Nutrition Flashcards
How many calories should a person consume?
25-35 kcal/kg/day
How can we estimate how much protein is being broken down?
Measure urinary nitrogen over 24 hours. Multiply number of grams of urinary N by 6.25 to get number of grams of protein that were catabolized.
What is an average protein requirement for sick patients?
0.8-1g protein/kg body weight/day
What is the BMI range for acceptable weight?
19-26
What is the most frequent cause of death in patients with anorexia nervosa?
Suicide
What is the average age of death in patients with anorexia nervosa
34 YO
Is low novelty seeking is a temperament of anorexia nervosa or bulimia nervosa?
Anorexia
Is higher novelty seeking is a temperament of anorexia nervosa or bulimia nervosa?
Bulimia
Which vitamins usually have stores in body; fat or water soluble?
Fat soluble (and Vit B12)
Which vitamins have high toxicity; fat or water soluble?
Fat soluble
What are the biochemical functions and major physiologic metabolic roles of Vitamin A?
Essential in photochemical basis of vision. Maintenance of conjunctival membranes and cornea. Critical for epithelial cellular differentiation and proliferation.
What are the biochemical functions and major physiologic metabolic roles of Vitamin D?
Maintains intra and extracellular Ca. Stimulates intestinal absorption of Ca and P, renal reabsorption of Ca and P, and mobilization of Ca and P from bone. Innate immune function.
What are the biochemical functions and major physiologic metabolic roles of Vitamin K?
Coagulation (cofactor for prothrombin, VII, IX, X)
What are the major dietary sources of Vitamin A?
Preformed VitA (retinol/retinal): liver, dairy products, egg yolks, fish oil. Precursor (carotenoids): orange and green veggies
What are the major dietary sources of Vitamin D?
Precursor dehydrocholesterol in skin is converted to cholecalciferol (VitD3) by UV light. Dietary sources: fish oil, egg yolks, D2 ergocalciferol from algae
What are the major dietary sources of Vitamin K?
Leafy veggies, fruits, seeds, synthesized by intestinal bacteria
What are the characteristic deficiency findings for Vitamin A?
Night blindness, xeropthalmia, Bitot’s spots on sclera. Immune deficiency.
What are the characteristic deficiency findings for Vitamin D?
Rickets. Low serum Ca and P. High alk phos.
What are the characteristic deficiency findings for Vitamin K?
Hemorrage. Hemorrhagic disease of the newborn.
What are the characteristic deficiency findings for Vitamin E?
Neurologic degeneration with loss of reflexes, spinocerebellar ataxia, and normocytic hemolytic anemia.
What are the lab findings of deficiency and insufficiency of Vitamin D?
25OH-D
What are signs of Vitamin A toxicity?
Liver damage
What are the biochemical functions and major physiologic metabolic roles of Vitamin E?
Antioxidant. Cell membrane stabilizer.
What are the major dietary sources of Vitamin E?
Polyunsaturated vegetable oils. Wheat germ. Whole grains.
Which fat soluble vitamin(s) deficiency presents with anemia?
Vitamin E and K
Which fat soluble vitamin(s) deficiency presents with rash/skin findings?
Vitamin A and K
Which fat soluble vitamin(s) deficiency presents with neuro symptoms?
Vitamin E
Which fat soluble vitamin(s) deficiency presents with mouth lesions?
None!
Which water soluble vitamin has a risk of toxicity?
B6
Which water soluble vitamin is not excreted in breast milk?
Folate
What is the biochemical function of thiamine?
Cell metabolism and nerve conduction.
What is the biochemical function of riboflavin?
Redox reactions in TCA and oxidative phosphorylation. Metabolism of amino acids, FAs, VitK, folate, and niacin.
What is the biochemical function of niacin?
Role in energy-related pathways.
What is the biochemical function of folate?
