diet and nutrition in adults Flashcards

1
Q

What is nutrition?

A

Processes for living organisms to receive and use materials from the environment to promote vital activities

For good health, prevention of disease and recovery from illness

Eat well, be well

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2
Q

How is our food choice determined?

A
Age
Gender
State of health
Mood
Socioeconomic factors (ads, income, environment, transport, social status)
Geographical location
Culture
Religion
Cost
Availability
Personal preferences
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3
Q

What are some dietary habits?

A

Long standing preferences
Strong opinions
Effective advice for change

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4
Q

What are different models of change?

A

Knowledge, attitude, behaviour
Capability, opportunity, motivation
Environment, access, support

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5
Q

What are adult nutrient needs?

A

Energy requirements decline from 19+ and again from 50+
Due to decrease in lean body tissue which grt fall in basal metabolic rate
Usually become less active

Need same fat, fibre, carb, vitamin, mineral intake
Except Fe until menopause, Vit A and B, potassium and zinc for immunity and wound healing

Therefore more nutrient dense foods required

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6
Q

What are the guideline daily amounts?

A

Women- 2000 calories, 260g carbs (30g), 70g fat (20g), 45g protein, 25-30g fibre, 6g salt

Men- 2500 calories, 300g carbs (30g), 95g fat (30g), 55g protein, 25-30g fibre, 6g salt

Salt= Na x 2.5

Gender differences as men have more muscle and less fat so different energy expenditure

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7
Q

What are some recommendations?

A
Eat wholemeal or high fibre
Have a wide variety of fruit/veg
Cut fat off meat, skin off poultry, fish w/o batter, cook w/o fat
Semi-skimmed milk, low fat yogurt
Have unsaturated oils/spreads
Have low fat/sugar options

However, some low fat options have high sugar

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8
Q

How might someone eat healthy on a budget?

A
Plan, list, buy in quantities you’ll use
Use supermarket brands
Buy fruit/veg regularly (markets)
Beware of processed foods
Have high starch meals
Buy lean meat and mix w veg to go further
Tinned/frozen fish and meat is cheaper
Cook carefully and reduce fuel use
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9
Q

What are recommended daily amounts of alcohol?

A

Less than 14 units a week spread out over more than 3 days
Should have some alcohol free days

Can increase ab weight, stroke, high BP, cancer, liver disease, mental health problems, smoking

No alcohol when pregnant

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10
Q

Why is cholesterol important?

A

Provides structure and function of cell membranes
Precursor to steroid and adrenocortical hormones
Involved in forming bile acids
Needed in neural tissue

1/3-1/2 made in liver, rest from diet

High levels of LDL are more important for disease compared to HDL
If someone smokes, their LDLs become stickier and HDLs decrease
Sat fat raises LDLs and polyunsat lowers LDLs and HDLs

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11
Q

What should be considered for pregnant women?

A

Correlation between nutrient intake and birth weight

Need folic acid for neural tube development
Need to watch out for excess Vit A for birth defects and oily fish for mercury and Vit A levels
Iron

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12
Q

What might affect a mans fertility?

A

Low levels of zinc

High levels of alcohol and smoking

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13
Q

During menopause what should be considered?

A

Any weight gain can have risks of CVD, diabetes and cancer (prev thought pre- [pear] and post- [apple])

Soy protein has phytoestrogens which mimics oestrogen which is reduced in menopause, can reduce symptoms (hot flushes etc) and complications

Risk of osteoporosis in older people so need to supplement with Ca, Vit D and activity

Must have <1.5mg/day Vit A to stop bone #
Vit D declines due to exposure of sun

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14
Q

What is the body mass index?

A

Healthy weight for height

W (kg) / h x h (m)

Healthy is 18.5-24.9

However, measure of fat so overestimates with muscular build and underestimates in older (less muscle)

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15
Q

How should obese people lose weight?

