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GI/Nutrition > Adult Nutrition > Flashcards

Adult Nutrition Flashcards

1
Q

Dietary Guidelines for Americans:

Goals

A
  1. Maintain healthy weight
  2. Chronic disease prevention
  3. Adequate nutrient intake
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2
Q

What do Americans need to improve on in their diet?

A
  • Maintain calorie balance
  • Increase whole grains and reduce refined sugars
  • Increase fruits & vegetables
    • Especially dark green, red/orange, beans/peas
  • Increase heart healthy fats especially proteins from seafood/fish
  • Reduce sodium
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3
Q
  • What is the gold standard for determining calorie need?
  • What is normal nutritional energy (kcal/kg)?
  • How many calories are recommended for:
    • Women
    • Men
  • When should caloric intake be increased?
A
  • Gold standard: indirect calorimetry
  • Normal nutrition: 25-35 kcal/kg
  • Calories
    • 1200-2000 for women
    • 1800-2400 for men
  • Increased calorie needs:
    • Infection, critical illness, wound healing, chronic illness, cancer
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4
Q

Macronutrient Distribution

Carbs, Proteins, Fats

A
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5
Q

What is the role of carbohydrate intake?

A
  • Supports energy metabolism
  • Maintains blood glucose
  • Immediate source of energy for brain
  • Maintains glycogen stores in liver
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6
Q

Dietary Fiber:

Soluble vs. Insoluble

A
  • Soluble
    • Forms gel-like substance in intestines
    • Food sources:
      • Oats, barley, fruits, vegetables, dried peas/beans
  • Insoluble
    • Increases stool bulk
    • Food source:
      • Bran, vegetables with skins, skins on fruits
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7
Q

Protein

  • Requirements:
    • Healthy Adults
    • Non-healthy adults
  • Food Sources:
  • How are proteins involved in underfeeding the obese?
A
  • Requirements:
    • Healthy adults 0.8g/kg
    • Critical illness, cancer, wound healing/pressure ulcers: 1.2-2.0g/kg
  • Food sources:
    • Meats, dairy, eggs, soy products
  • Permissive underfeeding of obese
    • Decreased calories, increased protein
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8
Q

Fat recommendations:

  • Saturated fats:
    • Function?
  • Unsaturated fats:
    • Function?
A
  • Limit saturated fats
    • Increases LDL cholesterol, heart disease risk
  • Increase monounsaturated fats and omega-3 polyunsaturated fats
    • Decreases LDL cholesterol
    • Decrease inflammation
    • Improves HDL cholesterol
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9
Q
  1. What is malnutrition?
  2. What are the consequences of malnutrtion?
A
  1. Decreased intake and increased nutrient needs
    • Weight loss, loss of lean body mass
  2. Consequences of malnutrition:
    • Increased morbidity & mortality
    • Decreased functional capacity
    • Decreased quality of life
    • Increased length of stay
    • Increased hospital costs
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10
Q

What are the diagnostic criteria for malnutrition?

A
  • Insufficient energy intake
  • Weight loss
  • Loss of muscle mass
  • Loss of subcutaneous fat
  • Localized or generalized fluid accumulation
  • Diminished functional status as measured by handgrip strength
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11
Q

Vitamin B1 (thiamine):

  • Role
  • Food Sources
  • RDA
    • ​Men
    • Women
A
  • Role: Energy metabolism
  • Food sources:
    • Pork, enriched & whole grains, legumes
  • RDA:
    • Men: 1.2 mg/day
    • Women: 1.1 mg/day
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12
Q

What two disease processes are caused by a thiamine deficiency?

