Introduction to Lifestyle Medicine Flashcards
Which of the following statements are not true
A. In Interheart study five of the risk factors ( smoking, lipids, HT, diabetes, Obesity) identified accounted for 80% on the population attributable risk for acute MI
B. Data in Interheart study is from 32 countries.
C. Ten life style risk factors in Interstroke study were associated with90% of the risk of stroke in men and women of all ages.
D. Data in interstroke study was from 52 countries.
Answer B&D
A. nine risk factors accounted for more than 90% of the PAR of AMI in men and 94% in women. + diet, physical inactivity, alcohol consumption and psychosocial factors ( stress, Mental health, isolation, addictions PAR 30% comparable to High BP and Abdominal obesity)
B. 52 countries
C. 10 risk factors: HT, Current smoking, abdominal obesity, unhealthy diet, physical inactivity, diabetes, alcohol intake, psychological stress, depression, cardiac causes and abnormal lipids.
D.32
With Reference to the Chicago Heart association detection project, making six life style changes the risk of heart disease can be reduced by 90-95%. which of the following are incorrect.
A. 50% decease in cholesterol- 50% risk reduction of heart disease.
B. smoking cessation- 50% risk reduction of sudden cardiac death
C. 6mm Hg decrease in diastolic BP - 16% risk reduction of heart disease ( 42% risk reduction of stroke)
D. Maintain ideal body weight and waist size- 60% risk reduction of heart disease.
E.>150 minutes/week of moderate exercise- 30% risk reduction of heart disease.
F. more than 5 serving of fruit and veg per day- 20-25% risk reduction of heart disease.
Answer D and E
D 35-55% not 60%
E 35-55% not 30%
Which of the following statements is not true:
A. In Framingham heart study men with optimal risk had 5% life time risk of atherosclerotic CVD versus men with 2 or more risk factors who had 69% life time risk at 50
B. Multiple risk factors intervention trial ( MRFIT) study outcomes included 6-10 years greater life expectancy.
C. Nurses Heart study: 5 health factors associated with low risk of CHD were absence of smoking, BMI <25, Physically active 30 minutes per day, moderate alcohol consumption (5-30 grams or 0.2-1 ounce per day), healthy diet score.
D. Three large prospective studies: the nurses health study, nurses health study 2, health professionals follow up study: found that higher adherence to a healthy plant based diet had positive correlation with coronary heart disease.
A figures for women were 8% and 50%. This adds 11+ years for men and 8+ years for women to their life expectancy.
B. 40-60% lower total mortality and 73-85% lower risk CVD mortality.
C. diet score were based on intake of cereal fiber, marine omega 3 fatty acids and folate.
D its was independently inverse relationship.
Name the biological processes affected by healthy lifestyle:
A) Reduces chronic Systemic inflammation
B) Reduces insulin resistance (the underlying cause of Hyperglycemia & related metabolic dysfunction)
C) Provides Antioxidants
D) Gene expression (epigenetics)
E All of the above
Answer E
Which of the following is incorrect:
A. Adventist 2 Study:Approx decrease in risks for vegans: Diabetes 50% (OR 0.51), metabolic syndrome 55% (OR 0.44), Hypertension 65% (OR 0.37)
B Lyons Heart Study:The protective effects of the Mediterranean diet were not maintained for 4 years following a first heart attack.
C. Portfolio diet - high in plant Sterols, Soy protein, viscous fibers & Berries
D The CHIP program at Vanderbilt University for diabetics :Approximately 24% of study participants were able to eliminate one or more of their medications.
B Protective effects were maintained for 4 years following a first heart attack. C Almonds not Berries
Which ONE is INCORRECT regarding the
main competencies for Physicians
prescribing Lifestyle medicine?
A. Leadership such as promoting healthy
personal behaviours at school, work and
home.
B. Knowledge on the evidences available
that influence a patient’s health eg the
effects of a plant based diet can reduce BP,
lower lipids and prostate cancer regression
etc.
C. Assessment skills including lifestyle
“vital signs” like tobacco use, alcohol
consumption, diet, physical activity, BMI,
stress level, sleep and emotional wellbeing.
D. Prescribe medications for the patient’s
chronic diseases as well as counselling and
psychotherapy.
E. Use of office and community support
F. A, B, and C.
D incorrect
Field of Lifestyle Medicine refers to all
the following except:
A)Holistic approaches to balance core
functional processes, control oxidative
stresses at a cellular level and promote
detoxification.
B) Evidence-based treatment and
prevention of chronic diseases related to
lifestyle and behaviours.
C) Reversal of certain lifestyle-related
diseases.
D) Assisting the patient in enhancing his diet
with whole foods, incorporating physical
activity and emotional well-being practices
and avoiding risky substances. Medications
are used as an adjunct.
Answer A.
Regarding adverse drug reactions, which
one of the following is incorrect?
A) They often occur despite appropriate
use.
B) They are the 3rd leading cause of
death in the US, ranking higher than
pulmonary disease, diabetes, AIDS,
pneumonia, accidents and motor vehicle
accidents.
C) There are more than two million serious
reactions per year.
D) The total cost of adverse drug reactions
is more than that of cardiovascular disease or
diabetes
Answer:
B 4th leading cause
which is the following is not true
A. Ideally, a ITLC includes an INDUCTION phase which precedes the MAINTENANCE and SUPPORT phases in lifestyle change
- outpatient programs have visits ~ 60 minutes 1-3x/week for 8-18 weeks
- Residential programs are generally 7-21 days long
- Shorter ITLC immersions can last 3-10 days.
B examples of 3 ITLC programs
1) Pritkin program 1970s
2) Ornish program - 1980s
3) Diehl CHIP program - 1990s
C A whole food plant based diet (WFPB diet):
1) Consists of mostly foods from plants (eg whole grains, vegetables, fruits, beans & legumes)
2) Little or no animal products (eg dairy, meat, eggs)
D LM approach include
Feet, fingers, forks, sleep stress love (Mnemonic)
Feet - REGULAR physical activity
Fingers - avoid risky substances (eg tobacco, drugs)
Forks - PREDOMINANTLY whole food plant-based diet
Sleep - ADEQUATE sleep
Stress - stress MANAGEMENT
Love - non-drug modalities to PROMOTE health & PREVENT disease
E All true
Answer E
With respect to lifestyle medicine and its impact on disease pathophysiology, the following are true except:
A. Change gene expression in men with low risk prostate cancer
B. Beta cell regeneration via fasting mimicking diet.
C. Normalisation of beta cell function.
D. Improved Oxygen uptake at peak exercise.
E. Acute systemic inflammation.
F. Increase in LDL-C
G. Change telomerase activity and telomere length.
Answer
E: its chronic systemic inflammation
F. Decrease in LDL-C
Physical inactivity if 4th leading risk factor for global mortality. It is the cause of 1:10 premature deaths.
notes
Health Coaching
assess readiness for change, collaboratively establishing client goals, evaluating successful and self limiting patterns, reassessing and modifying goals, articulating insights gained, and formulating post coaching plan to sustain changes that promote health and wellness.
notes
LM places emphasis on behaviour change. This is the most distinctive aspect of the principles and practice of LM.
notes
Group consultations or Shared medical appointments
these are conservative individual medical visits in a supportive group setting where all can listen, interact and learn.
advantages more time with the doctor, faster access to care, increased peer support, greater opportunity for self care.
notes
the following is the most appropriate technique in the behaviour change
Pre contemplation and contemplation =motivational interviewing
Preparation, Action and maintenance=CBT
overall positive psychology
PC PAM had MI she got depressed which helped by CBT and she learned the mantra of positive psychology.
notes
