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Epidemiology Flashcards

(71 cards)

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1
Q

What are the classifications of BMI

A

Normal(18-24.9)
Overweight (25-29.9)
Obesity (30-39.9)
Severe/Extreme Obesity (>40) Kg/m2

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2
Q

What are the classes of Obesity?

A

Class I - 30-34.9 kg/m2
Class II - 35 - 39.9 kg/m2
Class III - >40 mg/kg/m2

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3
Q

Describe Stage 0 of Edmonton Obesity Staging System(EOSS)

A

No signs of obesity complications:
Metabolic factors(BP, BS, Lipids, Liver enyzmes etc) are normal.
No physical symptoms
No Mental/psychological symptoms
No functional limitations

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4
Q

Describe Stage 1 of Edmonton Obesity Staging System(EOSS)

A

Subclinical Obesity related chronic diseases:
Prehypertension
Prediabetes
Transaminitis
Occasional joint pain, dyspnea on moderate exertion
Mild anxiety/depression

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5
Q

Describe Stage 2 of Edmonton Obesity Staging System(EOSS)

A

Established Obesity related chronic disease:
HTN, DM2, PCOS, OA, OSA, GERD, Major Depression, Anxiety

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6
Q

Describe Stage 3 of Edmonton Obesity Staging System(EOSS)

A

End organ damage from obesity related chronic disease:
MI, CHF, Diabetic retinopathy, Diabetic nephropathy, diabetic neuropathy, incapacitating OA

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7
Q

Describe Stage 4 of Edmonton Obesity Staging System(EOSS)

A

Severe(potentially end-stage) disability from obesity-related chronic diseases:
Advanced heart failure, cirrhosis, Advanced kidney failure, profound physical impairments(bedridden), regarding assistance with ADLs.
Severe mental health disorders that result in major impairments in functioning or a need for long term care

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8
Q

What is normal weight percentile in Peds?

A

5-84.9 percentile

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9
Q

What is considered overweight in Peds?

A

85-94.9 percentile

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10
Q

What is considered obesity in Peds?

A

> =95 percentile(assoc with > CM risk)

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11
Q

What Peds percentile is associated with >cardiometabolic risk?

A

> =95

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12
Q

What is Class I, II, III in pediatric obesity

A

Class I is >=95-<120 percentile of the 95%
Class II is >=120-140percentile of the 95 %
Class III is >=140 percentile of the 95 percentile

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13
Q

What does the EOSS classification take into account of?

A

Describes health based on Medical, mental and functional impact on a patient with obesity.

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14
Q

Which class of obesity for pediatric population is severe and puts them at greater risk of Cardiometabolic disease>

A

Class II
(>120% of 95th percentile or BMI >= 35, whichever is lower) % Class III (>=140% of 95th percentile or BMI >=40, whichever is lower)

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15
Q

What is issue with BMI?

A

Based on morbidity/mortality on White people so may not represent all races
Doesn’t take into acct muscle mass

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16
Q

What did the indian consensus group define as overweight and obesity in regards to BMI?

A

> 23 - 25 Overweight
25 Obesity

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17
Q

What BMI risks puts a Chinese person at risk for Diabetes?

A

25

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18
Q

What BMI risks puts a black person at risk for Diabetes?

A

26

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19
Q

What BMI risks puts a White person at risk for Diabetes?

A

30

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20
Q

In 2015, the ADA rec a Diabetes screen at 23 for what ethinic group?

A

South Asians

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21
Q

Who has a higher obesity rate from age 20-60? Men or Women?

A

Men(except Black Women who have higher risk than Black Men)

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22
Q

At what age do Men have less risk of Obesity compared to Women?

A

60

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23
Q

What age group in both sexes had higher rates of obesity?

A

Ages 40-59

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24
Q

Which age group had lowest rate of obesity?

