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317 NUTR > 317 NUTr > Flashcards

317 NUTr Flashcards

1
Q

How can cancer be prevented?

A
  • dietary factors

- weight

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2
Q

How can cancer be prevented?

A
  • dietary factors

- weight

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3
Q

WHAT IS THE MAJOR RISK FACTOR FOR CANCER INCIDENCE?

A

AGE

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4
Q

What to eat to DECREASE risk of cancer

A
  • low-dat diet
  • chol.- lowering drugs
  • fiber (moves things out quicker)
  • OMEGA 3
  • VIT D/ E
  • aspirin
  • fruits and veggies
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5
Q

WHY FRUIT AND VEGGIES GOOD?

A
  • decrs risk
  • reduce cals- nutrient dense
  • > 5 servings (HP2010)
  • Low income= poor diets
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6
Q

Inversely associated with some types of cancers

A
  • Isoflavones
  • phytochemicals
  • phytoestrogens
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7
Q

DIETARY FACTORS that increase CANCER

A
  • trans ftty acids
  • red meat
  • processed foods
  • meats cooked in high temps (BBQ, grill)
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8
Q

Inconsistent dietary factors

A

FOLATE
COBALAMIN
CAROTENES

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9
Q

Multivitamins

A

have no influence on cancer prevention

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10
Q

Palliative care

A

maintain comfort and quality of life
**DO NOT FORCE EATING AND DRINKING
NUTR & hydration med. interventions that can be STOPPED

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11
Q

GOAL OF NUTR THERAPY W/ Old PPL and cancer

A
  • maximize quality of life

- provide optimal nutr. status

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12
Q

PRO-ENERGY malnutr.

A

very common in elderly

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13
Q

Specific nutrient deficiencies

A
  • Fiber
  • omega 3
  • Vit D
  • Mg
  • Ca
  • Folic Acid
  • B6, 12
  • Se
  • Zn
  • Cr
  • Fe
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14
Q

BMI less than 21

A

consistent w/ malnutr in older adult

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15
Q

Serum albumin HL

A

15-20 days

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16
Q

Serum albumin 2.8 – 3.5 gm/dL

A

Mild depletion

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17
Q

Serum albumin 2.1 – 2.7 gm/dL

A

Moderate depletion

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18
Q

Serum albumin

A

– Severe depletion

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19
Q

Serum albumin

A
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20
Q

Prealbumin HL

A

half life 1-2 days

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21
Q

Prealbumin 10-15 gm/dL

A

– Mild depletion

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22
Q

Prealbumin

A

– Severe depletion

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23
Q

SERUM CHOL. indicator

A

separarte card

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24
Q

Prealbumin 5-10 gm/dL

A

– Moderate depletion

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25
Q

Prealbumin

A

– Severe depletion

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26
Q

LYM. CNT

A

– Severely malnourished

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27
Q

SERUM CHOL. indicator

A
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28
Q

Total lymphocyte count

1500 - 1800

A

– Mildly malnourished

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29
Q

LYM. CNT 1000 - 1500

A

– Moderately malnourished

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30
Q

LYM. CNT

A

– Severely malnourished

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31
Q

Weight loss and cachexia prevalence

A

total loss of fat and muscle 55-65%

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32
Q

What is a common cause for elderly hospitalization?

A

WEIGHT LOSS

HYPOALBUMINEMIA

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33
Q

FACTORS OF POOR NUTR

A 
Physiological changes of aging
BMI- reduction of HT
HT- 1/2 cm decade after age 50
Red. muscle mass/ fat
Incrs adipose tissue in trunk/abs
Subcutaneous fat decrs
Cals decrs
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34
Q

Factors of poor nutr

A 
polypharmacy
reduction of appt.
-illness
-dementia
-depression
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35
Q

Mechanical barriers to poor NUTR

A
  • poor oral health (aches, dentures, no teeth)
  • Physical activity more difficult (incrs morbidity, arthritis)
  • unrecognized feed probs (dysphagia, stroke, parkinson)
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36
Q

SLD 13 ch 14

A

poop

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37
Q

WHAT IS THE MAJOR RISK FACTOR FOR CANCER INCIDENCE?

