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CDCES > Nutrition & exercise > Flashcards

Nutrition & exercise Flashcards

1
Q

Beans

A

1/2 cup= 15 g

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2
Q

Rice

A

1/3 cup= 15 g

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3
Q

Small tortilla

A

1 6 inch

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4
Q

Saltines

A

5-6

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5
Q

Bread

A

1 slice

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6
Q

Corn

A

1/2 cup or 1 small ear

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7
Q

Cooked pasta

A

1/3 cup

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8
Q

Cold cereal

A

3/4 cup

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9
Q

Small baked potato

A

1

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10
Q

English muffin

A

1/2

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11
Q

Bagel

A

1/4 or 1 ounce

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12
Q

1 starch exchange

A

80 kcal 15 g CHO

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13
Q

Fruit exchange

A

60 kcal 15 g CHO

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14
Q

Grapes

A

17

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15
Q

Fruit juice

A

4 ounce

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16
Q

Prune juice

A

1/3 cup

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17
Q

Fruit juice blend

A

1/3 cup

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18
Q

Banana

A

1/2

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19
Q

Unsweetened applesauce

A

1/2 cup

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20
Q

Melon

A

1 cup

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21
Q

Dried fruit

A

1/4 cup

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22
Q

Raisins

A

2 tbsp

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23
Q

Strawberries

A

1.25 cup

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24
Q

Non starchy veggie

A

3 cups raw or 1.5 cup cooked= 15 grams

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25
Q

Milk exchange

A

90-150 calories. 12-15 grams

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26
Q

Diet hot chocolate

A

1 packet

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27
Q

Buttermilk

A

8 ounces

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28
Q

Plain yoghurt

A

6 ounces

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29
Q

Lite fruit yogurt

A

6 ounces

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30
Q

Cow milk

A

12 g In 8 ounce

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31
Q

Nondairy milk alternative

A

8 ounce

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32
Q

Brownie

A

1 ounce square

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33
Q

Cookies

A

2 small

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34
Q

Diet pudding

A

1/2 cup

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35
Q

Regular pudding

A

1/4 cup

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36
Q

Regular jello

A

1/2 cup

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37
Q

Light Syrup

A

2 tbsp

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38
Q

Regular syrup, jelly, jam, sugar, honey, agave

A

1 tbsp

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39
Q

Sorbet

A

1/4 cup

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40
Q

Sherbet

A

1/2 cup

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41
Q

Ice cream. Frozen yogurt

A

1/2 cup

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42
Q

PA recommendations for kids

A

60 minute/day moderate or vigorous aerobic ; muscle and bone strengthening 3 days/week moderate-vigorous

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43
Q

PA recommendations for adults

A

at least 150 minutes/week moderate/vigorous PA; spread over at least 3 days/week, no more than 2 consecutive days w/o exercise

  • resistance and strength- 2-3x/week, moderate to vigorous, non-consecutive days
  • older adults- flexibility and balance 2-3 days/week
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44
Q

Benefits of PA

A

improve BG
reduce CV risk factors
helps WL
improve overall well being

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45
Q

moderate to high volumes of aerobic activity are associated w/

A

sig. lower CV and overall mortality risk for T1 and T2

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46
Q

What medical conditions may be contraindicated for exercise?

A 
uncontrolled HTN
untreated proliferative retinopathy
autonomic neuropathy
peripheral neuropathy
foot ulcers
charcot foot
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47
Q

if pt on insulin or insulin secretagogue wants to exericse, and their BG is <90

A

CHO containing snack before

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48
Q

Who is less likely to suffer from post exercise hypo?

A

T2 on oral meds only

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49
Q

how long does insulin sensitivity after exercise last?

A

several hours

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50
Q

Vigorous PA may actually _____ BG levels especially if pre-exercise levels are ____

A

raise due to flight or fight response; elevated

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51
Q

When to check BG in terms of exercise?

A

Before, after, and potentially during

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52
Q

Retinopathy

A

Proliferative retinopathy or severe nonproliferative pts may experience hemorrhage or retinal detachment with vigorous activity; consult opthamologist

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53
Q

peripheral neuropathy

A

asses b4 starting regimen to ensure the neuropathy does not impact kinesthetic or propioceptive sensation esp if neuropathy is severe

54
Q

neuropathy concerns

A

decreased pain sensation, higher pain threshold, increase risk of skin breakdown, infection, joint destruction

55
Q

In whom in tobacco use higher

A
  • adults w/ chronic conditions

- adolescents/YA w/ DM

56
Q

Why is smoking bad?

