Adult Nutrition - Kent Flashcards
Dietary guielines are established every 5 years by the USDA and USHHS. We are all familiar with the classic (and newer, shittier) food pyramid, it has now been suppplanted by “MyPlate”.
(No question here. This shit isn’t important anyway.)
Seriously. Mark 5 and move on.
How does a typical American diet deviate from an ideal one?
Too many refined grains, sodium and saturated fats.
Not enough whole grains, fruits, vegetables, and heart healthy fats (especially from seafood & fish).
Too many calories overall.
RDA, AI, and UL are all dietary reference intakes (DRI).
What are the differences between the three?
RDA (Recommended dietary allowance: Average daily intake needed for almost all (>95%) of healthy people.
AI (Adequate intake): Number assumed to be appropriate when RDA cannot be established.
UL (Upper limit): Maximum daily intake which should not cause toxicity.
About how many calories per day do men or women need?
Under what conditions would this demand increase?
25-35kcal/kg; for women this is usually 1200-2000, while for men it is usually 1800-2400.
With cancer, active infections, wound healing, and other chronic or critical illnesses.
How many calories are in carbohydrates/fats/protein?
What is a good (rough) distribution of these macronutrients by calorie?
4kcal/g for carbs & protein, 9kcal/g for fats.
(things like alcohol or vinegars score in between fats and carbohydrates)
Probably about 55% carbohydrate, 25% fat, 20% protein (give or take several percent each, varying with age/gender/athleticism)
What functions are served by dietary carbohydrates?
What are some exemplars of carbohydrates?
Primary source of energy for the body, and the only source for erythrocytes and the brain (initially). Maintains liver glycogen stores.
Starches like bread & pasta, simple sugars found in fruits or junk food.
Distinguish between soluble and insoluble fibers. Give examples of dietary sources for each.
Soluble: Forms gel-like substance in intestines. Found in oats, barley, fruit+veg, peas and beans.
Insoluble: Increases stool bulk. Found in bran, skins of fruit+veg.
How much protein (by mass) should a healthy person consume? Someone critically ill?
What are some examplars of dietary protein?
0.8g/kg (~54g) for the healthy, 1.2-2g/kg (84-140g) for the ill (per day).
Meats, dairy, eggs, plant products like soy or nuts.
What is permissive underfeeding of the obese? How is its macronutrient composition altered?
Who should receive less protein than normal?
Obese patients undergoing dietary restriction are advised to consume a higher proportion of protein to avoid the wasting of lean mass that occurs with such weight loss.
Those with chronic renal failure (due to exacerbation of azotemia)
Why are mono- and poly-unsaturated fats considered better than saturated fats?
What are worse than saturated fats? Why?
They improve HDL:LDL profile and decrease inflammation (wat).
Trans fats (conjecture: trans fats are more prone to peroxidation than saturated fats; increasing atherosclerosis)
What are the consequences of malnutrition?
How is it assessed?
Weight loss, increased M&M (morbidity & mortality), decreased function and QOL (quality of life), as well as longer and more expensive hospitalization.
Measuring intake, weight loss, loss of fat & muscle, fluid accumulation, and handgrip strength.
What is the general role of B-vitamins?
“Energy metabolism”; probably better to refer to Twining’s lecture for specifics. B9 (folate) and B12 (cobalamin) are noted specially for hematopoiesis.
What is vitamin B1 also known as?
What are our dietary sources of it?
What are the consequences of its deficiency?
Thiamine
Pork, enriched & whole grains, legumes
Dry/Wet beriberi (wet features heart failure and edema), Wernicke-Korsakoff psychosis. Decreased appetite & fatigue…
What is vitamin B2 also known as?
What are our dietary sources of it?
What are the consequences of its deficiency?
Riboflavin.
Milk, dairy products eggs, enriched cereals and DLGs (Dark Leafy Greens) *Note: Mostly animal products
Cheilitis, glossitis, dermatitis, anemia. (Twining’s lecture says corneal neovascularization)
What is vitamin B3 also known as?
What are our dietary sources of it?
What are the consequences of its deficiency?
Niacin
Meats, legumes. Can be synthesized from endogenous tryptophan (inefficiently?)
Glossitis and Pellagra (seen in alcoholics); observe the 3 “D”s (diarrhea, dermatitis, dementia)
