ES340: Exam 2 Review

what is metabolic syndrome?

collection of other diseases or conditions

what is the PRIMARY treatment for overweight, obesity, dyslipidemia, and metabolic syndrome?

exercise

what chronic diseases are overweight and obesity linked to?

CVD, diabetes mellitus, forms of cancer, musculoskeletal problems

BMI range = overweight?

BMI of 25–29.9 kg · m−2

BMI range = obese?

BMI 30 kg · m−2 or greater

what range is good for sustained weight loss?

3-5% of total body weight

- reductions in triglycerides, blood glucose, and HbA1C levels

- Reducing the the risk of developing type 2

what is the weight regain average?

~30-50% of initial weight loss within one year of terminating weight loss treatment

what happens when you combine REDUCTIONS in EI and INCREASE EE?

initial 5-10% reduction in body weight

what is the best way to maximize weight loss?

COMBINATION of moderate reductions in EI with adequate levels of PA

what are the different treatments for obesity?

- diet and exercise

- drugs

- bariatric surgery

- various categories for therapy

what do drugs do for the treatment of obesity?

- promote weight loss, inhibit nutrient absorption, decrease appetite, control feelings of hunger and fullness

- watch for side effects and patient's needs

what are the diet and exercise recommendations for obesity?

- Consume nutrient-dense foods to limit energy intake but still achieve proper nutrient intake

- Participate in vigorous exercise for long duration

T/F moderate exercise alone does not typically result in significant weight loss

TRUE

what BMI range qualifies for bariatric surgery?

BMI > 40 kg · m−2

co-morbid factors and BMI > 35 kg · m−2

how do you maintain weight loss after bariatric surgery?

EXERCISE will likely facilitate the achievement and maintenance of energy balance

what are the different kinds of therapy for those who are obese?

diet, behavioral, exercise, pharmacotherapy, and surgical

suggested weight loss for BMI

- none

- consider weight gain

suggested weight loss for BMI 18.5 - 26.9

- exercise

- diet modification

- counseling

suggested weight loss for BMI 27 - 29.9

- weight loss program

- behavioral health services

- self-hep materials or programs

suggested weight loss for BMI 30 - 34.9

- weight loss program

- pharmacotherapy

- meal replacement

suggested weight loss for BMI 35 - 39.9

- very low energy diet

- residential programs

- pharmacotherapy

suggested weight loss for BMI >40

- very low energy diet

- suggest surgery

When should you keep the same or less intensive strategy for obesity treatment?

- no cardiovascular risk factors

- lower body obesity/overweight

- no previous weight loss attempts

- < 25lbs to lose or goal of less than 5-10% weight loss

when is exercise testing often unnecessary for overweight/obesity people?

if they are beginning at low-moderate intensity

T/F less than 150 min/week = minimal/modest weight lost

TRUE!

2-3 kg

T/F 225-420 min/week = significant weight loss

TRUE

5-7 kg

for maintenance of body weight, what are the aerobic exercise guidelines?

- at least 150 min/wk PA

- 30 min/d on most days of the week

- evidence supports up to 200-300 PA min/wk

what are the aerobic exercise guidelines if you want to do moderate - vigorous exercise?

- progress at least 30 min/d on most days of the week to promote long term weight maintenance

- progress to at least 250 min/wk

T/F resistance training is a big contributor to weight loss or maintenance

FALSE

- beneficial for general population

- does not typically result in significant weight loss

what is the recommended range for the weight loss phase?

3-10% of initial body weight over 3-6 months

if you want to lose 5-10% of initial body weight in 3-6 months, what should you do?

