Nutrition Flashcards
Inflammation associated with obesity includes the production of?
This can also block the absorption of?
Hepcidin, an acute phase protein made in the liver
Iron
What affects the absorption of vitamin B12 in the ileum?
Metformin
What is associated with decreased serum folic acid levels?
Metformin
What can increase homocysteine levels?
B12 and folic acid depletion
Hyperinsulinemia is associated with excessive urinary excretion of?
Zinc
The bioavailability of what nutrient is reduced in obese individuals?
Why does this occur?
Vitamin D
Vitamin D is sequestered in adipose tissue.
What to identify in nutrition focused physical findings?
- Fluid imbalance (symptoms of fatigue, muscle cramps, dark urine, constipation)
- Nutrition-related chronic disease (acanthosis nigricans)
- Undernutrition (symptoms of dry brittle hair and nails, inability to concentrate)
- Complex health issues - Intellectual and/or developmental disabilities
Strengths and limitations of 24-hour food recall?
Easy for low literacy
Low patient burden
Provides meal pattern information
Dependent on memory
Self-report
Not necessarily indicative of usual
Strengths and limitations of food frequency questionnaire?
Fairly low burden
Easy for low literacy
Dependent on memory
Doesn’t relate to meal pattern
Self-report
Strengths and limitations of diet history?
Fairly low burden
Provides meal pattern information
Dependent on memory
Time consuming
Self-report
Strengths and limitations of a food record?
Provides valid measure of intake when completed soon after intake
Provides meal pattern information
Intake may be modified because of focus in recording
Moderate to high literacy required
Time consuming
Self-report
Ideal way to determine energy needs?
What exactly does it measure?
Indirect Calorimetry
- Measures how much oxygen is consumed and carbon dioxide is produced
- Calculates resting energy expenditure and respiratory quotient
- Determines substrate utilization
Ideal way to determine energy needs IF indirect calorimetry not available?
Miflin-St. Jeor Equation using actual weight to estimate RMR in overweight and obese adults
How to calculate TEE?
Multiply RMR results by physical activity factor to estimate
total needs
▫ Sedentary: (1.0 or more to less than 1.4)
▫ Low active: (1.4 or more to less than 1.6)
▫ Active: (1.6 or more to less than 1.9)
▫ Very Active: (1.9 or more to less than 2.5)
Dietary intervention for weight loss includes?
Requires a decrease consumption of energy
Degree of weight loss generally reflects the size of the decrease in energy intake achieved.
Appropriate individualized patient/client-centered plan of care is nutritionally adequate, evidence-based, and based on patient preference, health, and nutrient status.
Energy deficit of 500-750 Kcals/day
What is the physiological role of macronutrients, sodium, and calcium?
Carbohydrate–energy
Protein—building block of muscle, hormones
Fat—satiety and adds flavor and texture; essential FFA
Sodium—regulates fluid balance, regulates function of muscles and nerves, impacts blood pressure
Calcium—supports skeletal structure, impacts muscle
contracting and nerve function
What are the characteristics of a very low calorie diet?
Less than 800 kcals/day
70-100 g Pro/day
BMI>30 or before bariatric surgery
What is the metabolic impact of a very low calorie diet?
*Reduces fasting glucose, insulin and triglycerides
*May modestly increase HDL
*May modestly decrease LDL
*Reduces blood pressure
What is the metabolic impact of a restricted carbohydrate diet?
How many grams of carbs recommended?
<20g/day
- Reduces fasting glucose, HgA1c, insulin and triglycerides
- Modestly increases HDL
- May modestly reduce BP
What is the metabolic impact of a low calorie, restricted fat diet?
What percent of calories comes from fat?
<30% kcals from fat
Modestly decreases LDL and HDL
May modestly reduce BP
What is the metabolic impact of a low glycemia index/load diet?
When combined with energy restriction, improves glucose and insulin metabolism more than high-glycemic, low-fat diet.
What is the metabolic impact of reducing sugar-sweetened beverages diet?
May reduce subjective feelings of hunger
Effective as long as energy restricted
What is the metabolic impact of an energy density diet?
No standard method for reducing energy density in the diet.
May assist with appetite control
Mixed results for weight loss
Lower energy density may improve micronutrient-rich foods
What are the characteristics of a low energy density diet?
Determine by water, fat, and fiber content
Lower fat
Fewer calories/grams weight
Weight loss >5% can lead to?
Greater amounts of weight loss will reduce BP, improve LDL-C and HDL-C, and reduce need for medications.
Weight loss of 3-5% can lead to?
Reductions of TG, BP, HbA1c, and risk of
developing type 2 diabetes.
Claims non-supportive fore weight loss?
Increasing fruits and vegetables without energy restriction
Small food-based changes (100-200 calories reduction/day)
What nutrition claims lack evidence on randomized controlled trials?
Minimize ultra-processed foods
What is the duration and frequency of MNT for weight loss?
Schedule 14 MNT encounters (either individual or group) over a period of at least six months.
High-frequency comprehensive weight loss interventions result in weight loss.
What is the duration and frequency of MNT for weight loss?
Schedule at least monthly MNT encounters over a period of at least one year.
