bc quiz Flashcards

1
Q

Nutritional Assessment

A

A - Anthropometry
B - Biochemical
C - Clinical
D - Dietary Assessmen

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2
Q

ANTHROPOMETRY

A

Measurements of the variations of physical dimensions and the gross composition of the human body at different age levels and degrees of nutrition

Weight • Height e.g., standing (stature), sitting • Length e.g., recumbent length, arm span, knee • Breadth e.g., wrist, elbow • Circumferences e.g., head, waist, hip, mid-ar

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3
Q

BODY COMPOSITION

CAFE

A

SPECIFIC BODY COMPARTMENTS
• Investigating body composition involves subdividing body weight into 2 or more compartments according to elemental, chemical, anatomical, or fluid compartment

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4
Q

2 Compartment Model

A

body fat – fat-free mass (FFM) • FFM = body wt – body fat (fat mass); LBM = body wt – adipose fat • LBM includes essential fat (e.g., cell membrane fat) • often FFM = LBM in literature

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5
Q

4 Compartment Model

A

aqueous – mineral – protein (muscle) – faT

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6
Q

6 Compartment Chemical Mode

A

– aqueous - includes ECW, ICW – mineral - osseous - extraosseous – organic - glycogen (negligible) - protein - fat

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7
Q

Elemental Model

A

body weight consists of 11 elements which comprise >99% of body weight in living subjects i.e., C, N, Ca, Na, Cl, K, H, P, O, S, Mg

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8
Q

Proportion of body weight:

A

Water 62.4 % Protein 16.4 % Fat 15.3 % Bone Mineral 4.8 % Non-Osseous Material 1.1 %

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9
Q

SPECIFIC BODY COMPARTMENTS

A

Total fat, regional fat, fat-free mass (FFM), regional FFM, muscle (e.g., ptn, K), total body water (TBW), extracellular water (ECW), intracellular water (ICW), bone mineral density (BMD), bone mineral content (BMC), elemental composition (e.g., N Ca P Mg Na Cl)

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10
Q

Statistical Treatment of Dat

A

Low accuracy, low precisio ECT.

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11
Q

ANTHROPOMETRY: Measurement

A

Examples - some will differ for infants, children, nonambulatory persons
• Weight - electronic or balance-beam scale - calibrated
• Height - stadiometer - technique - e.g., Frankfort horizontal plane
• Circumferences - landmarking, tape measure - placement, two people
• Skinfolds - landmarking, equipment, technique (skill

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12
Q

ANTHROPOMETRY Uses
Weigh
HEIGHT

A
  • Useful for extremes – 300 lbs or 80 lbs for an adult female – 140 lbs ???
  • Monitoring change – sudden gains or losses in weight

Useful for “stunting” – indicator for undernutrition – nutrient deficiencies e.g., Zn

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13
Q
negative linear
curvilinear
positive
no 
r values (correlation coefficient
A

a. Negative linear correlation (r = -0.70)
b. Curvilinear correlation (r = 0.20)
c. Positive linear correlation (r = 0.80)
d. No correlation (r = 0.10)

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14
Q

how do you deterine the variance

A

square of the CC (r2) represents the proportion of variance in one variable accounted for by the other i.e., coefficient of determination
e.g., x (height); y (weight); r = 0.7 r2 = 0.49 or 49%
– Therefore, 49% of the variability of weight can be accounted for by height – other 51% accounted for by other factors (tendency to eat fatty foods, resistance training ↑ muscle mass)
– remember, “variability” refers to how scores are spread out about the mean

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15
Q

cORRELATION AND CAUSATION

A

Rule: High correlation between 2 variables does not necessarily imply causal relationship
e.g., smoking (x) and lung damage (y)
high +ve correlation could mean: 1. x causes y 2. y causes x 3. a 3rd variable causes both x and y (e.g., stress) 4. the correlation occurred by chance
- use correlations as a source for subsequent hypothese

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16
Q

ANTHROPOMETRY: Uses

A

Weight Standards
• Height-Weight Tables – Guideline Tables • Weight for Height • Age-Specific Weight Standards – Metropolitan Life Insurance Company (1983) • Includes “frame size”

17
Q

Height-Weight Indices

A

Relative weight (i.e., Devine Formula) – (actual wt / reference wt) x 100% – Interpretation: <90% underweight, 90 - <110% normal weight, 110 - <120% overweight, >120% obese
• Body Mass Index (i.e., Quetelet’s Index) – wt/ht2
• CDC Growth Charts (children) – percentiles - weight, length, wt for ht, BMI for age

