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BPK 311 > MT2 > Flashcards

MT2 Flashcards

1
Q

What does insulin do?

A

peptide hormone that promotes glucose transport into cells to control blood plasma glucose levels

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2
Q

What is the AMDR of carbohydrates?

A

45-65% of total daily calories
20-30g/day of dietary fibers
50g/day to prevent ketosis

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3
Q

what are some functions of carbohydrates?

A

-Energy source (glucose)

-Antiketogenic (glucose) - prevents high fat mobilization

-spare protein breakdown (glucose) - gluconeogenesis

-Fiber (polysaccharides) - healthy GI

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4
Q

When can Ketosis occur?

A

Non-diabetics with low carb intake

type 1 diabetic who isnt managing disease well

some type 2 diabetics (less common than type 1)

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5
Q

What organs use ketones as energy?

A

Brain and heart

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5
Q

What is ketosis?

A

Large amounts of fatty acids are mobilized from adipocytes for energy metabolism, however large amounts of fatty acids cant be fully metabolized and ketones build up in the body

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6
Q

what is hyperglycemia

A

abnormally high levels of glucose in blood

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7
Q

what is type 1 diabetes

A

no insulin production by pancreas (no beta cells), requires exogenous insulin therapy

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8
Q

what is type 2 diabetes

A

insufficient insulin production (beta-cell dysfunction), alongside resistance to insulin

90% of diabetics are type 2

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9
Q

What are the hyperglycemic values

A

> 125mg/dL glucose
2 hour plasma glucose after 75g glucose load = >200mg/dL

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10
Q

what is glycated hemoglobin (A1C)

A

Indicator of glucose control
diabetic levels = >6.5%
prediabetic levels = 6-6.4%
normal values = 4-5.9%

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11
Q

How does insulin function in the body?

A

Insulin secreted by the pancreas interacts with cell surface receptors and this promotes glucose transport into cells through glucose transport proteins

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12
Q

What is the anabolic function of insulin?

A

glucose to glycogen
amino acids to proteins
pyruvate to fatty acids

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13
Q

What is the anticatabolic function of insulin

A

Inhibits lipolysis
inhibits glycogen
inhibits protein breakdown

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14
Q

what are counter regulators of insulin?

A

cortisol
glucagon
adrenaline
noradrenaline
growth hormone

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15
Q

What are some co-morbidities of poor glucose control?

A

Hyperglycemia is a component of metabolic syndrome

can cause retinal degeration

heart disease/hypertension

kidney disease

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16
Q

what are some treatment options for type 2 diabetes

A

diet changes to control glucose/exercise to lose weight

if not effective then oral hypoglycemic agents added (metformin) - lowers nlood plasma glucose

if not effective then insulin injections for glucose control

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17
Q

what are some ways to manage type 2 diabetes

A

increase exercise

lower saturated fatty acid intake and increase omega 3 fats

lose weight

avoid simple sugars and choose complex carbs

low glycemic index foods

lower calorie intake by 300-400kcal

keep protein at 15-20% AMDR to avoid kidney stress and gluconeogenesis

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18
Q

what is the glycemic index/load

A

potential for food to increase blood glucose

<55 is low GI, >70 is high GI

Glycemic load is GI x amount of carbs
ex/ GI for bread is 70, amount of carbs is 15%
70 x 15/100
GL=10.5

<11 is low GL, >20 is high GL

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19
Q

what are some issues with the glycemic index

A

determined for single foods, not meals

distracts individual from other factors like calories or saturated fat

there is a high variability in GI among people

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20
Q

what are the 3 steps to a nutritional approach to managing diabetes

A

assessment by health care provider (ex A1C and FPG lab tests, dietary assessment, etc)

intervention to develop a strategy (ex dietary plan and food planning such as carb counting)

Monitoring and evaluation of results (EX seeing if plan is working, and if it isnt making changes to the plan or introducing OHA or insulin therapy)

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21
Q

What is the most common cancer for women

A

breast (1 in 8.9 women)

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22
Q

What is the most common cancer for men

A

prostate (1 in 7.1 men)

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23
Q

What influences cancerous gene expression

A

genetic and epigenetic changes, as well as diet and other environmental factors

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24
Q

what is a genoprotective diet

A

low in harmful dietary factors (carcinogens)

sufficient in protective dietary factors like vitamin b folate

delays age on cancer onset

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25
Q

what is cancer characterized by

A

dysregulated cell growth/death as well as loss of differentiation

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26
Q

what are the 3 stages of carcinogenesis

A

Initiation - DNA mutation

promotion - mutation established and passed on to promote mutant cells

progression - metastasis or spreading of cancer cells through inactivation of tumor suppressor genes

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27
Q

What is cancer metastasis

A

spreading of cancer to other areas, commonly occurring in the brain, respiratory regions, skeletal regions, liver, and lymph nodes

hard to treat with high mortality

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28
Q

What are some events that can promote cancerous growth

A

DNA damage through mutations causing oxidative or non-oxidative damage

expression of cancer-promoting genes

suppressed immunity

diet can have a role in all of these events as deficiencies in antioxidant vitamins, folate deficiency, and vitamin A deficiency can all increase risk of these events

essentially, more damage to DNA through lack of protection or increased exposure causes mutations that can raise cancer risk

