Nutrition Assessment Module 2

Front 1

Define anthropometry

Back 1

is defined as the physical measurement of body size and composition. Examples of anthropometric measurements include height, weight, circumference measurements, elbow diameter, % body fat, and arm muscle area.

Front 2

What are anthropometric data taken from a patient compared to?

Back 2

NHANES (03-06) data

Front 3

What are the physical measurements that are affected by protein deficiency?

Back 3

are arm muscle circumference/arm area
fat free mass which is calculated as the difference between body wt and body fat.

Front 4

What are the physical measurements that are affected by energy imbalance?

Back 4

body fat, overall body growth (in children) or body size (under or over weight)

Front 5

what factors affect height?

Back 5

subjects are shorter standing than lying due to gravity on the vertebra also earlier in the day than later for same reason.
Age esp woman due to loss of bone mass but also loss in foot arch.

Front 6

An unintentional loss or gain in weight by what % indicates an underlying serious problem?

Back 6

>10%

Front 7

What is the calculation for BMI?

Back 7

wt (lb)/ht(in)/ht(in) x 703

Front 8

Define Fat mass

Back 8

•essential fat: lipids of the bone marrow, central nervous systems, mammary glands, and other organs
•non-essential fat: storage fat (subcutaneous, intermuscular, intramuscular, fat or thoracic and abdominal cavity)
•adipose tissue is about 10% water

Front 9

Define fat free mass

Back 9

fat free tissue such as water muscle bone and internal organs

•mixture of water, minerals (such as in bones), and protein
•most of the protein is stored in the muscle
•FFM is 72-74% water

Front 10

define total fat

Back 10

all extractable fat in the body

Front 11

Define essential fat

Back 11

fat in organs and tissues such as the brain, nerve, heart, lungs, liver and mammary glands

Front 12

Define non-essential fat

Back 12

fat found mostly in adipose tissue and used primarily for energy storage

Front 13

Adipose tissue mass

Back 13

contains about 85% fat, 10% water, 5% protein, minerals, etc

Front 14

Lean body mass (LBM)

Back 14

FFM + essential fat

Front 15

Subcutaneous fat

Back 15

adipose tissue underneath the skin

Front 16

Visceral fat

Back 16

adipose tissue within and around the organs in the thoracic cavity

Front 17

Abdominal fat

Back 17

subcutaneous and visceral fat in the abdominal region

Front 18

intra-abdominal fat

Back 18

visceral fat in the abdominal cavity

Front 19

What are the four variables of body composition?

Back 19

gender, age, diet, exercise

Front 20

Forecasting body weight

Back 20

Forecasting Body Weight

Example: 128# female with 25% body fat. She wants to know what she would weigh if she were to lose weight until she was 13% body fat - or gain weight until she was 30% body fat (assuming FFM remains constant)



Amt fat in Lb (#): 128 x .25 = 32 Lb body fat

Amt FFM: 128# - 32@ = 96 Lb FFM



Given: Low range fat percent (LRFT) is: 13% for females

High range fat percent (HRF%) is: 30% for females



Calculating low end recommended body weight (13% body fat):

FFM ÷ (1.0 - 0.13)

= 96 ÷ 0.87

= 110#



Calculating high end recommended body weight (30% body fat)

FFM ÷ (1.0 - 0.30)

= 96 ÷ 0.7

= 137#

Front 21

What are the guidelines for risk on measuring waist circumference?

Back 21

•For men, risk is associated with a circumferance >40 inches
•For women, risk is associated with a circumference >35 inches

Front 22

What is the most accurate method of assessing body composition?

Back 22

DIRECT CHEMICAL ANALYSIS but cannot be done on live subjects

Front 23

What is the most accurate method of estimating body fat and is considered the "gold" standard?

Back 23

hydrodensitometry

Cons, people with altered balance of water or osteoporosis will have incorrect reading.

Front 24

What is the most popular field method for estimating body fat percentage?

Back 24

skinfold measureements

Front 25

Children are classified obese when they are in what %?

