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105 Cards in this Set
- Front
- Back
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When does loss of bone and muscle mass begin to decline?
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in the 30's
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What is perimenopause?
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the end of a women's repoductive period when estrogen and progesterone levels fluctuate wildly and decline
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When does menopause start?
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point at which a year has lapsed since last menstrual cycle
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What happens to the metabolism in adults?
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REE decreases at first the accelerates as muscle mass declines leading to reduced kcal req
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Increased body fat is linked with increased risks in ______?
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coronary heart disease
hypertension diabetes miletus cancer |
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Assessing an adult what are the measurements for waist circumference that is associated for increased risk for disease?
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males 40+ inches
females 35+ inches |
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WHat are the 2002 DRI kcal needs for adult males 19-50?
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3067/day minus 10 kcal per year for every year greater than 19
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WHat are the 2002 DRI kcal needs for adult females 19-50?
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2403/day minus 7 kcal for every year over 19
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What is the amount of protein for adult m/f?
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56g men and 46g for women
should be approx 15% of ttl cal |
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What are the fat recommendations for adults?
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20-35% UFA's
<10% SFA |
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WHat are the 2002 DRI carbohydrate needs for adults?
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130g/day ages 19-70
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What is the calcium RDA for adults?
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1000 mg/day
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What is the RDA for folate women at child bearing age?
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400 ug/day
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What is the RDA for iron?
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8 mg.day men and post menopausal women
18 mg.day for menstruating women |
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What is the adult RDA for Vit C?
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males - 90 mg
females - 75 mg smokers increase +25 mg |
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What percentage of weight loss can have a positive impact on diabetes mellitus?
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10%
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What is the normal BP when screened for hypertension?
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119/79
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What is considered pre-hypertension for BP?
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120/80 to 139/89
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What are some of the recommendations for someone with hypertension?
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from the Joint National Committee
lose excess weight adopt the DASH diet restrict sodium moderate alcohol consumption weight loss will lower BP |
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What is the DASH diet?
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Dietary Approaches to Stop Hypertension
high in potassium, calcium, magnesium (comb acts as a diuretic) low SFA's and cholesterol focus on low fat dairy, fruits veg and nuts |
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What are the risk factors for CVD?
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age
gender family hx body wt tobacco use blood lipids dm inactivity |
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What guidelines for blood lipid profiles are markers for CVD?
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LDL less than 160 acceptable less than 100 optimal
HDL <40 is a risk factor totak cholesterol <239 borderline high <200 optimal |
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How do you raise HDL's?
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exercise
don't smoke moderate alcohol |
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How do you lower LDL's?
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lower intake of SFA's and exchange for USFA's
lose weight increase soluble fiber exercise add soy protein |
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WHat are some of the symptoms for metabolic syndrome?
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Need 3 out of the 5,
Abdominal obesity Waist circum >35 women, >40 men Elevated triglycerides >150 Elevated blood pressure >130/>85 mmHg Elevated fasting blood sugar >100 mg/dl Low HDL’s <40 mg/dl (men), <50 mg/dl (women) Wt reduction and physical activity can positively impact on all of the risk factors |
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How many years has the life expectancy increased in the US?
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29 years
due to decrease in death from infection, lower DR in children and young adults, improved technology and treatment of chronic diseases. |
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Why does surgery take a toll on older individuals?
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After surgery, serum protein levels return to normal slower than younger folks.
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What is sarcopenia
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loss of skeletal muscle and strength and loss of physical function
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What % of decrease in BMR due to a decline in muscle mass in older adults?
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15-20% decline
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What is the medical term for loss of taste?
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hypogeusia
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What is the medical term for loss of smell?
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hyposemia
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What is the medical term for dry mouth?
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xerostomia
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True or False
Dentures increase bitter and sour taste sensations |
True
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What is atrophic gastritis?
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chronic inflammation of the stomach with decreased thickness of mucosa
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What is dysphagia?
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weakening of the gag reflex causing swollowing difficulties
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What nutrients can become a deficiency in older adults due to reduced hydrochloric acid?
