Nutrition + Health Flashcards
How to calculate total daily energy expenditure
35 cal/kg
Describe motivational strategies for behavioural changes
Pre-contemplation = consider possibility of change Contemplation = encourage change Preparation = explore options, develop plan Action = design rewards for success, support + reinforce Maintenance = maintain motivation Relapse = help pt to view as learning experience
Canada food guide for adults
6-8 servings grains
7-10 servings of fruit + veg
2 servings milk/ alternatives
2-3 servings of meat/ alternatives
Dietary guide for reducing CVD risk
Fat intake at 26% of total energy Reduce trans fat intake >2 servings of oily fish a week <2400mg salt per day Max 10-15 drinks a week DASH diet Diet high in fruit + veg, low fat dairy, whole grains, poultry, seeds + nuts
How to lose weight
Aim for 500-1000 cal less than TDEE
1lb lost for every 3500 burnt
Low BMI associations
Osteoporosis
Eating disorders
Under-nutrition
Pregnancy complications
Classification of weight by BMI
<18.5 = underweight 18.5-25 = normal 25-30 = overweight 30-35 = obesity class 1 35-40 = obesity class 2 >40 = obesity class 3
Signs of hyperlipidemia
Atheromata Xanthelasma Tendinous xanthoma Eruptive xanthoma Lipernia retinals Corneal arcus
What score do you use to assess risk of T2DM?
CANRISK or FINRISC
When is bariatric surgery recommended?
If lifestyle changes have failed + BMI >35 + RF or >40 without RF
When is pharmacotherapy for obese pts recommended?
If BMI >27 + RF or >30 + no RF
What score do you use to assess dyslipidemia?
Framingham or Cardiovascular Life Expectancy Model (CLEM)
When are statins given?
Framingham >10% LDL >3.5 Non HDL >4.3 Men >50, women >60 with RF Age >30 + 25yr duration of T1DM CKD AAA Clinical atherosclerosis
What add-ons can you add to statins if optimal target not achieved?
Ezetimibe 1st line
BAS
PCSK9 inhibitors
What is the definition of metabolic syndrome?
Central obesity Men = waist >94cm Women >80cm AND 2 RF: High TG, low HDL, high BP or high fasting glucose
What is Ezetimibe?
Cholesterol absorption inhibitors
What is isolated hypertriglyceridemia?
Normal HDL + TC, high TG
Does not increase CV risk
Risk of pancreatitis
Management of hypertriglyceridemia?
Nicotinic acid
Fibrates
Exercise guidelines for adults
150 mins of moderate to vigorous aerobic activity a week, in bouts of 10 mins or more
Beneficial to add muscle/ bone strengthening activities 2 days a week
What are the 5 As for patients quitting smoking?
Ask if they smoke Advise to quit Assess willingness to quit Assist in quit attempt Arrange follow up
What is the 2-3 pattern of smoking cessation?
Onset of withdrawal = 2-3hrs Peak withdrawal = 2-3 days Expect improvement of withdrawal = 2-3 weeks Resolution of withdrawal = 2-3 months Highest relapse within 2-3 months
What is the STAR technique for developing smoking cessation plan?
Set quit date
Tell family + friends
Anticipate challenges
Remove tobacco-related products
What are the CAN-ADAPTT guidelines?
Update tobacco use status
Clearly advise all pts to quit
Monitor mental health while quitting
Pharmacological therapy to help quit smoking
Nicotine replacement
Antidepressants - Bupropion
Varenicline - nicotinic receptor agonist + antagonist
SE of nicotine gum
Mouth soreness
Hiccups
Dyspepsia
Jaw ache
SE of nicotine patches
Skin irritation
Insomnia
Palpitations
Anxiety
SE of nicotine inhaler or nasal spray
Local irritation
Coughing
Mechanism of action of bupropion
Inhibits reuptake of dopamine + norepinephrine
SE of bupropion
Insomnia, dry mouth
CI to bupropion
Seizures, eating disorder
Mechanism of action of varenicline
Nicotinic receptor agonist + antagonist
SE of varenicline
N/V, constipation, headache, dream disorders, insomnia, psychosis, depression, suicidal ideation
What are the 5 Rs for motivational intervention in a pt unwilling to quit smoking?
Relevance to pt Risks of smoking Rewards/ benefit Roadblocks? Repetition