A

AGE

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38
Q

What to eat to DECREASE risk of cancer

A
  • low-dat diet
  • chol.- lowering drugs
  • fiber (moves things out quicker)
  • OMEGA 3
  • VIT D/ E
  • aspirin
  • fruits and veggies
How well did you know this?
1
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39
Q

WHY FRUIT AND VEGGIES GOOD?

A
  • decrs risk
  • reduce cals- nutrient dense
  • > 5 servings (HP2010)
  • Low income= poor diets
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40
Q

Inversely associated with some types of cancers

A
  • Isoflavones
  • phytochemicals
  • phytoestrogens
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41
Q

DIETARY FACTORS that increase CANCER

A
  • trans ftty acids
  • red meat
  • processed foods
  • meats cooked in high temps (BBQ, grill)
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42
Q

Inconsistent dietary factors

A

FOLATE
COBALAMIN
CAROTENES

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43
Q

Multivitamins

A

have no influence on cancer prevention

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44
Q

Palliative care

A

maintain comfort and quality of life
**DO NOT FORCE EATING AND DRINKING
NUTR & hydration med. interventions that can be STOPPED

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45
Q

GOAL OF NUTR THERAPY W/ Old PPL and cancer

A
  • maximize quality of life

- provide optimal nutr. status

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46
Q

PRO-ENERGY malnutr.

A

very common in elderly

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47
Q

Specific nutrient deficiencies

A
  • Fiber
  • omega 3
  • Vit D
  • Mg
  • Ca
  • Folic Acid
  • B6, 12
  • Se
  • Zn
  • Cr
  • Fe
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48
Q

BMI less than 21

A

consistent w/ malnutr in older adult

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49
Q

Serum albumin HL

A

15-20 days

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50
Q

Serum albumin 2.8 – 3.5 gm/dL

A

Mild depletion

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51
Q

Serum albumin 2.1 – 2.7 gm/dL

A

Moderate depletion

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52
Q

Serum albumin

A

Severe depletion

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53
Q

Prealbumin HL

A

half life 1-2 days

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54
Q

Prealbumin 10-15 gm/dL

A

– Mild depletion

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55
Q

Prealbumin 5-10 gm/dL

A

– Moderate depletion

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56
Q

Prealbumin

A

– Severe depletion

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57
Q

SERUM CHOL. indicator

A
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58
Q

Total lymphocyte count

1500 - 1800

A

– Mildly malnourished

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59
Q

LYM. CNT 1000 - 1500

A

– Moderately malnourished

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60
Q

LYM. CNT

A

– Severely malnourished

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61
Q

Weight loss and cachexia prevalence

A

total loss of fat and muscle 55-65%

How well did you know this?
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3
4
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62
Q

What is a common cause for elderly hospitalization?

A

WEIGHT LOSS

HYPOALBUMINEMIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

FACTORS OF POOR NUTR

A 
Physiological changes of aging
BMI- reduction of HT
HT- 1/2 cm decade after age 50
Red. muscle mass/ fat
Incrs adipose tissue in trunk/abs
Subcutaneous fat decrs
Cals decrs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Factors of poor nutr

A 
polypharmacy
reduction of appt.
-illness
-dementia
-depression
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65
Q

Mechanical barriers to poor NUTR

A
  • poor oral health (aches, dentures, no teeth)
  • Physical activity more difficult (incrs morbidity, arthritis)
  • unrecognized feed probs (dysphagia, stroke, parkinson)
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66
Q

Incrs. metabolic req

A
  • fever-
  • parkinsons
  • infection
  • cancer
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67
Q

HEALING INCRS NEED FOR…

A

NUTRIENTS -chronic wound healing

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68
Q 
IBD
GERD
HYPOXIA
COPD
what kind of related issues?
A

Nutrition

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69
Q

Depression/ nutr

A
  • red wine/ sherry improves apt.