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iron
B6 B12 |
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What causes constipation in older adults?
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decreased activity
low fluid intake low-fiber diets medications |
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WHat happens in the liver in regards to medication in older adults?
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drug metabolism and detoxification is slower
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What are the 2 most common causes for weight loss in elderly?
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depression
side effects of medications |
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What happens to the CVD system in older adults?
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cardiac output declines due to increased rigidity of arterial walls
decreased blood flow decreased O2 uptake heart valces become more rigid |
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What is decubiti?
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pressure ulcers
from lack of mobility, inadequet nutrition, dehydration, certain medications that influence risks for pressure ulcers |
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What are dietary the recommnedations for decubiti?
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arinine and glutamine
Vit C Zinc |
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WHat are the nutrient needs for older adults?
kcal protein |
as listed for adults based on avg wt and phys activity
.8g/kg body wt |
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WHat are the calcium needs for older adults?
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1200 mg for adults over age 50
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True or False
Most iron deficiency anemia in older adults is not related to chronic illness or GI bleed |
False it is due to chronic illness or GI bleed
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How much water should an elderly person intake?
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1 ml per kcal of food or 30ml/kg body wt
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What are clinical assessments for undernurished elderly folks?
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unintentional weight loss
1-2% per week 5% per month 10% over 6 months clinically - confusion, low serum albumin, low TLC and low HG |
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What does NSI stand for?
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Nutrition SCreening Initiative essential for geriatric assessment
Levle I - SS or health care worker Level II - in healthcare setting, hospital, nursing home doctor |
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How many cm per decade does an older adult lose?
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.5 - 1.5 cm
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What do you need to assess in elderly patients in regards to dietary assessment?
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apetite
chewing ability swallowing bowel function food allergies alcohol and tobacco use medications supplements |
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What is stomatitis and causes?
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is an inflammation of the mucous lining of any of the structures in the mouth, which may involve the cheeks, gums, tongue, lips, throat, and roof of mouth.
Can be from a deficiency of B vitamins and iron |
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What are some chronic health concerns for elderly folks?
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Heart Disease
Hypertension Osteoperosis GERD Alzheimer's Disease |
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What is the most common eating disorder?
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obesity
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Define anorexia
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self-imposed starvation
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What is the 4 diagnosis signs for anorexia?
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1. refusal to maintain body wt at normal for ht and age
2. intense fear of gaining weight 3. distorted body image 4. amenorrhea for at least 3 cycles consecutively |
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What is the etiology for anorexia?
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multi-factorial - society, biological, psychological, familial factors
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What is amenorrhea?
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the absence of a menstrual period within in a women of reproductive age
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What are the goals when you are dealing with a pt with anorexia?
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restore normal eating patterns
est normal body wt resolve underlying psych conflicts need family therapy and support |
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What are the diet guidelines for anorexia?
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increae food intake slowly
start with 1000 - 1400 kcal refer to diet as "low cal" promote gain 1-2 kg/wk by gradually increasing intake up to 2500-3000 kcal/day limit bulky food to help with GI intolerance small freq meals are good emph pt to record and measure at first then lessen emphasis on food avoid caffeine (stimulant/diuretic effect) |
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Describe the 2 phases for counseling anorexia pt
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1. educate - about nutrition and eating disorder
2. experiment - help client make changes in food and weight related behaviors |
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What are the most common casuses of death in anorexic pt?
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cardiac arrest
electrolyte imbalance suicide |
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Define bulemia nercosa
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Binging on large amounts of food and then exhibiting inappropriate compensatory behaviors to include: purging, fasting, and excessive exercise
pt are slighlty above weight or normal weight |
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What is the diagnosis of bulemia nervosa signs?
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recurrent episodes of binge eating
recurrent inappropriate compensatory behavior to prevent weight gain occurs at least twice per week for 3 months emphasis on body weight and shape |
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What is the etiology for bulemia nervosa?
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societal pressure
lack of self-esteem perceptions of body image and appearance self-concept and self-esteem play a critical role anxiety and depression are more common more likely to experience loneliness, irritability, passivity, sadness and suicidal behavior |
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What are some of the side effects of repeated vomiting?
