Exam 2 Adult Nutrition Flashcards
(T/F) Menopause is associated with an increase in abdominal fat.
TRUE
(T/F) According to BMI ranges, a healthy BMI for most individuals is a BMI of 18.5 up to 28 kg/m^2.
FALSE
What phase of adulthood roughly corresponds to “around the forties to fifties?”
Sandwich generation
The additional energy required for the digestion, absorption, and metabolism of what people eat results from _________.
The thermic effect of food (TEF)
The type of fiber that promotes the development of beneficial mix of microbiota in the gut is known as __________ fiber.
Fermentable
The Mifflin-St.Jeor energy estimation formula calculates energy expenditure using ___________.
Gender, weight, height, age, and activity level.
A simple calculation used to give you a ballpark calorie level for weight maintenance is to multiply your body weight in pounds by the number ________.
15
If you drink, do so in moderation; as listed in the dietary guidelines for Americans is defined as _______________.
No more than 2 drinks per day for males and no more than 1 drink for females.
The physiological effects of atherosclerosis include ___________.
Decreased flexibility of blood vessels
A risk factor for cardiovascular diseases includes ____________.
Low level of HDL
Which criteria is a risk factor for coronary heart disease?
Blood pressure 142/95 mmHg
When eaten, plant stanol and sterol esters block particles responsible for _________ transport.
Cholesterol
A man who is 50 years old and has a BMI of 27.9 would have a BMI in which category?
Overweight
Viscous fiber escorts water in the gut, forming a liquid gel that increases the absorption of cholesterol-rich bile acids and carries them throughout the body (T/F).
False
The primary cause of death for HIV-infected persons is _________.
Cancer and cardiovascular disease
A loss of ________ of body weight can reduce or prevent the risks associated with obesity.
5-10%
If you are counting carbohydrates in your diet plan, it is important to know that 1/2 cup of fresh fruit or 4 ounces of orange juice is equal to ________ grams of carbohydrates.
15
There is a general agreement that tastes and smell senses are generally robust until age 50 (T/F).
False; 60 years old
Body-composition changes associated with ageing are irreversible (T/F).
False
Life expectancy has increased significantly since the 1900s. Today, life expectancy at birth in the US is roughly _________ years.
79
According to the CDC, environmental factors are thought to account for up to _______ of longevity.
1/5
Theories of ageing can be examined from two perspectives, one of which is the ________ theory.
Wear and tear
The molecular clock theory proposes that senescence occurs because ___________.
Telomeres capping the ends of chromosomes become shorter with each cell division, and their loss eventually stops the chromosomes from replicating.
The DETERMINE checklist from the NSI is used to alert seniors to possible nutrition-related health concerns, but is not in itself used to diagnose poor nutritional health (T/F).
True
On average, lean body mass decreases by ______ per decade from age 30 to 70.
2-3%
It is difficult to meet vitamin, and mineral needs via foods at calorie levels below ________.
1600
In contrast to measuring developmental stages, functional status is a more indicative measure of health than chronological age (T/F).
True
Diabetes diagnosis criteria and management goals for older adults are different from those for younger adults (T/F).
False; they are the same
To prevent a vitamin B12 deficiency, it is recommended that adults 51 and over obtain their vitamin B12 from ____________.
Fortified food and/or supplements
In older adults, BMI is an adequate indicator of excess body fat associated with morbidity and mortality (T/F).
False
The two leading causes of death among the elderly are heart disease and __________.
Cancer
What type of stroke occurs when a weakened blood vessel breaks?
Hemorrhagic
WHO defines grade 3 thinness as _________.
BMI less than 16
The amount of stored body water decreases with age (T/F).
True
Guidelines for treating dehydration in older adults include providing roughly ________ of the overall fluid deficit each day in the form of water or 5% glucose solution.
25-33%
Sarcopenia means _____________.
Loss of muscle associated with aging.
What are the 3 components of energy expenditure?
- Basal Metabolic Rate (BMR)- 60% of energy expenditure
- Thermic effect of food (TEF)- 10% of energy expenditure
- Activity thermogenesis- 3% of energy expenditure
How should energy intake be adjusted to change weight status?
