals with metabolic syndrome had a lower CVD risk than inactive individuals with metabolic syndrome

EXS 450 (5 decks)

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