Clinical Applications of Nutrition

Question 1

What are the fat soluble vitamins?

Answer 1

A, D, E, K

Question 2

What are the water soluble vitamins?

Answer 2

Bs and C

Question 3

Alternate names of:
B1 - 
B2 -
B3 - 
B6 - 
B9 - 
B12 -

Answer 3

"The Rhythm Nearly Proved Fully Contagious" 
B1 =  thiamine
B2 = riboflavin
B3 = niacin
B6 = pyridoxine
B9 = folate / folic acid
B12 = cobalamin

Question 4

Alternate name of vitamin C

Answer 4

ascorbic acid

Question 5

Alternate names of:
A - 
D - 
E - 
K -

Answer 5

A = Retinol / retinal / retinoic acid
D = cholecalciferol / ergocalciferol
E = tocopherol
K = 2 methyl 1, 4 naphthoquinone (3) derivatives

Question 6

Dietary sources of Vit A

Answer 6

Dark green and yellow vegetables
Tomatoes
Eggs
Fish

Question 7

Dietary sources of Vit D

Answer 7

Mushrooms
Fortified milk
Eggs
Fish

Question 8

Dietary sources of Vit E

Answer 8

Wheat germ
Avocado
Seeds and nuts
Fish

Question 9

Dietary sources of Vit K

Answer 9

Green leafy vegetables
Dairy products
Fruits
Vegetable oils
Cereals
Intestinal microflora

Question 10

Dietary sources of Vit B1

Answer 10

Legumes
Grains (whole and enriched)
Lean pork

Question 11

Dietary sources of Vit B2

Answer 11

Wheat germ
Leafy vegetables
Dairy products
Meat/poultry

Question 12

Dietary sources of Vit B3

Answer 12

Legumes
Wheat
Meats/poultry/fish
Everything except fat

Question 13

Dietary sources of Vit B6

Answer 13

Animal products
Vegetables
Whole grains

Question 14

Dietary sources of Vit B9

Answer 14

Leafy vegetables (but destroyed in cooking)
Fruits
Whole Grains 
Beans
Nuts

Question 15

Dietary sources of Vit B12

Answer 15

NONE IN PLANTS 
Dairy products
Meats
Liver
Eggs

Question 16

Dietary sources of Vit C

Answer 16

Fruits

Vegetables

Question 17

Calcium

Answer 17

Dark, leafy vegetables
Tofu
Broccoli
Cauliflower
Dairy products 
Flax seed
Beans and lentils

Question 18

Iron

Answer 18

Dark leafy vegetables 
Broccoli
Cauliflower 
Legumes (lentils, tofu)
Nuts and seeds
Quinoa
Lean meat
Clams/oysters
Dried prunes & raisins

Question 19

Metabolic role of Vit A (retinal / retinol)

Answer 19

Vision - needed for rhodopsin & iodopsin

Question 20

Metabolic role of Vit A (retinoic acid)

Answer 20

Embryonic development
Maintenance of epithelia
Cell growth, proliferation, and differentiation (deficiency issues can lead to kidney stones)

Question 21

Metabolic role of Vit D

Answer 21

Bone metabolism and calcium homeostasis

Question 22

Metabolic role of Vit E

Answer 22

ROS scavenger (membrane antioxidants)

Question 23

Metabolic role of Vit K

Answer 23

Blood clotting (II, VII, IX, X)

Question 24

Metabolic role of Vit B1

Answer 24

CHO metabolism

AA metabolism

Question 25

Metabolic role of Vit B2

Answer 25

Oxidoreductases | FMN, FAD

Question 26

Metabolic role of Vit B3

Answer 26

Oxidoreductases NAD, NADP Remember Niacin = N

Question 27

Metabolic role of Vit B6

Answer 27

CHO, AA, lipid metabolism | Neurotransmitter, sphingolipids, heme synthesis

Question 28

Metabolic role of Vit B9

Answer 28

1-C transfer rxns Choline synthesis of AA Purines and pyrimidine synthesis

Question 29

Metabolic role of Vit B12

Answer 29

Heme structure | Folate recycling

Question 30

Metabolic role of Vit C

Answer 30

Antioxidant (free radical scavenger) Collagen, bile acid synthesis NE neurotransmitter synthesis

Question 31

Metabolic role of calcium

Answer 31

M. contraction Cell transport B. metabolism

Question 32

Metabolic role of iron

Answer 32

Hgb, myoglobin and cytochromes a/b/c

Question 33

What is considered a leafy vegetable?