- reversible observed more in men

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70
Q

Consequences WT loss in older adults

A
  • often leads to death
  • suggests loss of lean body mass
  • may follow development of DZ
  • predipose them to other dzs (acquired pneumonia)
  • associated with bone loss and hip fractures (less VIT D, ca intake, less WT baring shit)
  • medications
71
Q

BMI 30 kg/m2 or greater

A

= obesity

higher in african americans

72
Q

BMI b/t 25-30

A

protective for mortality

73
Q

Loss of lean tissue

A

Sarcopenic obesity

74
Q

visceral body fat

A

incurs with age

75
Q

Physiological changes in obesity

A
  • Inactivity
  • Reduced growth hormone and testosterone levels
  • Poor Nutr
  • Smoking
  • Drugs (steroids, antideprs)
76
Q

Association b.t obesity/disabilty
highbody fat =mobility loss
experience functional imparment

A

problems associated with obesity

77
Q

CONSEQUENCES OF OBESITY

A
  • CAD
  • stroke
  • type 2 DM
  • htn
  • osteoarthritis in knees,
  • dyslipidemia
  • fatty liver dz
  • metabolic syndrome
  • Depression
  • discrimination
  • social stigmatization
  • eating disorders
  • poor self-image
  • reduced quality of life
78
Q

Favorable aspects of obesity

A
  • protective for falls and mortality
  • incrs muscle strength (women)
  • decrs pressure ulcers
  • may be protective against women w/ dementia
79
Q

Effective WT loss intervention includes….

A 
Nutrition education
Diet – empty calories
Exercise counseling
Behavioral strategies
Physical activity
80
Q

NUTR GL for losing WT

A

More exercise
Mediterranean diet – wholesome, flexible, culturally adaptable, lowers lipid levels, reduces mortality due to heart dz
Counseling

81
Q

Drug to kill appetite

A

SIBUTRAMINE

82
Q

FXs of obesity with adolescents

A

environment

genetics

83
Q

FXS and young obesity

A

Having one or more overweight parents
From a low income family
African American, Hispanic, American Indian or Native Alaskan descent
Having a condition that limits mobility
Inadequate physical activity
Diets high in calories, sugars, & fat

84
Q

BMI ≥85th to

A

are “overweight”

85
Q

BMI ≥95%

A

are “obese”

86
Q

Treatment for adoles. obesity should be based on

A

physical growth

presence of medical complications

87
Q
  1. PREVENTION PLUS
A

level of treatment depends on basic nutr, PA

88
Q
  1. structured WT mngment
A

Screen time

89
Q
  1. Comprehensive multidisciplinary intervention
A
  • structure eating
  • more PA
  • **DESIGNED TO LEAD TO NEG. CALORIC BALANCE
90
Q
  1. Tertiary care intervention
A
  • Appropriate with severely obese youth or those who have significant, chronic co-morbidity conditions
  • Level of treatment provided through a tertiary wt management center
  • Diet and activity counseling with behavior modifications
91
Q
  1. Tertiary care intervention (cont.)
A 
Treatments may include
Meal replacement
A very low energy diet
Medication
Surgery may be implemented
92
Q

Intensive medical supervision required with the following:

A
  • Very-low-calorie diets or protein-sparing modified fasts
  • Appetite suppressants or other drugs
  • Bariatric surgery
93
Q

Bariatric surgery adolescents

A

Adolescent must have completed growth spurt and have either:

  • BMI >35 with major complications
  • BMI >50 with minor complications
94
Q

Prevalence of supplement use

A 
Positively correlated with 
Household income
High food-security status
Some form of health insurance
Parental education

-those who take supplements usually have better nutritional diets than those who don’t

95
Q

Herb supplements

A

WT loss
ADD
incrs energy

96
Q

Adolescent athlete NUTRTION concerns

A
  • Fluid/ hydration
  • CHO loading
  • High-PRO dts
97
Q

Adolescent athlete NUTRTION increase what?

A
  • Energy
  • PRO
  • certain vitamins and minerals
98
Q

Adol. athlete nutrient needs higher during what time?

