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Obesity Medicine > Terms > Flashcards

Terms Flashcards

1
Q

EAR

A

Estimated average requirement - amount of a nutrient that is estimated to meet the requirement of HALF of all healthy individuals in the population
100 gm/d (carbs)

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2
Q

AI

A

Adequate intake - observed intakes of the nutrient by a group of healthy persons

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3
Q

9 Essential Amino Acids

A

HILL MPTTV

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4
Q

Principal contributor to resting energy expenditure

A

Lean body mass

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5
Q

Metabolic adaptation

A

Maintenance of > or = 10% reduction in body weight results in decreased EE and increased muscle efficiency

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6
Q

How does glycemic index vary?

A

Preparation - fat, fiber, and acid lower the glycemic index; cooking starches (pasta) longer - higher glycemic index
Ripeness - fruits like bananas have an increased glycemic index as they ripen
Combining high-glycemic index foods with lower will reduce the GI of a meal

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7
Q

Glycemic Index (GI)

A

How much and how quickly an ingested food affects blood glucose
Low GI >55, Med 56-79, High > 70

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8
Q

American Diet Association (ADA) Exchanges

A

Non-Starchy Veggies - 2 gm prot, 5 gm carb, 25 kcal
Protein - 7 gm prot, 0-8 gm fat, 35-100 kcal
Fat - 5 gm fat, 45 kcal
Dairy - 8 gm prot, 12 gm carb, 0-8 gm fat, 90-150 kcal
Fruit - 15 gm carb, 60 kcal
Starch - 3 gm prot, 15 gm carb, 0-1 gm fat, 80 kcal

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9
Q

RDA

A 
Recommended daily allowance - average daily dietary intake of a nutrient that is sufficient to meet the requirement of NEARLY ALL healthy persons
130 gm/d (carbs)
56 gm/d (prot - M)
46 gm/d (prot-W)
25-38 gm/d (fiber)
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10
Q

Calorie?

A 
Measure of energy 
1 Calorie (Cal) = kilocalorie (kcal) = 1000 calories
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11
Q

Kcal/gram of macro-nutrients

A 
Carbs - 4 kcal/gram
Fat - 9 kcal/gram
Protein - 4 kcal/gram
water - 0
alcohol - 7 kcal/gram (not a maconutrient)
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12
Q

TEF

A

Thermogenic effect of food (increased energy expenditure); it is highest for protein and high protein diets; fat has the lowest TEF

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13
Q

FITTE

A

Exercise Rx: Frequency, Intensity, Time, Type, Enjoyment

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14
Q

MET

A

Metabolic Equivalent of Task

1 = RMR; <3 = Light; 3-6 = Moderate; >6 = Vigorous

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15
Q

Diets and Health Benefits Summary

A

Low Carb: dec TAG and DM2, inc HDL
Low Fat: dec LDL and total cholesterol
Mediterranean: dec CV mortality and DM2 (as well as LDL)
Veg/Vegan: dec LDL, CV mortality, and DM2
DASH: dec BP
Meal replace: best weight loss
VLCD: dec DM2, most aggressive dietary strategy
High protein, low GI: maintaining weight loss

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16
Q

GI sites of Nutrient Absorption

A

Duodenum - iron and calcium
Jejunum - Carbs, AAs, Potassium, many vitamins
Ileum - Water, K, Minerals, Salts, Fats (ADEK)
Colon - Vit K, Biotin, B12, B2, B1, water, sodium, Cl

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17
Q

Protein Maintenance and Weight loss

A

Maintenance - .7-1 mg/kg/d

Weight loss - 1.2 - 1.5 mg/kg/d (90-120 gm/d)

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18
Q

Benefits of 5-10% of weight loss

A 
Reduction T2DM
Improved BP
Reduction CVD risk factors
Improved lipid profiles 
Improvement in sleep apnea up to 50%
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19
Q

Mortality Data For Obesity

A

Least among BMI 22.5 to 25; mortality increases for each 5 kg/m2 increase in BMI; overweight BMI (25-29) at age 40 lived 3 years less, 30-30 lived 2-4 years less, BMI 40-45 lived 8-10 years (comparable with the effects of smoking)

20
Q

BRFSS

A

Behavioral RIsk Factor Surveillance System -State level; telephone survey and underestimates obesity

21
Q

NHANES

A

National Health and Nutrition Examination Survey - Nationwide, interviews and physical exams - random selection via census data

22
Q

Edmonton Obesity Staging System

A

Stage 0 - No signs of risk factors
Stage 1 - subclinical risk factors
Stage 2 - Comorbidity requiring intervention
Stage 3 - Significant end organ damage
Stage 4 - End-stage disease or disability

23
Q

International Diabetes Federation (IDF)

A

Asian Countries (overweight >23-24; Obesity > 27-29)

24
Q

OMA Diagnosis of Obesity

A

Obesity is defined as a chronic, relapsing, multifactorial, neurobehavioral disease, wherein an increase in body fat promotes adipose tissue dysfunction and abnormal fat mass physical forces, resulting in adverse metabolic, bio mechanical, and psycho social health consequences.

