Domain I: Principles of Dietetics: Nutrient, energy needs, and feeding patterns throughout the lifespan Flashcards
Gravida refers to _____
Pregnancy
A female who is at a normal weight should gain ___-___ lbs during pregnancy
25-35
A female who is underweight should gain ____-____ lbs during pregnancy
28-40
A female who is overweight should gain ____-____ lbs during pregnancy
15-25
A female who is obese should gain ____-____ lbs during pregnancy
11-20
The target for pregnant women should be to achieve at least the ____ limit for weight gain during pregnancy
Lower
What two populations should strive to reach the upper end of weight gain during pregnancy?
-Black women
-Very young women
During the second trimester, women should increase their calorie intake by ____ calories
340
During the third trimester, women should increase their calorie intake by ____
452
For the first 6 months of lactation, women should increase their calorie intake by ____ calories
330
For the second 6 months of breastfeeding (6-12 months), women should increase their calorie intake by ____ calories
400
During the second half of pregnancy and during lactation, women should get ____ grams of protein per day
71
The minimum recommended hemoglobin level during pregnancy is ____ g/dL
11
The minimum recommended hematocrit level during pregnancy is ____%
33
Weight gain should be about ___ lb/month for the first 3 months, and then ___lb/week after that
1; 1
Mothers/babies are at risk if…
-They don’t gain 4 pounds/month in the last half of pregnancy
-Under 16 or over 35 years of age
-Under 12 months between pregnancies
A pregnant adolescent is a high risk pregnancy; they require additional…
-Iron
-Calcium
-Zinc
Pregnant women should receive supplementation of ____ mg of ferrous sulfate during the 2nd and 3rd trimesters
30
Ferrous sulfate should be taken ____ meals and not with milk, tea, or coffee
Between
Pregnant women should also receive supplementation of ____ mcg of folic acid (assumes an additional 200 mcg from food)
400
For pregnant and lactating women 18 or under, they require ____ mg of calcium/day
1300
For pregnant and lactating women over 18, they require ____ mg of calcium/day
1000
_____ is a hormone that develops the placenta after implantation
Progesterone
During pregnancy, ____ g/day of linolenic acid is recommended (300 mg DHA)
1.4
During lactation, ____ g/day of linolenic acid is recommended
1.3
Linolenic acid is needed for development of the fetal ____ ____
Nervous system
Pregnant women should avoid excess intake of preformed vitamin ___ (supplements over 5000 IU)
A
What types of fish should pregnant women avoid due to mercury levels?
-Shark
-Swordfish
-King mackerel
-Limit albacore
-Raw fish
Normal birth weight is between ____-____ g
2500-4000
Low birth weight is under ____ lbs/____ g
5.5 lbs; 2500 g
Very low birth weight is under ____ lbs/____g
3.3 lbs; 1500 g
Extremely low birth weight is under ____g
1000
Small for gestational age indicates under the ____ percentile for birth weight for gestational age
10th
Appropriate for gestational age indicates weight between the ___ and ___ percentile
10th and 90th
Large for gestational age indicates weight above the ____ percentile
90th
Infants need the most ____, ____, and ____ per unit weight compared to any other population
Calories, protein, water
Infants 0-6 months require ____ kcal/kg
108
The RDA for protein for infants 0-6 months is ____ g (1.52 g/kg)
9.1
Infants 0-6 months require ___-___ ml/kg of water (based on age)
125-155
Infants age 0-1 require a minimum of ____ g of fat per day
30
Infants 7 months to 1 year require ____ kcal/kg
98
The RDA for protein for infants 7 months to 1 year is ____ g/day (1.2 g/kg)
11
Infants 7 months to 12 months require ____ ml/kcal of water per day
1.5
A ____ is an infant from 0-1 year
Neonate
Neonates can absorb whole, intact ____
Protein
The average weight for infants 0-6 months of age is ____ kg; the average weight for those 7-12 months is _____ kg
6; 9
The average length for infants 0-6 months of age is ____ inches; the average height for those 7-12 months is _____ inches
24; 28
Hemoglobin in a newborn should be between ___-____; hemoglobin for those 6-23 months should be 10+
16.5-19.5
Hematocrit in a newborn should be between ____-____
49-54
Human milk contains ____ kcal/oz
20
_____ is a pituitary hormone that stimulates milk production
Prolactin
____ is a pituitary hormone that stimulates the movement of milk through the ducts
Oxytocin
_____ is the yellowish transparent fluid that is secreted from the breast during the first few days; it meets the infants needs during the first
Colostrum
Colostrum has ____ protein and ____ fat and carbohydrates than mature milk; also contains antibodies
More; less
It is recommended to exclusively breastfeed for the first ____ months of life, then supplemented by weaning foods for at least up to 12 months
6
Human milk is ___% protein, compared to cow’s milk, which is ____% protein
7; 20
Human milk is ___% carbohydrate, compared to cow’s milk, which is ____% carbohydrate
38; 30
Human milk is ___% fat, compared to cow’s milk, which is ____% fat
55; 50
Breast-fed infants need _____ IU of vitamin D/day from birth
400
Breastfed infants require ____ mg of fluoride/day after 6 months if water doesn’t contain adequate amounts
0.25
Milk supply is adequate if the infant gains weight and length, has frequent stools and has ____-____ wet diapers per day
