Nutrition Final

What are the Acceptable Macronutrient Distribution Ranges?

Carbohydrate 45-65%, Fat 20-35%, Protein 10-35%

What are the essential nutrients?

Nutrients that the body cannot make; we must eat them

Kcal/g of protein?

4

Kcal/g of carbohydrates?

4

Kcal/g of fat?

9

What are the key recommendations of Dietary Guidelines for Americans 2010?

Have healthy eating pattern that accounts for all foods and beverages within an appropriate calorie level and limiting added sugars, saturated fats, and sodium intake as well as alcohol; exercise

What are the health habits of Seventh Day Adventists (slides—not in textbook)?

Vegetarianism; regular exercise; avoid alcohol, smoking, and caffeine

What are the 4 lipoproteins?

Chylomicrons, HDL, LDL, VLDL

What is the function of chylomicrons?

Carry lipids from intestinal cells to body

What is the function of HDLs?

Carry cholesterol from body to liver

What is the function of LDLs?

Carry cholesterol from liver to body

What is the function of VLDLs?

Carry triglycerides from liver to body

What is the difference between peristalsis and segmentation?

Peristalsis is successive waves of involuntary muscle contractions along walls of GI tract that push stuff along; segmentation is periodic squeezing of the intestine by its circular muscles that both mixes and slowly pushes contents along

What does insulin do?

Brings glucose from the bloodstream into cells

What does glucagon do?

Promotes breakdown of glycogen to glucose and brings glucose from cells into bloodstream

What are the sources of soluble fibers?

Barley, legumes, fruits, oats, and veggies

What are the sources of insoluble fibers?

Fruits, veggies, and grain

What is the function of soluble fibers?

Lower risk of chronic diseases

What is the function of insoluble fibers?

Ease elimination

What are the health benefits of starch and dietary fibers?

Reduced risks of obesity, cancer, cardiovascular disease, diabetes, dental caries, GI disorders, and malnutrition

What are some sources of omega-3 fatty acids?

Mediterranean diet and olive oil, fatty fish, flax seed, chia seed, nuts, oils (canola, walnut, flaxseed, soybean), yeast

What are the effects of saturated and trans fats on LDLs?

Raise LDLs

What are the effects of polyunsaturated and monounsaturated fats on LDLs?

Lower LDLs

What are the top sources of saturated fats in US diet?

Grain-based desserts, pizza, regular cheese, and sausage, bacon, franks, and ribs

What oils do we recommend to patients for cooking?

Robust olive oil

Fats bring which important nutrients with them in the diet?

Fat-soluble vitamins and minerals (D, E, A, K)

What are complementary proteins?

Two or more proteins that together provide all the essential amino acids

What are some meals that contain complementary proteins?

Any combination of at least two of these four: legumes, seeds, grains, dairy

What are the characteristics of kwashiorkor?

Edema, bloated bellies, and reddish hair

What are the characteristics of marasmus?

"skin and bones" - loss of body fat and muscle

What is the RDA for protein for adults?

0.8g/kg/day

What are the roles of protein in the body?

Structure, enzymes, transporters, fluid and electrolyte balance, acid-base balance, antibodies, hormones, energy, glucose

What is a protein sparing diet?

Eating a diet high enough in carbs and fat to keep proteins from being used for energy

What are some examples of high-quality protein?

Meat, seafood, eggs, dairy

What occurs during feasting?

All excess energy is stored as fat

What occurs during early stages of fasting?

Glycogen stores fuel body for one day; nervous system uses exclusively glucose

What occurs during late stages of fasting?

Amino acids converted to glucose to fuel brain, ketone bodies produced, some brain cells adapt to using ketone bodies

Where do ketone bodies come from and when are they made?

The liver from fat breakdown; made when carbs are not available

What are the waist measurements for central obesity?

\>40 inches for men, >35 inches for women

What are BMIs for healthy, overweight, and obese people?