25
Q

Obesity definition - American Council on Exercise Classification (waist circumference)

A

Cau M - 40”; F - 35”
AA M - 37”; F - 31.5”
Latino M - 35.5”; F - 31.5”
Asian M - 33.5”; F - 31.5”

26
Q

American Association of Clinical Endocrinologists

A

Overweight - BMI 25-29.9 without complications
Obesity - BMI > 30 - no complications
Obesity Stage 1: BMI > 25 with mild-moderate complications
Obesity Stage 2: BMI> 25 with severe obesity related complications

27
Q

Treatment of choice for Binge Eating disorder and Bulima

A

CBT

28
Q

Stages of Change

A

Pre-contemplation (use motivational interviewing here)
Contemplation - use MI here
Preparation - Use CBT here and forward in stages
Action
Maintenance

29
Q

Upper leg length and obesity

A

Short upper leg length can indicate risk for metabolic syndrome (more than BMI or waist circumference); it is more reliable

30
Q

Laboratory Eval of Childhood Obesity

A

85-94%tile WITHOUT risk factors - Fasting Lipids
85-94%tile WITH risk factors (10 and up) - Fasting Lipids, glucose, LFTs
95%tile (10 and up) - Fasting lipids, glucose, LFTs, TFTs (consider others based on family hx or PEx

31
Q

ADMR

A

Acceptable Macro Distribution Range

32
Q

ADMR for Carbs

A

45-60%

33
Q

AMDR for proteins

A

10-35%

34
Q

ADMR for fats

A

25-35%

35
Q

Definition of Childhood Obesity

A 
<5% - underweight
5%-84% - Healthy Weight
85% - 94% - Overweight
95% - 99% - Obesity
120% of the 95 or BMI or >35 - Severe obesity
36
Q

Obesity EKG abnormalities

A

LAD, T wave, PACs (OSA), Hypertrophy (HTN), QT abnormalities

37
Q

TEE = REE + TEM + EEPA

A

Total Energy Expenditure = Resting energy expenditure (60-75%) + Thermic effect of meals (10%) + Energy expenditure from physical activity (15-30%)*
*Non-exertional (NEAT)and exertional/exercise

38
Q

Resting metabolic rate calculations

A

10xW (kg) + 6.25xHt (cm) - (5xAge) (+5 in males; - 161 in females) = Miffin-St Jeor Equation

Also is the Harris Benedict (more complicated formula…)

39
Q

BMR

A

Basic Metabolic Rate - comprises roughly 70% of TDEE; muscle and brain are most metabolically active tissues

40
Q

Increased neck circumference for OSA

A

Men - > 17 inches; Women - > 16 inches

41
Q

American Council on Exercise Classification of % body fat

A 
Obesity:  > or = 32% in women and > or = 25% in Men
Acceptable: 25-31% and 18-24%
Fitness: 21-24% and 14-17%
Athletes: 14-20% and 6-13%
Essential Fat: 10-13% and 2-5%
42
Q

Waist Circumference - Obesity

A

MEN > 40 inches or 102 cm; WOMEN > 35 inches or 88 cm

43
Q

Mediterranean Diet and effects

A

Diet plan that emphasizes healthy fats, fruits, veggies, whole grain, beans, nuts, and seeds. It decreases risk of atherosclerosis, coronary artery disease and cerebrovascular disease. Improves LDL (decreases) and TAGs (decreases); no affect on HDL

44
Q

Treatment of choice for Binge Eating disorder and Bulima

A

CBT

45
Q

OMA Diagnosis of Obesity

A

Obesity is defined as a chronic, relapsing, multifactorial, neurobehavioral disease, wherein an increase in body fat promotes adipose tissue dysfunction and abnormal fat mass physical forces, resulting in adverse metabolic, bio mechanical, and psycho social health consequences.

46
Q

Principal contributor to resting energy expenditure

A

Lean body mass

Obesity Medicine (6 decks)

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