Clinical Applications of Nutrition Flashcards
What are the fat soluble vitamins?
A, D, E, K
What are the water soluble vitamins?
Bs and C
Alternate names of: B1 - B2 - B3 - B6 - B9 - B12 -
"The Rhythm Nearly Proved Fully Contagious" B1 = thiamine B2 = riboflavin B3 = niacin B6 = pyridoxine B9 = folate / folic acid B12 = cobalamin
Alternate name of vitamin C
ascorbic acid
Alternate names of: A - D - E - K -
A = Retinol / retinal / retinoic acid D = cholecalciferol / ergocalciferol E = tocopherol K = 2 methyl 1, 4 naphthoquinone (3) derivatives
Dietary sources of Vit A
Dark green and yellow vegetables
Tomatoes
Eggs
Fish
Dietary sources of Vit D
Mushrooms
Fortified milk
Eggs
Fish
Dietary sources of Vit E
Wheat germ
Avocado
Seeds and nuts
Fish
Dietary sources of Vit K
Green leafy vegetables Dairy products Fruits Vegetable oils Cereals Intestinal microflora
Dietary sources of Vit B1
Legumes
Grains (whole and enriched)
Lean pork
Dietary sources of Vit B2
Wheat germ
Leafy vegetables
Dairy products
Meat/poultry
Dietary sources of Vit B3
Legumes
Wheat
Meats/poultry/fish
Everything except fat
Dietary sources of Vit B6
Animal products
Vegetables
Whole grains
Dietary sources of Vit B9
Leafy vegetables (but destroyed in cooking) Fruits Whole Grains Beans Nuts
Dietary sources of Vit B12
NONE IN PLANTS Dairy products Meats Liver Eggs
Dietary sources of Vit C
Fruits
Vegetables
Calcium
Dark, leafy vegetables Tofu Broccoli Cauliflower Dairy products Flax seed Beans and lentils
Iron
Dark leafy vegetables Broccoli Cauliflower Legumes (lentils, tofu) Nuts and seeds Quinoa Lean meat Clams/oysters Dried prunes & raisins
Metabolic role of Vit A (retinal / retinol)
Vision - needed for rhodopsin & iodopsin
Metabolic role of Vit A (retinoic acid)
Embryonic development
Maintenance of epithelia
Cell growth, proliferation, and differentiation (deficiency issues can lead to kidney stones)
Metabolic role of Vit D
Bone metabolism and calcium homeostasis
Metabolic role of Vit E
ROS scavenger (membrane antioxidants)
Metabolic role of Vit K
Blood clotting (II, VII, IX, X)
Metabolic role of Vit B1
CHO metabolism
AA metabolism
Metabolic role of Vit B2
Oxidoreductases
FMN, FAD
Metabolic role of Vit B3
Oxidoreductases
NAD, NADP
Remember Niacin = N
Metabolic role of Vit B6
CHO, AA, lipid metabolism
Neurotransmitter, sphingolipids, heme synthesis
Metabolic role of Vit B9
1-C transfer rxns
Choline synthesis of AA
Purines and pyrimidine synthesis
Metabolic role of Vit B12
Heme structure
Folate recycling
Metabolic role of Vit C
Antioxidant (free radical scavenger)
Collagen, bile acid synthesis
NE neurotransmitter synthesis
Metabolic role of calcium
M. contraction
Cell transport
B. metabolism
Metabolic role of iron
Hgb, myoglobin and cytochromes a/b/c
What is considered a leafy vegetable?
All kinds of lettuce + dark green leafy veggies
BMI calculation
weight (kg) / height (m^2)
BMI ranges (normal, overweight, obese)
Normal: 18-25
Overweight: 25.1-29.9
Obese: 30+
Weight circumference of ____ for males and ____ for females is considered obese.
Male: >40 in
Female: >35 in
Modest weight loss of 5-10% improves ____ & decreases ____.
Improves BP
Decreases insulin resistance
How do you counsel patients about food choices?
- Follow healthy, balanced eating pattern across lifetime
- Focus on variety, nutrient density, amount
(wide variety of veggies and protein, whole fruit better
than juice, low fat/fat-free dairy, meat 4 oz serving size
= palm/deck of cards size) - Limit calories from added sugars
- Limit saturated fats and fried foods
- Reduce sodium intake to <2300 mg daily
- Shift to healthier food and beverage choices
How do you counsel patients about exercise?
Exercise for sake of exercise; outside of daily activities
Choose an activity you like
Start slow and increase over time
Goal: build up to at least 150 minutes/week
If losing weight is a goal: 500 calories/day = 1 lb/wk
Condition associated w/ vitamin C deficiency?
Scurvy:
- impaired wound healing
- fatigue
- depression
- CT abnormalities
- inflamed gingiva
- bleeding issues: i.e. of gums, petichiae, hemorrhage
- hyperkeratosis
What constitutes as starchy vegetables?
potatoes, corn, starch, etc.
What are considered bad fats?
Saturated and trans fats:
- animal fats
- solid fats
- coconut & palm kernel oils
What are considered good fats?
Mono- and Polyunsaturated fats:
- Seafood (omega 3)
- Walnuts
- Pretty much all other liquid, vegetable/seed oils
Describe the Mediterranean diet
Plant based Small portion of egg, dairy, poultry, fish few times per wk Minimal red meat, sugar, fats Olive oil ok 1-2 glasses of red wine/day
Type of diet?
May or may not include egg or dairy products
Vegetarian
Type of diet?
Includes egg & dairy products
Lacto-ovo- vegetarian
Type of diet?
Includes dairy products, but not eggs
Lacto-vegetarian
Type of diet?
Includes eggs, but not dairy products
Ovo-vegetarian
Type of diet?
Excludes eggs & dairy products & sometimes honey
Vegan
Type of diet?
Uncooked food 75-100%, plant/nut/legume/grain based
Raw Vegan
Type of diet?
Includes fish & seafood
Pescatarian
Describe the DASH Diet
- low fat (limit high saturated fat) foods
- avoid added sugars
Diet helps lower BP and LDL
Nutrients that are required to be listed on food labels?
Ones that are optional?
Required: D, calcium, iron, potassium
Optional: A & C
What components are required by food label laws?
- Ingredient listing in descending order of predominance (highest amount present first)
- Labeling of major allergens
What type of patients are susceptible to Vit A deficiency?
Those with fat malabsorption conditions. (i.e. Crohn’s disease or hx of gastric bypass surgery)
Define:
- Sodium free
- Very low sodium
- Low sodium
- Reduced sodium
- Light in sodium or lightly salted
- No salt added or unsalted
- SF: <5 mg per serving
- VLS: = or <35 mg per serving
- LS: = or <140 mg per serving
- RS: 25% less than original product
- LIS: 50% less than original product
- NSA: none added during processing but DOES NOT = no sodium in product
Define:
- Fat free
- Low fat
- Reduced or less fat
- Trans fat free
- FF: <0.5g per serving
- LF: = or <3g per serving
- RF: 25% less than original product
- TFF: <0.5g trans fat per serving (0.49g considered TFF)
Measurement equivalents of:
- palm of hand
- DIP to end of thumb
- 1/2 cup
2. 1 tablespoon
How many fruits and vegetables should adults ideally aim for?
6-9
What are the 4 tools used to obtain a diet history?
- 24 hr recall
- Typical day
- Food diary (write everything down!)
- Food frequency (the how often questions)