Nutrition everything + DAFNE

Which diet is recommended to reduce cardiovascular disease risk?

Mediterranean diet.

Key components of a cardioprotective diet?

High fruits, vegetables, whole grains, olive oil, nuts, fish; low saturated fat.

What dietary change reduces LDL cholesterol?

Replacing saturated fat with unsaturated fats.

What fibre type helps reduce cholesterol?

Soluble fibre.

Examples of soluble fibre sources?

Oats, barley, legumes, fruits.

What condition results from gluten intolerance?

Coeliac disease.

What is the dietary treatment for coeliac disease?

Lifelong gluten-free diet.

What FODMAP stands for?

Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols.

Low-FODMAP diet is used for which condition?

Irritable bowel syndrome (IBS).

What is the synthetic form of folate?

Folic acid.

What is the main function of folate in the body?

DNA synthesis and cell division.

What deficiency disease is linked to folate deficiency?

Megaloblastic anaemia.

What congenital condition is folate supplementation designed to prevent?

Neural tube defects.

Recommended folic acid supplement before pregnancy?

400 µg/day.

What is epigenetics?

Changes in gene expression without altering DNA sequence.

What is nutrigenomics?

Study of how nutrients influence gene expression.

Example of epigenetic modification?

DNA methylation.

Which nutrients influence methylation pathways?

Folate, B12, B6.

What BMI is commonly associated with anorexia nervosa diagnosis?

<18.5 kg/m².

Key characteristics of anorexia nervosa?

Severe restriction, fear of weight gain, distorted body image.

What characterises bulimia nervosa?

Binge eating followed by compensatory behaviours.

Examples of compensatory behaviours?

Vomiting, laxatives, excessive exercise.

What is refeeding syndrome?

Dangerous electrolyte shifts when feeding malnourished patients.

What is the function of the urea cycle?

Detoxify ammonia by converting it to urea.

Where does the urea cycle occur?

Liver.

Why is protein intake often restricted in advanced kidney disease?

To reduce nitrogenous waste.

What electrolyte often accumulates in kidney disease?

Potassium

What is the difference between food allergy and intolerance?

Allergy = immune-mediated; intolerance = non-immune

Which antibody mediates most food allergies?

IgE

What blood pressure level defines hypertension (clinic)?

≥140/90 mmHg.

What diet is recommended for hypertension?

DASH diet.

What does DASH stand for?

Dietary Approaches to Stop Hypertension.

What nutrient reduction is key for BP control?

Sodium

WHO recommended maximum salt intake per day?

5 g salt/day.

Which mineral helps lower blood pressure?

Potassium.

Which vitamin is strongly linked with immune function?

Vitamin C.

Which mineral is essential for immune cell development?

Zinc.

What is the role of antioxidants in cancer prevention?

Neutralise free radicals that damage DNA.

Which lifestyle factor is the largest modifiable cancer risk?

Smoking (but diet and obesity also contribute).

Obesity increases risk of which cancers?

Breast, colorectal, endometrial.

What is cachexia in cancer?

Severe muscle and weight loss due to disease.

What are WHO growth charts used for?

Monitoring child growth compared with reference populations

What does the 50th percentile on a growth chart mean?

Average growth for that age and sex.

What does a drop across two centile lines suggest?

Possible growth faltering.

What anthropometric measure is most sensitive for acute malnutrition?

Weight-for-height.

What measure indicates chronic malnutrition?

Height-for-age (stunting).

What is exclusive breastfeeding recommended for?

First 6 months of life.

When should complementary feeding start?

Around 6 months.

What are the four main lipoproteins that transport lipids in blood?

Chylomicrons, VLDL, LDL, HDL.

Which lipoprotein is considered the "bad cholesterol"?

LDL (Low-density lipoprotein).

Which lipoprotein is considered the "good cholesterol"?

HDL (High-density lipoprotein).

What is the main function of LDL?

Transport cholesterol from the liver to peripheral tissues.

What is the main function of HDL?

Reverse cholesterol transport (from tissues to liver).

Which lipoprotein primarily carries triglycerides from the liver?

VLDL.

Which lipoprotein transports dietary triglycerides from the intestine?

Chylomicrons.

What does DAFNE stand for?

Dose Adjustment For Normal Eating.

What condition is DAFNE primarily designed for?

Type 1 diabetes.

What is carbohydrate counting used for in diabetes management?

To match insulin dose with carbohydrate intake

How many grams of carbohydrate are typically counted as one carb portion in DAFNE?

10 g carbohydrate

What dietary change reduces LDL cholesterol?

Replacing saturated fat with unsaturated fats.

What condition results from gluten intolerance?

Coeliac disease.

What is the dietary treatment for coeliac disease?

Lifelong gluten-free diet.

What FODMAP stands for?

Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols.

Low-FODMAP diet is used for which condition?

Irritable bowel syndrome (IBS).

Which diet is recommended to reduce cardiovascular disease risk?

Mediterranean diet.

Key components of a cardioprotective diet?

High fruits, vegetables, whole grains, olive oil, nuts, fish; low saturated fat.

What fibre type helps reduce cholesterol?

Soluble fibre.

Examples of soluble fibre sources?

Oats, barley, legumes, fruits.

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What are the DAFNE target glucose levels before breakfast?

5.0–7.0 mmol/L

What are the target glucose levels before other meals?

4.0–7.0 mmol/L

What is the bedtime glucose target?

5.0–9.0 mmol/L

What is the recommended overall glucose target range?

3.9–10.0 mmol/L

What does “time in range” mean?

Glucose levels within the defined target range

What does QA insulin stand for?

Quick-acting insulin

What is QA insulin used for?

Cover carbohydrates and correct glucose levels

QA insulin onset, peak, and duration?

Onset: 5–15 min; Peak: 50–90 min; Duration: 2–5 hrs

How long does QA insulin stay active in the body?

~4 hours

What does BI insulin stand for?

Basal insulin

What is the role of basal insulin?

Maintain glucose levels when not eating

How often should basal insulin doses be spaced?

At least 7 hours apart

Which basal insulin lasts the longest?

Tresiba (~42 hours)

How much does 1 unit of QA insulin lower glucose?

2–3 mmol/L

How much does 1 carb portion (10 g CHO) raise glucose?

2–3 mmol/L

What value is usually assumed for calculations?

3 mmol/L

What is the maximum correction dose allowed?

4 units QA

Why should you avoid correcting between meals?

Risk of insulin stacking

Why should you avoid correcting before bed?

Risk of nocturnal hypoglycaemia

When should you NOT correct high glucose after hypoglycaemia?

• Mild hypo → wait until next meal

• Severe hypo → wait 24 hours

When CAN you correct between meals?

• Illness

13 mmol/L 3 hrs post-meal with rising CGM

Name 2 factors that increase insulin requirements

Puberty, illness, weight gain, high CHO diet

Name 2 factors that decrease insulin requirements

Exercise, weight loss, honeymoon period, low CHO diet

What is the dawn phenomenon?

Early morning rise in glucose (≈3am–wake)

What is the first step in DAFNE adjustment?

Identify the problem

How long should you observe patterns before adjusting?

≥48 hours

How much should basal insulin be adjusted initially?

Reduce by 10–20%

Key rule when adjusting insulin?

Only change ONE dose at a time

Why does alcohol increase hypoglycaemia risk?

Inhibits liver glucose release

How long does it take to process 1 unit of alcohol?

~1 hour

Should you give correction insulin after alcohol?

No