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Exam 1- GI and CVD > Nutrition > Flashcards

Nutrition Flashcards

1
Q

What is the role of a healthy diet?

A

To provide sufficient energy and nutrients to maintain normal physiological functions and permit growth and replacement of body tissues. Must offer the best protection against the risk of disease e.g. cancer, cvd

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2
Q

What should our diet nutrition be able to provide us?

A
  • Prevention of deficiency symptoms
  • Optimises body stores
  • Optimises some biochemical/physiological function
  • minimises a risk factor for some chronic disease
  • minimises incidence of a disease
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3
Q

What does the Eatwell guide recommend for a healthy diet?

A
  • Plenty of water- can include sugar-free drinks, tea and coffee- BUT limit fruit juices/smoothies to 150 ml a day
  • 1/3 fruit and veg- 5 portions a day
  • 1/3 starchy foods- bread, pasta, rice= preferrable wholegrain and high fibre versions
  • Protein- chicken, fish, beans, pulses
  • Small amounts of oils and spreads- are needed for essential fatty acids, but should only be consumed in small quantities
  • Dairy- Provide calcium and vitamin D
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4
Q

What factors influence our nutritent requirements?

A

Age
Gender- males need more due to increased muscle mass
Physiological state- e.g pregnancy
Genotype
Environmental factors e.g. smokers need more vitamin c

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5
Q

What is the estimated average requirement (EAR)?

A

estimate of the average requirement for energy or a nutrient- approximately 50% require less than this value and 50% require more

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6
Q

What are the nutrient requirements like for infants?

A

Nutrition requirements are high due to rapid growth and development
- Breast feeding is recommended for first 6 months of life as provides babies with all the necessary nutrients
- Colostrum from the mother (first bit off milk) contains antibodies e.g. secretory iga wich can help protect a babies GI tract
- Formula e.g. SMA, cow and gate does mimic breast milk so babies should get the required nutrients but all companies have to promote breastmilk as the first choice

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7
Q

What are some of the adapted formulas that can be prescribe for infants?

A
  • Soya-based- if cows milk protein allergy e.g. SMA soya
    Concerns with use before 6 months due to soya being allergenic and the immune system is not yet fully developed
  • Extensively hydrolysd formula- modified cows milk that is hypoallergenic e.g.Nutramigen- used if allergies
  • Lactose-free
  • Anti-reflux
  • Higher energy content e.g. if a baby is premature
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8
Q

Why do babies need to be weaned off milk?

A

Because at this stage (around 6 months), their energy, vitamin and mineral requirements increase. Also they are growing and developing more so their nutrition requirements are no longer met by milk

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9
Q

What age does the department of health reccommend introducing solid foods to an infant?

A

6 months

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10
Q

What foods should be avoided when weaning?

A
  • Before 6 months: wheat/gluten (risk of developing allergies), fish/shellfish, fruit juice, soya, eggs
  • Before 1 year: Honey, salt, sugar- not necessary
  • Caution with textures- can cause a choking risk e.g. always cut up grapes
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11
Q

What are the requirements for pre-school children?

A
  • requirements vary depending on size and growth of the child
  • Important to offer a varied diet
  • Children often have small appetites so the food they are given needs to be nutrient-dense
  • Whole milk until 2 years, then can move to semi-skimmed etc
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12
Q

What are the common problems in pre-school children regarding eating and nutrients?

A

Faddy eating- refuse to eat, eating not well
Toddler diarrhoea- lots of picking up things and putting them in the mouth
Constipation- sue to potty training
Anaemia- lack of dietry iron
Dental carries e.g. lots of fruit juice in bottles

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13
Q

What are the nutrient requirements like for school children?

A

Healthy eating guidance
Varied diet
Adequate energy and nutrient intake- various growth periods, can be rapid
Good supply of protein, calcium, iron, vitamins A and D (D is in oily fish and eggs and sunlight) (A is in fortified spreads, carrots, sweet potato, swede, mango, dark geen veg)
Physical activity is important

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14
Q

What are the nutrient requirements like for adolescents?

A
  • most important are Calcium, vitamin D and iron
  • This is where growth spurts often happen so need lots of energy and protein
  • Peak bone mass occurs during adolescence- hence increase in calcium and viamin D requirements- need to ensure long-lasting strong bones to prevent osteoporosis later. Also physical activity aids this bone strength
  • Growth spurt begins around age 10 in girls and 12 in boys
  • Energy requirement is greater in boys due to larger muscle mass
  • iron requirements increase in girls after onset of menstruation ( as iron is loss during a period) - this continues to be higher until menopause
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15
Q

What are the nutrient requirements for adults?

