Malnutrition

Question 1

What are some of the consequences of obesity?

Answer 1

• High blood pressure
• Dyslipidaemia
• Type 2 diabetes
• CVD
• Gallbladder disease
• Osteoarthritis
• Sleep apnoea
• Cancers
• Mobility issues
• Mental health and low mood

Question 2

Where should you measure the waist?

Answer 2

The circumference at the mid point between hip and lowest rib- just above umbilicus

Question 3

What is the calorie availability of protein, fat, carbs and refined sugars?

Answer 3

Protein= 70% absorbed
Complex carbs= 90%
Refined sugars= 95%
Fat= 98%

Question 4

What are the Atwater factors?

Answer 4

It uses a single factor for each of the energy-yielding substrates (protein, fat, carbohydrate), regardless of the food in which it is found

Question 5

What are some strategies to avoid overeating?

Answer 5

Limit distractions whilst eating
Eat slowly
Eat regularly
Eat more dietary fibre and lean protein
Digital tracking
Stay hydrated
Eat breakfast- protein rich

Question 6

What are the

Answer 6

Tier 1= population wide health improvement
Tier 2= primary care
Tier 3= specialist weight management
Tier 4= specialist surgical service

Question 7

What are different surgical procedures to help patients lose weight?

Answer 7

Lap band (band placed around stomach)
Gastric bypass (food bypasses stomach)
Sleeve gastrectomy (stomach made smaller)
Gastric balloon (silicon balloon placed in stomach)
Endo-barrier gastrointestinal liner (plastic bag so food passes through without being absorbed)

Question 8

What is gastric bypass surgery?

Answer 8

It is where surgical staples are used to create a small pouch at the top of the stomach. The pouch is then connected to your small intestine, missing out (bypassing) the rest of the stomach

Question 9

What deficiences can be seen in obese people?

Answer 9

55-80% have vit D deficiency
50% have iron deficiency
Vit B12, thiamine (B1) and cholecalciferol (D) seen

Question 10

Why does pre-operative weight loss need to occur before patients undergo weight loss surgery?

Answer 10

To reduce the size of the liver- when there liver is larger than usual it straddles the stomach

Question 11

What is the post operative diet in those who undergo weight loss surgery?

Answer 11

Aim to get to maintenance diet by 6 weeks
Diet priorities are for lean protein, dairy products and fluids
About 1200-1500kcal/d
Low in fat, moderate in carbohydrate, high in fluid
Sipping water throughout day- usually lose thirst feeling
Need vitamin supplementation