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Life cycle in Nutrition > Exam 2 Material > Flashcards

Exam 2 Material Flashcards

1
Q

Cerebral Palsy

  • calorie needs
  • assessment parameters
A

Cerebral Palsy is a non-progressive but permanent, very individualized disorder

Calorie needs
-General rule: 10 kcal/cm
-Moderate activity (5-11 years): 13.9 kcal/cm
-Severe physical restriction (5-11 years): 11.1 kcal/cm
Athetoid CP: up to 6,000 kcal/day

Assessment Parameters
-CP growth charts available

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2
Q

Down Syndrome

  • calorie needs
  • assessment parameters
A

Down Syndrome is a chromosomal abnormality

  • early years: congenital heart disease leading to poor weight gain
  • increased risk of congenital hypothyroidism leading to increased risk of overweight and diabetes (2X)

Calorie needs

  • based on height, not weight (due to short stature)
  • Boys (5-12 years): 16.1 kcal/cm
  • Girls (5-12 years): 13 kcal/cm

Assessment parameters

  • Growth charts available
  • 5% have GI malformations or disorders (including Celiac’s)
  • Affects growth and development
  • 50% overweight by childhood due to lower energy expenditure
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3
Q

Main focus areas for the nutrition plan for the mental retardation disorders

A

Mental retardation

  • normal nutritional needs
  • focus mainly on life skills such as shopping, cooking, and choosing healthy foods
  • work with physical and occupational therapies
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4
Q

Main focus areas for the nutrition plan for the sensory integration disorders

A

Sensory integration disorders

  • feeding difficulties with certain textures
  • may need pureed diet or other altered textures
  • feeding environments may be overstimulating
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5
Q

6 possible causes of Failure to Thrive and 6 interventions

A

Causes

  • Nature of the disability (CP),
  • parents unaware of how to feed infant/child
  • genetics
  • self-feeding difficulties
  • medication side-effects
  • soda replacing food

interventions

  • Establish nutrition goals for catch-up growth
  • Optimize nutrition as best as possible
  • Oral supplements when appropriate
  • Supplement tube-feeding (overnight, snacks)
  • interdisciplinary feeding therapy to help with mealtime and self-feeding
  • recognizing when a child’s needs are above normal and using your best judgement
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6
Q

Calculate catch-up growth for FTT

A

kcal/kg/day = (IBW in kg X DRI kcal/kg/day) / actual weight

  • catch up needs for protein as well
  • calculate fluid needs
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7
Q

6 causes of overweight and 5 intervention for overweight children with special needs

A

6 causes

  • limited mobility due to disability
  • limited cognitive disability (healthy diet not understood)
  • socioeconomic factors
  • poor food choices
  • low metabolic needs
  • poor parental limits

5 interventions

  • Establish nutritional goals (lower than baseline, adequate protein)
  • find the source of the problem
  • education is key: use on a level appropriate for the patient and the parents
  • check medications (increased appetite) and school lunches (usually >1200 kcal meals)
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8
Q

Two types of feeding tubes and indications for each

A
  1. Percutaneous endoscopic gastrostomy (PEG)
    - easily ripped out by young children
  2. MIC-KEY button
    - surgical procedure but easily hidden
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9
Q

List 9 feeding problems common in developmental disorders

A

Feeding problems

  • Difficulty chewing/swallowing
  • oral aversion
  • food texture issues
  • long feeding times
  • oral losses: food falls out of mouth
  • aspiration: breathe food into lungs
  • food refusal and selectiveness
  • reflux, GI disturbances
  • Poor dental health
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10
Q

Value of interdisciplinary team for feeding issues

A
  • Dietitian, speech language pathologist, occupational therapist, physical therapist, psychologist or behavioral therapist
  • all aspects of feeding need to be addressed
  • pay attention to all behaviors (form of communication)
  • feeding clinics with all disciplines exist!
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11
Q

Reasons why parents may allow children with disabilities to have unhealthy foods

A

Given limited options due to need for altered textures and preferences or other feeding problems

  • not a battle parents want to fight
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12
Q

Person-first language

A

Address the child as a person first, then their disability

“He is a child with autism” not “He is autistic”

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13
Q

RDA for calcium for toddlers and preschoolers and how this translates to milk consumption

A

1-3 years: 700mg
4-8 years: 1000mg
getting excess kcal’s from milk, won’t eat as many other foods
calcium inhibits absorption of iron

