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KNPE255 > Test 2 > Flashcards

Test 2 Flashcards

1
Q

Type 2 Diabetes and PA

A

Intensity doesn’t matter

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2
Q

BMI and PA

A

Risk reduction is greater with no adjustment for BMI bc both pathways (PA and BMI) are involved in reducing the risk of T2D
Risk reduction is less after adjusting for BMI bc we can just see the direct effect of PA on T2D

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3
Q

Systolic blood pressure

A

Max pressure heart exerts while beating

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4
Q

Diastolic blood pressure

A

amount of pressure in arteries btwn beating

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5
Q

Is intensity associated w improvements in SBP and DBP?

A

Only diastolic bc as intensity increases so does the reduction in DBP.

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6
Q

Why is the reduction in risk of incident hypertension less after adjusting for BMI?

A

By adjusting for BMI, you remove the effect of the shared pathway of BMI and PA on hypertension, thereby leaving the direct effect of PA on hypertension
NO ADJUSTMENT FOR BMI: risk reduction greater bc we can reduce body weight by being physically active which then also reduces risk of hypertension
ADJUSTMENT FOR BMI: risk reduction less bc you take away one of the ways in which PA impacts blood pressure

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7
Q

Hypertension and PA

A

Linear inverse association

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8
Q

Blood pressure and PA

A

Regardless of blood pressure level or intensity, PA is associated with benefit in a dose-response pattern

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9
Q

Modifiable risk factors

A

diet
exercise
weight
radiation exposure
tobacco

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10
Q

Non-modifiable risk factors

A

Heredity
certain viruses
carcinogens

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11
Q

Colon cancer an PA

A

Dose response relationship
30-45min of PA a day is associated w benefit (all forms of exercise beneficial

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12
Q

Colon cancer and cardiorespiratory fitness

A

Powerful predictor of colorectal cancer
When we adjust for PA, relative risk remains same meaning regardless of your level of PA if you have a high CRF, you will reduce your risk of colon cancer

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13
Q

Sedentary time and colon cancer

A

If you are sedentary but very physically active, the risk that sedentary time has on developing colon cancer will be insignificant

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14
Q

Sitting time and cancer mortality

A

More time you spend sitting, the greater your risk of cancer mortality
However, performing large amounts of PA (ex. 35 MET-hr/week) risk of siting becomes insignificant

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15
Q

Breast cancer and PA

A

Threshold relationship
Must be exercising regularly, at high intensity, meeting guidelines to see benefit (gradual decline in risk as PA increases)
30 min a day
sedentary time increases risk

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16
Q

Lung cancer and PA

A

Smoking is a powerful predictor of lung cancer
In smokers there is a trend to the benefit of performing PA
In non-smokers there is no trend to the benefit of PA on lung cancer
*Relationship btwn PA and lung cancer must not be causal
ie. those who smoke the least tend to be more active and health conscious than those who regularly smoke causing a reduced risk of lung cancer

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17
Q

Sitting time and PA on all-cause mortality

A

Performing more PA for the same hours of sitting, reduces your risk to insignificant

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18
Q

Tv-viewing time, sedentary time and MVPA on all-cause mortality

A

For both daily sitting and TV viewing, MVPA mitigates the negative effects of sedentary time on all-
cause mortality in a dose-response manner.

The mitigating effects of MVPA on daily TV viewing time (greater than 5 hrs/day) is less pronounced
by comparison to an equal amount of sitting time.

The mitigating effects of MVPA on all-cause mortality for both daily TV viewing and sitting time is
greatest when going from no MVPA to 10 MET-hours per week.

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19
Q

Tv viewing

A

residual risk even with a high amount of PA

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20
Q

Screen time

A

Sitting while doing work has diff effects than sitting performing recreational screen time

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21
Q

Indirect field methods of body composition

A

Bioelectrical impedance (BIA)
Skinfolds
Ultrasound
Bod pod

22
Q

Skin fold

A

measure skin fold on a body part (ex triceps) then derive total body percent fat score
not super accurate to assume tricep has the same amount of fat as whole body

23
Q

Fundamental equation

A

C= f(Q)
C= unknown component (ex. total adiposity)
f= mathematical function that links c to Q
Q= measurable quantity/property (ex skin folds)

24
Q

Steps to develop a method for assessing an unknown component

A
  1. Choose a field method (ex. BIA) to measure unknown component (ex. muscle mass)
  2. Choose a reference (criterion) method to develop the BIA equation
  3. Select a large group from the population of interest to measure/asses BIA and the criterion measure (MRI)
  4. Develop a regression (prediction equation) that relates the BIA equation and MRI measurement

ex. take everyone in a class and use a direct/criterion method (MRI) to measure actual skeletal muscle mass.
Derive an equation that can predict skeletal muscle mass from the BIA resistance (Ht2/R)

25
Q

Derivation and validation of a BIA skeletal muscle prediction equation

A
  1. Derive/develop the prediction equation
  2. Cross validate the prediction equation
    -reference group used to develop the equation must be similar in characteristics in the other population to properly predict body composition in the other group (ex. gender, age, activity level)
26
Q

Cross validation ex

A

Create equation based on second year kin students at queens using MRI to develop the equation; this equation would be optimized and specific to that population
if this equation works on second year kin students at Western, it has been cross-validated

