Test 1

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