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14
Q

Failure to Thrive

  • Calorie needs
  • Protein needs
  • Assessment parameters
A

Failure to Thrive

Calorie Needs
-use calculation

Protein needs
-catch up growth for protein needs as well

Assessment Parameters
-weight, height, BMI, level of FTT, growth chart parameters

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15
Q

Name the method for describing sexual maturity

A

Tanner stages (AKA Sexual Maturity Rating, SMR)

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16
Q

Early Adolescence

  • age ranges
  • physiological changes
  • body image issues
  • level of peer influence vs parental influence
  • ability to think in the abstract
A

Early Adolescence

  • 13-15 years old
  • Rapid growth and development
  • Females
  • –Increase body fat (at about 12.5 years)
  • –lean body mass decreases (80% to 74%)
  • –Gain about 18.3#/year but then slows and continues through puberty
  • Males
  • –gain weight
  • –increase muscle mass

Body image issues
-emerge for both sides and may lead to dieting behaviors

-Peer pressure is highest; moving away from parental influence but still turn to parents during stress

Abstract thinking not yet developed

  • -egocentric
  • -impulsive
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17
Q

Middle Adolescence

  • age ranges
  • physiological changes
  • body image issues
  • level of peer influence vs parental influence
  • ability to think in the abstract
A

Middle Adolescence

  • 15-17 years old
  • Peer influence comes from fewer peers with closer bonds
  • Becomes more comfortable with adult body size/shape
  • —may be delayed in females or “late bloomer” males
  • More independent and less trusting of authority
  • –conflicts with parents may be heightened
  • Egocentrism decreases
  • Abstract thinking improves
  • –Limited thinking about future health consequences; feel invincible
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18
Q

Late Adolescence

  • age ranges
  • level of peer influence vs parental influence
  • ability to think in the abstract
A

Late Adolescence

  • 18-21
  • Develop fewer close relationships (boyfriends/girlfriends)
  • Fully developed abstract thinking
  • More oriented towards future
  • Develop independence
  • Develop own set of values to guide decision making
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19
Q

Calculate energy and protein needs for an adolescent

A

Energy needs
-EER and assess physical activity

Protein

  • 9-13 years old: 0.95 g/kg/day
  • 14-18 years old: 0.85 g/kg/day
  • 18-50 years old: 0.8 g/kg/day
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20
Q

List 5 nutrients of concern for adolescents and state why each is important during this time of development

A
  1. Fiber
    - –AI: 14 g/1000 kcal
    - –Females: 26 g/day—> avg. intake: 12.3 g/day
    - –Males: 31-38 g/day—> avg. intake: 15.2 g/day
  2. Calcium
    - –Bone density still increasing in mid-20’s
    - –soda displaces milk (High P content depletes Ca from bones)
    - –AI: 1300 mg
    - –Avg males: 1186 mg;
    - –Avg females: 849 mg
  3. Iron
    - –Menarche dramatically increases iron needs in females
    - –physiologic anemia of growth:rapid growth causes increased blood volume, decreases iron stores
    - –Ages 9-13
    - –males and females: 8 mg
  • –Ages 14-18
  • –males: 11 mg (avg intake 19.6 mg)
  • –females: 15 mg (avg intake: 13.3 mg)
  1. Folate
    - reducing neural tube defects if they get pregnant
  2. Vitamin D
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21
Q

Identify influences on adolescents’ food choices and 4 factors they value the most in their food

A

Influence on food choices

  • Family dinners associated with better nutrient intakes (but not if in front of the TV)
  • significant media influence plays into peer pressure, esp. early adolescence

4 factors

  • taste
  • accessibility
  • social support
  • fitting in with schedule
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22
Q

Overweight

  • Calorie needs
  • Protein needs
  • Assessment parameters
A

More straightforward than FTT

  • Calorie needs
  • lower than baseline calories

Protein needs
-adequate protein

Assessment parameters
-weight, height, BMI, level of obesity, growth chart parameters

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23
Q

Failure to Thrive

  • Calorie needs
  • Protein needs
  • Assessment parameters
A

Failure to Thrive

Calorie Needs
-use calculation

Protein needs
-catch up growth for protein needs as well

Assessment Parameters
-weight, height, BMI, level of FTT, growth chart parameters

