Exam 3 - questions from class Flashcards
What are the current recommendation for heart disease?
- Maintain or reach target weight
- Reduce calories from saturated fat (5-6%)
- Eliminate trans fat
- Limit sweets, sugar sweetened beverages, and red meat (Negative impacts on the heart)
- Follow diet therapy for other diseases
- It’s about the balance of fat (restrict saturated fats so that you consume enough healthy fats)
- Emphasize fruit, vegetables, legumes, whole grains, fish (fatty fish 2x/week), nuts, nut oils, low-fat dairy
- Antioxidant rich – through diet, not supplements
- 25-30g soluble fiber per day
- Plenty of stanols and sterols – plant based butters, etc
- Dietary cholesterol is no longer restricted – will be specifically tested over
- DASH diet great, vegan benefits and Mediterranean (Med) Diet fit recs
- Include exercise
What are the side effects of statins?
- peripheral neuropathy
- sexual disfunction
- pancreatic and liver disfunction
- slight increase in developing diabetes
- cognitive decline (memory loss, confusion)
- muscle cramps
If individuals have side effects from statins, what supplementation might be needed?
CoQ 10
What are the stages of blood pressure and hypertension?
Normal: <120/<80 mm Hg
Prehypertension: systolic 120-129 and diastolic less than 80
Stage 1: systolic 130-139 or diastolic between 80-89
Stage 2: systolic at least 140 or diastolic at least 90
Hypertensive crisis: systolic over 180 or diastolic over 120
What are the Dash Diet recommendations
- 7-8 whole grains per day (1 slice bread)
- 4-5 veggies per day (1/2 cup cooked)
- 4-5 fruits (1/2 cup)
- 2-3 low fat or fat-free dairy products per day (8 oz milk, 6 oz yogurt)
- 4-5 servings nuts, beans, or legumes per week (nuts ¼ cups, legumes ½ cup)
- 2-3 fats/oils/day (1 tbsp)
- 5 sweets per week
What are six current MNT guidelines for CVD?
- Maintain or reach target weight
- Reduce calories from saturated fat (5-6%)
- Eliminate consumption of trans fat
- Limit sweets, SSB and red meat
- Follow diet therapy for other diseases
- Emphasize fruit, vegetables, legumes, whole grains, fish (fatty fish 2 x week) or omega 3 (inhibits Apo B100 synthesis), nuts, nut oils, low-fat dairy
- Antioxidant rich diet
- 25-30 grams soluble fiber/day
- Plenty of stanols and sterols
- Dietary cholesterol is no longer restricted
- DASH diet great, vegan benefits and MedDiet fit recs.
- Include exercise too!
What are the risk factors for CVD?
- inflammatory markers
- blood lipids (thought half have normal levels and still presiposed for CVD)
- lifestyle factors: smoking, poor diet, physical inactivity, alcohol, insufficient sleep, stress
- Age: men > 45, women > 55
- gender: men higher likelihood, although women are more likely to die due to not knowing they are having a heart attack
- genetics: gamily members with heart evens put you at elevated risk
- presence of other diseases: diabetes, HTN, low HCL, glucose intolerance, obesity
stress vs starvation
Stress
* increased REE, mixed fuel source, hormone mediated response
* increased: gluconeogenesis, proteolysis, branched-chain oxidation, hepatic protein synthesis, ureagenesis, urinary nitrogen loss
Starvation
* Starvation = decreased energy expenditure, use of alternative fuels, decreased protein wasting, stored glycogen used in 24 hours
* Late starvation = fatty acids, ketones, and glycerol provide energy for all tissues except brain, nervous system, and RBCs
Energy requirements in critical care
- Patients will be on sliding scale insulin, when its over insulin will be given
- Circulating glucose is needed and helped to mobilize the trauma response
- glycemic level 150-180
What glycemic levels do we want to keep with our patients?
150-180
MNT for burns
CHO allow protein sparing to take place, preferred fuel source is CHO
- Ideal instead of using body protein
wound/burn teams with protocols
- Vitamin C, A, and zinc are given; levels vary depending on facility
- Supplement Mg, PO4 as needed (sometimes low)
- Can also do a corrective calcium score, could be artificially low due to low albumin
T/F You can introduce solid food when GI tract is ready?
TRUE
- advance quickly from clear liquids to solids
- Also don’t have to wait for bowel sounds
What formula could be used to calculate calories for burn trauma patients?
- Harris benedict x 1.5
- Ireton jones
- Curreri
Covid calorie formula
- ASPEN recommendations are 15-20 kcal/kg and 1.2-2 g protein
