Nutrition

Question 1

How many calories per g are CHO?

Answer 1

4 kcal/g

Question 2

What percentage A1C can diet reduce?

Answer 2

1-2%

Question 3

A 5-10% weight loss results in improvement in what 4 parameters?

Answer 3

BP
insulin sensitivity
Dyslipidemia
glycemic control

Question 4

What is sucrose made up of?

Answer 4

Disaccharide. Made from glucose and fructose.

Question 5

What percentage of daily energy intake can be added sucrose?

Answer 5

Up to 10%

Above this we can see increase in BG and TG in some people.

Question 6

How much fructose can be eaten in g before any rise in TG and Uric acid levels?

Answer 6

Up to 60G per day or less than 10% total daily energy. Of course choosing low gi fruit rather than added fructose provides glycemic and metabolic benefit.

Question 7

Should sugar alcohols be included in CHO count for rapid insulin?

Answer 7

No. Mannitol. Sorbitol. Xylitol. Lactilol. Maltitol. Have no significant effect on BG. Cause GI effects.

Question 8

What percentage of diet should be protein?

What about in CKD?

Answer 8

15-20%

Reduce to 0.8g/kg in CKD

Question 9

How many calories per g does protein have?

Answer 9

4 kcal/g

Question 10

What percentage of diet should be fats?

Answer 10

20-35%

In pregnancy 40%

Question 11

How many calories per g does fat have?

Answer 11

9 kcal/ g

Question 12

What percentage of diet should be CHO?

Answer 12

45-60%
45% so as to avoid too much fat
Can be up to 60% of total energy if derived from low glycemic high fiber foods
In pregnancy it’s 50!

Question 13

Does CDA endorse meal replacement programs?

Answer 13

Yes. Found to be effective for weight loss and glycemic control. No head to head study’s on specific ones.

Question 14

Does CDA recommend specific vitamin/mineral supplements?

Answer 14

No. Nutritional needs should be met by diet.
> 50 years should take 400iu vitamin D
Folic acid for pregnant worn.

Question 15

Which is more effective, nutrition counseling one on one or in a small group?

Answer 15

Either one.
Individual may be better for lower income patients.
Group is good when adult education principles are applied.
Barriers to healthy eating should be addressed.

Question 16

What are four main principles of nutrition counseling?

Answer 16

Individualized
Regularly evaluated
Reinforced in an intensive manner.
Incorporate self management education.

Question 17

What is the minimum amount of CHO in grams per day to provide glucose to the brain? Adult men and women

Answer 17

130g

Question 18

What is the benefit of soluble fiber?

Answer 18

Soluble fiber slows gastric emptying and delays glucose absorption therefore improving post prandial control.
Okra. Oats and beans and barley. Psyllium.

Question 19

How many grams of fiber are recommended for people with diabetes? Is this higher or lower than general population?

Answer 19

30-50g per day.
Higher.
A third or more coming from soluble fibre

Question 20

A standard alcoholic drink contains how many mls of pure alcohol?

Answer 20

About 17.2mls. So what is a “standard drink” depends on alcohol percentage.

Question 21

how can you increase the glycemic index of a meal?

Answer 21

• decreasing fibre
• decreasing acidity (Sourdough breads generally have a lower index than other breads.
• the easier it is to digest the the food the higher the glycemic index. This is because it spends less time in digestion and is more rapidly absorbed causing higher post prandial sugars. I counsel patients to cook thier pasta al dente to lower the glycemic index.

Question 22

how can you decrease glycemic index of a meal?

Answer 22

• add fat (not always a good thing)
• increase acidity of food (sourdough bread) - slows digestion
• cook pasta a la dente

Question 23

what factors affect the speed of stomach emptying?

Answer 23

• Fat and protein slow the rate of stomach emptying
• Foods are digested at a slower rate
• Lower glycemic response

Question 24

what is Glycemic Index?

Answer 24

Glycemic Index (GI) is a scale that ranks carbohydrate-rich foods by how much they raise blood glucose levels compared to a standard food. The standard food is glucose or white bread.

Question 25

Diabetes canada public health campaign advises that sugary beveragea be below what percentage of total daily calorie intake?

Answer 25

Less than 10%

Question 26

How often should follow up | With an RD occur?

Answer 26

Frequently. Every 3 months

Question 27

Culturally sensitive PEER education has been shown to improve (3)

Answer 27

A1C Nutrition knowledge Diabetes self management

Question 28

Are CHO restricted diets effective?

Answer 28

No consistent improvement in A1C lipids and BP. | Greater weight loss at 6 months BUT by 12 months bo difference.

Question 29

What are the concerns for low CHO in type one?