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24
Q

5 strategies to increase food acceptance

A
  1. provide (and eat) a variety of foods
  2. Introduce foods earlier in life (toddler vs. preschooler)
  3. Introduce new foods when child is most hungry but not tired or excited
  4. Maybe ask that the child try a bite (depending on child)
  5. Don’t set foods up as barriers (vegetables) or rewards (dessert)
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25
Q

Calculate calorie and protein needs for a child

A

Calorie: use EER
Protein: .95g/kg

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26
Q

Influences on a child’s food choice and how they have changed from preschoolers

A
  • family meals remain important but more time spent away from home-more responsive to peers and other adults (teacher, coach)
  • media influence-1/2 commercials are for food, 91% are for high fat/sugar foods, fast food restaurants with play grounds, online video games
  • start losing innate ability to control calories:overridden by time of day, people around, food availability
  • become conscious of body image
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27
Q

Name the method for describing sexual maturity

A

Tanner stages (AKA Sexual Maturity Rating, SMR)

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28
Q

8 risk factors for childhood obesity

A
  • adiposity rebound occurring earlier (age 3-4 instead of 5)
  • easy access to ready-to-eat foods
  • eating allowed during sedentary activities
  • children allowed to make more eating decisions
  • larger portion sizes
  • decreased physical activity
  • maternal obesity
  • low family income
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29
Q

Interventions for pediatric obesity

A
  • increase activity and decrease screen time to less than 2 hours/day
  • improve dietary quality while limiting excess calories
  • include child’s input
  • modify entire family’s food intake and activity: don’t single child out
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30
Q

Food insecurity and number of children it affects

A

-limited or uncertain ability to acquire or consume an adequate quality or sufficient quantity of food in socially acceptable ways
-affects 1/7 americans
1/4 children in OK affected

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31
Q

4 requirements for a school to participate in the National School Lunch Program

A
  • must meet at least 1/3 RDA for age group per meal and follow set patterns
  • price of meal must be within child’s ability to pay
  • if unable to pay full price, free/reduced lunch provided
  • if special dietary needs, must accommodate without extra charge
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32
Q

Early Adolescence

  • age ranges
  • physiological changes
  • body image issues
  • level of peer influence vs parental influence
  • ability to think in the abstract
A

Early Adolescence

  • 13-15 years old
  • Rapid growth and development
  • Females
  • –Increase body fat (at about 12.5 years)
  • –lean body mass decreases (80% to 74%)
  • –Gain about 18.3#/year but then slows and continues through puberty
  • Males
  • –gain weight
  • –increase muscle mass

Body image issues
-emerge for both sides and may lead to dieting behaviors

-Peer pressure is highest; moving away from parental influence but still turn to parents during stress

Abstract thinking not yet developed

  • -egocentric
  • -impulsive
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33
Q

4 potential benefits for school lunches

A
  • patter will provide full nutrient requirements
  • variety is encouraged; children can try foods they don’t usually get at home
  • day-to-day patterns may translate to adolescence and adulthood
  • lunch room can provide experiential learning for children
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34
Q

Five major changes to school lunch nutrition requirements as part of the Healthy Hunger Free Kids Act

A
  • offer both fruits and vegetables every day
  • increase whole grains
  • only fat-free or low-fat milk
  • limit calories available
  • focus on reducing saturated fat, trans fat, sodium
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35
Q

Middle Adolescence

  • age ranges
  • physiological changes
  • body image issues
  • level of peer influence vs parental influence
  • ability to think in the abstract
A

Middle Adolescence

  • 15-17 years old
  • Peer influence comes from fewer peers with closer bonds
  • Becomes more comfortable with adult body size/shape
  • —may be delayed in females or “late bloomer” males
  • More independent and less trusting of authority
  • –conflicts with parents may be heightened
  • Egocentrism decreases
  • Abstract thinking improves
  • –Limited thinking about future health consequences; feel invincible
How well did you know this?
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36
Q

Late Adolescence

  • age ranges
  • level of peer influence vs parental influence
  • ability to think in the abstract
A

Late Adolescence

  • 18-21
  • Develop fewer close relationships (boyfriends/girlfriends)
  • Fully developed abstract thinking
  • More oriented towards future
  • Develop independence
  • Develop own set of values to guide decision making
How well did you know this?
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37
Q

Calculate energy and protein needs for an adolescent

A

Energy needs
-EER and assess physical activity

Protein

  • 9-13 years old: 0.95 g/kg/day
  • 14-18 years old: 0.85 g/kg/day
  • 18-50 years old: 0.8 g/kg/day
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38
Q

