Chp 16 - addl diseases/conditions/consideration Flashcards
From CDC, chronic diseases affect how many US adults
1 in two
Lipid parameters associated with CVD
Elevated LDL and total cholesterol
Low HDL
Elevated TGs
Chronic elevated TGs associated with….
endothelial dysfunction AND an independent risk factor for CVD
Primary lipoproteins are…
LDL - major carrier, 60-70% of cholesterol
VLDL - major carrier of TG, 10-15% of total chol
IDL - formed from the b’down of VLDL, similar to LDL
HDL - made in SI and LIV – 20-30% of chol – TRANSPORTS lipids to the liver for recycling and removal. INVERSELY correlated with CVD
Non-HDL - TOTAL chol MINUS HD —OR— sum of LDL, VLDL, and IDL; STRONGLY associated with CVD
LDL chol values - optimal & very high
HDL, low and high
Total cholesterol
<100, >/equal to 190
HDL Low = <40
HDL High = >/= to 60
TOTAL = desirable, <200
High = >/= 240
TG normal
High
Very high
<150
High = 200-499
Very High = >/= 500
Prevalence of high cholesterol (>/= 240)
28.5 million
11.9% US adults
Most likely secondary cause of elevated/high - for those genetically predisposed
Sedentary
Excessive saturated fat, cholesterol, and trans fats
Dietary recs for managing dyslipidemia…
Lower LDL – 5-6% calories from sat fat, LIMIT sweets, sugar sweetened bevs, red meats
Exercise and lipid issues - type of exercise best? Plus what other factor?
Aerobic exercise PLUS weight loss - significant improvement
Typical problems contributing to dyslipidemia..
Sedentary lifestyle PLUS excess sat and trans fats, and cholesterol
Cancer, referred to as…
collection of approx 200 related diseases characterized by uncontrolled spread & growth of abnormal cells
Classification of different cancers based on…
cell type from which they orginate
Prevalence…
one of the leading causes of morbidity and mortality worldwide
Three general phases of cancer survivorship…
1) tx and recovery
2) living after recovery - survivors dz free or have stable dz
3) advanced cancer and end of life
Causes of cancer..
1) environmental exposures
2) lifestyle practices
3) medical interventions
4) viral infections
5) genetic traits
6) gender
7) aging
30% of deaths related to five leading behavior and dietary risks:
1) high BMI
2) low intake of fruits and veggies
3) physical inactivity
4) tobacco use
5) alcohol intake
Goals of nutritional care with cancer…
1) prevent/resolve nutrient deficiencies
2) achieve/maintain health weight
3) preserve LBM
4) minimize nutrition related side effects
5) max quality of life
Physical activity protection against acquiring cancers…how?
e.g. which cancers
balancing caloric intake with EE
other means = changes affecting hormonal environment(s)
colon, endometrial, ovarian, breast
Exercise in the TREATMENT of cancer is to….
maintain and improve CV conditioning
prevent MSK deterioration
reduce symptoms, e.g. nausea, fatigue
improve mental outlook and quality of life
American Cancer Society nutrition guidelines
Limit processed meat and red meat
Consume 2.5 cups of veggies and fruits daily
Choose whole grains vs. refined
Alcohol — limit consumption to no > than 1 drink/day for women and 2 drinks/day for men
Most common forms of arthritis
OA - leading cause of disability in the US
RA
Majority of cases d/t…
secondary to trauma and/or obesity
Joints most often affected by OA
C and L spine, hip, knee, distal joints of hand
Classification of functional status for RA
I = able to do self care and ADL, vocational and avo
II = able to do self care and vocational, lmtd avo
III - able to do self care, lmtd vocational and avo
IV = limited in self care, vocational and avo
Optimal approach to OA
exercise and weight loss
Primary goals of exercise
1) improve CV fitness and lower CAD risk
2) increase mm endurance and strength
3) maintain or improve ROM and joint flexibility
special considerations for exercise
Acute flare ups, pain –> avoid STRENUOUS exercise, gentle ROM is fine
Pain lasting longer than 2 hours post exercise, higher than pre session = reduce duration or intensity
LBP defn
recurring or persistent condition with a fluctuating course over time
Acute = < 3 mos
Chronic = > 3 mos
Typical age
45-64 years
80% of people will have a bout in their lifetime
Acute LBP is usually ______________ in nature
mechanical – yet underlying cause is unknown so tx is uncertain
Strategies for enhancing back health
a) prevent deconditioning of mm around spine
b) avoid painful ROM
c) choose low or nonimpact activities - cardiorespiratory endurance, e.g. walking, recumbent biking
Osteoporosis defn
bone mineral density (BMD) that is 2.5 standard deviations or more below the mean
Characterized by low bone mass and disrupted microarchitecture
Most common fracture sites
proximal femur, vertebrae spinal, distal forearm
Why are hip fractures most devastating?
associated with severe disability and increased mortality
Osteopenia bone density
between 1.0-2.5 standard deviations below the mean
Two most important nutrients are
Calcium and Vit D
Alcohol association, and servings
3 risks
More than 2 drinks/day for women
3 drinks/day for men
Impaired bone health
Increased risk of falling
Potential alcoholism
Vit D recs dosage
Under age 50 = 400-800 IU
50 and older = 800-1000 IU
Safe upper limit is 4,000 IU/day
Healthy range vit d in blood
30-60 ng/mL
Exercise and osteoporosis - 2 primary goals
1) retain and/or prevent loss of bone minerals
2) decrease the risk of falls/fractures
