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Albumin: This major protein constituent of blood is often given to individuals who need to retain more fluid in their bloodstream, such as burn victims or patients with liver failure or extremely heavy bleeding (hemorrhage). Albumin (along with clotting factors, growth factors, and immunoglobulins) is sometimes referred to as a minor blood fraction. If you are a Jehovah's Witness, whether or not you can accept treatment with a minor blood fraction may be considered an individual "matter of conscience."

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Allogeneic blood: Blood donated from another individual, which is typically stored and then provided through a transfusion. Jehovah's Witnesses do not accept allogenic blood.

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Anemia: A condition in which an individual's blood can't supply an appropriate amount of oxygen to their organs and tissues, either due to a low volume of blood, too few red blood cells in the blood, or too little hemoglobin or iron in the red blood cells. Patients who are suffering from severe anemia are sometimes more difficult to manage, unless they are treated by a team that is very experienced in transfusion-free medicine.

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Apheresis: A process used to obtain blood components (such as platelets) from a donor. The blood is removed from the donor, the necessary cells are harvested and retained, and the donor's plasma is returned to the donor. Donated platelets are considered a major blood fraction and are not acceptable to Jehovah's Witnesses. However, "therapeutic apheresis" may be acceptable to some Jehovah's Witnesses because it is a treatment performed on the patient's own blood.

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Blood banking: This is when blood is donated by a person for their own use or a specific individual's use at a later time. It is usually done because of fear that donor blood will not be available or might have contaminants, or because the person has a rare blood type. This procedure is not "bloodless medicine" because it involves blood storage and blood transfusions.

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Blood salvage: Blood salvage procedures collect blood lost during or after surgery. A variety of methods may be used to collect blood, including suction and drainage devices. The devices that are used are sometimes called "cell savers." Those who object to blood transfusions may feel comfortable with "closed loop" blood salvage, where the blood is never stored and retains a semblance of connection to the patient at all times.

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Cautery: Deliberate surgical destruction of tissue, either because the tissue is abnormal or to seal off a bleeding area. Cautery is a method of reducing bleeding during transfusion-free surgery. It may be achieved through heat, freezing, chemical scarring, electricity, light, and ultrasonic or microwave energy.

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Cell savers: Devices that capture and hold blood during or after surgery, so that the blood can be returned to the patient.

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Clotting: The complex chain of chemical events that produces a plug (clot) at the site of bleeding. It is important for a patient undergoing transfusion-free surgery to have good clotting ability, in order to reduce bleeding/blood loss. Certain medications may interfere with clotting, such as aspirin, ibuprofen, and other nonsteroidal anti-inflammatory drugs; anticoagulants (such as Coumadin); vitamin E; and herbal preparations containing garlic or ginkgo biloba.

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Clotting factors: Chemicals that circulate in the blood and interact together to help cause blood clotting at the site of an injury.

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Coagulation: The conversion of liquid (blood) into a somewhat solid plug that can prevent further bleeding from a particular site.

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Colloidal solutions: Intravenous fluid solutions that contain water, salts, sugars, and protein. They may be given to replace the fluids, salts, and sugars that you will invariably lose during the course of surgery. Some colloidal solutions contain albumin -- a protein whose use is a matter of personal conscience for Jehovah's Witnesses.

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Cryosurgery: A surgical technique that uses extreme cold to destroy abnormal tissues in the body. It is sometimes used as a bloodless medicine technique -- by freezing tissue, bleeding is minimized.

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Crystalloid solutions: Intravenous fluid solutions that contain water, salts, and sugars. They may be given to replace the fluids, salts, and sugars that you will invariably lose during the course of surgery. Jehovah's Witnesses find cystalloid solutions such as Ringer's lactate and normal and hypertonic saline acceptable therapy.

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Donor: A person who gives blood. The donated blood may be stored and distributed to hospitals and medical centers to be given to a patient when needed (as a transfusion). When a patient receives whole blood in this way, this is considered traditional medicine -- NOT "bloodless medicine." However, donated blood may be used to harvest blood components that may be used during some bloodless procedures.

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Embolotherapy: Refers to various methods of blocking a bleeding blood vessel, preventing further blood loss. These include chemical agents that scar the inside of the blood vessel; mechanical agents that block a bleeding vessel, including metal coils and latex or silicone balloons; particles or microspheres, including gelatin foam; and injected liquid that quickly turns into a thicker gel-like or spongy mass to prevent bleeding from a vessel.

