Lecture 32 Nutrition in Health and Disease Flashcards
Define diet
Sum total of all foods ingested
Define nutrients
chemically defined compounds required by the body
What informs food choices
Likes
Dislikes
Religious and ethical considerations
Social and psychological components
How do you measure the basal metabolic rate
Can be measured by direct calorimetry
Usually calculated
Depends on lean body mass
Schofield or Harris Benedict, Henry equations
Various adjustment factors for activity and illness
What does nutritional failure mean
o Failure to meet the nutritional requirements of the individual
What is the result of nutritional failure
o Development of deficiencies
o [Weight loss]
o Or Excess
o [Obesity]
What are the 2 types of malnutrition
Marasmus
Kwashiorkor
What is Marasmus
Body wasting
Protein calorie malnutrition
What is Kwashiorkor
Swelling of the abdomen
Protein calorie malnutrition with an acute or chronic inflammatory component due to lead capillaries and fluid retention
Define Obesity
• A state of nutrition in which a deficiency or excess (or imbalance) of energy, protein, and other nutrients, causes measurable adverse effects on tissue / body form, (body size, shape, composition) body function and clinical outcome.
What BMI is defined as overweight
> 25
What BMI is considered obese
> 30
What metabolic syndromes can obesity cause
Hypertension CV disease Type II diabetes Fatty Liver NASH Cirrhosis
What cancers are linked to obesity
Breast and Bowel
What BMI is considered underweight
<20
What BMI is considered Physical impairment
<18
What BMI is considered an increasingly severe consequences
<16
What is used to screen for undernutrition
Malnutrition Universal Screening Tool
What is step 1 of MUST
- Height
- Weight
- BMI
- If < 20 Score 1
- If < 18 Score 2
What is step 2 of MUST
Have you lost weight unintentionally in the last 3 – 6 months?
Yes – 10% Score 2
No – 5% Score 1
What is step 3 of MUST
Has the patient eaten in the last 5 days
No – Score 2
What does a MUST score over 0, 1, 2 suggest
suggests a risk of undernutrition
Score 1: supplements and watch
Score 0: Monitor
What does malnutrition associate with
- Illness
- Social isolation
- Age
- Socially vulnerable groups
Clinical consequences of Malnutrition
o Impaired immune response o Reduced muscle strength o Impaired wound healing o Impaired psycho-social function o Impaired recovery from illness and surgery o Poorer clinical outcomes
What are the 3 causes of Undernutrition
Appetite failure
Access failure
Intestinal failure
Examples of appetite failure
anorexia nervosa, disease related
Examples of Access failure
teeth, stroke, cancer of head and neck, head injury
Describe intestinal failure
Reduction in the functioning gut mass below the minimal amount necessary for adequate digestion and absorption of nutrients