To lose 1 pound per week, there should be a 250-calorie deficit in food intake and an additional 250 calories burnt from exercise.
What are the physical activity guidelines for general health and weight loss?
150-300 minutes of moderate-intensity exercise per week or 75-150 minutes of vigorous activity each week. This also includes aerobic activity, weight-bearing and stretching exercises 2 times per week.
What are the macronutrient ranges for adults?
Carbs- 45-65%
Protein- 10-35%
Fat- 20-35%
How does body composition change for women in adulthood?
This is when women enter menopause. It leads to increased abdominal fat, accelerated loss in bone mass, and increased risk of developing cardiovascular disease.
How does body composition change for men in adulthood?
Men have a decrease in testosterone and muscle mass.
What are the four components of a successful weight loss plan?
- Reduce caloric intake- 250 calories/day
- Meets nutritional needs- nutrient-dense food
- Consistent meal plan- 3 meals a day, including breakfast
- Incorporates physical activity- 300 minutes/ week of movement
What are the classifications of overweight and obesity by BMI and associated disease risk?
What are the criteria for bariatric surgery?
The US Department of HHS National Institutes of Health Clinical Guidelines state surgery would be a good option if the patient has the following:
- BMI greater than 40
or - BMI greater than 35 with at least one comorbidity
(if you want insurance to cover it)
What are the standard guidelines for a post-bariatric surgery diet?
The goal is to progress from liquid food to pureed to soft and finally eat solid foods again. The following guidelines are followed:
- SMALL amount- ounces at a time
- Eat SLOWLY and CHEW- chewing 15-20 times/bite
- Avoid concentrated sugars- leads to dumping syndrome
- Focus on PROTEIN- eat protein first at every meal
- Do not DRINK any liquids with meals- no water, diet coke, milk, etc.
- Create a schedule for regular supplementation- lifelong screening is needed for bariatric patients
- Do not use straws, chew gum, or drink alcohol
What are the specific risk factors for cardiovascular disease (CVD)?
- Dyslipidemia (high LDL, high triglycerides, and low HDL)
- High blood pressure
- Lifestyle factors- physical inactivity, cigarette smoking, atherogenic diet (high saturated fat, high cholesterol, trans fat, low fruit and veggie)
- Obesity- especially abdominal
- Diabetes
- Infection and longterm inflammation
What are the clinical measures of cardiovascular disease (CVD)?
What are the risk factors for diabetes and prediabetes?
- Obesity or a steady increase in weight
- Sedentary lifestyle
- Genetics
What are strategies for preventing diabetes and prediabetes?
- Preventative metformin use
- Healthy lifestyle changes
What are nutritional strategies for those with diabetes?
- Encourage weight loss- 5-10% of BW in 6 months
- Monitor blood glucose levels
- Increase physical activity- 150 MORE minutes than currently doing
- Decrease fat intake- with Heart Healthy Diet, keep fat intake less than 25% of calories
- Spread nutrient and carbohydrate intake throughout the day- 50% of calories from carbohydrates
What are the basics of carbohydrate counting?
1 CARB choice= 15 grams of carbs
Meal patterns are then chosen via # of carb choices per day and meal
What medical conditions list obesity as a risk factor?
All cardiovascular diseases like stroke, coronary heart disease, heart attack, and atherosclerosis.
What are the clinical measures of cardiovascular disease?
Which diet is prescribed to decrease the risk of cardiovascular disease?
The Therapeutic Lifestyle Changes (TLC) diet is given.
What are some specific guidelines for the TLC diet given for cardiovascular disease?
- Total fat intake is 25-35% of calories
- Less than 7% of calories from saturated fat
- Little to no trans fat
- Cholesterol less than 200 mg
- Total carb intake 50-60% of calories
- 20-30 grams of fiber
- Sodium less than 2300 mg/day
- Consume fish and omega-3 FA
- Limited alcohol
- Minimum of 200 calories burned from exercise
What are the US Census Bureau age categories?