A 
increased risk of CVD
premature death
microvascular complications
worse glycemic control
may contribute to T2 dx
57
Q

How to help pt quit smoking

A

Refer to pharmacologic tx counseling, which is more effective than either alone

58
Q

Screen older adults >/=65 for

A

cognitive impairment, depression

59
Q

When should MH be assessed

A 
@ dx
regular scheduled appts
hospitalization
new onset complications
transition in care
unable to reach A1c goal
QOL changes
SM difficulties
60
Q

SDOH

A

loss of employment
birth of child
family stressors

61
Q

Refer to MH specialist

A
  • positive screening for overall stress, work/life balance
  • DM distress
  • DM management difficulties
  • depression
  • anxiety
  • disordered eating
  • cognitive dysfunction
62
Q

How common is DM distress

A

45%; but only 25% were asked about it

63
Q

Why is DM distress bad

A

impacts medication taking

linked to higher A1c, lower self-efficacy, poorer diet/PA

64
Q

How to reduce DM distress

A
  • refer to DSMES

- address culprit of stress

65
Q

Other MH issues that affect DM self-care

A

depression
anxiety
disordered eating
cognitive abilities

66
Q

What can be done for those w/ hypo-unawareness

A

BG awareness training to re-establish s/s and reduce fear of s/s

67
Q

Hx of depression, current depression, antidepressant meds

A

risk for developing T2DM

68
Q

prevalence of depressive symptoms

A
  • 1/4 with T1D and T2D

- higher in women

69
Q

when to screen for ED behaviors

A

unexplained hyper and weight loss

70
Q

Why would someone with T1 skip insulin?

A

Skipping causes glycosuria –> weight loss

71
Q

T1 with ED have

A

high rates of DM distress and fear of hypoglycemia

72
Q

ED associated w/ T2DM

A

Binge eating disorder

May omit insulin

73
Q

Those taking atypical antipsychotics should be screened how often for pre-DM/DM

A

annually

74
Q

Monitor what carefully in pts on second generation antipsychotics

A

weight, BG, lipids

75
Q

Examples of DM advocacy include

A

cost barriers- insulin, other meds, DSMES
insulin access/affordability
employment
driving
schools/childcare/correctional setting care

76
Q

What are the goals of MNT?

A
  • attain BP, BG, lipid goals
  • attain and maintain BW goals
  • delay/prevent complication
  • encourage nutrient dense foods
  • help with meal planning
  • maintain pleasure of eating
  • appropriate portions
77
Q

Meeting with a RD reduces A1c how much in T1DM?

A

1-1.9%

78
Q

Meeting with RD reduces A1c how much in T2dM?

A

0.3-2%

79
Q

When should encounter with RD start?

A

At diagnosis or within 3-6 months of dx

80
Q

How many annual f/u with RD is recommended?

A

at least 1

81
Q

How many encounters with RD are recommended?

A

3-4, 45-90 minute sessions

82
Q

How much DSMES is covered?

A

1 hour individual assessment (G108)
9 hour group (1x during lifetime) (G109)
2 hours annually

83
Q

How much MNT is covered?

A

First calendar year- 180 minutes

annually- 120 minutes

84
Q

Can DSMES and MNT be billed on same day?

A

No, won’t be covered

85
Q

IF someone is on fixed insulin regimen, what to educate on?

A

consistent CHO, timing and amount of CHO to improve BG and risk of hypo

86
Q

IF someone is on flexible insulin regimen, what to educate on?

A

CHO counting, effect of fat/protein

87
Q

Specific nutrition recommendations:

A

-Emphasize non starchy vegetables
-Minimize added sugars and refined
grains
-Choose whole foods over highly
processed foods to the extent
possible
- Healthful approaches include:
* Mediterranean-style
*low-carb
*plant based or vegetarian
* Plate method good getting started
approach

88
Q

Sodium recommendations

A

2,300 mg/day

NOT less than 1,500 mg/d even if HTN

89
Q

Cholesterol recommendations

A

<300 mg/day

90
Q

Saturated fat recommendations

A

<10% kcal

91
Q

Fiber recommendations

A

25-38 g/day

92
Q

Trans fat recommendations

A

avoid

93
Q

5% WL in those with DM –>

A

Reduced TG, reduced need for meds,

improved glycemic control

94
Q

If possible avoid these DM meds that cause wt gain

A

Insulin, sulfonylurea, TZD

95
Q

When is low CHO diet contraindicated?