18
Q

android vs gynoid

A

android typical in men and aroind the belly, gynoid is the pear shape

19
Q

Body Fat Distributio

A

Waist Circumference – measure waist at iliac crest • men > 40 inches • women > 35 inches
• Waist to Hip Ratio - measure waist at mid-point between inferior margin of ribs & iliac crest • men > 1.0 • women > 0.8
Skinfold Measurements – Various sites and predictive equationsTriceps • Common: biceps, triceps, subscapular, suprailiac
• Percentile Charts – e.g., tricep skinfold

20
Q

BODY COMPOSITION Measurement

Direct Measures

A

Cadaveric (Dissection) Studies – fat, muscle (ptn), K, water? – assume cadavers similar to living subjects

21
Q

BODY COMPOSITION

Indirect Measures

A

Indirect Measures (measures which predict)
• Densitometry (underwater weighing) – body fat, FFM
• Dilution techniques – total body water TBW, extracellular water ECW
• TBK – FFM
Absorptiometry (single-photon, dual-photon, DXA) – total or regional FFM (LBM), total or regional bone mineral
• Ultrasound – regional fat (tissue thickness)
• Computerized tomography (CT) – regional body composition (fat, lean tissue, bone)
• Magnetic resonance imaging (MRI) – fat, water
Neutron activation analysis – multielemental composition - N Ca P Mg Na Cl
• Skinfolds (anthropometry) – body fat (density eqn.), FFM, muscle size
• Electrical conductance (TOBEC, BIA or BIS) – FFM, TBW, ECW
• Infrared interactance – body fat

22
Q

Biochemical parameter

A

– Urinary creatinine excretion → muscle mass – Total plasma creatinine → skeletal mass (muscle) – 3-methyl histidine → muscle mass

23
Q

BODY COMPOSITION

ASSUMPTIONS

A

Direct measures used to validate indirect measures e.g., neutron activation analysis – Are direct measures valid?
• Indirect measures used to validate other indirect measures e.g., BIA validated using dilution techniques since cannot perform BIA on cadavers
“Is there a GOLD STANDARD?”

24
Q

Compartment Analysis

A

Normality (compare to standards) – Change over time

25
Q

Cadaveric (Dissection) Studies

A

Only direct measure of body composition – Brussels Cadaver Analysis Study (CAS) n>30 (Drinkwater) – Garrow (1983) n=6 adults – Widdowson (1950s) human fetus
• fat (skinfolds and chemical analysis), muscle (ptn), K, water? • used to validate various in vivo methods
ADVANTAGES - most direct measure available DISADVANTAGES - limited # of studies (ages, weights etc) - assume cadavers have similar characteristics to living subjects (e.g., H2O) -cause of death often illness “Question whether representative sample”

26
Q

Densitometry
what is it
what 2 measurements are calculated, what are advantages and disadvantages

A

measurement of total body density through determination of body volume e.g., underwater weighing, helium displacement, partial water displacement and air displacement • therefore, body fat & FFM (2 compartment model) are calculated using density equation (like skinfolds)
ADVANTAGES - measurements are precise (repeatable) DISADVANTAGES - subject cooperation is necessary - not practical for large groups - unsuitable for young children, elderly etc (underwater weighing) - accuracy ↓ due to “lung volume” (estimate) - density in fat-free component (bone & muscle

27
Q

Hydrostatic Weighin

A

Errors – Equations – Residual lung volume – Water density – Consistency of tissues across races, gender, age • Recommended Technique. – Water tank – Nitrogen wash out • Residual volume – Weight belt – Maximal exhalation – Repeat 8-12 times • r = 0.94

28
Q

Dilution Techniques

advantages and disadvantages

A

TBW measured in FFM (no water in fat) by dilution with D2O, 3H2O or H218O • ECW measured by dilution of NaBr (Br does not enter cell) • a known amount of isotope is given (C and V), steady state reached, biological fluid sampled (e.g., blood, urine, or saliva) C1V1 = C2V2 solve for V2
ADVANTAGES - gives TBW, ECW (thus ICW) - stable isotopes can now be used DISADVANTAGES - difficult procedure with limited precision - cost (isotopes expensive)

29
Q

Total Body Potassium (TBK
what does is measure
advantages and disadvantages

A

40K is found in a known amount (0.012%) in ICW and not present in stored triglycerides • therefore, FFM is estimated by external counting of gamma rays emitted by 40K

ADVANTAGES - ↑ precision
DISADVANTAGES - assumes FF tissue has known/constant K content (differs gender, obesity, age) e.g., older and obese overestimate fat
- accuracy ???
- high cost & limited locations

