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What is the difference between an essential nutrient and a nonessential nutrient?
Essential Nutrient is a nourishing substance that a person must obtain from food because the body cannot make it for itself in sufficient quantity to meet physiological needs.
a nonessential nutrient is a substance that can be manufactured in the body by means of other nutrients. It is not essential to consume this nutrient regularly in the diet
What is the difference between an energy-yielding and non-energy-yielding nutrient? Give 3 examples of each type of nutrient
An energy-yielding nutrient is an essential nourishing substance that breaks down to yield energy within the body
Examples: carbohydrates, proteins, fats
A non-energy-yielding nutrient is a nourishing substance that does not break down to yield energy within the body.
Examples: vitamins, minerals, water
Recommended Dietary Allowances (RDAs)
Amount of particular nutrient that most healthy people with a similar life-stage and sex will need to decrease the risk of chronic disease
Adequate Intake (AI)
Set when there is insufficient data to define Recommended Dietary Allowances (RDA)
Chronic Disease Risk Reduction Intakes (CDRR)
Some essential nutrients are not only essential to life but are also linked to chronic disease risk. Sodium is the only one at this time.
Dietary guideline for Americans 2020-25
Contains evidence-based advice on food and beverages to consume to promote health, reduce the risk of chronic disease and meet nutrient needs
Acceptable macronutrient distribution ranges (AMDR)
Recommended percentages of intake for energy-yielding nutrients: carbohydrates, proteins, fats that is associated with a reduced risk of chronic disease
Tolerable Upper Intake Limit (UL)
The highest average daily intake level of a nutrient that probably poses no danger to most individuals in the group. Examples are vitamins A,D , E, and folate.
Carbohydrates total % of calories/day
45-65%
Energy produced for carbs
4 cal/g of energy
Daily recommendation of carbs
Sugars < 10% calories/day
Amount of energy fiber produces
1.5-2.5 cal/g
Daily recommendation of fiber
Women: 25 g
Men: 38 g
Fats/Lipids total % of calories/day
20-35%
10% or less saturated fat
Fats/lipids energy produced
9 cal/day
Daily recommendation of fats/lipids
Cholesterol max 300 mg/day
Proteins daily %/day
10-35%
Proteins energy produced
4 cal/g
Daily recommendation of proteins
0.8g/kg of desirable body weight
A client requires 2100 calories per day. An appropriate amount of carbohydrate calories per day for her would be?
2100 x 45% = 945
2100 x 65% = 1365
How many grams of carbohydrates will the client need to ingest to meet the calorie requirements?
945 cal divided by 4 cal/g = 236.25 round 236 g
1365 cal divided by 4 cal/g = 341.25 round 341 g
How to calculate nitrogen balance
Calculate total nitrogen intake for a 24-hour period
Measure protein intake in grams
Divide grams of protein consumed by 6.25 (6.25 because protein is 16% nitrogen)
Result is ____g of nitrogen
Calculate nitrogen excretion in a 24-hour period
Analyze 24-hour urine sample for grams of urinary urea nitrogen (UUN)
Add 4 grams to account for the estimated daily nitrogen loss in feces, hair, nails, skin
Result is ____g of nitrogen
Subtract nitrogen output from nitrogen intake
Interpret the results
*Negative = catabolic , Positive = anabolic
Mary is a 25-year-old who was admitted to the hospital with multiple fractures and traumatic injuries from a car accident. A nutritional intake study indicated a 24-hour protein intake of 64 g. a 24-hour UUN collection result was 19.8 g. Calculate Mary’s nitrogen balance.
64 g divided by 6.25 = 10.24 g intake
19.8 g + 4 g = 23.4 g output
10.24 g minus 23.4 g = -13.16 g in 24 hours
Negative nitrogen balance – due to trauma response
Calculate the following 24-hour intake of protein and using the UUN result, interpret the nitrogen balance for this 26-year old client named Mary who is 22 weeks gestation.
