ACE Health Coach Exam Study Set

High-density lipoprotein (HDL)

"Good cholesterol". Produced in the small intestine and liver and normally contains 20-30% of the body's total cholesterol. HDL transports lipids to the liver for recycling and removal. HDL levels are inversely correlated to coronary artery disease (CAD) - meaning that the higher the level of HDL, the lower the risk of developing CAD.

Medication and hypertension

-Thiazide diuretics are the 1st drug of choice for uncomplicated hypertension. Diuretics have a lowering effect on BP, decreases volume. Vasodilators decrease TPR, increases vessel diameter. Beta blockers lower BP, decreasing HR & contractability ACE inhibitors help lower BP by decreasing both fluid vol & vascular resistance

Key Dietary Guidelines

1. Follow a healthy eating pattern across the lifespan 2. Focus on variety, nutrition density, & amount 3. Limit calories from added sugars & saturated fats & reduce sodium intake 4. Shift to healthier food & beverage choices 5. Support health eating patterns for all

If a client has low motivation to make a healthy lifestyle change, 2 approaches can be useful..

1.Encourage the client to think about how healthy lifestyle behavior ties into things he or she values 2. Collaboratively structure the lifestyle behavior to enable the client to accomplish something else that is important

How much weight does a client with diabetes need to lose in order to see an improvement in HDL cholesterol levels?

10 pounds

What percentage of the US population is estimated to have total blood cholesterol levels of 240 mg/dL or more?

12%

The effects of exercise on hypertension

150 min/week

What is the percentage of people with diabetes who have elevated depressive symptoms and depressive disorders?

25%

How much are genetics responsible for obesity?

5%

What is the percentage of Americans with diabetes?

9.40%

Sole Proprietor

A business owned & operated by 1 person. Advantages - the ease of creation & the flow-through taxation, which means that financial profits and losses flow from the business directly to the owner, and that the business itself Dows not pay any taxes Disadvantages - personal liability and the need to raise capital

Nutrition recommendation for a client who has osteoarthritis or rheumatoid arthritis?

A diet rich in omega-3 fatty acids, antioxidants, and phytochemicals

In order to conduct business as a health coach, potential registrations include -

A health coach business license A health coach business name registration A federal tax ID #

Fair Use Rule

A person may use another person's work in a very limited way, and for very limited purposes, without the creator's permission.

Stressors

A stimulus that challenges the body's homeostasis and triggers arousal. Can be physical, emotional, or psychological, and responses to the same stressor can very significantly from person to person.

Self-awareness

Ability to perceive emotion in oneself and others accurately. Individuals are able to identify their own emotions/feelings and those of others

A-B-C-D-E of uncovering unproductive thoughts

Activating the Event - Belief - Consequences - both emotional and behavioral Disputing - the negative thinking. try to replace w/ a productive thought Effect -

Dietary Reference Intakes for Vitamin D

Adults under age 50: 400 - 800 IUs daily Individuals age 50+ need a total of 800-1000 IU The safe upper limit is 4,000 IUs per day for most adults

How many adults meet the Physical Guidelines for Americans?

Approximately 1 in 5 adults

Rheumatoid Arthritis (RA)

Autoimmune disease characterized by joint swelling, swelling, pain, and stiffness that can lead to severe motion impairment. Association with an increased risk for CVD, high levels of fatigue, and depression. Can effect lungs, skin, heart, and blood vessels.

Depression is associated with -Binge eating disorder -Causing diabetes -Anxiety -Causing sleep apnea

Binge eating disorder

Hypertension

Blood pressure (BP) greater than or equal to 130/80mmHg

Fasting Plasma Glucose

Blood test that measure fasting glucose levels after an overnight fast of at least 8 hours. The test measures the amount of glucose found in the plasma. Normal - 70-99 mg/dL Prediabetes - 100-125 mg/dL Diabetes - 126 mg/dL or above

Calcium

Bone health, nerve function, blood vessel constriction & dilation, & muscle contraction. Children, adolescent girls, adult women & adults 51+ y/o are at increased risk of neg effects of insufficient intake. Sources - milk/milk products, dairy, cereals, orange juice, soy & almond milk, sardines, & mustard spinach

What are the two screening/diagnostic tests that are used to detect calcium in the coronary artieres?

