Navigating the Nutrition World Flashcards
What does a registered dietician do?
- help clients to adopt healthy eating patterns depending on their health conditions and budget
- reduce referrals to secondary care
- reduce need for hospitalization
- enable self-care
- reduced demand on GP time
- make prevention happen
- manage usage of nutritional borderline substances
- manage prescribed medicines and identify nutrition interactions
What are the top 11 nutrition issue in family practice?
1) diabetes
2) CVD - dyslipidemia, HTN
3) weight concerns
4) GI - constipation, celiac, IBS
5) nutritional deficiencies - anemia, B12
6) pediatric - growth concerns, FTT, picky
7) vegetarians
8) prenatal, postnatal, breastfeeding
9) food allergies/intolerances
10) eating disorders
11) seniors - malnutrition, renal, hepatic
The majority of Canadians get their nutrition information from…
- labels, friends/relatives, and the internet
- often unreliable, 75% don’t check the source or date
Is the gluten-free diet effective for weight loss?
- no; people often gain weight or see nutritional deficiencies
- weight loss from removal of processed foods or restriction
- only recommended for those with celiac disease or gluten intolerance
- low iron and fibre
- costly
- increase the risk for metabolic syndrome
- more of a trend than evidence-based
What approach should nurses take to educating patients?
- ensure evidence-based advice
- don’t want to lecture
- keep the door open, listen to their comments
- listen and link them to supports and services they need
- need to have knowledge of nutrition-related care and who needs the dietician
- want people to enjoy treats but in moderation
- there are no good and bad foods
What is mindful or intuitive eating?
- eat in a manner that makes you feel healthy and happy
- eliminate negative feelings about eating
- eat when hungry
When reviewing health information…
- always question the magic bullet
- probe patient’s about where they heard about information
- remember one success story is not everyone’s success story, single studies are often disproven
How many Canadians have high cholesterol?
40%
The leading cause of hospitalization is….
Heart disease and stroke
What diets are recommended in the treatment and prevention of heart disease?
DASH, mediterranean, vegetarian
What is the mediterranean diet?
- pattern of eating that offers many positive benefits on health
- based on dietary patterns of several areas in Mediterranean including Souther Italy, Greece, and Crete
- rich in healthy monounsaturated fats
- enjoyable and easy to follow
- slightly adhering reduces risk of CVD by 10%
- also reduces cancer, dementia, depression, etc.
What is the effect of the mediterranean diet on BP, LDL, TGs, HDL?
- can lower systolic BP by 11 mmHg
- can lower TGs by 50%
- lower LDL by 30%
- increase HDL 5-10%
What is the DASH diet?
- similar to mediterranean diet
- high in fruit and veg, - high in fibre, magnesium, potassium and calcium
- high in plant sources of protein
- low in red meat, sweets, sweet drinks, salt and sodium
- better for people that like meat
What effect does potassium have on BP?
Lowers BP
What foods are high in potassium?
- potatoes
- bananas
- milk
- other fruits and veg
The average persin consumes how much calcium per day?
< 800 mg
T or F: dairy causes inflammation
False; seems to be anti-inflammatory
T or F: the cholesterol in eggs has a negative effect on cholesterol in the blood
- False; dietary cholesterol is not the biggest predictor in LDL
- instead it’s saturated fats
- eat eggs in moderation, how you cook them matters
T or F: coconut oil is better than olive oil for your heart
- False; coconut oil doesn’t protect the heart
- extra virgin olive oil is good for the heart, monounsaturated fats
- 4 tbsp/day is a good antioxidant, anti-inflammatory, raises HDL, MUFA, polyphenols
T or F: you should avoid peanut butter since it is so high in fat
- False; peanuts and nuts have MUFA, beneficial for heart
- don’t pick lite peanut butter - throw in sugar and take out fat
- ¼ cup nuts daily decreased CVD outcomes
T or F: rye or pumpernickel bread are more effective at lowering LDL cholesterol than whole wheat
- True; very high in soluble fibre, promotes bowel movements, whole wheat has lots of fibre but not the soluble kind
- soluble traps bile acids, decreases cholesterol
- other foods with soluble fibre: psyllium (bran buds, greatly increases gastric emptying and post-meal glucose), barley, legumes, oats, flax, several fruits and veggies
T or F: recent research identifies the importance of healthy gut bacteria to manage symptoms of gas, bloating, constipation, diarrhea, and cholesterol
- True
- probiotics have different health benefits
- for IBS - want certain yogurts like Activia
- on antibiotic pill, want Danactive for diarrhea
- prebiotics like fibre
Sitting can cause…
Insulin resistance
How much can nutrition therapy lower A1C?
