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KNPE 255 > Midterm 2 > Flashcards

Midterm 2 Flashcards

1
Q

Type 2 Diabetes and Physical Activity association

A

Intensity does not matter

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2
Q

BMI and Physical Activity association

A
  • Risk reduction is greater with no adjustment
    for BMI
  • Both pathways (PA & BMI) are involved in
    reducing the risk of T2D
  • Risk reduction is less after adjusting for BMI
    because we can see the direct effect of PA on
    T2D
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3
Q

Systolic Blood Pressure

A

Max pressure the heart exerts while beating

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4
Q

Diastolic Blood Pressure

A

Amount of pressure in the arteries between beats

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5
Q

Is intensity associated with improvements in SBP and DBP?

A

Only diastolic blood pressure because as intensity increases, so does the reduction

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6
Q

Why is the reduction in risk of incident hypertension less after adjusting for BMI?

A
  • By adjusting for BMI, you remove the effect of
    the shared pathway of BMI and PA
  • This leaves the direct effect of PA on
    hypertension
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7
Q

No adjustment for BMI

A
  • Risk reduction is greater because we can
    reduce body weight by being physically active,
    which then also reduces risk of hypertension
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8
Q

Adjustment for BMI

A
  • Risk reduction is less because you take away
    one of the ways in which PA impacts blood
    pressure
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9
Q

Hypertension and PA association

A

Linear inverse association

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10
Q

Blood pressure and PA

A

Regardless of blood pressure level or intensity, PA is associated with benefit in a dose-response pattern

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11
Q

Modifiable risk factors

A
  • Diet
  • Exercise
  • Weight
  • Radiation exposure
  • Tobacco
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12
Q

Non-Modifiable risk factors

A
  • Heredity
  • Certain viruses
  • Carcinogens
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13
Q

Colon cancer and PA association

A
  • Dose-response relationship
  • 30-45 min of PA a day is associated with the
    benefit
  • All forms of exercise are beneficial
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14
Q

Colon cancer and cardiorespiratory fitness

A
  • Powerful predictor of colorectal cancer
  • When we adjust for PA, the relative risk
    remains the same meaning regardless of your
    level of PA, if you have a high CRF, you will
    reduce your risk of colon cancer
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15
Q

Sitting time and cancer mortality

A
  • More time you spend sitting, the greater the
    risk of cancer mortality
  • However, performing large amounts of PA (35
    MET-hr/week) the risk of sitting becomes
    insignificant
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16
Q

Breast cancer and PA

A
  • Threshold relationship
  • Must be exercising regularly at high intensity,
    meeting guidelines to see a benefit (gradual
    decline in risk as PA increases)
  • 30 min a day
  • Sedentary time increases the risk
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17
Q

Lung cancer and PA

A
  • Smoking is a powerful predictor of lung cancer
  • In smokers, there is a benefit of
    performing PA
  • In non-smokers, there is no trend to the
    benefit of PA on lung cancer
  • Relationship between PA and lung cancer
    must not be casual
  • Ex. those who smoke the least tend to be
    more active and health-conscious, than those
    who regularly smoke, causing a reduced risk
    of lung cancer
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18
Q

Sitting time and PA on all-cause mortality

A

Performing more PA for the same hours of sitting, reduces the risk to insignificant

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19
Q

TV-Viewing time and PA on all-cause mortality

A
  • TV viewing leads to a higher risk of all-cause
    mortality than sitting (due to occupations)
  • Still a risk of this form of sedentary time on all-
    cause mortality, even at a high amount of PA
  • Might be because of the things one does as
    they view TV (eat, drink)
20
Q

TV-Viewing

A

Residual risk even with a high amount of PA

21
Q

Screen Time

A

Sitting while doing an occupation has different effects compared to sitting when performing recreation screen time

22
Q

Indirect field methods of body composition

A
  • Bioelectrical impedance (BIA)
  • Skinfolds
  • Ultrasounds
  • Bod pod
23
Q

Skin folds

A
  • Measure the skin fold on a body part
  • Derive total body percent fat score
  • Not accurate to assume a smaller body part
    has the same amount of fat as the whole body
24
Q

Fundamental Equation

A

C = f(Q)
C = unknown component (unknown adiposity)
f = mathematical function that links c to Q
Q = measurable quantity/property (skin folds)

