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Obesity Medicine > General Obesity, Random Info > Flashcards

General Obesity, Random Info Flashcards

1
Q

What is 5-2-1-0 for peds patients

A

5 defining a of fruits and veggies daily
2 or less hours of screen time
1 or more hour physical activity
0 sugary drinks

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2
Q

Advantages to higher protein diets

A
  • Evidence exists that proteins exert an increased thermic effect of food
  • Evidence is also growing that higher protein diets increase satiety when compared to lower protein diets
  • Higher protein intake may increase weight loss and possibly increase percentage of fat loss
  • Dietary protein helps maintain lean mass during weight loss, which is directly proportional to resting energy expenditure
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3
Q

Recommended protein intake during normal circumstances and during weight loss

A
  • Protein during Maintenance .7 – 1 mg/kg/d

* Weight loss 1.2-1.5 mg / kg lean body weight (have to get estiamte of body fat percentage), ~90-120 gm / d

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4
Q

Which gender and age group of pediatric patients has the highest rates of obesity

A

Girls 12-19

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5
Q

BMI naturally decreases in this age group before then trending up

A

Age 2-6

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6
Q

EKG changes with obesity

A 
Increased QTc
Non-specific T wave inversion/flattening
Low QRS voltage
LVH
LAD
Slightly elevated heart rate
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7
Q

What age group has been shown to have better weight loss success on average through weight loss treatment program

A

Older adults

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8
Q

Blood pressure criteria for metabolic syndrome

A

> = 130/85 or on meds

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9
Q

What body fat percentage in men and women roughly correlated with obesity

A

> 25% in men

>32% in women

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10
Q

What is the Acceptable Macronutrient Distribution Ranges (AMDR) for carbs in adults? Peds?

A

45-65

Similar in peds

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11
Q

What ethnicity has been shown to have better weight loss success on average through weight loss treatment program

A

White

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12
Q

Cholesterol criteria for metabolic syndrome

A

HDL <40 in men or <50 in women

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13
Q

“Bad fats”

A

Trans fats

Saturated fats

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14
Q

BMI for class III obesity

A

> 40

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15
Q

The excessive intake of calories after dinner that is voluntary and the patient recalls it is called

A

Night eating syndrome

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16
Q

The principal determinant of resting metabolic weight is

A

Lean body mass (not specifically just muscle mass)

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17
Q

This eating disorder is similar to bulimia but without the compensatory behavior

A

Binge eating syndrome

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18
Q

During rest, skeletal muscle mostly uses this macronutrient for respiration

A

90% fats

10% carbs

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19
Q

These 2 diets have been linked with decreased CV mortality and diabetes

A

Vegetarian

Mediterranean

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20
Q

Correlation between obesity and H1N1 influenza

A

Worse sevierity

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21
Q

Definition of a calorie

A

amount of energy required to raise the

temperature of 1 gram of H2O by 1°C

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22
Q

Highest correlation between adult obesity, and obesity in this pediatric age group

A

Teens 12-20. 60% chance of obese obese at age 35

Ages 3-5 only have 20% chance at age 35

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23
Q

Maternal HLD has what impact on the babies weight

A

None

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24
Q

DASH diet was primarily developed to change what health outcome

A

Blood pressure

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25
Q

Weight goal for patients age 2-5 with BMI of >99%

A

Acceptable to lose 1 lbs per month

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26
Q

The excessive intake of calories after dinner that is involuntary and the patient does not recall eating the next day is

A

Sleep related eating disorder

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27
Q

Eating inedible or bizarre items at night is seen in what eating disorder

A

Sleep Related Eating Disorder

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28
Q

Are very low calorie diets (VLCO) better than traditional diets at long term weight loss

A

No. Regain about half of what they lost

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29
Q

Recommended weight gain during pregnancy for BMI <18.5, 18.5-24.9, 25-29.9, and >30?

A 
<18.5 = 30-40 lbs
18.5-24.9 = 25-35 lbs
25-29.9 = 15-25 lbs
>30 = 10-20 lbs
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30
Q

Maternal HTN has what impact on the babies weight

A

None

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31
Q

What is the Acceptable Macronutrient Distribution Ranges (AMDR) for fat in adults? Peds?

A

20-35% of calories

A bit higher in peds (30-40% in ages 1-3)

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32
Q

The blood sugar criteria for metabolic syndrome

A

> = 100

Or on meds for diabetes/prediabetes

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33
Q

Weight goal for patients age 12-18 with BMI of 95%-99%

A

Up to 2 lbs weight loss

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34
Q

Are very low calorie diets (VLCO) better than traditional diets at short term weight loss

A

Yes have more rapid weight loss over the first couple months (~20%)

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35
Q

BMI criteria for VLCD?

