Atherosclerosis risk factors: Diet and exercise

Question 1

BMI ranges

Answer 1

• 30 is obese

- >35 is morbidly obese

Question 2

BMI and atherosclerosis

Answer 2

-increase BMI= increase risk

Question 3

First line rx of metabolic syndrom

Answer 3

-lifestyle change: diet and exercise

Question 4

Among equally obese patients, subjects with an excess of ______ adipose tissue have the most deteriorated metabolic risk profile.

Answer 4

-visceral/central/abdominal obesity!

Question 5

6 CV benefits of healthy diet, weight loss, and exercise

Answer 5

• improved lipid profile
• dec insulin resistance/reduced risk of DM
• dec metabolic syndrome parameters
• dec blood pressure
• dec inflammatory markers like CRP
• improved endothelial function

Question 6

Choosing which diet is best for a patient depends ultimately on the _______.

Answer 6

-goal: mainly wt loss or health benefits, too? short term or long term effects?

Question 7

Standard dietary recommendations

Answer 7

• reduce intake by 500-1000 kcal/day to lose 0.5-1.0 kg/wk
• balance this diet with >/55% carbs, ~15 protein, </ 30% fat (<10% sat fat)
• since less calories per gram of protein and carbs than fat

Question 8

Thought process behind low fat diet

Answer 8

Laboratory-based studies have shown that adults tend to eat a similar amount of food (by weight) each day, regardless of the dietary energy density of that food. Reducing the energy density of a meal (e.g., by adding water or fiber, or substituting carbohydrate or protein for fat) allows dieters to consume fewer calories without sacrificing the size of the meal.

Question 9

Low Carb diets were seen to offer greater wt losses compared to low-fat diets, but this trend evened out over time, why?

Answer 9

-people could not adhere to the low-carb diets and eventually gave up

Question 10

In terms of lowering overall CV risk, does low-fat or low-carb win?

Answer 10

-according to framingham, low carb wons: inc HDL and lower TGs but low fat does lower total-C and LDL more so.

Question 11

Compare wt loss between low-fat, mediterranean, and low-carb diets

Answer 11

• low carbs win, but mediterranian also lost a lot of wt and maintains loss
• low fat lost least amount

Question 12

Best diet depends on the goal: wt loss or CV effects. _________ may be optimal for both

Answer 12

• mediterranean diet

- reduces risk of DM and cholesterol, reduced risk of CV events, wt loss, good adherence!

Question 13

Dose and Intensity definitions of exercise

Answer 13

• dose: total amount of energy expended (kJs or kCals)

- intensity: absolute (METs) vs relative (% of max aerobic power maintained)

Question 14

T/F: many US adults are physically inactive.

Answer 14

-true: 38% irregularly active, 25% sedentary

Question 15

Physical activity vs exercise vs physical fitness

Answer 15

• PA: bodily movement produced by contraction of skeletal muscle
• exercise: subset of PA that is planned, purposeful, structured, and repetitive
• PF: cardiorespiratory fitness, muscle strength, body composition, flexibility (MET)

Question 16

CVD mortality rates and CV fitness

Answer 16

• regardless of risk factors or gender, high CV fitness decreases risk of CVD and death
• becoming unfit can cut risk of CVD mortality in half!

Question 17

Greater frequency of activity decreases rates of CV events. But does intensity matter?

Answer 17

• mortality rates in high LTPA intensity were similar to moderate intensity
• high amount high intensity > low amount high intensity, but low amount high intensity was similar to low amount moderate intensity; walking vs running 1 mile doesnt make a huge diference, just go do it!

Question 18

If you want to lose weight intensity is less important than if you want to lose wt and get fit.

Answer 18

-true
-regardless of intensity, everyone lost weight, but those with high intensity got more fit!
Exercising at a level of 19 km/wk at 40 to 55% of peak VO2is sufficient to increase aerobic fitness levels, and increasing either exercise intensity or the amount beyond these parameters will yield additional separate and combined effects on markers of aerobic fitness. Therefore, it is appropriate to recommend mild exercise to improve fitness and reduce cardiovascular risk yet encourage higher intensities and amounts for additional benefit.

Question 19

Life-threatening events during endurance sports, like marathons

Answer 19

-heat stroke is more deadly and likely to kill you than arrhythmias

Question 20

Biologial mechanisms (6) for the benefits of exercise

Answer 20

• antiatherogenic effects
• antithrombic effects
• endothelial function alteration
• autonomic functional changes
• anti-ischemic effects
• antiarrhythmetic effects

Question 21

Antiatherogenic effects of exercise

Answer 21

• PA is associated with less severe CAD, larger CA diameter, and reduced atherosclerosis progression
• reduction in adiposity, reduced in HTN, reduction in TGs, increase in HDL, improvement in insulin sensitivity and glucose use and reduction in T2DM

Question 22

Execise _______ not _______ improves HDL

Answer 22

• frequency

- not intensity

Question 23

Fit vs Fat

Answer 23

-even if you’re in obese BMI range, being fitter is better; adjusting for BMI does not remove fitness effect on reducing CVD; even obese and fit can be better off than normal and unfit

Question 24

Recommendation guidelines

Answer 24

• minimum of 30 min of moderate intensity PA is required on most (preferably) all days of the week to reduce risk of CAD events
• about walking 1.5 miles a day briskly
• goal 30 mins every day but at least 5 days/week