Study Guide: Exam 3 HWS 332/NSG 312 Chapter 11: Water Intracellular vs. extracellular fluid Intracellular fluid (ICF): Maintain a specific balance

Chapter 11: Water

• Intracellular vs. extracellular fluid

  • Intracellular fluid (ICF): Maintain a specific balance 

    • Within the cells

    • Largest fluid compartment in the body

    • Contains potassium, proteins, various acid

  • Extracellular fluid

    • Outside the cells

    • Contains sodium chloride and sodium bicarbonate solutions

• Role of sodium-potassium pump

  • The sodium-potassium pump is protein in the cell membrane

  •  Transports sodium ions out of a cell while moving potassium ions inside the cell

  • This active transport of ions requires energy

  • For every three sodium ions pumped out of the cell, two potassium ions are transported into the cell

• What hormones/enzyme play a role in the reabsorption of water and sodium as it relates to RAAS

  • Diuresis

• Sodium and water reabsorption by the kidneys are controlled by what hormones

  • ADH & Aldosterone

• Fluid needs for men and women (on average)

  • Adult women: Approximately 9 cups of fluid per day

  • Adult men: Approximately 13 cups of fluid per day

  • People who are very active have higher water requirements

• What impacts fluid needs?

  • Physical activity

  • Environmental factors

  • Diet

• What stimulates the thirst mechanism?

  • ADH

  • Blood volume drops

  • Hypothalamus detects decrease in blood pressure and increase in concentration of salts

  • Thirst mechanism and fluid intake are stimulated

Chapter 14: Body Composition

• What is energy balance? Who is likely to be in positive energy balance?

  • When the kilocalories you consume meet your needs

  • Weight is stable

  • Periods of growth (pregnancy, childhood, and adolescence)

• What are the pros and cons of the different methods of body composition?

  • Examples:

    • Hydrostatic weighing

    • Air displacement plethysmograph (BodPod)

    • DEXA

    • BIA

    • Skinfold Caliper

  • Accuracy, cost, ease of use, accessibility

• Components of TDEE, what is the greatest predictor of TDEE

  • TDEE (Total Daily Energy Expenditure)

  • Greatest predictor = body size (height and weight)

  • Components 

    • Age 

    • Gender

    • Body mass

    • Genes

    • Ethnicicity

    • Nutritonal State

    • Lean body mass

    • Environmental temperature

    • Caffine & Nicotine intake 

    • Emotional & Physical stress

• How to measure energy expenditure at home

  • Harris Benedict Equation

    • Based on gender, height, weight and age 

• Various assessment tools for measuring body composition

  • Hydrostatic weighing is expensive and access is limited

  • Skinfold tests are easy, inexpensive, but have risk for human error

  • BIA not extremely accurate

• BMI Categories

  • Underweight (<18.5)

  • Normal Weight (18.5-24.9)

  • Overweight (25-29.9)

  • Obesity (30-39.9)

  • Severe obesity (>40)

HAES/IE:- (Written)

Healthy at Every Size

What does the HAES movement promote?

• Eating in a flexible manner that values pleasure and honors internal cues of hunger, satiety, and appetite.

• Finding the joy in moving one’s body and becoming more physically vital.

• Accepting and respecting the natural diversity of body sizes

• What factors impact weight?

  • Genetics

  • Diseases and drugs

  • Environment
    
    

What are the potential impacts of weight-focused interventions (refer to HAES PPT, ex: increased risk of osteoporosis)

• Weight cycling

• Increased risk for osteoporosis

• Increased risk for psychological stress and cortisol production

• Increased anxiety about weight

• Weight gain

• Eating disorder behaviors

• Stigmatization and discrimination against fat individuals 

Nutrition & Fitness:

• FITT Principle

  • Can help you design a fitness program

  • Frequency, Intensity, Time, Type

• Pre-workout/Post workout-what macronutrients would be ideal and be able to give an example

  • Pre-workout = Carbohydrates

    • Example - 

  • Post workout = Protein and carbohydrates  

    • Example - 

• Hydration- symptoms of dehydration, best way to monitor hydration

  • Symptoms: 

    • Fatigue

    • Muscle soreness

    • Poor recovery from workout

    • Headaches

    • Nausea

    • Dark urine

  • Urine color is the best way to monitor

• Understand the role of the types of PA (muscular strength, cardiovascular fitness etc.)