CT and electron-beam CT

Osteoporosis

Characterized by low bone mass and disrupted microarchitecture. Bone mineral density (BMD) - 2.5 standard deviations or more below the mean for young adults

What is an American Cancer Society nutrition guideline for someone who has been diagnosed with cancer?

Choose whole grains instead of refined grain products

What is the most common cause of preventable death and disability?

Cigarette smoking

Classification of Functional status in Rheumatoid Arthritis

Class 1- completely able to perform usual ADL's Class 2- able to perform usual self-care & vocational activities, but limited in avocational activities Class 3- able to perform usual self-care activities, but limited in vocational & avocational activities Class 4- limited in abilities to perform usual self-care, vocational, & avocational activities

Behavioral-change Therapies

Coping-skills training CBT Family Therapy Brief behavioral interventions Self-help programs

Benefits of video-based coaching include:

Cost and time effectiveness for the coach & client. Minimial overhead coast for the coaching practice. Clients may be more at ease in an environment that is comfortable and familiar. Convenience for client & faster access to the coach when needed. Ability to see facial expressions & body language.

A checkup or graded exercise stress test may be necessary if someone is:

Currently sedentary Over 40 years old Planning to participate in vigorous activities Over 30 years old w/ any of these criteria: diabetes for more than 10 years, heart disease (family history) and high cholesterol, poor circulation in feet/legs, inconsistent mgmt of blood glucose levels, diabetic eye dz, kidney dz, numbness, burning, tingling, dizziness

What parameters have the highest correlation to cardiovascular disease?

Elevated levels of total cholesterol and LDL, as well as low levels of HDL and elevated triglycerides.

Self-regulation

Encompasses self-control and involves resisting impulsive behavior and making choices that align with one's values and vision.

Chronic elevation of triglycerides is associated with:

Endothelial dysfunction

Attributions

Explanations that people have for why things happen. Some people attribute their own behavior to the situation while attributing other's behavior to personality

What is the main reason why a client with depression, anxiety, or chronic stress should monitor his or her mood?

For the client to understand the impact of his/her lifestyle changes on mood.

Copper

Formation of red blood cells, bone growth, skin health Sources: oysters, nuts, organ meats, legumes

What is the initial goal of physical activity?

Function

What is a factor that is linked to overweight and obesity? -alcohol abuse -depression -CVD -Genetics

Genetics

What are the recommendations for those clients who suffer acute, painful flare-ups related to their arthritis during physical activity?

Gentle movement through a full range of motion is indicated

What is the reason for the decrease in the prevalence of high total cholesterol levels in adults from 18.3% to 11%?

Greater consumption of cholesterol-lowering meds.

When conducting small group sessions, what is a way to encourage openness and honesty?

Have the group develop ground rules

Shifting Perspectives

Health coaches can supports client to see lapses as soluble problems, not indicators of failure or reasons to abandon one's behavior-change efforts altogether.

A health coach's primary responsibility it to -

Help clients grow & progress toward their personalized wellness objectives by inspiring them to take charge of their own destiny & supporting them in their lifestyle and behavior-change efforts.

Cognitive Behavior Therapy (CBT)

Helps individuals become aware of thought & behavioral patterns that promote the unwanted behavior. People learn new ways of thinking & responding in high-risk situations. CBT typically addresses the immediate behavior change, as well as long-term relapse prevention.

What type of interval training is superior to moderate-intensity continuous training for patients with cardiovascular disease?

Hight-intensity interval training

When is a check-up or graded exercise necessary for a client with diabetes or prediabetes?

If the client is currently sedentary

Solid Fats

If the ingredient list contains beef fat, butter, chicken fat, coconut oil, cream, hydrogenated oils, palm kernel oils, pork fat (lard), shortening, or stick margarine, then the product contains solid fats.

Benefits of losing 10 pounds (diabetes)

Improves insulin action, lowers systemic inflammation, reduces A1C, enhances high-density lipoprotein (HDL/"good") cholesterol levels and lowers low-density liproprotein (LDL/"bad") cholesterol levels, improves metabolic efficiency, and dramatically reduces the risk of developing type 2 diabetes (in people w/ pre diabetes)

The importance of sleep

Inadequate sleep is linked to a variety of health risks, including heart disease, weight gain, depression, and dementia. In general, adults need about 7-8 hours of sleep per night & adolescents need an hour more.

