Missed questions Flashcards
Highest USDA grades
Meat: Prime
Poultry: Grade A
Eggs: Grade AA
Cheddar cheese: Grade AA
Fresh produce: Fancy
Cariogenic foods
contain fermentable carbohydrates, which cause the pH of saliva to decrease and stimulate dental caries. These are fruits, crackers, chips, pretzels, cereals, breads, sweetened dairy products, and sugars.
Cariostatic foods
do not contribute to tooth decay. These are high-protein foods (eggs, meat, etc.), most vegetables, fats, and sugarless gums.
Job specification
gives the minimum standards that an applicant must meet for a particular job. It includes duties, working conditions, and personal qualifications
Job description
list of duties that reflects the skills required and responsibilities of the position. A job description includes how the job relates to other positions, such as which position supervises that job.
Positive acute phase reactants
ferritin
c-reactive protein
fibrinogen
LNC
legislative network coordinator
PAC
political action committee
GRL
grassroots liaison
PPW
public policy workshop
dry storage temperature
50-70F
master menu
is the collection of all menus for a specific food service operation. It is used to manage both the front and back of the house.
Fat adaptation
type of nutrition periodization strategy where well-trained endurance athletes consume a high-fat, low-cholesterol diet for up to 2 weeks during their normal training, immediately followed by a high-carbohydrate diet and tapering of exercise 1-3 days before an endurance event.
Nutrition periodization
the type of strategy in which nutrient intake is timed with specific training patterns. Reducing carbohydrates and then increasing them is a type of carbohydrate/glycogen loading.
GLP-1
a hormone that sends a signal to decrease hunger and prolongs gastric emptying
Secretin
decreases motility and increases mucus output.
TQM
(Total Quality Management) identifies barriers to quality within the organization.
QWL
(Quality of Work Life) focuses on employees’ workplace experiences.
most important step in preliminary planning for a kitchen layout
Menu and type of service
square symbol fire extinguisher
gas, grease, oil, paint, or other flammable liquids
circle symbol fire extinguisher
electrical equipment
fidelity/faithfulness
evaluation criterion that assesses the extent to which a nutrition education program is implemented as intended, without deviation or modification.
assesses delivered as planned, the quality of program delivery, and whether the program components are delivered consistently across different settings and educators.
full gestation
40 weeks
5 weeks= 1 month
AIDS CD4+ count
<200 calls/ul
normal range= 500-1500
Methotrexate
Txt for cancer, rheumatoid arthritis, autoimmune diseases
Inhibits Folic acid (need to supplement)
Folic acid
production of DNA and RNA
normal growth and function of cells
CACFP
Child and Adult Care Food Program
USDA
Program requirements: serve 1 meal/day, some provide transport (not required)
Eligibility requirements:
</=130% the poverty level= free meals
130-185% poverty level= reduced-price meals
Break even point
Fixed costs/ (1- (variable costs/sales))
Stevia derivative
rebaudioside A
natural sweetener
synthetic sweeteners
sucralose
neotame
aspartame
Solvency ratio
Financial ratio that assesses a company’s ability to meet its long-term financial obligations by comparing its total assets to its total liabilities. It is an important measure of a company’s financial health and stability.
Acid- test ratio
Acid-test ratio (also known as quick ratio) measures a company’s ability to pay off its current liabilities with its most liquid assets, such as cash and marketable securities, without selling its inventory.