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Endoscopy: A scope that can be used to visualize the inside of the body, either through insertion into a tiny incision or by passing the scope through a body opening (such as the mouth or anus). Endoscopy is used to examine, biopsy, or surgically treat a variety of conditions. Types of endoscopy include arthroscopy (joints); bronchoscopy (bronchial tubes, lungs); colonoscopy/sigmoidoscopy (large intestine); colposcopy (vagina, cervix); gastroscopy (stomach, small intestine); laparoscopy (abdomen); and others. Endoscopy is considered a "minimally invasive" procedure, which results in reduced bleeding. It is therefore a valuable bloodless medicine technique.

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Erythropoietin: Erythropoietin is the name of a chemical normally produced by your body, primarily by your kidneys. Erythropoietin stimulates the bone marrow to produce red blood cells. Laboratory-made synthetic erythropoietin (e.g., Procrit, Epoetin alfa, Epogen, or Aranesp) may be administered prior to a bloodless surgery procedure in order to maximize your bone marrow's production of red blood cells. Other synthetic chemicals that mimic the activity of erythropoietin are in development.

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Fibrin glue: A substance made from human clotting factors. These clotting factors can be harvested from donor blood plasma or from a patient's own blood plasma. Fibrin glue can be applied to a bleeding vessel. It both blocks the vessel from bleeding and activates normal clotting/coagulation activity. Because fibrin glue is made from blood products, each individual will need to examine their own conscience to decide if its use is personally acceptable.

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Fluid expanders: Intravenous fluid solutions that are used to increase the volume of fluid in the circulating blood. The result is that when you bleed during surgery, your diluted blood contains a lower concentration of red blood cells.

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Gamma knife: A high-tech surgical tool that can be used for brain surgery. This technique utilizes a powerful and precise form of radiation to destroy tumors or abnormal blood vessels with less blood loss than a traditional scalpel.

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Harmonic scalpel: A surgical tool that uses ultrasound waves to cut tissue and seal bleeding vessels at the same time -- a helpful characteristic in transfusion-free surgery, because it helps keep blood loss to a minimum.

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Hemodilution: The process of making blood more dilute than normal. The result is that when you bleed during surgery, your diluted blood contains a lower concentration of red blood cells.

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Hemoglobin: A chemical within red blood cells that allows oxygen to be carried throughout the body.

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Hemophilia: A disease in which the blood clotting system is defective, resulting in an increased likelihood of serious bleeding after even minor injury.

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Hemorrhage: Heavy bleeding.

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Hemostasis: To stop bleeding.

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Hyperbaric: To be at higher-than-normal atmospheric pressure. Hyperbaric oxygen therapy is used in some facilities to assist bloodless medicine in certain situations. You enter a chamber and breathe pressurized oxygen, which concentrates oxygen in your blood.

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Hyperoxic: Having higher-than-normal oxygen saturation.

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Hypotensive: Having low blood pressure. Hypotensive anesthesia is a technique that lowers a patient's blood pressure below normal during surgery. Blood loss tends to be slower when your blood pressure is low. However, blood pressure must be maintained at a particular threshold to ensure that all of your body's organs and tissues are receiving blood, so the practice of hypotensive anesthesia requires great skill and extraordinarily careful monitoring.

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Intraoperative: During the course of an operation.

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Iron: A nutrient that is required by your red blood cells for good oxygen-carrying capacity. Iron is important for bloodless surgery and can be obtained from dietary sources like red meat or through supplements, such as ferrous sulfate or ferrous gluconate.

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Kidney dialysis: A procedure in which the blood is cleansed of toxins through an outside machine, replacing work that the kidneys normally do.

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Laparoscopy: A surgical technique in which a lighted scope is inserted into a tiny incision in the abdomen. Laparoscopy can be used to visualize the inside of the abdomen for diagnosis, to retrieve tissue samples for biopsy, and to perform surgery using tiny instruments that are also passed into the abdomen through tiny "keyhole" incisions. Laparoscopy is considered a "minimally invasive" procedure, which results in reduced bleeding and may therefore be valuable for bloodless treatment of some conditions.

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Laser surgery: A surgical technique that uses the energy from light to cut through tissues. It can reduce bleeding compared to traditional scalpels and may therefore be valuable for bloodless treatment of some conditions.

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Major fractions: Blood products containing plasma, red blood cells, white blood cells, and platelets. Jehovah's Witnesses do not accept major blood fractions as part of any treatment.