A

intense training
competitive season
MONITOR CHANGES IN BODY WT (nutrient intake vs output)

99
Q

Assessing nutrient needs for Adol. athlete

A 
What sport/ season?
What level of competition?
What kind of training do they engage in?
Sweat? Loose body wt during competition?
Special DT? Supplements?
100
Q

How many addition cals should be added for competing athlete?

A

500-1500 ++++++ cals per day

101
Q

athlete- PRO should supply no more than what %%% of cals?

A

NO MORE THAN 30%% of calories for dt

102
Q

when should athlete eat prevent meal?

A

2-3 hours before exercise

103
Q

what should athlete avoid before event?

A

Avoid foods high in fat, protein & dietary fiber for at least 4 hours before event

104
Q

POST event meals should include what?

A
  • 400-600 calories
  • high in complex carbs
  • high-quality protein
  • adequate non-caffeinated fluids
105
Q

Reasons adolescents are at risk for dehydration:

A
  • Young adolescents do not regulate body temperatures well
  • Ignore physiological signs of fluid loss
  • May be unaware of need for fluids

athletes should be counseled on fluid needs

106
Q

Fluid recommendations

A

6-8 oz fluids prior to exercise
4-6 oz every 15-20 minutes during activity
≥8 oz following exercise

107
Q

CHO LOADING

A
  • endurance athletes– distance runners

* Consists of high-carb diet to increase glycogen stores combined with resting prior to athletic event

108
Q

WHAT is the MOST COMMON nutritional deficiency?

A

IRON DEFICIENCY AMENIA

109
Q

RF for Fe deficiency

A
  • Rapid growth
  • decks intake iron- or vitamin C-rich foods
  • Vegan diets
  • Caloric restriction, meal skipping
  • Participation in strenuous or -endurance sports
  • Heavy menstrual bleeding
110
Q

Effects of iron deficiency on adolescents:

A
  • Delayed or impaired growth & development
  • Fatigue
  • Increased susceptibility to infection
  • Depressed immune system
  • Impaired physical performance & endurance
  • Increased susceptibility to lead poisoning
111
Q

Fe def. treatment

A

Increase intake of foods rich in iron & vitamin C

and iron supplements

112
Q

Side effx of Fe def.

A

constipation
nausea
cramps

113
Q

How to reduce side effc of fe def.

A

Taking small, frequent doses

Take with meals

114
Q

FACTORS that DECRS Fe absorption

A

Calcium supplements
Dairy products
Tea
High-fiber foods

115
Q

Substance use that would affect NUTR

A

Tobacco increases Vitamin C needs
Alcohol replaces nutritious foods and beverages
Illicit drugs may increase risk for disordered eating behaviors

116
Q

RF for HTN

A 
Family history of hypertension
High sodium intake
Overweight
Hyperlipidemia
Inactive lifestyle
Tobacco use
117
Q

NUTR counseling HTN

A

Decrease sodium intake

Limit fat to 30% of calories

118
Q

Hyperlipidemia RF

A 
Family history
Cigarette smoking
Overweight
Hypertension
Diabetes
Physically inactive
119
Q

how to reduce Hyperlipidemia

A
120
Q

What are common nutrition problems with special health care needs?

A 
Altered energy and nutrient needs
Delayed growth
Oral-motor dysfunction
Elimination problems
Drug/nutrient interactions
Appetite disturbances
Unusual food habits
Dental caries, gum disease
121
Q

EFFECTIVE NUTR. MESSAGES SHOULD FOCUS ON WHAT?

A

LIFESTYLE CHANGES

122
Q

for eating disorders what kind of approach should ya take?

A 
A multidisciplinary team approach
Team may consist of
Physician
Dietitian
Nurse
Psychologist
Psychiatrist
123
Q

GOALS FOR TREATING EATING DISORDERS

A

Restore body weight
Improve social and emotional well-being
Normalize eating behaviors

124
Q

Physiological Changes of Adulthood

A

Growing stops by the 20s
Bone density continues until 30
Muscular strength peaks around 25 to 30 years of age
Decline in size and mass of muscle and increase in body fat
Dexterity and flexibility decline

125
Q

Physiological Changes of Adulthood women

A

Hormonal and Climacteric Changes

Decline of estrogen =menopause

Increase in abdominal fat
Increase in risk of
cardiovascular disease & accelerated loss of bone mass