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dental disease
pitting of teeth thinning of enamel loose fillings sore throat esophagitis esophageal ulcers esophageal bleeding and rupture aspiration is a risk calluses on knuckles from using fingers to induce vomiting |
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What % of bulemics use laxative and diuretics regularly?
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40-60%
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What are the side effects for using diuretics and laxatives for bulmics?
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dehydration and electrolyte imbalance
cathartic colon leads to poss hypokalemia and hypocalcemia |
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How do you treat a bulemic patient?
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Deal with denial
Patient needs to acknowledge the problem Goal: reduce or eliminate binge eating/purging Normalize body perceptions Promote effective weight control while altering life-stress management |
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What nutrition plan do you recommend for bulemic pts?
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Structured eating patterns, avoid periods of fasting
3 meals and 2 snacks preferable Learn to avoid eating in response to boredom, anxiety, depression, etc Research has shown that once a structured eating pattern is established, the person experiences less hunger, less deprivation, and a reduction in negative feelings about food and eating |
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What is muscle dysmorphia?
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A preoccupation with the idea that the body is insufficiently lean or muscular
A new form of body image disturbance seen primarily in men, referred to as ‘reverse anorexia’ and ‘bigorexia’ Primarily begins in late teens, average onset 19.4 years Often accompanied by depression |
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What form of therapy is best for muscle dysmorphia?
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Cognitive Behavior Therapy
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Define binge eating disorder
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Eating in a discreet period (usually 2 hrs) an unordinarily large amount of food (up to 10,000 kcal)
A lack of control over eating Occurs at least 2 days per week for 6 months Most common eating disorder (2-5% adults) Patients are usually obese (do not purge) Typically affects women more than men |
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What are the characteristics and or treatment for binge eaters?
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Impaired social functioning
High concerns about body weight More likely to have depression/panic disorder May lose weight but typically regains it all back within a few years Preoccupation with wt and body shape beings early in childhood Boys and girls between ages 9-11 were concerned about their body image (2/3rd) Chronic dieting may predispose binge eating There is often a history of parental or personal alcohol abuse A single traumatic event, several years of unusual stress or pain, an extended period of emotional pain, or mood disorders may be involved |
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What group has highest obesity rates in women?
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non-Hispanic blacks
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Obesity there is a ________ % increased risk of death from all causes (mostly cardiovascular).
A. 5-20 b. 10-50 c. 30-40 d. 25-75 |
b. 10-50%
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What facilitates fat storage in people with obesity?
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Lipoprotein lipase is a regulator of body fat cells mass and facilitates in fat storage.
LPL levels may contribute to rapid regain of lost weight as levels rise with weight loss. |
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What combos work best to help patient fight obesity?
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diet, exercise and behavior modification
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A 5-10% loss in body weight can have a significant role by
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blood pressure
total cholesterol levels insulin resistance results in improved functional status |
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An initial loss of ______% over 6 months is recommended for obese patients.
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10%
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What is the preferred weight loss range in pounds per week for obese patients?
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1-2#
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What are the typical diets for obese pts?
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Typically 1200 kcal per day
Low kcal diet: 1000-1200 (women) and 1200-1600 (men) and may need multi-vitamin/mineral supplement VLCD: 800 kcal or less. Usually hospital or clinic based program that uses commercial products Typically for persons with BMI>30 who have been previously unsuccessful or BMI 27-30 when co-morbidities are present |
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What are the two pharmocotherapy for pts with BMI >30 or >27 with concomitant health risks?
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sibutramine regulates satiety (off market)
orlistat inhibits pancreatic lipase to hinder absorption of fat |
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When is gastric surgery suggested?
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severe obesity BMI >40 or >35 with co-morbid conditions who have failed other treatments
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What is gastroplasty?
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upper portion of stomach is banded creating a small pouch that severely restricts gastric capacity,
Usually lose less weight than gastric bypass patients and are less likely to maintain weight loss Safest of procedures but still has risks |
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Which food would not be recommended when re-introducing food to a person with anorexia nervosa?