Answer 29

1-Blunted response to glucagon | 2-If ketogenic, risk of ketoacidosis

Question 30

Someone on SGLT2 and on a ketogenic diet is at risk for

Answer 30

Ketoacidosis

Question 31

Benefits if low GI intervention

Answer 31

Improved glycemic control Reduce hypo in type 1 Improve total cholesterol

Question 32

Foods high in soluble fibre

Answer 32

``` Oats Barley Psyllium Mannan Pectin from pulses Eggplant Okra Applea Citrus fruit Berries ```

Question 33

Which 3 soluble fibres have the health canada claim for reducing cholesterol

Answer 33

Oats Barley Psyllium

Question 34

SSBs Sugar sweetened beverages are linked to

Answer 34

Hypertension | CAD

Question 35

Replacement of animal protein with Plant protein imrpoves which 3 metabolic parameters in people with type one and two? Non CV related

Answer 35

A1C, FBG Fasting insulin

Question 36

To resuce CVD saturated fats shoukd be resuced below what percentage of diet?

Answer 36

Less than 9% Replace with PUFAs (poly unsat) MUFAs (mono unsat) from plants and whole grains Or low GI CHO

Question 37

Consumption of fish at 1-2 servings per month up | To two servings per week have what benefits?

Answer 37

Reduced CAD. Reduced CKD. And less albuminuria

Question 38

Acceptable daily intake of sweeteners in mg/kg body weight per day

Answer 38

``` Sucralose 8.8 Saccharin 5 Aspartame 40 Asceksukfame k 15 Erythritol 1000 Cyclamate 11 ```

Question 39

``` How much rice is 15g CHO? How much pasta is 15g? How much mashed potato’s is 15g? Sweet potato? Baked or boiled potato? ```

Answer 39

``` Rice. 1/3 cup Pasta 1/2 cup. Potato 1/2 cup Sweet potato 1/3 cup 1/2 medium baked potato ```

Question 40

How much of each is 15g CHO FLOUR CORN STARCH SODA CRACKERS

Answer 40

3 TBSP flour 2 TBSP corn starch 7 soda crackers

Question 41

How much of each is 15g CHO? ``` pita Raisin bread taco shells Waffle Tortilla whole wheat ```

Answer 41

``` Bagel 1/4 to 1/2 Bannock. 1.5 x 2.5 inches Hamburger or hotdog bun 1/2 All bread is 1 Croissant 1 small English muffin. 1/2 Pancake 1 medium pita 1/2 Raisin bread 1 taco shells 2 Waffle 1 medium Tortilla 1/2 10” whole wheat or 1 white 6 inch ```

Question 42

``` How much of these “choose more often” cereals for 15 g CHO? All bran/ All Bran Buds Cream of wheat cooked Oatmeal Shredded wheat Wheat germ ```

Answer 42

``` All bran/ All Bran Buds 1/2 cup Cream of wheat cooked 3/4 cup Oatmeal 3/4 cup Shredded wheat 1 biscuit Wheat germ 1/3 cup ```

Question 43

``` How much of these choose less often cereals make 15g? BRan flakes Cheerios Corn flakes Granola Rice crispies Puffed wheat ```

Answer 43

``` BRan flakes 1/2 c Cheerios 2/3 c Corn flakes 1/2 c Granola 1/4 c Rice crispies 2/3 c Puffed wheat 1.5 cups ```

Question 44

``` How much of each fruit for 15g CHO? Apples Banana Strawberries Blueberries Saskatoon berries Raspberries Canned fruit Canned macaron oranges Dates Grapes Melons Orange Nectarine/peach ```

Answer 44

``` Apples 1 small or med Banana 1 small or 1:2 medium Strawberries 2 cups Blueberries 1 cup Saskatoon berries 1 cup Raspberries 2 cups Canned fruit 1/2 cup Canned mandarin oranges 3/4c Dates/figs. 2 Grapes 1 cup Melons 1 cup Orange one Nectarine/peach. One ```

Question 45

``` How much of each JUICE for 15g CHo? Grape juice Prune juice Apple Orange GRapefruit Lemon Like Tomato Clam Vegetable cocktail ```

Answer 45

``` Grape juice 1/3 c Prune juice 1/3 c Apple 1/2 c Orange 1/2 c Grapefruit 1/2 c Lemon. 3/4 c Lime. 3/4 c Tomato. 1 cup Clam 1 cup Vegetable cocktail 1 cup ```

Question 46

``` How much jello is 15g Cho? How much ice cream? Popsicle? Life savers? Pop? ```

Answer 46

``` 1/2 cup jello 1/2 cup icecream 1 piscine bar 6 life savers 1/2 cup pop ```