Treatment Strategies Flashcards
What composes lean body mass?
water, muscle, bone, tendons, ligaments, organs(everything except fat mass)
Weight increases from age 20-70. What is this increase due to mostly?
Increase in fat mass
What are some facts about lean body mass?
Less in female gender
Less as we age
Less in sedentary
What is trend of body composition as we go to midlife and then older?
Fat free mass increases slightly to midlife and then decreases
What precedes frailty?
Sarcopenia
What are characteristics of Frailty?
Weight loss
Fatigue/exhaustion
Reduced physical activity
What are some qualities to both sarcopenia and frailty?
Relate to aging
May be disease related
May be starvation related
What population is visceral adiposity mor prominent esp with aging?
Asian
What body comp parameter increases with aging?
Total body mass index(BMI) independent of body weight.
What provides a better assessment of adiposity as we get older?
WC and Dexa
What is forbes rule?
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.
What are some lean body mass variants?
Kcal intake
Gender
Diet composition
baseline adiposity
inactivity/exercise
metabolic state
hormonal changes
What are some common things if you are sarcopenic and obese?
Inflammation
Increased metabolic d/o
Increase risk of mortality over each alone
Decreased ADLs and QOL
What are the thresholds for excessive weight loss for BMI and %body fat in men and women
<18.5 kg/m2
<10% for men
<15% for women
What are some risks of EWL?
Weight regain/cycling
Eating d/o
Social isolation
Sarcopenia/frailty
Osteopenia/osteoporosis
Malnutrition(Protein, FE, thiamine)
What 3 nutritional deficiencies are seen with EWL?
Protein, iron, thiamine
What are some risks of rapid weight loss?
Gallstones
Dehydration
Gout
Electrolyte disturbances
Kidney stones
Hair loss(usually temporary)
Does weight cycling increase mortality and morbidity?
Yes, All cause mortality by 41%, CVD mortality 36%
CVD morbidity 49%
HTN increases by 35%
What percentage of weight fluctuation can have negative outcomes?
> 4%
How much muscle loss can you have with weight cycling?
5-6 fold
How long into weight loss journey do you hit a weight loss plateau?
6-12 months with a slight weight increase as energy intake increases and expenditure decreases
What are components of metabolic adaptation?
REE decreases
Increased appetite
Decreased T3 and T4, increased RT3
Decreased Leptin
Increased muscle efficiency