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Flashcards in Study Guide Deck (48):
1

Current clinical guidelines to eval overweight peeps and should weight loss be recommended? 3 pieces of info needed to perform eval

1. BMI (>/= 25)
2. waist circumference
3. Readiness for change
4. Fasting glucose?

2

Importance of genetics and childhood dev't for current understanding of obesity (3)

1. Positive correlation between aging and weight gain (decreased PA, increased body comp, decreased metabolic activity)
2. Darwinism (calorie conservation to prevent starving)
3. Genetics (appetite, activity, metabolic rate, adipose cell development, hormones, psychological factors)

3

Percentage of adults currently overweight and change in last 30 years

Significant increase over last 30 years.

4

Changes in adulthood that increase weight gain risk

Decreased PA
Changes in metabolism
Genetics

5

Health risks of overweight and obesity (13)

Mortality
Cardiovascular disease
DM Type 2
Cancer M: renal, esophageal, colon, thyroid
Cancer W: gallbladder, esophageal, renal, endometrial
Dementia
Biliary tract disease
GERD
Asthma
Pregnancy complications
Renal disease
LBP
OA (hip and knee)

6

Significance of learned eating behaviours and social environment in current understanding of obesity (4)

1. Cues trigger habitual eating disorders and consequences.
2. Food as entertainment
3. Social eating opportunity and pressure
3. Eating to reduce stress/satisfy unmet psychological/emotional needs
4. Common psychological disorders

7

Food environment and understanding of obesity (2)

1. Overconsumption of calories = abundance of high fat/high sugar foods available anywhere anytime
2. Modern society and increasingly sedentary lifestyles.

8

How a clinician can better understand health risks of obese patient through history, physical and lab assessment process (8)

1. BMI >/= 25
2. WC >35-27 (M), >31"(W)
3. Personal/family weight and disease hx
4. Type 2 DM
5. Metabolic syndrome
6. HTN
7. Dyslipidemia
8. Obesity related conditions

9

What diet will decrease metabolic rate, thus = bad results and increased risk of weight regain

WEIGHT CYCLING YO! Aka yo yo dieting

10

Complications of weight cycling (4)

1. Osteoporosis and related fractures
2. Gallbladder disease
3. HTN
4. Some cancers

11

Complications associated with rapid weight loss (4)

1. Increased risk of electrolyte and cardiac disturbance
2. Loss of bone density and lean body mass
3. Gallstones
4. Reduced metabolic rate

12

What is metabolic fitness? How does it differ from traditional approaches for obesity treatment?

De-emphasize fitness and focus on risk factor reduction and healthy lifestyle (optimal diet and exercise balance).
Base outcomes on health risks rather than a number on scale = more tangible and long term results

13

Correct method for measuring waist circumference

Measure upright relaxed position @ iliac crests w/ min respiration

14

Pre-existing risk factors used to gauge potential impact of overweight or high waist circumference?

1. Family history of obesity
2. Personal health history (eating disorders, meds w/ weight gain side effects, endocrine disorders)
3. Weight history (gains & losses, dieting attempts)
4. Diet history (typical intake, eating habits, influences on eating)
5. Exercise history

15

Important info about obstacles for patient's attempts to lose weight discovered in family history or personal health history?

Family: cardiovascular disease, diabetes, obesity
Personal: eating disorders, meds with weight gain side effects, endocrine disorders, psychological health

16

Therapeutic objectives more important than weight loss considering how to manage overweight patient

Improve overall obesity-related health risks in manner consistent with good health practice
STOP SMOKING, drug dependency treatment, improve BP, blood lipids and glucose tolerance

17

Potential contraindications to recommending weight loss, even when supported by national guidelines? How can these contraindications be minimized?

1. History of weight cycling. New weight loss attempts must be designed to overcome past obstacles to long-term success
2. Presence of eating/psychological disorder
3. Strong genetic, developmental, physiological, environmental or psychological obstacles to successful long-term weight loss
4. History of gallbladder disease. Rapid weight loss can aggravate cholecystitis and must be avoided
5. History of significant bone loss or osteoporosis

18

reasonable initial goal for weight losS? Alternative goals to be set instead of weight loss goal?

Percentage of overall weight
Inches
Eating goals
Decreasing risk factors

19

How would you decide which type of weight loss diet is most suitable for a patient?

Individual preferences
Partner with referrals in cummunity
As long as achievable

20

How beneficial is exercise as a strategy for weight-reduction and maintenance?

Improves results and exercise will prevent additional weight gain.
Improves heart risk factors.
Better when patient is compliant.
But not a good option if patient binge eats then expects to work it all off. Injuries! Unrealistic.

21

What is meant by self monitoring as a behaviour self-management term?

Eval how much/what they are eating, their PA, thoughts/feeling/concerns regarding eating, activity, weight, etc.

22

What is meant by portion control as a behaviour self-management term?

Triggers and conditions taht push you to overeat

23

What is meant by stimulus control as a behaviour self-management term?