- more aggressive nutrition, exercise, and behavioral interventions

- medical treatments

T/F lifestyle modification is the least effective maintenance of weight loss

FALSE

OVERWEIGHT/OBESITY aerobic recommendations

F = ≥ 5 d/wk

I = 40-59% HRR; progress to vigorous (≥ 60%)

T = 30 min/d (150 min/wk) --> 60 min/d (250-300 min/wk)

T = Prolonged, rhythmic activities using large muscle groups

OVERWEIGHT/OBESITY resistance recommendations

F = 2–3 d/wk

I = 60-70% 1RM; gradually increase

T = 2-4 sets, 8-12 reps

T = resistance machines and/or free weights

OVERWEIGHT/OBESITY flexibility recommendations

F = ≥ 2–3 d/wk

I = point of feeling tightness or slight discomfort

T = static; 10-30s, 2-4 reps

T = static, dynamic, and/or PNF

what is dyslipidemia?

abnormal amount of lipids in the blood

- high levels of LDL; low levels of HDL

what is hyperlipidemia?

lipids are too high

what is hypercholesterolemia?

LDL-C is too high

what is hypertriglyceridemia?

triglycerides are too high

why is LDL considered harmful?

it can lead to buildup of plaque in the arteries

why is HDL considered helpful?

helps the body get rid of excess cholesterol

what are the risks of having high triglycerides in the body?

- raises the risk developing metabolic syndrome

- raises the risk of other diseases

what is the major contributing factor of dyslipdemia?

genetics

consistent aerobic exercise reduces LDL by ____

3 - 6 mm/dL

consistent resistance training reduces LDL by _____

6 - 9 mm/dL

T/F exercise can have a direct effect on cholesterol and triglycerides

TRUE

____ drugs are very effective for the treatment of dyslipidemia

statin

what are the function of statin drugs?

lower cholesterol

statin therapy consistently improves survival by preventing _____ and ______

myocardial infarction and stroke

what are the 4 most important groups of people who benefit from statins?

1. established CVD
2. LDL >190 mg/dL
3. diabetics who are >40 years old
4. estimated 10-yr risk for CVD of ≥ 7.5%

DYSLIPIDEMIA aerobic recommendations

F = ≥ 5 d/wk

I = 40-75% HRR

T = 30-60 min/d to maintain; 50-60+ daily recommended

T = Prolonged, rhythmic activities using large muscle groups

DYSLIPIDEMIA resistance recommendations

F = 2–3 d/wk

I = 50-60% 1RM --> 70-85% 1RM to improve strength

T = 2-4 sets, 8-12 reps for strength; ≤ 2 sets, 12–20 reps for endurance

T = resistance machines, free weights, body weight

DYSLIPIDEMIA flexibility recommendations

F = ≥ 2–3 d/wk

I = point of feeling tightness or slight discomfort

T = static; 10-30s, 2-4 reps

T = static, dynamic, and/or PNF

adults who are ≥ 65 and have dyslipidemia should follow what guidelines?

older adult

when should those perform intermittent aerobic bouts (dyslipidemia)

when they cannot perform 30-60min in a single bout

What is an appropriate aerobic exercise prescription for an overweight person of average fitness with high LDL-C?

60 min/d, 5 d/wk of moderate intensity cycling

what is an appropriate resistance training exercise prescription for a person with high triglycerides that wants to improve strength?

- free weights 1 day/week, 2 sets of 10 reps per exercise at 70% 1RM

- body weight exercise 2 days/week, 2 sets of 10 reps at vigorous intensity

what is metabolic syndrome (metsyn) ?

A cluster of symptoms that increase the risk for cardiovascular disease and diabetes

what are the associated risk factors of metsyn?

CVD, diabetes, strokew

characteristic of metsyn: VISCERAL OBESITY

men = ≥ 40in

female = ≥ 35in

characteristic of metsyn: HYPERTENSION

stage I and II

characteristic of metsyn: INSULIN RESISTENCE

fasting BG ≥ 100 mg/dL

characteristic of metsyn: HIGH TRIGLYCERIDES

≥ 150 mg/dL

characteristic of metsyn: LOW HDL

men

Individuals categorized as having metsyn or a when they display at least _____ of those defining characteristics.

3

what may impact the development of atherosclerosis?

1. common genetic variants

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2. environmental risk factors

what are the IDF guidelines for primary intervention for Metsyn?