A

At least a BMI of 30

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36
Q

The Atkins diet primarily limits this

A

Carbs

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37
Q

Pre-exercise routine clearance recommendations

A

USPSTF no stress test for asymptomatic low risk patient, and no stress test for slowly progressive exercise regimen unless symptomatic. Doesn’t make a rec regarding intermediate/high risk asymptomatic patients

ACC/AHA recommend stress test before VIGOROUS exercise regimen in intermediate risk patients (diabetics, men >45, and women >55)

ACSM recommends pre-exercise “medical clearance” before starting an exercise regimen if have a history of cardiac, metabolic, or renal disease.

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38
Q

VO2 max is used as a surrogate to measure this

A

Physical fitness

Is the rate of O2 consumption at maximal exertion

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39
Q

Per 2016 data, the prevalence of obesity in patients age 2-19 is

A

~18%

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40
Q

Brown fat is higher in these individual

A

More brown fat in women, younger, and leaner people.

41
Q

Weight goal for patients age 6-11with BMI of 85-95%

A

Maintain weight

42
Q

Binge eating episodes must occur this frequently to meet criteria for binge eating disorder

A

At least once a week for 3 months

43
Q

What factor helps differentiate lipedema and lymphedema of the legs

A

Lymphedema includes the feet while lipedema (a genetic deposition of fat in the LE seen only in women) tends to mostly spare the feet

Lipedema also often has easy bruising and can be painful

44
Q

The feeling that one needs to eat in order to fall asleep is consistent with

A

Night eating syndrome

45
Q

Bed wetting can be a sign of this obesity related comorbidities

A

OSA

46
Q

A low carb high fat diet will typically cause what changes in lipid panel

A

HDL increase
LDL May increase
Triglyceride decrease

47
Q

Exercise recommendations per US Dep of Health

A

150 min/wk of moderate exercise or 75 min/wk of vigorous exercise

AND 2 or more days of resistance training

Need 150-300 min for weight loss or Maintenance of weight loss

48
Q

What is NEAT?

A

Non-Exercise Activity Thermogenesis (NEAT) = Activities that are NOT sleeping, eating, or exercise (intentional physical activity). Includes common daily activities like fidgeting, walking, standing, change in posture, ADLs, and climbing stairs. Up to 2000 kcal of energy expenditure per day. Decreases CV mortality and improves metabolic parameters like lipid and insulin levels. Hypothalamus appears to regulate NEAT

49
Q

According to the fetal programming hypothesis, the in utero environment during this trimester can lead to chronic disease later in life

A

2nd trimester

50
Q

Changes in fertility in obesity

A

Lower fertility in obese in both sexes

51
Q

Resting energy expenditure contributes about this % of total energy expenditure in the average person

A

60-75%

52
Q

Change in weight after smoking cessation

A

Varies widely. Average of about 4kg of weight gain after 1 year. However, 16% lose weight and only 13% gain more than 10kg

53
Q

What is the recommended amount of protein intake? In peds? During pregnancy/lactation? After Bariatric surgery? In the ICU? In elderly?

A 
0.8 g/kg for adult
Higher in peds (1.5 for infants, 0.95 children, 0.85 teenagers)
Higher in ages 65 and older, 1-1.2
Higher in ICU 2+
Higher after Bariatric surgery 1.5
Higher in pregnancy/lactation 1.1
54
Q

In the National Weight control Registry, this habit was most commonly reported among patients who lost weight and kept it off for 2+ years

A

Exercising at least 1 hour daily

55
Q

What is the preferred way to assess growth between the ages of birth and 2 years old

A

WHO normative growth chart

Weight for length percentage

56
Q

Criteria for Metabolic syndrome

A

Waist >40 inch men or >35 women (waist cut off varies by race in some definitions but there is no consensus)
Triglycerides >= 150
HDL <40 men or <50 women
BP > 130/85
Fasting sugar >=100 (other guidelines say 110)

3 of the above

If being treated for a condition still counts

57
Q

Relationship between bone marrow fat and obesity

A

None

58
Q

Use of skin fold testing in peds patients?

A

Don’t. Hasn’t been studied

59
Q

Use of waist circumference in peds patients

A

Don’t. Don’t have good data on what ranges are normal/abnormal etc

60
Q

Electrolyte abnormalities seems in bulimia

A

hypokalemia and metabolic alkalosis

61
Q

What is the Acceptable Macronutrient Distribution Ranges (AMDR) for protein in adults? Peds?

A

10-35%

Similar in peds

62
Q

Changes in testosterone levels in obesity? After weight loss?

