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PH 3407 - Nutrition > Module 9 Exam > Flashcards

Module 9 Exam Flashcards

1
Q

T or F: Harvard does not consider potatoes as vegetables. Processed potatoes and tomatoes go together!

A

T

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2
Q

2018 Canadian Food Guide - why did the change it and what’s the 4 main components?

A

o Half plate veggies and fruit
o Protein
o Whole grains
o Water

in order to make it more relevant to Canadians, more consistent and simple message. Also validated by research

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3
Q

How does the new Harvard’s The Healthy Eating Plate differ from the the Canadian Food Guide?

A

Harvard’s The Healthy Eating Plate – similar to CFG
o Less emphasis on fruit
o Added healthy oils
o Exam Q: Harvard does not consider potatoes as vegetables! Processed potatoes and tomatoes go together!

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4
Q

For the 24 hour athletes, what do the emphasize now?

A

o Fuel = protein + carbs + hydration (note: no fats)
o Rest + Recover (+ Rehab)
o Train

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5
Q

What is the spectrum of choice when it comes to healthy food choices?

A
  • Explain to patients the “spectrum of choice” (fried chicken vs. grilled chicken vs. boiled chicken)
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6
Q 
BMR
RMR
TEA
EPOC
TEF
NEAT
NEPA
A

o BMR – laying in bed, empty stomach, room temperature
o RMR – includes calories used burning food, exercise, and other small functions
o TEA – what’s burned moving around
o EPOC – Excess post-exercise oxygen consumption - after burn effect when you finish exercising (usually insignificant)
o TEF – 10% of the amount of calories you consumed for the day
o NEAT – Non-exercise activity thermogenesis – fidgeting
o NEPA – non-exercise physical activity – carrying grocery, going up stairs

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7
Q

Which BMR equation do they use for apps/calculators?

A

Harris-Benedict Equation

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8
Q

De Lorenzo Equation RMR - accurate for which population?

A

male athletes

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9
Q

Weir equation use in indirect calorimetry (BREEZING) calculates what?

A

Energy expenditure

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10
Q

T or F: bio-impedance is effected by hydration status and meals/exercise

A

T

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11
Q

Pro of Bod Pods?

A

FM and FFM

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12
Q

T or F: DEXA has radiation

A

T (gold standard for BMD)

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13
Q

What are EIM machines?

A

localized bio-impedance machines

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14
Q
  1. DASH Diet – Dietary Approaches to Stop Hypertension (1992, RCT, collaboration between all healthcare groups, sampled 5 different health centers – John Hopkins, Duke, Kaiser, etc)

Biggest take away?

A

Sodium intake is the main factor to decrease sBP (decreased by 11 mmHg) - this is significant

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15
Q

Conclusion from the MNT for diabetes (medical nutrition therapy)

A

doesn’t matter what you eat - it’s more about the TOTAL CARBS (bolus)

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16
Q

T or F: for DM 1, there is no change in glycemic response or HbAIc in an acute (6 week) of starches/sucros

A

T - proves the stability of blood glucose over time (but HbA1c is reflective of AVG GLUCOSE LEVELS OVEqR 6-8 WEEKS)

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17
Q

glucose galactose fructose are

A

Monosaccharides (sugars)

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18
Q

sucrose, lactose are

A

disaccharides (sugars)

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19
Q

sortbitol, mannitoo, isomalt, malnol are

A

sugar alcohols (polyol)s

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20
Q

HbA1c is also know ask?

A

• HbA1c also known as glycated, glycosylated hemoglobin, or glycohemoglobin

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21
Q

HbA1c

Normal levels =

A

6

7

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22
Q

T or F: fiber can help with diabetes

T or F: proteins can help with diabetes

A

neither Fiber MAY help with glycemic control, reduced hyperinsulinemia, decrease plasma lipids

F - no to proteins

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23
Q

Mediterranean diet

A

o Emphasis on plant food (even their desserts) – minimally processed, seasonally fresh, locally grown
o Olive oil, daily diary
o Chicken and fish in low-moderate amounts, red meat rarely, up to 4 eggs weekly
o Wine in low-moderate amounts