Breakfast: 2 eggs (12.6 g) + 1 slice grilled ham (14.1 g) + 2 slices whole wheat toast with 2 tsp butter. 8oz black coffee with artificial sweetener. 8oz orange juice.
Morning snack: 3 oz plain yogurt (4.9 g) with cup of blueberries; 8 oz water
Lunch: tuna sandwich (3 oz canned tuna with 1 tbsp mayo, celery, and onion) (20 g), 1 cup baby carrots, 1 dill pickle. 8oz. 1% milk (8.2 g)
Afternoon snack: 3 stalks of celery with 2 tablespoons with smooth peanut butter (7.1 g)
Dinner: 3 oz grilled chicken breast (26.4 g), 2 cups green salad with oil and vinegar dressing, 12 oz soda water.
24-hour UUN = 8.25 g
Total protein intake = 93.3g then divide by 6.25 = 14.928g intake
UUN = 8.25 g + 4 g = 12.25 g output
14.928 g minus 12.5 g = +2.678
Positive nitrogen balance – pregnancy, growth (adolescence)
A client weighs 176 pounds. What would be the daily protein requirement for this client in grams?
176 divided by 2.2 = 80 kg
80 x .0.8 = 64
If don’t change to kg then would get 140.8 = 141
A client is healthy and eats approximately 1600 calories per day. Based on recommendations, how much protein does the client need each day?
1600 x 10 % = 160 calories / divide by 4 cal/g for protein 160 by 4 = 40
1600 x 35% = 560 calories / 560 – 4 = 140g
If forget to divide by 4 = #4 is answer will choose
A client consumed 1800 calories of which 50 grams were from fat. What percentage of the total calories come from fat?
50g x 9 cal/g = 450 calories
450 divided by 1800 total calories = 0.25
0.25 x 100% = 25%
What are the 4 fat-soluble vitamins
Vitamins A,D,E,K
What are the 9 water soluble vitamins
Vitamin C
B complex vitamins (8 in total)
What are the 8 B vitamins
B1, B2, B3, B6, B9, B12, pantothenic acid, biotin
What is the difference between retinoids and carotenoids
Retinoids are active animal products, carotenoids are from plants and are not active
What’s the difference between rickets and osteomalacia
Rickets in children and osteomalacia in adults due to deficiency in Vitamin D
B12- Cobalamin
Deficiency is seen in a strict vegan diet and those with an absence of intrinsic factors needed for absorption
Vitamin C- Ascorbic acid
Stress and illness and cigarette smoking increase the need
Vitamin K-Phytonadione
Antidote for warfarin, given to newborn IM within 1 hour of birth
B9- folate
All clients of childbearing age need adequate amounts to prevent neural tube defects (neural tube often forms before the client knows is pregnant) Excessive intake can mask B12 deficiency
B3- Niacin
Megadoses used for hypercholesterolemia
Vitamin D-Calciferol
Sunlight enable the body to synthesize this vitamin in the skin, excess consumption can cause hypercalcemia
Vitamin A- Reitinol/Beta-cartene
Caution pregnancy as some forms are teratogenic to fetus
Vitamin A
Retinol
Beta-Carotene
Vitamin B1
Thiamine
Vitamin B2
Riboflavin
Vitamin B3
Niacin
Vitamin B6
Pyridoxine
Vitamin B9
Folate
Vitamin B12
Cobalamin
Vitamin C
Ascorbic acid
Vitamin D
Calciferol
Vitamin E
Alpha-tocopherol
Vitamin K
Phytonadione
Biotin
B-complex vitamin
Pantothenic acid
B-complex vitamin
What vitamin has a deficiency d/t pernicious anemia
b12
What vitamin has a deficiency d/t beriberi
B1
What vitamin has a deficiency d/t Pellagra
B3
What vitamin has a deficiency d/t scurvy
C
What vitamin has a deficiency d/t reduced night vision
A
What vitamin has a deficiency d/t increased bleeding time
K
What vitamin has a deficiency d/t cheilosis
B2
What vitamin has a deficiency d/t microcytic anemia
B6
What vitamin has a deficiency d/t xerophthalmia
A
What vitamin has a deficiency d/t neural tube defect
B9
What vitamin has a deficiency d/t glossitis
B2
What vitamin has a deficiency d/t rickets
D
What vitamin has a deficiency d/t megaloblastic anemia
B9
