Nutrition Flashcards
What are convincing risks for oesophageal cancer?
Body fat and alcoholic drinks
What are 3 things that increase the risk of colorectal cancer?
Red and processed meat, body fat, alcoholic drinks
What are 2 things that decrease the risk of colorectal cancer?
Physical activity and high dietary fibre
What can physical activity after a diagnosis of colorectal cancer do?
Improve survival and decrease recurrence
What can non-compliance with a gluten free diet cause?
Recurrence of symptoms, osteoporosis, infertility
What are the 5 basic principles of behaviour change?
Ask, assess, advice, agree, assist
Physical activity reduces the risk of what in terms of GI disease?
Constipation, diverticular disease, gallstones, colon cancer
Why is dietary fibre protective against GI cancer?
It reduces absorption of carcinogens and decreases pH of colon to reduce growth of pathogenic organisms
What makes red and processed meats bad?
They are a source of saturated fats and also form carcinogens when cooked at a high temperature
Haem iron in red meat increases what?
Free radicals which damages the lining of the gut
Who qualify as people who need nutritional support?
BMI < 18.5
Unintentional weight loss > 10% in the last 3-6 months
Have or are likely to eat nothing in the next 5 days
Poor absorptive capacity and high nutrient loss
What is enteral tube feeding?
Nutrient rich feed directly into the stomach, duodenum or jejunum
What is parenteral nutrition?
Delivery of IV nutrients
When are oral nutritional supplements given?
Dysphagia, IBD, post total gastrectomy, bowel fistulae
What are indications for enteral feeding?
Inadequate or unsafe intake of nutrients but with a functional GI tract
Which of Jevity and Osmolite contain fibre and which doesn’t?
Jevity- fibre
Osmolite- no fibre
What are indications for parenteral nutrition?
People at risk of malnutrition with inadequate or unsafe oral or enteral feeding and an inaccessible GI tract
When is home parenteral indicated?
Intestinal failure
What is malnutrition?
A state of nutrition which causes measurable adverse effects
What tool is used to measure malnutrition in the NHS?
MUST scoring
What is stage 1 of the MUST scoring and what do the results represent?
BMI:
> 20 = 0
Between 18.5 and 20= 1
< 18.5 = 2
What is stage 2 of the MUST scoring and what do the results represent?
Weight loss: Less than 5%= 0 Between 5 and 10%= 1 More than 10%= 2 (in the past 3-6 months)
How do you work out weight change?
Difference/original x 100
What does intentional weight loss score on the MUST system?
0
What is stage 3 of the MUST scoring and what do the results represent?
Acute disease- has the patient been acutely unwell and has there been/likely to be no nutritional intake for >5 days?
No= 0
Yes= 2
Score 0 on MUST means?
Low risk
Score 1 on MUST means?
Medium risk
Score 2+ on MUST means?
High risk
What are extra ways of measuring height?
Ulna length or mid-upper arm circumference
What test can be used to give an estimate of body fat?
Triceps skinfold
What is it sometimes appropriate to avoid in IBD?
High fibre, fatty foods ad lactose
What are dietary considerations of IBD complications?
Anaemia- give IV iron replacement
Osteoporosis- give calcium and vitamin D
What is measured annually in Crohn’s?
B12
Is enteral nutrition used in IBD?
Sometimes CD but never UC
What is modulin IBD used for?
Sole diet or supplement in IBD as it contains a naturally occurring anti-inflammatory
Who is modulin IBD first line in?
Children, not adults. Considered when medication has failed.
Is there evidence for parenteral nutrition in IBD?
No
What is first line management for IBS?
4 week trial of probiotics and check for food intolerances
What is second line management for IBS?
Low FODMAP diet
What is the first line test for Coeliac?
IgA tissue transglutaminase test
What should be done 6 weeks before testing for Coeliac?
Eat gluten
What test is done if the TTG test for Coeliac is positive?
Biopsy- only diagnostic test
How are some children now diagnosed with Coeliac?
Genetic screening
What should all Coeliac patients be told to avoid?
Wheat, barley and rye