24
Q

A low O3FA diet = __th largest cause of preventable death

A

6th

25
Q

Inflammation O3 vs. O6

A

O3 = reduce inflammaton, O6 = increase inflammation

26
Q

ALA vs. EPA/DHA

A

ALA - short chained O3FA (chia seeds, flax, hemp)

EPA/DHA - long chained - fish

27
Q

Conclusion of the GISSI study

45% RR reduction for sudden cardiac death due to __g/day

A

o GISSI (Gruppo Italiano per lo Studio della Streptochinasi nell’Infarto)
 11,300 post-MI patients, EPA + DHA over 3.5 years
 Omega-3 alone led to a significant reduction (20%) in cardiac death, nonfatal myocardial infarction or nonfatal stroke.
 The relative risk reduction for sudden cardiac death was up to 45%.

28
Q

Conclusions of the Diet and Reinfarction Trial

What were the 4 groups?

A
    1. Advice (AHA dietary guidelines
    1. Consume fish 2x/week (300 g total) for 2.5 g of EPA weekly
    1. Increase cereal fiber intake to 18 g/day
    1. Control – no advice

Group #2 had a 29% reduction in overall mortality during 2 year F/U study

29
Q

Lyon Diet Heart Study conclusions

2 groups

A

 68% decrease in primary end points (cardiac death and non-fatal MI)
 Inverse relationship between AL intake and risk for 2nd MI
 Group 1 = advised to eat fish, veggies, ALA-rich margarine (benefits seen in the group – fired up the margarine companies haha)
 Group 2 = not much advice

30
Q

Recommendations for O3?

GISSI 
DART (now the AHA guideline)
A

1g/day

3g/day

31
Q

How much O3 is in a 3 oz portion of salmon?

A

o Salmon = 1500+ mg per 3 oz portion

 So eat fish 2x/week and augment with supplements if you want

32
Q

List some of the 6 RFs discovered by the Framingham heart Study

Note: Framingham 10 Year Risk Ax is a good screening tool.

A
  • Smoking
  • Physical inactivity
  • OW or OB
  • HyperCHOL
  • HT
  • Diabetes
33
Q

List some of the 8 RFs discovered by the Heart & Stroke Foundation

A

Same as 6 RFs of Framingham + stress + lack of veggies/fruits

  • Lack of veggie, fruits
  • Smoking
  • Physical inactivity
  • OW or OB
  • HyperCHOL
  • HT
  • Diabetes
  • STRESS
34
Q

What’s so good about resveratrol? Where can you find it?

A

o Prevents oxidation of LDLs and neutralizes free ROS  decrease oxidation loads and tissue damage s
o Present in wine and purple/blue foods

35
Q

Statins inhibit what? Leading to? What are they usually used for?

A

o Inhibits HMG CoA reductase
o Found to reduce total CHOL, LDL-C, lower MI risk by 30% over 5 years
o Statins do work! They are used a lot! The HDL and LDL ratio is very important

used for: high CHOL

36
Q

What is cholestyramine?

A

MC bile acid sequestrants

Lower LDL by 10-15% but may excrete lipid soluble nutrients..

37
Q

Other chemicals that help lower CHOL

o Fibric acid derivatives
o MOA of fibrates
o Niacin

A

OK

38
Q

Why do sugar alcohols suck?

A

In some people sugar alcohols can cause bloating, flatulence, and diarrhea. This is because the sugar alcohol is not completely absorbed in the digestive system and this causes fermentation to occur in the intestines.

39
Q

2 difference between the new vs. old categories of hypertension

A

No such thing as “borderline”, it’s now “pre-HT”

“optimal” is now “normal”

40
Q

Range for HT

Normal 
Pre-HT 
HT
Stage 1
Stage 2

Which category is most responsive to intervention?