What vitamin has a deficiency d/t osteomalacia
D
What vitamin is associated with vegetable oils and certain nuts (almonds and hazelnuts)
E
What vitamin is associated with meats,grains,legumes
B1
B6
What vitamin is associated with carrots, eggs, dark green veggies (spinach, broccoli, asparagus)
K
What vitamin is associated with meat, shellfish, eggs, and dairy products
B12
What vitamin is associated with meats, legumes, milk, whole grain, and enriched breads and cereals
B3
What vitamin is associated with fatty fish, egg yolks, butter, cream, yellow/orange fruits, and veggies (carrots, yams, apricots, squash, and cantaloupe)
A
What vitamin is associated with meats, whole grain cereals, dried peas, and beans
Pantothenic acid
What vitamin is associated with citrus fruits, tomatoes, peppers green leafy veggies, strawberries
C
What vitamin is associated with milk, meats, and dark leafy veggies
B2
What vitamin is associated with liver, dark green leafy veggies, orange juice, and legumes
B9
What vitamin is associated with fatty fish, eggs, fortified products (ready to eat cereals, milk, and orange juice)
D
What vitamin is associated with eggs, milk, dark green veggies
Biotin
Manifestations of FVE
Increased BP
JVD
Tachypnea
Tachycardia
Bounding pulse
Weight gain
Edema- pitting, cerebral, periorbital
Crackles, dyspnea, cough
Bulging fontanelles
Manifestations of JVD
Orthostatic hypotension
tachycardia
weak, thready pulse
weight loss
dry mucous membranes
capillary refill > 3 seconds
tachypnea
poor skin turgor-tenting
Sunken fontanelles
Major Ca+ (calcium) food sources
dairy, broccoli kale, fortified grains
Major P+ (Phosphorus) food sources
dairy, peas, meat, eggs, legumes
Major Na+ (sodium) food sources
Table salt, added salt, processed foods
Major K+ (potassium) food sources
oranges, dried fruits, bananas, tomatoes, avocados, dried peas, broccoli, dairy products, meats, whole grains, potatoes
Major C- (Chloride) food sources
Table salt, added salts, processed foods
Major Mg+ (Magnesium) food sources
Green leafy veggies, nuts, whole grains, tuna, hailbut chocolate
Major Sulfur food sources
Proteins
Trace Iron food sources
Heme iron: meat, fish, poultry
Non-heme iron: grains, legumes, veggies
Trace iodine food sources
Seafood, Iodized table salt
Trace Fluoride food sources
Water with added fluoride, toothpaste
How must ingredients be listed on a label?
In descending order by weight
What are the 8 major food allergens that must be listed on a food label
milk, eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat, and soybeans
For a product to be label gluten free, how much gluen must the product contain
Less than 20 ppm of gluten
Name 3 examples of simple sugars, monosaccharides
glucose, fructose, galactose
Name 3 examples of simple sugars, disaccharides
sucrose, maltose, and lactose
Name 3 examples of the complex carbohydrates, polysaccharides
starch, glycogen, fiber
What is a starch
stored glucose not used by plants
What is glycogen and where is it stored in the human body
animal version of starch, stored in liver and skeletal muscles
What is the difference between soluble and insoluble fiber and list food sources of each
Soluble -dissolves in water and becomes a gel substance digested by bacteria in the colon & Insoluble can’tbe broken down. Food sources of soluble = oatmeal, legumes, lentils, citrus fruit – gums & pectin;
Food sources of insoluble = whole grains, bran, skin and seeds of fruits and vegetables – cellulose & lignin
What is the difference between whole grains, refined grains, and enriched grains
Whole – retain 3 elements of grain (bran, endosperm and germ); Refined – have 1 or more parts of grain removed;
Enriched – refined and then enriched with nutrients that were lost when refined