1-carbon transfers esp in synthesis of nucleic acids adn for metabolism of certain AAs. Conversion of homocysteine to methionine. Methyl-donor (epigenetics).
What is the biochemical function of Vit B12 (cobalamin)?
1-carbon transfers. Methylation. Metabolism of odd chain length FAs.
What is the biochemical function of Vit C?
Antioxidant, collagen synthesis,
What are the major dietary sources of thiamine?
Whole grains, enriched grains, lean pork, legumes.
What are the major dietary sources of Vit B12?
Animal products only. Absorbed with cobalamin in distal ileum.
What are the major dietary sources of Vit C?
Fruits veggies and potatoes
What are the major dietary sources of folate?
Deep green leaves, broccoli, OJ, whole grains
What are the major dietary sources of niacin?
Meats, poultry, fish, peanut butter, legumes (preformed niacin). Tryptophan (precursor) from milk and eggs.
What are the major dietary sources of riboflavin?
Liver, wheat germ, dairy, meats and poultry, leafy greens.
What are the characteristic deficiency findings of thiamine?
Beriberi
Dry (paralytic/nervous) Beriberi: Peripheral neuropathy with impairment of sensory, motor, and reflex functions. Foot drop.
Wet (cardiac) Beriberi: Edema and high output cardiac failure.
Wenicke-Korsakoff syndrome (cerebral): “Triad” - ocular signs, ataxia, and amnesia/confusion.
What are the characteristic deficiency findings of riboflavin?
Oral-ocular-genital syndrome - cheilosis and angular stomatitis. Increased vascularization of conjunctiva. Scrotal dermatitis.
What are the characteristic deficiency findings of niacin?
Pellagra - 4 “Ds”: Dermatitis, Dementia, Diarrhea, Death.
What are the characteristic deficiency findings of Vit B12?
Macrocytic megaloblastic anemia, hypersegmented neutrophils, neurologic disturbances (may be irreversible).
What are the characteristic deficiency findings of folate?
Macrocytic anemia, hypersegmented neutrophils, increased homocystine, neural tube defects
What are the characteristic deficiency findings of Vit C?
Scurvy, petechiae, bleeding gums, anemia, bruising, painful joints, tooth loss.
Which water soluble vitamin(s) deficiency presents with anemia?
Folate, VitB12, VitB6, Vit
Which water soluble vitamin(s) deficiency presents with rash/skin findings?
Niacin, VitC
Which water soluble vitamin(s) deficiency presents with mouth lesions?
Riboflavin, folate, VitB12, VitB6, VitC
Which water soluble vitamin(s) deficiency presents with neuro symptoms?
Thiamin, VitB12, VitB6, VitC
What is the physiologic function of iron?
Oxygen transport in blood and muscle. Electron transfer enzymes (cytochromes).
What is the physiologic function of zinc?
Regulation of gene expression, membrane stability, critical during growth and cellular/tissue proliferation, immune function.
What are the dietary sources of iron and zinc?
Iron: Cellular animal protein, legumes, nuts, whole grains
Zinc: Animal products.
What factors affect the bioavailability of iron and zinc?
Iron: Absorption ~40% for heme iron, 10% for non-heme iron. Phytates inhibit absorption. Fe deficiency increases absorption.
Zinc: Phytates inhibit absorption. Absorption not increased by deficiency. 25-30%.
What are the consequences of iron deficiency?
Most common deficiency. Microcytic hypochromic anemia, fatigue, impaired cognitive function.
What are the consequences of zinc deficiency?
Growth delays/stunting, anorexia, impaired immunity, diarrhea, personality changes, acrodermatitis enteropathica (fatal if not treated, horrible rash)
Compare the toxicity potentials of iron and zinc.
Iron toxicity has bad consequences and higher toxicity compared to zinc.
Describe the homeostasis of iron.
Bleeding is the major route of iron loss. Stores are in liver, marrow and spleen. Transported as transferrin and stored as ferritin or hemosiderin.