Answer 33

All kinds of lettuce + dark green leafy veggies

Question 34

BMI calculation

Answer 34

weight (kg) / height (m^2)

Question 35

BMI ranges (normal, overweight, obese)

Answer 35

Normal: 18-25 Overweight: 25.1-29.9 Obese: 30+

Question 36

Weight circumference of ____ for males and ____ for females is considered obese.

Answer 36

Male: >40 in Female: >35 in

Question 37

Modest weight loss of 5-10% improves ____ & decreases ____.

Answer 37

Improves BP | Decreases insulin resistance

Question 38

How do you counsel patients about food choices?

Answer 38

1. Follow healthy, balanced eating pattern across lifetime 2. 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) 3. Limit calories from added sugars 4. Limit saturated fats and fried foods 5. Reduce sodium intake to <2300 mg daily 6. Shift to healthier food and beverage choices

Question 39

How do you counsel patients about exercise?

Answer 39

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

Question 40

Condition associated w/ vitamin C deficiency?

Answer 40

Scurvy: - impaired wound healing - fatigue - depression - CT abnormalities - inflamed gingiva - bleeding issues: i.e. of gums, petichiae, hemorrhage - hyperkeratosis

Question 41

What constitutes as starchy vegetables?

Answer 41

potatoes, corn, starch, etc.

Question 42

What are considered bad fats?

Answer 42

Saturated and trans fats: - animal fats - solid fats - coconut & palm kernel oils

Question 43

What are considered good fats?

Answer 43

Mono- and Polyunsaturated fats: - Seafood (omega 3) - Walnuts - Pretty much all other liquid, vegetable/seed oils

Question 44

Describe the Mediterranean diet

Answer 44

``` 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 ```

Question 45

Type of diet? May or may not include egg or dairy products

Answer 45

Vegetarian

Question 46

Type of diet? Includes egg & dairy products

Answer 46

Lacto-ovo- vegetarian

Question 47

Type of diet? Includes dairy products, but not eggs

Answer 47

Lacto-vegetarian

Question 48

Type of diet? Includes eggs, but not dairy products

Answer 48

Ovo-vegetarian

Question 49

Type of diet? Excludes eggs & dairy products & sometimes honey

Answer 49

Vegan

Question 50

Type of diet? Uncooked food 75-100%, plant/nut/legume/grain based

Answer 50

Raw Vegan

Question 51

Type of diet? Includes fish & seafood

Answer 51

Pescatarian

Question 52

Describe the DASH Diet

Answer 52

- low fat (limit high saturated fat) foods - avoid added sugars Diet helps lower BP and LDL

Question 53

Nutrients that are required to be listed on food labels? Ones that are optional?

Answer 53

Required: D, calcium, iron, potassium Optional: A & C

Question 54

What components are required by food label laws?

Answer 54

1. Ingredient listing in descending order of predominance (highest amount present first) 2. Labeling of major allergens

Question 55

What type of patients are susceptible to Vit A deficiency?

Answer 55

Those with fat malabsorption conditions. (i.e. Crohn's disease or hx of gastric bypass surgery)

Question 56

# Define: 1. Sodium free 2. Very low sodium 3. Low sodium 4. Reduced sodium 5. Light in sodium or lightly salted 6. No salt added or unsalted

Answer 56

1. SF: <5 mg per serving 2. VLS: = or <35 mg per serving 3. LS: = or <140 mg per serving 4. RS: 25% less than original product 5. LIS: 50% less than original product 6. NSA: none added during processing but DOES NOT = no sodium in product

Question 57

# Define: 1. Fat free 2. Low fat 3. Reduced or less fat 4. Trans fat free

Answer 57

1. FF: <0.5g per serving 2. LF: = or <3g per serving 3. RF: 25% less than original product 4. TFF: <0.5g trans fat per serving (0.49g considered TFF)

Question 58

Measurement equivalents of: 1. palm of hand 2. DIP to end of thumb

Answer 58

1. 1/2 cup | 2. 1 tablespoon

Question 59

How many fruits and vegetables should adults ideally aim for?

Answer 59

6-9

Question 60

What are the 4 tools used to obtain a diet history?

Answer 60

1. 24 hr recall 2. Typical day 3. Food diary (write everything down!) 4. Food frequency (the how often questions)