Quasi-experimental designs
used when randomization is not feasible
rely on pre-existing groups (schools, communities)
compare outcomes before and after intervention
sometimes non-equivalent control group designs, in which a control group is used, but the groups are not randomly assigned
less expensive
Sulfonylureas
oral anti-diabetic drugs, type 2 DM
stimulate insulin secretion from pancreatic beta-cells
can cause hypoglycemia, weight gain, GI side effects (nausea and diarrhea), cardiovascular events
Biguanides
oral anti-diabetic drug, type 2 DM
reduce glucose production in the liver and improve insulin sensitivity in peripheral tissues
lower risk of hypoglycemia, weight loss or minimal weight gain, or GI issues
CAN cause rare side effect= lactic acidosis (those with renal impairment more at risk)
fruit ripening (pectin and gelling)
protopectin (not ripe)->pectin (underripe/just ripe; highest level of pectin)-> pectinic acid (looses ability to form a gel)-> pectic acid (softens)
total # of meals served
Total café sales / Meal equivalent factor
labor cost per meal
Total labor expenses / Total number of meals served
folate recs for prenatal/pregnancy
400 mcg (1 mo beforehand), 600 mcg
ligament of treitz
marks the separation of the duodenum and jejunum
alpha-gal allergy
carb produced in mammals
cows, pigs, sheep
avoid: beef, pork, lamb, venison
causes: hives, itching, swelling, nausea, anaphylaxis
TPN >6 month vit deficiencies
manganese and chromium
toxic at high levels, not typically in forumlas
loop diuretics
cause low potassium due to blocking the reabsorption of K in the loop of Henle
need to supp K or eat foods high in K
bananas, spinach, avocados
hypokalemia=> muscle cramps, weakness, irregular heartbeats, paralysis
nutrition risk screening scores
Score 0: Normal nutrition status
Score 1: Weight loss >5% in 3 months
Score 2: Weight loss >5% in 2 months
Score 3: Weight loss >5% in 1 month
best diet for NAFLD
Mediterranean diet
Cori cycle
in muscles: glucose to pyruvate then lactate
then to the liver: reconverted to pyruvate and then gluconeogenesis
glucose back to muscle
critical incident appraisal
supervisors identify good and bad behaviors that are indicators of excellent or poor performance
MBO
Management by objectives
performance evaluation requiring the setting of measurable performance goals that are mutually agreed upon by the employee and immediate supervisor
BARS
behaviorally anchored rating scale performance evaluation scale that contains specific behaviors identified for each performance level for each job category
chylomicrons
transport dietary fat and cholesterol to the liver, are composed of triglycerides, and high-fat meals produce more chylomicrons.
synthesized in intestinal enterocytes
high BUN
caused by dehydration or kidney damage
normal= 7-20mg/dl
4 most costly foodborne pathogens
Campylobacter jejuni, salmonella, listeria, and e. coli
GFR <25ml/min
stage 4 CKD = GFR 15-29 ml/in
protein= 0.6g/kg
Elastin
Yellow in color, resistant to heat, barely changes in cooking, found in ligaments and cartilage
Cartilage
Structural part of the tendon that surrounds the muscle. When it is heated, it is hydrolyzed to gelatin and becomes tender.
YRBSS
Youth Risk Behavioral Surveillance System
CDC, UDHHS
grades 9-12 (high school)
watching changes in health risk over time
monitors sexual health, substance abuse, physical activity, eating habits
informs public health policies and interventions
PEG tube insertion
inserted through the abdominal wall directly into the stomach
uses endoscopy to guide insertion
held in place by balloon
G-tube
gastronomy tube
inserted through the abdominal wall
surgically placed, held in place by sutures
more invasion, longer recovery than PEG
max/min heat temp for sanitation
max= 194F
min= 162-165F
normal=165-180F
federal registrar
publication that includes a wide range of information related to the activities of the federal government. It is published weekly, and includes notices of public hearings, proposed and final rules, and agency decisions related to various issues, including nutrition and food programs. Additionally, the Federal Register lists changes in USDA food programs, such as the National School Lunch Program.
black cohosh
recommended to women experiencing menopausal symptoms because it contains compounds that mimic the effects of estrogen in the body. However, it has the potential to cause clotting. Those taking anticoagulants and cholesterol medications should avoid taking this botanical.
Mayo theory
emphasizes the importance of social factors, such as good treatment by supervisors, in motivating employees. He also recognized the importance of breaks and attention as motivators for increased productivity in the workplace.
