Adult nutrition

Question 1

Deteremining calories

• Gold standard :
• Normal nutrition 25-35 kcal/kg
• Calories – 1200-2000 for____

– 1800-2400 for ___

• Increased calorie needs – Infection, critical illness, wound healing, chronic illness, cancer

Answer 1

indirect calorimetry

women

men

Question 2

Role of carbohydrate intake

Answer 2

– Supports energy metabolism, maintains blood glucose, immediate source of energy for brain, maintains glycogen stores in liver

Question 3

Role of soluble fiber and where you can get it

Answer 3

– Forms gel-like substance in intestines

– Food sources • Oats, barley, fruits, vegetables, dried peas/beans

Question 4

role and sources of insolbule fiber

Answer 4

Insoluble – Increases stool bulk – Food source: • Bran, vegetables with skins, skins on fruits

Question 5

how much protein does healthy adult need, when can we cut back on protein?

Answer 5

0.8g/kg

in obese people

Question 6

• Limit____ fats as it Increases LDL cholesterol, heart disease risk
• Increase_____ fats and omega- 3 polyunsaturated fats – Decreases LDL cholesterol – Decrease inflammation – Improves HDL cholesterol

Answer 6

saturated

monounsaturated

Question 7

Diagnostic Criteria for Malnutrition

Answer 7

• 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

Question 8

Sources of Thiamin B1

role of Thiamin B1

Answer 8

• Role: Energy metabolism
• Food sources: – Pork, enriched & whole grains, legumes

Question 9

– Decreased appetite, fatigue, peripheral neuropathy

Answer 9

thiamin or B1 deficiency

Question 10

severe deficiency of B1 or thiamin

– Advanced neuromuscular symptoms

– Edema (wet Beriberi) – Heart failure

Answer 10

Dry/Wet Beriberi

Question 11

Mental confusion , ataxia, uncoordinated eye movements

Answer 11

Wernicke-Korsakoff –Vit B 1 deficiency

Question 12

Role and sources of Vit B5

Answer 12

• Role: Energy metabolism
• Food sources – Widespread – Legumes/lentils, whole grains, sweet potatoes, meat

Question 13

Role and sources of Vit B3: Niacin

Answer 13

• Role: Energy metabolism
• Food sources: – Meats, legumes – Synthesize from tryptophan • 1 mg niacin per 60 mg tryptophan

Question 14

– Symptoms: Glossitis – Pellagra • Three “D”s – Diarrhea, Dermatitis, Dementia…Death

Answer 14

Niacin (Vitamin B3 ) deficiency

Question 15

Toxicity of Vit B3: niacin

Answer 15

Toxicity – Histamine induced flushing, liver damage

Question 16

Role and sources of Pyridoxine or Vit B6

Answer 16

• Role: Energy metabolism
• Food sources: – Plants & animal sources – Potatoes, chicken, salmon, nuts, fortified cereals

Question 17

Deficiency causes: • Irritability, nervousness, depression, peripheral neuropathy (severe) • Microcytic anemia

Answer 17

vit B 6; pridoxine

Question 18

Role and sources of : Riboflavin (Vitamin B2 )

Answer 18

• Role: Energy metabolism
• Food sources – Milk, dairy products, eggs, enriched cereals, dark leafy greens

Question 19

deficiency causes: • Cheilitis, glossitis, dermatitis, anemia

Answer 19

riboflavin Vit B2

Question 20

Biotin sources and role

Answer 20

• Role: Energy metabolism
• Food sources – Widely distributed – Egg yolks, liver, yeast, whole grains, vegetable

Question 21

deficiency in biotin:

Answer 21

hair loss

Question 22

Role and sources of Folate or Vit B9

Answer 22

• Role: Hematopoietic
• Food sources: – Liver, dark leafy vegetables, broccoli, legumes – Fortified grains/cereals

Question 23

Deficiency causes • Macrocytic or megaloblastic anemia, hyperhomocysteinemia, red tongue, cognitive decline, neural tube defects

Answer 23

Folate or Vit B9

Question 24

• Macrocytic or megaloblastic anemia, hyperhomocysteinemia, red tongue, cognitive decline, neural tube defects

What labs do we order to test this out?

Answer 24

– Serum folate, RBC folate, CBC

Question 25

what concerning about folate toxicitity

Answer 25

– May mask Vitamin B-12 deficiency

Question 26

Sources of coblamin/Vit B12 and function

Answer 26

• Hematopoietic • Food sources: – Only animal sources – Meat and meat products

Question 27

Funtions of Vit B12 or Cobolamin

Answer 27

– Megaloblastic anemia, pernicious anemia, homocysteine, neurological deterioration –

Question 28

who is at risk for Cobolamin /Vit B12 deficiency

Answer 28

At risk • Vegans, elderly, insufficient intrinsic factor/HCl in stomach • Vegans

Question 29

Labs to order if you suspect Vit B 12 deficiency

Answer 29

** Methylmalonyl Co-A**, Complete Blood Count, Serum B-12,

Question 30

Sources for Ascorbic acid or Vit C

Answer 30

• Food sources: – Plant sources – Citrus fruits, dark leafy greens, strawberries, bell peppers, cantaloupe

Question 31

this severe vit deficiency leads to:Hemorrhage, Hyperkeratosis, Hypochondriasis, Hematologic abnormalities

Answer 31

vit C deficient

Question 32

What do we worry about with Vit C toxicity

Answer 32

Toxicity/Excessive intake – Hyperoxaluria

• Increased risk for renal oxalate stones – Diarrhea – Iron overdose

Question 33

Sources and function of Vit E or Tocopheral

Answer 33

• Antioxidant • Food Sources – Plant oils, nuts, seeds, almonds, hazelnuts

Question 34

– Majority of Americans do not meet guidelines – Decreased antioxidant protection • Aging, arthritis, cancer, CVD, Alzheimer’s disease, infection…

Answer 34

Tocopherol; Vit E

Question 35

Fuction and sources of Vit A: Caratones and retinoids

Answer 35

• Functions – Cell differentiation, vision
• Food Sources

– Retinol • Animals Sources—fish oils

– Carotenoids • Plant foods—orange vegetables, dark leafy greens

Question 36

Night blindness, poor growth, xerophthalmia, follicular hyperkeratosis

Answer 36

Vit A deficient

Question 37

Excessive intake____

• Very low risk of toxicity from carotenoids
• Anorexia, dry itchy skin, hair loss, abnormal liver function
• Fetal malformations

Answer 37

retinol

Question 38

deficiency in Mg causes:

Answer 38

Muscle spasms, hypocalcemi a, bone resorption

Question 39

deficient Copper intake:

Answer 39

Anemia, neutropenia, leukopenia Menke’s syndrome

Question 40

Renal abnormality occur if you don’t get enough of this

Answer 40

Phosphorus

Question 41

Rash, anemia, hypoguesia, delayed wound healing, alopecia all signs of which mineral deficiency

Answer 41

Zinc

Question 42

upper limit for salt intake

Answer 42

<2, 300 mg (= 1 tsp salt)