A

Obese men have low total testosterone, low sex hormone binding globulin, and slightly low to normalish free testosterone.

Weight loss increases testosterone

63
Q

Does the speed of weight loss determine long term success?

A

No. Weight regain after slow and rapid weight loss is very similar

64
Q

Weight goal for patients age 6-11 with BMI of >99%

A

Up to 2 lbs per week

65
Q

What does a Very low calorie diet include?

A

<800 calories per day and 1.5g/kg of protein

66
Q

Weight goal for patients age 12-18 with BMI of >99%

A

Up to 2 lbs weight loss per week

67
Q

Changes in thyroid labs with obesity

A

mild changes in thyroid labs, that reverse with weight loss.

Elevated TSH, Elevated free T3, lower/normal free T4. T4 (levothyroxine) is the prohormone that is converted

68
Q

The thermic effect of food contributes about this % of total energy expenditure in the average person

A

10%

69
Q

Weight goal for patients age 2-5 with BMI of 85-95%

A

Maintain weight

70
Q

BMI for class 1 obesity

A

30-35

71
Q

“Good fats”

A

Monounsaturated fats like olive oil

Polyunsaturated fats

72
Q

The DASH diet primarily limits this

A

Fat

Dash diet increases low fat dairy and monounsaturated fats

73
Q

Waist circumference criteria for metabolic syndrome

A

White women >= 88cm
White men >= 102 cm

Asian, middle eastern, African, South American women >= 80cm

Japanese women >= 90cm

Asian men >= 85cm

African and Middle East me >= 94 cm

variance among many different definitions

74
Q

Exercise recommendation from the American College of Sports Medicine to prevent weight gain or to lose weight

A

150-250 min moderate exercise

75
Q

Pediatric BMI categories

A

Underweight = <5% BMI

Normal weight = 5-85% BMI

Overweight = 85-95% BMI (not weight) for sex and age

Obesity = greater than or equal to 95% BMI

Class 2 obesity = 120-140% of the 95% of BMI or BMI 35-40

Class 3 obesity = >140% of the 95% of BMI or BMI >40

76
Q

Weight goal for patients age 12-18 with BMI of 85-95%

A

Maintain or gradual weight loss

77
Q

Triglyceride criteria for metabolic syndrome

A

> = 150 or on medications

78
Q

In pediatric patients, how long should you wait to assess the effects of counseling on lifestyle interventions before increasing intensity of intervention

A

3-6 months

79
Q

Among pediatric patients this ethnic group has the highest rate of obesity

A

Hispanics

80
Q

Most common eating disorder

A

Binge Eating Disorder

Presents in 30% + of obese patients

81
Q

Does acanthosis nigricans improve with treatment of insulin resistance/obesity

A

Yes

82
Q

This condition is more common in obese children and includes progressive bowing of the legs due to disturbance in the medial proximal tibial growth plate

A

Blount’s Disease

83
Q

Most accurate way to assess diet

A

24 hour recall

84
Q

Are carbohydrates an essential nutrient?

A

No. Body can synthesize them

85
Q

Weight goal for patients age 6-11 with BMI of 95-99%

A

Gradual 1 lbs per month

86
Q

BMI for class 2 obesity

A

35-40

87
Q

Visceral adiposity trend in adults as age

A

Progressively increases

Progressive impairment in the ability of subcutaneous tissue to hold fat with aging

88
Q

Maternal smoking has what impact on the babies weight

A

Correlated with obesity

89
Q

Among adults, what ethnicity has the highest prevalence of obesity in the US

A

Non-hispanic blacks

90
Q

BMI formula

A

Kg / m ^2

91
Q

Physical activity contributes about this % of total energy expenditure in the average person

A

15-30%

92
Q

In elderly Caucasian’s this is the change in total adipose, body weight, and weight circumference

A

Weight decreases but adipose tissue and waist continue to increase

93
Q

Body weight in adults tends to increase until it peaks at about this age

A

60, then starts to drop

94
Q

Per 2016 data, the prevalence of obesity in adults is

A

~40%

95
Q

Headaches are commonly seen during the first few days of this type of diet

A

Low carb

Has deplete glycogen, loss of water leads to lower blood pressure

96
Q

Weight goal for patients age 2-5 with BMI of 95-99%

A

Maintain weight

97
Q

What is the preferred way to assess growth between the ages 2 and up

A

CDC normative growth chart

BMI percentage

98
Q

Strongest predictor of future obesity in a peds patient

A

Before age 6, biologic paterents weight is the strongest predictor of future obesity. After age 6 patients one weight strongest predictor

Obesity Medicine (5 decks)

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