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Physiology Final > module 7 adulthood > Flashcards

module 7 adulthood Flashcards

1
Q

early years

A

20s and 30s

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2
Q

middle years

A

40s and 50s

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3
Q

general nutrition goals of adulthood

A

Energy intake needs to be adjusted
Reduced BMR (Basal Metabolic Rate)
Lower lean body mass
Changes in physical activity

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4
Q

nutrients of concern in adulthood (don’t want too much of)

A

sugar
sodium

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5
Q

nutrients of concern for too little in adulthood

A

Fiber
Vitamin A
Vitamin D
Vitamin E
Choline
Calcium
Iron
Magnesium
Potassium

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6
Q

maintenance of health in adults (4)

A

Healthy weight
Less visceral adiposity
Prevent insulin resistance
Lower CVD risk

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7
Q

physiological changes in adulthood

A

Height: Final achieved by the 20s (males)
Bone density: Increases until 30 (males)
Muscular strength: Generally peaks around 25-30
Around 20-30 as a whole
Auditory: Hearing loss begins as early as 25
It can be detected at 25, but no hearing device would be needed
Vision: Changes become noticeable at 40
A lot of this data had been done before technology was so popular

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8
Q

climacteric =

A

critical period

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9
Q

females hormonal changes

A

Perimenopause/Menopause: Decline in estrogen levels
Increased abdominal fat: Lean mass declines bc of decline in physical activity or estrogen levels
(Low estrogen causes preferential distribution of fat as abdominal fat)
Increased risk of cardiovascular disease & accelerated loss of bone mass

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10
Q

males hormone changes

A

Gradual decline in testosterone level & muscle mass
Physical activity and weight training can help mitigate this
Increase in LH and FSH → decrease testosterone
Estrogen cycle starting at puberty causes peaks of estrogen
Highest peak in testosterone in men is around 30

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11
Q

when is hallmark onset of menopause?

A

50 is hallmark onset of menopause → sharp decline in amount of estrogen

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12
Q

energy requirements
increased activity = _ caloric need
increased age = _ caloric need

A

energy requirements
increased activity = increased caloric need
increased age = decreased caloric need

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13
Q

purpose of decreased caloric need as we age

A

sustain stable body weight

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14
Q

energy expenditure changes (metabolic rate)

A

Metabolic rate declines in early adulthood (2-3% per decade)
May be due to declines in physical activity and lean muscle mass
May be accelerated by obesity, musculoskeletal diseases, or other conditions

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15
Q

food intake changes

A

May be adjusted for lower energy expenditure
Baltimore Longitudinal Study on Aging: Caloric intake decreased from 2700 kcal → 2100 kcal per day from age 30 → 80

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16
Q

total energy expenditure =

A

AEE + TEF + REE

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17
Q

energy intake needs to be adjusted for (3)

A

Reduced BMR
Lower lean body mass
Changes in physical activity

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18
Q

diff types of vegan and vegetarian diets

A

Vegetarian or vegan – includes only food from plants: fruits, vegetables, legumes, grains, seeds and nuts
Lacto-vegetarian – plant foods plus cheese and other dairy products
Ovo-vegetarian (or lacto ovo vegetarian) – also includes eggs

19
Q

nutrients of concern for vegans/vegetarians

A

Vitamin B12
Vitamin D
Calcium
Iron
Zinc
Omega-3 fatty acids (EPA and DHA)
Adequate protein intake
Adequate energy intake

20
Q

benefits of vegan/vegetarian diets

A

Can have more/less micronutrients
Have been shown to promote weight loss (especially in those with higher starting weights)
Has been shown to lower blood sugars in individuals with T2D
May be protective against chronic diseases

21
Q

cons of vegan/vegetarian diets

A

Adherence is difficult (bold = bad)
Not accessible/affordable
Not complete
Need to be careful with processed products

22
Q

pros of intermittent fasting

A

Can have more/less beneficial macro and micro nutrient ratio
Have been shown to promote weight loss
Can help with glucose homeostasis and lipids

23
Q

cons of intermittent fasting

A

Could result in increases in cortisol
Could result in overeating/binge eating
May increase risk of dehydration
Not accessible

24
Q

pros of low-carb, high-protein, high-fat diets

A

Quick weight loss (water loss)
Ketosis causes loss of appetite

25
Q

cons of low-carb, high-protein, high-fat diets

A

Can be high in saturated fat
Low in carbohydrates, vitamins, minerals and fiber
Not practical long-term

26
Q

organic foods in US

A

fruits and veggies without fertilizers, radiation, GMOs
farm animals without growth hormones, antibiotics, non-organic feed

27
Q

should we eat only organic foods?