ID conditions/triggers asociated with overeating and inactivity; includes food temptations, dining out challenges, portion control issues and screen time

24

joining a support group increases changes of successful weight loss. Why?

provides patient with lower cost resources
Support groups

25

Obesity has convincing evidence for which cancers

BEEPCK =
Breast, esophageal, endometrial, pancreatic, colorectal, kidney

26

Obesity has probable evidence for which cancers

Liver, gallbladder, ovary, prostate, lymphoma, leukemia and Multiple myeloma.
L3MOPG

27

Glenn Gaesser, PhD and his article Obesity, Health and Metabolic fitness suggests what

Metabolic fitness is an alternative health paradigm,
Weight loss is misdirected
BEING FIT IS MORE IMPORTANT THAN BEING THING,
Thinner = not healthier

28

Health and Every Size movement suggests what

Natural diversity in body shape and size
Importance in relaxed eating in response to internal body cues
Contribution of social, emotional and spiritual and physical facts to health and happiness

29

Advantages of low fat, high carb diet for achieving and maintaining weight loss

No calorie restriction on allowed foods
Chronic dz prevention
Reduce BP, improve blood lipids, improve heart function (w/ aerobic exercise)
Improve glucose tolerance
Reverse coronary atherosclerosis, reduce symptoms of CHD

30

Disadvantages of low fat high car diet for weight loss

Deficient in Vit E, B12 and zince
Increase plasma TG's and lower HDL
Not so good for glucose control and insulin function

31

Advantages of high protein diet for weight loss

Increased satiety and metabolic energy expenditure
Faster initial weight loss (loss of body water)
Effective at 6months compared to low fat

32

Disadvantages of high protein diet for weight loss

Deficient in Vit A, E, thiamin, B6, folate, ca2+, mg2+, K+, fiber
Ketogenic: fatigue, nausea, dehydration, constipation, diarrhea
CVD
Renal = risk of stones and bone loss
DM = bad for glucose control or insulin sensitivity
Cancer risk: CPBL: colon, prostate, breast, lymphoma
Little compliance
Little long term efffects

33

Weight loss supplement stims sympathetic nervous system

Ephedra

34

Supplements good for weight loss

MVM
Fiber
Green tea
Green coffee bean
Caffeine
5HTP (reduce appetite)
Pyruvate (increased metabolic r8)
Chromium (promotes insulin sensitivity)

35

Plants with organosulfur compounds affecting carcinogen metabolism

Allium vegetables: garlic, onion, leeks, shallots
Brassica/cruciferous vegetables: cabbage, broccoli, cauliflower, kale, brussel sprouts, bok choy

36

Beta-carotene supplements didn't do the same as a high beta carotene diet. Why?

Other nutrients present in beta-carotene rich foods

37

Brassica family (cruciferous vegetables)

Broccoli, cabbage, cauliflower, kale, brussel sprouts, bok choy...
(BCCKBB)

38

Preparation of meat to influence cancer risk

Nitrite preservatives = increase colon cancer risk 15-20%/50g
High temp cooking and grilling = same increase

39

Lycopene

Tomatoes

40

Indole-3-carbinol

Brassica extracts

41

Isoflavones

Soy

42

Lignin's

Flaxseed

43

Soy and soy isoflavone controversy w/ cancer risk

- gonadal hormone-modifying activity
No studies have found an increased cancer risk, actually increased soy is consistent with prevention of aggressive prostate cancers.
Soy isoflavones = exhibit anti-estrogenic properties

44

Calcium and Vitamin D in cancer prevention

D: immunity, inflammation, cellular growth regulation/survival
Ca2+: binds tumor promoting substances in the gut, effects proliferation and differentiation and cell survival
Strongest link = against colorectal cancer from milk products
High milk intake = small increase in prostate cancer risk in men = 2 much Ca2+!

45

Vitamin or mineral deficiencies shown to increase cancer risk

High synthetic beta-carotene = increased lung cancer in smokers
Excess folic acid = growth of precancerous/cancerous cells, but pregnant women should have some
Deficient folic acid = impairs DNA health
Vitamin D deficiency for optimal calcium absorption
High calcium over RDA = increase risk of prostate cancer

46

What cancer sites have tomato etract supplements shown promise in prevention and treatment?

Prostate cancer
Note: diets high in AO's (vitamin C and flavanoids, alpha and beta carotene, lycopene) not supplements = effective in cancer prevention.
Vit A, C and flavnoids participate in carcinogen metabolism

47

BRASSICA VEGETABLE COMPOUNDS DO WHAT

Alter gonadal hormone metabolism and activity. Samesies with soybean compounds.
So good for gyne precancer lesions, not cancer prevention. Need more studies

48

Gene nutrient and microbiome nutrient interactions might influence which people may benefit from certain cancer prevention strategies

Gene varients = slower metabolism of brassica-related compounds allow them to have a larger benefit in cancer prevention.
Gut microbe differences = play a role in determining activity/health effects from consuming soy isolfavones and flaxseed lignin's