Back 25

95th

Front 26

What are the steps in assessing an obese patient?

Back 26

1. anthropometrics- ht wt BMI waist circ.
2. medical-potential causes or risk factors
3. psychological - identify causes
4 nutritional- wt history, readiness to change

Front 27

How many specialist should be involved when dealing with a patient who is obese?

Back 27

four, physician, dietitian, exercise specialist and behavior therapist

Front 28

How do you calculate BMI?

Back 28

BMI = Wt (kg) or Wt(lbs) ÷ 2.2 or Wt (lbs) ÷ Ht (in) ÷ Ht (in) x 703

Front 29

WHat are the classes for BMI?

Back 29

Underweight
< 18.5
Normal weight
18.5 - 24.9
Overweight
25 -29.9
Obesity (Class 1)
30 -34.9
Obesity (Class 2)
35 - 39.9
Extreme obesity (Class 3)
> 40

Front 30

Why are anthropometric measurements important for children?

Back 30

they are used to assess growth

Front 31

WHAT ARE THE MOST WIDELY USED ANTHROPOMETRIC MEASUREMENTS PERFORMED ON CHILDREN?

Back 31

1. STATURE
2. BODY WEIGHT
3. HEAD CIRCUMFERENCE (up to 36 months)
BMI can be used as well

Front 32

What are the four growth periods for children?

Back 32

Infancy
Pre-school
Middle school
Adolescence

Front 33

What is considered obese in terms of children's measurement percentiles?

Back 33

95% + on BMI for age and weight for length/stature

Front 34

What is considered overweight in terms of children's measurement percentiles?

Back 34

85 - 95% BMI for age

Front 35

What is considered underweight in terms of children's measurement percentiles?

Back 35

<5 % weight for length and BMI for age

Front 36

What is considered short stature in terms of children's measurement percentiles?

Back 36

<5% stature/length for age

Front 37

What is considered developmental problems in terms of children's measurement percentiles?

Back 37

<5% or >95% head circumference for age

Front 38

WHat is LBW?

Back 38

low birth weight babies are born weighing less than 5.5 lbs either preterm or full term. Higher mortality esp during the first 28 days prob with temp reg, blood glucose levels, and infectious diseases.

Front 39

What is VLBW?

Back 39

very low birth weight babies born 3.3 lbs or less

Front 40

Calculate the BMI for a female who is 67 inches tall and weighs 215#.
a. 28.2
b. 33.7
c. 34.8

Back 40

B. 33.7

Front 41

For the above question, how would this individual be classified based upon BMI?
a. normal
b. overweight
c. obese
d. extreme obesity

Back 41

C. obese

Front 42

Which of the following would be at nutritional risk based on waist circumference?
a. 12 year old girl - 37 inches
b. 45 year old female - 38 inches
c. 57 year old male - 39 inches

Back 42

B. 45 year old female-38 inches

Front 43

Describe the uses of the following and whom they are best used for,
Hydrodensitometry
Skinfold
Bioelectrical impedence
Near infraredinteractance
Air displacement (bod pod)
Magnetic resonance imaging
DEXA

Back 43

Hydrodensitometry gold standard, expensive time consuming
Skinfold popular, dependent on skill of examiner
Bioelectrical impedence quick, easy, portable, best for persons with normal fat
Near infraredinteractance portable, fast, easy to use, accuracy is questionable
Air displacement (bod pod) can be used with elderly & children, requires tight clothing,
Accuracy questionable
Magnetic resonance imaging safe for children, costly, limited to hospitals/research
DEXA low dose radiation, costly, effective

Front 44

Which of the following would be risk factors for osteoporosis and would signal testing for younger, pre-menopausal women?
[mark all correct answers]

a. being thin
b. current cigarette use
c. African American
d. amenorrhea

Back 44

ABD

Front 45

Which measurement device would be best suited for a health fair?
a. DEXA
b. QCT
c. Calcaneal radiography

Back 45

C. calcaneal radiography

Front 46

Is it possible for a measurement to be precise but not accurate?
True
False

Back 46

True. If you weigh yourself on an "inaccurate" scale that depicts your weight as 10# heavier than it really is - repeatedly - this is an example of precision but not accuracy.