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Mediastinal autotransfusion: A procedure performed most commonly after heart surgery, in which the fluids (including blood) that collect in the chest during and after surgery are collected and then given back to the patient through an IV.

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Minimally invasive surgery: Procedures that use small surgical cuts and holes, or no cuts at all. These methods can greatly reduce the amount of bleeding and are therefore of great importance to bloodless medicine. An example is endoscopy, which uses scopes inserted into small cuts or body openings. Another example is lithotripsy, which uses sound waves to break up a kidney or other stone into smaller bits, allowing it to pass out of the urinary system without having created any incision at all.

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Minor fractions: Blood products containing clotting factors, albumin, growth factors, and immunoglobulins. Some Jehovah's Witnesses accept minor blood fractions as an individual "matter of conscience."

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Normothermia: Normal body temperature.

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Normovolemia: All people maintain a particular volume of fluid circulating throughout their bodies; this is referred to as "normovolemia." During surgery, you will be given balanced intravenous solutions (volume expanders) to replace the fluids, salts, and sugars that you will invariably lose during the course of surgery.

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Oximeter: A device that monitors the amount of oxygen carried by the hemoglobin in red blood cells. In bloodless medicine, any blood a patient loses is not replaced by transfusion, so it is extremely important to monitor how much oxygen the patient's body is receiving from the remaining blood.

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Plasma: The fluid component of blood, in which the various types of blood cells are suspended. Jehovah's Witnesses consider plasma to be a major blood fraction and do not consider it to be an acceptable part of treatment.

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Plasmapheresis: A type of apheresis that is used to separate plasma from blood. Blood is removed from a donor, the plasma is harvested and retained, and the donor's blood cells are returned to him or her. Plasmapheresis may also be performed on a patient's own blood as a treatment for certain conditions.

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Platelet: A component of blood responsible for blood clotting at the point of an injury to a blood vessel. Without platelets, our blood would not be able to clot and hemorrhaging or uncontrolled bleeding would result. Platelets are considered a major blood fraction and are not acceptable to Jehovah's Witnesses as part of any treatment.

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Platelet gel: A concentrate made from a patient's own blood plasma, mixed with calcium and clotting compounds produced in cows. Platelet gel concentrates can be applied during the course of surgery to control bleeding. As with fibrin glue, platelet gel concentrates are produced from plasma, so their use by some individuals is a matter of conscience.

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Primary blood components: Red cells, white cells, plasma, and platelets (also called major fractions). Jehovah's Witnesses do not accept primary blood components (major fractions) as part of any treatment.

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Procuren solution: A solution made from an individual's own blood. The growth factors in the patient's own platelets are harvested, and reproduced in a laboratory to create the procuren solution. This solution is then applied to a wound to improve healing capacity and shorten duration of healing.

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RBC nuclear scan: A test in which the individual's own red blood cells are harvested, tagged with radioactive material, and then returned to the individual. Imaging scans are then performed that will highlight areas of bleeding, because the tagged red blood cells will be seen leaking from these areas.

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Scalpel: Originally, a scalpel was a very sharp, small knife used to perform surgery. Now a scalpel can use a variety of energy sources to cut through tissue, including light (laser scalpel), microwaves (microwave-coagulating scalpel), ultrasonic energy (ultrasonic and harmonic scalpels), and radiation (gamma knife).

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Stereotactic/Stereotaxic: A technique for locating the exact area needing treatment by using advanced imaging techniques that verify the three-dimensional coordinates of the abnormal area. By pinpointing the exact area, the surgeon can minimize the amount of cutting (and hence bleeding) that occurs during surgery.

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Transfusion: The delivery of blood products to an individual to replace blood that is lost during surgery or from injury. The blood or blood products are usually donated anonymously or through blood banking, then stored until the time they are needed. At that point, the blood products are administered through an intravenous (IV) line into a patient's vein. A blood transfusion is what bloodless medicine seeks to avoid.

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Ventilation: To provide a patient with oxygen.

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WBC nuclear scan: A test in which an individual's own white blood cells are harvested, tagged with radioactive material, and then returned to the individual. Imaging scans are then performed that will highlight areas of infection, because the tagged white blood cells will migrate to these areas.

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Adipose tissue: Fat tissue in the body.

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Bariatric surgery: Surgery on the stomach and intestines to help the patient with extreme obesity lose weight. Bariatric surgery is a weight-loss method used for people who have a body mass index (BMI) above 40. Surgery may also be an option for people with a BMI between 35 and 40 who have health problems like heart disease or type 2 diabetes.