A

Ages 20-39

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25
What percent of adults in US has a BMI >30?
42%
26
What percent of adults in US has a BMI >25?
73%
27
What is the expected rate of Obesity in US adults by 2030?
50%
28
What is the rate of Obesity of Asians in the US?
16%
29
What is the rate of Obesity of nonhispanic white adults?
41%
30
What is the rate of Obesity in the US of black people?
49.9%
31
What states have lowest rate of Obesity?
Hawaii and Washington D.C.
32
What states have the highest rates of Obesity?
Midwest and Southeast
33
What is the rate of Obesity in the US of hispanic people?
46%
34
How does income factor in obesity rates in Men and Women?
Higher rates in lower income women Higher rates in middle income men
34
Which pediatric populations have highest rates of obesity?
Black girls and Hispanic boys
35
How does income factor in obesity rates in pediatric population?
Highest income have lowest obesity rates
36
How does education affect Obesity rates in Men and Women?
Highest in Men with some college Lowest in Women with college education
37
What was the obesity rate in children ages 6-11 between 1963-1975 and what was it in 2018?
5%, 2018 - 19.3% and has been stable in last 5 years.
38
What is the rate of Severe Obesity in children?
6.1%
39
What percent loss of muscle mass can occur between ages 20-70 if nothing done to maintain it?
40%
40
What condition has a bidirectional link to Obesity?
Depression(Depression can cause Obesity and vice versa)
41
What does Ghrelin stand for?
Growth Hormone Releasing Inducing Peptide
42
Where is Ghrelin secreted from?
Fundus and body of stomach Proximal Small Intestine
43
When is Ghrelin secreted?
When stomach is empty. Will surge and peak prior to meals
44
Do levels of Ghrelin increase or decrease with fasting?
Increase
45
What does Ghrelin do?
Increases appetite and decreases energy expenditure
46
When does Ghrelin drop?
When stomach is full/stretched.(However, less of a drop in obese patients)
47
What is the prevalence of Adult Obesity in 2017-2018?
42%
48
What are some facts across lifespan in childhood obesity rates?
Rates stable in last 5 years Prevalence increases as we get older Overall trends worsened in last 50 years
49
What are some determinants of obesity?
Genetics/Epigenetics, Behavioral, SDOH, Cultural, medications/iatrogenic, Fetal environment
50
What are 2 questions to ask to screen for food insecurities?
In last 12 weeks, have 1. you worried that food would run out before having money to buy more 2. food ran out before we had money to buy more (Positive if answers sometimes true or often true to either question)
51
How do SDOH factors affect obesity rates?
Disproportionately affects those already at risk
52
Which SDOH contributes to depression?
Food insecurity
53
What are some factors that indicate housing instability?
Frequent moving Sleeping in places not meant for sleep Lack of nighttime residence Living with relatives or in overcrowded areas Children will lack inconsistent health coverage
54
What is housing instability often associated with?
Food insecurity
55
Who does housing instability disproportionately affect?
Households with children Blacks/hispanics Previously incarcerated
56
How do ACE's affect health?
Dose dependant. The more ACE's, the more decline in health
57
What are some cultural considerations for risk of Obesity?
Early feeding for babies Mode of feeding for babies Caregiving feeding practices Cultural beliefs of beauty and health Cultural traditions with food
58
What are main categories of medical determinants of obesity?
Endocrine Iatrogenic Neuropsych
59
What are endocrine conditions that can influence obesity?
Thyroid Adrenal Diabetes Female hormonal imbalance
60
What are iatrogenic medical causes of obesity?
Weight promoting medications Neurostructural damage
61
What are neuropsych causes of obesity?
Mood d/o Sleep d/o Eating d/o
62
When did obesity rates increase suddenly?
Stable from 1960-1980 but then starts to rise
63
What are genetic determinants of obesity?
Genetic syndromes Genetic variants
64
What are genetic syndromes that can affect obesity?
Prader Willi Bardt Biedel Fragile X Down Syndrome
65
What are genetic variants that can affect obesity?
MC4R deficiency Leptin deficiency POMC deficiency
66
What is the most common monogenic genetic variant that contributes to obesity?
MC4R(Monogenic)
67
What are 2 general characteristics of Genetic variants of obesity?
Hyperphagia Early onset Obesity
68
What is epigenetics?
How aging, behaviors and environment affect gene expression. It is variable and reversible
69
What are some epigenetic changes that influence obesity?
Care giving feeding practices ACEs Early Obesity Food insecurity
70

Obesity Boards (11 decks)

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