ABFM HEALTH COUNSELING AND PREVENTIVE CARE
h h h h h
ABFM HEALTH COUNSELING A
h h h
ND PREVENTIVE CARE
h h h
1h/h106
, ABFM HEALTH COUNSELING AND PREVENTIVE CARE
h h h h h
1. You are counseling a 45-year-old male with elevated LDL-
h h h h h h h h h
cholesterol. When discussing dietary changes to promote healthy lipid levels,
h h h h h h h h h h
which one of the following would be accurate advice?
h h h h h h h h
He should minimize his consumption of nuts
h h h h h h
The Dietary Approaches to Stop Hypertension (DASH) diet recommended for
h h h h h h h h h h
reducing hypertension will help lower his LDL-
h h h h h h
cholesterol level Saturated fats should comprise 15% or less of his caloric
h h h h h h h h h h h h
intake
He should aim for a fiber intake of 25 g daily
h h h h h h h h h h
He should record what he has eaten in a food diary at the end of each day: B
h h h h h h h h h h h h h h h h h
In 2013, the American Heart Association (AHA) issued lifestyle management guidelin
h h h h h h h h h h
es designed to reduce cardiovascular risk. For adult patients with elevated LDL-
h h h h h h h h h h h
cholesterol levels the AHA advises following diet plans such as the Dietary
h h h h h h h h h h h h
Approaches to Stop Hypertension (DASH) diet, the AHA diet, or the USDA Food Patt
h h h h h h h h h h h h h
ern. The AHA specifically recommends reducing the percentage of calories from satu
h h h h h h h h h h h
rated fat, aiming for a goal of 6%-
h h h h h h h
2h/h106
, ABFM HEALTH COUNSELING AND PREVENTIVE CARE
h h h h h
7% of calories from this source. The AHA also recommends a diet that emphasizes th
h h h h h h h h h h h h h h
e consumption of fruits, vegetables, and whole grains, and which includes fish, poultr
h h h h h h h h h h h h
y, low- h
fat dairy products, legumes, nontropical vegetable oils, and nuts. Consumption of red
h h h h h h h h h h h
meat, sweets, and sugar-
h h h h
sweetened beverages should be discouraged.Although dietary fiber has been shown
h h h h h h h h h
to have several beneficial health effects, the average daily intake for most Americans
h h h h h h h h h h h h h
is 15 g daily, which is much lower than the recommended amount. The recommende
h h h h h h h h h h h h h h
d daily fiber intake for males age 14-
h h h h h h h
50 is 38 g daily. For other populations the recommended amount is lower, and varies
h h h h h h h h h h h h h h h
according to age and sex. Several randomized, controlled trials have shown a reducti
h h h h h h h h h h h h
on of LDL- h h
cholesterol with higher fiber consumption. A food diary is an important aspect of dieta
h h h h h h h h h h h h h
ry behavior change but it is most accurate if entries are made immediately after food i
h h h h h h h h h h h h h h h
s consumed.
h
2. A 24-year-old female sees you for a preconception visit and removal of her
h h h h h h h h h h h h h h
IUD. This will be her first pregnancy and she tells you that she has smoked ¼-
h h h h h h h h h h h h h h h
½ pack of cigarettes a day for the past 5 years.Which one of the following would
h h h h h h h h h h h h h h h
be appropriate advice regarding the risks from smoking?
h h h h h h h
3h/h106
, ABFM HEALTH COUNSELING AND PREVENTIVE CARE
h h h h h
Smoking during pregnancy increases the risk of attention-
h h h h h h h
deficit/hyperactivity disorder h
Smoking during pregnancy increases the risk of clubfoot
h h h h h h h
Smoking during pregnancy increases the risk of congenital atrial septal defect
h h h h h h h h h h
s
Stopping smoking now will reduce the increased risk of orofacial defects in he
h h h h h h h h h h h h
r infant h
Reducing smoking now will reduce the risk of preterm delivery: D
h h h h h h h h h h
There are many reproductive problems related to smoking, including conception dela
h h h h h h h h h h
y and both primary and secondary infertility; an increased risk of ectopic pregnancy a
h h h h h h h h h h h h h
nd spontaneous abortion; an increased risk of abruption, preterm rupture of membra
h h h h h h h h h h h
nes, placenta previa, and premature delivery; and increased perinatal morbidity and
h h h h h h h h h h h
mortality, including stillbirth, low birth weight, and SIDS-
h h h h h h h
related deaths. The 2001 Surgeon General's Report on women and smoking makes i
h h h h h h h h h h h h
t clear that stopping smoking during pregnancy reduces and sometimes eliminates m
h h h h h h h h h h h
any of these consequences.Small for gestational age (SGA) infants are a dose-
h h h h h h h h h h h
dependent outcome of maternal smoking, with an odds ratio (OR) of 2.11 when wome
h h h h h h h h h h h h h
n smoke throughout pregnancy. Risks for prematurity (OR 1.15) and fetal death (OR
h h h h h h h h h h h h h
4h/h106
h h h h h
ABFM HEALTH COUNSELING A
h h h
ND PREVENTIVE CARE
h h h
1h/h106
, ABFM HEALTH COUNSELING AND PREVENTIVE CARE
h h h h h
1. You are counseling a 45-year-old male with elevated LDL-
h h h h h h h h h
cholesterol. When discussing dietary changes to promote healthy lipid levels,
h h h h h h h h h h
which one of the following would be accurate advice?