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29
Q

How do environmental factors impact cancer

A

2/3 cancer caused by these, can be dietary or non dietary, proven as when humans migrate to new environments their risk of cancers changes based on where they live, while maintaining their own culture’s genetic background

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30
Q

What is the ACS grading system

A

system for estimating contribution of dietary factors to cancer prevention,

A1-best established evidence (limit alcohol for oral/esophageal cancer)
A2 - probable benefit (limit red meat for colorectal cancer)

31
Q

What is the link between Beta-carotene supplements and Lung cancer

A

isolated beta carotene may increase the risk of lung cancer, however when in fruits and veggies it can lower risk

32
Q

What are the cancer risks with obesity and increased exercise

A

bmi - higher breast, colon, and endometrial cancer

exercise - lower breast and colon cancer

33
Q

What are the cancer risks with high dietary fat

A

higher colon, breast, and prostate cancer risk

34
Q

What are the cancer risks with high dietary protein

A

higher colon cancer risk with high red meat intake

35
Q

How do fruits and veggies lower cancer risk

A

higher fiber and other phytochemicals to increase GI microbiome health, eliminate carcinogens, prevent oxidative damage (flavonoids), and affect hormone action (phytoestrogens)

high nutrient density for vitamins and minerals

36
Q

How does alcohol increase carcinogens

A

mouth throat esophagus cancer risk
malnutrition is common in drinkers, leading to folate deficiancy

37
Q

How does your cooking method affect carcinogen content

A

smoking, grilling, or frying can cause polyaromatic hydrocarbons (PAH) - burned/smoked foods

heterocyclic amines (burned meats)

acrylamide (fried potatoes)

Nitrites (smoked/cured meats) - carcinogenic nitrosamines

38
Q

What are diet recommendations to lower cancer risk

A

more fruits n veggies

less booze

less fats

less red/processed meat

less burned/smoked/fried meat

less calories with more exercise

39
Q

What is cancer cachexia

A

Wasting disease

loss of weight and muscle mass due to muscle protien breakdown

anorexia due to low NPY and anemia

40
Q

WHat is the goal of nutritional cancer care

A

correct nutritional deficiencies

slow rate of or prevent weight loss through enhanced nutritional support

41
Q

what are some nutritional recommendations to the side effects of cancer therapy

A

low fat cold liquids for nausea

non acidic liquids for mouth inflammation

high moisture foods for xerostomia

caloric dense foods for early satiety

safe well cooked foods with A1 ACS rating for immunodeficiency

42
Q

What foods should be given for entral and parentral nutrition

A

entral (tube into nose down to gut) - milk/soy/predigested foods

parentral (IV, used with nonfunctional gi tract) -glucose, amino acids, albumin, minerals

43
Q

What are some neurological disorders chronic low intake of nutrients can cause

A

wernike-korsakoff syndrome -B1 defciency

peripheral neuropathy -vitamin B6 deficiency

44
Q

What are some neurological disorders chronic excessive intake of nutrients can cause

A

peripheral neuropathy - B6 excess

45
Q

What are some neurological disorders malabsorption can cause

A

fat malabsorption

vitamin binding deficiencies

46
Q

what are some nutritional related assessments for neurological disorders

A

comparing rate of chewing

extent of dysphagia

cognitive funtion

ability to self feed

47
Q

What is dysphagia

A

difficulty with swallowing, can cause lung infections, choking, and malabsorption

treated by mashing or liquifying solids, thickening liquids with starches/yogurt
micronutrient supplements
enteral nutrition

48
Q

WHat are the 2 types of strokes

A

85% thromboembolic
plaque blocks vessel with clotting or clot travels to vessel in brain

15% intracranial hemorrhage
ruptured blood vessel

49
Q

what are some stroke prevention techniques? what are some non-nutritional factors

A

preventing hypertension, obesity, diabetes, atherosclerosis, thrombosis

non nutritional factors include smoking, low exercise, age, and genetics

50
Q

What are nutritional management goals of a post stroke patient

A

lower cholesterol, lower fat, and lower salt not an immediate priority

major task is to implement a balanced diet to manage dysphagia and aid recovery

51
Q

What is epilepsy

A

different types of seizures that are characterized by abnormal neural activity

2 or more unprovoked seizures that occur more than 24 hours apart

52
Q

How do anti-epileptic drugs work

A

influence hepatic vitamin D metabolism, causing vitamin D deficiency

folic acid can influence absorption of these drugs, and shouldnt be mixed with the drugs

53
Q

What is a nutritional management method of epilepsy? How can the components of this strategy be measured?