Who are the best candidates to benefit from meditative therapies?

Individuals with subclinical anxiety and/or stress

What kind of exercise should be avoided by people with hypertension and cardiovascular disease?

Isometric exercise

What is the biggest advantage of remote coaching?

It can be a way for a coach to expand his or her business.

Why is physical activity an important component of lifestyle change for a person with diabetes?

It uses blood glucose independently of insulin

The AHA recommends limiting the. amount of trans fats to what percentage?

Less than 1%

How can a client w/ prediabetes reverse insulin resistance?

Lose weight

Dietary Approaches to Stop Hypertension (DASH) eating plan

Low in saturated fat, cholesterol, & total fat. Advised for those w/ hypertention. Recommends that men drink 2 or fewer & women drink 1 or fewer alcoholic beverages per day. Lowers systolic BP by about 5-6 mmHg and Diastolic BP by 3mmHg

Oral Glucose Tolerance

Measures blood glucose levels for 2-3 hours after drinking 75g of glucose. This tests the body's ability to respond effectively to a large influx of this simple sugar. Prediabetes - 2 hour value = 140 to 199 mg/dL Diabetes - >or equal to 200 mg/dL

What is a good source of potassium? -Milk products -Fish -Nuts -Whole grains

Milk products

Distress

More severe & negatie type of stress which can occur in both the short and long-term. A situation/event perceived as being outside one's coping abilities & is often marked by frustration, feeling overwhelmed, & demotivation It can result in significant psychological & physical disruption and strain, which over time can contribute to a variety of conditions

Scope of practice for Health Coaches

Open-ended questions, affirmations, reflective listening, and summarizing to help client. Support client in developing achievable & measurable goals to monitor success & motivate ongoing behavior change Empower clients to develop & leverage their strengths to support successful behavior changes

The Poetic Principle

People can choose what they work on and develop in their lives. What they focus on influences the directions they take.

Chronic stressors

Pervasive situations caused by life-changing circumstances that do not have a clear end-point in sight

What is a lifestyle factor that can affect someone's ability to get enough sleep?

Poor nutrition

Osteoarthritis (OA)

Results from overuse trauma, obesity, or the degeneration of the joint cartilage that takes place with age. A degenerative joint condition that leads to deterioration of cartilage and the development of boney growths, or spurs at the edges of joints.

The 4 Domains of Emotional Intelligence (EI)

Self-awareness Self-management Social awareness Relationship management

Intermediate Density Lipoprotein (IDL)

Somewhat similar to LDL, IDL transports a variety of triglycerides, fats, & cholesterol in the bloodstream and promotes atherogenesis. IDL are formed from the break down of VLDL.

Vegetables

Subgroups: dark green, red & orange, legumes (beans and peas), starchy, & other Dark green: highest in vitamin K Red & orange: highest in vitamin A Legumes: contain the most fiber Starchy: highest in potassium

SOAP notes

Subjective - client's feelings, experiences, or subjective complaints or symptoms Objective - actual measurements made by, or provided to, the health coach Assessment - consider both subjective & objective measure & how they inform each other. Plan - actionable steps agreed upon by the client-coach team to move forward the clients self-determined goals w/ the support of the health coach.. SMART goals

Prevalence of high cholestorol

The AHA reports that more than 28.5 mil adults (11.9%) are estimated to have total blood cholesterol levels greater than or equal to 240 mg/dL

It may be BEST to ask the client to complete which form before the initial session?

The Lifestyle and Health-History Questionnaire

Emotional Intelligence (EI)

The ability to recognize, interpret, and manage emotions in oneself and in others.

Resting energy expenditure (REE)

The amount of energy expended at rest; represents 60-75% of the body's total energy expenditure. REE is measured at rest in the morning. The energy required by your body to perform the most basic function when your body is at rest.

How can a health coach help a person with depression?

