Obesity and Adults Flashcards
- Discuss strategies associated with maintenance of weight loss.
reduce sodium intake to less than 2,300 (1,500 over 51yo)
consume less than 10% kcal from saturated fatty acids
consume less than 300mg per day of dietary cholesterol
trans fatty acid as low as possible
reduce intake of calories from solid fats and added sugars
limit refined grains
consume alcohol in moderation
planning, purchasing and preparation focused strategies to increase awareness and understanding; self monitoring can also be helpful
Name 4 nutrients that are of concern in American diets.
potassium
dietary fiber
calcium
vitamin D
- Define classification of weight based on body mass index.
underweight 18.5
Normal 18.5-24.9
overweight 25-29.9
obesity 30-34.9 (class I)
35-39 (class II)
extreme obesity >40 (class III)
super obesity >50
remember children measure of obesity is based on percentile
- Describe the difference in rates in obesity between genders and age.
rates in men and women have equalized
rates are “driven largely by women over 60”
- Describe the metabolic complications of obesity.
visceral fat depots flood liver and blood with free fatty acids, leading to greater blood glucose and VLDL production
visceral fat is linked to CVD, type 2 DM, colorectal and breast cancer as well as increased risk of premature death
CAD, HTN, stroke, liver and gallbladder disease, sleep apnea and respiratory problems, osteoarthritis, gynecological problems, NASH
- List the criteria for metabolic syndrome.
abdominal obesity measured by waist circumference (M>40, W>35)
triglycerides >150 mg/dL or on meds
HDL-C (M130/85 or on meds
fasting glucose >100mg/dL or on meds
- What are the goals of treatment for metabolic syndrome?
reduce risk of heart disease by lowering LDL cholesterol and hypertension and manage diabetes, prevent onset of diabetes by loosing weight being physically active, following DASH diet, quit smoking
- Define modest weight loss.
loss of 10-15% of weight can reduce symptoms
- Describe the elements and benefits of a team approach to weight loss?
physician provides strong message, dietitian with individualized therapy, trainer provides expertise, health care team provides follow up
- Describe the types of sugary currently used for obesity and potential side effects.
gastric band (gradual loss without bypass of intestine) gastric sleeve (restricts intake but not absorption, may lead to hormonal changes Roux-en-Y (causes caloric restriction and nutrient malabsorption- rapid weight loss)
Discuss the 2 mechanisms of drug treatments of obesity.
appetite suppression, lipase inhibitor
- ID risk factors for poor nutrition status in the older adult
sensory changes can cause reduced appetite and risk of contracting food borne illness
changes in ability to chew, swallow or digest food (acidity, motility, gastric emptying, digestion of lactose)
increased risk of isolation, boredom, depression related to physical ability or social supports
- Describe atrophic gastritis and its relation to vitamin B12 deficiency and bacterial overgrowth.
seen in 10-30% of healthy older adults, damage to the gastric mucosa which can lead to decreased ability to absorb protein bound B12 and to decreased intrinsic factor leading to pernicious anemia
Discuss recommendations for BMI in older adults
is controversial, association with mortality showed lowest point at BMI 25-27 despite association between increasing BMI increasing DM, HTN, osteoporosis and heart disease
- LIst dietary risk factors and describe nutritional treatment for osteoporosis.
risk of fracture greater in women but mortality due to fracture greater in men; risk factors include low weight and BMI, smoking, female sex, FH, sedentary lifestyle, low calcium or vitamin D earlier in life, excessive alcohol or caffeine use
treatments include adequate Ca++(ie. carbonate, citrate w/PPI), fit D, moderate sodium and moderate alcohol/caffeine