Pervasive Development Disorders-4 nutritional issues and 6 components of the corresponding nutrition plan

A
  • autism, asperger’s, PDD-not otherwise specified, Rett’s
  • social disorder with other impairments
  • in general, normal lifespan and normal nutritional needs
  • 4 issues: sensory issues (hypersensitivity or under-sensitive, may dislike certain textures), limited diets (child may eat very few foods), special diets (gluten free casein-free), GI problems, food allergies, food sensitivities
  • 6 components
    1. healthy diet+multivitamin
    2. elimination of “unnatural ingredients” (preservatives, added colors or flavors, processed)-may help with behavioral disturbances
    3. Food allergies
    4. GI disturbances-investigate for lactose-intolerance, celiac disease
    5. Special diets: GFCF, specific CHO diet (lower blood sugar level)
    6. High dose vitaminds (B6, Mg), treat inflammation-omega3
39
Q

List 5 nutrients of concern for adolescents and state why each is important during this time of development

A
  1. Fiber
    - –AI: 14 g/1000 kcal
    - –Females: 26 g/day—> avg. intake: 12.3 g/day
    - –Males: 31-38 g/day—> avg. intake: 15.2 g/day
  2. Calcium
    - –Bone density still increasing in mid-20’s
    - –soda displaces milk (High P content depletes Ca from bones)
    - –AI: 1300 mg
    - –Avg males: 1186 mg;
    - –Avg females: 849 mg
  3. Iron
    - –Menarche dramatically increases iron needs in females
    - –physiologic anemia of growth:rapid growth causes increased blood volume, decreases iron stores
    - –Ages 9-13
    - –males and females: 8 mg
  • –Ages 14-18
  • –males: 11 mg (avg intake 19.6 mg)
  • –females: 15 mg (avg intake: 13.3 mg)
  1. Folate
    - reducing neural tube defects if they get pregnant
  2. Vitamin D
40
Q

Identify influences on adolescents’ food choices and 4 factors they value the most in their food

A

Influence on food choices

  • Family dinners associated with better nutrient intakes (but not if in front of the TV)
  • significant media influence plays into peer pressure, esp. early adolescence

4 factors

  • taste
  • accessibility
  • social support
  • fitting in with schedule
41
Q

Ways to target this age group with nutrition counseling

A
  • Focus on fitting in with peers
  • –eating at fast food restaurants
  • –snacking at vending machines

-Counsel on short-term gains, not long-term health, while fitting in with teen’s preferences

42
Q

2 types of feeding tubes in children and indications for each

A

G tubes

  • gastronomy tube:placed through abdominal wall directly into stomach
  • percutaneous endoscopic gastronomy tube (PEG) or MIC-KEY button
43
Q

9 feeding problems that are common in developmental disorders

A
  1. difficulty chewing/swallowing
  2. oral aversion
  3. food texture issues
  4. long feeding times
  5. oral losses: food falls out of mouth
  6. aspiration: breath food into lungs
  7. food refusal and selectiveness
  8. reflux, GI disturbances
  9. poor dental health
44
Q

Value of interdisciplinary team for feeding issues

A

dietitian, speech language pathologist, occupational therapist, physical therapist, psychologist or behavioral therapist

  • all aspects of feeding need to be addressed
  • pay attention to all behaviors
  • all behavior is a form of communication
  • feeding clinics with all disciplines
45
Q

Reasons parents may allow children with disabilities to have unhealthy foods

A
  • limited options due to need for altered textures and preferences
  • not a battle that parents want to fight
  • parents need to be proactive in teaching what a healthy diet should look like
46
Q

People-first language

A

Address child as person first, and then their disability

47
Q

Name DSM IV criteria for diagnosis of anorexia nervosa

A
  • exaggerated drive for thinness
  • refusal to maintain a body weight above the standard minimum
  • intense fear of becoming fat with self-worth based on weight or shape
  • evidence of an endocrine disorder
48
Q

Identify 7 risk factors for eating disorders

A
  1. sex
  2. ethnicity
  3. early childhood eating and gastrointestinal problems
  4. elevated weight and shape concerns
  5. negative self-evaluation
  6. sexual abuse and other traumas
  7. general psychiatric morbidity
49
Q