The health coach can help the client identify the barriers that depression may be causing to making lifestyle changes

General Partnership

The joining of 2 or more individuals to own and operate a business. Same advatages/disadvantages as sole proprietorship. Unlimited person liability. May also have limited partners- investors who retain no control of any management decisions, but who enjoy the benefits of limited liability only to extend of their initial investment. General partnership ends with the death of a partner, or a partner transferring his/her half w/ consent.

Very low density lipoproteins (VLDL)

The major carrier of triglycerides, which are a major form of fat that tends to be associated w/ low levels of LDL. VLDL also contains 10-15% of the body's total serum cholesterol.

What is the issue with insulin for a client with diabetes?

The pancreas does not release enough insulin or the cells are resistant to insulin

What is the rationale for a client w/ diabetes to do aerobic activity 3 to 7 days a week, and to not skip more than two days in a row?

The positive effects from the last bout of aerobic activity are lost within 24-48 hours in most cases.

What is the one reason women are more susceptible to the effects of alcohol?

The rate of alcohol breakdown is slower in women.

Addiction is not simply a function of the substance or activity in questions, as it also depends on __________________.

The reasons for the use

For anxiety to be diagnosed...

The symptoms must be severe enough to interfere with daily activities, relationships, and/or work

Given that total energy expenditure is more important to a client who is trying to lose or maintain weight, an emphasis should be placed on ________.

The total distance or time of walking or running

Whole grain

To be considered 100% whole grain, the product must contain all of the essential parts of the original kernel - bran, germ, & endosperm. Ex: brown rice, oatmeal, whole rye, wild rice, rolled oats, etc.

What is the goal of the physical activity readiness questionnaire for everyone (PAR-Q+)?

To reduce unnecessary barriers to exercise

Non-HDL Cholesterol (non-HDL)

Total cholesterol minus HDL. or the sum or the LDL, IDL, and VLDL. Strongly associated w/ the development of CVD, and non-HDL levels appear to be equal or better than LDL levels at identifying atherogenic particles.

What is a key factor related to energy balance?

Total energy intake and composition of kilocalories

Which mindfulness practice was found to cause a significant reduction in blood pressure?

Transcendental meditation

Which type of diabetes is caused by the body's immune system attacking and destroying the beta cells which produce insulin?

Type 1

Diagnostic criteria for diabetes and pre diabetes

Type 1: A1C-6.5% or higher. Fasting Plasma Glucose- > or greater than 126mg/dL. Oral Glucose- 2 hours value > or equal to 200mg/dL Type 2: A1C-6.5% or higher. Fasting Plasma Glucose- > or greater than 126mg/dL. Oral Glucose- 2 hours value > or equal to 200mg/dL Gestational Diabetes Mellitus: Fasting- >or greater 92mg/dL. Oral Glucose- (1 hour) >greater 180mg/dL (2hour) >greater 153 mg/dL Prediabetes: A1C-5.7-6.4%. Fasting- 100-125 mg/dL. Oral Glucose- (2hour) 140-199mg/dL

Unconditional Positive Regard

Unwavering acceptance

Hemoglobin A1C

Used to diagnose diabetes. Indicates avg blood glucose levels over the past 2-3 months. Prediabetes - 5.7-6.4% Diabetes - 6.5% and above

Informed consent

Utilized by a health coach to demonstrate that a client acknowledges that he or she has been specifically informed about the risks associated w/ the activity in which he/she is about to engage

Lifestyle modifications to manage hypertension

Weight reduction. Adopt DASH eating plan. Dietary sodium reduction. Physical activity. Moderation of alcohol.

When is the talk test especially useful for monitoring exercise intensity?

When a client is new to monitoring him-or herself when exercising

Impaired glucose tolerance

When blood glucose goes up or stays too high for too long after oral load

Excessive alcohol use is linked to an increased risk of

digestive problems

Resistance training

improves muscular strength & endurance. Frequency - at least 2 days per week (day of rest in between) Intensity - moderate level Time - depends on # of exercises ( ~20-30 min for full body) Type - all major muscle groups using free weights, machines, or body-weight exercises

If a client with type 2 diabetes takes an oral medication for diabetes, then the dosage:

may need to be lowered when increasing physical activity

Why is it important to have regular meetings with a client who is trying to lose weight and has CVD?

to assess how closely the client is sticking to the plan