intro to nutrition

Question 1

1) Name at least 3 applications of nutrition in medicine

Answer 1

1. public health issues: dietary practices are 2nd leading cause of preventable death in US. 2. Ambulatory medicine: pregnancy, healthy children, obesity, etc. 3: nutrition support/in patient: ICU, surgery

Question 2

2) Describe situations that place a patient at risk for nutritional problems

Answer 2

surgery, illness

Question 3

3) Identify & describe the components of nutrition assessment;

Answer 3

1. history: intake relative to needs, medical hx. 2. Anthropometrics: length/height, weight, (head circumference in infants), waist circumference, etc. 3. Exam: Clinical signs. 4. Labs: Biochemical changes/levels

Question 4

4) Describe 3 methods of obtaining diet information: questions to be asked, content to be seeking

Answer 4

1. qualitative: open ended (tell me about your diet) or specific questions (diet restrictions, how many meals, etc). 2. quantitative- 24 hr recall. 3. diet record for multiple days

Question 5

methods for evaluating dietary intake

Answer 5

My Plate, 2010 dietary guidelines for americans

Question 6

dietary reference intakes

Answer 6

From the Food and Nutrition board, national academy of sciences- present a shift in emphasis from preventing deficiency to decreasing the risk of chronic disease through nutrition

Question 7

5) Define nutrient requirement and allowance

Answer 7

1. estimated average requirement: intake needed to meet requirement defined by adequacy in 50% of the individuals in a life stage and gender group. Applies to a GROUP.

Question 8

define recommended dietary allowance

Answer 8

2. recommended dietary allowance: average daily dietary intake level sufficient to meet the nutrient requirements of nearly all (95-97%) individuals in a life stage and gender group; RDA applies to individuals, not to groups

Question 9

Avoid diagnosing deficiency on basis of ______ alone

Answer 9

dietary intake

Question 10

What are anthropometrics

Answer 10

Reflect growth and development or an increase/decrease in body fat and muscle tissue. Compares height and weight to standards based on age, sex. Peds: WHO/CDC growth charts (0-24months), NCHS/CDC w/ BMI: 2-20 yr. Adults: BMI (kg/m^2)

Question 11

BMI interpretation

Answer 11

Underweight < 19; Acceptable weight 19-26; Overweight 26.1-29 (85-95% percentile); Obesity 30-40 (>95% percentile); Morbid Obesity > 40

Question 12

what is waist circumference associated with?

Answer 12

visceral adiposity & insulin resistance

Question 13

PE for nutrition status

Answer 13

Skin: rash, petechiae, bruising, pallor. Hair: pluckability, color changes, texture. Mouth: sores, cracked lips. Edema. Neuro exam

Question 14

specificity and senstivity of lab studies for nutrition

Answer 14

Measurements specific but not sensitive (e.g. abnormality in single nutrient can be measured (specific) but no detectable change in blood/urine level until deficiency quite marked (not sensitive)

Question 15

Which labs are used to assess nutrition

Answer 15

a) albumin - reflects protein synthesis, but levels decr w/ stress/inflammation. b) prealbumin - shorter half-life compared to albumin; reflects more acute status but also ↓’s w/ stress. c) transferrin - iron and protein status. d) complete blood count and total lymphocyte count. e) Specific nutrient levels (e.g. retinol, 25-OH-Vit D, ferritin, etc)

Question 16

6) Describe how to begin to address dietary and lifestyle changes with a patient

Answer 16

Reduce difficulty of changing diet and increase motivation for change. Barriers to change typically&raquo_space; factors contributing to motivation for change?

Question 17

Readiness to change is related to what two key concepts?

Answer 17

: importance (Is change worthwhile?) & confidence (Whether pt believes he/she can achieve the change).