Treatment Strategies

Question 1

What composes lean body mass?

Answer 1

water, muscle, bone, tendons, ligaments, organs(everything except fat mass)

Question 1

Weight increases from age 20-70. What is this increase due to mostly?

Answer 1

Increase in fat mass

Question 2

What are some facts about lean body mass?

Answer 2

Less in female gender
Less as we age
Less in sedentary

Question 3

What is trend of body composition as we go to midlife and then older?

Answer 3

Fat free mass increases slightly to midlife and then decreases

Question 4

What precedes frailty?

Answer 4

Sarcopenia

Question 5

What are characteristics of Frailty?

Answer 5

Weight loss
Fatigue/exhaustion
Reduced physical activity

Question 6

What are some qualities to both sarcopenia and frailty?

Answer 6

Relate to aging
May be disease related
May be starvation related

Question 7

What population is visceral adiposity mor prominent esp with aging?

Answer 7

Asian

Question 8

What body comp parameter increases with aging?

Answer 8

Total body mass index(BMI) independent of body weight.

Question 9

What provides a better assessment of adiposity as we get older?

Answer 9

WC and Dexa

Question 10

What is forbes rule?

Answer 10

That there is 3:1 fat:muscle loss or 1/4 muscle loss with weight loss especially as you have less fat mass to lose.

Question 11

What are some lean body mass variants?

Answer 11

Kcal intake
Gender
Diet composition
baseline adiposity
inactivity/exercise
metabolic state
hormonal changes

Question 12

What are some common things if you are sarcopenic and obese?

Answer 12

Inflammation
Increased metabolic d/o
Increase risk of mortality over each alone
Decreased ADLs and QOL

Question 13

What are the thresholds for excessive weight loss for BMI and %body fat in men and women

Answer 13

<18.5 kg/m2
<10% for men
<15% for women

Question 14

What are some risks of EWL?

Answer 14

Weight regain/cycling
Eating d/o
Social isolation
Sarcopenia/frailty
Osteopenia/osteoporosis
Malnutrition(Protein, FE, thiamine)

Question 15

What 3 nutritional deficiencies are seen with EWL?

Answer 15

Protein, iron, thiamine

Question 16

What are some risks of rapid weight loss?

Answer 16

Gallstones
Dehydration
Gout
Electrolyte disturbances
Kidney stones
Hair loss(usually temporary)

Question 17

Does weight cycling increase mortality and morbidity?

Answer 17

Yes, All cause mortality by 41%, CVD mortality 36%

CVD morbidity 49%
HTN increases by 35%

Question 18

What percentage of weight fluctuation can have negative outcomes?

Answer 18

> 4%

Question 19

How much muscle loss can you have with weight cycling?

Answer 19

5-6 fold

Question 21

How long into weight loss journey do you hit a weight loss plateau?

Answer 21

6-12 months with a slight weight increase as energy intake increases and expenditure decreases

Question 22

What are components of metabolic adaptation?

Answer 22

REE decreases
Increased appetite
Decreased T3 and T4, increased RT3
Decreased Leptin
Increased muscle efficiency