10] Nutrition Flashcards
Nutrient deficiency diseases (2)
Scurvy
Pellagra
3 chronic diseases strongly associated with poor nutrition
Heart disease
Stroke
Diabetes
2 diseases in which nutrition plays a role
OA
Osteoporosis
Primary link b/w poor nutrition and mortality
Obesity
What are nutrients
The chemicals in foods that are critical for human growth and function
6 essential nutrients found in foods
Carbs Fats/oils Proteins Vitamins Minerals Water
What does DRI stand for
Dietary reference intake
DRIs identify (3)
How much nutrients are needed to prevent deficiency.
Amount of nutrients that may reduce risk of chronic disease.
Upper level of safety for nutrient intake.
What 4 values fo DRIs consist of?
EAR
RDA
AI
UL
What does EAR stand for
Estimated average requirement
RDA stands for what
Recommended dietary allowance
what does AI stand for
Adequate intake
What does UL stand for
Tolerable upper intake level
What is EAR
Average daily intake level that meets the needs of half of healthy people in a certain life stage and gender
Used to determine the Recommended DietaryAllowance (RDA) of a nutrient
EAR
What is the RDA
The average daily intake level required to meet the
needs of 97–98% of healthy people in a particular lifestage and gender group
Macronutrients that provide energy
Carbs
Fat
Proteins
Micronutrients that dont provide calories/direct energy
Vitamins
Minerals
Water
What is the AI
Recommended average daily intake level for a nutrient
- Based on observations and estimates from experiments
* Used when the RDA is not yet established: vitamin D, vitamin K, fluoride
AI
What does vitamin B do?
Facilitate the release of energy by breaking down macros
What is the EER
Average dietary energy intake to maintain energybalance
Based on age, gender, weight, height, and level of physical activity
EER
What does AMDR stand for
Acceptable Macronutrient Distribution Range (AMDR)
What is the AMDR
The range of macronutrient intake that provides adequate levels of essential nutrients
The range of energy intake from carbohydrate, fat, and protein associated with reduced risk of chronic disease
AMDR
AMDR for carbs
45-65%
AMDR for fats
20-35%
AMDR for proteins
10-35%
Avoid what before PT?
Avoid high fat and high fiber foods before PT
WHy Avoid high fat and high fiber foods before PT?
May lead to gas, bloating, abdominal pain duringactivity
High fiber diet: how much and what does it do
25-35 g per day to decrease constipation (pain meds)
3 Principle goals of nutrition therapy
- Preserve lean (muscle) tissue
- Maintain immune defenses
- Promote healing
Estimating energy needs for acute stress
• One method:
multiply the resting metabolic rate (RMR) by a stress factor
Quick method for estimating energy needs for acute stress
multiply a person’s body weight by a factor appropriate for the medical condition
• 25-35 kcal/kg BW
Protein requirements in acute stress
• Non-obese critically ill patients:
1.2 to 2.0 grams per kilogram
Protein requirements in acute stress for obese patients given hypocaloric feedings
2 - 2.5 grams/kg ideal body weight per day
Fluid requirements
1 mL/kcal or 35 kcal/kg
Nutritional status and pulmonary function are
Interdependent
What kind of protein and when do you have it with PT?
Lean sources before and after PT
Fiber from bread
100% WHOLE WHEAT
Acute stress examples
Organ failure, infections, wounds, post op, etc
Fat may supply up to 50% of calories for patients with?
Severe hyperglycemia
Breaking down macronutrients requires (2)
Oxygen and end product of metabolism is CO2
Malnutrition can evolve from
Pulmonary disorders
Protein-energy malnutrition
When someone isnt getting enough proteins, calories, vitamins, minerals, etc
What’s affected in the patient that has protein-energy malnutrition (3)
Strength and endurance of respiratory muscles
Reduction in lung parenchyma
Pulmonary infection
Effects of protein-energy malnutrition (4)
Early satiety
Anorexia
Cough
Dyspnea during eating
Healthy BMI
18.5 - 24.9
Anthropometric measurements
Height Weight BMI UBW IBW % body fat
COPD medication use that affects nutrition
Corticosteroids
Diuretics
Bronchodilators
Main goals with nutrition for COPD (3)
Correct malnutrition
Promote maintenance of healthy body weight
Prevent muscle wasting
Enteral formulas for COPD
Higher k-calories from fat;
Lower from carbs
Energy and nutrient needs for COPD
125-156% energy above BEE, 25-30 kcal/kg BW
1.2 - 1.7 g/kg protein
Overfeeding concern with ventilation
Glucose more than 5 mg/kg/min increases CO2 production b/c then it gets harder for them to breathe
Food/nutrient delivery for COPD- 3 things
Small, frequent meals
Rest before meals
Nutritional supplements (Ensure)
What does DASH diet stand for
Dietary approaches to stop HTN
What’s different about the DASH diet
Higher fiber, K, Mg and Ca.
Limits red meat, sweets, saturated fat, etc.
Normal sodium intake
No more than 2400 mg /day
SBP reduction when you reduce weight
5-20 mm Hg/10 kg
SBP reduction if you do DASH
8-14 mm Hg
SBP reduction when you reduce sodium intake
2-8 mm Hg
Reduction in SBP with physical activity
4-9 mm Hg
Reduction in SBP when you moderate alcohol
2-4 mm Hg
Sodium in processed cheese
490 mg per OUNCE
Calcium in processed cheese
100 mg per OUNCE
Sodium in natural cheese
240 mg per OUNCE
Calcium in natural cheese
200 mg per OUNCE
Limit saturated fats and cholesterol to less than how much to reduce risk fo CHD?
Less than 7% of total kcal and cholesterol to less than 200 mg/day
For coronary heart disease, total fat should be how much %?
25-35% of kcal
Polyunsaturated fats for CHD
10% of total kcal
Monounsaturated fats for CHD
Consume up to 20% of kcal
Trans fat for CHD
Keep intake as LOW as possible
Daily cholesterol intake for CHD
Less than 200 mg/day
Main features of TLC plan (9)
Saturated fats Poly, mono fats Total fat Trans fat Cholesterol Plant sterols and Stanols K and Na Fish and omega 3 fatty acids Alcohol
What does TLC stand for
Therapeutic lifestyle changes
Right sided heart failure
- Abdominal bloating and enlarged liver
* Pain/discomfort worsen with meals
Left sided heart failure
Limb weakness and fatigue
Syndrome of malnutrition
Cardia cachexia
Sodium for heart failure
Less than 2000 mg
Protein for heart failure
- 13 g/kg - nourished
1. 37 g/kg - malnourished
Fluid restriction for heart failure
2 liters/day