A

While organic foods have fewer synthetic pesticides and fertilizers and are free of hormones and antibiotics, they don’t appear to have a nutritional advantage over their conventional counterparts

28
Q

organic foods have hidden

A

sodium and sugar

29
Q

classifications of obesity

A

class I: BMI: 30-34.9
class II: BMI: 35-39.9
class III: BMI: >40

30
Q

BMI does not accurately reflect adiposity in the following populations

A

Athletes with increased muscle mass
Sedentary individuals with increased muscle mass & increased fat depots
Individuals with dense, large bones
Dehydrated or over-hydrated individuals
Asian and Pacific Islanders may require a lower BMI cutoff for disease

31
Q

what is more indicative of health risk than weight or BMI?

A

distribution of body fat

32
Q

metabolically healthy people with obesity are

A

protected from negative effects of obesity

33
Q

addressing obesity: readiness to change

A

Appropriate timing
Ask: if ok to discuss, if want to lose weight, thoughts on how to achieve
Brief discussion -> 5% weight loss at 1 yr more likely
If someone is fine where they are, that is okay!
Meet patient where they are
Patients may get overwhelmed by having too much weight to lose (losing 5-10% of weight can be significant)

34
Q

stages of change model

A

Pre-contemplation, contemplation, preparation, action & maintenance, relapse; stages are cyclical and dynamic

35
Q

weight bias/stigma

A

Student trainees in many health disciplines and providers use terms such as “lazy, noncompliant, stupid” to describe patients with obesity
Steps for providers/educators:
Do not attribute all problems to excess weight
Be aware that weight stigma is not an effective motivator for patients
Be aware of example we set for healthcare trainees
Throughout med school, weight bias increased!

36
Q

supportive office environment

A

Speech
People-first language: patient with obesity NOT obese patient
Avoid hurtful comments or jokes
Space:
Sturdy, armless chairs/high firm sofas/sturdy, wide exam tables
Extra-large patient gowns
Reading materials focusing on healthy habits, not looks or being “thin”
Equipment:
Scales to measure over 400 pounds
Large adult or thigh blood pressure cuffs

37
Q

weight history

A

Length of overweight?
Highest weight?
Why they want to lose weight? Increase mobility, resolve comorbid conditions, decrease medications, decrease risk of peri-operative complications, example for children
Precipitating factors? Pregnancy, menopause, change in job/home, COVID pandemic
Periods of rapid weight gain?
Medications which increase body weight?
History of weight loss attempts and efficacy?
Diets (structured/self-directed), medications (OTC or Rx)
Current dietary intake, physical activity
PMHx: weight-related comorbidities
Family Hx: overweight, diabetes, thyroid dz

38
Q

physical symptoms of obesity

A

vitals, facial features, mouth, neck (dorsal fat pads), skin, muscle weakness (sit to standing without hands), neurological

39
Q

dietary plans for weightloss: what macros are best

A

all types of diets have same weightloss
compliance is what matters!

40
Q

diet challenges with limited means

A

Food insecurity: 11.8% of American households affected
Low or fixed income
Reliance on food pantries
Food swamps: high-density of stores selling high-calorie fast food and junk food, relative to healthier choices (i.e. supermarkets w/ affordable high-quality fruits/vegetables)

41
Q

dietary tips for limited means

A

Meal replacements: SNAP benefit eligible, Costco (discount warehouses)
Food swamps (encourage frozen veggies, in-season produce, green cart’s, farmer’s markets)
Food pantry goods: rinse off salt/sugar for canned items
DM patients: consume carbohydrate portion of meal last to improve postprandial glycemia

42
Q

carbohydrate-last meal patterns

A

lower postprandial glucose and insulin excursions in type II diabetes

43
Q

when to intensify interventions?

A

Intensify therapy if unable to meet health/wt loss goals, lifestyle -> pharmacotherapy -> medical devices -> bariatric surgery

Physiology Final (7 decks)

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