Chapter 17 - Final Exam Flashcards
Overweight/Obesity Nomenclature
1980's - ideal body weight mid 80's - desirable body weight 1995 - healthy body weight overweight - weight level associated with higher risk for disease, disability, and death obesity - degree of overweight
Obesity Education Initiative (NIH)
developed BMI (kg/m^2) approximates body fat (important indicator of health) overweight = BMI of 25.0-29.9 obese = BMI of over 30
Exceptions for use of BMI
BMI measures do not accurately represent healthy weights of people who are:
athletes with ^ muscle mass
individuals with low muscle mass
individuals with large, dense bones
Effects of Obesity
^ body weight = ^ morbidity
hypertension, stroke, dyslipidemia, coronary heart disease, type II diabetes, gallbladder disease, osteoarthritis, sleep apnea, cancer, orthopedic problems
Etiology of Obesity
Overweight and obesity have multiple causes
more cal consumed than ecpended
Leptin-Ghrelin-Neuropeptide Y (NPY)
stimulates appettitie
Leptin defcient children
absence of pubertal growth spurt with final adult height of subject reduced
respond to leptin therapy
reduced energy intake up to 84%
Leptin and obesity
plays large part in causing obesity if insufficient, but can get treatment
administration of leptin directly to hypothalamus
Central Leptin Gene therapy
Long-term expression
low immunogenicity
Leptin Conclusion
techniques that augment hypothalamic leptin are likely to curtail obesity and ailments associated with the metabolic syndrome
Nutrition Interventions for Obesity
realistic goals: loss of 0.5-1.0 lbs/wk
meal plan: readily available and enjoyable foods
anticipate/solve potential weight-management problems
stress management: other than eating to deal
regular exercise
cultivate self image
behavioral change for lifetime
Metabolic syndrome
spectrum of metabolic abnormalities that ^ risk of cardiovascular disease and type 2 diabetes
20-30% of adults
diet therapy: weight reduction with diet and exercise (diets high in antiox-rich fruits and veggies, whole grains, fiber, low-fat dairy)
Cardiovascular disease (CVD)
diseases related to heart/blood vessels
associated with atherosclerosis-consists of; coronary heart disease, cerebral vascular disease, blood vessels in legs
over 82 mil adults
#1 cause of death in US adults
Characteristics of CVD
Atherosclerosis - hardening of arteries
due to plaque build up, increases risk of stroke (lack of O2 to brain)
Etiology of Atherosclerosis
multifactorial; chronic arterial inflammation, thickening as result of cell damage, formation of fibrous plaque at point of injury, calcification of fibrous plaque
Effects of CVD
build up of plaque leaves less room for blood flow, resulting in:
decreased blood flow to heart, reduced energy, decline in organ function, inability to perform ADL (activities of daily living), shortness of breath, chest pain (angina)
Medical Nutrition Therapy for CVD
Therapeutic Life Changes (TLC):
recommended for high-risk individuals
diet/lifestyle change is cornerstone of therapy
Nutrition Interventions for Coronary Heat Disease CHD
national cholesterol education program:
total fat intake from 25-35% of cal
daily cholesterol or eq to 200 cal/d in PA
Diabetes Mellitus
Def: fasting blood glucose levels ≥ 126 mg/dL 25.6 mil people in US < 1% of pop. in 1960 ~ 11.3% of pop. in 2010 79 mil have "prediabetes"
Type 1 Diabetes
progressive autoimmune disease pancreatic b (beta) cells destroyed daily insulin injections required
Type 2 Diabetes
insulin resistance
most common type
Cost of Diabetes
$174 billion: total costs of diagnosed diabetes in US in 2007
- $116 billion for direct medical costs
- $58 billion for indirect costs (disability, work loss, premature mortality)
Etiology of Diabetes
Type 2 caused by insulin resistance combined with insulin insufficiency
insulin: hormone produced by pancreatic b-cells, facilitates passage of glucose into cells
Insulin Resistance
what is it: condition where cells “resist” the action of insulin in facilitating the passage of glucose into cells
contributors: abdominal obesity, decreased PA, genetic predisposition
Short-Term Effects of Diabetes
blurred vision, ^ urination, ^ infections, ^ hunger and thirst, decreased wound healing
Long-Term Effects of Diabetes
heart disease, hypertension, stroke, blindness, kidney failure, poor circulation, loss of limbs
Risk Factors of Diabetes
main risk factors for type 2;
genetics, history of gestational diabetes, obesity and central obesity, physical inactivity, low whole grain/fiber intake
(lowering weight + ^ exercise = lowered risk)
Nutrition Assessment of Diabetes
diabetes management plan determinants;
weight status, current eating pattern, knowledge about diabetes, PA, lab values, med/social history, past education/experience with diabetes
Diabetes Interventions
clinical goals;
normalize blood glucose/glucose metabolism, prevent/slow progression of diabetes complications
treatment focus: empower person to self-manage
Medical Nutrition Therapy
diet flexibility and individualization;
diet plan, cal level, cal/CHO distribution, variety of foods, consistent eating pattern
Medical Nutrition Therapy - Diet
consist of;
whole grains and other fibrous foods, unsaturated fats, regular meals/snacks, CHO counting
may also need anti-hyperglycemic drugs
use herbal remedies with caution
Cancer
group of diseases in which abnormal cellular growth affects specific organ systems
tissues affected;
connective - sarcomas
muscular - myosarcomas
nervous - gliomas
epithelial - main: skin, GI, urogenital, secretory, and respiratory
Etiology of Cancer
stages; activation initiation (injury/insult to DNA by carcinogen such as; free radicals, toxin, virus, or radiation) promotion (damaged DNA divides) progression (uncontrolled growth) invasion metastasis (spread to other tissues/organs) possible remission
Initiation & Progression of Cancer
linked to:
environmental exposures
lifestyle
dietary constituents (promotion or inhibition)
Incidence of Cancer
estimates for 2011:
~1.6 mil will be diagnosed with cancer
~600,000 die of cancer annually
white women, black men - highest rate or new cancers
american indian, alaskan natives - lowest rate
Most Common Cancers for Adults
prostate, breast, colorectal, and lung
Risk Factors of Cancer
smoking - linked to 30% of cancers
nutrition-related risks:
obesity/insulin resistance, excessive alcohol consumption, low intakes of fruits/veggies, N-nitorso compounds on processed meats
Nutrition Intervention for Cancer
to minimize nutritional risk;maintain or reach healthy weight, eat fruits/veggies, limit processed meats, alcohol in moderation, exercise
if cancer diagnosed, good nutrition supports treatments (chemo, radiation, surgery)
Breast Cancer Metastasis to Bones
skeleton one of most common organs affected by metastatic breast cancer (BC)
HIV/AIDS Prevalence
worldwide ~ 40 mil
US ~ 1.1 mil
new cases declining
african americans/hispanics affected > caucasians
Etiology of HIV/AIDS
HIV transmitted through blood and body fluid exchange
main causes: unprotected sex & sharing contaminated needles
mother may transmit to baby during preg, at birth, or during breastfeeding
Effects of HIV/AIDS
penetrates and destroys body’s immune cells, leading to more infections/cancer
latency stage: weeks to 2 years
not all people wit HIV develop AIDS
AIDS Affecting Nutritions
seizures/lack of coordination, difficulty/painful swallowing, confusion/forgetfulness, sever/persistent diarrhea, fever, nausea/cramps/vomiting, weight loss and fatigue
Nutrition Interventions for Symptoms of HIV/AIDS
maintain weight and nutritional status
nutrition very important part of treatment and ability to live with infection
