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Block 1 > Body Composition > Flashcards

Body Composition Flashcards

1
Q

Define body composition.

A

The relative proportions of protein, fat, water + mineral components in the body that make up total body weight

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2
Q

What are the components of body composition?

A

Fat free mass (FFM) = 72% water, 21% protein + 7% bone minerals

Fat mass (FM) = 20% water + 80% adipose tissue

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3
Q

What is the difference in body composition between men and women?

A

Men have more muscle than women whereas women have more fat than men

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4
Q

What are the 2 types of body fat distribution?

A
  1. Andoid

2. Gynoid

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5
Q

What are the features of andoid body fat distribution?

A

Upper body obesity (mostly stomach area)

Higher risk for T2DM, CVD + HTN

Mostly in males

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6
Q

What are the features of gynoid body fat distribution?

A

Lower body obesity

Harder on hip + knee joints

Found mostly in women

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7
Q

What is another word for body type?

A

Somatotype

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8
Q

Describe the ectomorph body type.

A

Lean + angular, long limbs, slim + narrow waist

Weight loss easy

Low levels of body fat

Difficult to gain LBM

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9
Q

Describe the mesomorph body type.

A

Strong, athletic, muscular with slim hips

Faster metabolism

Gain muscle mass easily

Lose weight easily

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10
Q

Describe the endomorph body type.

A

Round, short, tapering limbs, larger boned, plump/stocky appearance, round faces, large thighs + hips

Higher body fat

Easily build muscle

Weight loss difficult

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11
Q

What should you consider when measuring and assessing body composition?

A

How
Practicalities
Patient group

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12
Q

What is a body weight assessment?

A

Total weight of FFM + FM combined

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13
Q

What is a body composition assessment?

A

Assessment of varying components of the FFM compared to the FM

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14
Q

What assessment is most common on nutrition screening tools?

A

BMI/Quetelets index - measure of body weight

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15
Q

What is Body Mass Index (BMI)?

A

Ratio of weight + height often used to express clinical risk

Mass (kg) / (height(m))^2

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16
Q

What is the Body Mass Index (BMI) that reflects the lowest risk of illness?

A

18.5-24.9kg/m^2 (23kg/m^2 classed as overweight for Asians)

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17
Q

What are the limitations of measuring Body Mass Index (BMI)?

A

Doesn’t consider body composition

Should be used in conjunction with other measures e.g. waist circumference

Age + gender independent

Different classifications for Asians + Afro-Carribean’s

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18
Q

How is Body Mass Index (BMI) linked to mortality risk?

A

Risk increases as BMI declines but also as BMI rises

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19
Q

Why do Asian people have a different ideal BMI to White Caucasian individuals?

A

Because overall their body composition is lower than that of white people so they should weigh less under normal circumstances

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20
Q

What alternative height measurements can be used to predict BMI without scales or a height measure?

A

Ulna length
Knee height caliper
Demi span

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21
Q

What does Mid Upper Arm Circumference (MUAC) give you an indication of?

A

Body weight changes over time (can be used if patient cannot be weighed)

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22
Q

What are the normal values for Mid Upper Arm Circumference (MUAC) and how does this relate to Body Mass Index (BMI)?

A

< 23.5cm = BMI < 20kg/m^2

> 32cm = BMI > 30kg/m^2

23
Q

What part of body composition relates to disease risk?

A

% body fat

24
Q

What are the 4 ways of measuring body composition?

A
  1. Anthropometry
  2. Densitometry
  3. Bioelectrical impedance
  4. Imaging techniques
25
Q

What test can be used to look at muscle function? How does it work?

A

Hand grip dynamometer as it indicates general upper body strength

Decreased strength = increased all cause mortality

26
Q

Why would you test muscle function when looking at body composition?

A

As muscle function responds earlier to nutritional deprivation than muscle/body mass

27
Q

What does an anthropometry test involve?

A

Estimates volume of subcutaneous fat (adipose) via skinfolds

28
Q

What are the pros and cons of anthropometry testing?

A

Pros: sensitive to ethnic + age variations in fat distribution, serial measurements most sensitive with comparison tables available

Cons: assumes constant ratio of subcutaneous + total fat

29
Q

What is the aim of measuring the waist circumference?

A

To assess body fat distribution i.e. andoid (apple) vs gynoid (pear)

30
Q

What must you bare in mind when measuring the waist circumference?

A

Men in different ethnic groups have differing waist circumference risk factors

At risk waist measurements:

  • Sub Saharan African, Eastern Mediterranean + Middle Eastern = >94cm/37inch
  • South Asian, Japanese + Chinese = >90cm/35inch
  • ALL WOMEN = >80cm/31.5inch
31
Q

What is densitometry testing?

