Therapeutics Nutrition and Obesity

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1 in ___ adults is obese and 1 in ___ children is obese.

3, 6

___ and ___ females have the highest prevalence of obesity.

African-American, Mexican American

___ or ____ can increase or decrease eating.

Biogenic amines, neuropeptides

What are some diseases that can secondarily cause obesity?

hypothyroidism, Cushing's syndrome, insulinoma, hypothalmic disorders

Food gives energy in the form of ___, which is a measure of heat.

kilocalories

___ are found in carbohydrates, fat, protein, and alcohol.

Calories

___ is the rate at which energy is used in the body.

Metabolic rate

The ___ is energy used by the body to absorb, transport, store, and metabolize food.

thermogenic effect

The ___ is the energy required to complete cellular processes in the body to sustain normal physiologic activity.

basal metabolic rate

EER (male >19 years) = ___

662 - (9.53 x age) + PA [15.9 x weight + 540 x height]

EER (female >19 years) = ___

354 - (6.91 x age) + PA[9.36 x weight + 726 x height]

You want to use BMI in conjunction with waist circumference, especially if BMI is <___ kg/m2.

35

You measure the waist circumference at the ___ (beginning, end) of expiration.

end

Goal of WC for men is <___ inches and for women is <___ inches.

40, 35

A patient with metabolic syndrome will have increased risk for ___ and/or ___.

ASCVD, DM 2

Risk factors for metabolic syndrome include ___, ___, ___, ___, and ___.

waist circumference, triglycerides, HDL, HTN, fasting glucose

The waist circumference must be >___ inches for men and >___ inches for women.

40, 35

The triglycerides must be at or above ___ mg/dL or on lipid medications.

150

A low HDL is <___ mg/dL for men and <___ mg/dL for women.

40, 50

HTN must be at or above ___/___ mmHg or on HTN medications.

130, 85

Elevated fasting glucose must be at or above ___ mg/dL or on DM medications.

100

Carbohydrates should comprise about ___% of the diet.

50-60

Carbohydrates contain ___ calories per gram.

4

___ include glucose, fructose, and galactose.

Monosaccharides

___ include sucrose, lactose, and maltose.

Disaccharides

___ are sweeteners for food.

Trisaccharides

The storage form of carbohydrates is ___.

glycogen

___ (Insoluble, Soluble) fiber prolongs stomach emptying and thus glucose is absorbed slower and binds with fatty acids.

Soluble

___ (Insoluble, Soluble) fiber adds bulk and regulates pH.

Insoluble

For patients with diabetes, 1 carbohydrate choice = ___ grams.

15

You should generally have ___ carbohydrate choices per meal and ___ per snack.

2-5, 1-2

Protein should comprise ___% of the diet.

15

Protein contains ___ calories per gram.

4

Proteins are two or more ___ linked together.

amino acids

Humans cannot make ___ amino acids that are essential to obtain in the diet.

9

Fats should comprise ___% of the diet.

20-35

Fats contain ___ calories per gram.

9

Fats can serve as a ___ source.

energy

Saturated fat should comprise <___% of caloric intake, is usually ___ (liquid, solid) at room temperature, and increases ___ and ___ cholesterol.

7, solid, total, LDL

Polyunsaturated fatty acids are ___ (liquid, solid) at room temperature and ___ (liquid, solid) when stored in the fridge.

liquid, liquid

Monounsaturated fatty acids are ___ (liquid, solid) at room temperature and ___ (liquid, solid) when stored in the fridge.

liquid, solid

Trans fatty acids should comprise <___% of caloric intake.

0.5

Trans fatty acids increase ___ cholesterol and decrease ___ cholesterol.

LDL, HDL

A patient should consume <___ mg/day of cholesterol, and essentially <___mg/day if they have diabetes or cardiovascular risk factors.

300, 200

Cholesterol is naturally produced in the ___.

liver

Cholesterol increases ___ and ___ cholesterol.

total, LDL

Alcohol contains ___ calories per gram.

7

Most alcoholic drinks are high in ___ and ___.

carbohydrates, calories

The fat-soluble vitamins are ___.

A, D, E, K

The water-soluble vitamins are ___.

B, C

People older than 50 years should consume vitamin ___.

B12

Women of childbearing age should consume at least ___ mcg of folate.

400

It is recommended to consume <___ mg of sodium per day.

1500

It is recommended to consume at least ___ mg per day of potassium.

4700

It is recomended to consume ___ mg of calcium per day.

700-1500

___ is not currently considering change.

Pre-contemplation

___ is ambivalent about change.

Contemplation

___ is testing the waters.

Preparation

___ is practicing new behavior.

Action

___ is sustaining new behavior.

Maintenance

___ is resumption of old behavior.

Relapse

Set an initial goal to decrease body weight by ___% from baseline over ___ months.

10, 6

Generally, do not lose more than ___ pounds per week.

1-2

Determine the EER then decrease the caloric intake by ___ calories per day.

500

1 teaspoon salt = ___ mg

2400

The TLC diet recommends consuming ___ grams of dietary fiber per day.

20-35

The TLC diet recommends consuming ___ grams of soluble fiber per day.

10-25

The TLC diet recommends consuming ___ grams of plant stanols per day.

2

The TLC diet recommends expending at least ___ kilocalories per day of physical activity.

200

It is recommended to take part in at least ___ minutes of moderate intensity activity per week.

150

Pharmacological therapy is indicated for patients with a BMI equal to or greater than ___ kg/m2 or a BMI equal to or greater than ___ kg/m2 in the presence of other risk factors.

30, 27

An example of a noradrenergic/serotonergic agent is ___.

phentermine

The MOA for noradrenergic/serotonergic agents is enhanced ___ and ___ neurotransmission.

NE, dopamine

Noradrenergic/serotonergic agents have ___, ___, and ___ adverse effects.

cardiovascular, CNS, GI

You administer noradrenergic/serotonergic agents orally ___, usually ___ hour prior to breakfast.

daily, 1

Noradrenergic/serotonergic agents are indicated for ___ (long, short) term use, about ___ weeks.

short, 12

Is weight regain common?

Yes

An example of a lipase inhibitor is ___.

orlistat

The MOA of a lipase inhibitor is that it inhibits digestive ___, reduces dietary fat absorption by ___%, with minimal systemic absorption.

lipases, 30

Lipase inhibitors are contraindicated in ___ syndromes or ___.

malabsorption, cholestasis

The dosing of Xenical is one ___ mg capsule ___ with meals.

120, TID

The dosing of Alli is one ___ mg capsule ___ with meals.

60, TID

Alli use suggests limiting fat intake to ___ grams per meal.

15

Xenical is approved for equal to or greater than ___ years.

12

There are ___-soluble vitamin issues, so it is important to take a ___ ___ hours before or after lipase inhibitors.

fat, MVI, 2

Ephedra and MaHuang caused ___ effects.

CV

Caffeine may cause ___ or ___.

tachycardia, HTN

Surgery is indicated for patients with a BMI equal to or greater than ___ kg/m2 or equal to or greater than ___ kg/m2 with comorbidities.

40, 35

Significant morbidity issues include ___, ___, and ___.

malabsorption, DVT, infection

___ restricts gastric volume.

Vertical banded gastroplasty

___ limits food intake and alters digestion.

Gastric bypass

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