A

Rapid weight loss not recommended
Don’t reduce consumption by more than 500kCal/day

Toxins such as DDT and pesticides in fat tissue are released to quickly

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16
Q

What are different veg names?

A

Lactoovo- plant, dairy and eggs
Lacto- plant and dairy
Vegan- plant only

17
Q

What can be substituted in veg diets?

A

Fortified soya and plant products instead of dairy
Pulses, nuts and seeds instead of meat
Vit B12 needs to be supplemented
GIT needs to adapt to non-haem Fe which can bind to non starch polysaccharides

Religious reasons- buddhism (lactoovo veg)
Economic, environmental, ethical reasons
Health benefits- lower risk of CHD, stroke and cancer, less sat fat, more complex carbs, more fruit/veg (antioxidants)
However is this just diet but also lifestyle?

18
Q

When does a person start ageing?

A

Once 25 years old
Frailty due to physiological changes, Malnutrition
Nutrition contributes to health and recovery illness
Death due to infection, disease, accident or gradual degenerative process

19
Q

What are the nutritional requirements for older people?

A

Women- 2000-2200kcal/day from ages 15-75, 1900kcal/day from 75+

Men- 15-35 (2500-3000), 35-65 (2500-2900), 65-75 (2350), 75+ (2100)

Activity declines as age
BMR decreases
Should eat nutrient dense food
If house bound- increase Vit D all year round

20
Q

Is there malnourishment in older people?

A

Generally nutrient deficient due to ill health, self neglect
Specific nutrient deficiency due to eg. Less Fe, no meat as a result of poor teeth, limited mastication
Sub-clinical malnutrition- poor diet, not clinically obvious, body stores depleting

Underweight- leads to morbidity/mortality
Lack of metabolic reserves for infection response

Overweight- young elderly
Eg. Osteoarthritis of knee

21
Q

What might lead to malnutrition in the elderly?

A

Failing sight/smell/taste
Dental problems (oral discomfort)
Loss of appetite
Less salivary secretion (Sjögren’s syndrome, xerostomia, chemotherapy)
Bowel problems (less gut motility and inactivity)
Osteoarthritis/porosis (less strength, reduced nutrient absorption)
Physical disability (mobility for shopping)
Extreme age (frailty)
Dysphagia (MS, MND, CV- leads to liquid diet)
Mental issues (dementia- forget, confusion)

Leads to soft, bland diet- indigestion
Need to have smaller nutrient dense meals and enhance flavours w/o salt or sugar

22
Q

What is PEG feeding?

A

Percutaneous endoscopic gastrostomy

Feed through tube into stomach

23
Q

How should malnutrition be prevented in the elderly?

A

Dehydration- account for spills (6-8 glasses)
~can lead to headache, constipation, UTIs, confusion

Home care assistants- buy and prepare

Meals on wheels- consider nutritional content

Lunch clubs- social contact, ideal

Institutions- puréed food unappetising, tastes similar, sip feeds (fortified drinks)

24
Q

What was the SACN position statement 2021?

A

Looked at nutrition, health and changes with age
Dietary intakes and nutritional status

Nutrition society published overview in British journal of nutrition

Concluded need for RCTs and longitudinal studies

25
Q

How is food labelling better?

A

Trading standards

Traffic light system
Guideline daily amounts
More choice
Best before- quality
Use by- safety (more risk to listeria etc due to transplants, drugs, cancer affecting immune system)
26
Q

How are adults categorised?

A

19-64- adults
65-74- young old
75+- old old

27
Q

What does the NDNS show about adults nutrition?

A

2018/19, follow up 2020
Sugary drinks falling
Fruit/veg (33, 40, 27% meeting 5 a day, follow up even less)
Saturated fat above
Free sugars reducing but still above
Vitamins, minerals, blood folate, fibre all below
Oily fish below
Large range of red and processed meat but decreasing
Follow up showed alcohol increase
Trends towards healthier