Describe the association of BMI with anorexia nervosa versus bulimia nervosa

A

Anorexia nervosa was associated with lower BMI status (reverse pattern found for binge eating disorder)

50
Q

Name 3 special populations associated with eating disorders

A
  1. Athletes
  2. Adolescents
  3. Bariatric Surgery
51
Q

Name DSM IV criteria for diagnosis of bulimia nervosa

A
  • overwhelming urges to overeat and inappropriate compensatory behaviors or purging that follow binge episodes (vomiting, excessive exercise, alternating periods of starvation, and abuse of laxatives or drugs)
  • similar to anorexia nervosa, individuals with bulimia nervos also display psycopathology, including a fear of being overweight
52
Q

Name DSM IV criteria for diagnosis of binge eating disorder

A

classified under eating disorders not otherwise specified

53
Q

Name DSM IV criteria for diagnosis of eating

disorder not otherwise specified

A
  • considered to be partial syndromes with frequency of symptoms that vary from above diagnostic criteria
  • distinguishing feature of binge eating disorder is binge eating, with a lack of self-control, without inappropriate compensatory behaviors
54
Q

Identify warning signs of eating disorders: family and friends’ observations

A
  • Reduced spontaneity and flexibility concerning food intake
  • Avoidance of specific foods
  • Poor food variety
  • Statements about being or eating “healthy”
  • Avoidance of social situations with food
  • Abnormal speed of eating a meal
  • Attempt to “bargain” about foods (eg, I will eat this if I do not have to eat that)
  • Inability to identify hunger or satiety
  • Unusually small portions
  • Inability to define or eat a balanced meal
55
Q

Describe the eating disorders treatment team

A

-minimally consist of a primary care physician, a mental health professional, a RD, and in cases involving preadolescents and adolescents, the family, unless there is compelling reason to exclude family members
-family may be important in treatment of older patients
-often a psychiatrist is involved to manage medication and to assess and treat comorbid conditions
-teams need to be coordinated for consistent communication and to avoid “splitting.”
-frequently medical doctors do not have the time
for team coordination;this is a role appropriate for RDs,
nurses, therapists, and physician assistants with specialty
training in EDs.

56
Q

Understand 8 factors in the nature of eating disorders (page 3)

A
  1. people do not choose to have EDs
  2. eating disorders are spectral disorders; they exist on a continuum of severity and often become more severe the
    longer they are present
  3. family dynamics might be part of the environmental influences that cause stress and stressful environments
    can exacerbate EDs, but families are not causative in ED
    etiology
  4. EDs often co-exist with other psychiatric illnesses especially anxiety related disorders
  5. the longer a person remains in a state of suboptimal nutrition or continues with ED behaviors, the more
    persistent and severe the disorder can become
  6. both physical restoration and cognitive/emotional restoration have to occur; physical restoration alone does
    not constitute recovery
  7. eating disorders have an emotional/behavioral component and a neurophysiological/genetic component. The latter may set the stage for ED development, be triggered by weight loss, and may be the reason many ED psychological symptoms resolve with physical restoration
  8. nutrition education alone is ineffective as is therapy/counseling alone
57
Q

Describe information that should be collected during a full nutrition assessment for an eating disorder, including special factors in children and adolescents

A
  • A full nutrition assessment reveals current dietary intake, present eating patterns, history related to foods, nutrient deficiencies, supplement use, risk of refeeding syndrome, beliefs about food, binge purge patterns, and physical activity patterns.
  • In children and adolescents, it is important to find out about family meals, who buys and prepares food and who will be providing care to the young person with an ED.
58
Q

List information to collect about purging behaviors, including exercise purging

A

-A review of purging behaviors includes asking about amount, frequency, and type, including self-induced vomiting, laxative use, use of enemas, suppositories,
diuretics, and diet pills.
-Review physical activity routines including type of activity, sessions per week, intensity, and duration of exercise. -Obtain information about exercise compulsions or exercise purging behaviors

59
Q

Describe basic features of a refeeding regime for patients at risk for refeeding syndrome
(pg 7, practice paper)

A 
-Day 1:
10 kcal/kg/day
For extreme cases (BMI 15 days) 
5 kcal/kg/day
Carbohydrate: 50%–60%
Protein: 15%–20%
Fat: 30%–40%
Prophylactic supplement PO2- 0.5–0.8mmol/kg/day
K+4: 1–3 mmol/kg/day
Mg2+: 0.3–0.4 mmol/kg/day
Na+: <1 mmol/kg/day (restricted)
IV fluids-Restricted, maintain “zero” balance IV thiamin + vitamin B complex 30 minutes prior to feeding