A
  • pregnancy or lacatation
  • ED’s
  • children
  • SGLT2-i takers
  • renal dz
96
Q

CHO consumption causes BG levels to peak in how many hours?

A

1-2 hours

97
Q

Why is MUFA beneficial?

A

Raises HDL; lowers total and LDL cholesterol

98
Q

Why is PUFA beneficial?

A

lowers total cholesterol and LDL

99
Q

HFCS may adversely affect

A

lipids

100
Q

Why is trans fat harmful?

A
  • lowers HDL
  • raises LDL
  • may contribute to t2DM
  • may cause wt gain and abdominal fat
101
Q

What is protein recommendation in CKD?

A

0.8 g/kg

102
Q

How common is celiac dz in T1D

A

10%

103
Q

How common is gastroparesis?

A

20-30% in longstanding DM

104
Q

What is gastroparesis?

A

Delayed gastric emptying d/t nerve damage

s/s- early satiety, fullness, n/v, postprandial hypo

105
Q

treatment for gastroparesis

A

small, low fiber, low-fat meals
take insulin with meal or after meal
reglan, erythromycin

106
Q

what are s/s of diabulimia?

A

unexplained WL, unexplained HYPER
records that don’t match A1c
no finger prick marks
unfilled rx for insulin

107
Q 
how many kcals/g
fat
alcohol
CHO
protein
A

fat- 9
alcohol-7
CHO and PRO- 4

108
Q

how many g CHO in 8 ounce cow milk

A

12

109
Q

how many steps/day recommended

A

7,500-10,000

110
Q

how many steps is 1 mile

A

2,000

111
Q

how many kcals to burn 1 lb

A

3,500

112
Q

servings of alcohol

A

5 ounce wine
12 ounce beer
1.5 ounce distilled spirits

113
Q

Why is exercise helpful for lowering BG?

A

Increase muscle uptake of GLU by 5x, for 24-48 hours
includes fat, liver, muscle cells for increased insulin sensitivity
Reduce BP, lipids, BG, A1C

114
Q

An 8 week walking program reduced A1c by how much in T2DM?

A

0.6% w/o weight loss

115
Q

Those w/ T1D are at increased risk of hypo for how many hours after exercise?

A

4-15

esp at night

116
Q

WHy are people at risk for hypo after drinking alcohol?

A

glycogenolysis in liver is not happening bc liver is busy detoxifying the alcohol

117
Q

T1D exercise recommendations
BG <90
BG 90-150

A

<90- 15-30 g CHO

90-150 may need 15 g

118
Q

After exercise what should those with T1 D do?

A
  • avoid alcohol
  • may have a snack w/ extra CHO
  • monitor BG frequently esp at night
  • reduce insulin after exercise, some may reduce it before too
119
Q

Hormonal response to exercise in T2DM

A
  • decreased secretion of endogenous insulin
  • increase insulin sensitivity
  • increase glucose disposal
120
Q

Hormonal response to exercise in T1DM

A
  • exogenous insulin remains high
  • increased absorption of insulin
  • increased insulin sensitivity
121
Q

Why should PWD w/ ketones NOT exercise?

A
  • can worsen hyperglycemia and ketosis
122
Q

When to check for ketones before exercise?

A

T1D BG >240

T2D BG>300

123
Q

how much popcorn is 15 g CHO

A

3 cups

124
Q

How much berries is 15 g CHO?

A

1 cup razzies

125
Q

how much rice milk sweetened has 15 g CHO?

A

4 ounces

126
Q

how much winter squash has 15 g CHO

A

1 cup

127
Q

how much pita bread is 15 g CHO?

A

1/2 6 inch

128
Q

cooked oatmeal is how much CHO?

A

1/2 cup cooked =15 g

129
Q

how much muffin is 15 g CHO

A

1/4

130
Q

how much canned fruit w/o added sugar has 15 g CHO

A

1/2 cup

CDCES (13 decks)

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