  • Cardiovascular fitness 

    • Improve cardiorespiratory endurance

    • Improve body composition

    • Reduces stress

    • Reduces risk of heart disease

  • Strength training

    • Improves muscle strength

    • Improves muscle endurance

    • Improves body composition

  • Stetching

    • Improves flexibility

• Understand what types of energy systems that are used during exercise. Consider the use of fat versus glucose in exercise

  • Carbohydrate is the primary energy source during high intensity 

  • Glucose and glycogen increase as intensity increases

  • Fat is the primary energy source during low intensity exercise

• Recommendations for amount of PA

  • Carbohydrates 

    • 60-90 mins moderate intensity = 5-7g

    • 1-3 hr moderate intensity = 7-12g

    • 4-6+ hrs extreme endurance = 10-13g

  • Fats

    • 20-35% of calories 

  • Protein (after workout)

    • Endurance athletes = 1.2-1.4 g/kg body weight

    • Resistance/strength training = 1.4-1.8 g/kg body weight

Lifecycle Nutrition:

• Increased nutrient needs in pregnancy-carbohydrate needs in pregnancy (grams)

  • Folate

  • Iron

  • Zinc

  • Copper

  • Calcium 

  • Vitamin D

  • Carbs = minimum of 175g

  • Protein = minimum of 71g (90-100g is better)

• What fat-soluble vitamin is associated with birth defects?

  • Vitamin A 

• Weight gain goals during pregnancy

Pregnancy BMI  > Recommended WG

     18.5-24.9 25-35 lbs 

Avg = 27.5 lbs

• Complications of pregnancy (PICA, gestational diabetes, preeclampsia)

  • PICA

    • Craving non-food substances 

  • Gestational Diabetes 

    • High glucose levels during pregnancy

    • Results in macrosomia (high weight babies)

    • Increased risks for jaundice, breathing problems, birth defects

    • Risk Factors: Age, Weight, Prediabetes

  • Preeclampsia 

    • Hypertension, severe edema, and protein losses in urine; deprives fetus of oxygen and nutrient rich blood from the placenta 

    • #1 cause of death in mothers during pregnancy

• Know risk factors for GDM

  • Weight, Age, Prediabetes, Ethnicity, hx of GDM, fam hx of DM, previous delivery of large baby at birth

• How do we screen for GDM?

  • Screening conducted between 24-28 weeks

  • 1 hour and 3 hour OGTT

  • 1 hour OGTT is a screener (not fasted)

  • 3 hour OGTT is a diagnostic test (fasted)

  • If it's above 140 mg/dL after 1 hour test, women have to go back for 3 hr

  • After 3 hours you are diagnosed with GDM if you fail 2 of these:

  • Fasting: Less than 95 mg/dL

  • 1-hour: Less than 180 mg/dL

  • 2-hours: Less than 155 mg/dL

  • 3-hours: Less than 140 mg/dL

• If someone were to have gestational diabetes what would you recommend for them

  • Monitor blood sugar 

  • Managing blood sugar levels

  • Regular exercise 

  • Balanced diet

  • Limit sugary and processed foods 

  • Eat fiber 

• Calorie needs during each trimester and during lactation

  • 2nd Trimester = 340 kilocalories

  • 3rd Trimester = 450 kilocalories

  • Breastfeeding = 500 kilocalories in first 6 months, 400 kcals in second 6 months 

• Concerns associated with young mothers and women of advanced maternal age

  • Teenage mothers face nutritional challenges

  • Older mothers are higher risk for complications (35+)

• Breastfeeding, benefits, and associated hormones

  • Prolactin: Stimulates milk production

  • Oxytocin: Releases milk for infant to receive through the nipple “letdown response”

    • Helps return mother’s uterus to normal size and shape 

  • Colostrum - yellow, high in protein and vitamin A

  • Protects against bacteria, viruses, fungi

  • Decreases diarrhea, intestinal and respiratory disorders, ear infections

  • Brain development 

  • Exclusive breastfeeding for 1-6 months  

  • Reduces blood loss and ovarian/breast cancer for mothers