Lecture 2 Lifestyle Modifications

Discuss the importance of proper nutrition for the prevention of chronic diseases Describe the 6 classes of nutrients for overall health Summarize the healthy eating recommendations in the American Heart Association Dietary Guidance Counsel a patient on the appropriate use of Alli (orlistat) Describe the Physical Activity Guidelines for Americans recommendation

The health behavior change fundamental concepts (4) are…

• Self efficacy

• Patient is the center of _____ _____ process

• Effective communication, intervention, AND ______

• Evaluate and discuss concepts w/ patient when designing a disease ____ program

behavior change

follow-up

prevention

What are calories? (Units)

Amount of energy it takes to raise 1 g of water 1^oC

Units: kilocalories, kcal, cal

1 g carbohydrate = ? kcal

1 g protein = ? kcal

a. 4 kcal

b. 7 kcal

c. 9 kcal

a. 4 kcal

1 g alcohol = ? kcal

a. 4 kcal

b. 7 kcal

c. 9 kcal

b. 7 kcal

1 g fat = ? kcal

a. 4 kcal

b. 7 kcal

c. 9 kcal

c. 9 kcal

True or false: Metabolic rate is the sum total of all energy expended each day.

True!

Metabolic Rate is dependent on (select all that apply 3 total) …

a. Genetics

b. Basal metabolic rate

c. Sleep

d. Thermic effect on food

e. Physical activity

b. Basal metabolic rate

d. Thermic effect on food

e. Physical activity

What are the 6 classes of nutrients for overall health?

Hint: Macronutrients class (3) & Micronutrient class (3)

Macronutrients class

• Carbohydrates

• Fats

• Protein

Micronutrients class

• Vitamins

• Minerals

• Water

Which of the following nutrients for overall health composes of 45-65% of daily calories and is our major energy source?

a. Carbohydrates

b. Fats

c. Proteins

d. Vitamins

e. Minerals

f. Water

a. Carbohydrates

Which of the following nutrients for overall health composes 20-35% of daily calories and is a carrier for absorption of fat-soluble vitamins?

a. Carbohydrates

b. Fats

c. Proteins

d. Vitamins

e. Minerals

f. Water

b. Fats

Which of the following nutrients for overall health composes 10-35% of daily calories and is another source of energy?

It is also converted to carbs during starvation.

a. Carbohydrates

b. Fats

c. Proteins

d. Vitamins

e. Minerals

f. Water

c. Proteins

Which of the following nutrients for overall health has no caloric value and is not a source of energy but maintains physiologic and energy processes?

a. Carbohydrates

b. Fats

c. Proteins

d. Vitamins

e. Minerals

f. Water

d. Vitamins

Which of the following nutrients for overall health has no caloric value but is used to build tissue and regulate metabolism?

a. Carbohydrates

b. Fats

c. Proteins

d. Vitamins

e. Minerals

f. Water

e. Minerals

Which of the following nutrients for overall health is the most essential nutrient?

Hint: it influences food digestion, metabolism, regulates body temp, and is a carrier for all electrolytes

a. Carbohydrates

b. Fats

c. Proteins

d. Vitamins

e. Minerals

f. Water

f. Water

True or false: Simple sugars (mono/di/tri) have calories with sufficient nutrients to our diet and supplies energy as glucose!

False!

Simple sugars → little to no nutrients in diet

Example: table sugar, brown sugar, dextrose, honey, milk

COMPLEX CARBS (Starches/Poly) supplies energy as GLUCOSE

Example: flour, bread, rice, corn, oats

Dietary fiber is a ____ ______ carb from plant food not digested by enzymes in the small intestine. Recommended intake is 14 g/1000 cal

non-starch

• decrease risk of coronary ❤ disease and lowers diabetes

• Examples: navy beans, lentils, oats, citrus fruits, strawberries, barley, carrots

Which kind of fatty acid is is liquid in room temp, is healthier (↓ amount of newly formed cholesterol and help lower blood cholesterol lvls) and should represent 10-20% of total daily caloric intake?

a. unsaturated (mono/poly)

b. saturated

c. cis/trans

d. cholesterol

a. unsaturated (mono/poly)

Examples: canola, olive, peanut oils, avocados, sunflower, sesame, soybeans, nuts, seeds

Which kind of fatty acid is solid in room temp and ↑ in total and LDL cholesterol? It should represents <10% of total calories

a. unsaturated (mono/poly)

b. saturated

c. cis/trans

d. cholesterol

b. saturated

Examples: beef, lamb, pork, poultry fat, butter, cream, milk, coconut oil, cocoa butter

What kind of fatty acid ↑ risk for coronary <3 disease?

a. unsaturated (mono/poly)

b. saturated

c. cis/trans

d. cholesterol

b. saturated

c. cis/trans

• Example for cis/trans: shortenings, butter, animal fat, cakes, cookies, salty snacks, cake frostings, sweets

d. cholesterol

What kind of fatty acid is not an essential nutrient and should be <300mg/day? It is a fat-like substance found in animals

a. unsaturated (mono/poly)

b. saturated

c. cis/trans

d. cholesterol

d. cholesterol

Examples: Meat (especially organ meats), poultry, seafood, dairy products, egg yolks

True or false: Proteins not only provide essential AAs and are structural bases for tissues, but they also regulate metabolism!