30
Q

Absorptiometry (single-photon, dual-photon DEXA [dual energy Xray absorptiometry] or DXA)

what is it- what element
advantage disadvantage

A

body (region) is scanned transversely in small steps by radiation from gadolinium-153 • 153Gd emits 2 gamma rays of different energies for quantitation of bone mineral/soft tissue (FFM/LBM)
ADVANTAGES - DEXA allows for regional body composition (body sections differences) measurements
- small error = ±1-5%
- quick, subject friendly
DISADVANTAGES - expensive equipment & limited locations
- calibration and mathematical treatment of data is complicated
- x-ray

31
Q

ultrasound

A

electrical energy is converted to high-frequency ultrasonic energy in a probe • transmission of sounds waves through various tissues (fat and muscle tissue have differing densities) can be used to calculate tissue thickness (e.g., subcutaneous fat)

ADVANTAGES - portable equipment available
- safe & non-invasive
- compares well with skinfolds
DISADVANTAGES - constant pressure of probe is difficult, thus prejudicing determination of fat thickness i.e., resolution not as good as with CT
- validity for wide range of body fatness unknown

32
Q

Computerized tomography (CT

A

Method measures attenuation (consistency) of X-rays as they pass through tissues • degree of attenuation is related to density of tissue • an image is generated by computerized processing of density-frequency distribution data • regional body composition (fat, lean tissue, bone)
ADVANTAGES - additional use, organ size (liver, spleen, kidneys) can be measured DISADVANTAGES - exposure risk (X-rays), limits use for whole-body and multiple scans - no chemical composition information - expensive & limited locations

33
Q

Magnetic resonance imaging (MRI)

measures what

A

based on the fact that atomic nuclei can behave like magnets • external magnetic field is applied across body and nuclei attempt to align with the external field • radio-frequency is directed into the body & nuclei absorb energy (change in positioning of magnetic field) • radio-frequency turned off (return to orginal state) • emit signal which is imaged by computer (level of hydration and fat content)

ADVANTAGES - safe (e.g., children etc, multiple studies) & noninvasive
- both amount and distribution of body fat obtained
- high quality images of the body (better than CT)
- can currently image hydrogen and phosphorous (will soon image C, N, Na, Cl)
DISADVANTAGES -limited locations & high cost

34
Q

Neutron activation analysis

A

radioisotopes of N, P, Na, Cl, Ca are created by irradiating the subject • radioactivity of element is measure using a whole body counter and is related to content
ADVANTAGES - only technique currently available for measurement of multielemental composition of the human body (Ca P Mg Na Cl) in addition to muscle mass (N)
DISADVANTAGES - subjects exposed to radioactivity
- elements not uniformly activated, thus sensitivity varies
- expensive & limited locations

35
Q

Skinfolds (anthropometry)

A

covered in detail in in anthropometry section and laboratory
SOME ADVANTAGES - measurements (for fat etc) can be made in field but require skilled technicians for accuracy SOME DISADVANTAGES - dependence on technicians skill - not applicable to all population groups for exmple black people harder to distinguish fat from muscle

36
Q
  1. Electrical Conductance (TOBEC, BIA/BIS/BEI)
A

based on the difference in electrolyte content between fat and fatfree tissue • electrolytes in water are capable of conducting electricity better than its fat mass • determinations of resistance and reactance are made, and used to calculate conductance and to predict LBM/FFM, TBW, ECW from “various” equations

ADVANTAGES - safe, convenient to use, portable, rapid, and non-invasive
- BIA (measures extremities) less expensive than TOBEC (whole body)
DISADVANTAGES - affected by conditions (fed, fasted, edema, dehydration etc.)
- extent to which variation in body shape and size affects readings not yet known

37
Q

Infrared Interactanc

A

recently developed to estimate fat • measurement of body fat is made at various sites on the extremities through use of short wavelengths of infrared light • fat is calculated from the absorption spectra • predictive equations used to estimate total fat
ADVANTAGES - safe, non-invasive, rapid, convenient (used in health clubs and weight loss clinics) DISADVANTAGES - validation studies (comparing with other techniques) have not been favourable - depends upon regional fat distribution to predict TBF - believed to be inferior to skinfolds - not a recommended approach for determining body composition

38
Q

Biochemical Parameter

what is measured

A

Urinary creatinine excretion – muscle mass • Total plasma creatinine – skeletal mass (muscle) • 3-methylhistidine – muscle mass
• major problem is accounting for amounts found in diet