A

Nutrient requirements dont change much from ages 19-64
- Energy depends on levels of physical activity but average:
Males= 11.6 MJ/day (2772 kcal)
Females= 9.1 MJ/day (2175 kcal)
- Protein = 0.75g protein/kg of body weight
- Carbohydrate = 50% of total energy
- Fibre- 30g per day- difficult to achieve as average piece of fruit only contains 2g (also present in veg and cereals)
- Fat- 35% of total energy, increase omega 3s e.g. in fish

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16
Q

What are the alcohol guidlines in the UK?

A

No more than 14 units per week
Spread these over 3 or more days- don’t binge drink
Alcohol increases risk of cancers, injuries and death
Recommend several drink free days per week to cut down

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17
Q

What are the energy requirements for pregnant women?

A

Energy requirements don’t change much!
Energy increases by 200 kcal a day in the final trimester
energy requirement increases by 0.8 mj/day (200kcal)- not eating for two!
- small increase in daily protein (6g) due to developing new tissues
- when lactating, protein increases by 11g/day
- avoid certain foods- shark, swordfish, marlin, limit tuna- due to long-living fish can have an accumulation of methylmercury and this is teratogenic
- Micronutrients e.g. Need 400mcg of folic acid per day in first trimester- usually via a supplement (reccommended before start trying to conceive and for first 12 weeks- helps babies brain and spinal development- prevent spinal bifida, anencephaly), need iron-rich foods (or can suffer tiredness/anaemia) and possibly supplements, Folic acid rich foods e.g. broccoli, brussels, leafy green veg, fortified cereals
- Avoid vitamin A supplements and cod liver oil products- high amount of 1500 mcg+ per day can be teratogenic
- no smoking, limit caffeine, stay acitve
- Vitamin D supplement - need 10mcg per day. Supplements reccomended between winter months sptember-march. During these months the body cant make vit D from sunlight alone. is also in oily fish, eggs
- calcium for babys bone development e.g. milk, cheese yoghurt
- need vit c - oranges, OJ, peppers, strawberries

18
Q

What do smokers need to increase their uptake of?

A

vitamin c - as vit c neutralises the pro-oxidants in smoke

19
Q

What are the nutrient requirements like for older adults/elderly?

A
  • Main requirement is vitamin D
  • Energy requirements decrease with age as physical activity reduces
  • Nutrients stay similar to adulthood
  • Malnutrition is common in this age due to inadequate food intake- decrease body weight, fat stores and muscle wasting
  • Nutrient deficiencies- don’t eat as much e.g. sue to ill-fitting dentures/lack of teeth, illness
20
Q

What are vitamins and where do they come from?

A

organic compounds (micronutrients) required for normal functioning of the body.
They can’t be synthesises- we have to obtain them from our diet e.g. fruits and vegetables

21
Q

What are minerals and trace elements?

A

inorganic compounds required by the body e.g. magnesium, calcium, phosphorus, iron, fluoride
roles in:
structure e.g. bones and teeth
components of biological fluids
nerves and muscles
iron- required for oxygen-carrying
osmotic balance e.g. sodium, chlorine
incorporated into enzymes as cofactors e.g Cu, Fe, Mn
incorporated into hormones e.g. iodine for thyroxine

22
Q

What are the functions of iron in the body?

A
  • Essential in making haemoglobin - a protein found in RBCs to carry oxygen around the body
  • Iron is incorporated into myoglobin- is found in muscle cells and stores and transports oxygen (has a higher affinity for o2 than haemoglobin)
  • CYP 450 enzymes- have an active site made of a heme iron centre
  • Role in the anti-oxidants catalase and peroxidase
  • role in cell growth and differentiation
23
Q

What percentage of dietary iron intake is absorbed by gut epithelial cells?

A

only 10%

24
Q

LOOK AT IRON METABOLISM DIAGRAM IN NOTES!!!

A
25
Q

What is the difference between ferric iron and heme iron?

A

Ferric iron= Fe 3+
Heme iron = Fe 2+

26
Q

What is the process of iron absorption (LOOK AT DIAGRAM IN NOTES)?