6-8
The Baby Friendly Hospital Initiative is a global effort to increase ____ and ____ of breastfeeding (measurable outcomes); a hospital must show it implements 10 steps to successful breastfeeding
Incidence and duration
Infant formula is ____ kcal/oz
20
Infants need ____ oz/lb/day of formula
2.5
Infant formula has more ____ and ____ than breastmilk, but lacks antibodies
Protein and iron
Vitamin D requirement is met if infant receives at least 1 ____ of standard (vitamin D fortified) infant formula daily
Quart
Formula-fed infants also need fluoride supplementation of ____ mg/day after 6 months of age if water supply is inadequate (0.3 ppm)
0.25
Unmodified ____ milk in formula is inappropriate because of tough, hard, curd; it is hard to digest
Cow’s
Unmodified cow’s milk contains less ____ ____ ____
Essential fatty acid
Unmodified cow’s milk also causes increased ____ solute load
Renal
Dried whey contains ____% lactose (casein hydrolysate does not contain lactose)
73
____-fortified formula is recommended for all infanta on formula
Iron
____ indicates that unconjugated bilirubin levels are elevated within the first week of life as a result of increased breakdown of red blood cells or decreased intestinal motility
Hyperbilirubinemia
If an infant has hyperbilirubinemia, encourage ___-___ feedings per day of breastmilk or formula to promote hydration and intestinal motility
9-12
Fetal iron stores decrease at ___-___ months which means they require additional iron, preferably from formula or supplemental foods
3-4
Infants can start getting cereal at ___-___ months
4-6
Add solids at 4-6 months when ____ posture can be maintained and ____ reflex diminishes
Sitting; extrusion
When starting solids, begin with iron-fortified rice cereals, then strained ___ and ___
Fruits and vegetables
At 6-8 months of age, add large finger foods (teething biscuits) that can be secured with the _____ grasp
Palmar
At 9-12 months, add small finger foods (dry cereal) as the ____ grasp (thumb and forefinger) develops
Pincer
Infants should not get cow’s milk or ____ for the first year of life
Juice
Low-fat and non-fat milk are inappropriate during the first ____ years of life
2
For infants that cannot tolerate cow’s milk-based or soy products, use formulas that are made from a ____ ____ (Pregestimil)
Casein hydrolysate
Infants should get one serving of vitamin ____ rich foods by around 6 months to enhance iron absorption from non-heme iron sources
C
A sunken fontanel may be due to ____ or ___ ____
Dehydration or protein malnutrition
From ages ___-___, growth rate slows
1-3
Food serving sizes for those 1-3 years old is ___-___ ounces/tablespoons
2-4
From ages ___-___, there is growth in spurts, and from ages 7-10, growth slows down
4-6
The RDA for protein for ages 1-3 is ____ grams/day
13
The RDA for protein for ages 4-8 is ____ grams/day
19
The RDA for protein for ages 9-13 is ____ grams/day
34
____ needs are the same for boys and girls up to age 10
Iron
Limit fruit juice to ___ ounces per day up to age 6
4
Children should get at least ____ minutes of physical activity per day
60
The final growth spurt occurs during _____ (this is also where most dietary deficiencies occur)
Adolescence
RDA for males age 14-18 is ____ grams
52
RDA for females age 14-18 is ____ grams
46
Adequate intake for calcium for males and females ages 9-13 is ____ mg
1300
We use ____ growth charts from birth to 2 years of age and ____ growth charts from 2 to 20 years of age
WHO; CDC
Weight for length/stature is used from birth to ____ years of age (normal is between the 5th and 95th percentile)
5
Weight for length/stature can identify overnutrition or undernutrition, and can be used to distinguish between ____ and ____
Stunting and wasting
Weight for length/stature detects ___-___ changes in nutritional status
Short-term
Weight for length/stature under the 5th percentile may reflect…
-Acute illness
-Wasting
Weight for length/stature over the 95th percentile may reflect _____
Overnutrition
Stature/length for age is used from birth to ___ years (0-24 months recumbent length; 2-20 years height)
20
Stature/length for age defines ___/___
Shortness/tallness
Stature/length for age reflects ___-___ nutrition status and can determine the extent of stunting
Long-term
Stature/length for age is affected by long-term nutritional ___ or ____ illness
Stress; chronic
A stature/length for age under the 5th percentile indicates a ____ stature
Short
Weight for age is used from birth to 20 years of age; normal is between the ___ and ___ percentile
5th and 95th
Weight for age is NOT used for classify ____ or ____
Underweight or overweight
Weight for age is a ____-term marker for growth; affected by acute nutritional stress or illness
Short
Weight for age cannot distinguish between ___ and ____ because it does not include height
Wasting and stunting
BMI for age percentiles are used starting at ____ years of age (age and sex specific)
2
A BMI under the ____ percentile indicates underweight
5
A BMI between the ____ and ____ percentile indicates healthy weight
5th to 84th
A BMI between the ___ and ___ percentiles indicates overweight
84th-94th
A BMI in the ____ percentile or over (or BMI over 30) indicates obesity
95th
BMI is the best way to assess ____ in children because it includes height, weight, and age
Weight