A

Under water/hydrostatic weighing measuring % body fat

32
Q

What are the problems with densitometry testing?

A

Hard to use in young, old + sick

Need to breath out as much as possible underwater

Multiple measures best

Sensitive to variations in bone mass + changes in water temp

33
Q

What has superseded densitometry testing? Describe this test.

A

Air displacement methods - BODPOD - calculates volume of air displaced + calculates body composition from this -> results provided % body fat, lean body mass + estimate of energy expenditures

34
Q

What are the pros and cons of air displacement plethysmography?

A

Pros: accurate

Cons: extensive hair has to be removed, expensive equipment + not portable

35
Q

What is the bioelectrical impedance test?

A

Non invasive bedside measure which works on premise that fat does not contain water + that electrical current flows through tissues containing water + ions but not fat

36
Q

What are the limitations of bioelectrical impedance?

A
  • Error on data entry
  • Requires standardised conditions
  • Assumes hydration of FFM constant
  • Affected by skin temperature
  • Cannot use in dehydration, ascites or extremes of BMI range
37
Q

What factors determine what measurement of body composition will be used?

A

Population group assessing
Facilities funding
Time available

38
Q

What is malnutrition?

A

A state of nutrition in which a deficiency or excess (or imbalance) of energy, protein + other nutrients causes measurable adverse effects on tissue/body form (body shape, size + composition) + function, + clinical outcome - refers to both over + under nutrition (more commonly used to refer to undernutrition)

39
Q

Give some examples of chronic, comorbid conditions that overnutrition is associated with.

A 
Sleep apnoea
Pulmonary disease
NAFLD 
GI disease
T2DM
Coronary disease e.g. HPN
Stroke
Depression
40
Q

How much does overnutrition shorten a person’s lifespan?

A

8-10 years

41
Q

Risk for certain types of cancer increases with ___

A

BMI

42
Q

If an obese individual loses 5-10% of their weight (20% in severe obesity), what effects will ensue?

A
  • Reduction in risk of T2DM
  • Reduction in CVD risk factors
  • Improvement in blood lipid profile
  • Improvement in BP
  • Improvement in severity of obstructive sleep apnoea
  • Improvement in health-related QoL
43
Q

At what age does malnutrition become more common?

A

> 65 years

44
Q

What is the Malnutrition Universal Screening Tool (MUST)?

A

All hospitals should have nutrition screening + all patients should be screened within 24hrs - developed by BAPEN

45
Q

Define the term cachexia.

A

A condition of abnormally low weight, weakness + generally bodily decline associated with chronic disease

Wasting syndrome characterised by unintentional weight loss

46
Q

What are the symptoms of cachexia?

A 
Weight loss
Muscle atrophy
Fatigue
Weakness
Loss of appetite
47
Q

How does cachexia occur?

A

Associated with a disproportionate loss of skeletal muscle rather than body fat

Metabolic stress e.g. injury or illness may inhibit body from using fat stores to provide energy in certain conditions which is why it is associated with cancer + other chronic disease

48
Q

Why is cachexia such a big problem?

A

Impairs QoL + response to therapy which increases morbidity + mortality of cancer patients

49
Q

What can cancer cachexia affect?

A 
Brain (anorexia)
Brown adipose tissue (thermogenesis)
White adipose tissue (wasting)
Heart (cardiac dysfunction)
Gut (malabsorption)
Liver (acute-phase response)
50
Q

What complications relate to loss of lean body mass occur?

A

10% loss = impaired immunity, increased infection + 10% mortality

20% loss = decreased healing, weakness, infection + 30% mortality

30% loss = too weak to sit, pressure sores, pneumonia, no healing + 50% mortality

40% loss = death, usually from pneumonia + 100% mortality

51
Q

What are some consequences of malnutrition?

A 
Decreased QoL
Increased risk of illness/infection
Increased pressures sores/impaired wound healing
Medicine less effective
Longer healing times
Longer hospital stays
Confusion/depression/mood disturbance
Increased falls (elderly)
Decreased respiratory muscle strength 
Increased mortality
52
Q

What is the cycle of malnutrition?

A
  1. Decreased energy + nutrition intake
  2. Muscle catabolism + weight loss
  3. Delayed recovery
  4. 2ndary infections
  5. Depression + lethargy
  6. Further decreased intake
  7. Serious complications e.g. pneumonia

Cycle starts again until morbidity/mortality occurs (CYCLE CAN BE BROKEN!)

53
Q

What factors affect body composition?

A
  1. Biological: age (sarcopenia), gender, genetics, ethnicity, menopausal state
  2. Lifestyle: diet, physical activity smoking, alcohol
  3. Health-related factors: presence of disease, genetic predisposition
  4. Biometric: height, fat + muscle distribution
  5. Environment

Block 1 (54 decks)

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