ECR Nutrition Flashcards
What is the normal BMI?
19-25
What percent of U.S. adults are overwieght or obese BMI>25
60%
what percent of US children and adolescent are overweight
> 14%
What ethnicity has highest prevalence of being overweight or obese in adolsencent?
Mexican-American boys, black girls, white boys from lower-income families
What is prevalence of white vs black women (obesity)
black women-69%
white women 47%
women with income <130% of poverty threshold are 50% more likely to ve obese than those at higher icome leels`=
what is prevalence of white vs black men (obesity>)
black men -58%
white men 62%
What does overweight and obeisty increase risk of?
heart disease, numerous types of cancers, type 2 diabetes, sstroke, arthritis, sleep apnea, depression
What percent of peopel with non-insulin-depenent diabites are overweight or boses?
more than 50%
what precent of people are hypertensive or have elevated cholesterol are overweight or obese?
20%
how many obese US adults reprot htat health care professionals have advised them to lose weight?
only 42%
Reducing weight by what percent can improve BP, lipid levels, and glucose tolerance and reduce risk of diabetes or hypertension.
Reducing 5-10%
What are 4 tips for promoting optimal wieght and nutritoin
- Measure BMI and waist cricumference, identify risk of overwieght and obseity
- establish additoanl risk factors for heart disease and obesity related diseases
- assess dietary intake
- assess the patient’s motivation to change; provide counseling about nutrition and exercise
If BMI> 25, assess for WHAT additioanl risk factors?
heart disease and otehr obsiety related diseass: hypertention, high LDL, cholesterol, how HDL cholesterol, high TAGs, high blood glucose, family history of premature heart disease, physical inactivity, cigarette smoking
Patients with BMI >25 and two or more risk factors should pursue wegith loss, esp if wasit circumference is elevated.
yes
What BMI is considered underweight
<18.5 kg/m2
What is normal BMI
18.5-24.9
What is overweight BMI
25-29.9
What is obsesity class I BMI
30-34.9
What is obesity class II BMI
35.0-39.9
What is extreme obesity III
> or = to 40
What percent of weight loss is recommended for individuals with BMIs between 27-35?
10% weigth reduction over 6 months or decrease of 300 to 500 kcal/day
Does a weight loss goal of 1/2 to 1 lb per week okay?
yes b/c more rapid weight loss does not lead to better results at 1 year
Once you assess food intake, nurtitional status, and motivation to adopt healthy eating behaviors or lose weight, what are the “nin major messages” to give to patients
- consume a variety of foods within and among the basic food groups while staying within energy needs
- control calorie intake and protion size to manage body weigth
- maintian moderate physical activity for at least 30 mins each day ,walking 3-4 miles per hours
- increase daily intake of fruits and veggies, whole grains, and non fat or low-fat milk and milk producets
- choose fats wiesely, keeping intake of saturated fats, trans fat, dfound in partially hyddrogenated vegetable oils, and cholesterol low
- choose and prepare foods with little salt
- if youd rink alcoholic beverages, do so in moderation
- keep food safe to eat
waht is the RDA (recommended daily allowance)of sodium?
<5% f RDA of 2400 mg or less
What does body fat consist of and where?
primarly adipose in teh form of TAG and is stored in subcutanesou , inter-abdominal, and intramuscular fat depoists that are difficult to measure direclty.
what does BMI measure>
incorporates estimated but more accurate measures of body fat than weight alone
BMI criteria for overweight and obse ar not rigid cut points abut guidelines for estimating increasing risks to patient health and well-being form both excess and low weight
where are BMI standards dervided from?
two surveys:
National Health Examination Survey, consisting of three survey cycles between 1960-1970 and
National Health and Nutritiona Examination Survey, conducted over 3 cycles between 1970s and 1990s
If the BMI is 35 or highger, you should measure
the pateint’s waist circumference (wasist just above the hip bones)
Patiente may have excess body fat if waist circumference is
> 35 for women
> 40 for men
What aprat of the lower back is the most vulnerable?
L5-S1, where sacral vertebrae take a sharp posterior angle
What precent of the population experiences low back pain at lest onece in a lifetime
60-80%
how many american’s have osteoporosis?
10 million and 34 million are at increased risk
waht percent of men are at risk for osteoporosis?
42% of those at risk are men
What does bone strength reflect?
both BONE DENSITY and BONE QUALITY
what is bone density?
determined by the interaction of bone mass (highest in send decade) , new bone formaiton, and bone resorption or loss
what is bone quality?
architecture, turnover, damage accumulation from microfratures and mineralization
whawt is osteoporosis?
skeletal disoder characterized by compromised bone strength predisposing a person to an increased risk of fracture
How is bone strength measured?
there is no direct measuremten of bone strength
bone mineral density, which accounts for approx 70% bone strenght, is used to proxy meausre
What is Osteopenia
Bone density 1.0-2.5 standard deviations below mean for young adult white women (T score between -2.5 and -1.0)
Wht is Osteoporosis?
Bone density 1.0-2.5 or more standard deviations below the mean for young adult white woment (T score less tahn -2.5)
what part of body is bone density measured?
1 hip, femoral neck, Ward’s triagnle at the femoral neck, greater trochanater, an dtotal hip
What is a 10% drop in bone density, equivaletn to in fractures?
10% drop in bone density is 1.0 standard devtiatino, is ass. with 20% increase risk for fracture
What are basic screening questinos for older women?
Have you ever had a fracture Did either parent ever have a fracture? Do you smoke? What is your weight? Have you ever taken estrogen replacement therapy?
What are risk factors for osteoporosis?
Postmenopausal status in white women
Age odler than 50 years
weight lass than 70 kg
Family Hx of fracture in a first degree relative
Hx of fracture
Higher intakes of alcohol
Women with delayed menarche or early menopause
current smokers
low levels of 25 hydroxyvitamin D
Use of corticosteroids for more than2 months
Inflammatory disorders of MC, pulmoanry or gasstrointestinal systems, including celiac sprue, chrhonic renal disease, organ tranplantaiotn, hypognoadism, anorexia nervosa
What are some therapeutic uses of avaialbe agents for treating osteoporosis?
increase clacium intake to reduce age-related hyperparathyroidism and increase minearlization of newly formed bone
2/3 of patients with hip fractures are deficient in Vitamin D (for Ca absorption and muscle strength)
antiresportpive agents
anabolic agents such as parathyroid hormone stimulate bond formation by acting priamrly on osteoblasts
Exercise