A
  1. Wernicke-Korsakoff
  2. Dry/Wet Beriberi (severe deficiency)
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13
Q

Thiamine (Vitamin B1) deficiency:

  • Symptoms
  • Wernicke-Korsakoff
  • Dry/Wet Beriberi
  • Labs?
A
  • Symptoms
    • Decreased appetite, fatigue, peripheral neuropathy
  • Wernicke-Korsakoff
    • Mental confusion (Wernicke’s encephalopathy)
    • Ataxia
    • Uncoordinated eye movements
  • Dry/Wet Beriberi—severe deficiency
    • Advanced neuromuscular symptoms
    • Edema (wet Beriberi)
    • Heart failure
  • Labs: serum thiamine
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14
Q

Vitamin B2 (Riboflavin):

  • Role
  • Food Sources
  • RDA
    • ​Men
    • Women
A
  • Role: Energy metabolism
  • Food sources
    • Milk, dairy products, eggs, enriched cereals, dark leafy greens
  • RDA
    • Males: 1.3 mg/day
    • Females: 1.1 mg/day
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15
Q

Riboflavin (Vitamin B2)** deficiency:**

  • Symptoms:
  • Toxicity:
A
  • Symptoms:
    • Cheilitis, glossitis, dermatitis, anemia
  • Toxicity:
    • Rare
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16
Q

Vitamin B3 (Niacin):

  • **Role **
  • **Food sources **
  • RDA
    • Men:
    • Women:
A
  • Role: Energy metabolism
  • Food sources
    • Meats, legumes
    • Synthesize from tryptophan
      • 1 mg niacin per 60 mg tryptophan
  • RDA
    • Men: 16 mg/day
    • Women: 14 mg/day
17
Q

Niacin (Vitamin B3)** **Deficiency:

  • Symptoms:
  • Toxicity
  • What is the therapeutic use for Nicotinic Acid?
A
  • Symptoms: Glossitis
    • Pellagra (Three “D”s)
      • Diarrhea, Dermatitis, Dementia…Death
  • Toxicity
    • Histamine induced flushing, liver damage
  • Therapeutic Use for Nicotinic Acid:
    • Used to treat elevated cholesterol
18
Q

Vitamin B5 (Pantothenic Acid):

  • **Role: **
  • Adequate Intake (AI)
  • Food sources
  • **Deficiency & toxicity **
A
  • Role: Energy metabolism
  • Adequate Intake (AI)
    • 5 mg/day
  • Food sources
    • Widespread
    • Legumes/lentils, whole grains, sweet potatoes, meat
  • Deficiency & toxicity rare
19
Q

Vitamin B6 (Pyridoxine):

  • **Role: **
  • Food sources:
  • RDA
A
  • Role: Energy metabolism
  • Food sources:
    • Plants & animal sources
    • Potatoes, chicken, salmon, nuts, fortified cereals
  • RDA
    • 1.3 mg/day
20
Q

**Pyridoxine **(Vitamin B6) deficiency:

  • Symptoms
  • Toxicity
A
  • Symptoms
    • Irritability, nervousness, depression, peripheral neuropathy (severe)
    • Microcytic anemia
  • Toxicity
    • Neurotoxicity, photosensitivity
21
Q

Vitamin B7 (Biotin):

  • **Role: **
  • Food sources
  • Adequate Intake (AI)
  • Deficiency
A
  • Role: Energy metabolism
  • Food sources
    • Widely distributed
    • Egg yolks, liver, yeast, whole grains, vegetables
  • Adequate Intake (AI)
    • 30 mcg per day
  • Deficiency
    • Hair loss
22
Q

**Vitamin B9 (Folate): **

  • **Role: **
  • Food sources:
  • RDA
A
  • Role: Hematopoietic
  • Food sources:
    • Liver, dark leafy vegetables, broccoli, legumes
    • Fortified grains/cereals
  • RDA
    • 400 mcg/day
23
Q

Folate (Vitamin B9) Deficiency:

  • Symptoms
  • Toxicity
  • Labs:
A
  • Symptoms
    • Macrocytic or megaloblastic anemia, hyperhomocysteinemia, red tongue, cognitive decline, neural tube defects
  • Toxicity
    • Rare
    • May mask Vitamin B12 deficiency
  • Labs:
    • Serum folate, RBC folate, CBC
24
Q

Vitamin B12 (Cobalamin):

  • **Role: **
  • Food sources:
  • RDA:
A
  • Role: Hematopoietic
  • Food sources:
    • Only animal sources
    • Meat and meat products
  • RDA:
    • 2.4 mcg/day
25
Q

