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mnt prep > Obesity > Flashcards

Obesity Flashcards

1
Q

Obesity increases risk for

A

Colon cancer
Gb disease
Osteoarthritis

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2
Q 
Name BMI associated with classifications 
Underweight 
Normal
Overweight 
Obesity Class 1 
Obesity Class 2 
Extreme Obesity 3
A

HB

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3
Q

Risk factors for metabolic syndrome

A 
Waist over 102cm or 88cm (40 or 35 in)
TG over 150mg/dL
HDL less than 40 (men) less than 50 (women) 
BP equal or over 130/85
FBG equal or over 100
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4
Q

What is the main concern with obesity?

A

The complications!!

Lung disease, NAFLD, Gb disease, PCOS, cancer, cataracts, phlebitis

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5
Q

3 parts of obesity Tx pyramid.

A

Lifestyle changes, pharmacotherapy, and surgery

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6
Q

What is step 1 of diet intervention?

A

Low calorie diet (LCD)
Women 1000-1200kcal
1200-1600 kcal for men

VLCD- 800 kcal- not used

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7
Q

What is the most variable energy factor?

A

PA! (TEE=PA+TEF+REE)

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8
Q

What is the best formula to use with obese patients?

A

Harris-Benedict with adj BW

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9
Q

What is the goal of obesity treatment?

A

Decrease co-morbidities
Decrease mortality and morbidity
Increase QOL
Stop intergenerational cycle! (Team Barker)

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10
Q

What risks can you modify? What risks can you not modify?

A

Can’t change genetics

Can change metabolic, biochemical, behavior, psych, environmental

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11
Q

What is obesity?

A 
Life long 
Progressive 
Life threatening 
Genetically related 
Costs money
Multifactorial disease with co-morbidities
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12
Q

What are the US OW and OB statistics.

A

37.5% obese
68% overweight or obese

17% children are obese and 21-24% overweight

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13
Q

Can obesity be cured?

A

No, it can be treated and controlled. Technically cure with bypass. Chronic condition controlled by treatment.

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14
Q

Famous researcher from Colorado health sciences center?

A

James O Hill

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15
Q

Where are obesity tx guidelines published?

A

NHLBI with AHA/ACC

Journal of Cardiology (ACC)
Obesity (TOS)

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16
Q

AHA/ACC guidelines

A

Use BMI and waist circumference
Comp lifestyle approach with 6-12 months counseling.
Rec 1200-1500 or 1500-1800 kcals OR decrease by 500-750 kcals
Surgery if >40 or >35 BMI with co-morb

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17
Q

What meds are used?

A

Appetite suppressants (anorectants)

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18
Q

What is Orlistat and Alli?

A

Lipase inhibitor to cause less digestion and absorption of fat. Alli is lower strength
A D E K deficiencies may be present.

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19
Q

What impact does Medicare D have on obesity drugs?

A

It does not cover FDA approved drugs.

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20
Q

What is the national weight loss registry?

A

James Hill

People join if adult lost over 30# and kept off for at least 1 year

Shows breakfast importance, use scales, 90%exercise

21
Q

What are 2008 US adult PA guidelines?

A

At least 150 min/wk MPA
To decrease risk of chronic disease and increase health related fitness.
Strength at least 2x per week

22
Q

What are weight loss PA guidelines?

A

300min/wk of VPA to lose weight or maintain amount that you lost.

23
Q

What amount of daily steps count as active activity level?

A

At least 10000 steps.

7500-9999- somewhat active
> 12500 highly active

24
Q

What does MET stand for and what does number reflect?

A

Metabolic equivalent of task

Reflect oxygen consumption (describes aerobic capacity =VO2 max)

25
Q

What is the units label for MET?

A

mL/kg/min

Kcal/kg/hour

26
Q

Absolute MET

A

Based on rate of energy expenditure
Not related to speed

Is sped/pace

27
Q

Relative MET

A

Uses personal fitness to find level of effort.

Target HR, talk test, RPE, VO2 max

28
Q

How is volume of activity measured?

A

In MET minutes or MET hours.

MET*time done=total MET min

(Goal of 500-1000/wk)

29
Q

What is combined to kill less people than poor CRF?

A

Smoking, DM, and obesity

30
Q

Who found that low fitness was leading cause of death?

A

Steve Blair, lean unfit is worse than obese and fit.

31
Q

What is the main purpose of the Socio ecological model behavior theory?

A

Looks at the individuals relationship with the environment. For example, the gym, supporting people, fruit on the counter.

32
Q

Describe the topic of self-determination Theory.

A

Intrinsic and extrinsic motivation

Dr giving a money reward versus valuing a jog for mental health

33
Q

Describe the purpose of transtheoretical model?

A

Stages of change: pre, cont, prep, action, maintain

Self efficacy, balance, change

34
Q

Social cognitive theory

A

Foundation is self-efficacy
Self-regulation
Social support

35
Q

Who was Robert Sallis?

A

Exercise in Medicine campaign to get the topic talked about in Dr offices!
ACSM

36
Q

What is the end result of a banded gastroplasty?

A

Restrict gastric volume
Reversible
Adjustable band

37
Q

What is the end result of roux-en- Y procedure?

A

Restricts volume eaten and decreases digestion/absorption (no stomach or duodenum)

38
Q

What improvements are made for bariatric surgery patients? This is from a 2004 JAMA study.

A

Diabetes remission, eliminated high blood pressure, reduced high cholesterol, eliminated sleep apnea, and improved fertility asthma and joint disease.

39
Q

What are two forms of banded gastroplasty?

A

Adjustable gastric banding and vertical sleeve gastrectomy

40
Q

What is the main side effect of Roo and why and what are the stages of it?

A

Dumping syndrome. There is no more pyloric sphincter so too much chyme draws water into SI.

41
Q

Early-stage dumping syndrome

A

10-20 min after eating, high refined CHO meal, too much blood into intestine, decreased body blood flow, diarrhea and cramping from fluid. Faint, dizzy, sweat.

42
Q

Intermediate dumping syndrome.

A

20-30 min after eating. Malabsorption of Complex CHO in colon. Bloat, cramp, gas, diarrhea

43
Q

Late stage dumping syndrome

A

1-3 hours after eating. Reactive hypoglycemia, sweat, anxiety, shaky, hungry, confused, week.

44
Q

MNT for dumping syndrome

A

No liquids with meals, decrease refined carbs and increase complex, 20% protein, 30 to 40% fat, small frequent meals, to 20 times, decreased lactose. Lying down after meals.

45
Q

Long term deficiencies of gastric surgery.

A

B12, folic acid, and Fe deficiencies. Decreased lipase and bile amounts.

46
Q

What should patient do before gastric surgery?

A

Stop smoking, start exercising, join social group, start multivitamin supplement, quit caffeine and Pop, start protein supplement, lose 10% of weight.

47
Q

What are the main nutritional focuses of surgery Tx?

A

Protein
Fluid
Multivitamin

48
Q

Post operation food schedule.

A

Clear liquids 24 hours
Full liquids 24hoir-2weeks
Purée/blender- after 2 weeks
Soft foods at 6 Weeks

49
Q

What are the common Roux en y deficiencies?

A

Dehydration, protein (60-80g per day), iron, calcium, Vitamin B12, folate,

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