Nutrition Flashcards
Ileum
B12, fat absorbed
Duodenum
Fe, Ca absorbed
Steatorrhea
Pancreatitis Cystic fibrosis Crohn's Celiac disease Formation of oxalate kidney stones Risk of bone loss
Enhance intestinal adaptation after short bowel syndrome
Glutamine Short chain fatty acids Glu-peptide 2 Better if ileum and colon intact Oral feed sooner the better
Colon resection
Fluid electrolyte losses
Diarrhea
Short bowel syndrome
Low fat High complex carb Small frequent feedings short chain fatty acids - retain h2o Medium chain triglyc Low oxalate Avoid lactose
Restrictive surgery
Vertical band
Sleeve gastrectomy
Gastric binding
Weight loss due to reduced food intake
Gastric bypass surgery (most common)
Malabsorption and restrictive
Weight loss is from decreased intake and malabsorption
Change in GI hormones (GLP, PYY, Leptin) decrease ghrelin
Water, liquid, purée, soft foods
70g protein/day, multivitamins
Malabsorptive (infrequent)
Bileopancreatic diversion
Jejunal-ileal bypass
Weight loss due to malabsorption
Celiac disease
Lifelong Gluten free diet
Fresh fruit and vegetables, meat
Crohn’s disease
Any part of GI tract
High calorie, high protein diet
Low fiber
Liquid supplements
Ulcerative colitis
Only in the colon
Colectomy may be curative
Replace fluid and electrolyte losses
Low fiber
Inflammatory bowel disease treatment
Antidiarrheal
Immunosuppressant
Anti inflammatory
Pancreatitis acute
Nothing by mouth (NPO) until pain subsides Fluids and electrolytes Mild-low fat diet Severe-J tube High protein, high kcal
Pancreatitis chronic
Steatorrhea treat w/ enteric coated pancreatic enzymes
Low fat diet, MCT oil
Cystic fibrosis
High calorie, high fat Frequent meals&snacks with Pancreatic enzyme replacement Multivitamins, fat sol vit Liberal use if salt&salty foods
Extensive bowel resection
Colon present
High carbs - colonic salvage Low oxalate Vit B12 injections Calcium due to fat malabsorption Anti motility agents
Extensive bowel resection
Colon absent
High salt Vit B12 Multivitamins Calcium Oral rehydration solution Antimotility agent
Irritable bowel syndrome
High fiber
Low fat
Bulk agent psyllium
Low FODMAP
Diverticular disease
High fiber
Bulk forming psyllium
Avoid nuts, seeds
Clear liquid diet
Conditions that may require an ostomy
Inflamm bowel disease Diverticulitis Colorectal cancer Clear liquid to low fiber diet Carefully chew food
Colostomy
High fiber diet
Diarrhea
BRAT diet
Cheese, peanut butter
Lactose intolerant
Most can tolerate 6g/day of milk products
Concern for Ca, vit D, riboflavin
AREDs 1
Antioxidants and zinc good for intermediate/advanced AMD
No effect of nutrients on cataracts
AREDS 2
Lower risk with fish and green veg Lower risk in both with lutein and zeaxanthin (green veg) Helped AMD Supplements good Not helpful for cataracts
Nephrotic syndrome
Plasma protein in urine
Wasting
Infection
Rickets
Edema
Protein restriction
Low sat fat, sodium
Osteodystrophy
Decrease serum phosphate - binders
Calcitriol supplement
Calcium supplement
Hepatitis
Adequate energy and protein
Eliminate alcohol
Hepatic encephalopathy
Hyperammonemia
Treat with lactulose, antibiotics
Branched chain amino acids (veg, milk protein)
Cirrhosis
20-75% above expenditure
Multivitamins
Dialysis nutrition
Folate, riboflavin, vit B6
Calcium
Restrict phosphorus
Orlistat
Pancreatic Lipase inhibitor - fat is unabsorbed and excreted
Use with low fat diet
Approved for long term use
Belviq
Increase brain serotonin levels
Qysmia
Has phentermine appetite suppressant
& topiramate
Soluble fiber
Slows transit
Good for diarrhea
Insoluble fiber
Speeds transit
Good for constipation
BMI
Weight/height^2
Abdominal fat
Independent predictor of morbidity
Recommended weight loss
5-10% Reduce intake by 500kcal/day 1 pound/week Lose weight over 6 months Maintain weight after 6 months
Improved control of HTN, blood sugar, blood pressure
Low fat diet
Increase TG
Decrease HDL
Atkins diet
High protein - preserve LBM
High fat
Very low CHO
Causes insulin levels to decrease
Reduce B vitamins
Goal ketosis/lipolysis
Sleep deprivation
Increase ghrelin (increase appetite) Decrease Leptin (increase appetite)
BMI increase to decrease in sleep
Weight loss drugs approved for
BMI > 30
BMI =27+T2DM, HTN, or high cholesterol
