Obesity and Hypertension Flashcards
What are some general outlines for health providers when dealing with obese patients?
No one size fits all eating pattern - various interventions can work
Interventions should focus on achieving health outcomes for chronic disease risk - not just weight changes
What are the recommendations for adults with obesity and prediabetes?
Consider intensive behavioural interventions that target a 5-7% weight loss
Non-dieting approach to improve quality of life
What anthropometric measurements can be taken to assess the degree of overweight or %bodyfat?
BMI
Waist circumference, in conjunction with BMI can help assess risk for CVD and T2D
What is the difference between primary and secondary hypertension?
Primary: no obvious cause, not related to a primary disease
Secondary hypertension: disease is evolving out of already having a condition such as renal disease, diabetes, CVD, or other endocrine disorders
What are prepackaged meal programs? What considerations should be if a client chooses these for weight loss?
Client does not need to plan or prepare meals - may be effective for short term weight loss but should have a counselling component and include physical activity
What is the PSMF?
Protein sparing modified fast
High protein diet (2-3g/kg/d) with limited CHO (1-2% w/v max)
No dairy, fruits/vegetables or grains in initial stages
Low CHO facilitates a metabolic state of increasing ketosis, rapid weight loss and appetite suppression
High protein spares lean mass
What are risks of PSMF?
Nutritionally incomplete - requires close monitoring of electrolytes, fluids
Deficient in potassium and many other nutrients, patients have to be medically monitored
Rarely used due to electrolyte risks (cardiac in particular)
What is the Atkins diet?
Involves four phases starting with the lowest amount of CHO intake and leading to a more moderate, controlled, CHO intake. High protein
What is the CHO addicts diet?
Begins with a restricted 2 week phase, hast strict rules, foods not on the allowed list should be avoided
What is the zone diet?
CHO/Protein/Fat diet ratio of 40/30/30
categorizes CHO into favourable vs. unfavourable types and considers portion sizes
What is the South Beach Diet?
Involves three phases, claims its neither low-carb nor low-fat, and suggests consuming the “right carbs” and “right fats” and avoiding the “bad carbs” and “bad fats”. Based on some concepts related to GI.
What is the weight watchers diet?
Involves a points system
Healthy eating and physical activity
Does not prohibit foods
What is the difference between physical activity and exercise, why does it matter?
Physical Activity: any bodily movement produced by skeletal muscles that results in energy expenditure
Exercise: Specific type of physical activity that is planned and structures, and involves repetitive bodily movement to improve or maintain one or more components of physical fitness
Health messaging has shifted from promoting exercise to promoting physical activity
What is considered normal blood pressure?
<120 and <80 mmHg
What is considered elevated blood pressure?
120-129 and <80mmHg
What is considered Hypertension stage 1?
130-139 mmHg or 80-89 mmHg
What is considered stage 2 hypertension?
> or = 140mmg or > or = 90mmHg
Which measurement is more important, systolic or diastolic?
More important to consider diastolic, when elevated it is directly related to increased stroke risk
What are general guidelines for measuring Blood pressure?
Just one measurement is not good enough, need to take 2-3 in a quiet environment with the patient relaxed, sitting in a chair with their feet on the floor and back supported.
What are some basic lab tests that can be performed to test for primary hypertension?
Fasting blood glucose
Complete blood count - bp can go up with an infection thus do a CBC to look for infection
Lipid profile - look for cardiometabolic dysregulation
Serum creatinine with eGFR - screen for renal disease
Serum Sodium, potassium, calcium - electrolytes influence blood pressure
TSH - changes in thyroid function can have an indirect impact on blood pressure
What are hypertensive meds?
ACE inhibitors - dilate blood vessels
ARB - block angiotensin II which causes blood vessels to narrow
Beta-blockers - help heart work less hard by blocking receptor site of adrenaline and noradrenaline
Thiazide and Thiazide like Diuretic - helps kidneys produce more urine to flush out water and salt
CCB - calcium channel blockers, vasodilate the blood vessels
What are lifestyle interventions for hypertension?
Physical Activity - especially if overweight, associated with most significant impact on BP control
Healthy eating to promote weight reduction - higher sodium intakes directly related to hypertension, some people are sodium sensitive genetically. Also increasing K can be beneficial
Alcohol - causes oxidative stress to the blood vessels
Stress management - stress can be a primary cause of hypertension - long term elevated cortisol can influence BP
What diet therapies can be used to treat hypertension?
DASH diet - best outcomes for hypertension
Portfolio diet
Mediterranean diet - more evidence for CVD than hypertension
Describe the Mediterranean Diet Pyramid
Less often - meats and sweets
weekly (1x a week) - poultry, eggs, cheese and yogurt
Often (2x a week) - fish and seafood
Every day - vegetables, fruits, whole wheat grains, olive oil, beans, nuts, legumes and seeds
Every day - activity
What are the guidelines for the portfolio diet?
Aim for 30g of nuts a day
Aim for 10g of soluble viscous fibre a day
Aim for 30g of soy protein a day
Aim for 1000-2000mg of plant sterols a day
What are the most common sites for waist circumference measurements?
Umbilicus
Narrowest waist
Level of lateral crease
Midpoint between the lowest rib and iliac crest (WHO - gold standard)
What is a healthy waist circumference for men and women?
<102cm in men
<88cm in women
