Body Composition III: Clinical Practice Flashcards
BMI is generally accepted as an overall predictor of _____ and _____.
- morbidity
- mortality
Main limitation of BMI:
due to differences in body composition
The article “A requiem for BMI in the clinical setting” states that BMI is not appropriate to accurately differentiate between important ____ ____ _____ and therefore should not be used for…
- body weight components
- making clinically important decisions at the individual patient level
BMI has a good correlation with ____ ____ ____ at the _____ level, but the predictive value at the _____ level is very limited.
- % body fat
- population
- individual
BMI use in clinical practice may jeopardize the _____ _____, in particular of _____.
- nutritional diagnosis
- malnutrition
BMI less than 30 kg/m^2 does not exclude the presence of ____ ____ associated with the _____ of _____.
- metabolic risks
- excess
- adiposity
BMI at least 30 kg/m^2 does not exclude the presence of ____ ____ ____ (_____ _____), mainly in some clinical situations as in …..
- low muscle mass (sarcopenic obesity)
- elderly
- cancer
- chronic diseases
- critically ill patients
Who is at risk for low muscle mass?
- obesity
- aging
- HIV/AIDS
- CV conditions
- COPD
- cancer
- rheumatoid arthritis
- hospitalized patients
- diabetes
Muscle function:
- strength and power
- posture and balance
- mobility
- regulates blood glucose
- stores proteins
10% muscle mass loss:
- impaired immunity
- increase chance of infection
20% muscle mass loss:
- weakness
- decreased healing
30% muscle mass loss:
- physical impairment
- no wound healing
40% muscle mass loss:
death
Techniques to measure muscle strength:
- handgrip strength
- knee flexion/extension
- peak expiratory flow
Techniques to measure muscle function:
- gait speed
- short physical performance battery
- time up and go test
In grip strength, it is important that the _____ of the subject is _____:
- position
- standardized
- sitting
- shoulders relaxed
- elbow at 90 degrees
- upper arm not touching body
Calf circumference:
- tape measure placed around calf without compressing the subcutaneous tissue
- tape is moved along the length of the calf to obtain the maximal circumference
- 4 times (2 times for each leg)
Calf circumference should be ____ for males and females.
< 33
Calf circumference is inversely correlated with ____.
mortality
Low calf circumference is an indicator of _____ among elderly people.
malnutrition
Calf circumference validity is lower for ____.
women
Low muscle mass is a powerful and independent predictor of poor prognosis:
- physical impairment disability
- greater length of hospital stay
- need for rehab
- post op complications
- disease progression
- poorer quality of life
- shorter survival
Gaining muscle mass is ______, it is better to ____ the ____.
- difficult
- prevent the loss
Evidence shows it can take ____ to rebuild muscle mass lost over ____ days.
- weeks
- 3-10 days
What can lead to low muscle mass?
- endocrine
- neurological
- inadequate nutrition
- treatment/surgery
- disuse
- age related
Endocrine factors that lead to low muscle mass:
- corticosteroids
- GH
- IGF-1
- IR
- abnormal thyroid function
Neurological factors that lead to low muscle mass:
motor neuron loss
Disuse factors that lead to low muscle mass:
- immobility
- lack of PA
Age related factors that lead to low muscle mass:
- sex hormones
- apoptosis
- mitochondrial
- dysfunction
Lean mass and ____ ____ are not strongly correlated.
body weight
Screening –> ______ –> ______ –> ______ –> _______.
- assessment
- diagnosis
- intervention
- monitoring and evaluation
Monitoring and intervening means utilizing tools:
- MUST
- SGA
- MNA
Monitoring and intervening means measuring:
- BIA
- DXA
- muscle function/strength tests
Monitoring and intervening means ____ support, ____ _____ supplements, ____.
- nutritional support: adequate energy and high protein
- oral nutritional supplements
- exercise: resistance training, adaptation needed
ICD:
- International Statistical Classification of Diseases and Related Health Problems
- medical classification list by the WHO
ICD 10 code for….
sarcopenia
ICD - 10 code for sarcopenia (low LM) lists that:
- increase awareness and attention
- acceptance as a condition: indication for treatment
- enable storage and retrieval of diagnostic information
- basis for reimbursement and resource allocation
- potential to influence public health and health policy
To progress the knowledge and recognition of sarcopenia, the task force recommends the following actions:
explore the impact of targeted nutritional approaches to countermeasure muscle loss alone and in a multimodal approach to maximize anabolic potential (eg. exercise and anabolic therapy)
Body composition evaluation should be integrated into ____ ___ _____ for the initial ____ and sequential ___ ___ of ____ status.
- routine clinical practice
- assessment
- follow up
- nutritional
Vision is to allow _____, _____, and ____ screening of malnutrition and promote the ____ and early initiation
of optimal _____ ______, thereby contributing to
reducing ….
- objective, systematic, and early
- rational
- nutritional support
- malnutrition-induced morbidity
- mortality
- worsening of the quality of life
- global health care
costs.
Low muscle across the continuum of care:
- primary care
- acute setting
- chronic disease
- long term care
- population health
