Nutrition Flashcards
what affects food choice?
> likes and dislikes
religious and ethical considerations
social and psychological components
what makes up the fixed component of demand of food?
> basal requirements (membrane function; pumps, transport, signalling)
mechanical work (cellular and tissue level)
substrate turnover
what part of the demand for food is variable?
> cost of processing dietary intake
physical activity
maintaining body temperature
growth
how can the basal metabolic rate be calculated?
by direct calorimetry
depends in lean body mass and there are various adjustment factors for activity and illness.
what does the metabolic supply fall onto?
the gut and its associated organs
define nutritional failure
> failure to meet nutritional requirements of the individual resulting in the development of deficiencies or excess
what is marasmus?
deficiency in both proteins and calories resulting in severe wasting in infants
what is kwashiorkor?
Protein calorie malnutrition with an acute or chronic inflammatory component (leaky capillaries, fluid retention, ascites)
define malnutrition
a state of nutrition in which a deficiency or excess of energy, protein and other nutrients causes measurable adverse effects on tissue/body form, function and clinical outcome
what bmi is overweight?
> 25
what bmi is classed as obese?
> 30
what can lead to obesity?
> environment
exercise
genes
what metabolic syndromes can arise from obesity?
> hypertension > cv disease > type 2 diabetes > fatty liver > NASH > cirrhosis
what cancers can obesity lead to?
> breast
> bowel
what bmi is underweight?
< 20
at what bmi is the patient considered physically impaired?
<18
at what bmi is there increasingly severe consequences in under nutrition?
<16
what percentage of body mass loss is associated with increasing morbidity?
10%
what is used to screen for under nutrition?
the MUST, malnutrition universal screening tool. this can be carried out by people without special training.
what is step one on the MUST?
calculate their BMI
< 20 score 1
< 18 score 2
what is step 2 in MUST?
have you unintentionally lost weight in the last 3-6months?
> yes 10% score 2
> yes 5% score 1
what is step 3 in MUST?
has the patient eaten in the last 5 days?
> no: score 2
what would a score of 2 suggest?
a risk of under nutrition
what would score 1 suggest?
supplements and watch
what does malnutrition associate with?
> illness
social isolation
age
socially vulnerable groups
what are the clinical consequences of malnutrition?
> impaired immune response > reduced muscle strength > impaired wound healing > impaired psycho-social function > impaired recovery from illness > poorer outcomes
what are the broad causes of under nutrition?
> appetite failure
access failure
intestinal failure
what can lead to access failure of food?
> teeth
stroke
cancer of the head and neck
head injury
define intestinal failure
reduction iin functioning gut mass below the minimal amount necessary for adequate digestion and absorption of nutrients
describe percutaneous endoscopic gastrostomy
> patient sedated
needle and guidewire into the stomach via endoscopy
tube pulled back down and out of skin
can last 18 months without replacement