18.5-24.9, 25-29.9, 30+

What are the factors that influence BMR?

Body build, height, gender, nutritional status, age, illness, prolonged stress, smoking, caffeine, hypothyroidism, sleep

What are the three components of energy expenditure?

Physical activity, basal metabolism, thermic effect of food

What are the daily amounts from each food group for 1800 kcal diet?

1.5c fruit, 2.5c vegetables, 6oz grains, 5oz protein, 3c milk, 5tsp oils

What are some physical activity strategies for weight management?

Weight gain prevention: 150 min/week, weight loss: 250 min/week

What is the difference between appetite and hunger?

Hunger is the physiological need to eat, appetite is the desire to eat

What are some benefits of physical activity?

Improved body composition, lower disease risks, short-term increase in energy expenditure, long-term increase in BMR, appetite control, stress reduction, control of stress-eating, physical and psychological well-being, improved self-esteem

What are some behavior modification strategies for losing weight?

Keep a food and activity diary, make small changes, use positive self-talk, have a good attitude, reward yourself

What are some healthy weight maintenance habits?

See it as a lifestyle change, eat breakfast daily, one hour of exercise/day, monitor weight once/week, consistent low-kcal diet, less than 10 hours TV/week, fiber, water, realistic expectations

What four things are necessary for vitamin B12 absorption?

Intake of animal products, low stomach pH, intrinsic factor, functional ileum

What are the symptoms of vitamin B12 deficiency?

Large and immature RBCs (macrocytic anemia), weakness, SOB, pale skin (anemia), fatigue, smooth and red tongue, numbness, tingling in hands and feet, constipation, diarrhea, gas, decreased appetite, weight loss, difficulty walking, impaired balance, staggering paralysis, depression, problems concentrating, behavioral changes, memory problems, confusion, dementia

What are the sources of vitamin B12?

Animal products

Who is at risk for vitamin B12 deficiency?

Vegans, people taking meds to raise stomach pH, people who've stopped making intrinsic factor, people without a working ileum, long-term users of Metformin

What are the symptoms of vitamin A deficiency?

Infectious diseases, night blindness, blindness, keratinization

What are the sources of vitamin A?

Milk, eggs, spinach and other dark, leafy greens

What is vitamin D's function?

Mineralization of bones

What are the symptoms of vitamin D deficiency?

Rickets, osteomalacia

What are the symptoms of vitamin D toxicity?

Excess blood calcium, calcification

What are the sources of vitamin D?

Fortified milk, made in body with help of sunshine

What is vitamin C's function?

Synthesis of collagen, wound healing

What are the sources of vitamin C?

Citrus fruits, sweet red peppers, green peppers, brussels sprouts, broccoli

What vitamin might alcoholics be deficient in?

Thiamin

What is Wernicke-Korsakoff syndrome, and how does it affect glucose absorption?

Severe thiamin deficiency; thiamin necessary for glucose to enter CNS cells

What group of vitamins are necessary for energy metabolism?

B vitamins

What is the function of renin?

Eventually leads to water retention and increased BP

What is the function of aldosterone?

Causes sodium retention which leads to water retention

What is the function of ADH?

Causes kidneys to retain water

How do calcium, magnesium, and phosphorous promote bone health?

Calcium forms bone structure, and magnesium and phosphorus are also part of bones

Who is at risk for iron deficiency?

Toddlers, teenage girls, women of child-bearing age

How can we assess for iron deficiency?

Check conjunctiva for color, check for pallor, weakness, fatigue, reduced work productivity, inability to concentrate, apathy, lowered cold tolerance, spoon-shaped nails

What are the sources of iron?

Meat, poultry, fish, plant foods

What are the sources of sodium?

Cold cuts, pizza, soups, restaurant/processed foods, breads

What is sodium's function in the body?

Primary regulator of ECF volume, principal electrolyte in ECF

What are the sources of potassium?

Fresh fruits and vegetables

What is potassium's function in the body?

