Nutrition

Question 1

Macronutrient intake/balance

Answer 1

Balance of Protein, Fat, Carbohydrate, Minerals, Vitamins, Water (and Fibre)

Specific Disease Processes:
Cardiovascular disease
Diabetes
Coeliac Disease
Allergies

Question 2

How can individual clinicians, government and other organisations help patients to eat a healthy diet?

Answer 2

Health Promotion - vitamin D for breastfed babies and breastfeeding Mums, healthy start vitamins (all children under 5 to have mutivitamin supplement), reduce saturated fats
Education - part of curriculum
Government Policies eg recent requirement to state calories on menus
Labelling foods
Taxes on less healthy foods
Screening for eg diabetes and heart disease with dietary advice for those at increased risk

Question 3

Varying nutrition across life course

Answer 3

Infants - rapid growth therefote increase requirements /kg

Adolescents - rapid growth

Older age - reduced lean body mass, reduced metabolic rate and reduced physical activity affects requiremnst but aso speacific disease processes may affect nutritional needs - diabetes, cardiovascular disease

Question 4

Key principles of nutrition

Answer 4

Balance

Mediterranean diet leads to reduced cardiovascular disease - fruit/veg and less meat

Question 5

Key micronutrients, sources and effect of deficiency

Answer 5

Iron - anaemia

Vitamin C - antioxidant, enhances absorption of iron and aids wound healing, deficiency leads to scurvey,

Folate - megaloblastic anaemia, really important in pregnancy to prevent neural tube defects (Spina Bifida) in babies

Selenium (very high levels in brazil nuts) - antioxidant, reduces cancer risk, anti-ageing, involved in activation of thyroid hormones, improves cognition and may reduce dementia, improves immune function and fertility

Vitamin D - bones, rickets in children

Question 6

How to assess nutritional status

Answer 6

History, Physical examination, Antropometric measurements, Laboratory results, Immune Function

Question 7

Calculate and interpret BMI

Answer 7

BMI - Weight in kg divided by height squared
Overweight >25
Obese >30
but note muscle mass may affect BMI

Question 8

Use of waist measurement

Answer 8

Waist measurement measure of truncal fat