A. black beans B. carrots C. Banana D. whole wheat bread |
A. blck beans
it has the most amount of fiber causing bulking and possible digestive issues. |
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In regards to increasing cardio for a sedentary person: exercise large muscles for a minimum of ______ min 5 times a week.
A. 5 B. 10 C. 15 D. 30 |
D. 30
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Which of the dx should receive priority with an older adult who is hospitalized?
A. stomatitis B. zerostomia C. Pressure ulser D. edenturours |
C. Pressure ulcer
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You have a pt that is insulin resistant has hypertension and weighs 240#. What is the min amount he needs to lose to improve health status?
A. 5# B. 12# C. 30# D. 40# |
B. 12#
as little as 5% can help improve health |
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What is the ftness recommendations for adults?
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30 min moderate physical activity 5 days a week or 20 min vigerous activity 3 x a week. Surgeon General recommends 150.wk moderate exercise
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How much exercise should youth strive for?
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1 hour a day
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Which chronic diseases are reduced by endurance exercises?
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CVD
Cancer DM Osteoperosis Deaths from all causes |
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What are the muscle fiber types?
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Type I: slow twitch, fatigue-resistant, red color
(most sedentary people have this or endurance training) Type IIA: fast twitch, fatigue resistant, red in color, faster velocity of contraction than type I Type IIB: fast twitch, fatigable, white in color (little myoglobin and blood capillaries), easily fatigued but velocity of contraction is fast (speed and strength training prevelance) |
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Energy sources:
What ar ethe four sources for ATP? |
1. free ATP (first 2-3 sec)
2. ATP-CP (forst 6-8 sec) 3. ATP + glycolysis (1-2 min max effort) 4. Krebs cycle (after 2 min) |
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What is the DASH diet?
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Dietary Approaches to Stop Hypertension
high in: potassium, calcium, & magnesium Combination of minerals acts as a diuretic low saturated fats and cholesterol results in high emphasis on low fat dairy, fruits and vegetables and nuts |
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What is the intensity, duration and freq for flexibility?
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stretches for all muscle groups
4 reps/exercise, 10-30 seconds/stretch, 3-5 times a week |
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T or F
Always a small meal before pre-event? |
True
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T or F
Load up on sugar 15-45 min before an event? |
False
avoid sugar sugar may cause hypoglycemia and needless fatigue |
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What is the female athlete triad?
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three interrelated disorders
abnormal eating patterns and excessive exercising amenorrhea premature osteoperosis irreversable if not treated by age 30-35 |
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What are the signs of female athlete triad?
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dry skin, loss of hair, cold, low BP and HR, brittle nails weak bones
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True or False
It is difficult to diagnose iron deficiency due to hemodilution of blood that occures in endurance training. |
True
causes a false anemia called sports anemia |
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Explain why water is essential during exercise.
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Needed to keep body cool during exercise and to prevent dehydration due to sweat loss
Exercise less than 60 minutes- water is adequate Greater than 60 minutes- diluted CHO beverage such as Gatorade, Powerade, 50% diluted fruit juice CHO will help maintain normal blood sugars and provide some energy for the working muscles |
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What are some tips for staying hydratedduring sporting events?
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Drink before you are thirsty
By the time you are thirsty, you have already lost about 2% of body weight, enough to hurt performance If you stop drinking water once thirst is satisfied, you will only get about 1/2 the amount you need For each # of weight lost, drink 2-3 cups of fluid as soon as possible Drink small amounts (4-8 oz) every 15-30 minutes |
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What are the water requirements in ounces per hour?
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14-28 oz
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What is hyponatremic encephalopathy
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swelling of the brain due to low levels of salt in the blood
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What are some of the hydration guidelines for athletes?
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400-600 mL (~2 cups), 2-3 hours before exercise
6-12 oz every 15-20 minutes of exercise Weigh yourself before/after Weight loss due to fluid that needs replacing! ~2-3 cups fluid for each pound lost Exercise 60 minutes or less– cool water Exercise >60 minutes – sports drink 4-8% Carbohydrate Solution |
