IAS09

Question 1

what is nutrition

Answer 1

using food and drink to provide nutrients for metabolism into energy & conversion into compounds for sustaining life

Question 2

nutrition science definition

Answer 2

CEDHD: study of components of food:
where & how is energy derived from food;
factors influencing dietary intakes & patterns;
actions, interactions & balance w.r.t. health & disease

Question 3

core of nutrition

Answer 3

IAXM
ingestion & digestion, absorption (assimilation & transport), excretion, metabolism (anabolism & catabolism)

Question 4

factors determine nutritional status

Answer 4

BEDSP
biological
energy expenditure
presence of disease
social: food availability & cultural customs
psychological: satiety, palatability & appetite

Question 5

biological factors affecting nutritional status

Answer 5

nutrigenomics: ind. response to nutrition due to genes (taste, satiety, IAXM)
digestion, absorption, excretion: controlling metabolism & release of toxic waste
age & phase of lifecycle: diff. phy. state, diff. demands to nutrients e.g. increased demand of nutrients at pregnancy

Question 6

nutrition in prevention of disease e.g. obesity

Answer 6

obesity linked w/ CVD, diabetes II, COVID-related symptoms & mortality, liver & respiratory diseases -> plan diet to prevent living with excess weight

Question 7

obesity vs COVID

Answer 7

increased BMI increase COVID complications
- Excess fat tissue deposition in upper airway, reduce respiratory function & O2 circulating levels
- Fat tissues contain high levels of ACE-2 enzymes used by virus to attach to & access body cells
- Enhanced inflammatory & immune response, affect antiviral treatment
- Thrombosis -> stroke & heart attack

Question 8

nutrition in progression & management of diseases

Answer 8

chronic diseases (diabetes, renal diseases, etc.) manage nutrition e.g. dietary req for treatment
surgical & anesthetic conditions affected by nutrition
note: supplement not recommended to prevent chronic disease

Question 9

emergency treatment priorities (nutrient, O2, water)

Answer 9

O2&raquo_space;> water&raquo_space;> nutrients
1. reestablish O2 supply & circulating volume as 1st priority immediately
2. repletion of lost fluids & electrolytes in hours
3. provision of other nutrients within 7 days

Question 10

purpose of nutrients

Answer 10

To supply the energy needed for the body to perform work i.e. metabolism
To provide the building blocks for the synthesis of other important molecules
To support the function of metabolic pathways

Question 11

classification of nutrients

Answer 11

macro: carbs, proteins, fats
micro: vitamins & minerals

Question 12

carbs function

Answer 12

major energy source (w/ lipid)
Some create a sense of satiety over a longer period of time –> weight control and diabetes treatment
Some digested rapidly and stimulate craving –> promote fat deposition in tissues

Question 13

fiber function

Answer 13

indigestible, regulate gut motility & transit

Question 14

fat function & essential fats

Answer 14

major energy source w/ carbs
energy storage
essential: linoleic acid, alpha-linolenic acid

Question 15

protein function & essential AA

Answer 15

provide cell structure & involved in many functions, communication, signalling
last resort energy source: muscle wasting by releasing muscle AA
FVW TIM H(A)LL: phenylalanine valine tryptophan threonine isoleucine methionine histidine (arginine for children) lysine leucine
animal sources contain all essential AA
plant sources contain some essential AA

Question 16

energy input

Answer 16

4kcal/g for carbs & AA, 9kcal/g for lipid
food digested & absorbed -> circulation -> taken up by cells & oxidized to provide ATP energy

Question 17

energy expenditure & components definitions

Answer 17

total TEE = basal metabolic rate BSR (60-70%) + phy activity (most variable) + thermic effect of food
BMR: energy to maintain metabolism at rest
TE of food: energy used during digestion, absorption & excretion of food

Question 18

basal metabolic rate factors

Answer 18

gender: M>F
age: child > adult
health: fever, pregnancy, lactation, hyperthyroidism +
hormones: high level of thyroid, growth & sex hormones, epinephrine, cortisol +

Question 19

energy balance

Answer 19

I>E: body fuel stores accumulate, excess food stored in fat tissue, muscle, liver, etc. -> gain weight
I<E: body fuel stores draw fuel & supply the remainder -> lose weight

Question 20

disadvantage of fuel stores increase exemplified by fat stores

Answer 20

3 fat stores
visceral in abd cavity: actively produce mediators that promote atherosclerosis, CVD & T2DM
ectopic in cardiac & pharyngeal fat pads: obstruct heart & pharynx (cardiac function impair & respiratory difficulties)
subcutaneous: mostly benign except when they affect movement

Question 21

obesity treatment

Answer 21

comb. of 3 things:
diet: take less high-calorie food, but risk of undernutrition if done solely
exercise: increase phy activity
behavioral intervention: goal-setting & relapse avoidance
(evidence-based interventions except surgery rarely work)

Question 22

DRI

Answer 22

dietary reference intake values (4): ERAU
estimated average requirement EAR: meet the req of 50% of the healthy individuals in a particular life stage and gender group (group)
recomended dietary allowance RDA: meet the req of nearly all (98%) inds in the group
adequate intake AI: (if EAR or RDA not available) estimates of adequate nutrient intake by group of (appa.) healthy people
Tolerable upper intake level UL: highest level likely to pose no risk of adverse health effects to almost everyone in group
intake btn UL & RDA considered no adverse health effects among most people

Question 23

dietary recommendations

Answer 23

MyPlate (US) / eatwell guide (UK)&raquo_space;> food pyramid

Question 24

MUST screening

Answer 24

malnutrition universal screening tool
fast assessment to determine nutrition state of adults, identify risk of malnutrition
1. determine BMI (18.5-20: 1, <18.5: 2)
2. note % of unplanned weight loss (5-10%: 1, >10%: 2)
3. establish acute illness of patient / no nutritional intake for >5 days (2)
4. adds scores together to obtain overall risk of malnutrition (1: med risk, 2: high risk)
5. management guidelines / local policy to develop care plan

Question 25

nutrition assessment methods

Answer 25

ABCD done in combination for holistic assessment
anthropometric biological clinical dietary

Question 26

nutrition assessment methods e.g., advantages & disadvantages

Answer 26

A e.g. BMI w/ diff. anal. w.r.t. age & gender btn age 2-20, waist circum., waist-to-hip ratio, mid-arm circum., skinfold thickness
ad: easy, portable, cheap, non-invasive, quick
dis: no detailed analysis, methods may not be suitable for all subgroups e.g. BMI unsuitable for athletes / limb deformity
B e.g. blood, urine, feces, metabolic para., biomarkers
ad: objective, quantitative indicator
dis: not exclusively determined by nutri state e.g. medication or disease

Question 27

dietary habits e.g.

Answer 27

DMCA: dietary intake records, meal patterns, composition & amount of food
BCSP aspects: bio factors (state of systems responsible for IAXM), cultural (eating patterns & preference), dietary habit, sociological (food availability), psychological (eating disorders)
methods: food frequency questionnaires, dietary recalls, food records, metabolic balance studies