Disease Related Malnutrition

Question 1

Define Malnutrition

Answer 1

a state of nutrition in which a deficiency, excess or imbalance
of energy, protein and other nutrients cause measurable adverse
effects on tissue/body form and function and clinical outcome

Question 2

categorises of malnutrition

Answer 2

Underweight
micronutrient related (over and under)
overweight and obesity

Question 3

List some consequences of malnut

Answer 3

higher risk of mortality
decreased quality of life
weakness, fatigue, depression
prolonged recovery time and length of hospital stays

Question 4

Why treat malnut?

Answer 4

Reduce chronic effect of disease
improve treatment outcomes
decrease healthcare cost
improve wound healing

Question 5

How is malnut recognised

Answer 5

Usually, screening tools. not mandated in practice

Question 6

Which screening tool is most popular in IE

Answer 6

Malnutrition Universal Screening Tool
(MUST)

Question 7

why are screening tools used?

Answer 7

Fast, cheap, reproducable.

Question 8

What approaches are used in NT Care?
(what us done with regards to nutrition in a jospital)

Answer 8

Fluids and electrolytes are looked after
Intravenous or tube feeding if requiered
high protein and calorie diets are prescribed
NT supplements

Question 9

WHat happens when you overfeed a patient?

Answer 9

Hyperglycemia, increased metabolic and respiratory stress

Question 10

what happens when you underfeed a pateitn

Answer 10

worse N2 balance and increased lean tissue loss.

Question 11

how does fluid imbalance affect assesment?

Answer 11

Impacts weight, therefore gives a higher or lower result, resulting in incorrect calorie prescription

Question 12

How does illness affect lab results?

Answer 12

Illness alters metabolism, and labs will reflect illness and not NT status.

Question 13

In what order is NT support provided?

Answer 13

Oral diet first: Fortified and high protein + energy
Supplementation second
Enteral or parenteral feeding is last resort

Question 14

What is food fortification?

Answer 14

Adding extra ingredients to normal food to increase NT value

Question 15

What is the aim of food fortification

Answer 15

to increase NT quality and energy intake by 500kcal per day

Question 16

what is the ‘little and often approach’

Answer 16

6 small meals and snacks per day

Question 17

describe the little and often approach

Answer 17

High protein and energy foods
small portions, high energy density

Question 18

Give tips on fortifying food

Answer 18

No need to fortify everything, just fortify enough
identify which foods are eaten best and fortify does
use nutritious ingredients, not just cream and butter. (focus on micro nt just as much as macro)
Use enough to make a difference.

Question 19

Examples of fortifiers

Answer 19

Cheese on pasta, potatoes and egg
add sugar to tea
drizzle oil on salads and veg
etc etc etc.

Question 20

What is a nourishing drink?

Answer 20

smooties, enriched soups, milksakes, malted milk drinks, juices, hot chocolates

Question 21

why should nourishing drinks be used

Answer 21

easy way to add calories and NT (compared to water? gimme a milkshake)

Question 22

example of how to fortify nourishing drinks?

Answer 22

add skimmed milk powder to milkshake

Question 23

Tips on increasing protein and calories?

Answer 23

Add butter or oil to veg
use starch veg like potatoes, corn ,peas.
overall, add gravy, cream, butter, oil to whatever can take it.
fruits with cream or icecream.

Question 24

what foods are not recommended on a high cal diet?

Answer 24

light or diet foods
plain bevereages like water , tea, etc.
plain fruit and veg (fill you up and dont have cals)

Question 25

What is oral Nutritional supplementation (ONS)

Answer 25

provides additional NT (including protein and cals) to people who do not meat their requiered intake.

Question 26

what can cause poor NT intake?

Answer 26

Poor appetite, illness, reduced food intake, poor absorbtion

Question 27

How are ONS available?

Answer 27

Drinks, milkshakes, juices, powders or puddings (desserts)

Question 28

Why are ONS used

Answer 28

Increase total energy and protein intake
improve body comp (muscle vs fat
impove quality of life

Question 29

when should ONS be used?

Answer 29

Underweight,
loss of appetite
temporarily cant or wont eat but can drink
increased nt requeirments

Question 30

Describe modular (incomplete) products

Answer 30

Low volume, protein or fat supplements used to tackle unintended weight loss
milkshakes, mashed potatoes, yoghurts
They are FLAVOURLESS! Mixed with things

Question 31

Describe creme-style supplements

Answer 31

basically pudding

Question 32

Shake style feed

Answer 32

powders, mix with whole milk

Question 33

Sip feed?

Answer 33

basically ready made milkshakes. what we tasted in the lab