MacGregor
theory x and y
Herzberg
2 factor theory- satisfiers and dissatisfiers
good txt is not a motivator, but hygiene
bicarbonate levels
normal range= 21-28
critical levels= <15 and >40
low levels result of: diarrhea, chronic loop diuretics, acute renal failure, starvation DM ketoacidosis
high levels result of: COPD, aldosteronism, mercurial diuretics, chronic vomiting
process control chart
used to analyze tray line accuracy
can monitor and analyze variation over time, plot data, find trends, make corrective action
Ebb phase
initial phase following trauma/injury
sympathetic nervous system engaged
hypovalemia, tissue hypoxia, shock, vasoconstriction, increased BP, decreased cardiac output, decreased metabolic rate, decrease body temp, decrease oxygen consumption
shift from aerobic to anaerobic metab
flow phase after 48 hrs
inventory turnover rate
sales/ MONTLY AVERAGE inventory
Theory Z
Ouchi
value of the company is the people
emphasizes collaboration, group decision-making, and long-term employment security
opportunity for personal and professional growth
company balances needs of employees with the goals of the organization
antecedents
environmental or internal cues that prompt a behavior to occur
specific events, situations, or stimuli that trigger a behavior
Fe supplementation for infants
for all exclusively breastfed babies
start at 4-6 months
for premature: start at 2 weeks
scleroderma
autoimmune disease that causes hardening and tightening of the skin and connective tissues, as well as damage to internal organs. It can affect the digestive system and cause malabsorption of nutrients, leading to deficiencies in vitamins, minerals, and other essential nutrients. This malabsorption can be due to a number of factors, including damage to the intestinal lining, impaired gut motility, and reduced secretion of digestive enzymes.
lupus
auto immune disease
causes inflammation
damage to kidneys, hearts, lungs, skin
process evaluation
assesses how well the program is being implemented and whether the program activities are being delivered as intended. It is focused on measuring the quality and fidelity of program delivery
health literacy
cultural and conceptual knowledge related to health beliefs, attitudes, and practices, as well as oral and print literacy, and numeracy
BMI percentiles for children w AN
Mild: BMI greater than or equal to 17
Moderate: BMI 16-16.99
Severe: BMI 15-15.99
Extreme: BMI less than 15
3-compartment sink temps
Wash: 110-120°F
Rinse: warm water
Sanitize: 170°F for 30 sec OR chemical solution 75F for 60 sec
FOCUS-PDSA
F - find a process to improve
O - organize a team that knows the process
C - clarify current knowledge of the process
U - understand the causes of process variation
S - select the process improvement
P - Plan
D - Do
S - Study/Check
A - Act
PICC insertion site
peripherally inserted central catheter
arm
superior vena cava (return of deoxygenated blood from body to the heart-> quickly circulated to the body)
NSLP rules
entitlement program, to improve nutrition of children esp. from low income fams
graham flour considered a whole grain
lunch must provide average of 1/3 RDA of pro, Ca, vit C, vit A, Fe
100% full-strength fruit juice may be used for 1/2 of the weekly servings of fruit
DESIGN procedure
use to develop nutrition education plan
will be well-designed, relevant, effective
used to tailor needs to specific target audience
Step 1: Decide behaviors
Step 2: Explore determinants
Step 3: Select a theory-based model
Step 4: Indicate objectives
Step 5: Generate plans
Step 6: Nail down evaluation
acute phase response (infection)
increase glucose, free fatty acids
decrease iron, zinc (sequestration and excreted)
cyclosporine
immunosuppressant
may cause hyperlipidemia, hyperkalemia (may lead to muscle fatigue, weakness, irregular heartbeat)
average inventory ratio
desirable= turnover rate of 2-4x/mo
high ratio= low amount of inventory being kept on hand