126
Q

Physiological Changes of Adulthood men

A

Gradual decline in testosterone level & muscle mass

127
Q

Physiological Changes of Adulthood-body composition

A

Bone loss begins around age 40
Positive energy balance resulting in increase in weight and adiposity
Decrease in muscle mass
Fat redistribution – gains in the central & intra-abdominal space, decrease in subcutaneous fat

128
Q

Resilient and “Healthy”

A

Metabolic systems in homeostasis

Organs are functioning at optimal level

Nutritional guidance
Encourage adequate intake
Not too much, Not too little
Mantra: 
“Moderation, variety, and balance”
129
Q

Altered Substrate Availability

A

Early, subclinical state of nutritional harm when intake doesn’t meet needs
Loss of reserves and/or accumulation of excess-lead to buildup of by-products

130
Q

Nonspecific Signs and Symptoms

A

Visible changes to insufficient or excessive intakes
Recognized risk factors for chronic disease
Dietary guidance:
Target specific risk factors and observable signs and symptoms
Measure and monitor for progress to halt or reverse risk factors for disease

131
Q

Clinical condition

A

Definite signs and symptoms of illness present  medical diagnosis

Examples: atherosclerosis, cancer, osteoporosis, type 2 diabetes, depression
Dietary Guidance
Change is difficult
Intensive intervention needed (medical nutrition therapy or therapeutic behavior-change programs)

132
Q

Chronic condition

A

Altered metabolism and structural changes in tissues become permanent & irreversible

Examples: structural damage to coronary arteries, invasive & metastatic cancer, loss of kidney function or blindness
Dietary guidance:
Aimed at managing the condition
Preventing further complication
Reduce degree of disability optimize quality of life

133
Q

Terminal Illness and Death

A

Final stage in the continuum
Complications advance
Body systems shut down
Life ceases

134
Q

Estimating Energy Needs Based on….?

A

BMR + TEF + Activity

135
Q

BMR

A

basil metabolic rate

Daily BMR expenditure – 60 to 75% for involuntary processes

136
Q

TEF

A

Thermal effect of food

metabolism of food ~10%

137
Q

Activity thermogenesis

A

most variable component is which accounts for 20-40% of total energy needs

138
Q

Indirect Calorimetry

A

Measurement of heat given off and utilized for the body’s metabolic processes

The respiratory quotient (CO2 / O2) is used to estimate 24-hour energy expenditure

139
Q

Mifflin-St. Jeor Energy Estimation Formula

MALES

A

Males: REE = (10 x wt) + (6.25 x ht) – (5 x age) + 5

140
Q

Mifflin-St. Jeor Energy Estimation Formula

FEMALES

A

Females: REE = (10 x wt) + (6.25 x ht) – (5 x age) - 161

141
Q

Ball park weight loss

A

13 cals per lb.

142
Q

Ball park weight maintenance

A

15 cals per lb

143
Q

Ball park weight gain

A

17 cals per lb

144
Q

1 lb of body fat = XX cals?

A

3500
To lose 1 lb a week, an adult would need to create a negative balance of 500 calories per day
A combination of decreased intake and increased use (i.e. exercise) is one approach to use
A positive balance of just 100 extra calories per day will result in a gain of 10 lbs in a year

145
Q

FAT nutr. recc.?

A

20-35% cals

146
Q

CHO %?

A

45-65% cals

147
Q

PRO %?

A

10-35% cals

148
Q

Consuming greater amounts of
Fruits, vegetables, fiber, and low-fat dairy products
Limiting saturated fat intake, trans fats
More nutrient rich foods, less sugar
Keeping sodium low
Regular physical activity
Energy intake balanced with energy expenditure  healthy weight

A

DIETARY GL sys focuses on these

149
Q

Recommendations in dietary guidance systems:

A

Consume fewer or smaller portions of beverages containing fats and added sugar
Plan beverage intake as part of total calorie intake
Make beverage choices that fit into the dairy, vegetable, and fruit groups

150
Q

Alcoholic drinks..