True!

Examples: peanuts, soybeans, milk, yogurt, cheese, eggs, beef, chicken, turkey, salmon, veal, lamb, wheat bread

What are examples of antioxidants?

a. 8 B-Complex vitamins and Vitamin C (ascorbic acid)

b. Vitamins A, D, E, K

c. Vitamins E, C, beta carotene

c. Vitamins E, C, beta carotene

What are examples of fat soluble vitamins?

a. 8 B-Complex vitamins and Vitamin C (ascorbic acid)

b. Vitamins A, D, E, K

c. Vitamins E, C, beta carotene

b. Vitamins A, D, E, K

What are examples of water-soluble vitamins?

a. 8 B-Complex vitamins and Vitamin C (ascorbic acid)

b. Vitamins A, D, E, K

c. Vitamins E, C, beta carotene

a. 8 B-Complex vitamins and Vitamin C (ascorbic acid)

True or False: The recommended intake for water intake for males > 19 yo: 2.7 L/day

females > 19 yo: 3.7L/day

False!

Males (>19 yo) → 3.7L/day

Females (>19 yo) → 2.7 L/day

• Before exercise (2hrs) → 17 fl oz

Healthy Eating Recommendations in the American Heart Association Dietary Guidance

1. Adjust ____intake & expenditure to achieve & maintain a healthy ______

energy, body weight

Healthy Eating Recommendations in the American Heart Association Dietary Guidance

2. Eat plenty of fruits & veggies, choose a wide variety

• Whole fruits/veggies have more _____

True or False: Lighter colored fruits/veggies are more nutrient dense than darker.

dietary fiber

False → darker color are more nutrient dense

Healthy Eating Recommendations in the American Heart Association Dietary Guidance

3. Choose foods mostly made w/ ____ grains (rather than ____ )

• Whole grain products = have at least 51% whole grains

whole, refined

Healthy Eating Recommendations in the American Heart Association Dietary Guidance

4. Choose healthy sources of protein

• Mostly protein from ____ (legumes & nuts)

• fish, seafood

• Meat/poultry → lean cut, avoid processed

• low-fat/fat-free

plants

Healthy Eating Recommendations in the American Heart Association Dietary Guidance

5. Use liquid ____ oils rather than _____ oils (coconut, palm, palm kernel)

liquid, tropical

Healthy Eating Recommendations in the American Heart Association Dietary Guidance

6. Choose minimally ______ foods

Unprocessed or processed?

Processed

• Greater risk of DM2, incident CVD, all-cause mortality

Healthy Eating Recommendations in the American Heart Association Dietary Guidance

7. Minimize intake of beverages & foods w/ ____ sugars

Examples: glucose, dextrose, sucrose, corn syrup, honey, maple syrup

added sugars

• any sugar added to food/beverage during preparation

Healthy Eating Recommendations in the American Heart Association Dietary Guidance

8. Choose and prepare foods w/ little or no salt

True or False: There is a direct (+) relationship between salt (NaCl) intake & blood pressure

True!

Leading salt of dietary sodium → processed foods, outside-prepared foods, packaged foods

Healthy Eating Recommendations in the American Heart Association Dietary Guidance

9. If you dont drink alcohol → do not start

   If you choose to drink → limit intake

   Women drink up to ___ drink/day; Men drink up to 2 drinks/day

1 drink/day

Drink

• 12 oz beer

• 5 oz wine

• 1.5 oz hard liquor

Healthy Eating Recommendations in the American Heart Association Dietary Guidance

10. True or False: Adhere to guidance regardless of where food is prepared or consumed

True!

• Food-based dietary guidance applies to all foods and beverages, regardless of where prepared, procured, and consumed

What is the active ingredient in Alli?

Orlistat

What is the indication for Alli? What should you remember when taking the medication? (Hint: diet)

Weight-loss in overweight adults

• Used along with a reduced-calorie and low-fat diet

What is the efficacy of Alli?

Inhibits dietary fat absorption by approx. 30%

What is the mechanism of action for Alli?

It is a reversible inhibitor of intestinal lipases

True or False: The dosing for Alli (OTC) is 60 mg PO 3x/day during or within 1 hr of a non-fat containing meal.

FALSE! Must be a fat-containing meal!

What are the important precautions to know before taking Alli? (2 precautions)

Decreases absorption of …

cyclosporine

• counseling pt: separate administration >2hrs & cyclosporine lvl monitoring

fat-soluble vitamins (ADEK) & beta-carotene absorption

• counseling pt: separate administration >2hrs

Match the key recommendation to the correct age group.