27
Q

Deriving an equation

A

Not always access or money for MRI technology
Can also locate an equation in the literature (academic journals)
Must resemble your population of interest
**Do not measure BMI with an equation that is inaccurate for your specific population

28
Q

Applying field methods of body composition properly

A

No exercise or sauna 8 hours before measurement (body must be properly hydrated to achieve an accurate impedance value)
No alcohol within 12 hours
height and weight accurately measured

29
Q

Bioelectrical impedance

A

Measures resistance by alternating currents

30
Q

Bioelectrical impedance limitations

A
  • Instrumentation
  • Client factors
  • Technician skill
  • Environmental factors
  • Prediction equation used
31
Q

BMI and Obesity related morbidity and mortality

A

BMI alone is not optimal for identifying obesity related mortality

32
Q

BMI and waist circumference

A

These two variables together are a better indicator of obesity-related mortality than either one alone

33
Q

Ectopic fat accumulation

A

Visceral, liver, heart, skeletal muscle pancreas
accumulation of this may be why BMI and WC together are strong predictors of obesity mortality

34
Q

Gender and location of excess adiposity

A

Men: abdominal region (apple)
Women: pre-menopause= lower body region (hips, thighs) *pear
post-menopause: abdominal region

35
Q

Issues with use of BMI and WC to identify risk

A
  1. BMI is only positively related to health risk (causes risk) after consideration of WC
  2. We base risk off of BMI categories where they could be individuals at the extremes of each category who undergo a different risk (ex. assuming that all people w a BMI greater than 25 have the same risk)
  3. When BMI and WC are considered as individual continuous variables, WC is a positive predictor of risk whereas BMI is unrelated or negatively related to health risk
36
Q

Mortality risk in adults (BMI and WC)

A

The relationship btwn WC and mortality risk is improved when BMI is adjusted for (take out the effect of BMI on mortality risk)
When we adjust for WC, a higher BMI actually decreases risk
**seems like BMI masks the effects of WC

37
Q

Low BMI

A

At greater risk
For a given WC, a lower BMI means the individual has greater visceral fat and therefore a greater health risk

38
Q

Healthy cardio-metabolic profile

A

Functional adipocytes (subcutaneous adipose tissue) store excess fat so it doesn’t go to unwanted places (visceral, heart, liver etc.)

39
Q

Cardio-metabolic risk profile

A

Dysfunctional adipocytes (subcutaneous adipose tissue) can’t store excess fat and fat goes to unwanted places

40
Q

Person A

A

WC= 100 cm
BMI= 35 kg/m2
Thigh= 45 cm

  • less visceral fat bc higher BMI
  • functional SAT allows excess fat to be stored in adipocytes
41
Q

Person B

A

WC=100cm
BMI= 30 kg/m2
Thigh=35cm

-more visceral fat bc lower BMI
- dysfunction SAT; no room for excess fat in subcutaneous adipose tissue
- at higher risk

42
Q

Obesity management

A

It is said that you must achieve a weight loss of greater than 5% of body mass in order to deem the treatment as successful

43
Q

Clinically significant weight loss

A

5% or more

44
Q

Maintaining weight

A

less than 3%

45
Q

A revised approach to obesity management

A

Change focus from the bathroom scale to adoption of healthy behaviours
Target the causal behaviours (diet and exercise)
Must go upstream and look at causes of obesity

46
Q

Public interpretation of weight loss

A

Weight loss is required for benefit (I will see no benefit to diet and exercise if I do not lose weight)
No weight loss or limited weight loss is a failure

47
Q

Futile obesity management cycle

A
  1. Increased obesity
  2. Public desires weight loss
  3. Prescribe weight loss program (diet and exercise)
  4. Obesogenic environment (the collective physical, economic, policy, social and cultural factors that promote obesity)
  5. Weight loss doesn’t meet expectation
  6. Frustration, sporadic adherence to diet and exercise
  7. Weight regain
  8. Discontinue diet and exercise
  9. starts over
48
Q

Desired health outcomes related to obesity risk

A

Improve CRF
decrease total adiposity
decrease visceral/abdominal adiposity
maintain/increase skeletal muscle mass
improve cardiometabolic risk factors
**WEIGHT LOSS IS NOT A PREREQUISITE FOR ANY OF THESE

49
Q

Exercise and weight loss

A
  • exercise will improve cardiometabolic risk factors, skeletal muscle mass and CRF regardless of weight loss
  • exercise without weight loss is not a failure
  • even exercise without weight loss causes a decrease in WC due to an increase in skeletal muscle mass
50
Q

Public health message regarding sedentary behaviour

A
  1. The more I sit, the more I increase my risk of all-cause mortality if I perform no PA
  2. The more PA I do, regardless of sitting time, I will reduce my risk of all-cause mortality
  3. The negative effect that sitting time has on all-cause mortality is stronger in those who perform little amounts of MVPA
51
Q

Physical activity importance

A

The strongest modifiable determinant
Indirect effect on risk factors which impact mortality
TREATMENT FOR THE SYMPTOMS

52
Q

CRF

A

Low levels are associated w increased risk of CVD, all-cause mortality and cancers
A stronger predictor of mortality than established risk factors such as smoking, hypertension etc.

KNPE255 (3 decks)

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