Front 47

An elderly female recently underwent hip replacement surgery and is receiving physical therapy in the hospital and is ambulatory. Using 1200 as her BEE/REE, 1.2 as her injury factor, and 1.3 as her activity factor, what is her calculated total energy expenditure?
a. 1440 kcal
b. 1560 kcal
c. 1800 kcal
d. 1872 kcal

Back 47

C 1800

Front 48

Which of the following equations is validated for a 14 year old girl?
a. Harris Benedict
b. Mifflin
c. Quick Method
d. DRI TEE

Back 48

D. DRI TEE

Front 49

According to the NHANES over the last 30 years what is the 2010 trends in overweight and obesity in adults and children?

Back 49

in 2010, 2/3 of the adult population was overweight or obese using BMI as a criterion, and 1/3 of these were obese.
Between 1999–2000 and 2009–2010, there was an increase in the prevalence of obesity among boys but not among girls.

Front 50

When is weight loss recommended for individuals?

Back 50

If over weight and has two or more risk factors.

Front 51

Clinical Guideline recommends losing how much in what length of time?

Back 51

10% of baseline weight over 6 months at a rate of 1-2 lbs a week and est energy deficit of 500-1000 kcal/day.

Front 52

When is surgery recommended?

Back 52

co morbidities at greater to or equal to 40 BMI, at 35+ with co-morbidities would be under consideration.

Front 53

Name the two types of bone.

Back 53

Cortical and trabecular

Front 54

At what age does peak bone mass become achieved?

Back 54

girls 18 and boys 20 90%
age 30 100%

Front 55

Symptoms of osteoporosis appear in what type of bone first and where?

Back 55

trabecular and in the spine and wrists

Front 56

Define primary osteoporosis

Back 56

not related to other diseases
type 1 in postmenopausal women 51-75 loss of trabecular bone
type 2 seen in m and w after 70 due to age-related changes and involves both cortical and trabecular bone. Most common fractures are hips and vertebrae

Front 57

Osteoporosis is defined as bone mineral density (BMD) ______ standard deviations or more below that of young, healthy adults

Back 57

2.5

Front 58

What is secondary osteoporosis and what is it caused by?

Back 58

identifiable cause other than age or osteoporosis such as Cushing's syndrome, amenorrhea, hyperthyroidism

Front 59

What is the DRI for vitamin D and calcium?

Back 59

DRI Adequate Intakes for calcium are:
•9-18 yrs: 1300 mg
•19-50 yrs: 1000 mg
•51+ years: 1200 mg

DRI for vit D:
•9-18 yrs: 10 ug/day
•19-50 yrs: 10 ug/day
•51+ yrs: 10 ug/day

Front 60

Ways adults can help preserve bone?

Back 60

•Mode—weight-bearing endurance activities such as tennis and jogging, activities that involve jumping, and resistance exercise (weight lifting)
•Intensity— moderate to high
•Frequency—weight-bearing activities at least 3 to 5 times per week, resistance exercise 2 to 3 times per week
•Duration—30 to 60 minutes a day (combination of weight-bearing and resistance exercises)

Front 61

Ways children can help build bone?

Back 61

•Mode—impact activities such as gymnastics and jumping activities combined with moderate resistance training
•Intensity—high, but with appropriate weights for resistance training (no more than 60 percent of the maximum amount a person can lift one time)
•Frequency—at least three days per week
•Duration—10 to 20 minutes with multiple sessions within the same day potentially being more effective

Front 62

What are "T scores"?

Back 62

compared to young, normal, healthy same-sex adults are measured in standard deviations (SD)

Front 63

What are "z scores"?

Back 63

•"Z scores" - compared to same age, sex, and ethnicity

Front 64

Who should be tested for osteoporosis?

Back 64

•all women aged 65 and older regardless of risk factors
•younger post-menopausal women with one or more risk factors
•post-menopausal women who have had a fracture