* moderate restriction in energy intake to achieve a 5-10% weight loss within 1 year

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* 30min of moderate intensity PA on most days of the week

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* change in dietary intake

T/F those with METSYN are required to perform exercises testing

FALSE

if one is performed, the general recommendations can be followed with considerations for hypertension

when developing Ex Rx for Metsyn, what should you pay attention to?

the given risk factor/condition present, with the most conservative criteria used to set initial workloads

what is the initial training recommendation for those with Metsyn?

moderate intensity totalling a minimum of 150 min/wk or 30 min/d, most days of the week

what are the benefits of exercise (Metsyn)

1. INCREASED cardiorespiratory functioning
2. DECREASED risk for type 2 diabetes
3. DECREASED overall discomfort
4. Improved mood and DECREASED anxiety

what are the precautions of Metsyn?

increased risk for

* cardiac event (MI, stroke)
* debilitation joint injury/MSK condition
* hyperthermia

what are the potential barriers for Metsyn?

* Unavailability of exercise equipment to accommodate large body sizes
* Diminished physical capacity
* Lack of time
* Comorbidities

what are the macronutrient considerations for those with Metsyn?

CHO = 45-65%

PRO = 10-35%

Fat = 20-35%

what is the water recommendation? (Metsyn)

Females = 2.7 L/d

Males = 3.7 L/d

what is the target minimal reduction in body weight during the initial 3-6 months of a weight loss intervention?

3-6%

overweight and obesity are linked to all the following health issues EXCEPT?

osteoporosis

studies show that BMI correlates well with ____

risk for chronic disease

an individual with a BMI of 36 would be classified as?

obese

which of the following would be diagnosed with metabolic syndrome?

* Female with a waist circumference 33’,
* blood triglycerides 160 mg/dL
* blood pressure 130/85
* fasting blood glucose 100 mg/dL
* HDL 45 mg/dL.

which of the following is a benefit of resistance training in the obese population?

increased muscular strength and endurance

what is not a criterion for the diagnosis of metabolic syndrome in a male patient?

elevated blood pressure

what warms, moistens, and filters air?

nasal sinuses

what is NOT a known benefit of exercise for people with asthma?

decreased lung vital capacity

for people with asthma, which of the following is a special concern regarding exercise?

perform a longer cooldown after exercise

during an asthma attack …

the airways become constricted

which of these is NOT a known trigger of asthma?

UV exposure

COPD is an obstructive pulmonary disease characterized primarily by what 2 conditions?

1. emphysema
2. bronchitis

which of the following is a non-invasive measure of arterial blood oxygen levels?

SaO2

which of these is a reasonable treatment that may improve COPD symptoms?

supplemental oxygen during exercise

which of these is NOT typically addressed in pulmonary rehabilitation?

basic ambulation and movement for activities of daily living (ADLs)

with emphysema, the alveoli experience an increase in ______ which interferes with gas exhange

vasodilation or capillary permeability

which of these is an appropriate intervention for a patient with COPD?

supplemental oxygen, if prescribed, used during aerobic exercise

which of these is an appropriate aerobic training prescription for a COPD patient who is currently able to walk for about 10 min before hes dyspnea is a 7 on the CR10 scale?

intermittent walking 3 bouts of up to 10 min at an intensity that corresponds to 5 on the CR10 scale, 4 days per week

during which trimester do hormones fluctuate dramatically promoting nausea?

first

a period of relative inactivity is recommended after childbirth, however some exercise may begin withing 1 week of a normal vaginal delivery. Which of these is an appropriate exercise prescription during this time?

walking daily, 15-30min, limited by pain and vaginal bleeding

which of these statements about pregnant women and physical activity is false?

pregnant would should avoid vigorous intensity resistance training

what is diastasis recti?

separation of abdominal muscles due to expansion of the abdomen

preeclampsia is a condition characterized by?

maternal hypertension

during pregnancy, the metabolic demand increases; therfore, pregnant women who are physically active should…..

likely increase caloric intake