low ratio= more money being tied up in inventory
profit margin
net profit/gross profit
hyperalimentation nutrition support
TPN
Erythritol
sugar alcohol not metabolized by the body, excreted as the same thing
used in sugar-free chewing gum, mints, and other confectionery products
minimal effect on BG levels
Isomalt
metabolized in the body
slightly effect BG levels
used in hard candies and toffee
Sorbitol
metabolized in the body
slightly effect BG levels
used in sugar free candies and gums
Xylitol
metabolized in the body
slightly effect BG levels
used in oral care products due to its potential dental benefits
Wilson’s disease
accumulation of copper
low copper diet, take zinc to prevent Cu absorption
IIFYM
if it fits your macros
meal planning tool
SFMNP
senior farmer’s market nutrition program
>60 yo
<185% poverty level
nutrition facts label nutrients
actual amount and % daily value
vitamin D, calcium, iron, and potassium
vit A, vit C (no longer required because deficiencies are rare now)
batch cooking
best used for menu items that don’t hold well after cooking
cooked to order
pasta, rice, vegetables
CAC
Codex Alimentarius Commission
funded by FAO and WHO
develop international standards and codes to protect customers
foremilk
hindmilk
foremilk= first milk released during BF, high in water content
hindmilk= next after foremilk, higher in fat content
pro and cho stay about the same in fore/hindmilks
Ma Huang
reduced hypotensive effects of calcium channel blockers
dehydration affects which athletes most
athletes >40yo
lower thirst drive, restore fluid losses more slowly
boiling water bath
canning process for all fruits
high acid foods
roasting temp meat and poultry
NO LOWER than 325
reheat temp
165F
GRAS
Generally Recognized as Safe
FDA approved supplements
sold prior to 1994 (when DSHEA was created)
after Oct 15, 1994-> must ask for approval 75 days before, can include GRAS ingredients
not tested for safety
management rights lost after unionization
The right to hire or fire
Changing work assignments and schedules
Setting wages and fringe benefits
Changing policies without appeal
Disciplining workers without being subject to appeal by the union
Acting on grievances directly
The right to utilize volunteer workers
ADA guidelines
aisles 36”
doorways 32”
desk height 28-30”
ramps 8.5% grade
print literacy
printed materials should be at 5th/6th grade level
accurate reading of food label DOES NOT = correct interpretation
low literacy -> decreased likelihood of taking Rx
NND
national nutrient database
USDA
nutrient content of foods (ingredients, raw and cooked products)
FDPIR
food distribution program on indian reservations
USDA
food to income-eligible households
people living on Indian reservations or Native Americans residing in specified areas near reservations or in Oklahoma
RQ
respiratory quotient
1= CHO only
0.85= mixed intake
0.82= pro only
0.7= fat only
promotion types
Share-of-mind= change customer’s preference for or feeling of a product
Share-of-market= increase sales and/or the number of customers
intracellular electrolytes
extracellular elevttrolytes
Intra: K+, Mg++, and P
Extra: Na+, Ca++, Cl-, and HCO3-
Stages of pressure ulcer
Stage 4 pressure ulcers are characterized by full-thickness skin and tissue loss.
Stage 3 pressure ulcers have full-thickness skin (but not tissue) loss.
Stage 2 pressure ulcers have partial-thickness skin loss.
Stage 1 pressure ulcers have intact skin and nonblanchable erythema.
Disaster menu
Determine a short-term plan to use for the first 72 hours of the disaster.
Develop a long-term contingency plan to use if the disaster continues for more than 72 hours.
Each health care facility is required to have a 7-day disaster menu with a nutrient analysis.
The disaster menu should be adapted to use fresh produce and dairy products first.
A hospital should consider an inventory of food products for 96 hours.