1 to 2%
How many carbs are in a balanced meal?
60 g
How many carbs are recommended for a healthy snack?
15 g
What meal spacing is best for blood sugar?
- regular, spaced out intervals
- too long of intervals leads to low blood sugar and spikes
Does A1C always indicate good BG control?
No; if someone is fluctuating between hypo- and hyperglycemia can even out to a good A1C
T or F: certain fruits should be limited if you have diabetes because of the high sugar content, including grapes and bananas
False; fruit has healthy sugars and fibre, medi and dash are very high fruit
- too many nutritional benefits even though they do have sugar
- watch grapefruit (meds) and JUICE due to high amount of sugar and no fibre
- want to eliminate food with added sugar, not natural sugars
- avoid liquid sugar in drinks
T or F: when it comes to weight loss, cutting out carbs is more effective than cutting out fat
- neither; trick question because you want a balanced diet
- both are energy, too little and you will miss key nutrients
- choose healthy portions and low glycemic index
- anemia is very common with people cutting out carbs, fullness is also an issue and mood
- no carbs = cranky and constipated because they affect serotonin
- no carbs can also bring out hypoglycemia, nutrient deficiencies like magnesium, poor glycemic, lipid and BP control
T or F: drinking tea or coffee impairs iron absorption
- True; contains tannin, blocks 70% of dietary iron
- want to separate tea from meals by 30 min and don’t take multivitamin with tea
- coffee blocks 30% - if vegetarian- will consume even less dietary iron because phytates in veggies
- vegans need even more.
- # 1 deficiency in the world, add fruit veg as vitamin C source to enhance absorption
T or F: a 3 kg weight gain in the first trimester is a risk factor for gestational diabetes
- True; gaining a lot early on is a huge risk factor
- 1st trimester don’t need extra cals, 2nd 350, 3rd 450
- not “eating for two”
- Low or high BMI starting pregnancy both have risks
What are risk factors for neonatal anemia?
- low birth weight
- premature
- iron deficient mother
- low SES
- new immigrants
- insufficient iron rich foods at 6 months
- breastfed babies
- South Asian mom (high prevalence iron deficiency anemia, maybe because vegetarian)
What foods can infants be fed at 6 months for iron needs?
- iron fortified cereals
- not meat because unable to digest it
- no iron in breast milk
- formula
Why is anemia in infancy problematic, and how is it treated?
- can lead to irreversible cognitive damage
- formula
- supplementation - can stain teeth so put at back of mouth and wipe teeth
- look for signs such as paleness and lethargy
Normal BMI for seniors?
- 65 years old and less want below 25
- 65+ want above 23 because risk of falls, ideal is 23-28
Is malnourishment a problem in seniors?
- yes; 1/2 coming into hospitals are malnourished
- mostly unplanned weight loss, risk of muscle loss, and malnutrition
- stay is longer, costs 2k more
- high readmission in 30 days
- only 11% referred to RD for management
What can we do to prevent malnutrition in seniors?
- in hospital protect meal times, record intake and weigh patients, refer to RD if unintentional weight loss or loss of appetite
- in family practice screen for loss or low appetite, offer suggestions to improve intake, alert team if declining, refer to RD on health teams if needed
Most of a RDs time is spent on…
Chronic diseases