- 65-74 years: young old
- 75-84 years: aged
- 85 years and older: oldest age
What are the two basic theories of ageing?
- Programmed ageing theories- these state that the body can be adaptable, but over time things wear down. This is not within our control.
- Wear-and-tear theories- these state that the more you use your body (in a bad way), the quicker you are going to age. We have some control over this.
What are the older adults changes in body composition?
Possible loss of up to 15% fat-free mass (muscle) and an increase in visceral body fat.
What are changes in senses and oral health in older adults?
Taste and smell senses are good until the age of 60. Senses start to decline here due to disease, medications, and/or dentures. Dental caries and tooth loss are common in this group. This age group also can have chewing and swallowing difficulties.
What are nutritional risk factors for older adults?
- Hunger, poverty, low food and nutrient intake
- Functional disability
- Social isolation
- Urban and rural demographics
- Depression, dementia, dependency (3 Ds)
- Poor dental and oral health
- Polypharmacy
What are the protein guidlines for older adults?
Currently, the guidelines say the minimum amount of protein consumed should be 0.8 grams/kg of body weight. However, to prevent muscle and organ wasting, it is better to consume 1-1.5 grams/kg of body weight in older adults. Protein should constitute 10-35% of daily calories.
What are the nutrients of concern for older adults?
- Vitamin A- increased risk of toxicity due to decreased excretion and increased storage in plasma and liver.
- Vitamin D- less ability to synthesize for the skin
- Vitamin E
- Vitamin K- maintaining levels that do not interfere with the commonly used drug Warfarin
- Vitamin B12- blood levels naturally decrease with age due to decreased absorption
- Folate- Absorption of folate is decreased with commonly used drugs
- Iron- increased risk of toxicity due to increased stores of iron.
- Calcium- absorption declines with age, and low calcium levels are not good.
- Sodium and potassium
- Magnesium
What are sarcopenia and sarcopenic obesity?
Sarcopenia is muscle wasting. Sarcopenic obesity is low lean body mass combined with excessive fat stores.
What are the needed vitamins and minerals for bone health?
Vitamin D, calcium, magnesium, phosphorus, fluoride, boron, zinc, copper, and manganese.
Who is at the highest risk for developing osteoporosis?
Non-Hispanic white women
What is dementia?
Dementia is a set of symptoms and conditions of progressive cognitive decline.
What are nutritional interventions for cognitive disease?
The use of the MIND diet. This diet focuses on nutrient density, maintaining hydration, and meeting energy needs (35 kcal/kg BW). It is a specific diet that consists of berries twice a week, one dark green salad per day, three servings of whole grains per day, a 5 oz glass of red wine per day, fish once a week, and cheese and fried foods no more than once per week.
What are nutritional interventions for older adults who have cognitive diseases affecting their eating habits?
- Make sure the mode of feeding is appropriate- mouth or feeding tube
- Food consistency is adequate- particle size, texture, thickness
- Fluid consistency is adequate- dysphagia patients need to prevent aspiration pneumonia.
What is intuitive eating?
This is a non-diet approach to nutrition and health. It encourages us to listen to our internal hunger and satiety cues to decide when, what, and how much to eat.
What are the principles of intuitive eating?
- Reject diet mentality
- Honor your hunger
- Challenge the food police
- Make peace with food
- Respect your fullness
- Discover the satisfaction factor
- Honor feelings without using food
- Respect your body
- Exercise to feel a difference
- Honor your health
What is Health at Every Size?
HAES principles help us advance social justice, create an inclusive and respectful community, and support people of all sizes in finding comprehensive ways to take care of themselves. It encourages healthy habits and attitudes. It values respect, critical awareness, and compassionate self-care.
What are ways to combat weight stigma in healthcare?
Treat the person as a whole and not just their physical appearance. Identify your own bias and assumptions about larger people and fight those. Focus on patient-centred communication by asking for permission to bring up weight. Finally, create a welcoming environment for all people that is inclusive. This means having large enough chairs, blood pressure cuffs, and scales for patients with a higher BMI.
Obesity classifications with disease risk?
