Body Composition III: Clinical Practice

Question 1

BMI is generally accepted as an overall predictor of _____ and _____.

Answer 1

• morbidity

- mortality

Question 2

Main limitation of BMI:

Answer 2

due to differences in body composition

Question 3

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…

Answer 3

• body weight components

- making clinically important decisions at the individual patient level

Question 4

BMI has a good correlation with ____ ____ ____ at the _____ level, but the predictive value at the _____ level is very limited.

Answer 4

• % body fat
• population
• individual

Question 5

BMI use in clinical practice may jeopardize the _____ _____, in particular of _____.

Answer 5

• nutritional diagnosis

- malnutrition

Question 6

BMI less than 30 kg/m^2 does not exclude the presence of ____ ____ associated with the _____ of _____.

Answer 6

• metabolic risks
• excess
• adiposity

Question 7

BMI at least 30 kg/m^2 does not exclude the presence of ____ ____ ____ (_____ _____), mainly in some clinical situations as in …..

Answer 7

• low muscle mass (sarcopenic obesity)
• elderly
• cancer
• chronic diseases
• critically ill patients

Question 8

Who is at risk for low muscle mass?

Answer 8

• obesity
• aging
• HIV/AIDS
• CV conditions
• COPD
• cancer
• rheumatoid arthritis
• hospitalized patients
• diabetes

Question 9

Muscle function:

Answer 9

• strength and power
• posture and balance
• mobility
• regulates blood glucose
• stores proteins

Question 10

10% muscle mass loss:

Answer 10

• impaired immunity

- increase chance of infection

Question 11

20% muscle mass loss:

Answer 11

• weakness

- decreased healing

Question 12

30% muscle mass loss:

Answer 12

• physical impairment

- no wound healing

Question 13

40% muscle mass loss:

Answer 13

death

Question 14

Techniques to measure muscle strength:

Answer 14

• handgrip strength
• knee flexion/extension
• peak expiratory flow

Question 15

Techniques to measure muscle function:

Answer 15

• gait speed
• short physical performance battery
• time up and go test

Question 16

In grip strength, it is important that the _____ of the subject is _____:

Answer 16

• position
• standardized
• sitting
• shoulders relaxed
• elbow at 90 degrees
• upper arm not touching body

Question 17

Calf circumference:

Answer 17

• 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)

Question 18

Calf circumference should be ____ for males and females.

Answer 18

< 33

Question 19

Calf circumference is inversely correlated with ____.

Answer 19

mortality

Question 20

Low calf circumference is an indicator of _____ among elderly people.

Answer 20

malnutrition

Question 21

Calf circumference validity is lower for ____.

Answer 21

women

Question 22

Low muscle mass is a powerful and independent predictor of poor prognosis:

Answer 22

• physical impairment disability
• greater length of hospital stay
• need for rehab
• post op complications
• disease progression
• poorer quality of life
• shorter survival

Question 23

Gaining muscle mass is ______, it is better to ____ the ____.

Answer 23

• difficult

- prevent the loss

Question 24

Evidence shows it can take ____ to rebuild muscle mass lost over ____ days.

Answer 24

• weeks

- 3-10 days

Question 25

What can lead to low muscle mass?

Answer 25

- endocrine - neurological - inadequate nutrition - treatment/surgery - disuse - age related

Question 26

Endocrine factors that lead to low muscle mass:

Answer 26

- corticosteroids - GH - IGF-1 - IR - abnormal thyroid function

Question 27

Neurological factors that lead to low muscle mass:

Answer 27

motor neuron loss

Question 28

Disuse factors that lead to low muscle mass:

Answer 28

- immobility | - lack of PA

Question 29

Age related factors that lead to low muscle mass:

Answer 29

- sex hormones - apoptosis - mitochondrial - dysfunction

Question 30

Lean mass and ____ ____ are not strongly correlated.

Answer 30

body weight

Question 31

Screening --> ______ --> ______ --> ______ --> _______.

Answer 31

- assessment - diagnosis - intervention - monitoring and evaluation

Question 32

Monitoring and intervening means utilizing tools:

Answer 32

- MUST - SGA - MNA

Question 33

Monitoring and intervening means measuring:

Answer 33

- BIA - DXA - muscle function/strength tests

Question 34

Monitoring and intervening means ____ support, ____ _____ supplements, ____.

Answer 34

- nutritional support: adequate energy and high protein - oral nutritional supplements - exercise: resistance training, adaptation needed

Question 35

ICD:

Answer 35

- International Statistical Classification of Diseases and Related Health Problems - medical classification list by the WHO

Question 36

ICD 10 code for....

Answer 36

sarcopenia

Question 37

ICD - 10 code for sarcopenia (low LM) lists that:

Answer 37

- 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

Question 38

To progress the knowledge and recognition of sarcopenia, the task force recommends the following actions:

Answer 38

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)

Question 39

Body composition evaluation should be integrated into ____ ___ _____ for the initial ____ and sequential ___ ___ of ____ status.

Answer 39

- routine clinical practice - assessment - follow up - nutritional

Question 40

Vision is to allow _____, _____, and ____ screening of malnutrition and promote the ____ and early initiation of optimal _____ ______, thereby contributing to reducing ....

Answer 40

- objective, systematic, and early - rational - nutritional support - malnutrition-induced morbidity - mortality - worsening of the quality of life - global health care costs.

Question 41

Low muscle across the continuum of care:

Answer 41

- primary care - acute setting - chronic disease - long term care - population health