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Chronic Obesity and Disease Exam 1
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Terms in this set (76)
Underweight BMI
<18.5
Normal BMI
18.5-24.9
Overweight BMI
25-29.9
Obesity BMI Class I
30.0-34.9
Obesity BMI Class II
35-39.9
Obesity BMI Class III
>40
What is the relationship between BMI and relative risk of death due to heart disease?
The higher the BMI the greater the risk of death due to heart disease
What are the most recent prevalence rates of overweight and obesity in the US?
Total: 9.2%
Women: 11.5%
Men: 6.9%
What are the geographical trends in obesity?
The South is more obese, the west is less
What populations are at a greater risk of obesity geographically?
The south
- food
- driving everywhere
- Hot weather (not wanting to exercise)
- generally lower economic classes
What is the general relationship between BMI, dyslipidemia, hypertension, diabetes?
As BMI goes up, you're at an increased risk for all diseases
What is heart disease?
any disease that affects the heart
What is Cardiovascular disease?
Any disease that affects the whole cardiovascular system
What is Arteriosclerosis?
The natural hardening of the arteries with age
What is atherosclerosis?
A form of arteriosclerosis where there is a buildup of plaque along the inner lining of the artery wall
How does atherosclerosis begin?
- Damage to the endothelial lining of the artery
- Inflammatory response to the damage
- Lipid deposition in damaged areas
What are the effects of LDL on the atherosclerotic process?
LDL becomes oxidized and then attracts monocytes, which then change into macrophages to inject the LDL's
After injecting the LDL's the macrophages transform into foam cells and real ease growth factors that accumulate to form fatty streaks
What are the effects of HDL on the atherosclerotic process?
HDL's remove the cholesterol from the foam cells by inhibiting the oxidation of the LDL's
What are the effects of physical activity on lipid levels?
It lowers triglycerides and helps with slow/stop the progressions of dyslipidemia
Exercise reverses the cholesterol transport
What is normal blood pressure?
less than 120/80
What is elevated blood pressure?
120-129/<80
What is stage 1 Hypertension?
130-139 or 80-89
What is stage 2 hypertension?
140/90
What acute response to physical activity does blood pressure have?
SBP is usually down following aerobic exercise and may remind below pre-exercise values for up to 24 hours
Done 5-7 mmHg
What chronic response to physical activity does blood pressure have?
Lowers resting blood pressure and lower blood pressure response to a given sub maximal exercise intensity
Down 2.4-3.4 mmHg
What is the role of Renin-Angiotensin-Aldosterone system in BP regulation?
RAS increases blood solute and vasoconstriction which increases peripheral resistance and cardiac output which increases blood pressure
What is the type II diabetes-diagnostic criteria?
Resting glucose of >=126 mg/dL
A1C of 6.5%
2-hour plasma glucose of >=200 mg/dL
What does hemoglobin A1C measure?
Your average blood sugar levels over the past 3 months
What should your target A1C level be?
Below 5.7%
What are the symptoms of hyperglycemia?
extreme thirst, need to urinate often, dry skin, hungry, blurry vision, drowsy, slow healing wounds
What are the symptoms of hypoglycemia?
Tachycardia, palpitations, sweating, nervousness, headache, confusion, drowsiness, fatigue. Also convulsions, coma, death.
How does insulin work in the body?
Insulin binds to respect is on muscle, fats, and other target cells. This causes Glut 4 to come to the surface of the cells and let glucose enter the cell.
What are the effects of acute exercise on diabetes
Physical activity causes increased glucose uptake into active muscle with a greater reliance on CHO to fuel muscular activity
Can bypass the process and get into glucose and can last from 2-72 hours
What are the effects of chronic exercise on diabetes?
Improve insulin action, blood glucose control, and fat oxidation and storage in muscle
Increases PA and fitness can reduce symptoms of depression and improve HRQOL in those with type II diabetes
What are the micro vascular complications of diabetes?
retinopathy, neuropathy, nephropathy
What are the macro vascular complications of diabetes?
Coronary artery disease
Peripheral vascular disease
What are the complications of Hypertension?
Major risk factor for atherosclerosis, CHD, stroke, heart failure, chronic kidney disease, and other cardiovascular conditions
How do you diagnose Metabolic Syndrome?
3 of following
Waist circumference >40 men, >35 woman
TG > 150
HDL < 40 in men, < 50 in women
BP > 130/85
Fasting Glucose > 110
Why is visceral fat bad?
Causes tissue level abnormalities that lead to systemic metabolic abnormalities
Causes organs to have to work harder
What is the relationship between obesity and insulin resistance
Adipose tissue releases increased amounts of hormones making it harder for insulin to bind to their receptors
What is the relationship between obesity and rate of lipolysis?
Obesity is associated with an increase in basal lipolysis
What is the relationship with obesity and glucose genesis?