-Day 2 to 4:
Increase by 5 kcal/kg/day
Check all biochemistry and correct any abnormality
Thiamin + vitamin B complex orally or IV until day 3
Clinical and biochemical monitoring

-Day 5 to 7:
20–30 kcal/kg/day
Check electrolytes, renal, and liver functions and minerals
Fluid: maintain zero balance
Consider iron supplement from day 7

-Day 8 to 10
30 kcal/kg/day or increase to full requirement
Clinical and biochemical monitoring

60
Q

Describe APA weight gain recommendations for anorexia nervosa during inpatient treatment versus
outpatient treatment

A
  • Inpatient: 2 to 3 lb/wk (0.9-1.4 kg/wk)

- Outpatient: ½ to 1 lb/wk

61
Q

Name 2 strategies to reduce purging behaviors in bulimia nervosa

A
  1. Self monitoring (of eating behaviors, factors that precede and follow restricting, binging, and purging)
  2. Menu planning
62
Q

Identify warning signs of eating disorders: behavioral

A
  • Active and restless, stands frequently when most people would sit
  • Disproportionate time spent thinking about food and body weight
  • Interest in recipes, food channels, and food shopping
  • Prepares food for other people without eating themselves
  • Subjective or objective binge eating
  • Hoards food or rations until the end of the day
  • Food seems to go missing, especially sweets, cereals, high-carbohydrate foods
  • Appears to be angry, tense, or hostile at meals
  • Abnormal timing of meals and snacks
  • “Debiting” food intake (eg, with exercise/food choices)
63
Q

Identify warning signs of eating disorders: rituals when eating

A
  • Excessive use of condiments (eg, salt, hot sauce)
  • Cutting food into very small pieces before eating
  • Inappropriate food utensils with preference for eating with fingers
  • Picks, blots, and tears food apart
  • Inappropriate food combinations and concoctions
  • Eats food in a certain order
  • Hides food in napkins, handbags, gives to dog, throws food away
  • Doesn’t let food touch lips
64
Q

Identify warning signs of eating disorders: physiological

A
  • General: Marked weight changes or absence of expected weight gain in children or adolescents, growth delay in child/adolescent; weakness, fatigue, or lethargy.
  • Cardio pulmonary: Low pulse, dizziness, low blood pressure, slow capillary refill
  • Gastrointestinal: Abdominal pain, constipation, reflux, vomiting, delayed gastric emptying (feels full immediately after eating small amounts)
  • Endocrine: loss of menstrual cycle, delayed menarche, or hypogonadism for boys/men
  • Neuropsychiatric: Poor concentration, memory loss, insomnia, depression, anxiety, obcessiveness, over concern with weight and shape
  • Integument: Dry skin, brittle nails, hair loss, yellow orange skin tone, white downy hair growth (lanugo), dull eyes, pale skin,cold intolerance
65
Q

Identify warning signs of eating disorders: medical findings

A
  • Anorexia Nervosa: Bradycardia, orthostasis by pulse or blood pressure, hypothermia, cardiac murmur, atrophic breasts and vaginitis (postpubertal), pitting edema of extremities, emaciated, cold extremities, slowed capillary refill time
  • Bulimia Nervosa: Sinus bradycardia, orthostatic by pulse or blood pressure, dry skin, parotid gland swelling, Russell’s signs, mouth sores, dental enamel erosion, cardiac arrhythmias, may be normal weight
  • Binge Eating Disorder: Weight-related hypertension, abnormal lipid profile, and diabetes
66
Q

Compare and contrast fat and carbohydrate as fuel sources for the athlete

A

Fat

  • Fuel store: can store up to 80,000 kcal of fat
  • Energy output: 9 kcal/g
  • Kcals produced per L Oxy consumed: 4.61 kcal/L

Carbohydrate

  • Fuel store: can store up to 2,000 kcal (critical to endurance activities)
  • Energy output: 4 kcal/g
  • Kcals produced per L Oxy consumed: 5.05 kcal/L
  • Carbs more efficiently metabolized than fat
  • ATP produced 3x faster with carbs than fats
  • carbs are necessary for fat metabolism, not vice versa
67
Q

