2. Nutrition in medicine Flashcards
What is ‘undernutrition’?
This is a form of malnutrition
Results form a reduced supply of food from an inability to digest, assimilate and utilise the necessary nutrients
What is meant by micro and macro nutrients?
Macronutrients - a food type required in large amounts in the diet e.g. protein and energy
Micronutrients - a food type required in smaller amounts in the body e.g. calcium, iron, manganese
What is the prevalence of undernutrition in the UK?
5% of the population of UK adults
About 2-3 million of the population of UK adults
Who are the most vulnerable groups of people for undernutrition?
People suffering from chronic diseases The elderly Those recently discharged from hospital Low income Socially isolated
What are the consequences of undernutrition in the community?
Increased risk of falls - elderly undernourished people will be more prone to falls due to an increased level of frailty
Undernourishment contributes to depression
More prone to infection
Increased dependency on families, carers etc
What are the consequences of undernutrition in hospitals?
Increased morbidity Increased length of stay Increased dependancy Increased mortality Increased costs of care
What are the different causes of undernutrition?
Reduced nutritional intake e.g. anorexia, pain, dysphagia, physical disability, nil by mouth
Increased nutritional requirements e.g. inflammation/infection, tissue healing, metabolic effects
Increased nutritional losses e.g. malabsorption
What are the consequences of undernutrition on the body and body weight?
Decreased muscle mass Decreased visceral proteins Impaired immune response Impaired wound healing Multiple organ failure
What are the consequences of undernutrition on the quality of life?
Fatigue and general weakness Lack of initiative Bedridden Apathy Depression Changes of behaviour and personality
What investigations can be used for a nutritional assessment?
Anthropometrics i.e. measure of tissues
Muscle functions i.e. dynamometry
DEXA scans to look at bone density
Blood test to look at vitamin and mineral concentrations, plasma proteins, lymphocyte count
What components make up the total energy requirements of the body?
Basal metabolic rate (obligatory energy requirements of the cells) + thermic effect of food (energy required to digest food) + physical activity + stress factors
Define ‘enteral’
Feeding via the gastrointestinal tract e.g. the oesophagus, stomach and the small and large intestines
When might a patient require gastrostomy feeding?
If the patient has a reduced consciousness e.g. due to brain injury
If they have an unsafe swallow e.g. motor neurone disease or Parkinson’s disease
Define ‘parenteral’ and why might this be required?
Administration occurring elsewhere in the body other than the mouth and the AI canal e.g. intravenously
If the patient has a short bowel or there is something wrong with the intestines
If you cannot access the gut
If the patient has acute pancreatitis or GI motility disorders