A

contains roughly 13-15 gs of alcohol or .5 oz ethanol

151
Q

Dietary supplements indicated with:

A

Pregnancy
Certain illness
Low calorie or nutrient restricted diets

152
Q

FUNCTIONAL FOODS

A

term used for food products that have a physiological benefit or reduce the risk of chronic disease beyond basic nutritional functions

153
Q

PA reccomd.

A

At least 150 minutes/week of moderate-intensity physical activity

Muscle strengthening activities 2 Xs a week

154
Q

Indications for Nutrition Support

A

To optimize health and nutritional status that cannot be achieved through basic diet alone
enteral- mouth or tube
PARENTERAL-
Intravenous via a central or peripheral vein

155
Q

Indications for Nutrition Support importance

A

Provide least restrictive type of support

Upgrade person to highest functional level

E.g consider oral support prior to placing tube

156
Q

Oral Supplements

A

Commonly used to increase calorie & protein intake

Disease-specific supplements are available

Can play a significant role in
Increasing energy intake
Improving body weight
Preventing malnutrition

Consider acceptability factor
Evaluate nutritional status regularly

157
Q

Enteral Nutrition Support

A

LAST RESORT- EN after all oral nutrition support options have been exhausted

Used in individuals who are unable to consume nutrients by mouth
Short term
Long term

158
Q

Standard formulas
Likely to meet nutrition needs
Less costly

Disease-specific formulas
Diabetic formulas
Acute and chronic kidney disease
High-protein formulas
Pulmonary formulas
Elemental or partially hydrolyzed formulas (amino acids broken down)
A

enteral feeding formulas

159
Q

Used when enteral feeding is not an option
Managed by a health care team
Vascular access route

A

Parenteral Nutrition

160
Q

HOME NUTR-support

A

Patient’s caregiver has ultimate responsibility for patient’s care

161
Q

Ethics and Nutrition Support end-of-life- care

A 
May actually worsen the dying experience
Restricts movement, discomfort
Medical necessity
Can increase risk of infectious and metabolic complications
Cultural and religious beliefs
162
Q

Advanced directives

A

Legal documentation saying what person wants done to them when the time comes..

Decision difficult if patient becomes vegetative, and/or requires wrist restraints

Support staff helps families make an informed decision

163
Q

Admission criteria for LTC

A

Hospice unit

Patient may or may not be eating
Patient may or may not have tube placement

Non-hospice unit

Patient must have either adequate oral intake or a permanent tube placement
Families at times get tubes placed in terminally ill patients just to get them admitted in LTC/SNF

164
Q

Patients with chronic illness and inability to consume food, but having intact minds

A

Experience improved quality of life

165
Q

Patients with debilitating chronic illness and unaware of surroundings or vegetative

A

May not experience improved quality of life

166
Q

Benefits of PA for older adults

A

Amelioration of the biological changes of aging
Prevention or delay in development of risk factors for chronic diseases
Primary prevention of some of the most common chronic diseases
Treatment for disabling geriatric syndromes
Adjunctive treatment for established diseases

167
Q

PA for diabetics

A

makes the muscle sensitive and more likely to accept insulin

168
Q

Progressive resistance training

A

Reverses sarcopenia and osteopenia

169
Q

Nutrition supplementation

A

For anorexia, weight loss

170
Q

Protein-calorie malnutrition

A

Leads to loss of lean body mass
Sarcopenic obesity(someone fat w/ no muscles)
Micronutrient status

171
Q

Nutrients for exercise

A

Protein supplementation for muscle synthesis

Vitamin D for improving muscle strength

Ca, Mg, K for muscle contraction

172
Q

Medical problems that place older patients at higher risk for exercise-related adverse events

A

Visual impairment
balance problems
osteoarthritis

173
Q

Four major components of fitness

A
  • strength
  • endurance
  • flexibility
  • balance
174
Q

NUTR and exercise considerations

A

Energy requirements may increase with exercise
Increased protein may be required for anabolic adaptation to resistance training
Be aware of nutrition quackery

317 NUTR (1 decks)

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