A 
	Normal = <120/80
	Pre-HT = 120-139/80-89
	HT = >140/90
	Stage 1***= 140-159/90-99 = intervention may be helpful
	Stage 2 = 160->180/100-110 = refer out
41
Q

T or F: 2 mmHg reduction in SBP can significantly reduce the risk for stroke

A

T

42
Q

BP Meds

	Thiazide diuretics
	Loop diuretics
	Potassium sparing diuretics
	Aldosterone receptor blockers
	Beta-blockers
	BB with Intrinsic Sympathomimetic Activity
	Combined Alpha and BB
	ACE Inhibitors
	Angiotensin II Antagonists
	Calcium Channel Blockers
	Alpha-1 Blockers
	Central Alpha-2 Agonists
	Direct Vasodilators
A

OK

43
Q

What are ARBS and ACEIs?

A

ACE inhibitors (angiotensin converting enzyme inhibitors) and ARBs (angiotensin-receptor blockers) are used to treat high blood pressure (hypertension) and congestive heart failure, to prevent kidney failure in patients with high blood pressure or diabetes, and to reduce the risk of stroke.

Angiotensin II acts as a potent vasoconstrictor that serves to increase peripheral vascular resistance and maintain arterial tone in the face of reduced cardiac output. Angiotensin II also enhances release of catecholamines from noradrenergic nerve endings[20] and directly stimulates the adrenal cortex to increase secretion of aldosterone.[21] Aldosterone acts in the distal nephron to increase sodium and water retention and excrete potassium.

44
Q

How do beta-blockers work?

A

Block catecholamine action on beta-adrenergic receptors

Catecholamines are hormones made by your adrenal glands, which are located on top of your kidneys. Examples include dopamine; norepinephrine; and epinephrine (this used to be called adrenalin or adrenaline). Your adrenal glands send catecholamines into your blood when you’re physically or emotionally stresses

45
Q

Beta 1 - cardiac vs. renal

A

Cardiac

Positive chronotropic: Chronotropic drugs may change the heart rate and rhythm by affecting the electrical conduction system of the heart and the nerves that influence it, such as by changing the rhythm produced by the sinoatrial node.

Ionotropic (ligand-gated ion channel)

Increase cardiac conduction velocity and automaticity

Renal

Renin release

Change HR by affecting the electrical conduction system of the heart (SA node)

Transmitter or hormone activates or deactivate ionotropic receptors

46
Q

T or F: ~50% of the population is OW or OB

A

T

47
Q

Categories for BMI

Normal
OW
OB

A

 Normal = 19-24.9
 OW = 25-29.9
 OB = 30.0+

48
Q

PA Guidelines for Adults (18-64 years old)

A

 150 mins/week of moderate-vigorous of aerobic PA (in bouts of minimum 10 mins) – reduce risk for CVD, HT, cancer, diabetes, osteoporosis, OW/OB
 Strengthening = 2x/week

49
Q

PA Guidelines for Elderly (65+ years old)

A

Same as Adult Guidelines + balance/proprioceptive exercises

50
Q

Secondary Analysis of O-COAST Study

What % of chiros patients were OB/OW?

Conclusions

Limitations

A

61.3%

 Chiros (2005+) are more likely to offer weight management info than those who graduated before then.

Conclusions: we need a step it up with weight management in our patients

Limitations: selection bias, used BMI (not accurate measure of health), reporting bias (poor note taking and recall by DCs)

51
Q

T or F: A 70 year old triathlete can have a higher muscle mass and cross-section than pretty much all of us

A

T - life long exercise matters!

52
Q

T or F: Resistance training twice per week (guidelines) reduces all cause, cancer, and cardiac death.

A

T - they also have a 46% lower chance of all cause mortality

53
Q

Diabetes prevention program

Low-fat diet, increase PA, educational sessions

Result: __% BW loss in first year and sustained __% of the change 3 years later

A

7

5

54
Q

T or F: You can be skinny fat

A

Yes

55
Q

Sarcopenia starts when?

loss up to __%/decade until the age of 70 when it is a loss of __%/decade

A

30-40s

8

15

56
Q

What is obesogenic environment?

A

The term “obesogenic environment” refers to changes in the food environment as well as changes in physical activity demands
‘That is, the drastic change in the global food supply, the huge increase in fast food outlets and the loss of a “food culture” to explain the change in eating habits over recent decades combined with the overall decrease in the daily activities of living, have resulted in the “obesogenic environment”: an environment that makes it too easy to eat poorly and remain sedentary.’

PH 3407 - Nutrition (1 decks)

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