nutrition

Question 1

what to do with person BMI 25-35 and no co-morbidities?

Answer 1

signpost to tier 2 = winning weigh (learn to lose), give phone number or referral to group or commercial slimming organisation referral

Question 2

what to do with person greater than 30 BMI and co-morbidities?

Answer 2

refer to tier 3 = specialist weight management service (patient must phone to activate referral)

Question 3

what is tier 4 of weight management?

Answer 3

bariatric surgery

Question 4

what are the primary components of food, serving energy to body?

Answer 4

carbohydrate, protein, fats

Question 5

what are fat types?

Answer 5

saturated = ok (butter, cheese, meats)

trans = bad (deepfried)

unsaturated = good = polyunstaurated (omega 6 - peanut butter and omega 3 - oily fish) & monounsaturated (olive oil and avocado)

Question 6

what are EFA’?

Answer 6

essential fatty acids = body can’t make
= precursors to various molecules in the body, including vitamins, cofactors, and derivatives

2 categories = omega 3 and omega 6

Question 7

what are essential fatty acids involved in?

Answer 7

• The immune system
• The central nervous system
• Other physiological processes

Question 8

what are omega 6 fatty acids?

Answer 8

linoleic acid and arachidonic acid (makes leukotrines)

Question 9

what are omega 3 fatty acids?

Answer 9

alpha-linoleic acid, eicosapentaenoic acid (polyunstaurated fatty acid), docosahexaenoic acid (polyunsaturated fatty acid)

Question 10

how many are essential amino acids?

Answer 10

9 are essential and can’t be made in our body (20 in total)

Question 11

what is the limiting AA?

Answer 11

the amino acid that is missing in a certain food

• a varied diet will include all the amino acids needed

Question 12

what is the complementary action of proteins?

Answer 12

If a food lacking in an AA is eaten with another food that contains it, then the second food compensates for the first

Question 13

what are dietary recommendation? why do we need them?

Answer 13

• Standard average amounts of nutrients (and sometimes food groups) required to maintain health.
  →To prevent deficiencies, optimize stores and function, minimise risk of disease
• allow adequacy of nutrient intakes ofgroups or populations to be assessed

e.g. dietary reference values (should NOT be viewed as recommendations for goals of individuals)

Question 14

what are the main nutrients in potatoes, bread, rice, pasta and other starchy carbs?

Answer 14

• carb
• fibre
• calcium
  -iron

Question 15

what are the main nutrients in fruit & veg?

Answer 15

• fibre
• vitamin C
• carotene folate
• potassium
• magnesium

Question 16

what are the main nutrients in beans, pulses, fish, eggs, meat and other proteins?

Answer 16

• protein
• fibre
• B vitamins
• vitamin B12
• iron
  -zinc
• magnesium

Question 17

what are the main nutrients in oils spreads?

Answer 17

• energy
• fat
• fatty acids
• vitamins A & D

Question 18

how do you calculate energy expenditure?

Answer 18

BMR X physical activity level

Question 19

what is rough requirements of energy? (calories)

Answer 19

roughly 2300-2700 for males depending on age

roughly 1840-2200 for females depending on age

(varies less with age in women until 65+ when decreases)

Question 20

what % of total energy should you get from what food types?

Answer 20

50% = carbs
no more than 5% = free sugars
no more than 35% = total fat
no more than 11% = saturated fat

Question 21

what are 4 categories of carbs and examples?

Answer 21

monosaccharides = glucose, fructose, galactose
disaccharides = sucrose, lactose, maltose
oligosaccharides = raffinose, stachyose
polysaccharides = starch, glycogen, cellulose

Question 22

when should you decrease dietary fibre intake?

Answer 22

• disorders of oesophagus
• acute phase diverticulitis, crohns disease
• bowel obstruction
• diarrhoea or dehydration episodes
• mineral absorption interference

Question 23

what is recommended dietary fibre?

Answer 23

2-5 year olds = 15
5-11 year olds = 20
11-16 year olds = 25
17+ = 30

Question 24

what is protein requirements?

Answer 24

0.75g protein per kg bodyweight per day (pregnancy and lactation requires more)

• should increase 1.2-1.5g per kg for older adults

Question 25

what happens to muscles in old people?

Answer 25

lots of loss of muscle (50%)

Question 26

why do old people lose muscle?

Answer 26

• Decline in muscle strength
• Lower physical ability (mobility / function)
• Reduction in energy needs
• Lower basal metabolic rate
• Reductions in activity due to sickness / disability
• Skeletal muscle important for glucose disposal, glucose tolerance
• Overweight common (sarcopenic obesity)

Question 27

when does the demand for nutrients change?

Answer 27

in relation to growth and certain disease status

Question 28

why is first 1000 days of life critical window to get nutrition right - in what way is it crucial?

Answer 28

quality of mother’s dietary intakes influences fetal growth and development (can be higher susceptibility for NCDs in later life)