Obesity and Hypertension Flashcards

1
Q

What are some general outlines for health providers when dealing with obese patients?

A

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

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2
Q

What are the recommendations for adults with obesity and prediabetes?

A

Consider intensive behavioural interventions that target a 5-7% weight loss

Non-dieting approach to improve quality of life

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3
Q

What anthropometric measurements can be taken to assess the degree of overweight or %bodyfat?

A

BMI
Waist circumference, in conjunction with BMI can help assess risk for CVD and T2D

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4
Q

What is the difference between primary and secondary hypertension?

A

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

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5
Q

What are prepackaged meal programs? What considerations should be if a client chooses these for weight loss?

A

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

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6
Q

What is the PSMF?

A

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

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7
Q

What are risks of PSMF?

A

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)

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8
Q

What is the Atkins diet?

A

Involves four phases starting with the lowest amount of CHO intake and leading to a more moderate, controlled, CHO intake. High protein

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9
Q

What is the CHO addicts diet?

A

Begins with a restricted 2 week phase, hast strict rules, foods not on the allowed list should be avoided

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10
Q

What is the zone diet?

A

CHO/Protein/Fat diet ratio of 40/30/30

categorizes CHO into favourable vs. unfavourable types and considers portion sizes

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11
Q

What is the South Beach Diet?

A

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.

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12
Q

What is the weight watchers diet?

A

Involves a points system
Healthy eating and physical activity
Does not prohibit foods

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13
Q

What is the difference between physical activity and exercise, why does it matter?

A

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

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14
Q

What is considered normal blood pressure?

A

<120 and <80 mmHg

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15
Q

What is considered elevated blood pressure?

A

120-129 and <80mmHg

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16
Q

What is considered Hypertension stage 1?

A

130-139 mmHg or 80-89 mmHg

17
Q

What is considered stage 2 hypertension?

A

> or = 140mmg or > or = 90mmHg

18
Q

Which measurement is more important, systolic or diastolic?

A

More important to consider diastolic, when elevated it is directly related to increased stroke risk

19
Q

What are general guidelines for measuring Blood pressure?

A

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.

20
Q

What are some basic lab tests that can be performed to test for primary hypertension?

A

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

21
Q

What are hypertensive meds?

A

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

22
Q

What are lifestyle interventions for hypertension?

A

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

23
Q

What diet therapies can be used to treat hypertension?

A

DASH diet - best outcomes for hypertension
Portfolio diet
Mediterranean diet - more evidence for CVD than hypertension

24
Q

Describe the Mediterranean Diet Pyramid

A

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

25
Q

What are the guidelines for the portfolio diet?

A

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

26
Q

What are the most common sites for waist circumference measurements?

A

Umbilicus
Narrowest waist
Level of lateral crease
Midpoint between the lowest rib and iliac crest (WHO - gold standard)

27
Q

What is a healthy waist circumference for men and women?

A

<102cm in men
<88cm in women