A
  • Only a portion of iron ingested is in a form that can be absorbed- heme iron or ferrous iron. Absorption is tightly regulated- usually only 10% of dietry intake is absorbed .
  • Iron is absorbed across the luminal membrane of the small intestine (in duodenum and jejunum) epithelial cells by different energy-dependent carriers e.g. Divalent metal transporter 1 (DMT1) and haeme-carrier protein-1 facilitates uptake of iron. Any ferric iron (3+) has to be reduced by duodenal cytochrome B reductase to ferrous iron (Fe2+) before uptake by DMT1
  • Iron that is absorbed into epithelial cells in the small intestine and is immediately needed for RBC production is transferred into the blood by the membrane iron transporter- ferroprotein
  • In the blood, the iron is carried to the bone marrow bound to transferrin (a plasma protein carrier) to make RBCs
  • A small part of iron is taken up by macrophages in the reticuloendothelial system. Here, the system recycles iron from senescent RBCs (back to plasma transferrin iron to make new rbc) and also acts as a storage depot for excess iron.
  • Absorbed iron that is not immediately needed, is stored in the epithelial cells as ferritin
  • This unused iron is lost in the feaces as ferritin containing epithelial cells are shed gut replaces its cells frequently. dietry iron that was not absorbed is also lost in faeces
27
Q

What foods are iron-rich?

A

Haem iron = Red meat, fish, poultry]
Non-haem iron = plant food, lentils, beans, cereals

28
Q

What is the reccommended dietary intake of iron for males and females?

A
  • Males = 8.7 mg/day
  • Females = 14.8 mg/day
    females is higher due to menstruation
29
Q

What are the symptoms of anaemia?

A
  • Pallor, weak, tired, poor performance
30
Q

What are commonly used iron supplements?

A

Ferrous salts- Ferrous fumarate, ferrous sulphate
The amount of iron absorbed decreases with higher doses= oftem give 3 equally spread daily doses
side effects- GI, nausea, vomiting, constipation

31
Q

Can anyone take iron supplements?

A

NO - iron supplements should only be taken if the patient knows they are iron deficient
This is because if iron stores are normal, it can cause iron overload:
- A chronic iron toxicity

32
Q

What is haemochromatosis?

A

A genetic iron storage disease- where iron is deposited in different tissues causing damage= iron is slowly deposited over many years = iron overload
Symptoms= often between aged 30-60
- Fatigues
- weight loss
- weakness
- irregular weakness

33
Q

What is the treatment for haemochromatosis (iron overload)?

A
  • Iron chelators- medicine that reduces amount of iron in the body e.g. Desferrioxamine
34
Q

What are possible causes of undernutrition?

A

Decreased food intake
Decreased absorption
Decreased activity of cofactors
increased metabolisn
Underlying disease e.g. cancer, HIV/AIDs, Anorexia, post-surgery

35
Q

What is cachexia?

A

Disease-related malnutrition
- is common in hospitals and in conditions such as:
IBD
AIDs
cancer
heart failure
drug addiciton
COPD

36
Q

What is the treatment for cachexia?

A
  • Small and frequent meaks
  • food fortifiation- increase enrgy density e.g. adding skimmed milk powder
  • Use of supplements e.g. complan, fresubin, fortisip, maxijul
37
Q

Which prescribable food supplement cant be given to diabetics and why?

A

Maxijul- increase sugar intake = increase blood glucose

38
Q

What are neutraceuticals (like an exam q)?

A

Food/ingredients with medical benefits
e.g. Dietary supplements- capsules, powders, multi-vitamins taken in addition to normal food to add a concentrated source of nutrients

or

functional food/beverage - contain an ingredient that gives a health benefit beyond its nutritional value e.g. benecol, actamils
- e.g. decrease disease risk (cancer, cvd, arthritis)
- or increase performance (mental or physical)- improve wellbeing, aid skin ageing, better gut function e.g. probiotics, detoxification

WHY?
- decrease disease or prevent
- we have an ageing population
- we have a rising healthcare cost
- growing fixation with beauty

39
Q

What are the claimed benefits of omega-3 supplements?

A

Fish oils
Have effects on skin, cholesterol, inflammatory mediators
- health claim- that improve heart and anti-inflammatory - by producing resolving mediators decrease inflammation
- added to foods e..g fish, eggs, yogurts, supplements

40
Q

What are the claimed benefits of phytosterols?

A

Phytosterols are plant sterols and stanols
e.g. in margarines, mayo, oils, yoghurt, milk
They lower cholesterol absorption via competitively competing with cholesterol
- 2g daily portion decreases LDL cholesterol in body

Exam 1- GI and CVD (43 decks)

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