Nutrition Flashcards
1
Q
Malnutrition
A
- an acute, subacte or chronic state of nutrition in which a combination of varying factors of over nutrition or undernutrition with or without inflammatory activity have led to a change in body composition and dminished function
2
Q
Malnutrition
incidence
A
15-60% of hospitalized patients, depending on the patient population and criteria used to identify malnutrition
3
Q
Malnutrition
etiology
A
- stavartion
- inadequate consumption of appropriate foods
- acute or chronic illness
4
Q
Malnutrition
impact on patient outcomes
A
increased length of stay
complications
costs
mortality
readmissions
5
Q
Malnutrition increase vs decreases
A
increase
- complications
- infections
- length of stay
- readmissions
- mortality/treatment
decrease
- wound healing
- convalescence
- quality of life
6
Q
Nutrition risk factors
A
- Poor appetite or early satiety
- PO intolernace
- dysphagia
- inability to feed self
- oral thrush: infection
- alterantive route of feeding
- edema dehydration
7
Q
malnutrition:
prevalence based on location
A
- hospital 30-50%
- long term care: 21-51%
- outpatient and homecare: 13-30%
8
Q
Malnutrition
at increased risk
A
- older adults
- critically ill patients
- patients wit comorbid chronic disease
9
Q
screening for malnutrition
A
- academy nutrition and dietetics/american society or parenteral and enteral nutrition (ASPEN)
- subjective global assessment (SGA)
- malnutrition screening tool (MST)
- mini nutritional assessment MNA
- malnutrition universal screening tool (MUST)
10
Q
nutrition focused clinical exam
A
- weight status:
- indications of nutrient deficiencies
- functional status: ambulatory, bedridden
- fluid assessment: edema turgor tests
- wound status
- mental status
11
Q
Medications related to nutirtion
A
- appetite enhancers: appetite stimulants, antipsychotics and antidepressants
- anti-emetics: ondanestron, aprepitant, metoclopramide, meclizine, canabinoids
- Bowel regimens
- negative effects: chemo, tricyclic antidepressants, pain medications, steroids
12
Q
Medication, food and drug interactions
A
- coumadin and vitamin K, brussel sprouts, collard greens, swiss chard, chamomile tea, mango
- Zyvox, MAOIs and tyramine-containg foods, fermented foods and alcohol
- lithium and caffeine or salt
- cholesterol-lowering statins and grapefruit jucie
- digoxin, coumadin and natural black licorice
- digoxin, AC inhibitors and salt substitutes
13
Q
Supplements are beneficial for
A
- individuals restricting caloric intake or following restrictive diets
- pregnent women
- vegetarians
- vegans
- anyone >50
- individuals with wounds
- vitamsn are not run through the same screening process - look for USP
14
Q
Timing Nutrition for exercise
pre-workout
A
- eat 1-3 hours prior to workout
- peanut butter and banana
- greek yogurt with berries
- turkey and cheese sandwhich on whole wheat bread
15
Q
Timing nutrition for exercise
post-workout
A
- eat CHOs and protein as soon as possible
16
Q
Whey protein supplementation
A
- water soluble and allows for faster gastric emptying
- processed into isolates, concentrates and hydrlysates
- isolates have higher concentrations of protein little or not lactose and have minimal mineral and fat in smaller volumes
- concentrates have lower concentration of protein and higher concentraction of lactose
- hydrolysates are pre-digested and partially hydrolyzed to be more easily absorbed
17
Q
casein protein supplementation
A
- clots in the acid environemnt of the stomach, delays gastric emptying and has slower release of amino acids
18
Q
Protein bars
A
- help to curb hunger and increase satiety
what to look for
- less than 200 calories
- at least 3g of fiber
- at least 4g of protein
- aim for less than 12-15g of surgar
19
Q
Paleo diet do eat
A
- grass-produced meats
- fish/seafoods
- fresh fruits and veggies
- eggs
- nuts and seeds
- healthful oils
20
Q
paleo dont eat
A
- cereal grains
- legumes
- dairy
- refined sugar
- potatoes
- processed foods
- refined vegtable oils
21
Q
gluten free diet
A
- main way to manage celiac disease
- autoimmune disease caused by sensitivity to gluten
- has become a fad diet in the past several years
- non-celiac gluten sensitivity
22
Q
gluten containing grains
A
- wheat
- barley
- rye
- triticale
23
Q
Organic vs non-organic
A
- organic = foods grown without using artificial materaials such as pesticides and antibiotics
- according to the AICR at this time it is not known whether organic foods help to reduce cancer
- use the environment working groups the shopper’s guide to pesticides in produce
24
Q
EWG’s dirty dozen plus two
A
- apples
- strawberries
- grapes
- celery
- peaches
- spinach
- sweet bell peppers
- nectarines
- cucumber
- cherry tomatoes
- snap peas
- potatoes
- hot peppers
- kale/collard greens
25
EWG's clean 15
- avocadoes
- sweet corn
- pineapple
- cabbage
- sweet peas (frozen)
- onions
- asparagus
- mangoes
- papayas
- kiwi
- eggplant
- grapefruit
- cantaloupes
- cauliflower
- sweet potatoes
26
GMOs
- a plant or meat product that has had DNA artificially altered in a lab by genes from other plants, animals, viruses or bacteria in order to produce foreign compounds in that food
- FDA regulates GE crops in conjunection with the US department of agriculture and envirnmental protection agency
- most common GE foods are cotton corn and soybeans
- US and canda do not require labeling of GMOs
27
macronutrients and micronutrients
`macronutrients and building blocks`
- carbs => glucose
- proteins => amino acids
- fats => fatty acids
micronutrients:
- vitamins - fat soluble and water soluble
- minerals carbon, hydrogen, oxygen and nitrogen etc
28
bariatric surgery
- sleeve gastrectomy
- LAP band (can come off = complication)
- Roux-en-Y bypass - deficiences
- duodenal switch - deficiencies in nutrients
29
goal before surgery
- practice eating slowly and chewing foods thoroughly
- wean off beverages containing caffeine, carbonation and sugar
- choose foods with < 3g fat per ounce or per serving
- start eating protein at each meal
- purchase and trial protein supplements
- purchase vitamin and mineral supplements
30
after bariatric surgery 1st week
- no conentrated sweets
- no caffeine
- no carbonation
- each meal should equal 3 ounces
- sip liquids slowly take a minimium of 15 minutes
31
# after bariatric surgery
2nd week
- no concentrated sweets
- no caffeine
- no carbonation
- each meal should equal 3 ounces
- sip liquids slowly should take a minimum of 15 minutes
32
# after bariatric surgery
3rd and 4th week
- 3 pureed meals per day plus 11-15 oz
- make each meal last 30 minutes
- only drink fluids between meals
- eat protein foods first
33
after bariatric surgery: 5th week
- 3 meals per day plus 2 protein rich snacks
- make each meal last 30-45 minutes
- chew foods thoroughly
34
medications for weight loss
- semaglutide under brand names such as
- ozempic, rybelsus and wegovy
- for long term treatment of type 2 diabetes or obesity
35
how does semaglutide work
- incretin glucagon-like peptide-1 GLP receptor agonists:
- increases insuling production when blood glucose is elevated
- slows gastric emptying
- acts on parts of brain resposible for hunger and cravings
36
risk with semaglutide
- nausea, vomiting, diarrhea, constipation
- increased risk of pancreatitis, kidney failure and medullary thryoid carcinoma
- gall bladder disease
- ozempic faces- loss of fat and skin sagging
- possible nutrient deficiences
- possible muscle loss
- regainning weight within a year of stopping