Should be physically active throughout the day to enhance growth & development

a. Preschool-Aged (3-5 yrs)

b. Children & Adolescents (6-17yrs)

c. Adults

d. Older Adults

a. Preschool-Aged (3-5 yrs)

Match the key recommendation to the correct age group.

60 minutes (1hr) or more moderate-to-vigorous physical activity daily

a. Preschool-Aged (3-5 yrs)

b. Children & Adolescents (6-17yrs)

c. Adults

d. Older Adults

b. Children & Adolescents (6-17yrs)

Match the key recommendation to the correct age group.

AVOID INACTIVITY

Aerobic Physical Activity

150-300 min (2 hr & 30 min - 5 hrs) a week; moderate-intensity

i.e. brisk walking

75-100 min (1 hr 15 min to 2 hr & 30 min) week of vigorous-intensity

i.e. jogging or running

a. Preschool-Aged (3-5 yrs)

b. Children & Adolescents (6-17yrs)

c. Adults

d. Older Adults

c. Adults

Match the key recommendation to the correct age group.

do multicomponent physical activity that includes balance training as well as aerobic and muscle-strengthening activities

cannot do 150 minutes of moderate-intensity aerobic activity a week because of chronic conditions, they should be as physically active as their abilities and conditions allow

a. Preschool-Aged (3-5 yrs)

b. Children & Adolescents (6-17yrs)

c. Adults

d. Older Adults

d. Older Adults

Which of the following is not a component of physical activity?

a. Warm-up

b. Cool-down

c. Aerobic conditioning

d. Resistance training

e. Stretching

f. None of the above

f. None of the above

What are the tips when stretching joints?

Slow movements for 10-30secs

No pain, mild discomfort

4 repetitions per muscle group for 2-3days/week

Stretch smoothly & NEVER BOUNCE!

True or False: Drinking the most preventable cause of death.

False! Smoking!

Match the key recommendation to the correct age group.

• Aerobic: most of the 60 min+/day should be moderate/vigorous intensity at least 3 days/week

• Muscle-strengthening: at least 3 days a week

• Bone-strengthening: at least 3 days a week

a. Preschool-Aged (3-5 yrs)

b. Children & Adolescents (6-17yrs)

c. Adults

d. Older Adults

b. Children & Adolescents (6-17yrs)

Match the key recommendation to the correct age group.

• = combo of moderate & vigorous intensity aerobic activity

• Spread aerobic activity throughout the week

• Add. health benefits if aerobic physical activity >300 min (5 hrs) of mod. Physical activity/week

a. Preschool-Aged (3-5 yrs)

b. Children & Adolescents (6-17yrs)

c. Adults

d. Older Adults

c. Adults

What is considered being Active?

a. Not getting physical activity beyond basic movement form daily life activities

b. Doing some mod- or vigorous-intensity physical activity but <150 minutes of mod-intensity/week or 75 minutes of vigorous-intensity physical activity

c. Doing the equivalent of 150 minutes to 300 minutes of moderate-intensity physical activity a week

d. Doing the equivalent of more than 300 minutes of moderate-intensity physical activity a week

c. Doing the equivalent of 150 minutes to 300 minutes of moderate-intensity physical activity a week

What is considered being Inactive?

a. Not getting physical activity beyond basic movement form daily life activities

b. Doing some mod- or vigorous-intensity physical activity but <150 minutes of mod-intensity/week or 75 minutes of vigorous-intensity physical activity

c. Doing the equivalent of 150 minutes to 300 minutes of moderate-intensity physical activity a week

d. Doing the equivalent of more than 300 minutes of moderate-intensity physical activity a week

a. Not getting physical activity beyond basic movement form daily life activities

What is considered being Insufficiently Active?

a. Not getting physical activity beyond basic movement form daily life activities

b. Doing some mod- or vigorous-intensity physical activity but <150 minutes of mod-intensity/week or 75 minutes of vigorous-intensity physical activity

c. Doing the equivalent of 150 minutes to 300 minutes of moderate-intensity physical activity a week

d. Doing the equivalent of more than 300 minutes of moderate-intensity physical activity a week

b. Doing some mod- or vigorous-intensity physical activity but <150 minutes of mod-intensity/week or 75 minutes of vigorous-intensity physical activity

What is considered being Highly Active?

a. Not getting physical activity beyond basic movement form daily life activities

b. Doing some mod- or vigorous-intensity physical activity but <150 minutes of mod-intensity/week or 75 minutes of vigorous-intensity physical activity

c. Doing the equivalent of 150 minutes to 300 minutes of moderate-intensity physical activity a week

d. Doing the equivalent of more than 300 minutes of moderate-intensity physical activity a week

d. Doing the equivalent of more than 300 minutes of moderate-intensity physical activity a week