h h h h h h h h
He should minimize his consumption of nuts
h h h h h h
The Dietary Approaches to Stop Hypertension (DASH) diet recommended for
h h h h h h h h h h
reducing hypertension will help lower his LDL-
h h h h h h
cholesterol level Saturated fats should comprise 15% or less of his caloric
h h h h h h h h h h h h
intake
He should aim for a fiber intake of 25 g daily
h h h h h h h h h h
He should record what he has eaten in a food diary at the end of each day: B
h h h h h h h h h h h h h h h h h
In 2013, the American Heart Association (AHA) issued lifestyle management guidelin
h h h h h h h h h h
es designed to reduce cardiovascular risk. For adult patients with elevated LDL-
h h h h h h h h h h h
cholesterol levels the AHA advises following diet plans such as the Dietary
h h h h h h h h h h h h
Approaches to Stop Hypertension (DASH) diet, the AHA diet, or the USDA Food Patt
h h h h h h h h h h h h h
ern. The AHA specifically recommends reducing the percentage of calories from satu
h h h h h h h h h h h
rated fat, aiming for a goal of 6%-
h h h h h h h
2h/h106
, ABFM HEALTH COUNSELING AND PREVENTIVE CARE
h h h h h
7% of calories from this source. The AHA also recommends a diet that emphasizes th
h h h h h h h h h h h h h h
e consumption of fruits, vegetables, and whole grains, and which includes fish, poultr
h h h h h h h h h h h h
y, low- h
fat dairy products, legumes, nontropical vegetable oils, and nuts. Consumption of red
h h h h h h h h h h h
meat, sweets, and sugar-
h h h h
sweetened beverages should be discouraged.Although dietary fiber has been shown
h h h h h h h h h
to have several beneficial health effects, the average daily intake for most Americans
h h h h h h h h h h h h h
is 15 g daily, which is much lower than the recommended amount. The recommende
h h h h h h h h h h h h h h
d daily fiber intake for males age 14-
h h h h h h h
50 is 38 g daily. For other populations the recommended amount is lower, and varies
h h h h h h h h h h h h h h h
according to age and sex. Several randomized, controlled trials have shown a reducti
h h h h h h h h h h h h
on of LDL- h h
cholesterol with higher fiber consumption. A food diary is an important aspect of dieta
h h h h h h h h h h h h h
ry behavior change but it is most accurate if entries are made immediately after food i
h h h h h h h h h h h h h h h
s consumed.
h
2. A 24-year-old female sees you for a preconception visit and removal of her
h h h h h h h h h h h h h h
IUD. This will be her first pregnancy and she tells you that she has smoked ¼-
h h h h h h h h h h h h h h h
½ pack of cigarettes a day for the past 5 years.Which one of the following would
h h h h h h h h h h h h h h h
be appropriate advice regarding the risks from smoking?
h h h h h h h
3h/h106
, ABFM HEALTH COUNSELING AND PREVENTIVE CARE
h h h h h
Smoking during pregnancy increases the risk of attention-
h h h h h h h
deficit/hyperactivity disorder h
Smoking during pregnancy increases the risk of clubfoot
h h h h h h h
Smoking during pregnancy increases the risk of congenital atrial septal defect
h h h h h h h h h h
s
Stopping smoking now will reduce the increased risk of orofacial defects in he
h h h h h h h h h h h h
r infant h
Reducing smoking now will reduce the risk of preterm delivery: D
h h h h h h h h h h
There are many reproductive problems related to smoking, including conception dela
h h h h h h h h h h
y and both primary and secondary infertility; an increased risk of ectopic pregnancy a
h h h h h h h h h h h h h
nd spontaneous abortion; an increased risk of abruption, preterm rupture of membra
h h h h h h h h h h h
nes, placenta previa, and premature delivery; and increased perinatal morbidity and
h h h h h h h h h h h
mortality, including stillbirth, low birth weight, and SIDS-
h h h h h h h
related deaths. The 2001 Surgeon General's Report on women and smoking makes i
h h h h h h h h h h h h
t clear that stopping smoking during pregnancy reduces and sometimes eliminates m
h h h h h h h h h h h
any of these consequences.Small for gestational age (SGA) infants are a dose-
h h h h h h h h h h h
dependent outcome of maternal smoking, with an odds ratio (OR) of 2.11 when wome
h h h h h h h h h h h h h
n smoke throughout pregnancy. Risks for prematurity (OR 1.15) and fetal death (OR
h h h h h h h h h h h h h
4h/h106