Obesity redirects glucose metabolic flux into glycogen synthesis in adipose tissue
What is the relationship between obesity and hyperglycemia?
Obesity causes insulin to not be able to bind to it's receptors causing Glut 4 to not rise to the surface of the cell so glucose remains in the blood stream making the individual hyperglycemic
What are the primary hormones secreted by adipose tissue?
Adiponectin - promotes use to fatty acids and slows hepatic glucose production
Leptin - promotes satiety by decreasing appetite
Optimal LDL Levels
<100 mg/dL
Borderline high LDL levels
130-159 mg/dL
Desirable Total Cholesterol levels
<200 mg/dL
Borderline high total cholesterol levels
200-239 mg/dL
Low HDL levels
>40 mg/dL
High HDL levels
>60 mg/dL
How do you calculate BMI?
weight (kg) / height (m^2)
Coronary Artery Disease (CAD) Risk Factors?
smoking, hypertension, stress, physical inactivity, family history, diabetes, obesity, high cholesterol
Why do we use clinical exercise testing?
Objectively evaluate the physiology functions
What is the formula for the heart rate max method?
(220-age) X %intensity
What is the Karvonen Heart Rate reserve method?
Target HR Range = ([HRmax-HRrest] X percent intensity) + HRrest
What are the considerations for Heart Diesase?
Recent Surgery?
Medications?
Cardiac rehab?
Symptoms?
Outcome they're looking for?
What is the aerobic FITT for Heart Disease?
F: 3 d/w min
I: 40-80% HRR RPE 12-16
T: 20-60min
T: trends, Argometer, stairclimber, elliptical
What is the resistance FITT for Heart Disease?
F: 2-3 /w
I: 10-15 reps, RPE 11-13, 40-60% ORM
T: 1-3 sets of 8-10 muscle groups
T: equipment safe for patient
What is the flexibility FITT for Heart Disease?
F: >2-3 days/w
I: slight discomfort
T: 15s >4 reps
T: static or dynamic focus on major joints
What is the aerobic FITT for Heart Failure?
F: 3-5 days/wk
I: 60-80% HRR, 11-14 RPE
T: 30 min up to 60 min
T: large muscle groups (Tread, walking)
What is the resistance FITT for Heart Failure?
F: 1-2 noncon
I: 40% ORM for upper 50% OMR for lower —> 70%
T: 2 sets of 10-15 reps
T: machines
What is the Flexibility FITT for Heart Failure?
F: 2-3 days/wk
I: slight discomfort
T: 10-30 sec 2-4 reps
T: static our dynamic
Special considerations for Heart Failure?
Sudden death
Prolonged fatigue
Status can change quickly
Limited workouts
Avoid iso
Consider med
What is the primary consideration for Dyslipidemia?
Presence of other conditions likely
What is the Aerobic FITT for Dyslipidemia?
F: >5 days/wk
I: 40-75% of HRR
T: 30-60 min/day
T: prolonged (walking, cycling, swimming)
Special considerations for dyslipidemia?
High risk of cardiac insufficiency
Meds
What is the FITT for Hypertension?
F: 5-7 days/wk resistance 2-3 wk
I; moderate 40-60% HRR or 12-13 RPE
T: >30 min is continuous or in 3, 10 min sections
T: Prolonged rhythmic activities using large muscle groups
Special Considerations for Hypertension?
SBP >200
DBP >110
Medications
Precautions for Diabetes
Medications
Timing of insulin
Blood glucose levels
Previous food intake
Medications
What is the Aerobic FITT for diabetes?
F: 3-7 days/wk no more than 1 off day in a row
I: moderate to high
T: Type 1 —> 150 min, mod or 75 min vig Type 2 —> at least 150 min at mod or vig
T: large muscle groups
V: 1000->2000 kcal/week or 500-1000 met min
P: gradual
What is the Resistance FITT for Diabetes?
F: 2-3 noncon days/wk
I: moderate to vig (40-60% ORM or 70-80% ORM)
T: 3x10-15reps for 8-10 muscle groups
T: machines and free weights
V: 3 days/wk
P: slow, increasing reps and sets
What is the Flexibility FITT for diabetes?
F: 2-3 days/wk
I: point of discomfort
T: 10-30 sec 2-4 reps
T: Static, dynamic
V: progressive
Special Consideration for Obesity
Low physical work capacity
Confounding influences
Poor biomechanics
Hypertensive
Poor body awareness
What is the Aerobic FITT for obesity?
F: >5days/wk increase ADL
I: mod (40-60%)
T: 30 min/day (150 min/wk)
T: prolonged
What is the Resistance FITT for Obesity?
F: 2-3 days/wk
I: 60-70% ORM; increase
T: 2-4 sets for 8-12 muscle groups
T: machines to free weights
What is the Flexibility FITT Obesity?
F: 2-3 days/wk
I: slight discomfort
T: 10-30 sec 2-4 reps
T: static and dynamic
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