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GI > Medical Nutrition I > Flashcards

Medical Nutrition I Flashcards

1
Q

One of the most pressing and concerning public health problems in the US and other resource rich countries

A

Obesity

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2
Q

Adult obesity prevalence increased from 22.9% in 1988 to

A

35% in men and 40.4% in women

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3
Q

Equally as troublesome as these statistics is the trajectory of these findings. The projected prevalence of obesity is

A

50% by 2030

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4
Q

What is a good initial goal for weight loss?

A

Losing 5-7% of body weight

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5
Q

The rate of weight loss has the potential to reduce after

A

3-6 Months of weight loss

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6
Q

With weight loss, we see an increase in hunger stimulation by

A

Ghrelin

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7
Q

With weight loss, energy storage is increased by

A

GIP

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8
Q

Work to decrease appetite during weight loss

A

CCK and Leptin

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9
Q

If patients lose 10% of their weight, their energy expenditure goes

-makes it harder to continue to lose weight

A

Down

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10
Q

Diets that promise quick weight loss through what is usually an unhealthy, unbalance diet

A

Fad diets

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11
Q

Short-term, typically unsupported by data, and promise results without commitment or lifestyle changes

A

Fad diets

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12
Q

A common theme with many of these fad diets is

A

Weight cycing

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13
Q

An important determinant of short term (less than 2 weeks) weight loss

A

Carbohyrate content of diet

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14
Q

What is the classification for a

  1. ) Low carbohydrate diet
  2. ) Very low carbohydrate diet
A
  1. ) 60-130 g/day

2. ) 0-60 g/day

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15
Q

When no carbohydrates are ingested, body energy stores are mobilized, particularly

A

Glycogen

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16
Q

Glycogen is broken down and fluid loss is

A

Plentiful

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17
Q

Further reduction in carbohydrate ingestion results in break down of

A

TAGs

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18
Q

Begins at ingestion of less than 50 g of carbs per day

A

Ketosis

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19
Q

In the short-term, however, high-fat, low-CHO ketogenic diets cause a greater loss of body water than

A

Body Fat

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20
Q

What are two examples of popular low carb diets?

A

Paleo diet and Atkins diet

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21
Q

The body is taking in no nutrition. As a result, the body reaches to its own stores and tissues in order to provide substrate for energy production

A

Starvation

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22
Q

Muscle is broken down to feed amino acids into gluconeogenesis during

A

Starvation

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23
Q

This diet focuses on high fat and protein but minimal carbohydrate intake

A

Ketosis diet and low carb diet

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24
Q

In the ketosis and lo carb diets, the triglycerides consulted are shunted to production of acetyl coA as a substrate for the

A

TCA cycle

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25
Q

Also, the protein is broken down into amino acids, which shunted into

A

Gluconeogenesis and the TCA cycle

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26
Q

What are some of the benefits of a low carbohydrate diet?

A

Rapid weight loss, decread TAG, increased HDL

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27
Q

Low carbohydrate diets can cause deficiency in

A

B6, Folate, Ca, Mg, K, and fiber

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28
Q

Constipation and headaches are common with

A

Low carbohydrate diets

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29
Q

Focus on reducing fat intake and eating healthy carbohydrates like beans, vegetables, and fruits

A

High carb and low fat diets

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30
Q

In the high carb/low fat diet, what percentage of calories come from fat?

A

Less than 10%

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31
Q

What can not be eaten in the high carbohydrate/low fat diet?

A

Meat, avocado, nuts, seeds

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32
Q

What are the benefits of a high carbohydrate, low fat fad diet?

A

High fiber, plenty of vitamins and minerals

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33
Q

What are some of the potential risks of a high carbohydrate, low fat fad diet?

A

Increased TAGs, decreased HDL, difficult to sustain

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34
Q

Studies have shown that some people that adopt gluten-free diet actually might

A

Gain weight

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35
Q

Improvement of symptoms and growth issues, if patient has celiac disease of gluten-sensitivity

A

Benefit of GF diet

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36
Q

The GF diet could cause deficiency in

A

Iron, folate, niacin, and other vitamins

37
Q

A gluten free diet can also reduce beneficial

A

Gut bacteria

38
Q

Has been associated with improvement in dyslipidemia in individuals without celiac or gluten-sensitivity

A

Gluten

39
Q

Have been reported to inhibit angiotensin converting enzyme (ACE)

A

Gliadin hydrosylates

40
Q

Gluten may boost the

A

Immune system

41
Q

Refers to a period of 3-10 days of mainly fruit and vegetable juices

A

Juice cleanse

42
Q

Is there any scientific evidence to support juice cleanses?