Three groups of athletes who need carbohydrates most

-describe their needs in terms of metabolism

A
  1. Endurance athletes who participate in prolonged events (>90 mins)
    - incremental depletion in muscle glycogen stores from slow to intermediate to fast twitch fibers will occur
    - performance can suffer without complete depletion of glycogen
    - hypoglycemia leads to development of fatigue
  2. Athletes who train for less time (30-45 mins) on consecutive days
    - depletion will occur incrementally when exercising/active daily
    - depletion will be exacerbated with a low carbohydrate, high fat diet
  3. Those involved in sports requiring intermittent bursts of high intensity for extended periods of time (>60-90 min)
    - Selective depletion of muscle glycogen in fast twitch fibers may occur
    - Even though overall muscle glycogen may not be low, glycogen may be located in a place where it is not readily available for glycolysis
68
Q

Describe modified carb loading

A
  • Inconsistent (but majority of) evidence that a high carb intake 1-3 days before activity may have performance benefit
  • High carb defined as >70% of calories (8-10 carb/kg body weight)
  • combine with reduced activity
  • no benefit shown for women
69
Q

Three factors that are important for choosing carbohydrates appropriate for athletes

A
  1. Nutrient density
  2. Glycemic index: all dietary carbs increase blood glucose, but to differing degrees
  • –High (>85)
  • —white bread, whole wheat bread, bagel, rice, cornflakes, potato, banana, gatorade
  • –Moderate (60-85)
  • —spaghetti/macaroni/noodles, oatmeal, biscuits, potato chips, grapes, oranges
  • –Low (<60)
  • —Apples, peaches, plums, baked beans/lentils, milk, yogurt, ice cream, PowerBar
  1. Concentration
    - –g carb per serving and % of calories
70
Q

Create a plan for how much carbohydrate should be consumed before, during, and after an activity

A

Before

  • –4 hours before: 4-5 g/kg body weight
  • –1 hour before: 1-2 g/kg body weight
  • –Immediately before: 50-60 g of glucose polymer in one-half cup water

During
Consume every 15-30 minutes as tolerated/necessary
—60-100 g/hr results in maximum oxidation
—higher oxidation if have mixture of CHO, such as glu and fru
—high intake increases risk of GI distress
—determine optimal intake by trial and error

After
-consume high glycemic index foods

71
Q

Protein RDA for adults
RDA for endurance athletes
RDA for strength athletes

A

Adults
-0.8 g/kg

Endurance athletes
-1.2-1.4 g/kg

Strength athletes
-1.2-1.7 g/kg

72
Q

Create a meal with complementary proteins

A

Legumes: beans, lentils, peas, soybeans

Grains: wheat, rice, corn

Seeds and Nuts: sesame, sunflower, peanuts

Legumes + Grains

Legumes + seeds and nuts

73
Q

Describe recommendations for fluid and electrolytes before and during activity

A

Before
-intake of 2 cups of water at about 2 hours before exercise is recommended

During
-dilute solutions of sodium (50 mg/8 oz) are acceptable during activity

-in prolonged fluid loss and during recovery from activity, dilute sodium solutions may enhance blood volume replenishment

74
Q

Define Hyponatremia and identify athletes who are most at risk for this

A

Hyponatremia
-low blood sodium levels (life threatening)

At risk

  • occurs when only drinking water during sweating periods
  • those who cramp easily
  • heavy sweaters (large volume of high sodium sweat)
75
Q

Define ergogenic aid

A

Ergogenic aid

  • anything that may improve sport performance
  • ergogenic aids classified according to their application to sport
  • can be mechanical, psychological, physiological, pharmacological, or nutritional
76
Q

Briefly describe NCAA regulations on supplements use in athletes, and name 2 examples each of banned, nonpermissible, and permissible supplements

A

Banned
-illegal drugs, steroids

Non-permissible
-protein (>30% of calories), creatine

Permissible (can be purchased by the University)
-vitamins, minerals, energy

77
Q

Growth enhancer supplements

A

Growth enhancers

  • Creatine,
  • androstenedion (precursor to testosterone)
  • HMB (beta-hydroxy beta-methylbutyrate)
  • GHB (Gamma hydroxy butyrate)
  • DHEA (dehyroepiandrosterone)
  • Amino Acids
  • Chromium
  • Vanadium
78
Q

Enhanced fat metabolism supplements

A
  • Medium chain triglycerides (6-12 carbon fatty acids)
  • Caffeine
  • Carnitine
79
Q