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Bioelectrical impedance analysis (BIA) : A way to estimate the amount of body weight that is fat and nonfat. Nonfat weight comes from bone, muscle, body water, organs, and other body tissues. BIA works by measuring how difficult it is for a harmless electrical current to move through the body. The more fat a person has, the harder it is for electricity to flow through the body. The less fat a person has, the easier it is for electricity to flow through the body. By measuring the flow of electricity, one can estimate body fat percent.

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Body mass index (BMI): A measure of body weight relative to height. BMI can be used to determine if people are at a healthy weight, overweight, or obese. A body mass index (BMI) of 18.5 - 25 refers to a healthy weight, a BMI of 25 - 30 refers to overweight. A BMI of 30 or higher refers to obese.

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Calorie: A unit of energy in food. Foods have carbohydrates, proteins, and fats. Some beverages have alcohol. Carbohydrates have 4 calories per gram. Proteins have 4 calories per gram. Alcohol has 7 calories per gram. Fat has 9 calories per gram.

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Carbohydrate: A major source of energy in the diet. There are two kinds of carbohydrates -- simple carbohydrates and complex carbohydrates. Simple carbohydrates are sugars and complex carbohydrates include both starches and fiber. Carbohydrates have 4 calories per gram. They are found naturally in foods such as breads, cereals, fruits, vegetables, and dairy products. Foods such as sugar cereals, soft drinks, fruit drinks, fruit punch, lemonade, cakes, cookies, pies, ice cream, and candy are very rich in sugars.

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Diet: What a person eats and drinks. Any type of eating plan.

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Energy expenditure: The amount of energy, measured in calories, that a person uses. Calories are used by people to breathe, circulate blood, digest food, and be physically active.

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Fat: A major source of energy in the diet. All food fats have 9 calories per gram. Fat helps the body absorb fat-soluble vitamins, such as vitamins A, D, E, and K, and carotenoids. Some kinds of fats, especially saturated fats, may cause blood cholesterol to increase and increase the risk for heart disease. Other fats, such as unsaturated fats, do not increase blood cholesterol. Fats that are in foods are combinations of monounsaturated, polyunsaturated, and saturated fatty acids.

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HDL: See high-density lipoprotein.

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Healthy weight: Compared to overweight or obese, a body weight that is less likely to be linked with any weight-related health problems such as type 2 diabetes, heart disease, high blood pressure, high blood cholesterol, or others. A body mass index (BMI) of 18.5 - 25 refers to a healthy weight, though not all individuals with a BMI in this range may be at a healthy level of body fat; they may have more body fat tissue and less muscle. A BMI of 25 - 30 refers to overweight, and a BMI of 30 or higher refers to obese.

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High blood pressure: Another word for "hypertension." Blood pressure rises and falls throughout the day. An optimal blood pressure is less than 120/80 mmHg. When blood pressure stays high, greater than or equal to 140/90 mmHg, then it is considered high blood pressure. High blood pressure increases the risk for heart disease and stroke.

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High-density lipoprotein (HDL): A form of cholesterol that circulates in the blood. Commonly called "good" cholesterol. High HDL lowers the risk of heart disease. An HDL of 60 mg/dl or greater is considered high and is protective against heart disease. An HDL less than 40 mg/dl is considered low and increases the risk for developing heart disease.

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Hydrogenation: A chemical way to turn liquid fat (oil) into solid fat. This process creates a new fat called trans fatty acids. Trans fatty acids are found in margarine, shortening, and some commercial baked foods like cookies, crackers, muffins, and cereals. Eating a large amount of trans fatty acids may raise heart disease risk.

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Kcal: The abbreviation for "Kilocalories," a unit of energy. This is equivalent to the unit of energy known as a Calorie (which is generally not capitalized in common usage).

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LDL: See low-density lipoprotein.

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Lipoprotein: Compounds of protein that carry fats and fat-like substances, such as cholesterol, in the blood.

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Low-density lipoprotein (LDL): A form of cholesterol that circulates in the blood. Commonly called "bad" cholesterol. High LDL increases the risk of heart disease. An LDL less than 100 mg/dl is considered optimal, 100 - 129 mg/dl is considered near or above optimal, 130 - 159 mg/dl is considered borderline high, 160 - 189 mg/dl is considered high, and 190 mg/dl or greater is considered very high.