Maintains F&E balance and cell integrity, principal positive ion in ICF

What does iodine have to do with the thyroid?

Forms an integral part of thyroid hormones

What is cretinism?

Iodine deficiency in pregnancy leads to mental retardation of child

How does iodine impact BMR?

Iodine affects metabolism because it forms an integral part of thyroid hormones, which regulate metabolism

How is pre-pregnancy weight important to birth weight?

Birthweight correlates with pre-pregnancy weight and weight gain

What are the RDAs for kcals for pregnancy/lactation?

2nd trimester: extra 340 kcal/day, 3rd trimester: extra 450 kcal/day

What is an appropriate weight gain in pregnancy?

Healthy weight: 25-35 lbs, underweight: 28-40 lbs, overweight: 15-25 lbs, obese: 11-20 lbs

What is the RDA for folate in pregnancy, and what does folate prevent?

600 mcg/day; prevents neural tube defects

What are the iron recommendations for pregnancy?

Eat foods that supply heme-iron and are iron-rich; take supplements

What are the recommendations of the American Academy of Pediatrics for breast feeding and food introduction?

Breastfeed exclusively for first 6 months, then add complementary foods one at a time

What are the benefits of breast feeding?

Good nutrition for infant, antibodies, hormones, improves cognitive development, protects against food allergies, reduces risk of SIDS, contracts uterus, delays return of regular ovulation, conserves iron stores, saves time and money

What are some recommendations to prevent childhood obesity?

Create permanent healthy lifestyle habits, have regularly scheduled meals and snacks, take time to have conversations while eating, model healthy eating, show enjoyment of healthy foods

How does iron deficiency affect behavior?

Iron deficiency impairs attention span and learning ability and affects intellectual performance

What are examples of iron-rich foods?

Cream of wheat ¼ c, cooked snow peas ½ c, 3 canned plums, 1 tbsp raisins, ½ PB&J sandwich, ½ sloppy joe sandwich

What are the effects of lead toxicity?

Early: diarrhea, irritability, fatigue; then: learning disabilities and behavior problems; severe: balance, irreversible nerve damage, paralysis, mental retardation, death

How can we prevent lead toxicity?

Feed kids balanced and timely meals with ample iron and calcium; wash floors, window frames and sills, pacifiers, toys, bottles, hands; don't use contaminated water with formula; test water for lead; let cold water run before drinking it; keep old painted or dirty objects out of kids' mouths; beware of toys and food from countries without lead regulations

What are some recommendations from Mealtimes at Home?

Provide variety of foods, avoid power struggles, prevent choking, play first, allow kids to help plan and prepare meals, have healthy snacks, prevent dental caries, be a role model

For which nutrients are teens likely to develop a deficiency?

Vitamin D, iron, calcium

What are the nutrition recommendations for rheumatoid arthritis?

Omega-3 fatty acids in fish oil to reduce inflammation

What are the nutrition recommendations for osteoarthritis?

Weight loss

What are the nutrition recommendations to prevent cataracts and macular degeneration?

Antioxidants like vitamins C and E

What are the nutrition recommendations for brain health?

Whole grain ≥3x/day, green leafies ≥6x/week, berries ≥2x/week, fish ≥1x/week, poultry ≥2x/week, beans ≥3x/week, nuts ≥5x/week, red meats

What is the treatment for sarcopenia?

Physical activity and high protein diet

What nutrients are of concern for elderly people?

Vitamin D, calcium, vitamin B12, iron, folate

How do we identify a patient at risk of malnutrition?

Weight loss, appetite change

What are the 6 signs of malnutrition from Consensus Malnutrition Characteristics?

Unintentional weight loss, evidence of inadequate intake, loss of muscle mass, loss of subcutaneous fat, edema, reduced hand grip strength

What are clinical signs of vitamin C deficiency?

Corkscrew hair, bleeding gums, poor wound healing, bruising or bleeding under skin