____ ____ ____ in infants is indicated when weight for age falls below the 5th percentile on multiple occasions or weight deceleration that crosses two major percentiles on a growth chart
Failure to Thrive
Other factors/measures that may indicate failure to thrive:
-Measure of head circumference (measured until age 3)
-Measure of supine length (used until age 2)
-Change in rate of growth
Growth usually does not deviate by more than ____ percentile points from the established pattern of growth (one of the main reasons for large discrepancies in growth patterns is human error in measurements)
25
Newborn initial 6% weight loss should be regained by ___-___ days
10-14
By the 4th/5th month, birth weight should be ____
Doubled
By one year, birth weight should be _____ and length should be increased by ____%
Tripled; 50
By two years, birth weight should be ____ and length should be increased by ___%
Quadrupled; 75
Normal gestation is approximately ____ weeks
40
An infant born at 28 weeks is ____ weeks premature; four months after birth, the growth parameters of him at 28 weeks should be compared with those of a one-month-old born at term
12
The American Academy of Pediatrics has growth charts to assess children with ___ ____ that are no longer reflect the population and should not be used
Down Syndrome
Growth charts for other special needs are based on relatively small populations; if used, use them along with the ___ or ____ growth charts
WHO; CDC
Failure to thrive in children may result from…
-Acute or chronic illness
-Restricted diet
-Poor appetite
-Lack of fiber leading to chronic constipation
-Diminished intake
Lead poisoning is common in children and can cause symptoms such as…
-Irritability
-Lethargy
-Anorexia
-Vomiting
-Constipation
-Anemia
In adulthood, ___ ___ level determines nutritional needs
Physical activity
RDA for men age 19 and older is ____ g/day
56
RDA for women age 14 and older is ____g/day
46
In adulthood, ___-___% of the calories should be made up of carbohydrates, ___-___% should be fat, and ___-___% should be protein
-45-65 carbohydrate
-20-35 fat
-10-35 protein
Adult men under 50 should get ____ grams of fiber/day, women under 50 should get ____ g/day
38; 25
Adult men over 50 should get ____ grams of fiber/day, women over 50 should get ____g/day
30; 21
Adults should get ____ ml/kg (or 1 ml/kcal) of fluid per day
35
The adequate intake of fluid for men over 19 is ____ L/day; for women over 19 it is ___ L/day
3.7; 2.7
The adequate intake of sodium for men and women 19-50 is ____g/day (equivalent to 3.8 g NaCl)
1.5
The adequate intake for alpha-linolenic acid (omega 3) for adult men is ____ g/day and for adult women, ___ g/day
1.6 (men); 1.1 (women)
The adequate intake for linoleic acid (omega 6) for adult men is ____ g/day and for adult women, ___ g/day
17; 12
According to the US Census Bureau, young old is ages ___-___, aged is ___-___, and oldest-old is ages ___ and up
65-74; 75-84; 85
For elderly people, calorie needs _____, but protein needs remain the same (1 g/kg)
Decrease
Elderly individuals often lack ____ and ____ due to decreased absorption caused by decreased hydrochloric acid secretion
Calcium; iron
Elderly people commonly have constipation due to decreased ____ ____ and decreased hydrochloric acid in the stomach
Gastric motility
Elderly people should get ___-__ ml/kg of fluid/day
25-30
For elderly people, we should encourage ____-rich foods; supplementation of ___ and ___ may be needed
Folate; B6 (pyridoxine), B12 (cyanocobalamin)
We should also recommend a diet high in antioxidants (beta carotene, selenium, C, E, resveratrol) as it may delay the development of _____
Cataracts
____ is the loss of muscle mass during aging
Sarcopenia
Elderly individuals are more vulnerable to toxicity of vitamin A due to…
-Increased liver storage
-Decreased clearance from the blood
Athletes need water during physical activity; recommended to get ____ ounces of water for every 1lb body weight lost
16
During and after continuous endurance physical activity of 1-4 hours, consume fluids that contain ____ and ____
Carbohydrates and sodium
Carbohydrate loading/glycogen load leads to stores of ___-___ times the normal amount of muscle glycogen
2-3
Adverse effects from carbohydrate loading include…
-Weakness
-Bloating
-Dizziness
-Soreness
At rest and during normal activities, ____ are the primary energy source (___-___%), while carbohydrates account for ___-___% of energy and protein ___-___%
80-90 fat, 5-18 carbs, 2-5 protein
During low- to moderate-intensity aerobic exercise (long duration, steady pace, endurance training), ____ is a significant energy source
Fat
During exercise above 60-65% of maximal oxygen uptake, ____ are needed as a fuel source
Carbohydrates
During prolonged exercise, there is reliance on carbohydrates to provide ____ for continued lipid oxidation
Pyruvate
Muscle glycogen is depleted after ___-___ hours of continuous exercise at 60-80% oxygen consumption
2-3
____ supplements do not enhance endurance (not helpful for marathon runners, soccer players, etc)
Creatinine
Examples of non-nutritive sweeteners:
-Saccharin (Sweet N Low)
-Aspartame (NutraSweet, Equal)
-Acesulfame-K (Sunette, Sweet One)
-Sucralose (Splenda)
-Stevia (Truvia)
-Neotame
Non-nutritive sweeteners provide minimal to no energy and must be approved by the ____
FDA
What are three sugar alcohols?