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Metabolism: All of the processes that occur in the body that turn the food you eat into energy your body can use.

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Monounsaturated fat: Fats that are in foods are combinations of monounsaturated, polyunsaturated, and saturated fatty acids. Monounsaturated fat is found in canola oil, olives and olive oil, nuts, seeds, and avocados. Eating food that has more monounsaturated fat instead of saturated fat may help lower cholesterol and reduce heart disease risk. However, it has the same number of calories as other types of fat, and may still contribute to weight gain if eaten in excess.

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Obesity: Having a high amount of body fat. A person is considered obese if he or she has a body mass index (BMI) of 30 or greater.

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Overweight: Being too heavy for one's height. It is defined as a body mass index (BMI) of 25 - 30. Body weight comes from fat, muscle, bone, and body water. Overweight does not always mean over fat.

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Percent body fat: A measurement of how much of your body weight is due to fat versus muscle and other tissues. Percent body fat can be a good indicator of how overweight you are and the potential impact of your weight on your health. However, there is no easy way to measure this at home. For most purposes, other methods like body mass index, waist circumference, and waist-to-hip ratio are sufficient for determining whether you are overweight. Percent body fat can be determined with calipers that measure a fold of skin, water displacement, or bioelectrical impedance analysis (BIA).

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Physical activity: Any form of exercise or movement. Physical activity may include planned activity such as walking, running, basketball, or other sports. Physical activity may also include other daily activities such as household chores, yard work, walking the dog, etc.

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Polyunsaturated fat: A highly unsaturated fat that is liquid at room temperature. Fats that are in foods are combinations of monounsaturated, polyunsaturated, and saturated fatty acids. Polyunsaturated fats are found in greatest amounts in corn, soybean, and safflower oils, and many types of nuts. They have the same number of calories as other types of fat, and may still contribute to weight gain if eaten in excess.

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Protein: One of the three nutrients that provides calories to the body. Protein is an essential nutrient that helps build many parts of the body, including muscle, bone, skin, and blood. Protein provides 4 calories per gram and is found in foods like meat, fish, poultry, eggs, dairy products, beans, nuts, and tofu.

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Registered Dietitian (R.D.): A health professional who is a food and nutrition expert. A person who has studied diet and nutrition at an American Dietetic Association (ADA) approved college program and passed an exam to become a registered dietitian.

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Saturated fat: A fat that is solid at room temperature. Fats that are in foods are combinations of monounsaturated, polyunsaturated, and saturated fatty acids. Saturated fat is found in high-fat dairy products (like cheese, whole milk, cream, butter, and regular ice cream), fatty fresh and processed meats, the skin and fat of chicken and turkey, lard, palm oil, and coconut oil. They have the same number of calories as other types of fat, and may contribute to weight gain if eaten in excess. Eating a diet high in saturated fat also raises blood cholesterol and risk of heart disease.

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Trans fatty acids: A fat that is produced when liquid fat (oil) is turned into solid fat through a chemical process called hydrogenation. Eating a large amount of trans fatty acids also raises blood cholesterol and risk of heart disease.

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Underwater weighing: A research method for estimating body fat. A person is placed in a tank, underwater, and weighed. By comparing weight underwater with weight on land, one can get a very good measure of body fat.

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Unsaturated fat: A fat that is liquid at room temperature. Vegetable oils are unsaturated fats. Unsaturated fats include polyunsaturated fats and monounsaturated fats. They include most nuts, olives, avocados, and fatty fish, like salmon.

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Very-low calorie diet: A person following a VLCD eats or drinks a commercially prepared formula that has 800 calories or less, instead of eating food. A VLCD can allow a person to lose weight more quickly than is usually possible with low-calorie diets, but should only be used under the supervision of a health care provider.

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Waist circumference: A measurement of the waist. Fat around the waist increases the risk of obesity-related health problems. Women with a waist measurement of more than 35 inches or men with a waist measurement of more than 40 inches have a higher risk of developing obesity-related health problems, such as diabetes, high blood pressure, and heart disease.

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Weight control: Achieving and maintaining a healthy weight by eating well and getting regular physical activity.

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Yo-yo dieting: Losing and gaining weight over and over again.

 

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Review Date: 4/17/2007

Reviewed By: Patrika Tsai, M.D., M.P.H., Assistant Clinical Professor, Pediatric Gastroenterology, Hepatology and Nutrition, University of California, San Francisco, San Francisco, CA. Review provided by VeriMed Healthcare Network.


The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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