Cobalamin (Vitamin B12) Deficiency

  • Symptoms:
  • Who is at risk for this deficiency?
  • Labs:
A
  • Symptoms:
    • Megaloblastic anemia, pernicious anemia, homocysteine, neurological deterioration
  • At risk:
    • Vegans, elderly, insufficient intrinsic factor/HCl in stomach
  • Labs:
    • Serum B12, Methylmalonyl Co-A, Complete Blood Count
26
Q

**Vitamin C (Ascorbate): **

  • Food Sources:
  • RDA
    • ​Men
    • Women
    • *increased for ….
A
  • Food sources:
    • Plant sources
    • Citrus fruits, dark leafy greens, strawberries, bell peppers, cantaloupe
  • RDA
    • Men: 90 mg/day
    • Women: 70 mg/day
    • *increased for smokers
27
Q

Ascorbate (Vitamin C) Deficiency:

  1. Symptoms:
  2. What can severe deficiency cause?
A
  1. Symptoms
    • Easy bruising, petechiae, decreased immunocompetence
  2. Severe deficiency ⇒ **Scurvy (4 “H s”) **
    • Hemorrhage, Hyperkeratosis, Hypochondriasis, Hematologic abnormalities
28
Q

Ascorbate (Vitamin C):

  • Toxicity/Excessive intake
  • Upper Limit:
A
  • Toxicity/Excessive intake
    • Hyperoxaluria
      • Increased risk for renal oxalate stones
    • Diarrhea
    • Iron overdose
  • Upper Limit: 2000 mg/day
29
Q

Vitamin E (Tocopherol):

  • Role:
  • Food Sources
  • Adequate Intake (AI)
    • Males:
    • Females:
A
  • Role: Antioxidant
  • Food Sources
    • Plant oils, nuts, seeds, almonds, hazelnuts
  • Adequate Intake (AI)
    • Males: 15 mg alpha-tocopherol/day
    • Females: 15 mg per day
30
Q

Tocopherol (Vitamin E):

  • Inadequate intake
  • Deficiency
  • Toxicity
A
  • Inadequate intake
    • Majority of Americans do not meet guidelines
    • Decreased antioxidant protection
      • Aging, arthritis, cancer, CVD, Alzheimer’s disease, infection…
  • Deficiency—rare
    • Neuromuscular degeneration
  • Toxicity
    • Low risk
31
Q

Vitamin A (Carotenes, Retinoids):

  • Functions
  • Food Sources
    • Retinol
    • Carotenoids
  • RDA
A
  • Functions
    • Cell differentiation, vision
  • Food Sources
    • Retinol
      • Animals Sources—fish oils
    • Carotenoids
      • Plant foods—orange vegetables, dark leafy greens
  • RDA
    • Men: 3,000 IU
    • Women: 2,333 IU
32
Q

Vitamin A:

  • Deficiency Symptoms:
  • Toxicity
    • Excessive intake of ….​
  • Important labs:
A
  • Deficiency Symptoms:
    • Night blindness, poor growth, xerophthalmia, follicular hyperkeratosis
  • Toxicity
    • Excessive intake of retinol
      • Very low risk of toxicity from carotenoids
      • Anorexia, dry itchy skin, hair loss, abnormal liver function
      • Fetal malformations
  • Important labs: Plasma Retinol
33
Q
  • What is the key micronutrient of importance in the elderly?
A

Sodium

34
Q

What foods increase sodium?

A
  1. processed foods
  2. restaurant/fast food
  3. canned foods
  4. meats
  5. bread
  6. condiments
  7. cured meats
  8. pickled/fermented foods
  9. seasonings with salt
35
Q

RDA for sodium intake:

  • < 2,300 mg/day = 1 tsp:
  • 1500 mg/day:
A
  • < 2,300 mg/day = 1 tsp:
    • Healthy Americans over age 2
  • 1,500 mg/day:
    • Adults age 51 or older All African Americans Chronic disease
    • Kidney disease
    • Hypertension
    • Congestive heart failure
    • Liver failure

GI/Nutrition (36 decks)

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