A

Ketogenic diet is used when drugs cant control the seizures, and is an alternative to brain surgery

creates a state of ketosis, but requires very strict diet and only works in 1/3 people, can also raise risk of GI issues and CVD, medium chain triglycerides can facilitate the use and can cause rapid and efficient ketosis due to dast absorption (meat, eggs, fish, butter, etc)

may involve fasting period, followed by 9:1 ratio of fat to protein, with about 5kcal/kg/day of protein for a child (about 1.25g)

to calculate how much of each, do energy requirement/10 parts, then calculate protein by multiplying 5kcal/kg by weight of child

54
Q

What is parkinsons disease

A

progressive loss of dopaminergic neurons, causing disorders with movement control (more movement inhibition)

L-dopa is used to control symptoms as it is converted to dopamine to make up for missing dopamine, high B6 and amino acids compete with absorption and lower availability to brain

55
Q

what are some nutritional management approaches to parkinsons

A

minimize daytime protein, by intaking most of it during dinner

56
Q

what is Alzheimers disease

A

most common form of dementia due to degeneration of cortical neurons

57
Q

what are some nutritional consequences of alzheimers

A

increased dependancy on others for feeding and dysphagia causes weight loss

abnormal eating behaviours such as not recognizing foods and increased distraction during meals

frequent snacks and nutrient supplements recommended

58
Q

What is the difference between life expectancy and life span

A

life expectancy is the average number of years people live

life span is the maximum time members of a population are to live

59
Q

What is essential life span?

A

theory that maintenance and repair systems (MRS) of the body assure reproductive fitness, genes to next generation

MRS function deteriorates after ELS, and genetic factors influence the rates

60
Q

WHat is oxidative stress

A

imbalance between free radicals (oxygen containing molecules with uneven electrons) and antioxidants in the body, the damage done and repairs results in aging and chronic diseases

free radicals cause chain reactions due to high reactivity, so when more free radicals than antioxidants exist, damage can be done to fatty tissue, DNA, and proteins causing hypertension, atherosclerosis, inflammation, and cancer

61
Q

what factors increase oxidative stress

A

decreased dietary intake of antioxidants

decreased activity of endogenous antioxidants like glutathione

increased pro-oxidant exposure

decreased repair of damage (of DNA damage for example)

excessive levels of iron and copper

62
Q

What are some examples of dietary antioxidants

A

vitamins, flavonoids, and phytochemicals

63
Q

what are some examples of endogenous antioxidants

A

endogenous - made in body

glutathione, GPx (glutathione peroxidase - needs selenium), transferrin (has high levels of iron n copper - can cause oxidative damage)

64
Q

what are some sources of pro-oxidants

A

incomplete reduction of oxygen (energy metabolism)

killing of microbes (immune system)

cytochrome P450 (detox and other chemical reactions

excessive levels of iron or copper

exposure to radiation, smoke, and pollutants

65
Q

How does aging affect muscle function

A

decreased lean body mass (sarcopenia - age-associated skeletal muscle loss, usually due to lack of activity)

66
Q

How does aging affect senses

A

decreased sense of taste/smell, associated with zinc deficiency and cancer treatments, impaired ability to detect spoiled foods and less pleasure from food

67
Q

How does aging affect the mouth

A

causes xerostomia (dry mouth), tooth loss, which can lower intake of food as well as causing decreased saliva and dysphagia

68
Q

How does aging affect the GI tract

A

causes gastritis and decreased intestinal absorption of nutrients such calcium, vitamin b12, lactose intolerance, and higher risk of constipation - higher fluid and fiber intake recommended

69
Q

How does aging affect the kidneys

A

dehydration risk increases, and high protein intake can further compromise kidney function

70
Q

How does aging affect nervous system

A

affected appetite, memory, attention, and increased risk of dysphagia due to decreased neurotransmitter production and increased oxidative stress

71
Q

How does aging affect the immune system

A

more likely to be compromised in elderly, causing increased risk of infections and malignancies

72
Q

How does aging affect the endocrine system

A

decreased insulin secretion capacity of pancreas and increased insulin resistance

73
Q

How does aging affect the cardiovascular system

A

increased risk of hypertension, lower vascular elasticity, and increased atherosclerosis

74
Q

WHat are the 6 main nutritional requirements for the elderly

A

lower energy requirements (300-600 less) due to lower BMR and less activity

no change in protein requirements to lower risk of sarcopenia, while also minimizing stress on kidneys

20% higher calcium requirement due to increased rates of bone loss/ lower intake and absorption of calcium

higher or altered requirements for vitamins due to lower absorption/altered metabolism (+25% vitamin D for lower sun exposure, +15-25% B6 for lower activation/absorption, +B12 for lower absorption)

higher fluid due to decreased thirst response and lower water conservation

maintain normal fat intake for energy and lower risk of deficiency of fat-soluble vitamins

75
Q

What are some general points when preparing food for elderly

A

safe foods - pasturized/cooked (due to lower immune function and senses)

nutrient dense foods

appropriate consistency (dependent on levels of dysphagia

supplements if food groups are avoided (like dairy)

deal with external causes of under nutrition (depression, dementia, financial hardship, etc)

BPK 311 (2 decks)

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