chd more

Question 1

Metabolic Syndrome

3 or more of the following risk factors:

Answer 1

1) elevated blood glucose
2) high blood pressure
3) elevated TG
4) elevated waist circumferenc,
5) reduced HDL-C.

Question 2

•Is every person who is overweight or obese at equal risk for associated chronic diseases?

Answer 2

•No. Risk needs to be assessed according to the algorithm (2006 Obesity Guidelines) before treatment/management (Table 5):

a) Assess BMI : 34.7: (89kg/1.6^2): class 1 obesity
b) Then measure waist circumference: 98cm: classifys as very high risk
Classify for disease risk
c) Combine this information with other risk determinants (smoking, diet, other diseases, physical activity, family history).: family history: type 2 diabetes, CAD, former smoker, does not exercise, unhealthy diet, depressive state, borderline hypertensive

Question 3

Results: Summary of Successful Strategies for Weight Loss

Answer 3

• Must be an energy deficit: minimum caloric intake of 1200 kcal/d for F and 1500 kcal for M. Having a specific caloric target appeared helpful.
• Commonly combined with a decrease in fat (< 30% of total energy).
• Increasing dietary fibre was a key component in 21% of the studies.
• As well as dietary intake, both physical activity (at least 150 min of aerobic activity/week) (88% of studies) and behavioural therapy/support (92% of studies) were important factors.
• Self-monitoring important e.g. food and activity diaries.

Question 4

• •Liver enzymes and urinalysis WHY?

Answer 4

• Obesity increases risk for “non alcoholic steato(fat accumulating) hepatitis (with inflammation)” if there is damage to the liver cells the enzymes tend to leak out.

Question 5

1. Behavior modification techniques

Answer 5

a) self-monitoring •keep records of food eaten, when, where, and accompanying thoughts and feelings.

b) stimulus control - identify stimuli that bring about unhealthy behavior
•settings or events that precede eating
•types of food
•certain situations or people

c) modify specific eating behaviors and stimuli. e.g.
• slow rate of eating to pay attention to satiety signals, put down utensils between bites, pausing, chewing thoroughly
• avoid certain social circumstances
• don’t keep high fat, high energy dense foods in the house or only in small quantities.

d) reinforcement management
• the client gives her- or him-self a reinforcement for accomplishing a certain behavior (e.g. buying a new piece of clothes after maintaining an exercise goal for 1 month).