kin 146 midterm 5 Flashcards
What is secondary deficiency caused by and which assessment method reveal these changes
caused by problem inside the body (doesn’t absorb enough or excretes too much nutrients)
- revealed in clinical examination
What is primary deficiency and which assessment method reveals these changes
caused by inadequate diet
- revealed in diet information
Subclinical deficiency and which assessment method reveals these changes
in early stages before outward signs have appeared
- biochemical analyses
Which assessment method can be used to detect physical signs and symptoms
clinical examination and antrhopometric measurement
Anthropometry (what does it measure and why)
- measures weight, height, BMI , circumferences
- because body composition and development, for growth, nutritio status
- detect after symptoms appear
- dexa, hydrodensitometry, bioelectric impedence
Biochemical analyses
Detection of deficiency, imbalance , toxicity from blood and urine samples
Best used to uncover early signs of malnutrition
Clinical examination:
Gathering information from a person’s medial record with respect to their health status, socioecominc status, drug use, conducting. Nutrition focused physical examination
Direct diet assessment
chemical analysis, aliquots or duplicate portions; very accurate and ‘actual’ intake but may not be ‘usual’
Indirect diet assessment
- self report
- length,burden
- qualitative (food frequency questionnaires)
Challenges with indirect mehtods
- accuracy of portions
- accuracy of nutrient analysis software
- mix of actual and usual intake
Multiple-pass method for 24 hour recall
- single day, guided interview 30-45 minutes
- 4 or 5 passes of the daily intake
- determine if intake ‘typical’
Food records
- write down all food consumed
- done at time of consumption to reduce recall error
- Types and amounts, how prepared, where consumed
- reported or weighted
- issues of burden, accuracy, compliance
issues with food frequency questionnaire
- tend to based on large cohort studies
- length impacts quality
- portion size
- frequency may be several categories or few
- requires mental gymnastics
Diet history
- detailed account to food habits
- examines 24 hour recall - recent intake
- identifies usual food choices
Examples of indices
- healthy eating index
- nutritional risk index
- prognostic inflammatory nutritional index
- bmi
Examples of equations
- Harris benedict to estimate energy needs
- HBE - basal/resting metabolic rate
Observational research
- cross-sectional
- cohort
- case-control
- quantifies the exposure and outcome
- identify prevalence, associations
Important considerations in experiemntal studies
- randomization
- sample size
- use of an appropriate placebo
- double blind
- replication
Antigens
Foreign substances that get past skin, mucous membranes and gastrointestinal tract
White blood cells: phagocytes
- scavengers; engulf antigen and digest it
- secrete cytokines that activate metabolic and immune response to infection
- neutrophils - most common type of WBC
- Marcophages - larger, engulf larger antigens
White blood cells: lymphocytes B cells
rapidly divide and produce antibodies (immunoglobulins)
- inactivate antigen, remember for next exposure
White blood cells: lymphocytes T cells
go to site of antigen, release chemical to destroy antigen; release signals to slow down immune response when infection controlled
- specific to an antigen
- some serve as memory cells for future use
What are nutrients needed for
- maintenance of WBC
- production of cytokines
- production of antibodies
- cell multiplication
- free radical generation
- active process of stopping the immune response
Purpose of acute inflammation
- fight infection
- release oxidative products
- remove damaged tissue
Results of chronic inflammation
- cytokines
- free radicals
- blood clottign factors
- chronic disease
Leading cause of death in canada and what are its components?
Cardiovascular disease (CVD)
- includes hypertension (HTN)
- atherosclerotic cardiovascular disease
- congestive heart failure
What is the most common manifestation of CVD
atherosclerosis
Aneurysm
an abnormal enlargement or bulging of a blood vessel (an artery) caused by damage to or weakness in the blood vessel
angina
painful feeling of tightness or pressure in and around the heart, often radiating to the back, neck, jaw, arms
- lack of oxygen to heart
atherosclerosis
type of artery disease formed by plaques along the inner walls of the arteries
Coronary heart disease
damage that occurs when blood vessels carrying blood to the heart become narrow and occluded
CHD risk equivalents
disorders that raise the risk of heart attacks, strokes, other complications associated with cardiovascular disease to the same degree as existing CHD
embolism
the obstruction of a blood vessel by an embolus - a travelling clot - causing sudden tissue death
heart attack / myocardial infarction
sudden tissue death caused by blockages of vessels that feed the heart muscle
Hypertension
higher than normal blood pressure
plaque
accumulation of fatty deposits, smooth muscle cells, calcium, and fibrous connective tissue that develops in the artery walls in athersclerosis
Stroke
an event in which the blood flow to a part of the brain is cut off
thrombosis
blood clot that obstruct blood vessel
transient ischemic attack
temporary reduction in blood flow to the brain (light headedness, visual disturbances, paralysis)
Describe the prior steps that led to congestive heart failure
- Athersclerosis
- Hypertension
- Myocardial infarction/stroke
- Congestive heart failure
components of the DASH diet
- sodium to less than 2300 mg
- increase: potassium, calcium, magnesium, fibre, protein
Type 1 diabetes (less common type_
Pancreas loses ability to synthesize insulin
Autoimmune disorder; immune cells mistakenly attack and destroy insulin producing beta cells of the pancreas
No insulin is available to allow any glucose to enter the cells
Recommendation: maintaining optimal nutrition status
Diagnosed before the age of 25
Always require insulin therapy
Type 2 diabetes (most relevant)
Insulin resistance, reduced sensitivity to insulin
Muscle and adipose cells cannot remove glucose from the blood – blood glucose remains elevated
Some glucose enters the cells
Recommendations: 5-10 % of body weight weight loss
Associated with obesity, aging, genetics
How can drugs alter nutrient absorption
- damage intestinal mucosa
- change stomach acidity
- bind nutrients (both can be ineffective)
- transport into mucosal cells (compete for transport)
Haw can drugs alter metabolism
- share similar enzyme systems (enhance or inhibit those needed for nutrient use
How can drugs alter excretion
urine production, dec nutrient reabsorption at kidney
How can diet affect absorption of drugs
- absp at top of small intestine
- stomach emptying rate
- acidity
- nutrients, phytates, fibre bind
- fat may promote some lipophilic drugs
How can diet affect metabolism of drugs
- some foods interfere with enzymes needed to metabolize drug
- affect activity of drug
How can diet affect excretion of drug
- alter drug reabsorption by kidney
- urin acidity
Alternative medicine
when used instead of conventional
complementary medicine
when used alongside conventional
integrative medicine
combines conventional and complementary where there is good evidence
what foods can cause colon cancer
red meat, processed meat
what cancers can alcohol cause
- upper GI cancer
- head, neck, breast, colon, liver
What causes GI cancer
alcohol
- heterocyclic amines and polycyclic aromatic hydrocarbons