25
Q

Steps to derive and validate a field method equation

A
  1. Choose a reference (criterion) method to
    measure the unknown component
    (dependent variable)
  2. Choose a well characterized subject group
  3. Apply statistical method to derive a function
    (equation) for predicting the component from
    the measured property
    ex. take everyone in a class and use a
    direct/criterion method (MRI) to measure
    actual skeletal muscle mass.
  4. Derive an equation that can predict skeletal
    muscle mass from the BIA resistance (Ht2/R)
26
Q

Derivation and validation of a BIA skeletal muscle prediction equation

A
  1. Derive/develop the prediction equation
  2. Cross-validate the prediction equation
    • reference group used to develop the
      equation must be similar in characteristics in
      the other population to properly predict body
      composition in the other group (ex. gender,
      age, activity level)
27
Q

Cross validation example

A
  • An equation based on second-year kin
    students at queens using MRI to develop the
    equation is created
  • this equation would be optimized and specific
    to that population, if this equation works on
    second-year kin students at Western, it has
    been cross-validated
28
Q

Deriving an equation

A
  • Some don’t always have access to money
    for MRI technology
  • Can locate an equation in the literature
    (academic journals)
  • Must resemble the population of interest
  • Do not measure BMI with an equation that is
    not specific for the population
29
Q

Applying field methods of body composition

A
  • No exercise or sauna for 8 hours before
    measurement
  • The body must be properly hydrated to
    achieve an accurate impedance value
  • No alcohol within 12 hours
  • Height and weight are accurately measured
30
Q

BMI and Obesity-related morbidity and mortality

A

BMI alone is not optimal for identifying obesity-related mortality

31
Q

BMI and waist circumference

A

These two variables together are a better indicator of obesity-related mortality than either one alone

32
Q

Ectopic fat accumulation

A

Visceral, liver fat accumulation of this may be why BMI and WC together are strong predictors of obesity mortality

33
Q

Gender and location of excess adiposity

A
  • Men: abdominal region grows (apple)
  • Women: pre-menopause, lower body region
    grows (hips and thighs) (pear)
34
Q

Issues with use of BMI and WC to identify risk

A
  1. BMI is only positively related to health risk
    (causes of risk) after consideration of WC
  2. We base risk off of BMI categories where they
    could be individuals at the extremes of each
    category who undergo a different risk
    (assuming that all people with a certain BMI
    have the same risk)
  3. When BMI and WC are considered as
    individual continuous variables, WC is a
    positive predictor of risk, whereas BMI is
    unrelated or negatively related to health risk
35
Q

Mortality risk in adults (BMI and WC)

A
  • The relationship between WC and mortality
    risk is improved when BMI is adjusted for (take
    out BMI effect on mortality risk)
  • When we adjust for WC, a higher BMI
    decreases the risk
  • BMI masks the effects of WC
36
Q

Low BMI

A
  • At greater risk
  • For a given WC, a lower BMI means the
    individual has greater visceral fat and
    therefore a greater health risk
37
Q

Healthy cardio-metabolic profile

A
  • Functional adipocytes store excess fat so it
    does not go to unwanted places
  • Ex. Subcutaneous adipose tissue going to the
    heart or liver
38
Q

Cardio-metabolic risk profile

A
  • Dysfunctional adipocytes cant store excess fat
    and therefore fat goes to unwanted places
  • Ex. subcutaneous adipose tissue
39
Q

Obesity management

A

It is said that one must achieve a weight loss of greater than 5% of body mass in order to deem the treatment as successful

40
Q

Clinically significant weight loss

A

5% or more

41
Q

Maintaining weight

A

3% or less

42
Q

A revised approach to obesity management

A
  • Change focus from the bathroom scale to
    adaption of healthy behaviours
  • Target the casual behaviours (diet & exercise)
  • Must go upstream and look at causes of
    obesity
43
Q

Public interpretation of weight loss

A
  • Weight loss is required for the benefit
  • Ex. I will see no benefit to diet and exercise if i
    do not lose weight
  • No weight loss or limited weight loss is a
    failure
44
Q

Desired health outcomes related to obesity risk

A
  • Improve CRF
  • Decrease total adiposity
  • Decrease visceral/abdominal adiposity
  • Maintain/increase skeletal muscle mass
  • Improve cardio-metabolic risk factors
  • Weight loss is not a prerequisite for any of
    these
45
Q

Exercise and weight loss

A
  • Exercise will improve cardio-metabolic risk
    factors, skeletal muscle mass and CRF
    regardless of weight loss
  • Exercise without weight loss is not a failure
  • Even exercise without weight loss causes a
    decrease in WC, due to an increase in skeletal
    muscle mass

KNPE 255 (1 decks)

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