APHIS
Animal and plant inspection service
under USDA
main department that regulates agricultural products made with biotechnology
Dr. Dean Ornish Program
for reversing heart disease
very low fat (<10% of kcal), high carbs
doesn’t fit 2005 DRIs
steps of program development and planning
- Conduct a needs assessment
- Develop program goals and objectives
- Develop a program plan
- Identify funding sources
- Seek support from stakeholders
Solanine
glycoalkaloid
natural toxin found in nightshade family (potato, tomato, and eggplant)
green pigment under skin, chlorophyll develops during light exposure in storage
sxs= vomiting, weakness, trouble breathing, and possibly paralysis
Figurehead
People look up to you as a person with authority and a source of inspiration. You have social, ceremonial, and legal responsibilities.
Nutrition Labeling Regulations
voluntary
except in cases of fortified foods or foods with a nutritional claim
gluten containing foods
Wheat
Rye
Barley
Triticale
Bran
Graham
Malt
Bulgur
Couscous
Durum
Orzo
Thickening agents
gluten free options
Corn
Potato
Rice
Soybean tapioca
Arrowroot
Carob bean
Guar gum
Flax
Amaranth
Quinoa
Millet
Teff
Buckwheat
compensation for hard water
more detergent
higher mineral water, more difficult for surfactants to form lather
compensation for water spots
drying agent
DHEA
Dehydroepiandrosterone
hormone made by body’s adrenal glands
production of sex hormones (androgens, estrogens)
hemophilia
inherited bleeding disorder
difficulty with blood clotting
AVOID FISH OIL (>3 g increases bleeding risk)
reporting ethical violation of an RD
A complaint must be made within 1 year of the complainant becoming aware of the violation.
The complaint must cite the section(s) of the Code of Ethics for the Profession of Dietetics violated.
The complainant does not have to be a member of the Academy of Nutrition and Dietetics.
Details of the violation must be included (basis of the complainant’s knowledge of the violation, whether it has been submitted to a state licensure board, etc.).
folate
food sources contain glutamic acid molecules, have to be hydrolyzed off
food sources= leafy greens, fortified cereals, liver, kidney, citrus, lentils, beans
Pantothenic acid
vitamin B5
synthesized by intestinal bacteria
helps w synthesis of fatty acids
food sources= animal foods, grains, legumes
C-peptide
clinical indicator of endogenous insulin production
insulin is 2 polypeptide chains, connected by disulfides and C-peptide
when it is released and broken down, C-peptide left to circulate in the blood
FSMA
Food Safety Modernization Act
shifts focus from responding to contamination to preventing it
NSSP
national shellfish sanitation program
The food code
model for safeguarding public health and ensuring food is unadulterated and honestly presented when offered to the consumer
FDA, CDC, and USDA made it together
not an act of Congress or law
Albumin levels
3.5-5.0 mg/dL
decreased: liver disease, acute inflammatory disease, overhydration
increased: dehydration
labs in AN
normal to low prealbumin
normal to low albumin
high total cholesterol, LDL, HDL
DSHEA
Dietary Supplement Health and Education Act
SWOT
Strengths, Weaknesses, Opportunities, and Threats
for strategic planning
storage form of iron
ferritin
best assessment of iron status
food form of iron
ferric
heme: animal sources
non-heme: non animal sources, need vit C
exponential smoothing
time series model that is like the moving average model, but takes into account the seasonality of data and adjusts for forecast error
DESIGN procedure
D - Decide behaviors
E - Explore determinants
S - Select theory-based model
I - Indicate objectives
G - Generate plans
N - Nail down evaluation
2017 scope of practice was revised to cover
changes in ethical billing practices, ordering privileges and delegated orders for RDNs, and new practice areas of coaching, global health, and telehealth
Hunger-free Kids Act
Expanded the after-school meal program
Created a universal meal program that allows schools with a high percentage of low-income students to receive meals at no charge