Protective Factors (supplements)

A
  • Antioxidants

- Glutamine

80
Q

Name 6 causes of iron deficiency in athletes and 5 strategies to avoid deficiency

A

6 causes
-low dietary intake of iron (especially females)

  • increased blood volume (formerly referred to ask sports anemia)
  • foot-striking hemolysis
  • hematuria
  • GI tract and sweat losses
  • Menstruation

5 strategies to avoid deficiency
-Consume 3 oz of foods rich in heme iron (meats) twice/week

  • consume vitamin C-rich foods with meals to enhance iron absorption
  • Limit tea/coffee consumption with meals
  • May need to limit calcium-rich foods with meals; calcium interferes with absorption
  • take iron supplements only with true anemia (low hemoglobin) and after diet fails
81
Q

Define the three components of the female athlete triad

A
  1. Disordered eating
  2. Amenorrhea
  3. Osteoporosis
82
Q

Describe why inadequate calorie intake is detrimental to athletes

A

Low energy intakes can result in loss of muscle mass, menstrual dysfunction, loss of or failure to gain bone density, increased risk of fatigue, injury and illness, and a prolonged recovery process

83
Q

Energy needs equation most commonly used by sports dietitians

A

Harris-Benedict equation

84
Q

5 methods for determining body composition and rank them according to technique levels

A

Level 1-direct assessment based on analysis of cadavers
2- indirect assessment (underwater weighing, dual-energy x-ray absorptiometry and air displacement plethysmography
3-doubly indirect assessments (skinfold measurements and bioelectrical impedance)

85
Q

Estimated minimum percentage of body fat for men and women

A

5%-males

12%-females

86
Q

Current RDA and AMDR for protein and position paper’s recommendations for both endurance and strength athletes

A

RDA- .8g/kg
AMDR- 10-35% calories
Endurance athletes: 1.2-1.4g/kg
Strength athletes: 1.2-1.7g/kg

87
Q

Three reasons fat is a necessary part of an athlete’s diet

A
  • Provides energy
  • provides essential elements of cell membranes
  • provides associated nutrients such as vitamins A, D, E
88
Q

Identify micronutrients that are commonly of concern in athlete’s diets, what they do for an athlete’s body

A
  • calcium(growth, maintenance and repair of bone tissue; maintenance of blood calcium levels, regulation of muscle contraction, nerve conduction and normal blood clotting) and vitamin D (required for adequate calcium absorption, regulates development and homeostasis of nervous system and skeletal muscle) , iron (required for formation of hemoglobin and myoglobin), zinc (role in growth, building and repair of muscle tissue, energy production, and immune status), magnesium (variety of roles in cellular metabolism, and regulates membrane stability and neuromuscular, cardiovascular, immune and hormonal functions) and antioxidants such as vitamins C and E, beta carotene, and selenium ( protect cell membranes from oxidative damage-exercise can increase oxygen consumption)
  • adequate intake of B vitamins is important to ensure optimum energy production and the building and repair of muscle tissue. Thiamin, riboflavin, niacin, pyridoxine (b6), pantothenic acid and biotin are involved in energy production during exercise. Folate and B12 are required for production of red blood cells, protein synthesis and in tissue repair and maintenance
89
Q

4 groups of athletes at greatest risk for poor micronutrient status

A
  • those who restrict energy intake
  • have severe weight loss practices
  • eliminate one of more food groups from their diet
  • consume unbalanced and low micronutrient-dense diets
90
Q

When multivitamin/mineral supplements appropriate

A

athletes who have poor micronutrient status would benefit

athletes that consume nutritionally adequate diets would not benefit

91
Q

Fluid recommendations for before, during, and after exercise

A
  • at least 4 hours before exercise individuals should drink 5-7 mL/kg body weight
  • amount and rate of fluid replacement during exercise is dependent on an individual athlete’s sweat rate
  • after exercise-16-24 oz of fluid for every pound of body weight lost during exercise
92
Q

Name situation when sports drink (6-8% CHO) are indicated

A

Recommended for exercise events lasting longer than 1 hour

93
Q

Amount of CHO that should be consumed during activities lasting longer than an hour

A

.7g CHO/kg per hour

94
Q

Type of CHO that will replete muscle glycogen more quickly after an exercise event

A

CHO with higher glycemic index, including protein and fat with CHO

Life cycle in Nutrition (4 decks)

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