-Xylitol
-Mannitol
-Sorbitol
Sugar alcohols are ___-___% as sweet as sucrose
40-100
Sugar alcohols are resistant to ____, and provide fewer calories
Digestion
Sugar alcohols (or products that contain them) can be labeled as ___-___, but not calorie-free
Sugar-free
Sugar alcohols are ____-preventing (cariostatic), as they cannot be digested by bacteria that is normally responsible for them
Cavity
Sugar alcohols function as ____ (hold water) and _____
Humectants; emulsifiers
Sugar alcohols can prolong ___-___
Shelf-life
Sugar alcohols are absorbed more slowly than other sugars, which can cause…
-Diarrhea
-Abdominal pain
-Gas
Due to adverse effects, consuming more than ____ g of sorbitol is not recommended
30
Herbals, botanicals, and supplements are regulated by the Dietary Supplement ___ and ____ Act of 1994
Health and Education
The Dietary Supplement Health and Education Act of 1994 clarifies marketing regulations for botanicals and reclassifies them as ____ ____
Dietary supplements
Plant extracts, enzymes, vitamins, minerals, and hormonal products available without prescriptions may carry ___/___ claims
Structure/function
The physiological effect of supplements may be noted, but no claims about ____ or ____ of specific conditions may be made
Prevention or cure
The primary use of black cohosh is to ease _____ symptoms
Menopause
What are two potential interactions with black cohosh?
-May act as a blood thinner
-Effects statin drugs
The primary use of echinacea is to prevent or moderate ____ symptoms
Cold
Use of comfrey has the potential to cause irreversible ____ disease
Liver
Ephedra is primarily used to promote ___ ___
Weight loss
Ephedra is very likely hazardous and can cause…
-Rapid heart rate
-Headache
Garlic may lower ____ and ____ ____
Cholesterol and blood pressure
Garlic can reduce clotting time, so avoid use with _____
Warfarin
The main medicinal use of ginger is for ____
Nausea (antiemetic)
Ginger should be avoided with drugs that affect ____
Bleeding
Ginko biloba is mainly used to promote _____
Vasodilation
Ginko biloba should be avoided in those taking ____ or those who are pre-surgery, and used with caution in those with diabetes
Warfarin
Ginseng is commonly used to improve ____ and ____
Immunity and endurance
Ginseng can lower high ___ ___
Blood pressure
Ginseng should be avoided in those on ____
Warfarin
Ginseng may also _____ blood glucose
Decrease
Kava is mainly used in order to relieve _____
Anxiety
Kava is likely very hazardous and can lead to ____ ____
Liver failure
Milk thistle may help protect the ____
Liver
St. John’s Wort is commonly taken for its ____ effects (serotonin-enhancing)
Antidepressive
Potential interactions with St. Johns Wort:
-Reduces effects of warfarin
-Avoid with hypertensives
-Avoid with anti-hypertensives
-Avoid with oral contraceptives
-Avoid with certain statins
-Avoid with spironolactone, thiazide and loop diuretcis
Saw palmetto is commonly taken as a remedy for an ____ ____
Enlarged prostate
Saw palmetto may act as a ____ and should not be taken prior to surgery
Diuretic
Valerian root may calm ____
Nerves
Valerian root should be avoided in those with ____ disease
Liver
Yohimbe is used to combat ____ ____, but should be avoided in those with high blood pressure at is is known to raise BP
Erectile dysfunction