Increased WIC coverage to 1 year (from 6 months)
Mandated electronic benefits to be used by WIC
Provided new nutrition standards to school-served foods
exercise requirements
ages 6-17 yo: 60 min/day/week
aged 18-64 yo: 150 min mod intensity per week or 75 min intensity per week
steps in facility design planning
Prepare a prospectus (this must be first)
Organize a planning team
Conduct a feasibility study
Make a menu analysis
Consider the architectural features
Consider the costs and adjust as needed for the money available
Adult Treatment Panel 4 (high CVD risk)
Adults with atherosclerotic cardiovascular disease
Adults with diabetes, aged 40-75 years, with LDL levels 70-189 mg/dL
Adults with LDL at least 190 mg/dL
Adults aged 40-75 years, with LDL levels 70-189 mg/dL and at least 7.5% 10-year risk of atherosclerotic cardiovascular disease
Bumetanide/Furosemide
diuretics
avoid natural licorice
When in the GI tract stable
age 3 yo, through adulthood
Sertraline
Zoloft
antidepressant
avoid grapefruit juice (increased toxicity)
Enalapril
antihypertensive
avoid potassium
carry over cooking
10 min
15-25 degrees increased temp
mEq equation
mEq= (mg/atomic wt) x valence
atomic wts:
Na: 23, valence 1
K: 31, valence 1
Ca: 40, valence 2
sickle cell disease
avoid iron due to high number of blood transfusions
increase folate, copper, zinc
1 oz =
2 Tbsp
29.5 oz
0.15 cup
REACH program
Racial and Ethnic Approaches to Community Health
CDC
main goal is to decrease racial and ethnic health disparities
PICH
Partnerships to Improve Community Health
3 yr initiative
improves health of communities and reduces prevalence of chronic disease
sustainable changes in communities where people live, learn, work, and play
National Implementation and Dissemination for Chronic Disease Prevention program
3 yr initiative
helps national orgs and local networks to promote healthy communities, prevent chronic diseases, and reduce health disparities
thyroxine
T4
raises blood sugar
stimulates liver glycogenolysis (glycogen –> glucose) and gluconeogenesis (noncarbohydrate substrate –> glucose)
TSH
thyroid-stimulating hormone
activated when T3/T4 levels drop too low
pituitary gland releases TSH
stimulates thyroid gland to produce more hormones
indirectly raises blood sugar (increases T4)
ELM
Elaboration Learning Model of communication
Ability to process: repeat, clear, straightforward, minimal distractions
Motivation to process: meaningful, memorable, culturally appropriate, what does audience have to gain, humor
ADA glycemic control goals
A1C <7%
Preprandial glucose 80-130 mg/dL
Peak postprandial glucose <180 mg/dL (this is 1-2 hours after a meal)
American Association of Clinical Endocrinologists glycemic control goals are:
A1C ≤6.5%, preprandial glucose 110 mg/dL, peak postprandial glucose <140 mg/dL
storage times
fresh poultry refrigerated: 1-2 days
poultry freeze time: 1 year
refrigerated fresh beef, veal, lamb, and pork: 3-5 days
freezer ground meats: 3-4 months
FTE =
hours of work needed / working hours in a day
AMPM
USDA Automated Multiple-Pass Method
computerized interactive method for 24-hour recall used in government-sponsored nutritional studies
used for What We Eat in America survey
- Quick List
- Forgotten Food List
- Time & Occasion List
- Detail Cycle
- Final Probe
cash budget
projects receipt of revenue and the expenditure of funds
purpose is to determine if CASH will be available when needed
Operating budget
forecast of revenue, expenses, and profit for a specified period of time
parts of the budget= volume indicator (forecast activity and cost) and revenue budget (estimates anticipated income)
Fire extinguishers classes
Class A- ordinary combustibles
Class B- flammable liquids (paint)
Class C- electrical equipment
Class D- metals
Class K- grease kitchen fires
BP readings and HTN stages
Normal blood pressure: <120/80
Elevated blood pressure: 120-129/80
Stage 1 hypertension: 130-139/80-89
Stage 2 hypertension: >139/>90
Thiazolidinediones
improves peripheral insulin sensitivity
promotes wt gain and edema-> aka should not be used with CHF