A

No

43
Q

For example, there is a case report of oxalate nephropathy requiring hemodialysis and reduction in GFR due to increased consumption of

A

Oxalate-containing fruits and veggies

44
Q

The nutritional properties of whole foods and food patterns — rather than macronutrients and micronutrients — are an important focus of the

A

Mediterranean diet

45
Q

Rather than restricting foods and calories or eating like a Mediterranean for several days, this is viewed as a

A

Lifestyle change

46
Q

The diet focuses on vegetables and fruits, whole grains, lean proteins, nuts, with olive oil or fats with oils high in PUFA like olive oil

A

Mediterranean diet

47
Q

An important part of the Mediterranean diet is the bottom row, which is the

A

Social component of the diet

48
Q

In an older population, a Mediterranean diet supplemented with olive oil and nuts is associated with improved

A

Cognitive function

49
Q

A Mediterranean diet was associated with reduced incidence of major

A

CVD

50
Q

Was associated with reduced insulin resistance, endothelial dysfunction, inflammatory markers, and metabolic syndrome

A

Mediterranean Diet

51
Q

Immediately starting the diet, there is a significant weight loss in patients with the

A

Low carb diet

52
Q

However, this eventually turns into

A

Returned weight gain

53
Q

A patient on this diet loses weight and then levels off at a new set point without regaining to initial weight or fluctuating significantly

A

Mediterranean Diet

54
Q

Preferable and easier to maintain and adhere to leading to better long term outcomes for weight loss and other lipid and cholesterol levels

A

Meiterranean diet

55
Q

What is stage one of hypertension?

A

Systolic 130-139 mm Hg OR diastolic 80-89 mm Hg

56
Q

What is stage 2 of hypertension?

A

Systolic greater than 140 OR diastolic greater than 90

57
Q

Causes are other general medical conditions that can lead to hypertension. For example, if your body has a tumor of the adrenal gland zona glomerulosa that is independently and inappropriately secreting aldosterone into the blood stream

A

Secondary hypertension

58
Q

One of the diets recommended for people with high BP is the

A

DASH diet

59
Q

Showed in an NEJM article to have a significantly lower systolic BP at every sodium level

A

DASH diet

60
Q

The diet itself emphasizes fruits, vegetables, and low-fat dairy foods; includes whole grains, poultry, fish, and nuts; and contains smaller amounts of red meat, sweets, and sugar-containing beverages than the typical diet in the United States

A

DASH diet

61
Q

Very similar to the Mediterranean diet

A

DASH diet

62
Q

Also contains smaller amounts of total and saturated fat and cholesterol and larger amounts of potassium, calcium, magnesium, dietary fiber, and protein than the typical diet

A

DASH diet

63
Q

What are the normal levels for total cholesterol?

A

Less than 200

64
Q

High cholesterol is classified as total cholesterol greater than

A

240

65
Q

Has been proven to improve reductions of LDL beyond changes in diet alone. These changes can be evident in 6-12 months

A

Exercise

66
Q

In patients with poor baseline diets, it has been shown that changes in diet alone can lower LDL by as much as

A

30%

67
Q

Have also been shown to reduce LDL levels

A

PUFAs

68
Q

Lower LDL and TAGs without lowering HDL

A

MUFAs

69
Q

Once diagnosed, the goal of diabetes management is

A

Glycemic control

70
Q

In treating diabetes, we want HbA1c levels to be

A

Less than or equal to 7

71
Q

A measure that indicates blood sugar control over the last 3 months

A

HbA1c

72
Q

Tells you the percent of red blood cells that have had sugars attached to their membrane due to the high amounts of circulating sugars in a patient with diabetes

A

HbA1c

73
Q

The following are the indications for?

BMI ≥ 40 without comorbid illness
BMI 35 – 39.9 with at least one serious comorbid illness BMI 30 – 34.9 and uncontrollable Type 2 DM or metabolic syndrome

A

Bariatric surgery

74
Q

What are the 4 types of bariatric surgery?

A

Roux-en-Y, Sleeve, Lap Band, and Biliopancreatic diversion

75
Q

Take a small pouch of the proximal stomach and connect it to the small bowel

A

Roux-en-Y

76
Q

Results in restrictive weight loss but also a malabsorptive component

A

Roux-en-Y

77
Q

With a Roux-en-Y, the connection between the small stomach pouch and the jejunum causes dumping syndrome if the patient eats too much

A

Sugar

78
Q

Inhibited by a Roux-en-Y as it is released by the foregut and much of the foregut is bypassed

A

Ghrelin

79
Q

Increased after a Roux-en-Y procedure

A

CCK and GLP-1

80
Q

Most of the greater curvature of the stomach is removed and a tubular stomach is created

A

Sleeve

81
Q

With the sleeve, there is restricted food intake as well as a

  1. ) Decrease in
  2. ) Increase in
A
  1. ) Ghrelin

2. ) GLP-1 and PYY

82
Q

Insulin resistance improves with the

A

Sleeve

83
Q

A soft silicone ring is connected to an infusion port in the subcutaneous tissue. The port allows for adjustment of the ring by infusing saline resulting in restrictive weight loss

A

Lap Band

84
Q

This procedure divides the duodenum from the pylorus, removes the pylorus, and then divides the ileum

A

Bilopancreatic Diversion

85
Q

Then, the surgeon anastomoses the distal ileum to the stomach and proximal ileum to the

A

Distal ileum

86
Q

This procedure is not as well studied from a diabetes perspective and few centers actually do it

A

Bilopancreatic diversion

87
Q

The result of a bilopancreatic diversion is essentially having two parallel circuits running and connecting to a

A

Common limb

88
Q

Medical literature has shown that bariatric surgery can be the best option for severely obese patients with diabetes. Even without weight loss, patients who have bariatric surgery have improved

A

HbA1c

89
Q

What is the minimum protein requirement per day for patients who have undergone bariatric surgery?

A

Minimum 60g protein per day

GI (59 decks)

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